Fairfield Ledger

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Neighbors Growing Together | Nov 23, 2017

Supervisors still dealing with mental health services issue

By DIANE VANCE, Ledger staff writer | Jan 21, 2013

Two of three Jefferson County supervisors said they learned more about the state’s plan to regionalize county mental health services when they listened to a presentation at the Jan. 14 supervisors meeting, but are still grappling with unknowns.

Supervisors Dick Reed and Becky Schmitz said they received more information, but supervisor chairman Lee Dimmitt said he had not received complete answers to his questions, when two state Department of Human Services administrators attended the board meeting last week to discuss mental health services redesign plans.

Rick Shults an administrator in the Mental Health Disability Services Division, state Department of Human Services and Julie Jetter from the same division brought an outline of the regionalization plan and met with the supervisors for 80 minutes a week ago.

At this morning’s supervisors meeting, Central Point of Contact Jefferson County Mental Health Administrator Sandy Stever told the board Jetter offered to return to Fairfield if requested and provide technical assistance to her department in the regionalization process.

“She offered to come down and go over the core services and what they consider evidence-based practices and what they are looking for as outcome measures,” Stever said. “She also is willing to attend another supervisors board meeting and review how to do the 28E Agreement needed to go with another county. What else would you want technical assistance with?”

Reed said if the county is going as a stand-alone county, or region by itself, he’d like Jetter to provide technical assistance with the application process.

“What if we do become our own region, what does that mean to us in dollars and cents, and how does it impact the services we offer?” said Reed.

Stever said if Jefferson County were approved as a stand-alone county for mental health services, it would receive state funding of more than $180,000 annually.

“If the deciders say ‘no’ to an application to stay out of regionalization, the county would not get the state funding,” said Stever. “And we’d get assigned to a region and either we would or would not sign a 28E Agreement.”

Stever also pointed out the state has not appropriated the funds.

“We wonder where the money will come from,” she said.

Dimmitt said he’d like to clarify if there is a county or region population size requirement.

“It appears Wapello County may be denied [stand-alone status] because of population,” said Dimmitt.

Schmitz said she’d like more information about integrated treatment for co-occurring diagnoses and she’d like to see samples of contracts with area hospitals and medical care facilities used for mental health clients.

“If they are coming back to give technical assistance, I’d like to attend so we could hear their answers,” said Dimmitt.

Schmitz also said she’d like to attend, and it was agreed Stever will contact Jetter to return to Fairfield. The supervisors will set a board work session to meet together to hear Jetter’s technical assistance ideas.

Reed said the biggest issue clarified for him at the Jan. 14 meeting is, “the rules and plans are not all solidified. The state has already said the restructuring will take place, but it needs to be spelled out better.”

Schmitz said the presentation confirmed for her it will be difficult for a county to qualify for a waiver to “stand alone” as its own region.

“The rules were detailed a little more and the rules committee emailed an update, but I didn’t see it until after last week’s meeting,” said Schmitz. “It is clear the deadline to join a region is the end of April.”

Dimmitt held a different perspective of the presentation from Shults.

“I still did not hear any answers to our questions,” said Dimmitt. “The answers given during discussion were canned. If my questions had been answered correctly, they would have said, ‘you’re right.’”

One of Dimmitt’s — and others’ — strong objections is sharing Jefferson County taxpayers’ money with another county.

“He [Shults] went into great detail about sharing and waiting lists to say — no, tax payers’ money doesn’t have to cross county lines,” said Dimmitt.

One of the provisions of two, three or more counties joining together to provide mental health care services is that a county cannot put clients on a waiting list, unless all the counties in that region have a waiting list.

“So if one county cannot care for all its clients, the other counties in the same regional would be helping out so as not to create a waiting list,” said Dimmitt. “Shults agreed the counties could need to ‘share resources.’ To me, resources include money.”

Dimmitt said he wants county mental health services to remain local.

“Sandy [Stever] does a very good job of making sure our clients have access to all the services, locally, regionally and across the state,” he said. “I do wear my biases on my sleeve.”


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