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The question of who is going to pay for services for people with mental health, brain injury, mental retardation, and developmental disabilities is frustrating for many Iowans, especially disabled Iowans on fixed incomes. After applying for services and being denied or being told to wait while counties fight over payment, many who are disabled give up. Knowing all your options will help. If your county will not pay for services, or you are having other problems with services, you have rights that may help you solve this problem.

I want to apply for county mental health services but do not know where to start. What should I do?
         
You should contact the Central Point Coordinator ("CPC") in your county. You can ask where to go at the Iowa Department of Human Services in your county. Under Iowa law, counties must have a CPC for the delivery of mental health, brain injury, mental retardation, and developmental disabilities services.

You will fill out an application and answer questions about:

• Income/assets;
• The kind of help you want;
• Where you last received county mental health services;
• County of legal settlement.

What does "county of legal settlement" mean for purposes of county mental health services?

Figuring out the county of legal settlement can be complicated. Generally, your county of legal settlement is the county where you have lived for one year without receiving services. If you have a question about your county of legal settlement you should call for help.

What do you mean "without receiving services?"

Iowa law says a person receiving some kinds of services and residing in a county does not have that time counted toward the 12 months of residency. It is not clear what types of services count.  If you are being denied assistance because they say you do not have legal settlement in a county in which you have resided for 12 months, you should talk with a lawyer.

I applied for county services but was denied because the CPC said I did not qualify. What can I do?

You have a right to appeal the decision. Each county is required to have time limits for filing an appeal that can be found in writing in each county's management plan. Your notice of decision should also have a time limit for appeal.

Should I try to appeal the decision on my own?

Mental health services law is complicated. It requires an understanding of state, federal and administrative law. You should try to get help.

What if I do not have a county of legal settlement?
If you have no county of legal settlement then you are a "state case". You have the same right to county services and right to appeal.

I am receiving county services but I am being terminated. What should I do?

If you are terminated, you have a right to appeal. Again, each county must have an appeal process in its management plan. Your notice of decision should tell you the time limit for appeal.
 
I am having a problem with the way I am receiving county services. What can I do besides appeal?

You may be able to ask for a compliance hearing. This compliance hearing is different than a normal appeal. You must make the request for a compliance hearing within 30 calendar days of the last action by the agency. You make the request in writing to:

Division of Mental Health, Mental Retardation, and Developmental Disabilities
Iowa Department of Human Services
Hoover State Office Building, 5th Floor
Des Moines, IA 50319-0114.

I received a bill for county services from the county where I live because my "county of legal settlement" should pay. What should I do?
          
Under a new law, you should contact the CPC in the county where you are currently receiving services. The CPC should try to resolve the payment issue for you. The CPC must follow that county's management plan. The person's county of legal settlement must pay the cost of the services or other support.

I applied for and have been receiving services in the county where I live that are not covered by my county of legal settlement. Who pays?

Under the new law, even if your county of legal settlement does not provide the types of services you are receiving, your county of legal settlement should pay.

What if I want to move to another county? Will I still be eligible for services?

Yes. You should apply for services in the new county. That county will make a determination under their county plan.

If I file an appeal, what happens next?

The county will set up a hearing in front of a hearing officer, administrative law judge, or appeal board. The judge, officer, or board should not have been involved in the decision to deny or terminate services. At the hearing, the county will be able to give evidence, and so will you. The judge will make a decision based on the evidence. You have the right to be represented at the hearing.

If I lose a decision, what happens next?

Generally, a decision about funding for county services can be appealed to district court. You can file a special kind of lawsuit, called 'certiorari." That lawsuit must be filed within 30 days of the decision that says you are not eligible.
    
I live in a county that does not have the services I need. What can I do?

You should look at your county's management plan. Each county must have a plan for mental health, mental retardation, brain injury, and developmental disabilities services. You should be assigned a worker to make sure that you receive an evaluation and diagnosis, assistance with living arrangements, and delivery of services and monitoring of those services.

This sounds complicated.  How is somebody who is in need of mental health services supposed to understand all of these requirements?

Iowa's system for delivering mental health services is complex.  That is why in many of these situations, if a person is denied services for whatever reason, a lawyer or other advocate should be contacted for assistance.

Where can I get help?

You can call Iowa Legal Aid toll-free at 1-800-532-1275. Iowa Legal Aid can provide free legal help and has 10 regional offices throughout the state to serve you. Office hours are weekdays 8:30 a.m. to 5:00 p.m., except holidays.