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Black Hawk County officials warn service gaps after state reorg of mental health regions
Summary
Mary, a county social services representative, told the Black Hawk County Board of Supervisors on June 24 that state legislation will dissolve existing mental health and disability service regions on June 30 and shift intake and payment duties to new regional contractors, leaving local staff and the county’s hospitalization-referee system in limbo.
Mary, a county social services representative, told the Black Hawk County Board of Supervisors on June 24 that state legislation signed this year will "sunset" the current mental health and disability service regions effective June 30, and that intake and most behavioral-health and substance-use contacts will move to new regional contractors beginning July 1.
Mary said the East Central Region (disability access) and Iowa Primary Care Association (behavioral health and substance use) will be the points of contact for many services, and that local office-based coordinators at the Pinecrest Building will not be available after Friday. "I was told that in the meeting with HHS. I have not seen that in writing," Mary said about assurances that current payments will continue through the end of the calendar year.
The county representative provided phone contacts that residents and providers can use: (319) 892-5671 for East Central Region-related disability access, ecriowa.com for the East Central Region web page, and the existing Your Life Iowa number for behavioral-health referrals, (855) 581-8111, with 988 reserved for crisis response.
Board members and legal and court representatives focused on the downstream effect this reorganization could have on court-ordered hospitalizations and the role known locally as the hospitalization (or judicial) referee. Brian Wade, Black Hawk County attorney, described the referee position as "indispensable" given the county's caseload and the way hearings are scheduled: "This role is indispensable," Wade said, explaining that the county attorney's office supports petitioners and that hospital-referee hearings are currently conducted often Monday through Friday.
Diane Larson, who has served as the county's hospitalization referee for more than two decades, explained the operational role. "It does tend to kind of grease things a little bit and get things moving," Larson said, describing how a dedicated referee helps hospitals, petitioners and courts by scheduling hearings, moving hearings when needed and chasing paperwork so care can proceed.
County staff and the board said they lack written guidance from the state about what services the new regional contractors will perform locally, whether local offices will be staffed beyond a possible occasional presence, and which contracts will be continued. Mary told supervisors about staff effects within county social services: "About half my staff have found other jobs and half of us are going to be unemployed," she said, adding an estimate heard in regional conversations that "approximately 200 people will be unemployed" statewide because of the change.
Board members, county legal staff and court representatives said they will seek clarity this week and consider options at the board's next meeting, including whether the county should temporarily fund the referee position. Judge-related materials included a memo from the chief judge describing statutory authority and noting the county's historical involvement in these proceedings; county staff provided a rough budget estimate that retaining the referee position for fiscal 2026 could be in the ballpark of $60,000.
No formal board action was taken on June 24. Supervisors directed staff to continue gathering written confirmations from the state, to invite judicial leadership to the next meeting and to return with options that clarify legal authority and funding responsibilities.
Why it matters: Black Hawk County hosts two hospitals that receive involuntary hospitalization petitions from surrounding counties; changes to how and where hearings and intake are organized could delay hearings, change who pays for transportation and attorney fees, and affect whether local hospitals can rely on a single referee to keep hearings and discharges moving.
What’s next: County staff and legal counsel said they will pursue written confirmation from state agencies and regional contractors, update the board on any firm offers of contract funding, and place the referee and funding options on next week’s agenda so supervisors can consider formal direction.
