It’s been about one year since statewide changes caused a shift in how the local mental health region is run.

Administrator Alison Hauser and nine employees shared some of the successes with the Webster County Board of Supervisors on Tuesday, and they explained their specialized roles within the Western Quadrant of County Social Services.

CSS is the 22-county mental health region, which includes Webster County, formed in 2012 to administer mental health services by region instead of county by county.

The “pivot” came about one year ago; it aligned CSS into four quadrants after changes to Iowa Medicaid required changes in staffing at CSS.

The Western Quadrant team has reduced the amount of county dollars used for mental health and developmentally disabled services, Hauser said, by moving clients onto Medicaid-funded programs.

“We have been diligently working to integrate our more specialized roles and responsibilities with the standards set forth by Senate File 504,” Hauser said. “We started first within the Webster County Jail, by partnering with Community Health to assess and provide comprehensive mental and medical health.

“We have been active within the educational system by supporting students and families with community-based needs,” she said.

“We are continuing to work with the Emergency Department to assist with determining access to appropriate placements and services based on the individuals’ needs.”

Much of that jail partnership work is done by Jen Sheehan, justice coordinator.

“That entails making sure we’re breaking those silos between the county criminal justice system, the state criminal justice system, and county mental health systems,” Sheehan said. “We have historically done horrible at having two separate systems. Over and over in the last five years, that’s all that’s in the news is how broken the state mental health system is, and how people are in jails or prisons that shouldn’t be, that actually have mental health needs.”

The state passed a law a few years ago to increase cooperation, and it’s made a big difference, Sheehan said.

“Webster County has honestly been going really fantastic. Credit to your sheriff’s department, your jails, it’s been a lot more welcoming than other counties, per se,” she said. “Multiple agencies within the county have done a really good job collaborating with each other.”

Webster County Attorney Darren Driscoll said he’s heard “wonderful things” about what Sheehan is doing from the jail staff.

“Recently, we’ve had a number of cases where without these services in place, we’d have people sitting in jail that are just fine once they get the treatment they need,” Driscoll said.

“There’s a collaborative team on that issue called the Stepping Up program — law enforcement, jail, service providers, etc., working as a team. I’m going to start from our office being more involved in that, to try to keep mental health people in treatment, out of the jail.”

Stepping Up has led to better coordination between providers including Community and Family Resources, the UnityPoint Health — Berryhill Center and Fort Dodge Community Health, Sheehan said.

“We’ve literally had people diverted from going to jail, and being booked for disorderly conduct at the ER, or meeting them downstairs at the Law Enforcement Center, when Berryhill will arrive and say, ‘this is what I can do to help them,'” Sheehan said. “‘Please don’t take them upstairs. I’ve got this.'”

The program also helps people in jail, and in the Residential Correctional Facility, to stay out once they get out.

Community Health provides a great partnership, Sheehan said. The jail is equipped to do telehealth, but usually a doctor comes to meet with the client in jail in person.

“The awesome thing about that is, that’s a local provider,” she said. “They’re meeting that local doctor with the hope that they see her in jail, and then they can continue that relationship with her when they’re in the community.”

The supervisors also heard from Saundra Vorland, the ISTART program coordinator, who works with mental health and co-occurring disorders.

“We work closely with families, law enforcement, emergency departments, to try to figure out what challenges they’re struggling with, behaviorally,” Vorland said, “if there’s something in the environment we can change to make a person’s life better.”

They have an on-call system for individuals, who can call in and get help 24 hours a day.

• Tanya Martinson serves as the office manager and intake specialist and also provides information and referral to clients.

• Kathy Erickson is mental health advocate for multiple counties, and works with individuals who are under civil mental health commitment.

• Deborah Schemer, provides Medicaid targeted case management for individuals in the western and southern counties in the quadrant. Clients in certain Medicaid programs still require case management from CSS, while most clients now get case management from their managed care organizations.

• Brittany Baker works as the housing coordinator and service broker. She provides information and referral to individuals who need assistance accessing services.

• Sarah Feldman provides care coordination for the quadrant, helping to connecting individuals with mental illness, brain injury and other developmental disorders with services and supports.

• Dee Stern serves as the case management support specialist, and her duties include payroll, payee services, claims team, and information and referral.

• Lisa Leanhart serves as the support staff for mental health and jail applications and information and referral.

• Donna Nielsen and Savanah Trotter, who is part time, were not present to attend the board meeting. Nielsen serves the quadrant providing care coordination specializing in family support which includes the school systems.