Greene County withdrawing from mental health region

Also continuing to look at county-based public health

The Greene County supervisors made decisions about mental health and public health services at their Oct. 16 meeting.

The board voted unanimously to approve a resolution to accompany a letter of intent to withdraw from the Heart of Iowa community services region, ending many months of frustration for supervisor Dawn Rudolph, who has served on the Heart of Iowa board as the county’s representative since it was organized in 2014.

Dallas, Greene, Audubon and Guthrie counties comprise the region, and each county has a representative on the board. “There have been big concerns with the region that seem to never get resolved,” Rudolph said Monday.

She has repeatedly mentioned a lack of communication and an imbalance in influence and decision-making of Dallas County, and particularly of CEO Darci Alt. The rift as grown larger since the Hope Wellness Center opened in Woodward. According to Rudolph, Greene County residents have not been able to access services at the short-term crisis management facility.

Rudolph has also been frustrated in providing financial oversight, saying the list of bills they see for approval is in Morse code.

Rudolph said she has done lengthy research into how other community service regions function and concluded that the Heart of Iowa region is not doing as well as it should.
At a Heart of Iowa board meeting earlier this month Rudolph and Ellen Ritter, who is a Greene County employee who was hired to serve as coordinator of disability services to serve all four counties, learned that Alt had rewritten job descriptions (without board approval), taking Ritter out of the management level in the organization. That prompted the decision to withdraw from the region effective June 30, 2018.

Rudolph said the board members from Guthrie and Audubon counties also have concerns, but they don’t bring them to the board table. Both are newer to the board than Rudolph.
Rudolph suggests Greene County become part of the Central Iowa Community Services (CICS) region, which now includes Boone, Franklin, Hamilton, Hardin, Jasper, Madison, Marshall, Poweshiek, Story and Warren counties. She has talked with board members representing the less populated counties in the region and they’re happy with the way the region functions.

“I know not every region is perfect, but I’ve beat my head against the wall on this long enough,” Rudolph said.

The supervisors approved a resolution per Iowa Code 28E to withdraw from the Heart of Iowa region. The resolution and letter of intent were reviewed by assistant county attorney Thomas Laehn to be sure they are in compliance with the law. The county will continue to be financially committed to the region until the end of the fiscal year.

In joining the CICS region, Greene County will be part of formulating the FY19 budget but will not have a vote on it.

The supervisors also agreed by consensus to continue looking at a county-based public health department. Rudolph has been the county’s representative on the board of health for several years. She reported attending a board of health meeting last week.

The idea of ending the contract with Greene County Medical Center for providing public health services has been discussed since last December, when the medical center suggested a staggered increase in county funding.

Rudolph said the board heard presentations from contractors providing services to the public health department and an update on the direction of public health. Bill Raney, a Greene County Medical Center trustee and a member of the board of health. “I was surprised at the response that Bill gave the board. It wasn’t in our conversation,” Rudolph said, but didn’t elaborate on what that response was.

“I think we need to seriously as a board (of supervisors) really move forward to what the future of public health will be, whether it will be hospital-based or county-based. That’s our decision,” Rudolph said Monday.
She said there are many steps to take to move to a county-based public health department, too many to accomplish before the start of the new fiscal year next July 1.
She said there has not been recent conversation with medical center CEO Carl Behne about a compromise in funding, “but with brief visits with some of the hospital board members, the comments are, ‘public health just costs us too much,’” she said.

Rudolph said she would work with public health director Becky Wolf to determine what to start looking at. The supervisors asked her to gather that information.

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