Polk County staff warn FY26 behavioral health budget hinges on state RFP decisions

Annie Utes, Polk County Behavioral Health and Disability Services director, told supervisors the department's FY26 budget will change materially depending on state awards and contract allocations.

“We submitted the budget on our current FY '25 expenses,” Utes said, noting the budget prepared in September assumed two state Requests for Proposals (RFPs). “We then learned that we were not awarded the behavioral health administrative service organization RFP,” she said, and added that fund 10 figures in the county's presentation will therefore be “totally different.”

Utes said Polk County is still in the running for the Iowa HHS Disability Access Point contract. The state will announce that award no later than Feb. 21; if Polk County receives it, Utes said the county must be ready to begin operations on July 1 and will need to amend fund 10 in the first-quarter budget cycle to reflect contracted dollars and scope of work.

County staff provided a high-level funding snapshot: total revenue estimated at about $26,300,000; Fund 10 projected at $21,000,000 under earlier assumptions; Fund 35 (opioid settlement) listed at $4,600,000. Utes said expenses for the MHDS region dropped in the county's FY26 projection after the state realigned several long-term services and supports and removed some incentive-fund items that were present in the FY25 Q1 amendment.

On staffing, Utes said the department currently lists herself, a CJCC coordinator, an opioid settlement program planner, eight MHDS-region staff and 1.5 FTEs for a mental health advocate, with three vacancies. She said one vacancy follows a retirement and two reflect pretrial-release positions that were approved but never filled.

Supervisors asked about contingency and transition logistics. Utes said some services originally listed as county expenses may be paid directly by the state under the new ASO model, leaving the county responsible for administration and navigators or, alternatively, requiring invoicing to recover costs if the ASO pays certain items directly. She said the county submitted 89 documents to the state for review so the state can allocate responsibilities among the ASO, disability access point, and state-run services.

On client eligibility, Utes warned a draft of the new rules would disqualify people above 200% of the federal poverty level, and she said Polk County has people on a sliding-fee scale who would be affected. “I believe there's 77 individuals,” she said, but added that town-hall discussions mentioned director's exceptions that could preserve services for some clients.

Utes also clarified that the county's opioid settlement dollars are a separate fund and will remain under the Board of Supervisors' direction; staff paid from that fund will stay county-funded even under the state's transition.

Utes said the county will continue to monitor expenses and provide updated budget amendments once state decisions are known. If awarded the Disability Access Point, she said the county will need to hire quickly to meet the July 1 operational deadline.

The board did not take formal votes on the department's presentation; supervisors asked follow-up questions and thanked staff for transition planning. The county's budget deliberations are scheduled to begin the following Tuesday.