A plan to merge the Iowa Departments of Public Health and Human Services could make it easier for clients to access programs and for the departments to share resources, officials said.

Both departments are helmed by Kelly Garcia, director of human services and interim director of public health. This week, she detailed the merger process so far at a meeting at the Statehouse of the Iowa House of Representatives Human Resources committee.

Garcia said the idea of the merger started with noticing the state’s two silos of behavioral health.

“I was working on, today, mental health and disability services under Department of Human Services, funneling to our work with the mental health regions. Over on the public health side sits substance abuse treatment,” she said. “In most states, we think about behavioral health — that’s the language they use — because most people who struggle with a substance abuse disorder also struggle with a mental health disorder or vice versa.”

Area providers, elected and public health officials regularly complain of the difficulties the separation causes.

“Having those two apart affects access to care at times and affects funding streams at times,” said John Bellini, chief business development officer with Hillcrest Family Services in Dubuque. “In the spirit of collaboration, we believe that this move makes sense. We believe this would make clients’ ability to access care simpler.”

But health officials have expressed concerns about what the merger could mean for local public health authority.

Dubuque County Board of Health members delayed beginning their search for a permanent successor to retired health department Director Patrice Lambert in part because of uncertainty around the merger changing the public health landscape.

After the committee meeting in Des Moines, Garcia told the TH that the merger should not impact county health departments’ authority or operations.

“It shouldn’t be something that adversely impacts because there is no change in the relationship other than to better support the work that they do, to have it more clearly focused, to make it easier to understand all of those entry points,” she said.

Iowa Rep. Shannon Lundgren, R-Peosta, serves on House Human Resources and supports the merger.

“It can be smaller and smarter,” she said. “Let’s make sure we’re not loading down on bureaucracy and red tape and staff and nobody gets the service.”

Iowa Rep. Lindsay James, D-Dubuque, said she supports getting away from silos in state government but had some reservations.

“My only concern would be that Public Health would lose prominence in the merger, which could have major negative impacts,” she said.

During her presentation, Garcia addressed that concern repeatedly.

“This is not DHS swallowing IDPH,” she said. “People are fearful of that because DHS is so big.”

Programs currently under IDPH would be led by a state medical director, for whom a search is underway.

If the Legislature approves the merger, the new Health and Human Services Department would be in place officially on July 1, with internal changes ongoing.

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