After much discussion and postponing a decision for several weeks, Palo Alto County Supervisors reluctantly approved a 28E agreement between the county and Northwest Iowa Care Connections for mental health services beginning July 1. The approval followed a 3-2 vote of the board during its meeting on Tuesday, Feb. 11.
The 28E agreement was required of each of the participating counties in the regional mental health organization, which was created following the implementation of the state's Mental Health Regionalization legislation. With the regionalize operation of mental health services slated to begin on July 1, the 28E agreement was needed so that Northwest Iowa Care Connections, the entity created by six counties, Palo Alto, Clay, Dickinson, O'Brien, Osceola and Lyon, to submit to the state for approval so that the organization's care management plan could be developed and filed with the Department of Human Services prior to July 1.
However, over the past weeks, the Supervisors had hesitated in signing the agreement, primarily due to a disagreement with certain language addressing funding in the agreement.
After tabling the signature of the agreement on Feb. 4, County Mental Health Coordinator Maureen Sandberg appeared on Tuesday morning accompanied by Kim Wilson of Clay County, who will be the Region Administrator, and Beth Will of Dickinson County. Both women serve as their county's mental health coordinators, and appeared at the request of Supervisor Linus Solberg, to answer questions for the board.
"Dickinson County had the same concerns that you have,"?Will told the board.?"But their mindset has changed. We're a region now, and its all for one and one for all. Some Core services will be changing, because providers offer different options, and there will have to be some changes."
Wilson addressed funding for the Region. "The equalization money will be there for next year, but the state will look at the $47.28 levy to see if it is too much, because they don't want the Regions to have surpluses."
But concern over what would happen to Palo Alto County's current Mental Health surplus remained. Sentiment of the Board was to give the surplus money to local mental health services, rather than have the state come in and take the surplus funds.
"Is there any way we can give our providers a one-time payment?" Solberg asked.
"I think you can, but there are hoops to jump through,"?Will answered. "For a specific service, you can do that, but it has to be provided for in your mental health plan."
"If it's not set up in the Management plan, we would have to amend the plan to show a block grant,"?Sandberg agreed.
"I think the taxpayers want us to take care of our people," said Supervisor Ron Graettinger.
"Than's not even part of this discussion,"?Board Chair Ed Noonan replied.
"People don't complain about mental health," Solberg said, "But they are not happy about sending our $800,000 surplus to the region,"
"The Region is responsible to the clients of each county and the communities,"?Wilson stated.
"What's happened to us in the last 80 years?" Solberg asked. "We used to have county homes and didn't have homeless people living in the streets."
"They are here, but they're invisible,"?Wilson answered. "They flop back and forth from couch to couch or are in and out of jail. The Region is a networking thing - getting people in touch with the help they need, that's what the money is for."
"I agree with you, it's very frustrating because the rules for this are changing all the time," Will added.
With that, Merrill moved to approved the 28E agreement and the motion was seconded by Supervisor Keith Wirtz.
On a roll call vote, Merril voted nay, while Wirtz, Graettinger and Solberg cast aye votes. Noonan voted nay, but declared the motion approved on a 3-2 voted.
"I'm not against taking care of our people,"?Merrill said. "It's just that phrase in the agreement, 'and fund balance' that I?can't agree to."
Of the Region members, only Lyon County had not signed the 28E agreement after Palo Alto had approved the agreement.