Henry County weighs shift in General Assistance oversight as statewide behavioral health system restructures

MT. PLEASANT — As Iowa transitions to a new behavioral health system structure, Henry County officials are evaluating a shift in General Assistance oversight to the county’s Public Health department.

“There will no longer be county employees doing regional work,” General Assistance Director Sarah Berndt said during a Feb. 6 Department Head meeting. “So, one way or another, I will be no longer working in the county system, whatever my future looks like.”

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The restructuring follows a legislative change in May 2024, aligning Iowa’s mental health system into seven statewide districts and eliminating county employees from regional mental health work. The transition will culminate with the sunset of the current regional Mental Health and Disability Services (MHDS) system on June 30. Iowa Primary Care Association has been selected as the Behavioral Health Administrative Service Organization (BH-ASO) for all seven districts.

With the regional system’s dissolution, county officials are looking for a new home for General Assistance, which currently requires only four to 10 hours per month of work on average. After considering multiple possibilities, the Henry County Public Health Department has been identified as the best fit.

Berndt highlighted the importance of placing the program where people can consistently find help.

“The thing that I think is important is to have somebody at a front desk to at least acknowledge that this person has a general request or need or assistance,” she said. “If you have somebody very part time that is going to be so random, they’re not going to make connections. So, it makes sense to put it someplace where there’s a receptionist.”

Public Health Director Katie Reuter expressed support for the transition, emphasizing the department’s existing structure and resources.

“We also thought it would make sense for us to take it on because we do have the receptionist,” Reuter said. “But we also have a program called Care Links, which links people to different services, so that if they don’t qualify, maybe we can find some other way to help them.”

She also reassured officials that the department has the necessary capacity.

“We have a conference room that’s private. We also have each our own offices, and we have our immunization area, which is private too. So, if Sarah’s saying there is four to 10 hours a month, I feel like we have the bandwidth to keep that on,” she said.

Berndt and Reuter have already begun working on the logistics of the transition, with Berndt reviewing and updating policies to ensure clarity and continuity.

“My goal is to get you a new, updated policy to approve before this transitions out of my hands into Katie’s hands, and it’ll be in the best shape that it can be at that moment in time,” Berndt said. “I personally believe it needs to be a living document … taking things out of the budget that you haven’t paid for in years and looking at other things that might improve access.”

She also encouraged the supervisors to consider continuing to track General Assistance wages separately to maintain oversight of the program’s costs.

“You have always had general assistance in its own category with wages,” she told the board. “So, my concern is, if you don’t continue to show the wages separately, you’re not really going to know how much that program costs you if it’s absorbed in public health.”

One major shift accompanying this transition is the loss of the county’s substance abuse prevention grant, which has been administered through the Department of Public Health. That funding, which covered a portion of prevention services through Alcohol and Drug Dependency Services (ADDS), will now be overseen by the BH-ASO.

“There’s times when there’s a significant uptick for that,” Berndt noted. “That grant goes away because what that grant was funding will now be the responsibility of the behavioral health administrative service organization.”

While no official action was taken at the Feb. 6 meeting, county officials are set to revisit the discussion at their Feb. 13 meeting. Supervisor Marc Lindeen clarified that decisions on the transition were not yet final.

“As written on the agenda, it says present the budget and discuss,” Lindeen said. “So, I don’t think we can actually vote on that today. But I did sit down this past week and talk with Katie about the budget, and I saw nothing needed to change at all.”

Berndt urged the board to finalize a decision soon so that she and Reuter can begin implementing the transition plan.

“We’ve had conversations,” she said. “Katie’s had conversations, and so now we’re at that point where we need to make a decision going forward, so that Katie and I can — if that decision is made — start working toward that day when I will eventually give notice and she will take it over.”

The Board of Supervisors is expected to continue discussions on Feb. 13 as officials work toward a smooth transition before the regional mental health system formally dissolves next year.

Comments: AnnaMarie.Kruse@southeastiowaunion.com