States wage internal battles to fund mental health systems, overhauls

States are grappling with funding mental health programs: Iowa lawmakers are fighting over how to pay for an overhaul of the system, Kansas' mental health workforce is dwindling and Illinois cuts endanger emergency care for the mentally ill.

The Associated Press/Des Moines Register: Mental Health Funding: Dems Say Counties Must Pick Up Some Costs; Republicans Disagree
Despite weeks of quiet bargaining, legislators acknowledged Tuesday that deep divisions remain about paying for an overhaul of Iowa's mental health system. Lawmakers of both parties support dramatically changing the system, now financed by local property taxes and augmented by federal Medicaid funding. Although legislators want to use state money to replace at least some of the local property taxes, they haven't been able to agree to specific figures (2/22).

Des Moines Register: Senate Democrats: No Way We're Backing Down On Iowa Mental Health Finances
One of the biggest differences in a major reform of Iowa's mental health system between the House and the Senate would be how the ultimate changes are paid, which was highlighted today in a Senate Human Resources subcommittee meeting. Parts of Iowa's mental health system have been broken for years, both Democrats and Republicans agree. Long waiting lists in some counties and inconsistent services are among the chief complaints (Clayworth, 2/21).

Kansas Health Institute News: Fewer Workers Caring For More Patients At State Hospitals
State hospitals for the mentally ill and the developmentally disabled have not replaced many employees who've quit or accepted Gov. Sam Brownback's invitation to take early retirement. ... The governor's budget proposal for the coming fiscal year would allow for 2,298 full-time positions at the five state hospitals, or 311 fewer slots than there were in fiscal 2011 and about 100 fewer than the current fiscal year (Ranney, 2/21).

Bloomberg: Illinois Mental-Health Cuts Endanger Patients' Access to Emergency Care
The cutting of mental-health facilities and Medicaid payments in budget-challenged Illinois threatens to swamp emergency rooms with low-income psychiatric patients and limit doctors' ability to treat others. Chicago's Public Health Department will shutter half its 12 psychiatric clinics by the end of April, and the state will close as many as two hospitals in the coming budget year. The measures are in addition to state trims in Medicaid that Governor Pat Quinn, a Democrat, is expected to announce today in his fiscal 2013 budget address (Kazel, 2/22).