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Iowa House Republican proposals focus on expanding the mental health workforce and increasing the number of beds

representative ann meyer speaks in the house chamber
Katarina Sostaric
IPR News
Rep. Ann Meyer, R-Fort Dodge, announced a series of mental health proposals Tuesday at the Iowa Capitol.

A key state lawmaker is proposing four new policies aimed at increasing the capacity of Iowa’s mental health system to care for people with severe mental illness.

Rep. Ann Meyer, R-Fort Dodge, chair of the House Human Resources Committee, said she has heard many stories while she’s out knocking doors about constituents’ family members who are struggling with mental health issues. But a story from one woman in Fort Dodge stood out to her.

“She was telling me about her brother who had been away in Iraq, and was back,” Meyer said. “He had PTSD from being in combat. He’d lost several friends. And when he came back, he used drugs, substances to numb that pain. And since that happened, he became homeless.”

Meyer said the legislature has made a lot of changes in the past few years, like establishing a framework for a children’s mental health system and directing insurance companies to pay the same rate for telehealth mental health services as for in-person services. But there are still a lot of gaps.

“Law enforcement’s telling me that they still have the same amount of people on the street,” Meyer said. “They still have no place to take them. My hospitals are telling me any day, there could be one to five sitting in the emergency room or the ICU… and no treatment, no place to send them. And sometimes they’re released without treatment.”

Meyer said some hospitals aren’t accepting patients that need help, including people who are suicidal or violent. She said House Speaker Pat Grassley, R-New Hartford, is “completely on board” with her proposals that are intended to help fix these problems.

The first bill, which advanced Tuesday with bipartisan support, would establish a state-funded psychiatric residency program at a cost of $4.8 million a year when it’s at full capacity.

“We need to do something to get psychiatrists into the state of Iowa,” Meyer said.

There would be 12 residency positions each year, and they would be divided evenly between the Independence and Cherokee state mental health institutes and the Iowa Medical and Classification Center at Oakdale.

The University of Iowa Hospitals and Clinics would administer the program, and the bill says preference would be given to people who live in Iowa or completed their undergraduate degree or medical school in Iowa.

“I can tell you from my firsthand experience that the need is great, and getting worse,” said Dr. Gerard Clancy, a psychiatrist at UIHC. “In the emergency room at the University of Iowa, we have gone from 10 percent of our visits to the ER to 30 percent of our visits to the ER being psychiatric.”

Clancy said there’s been a nationwide increase in suicides among girls ages 12 to 17, and among Black and Latino Americans. He said he’s very supportive of Meyer’s proposals.

“We know that the need is great,” said Rep. Timi Brown-Powers, D-Waterloo. “Our families and folks with mental health have been waiting for this for a long time, so it is good that we’re finally taking steps forward.”

Rep. Eddie Andrews, R-Johnston, said he is “100 percent in favor” of the bill.

“My family has been affected by mental health,” Andrews said. “Three years ago, we lost our child—19, almost 20—and that’s one of the reasons why I came here, to help other families not go through the same things that we did. And so anything that will aid that, I’m for.”

The second bill would establish a loan repayment program for psychiatrists, nurse practitioners and therapists who can prescribe medications if they agree to stay in Iowa for at least five years. It proposes putting $1 million of state funding into the program in the next fiscal year.

The third bill would increase the number of beds at the state’s two mental health institutes at Independence and Cherokee by 50 percent. That’s an additional 32 beds for adults and 14 for children.

“We need to have places for our highest crisis patients to be treated,” Meyer said.

She said she does not yet know how much it will cost the state to increase the number of beds, and she estimates it would take at least six to eight months to get those additional beds fully staffed.

Meyer’s fourth bill would establish a higher rate of paymentthrough Medicaid to better cover the costs of caring for patients with the most complex mental health needs.

In the U.S., the National Suicide Prevention Lifeline’s # is 1-800-273-8255. Crisis Text Line can be reached by texting HOME to 741741 (US), 686868 (Canada), or 85258 (UK).

Katarina Sostaric is IPR's State Government Reporter