Board of Supervisors hears update on redesign of mental health and disabilities system

by Bob Beach

During its regular meeting Monday, May 21, the Allamakee County Board of Supervisors met with CPC Administrator Jan Heikes, who updated the Board on the recently passed redesign of the mental health and developmental disabilities system in the state. Heikes said that under Iowa Senate File 2315, the State would begin to assume responsibility for the non-federal share of Medicaid expenses for services beginning July 1, 2012, which she said accounts for 70% of Allamakee County’s mental health and developmental disabilities (MH/DD) budget.
Heikes said that while the State will be picking up expenses for the non-federal share of Medicaid expenses, counties will no longer receive property tax relief, growth, local purchase of community services funds from the State. In terms of sufficient funding for continuing MH/DD services, Heikes said, “We’re okay.”
Starting in fiscal year 2014, Heikes said counties will levy $47.28 on a per-capita basis, which, based on taxable valuation, would result in a levy rate of approximately 99 cents per thousand, a decrease from the fiscal year 2013 levy rate of approximately $1.15 per thousand, ultimately resulting in a net loss in county revenue of approximately $112,000. Again, Heikes said that with the State paying Medicaid expenses, “we should be okay.”
Heikes said that the County could apply by October 15 for funds to cover expenses during the transition to the new system, but the rules for distribution of those funds would not be established until December.
Another major change under the system, Heikes explained, is that regions will be established to provide “core services” and those regions will be established by counties who chose to form a group with other counties. Counties must submit their intent to join a region by April 1, 2013 or their intent to apply for an exemption from joining a region by May 1, 2013. Counties that have not joined a region or applied for an exemption will be assigned to a region by the Department of Human Services July 1, 2013, when the new core services will begin.
Also July 1, 2013, Heikes said that criteria for determining residency will change, but it is unclear how that change will affect the number of people the County is responsible for providing services to. Regional management plans will be due by April 1, 2014 and regional governance will be established by June 30, 2014.
Heikes said that a meeting has been scheduled for Tuesday, May 22 at the Fayette County Courthouse in West Union where more details about the upcoming changes would be discussed. All three members of the Board said they plan to attend that meeting.
Heikes also presented the Board with the results of a survey sent to MH/DD clients and their guardians. Heikes said that 38% of the surveys were returned and the responses were generally very positive.
The Board also met with David Boss and Mary Ann Humpal of Northeast Iowa Community Action Corporation (NEICAC) and Allamakee County Relief Director Linda Kruse to discuss the continuation of relief services in the county following Kruse’s upcoming retirement. Humpal said that NEICAC would provide whatever services the Board desired, using eligibility requirements set by the Board. The cost of providing those services, Boss said, would be billed at an hourly rate. “I’m not saying we’re the best option,” he said, “but we are an option.” He added that there would be some benefits to clients in that NEICAC would be a “one-stop-shop” for relief services.
Chairman Larry Schellhammer said that after hearing many comments on the subject, he had come to like the idea of keeping local control of relief services, though he appreciates NEICAC’s willingness to work with the County. He also expressed some concern about whether a new Relief Director could be found that will be as dedicated as the current one.
Supervisor Sherry Strub said that she, too, would like to see relief services remain as they are and administered by a County employee, but is not comfortable with the starting salary of $14.00 per hour suggested by Kruse. The Board tabled the issue for further discussion.
In other business, Case Management Director Kim Waters presented her projected cost report for fiscal year 2013, which includes the 1.5% indirect costs presented to the Board two weeks ago. Waters said that the unusually low indirect costs are the result of an overpayment from the previous fiscal year and a reduction in the paperwork handled by the County Auditor’s office. The Board approved the cost report and accepted and placed on file the Sheriff’s quarterly report.