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Response to story about children’s mental health legislation

Over the past two years, both Republicans and Democrats in the Iowa Legislature have made mental health a priority. This year, we focused our attention on developing the framework for a children’s mental health system. I am proud to have voted for this bipartisan plan that ensures parents have a dedicated, local resource to turn to when seeking mental health treatment for their child. I have also repeatedly stated that funding will be difficult and that the ultimate answer is to rebuild Iowa’s families and make them stronger, lessening the need for mental health services.

The legislation was developed based on recommendations from health care providers, educators, parents, and mental health advocates, as well as a representative from Iowa’s Mental Health and Disability Services (MHDS) Regions.

In addition to this legislation having significant bipartisan support, almost all stakeholders registered in support, including National Alliance on Mental Illness (NAMI), Iowa Hospital Association, Iowa Medical Society, Coalition for Family and Children’s Services, United Way, Iowa State Sheriff’s & Deputies’ Association, and Area Education Agencies. A companion bill that dealt with MHDS funding received support from the Iowa State Association of Counties and County Supervisors. No group registered in opposition to the legislation. At no time was I contacted by anyone representing the mental health regions or county supervisors to voice concern, and at no time did the counties or mental health regions register against either bill. In speaking to staff, I found that they also did not receive any complaints or concerns.

The legislature has closely monitored the financial sustainability of Iowa’s regional mental health system. For the MHDS Region that Crawford County is a part of, Rolling Hills Community Services Region had an ending fund balance of $4.2 million at the end of State Fiscal Year 2018. That is a matter of record. With Woodbury County joining the Region in July, there will be at least an additional $2.3 million added to Rolling Hills’ budget, understanding that they will also bring additional spending needs.

The funding available should enable our MHDS Regions to pay for the beginning costs associated with the children’s mental health legislation. Statewide the 14 MHDS Regions had a combined $121.66 million in ending fund balances. With the fiscal note for the legislation being $5.1 million statewide starting in July 2020, this legislation logically fits in with the current financial situation of Iowa’s mental health system. I understand the concerns expressed by some of the supervisors as to cost and sustainability, as do other members of the legislature in both parties. We are only at the beginning of this process.

The legislature appropriated additional funding to pay for Assertive Community Treatment teams, a statewide crisis hotline, and eliminated the waiting list for children’s mental health waiver. These services were previously subsidized by the MHDS Regions, but now will be the sole responsibility of the state, freeing up additional funding for the MHDS regions.

I am dedicated to ensuring there is a sustainable and affordable mental health system in Iowa and will continue to work to ensure that Iowans are able to receive the care they need close to home. Discussions will continue as to how to best fund these priorities.

I have always strived to stay in contact with the county supervisors in the three counties I serve. Communication is of course a two-way street. County supervisors often contact me to express their concerns on a myriad of issues. I have spoken with Kyle Schultz on issues of concern. I spoke with Supervisor Eric Skoog frequently during the last session, when eliminating or reducing the backfill to cities and counties was being considered. I told him what I was working for and asked that he inform the other supervisors. I was grateful for this level of communication. Mr. Skoog contacted me to voice his concerns, as did several Mayors and other city officials in my district, and I listened, fighting to ensure that the backfill was not eliminated for counties that had not seen the growth needed to replace the lost revenue. I communicate constantly with local officials to get feedback and they also contact me when they are concerned about an issue.

I heard from several county supervisors on various issues this session, but none contacted me to voice concerns and discuss HF690 and 691 that established the Children’s Mental Health System. Given that no one was registered in opposition to the proposals and that the association representing the counties and the mental health regions were in support, I had no reason to believe there were concerns that needed my attention. Had I been contacted; I could have articulated the plan and the concerns that I share on cost and sustainability.

Communication with constituents and local officials has always been a top priority in my service to the citizens of District 18. I attend numerous legislative forums, hold office hours and breakfasts, and my phone number is widely known. I see many county and city officials at parades, at events around town and sometimes in the grocery store or local restaurant. I publish a weekly newsletter during session highlighting legislative proposals and ask for feedback, and my legislative email address is published in numerous places, including on the Iowa legislative website. While I do my best to communicate on the many issues that we confront each year in the 110-day legislative session, I have no way of knowing all concerns that might exist if I am not contacted by those having the concerns. I am certain that concerns about the Children’s Mental Health framework we established could have been easily voiced to me prior to the legislation being voted on. None were.

I will continue to do my best to communicate with city and county officials and hope that they will reach out to me when they have a concern on pending legislation. I also continue to hope that Mr. Mundt will communicate with me while writing these stories, as he has not reached out to me once during these articles to get the legislative perspective. This is curious, if he is truly interested in the complete story.

The more I reviewed the Dan Mundt story of May 17th, titled “Says Local Taxes will likely pay for Mental Health Services,” the more mistakes I found.

• The article states Supervisor Muhlbauer said “they were very disappointed it did not come along with funding of $700 million it needed to have.” This is an absolutely insane number. The total FY2020 MHDS Region responsibility is $13.27 million, for all 14 MHDS Regions combined.

• The article disputed the 122% ending fund balance for Rolling Hills. This information was provided by DHS from the Regions for the Mental Health funding legislative interim committee last interim. The information is accurate.

• The article states that the Regions took over a state program. That could not be farther from the truth. Mental Health has always been a county funded system in Iowa.

• If you look at the HF691 registrations, registered for are Lucas Beenken, Jamie Cashman, Kristi Harshbarger, and William Peterson representing the Iowa State Association of County Supervisors and Iowa State Association of Counties.

• If the Iowa Association of Counties was not articulating all of the counties concerns with the bill, there is no way legislators could know that.

As continues to be the case, Mr. Mundt never contacts me when writing stories that would directly benefit by having the entire perspective and accurate information. I can only conclude he is not interested in the entire perspective. This is truly unfortunate.

Respectfully, Steven Holt,

State Representative, District 18

Editor’s note: The content of Dan Mundt’s May 17 article was from a discussion by the Crawford County Board of Supervisors about a letter Representative Holt had published in the May 10 Denison Review. The figures and opinions used in the article were those given by the supervisors who spoke about Holt’s letter.

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