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Kathie Anderson-Noel

Kathie Anderson-Noel explains the challenge of stretching the mental health region's budget when the region will be responsible for providing more core services without additional funding authority.

MUSCATINE — Midway through Monday's broadcast of the board of supervisor's meeting, Nathan Mather, district four supervisor, looked into the camera to address unfunded mandates in mental health care:

"I'll say two more things, and they are pieces of advice to folks in Des Moines," Mather said. "Number one, back off. It's fine to tell us what you want us to do, but let us do it."

Last week, the Gov. Kim Reynolds signed into law House File 2456, expanding the mental health services regions are required to provide.

Mather, who represents Muscatine County at the Eastern Iowa Mental Health/Disability Region, said it is premature to expand services when there are funding inequalities among the regions. County contributions to the region have been capped since the 2012 legislative session's Senate File 2315. 

"Second, take away the caps," Mather went on. "Let us fund it how we need to fund it. When you tell us to do something and you don't let us levy for the resources ... you are screwing over real people."

For Jeff Sorensen, district five supervisor, services cannot be increased until current funding is improved.

"They have an excess fund balance in these regions because they have inequities in the funding that they've never solved," Sorensen said. "If they solved the inequities in the funding they are going to find that they don't have that excess fund balance."

Four counties participating in the Eastern Iowa Mental Health/Disability Region set their levy for the region to zero dollars and zero cents. The state required the district to spend down its reserve fund balance, and the plan was to stop the flow of money and use the excess to pay for services. 

But with additional required services, Mather said the region must now find new funding resources. 

"We've gone from desperately needing to spend our money to desperately needing to find money," Mather said. "The sickening thing is that they created this race to the bottom last year. That's the reason the counties set the levies the way we did."

Kathie Anderson-Noel, Muscatine's coordinator of disability for the region, said the new services are "core-plus" services; services that counties could offer if they had the need, or the money.

"The region and the county want to see the appropriate services for people in need," Anderson-Noel said. "We want people to have access to good solid community-based services so that they can have their needs met."

When changes occur, it puts pressure on the whole region to provide additional services even though county levy rates were approved before the changes were made. 

"Legislators need to be aware of some of the consequences of their legislation," Anderson-Noel said. "Especially in the mental health world. We’ve got budgets that have to be in by March for the next fiscal year and then something comes along and forces us to alter that. These affect real services. That affects real people."