I was catching up on 2014 Iowa Caucus happenings. (I admit it. I didn't go. I was very tired. I walked the dog and then I went to bed early.) Anyway, I read up on some of the 2014 Iowa Caucus happenings and learned of a new Democratic candidate for Iowa Governor. His name is
Zachary Newbrough and he lives in West Des Moines. But he appeared at at least one caucus location (Indian Hill Junior High School) and updated the folks there about his candidacy.
Newbrough readily admits that he has no political experience, but boasts "life experience." He admits to a criminal background (convictions of 5th degree theft and possession of drug paraphernalia). Plus he's going through a custody battle over his young daughter.
Newbrough is seeking campaign signatures and he's seeking monetary donations. He has identified his
key campaign issues: education, mental health reform, marijuana legalization & reformation, and smoker's rights. It was the mental health portion of his website that convinced me that he needs to learn more before running for state office:
I have some ideas on that issue (mental health reform) exactly. First I want to say I am not going to make any promise ...that I cannot keep in this campaign. The only promises you will see or hear me making during this are ones that involve trying to get my ideas across. Obviously there is still the house and senate standing in between any law. What I can say is that I promise to make this one of the key elements of my campaign. Our current leader could not even accept the federal healthcare money just because he did not like the law. He thought about himself before his constituents. That being said, my plan would start with taking the extra money from the healthcare reform law. Enacting a lot of changes or totally rewriting the mental health policies of this state. I am not just stating for Medicare, anyone who needs it will get it. It will start with The national Guard. All returning active duty soldiers would be required to undergo 3 months of bi- weekly counseling at state expense at a doctor of there choice. If the doctor decides after 3 months more treatment is needed, it will be paid for. Second all Medicaid recipients would be allowed to go to a private therapist. No longer would they be required to go to Broadlawns or Iowa City. By doing this it will unclog our hospitals and make them more useful for emergencies. I would like to see a tuition reimbursement plan made for students that get involved in a career in mental health. If they agree to work so many years in the state then their tuition would be cut or paid for. This will allow more private doctors to take on patients that they normally could not do.
Newbrough's mental health reform ideas need some updating as he is starting from faulty ideas about the current mental health system here in Iowa.
The most glaringly example of this is the suggestion that Iowans on Medicaid must seeking mental health services only at the UIHC in Iowa City or at Broadlawns in Des Moines. I believe that Newbrough is confusing Medicaid with the newly defunct Iowa Care program. Iowa Care was a bare-bones state insurance program for Iowans with no insurance and very little income. As far as mental health services go, Iowa Care only paid for inpatient mental health treatment at the UIHC and at Broadlawns, which was problematic if you were poor, on Iowa Care, and living in Sioux City (or Decorah, or Dubuque, or Ames, or Wapello, or whatever). It was problematic because most people who were poor enough to qualify for Iowa Care generally did not have money to travel to Iowa City or Des Moines for bare-bones medical treatment except in emergency situations. It also sucked because those two hospitals were overwhelmed by Iowa Care cases and often had extensive wait lists.
But Iowa Care doesn't exist anymore. It was replaced by Iowa's version of the Affordable Care Act (AKA Obamacare): Iowa Health & Wellness Plan. Iowa's very poor now qualify for a full range of medical and mental health services (minus dental at this time) and they can be treated in or very near their home communities.
But the other faulty idea is about using Medicaid to pay for private therapists and deciding that this will solve the issue of clogged-up hospital emergency rooms. First, there are already private therapists in Iowa who accept Medicaid funding. Not all do, but there are plenty who do.
More importantly, people don't usually go to the emergency room because they need to chat with a therapist. They go to the emergency room (or they're taken there by family or the police or by some other concerned individual) because they are suicidal, or because they have attempted suicide, or because they are acting bizarrely, or because they are demonstrating unsafe behaviors. Sadly, many of these people are treated in the ER and then sent home with the instructions to see an outpatient psychiatrist. This happens because there aren't enough mental health beds in that hospital or in other hospitals across the state.
The sad truth is that there are people currently inpatient -- people whom insurance/Medicaid have long-since stopped funding because they have been inpatient too long -- who remain inpatient because there is no place safe for them to go. The state has slowly reduced funding for services for those who don't need to be in the hospital but who are not safe to return to the community. Twenty years ago, these people might have been sent to the Woodward or Glenwood Resource Centers or to one of the Mental Health Institutes. Or maybe they would be sent to the juvenile treatment center in Toledo (which Iowa's governor just closed). People with ongoing behavioral challenges and/or psychoses remain in the psychiatric wings of Iowa's hospitals and prevent those with current mental health emergencies from being admitted.
In other words, we need to improve funding options for those who no longer need to be hospitalized for mental health treatment and re-fatten the programs that we have slowly starved that previously served those who cannot return to their homes because of severe chronic mental health needs.
All this is to say that I believe Newbrough needs to fine-tune his mental health reform policy.
