Rebecca Peterson joined House of Mercy 10 years ago as a resident counselor, and after moving up through several supervisory and management positions she became director on March 5. As director, she oversees a 70-bed facility that provides safe housing and support services for women and their children dealing with mental health and substance abuse issues. She is a licensed mental health counselor and certified alcohol and drug counselor, and is currently working on her doctoral dissertation in educational leadership at Drake University. For the past five years, she has taught as an adjunct professor in Drake’s counseling department. Peterson is currently serving a second term on the state’s Mental Health and Disability Services Commission, where she advocates for improvements to mental health care in the state.

How do you describe House of Mercy? 
Our mission is to be a pre-eminent provider of health services — maybe what we’re best known for is our residential program for women and children. We currently have 70 beds for women, who can come with their children. We also provide long-term treatment, so women can stay up to two years here if they choose to and continue to make progress in their self-sufficiency and parenting skills. We offer substance abuse treatment, psychiatric services, parenting classes and self-sufficiency sessions, and we have an accredited day care on-site to really minimize the barriers to people getting the help they need. We also offer outpatient mental health services in Des Moines, Indianola and Newton, and we have outpatient substance abuse treatment at those locations. 

Are most of the clients covered under Medicaid? 
Yes, because of the population we serve, many have no or limited income. They are either on Medicaid or we assist them in getting signed up for Medicaid while they’re here. We also take private insurance and offer a sliding fee scale for the uninsured. We try not to make payment a barrier for people to get the help they need. 

Has your whole career been in counseling?  
No. After I finished my undergrad I moved to New York and worked for a state senator for about three years, and then I returned to Des Moines to work on a gubernatorial campaign. After that campaign, I switched my focus to counseling and got my master’s at Drake University in mental health counseling and started working at House of Mercy. 
Did your work in politics lead to your move to counseling? 
I wouldn’t say it was legislative or policy (driven). It was more working with the constituents. I did constituent services out in New York and had a lot of phone calls and meetings with constituents about a variety of things, and that just got me interested in helping people in a different way. 
What changes have you seen in your 10 years with House of Mercy? 
Changes related to HUD expectations are still some things that we are going through as far as expectations for our permanent housing program. (Under changes in the Housing First Act that went into effect earlier this year, House of Mercy can’t mandate that clients undergo treatment as a condition of staying in the housing program.) Also, a really big change that we had to go through was switching from Magellan to the three Medicaid managed care organizations. That’s been the biggest change since I’ve been in this field — trying to navigate all the change of three different companies having us do things differently, instead of having one streamlined system. They’ve increased our prior authorization (requirements). Previously we didn’t have to get prior authorization for every residential level of care; only the highest levels of care required authorization. Now we have to spend that much more time on the phone, trying to justify why these individuals need treatment. That’s been a huge change for the entire team.
Has that hurt House of Mercy financially? 
We’ve definitely been impacted by the delays in payment, by the struggles to get authorization. We’re not immune to the problems that everybody is having. What makes us different, I think, is that we’re blessed to have Mercy Medical Center that supports us, and our private donors that care about our mission so we can still stay strong in this type of environment. We’re also very adaptable; we are forward-thinking and look ahead to how we can work in the system we have. 

How much support have donors provided? 
We have a yearly gala; we raised $291,000, which is the most that we’ve raised in that fundraiser. I think that’s because we have gotten the word out that we do need more funding, and that the community support is vital for our organization. That’s something we’re really proud of. Mercy is also making up for the shortfalls. We have been owed anywhere from $300,000 to $500,000 (by the managed care organizations, or MCOs) in the course of the year that we are still waiting to get. 
What priorities do you have for the next year or two? 
Priorities for me are expanding our adult women and children’s programs. We’re going to be opening 10 additional beds July 1, and that is because of the incredible need. We maintained a waiting list of around 20 women this past year, and because it’s been so consistent we decided that as space became available we would expand by 10 beds. My next priority is what I call building a mental health unit. We do have mental health services on-site here, but I’m trying to raise funds to renovate another space on our grounds to really expand our mental health unit and be able to provide even more services to the community. 
Are you seeing any positives locally in mental health treatment? 
I think one positive is that there’s been a lot of discussion and legislation around the opioid epidemic. So I think that’s a positive anytime there is a crisis and we can come together as a community and say we’re not going to let this happen. And law enforcement, legislators coming together saying, what can we do? I think with the MCO changes also, people are coming together to make positive changes in the system. So when negatives happen it brings about ripples of a positive response. 
Tell me about your teaching experiences at Drake. 
About 2012 was when I first taught counseling diverse populations. I more recently taught a substance abuse disorder class last year. That is a great opportunity for House of Mercy as a provider to be able to teach new counselors what to expect in the real world when they get into counseling situations. It also keeps me up to date with the most recent research. We’re also going to be participating in a research project together. I recently got approved through both Mercy and Drake to do a study of women who are coming out of prison to House of Mercy, in which they will do some surveys so we can look at whether women coming out of prison have different treatment needs than women who have not been incarcerated. 
Have you decided what you’ll study for your Ph.D. dissertation? 
What I’m studying is so relevant to what’s been going on in Iowa right now, which is looking at child abuse and the way we currently handle those reports in Iowa. It’s looking at differential response, which is currently what happens if there is a report of child abuse. It either goes to a family assessment or a criminal investigation, depending on the severity. I think there are a lot of questions out there over whether we are keeping children safe, and I’m hopeful that through my research we’ll be able to have some more answers about that. 

Your favorite story about making a difference?  
I don’t have just one favorite story because so many resonate with me. But I think something that helps build empathy with people is the story of a woman who comes in to House of Mercy pregnant who now has a safe room, can put together the baby’s crib and get all the baby’s clothes together and really create a safe place not only for herself but for her new baby. And then being able to see that mom blossom as a mother, being able to help her with the struggles along the way. So somebody who went from being a homeless substance abuser to a mom who is working and has her own apartment. That’s small for you or me, but huge for that person and for her baby. 
What are your hobbies?  
I’m married and have a 5-year-old son, so my family keeps me pretty busy. I’m active in small group through Lutheran Church of Hope, so that’s an important part of my weekly schedule.