Iowa
Iowa reaches final settlement in lawsuit alleging state hasn’t provided adequate mental health care for kids
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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.
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Iowa
Iowa basketball vs. Northwestern is crucial step in Hawkeyes’ path to Big Ten Tournament
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Video: Fran McCaffery on why every team should make Big Ten Tournament
Fran McCaffery discusses a variety of topics ahead of Iowa’s matchup with Northwestern.
IOWA CITY — Iowa basketball’s season was in a dramatically different place the last time it faced off against Northwestern.
Their first meeting this season, which came back on Dec. 3, 2024, ended in theatrics. Down by two with less than one second remaining, Josh Dix’s long-range 3-pointer splashed through the net to deliver a dramatic victory.
With the win, Iowa improved to 7-1 on the season, including 1-0 in Big Ten play. There was still plenty of optimism surrounding what the Hawkeyes could accomplish. At least for one night, Iowa seemed like a team of destiny.
A lot has changed since then.
Iowa and Northwestern will play for the second time this season on Friday. This time, in Evanston, Illinois. The tenor of Iowa’s season is drastically different than it was after that December matchup.
The Hawkeyes (15-13, 6-11) have seen their season take a plunge. Since those back-to-back wins over Nebraska and Indiana, Iowa is just 3-9 over its last 12 games. Barring an improbable run, making the NCAA Tournament is not in the cards for the Hawkeyes.
The more relevant picture is that of the Big Ten Tournament. Friday’s matchup with Northwestern will be crucial to Iowa’s chances of making the event, which includes 15 of the league’s 18 teams.
Here is a look at the bottom of the Big Ten standings, as of Friday morning:
- Nebraska (7-10)
- Rutgers (7-11)
- Minnesota (6-11)
- Northwestern (6-11)
- USC (6-11)
- Iowa (6-11)
- Penn State (5-13)
- Washington (4-13)
Iowa is currently in a four-way tie with Minnesota, Northwestern and USC. But the Hawkeyes can gain some separation from the Wildcats with a win on Friday. If Iowa loses, it would face even more uncertainty.
After Friday’s contest, Iowa hosts Michigan State, who is in the race to win the Big Ten regular-season title. Then the Hawkeyes play at Nebraska, which doesn’t provide much hope, given Iowa’s shortcomings on the road.
That raises the stakes for Friday’s contest at Northwestern.
Scouting Northwestern basketball
Friday will be a clash between two depleted teams.
Iowa is without Owen Freeman for the rest of the season after the big man underwent finger surgery. Drew Thelwell has been in and out of the lineup recently due to an ankle injury, but Iowa coach Fran McCaffery said he expects Thelwell to play on Friday.
Northwestern hasn’t avoided an unfavorable injury situation, either. Brooks Barnhizer and Jalen Leach are both out for the season, both of whom were starters when healthy. Barnhizer was among the best players in the league, averaging 17.1 points, 8.8 rebounds and 4.2 assists per game. Meanwhile, Leach packed another scoring punch, averaging 14.3 points per game.
Despite the injury situation, Northwestern has actually found success recently. The Wildcats enter Friday’s matchup off back-to-back road wins, the first of which came in blowout fashion over Ohio State.
The Wildcats are spearheaded by leading scorer Nick Martinelli (20.1 points per game) and sharpshooter Ty Berry. But they’ve also gotten contributions from a supporting cast that includes emerging freshman K.J. Windham.
Northwestern features one of the better defenses in the league by points allowed per game, which could present a challenge for Iowa’s offense. Without Freeman, the Hawkeyes are even more reliant on Payton Sandfort and Dix to score. If they don’t play like stars, Iowa’s offense can suffer.
That was on display in Iowa’s 20-point loss to Illinois on Tuesday. Sandfort and Dix combined for just 18 points as the Hawkeyes scored a season-low 61 points. That came after Illinois had given up at least 95 points in each of its previous two contests.
Update on Owen Freeman’s injury recovery
Freeman is not playing for the remainder of the 2024-25 season. The big man will finish his sophomore campaign averaging 16.7 points, 6.7 rebounds and 1.8 blocks per game in 19 appearances.
After undergoing finger surgery in early February, Freeman is in recovery mode.
“He was actually shooting (Wednesday),” McCaffery said of Freeman. “So he was able to catch the ball, shoot the ball. It’s coming well. It’s one of those things where essentially it’s a 2-3 month rehab before you can go out and compete and risk somebody chopping your hand and getting similar situations to happen before it completely heals. But he’s progressing well.”
Iowa vs. Northwestern prediction
Friday is Iowa’s best opportunity to pick up a win for the remainder of the regular season, though KenPom only gives the Hawkeyes a 30% chance. The Michigan State and Nebraska games trail just behind. That’s pretty revealing about what Iowa faces the rest of the way. The Hawkeyes could really use a bounce-back performance from Sandfort on Friday, who was just 2-of-10 from the field against Illinois.
For a team whose resilience is one of its redeeming qualities, Friday should be another test to Iowa’s character with its Big Ten Tournament life hanging in the balance and considering the team’s road struggles this season. Sandfort described Iowa’s victory over Rutgers on Feb. 12 as a “culture win.” Friday has a chance to be another. Iowa 81, Northwestern 77.
Follow Tyler Tachman on X @Tyler_T15, contact via email at ttachman@gannett.com
Iowa
PODCAST: On a big-time win for Iowa women’s basketball, Ladell Betts’ departure
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Hear from Sydney Affolter after Iowa women’s basketball wins at Michigan
Hear from Sydney Affolter after Iowa women’s basketball wins at Michigan
The Register’s Chad Leistikow kicks off this Thursday Hawk Central Radio Hour with Dargan Southard, who was in Ann Arbor to cover the Hawkeye women’s 79-66 win at Michigan.
Chad does an audio version of his “five thoughts” column to underscore the importance of Wednesday’s W.
Later, Chad and Tyler Tachman discuss the big loss of Ladell Betts from Iowa’s football staff and the Iowa men’s basketball team’s Big Ten Tournament chances.
For a direct link to the podcast, click here.
Iowa
Iowa vs. Michigan women’s basketball: How to watch Big Ten showdown
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Why the women’s Texas Longhorns are the team to pay attention to
USA Today’s Jordan Mendoza gives his insight on why the Longhorns a dominate team to watch out for.
Sports Seriously
The Iowa Hawkeyes travel to Crisler Center to face the Michigan Wolverines in a must-watch Big Ten women’s basketball matchup on Wednesday night.
The Wolverines are celebrating a 78-68 victory over the Penn State Lady Lions, bouncing back from a tough loss to Maryland in their last game. Syla Swords delivered an impressive performance with 24 points and 6 rebounds, while Jordan Hobbs contributed significantly with 18 points and 4 rebounds, setting up an exciting matchup.
On the other hand, Iowa is in the midst of a challenging phase, grappling with a two-game losing streak after a heart-wrenching 67-65 loss to UCLA. Despite the defeat, Lucy Olsen shined with an impressive performance of 17 points and five rebounds. Hanna Stuelke also gave a valiant effort, with 11 points, eight rebounds, and two assists.
Here is how to watch the Big Ten showdown between Iowa and Michigan.
How to watch Iowa vs. Michigan women’s basketball
- Date: Wednesday, March 26
- Time: 7 p.m. ET
- Stream: Big Ten Plus
- Location: Crisler Center (Ann Arbor, MI)
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