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Candidates For Governor Discuss Iowa's Mental Health System

candidates for Iowa governor
John Pemble /IPR
Gov. Kim Reynolds, Fred Hubbell and Jake Porter are the major party candidates for Iowa governor in 2018.

The three major-party candidates for Iowa governor gathered at a forum in Des Moines Sunday to discuss how the state can improve its capacity to care for people with mental health issues.

Republican Gov. Kim Reynolds took the stage first and said the state is making progress in increasing access to mental health care. She signed a bill into law this spring to expand services.

“The landmark legislation includes access centers, assertive community treatment teams, comprehensive crisis services and intensive residential service homes, and a 24-7 access hotline, to name a few,” Reynolds said.

But the legislature did not allocate new state funding for those mental health treatment options. Asked what she would do to fund the system, Reynolds said the mental health regions have some money, Medicaid contracts have new provisions that will help, and a work group will make recommendations for long-term funding.

“Every single legislator, Republican and Democrat, voted for comprehensive mental health care reform,” Reynolds said. “So I can tell you that the commitment is there to make sure we can now implement the legislation that passed.”

She added she signed an executive order creating a state boardto make recommendations for a children’s mental health system, after several failed attempts by the state.

Reynolds was also asked about the private companies that run Iowa’s Medicaid system. Some mental health providers are going out of business because of delayed payments from those companies.

“We put additional oversight in place last year—financial penalties. If I continue to hear this as I travel the state, we’re going to up the ante,” Reynolds said.

Reynolds also discussed substance abuse treatment, saying it should get as much attention as mental health.

“This year I will be celebrating 18 years of sobriety, and I can tell you that I would not have been able to do it on my own,” she said.

Reynolds added it’s important to fight the stigmas that surround mental health and substance abuse issues that can prevent people from getting help.

Fred Hubbell

Democratic challenger Fred Hubbell said there is a serious mental health crisis in Iowa. He hasn’t held public office before, but he touted his financial support of Broadlawns Medical Center in Des Moines.

“Charlotte and I helped them expand their facilities to provide a 50 percent increase in mental health beds and add two new psychiatrists to better serve patients with mental health needs,” Hubbell said.

He called Reynolds’ mental health legislation a “political Band-Aid.”

“The bill was a step we can all agree on. But it provided no funding to local communities to deliver the care,” Hubbell said. “Instead, it just burdened them with more unfunded mandates.”

Asked what he would do to fund mental health services in Iowa, Hubbell said part of the solution is diverting people with mental illness from costly county jails and emergency rooms.

“If we start focusing our attention on early identification and prevention, we can save a lot of money,” he said.

Hubbell added the state should stop what he calls “wasteful corporate tax giveaways”, and it should consider allowing local governments to raise more money through property taxes. 

He also criticized Reynolds for signing legislation allowing new health benefit plans that can deny or charge more to people with preexisting conditions, including mental illness.

“Instead we should be working with insurance providers to make sure we actually have parity for mental and physical illnesses in our state,” he said.

Hubbell also emphasized cracking down on the private companies that run Iowa’s Medicaid system as necessary for improving mental health care in the state. And he said the state needs to increase school funding to help bring in more school counselors to address mental health issues earlier in life.

Jake Porter

Libertarian candidate Jake Porter said he’s happy that people are finally talking about mental health issues, and he noted a lot of problems facing the state are connected. 

“Whether it be the budget, prioritizing things in the budget, that’s very important. Medicaid privatization, criminal justice reform, the mental health facilities closing—all these things are tied together in some way,” Porter said.

He also shared a personal experience.

“Back in 2011, I contemplated suicide. Looking back at it, the issues I was having, at the time it seemed disastrous, like it was the end, like there was no hope,” Porter said.

He said sharing these stories, though it can be uncomfortable, can help end stigmas surrounding mental illness.

After the forum, Traci Rudolf-Hanrahan, a licensed social worker in Warren County, said dealing with Medicaid privatization should be a priority because she has seen how it can hurt mental health providers.

“Several of those programs in the rural areas have closed because they couldn’t afford to stay open,” Rudolf-Hanrahan said.

The forum was hosted by the Des Moines Register at Des Moines University and can be viewed here.

Katarina Sostaric is IPR's State Government Reporter