From The Gazette in Iowa:CEDAR RAPIDS, Iowa -- Luvoria Sanders (pictured) depends on the government for help.
She's a 36 year old with cerebral palsy. Public money pays for one of her jobs, for someone to help her grocery shop and for her to get to work.
She uses a wheelchair, holds two part-time jobs, lives by herself in Cedar Rapids and is fiercely independent. But in many ways, she must depend of others, and that network of support is weakening.
Chronic underfunding of mental health and developmental disabilities services — along with looming new state spending cuts — will deal a blow to many Iowans.
"Bricks and mortar are important, but the foundation of what our mental health system is based on is crumbling as we speak," said Dale Todd, chairman of the Iowa Mental Health, Mental Retardation, Developmental Disabilities and Brain Injury Commission.
One-fourth of the state's population already live in a county where people are shunted to waiting lists for mental health services, and more counties plan to start waiting lists.Counties — the main provider of such state services — are running out of money. At least 24 counties have no reserves to carry over for operating expenses. Eighty-one of Iowa's 99 counties already levy the maximum in property taxes for mental health services.
Because of a state law passed in 1996, any new mental health/developmental disabilities funding must come from the state. Mental health officials are stuck. Either they must beg the state — unsuccessfully, up to now — for more money, or they must cut programs.
Some of the ideas that providers have come up with: start more waiting lists, cut funding to group homes, change the rules so fewer people qualify for help, send staff on extended unpaid furloughs, move people to nursing homes, eliminate certain therapies and counseling, stop paying for medication entirely.
The mental health commission, a 16-member board that advises the governor and Legislature, recommended the state boost mental health spending by 8.5 percent for fiscal year 2010. That's unlikely, given the recession and the history of such past requests.
Last week, Gov. Chet Culver announced a 6.5 percent across-the-board spending cut for the fiscal year beginning July 1. Culver has already cut state spending by 1.5 percent for the current fiscal year. Mental health funding is not exempt.
In Linn County, the flood makes the problem worse. Mental health officials expect a 10 percent spike in demand because of the disaster. They also expect diminished property tax receipts.
"We have a major problem," said Craig Wood, Linn County's director of mental health and developmental disabilities services. "There's going to be some services that end up getting cut."
Wood must cut at least $2.3 million from his department's budget for the coming fiscal year. Cuts are coming in Johnson County, too, said Kris Artley, director of mental health and developmental disabilities services there.
"I either have to cut services, reduce the eligibility criteria, or figure out some type of internal way of doing some cost savings," she said. "Probably to the tune of a little over $1 million."
Once a week, a case worker visits Luvoria Sanders. They shop for groceries. Sanders learns to cook. They talk about how she manages her finances. Sanders works 20 hours a week at the Arc of East Central Iowa and one afternoon a week at Goodwill Industries. The job with Goodwill, the case worker's visits and her occasional subsidized rides to Arc are all in danger of losing funding, Sanders said.
"All of this waiting is nerve-racking — and I don't like it," she said. "But it's out of my hands, and I can't do anything else but wait and see."
The money chase Mental health and developmentally disabled services in Iowa are funded by the state, the federal government and local property taxes.
The funding problems can be traced to 1996, when the state Legislature froze the amount of property taxes each county can levy for mental health services.
The measure was meant to reduce the property tax burden and shifted half the cost of mental health services to the state budget. The Legislature promised to pay for new clients and cost increases directly from the state budget. It's been a promise lawmakers have been unable to keep.
Since 2000, state funding for mental health services increased by $20 million to $252 million in 2008. The cost of services has risen faster, main because of the costs of medication and gas and the rise in demand, Wood said. He estimates an additional $20 million would cover the shortfalls.
In Linn County, $32 million is earmarked for mental health and developmental disabilities — one-third of the county's annual budget.
The Iowa State Association of Counties wants the Legislature to allow counties to raise property taxes for mental health funding, but Republican lawmakers don't support that approach and Democrats haven't thrown their weight behind it.
"There's discussion about it," said Rep. Tyler Olson, D-Cedar Rapids. "I haven't had conversations with enough House Democrats to give any perspective on ... what portion of our caucus support it."
Legislators from both political parties say mental health/developmental disabilities funding is a priority, but are making no promises.
Rep. Scott Raecker, R-Urbandale, said he's interested in tapping the $35 million ending balance in Culver's proposed state budget and trying to get mental health funding exempted from the budget cuts.
"It's going to be difficult," said Raecker, a ranking member of the House
Appropriations Committee. "I think we need to be looking more strategically at
cuts."'
The outcome matters to Jo Ellen Marconi, who lives in Palo with her 18-year-old twins, BethAnne and Gary, both 11th graders and both autistic.
Marconi, 58, a widow who lives on Social Security and whose home was flooded in June, wants her children to move to a group home when they graduate from high school.
But funding for group homes, which Marconi sees as crucial to her children's future, also is in danger, with longer waiting lists and less subsidy possible."Maybe it'll be ten years before they have a slot for them," she said.
She's afraid that if her children don't move out and learn to be somewhat independent, her eventual death will leave them defenseless and traumatized.
"I would keep the kids with me forever, but that's not what's best for them," she said. "If I'm gone, somebody's going to have to do something. You can't just throw these kids out on the street."