Board authorizes Jefferson County to join regional MOU for mental health patient advocates despite open cost questions

Jefferson County supervisors voted June 16 to authorize the chair to sign a memorandum of understanding among participating counties to provide a shared mental health patient advocate, with Des Moines County designated as fiscal agent.

Staff explained the MOU begins July 1, 2025, automatically renews yearly unless terminated, and contains an immediate out clause that allows any party to withdraw with written notice. The agreement does not set a fixed dollar contribution; instead, Des Moines County will bill participating counties quarterly, and if the state Behavioral Health Administration does not reimburse Des Moines County, costs would be prorated among participants based on case counts over the previous 12 months. County staff noted Jefferson County historically had more cases per capita and therefore could incur the largest share if reimbursement were not forthcoming.

Supervisors debated the trade-offs: joining the MOU preserves eligibility for state reimbursement and shares the cost of having a dedicated advocate, while staying out could force the county to contract for advocacy services at full cost or supply its own advocate to meet statutory obligations. Several supervisors said they preferred to join now because the agreement is cancellable and spreading a nominal shared cost seemed less risky than sole responsibility. The motion to authorize the chair to sign the MOU passed by voice vote.