Recently, Governor Branstad completed action on the 2016 session by signing the final bills from this year. This year the Governor signed all the bills that came across his desk. No bills were vetoed. The Governor did line-item veto a few things from budget bills. In Iowa, our Governor is allowed to veto parts of a budget bill, but sign the rest into law. The Governor vetoed:
It is important to note that the Governor line item vetoed language that required Managed Care Organizations (MCOs) to honor reimbursement methodology changes or rate increases for fee-for-service included in the budget. This does not affect the 1% increase in HCBS provider reimbursement (as we had previously reported). So the 1% HCBS provider rate increase will go into affect, and will apply to MCO contracts!
All other items noted in our End of Session report were signed into law, including:
Make sure you thank your legislators for their work this session, and ask them what their priorities are for next year. Make sure you share YOUR priorities with them as well. You never know what makes its way into law!
On June 7, the members of the Democratic Party and Republican Party picked who will represent them in Congress, at the State Capitol, and in local county courthouses. Unfortunately it appears that most of the voters' attention has been focused this year on the Presidential elections, and many Iowans forgot about these other important races on the June 7 Primary Election ballot.
Only one in ten registered voters exercised their right to vote on June 7 - the lowest turnout since 2004. According to Secretary of State Paul Pate's twitter feed, only 9.75% of registered Iowa voters exercised their civic duty and voted in the primary. We hope our readers all got out to the polls - because the results were close in some areas! Here's a quick recap of the primary results. You can see all results on the Secretary of State's website here.
Since Senators are elected to four-year terms, only half of the Iowa Senate is up for re-election this year. The 25 Senators representing even numbered Senate districts are up for re-election. No current State Senators faced primaries this year.
All of Iowa's 100 State Representatives are up for re-election this year.
The only thing you can predict about elections is that they are unpredictable. The Presidential election could have an impact on local races - will the candidates bring out new voters? will people stay home and not vote in protest of their party's Presidential candidate? will people vote a straight party-line ticket? will it be snowing on Election Day (November 8)? will a flu bug keep people home? There are many factors that could change this election. Remember, the last two can be addressed by early voting (either in-home by absentee ballot, or in your county auditor's office or another satellite voting location).
Watch for more information about voting in the coming months, and consider getting together with others in your area to host an ID Action Voter Training! Click here for more information about this.
Voting in Iowa is pretty easy. You just need to register to vote, and then choose how you want to vote (in person on election day, or early by absentee ballot, at a satellite voting site, or in your county auditor's office). While not advisable, you can register to vote at the polls if you have proof of who you are (photo ID) and where you live. What can be difficult though is finding out information on the people running for office. Becoming an informed voter can be really tough, even in this age where everything is online.
The best way to find out about candidates is to read the newspaper, watch debates, and simply meet the candidates yourself. You can also get information about them online - including their websites and their social media posts. If you want to find out more information about the legislative candidates, each caucus puts out their own candidate book. You can find information about:
We will post all legislative candidate bios on our website soon so you can find all the bios in one place - so check back at www.infonetiowa.org later this summer.
This year, the Iowa Legislature passed 141 bills, all of which were signed into law by the Governor. That may seem like a lot, but it's really not when you consider 1,204 bills were introduced this year. That means only 12% of the bills introduced this year became law. You can see that it takes a lot of advocacy to get the attention of legislators. Congrats to all of you that advocated this year, whether you were successful or are on your way to being successful!
HF588 - Removable Disability Parking Placards: Current law allows individuals with disabilities to get a removable windshield parking placard that does not expire. There has been reported misuse of these placards, as they are not always returned upon the person's death. To address this misuse, this bill eliminates non-expiring placards, and replaces them with a placard that expires every five years. The placard can be renewed as many times as needed. The bill also requires the removable windshield placard to be displayed so that the entire placard is visible through the vehicle's windshield. The bill applies to any new placards issued after 1/1/17 and does not impact existing non-expiring placards.
HF2394 - Insurance Bill: Requires small group and individual health insurance providers to put information on their website that can be used to compare policies, contracts, and plans, and coverage and premiums - and the information must be presented in a clear and understandable way. Applicable to plans offered/changed after 1/1/17.
HF2414 - Uber Rides: Creates new statewide rules for ride sharing companies such as Uber and Lyft. Establishes a new regulatory system requiring liability insurance for vehicles and background checks for drivers. Effective 1/1/17.
HF2454 - Agriculture/Natural Resources Budget: Maintains funding for the Farmers with Disabilities Program ($130,000). Effective 7/1/16.
