State reorganization prompts end of Southeast Iowa mental health region

MT. PLEASANT — A significant shift in Iowa’s mental health infrastructure is underway following the official termination of the Southeast Iowa Mental Health and Disability Services (MHDS) Region, a move made in compliance with a sweeping new state law reorganizing behavioral health systems.

The Henry County Board of Supervisors voted unanimously on May 8 to approve the dissolution of the region’s 28E agreement — a legal contract among member counties — marking the end of the multicounty mental health agency.

“This is a requirement that is going to be set forth by the state — that come June 30, our mental health region is going to be no longer in existence,” Henry County Supervisor Marc Lindeen said.

While the region officially closes on June 30, the agency, which served 13 counties including Henry, Jefferson, Lee, Louisa, and Washington, will officially cease operations on Nov. 30 this year following a transition period allowing for administrative closure and claim processing.

The action comes in response to House File 2673, signed into law by Gov. Kim Reynolds on May 15, which consolidates and realigns Iowa’s behavioral health and disability services. Under the new law, the state eliminates county-run MHDS regions in favor of a streamlined, state-administered behavioral health district system overseen by the Department of Health and Human Services (HHS).

In a May 15 press release Gov. Reynolds described the legislation as a necessary step to modernize care.

“Iowa is improving how behavioral health services are delivered by streamlining programs, reducing fragmentation, and making it easier for Iowans to access the care they need,” she said.

The law restructures mental health, disability, and substance use disorder services, transferring responsibilities to specialized divisions within the Department of Health and Human Services. This includes creating a Behavioral Health Services Division and a separate Aging and Disability Services Division. It also eliminates certain agencies and phases out regional governance models like the 28E agreement that has governed the Southeast Iowa region for years.

Each of the 13 counties in the region passed similar resolutions terminating the regional partnership, following approval from the Iowa HHS and in accordance with the Southeast Iowa region’s state-approved closure plan. A small number of staff — reportedly three — will remain employed through the end of the closeout period to manage outstanding claims and administrative wrap-up.

As Iowa moves from a decentralized model of county-run mental health regions to a unified state-directed behavioral health structure, many local leaders say they are hopeful for better efficiency and access to services. Still, the closure of long-standing regional partnerships like the one in Southeast Iowa marks the end of an era.

The newly formed Behavioral Health Services Division will oversee policy, standards, and funding allocations, aiming to ensure more consistent care across the state. Though the transition period will stretch into late 2025, the groundwork for the new system is already being laid.

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While local public health departments prepare to collaborate under this new structure, Henry County Public Health Director Katie Reuter stressed that the mission remains the same: protecting and promoting health in the community.

In an update to the Board of Supervisors or May 8, Reuter told them that much of her department’s recent focus has been on measles outbreak preparedness. Nationwide, over 900 cases have been reported across more than 30 states, with three confirmed deaths — two of them children.

“Ninety-six percent of the cases were in unvaccinated individuals or people whose vaccination status was unknown,” Reuter said. “Since we last met, the state has expanded funding for measles vaccinations. So, MMR is now free for anybody in Iowa, regardless of insurance.”

Reuter said vaccinations are available for both adults and children at regular immunization hours and emphasized the department’s flexibility for scheduling.

“If those hours don’t work for folks, we are definitely willing to work with people to get them in,” Reuter said.

She also highlighted an upcoming stride-into-summer wellness event and a “Walk With Ease” program designed to help residents with arthritis improve mobility. Both events are part of a continued effort to promote public engagement in preventive health practices, even amid broader changes at the state level.

Reuter noted that ongoing state budget challenges — particularly federal cuts — are impacting health services and funding streams.

“Most of the discussion this month was surrounding funding and changes in funding,” she said. “The state unfortunately doesn’t have a lot — just funding cuts from the federal level — but they do keep us informed.”

Comments: AnnaMarie.Kruse@southeastiowaunion.com