Representatives of a five-county mental health region say it needs $4 million to cover a shortfall or it will have to cut services in its last year of existence in its current form.
The Eastern Iowa Mental Health and Disability Services region, which provides mental health and disability services funded by the state to residents in Cedar, Clinton, Jackson, and Scott counties, is planning to send a letter to the state requesting funding to cover the shortfall.
Gov. Kim Reynolds signs House File 2673 into law at the new Foundation 2 Crisis Services headquarters in southeast Cedar Rapids, Iowa, on Wednesday, May 15, 2024. The law combines Iowa’s 32 mental health and substance use regions into seven unified behavioral health districts.
It’s also the last year of the state’s mental health region system. Iowa Gov. Kim Reynolds earlier this year signed into law an overhaul that would combine 32 mental health and substance use regions into seven districts beginning July 1, 2025. Advocates hope will improve delivery of and access to resources in a system which is currently fractured and offers duplicating or inefficient substance abuse and mental health services.
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Funding for those services would also be merged into one behavioral health fund overseen by Iowa Health and Human Services.
Lori Elam, Scott County Community Services director, presented information Tuesday to the Scott County Supervisors on the funding problem facing the regional organization and a letter its governing board plans to send lawmakers and state officials.
The letter requests $4 million from a state incentive fund “to avoid making significant budget cuts and eliminating services.”
The state claws back money appropriated to the regions if they don’t hit a fund balance cap, Elam said.
That extra money goes into the state’s incentive fund, which is then meant for regions who have financial difficulties to ensure services can still be provided.
Regions can apply for the funding, which currently stands at about $31 million. Elam said only one region, Polk, has applied for the money in the past four years.
But the challenge for the Eastern Iowa region is that the state looks at each region’s past two years’ worth of fund balances, and the eastern Iowa region did not hit the fund balances prescribed by Iowa code.
The state took back about $2.9 million of the region’s funding across fiscal 2023 and fiscal 2024.
Then, Elam said, the regional organization had unexpected costs, paying more than $800,000 in fiscal 2024 to individuals who lost their Medicaid for various reasons and for individuals on a wait list for Home and Community Based Services.
“Our region paid over $800,000 this past year to make sure those people were safe or that they had medicine, or they had therapy, that type of thing,” Elam said Tuesday. “So, between losing almost $3 million, paying out another $800,000 that we weren’t expecting, we’re in a shortfall of about $4 million.”
The Eastern Iowa Mental Health and Disability Services Region has been forced to use fiscal 2025 revenue to pay the final fiscal 2024 bills, the letter states.
If the region doesn’t receive additional funds, services and programs will be reduced or eliminated as soon as October 2024, the letter states.
“The Eastern Iowa MHDS Region is not asking for any ‘new’ state money,” the letter states. “It is simply asking for money from a fund that was created to help regions if they ran short. A majority of the money in the Incentive Fund is a result of funds being withheld from many of the MHDS Regions over the past four years when they failed to meet the fund balance requirement.”
Scott County Board Chair Ken Beck, who also chairs the mental health region governing board as part of his supervisor duties, said the region would likely reduce co-responding services, where mental health professionals respond with law enforcement to someone having a crisis.
“I will guarantee you one of the things we’re doing is co-responders. There was some discussion that got out there about cutting co-responding services and we had every law enforcement person in the region sitting in that room because this is a service that they’ve been asking for,” Beck said.
Beck added that the region has been running a telehealth program for students in rural school districts so they don’t have to drive a long ways to see a therapist.
Beck called the letter a “Hail Mary pass,” but said they needed to try something.
Elam said the other four counties have already signed onto the letter.
“We tried to do what we could to not get these funds clawed back, but unfortunately, we weren’t successful,” Beck said.
The world is experiencing its highest levels of happiness since the COVID-19 pandemic, according to Gallup’s Global Emotions Report for 2024.
States with the highest rates of people receiving mental health treatment
States with the highest rates of people receiving mental health treatment
More than 5 million American adults were receiving mental health treatment at a state-monitored mental health facility in 2022, according to a report from the Department of Health and Human Services released in April, an increase from last year.
However, getting treatment can largely depend on where someone lives or what kind of insurance they have. More than half of adults receiving treatment lived in just 10 states, as many Americans lack access to mental health care.
This year, as the Biden administration works to combat the mental health crisis spurred by the COVID-19 pandemic, the Centers for Medicare & Medicaid Services expanded Medicare access to behavioral health services.
Wysa analyzed data compiled by the Substance Abuse and Mental Health Services Administration to find which states had the highest rates of adults receiving mental health treatment. Each state’s mental health administration reports the data individually. Maine did not report sufficient data and was excluded from this report.
States and communities take a patchwork approach to treatment
Nationwide, 15 out of every 1,000 people were receiving mental health treatment in 2022. However, disparities between states vary widely. In New Mexico, for example, 7 of every 100 people are receiving mental health treatment. Meanwhile, in Illinois, roughly only 2 out of every 1,000 residents are being treated for mental health.
People who live in rural states have high rates of people receiving mental health services at state-monitored facilities. Isolation, diminishing economic prospects, and the stigmatization of mental health conditions can lead to higher rates of depression in rural communities. In Iowa, where about one-third of its population lives in rural areas, an estimated 473,000 people have a mental health condition. However, the state ranked last in terms of psychiatric bed availability, with only 2 available beds per 100,000 residents.
Beyond access to care, each state runs its own mental health administration differently, including the types of facilities each state monitors. In Wisconsin, for instance, private facilities and individual practitioners are regulated, while Connecticut only regulates mental health treatments at what are known as private intermediate treatment facilities, or dedicated institutions for mental health treatments that don’t require hospital-level care. Vast differences in the quality of treatment, with some facilities receiving more oversight than others, further stratify mental health care across the nation.
No matter how you measure it, the mental health crisis is impacting millions of Americans. Along with federal grants and initiatives, states and community organizations are taking individual steps to increase access to treatment.
In Montana, where 5 out of every 100 residents are receiving mental health treatments, Gov. Greg Gianforte signed a bill last year allocating $300 million to improve and expand access to behavioral care. Last month, the state’s behavioral health commission presented recommendations to divide the funds, including improving case management, expanding services, and recruiting and retaining mental health care specialists.
Story editing by Alizah Salario. Copy editing by Tim Bruns.
This story originally appeared on Wysa and was produced and distributed in partnership with Stacker Studio.
