Mental health services in East Central Iowa get $5.47M boost from regional board

The noon sun shines March 11, 2022, on the Linn County Mental Health Access Center in northwest Cedar Rapids. (Geoff Stellfox/The Gazette)

HIAWATHA — Mental health and disability services throughout a nine-county area in East Central Iowa will get an additional approximately $5.47 million boost after a regional board Thursday approved spending down much of its end-of-budget year surplus.

With the end of fiscal 2023 on June 30 quickly approaching, the East Central Mental Health Region governing board directed regional staff to spend the money it had in excess of the state-mandated fund balance to better support locally provided mental health services.

The Iowa Department of Health and Human Services allocates property tax dollars to regions. If regions carry too much of a surplus at the end of a budget year, the agency withholds further dollars in the next fiscal year. Local service providers within the region would then lose out on funding that could otherwise address unmet local needs.

State lawmakers require the regions to hold fund balances of no more than 20 percent. That requirement will fall to 5 percent next fiscal year.

After reaching out to providers based on priorities the board identified in May, Regional Chief Executive Officer Mae Hingtgen at the board’s meeting Thursday at the Kirkwood Regional Center came with a proposal for how to spend much of the balance. The region covers services in Benton, Bremer, Buchanan, Delaware, Dubuque, Iowa, Johnson, Jones and Linn counties.

The board voted 6-5 to approve the nearly $5.47 million in spending agreements. That included an additional $300,000 for Shelter House’s permanent supportive housing project in Iowa City, beyond what was initially proposed by Hingtgen. Linn County Supervisor Ben Rogers and Johnson County Supervisor Rod Sullivan were among the yes votes.

Among the services that received funds were:

• $700,000 for Iowa City-based CommUnity’s crisis stabilization residential services capital project
• $41,000 for Cedar Rapids-based Tanager Place’s crisis stabilization residential services startup
• $500,000 for Foundation 2 Crisis Services’ new building in Cedar Rapids
• $124,506 for the Linn County Mental Health Access Center’s unreimbursed crisis expenses
• $504,670 for the Johnson County GuideLink Center’s unreimbursed crisis expenses
• $39,578 to Cedar Rapids-based Willis Dady Homeless Services for unreimbursed brain health services and $250,000 for permanent supportive housing
• $155,393 to the Cedar Rapids-based Catherine McAuley Center for unreimbursed brain health services
• $75,000 to Four Oaks for staff overtime expenses

Schools and sheriff’s offices also were on the list for a variety of mental health services, though not all within the region responded to inquires about their unmet needs. Schools will receive another $307,277 and sheriff’s offices will receive another $187,635 for mental health services.

That puts the region’s fund balance around 19 percent for the end of the budget year, Hingtgen said, though the actual dollar amount still needs to be calculated. That means the state wouldn’t withhold money as it has in past years that have ended with a surplus.

With the fund balance dropping next fiscal year, Hingtgen said she was somewhat worried about having enough money leftover for fiscal 2024.

As some of the factors fueling budget uncertainty, she mentioned providers were not billing the region in a timely fashion, they faced worker shortages and were sometimes unresponsive to requests for proposals when the region issues them for certain services.

Jenn Day, the board’s adult and family peer representative, said as the liaison effectively between providers and the board, she’s aware there are things providers are not sharing about their needs for fear of “retribution.”

“There is a subcurrent of intimidation between providers openly speaking their needs in a respectful manner and the region and the board responding,” Day said. “I’ve heard it put as, ‘Don’t bring up dad’s drinking and then ask for money.’”

The board is looking to improve long-term financial planning, though, and took steps to form a subcommittee focused on monitoring finances at least quarterly.

Board members supported Sullivan’s suggestion to include provider voices from the board’s advisory council to be better in tune with their needs as financial planning is done throughout the year, instead of trying to close this gap and spend surplus dollars in the final month of a budget year.

Supervisors this year have pushed to boost funding for the Linn and Johnson County mental health access centers, anticipating the region would end up holding a multimillion-dollar surplus at the end of fiscal 2023. The board passed a fiscal 2024 budget in March that devoted $2.9 million to the facilities — up from the initially proposed $2.5 million.

County officials have said regional funding and low Medicaid reimbursement rates don’t cover the cost of providing services such as access center operations. They supported better funding services such as the access centers, law enforcement, education and homeless shelters with available surplus dollars.

“I would just challenge us to keep the eye on adequately funding our highest priorities to meet their needs and maybe not be as skeptical of the way they portray their need,” Dubuque County Supervisor Ann McDonough said.

Comments: (319) 398-8494; marissa.payne@thegazette.com

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