Mental health districts streamline services

MARENGO — Iowa’s new behavior health system, launched July 1, put mental health and substance abuse cases under one umbrella to streamline services.

The new districts will spend the next two years learning how to grow and change to meet the needs of Iowans, Sarah Berndt, district lead for Primary Care Association, the administrative service organization for District 6, told Iowa County Supervisors last week.

Mental health and substance abuse problems often go hand in hand, said Berndt. Combining the systems makes access to services for all Iowans easier, she said.

Iowa Primary Care Association is a nonprofit organization that, since about 1988, has been supporting community health centers throughout the state, said Berndt. It made sense that Iowa Primary Care would be the ASO for Iowa’s mental health districts.

“Their focus is on being proactive,” said Berndt. The ASO will spend the next couple of years exploring what the new system is going to look like.

“We have seven districts across the state,” said Berndt. The goal is to deliver consistent services in every one of them while also recognizing the each district is different and may need services in different degrees.

“Our district needs are different than district 7’s district 1’s, district 4’s,” said Berndt.

“I worked in the system 24 years before I came to Iowa Primary Care, and it’s always been a struggle with communication, consistent communication from the county level to the region level and so the work of Iowa Primary Care is to ensure that our message is consistent,” said Berndt.

“One of the things that we are doing in system alignment is that we are ensuring access to the comprehensive prevention, early intervention, treatment, recovery and crisis services for mental health and addictive disorders,” Berndt said.

As of August 2025, Iowa Primary Care has contracted with 125 providers, said Berndt. It’s keeping the same services in place and the same funding they had in the former regional system.

Iowa Primary Care is looking at co-responder model for law enforcement and behavioral health professionals, said Berndt.

In many jails, the regional system was inconsistent in paying for services, Berndt said. Iowa Primary Care is paying for those services now.

Iowa County Supervisor Jon Degen, who served on the regional board, asked about the law enforcement liaison program that Iowa County has been a part of. Degen believes the program has been successful.

“Definitely funding for that is stable for this first year,” said Berndt. It’s going to take a couple of years to determine where the funding is most needed to sustain those services that are most valuable, she said.

The statistics he's seen shows that the liaisons save money and help people by dealing with their issues rather than putting them in jail, Degen said. “It just seems to me like it’s a win-win program for everyone and it saves quite a bit of money.”

Berndt described another model, a sequential intercept model, with a 0-5 scale.

Zero refers to anyone in the community with a crisis based on behavioral health, and they are diverted into those services, Berndt said. “We want to route those folks to those services first.”

Intercept 1 might require that law enforcement be called, said Berndt. Intercept 2-4, refers to people who have been booked into jail and are going into the court process.

Intercept 5 refers to people who are out in the community and have probation and parole officers. The District will help them find services where they are.

“That’s kind of the model that … I look at when I’m looking at interfaces with individuals that have crisis and those types of things and their potential to interface with law enforcement,” said Berndt.

“We have a lot of champions for the liaison program in our agency,” said Unity Stevens, senior lead system navigator for the District. Abby Ferenzi, senior director of behavior health services, used to supervisor the liaison in Johnson County, so they understand how important it is, she said.

Stevens said she doesn’t envision a system where liaisons disappear. “They are a crucial part of our systems,” she said.

“It was working great here [according to] the numbers I saw,” said Degen.

“And everybody that had liaisons wants to continue that,” said Berendt, “so that message has been heard by our leadership.”

District advisory councils oversee the mental health districts. The boards consist of one person for a sheriff’s department, three providers, three elected officials and three people with experience in the system.

Current advisory council members include vice-chair Jackie Smith Duggan, a provider from Benton County, and chairwoman Jennifer Olson, director of Iowa County’s Commission of Veteran’s Affairs.

The council is tasked with identifying opportunities and challenges in implementing services.

The districts are still new and are still identifying community needs, said Berndt.

“Our system navigators are tenacious and they will dive deep to figure out where that resource is for the folks that are calling them,” said Berndt. “If they can’t find that resource that means that service doesn’t exist,” she said, “and that’s what Iowa Health and Human services needs to know.”