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Jasper County Tribune

Capitol Issues

Sinclair wants focus on school funding, mental health in 2018

KNOXVILLE — Iowa Senate Education Committee Chairperson Amy Sinclair, R-Allerton, said she does not anticipate a negative number when the legislature announces next year’s supplemental state aid for public schools. Despite the state’s $131 million budget shortfall, Sinclair said, “I see, at worst, status quo.”

“If there is any (new) money, I want to be able to use it,” Sinclair said. “I have the framework of the bill filed. I’m waiting for a number to approve the bill because I want it done immediately so schools know what they’re working with immediately,” she said.

Whatever the dollar amount, the Republican Senator said it is her priority to get education funding levels approved early in 2018 Iowa Legislative Session to eliminate uncertainty for Iowa’s public school districts.

In 2017, the state legislature approved a 1.1 percent increase in SSA, or roughly $40 million in new money, for Iowa’s public schools. This allotted about $6,664 per student, up about $73 from the 2016-17 school year. This was unpopular with many educators and school district administrators and did not receive a single Democratic vote in the Iowa Senate. But the Republican majority, led by Sinclair’s education committee bill, felt the amount was realistic and affirmed a commitment to funding public education.

During a recent interview in Knoxville, Sinclair said before proposing a dollar amount for 2018-19 SSA, she is waiting for projections at the state’s revenue estimating conference, but a no allowable growth scenario is not out of the question. Sinclair said the legislature needs to be frugal in order to pay back money borrowed from the state’s reserve fund to make up for this year’s revenue shortfall.

Sinclair said the legislature’s focus going into 2018 should providing Iowa school districts more local control and limiting the number of programs which require additional reporting to the Iowa Department of Education. Sinclair said she sees some cost savings in letting local districts decide on things like busing times.

“I had one district tell me if they could have 10 more minutes, they could eliminate an entire route and save something in the neighborhood of $100,000, take that and put it into classrooms,” she said. “Just with 10 minutes.”

Sinclair is the Iowa Senate assistant majority leader. She represents Iowa Senate District 14 including rural portions of Jasper County, Lynnville, Sully and Monroe, as well as the vast majority of Marion County and Clarke, Lucas, Decatur and Wayne counties on the Missouri border.

Sinclair worked for the Ad Express/Daily Iowegian newspaper in Centerville and taught at Central Decatur Community Schools and was an instructor GED test preparation and adult education for Southwestern Community College. Before she was elected to the state legislature, Sinclair served two terms on the Wayne County Board of Supervisors.

Mental Health

A growing theme among legislators on both sides of the aisle in combating Iowa’s mental health crisis is developing a more community-based approach. Sinclair said former Gov. Terry Branstad’s closure of two state-run mental health facilities in Clarinda and Mount Pleasant disproportionately affected the number of beds within reach of her rural constituency and all rural Iowans.

Sinclair said she supports a legislative push to work with county hospitals and local providers to increase access to sub-acute care for patients who are not to the level where they need in-patient psychiatric treatment. She cites Wayne County Hospital and Clinic System in her district as an example of where telemedicine is helping rural facilities do psychiatric evaluations and provide base-level mental health care.

The Senator said a large part of the costs for rural residents suffering from mental health issues in transportation to in-patient treatment. This geographic divide separates families. Sinclair said some of her constituents near the Missouri border were leaving the state for care because it was closer than Des Moines hospitals and closer to their family support system.

Sinclair said Iowa needs to address a person’s mental health before the problem contributes to the incarceration of an individual where the issue becomes much more difficult to treat. In Iowa, 40 to 60 percent of the prison population suffers from mental health problems.

“As a state, as a taxpaying citizenry, we will pay for our mental health issues either by treatment or incarceration. Take your pick, and incarceration is far more expensive,” Sinclair said.

Sinclair cites the hiring of Jerry Foxhoven to lead the Iowa Department of Human Services as a key component to addressing Iowa’s mental health crisis. Although the new DHS director was appointed by Gov. Kim Reynolds with a focus on reforming protections in the state’s foster and child welfare system, Sinclair said she sees a definite link between Iowa’s mental health crisis and child welfare.

“His history is clearly with child welfare, but a lot of child welfare issues clearly stem from mental health issues and I think we would be remiss in not identifying that.”

Sinclair said she does not know what the fix will be but equated the situation to the rising cost of Iowa’s Medicaid program, which is currently struggling to make a management switch to private companies. Despite the addition of Des Moines Broadlawns Hospital’s new mental health in-patient wing, access for rural Iowans remains difficult.

“Both in Medicaid and Iowa’s mental health system, the costs were rising exponentially where it would be unsustainable. Changes needed to be made. We have a net positive number of beds, even after the closures (of the mental health facilities) because the opening of the new wing, but that doesn’t help if you’re five hours away,” Sinclair said.

Medicaid privatization:

Sinclair said she has asked Gov. Kim Reynolds about the future of Medicaid’s new privatized managed care system and was given assurances the governor’s office is committed to fixing the problems.

Iowa’s Medicaid privatization program came under scrutiny Oct. 31, after the state announced AmeriHealth, one of three private health insurers contracted to manage the state’s health plan for low-income citizens, would be pulling out of its contract and dropping more than 10,121 members from coverage. This forced the state to re-enrolled the affected people in the state-run “Fee-for-service” Medicaid system Iowa used before privatization began.

Sinclair is not in favor of abandoning the new private system and said the action would “take us back decades.” She cited the state’s use of Magellan Health’s Medicaid management of mental health care patients as an example of how Iowa’s been partially privatized for years.

Sinclair said she could support classifying patients who require chronic care differently in the future to make Medicaid more sustainable.

“Certainly there are ways we can make the system work better without abandoning the notion we want people to be healthy,” she said. “... I whole wholeheartedly agree with a holistic approach to health rather than a fee for service, and outcomes based. I’m fine with helping people to finds ways to become healthier, because, ultimately, that saves money. But there are people who are not going to become healthier who are on Medicaid because they’re 80 years old and need to maintain a level of care. ... Is there a place for having a fee for service for those folks? I think there could be.”

The legislative session begins Jan. 8.

Reporter David Dolmage contributed to this report

Contact Mike Mendenhall at mmendenhall@jaspercountytribune.com

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