(Updated March 29, 2018)
Today was a great day! Not only did Governor Reynolds sign two important bills for Mental Health, she promised to sign an executive order establishing a platform to begin building a Children’s Mental Health System! I cried when I heard that. I had to watch it from home because I was not able to spend two day at that Capital this week and needed to be there yesterday to speak to legislators on this very issue. But maybe that is a good thing, because at least the tears started in the privacy of my home. I cried like a baby for several minutes – all out sobbing. I think this the first time in a long time I feel like there is hope for our kids in Iowa to get the mental health system they so desperately need. I know it will take time to get everything our kids need in place and I know we advocates will still need to be active to ensure that that happens. But tonight, let us all let out a collective sign of relief. We are being heard. And, we are hearing that our kids matter to Iowa’s leadership. Thank you Governor Reynolds!
The following are my recommendations that I have been sharing with legislators based on my experience as a mother who serves on the Children’s Mental Health & Wellbeing Committee and the Iowa Mental Health Advisory Council. While my recommendations include all of the recommendations of the committee, I am supplementing them with points I think are essential to keep Iowa moving forward.
Click here to see what a full array of Core Cross-System Children’s Mental Health Services and Supports looks like.
Note my additions beyond the
1. I recommend that a legislative committee convene this summer to determine a sustainable funding stream for a children’s mental health system. There is no explicit discussion in the committee’s recommendation about how the children’s mental health system will be funded or who will determine the funding stream. (The current Mental Health Tax Levy is only for adult mental health care and will not be able to fund child services without a making a change in the law.) Without funding, all this planning amounts to nothing more than mere talk because without a dedicated funding stream that can fund child services, none of the recommendations can be implemented. If children’s mental health is truly a priority for Iowa, it will appear in our budget.
2. I recommend that we resume the crisis planning grants. Crisis planning grants were the main mental health recommendation by the 2015 Work Group:
“The subcommittee recommended that the Legislature approve a phased-in approach for children’s mental health crisis services. The approach would involve awarding two planning grants one year followed by full implementation of children’s mental health crisis services in the two areas awarded a planning grant and awarding two additional planning grants the next year. In state fiscal year (SFY) 2016 two entities would be awarded planning grants. The selected entities would develop children’s mental health crisis services to the extent possible within available resources. The entities would also develop a plan for implementation of the full range of children’s mental health crisis services in each entity’s defined region. The entities’ plans would identify the amount of state funds needed to fully implement their plans. The plans would be reported to the Department of Human Services. The Department would combine the information from the two planning grants and provide a recommendation to the Governor and the Legislature during the 2017 session. The Governor and Legislature would consider the funding needs of the first two planning grants and authorize two more planning grants for SFY 2018.” (Page 8)
The plan was to continue additions of planning grants each year until there were children crisis services in every part of the state.
Two Crisis Planning Grants were awarded in 2016: to Seasons Center for Behavioral Health and Youth and Shelter Services (YSS). These agencies did a great job and laid out clear budgets for crisis service implementation: (click here to see their grant reports).
However, none of these recommendations ever made it into the next budget and the crisis planning grants were dropped all together.
I recommend that we resume the Crisis Planning Grants and actually follow through with funding service implementation while the children’s system and its funding stream are established. This will allow the addition of actual services in a timely manner. The first pilots showed us how to do this – the only thing stopping us from doing this now is funding. This is something the Governor could put in the next Fiscal Budget.
3. Write into the Appropriations bill clear and specific tasks with timelines to be completed by the State Board and /or Children’s Mental Health & Wellness Advisory Committee:
The Committee did not make significant progress this year nor did it make any recommendations in a timely manner that could have considered in time for budget planning or legislative planning. Clear timelines and tasks will help ensure that actual work towards implementing a system is occurring.
Further, it must be specified that mental health and brain injury medical experts and parents with experience raising children with serious mental illness and brain injury are on the State Board. I often hear comments during committee discussions that reduce mental illness to emotional trauma. This view is misinformed and will result in bad policy. The Children’s Mental Health system must be able to serve all children with brain disorders, no matter their cause (e.g., genetics, physical injury or emotional trauma). We all have a tendency to focus on our own personal and professional experience – so we need to ensure that professionals and family members are involved that represent the wide span of chidlren’s mental health. Otherwise, we will overlook key needs.
Finally, we must direct the Advisory Committee to continue its work on each part of the Array of Services and Supports. We focused on crisis services in 2015 and Prevention services in 2016 and were told that we would continue each year until each level of the array was addressed. This did not happen. We have not moved beyond prevention. I recommend that the next focus be community and educational needs for children with complex needs. These supports currently do not exist in most of the state. The result is preventable and more expensive hospitalizations and residential stays. And as must be noted, the recently passed Complex needs bill does not address children because 1) it does not have a funding stream that can serve children and 2) it does not include complex needs specific to children (e.g., therapeutic schools and day programs).
Again, I want to thank and congratulate Governor Reynolds for her support of mental health reform in our state. Let’s make sure that this happens by all working together!
For more details on the Committee’s recommendations, see the following documents:
Children’s Mental Health and Well-Being Summary of Recommendations
Children’s Mental Health & Wellbeing Advisory Committee February 28, 2018 Presentation to the Human Resources Appropriation Committees (House and Senate)