House lawmakers on Tuesday highlighted four proposals to support mental health care workers and increase access to mental health treatment in the state.

Rep. Ann Meyer, R-Fort Dodge, said she met with constituents during her campaign who spoke about the mental health needs of their family and friends – and the difficulties having those needs met in the state.

“I had so many people standing at their doors telling me 20-minute stories about loved ones that don’t have access to mental health services, that are living on the streets, that are in crisis constantly,” she said. “I really took that to heart.”

Meyer, chair of the House Human Resources Committee, highlighted four bills: two proposals to increase the health care workforce, a change to Medicaid reimbursement rates and the creation of 46 new beds for mental health patients.

Rep. Timi Brown-Powers, a Democrat on the committee, told reporters she was “excited” about the proposed changes and intends to support all four bills.

“I’ve been here for eight years,” Brown-Powers, D-Waterloo, said. “We are finally taking the steps that people with mental health and those families have been waiting for.”

Two of the proposals targeted a shortage of mental health care workers, which Meyer identified as the reason people with mental health crises were sometimes turned away from Iowa hospitals.

“They don’t have nurses and direct care workers that will want to work with those patients,” Meyer said.

The first, House Study Bill 532, would create a new residency program through the University of Iowa. The program would support 12 students each year working at the state’s mental health facilities at Independence and Cherokee, or at the Oakdale Medical and Classification Center.

Speakers at a subcommittee meeting Tuesday welcomed the proposal. Dr. Gerry Clancy, a psychiatrist at University of Iowa hospitals, said the need for the program was “very, very high.”

“I can tell you from my first-hand experience, the need is great and getting worse,” Clancy said. “In the emergency room at the University of Iowa, we have gone from 10 percent of our visits to the emergency room to 30 percent of our visits to the emergency room being psychiatric.”

Another bill, scheduled for a subcommittee discussion Wednesday, would appropriate $1 million for loan forgiveness programs for mental health practitioners who agree to work in Iowa for at least five years.

Meyer noted it would also be a workforce challenge to add the 46 new beds — 32 for adults and 14 for children — at Independence and Cherokee Mental Health institutes. The new beds would increase the capacity at those facilities by 50%. She said it would be six to eight months, at minimum, before the beds were operational after the passage of House Study Bill 531.

Brown-Powers noted that broader changes would also be needed to attract more health care workers to the state, including higher wages and making Iowa a “friendly place” that draws employees in. She also emphasized that the changes made this year would become annual appropriations that need to be sustained long-term.

“We need to be careful, because nothing is guaranteed in the general fund… We can’t just do this for a few years and look good, and then all of a sudden take it away from them and move that money somewhere else,” Brown-Powers said.

The proposed Medicaid change in House Study Bill 530 would create a new reimbursement rate for patients who require a higher level of mental health care. Meyer compared it to the reimbursement rate for a stay in an intensive care unit, compared to a normal hospital stay.

“This would be more like an I.C.U. level, because these patients do have complex needs,” she said. “They do need more care in the hospital.”

The bills are separate from Gov. Kim Reynolds’ 2022 proposals on mental health, which include a larger loan repayment program for health care workers and an additional slots in the Rural Psychiatry Residency Program.

Meyer said House Speaker Pat Grassley is “completely on board” with the Human Resources committee proposals, and she noted that lawmakers from across the state faced the same difficulties with mental health access.

Bipartisan bills would create 46 mental health beds, increase psychiatric residencies