MUSCATINE, Iowa — Every year since 1996, Mike Johannsen, Muscatine County’s community services director, has been handed the same allotment of money — $2.055 million — to provide mental health services for county residents who don’t have insurance to pay for services they need.
Put a different way, the mental health portion of a local homeowner’s property tax bill fell from $2.09 per $1,000 assessed valuation in 1996 to $1.26 today.
However, owing to inflation, purchasing those same mental health services today would cost about $2.9 million annually.
That’s where finding creative solutions and unleashing the competitive power of the market can come in handy, Johannsen told the Muscatine Rotary Club on Monday — but that kind of local innovation could be out the window as soon as next year.
That’s when the Iowa Legislature’s plan to begin revamping the delivery of mental health services — from local counties to a regional approach, in an effort to equalize access to services across the state — begins in earnest.
Each of Iowa’s 99 county boards of supervisors must decide which region it will join — or whether the county will seek a state waiver from joining the new system, which will begin in July 2013 and be fully implemented the following year.
Muscatine County supervisors have met with mental health and elected officials in Scott and Johnson counties and others, Johannsen said. They don’t have to decide which district is the best fit until next spring.
“The Iowa Legislature wanted to lay on another layer of bureaucracy,” Johannsen said, “but the best government is the government that’s closest to the people — local government.”
“The citizens of Muscatine County have told us to take care of the most vulnerable citizens,” he added. “We’ve changed (since 1996) and not without some pain.”
There will be even more change as a result of the new legislation, although Johannsen said it’s too soon to know the extent of the changes.
State rule-makers will define the core mental health services that each county must provide. But some counties, including Muscatine County, provide a level of service beyond the core.
In Muscatine County, for example, Community Services helps fund Special Olympics and sheltered workshop sites for people with developmental disabilities at places like CrossRoads, Inc.
Under the new system, that funding could be threatened.
Supervisors also weighed in on the future of mental health services during their regular meeting Monday morning.
Unknown at this point, supervisors said, is how regions will be governed. Should each county in the region have one vote in deciding important matters? Or should the boards be proportional, reflecting each county’s population?
Bob Howard compared the mix of large and small counties seeking to partner together to “a big bear looking at a little rabbit, drooling.”
Jeff Sorensen noted that Muscatine County taxpayers pay an average rate in their property taxes among the 99 counties.
Under the new system, the real savings, according to Sorensen, will be for taxpayers in rural counties, where economies of scale to help reduce costs are less readily available.
“We will have growing pains,” Chairwoman Kas Kelly said. “There will be unintended consequences.”