Black Hawk County hears plan for behavioral health 'disability access point' and optional 28E governance

Julie Davidson, chief operating officer and interim CEO for the reorganized regional behavioral health/disability services entity, told the Black Hawk County Board of Supervisors on Nov. 4 that the new Disability Access Point (DAP) model will focus on navigation, information and short-term supports while the Iowa Department of Health and Human Services will set funding guidelines.

Under the realignment, Davidson said the Administrative Service Organization (ASO), Iowa Primary Care Associates, will handle crisis services and most outpatient and inpatient mental-health and substance-use services, while DAPs will primarily help people find appropriate long-term services and supports and assist people with Medicaid and other funding referrals. "Our job is really to find individuals with a disability who — or they don't even have to reach a level — if somebody has a need, we will assist them," Davidson said in the presentation.

Davidson described the DAP role as a mix of information-and-assistance, options counseling and limited service coordination for long-term supports; most of the DAP budget goes to navigator positions. She said the region currently employs 12 navigators and that "we do have one navigator who is assigned just to Black Hawk County," with additional coverage being added from neighboring counties to meet demand.

On governance, Davidson explained that a surviving 28E entity remains from the previous regional structure and that counties may opt in to a new 28E governing board. She said the board would provide oversight of the CEO and approval of budgets and expenditures, but that HHS ultimately controls funding decisions. Counties that do not sign the 28E will still receive services under the state contract, she said.

Board members asked about outreach to people who previously accessed in-person county offices and about how navigator staffing levels were determined; Davidson said the organization is tracking referrals and adjusting navigator assignments based on demand. She also said legacy funding carried over through Dec. 31 to avoid service interruptions during the transition.

The presentation concluded with Davidson encouraging counties to consider 28E membership for advisory and oversight roles but noting that signing is optional. Board members thanked Davidson and said they will follow up as staffing and 28E details are finalized.