House File 2456

Last week a Senate subcommittee recommended passage of House File 2456, a bill that many in Des Moines believe will help alleviate the mental health crisis in our state. The bill is expected to sail through the Senate and land on the governor’s desk. The general consensus in Des Moines is that this is a really good bill. But what does it mean for providers in the East Central Region?

First, it’s important to understand what’s in the bill. A number of very hard-working and dedicated people came together as part of the Complex Needs Workgroup to develop the recommendations that make up this bill. The people in the workgroup understand the needs of the communities we serve and they know how critical these improvements to our mental health system are. This bill will build on what the regions are already doing to improve care by:

  • Expanding services along the continuum of care to include evidence-based preventative services to de-escalate mental health patients before crisis and to treat them in the proper setting;
  • Removing the statewide sub-acute bed cap and allowing these facilities to transition individuals to a lower level of care before they are prepared to return home;
  • Improving communication and processes between mental health professionals and law enforcement to prevent long-distance trips across the state;
  • Allowing mental health providers, rather than judges, to make mental health care determinations in the least restrictive environment;
  • Expanding the services covered by Medicaid.

The governor has been talking a lot about access centers, which we know quite a bit about here in the ECR. Both Linn and Johnson Counties have been in the planning process for their own access centers for some time. However, it is unclear how much flexibility individual communities will have over what goes into their access center.

The most exciting and least understood part of this bill is in regards to the Assertive Community Treatment teams. There are currently just 10 ACT teams in the state. These interdisciplinary teams provide individualized and flexible care to individuals with mental illness in their homes and communities, 24 hours a day, 7 days a week, 365 days a year. Increasing the number of communities who have ACT teams is going to be a very positive thing for the people we serve.

Finally, this bill has received bipartisan support and it seems like it’s going to do a lot of really good things. However, there is no funding currently attached to this bill. Likely, it will be expected that the regions are going to have to pay for this. Considering a number of regions have already spent down their fund balance because of last year’s Senate File 504, this could be difficult. Also, it is assumed that the expansion of Medicaid-reimbursable services will help. At this point, we’re in wait-and-see mode. The budgets have not been taken up yet and we just don’t know what it’ll look like. We will continue to follow this bill and the appropriations that will likely follow and keep you all updated.