Iowa
Iowa reaches final settlement in lawsuit alleging state hasn’t provided adequate mental health care for kids
Iowa’s youth struggle to find mental, behavioral health services
Rachel Callahan constantly hit roadblocks over several years as she worked to find mental health services for her son.
Iowa will take steps to ensure Medicaid-eligible children with mental illness diagnoses will receive the necessary mental and behavioral health care services as part of a recently announced settlement agreement.
The lawsuit, filed in early 2023 by Disability Rights Iowa and other national health and law advocacy organizations, accused Iowa of “longstanding failure” to provide Medicaid-eligible children with legally required and medically necessary mental and behavioral health services.
The suit was filed against Iowa Department of Health and Human Services Director Kelly Garcia.
The plaintiffs alleged that Iowa administers an inadequate mental health system, despite receiving federal funds for children’s mental health care. As a result, Medicaid-eligible children younger than 21 who require intensive home and community-based services face a high risk of being placed in institutions away from their families and communities, they argued.
More than 300,000 youth — or about three out of every eight Iowa youth under the age of 21 — are covered by Medicaid. Of that population, nearly 90,000 had a serious emotional disturbance in state fiscal year 2020, according to court records.
Advocates behind the lawsuit say the steps proposed by the state in the agreement present a “radical change” that will ultimately be a positive move for youth in Iowa who need mental and behavioral health services.
“That’s a lot of children that this is going to directly impact in terms of the services they’re able to receive, and change the trajectory of not only their immediate circumstances and immediate mental health needs, but also their long-term prospects,” Catherine Johnson, executive director of Disability Rights Iowa, told the Register.
A preliminary settlement was reached in December after more than a year of negotiation between the plaintiffs and the state health and human services agency. The judge issued preliminary approval of the agreement last week, and set a final approval hearing for early May.
What does this settlement mean?
To address the plaintiffs’ alleged shortfalls in behavioral health services for children, the state agreed to ensure key services are available statewide to Medicaid-eligible children with serious emotional disturbances. The state is required to complete this process by the end of 2032.
The settlement agreement includes a detailed implementation plan Iowa HHS, which has been dubbed by state officials as the Iowa REACH initiative.
The plan includes specific steps the state will take to develop and deliver intensive home and community-based mental health services to children statewide when deemed medically necessary, and will be lead by a team from across the agency who will be responsible for overseeing the plan.
The agreement, along with the state’s REACH strategy, signals “a major step in the right direction for Iowa youth and their families,” Garcia said in a statement Wednesday.
“Iowa HHS is fully committed to implementing new strategies and evaluating current outcomes to ensure we are meeting the needs that our children and youth deserve and families expect,” she said.
Johnson praised the significant work to develop the settlement agreement, noting that the plan laid out by the state would create major structural change to Iowa’s current mental and behavioral health system for youth. Because of this plan, she said youth will be able to stay with their families in their community, receiving the services and supports they need to succeed.
“They get to go to school with their friends and they don’t have to go to an institution or a hospital that’s scary and they don’t know anyone,” Johnson said. “They get to stay with the people that love them, and grow up with mental health services in place. Your future is different, perhaps, than it might have been without this brand new structure.
“I think it’s just very, very significant, and I’m really excited for the implementation to begin so that Iowa can have these services in place as soon as possible for our kids.”
What are the terms of the settlement?
Among the terms of the settlement, the state must ensure Medicaid-eligible children receive mental health services “in the most integrated setting appropriate to their needs and are free from serious risks of segregation and institutionalization, including the unnecessary use of out-of-home placements.”
These changes must ensure Iowa youth receive the supports necessary to maximize their success growing into healthy and independent adults, the settlement agreement states.
To reach that goal, the state must develop and implement certain relevant services, which include intensive care coordination. This is a “single point of accountability” for ensuring medically necessary Medicaid services are coordinated and delivered appropriately to Iowa youth, according to the settlement agreement.
State officials also agreed to provide intensive in-home and community therapeutic services, with the goal to “maximize the child’s ability to live and participate in the community and to function independently.” That includes individual and family therapy.
The state must also boost its 24/7 mobile crisis intervention and stabilization services for young Iowans as part of this settlement agreement.
To support their effort, state officials say they will utilize additional Medicaid services to support children with serious emotional disturbances and “to help maintain them in their homes and communities and avoid higher levels of care and out-of-home placements.”
