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MANCHESTER, Iowa – Gov. Terry Branstad had little, if any, success changing the minds of mental health providers who said the state has put the cart before the horse in redesigning the delivery of mental health services and is ignoring advice from people on the front lines.

The redesign calls for the state to pick up a larger portion of the cost of mental health and move from county mental health programs to a service network of services administered regionally and delivered locally.

“We’re going into a new system from an antiquated system that should have been changed years ago,” Branstad said at a town hall meeting in Manchester Aug. 20.

The changes dominated the question-and-answer portion of his hour-long meeting with about 70 people. He has another town hall meeting at 10 a.m. Aug. 21 at the Tipton Family Restaurant in Tipton, followed by a 12:30 p.m. event at the Environmental Learning Center in Muscatine.

“We’ve had a hundred years of doing it one way and now we’re going to a more holistic system,” Branstad said. “It’s not easy.”

However, he assured mental health providers and county government officials that although “it won’t happen overnight, we should see significant improvements.”

It’s not that she opposes the changes, but Peggy Petlon thinks the state “has put the cart before the horse.”

“I’m not trying to be negative,” the Delaware County central point coordinator for mental health services said. “It seems like we’re eliminating what we have before the replacement is in place.”

Branstad also defended using his line item-veto authority to block the transfer of $13 million to the risk pool administered by the Iowa Department of Human Services for payment of mental health costs at the county level and $8.7 million intended to whittle down the waiting list for medical assistance home and community-based services waivers.

As a result, Petlon said, the Delaware County waiting list is growing and people are being moved out of residential care to nursing homes or the community. The closing of the Abbe Center for Community Care – attributed to the Branstad vetoes – eliminates one option for residents who need a transition from psychiatric hospital treatment to other levels of care, she said.

The $100 million-plus the state is putting into mental health services is a “significant commitment,” Branstad said, “and the funds he vetoed were “beyond our budget.”

Branstad said he understands the challenge at the county level and understands the transition may not be without bumps, but will produce better results.

“Change is challenging and threatening,” he said. “Iowans hate change, but they love progress. So we need to get through this change so people can see progress. I know we can do it.”

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