Iowa House lawmakers seek to boost mental health workforce, psychiatric beds

Iowa would add nearly four dozen new beds at its state-run mental health institutions and would expand programs aimed at attracting mental health workers under a series of proposals House Republicans began advancing Tuesday.

Republicans say their mental health package would help Iowa add more services for those who need mental health treatment, some of whom are currently ending up in jails and emergency rooms across the state.

Rep. Ann Meyer, R-Fort Dodge, who chairs the House Human Resources Committee, said that Iowa has worked over the past few years to bolster mental health services, but she’s heard from her constituents that they need more mental health providers and additional treatment locations for difficult patients.

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“Law enforcement is telling me that they still have the same amount of people on the street. They still have no place to take them,” Meyer told reporters Tuesday morning. “My hospitals are telling me any day there can be one to five (people) sitting in the emergency room or the (intensive care unit).”

So far this session, Meyer has introduced four bills aimed at addressing the problem. The bills include:

• House Study Bill 532: A proposal to fund 12 additional psychiatric residencies in Iowa, which Meyer said would expand the number of psychiatrists trained in the state.

• House Study Bill 537: A proposal to add $1 million a year to a loan repayment program for mental health providers who can prescribe medication and practice for at least five years.

• House Study Bill 531: A proposal to expand the number of beds at the mental health institutes at Cherokee and Independence, providing the capacity to house as many as 32 more adults and 14 more children.

• House Study Bill 530: A proposal to direct the Iowa Department of Human Services to establish a Medicaid reimbursement rate for patients who need a higher level of psychiatric care.

Rep. Timi Brown-Powers, D-Waterloo, who also serves on the Human Services Committee, said she plans to support all the bills that House Republicans have proposed on the subject of mental health.

“We are finally taking the steps that people with mental health and those families have been waiting for, they’ve needed and we’ve talked about and talked about, but we’ve kind of kicked the can down the street,” she said.

She said steps like increasing funding for mental health programs and raising reimbursement rates for providers will help increase pay for people working in the mental health field.

More: The Iowa Legislature is returning for its 2022 session. Here are 5 issues to watch.

A House subcommittee advanced the bill related to residencies Tuesday afternoon with a 3-0 vote. Another House subcommittee will discuss the bill related to loan repayments on Wednesday.

Gerard Clancy, a professor of psychiatry and emergency medicine at the University of Iowa Hospitals and Clinics, spoke Tuesday in favor of the bill expanding psychiatric residencies in Iowa. He said Iowa and the country are experiencing an increase in clinical anxiety, clinical depression and suicides.

“I can tell you from my firsthand experience that the need is great and getting worse,” he said. “In the emergency room at the University of Iowa we have gone from 10% of our visits to the emergency room to 30% of our visits to the emergency room being psychiatric.”

Lawmakers will discuss the remaining proposals in the coming weeks. All bills must pass both a subcommittee and a committee before going to a full vote of the chamber.

Meyer said she believes Republican leadership in the House is behind the proposals. In a statement, House Speaker Pat Grassley said mental health is a priority and thanked Meyer for "getting straight to work” on the issue at the start of the session.

Previously: Gov. Kim Reynolds endorses state taking over mental health funding — but there's no deal yet

Gov. Kim Reynolds in her budget proposal has separately proposed additional investment in residency programs and loan repayment programs to add to Iowa’s mental health and health care workforce.

If approved, the bills would follow on other changes lawmakers have made to mental health services in the state. After passing a wide-ranging tax bill last year, Iowa is beginning the process of taking over funding for Iowa’s mental health system, which previously relied on county property taxes. As part of the same piece of legislation, Iowa also requires Iowa health carriers to reimburse health care providers at the same rate for both telehealth and in-person mental health services.

Brown-Powers said she wants the state to be consistent in its funding for mental health services so there’s a reliable stream of revenue.

“We need to make sure that’s sustainable,” she said. “So we can’t just do this for a few years and look good and then all of a sudden take it away from them and move that money somewhere else.”

More: Behavioral center on Des Moines' east side takes first steps toward expansion

Iowa’s two mental health institutes in Cherokee and Independence provide short-term care for those experiencing severe mental illness symptoms. The two facilities combined have 96 beds, according to the Iowa Department of Human Services.

Overall, there were 712 staffed inpatient psychiatric beds in the state, counting Iowa’s mental health institutes and hospital programs, the department reported in March 2021.

Meyer said Tuesday morning that she didn’t have a cost estimate for adding the beds to the institutes. But she said the beds could be added in as little as 6 to 8 months if the legislation passes, depending on the state’s ability to find workers to staff the positions.

Ian Richardson covers the Iowa Statehouse for the Des Moines Register. Reach him at irichardson@registermedia.com, at 515-284-8254, or on Twitter at @DMRIanR.

Stephen Gruber-Miller covers the Iowa Statehouse and politics for the Register. He can be reached by email at sgrubermil@registermedia.com or by phone at 515-284-8169. Follow him on Twitter at @sgrubermiller.

This article originally appeared on Des Moines Register: Iowa Legislature considering adding beds at mental health institutes