HF2456 - MH/DS Regional System Extension: Continues current cap on MH/DS property taxes for another year (through June 30, 2017). Counties are currently allowed a per capita levy up to $47.28 or the total dollar cap in place since 1996, whichever is lowest. Without this legislation, the 45 counties that had been levying above $47.28 per capita prior to the redesign would have been allowed to raise property taxes. This keeps the property taxes in those 45 counties at or below $47.28 per capita for another year, but does not help the handful of counties struggling. Effective 7/1/16.
HF2459 - Standings Budget: Eliminates an unlimited appropriation for costs associated with the transfer of a nonresident person with a mental illness to a state hospital or to their place of residence (DHS will pay any expenses now - this hasn't been used since FY08). Establishes a new budget process for next year by requiring state agencies to include funding needed, supporting data, and explanations when they submit budget requests. Effective 7/1/16.
HF2460 - Health and Human Services Budget: In addition to the items highlighted in opening story above: Adds $1 million new appropriation for aging and disability resource centers (LifeLongLinks); increases the Office of Substitute Decision Maker by $61,334 ($350,000 total); and extends the date for statewide coverage for local substitute decision maker offices until 7/1/18 (was to be established by 7/1/17). Continues funding at current levels for direct care worker advisory council ($213,400), Iowa Caregivers Association contract ($216,375), and direct care giver education and training scholarships ($75,000). No change in funding for donated dental services for elderly or persons with disabilities ($74,640), hearing aids and audiological services for children ($162,768), youth suicide prevention ($50,000), ACES survey ($50,000), epilepsy education and support ($149,823), child health specialty clinics ($785,114), regional autism assistance program ($400,000), and Prevent Blindness Iowa vision screening ($100,000). Increases Medicaid by $15.1 million, for a total of $1.32 billion (1% increase). Requires DHS to report on the impact of changes in the HCBS waiver supported employment and prevocational services (due 12/15/16). Cuts $16.8 million for undefined "process improvement savings." Continues cost-based reimbursement option for community mental health centers that haven't changed to enhanced rate. Medicaid Managed Care Oversight: Requires DHS to submit a report to appropriate legislative committees on MCO consumer protections, outcome achievement, and program integrity; all information is to be posted publicly. Requires DHS Council, Medical Assistance Advisory Council (MAAC), hawk-I Board, MH/DS Commission, and Office of Long Term Care Ombudsman all regularly review and report on their Medicaid managed care duties (due 11/15 annually). DHS, MAAC, and hawk-I board are all to submit minutes to any meeting where Medicaid managed care is discussed (submitted on quarterly basis). Requires Medicaid MCOs to continue recipient benefits during an appeal process (they must notify the person in advance if benefits may be recoverable should the appeal fail), allow providers to appeal on behalf of a recipient; attempt to negotiate in good faith a single case agreement with a recipient's out-of-network provider (at request of Medicaid member), including an out-of-state provider, to provide for continuity of care when a recipient has an existing relationship with such a provider; requires the MCO to attempt to negotiate with an out of network provider for a single-case agreement, regardless of whether the recipient has an existing relationship with them, if an appropriate service provider is not in-network and the service is medically necessary. Continues the ten-legislator Health Policy Oversight Committee, which is to meet at least two times annually during the legislative interim to continue oversight of the Medicaid managed care system, ensure effective and efficient administration of the program, address stakeholder concerns, monitor program costs and expenditures, and make recommendations. States that the Office of the Long-Term Care Ombudsman is an independent agency, and allows state funds used to provide advocacy and assistance to people receiving Medicaid HCBS services can be matched with federal funds. Adds a public member as MAAC co-chair; makes the IDPH Director a non-voting member; requires appointment of ten voting public members (recipients, families, consumer organizations, to be appointed by 6/30/16); adds a hawk-I Board member as a voting member; and adds the state's long-term care ombudsman as a non-voting member. Continues the monthly statewide public meetings DHS is hosting on managed care that started in March 2016 through February 2017 (March-December 17 will be bimonthly). Adds occupational therapy to the list of required hawk-i services, and requires the hawk-I board to monitor capacity of MCOs to manage the unique needs of children. Juveniles/Child Welfare: No change in funding for community circles of care (NE Iowa, Polk County, Cerro Gordo & Linn Counties). Cuts funding for the Family Support Subsidy program by $4,650 (children aging out), but adds $86,000 to the Children at Home program so that it can expand to new service areas. Autism Services: No change in funding for the Autism Treatment Program ($2 million) but creates a separate fund so that unspent dollars can be retained, and earmarks $250,000 for a board-certified behavior analyst and assistant grants program, $25,000 for Four Oaks and $25,000 to a Dubuque provider. The grant program portion is expanded to any accredited university, community college, or private college in or outside of Iowa (but maintains priority for Iowa residents). Requires grant recipients to agree to practice in Iowa for a period of time (contracts can require up to four years of commitment) and agree to supervise others working toward certification. Caps grants at 50% of program tuition and fees, and requires report back annually on demand and recommended changes. Expands eligibility for the program itself from age 9 to age 14. Expands income eligibility from 400% to 500% of the federal poverty level (500% for a family of four is $121,500), and expands the maximum cost-sharing required from 10% to 15%. No change in funding for the Children's Mental Health Home Project ($50,000), contracts to implement standardized assessment tools for persons with MI/ID/DD ($3 million), and ABLE Account funding ($250,000).
