Chatham Oaks, Johnson County’s only residential care facility for mentally ill adults, houses 73 residents. But after Oct. 31, staff members are worried it will be empty.
On Thursday, Vivian Davis, the executive director of Chatham Oaks, voiced her concerns to the Johnson County Board of Supervisors about whether Chatham Oaks will continue to receive the required funds to sustain care for its residents after the county’s current commitment runs out in under four months.
"We have had some counties pull people already. If we have too many counties pull people or not place people with us due to inadequate funding, that could have a negative impact on us even with Johnson County funding," she said. "I don’t want people to think that it’s the Johnson County Board of Supervisors that is going to close down Chatham Oaks. It’s a county by county and person by person situation. … That uncertainty is just really hard. It makes it hard for the families, for residents, and for staff."
Counties currently fund 100 percent of the cost of the facilities, and Johnson County is directly responsible for funding 36 of Chatham Oaks’ residents.
The uncertainty comes from the Mental Health and Disability Services Redesign passed by the Iowa Legislature earlier this year, which shifts responsibility for funding facilities from the county to the state through a system of regional administrators.
Sen. Joe Bolkcom, D-Iowa City, who attended the meeting, said the new legislation will provide $47 million in increased money for a system that is "chronically underfunded."
"Our goal is to provide access, no matter where you live in Iowa, to a basic core set of services, and we can’t say that we do that right now. [Now there are] 99 sets of services with 99 sets of supervisors with different ideas of what they’re going to fund," he said.
Frank Fleming, a nurse at the UI Hospitals and Clinics, said the last time the state tried to reduce the number of people in mental-health institutions, there was a corresponding increase in the mentally ill population in prisons.
"We always try to move people to the least restricting environment, but some people need this," he said.
Supervisors’ Chairman Rod Sullivan assured Davis and the public the county doesn’t plan to close down Chatham Oaks.
"The notices of decision [distributed by the county] got people concerned to a greater degree than I think was necessary," he said. "It certainly wouldn’t be throwing people from Chatham Oaks out on the streets."
Davis said that if funding isn’t secured, the welfare of the residents are placed in jeopardy, because no adequate alternatives to Chatham Oaks exist.
"You can’t always keep a member of your [mentally ill] family member with you; it just doesn’t always work," she said. "There was one situation last week where we had someone go to a homeless shelter. That was not entirely the counties’ fault — the individual didn’t accept other options that were available … but they haven’t really given us any other answers for where we would take them? [Facilities] sometimes keep people without funding because they couldn’t with their conscience just put people on the street."
Dolores Slade, who serves on the board of Chatham Oaks, seconded Davis’ concerns.
"I can hardly keep from weeping when I think of where they might go," she said. "These are sick folks. They can’t be in a group home; they need a medical staff to make sure that they take their medications … and to keep them out of situations that might be harmful."
Bolkcom said despite concerns the facilities might be eliminated by 2013 as a part of a federal push to downsize large mental institutions, there has been no policy change on facilities or in federal Medicaid funding for mentally ill patients.
"There are a lot of decisions to make about the counties [Johnson County] will be joining with and how you’ll move forward," he said. "We’ve got your back, and we’re going to work hard to see that services are maintained."
