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Change to the state’s mental health system affects jail diversion in Eastern Iowa
The regional jail diversion program was eliminated as part of a broader effort to centralize and standardize mental health care across the state
Dec. 21, 2025 5:30 am
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CEDAR RAPIDS — Sheriffs’ departments in east-central Iowa are having to adjust their approach to helping certain mentally ill inmates after a change to the state’s behavioral health system eliminated funding for a longtime jail diversion program.
The Intensive Pretrial Jail Diversion and Mental Health Re-Entry Program was discontinued this summer in conjunction with Iowa Department of Health and Human Services’ behavioral health system realignment that took effect July 1.
The program focused on connecting staff from Iowa’s 6th Judicial District with jail inmates to address pressing mental health needs that could lead to potential reoffense or re-entry into the criminal justice system.
It was previously funded by the Mental Health/Disability Services of the East Central Region using funds it received from the state before this summer’s overhaul that combined Iowa’s 32 mental health and substance use regions into seven unified districts.
The program was unique to the East Central Region, which was the only region to directly provide funding for diversion staff within the Department of Corrections. That distinction ultimately led to the program’s termination during a realignment aimed at standardizing care statewide.
State officials say the move “reflects a broader commitment to consistency in service delivery” statewide and that work is underway to ensure “behavioral health services and supports are available to justice-involved individuals, regardless of their location.”
Meanwhile, area law enforcement are still adjusting to the change with some departments exploring pathways toward providing certain services internally to ensure the stability of future diversion programming.
Program aimed to ‘break the cycle’
The Intensive Pretrial Jail Diversion and Mental Health Re-Entry Program began in 2004 in Linn County as an effort to address unmet mental health needs of individuals working their way through the criminal justice system.
It was backed by the East Central Region, which until this year funded five staff members within the Department of Corrections to run the referral-based program, meet with eligible inmates and coordinate treatment and re-entry plans.
Over time, the program expanded its reach to all nine counties within the East Central Region service area, which covered Benton, Bremer, Buchanan, Delaware, Dubuque, Iowa, Linn, Johnson and Jones counties.
Individuals would be referred for program participation by members of law enforcement, attorneys and/or mental health providers following an arrest.
Beyond that, exact program operations varied by county depending on general jail population trends, collaborating county staff and available community resources, according to a virtual presentation delivered last year by participating community treatment coordinator Andrew Elam.
The overall goal was to “break the cycle of defendants who are arrested, jailed and released, only to reoffend due to unmet brain health needs,” said Elam, whose presentation was recorded and posted to the Iowa HHS website.
The Gazette reached out to the Department of Corrections communications department to seek additional information about the program beyond the 2024 presentation, but the department did not respond.
In fiscal year 2025, the program served 79 unique individuals within Linn County. Since the program ended in July, an additional 22 inmates have been identified who previously would have been referred for services.
Chief Deputy Doug Riniker said the majority of the Linn County Sheriff’s Office program referrals were the result of inmates’ answers to intake questionnaires meant to help assess potential mental health concerns.
Others were the result of staff reports about individuals in the jail who exhibited behaviors or sentiments that could point toward similar difficulties, and some were a result of a referral recommendation from the Linn County Attorney’s Office.
“It’s a way we could (divert) some of the people that we currently have in jail that really are not suitable to be there like some of those lower-level offenders that really just need to get out and get treatment” for a certain mental health concern, Riniker said.
Once determined eligible and interested by Department of Corrections staff, individuals were connected with mental health services and received ongoing support and supervision from the program team to ensure compliance with any pretrial release conditions and court dates.
That mix of support and supervision aimed to improve clients’ mental health, increase public safety through reduced recidivism and lower participating counties’ carceral costs by lowering the overall jail population, per Elam’s presentation.
Realignment stresses ‘consistency’ in statewide care
The East Central Region program was unique from most jail diversion efforts in that it directly funded staff within the state corrections department to oversee the program. Some mental health regions provided similar programming using internal staff while others contracted with local nonprofits.
The mix of approaches speaks to the variability of statewide care that ultimately led to the state Legislature’s push for system realignment. The realignment was mandated by law in 2024 and took effect this year.
