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Des Moines County's Mental Illness and Disabilities Services budget leaves padding

Hawk Eye, The (Burlington, IA) - 1/28/2015

Jan. 28--The amount of change that has and still is to come with the state's redesign of mental illness and disabilities services can be gauged by looking at Des Moines County's Community Services eight-page budget.

Of the 331 lines in the budget, 257 are new.

The state took over Medicaid services about a year ago, and counties were told to deliver services not covered and to expand services such as crisis care.

But the state has a $1.8 billion backlog of services covered by Medicaid not being delivered, Des Moines County Community Services Director Ken Hyndman said at a meeting Tuesday.

There are more than 10,000 people in the state on waiting lists for "waivers" for Medicaid services.

"They (the state Human Services Department, which oversees mental illness and developmental disabilities services for the state) are in a holding pattern," Hyndman said.

Since the state is not delivering those services, Hyndman said it's difficult to ignore the individuals in need. He recommended the county leave a cushion in the budget to help those waiting to see if they are Medicaid eligible.

Hyndman said there are about five people on the intellectual disabilities waiting list now, who are those with an IQ lower than 70. He estimated there may be up to eight people per year who need services costing about $40,000 a year each, totalling $320,000.

All services, including case management, crisis care, home health care, rent aid, utility aid, court-ordered hospitalizations, evaluations and transportation, among several other services, will cost about $1.9 million.

The state also ordered counties to band together and form a regional community services organization. Hyndman said the regional organization, Southeast Iowa Link, or SEIL, expects the county to spend that amount at minimum.

Using that measure, Des Moines County supervisors estimated the $1.21 for $1,000 taxable value property tax for mental illness and developmental disabilities can be reduced to about 60 cents, which will produce about $850,000 revenue.

Hyndman's department has about $2.5 million in reserves, which will be spent down to make up the $1.05 million difference between the $1.9 million budget expense and $850,000 tax revenue.

If the county needs to pick up people in need on the state's waiting lists, more reserves will be spent, supervisors agreed.

The state expects a 25 percent reserve, which would be about $500,000, Hyndman said, and the $2.5 million far exceeds that.

The supervisors agreed the county should spend down reserves and lower taxes.

Supervisor Tom Broeker asked to look at the figures further, just in case the tax needs to be 70 cents, for example, and not 60 cents.

The county has about two weeks to refine the budget.

The counties and cities must turn in their budgets to the state by March 1, which means a final version must be done by Feb. 13, county Budget Director Cheryl McVey said. A notice of a public hearing must be published and then held before submitting the budget to the state.

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(c)2015 The Hawk Eye (Burlington, Iowa)

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