Iowa picks health care association to manage new behavioral health system

State officials have selected a Des Moines-based health care association to manage Iowa's new behavioral health system that’s meant to better coordinate care and improve access for patients.

The Iowa Department of Health and Human Services announced Friday that the Iowa Primary Care Association was selected to serve as the organization to oversee the new system statewide.

The organization is a nonprofit membership association that supports Iowa's 14 federally qualified health centers, which provide primary care and preventive services to low-income and underserved populations regardless of their ability to pay.

Gov. Kim Reynolds in May signed into law a plan to overhaul and combine Iowa’s delivery system for mental and behavioral health services — which advocates hope will improve access for patients. It combines Iowa’s 32 disparate mental health and substance use regions into seven unified behavioral health districts, while placing disability services under the jurisdiction of the Iowa Department of Health and Human Services.

  Buy Photo

The proposal aims to improve a system that both state officials and advocates agree is badly fractured. Some, though, have worried the proposal does not go far enough to address underlying issues that hinder access to treatment and services in the state — including Iowa Medicaid reimbursement rates. Others have expressed concerns whether a large state-run system would have enough resources to fully address the needs of all Iowans.

The legislation states the new behavioral health services system shall provide equitable statewide access to all services and offer specialized services with a focus on at-risk populations. That includes children, young adults, individuals with disabilities, pregnant women, older Iowans and those with limited financial resources.

The bill passed the Iowa Legislature with large bipartisan support, and was backed by the Iowa Hospital Association, Iowa Mental Health Advocacy, National Alliance on Mental Illness, Coalition for Family and Children's Services in Iowa and others.

“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,” Reynolds said in a statement Friday.

Details about the new behavioral health system still are being finalized. State officials will be begin negotiating a contract with Iowa PCA now that they have been selected to manage the new system, Iowa HHS spokesman Alex Murphy told the Gazette in an email. Murphy said there will be an on-boarding period and readiness review check with a launch goal date of July 1, 2025.

The Iowa Primary Care Association will be responsible for establishing a statewide network of providers and “ensuring that all Iowans have clear, consistent pathways to care and support they need,” state officials said in a statement.

The nonprofit will be responsible for overseeing the management and operations of all behavioral health services in each of the new system's seven districts, starting July 1.

State officials said the association will work with local leaders, school officials, law enforcement, health care providers and public health professionals to develop strategies to meet the distinct needs of communities within each district.

  Buy Photo

Iowa Health and Human Services Director Kelly Garcia, in a statement, said Iowa Primary Care Association was selected as “an established and trusted health care provider in the state.”

“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.

Marissa Eyanson, the department’s Behavioral Health Division director, said the association “laid out a robust plan to ensure continuity of services to Iowans throughout the transition period and into the launch of the new system.”

“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 a statement.

Download: Iowa Primary Care Association proposal.pdf

The state solicited proposals from existing agencies that oversee mental health regions, as well as from other public and private nonprofit entities to administer the seven new regions.

The Mental Health/Disability Services of the East Central Region — a partnership between nine counties, including Benton, Iowa, Johnson, Jones and Linn counties, to provide comprehensive mental health and disability resources, referral and funding to individuals in Eastern Iowa — was among those groups that submitted proposals.

With the selection of Iowa Primary Care Association, the Mental Health/Disability Services of the East Central Region will cease to exist as an organization on June 30, per Iowa law. The region will now be part of the new District 7, comprised of Black Hawk, Buchanan, Delaware, Dubuque, Linn, Jones, Jackson, Johnson, Cedar, Clinton, Muscatine, Scott, Louisa and Des Moines counties.

“To not be selected is a blow to our organization,” said Mae Hingtgen, chief executive officer of the East Central Region. “ … Me and my staff have over 265 years combined experience working in this system, and we thought we were the best candidate.”

  Buy Photo

Hingtgen said East Central Region staff began working on their proposal — including meeting with providers, county supervisors, law enforcement, educators and health care professionals across the new 14-county district and creating an interim plan — as soon as Reynolds announced plans for the new behavioral health system during her Condition of the State address last January.

She said the change will affect 35 employees across the East Central Region.

“I recommend all of my staff to any provider or (health care) system that is looking to hire, because we have very dedicated and passionate and skilled staff who will need to find new jobs,” she said. “It will be my work for the next six months to help them to make that transition.”

While not as intimately involved in the delivery of government-funded mental health and disability services in Iowa, Hingtgen said the Iowa Primary Care Association is “a great organization” that will “do good work” administering behavioral health services in Iowa.

Aaron Todd, Iowa PCA Chief Executive Officer, said in a statement the health care association is committed “to address the very real barriers Iowans face to access behavioral health services that we have witnessed first-hand in our work with community health centers and other stakeholders across the state.”

“The behavioral health redesign efforts are a once-in-a-generation opportunity to build a more holistic, integrated model of service delivery to better serve Iowans,” Todd said.

Hingtgen said the East Central Region will continue to administer mental health and disability services over the next six months to ensure access to services are not compromised in the transition to the new behavioral health system. She said employees will work with providers and the association to facilitate a seamless transition.

Hingtgen said Iowans should not see a disruption in services.

“I want to express confidence in the fact that the people who will be administering behavioral health services in Iowa are the people who are fully committed to the work and have the best intentions,” Hingtgen said. “And we will, as we transition out of this work, we will do whatever we can to help them to get there.”

Emily Blomme, chief executive officer of Foundation 2 Crisis Services in Cedar Rapids, said the organization looks forward to working with the Iowa Primary Care Association.

“They have been thoughtful and curious to learn about our history, services, and the crisis system as a whole,” Blomme said in a statement to The Gazette. “We are excited to continue to provide crisis services to Iowans in partnership with Iowa PCA and the realigned behavioral health system.”

Comments: (319) 398-8499; tom.barton@thegazette.com