The pending re-design of Iowa's Mental Health system and how it will directly impact Palo Alto County generated some discussion at the Aug. 7 meeting of the Board of Supervisors. County Mental Health Director Maureen Sandberg led the discussion as part of her weekly briefing to the supervisors.
Sandberg informed the board of an upcoming meeting in Spencer, set for Aug. 29, for the counties in the northwest corner of the state to learn more about setting up a Region, as is being proposed by the State, to take over the administration of mental health services.
"The Clay County Board of Supervisors is inviting all of the county Boards of Supervisors to talk about the re-design, so I do encourage you to go," Sandberg started out.
" We really know for sure that we're going to be in regions?" asked Board Chair Keith Wirtz.
"The only way it won't be in regions is if they totally take out that new Senate File," Sandberg said, "It's in force now."
"Well, it just seems like they've just kept pound, pound, pounding this and nothing's really happened," Wirtz observed.
Supervisor Jerry Hofstad agreed, "Yeah, nobody knows nothing."
Sandberg noted she felt that the mental health system would go to the regional concept, but was unsure if there would be changes to rules for the regions, money situation for the regions or any chance the re-design plan would be scrapped.
"So what's the purpose of this Region?" Supervisor Ed Noonan asked Sandberg, who answered the state Legislature had that answer. "Their initial reasoning was to save money."
"So if they're going to save money, why are we going to these board meetings?" Noonan asked.
"We're going to form regions so we can send our money to the bigger cities," Hofstad replied.
"Why are we setting up regions? Because we have to, that's the way it's written," Sandberg answered.
Noonan expressed his displeasure with the idea of the county belonging to the multi-county negotiating consortium and then also having to establish a region to do basically the same thing. "I think they need to be combined into one."
Sandberg noted that during a mental health meeting in July, a Plymouth County supervisor made the observation that the 11-county contracting consortium was 'falling apart.' "His issues included the financial health of each county, a desire not to get too big and lose control, and does the Region need a full-time CEO," Sandberg said.
Sandberg noted other concerns raised in that meeting included the tight timeframe for the re-design and the possible number of counties requesting waivers to operate as a region on their own.
"First off, I think we need to find out what we're gonna do," Hofstad said.
"That's right," agreed Supervisor Ron Graettinger. "Otherwise they're gonna tell us where we have to be."
"I don't think we should make this process easy for them," Noonan said. "They're ruining the system."
The discussion continued for several minutes, with Sandberg reminding the Board that counties were being told to operate as if the region would occur.
"I'd hate to go into a region that's already short on money," Graettinger noted. "Our money would go to them."
"I'd say we should apply for a waiver and go it ourselves," Noonan said. "Let's just tell them they're going to ruin the system."
Sandberg wasn't receptive to that idea, citing the increases in accountability, paperwork and other requirements to meet the redesign. "There's more power in a group, Ed."
"You say there's more power in numbers, I say there's more power in having options to go places," Noonan observed. "We need to reward those providers that are doing the best job with their rates. I don't feel the consortium is doing that."
"We're stuck between a rock and a hard place," Sandberg said, "the Legislature said we have to do this and we have no choice," as the discussion came to a close.