Iowa's Behavioral Health Service System

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Iowa's Behavioral Health Service System

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On May 15, 2024, House File 2673 was signed into law. Under this legislation, Iowa will: 

  1. Combine the work and funding for mental health and addictive disorders into a Behavioral Health Service System, guided by a statewide plan, focused on ensuring equitable access to prevention, treatment, recovery, and crisis services.  
  2. Transfer the management of disability services from the local Mental Health and Disability Services (MHDS) Regions to the Division of Aging & Disability Services. To focus on systems of support, care, and connection for all Iowans and families with disability-related needs, management activities will include identifying additional organizations to participate in the Aging and Disability Resource Center (ADRC) network and the creation of a disability services system.  
  3. Strengthen important system connections to Medicaid, Public Health, and Child Protective Services by gathering meaningful feedback from Iowans to inform system planning.

Using a shared responsibility model between HHS and system stakeholders, Iowans will build a Behavioral Health Service System that: 

  • Is well-coordinated with clear access points throughout behavioral health districts, 
  • Ensures that individuals and families have access to person-centered services and supports no matter where they live, 
  • Reduces duplication by linking Federal, State and local governance and authority, 
  • Eliminates administrative red-tape, and the same efforts happening in multiple places.  
  • Links funding to measurable outcomes. 

The new Behavioral Health Service System will start July 1, 2025

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Behavioral Health Districts

Behavioral health districts outline geographic boundaries for local coordination.  

In June and July 2024, HHS worked with Health Management Associates (HMA) to get public feedback for proposed district boundaries. A total of four public comment sessions were held; two virtual sessions and two in-person sessions in Des Moines and Sioux City. Written feedback was also collected from respondents through an online public comment form and via email.   

A summary report was created to show the breakdown of stakeholder representation and key themes from the public engagement process. Feedback from this work helped define seven districts that ensure fair resource distribution, workload balance, and access to care. The map of the seven behavioral health districts is available here. 

An overview of the map development process was provided via webinar in August 2024. To view a recording of that overview please click here. 

Local Coordination 

HHS will work with local Behavioral Health Administrative Service Organizations (BH-ASOs) to collaboratively coordinate and oversee services in each behavioral health district. Behavioral Health Administrative Service Organizations will be selected by December 31, 2024. 

In each district, BH-ASOs will: 

  • Ensure equitable access to comprehensive prevention, treatment, recovery, and crisis services for mental health and addiction (including alcohol, drugs, tobacco, and gambling). 
  • Connect and collaborate with local leaders and systems like schools, law enforcement, and public health to meet behavioral health needs. 
  • Provide information, referrals, and support to help Iowans navigate the behavioral health system. 
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Behavioral Health Administrative Service Organization

On December 13, 2024, Iowa HHS announced the selection of the Iowa Primary Care Association (Iowa PCA) to serve in a statewide capacity as the Administrative Service Organization for the state’s redesigned Behavioral Health System. Operational go-live for this new system remains on-track for July 1, 2025. 

Behavioral Health Administrative Service Organizations (BH-ASOs) are responsible for ensuring all Iowans have clear, consistent pathways to care and the support they need within each behavioral health district. They will do this by instilling a unified operational approach for each of the seven districts. Additionally, they will meet regularly with local leaders, school officials, law enforcement, health care providers and public health professionals to discuss behavioral health needs at a local level and ensure the state’s Behavioral Health Service System is adapting and meeting those needs.

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Iowa's Behavioral Health Service System Statewide Plan

The Behavioral Health Service System Statewide Plan will provide system-level guidance using a shared responsibility model and include strategies and tactics for 2025-2027. Iowa HHS, Behavioral Health Administration Services Organizations, and Local Stakeholders will implement these strategies and tactics to improve behavioral health outcomes for all Iowans and ensure equitable access to the full Behavioral Health continuum of prevention, treatment, recovery, and crisis services. 

Iowa HHS has worked together with behavioral health partners to begin the development of the 2025-2027 plan. The initial draft of system-level strategies and tactics for the statewide plan can be found here. 

Iowa hosted three virtual public town halls on November 6, 2024, with an opportunity for the public to provide written feedback.  View the recording below. 

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Frequently Asked Questions

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Resources

Behavioral Health District Map - Public Comment Resources: 

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