Iowa’s already-struggling mental health care system has taken another hit , as Ellsworth Municipal Hospital (EMH) in Iowa Falls announced that, within the next two months, it would be closing its inpatient behavioral health service and its chemical dependency program. 

This was not an easy decision for EMH leaders to make.  Only a handful of mental health programs like these exist in Iowa and the services at EMH are heavily used by patients from all over the state.  In fact, only 15 percent of the hospital’s inpatient behavioral health patients come from Hardin County.  This is no surprise; after all, 83 of Iowa’s 99 counties are considered mental health professional shortage areas.  With only about seven practicing psychiatrists for every 100,000 residents, Iowa ranks 47^th in the nation for access to mental health care. 

In Iowa Falls, EMH has done all it could to keep its inpatient program functioning.  The hospital streamlined the program, reduced staff and discontinued its transportation program.  But because of lagging reimbursement, particularly from Medicare and Medicaid, the program has been a drain on overall hospital finances.  This is a problem for all Iowa hospitals offering behavioral health services, but the impact is much greater for small facilities like EMH, which do not have the patient volume to make up for the losses.  This is why only a handful of these small hospitals offer any kind of behavioral health program (inpatient or outpatient). 

The good news for people in and around centrally located Hardin County is that inpatient behavioral health services in Des Moines and Waterloo are relatively close by.  For much of the rest of Iowa, particularly in the western half of the state, the distances are much greater.

What needs to be done?  IHA is advocating for programs that would attract more psychiatrists to the state, such as student loan repayment programs.  Expanding telemedicine services through high-speed Internet would allow more patients to utilitize online counseling rather than having to travel to urban areas where behavioral health programs and practitioners are concentrated.  IHA has been steadfast in pushing to keep the state’s mental health institutes in Cherokee, Clarinda, Independence and Mount Pleasant open – Iowa needs more access to mental health services, not less. 

IHA also continuously advocates for increasing Medicare and Medicaid payments to hospitals and doctors.  Hospitals lose millions of dollars each year because these programs do not cover the full cost of care.