DES MOINES — The Iowa Senate voted 46-2 Tuesday to create a first-ever statewide children’s mental health system, sending Gov. Kim Reynolds one of her top priorities of the 2019 session.

“This bill will finally help organize what was once a piecemeal system for our children’s mental health and youth services,” said Sen. Jeff Edler, R-State Center, who served as floor manager for House File 690.

HF 690 — a proposal that came from Reynolds and was based on recommendations made by experts and advocates — establishes a system just for children, lays out what core services must be provided, and creates a state board to oversee it. The bill would create a system by 2020 to serve children up to age 18 who have serious emotional disturbances.

“We’ve talked about a children’s mental health system for a long time, and it’s time to finally put the structure in place, to talk about what the governance looks like, to align it with the adult mental health system,” Reynolds told reporters Tuesday. “People don’t know where to start, so little things can make a big difference in getting kids the help they need.”

The governor’s proposal — which called for an initial $3 million state investment — establishes eligibility requirements, outlines core services to be provided statewide, aligns the new children’s system with the regionally focused adult system and creates a board to oversee the new system.

The bill establishes a children’s behavioral health system and an oversight board; eligibility requirements and core services; new duties of the state Department of Human Services’ Division of Mental Health and Disability Services; regional mental health services provided through the adult Mental Health and Disability Services system; and regional governance.

“Iowans understand this crucial effort has the potential to improve and even save lives,” Reynolds said in a statement her office issued after Tuesday’s Senate vote. “I commend the Iowa Legislature on their bipartisan approach to get this done and look forward to signing this bill once it reaches my desk.”

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Sen. Rob Hogg, D-Cedar Rapids, one of two senators who voted no, expressed disappointment that the legislation was not as strong as it could be and lacked a needed funding commitment.

“It’s just a facade. It’s based on money that’s not provided,” Hogg said, noting that about 80 percent of the cost will be covered by the county-based regions.

The non-partisan Legislative Services Agency estimated the bill would cost Iowans nearly $3.7 million in fiscal 2020 and more than $6.3 million the following year. Medicaid would cover $423,110 in year one and $1.3 million in year two, with Iowa’s 14 Mental Health and Disability Services regions — which are partly supported by property taxes — covering the remainder.

“I’m really disappointed today that one of the things that I thought had the potential to be a good bipartisan bill instead has fizzled and it’s a facade,” Hogg said. “There’s less of this bill left than there is of the cathedral in Paris, and I’m really, really disappointed.”

Sen. Liz Mathis, D-Hiawatha, agreed that “funding is an issue, it always is,” but she held out hope the legislation would be the first step in a process that addressed children in crisis and made sure they had access to needed services.

Edler said the bill included language contingent on available funding to reflect fluctuations in federal Medicaid funding and provisions of the Affordable Care Act that may affect financial considerations.

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