SF2109 - Supplemental Appropriation-Medicaid: Adds $67 million to Medicaid for the current year (which ends 6/30/16). This, combined with $15 million in transfers included in the HHS Budget (HF 2460), make up the expected shortfall for the current fiscal year. Effective 5/27/16.
SF2144 - Mental Health Information Disclosure: Allows mental health and substance abuse information to be disclosed for patient care coordination, as long as it is consistent with federal law. This will allow mental health and substance abuse professionals and other health care providers to see an integrated patient record; only information about treatment, prescriptions, and diagnosis would be exchanged (so patient therapy notes continue to be confidential). Effective 4/6/16.
SF2188 - Psychologist Prescription Authority: Allows a doctorate-level psychologist who completes a post-doctorate master degree in clinical psychopharmacology, passes a national exam, and practices for two years under physician supervision to prescribe a limited list (about 100) of medications that are approved by the FDA for the treatment of mental health conditions. Prescribing psychologists are to have a collaborative practice agreement in place with a physician as a condition of licensure, and must consult a patient's primary care physician regularly. The Board of Medicine and the Board of Psychology are to develop joint rules related to the training requirements, and the structure of the collaborative practice agreements. Effective 7/1/16.
SF2260 - Medicaid Provider Information Disclosure: Federal law requires Medicaid agencies to collect information on each person who has an ownership or controlling interest in a Medicaid provider, including social security numbers. People serving on Medicaid provider boards fall under this requirement, even if they serve in a volunteer capacity. Information provided is checked against a national database to see if that person has committed Medicaid fraud in any other part of the country (which prohibits them from serving on a board receiving Medicaid funds). This bill prohibits Medicaid MCOs from collecting this information, and instead allows DHS to collect the necessary information. DHS can only redistribute the information to an MCO if it is explicitly required by federal law. Effective 4/13/16.
SF2314 - Administration/Regulation Budget: Small across-the-board cuts (.5%) to nearly all of this budget, including the Department of Human Rights' Offices on Persons with Disabilities and Deaf Services. Effective 7/1/16.
SF2323 - Education Budget: No change in funding for the Iowa Department for the Blind ($2.3 million) and Newsline for the Blind ($52,000); vocational rehabilitation ($5.9 million); independent living ($89,128); Entrepreneurs with Disabilities Program ($145,535); and Independent Living Center grants ($90,294). Effective 7/1/16.
SF2324 - Infrastructure Budget: Includes new $485,000 appropriation for the Homestead Autism Facility. No change in funding for public transit funding ($1.5 million). Effective 7/1/16.
SJR2006 - Special Education Rules: Nullifies an administrative rule adopted by the Board of Educational Examiners that establishes a special education endorsement and specializations. Effective 3/28/16.
HCR107 & SR114 - Cannabis Reclassification Resolution: Urges Congress and the President to reclassify cannabis as a schedule II controlled substance so that it can be prescribed for medical conditions, and research can be fast-tracked.
HF2039 - Disclosure of Mental Health Information: Requires a health care provider give an adult patient's immediate family information about involuntary commitment, if the family member asks and the patient is likely to seriously injure him/herself or commit suicide.
HF2087 - Medical Cannabis Act: Expands diagnosis for individuals allowed to use medical cannabis, allows all forms of medical cannabils (not just cannabidiol oil), and allows authorized individuals to purchase medical cannabis from authorized distributers in the state.
HF2091 - Public Accommodation Restroom Access: Makes the denial of access to a public accommodation restroom for persons with certain medical conditions a discriminatory practice under the Iowa Civil Rights Act of 1965.
HF2138 - AEA Dyslexia Specialists: Requires Area Education Agencies employ at least one dyslexia specialist beginning July 1, 2017.
HF2287 - Commission for the Blind Membership: Increases the number of members on the Commission for the Blind from 3 to 5, and requires that at least one member be blind, one be appointed by the National Federation of the Blind of Iowa, and another be appointed by Iowa Council of the United Blind.
HF2298 - Jail Diversion Program: Directs the Department of Human Rights to conduct a jail diversion study to reduce recidivism rates for nonviolent offenders with a mental illness.
