Berndt hopeful for Behavioral Health restructuring

MT. PLEASANT — Henry County Disability Services Director Sarah Berndt sees promise in Iowa’s decision to select the Iowa Primary Care Association (Iowa PCA) as the new statewide Administrative Services Organization (ASO) for behavioral health services. As the state transitions from a regional system to a centralized model, Berndt believes the move has the potential to improve care access and coordination but warns of challenges in ensuring funding and continuity.

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“It has always made absolute sense that one entity would manage this,” Berndt said during a Dec. 26 meeting with the Henry County Board of Supervisors. “I think the Iowa Primary Care Association is a strong choice. They’ve worked with community health centers across the state and already have infrastructure in place for data management and reporting. It’s a big job, but they seem capable.”

The restructuring, announced by the Iowa Department of Health and Human Services (HHS), is part of an effort to streamline services and ensure equitable access across the state. According to a press release from HHS, Gov. Kim Reynolds supports the decision.

“Last session we passed a historical behavioral health bill with overwhelming bipartisan support that will align Iowa’s 32 separate mental health and substance use service regions into one system,” Reynolds said. “By bringing services together in this way, we will enable better coordination of care supporting the best possible outcomes for each individual. It’s what Iowans deserve, and it’s what we intend to deliver.”

The new model will replace the Southeast Iowa Link (SEIL) and 31 other regional systems, consolidating responsibilities under Iowa PCA. The organization will oversee critical services such as crisis response, recovery programs, and mental health and substance use treatment. Iowa PCA’s existing relationships with community health centers and its robust IT infrastructure make it well-positioned to take on the challenge, according to Iowa HHS officials.

Iowa HHS Director Kelly Garcia says that Iowa Primary Care Association is, “an established and trusted health care provider in the state, and now, as the statewide ASO, they become the welcoming front door to individuals in need of behavioral health support and care.”

“With an existing footprint embedded in communities across our state, and a comprehensive IT infrastructure to help streamline service delivery, Iowa PCA has demonstrated that they are uniquely qualified to fulfill the vision of this new system,” Garcia said.

Berndt agreed with Garcia stating that all these things make Iowa PCA “uniquely equipped to handle a statewide system like this and meet the expectations laid out by HHS.”

Berndt noted that the change was not entirely unexpected, as state officials have long considered centralizing behavioral health management to reduce redundancies and streamline services.

“Whenever the state has changed the behavioral health world, it’s always gotten better,” she said. “I have no reason not to believe this transition will improve access for our community.”

However, she also highlighted several uncertainties. One of the main concerns is how non-Medicaid services — those not covered by state or federal insurance — will be funded. Programs such as drop-in recovery centers and crisis stabilization units rely heavily on regional funding, which could disappear with the dissolution of SEIL.

“Some services are in limbo right now,” Berndt said. “We don’t know exactly how the state or Iowa PCA plans to handle funding for programs that fall outside Medicaid. That includes safety-net services like jail diversion or recovery centers, which have been critical for our community.”

Another challenge is the financial burden Iowa PCA faces as it prepares to take over operations. Berndt explained that the state’s Request for Proposals (RFP) did not include funding to help the winning ASO establish operations before the July 2025 transition date.

“They’re supposed to get up and running for six months without any initial funding,” she said. “It’s a big leap of faith for an organization to invest that kind of money up front, especially with so many unknowns.”

Marissa Eyanson, Behavioral Health Division Director for Iowa HHS, acknowledged the complexities of the transition but expressed confidence in Iowa PCA’s approach.

“Iowa Primary Care Association embraces innovative delivery models of care and promises to expand that approach in order to provide a standard set of core services consistently systemwide,” Eyanson said. “In addition, Iowa PCA has laid out a robust plan to ensure continuity of services to Iowans throughout the transition period and into the launch of the new system.”

For Henry County residents, maintaining access to crisis services remains a priority. Programs like mobile crisis response, which dispatches trained counselors to help individuals during emergencies, and the 988-crisis hotline, which provides immediate access to mental health support, are expected to remain central to the new system.

“Families often don’t know how to access help when they need it most,” Berndt said. “That’s why programs like 988 and mobile crisis response are so critical. They make sure people get the help they need at the beginning of a crisis, not when it’s already too late.”

Berndt also highlighted the availability of assertive community treatment (ACT) services in the SEIL region, which provide comprehensive, wraparound care for individuals with severe mental illnesses. She expressed hope that such programs would continue under the new system.

“There are a lot of unanswered questions,” Berndt said. “For example, mental health and substance use commitments are currently a partnership between counties and regions. It’s not clear how that’s going to be handled under the new system. We’ve raised these concerns with HHS, but we don’t have answers yet.”

As the SEIL region winds down its operations, Berndt and her team are focused on ensuring a smooth handoff to Iowa PCA.

“Our goal is to make sure there’s no interruption in services for the people who rely on them,” Berndt said. “This is a big change, but I believe it’s an opportunity to build something better.”

For Henry County, the restructuring represents both challenges and opportunities. While the transition raises questions about funding and local control, Berndt expressed confidence that the new system will ultimately benefit the community by improving access to essential behavioral health services.

Comments: AnnaMarie.Kruse@southeastiowaunion.com