The Issue of Mental Health Home Rule

Winnebago, Hancock, Kossuth, and all surrounding counties belong to a vast 22 county mental health region called County Social Services or CSS. The expansive region was created to theoretically help the smaller, less populace counties pay for mental health services. The general feeling among some local county officials is that it does the exact opposite, essentially funneling money from rural counties to help pay for metropolitan cases.

Recently, some area counties have explored the idea of forming their own region so as to have better control of local tax dollars in order to help pay for local patient cases. However, some state officials have made the idea nearly impossible to accomplish. They have set guidelines such as population quotas, common county borders, a qualified treatment center within the district, and other requirements which some area officials say hinders the development of a local mental health region.

Those at the state level disagree. Lt. Governor Adam Gregg spoke with KIOW News in an upcoming SUNDAY TALK segment this Sunday on He feels that the state has made good progress in the area of mental health care, but it needs improvement.

Iowa Lt. Governor Adam Gregg

All that changed when the state began to try and unify the systems through regionalization according to Gregg.

County officials along with mental health professionals began to see a problem with the regionalization, and they were not alone. The Governors Office saw issues beginning to develop too.

Governor Kim Reynolds

The mental health legislation is designed to get care to those in need and make it closer to home. What many family members of patients were discovering was that they were having to drive 3 to 4 hours to a qualified center for their care. The families were forced to leave that patient there alone if the patient required extended care, so that the family members could go to work or take care of things at home. This may have caused a lot of stress for both the patient and the family.

According to Gregg, a new system is now in place that may alleviate that problem.

Area county officials still see a problem with the current regionalization. Each county pays into the County Social Services region which for Winnebago County is over $300,000. The figure is based on the population of the county. Recent spending by the County Social Services has been $2 million over budget. Most of these tax dollars have been spent on programs and services that have not lived up to expectations.

CSS Region Director Bob Lincoln, who authorized many of these programs and services, believes that the region will be able to pay their bills in the next budgeting cycle. However, county representatives to the CSS like Winnebago County Supervisor Bill Jensvold are exploring to the idea of forming a new, closer to home region to better serve local residents and keep local tax dollars closer to home. Counties such as Hancock, Kossuth, Cerro Gordo, and Worth are also open to the new regions formation and creating more of a “home rule” scenario.

For Lt. Governor Adam Gregg, this whole process is a good step.