HF2366 - Mental Health Advocate Duties: Makes changes to mental health advocate oversight by giving Judicial Branch authority to develop best practices and guidelines for advocate performance.
HF2384 - Medical Cannabidiol Act: Amends the Medical Cannabidiol Act by expanding Iowa's existing law to allow use for epilepsy, MS, and terminal cancer and allowing the manufacture and sale of the product through two in-state dispensaries.
HR114 - Online Voter Registration Resolution: Urges the State Voter Registration Commission to provide online voter registration to all qualified applicants (currently only allowed for those with driver's licenses or non-operator IDs).
SF2048 - Lottery Games to Benefit Persons with MS: Requires the Iowa Lottery to develop games whose proceeds benefit persons with multiple sclerosis.
SF2101 - Supported Employment Reimbursement Rates: Directs Medicaid to increase supported employment provider Medicaid rates by 20% beginning January 1, 2016.
SF2125 - Medicaid Managed Care Termination: Requires DHS terminate contracts with Managed Care Organizations.
SF2126 - Medicaid State Plan Amendments/Waivers Authorization: Requires all Medicaid state plan amendments and waivers be authorized first by the Legislature.
SF2213 & SF 2305 - Medicaid Managed Care Oversight & Program Improvement: Sets up structures to make sure there is good government oversight of the Medicaid managed care system, including enhancing the role of various advisory boards, appointment of an interagency program integrity work group, expansion of the role of the state's long-term care ombudsman, establishing a Medicaid Reinvestment Fund to pay to expand access and improve outcomes, and amending the Managed Care Organization (MCO) contracts to address concerns that have been raised. Some of this was in HF 2460.
SF2225 - High School Sports Concussions: Requires the home team at certain high school sporting events to have a health care professional present and available to assess athletic injuries.
SF2244 - Vehicle Registration Plates: Allows the authorized representative of an irrevocable trust to apply for special registration plates for vehicles on behalf of a person with a disability.
SF2254 - Autism Coverage/Insurance Mandate: Requires insurance plans pay for the screening, diagnosis, and treatment of autism spectrum disorders.
SF2318 - MH/DS County Levy : Sets a statewide standard ($47.28 per capita) property tax levy for mental health and disability services (MH/DS) beginning July 1, 2017. This allows all counties to levy up to $47.28 per capita - even those whose levies are frozen at a lower level. This allows counties to raise all funds needed for regional MH/DS services through property taxes - and no longer depend on state funding.
On May 18, the US Department of Labor (DOL) issued a new rule that gives nearly 4.2 million US workers new protections under the Fair Labor Standard Act. Currently salaried workers earning up to $26,660 a year ($455 per week) are entittled to overtime pay. The new rule, which will go into effect December 1, increases that wage threshtold to $47,476 ($913 per week). So anyone earning up to that new level after December 1, 2016, will be entitled to overtime pay. To avoid paying overtime, employers could raise salaries to that new level.
So who are these workers? More than half (56%) are women. More than half (53%) have a four-year degree, and nearly two-thirds (61%) are age 35 and older. They may also work for providers of direct services to Iowans with disabilites.
Along with the rule, DOL announced a non-enforcement policy for some employers. From December 1, 2016 to March 17, 2019, the Department will not enforce the updated salary threshold of $913 per week for some employers, and will instead conduct extensive outreach and technical assistance. It is important to note:
The non-enforcement timeframe is intended to align with the implementation timeline of the Home and Community Based Settings (HCBS) final rule, which will allow Medicaid HCBS providers to prepare for the implementation. DOL has prepared lots of information for people interested in finding out more, including employer guidance, fact sheets, frequently asked questions, help for non-profits, and much more here.
Thursday, June 16th is the last day Medicaid members can change their Medicaid managed care organization (MCO) for any reason. After that date you will have to show good cause to make a change. Call the Iowa HealthLink Member Call Center if you want to make the changes or have questions 1-800-338-8366 (515-256-4606 in Des Moines).
Now that the legislative session is over, there will be fewer public forums and town hall meetings with legislators. However, we will continue to track these opportunties, as well as meetings to discuss Medicaid managed care and other opportunities for public input. These are excellent opportunities for your voice to be heard. Click here to find a public forum, town hall meeting or other event near you.
Lots of people think you need to be able to give candidates money to go to their campaign events. This is simply not true. Candidates want to meet people, and earn their votes. Contact your local Republican and Democratic party chairs or the candidates themselves to find out when candidates will be having events in your area. Meet them - talk to them about your priorities - or just introduce yourself. If you like the person, and you like their answers, help them on their campaign. March in a parade, help with mailings, make phone calls, or go door-to-door. There are lots of opportunities - just let them know you want to help!