The sobering and medical detox services at Iowa City’s GuideLink center have been a valuable resource for members of the community over the past five years, as the rate of overdoses has been increasing, but funding, staffing, and resource shortages are making it difficult for those in need to receive help.

Johnson County’s rising drug issues make GuideLink’s services useful for county residents. According to the District 7 Profile and Plan, a comprehensive summary of southeastern Iowa’s behavioral health, drug-involved overdoses  from 2018 to 2023 have been similar or higher than Iowa’s average, with the rates of these overdoses only increasing, ranging from 10 to 16 deaths per 100,000. 

Since opening, GuideLink has worked to combat this issue, but a lack of funding makes this difficult, representatives of the center said.

Tanya Havlik-Smith, the lead emergency medical technician at GuideLink, defined the sobering center as a place for people to come if they’re under the influence or wish to refrain from using substances before going to other substance use treatment facilities.

The Johnson County Board of Supervisors has been discussing the budget for Iowa City’s GuideLink Center at its past few meetings, where they reviewed an October 2025 invoice for Community and Family Resources for their medical detox and sobering services, which the board had been funding for a period of 120 days.

On Feb. 12, the supervisors approved a proposal to continue funding GuideLink and extend the billing process through June 2026.

Supervisor Rod Sullivan, who has been involved throughout the partnership with GuideLink, said the board has spent substantial time talking with Michelle De La Riva, Community and Family Resources’ executive director, and he is appreciative of the service’s willingness to lay out all the financial information.

Sullivan said since the early 1970s, Johnson County has always paid for the detox of people who are neither on private insurance nor Medicaid in other counties, and this has never changed. 

“Because of the lack of providers around the state, it’s probably ended up becoming more of a problem for us. Because of the old issues of legal settlement, we get people who come here to receive services,” Sullivan said.

Kristina Kron, the lead paramedic at GuideLink, estimated that around 25 to 35 percent of people utilizing GuideLink’s services come from outside of Johnson County, depending on the month.

Around a year before GuideLink opened, Sullivan and Vice Chair Lisa Green-Douglass had come up with an average number of $400,000, which they felt represented how much the county had already been spending on these services without GuideLink. Sullivan said that number is almost $500,000 now and is not an unreasonable increase.

“So it seems that we are continuing to pay for exactly what we’ve paid for for 50 years, but the difference is the sobering service,” Sullivan said.

Sullivan said services in Johnson County were introduced after GuideLink opened. Sobering services are not recognized as a billable service by the state and therefore receive no funding from the state, leaving the financial burden to the county.

Kron said this lack of state funding for sobering and detox services creates many issues for GuideLink, the greatest being staffing.

“We try to staff an assistant in there so we’re not by ourselves with anybody, but many times we have to operate on our own because we don’t have enough funding to have an assistant 24/7,” Kron said.

GuideLink uses staff from the Johnson County Ambulance Service, with four full-time employees on staff at all times. Kron said this can create challenges because GuideLink does not want overtime for these employees.

She said the paramedics and EMTs on staff are valuable because they can act as an emergency room diversion so they do not have to send every patient to the emergency room for minor complaints or first aid issues.

Kron said the lack of funding and staffing prevents them from taking in every person who needs help because they are capped based on the number of staff available. If they were to receive more funding, she said they would spend it on staffing so that they could take on more clients at a time.

GuideLink’s sobering and detox programs also offer many resources, such as snacks, electrolyte drinks, and toiletries for patients. Kron said these expenses are difficult to justify with no state funding coming in.

“The challenge would be finding those funds, whether that be through grants or just the generosity of Johnson County and the Board of Supervisors offering to fund those services,” Kron said.

Havlik-Smith said a lack of state funding puts the organization in a tough situation because they do not generate revenue. 

“The county sees us as an important service that they want to allow to all of the people of Johnson County and outside counties as well to come to, but it’s at a cost to them, which is not a cheap cost when you look at yearly wages, benefits, that kind of stuff,” she said.

Havlik-Smith said GuideLink is available to everyone, no matter what insurance or issues they might have, and is noninvasive.

“A lot of things that people hold really private are things that don’t necessarily matter in our situation because we’re not charging their insurance, and we’re not tying it to their medical record at the hospital,” she said.