Millions for mental overall health care at threat if surplus is not spent

HIAWATHA — County supervisors on the board that governs regional mental overall health and disability solutions advocated Thursday for spending down significantly of its almost $9.two million surplus ahead of the finish of the spending budget year subsequent month by boosting assistance for initiatives inside its nine-county location to stay clear of the state withholding future funds.

As the finish of fiscal 2023 looms on June 30, the East Central Mental Well being Area governing board directed regional employees to draft a program for how to invest component of the surplus — at least about $four.two million that goes beyond the state-mandated fund balance — to superior spend mental overall health care providers, who are seeing higher levels of demand for underfunded solutions.

The Iowa Division of Well being and Human Solutions allocates state house tax dollars to regions, but if regions carry as well significantly of a surplus the agency withholds additional dollars. That primarily signifies providers inside the area drop out on funding that would otherwise go toward enhancing solutions and addressing unmet regional demands.

State lawmakers need the regions to hold fund balances of 20 %, but that will drop to five % subsequent fiscal year.

Regional Chief Executive Officer Mae Hingtgen asked the board for path at the board’s meeting Thursday at the Kirkwood Regional Center on how to invest the fund balance, or no matter whether to let it stay as is. The area covers solutions in nine counties: Benton, Bremer, Buchanan, Delaware, Dubuque, Iowa, Johnson, Jones and Linn.

“These dollars are appropriated for the taxpayers of the area to have spent on men and women in the area who have these demands,” stated Johnson County Supervisor Rod Sullivan, who represents the county on the board. “I hear from men and women definitely in my personal county there’s lots of unmet need to have, so I assume we need to do what we can to get the income out the door.”

Dubuque County Supervisor Ann McDonough stated it produced her heart ache that the board had so significantly obtainable to invest when there are millions of dollars necessary on the ground that could be spent in partnership with providers.

In current months, supervisors pressed for far more funding for the Linn and Johnson County mental overall health access centers, anticipating the area would finish up holding a multimillion-dollar surplus. The board passed a fiscal 2024 spending budget in March that allocated $two.9 million to the facilities — up from the initially proposed $two.five million.

County officials have stated regional funding and low Medicaid reimbursement prices do not cover the price of solutions, and for Linn County the resource gap is a barrier to the access center’s expansion to be open about the clock.

It is these types of solutions — and other people such as youth or homeless shelters — that supervisors are hunting to superior fund with the obtainable surplus.

McDonough stated the area is getting as well conservative in the awards it tends to make, and there’s not a stick to-up method to reconsider rising allocations. She and Linn County Supervisor Ben Rogers took challenge with CEO Hingtgen’s lack of suggestions for spending down the surplus, which McDonough stated felt like a scramble to now allocate with only about 5 weeks to go.

Rogers stated this area could determine to be a model and opt to supplement the gap providers face from low Medicaid reimbursement prices.

“We have so significantly in fund balance that is not getting spent down, and now by legislative decree, we have to surrender it,” Rogers stated. “And we have surrendered it for final year. Now it is May possibly 25, and we’re going to come back at the finish of June, asking for proposals (from providers).”

Saddled with a surplus just about every year that is in excess of the state-mandated fund balance, the supervisors urged superior economic organizing to guarantee the board is not faced with the similar challenge in future years of possessing a single month to figure out how to invest millions.

“There has to be a answer to this that is sustainable. We can not run into this brick wall year immediately after year,” McDonough stated. “ … We have so significantly income left at the finish of the year when we know our communities, it is dry earth nevertheless, that there is not sufficient solutions.”

McDonough recommended forming a subcommittee of the board focused on finances.

Deborah Seymour-Guard, finance coordinator for the area, stated there are a quantity of challenges involved with spending budget estimates. She stated occasionally providers are not billing for solutions in a timely style, so it is not possible to accurately track how significantly is spent. Also, regional employees stated occasionally solutions could not come to fruition till a later date than anticipated, throwing off providers’ estimates.

She recommended possibly boosting funding allocated to the Linn and Johnson County mental overall health access centers, which she estimated could invest down at least $two million. Access hubs in Dubuque and Benton counties, which are not state-designated facilities and offer a smaller sized scope of solutions, could potentially get a increase as nicely.

Supervisors indicated assistance for reviewing prior proposals that have been not completely funded, especially rising allocations to the access centers and hubs.

If the area opted not to additional invest down its surplus, McDonough stated that would fuel lawmakers’ arguments in the future to decrease the quantity of funding for regions — hindering the board’s capacity to assistance suggestions such as jail diversion and access centers.

Lobbyist Gary Grant stated a single of the region’s legislative priorities for the 2023 legislative session — to increase the needed fund balance from five to ten % — didn’t get traction amongst lawmakers due to the fact some of the 14 regions have as well significantly of a surplus.

“Now, I do assume the legislature understands the utility of getting ten % rather than five %,” Grant stated. “However, as lengthy as there are regions out there that way exceed that, I assume it is going to fall on deaf ears.”

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