DES MOINES, Iowa - The legislature approved moving from a county-by-county mental health system in Iowa to a regional system. The result was that when people moved from one county to another that county would have to shoulder the cost of the new residents. Lawmakers set aside $13 million to help counties during the switch but Governor Terry Branstad vetoed the money.

O'Brien County is the first to run out of money for services, but according to Rik Shannon with the Iowa Developmental Disabilities Council, it probably won't be the last.

"I don't know that you will see county after county but I don't believe O'Brien County is an isolated case," he said. "I think there are likely to be other counties."

Shannon said the end result may be that people needing mental health services will have to wait in line.

"What counties do when they don't have the money to meet the need is they'll establish waiting lists for people," he said. "People will be on waiting lists for those services; as other people go off, those people may have the opportunity to come on."

O'Brien County suddenly had to cover costs for an additional 40 residents, which would put the county a million dollars in the red by the end of the fiscal year. Next year the new federally-financed national health insurance program kicks in, which the governor says will provide more than enough funding.

However, many legislators plan to try to reinstate the money which they convene in January. In the meantime additional counties may face the kind of budget shortfall experienced in O'Brien County.




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Nevadans with disabilities are concerned with proposed federal cuts to Medicaid, despite claims from GOP lawmakers that the cuts target only waste, fraud and abuse.

The U.S. Senate is currently considering a federal budget reconciliation package containing cuts to Medicaid and other social safety nets. The bill narrowly passed the House last month, with the latest version proposing cuts to Medicaid worth more than $700 million.

Ace Patrick, a Nevadan living with a disability, said other proposed changes in the bill, such as implementing work requirements to qualify for Medicaid, would be particularly challenging for those with disabilities.

"Those of us that could work, are working," Patrick said. "Those of us that cannot work, and there are many people on disabilities who are unable to work, who are in their homes, in apartments, in group homes, in nursing care facilities - what are they supposed to do without care? It will be devastating and many of us will die."

Republican lawmakers have said work requirements may help boost employment. The majority of Medicaid recipients already work, even if it's for informal jobs that don't produce pay stubs. Health-care advocates argue low-income Americans are already struggling to put food on the table and cover their housing costs, and clearing a work requirement would be yet another hoop to jump through.

About 740,000 Nevadans are enrolled in Nevada Medicaid, according to KFF, a nonprofit specialized in health policy research. The state program covers about 35% of working-age adults living with a disability in the Silver State.

Patrick said politicians in the nation's capital aren't thinking about the consequences of the cuts.

"I don't know what they think we're all going to do," Patrick said. "It's going to overload the ER, if they're even able to manage without getting that kind of income."

Advocates have warned that significant cuts to Medicaid could increase the number of unprofitable hospitals, especially in rural parts of the state, which can then put them at greater risk of financial distress or even closing their doors.

Indiana University now trains police academy recruits in Deaf culture awareness and basic American Sign Language.

The program aims to improve communication between future officers and the Deaf community across campuses statewide.

Brennan Cox, a law student and part-time officer for the Indiana University Police Department, helped launch the course after noticing a gap in police training on interacting with Deaf individuals.

"This training is beneficial for the Deaf community because it creates safer interactions with officers and members of the Deaf community, creates more engagement with the Deaf community," Cox explained. "Really, we just want the Deaf community to know that we want to learn and that officers have a desire to learn about the Deaf community."

The nearly three-hour course features Deaf faculty who teach recruits key signs like "police," "help," and "stop," while emphasizing patience and alternative communication methods.

Cox noted the training also benefits officers themselves.

"What made me want to bring this training to IU Police Academy is I took ASL when I was in my undergraduate at IU for two years," Cox recounted. "It made me really just become passionate about how law enforcement interacts with members of the Deaf community and how we can better serve them."

The program now includes recruits from Indiana University campuses in Bloomington, Indianapolis, and South Bend and plans to expand to other agencies.


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Rural Nevada is facing a housing and transportation crisis. Advocates for those with disabilities say things are getting out of hand.

Dee Dee Foremaster, director of the Rural Center for Independent Living, said there is not enough available low-income housing, and added the units that are available to folks on the Housing Choice Voucher program, formerly called Section Eight, is "substandard."

She added the average Nevadan on Social Security receives almost $1,000 a month. But the average Nevadan can expect to pay around $1,400 a month in rent.

"People are having to double up to be able to make their rent. And it makes it difficult because a lot of times some people with disabilities really would prefer to live by themselves," she said.

Foremaster added she is among those who feel like the calls they are making for housing reform are falling on deaf ears. And while local leaders are eyeing federal lands as part of the solution to address the housing shortage, Foremaster said she has solutions that are more immediate, including creating a program for landlords to receive tax incentives for allocating units to low-income Nevadans.

She stressed that even in rural Nevada, the housing supply isn't able to keep up with demand, and said easing restrictions on accessory dwelling units would help everyone.

"So that people have an array of plans to be able to draw from that are approved, so that they don't have to go through the building commission and hoops that we all have to jump through every time we want to build something on a property," she explained.

Margaret Marcucci, with the Elko support staff of the Rural Center for Independent Living, said a lack of transportation is another issue impacting people's daily lives.

"I won't tell you how many times I get calls from friends, going 'I'm stuck, can you come get me?' or 'Can you take me to an appointment?' said Marcucci. "A lot of our seniors and a lot of disabled do not go to the doctor because they can't get there."

Last year, a free ride-share program launched in rural Nevada to help remove barriers to access medical care. But Marcucci is calling for a more diversified and flexible fleet of services that can get folks to where they need to go.


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