First, the rural counties in our region cannot all float their costs in the first quarter. The money just won’t be there.
Second, it has been a relief to manage the budget knowing what amount there is to spend from the beginning of the year. We have known before the year starts a fairly close approximation of the amount that will be available through property tax dollars instead of waiting until the third quarter to find out 9 months too late if there was any money to spend or not. We haven’t had to play the guessing game of wondering what the formula will be for funding and to find out what regions are the winners and losers. The sad part is that the biggest losers are always the people who count on behavioral health services. We’ve been able to expand services as they are needed because there is money in the fund balance and we can pay for the services necessary to help the people with the most challenges.
It is has also been a relief to be able to go through the legislative session knowing that one decision is not going to take down the system and not to have people and their families constantly stirred up thinking there will be no services if the worst happens. This past year, we’ve known that a sudden change in the federal policy regarding mental health care could likely be weathered at least in the short-term and providers haven’t worried that there will be cutbacks that will happen quickly.
Moving forward, however, this will all change. As a region that has complied with all of the expansion that was requested, built services that cover every county and has been responsible with spending while providing the services needed for people to succeed, it is disheartening to think we will soon be returning to a system where there is absolutely no stable funding and that the reserves are inadequate to cash flow most of our counties before the system even starts. And it is scary to think that if federal policy changes and Iowa loses a massive amount of federal funding, neither the state nor the regions will have the money to deal with it.