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Mental Health

Iowa Overhauls MHDS, Expands Mental Health Policy Coverage

— February 3, 2023

Iowa expands his mental health services.

In December 2022, Iowa policymakers planned to expand mental health policy coverage for thousands of Iowa residents, finally implementing changes that began to circulate back in 2021 with the overhaul of the Iowa Mental Health and Disability Service, or MHDS. This change was aimed to localize funding for mental health groups but damaged many clinic’s service models and caused major service disruptions. Many opposed these changes, including the Southeast Iowa Link as well as other Iowa residents and lawmakers. 

In December 2022, the Iowa commission released a 20-page reporting reviewing the current needs and requests of the mental health provider community, as well as what the MHDS was able to address and provide capabilities for. “We urge all stakeholders to recognize what has been accomplished and renew their commitment,” the report writes, “to ensure that our MHDS system has adequate and predictable resources to meet the challenges of transition and growth, and to achieve high quality and long-term stability.” 

Iowa Overhauls MHDS, Expands Mental Health Policy Coverage
Photo by Tima Miroshnichenko from Pexels

While the report focused on current and upcoming mental health needs, it also highlighted some accomplishments since the original MHDS overhaul. These changes included the moving of the Iowa Crisis Services to the central service sector, creating 23-hour observation for acute mental health crises, as well as creating additional Crisis Stabilization and Subacute Services Departments. In addition, the program also is planning to increase the funding provided to children’s mental health services as well as tiered reimbursement rates.

When citing the current areas of growth and improvement, the report stated, “Siloed services related to brain injury, intellectual disabilities, developmental disabilities, and addictions” were some of the largest areas of need. As Iowa currently ranks 44th in mental health training and access, the report additionally aimed to increase the complexity of psychological issues funded and treated by psychiatrists and mental health facilities.

In addition, in order to get more clinics on board with the new changes, the report promised to fight for the funding of the community hospital network, as well as the reimbursement rates for insurance-funded services. 

Critics of the bill and report stated that the baseline issue is the lack of trained mental health providers entering the workforce in Iowa. They cited the lowering rates of workforce entry and retention of staff as a barrier to the increased funding, as adding additional patients to the mental healthcare system would overload and over burden existing professionals. Addressing this, the report stated, “The shortage of psychiatrists and other prescribers, and the barriers to accessing acute psychiatric care in our state are still readily apparent.” 

Lawmakers plan to open additional training and educational incentives to encourage interested students to pursue training and licensure in the mental health field. Two of the proposed actions from lawmakers include additional loan forgiveness for recently graduated mental health professionals as well as fellowship opportunities to decrease the financial burden on students. Additionally, lawmakers proposed a possibility for additional low-cost, on-the-job training programs for mental health professionals.

While it is clear that lawmakers are attempting to expand mental health access, the next year will be crucial in determining whether or not these plans come to fruition. 


Iowa House passes bills increasing access to mental health

Iowa commission suggests mental health policy changes

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