State officials' plan to end a program for Iowans who have severe mental illness in the next six months has left providers and family members concerned about the future of care.
The Integrated Health Home program (IHH) is a Medicaid-covered network of professionals who coordinate care for Iowans with severe mental illnesses.
Iowa Department of Health and Human Services (HHS) officials recently announced that they will phase out the program by January 2026 starting this month, with the plan for adults to be transitioned off the program by the end of September and children by the end of December.
In its place, the state is launching Certified Community Behavioral Health Clinics (CCBHC) this month as part of its new statewide behavior health system. The clinics provide a range of mental health and substance abuse services that officials say will better serve Iowans.
"Unlike IHH, which focused on care coordination for a limited population of Medicaid enrollees with mental health diagnoses, CCBHCs serve anyone who walks through their doors, regardless of diagnosis or insurance status, and provide a broad range of behavioral health services," Iowa HHS spokesman Alex Murphy said in a statement.
Murphy said Iowa HHS plans to start working with IHH providers this month on the transition.
"IHH care coordinators will contact each current member to ensure they understand their options, assess for potential gaps in care and create an individualized transition plan to ensure needs are addressed. [Managed Care Organizations] will hire additional team members to serve individuals transitioning from IHH care coordination. It is likely that many care coordinators currently employed by IHHs will be able to secure new roles with an MCO if they choose to do so," he said
But the state's announcement came as a shock and surprise to many IHH providers, who say they're concerned about how the transition will work, what will happen to their employees and how it could affect the people they serve and their families.
Billie Butler, CEO of Zion Integrated Behavioral Health Services, called the state's timeline "aggressive" to transition the organization's approximately 175 children and adults on their IHH program to the new case managers under the CCBHCs.
"There's a very short amount of time to make sure that people are able to meet a new person and make sure that the services continue. These are vital services for some of the most vulnerable people in the state," Butler said.
Murphy said in his statement that there have been "significant" issues with the IHH program and that Iowa HHS officials have been "actively discussing the future of IHH with providers and members for over a year."
Additionally, Murphy said the state reached a settlement in January in a class action lawsuit filed on behalf of Medicaid-eligible children with severe emotional disturbances that "laid out the evaluation of IHH performance and creation of a new approach to intensive care coordination as activities occurring in 2025."
"We were all shocked, you know, just like, why now? What's happening?"Anne Starr, CEO of Orchard Place in Des Moines
Anne Starr, CEO of Orchard Place in Des Moines, said she's been part of the discussion of IHH's future with state officials, but was under the impression that the program was on track to phase out in 2027.
Starr said she was alerted to the news through a June 30 phone call from Iowa HHS and said she's unsure of what to tell the families of the organization's 350 children who are set to be transitioned to the CCBHCs.
"We were all shocked, you know, just like, why now? What's happening? [The] lack of clarity about it," she said. "One of the really important things when you're working with children with an emotional disturbance and their families is being able to empower them with information."
Starr said it's also unclear what will happen to organization's IHH employees.
"We can certainly look for things within our own organization for them, but there's a limited number of people that we would be able to absorb into other positions," she said. "So, you know, they start thinking about, 'I have to leave, right? I have to go find another opportunity.'"
Paula Davis said her 44-year-old son Jeffrey, who is bipolar and on the autism spectrum, has been with the same IHH case manager in eastern Iowa for years.
"He knows Jeffrey inside and out, and he knows how to deal with Jeffrey. He can calm him down. He can talk things through with him," she said.
Davis said she was alerted to the end of the program by Jeffrey's case manager and said she's concerned about how her son will handle the sudden transition to another program with potentially new case managers.
"They don't know his disability. They don't know how to deal with them," she said. "To me, that's just ludicrous, because Jeffrey could actually go backwards instead of forwards because of this move."
