Fighting among the counties in the Eastern Iowa Mental Health Region might result in Muscatine County getting kicked out. The first step may be taken at a special meeting called by regional chair Jack Willey for Friday.

The mental health regions were formed in 2014 in a move away from differing models of county-level care toward more-standardized treatment models. The process has been wracked by bickering over funding levels among counties and between the regions and the state Legislature, as well as over the services required by the state.

Willey, who is a Jackson County supervisor, has been at the center of mental health debates for years. He serves as chairman of the Eastern Iowa Mental Health and Disabilities Services region, which includes Jackson, Clinton, Scott, Cedar and Muscatine counties.

The biggest conflict in the region is with Muscatine County, which tried to withdraw from the region but was rejected by an adjoining region. Now, Willey wants to eject Muscatine County from the region anyway, after Muscatine’s representative on the regional board called a provider of peer services and raised concerns that funding could be cut to Rhonda’s House, a DeWitt peer respite home.

Todd Noack of Rhonda’s House and Nathan Mather, Muscatine’s representative on the regional mental health board, have differing accounts of that conversation. Noack said Mather told him that funding would be cut without warning. Mather said he only wanted Noack to be able to lobby for the importance of peer-run services.

“For a board member to, on their own, call a provider and tell them, ‘You’re going to get cut, you’re going to have to close the doors’ … we just thought that was totally out of line,” Willey said.

At a special meeting Friday, Dec. 20, the regional board was planning to vote on whether or not to kick out Muscatine. After that, the change would need to be approved by a majority of the five counties and again the regional board before going into effect.

If Muscatine is ejected from the Eastern Iowa region, it would basically be up to the Department of Human Services whether Muscatine County would be aligned with any of its three adjoining regions, or if it could go it alone.

Throughout the region, much of the frustration of officials is over convoluted funding streams and requirements set by the Legislature has set limits regarding county levies for mental health, as well as how much money the individual counties and region as a whole can have on hand.

The highly variable costs of mental health service needs make it difficult to keep fund balances low enough to satisfy the state without constantly threatening budget cuts, officials said. Differing levy requirements also invite in-fighting among counties who easily see inequitable contributions and services.

Willey says county management of mental health was not a broken system before regionalization. 

“The only thing that was broken was the funding streams,” he said.