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Three Western Iowa Counties Consider Joining New Mental Health Regions

Courtesy of Iowa Department of Human Services
A map of all of the mental health regions in Iowa.

Three Western Iowa counties are exploring new ways to coordinate regional mental health services next fiscal year after a series of disagreements led to what some call an uncooperative relationship.
Plymouth, Sioux and Woodbury counties have shared a community mental health system called Sioux Rivers Regional Mental Health & Disability Services since it went into effect in 2014. The region is one of 14 community systems mandated by Iowa’s Department of Human Services that operates with a regional plan to support people with mental health needs.

Woodbury officials decided last year to leave Sioux Rivers. Board of Supervisors Chair Rocky De Witt says the county did not always agree with the votes taken by the regional board.

De Witt also called the relationship “a discrepancy of ideas of management.” Woodbury County, he said, felt like it had more at stake because it pays more for services.

“It just was not working very well. And it’s in the best interest of the taxpayers and the mental health patients in Woodbury County that we move to a different region,” De Witt said.

They’re on track to join a region next July called Rolling Hills Community Services that caters to several nearby eastward counties, including Sac and Ida. De Witt said Rolling Hills has expressed an interest in meeting with them to talk about budgeting for next year.

"It's in the best interest of the taxpayers and the mental health patients in Woodbury County that we move to a different region." -Rocky De Witt, Woodbury County

Both Plymouth and Sioux counties would need to bring in one county to replace Woodbury and keep Sioux Rivers, but at a meeting last week, Plymouth County officials approved Board of Supervisors chairman Don Kass’ letter expressing an interest in joining the Northwest Iowa Care Connections region that serves Dickinson, Lyon and several other counties just to the northeast of them.

Kass sits on the governance board for Sioux Rivers, and says he feels confident in a change after the falling out between the Sioux Rivers counties.

“It’s not something that should have happened, but I guess we just have to move on,” Kass said. “In the end, Plymouth and Sioux counties will both be in a better fiscal situation, because we no longer have to subsidize Woodbury County.”

Under the current model, Woodbury County pays between 61 to 63 percent of the cost services, but uses about 73 percent. Plymouth and Sioux split the remainder of the share.

"It's not something that should have happened, but I guess we just have to move on." -Don Kass, Plymouth County

Shane Walter, the CEO for Sioux Rivers and the community services director of Sioux County, said his county has a great working relationship with Plymouth, and will likely follow suit try to join the NWIACC region. Both Walter and Kass said their counties are the most populous compared to others in the NWIACC and have higher budgets for mental health.

“We have something to bring to the table,” Walter said. “They [NWIACC] should want us. And they do.”

Walter said when the counties first started working together in their mental health region, they got along very well. But county elections led to changes in leadership, changes to the members of the Sioux Rivers board and a change in dynamic.

"We were in a position to have to defend what we had put together and it's just unfortunate, because it didn't in my mind, and in the minds of a lot of people - providers and consumers in particular - didn't need to be that way," he said.

Plymouth, Sioux and Woodbury counties together operate a center for patients with mental health symptoms, called the Assessment & Stabilization Center. The center is located in Woodbury County. 

If Sioux Rivers is dissolved, the three counties would sell the center, possibly to one of the nearby regions. Walter said Plymouth, Sioux and Woodbury would then distribute the proceeds among themselves, dividing them up by their population sizes.

Katie Peikes was a reporter for Iowa Public Radio from 2018 to 2023. She joined IPR as its first-ever Western Iowa reporter, and then served as the agricultural reporter.