These additional services include respite care or other supports meant to help children build skills and help the family’s ability to successfully care for the child at home.
However, state officials warn that while it can request funding from state lawmakers for these initiatives, the settlement ultimately does not have authority over the Iowa Legislature.
Both parties also agreed to an independent monitor tasked with evaluating the state’s progress in implementing the proposed plan. The monitor — which will be a third-party selected at a later date — will issue reports on the state’s effort each year, per the settlement agreement.
Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com or at (319) 339-7354.
Iowa
New Iowa program aims to remove barriers to family support
Thrive Iowa launches in Warren County and across the state
The new program aims to reduce barriers to families seeking help from local organizations.
Thrive Iowa, a new initiative from the Iowa Department of Health and Human Services, has officially launched in a number of counties across the state with the goal of helping struggling Iowa families connect with local resources and build a network of support in their community.
On June 23, Warren County celebrated its own program site launch as one of eight initial sites. Other counties that are celebrating their own site launches are Cass, Lee, Black Hawk, Webster, Buena Vista, Fayette and Clayton. A site is officially launched once it has enrolled a minimum of 20 participants, Iowa HHS Director of Communications Danielle Sample said in a statement.
The eight sites serve 11 counties in total, with services also available in Henry, Madison, and Van Buren counties, according to the Thrive Iowa website.
What is Thrive Iowa?
The initiative is focused on serving families, such as parents, caretakers, and pregnant individuals, according to the program’s website. To be eligible to receive help from the program, families must be living in Iowa, be a U.S. citizen or legal resident, and have an income at or below 200% of the federal poverty level.
The 2026 federal guidelines consider a family of four to be at the 200% threshold if they make $66,000 or less annually.
The program also outlines 13 core areas of well-being where it offers support. These include housing, recovery, employment, transportation, education, mental health, physical health, safety, dental, financial stability, food, child care and legal assistance.
The overall goal of the program is to reduce barriers to accessing support for families by doing the work of finding the right organization to meet their needs for them. Instead of having to reach out to multiple sources, a family can visit the program’s HopeHub, a case management system, to create a free account and receive a referral. Once referred, the individual is connected with a Thrive Navigator who will create a personalized plan and build local connections to assist the family.
Thrive Iowa is modeled after Restore Hope, an Arkansas-based nonprofit that began in 2015 to reduce the number of individuals in incarceration and the foster care system through community-based approaches. In addition to Iowa, this model is also used in Tennessee and Canada, according to the organization’s website.
The Iowa program plans to expand to other counties in the near future, Sample said. In July, Iowa HHS will begin onboarding more participating organizations and counties, expanding the program to serve 22 counties.
Warren County launch pledges to take families from crisis to careers
At the Warren County launch, the county’s initiative coordinator, Sarah Downard, was joined by Iowa State Rep. Brooke Boden, Ben Segebart, senior pastor at Indianola Freedom Fellowship Church, Sue Wilson, executive director of WeLIFT Job Search Center in Indianola, and Paul Chapman, executive director of Restore Hope.
Downard said the Warren County site is currently serving over 20 families.
To a room of around 75 community members and local organizations at The Hive event venue in Indianola, the five speakers emphasized the importance of the mission behind Thrive Iowa, which is collective impact and helping build strong communities through supporting the families that live there.
The group also invited the whole room to sign the site’s declaration of participation in the program, which stated the goals of the program and a pledge to work together to help take families from crisis to career.
“When families are struggling, we feel the impact everywhere,” Boden said. “We see this in our schools, our health care systems, our workplace, and our communities.”
Isabelle Foland is a communities reporter for the Register. Reach her at ifoland@registermedia.com.
Iowa
Iowa one of nine states that won’t have to match portion of federal SNAP benefits
CEDAR RAPIDS, Iowa (Iowa Capital Dispatch) – The majority of U.S. states will soon have to pay 5% to 15% of federal nutrition assistance benefits in their state, according to the U.S. Department of Agriculture’s release Wednesday of Supplemental Nutrition Assistance Program payment error rates.
House Resolution 1, commonly known as the One Big Beautiful Bill Act that was enacted in 2025, stipulated that states with SNAP payment error rates greater than 6% would be required to foot 5%, 10% or 15% of SNAP benefits costs in their state.
Iowa, with a payment error rate of 5.34% in 2025, is just one of nine states with an error rate below 6% and that won’t have to match a portion of the SNAP benefits it pays out, starting in October 2027.
