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Mental Health Region to hold meeting on Muscatine's status in region

Quad City Times - 12/18/2019

A quarrel over fair funding for mental health services could cost Muscatine County its place in a regional cooperative.

Currently, Muscatine, Scott, Clinton, Cedar and Jackson counties comprise the Eastern Iowa Mental Health and Disabilities Services Region, which was founded in 2014. The five-county group established the Region for the purpose of providing support and linkage of services.

The Region is having a special meeting Friday to decide whether Muscatine County should be removed from the group earlier than already was expected. Muscatine had been set to opt out of the group at the end of its fiscal year on June 30, 2020.

At issue is Muscatine County's failure to pay its share of costs, among other disputes.

"The problem is: We're all trying to move forward in a positive manner, try to solve the problem, but it seems that the obstacle is coming from Muscatine," said Ken Beck, who represents Scott County on the Region board.

Beck, the vice chair for the Scott County Board of Supervisors, was referring to the possibility Muscatine County will not be able to pay its $311,000 obligation to the Region.

Muscatine County's Nathan Mather previously told fellow board members for the Region that Muscatine County's fund-balance projections show inadequate resources to pay, though it had been the county's intention to do so.

At Monday's meeting of the Muscatine County Board, a motion was made to defer the transfer of its payment to the Region until May 2020.

"The reason for that ... is that we don't have the money now," Mather said. "We don't know if we're going to have it. We could very well greatly endanger our people if we make that transfer without knowing.

"So, essentially, my board has said we can't pay you now, so all we can do is wait and see, and we will pay it if we can."

Beck then reminded Mather he previously committed to paying the $311,000, but Mather countered that his commitment had been to take the matter to county decision-makers.

Mather said it is the view of some in Muscatine County that they pay more than the other counties when populations are considered.

Scott County, whose population is about 172,000, has made total contributions of around $5.2 million since the Region's foundation five years ago. Muscatine County's population is about one-fourth that of Scott County (42,900) and has contributed about $2.2 million in total.

"I would also ask why it gets so worked up over $311,000 from one of the counties that has paid almost more than anyone else per capita in this region," Mather said, adding that the Region's finance director, David Farmer, confirmed to him that Scott County could pay more to help lift Muscatine's burden.

Scott County's fund balance is $1.3 million.

"So, could we make an additional fund-balance transfer right now?" asked Farmer, who also serves as Scott County's Budget and Administrative Services Director. "Yeah, that answer is correct. Has this board asked Scott County to contribute more than it's currently budgeted for this year? The answer's no, not yet."

Farmer said the Region's plan is to ask Scott County to contribute more to the budget, regardless of Muscatine County's ability or willingness to pay their share.

During a presentation by Farmer on the Region's fund-flow analysis, Mather again addressed Scott County's contributions.

"So, Muscatine County residents will be depending on the goodwill of the Scott County Board," he said, saying the Region's agreement doesn't specify that Scott County must pay more than currently obligated. "Lack of trust is an issue, and I'm not trying to say, 'He said, she said, two wrongs make a right.'

"But the fact is this trust issue has been brewing for years, and this is the first time it's being addressed and it's being addressed because Muscatine County, much like Jackson and Cedar County, has over-contributed."

Clinton County Supervisor Jim Irwin said the possibility of Muscatine stepping away from its membership with the Region is based on negativity by Mather.

In response, Mather said his obligation is to those who elected him in Muscatine County, where he must protect those in need of mental-health services.

Call to provider another point of contention

Another point of contention brought up by members of the governing board was a call Mather made to a provider in his county about the possibility of budget and/or service cuts.

After a steering committee meeting last week, Mather called Todd Noack of Rhonda's House to inform him about potential cuts.

"I don't think it was right as one board member for you to call Todd and tell him we're cutting your services; you won't be getting any money from the Region," Board President Jack Willey said at the meeting.

Noack, who was in the audience, said Mather had first asked him if he'd gotten a $200,000 increase that he'd asked for. Noack said no.

"You told me that the services for peer support and mobile crisis are on the table to be cut, and that I would not have any notification ahead of time that my funding would stop immediately," Noack said, adding the news filled him with anxiety. "I can't believe that somebody on this governing board in my region would call me and say those things, Nathan. That was ridiculous."

In response, Mather said that the steering committee had discussed cuts last week, and that there had been pushback on the possibility of cutting telehealth services. Three other services had been talked about in that meeting: mobile crisis, Vera French crisis beds and peer support. Mather said a member of the steering committee had said, in all likelihood, not cutting telehealth would necessitate cuts in one of the other three services.

"Peer support should have as much opportunity to rally support as telehealth folks do," Mather said. "I don't know if I did anything wrong. I don't know if I violated any policy, and I don't know if any of you can say that you, as governing board members, haven't talked privately with any of your providers."

Willey and board member Dawn Smith immediately responded that they never have spoken privately with a provider.

"This is what's interpreted," Beck said. "This is perspective, and this is why we call a protocol where we vote on something first before we start calling our providers to discuss maybe what's going to happen."

While the board approved cuts later in the meeting, none of them were to telehealth or peer support services like Rhonda's House.

Also at Friday's meeting, the matter of Scott County's portion of Region funding is to be on the agenda. It is scheduled for 10:30 a.m. at the Scott County Administrative Center, Davenport.

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