Behavioral health map disappoints Iowa County officials

MARENGO — The map of the new mental health districts for the state of Iowa surprised Iowa County Supervisors and Marilyn Austin, Iowa County’s liaison to the regional mental health board.

The new mental health districts are “not even close to what they showed before,” said Supervisor Jon Degen when a tentative map was circulated in early August. “They didn’t do anything by population.”

The final map, presented to supervisors last week, grouped counties with large populations together.

The State of Iowa moved Iowa’s mental health services from county control to mental health regions as of July 1, 2014. The 14 regions were required to provide access to a core set of services to a target population of individuals with a mental illness or intellectual disability.

Iowa County was part of the East Central Region which included Linn and Johnson Counties with the populations of Cedar Rapids and Iowa City.

Benton, Jones, Buchanan, Delaware, Dubuque and Bremer Counties were also part of the East Central Region.

Poweshiek County was part of Central Iowa Community Services Region with Jasper, Marshall, Story, Boone and other counties.

The new system creates seven districts. Iowa County had asked to stay in the same region as Linn and Johnson Counties because the county uses services there.

But the new configuration puts Linn and Johnson County with the eastern counties of Jones, Cedar, Muscatine, Jackson, Clinton and Scott. It also includes Black Hawk, Buchanan, Delaware and Dubuque in the north and Luisa and Des Moines Counties in the south.

That district contains more than a million residents.

The region that includes Polk County and the state capital serves a population of 924,000.

The other five districts serve populations of 200,000 to 295,000, Austin said.

Iowa and Benton Counties are grouped with Poweshiek, Mahaska, Keokuk, Washington, Monroe, Wapello, Jefferson, Henry, Appanoose, Davis, Van Buren and Lee, counties with no large metropolitan areas.

The new districts will be managed by Administrative Service Organizations. Of concern to Austin is the fact that the Mae Hingtgen, East Central Region chief executive officer, with whom Iowa and Benton Counties have previously worked, plans to apply for ASO of the eastern region rather than the region Iowa County will be in.

Right now “it’s just a bunch of wait and see,” said Austin. Administrative Service Organizations and budgets won’t be in place until later this year. The system won’t be in operation until July of 2025.

“They’re indicating [funding will be] based on population,” said Degen last month. “I was just surprised when it came out like that.”

Austin said the new system will not disrupt services. “Anybody can get services wherever they want,” said Austin.

“It’s just a matter of who’s going to be operating them,” said Degen in August. Iowa County will still use Linn and Johnson County facilities. “The services are still going to be available.”

“It’s not true that this is going to disrupt service,” said Austin. She doesn’t think anyone except possibly employees will see a difference.

Still, Austin isn’t happy with the change. “I believe in grassroots services provision,” said Austin. “And this isn’t grassroots any more.”

The Iowa Department of Health and Human Services hasn’t given a reason why the map is the way it is, said Austin. “Most people are just stunned,” she said.

“This system is built on a system that is currently function in Colorado,” said Austin.

According to the Iowa Health and Human Services website, navigation is confusing in the current system. Outcomes are not satisfactory, and administrative services are duplicated.

The new system will create consistent ways to access services and use existing funding more effectively, producing better outcomes. It will also streamline administrative work.

Mental health regions were reorganized into larger districts because the state thought people didn’t know how to get services,” said Austin. She doesn’t believe it.

Austin has gone to schools and health fairs to inform the public of mental health services. The problem is an age-old one, she said: people don’t listen until they need the service.