According to USDA, SNAP payment error rates measure the accuracy of states in determining who is eligible for SNAP and how much they receive. The rate is calculated via a series of reviews from state and federal agencies where instances of overpayments and underpayments are identified.
USDA’s SNAP quality control page says errors are “largely unintentional” and might be the fault of a state agency or a SNAP household.
Eighteen states had payment error rates above the national average of 10.62%. Per the quality control process, these states will have to either pay USDA a determined amount, or invest 50% of that amount into activities that will fix the root causes of the payment errors.
USDA said that while the 2025 average payment error rate is a “modest” decrease from the 2024 average error rate of 10.93%, it represents $10.1 billion in improper payments.
Secretary of Agriculture Brooke Rollins said the latest payment error rates show that “state accountability is severely lacking” in SNAP.
“USDA has taken historic action to help interested states curb SNAP waste, and I hope other states, regardless of political leadership, prioritize needy families and the American taxpayer over politics,” Rollins said in a news release.
An analysis of H.R. 1 from the Congressional Budget Office estimated that the law, which included several changes to SNAP benefits in addition to the error rate cost share, would reduce federal spending on the SNAP benefits by $255 billion between 2025 and 2034. CBO also estimated that state spending on SNAP benefits would increase during the same period by $85 billion.
Critics of the bill said the cost shift to states would endanger the SNAP program and stress state budgets.
According to the 2025 error rates from USDA, 41 states had payment error rates above the 6% threshold set by the 2025 law. South Dakota had the lowest error rate at 2.47%. Idaho, Kentucky, Nebraska, Utah, Vermont, Wisconsin and Wyoming were the other states with rates below 6%. Alaska had the highest error rate of 23.15%.
The higher the error rate, the greater the share, up to 15%, the state will have to pay of its SNAP benefits, which are otherwise 100% footed by the federal government.
In addition to the cost share, states with a payment error rate in excess of 6% are required to submit a corrective action plan to the Food and Nutrition Administration, formerly known as the Food and Nutrition Service, to explain the root cause of the payment errors and how the state plans to correct the errors.
Copyright 2026 KCRG. All rights reserved.
Iowa
Dima Petrov Dishes On Iowa Offer – Hawk Fanatic
Sometimes you see something you like and go right after it. That was the case with Iowa when it watched Dima Petrov kick a football last week. The Hawkeyes offered a full-ride scholarship to the specialist.
While the days of top kickers and punters walking on in hopes of maybe earning a scholarship when they were upperclassmen are gone, a junior picking up a scholarship is still uncommon. Iowa doing it gives it a leg up on whatever the competition might end up being.
“Iowa is definitely my No. 1 school at the moment,” he said. “Although it’s too early for me to make any big decisions, the likelihood of me becoming a Hawkeye is very high.”
Petrov (6-2, 190) also worked out for Wake Forest and UConn this month. The Hanover (N.H.) High all-stater was invited to camp at Virginia Tech, Arizona, Michigan State, Florida State and others. Interest in him is on the rise.
“Right now, it’s too early for me to make any big decisions. My plan is to commit in the next year or so, as soon as I’m 100 percent certain that I’ve found the right place. A lot of factors go into that, with the most significant one being education,” he said.
Petrov plans on majoring in Business. Iowa has a good one in the Tippie Business School.
“That was what my parents studied and then built their careers in, and I see my future in that same sphere,” he said.
The Hawkeyes did well in impressing a prospect visiting a state half a country away from his home.
“I had a fantastic time exploring all the incredible facilities and campus. Coach (Chris) Polizzi and the rest of the Hawkeyes’ special teams staff were absolutely amazing and made the visit unforgettable. I also loved how proud and passionate the whole city seemed about the program, which is something that you don’t see often.”
Access to advanced technology at Iowa also stood out.
“The workout with the Trackman system helped me identify other areas for improvement in my kicking by providing precise numbers,” he said.
After leaving Iowa, Petrov was invited to the Chris Sailer Kicking Showcase on Sunday. Following his performance, he’s now the second-ranked kicker nationally in the 2028 Class. Perhaps more offers will be on the way.
For now, the Hawkeyes are the leaders in the clubhouse. Petrov is looking forward to visiting them again.
“I can’t wait to come back to Iowa, hopefully very soon. I’d love to go on a game-day visit and see how electric Kinnick (Stadium) gets. Although I don’t know the exact dates yet, my plan is to be back there in the next few months,” he said.
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