County opioid fund to be used for inmate rehabilitation

A proposed program will help give inmates the mental health support they need to rehabilitate back into normal life.

From a partnership between Union County law enforcement and Crossroads Behavioral Health Services, Union County will use opioid dollars to fund a jail-based treatment program. Union County Sheriff Brian Bolton said a major component of the program will extend outside of when individuals are released from jail.

“That’s what I like about Crossroads running something like this because it’s not just a service for when they’re in jail, it’s when they get out of jail too,” Bolton said. “They can continue to try to stay engaged with these people and try to keep them focused and directed so they don’t come back to jail, if possible.”

The program would cover any inmate who is referred to Crossroads either through a court order or a mental evaluation requested from the jail.

Representing Crossroads during Wednesday’s Union County board of supervisors meeting was Executive Director Brittany Palmer and Community Services Director Ashley Armstrong. For the program, Armstrong would take the role of care coordinator in the partnership.

Part of the program would also involve creating a county-based hotline for those in a mental health crisis. When someone is suffering from mental health issues and the call comes, there’s often no other option for them.

“[Law enforcement is] getting the crisis call because there’s nowhere else to call,” Armstrong said. “They might not be doing anything that they need to be charged with, they just need someone to deescalate them.”

Funding for the partnership will come from the county’s opioid settlement fund. The state of Iowa will receive, based on the state’s attorney general’s office, $325 million through fiscal year 2039 into the opioid settlement fund. This funding is required to be spent for opioid addiction treatment and prevention services.

The opioid funding is not funded through taxpayer dollars. If the opioid funding for Crossroads’ program runs out, the funding will not come from any other source. Bolton and Union County Auditor Sandy Hysell agreed the opioid dollars are restrictive on their use, making the rare program which fits criteria a priority to receive funding.

In 2022, the United States made settlements with drug manufacturers and pharmaceutical companies and has been sending funds to states across the nation since. After some discussion in Iowa, it took until this year’s legislative session to come to a decision, finally deciding how to spend a stockpile of $56 million the state has received in the past two years.

As a part of streamlining behavioral health in the state, seven districts were formed by Iowa HHS. Union County is a part of District 4, which also includes Shelby, Audubon, Guthrie, Pottawattamie, Cass, Adair, Mills, Montgomery, Adams, Fremont, Page, Taylor and Ringgold counties.

According to the Iowa Primary Care Association, District 4 ranks the highest in the state in suicide mortality and third in drug overdoses per 100,000 people.

A KFF analysis noted Iowa’s suicide rate was 17.5% of deaths per 100,000 in 2021 compared to the national rate of 14.1%. Drug overdoses were lower in Iowa, with 8.6% of deaths per 100,000 in 2021 compared to the national rate of 24.7%.

Nationally, 75% of females and 63% of male inmates in jail experience a mental health problem requiring mental health services in any given year according to statistics from the Bureau of Justice.

“Mental health continues to be a growing problem and nobody has an answer for it,” Bolton said. “It’s hard for our community. Jail is not a place for them to be. It’s difficult. ... What’s going on in their head, that’s their reality, and it’s a sad thing. That’s real to them. They have to live with that. Just trying to get them the help they need.”

With changes which come from larger restructuring to health services in Iowa, the Iowa PCA has pulled funding and models for their available jail-based treatment programs. To replace them, Crossroads has generated a new treatment program for use in Creston and Union County.

“I think the good thing is we’re trying to take the reins and keep something going in our area and strengthen it for service-based treatment we’re seeing in and out of our court system, in and out of jail,” Palmer said.

Crossroads’ program with Union County is the first attempt for the health service organization, but Palmer said she envisioned the “pilot” program building a hub for mental health in the area. In addition, a strong program could be used as an early example for the rest of the state.

Through the program’s facets, Crossroads hopes to cover multiple phases of mental health care, from the beginning with the crisis hotline, active care for those in jail and after release with continued support.

“If a community member or someone is dealing with a crisis, creating more awareness around that phone number and having someone available on the other end for that resident, that can potentially be an early intervention, prevention type of aspect of this whole picture,” Armstrong said. “They’re not necessarily taking up law enforcement time or being diverted somewhere when they need to be diverted to us.”

Union County has already received $100,663.86 in the county’s opioid fund and receives between $2,000-$12,000 per installment. Crossroads can use the fund for the program, billing the county through monthly invoices.

Bolton also proposed a sheriff app for Union County which would be paid with the county’s opioid funds. The app would have resources specifically for those suffering from addiction to be directed to services such as Crossroads. These resources will help meet the criteria for the opioid funding to be used according to Bolton.

In addition, information on weapons permits, tips for law enforcement, a sex offender map, inmate search and push notifications for local alerts such as tornado warnings are other facets of the proposed app. The app would work functionally similar to sheriff apps in Adams, Wayne and Ringgold counties.

The first year of operation for the app will cost $12,506, which includes the build cost. Each annual cost for maintenance after will cost $5,765.