Under that law, each of the seven newly created districts are expected to provide a standard set of core services to ensure consistent care statewide, and funding for those services has merged into one behavioral health fund.
The districts are overseen by the Iowa Primary Care Association, a Des Moines-based health care association awarded a state contract to be the administrative service organization for all seven.
Iowa Primary Care Association, or PCA, this spring worked to evaluate existing system services and establish contracts with a statewide network of providers ahead of the July 1 realignment. Some programs previously offered by the mental health regions remained while others were discontinued.
The East Central Region’s jail diversion program fell into the latter category and was ultimately sunset in an effort to “transition to a more coordinated statewide approach to justice-involved programming,” said Iowa HHS spokesperson Danielle Sample.
“This shift reflects a broader commitment to consistency in service delivery across Iowa, ensuring that all individuals regardless of location have access to the behavioral health resources they need,” Sample said in an emailed statement.
Related programming components include the establishment of a team of statewide behavioral health system navigators who work to connect Iowans with appropriate and available mental health care and support.
Sample said PCA also is “actively collaborating” with law enforcement across the state to ensure behavioral health services are available to those involved in the justice system.
Even with those initiatives in place, however, some area departments are still working to adjust to the loss of the regional program.
Gretchen Bradshaw, a social worker at the Dubuque County Jail, said establishing re-entry plans for inmates has been one of the biggest challenges since the program’s elimination.
Diversion program staff historically would work with housing insecure inmates to assist with finding housing as part of their re-entry plan and/or to connect individuals with residential care facilities when appropriate.
Without the program in place, Bradshaw said in a written statement that some of that work now falls to other criminal justice staff.
“Unfortunately, though, it is still putting a strain on the existing resources and support systems,” she wrote. “Without this program, it has become increasingly more crowded in jails, and individuals with mental illness are left in jail way longer than needed.”
Not all departments have been affected equally by the elimination, however, given the historically disproportionate by-county referral rates.
Referrals from Dubuque and Linn counties combined accounted for nearly 80 percent of the 248 unique individuals served through the program in the most recent fiscal year, for example.
Other agencies had fewer referrals such as Johnson County, which only joined the program in 2023 and has several of its own in-house jail diversion programs aimed at safe re-entry and monitoring.
Linn County creates new position focused on mental health
Riniker said Iowa Primary Care Association has been in touch with the Linn County Sheriff’s Office about facilitating behavioral health services for inmates and that the department will continue those communications. But he noted that the department is now working to handle some of those operations internally, too.
Interest in such an effort started this spring when Linn County Attorney Nick Maybanks communicated the impending program elimination to the Linn County Board of Supervisors and expressed a strong desire to see some sort of replacement implemented.
“When we found out that the funding was going to end June 30, it raised an alarm for us about what we were going to do,” Maybanks said. “No one wants to imprison people if the reason for them coming into the system is that they are suffering from mental illness that can be treated.”
That alarm sparked interdepartmental communications among county staff that led to the Linn County Sheriff’s Office spearheading an initiative to add a new position to the department focused on mental health and diversion.
The department this fall sought and received $62,000 in grant funding from the county to establish the behavioral interventionist position. The application period for the position closed last week, and interviews are expected to occur next month.
Once hired, the interventionist will work alongside current Linn County Jail medical staff to identify incarcerated individuals who may be appropriate for jail diversion and to coordinate with community service providers to ensure those inmates receive needed supports.
“In application, this would reduce jail overcrowding and … and free up (department) resources for individuals who pose genuine public safety threats,” Riniker said. “It should also lower recidivism by addressing root causes and improving long-term outcomes.”
The position received unanimous support from the Linn County Board of Supervisors, who discussed the matter at several board meetings throughout the fall and early winter months.
The board last month voted to create the new position, which is funded in part using some of the funds the county received as part of national legal settlements with opioid manufacturers and distributors.
In doing so, board members stressed the importance of addressing the mental health needs of those within the Linn County Jail and how doing so can improve overall community safety.
“I don’t believe we’re able to fund the whole program back to the way the state had it (before the behavioral health realignment), but I think this is a really great step for us to look at ways we can better jail diversion,” said District 1 Supervisor Kirsten Running-Marquardt.
Comments: grace.nieland@thegazette.com
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