HIAWATHA — County supervisors on the board that governs regional mental overall health and disability solutions advocated Thursday for spending down substantially of its practically $9.two million surplus ahead of the finish of the spending budget year subsequent month by boosting assistance for initiatives inside its nine-county region to keep away from the state withholding future funds.

As the finish of fiscal 2023 looms on June 30, the East Central Mental Well being Area governing board directed regional employees to draft a program for how to devote element of the surplus — at least about $four.two million that goes beyond the state-mandated fund balance — to improved spend mental overall health care providers, who are seeing higher levels of demand for underfunded solutions.

The Iowa Division of Well being and Human Solutions allocates state house tax dollars to regions, but if regions carry as well substantially of a surplus the agency withholds additional dollars. That primarily suggests providers inside the area drop out on funding that would otherwise go toward enhancing solutions and addressing unmet neighborhood desires.

State lawmakers call for the regions to hold fund balances of 20 %, but that will drop to five % subsequent fiscal year.

Regional Chief Executive Officer Mae Hingtgen asked the board for path at the board’s meeting Thursday at the Kirkwood Regional Center on how to devote the fund balance, or irrespective of whether to let it stay as is. The area covers solutions in nine counties: Benton, Bremer, Buchanan, Delaware, Dubuque, Iowa, Johnson, Jones and Linn.

“These dollars are appropriated for the taxpayers of the area to have spent on folks in the area who have these desires,” mentioned Johnson County Supervisor Rod Sullivan, who represents the county on the board. “I hear from folks definitely in my personal county there’s a lot of unmet want, so I feel we should really do what we can to get the dollars out the door.”

Dubuque County Supervisor Ann McDonough mentioned it created her heart ache that the board had so substantially readily available to devote when there are millions of dollars necessary on the ground that could be spent in partnership with providers.

In current months, supervisors pressed for a lot more funding for the Linn and Johnson County mental overall health access centers, anticipating the area would finish up holding a multimillion-dollar surplus. The board passed a fiscal 2024 spending budget in March that allocated $two.9 million to the facilities — up from the initially proposed $two.five million.

County officials have mentioned regional funding and low Medicaid reimbursement prices do not cover the expense of solutions, and for Linn County the resource gap is a barrier to the access center’s expansion to be open about the clock.

It is these sorts of solutions — and other individuals such as youth or homeless shelters — that supervisors are hunting to improved fund with the readily available surplus.

McDonough mentioned the area is becoming as well conservative in the awards it tends to make, and there’s not a adhere to-up approach to reconsider escalating allocations. She and Linn County Supervisor Ben Rogers took challenge with CEO Hingtgen’s lack of suggestions for spending down the surplus, which McDonough mentioned felt like a scramble to now allocate with only about 5 weeks to go.

Rogers mentioned this area could choose to be a model and opt to supplement the gap providers face from low Medicaid reimbursement prices.

“We have so substantially in fund balance that is not becoming spent down, and now by legislative decree, we have to surrender it,” Rogers mentioned. “And we have surrendered it for final year. Now it is Might 25, and we’re going to come back at the finish of June, asking for proposals (from providers).”

Saddled with a surplus just about every year that is in excess of the state-mandated fund balance, the supervisors urged improved economic preparing to make certain the board is not faced with the exact same challenge in future years of possessing 1 month to figure out how to devote millions.

“There has to be a resolution to this that is sustainable. We can not run into this brick wall year just after year,” McDonough mentioned. “ … We have so substantially dollars left at the finish of the year when we know our communities, it is dry earth nevertheless, that there is not adequate solutions.”

McDonough recommended forming a subcommittee of the board focused on finances.

Deborah Seymour-Guard, finance coordinator for the area, mentioned there are a quantity of challenges involved with spending budget estimates. She mentioned in some cases providers are not billing for solutions in a timely style, so it is not possible to accurately track how substantially is spent. On top of that, regional employees mentioned in some cases solutions may possibly not come to fruition till a later date than anticipated, throwing off providers’ estimates.

She recommended possibly boosting funding allocated to the Linn and Johnson County mental overall health access centers, which she estimated could devote down at least $two million. Access hubs in Dubuque and Benton counties, which are not state-designated facilities and supply a smaller sized scope of solutions, could potentially get a increase as properly.

Supervisors indicated assistance for reviewing preceding proposals that had been not completely funded, especially escalating allocations to the access centers and hubs.

If the area opted not to additional devote down its surplus, McDonough mentioned that would fuel lawmakers’ arguments in the future to cut down the quantity of funding for regions — hindering the board’s potential to assistance suggestions such as jail diversion and access centers.

Lobbyist Gary Grant mentioned 1 of the region’s legislative priorities for the 2023 legislative session — to increase the essential fund balance from five to ten % — didn’t obtain traction amongst lawmakers since some of the 14 regions have as well substantially of a surplus.

“Now, I do feel the legislature understands the utility of becoming ten % rather than five %,” Grant mentioned. “However, as lengthy as there are regions out there that way exceed that, I feel it is going to fall on deaf ears.”

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