Iowa officials unveil new behavioral health system map to better address mental health

State officials have unveiled the proposed districts for Iowa's new behavioral health system.

Gov. Kim Reynolds signed into law earlier this year a plan to merge mental and behavioral health services offered in the state, which top state officials hope will streamline system functions and improve access for Iowans who struggle with mental or substance use disorders.

The Iowa Department of Health and Human Services released a map of the seven districts that will make up the new behavioral health system, and offered during a Tuesday public meeting new detail on how the system will work in the future.

Under the plan, Polk County will part of a 14-county district in central and south central Iowa. Other counties in the district include Hamilton, Greene, Boone, Story, Dallas, Jasper, Madison, Warren, Marion, Clarke, Lucas, Decatur and Wayne.

The new system is scheduled to go online by July 1, 2025.

What will Iowa's new behavioral health system do?

The plan would dissolve Iowa's current system, which is currently made up of 13 Mental Health and Disability Service regions and 19 Integrated Provider Networks that manage substance use and problem gambling services. Instead, these 32 districts would be merged into seven new districts that oversee mental health and substance use treatment.

The seven new districts will be charged with coordinating and overseeing an array of services that include prevention, early intervention and treatment and crisis services. These regions will be overseen an "administrative services organization," which can be a public entity or private nonprofit group hired by the state.

More: Reynolds signs 'transformative' behavioral health overhaul into Iowa law. What it does:

Reynolds has said the move to merge mental health and substance use services will remove barriers that have historically separated those programs. Though one in four Iowa adults have co-existing mental health challenges and substance use disorders, the current regions are disconnected from one another.

"By bringing services together in this way we will enable better coordination of care supporting the best possible outcomes for each individual," Reynolds said during the bill signing in Cedar Rapids. "It's what every Iowan deserves, and that's what we intend to deliver."

Disability services would not be managed by the seven districts, but instead overseen directly by the state HHS agency under its division of Aging and Disability Services. As with behavioral health, Iowa HHS Director Kelly Garcia has said the shift in disability services is focused on streamlining access to services and provide more coordinated care for those Iowans.

How did the state build these districts?

HHS Director Kelly Garcia said during a public meeting Tuesday that the make-up of the districts will help address the main goals of the new system. That includes equitable access to services for all Iowans, removing cumbersome administrative burden from providers and funnelling state and federal dollars to measurable outcomes, she said.

The announcement of the new district boundaries came after Iowa HHS hosted stakeholder sessions in June and July to collect feedback from providers, advocates and those with lived experience. Agency officials say more than 1,000 attendees participated across all four sessions.

HHS officials say they created the district map by measuring certain criteria within each county, which included metrics like the county's Medicaid enrollment rate or its access to mental, dental and mental health care. Marissa Eyanson, the director of behavioral health for Iowa HHS, the state also used data from the social vulnerability index to measure potential risk that residents within those counties could face in the future. The maps were created using these combined scores, Eyanson said.

Many details of the state's new behavioral health system and how it will operate are still unknown. The scope of work that will be done by the administrative services organizations overseeing the districts will be developed and publicly available by the end of September, according to the state's timeline.

Those organizations will be selected by Dec. 31, 2024.

The new system, which was one of Reynolds' legislative priorities, received broad bipartisan support as it made its way through the legislative session. It also garnered the support of major groups like NAMI Iowa and the Iowa Hospital Association.

"NAMI is ready to partner with HHS and other agencies to ensure high-quality, effective, and new treatment options are available for those with a mental health condition and their families," Ryan Crane, executive director of NAMI Iowa, said in a statement.

However, many behavioral health providers and other advocates have held back their full endorsement of the move so far this year, saying they were instead "cautiously optimistic" about the governor's proposals within the plan.

"We know that HHS has been thoughtful and deliberate about its plans so far, so NAMI trusts that they are making positive decisions about how they are structuring these new regions, which integrate mental health and substance use disorder resources and services," Crane said.

Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com , at (319) 339-7354 or on Twitter at @Michaela_Ramm .

This article originally appeared on Des Moines Register: Iowa officials unveil new behavioral health system map to better address mental health