Behavioral Health System Transition Planning in Iowa
Supporting Regional Leadership During Statewide Redesign
Heart of Iowa Community Services (HICS) Region | Strategic Planning and Transition Support | 2024-2025
Client
Heart of Iowa Community Services (HICS)
The Charge
Heart of Iowa Community Services was one of Iowa’s regional mental health and disability service organizations, serving a 13-county region. HICS was responsible for helping ensure access to local mental health, disability, crisis, and children’s behavioral health services across the region.
As Iowa prepared for a major redesign of its behavioral health service system, HICS faced a complex leadership challenge: continue operating and supporting local services while also preparing for an uncertain future under a new statewide structure.
Rural Policy Partners supported HICS by bringing structure, strategy, and practical project management to this transition period. RPP helped HICS clarify its goals, organize decision points, assess future service and funding opportunities, support provider communication, and prepare for transition responsibilities in a way that aligned with HICS’s purpose, promise, guiding principles, and core values.
The System Challenge
Iowa’s behavioral health system redesign created a period of significant uncertainty for regional entities like HICS. The organization had to keep local services functioning while preparing for new governance, funding, and administrative structures. This was not a simple planning exercise.
HICS needed to manage multiple realities at once:
- Continue supporting access to mental health and disability services for adults and children.
- Maintain provider relationships and service continuity.
- Evaluate whether HICS could serve as an Administrative Service Organization in the future system.
- Explore future contracting or service delivery roles.
- Support staff through uncertainty.
- Prepare for the possible transition or closeout of existing regional responsibilities.
The leadership challenge was clear: HICS needed a practical roadmap for making timely decisions without losing sight of the people, providers, and communities depending on the regional system.
Rural Policy Partner’s System Design Approach
Rural Policy Partners worked with HICS to organize the transition into a clear strategic planning framework. The work helped HICS leadership move from uncertainty to defined goals, timelines, roles, and action steps.
RPP’s role was especially important because system redesign required both strategic thinking and operational discipline. HICS needed to evaluate future possibilities while still managing present-day responsibilities. RPP helped create a process that allowed leadership to do both.
Strategic Planning Priorities
The HICS Strategic Plan organized the work around five major goals. These goals created a practical framework for decision-making during the state transition period.
1. Evaluate ASO Readiness
HICS identified a goal to serve as an Administrative Service Organization within Iowa’s behavioral health service system. Objectives included identifying the organizational entity that could submit an ASO proposal, reviewing potential RFP elements, collecting stakeholder recommendations, gathering service programming and quality data, developing staffing and financial plans, reviewing the state plan and district map, and convening regular ASO RFP status meetings.
2. Explore Future Service Contracting Roles
HICS also considered whether it could continue as an organization that contracts prevention and mental health services in the new system. This included evaluating future organizational structures, possible partnerships, service opportunities, financial pro formas, and continuation of services such as jail alternative, service coordination, children’s navigation, counseling, teen peer support, and peer support.
3. Sustain Operations Through Transition
HICS needed to continue program development and operations through the transition period. The strategic plan included goals to retain staff, convene open and honest staff meetings, develop a written transition plan, provide regular communication updates, and explore subcontracting or temporary staffing as needed.
4. Support Existing Provider Organizations
The transition also affected provider organizations across the region. HICS identified the need to communicate regularly with providers about funding, billing, contracting, client transition concerns, and provider support needs. The plan also identified continued support for specific provider initiatives, including Inside Out Wellness & Advocacy, OPTIMAE, and Flowstate.
5. Prepare for Responsible Closeout
The strategic plan also recognized the possibility that HICS would need to close out regional responsibilities. This included coordinating transition activities with Iowa DHHS, supporting budget development, closing out provider contracts, outlining final invoice requirements, and developing a human resources plan for employees.
Key Project Activities
RPP supported HICS through a mix of facilitation, project management, analysis, and strategic consultation. The work included:
Strategic planning facilitation
RPP helped HICS leadership define goals, decision points, and timelines during a rapidly changing state policy environment.
Transition planning
RPP helped organize the practical steps needed to sustain operations, communicate with staff and providers, and prepare for possible closeout responsibilities.
System and service analysis
RPP supported review of current services, future service opportunities, provider capacity, and system needs.
ASO and future role assessment
RPP helped HICS think through whether and how it could participate in the future behavioral health system structure.
Provider support and communication planning
RPP helped HICS identify what providers needed during the transition, including information about contracting, funding, billing, client transition issues, and future service opportunities.
Policy and operational alignment
RPP’s scope included helping validate alignment with policies, rules, contracts, certification requirements, licensure expectations, and accreditation requirements.
“System redesign requires more than compliance with a new structure. It requires local leaders to make disciplined decisions while protecting access, relationships, and continuity of care.”
Outcomes and Impact
Strategic Transition Framework
RPP’s work gave HICS a structured roadmap for navigating a complicated statewide transition. The strategic plan clarified HICS’s immediate priorities and helped leadership organize decisions around ASO readiness, future service contracting, operational continuity, provider support, and organizational closeout planning.
Disciplined Decision-Making
The work helped HICS move from a reactive posture to a disciplined transition process. Rather than treating state redesign as a series of disconnected decisions, HICS had a framework for evaluating options, assigning priorities, communicating with stakeholders, and preparing for the future.
Mission-Aligned Leadership
Just as importantly, the planning process kept HICS’s mission and values at the center. HICS’s stated purpose emphasized access to high-quality care with no exceptions, while its guiding principles focused on improving health, increasing hope, building successful futures, and putting heart into the work.RPP helped translate those values into practical leadership action during a period of significant structural change.
Why Iowa’s Experience Matters
Behavioral health system redesign is not only a policy change. It is an operational, relational, and human transition. When governance structures change, local systems still have to function. Providers still need clarity. Staff still need communication. Individuals and families still need access to services.
The HICS project demonstrates the importance of structured transition planning during statewide system redesign. Regional behavioral health organizations often carry deep local knowledge, trusted relationships, and practical understanding of service gaps. When systems change, that knowledge must be organized, communicated, and carried forward.
RPP helped HICS do that work with clarity and discipline.
About Rural Policy Partners
Rural Policy Partners works alongside states, health systems, and community leaders to bring structure to complex behavioral health systems.
We specialize in:
- Cross-sector facilitation
- Rural system design
- Translating stakeholder input into actionable strategy
Our work is grounded in real-world conditions—where policy, operations, and community dynamics intersect.Through its work with Heart of Iowa Community Services, Rural Policy Partners helped a regional behavioral health organization navigate uncertainty with structure and clarity. The project reflects RPP’s core strength: helping rural and regional systems turn complex policy change into practical, organized, and mission-focused action.