As you may have already realized, the Iowa Legislature did not end its 2014 legislative session before Easter. At the current time, it looks like lawmakers will continue their work at the Capitol for another two weeks. Legislators will stop getting reimbursed for expenses (meals, mileage, and hotel) on the 100th day, which is Tuesday (April 22). So they will be working without pay as they try to wrap up session.
Nearly all budgets are now in conference committee, where the final agreements will be made. Expect legislators to spend time in these conference committees next week, although most of the real work will happen privately between the House and Senate committee chairs. It is important to note that a conference committee report cannot be amended, so once the agreement is made, legislators can only vote yes or no. That saves time once these committees make decisions.
You will not see much floor debate in the Senate next week; at least two Democratic Senators will be gone for a day with family commitments (like taking kids on college campus visits and orientations). With a 26-24 split in the Senate, Democrats cannot spare one legislator, or they do not have the votes to pass bills. So look for conference committees to finish up their work this week, with the following week spent passing the conference committee reports and wrapping up work other bill work. By May Day, we should be done.
A conference committee is assigned when the House and Senate cannot agree on a bill. The Senate and House leaders assign five members each to this conference committee. So the House will assign three Republican Representatives, and two Democratic Representatives, and the Senate will assign three Democratic Senators, and two Republican Senators. That means there will be five Senators, five Representatives; five Republicans and five Democrats. So the decisions made by this conference committee will have to be bipartisan and acceptable to both chambers (House & Senate). The report issued by the conference committee, which outlines the compromise position, cannot be amended. If it is voted down, a second conference committee is assigned and the process starts all over, but that is very rare.
There are normally ten budget bills, but this year there is an additional one that legislators may use for some one-time spending for short term projects and to pay off some of the state’s bond debt. The “Standings” budget and this new “Standings II” budget are both catch-all bills where legislators throw things that they couldn’t get passed the traditional way, or issues that had a last-minute agreement. So if your legislator tells you its too late to do something – suggest throwing it in the Standings bill where everything is fair game!
Below is the current status of these eleven budget bills. Only two have been sent to the Governor; the rest are either in conference committee or on their way to conference committee.
The Health and Human Services Budget (House File 2463) passed out of the Senate Appropriations Committee late Thursday afternoon (April 17). The committee passed a 46-page amendment that shifted spending around while still staying within the $1.9 billion joint budget target. The House had proposed spending $2 million less than the target; the Senate spends every dime. Below we highlight some key areas of agreement – and disagreement.
|Medicaid Waiver Waiting Lists – funding is needed to reduce the current waiting lists for services under the Health and Disability Waiver (2,793), Physical Disabilities Waiver (2,239), Children’s Mental Health waiver (1,644), and Brain Injury Waiver (914). It is estimated that more than $8 million is needed to eliminate current waiver waiting lists.||$0||
|MH/DS Redesign/Equalization – This is the last year for equalization funding, so the Legislature needs to extend the funding formula by an additional year so counties/regions can finalize their budgets and management plans in March of 2015 (since the Legislature will not have time to act before that time). In addition, the Governor proposed the same amount of money for equalization as last year, but because of population growth, it needs to be increased to keep funding at the $47.28 per person formula (as the House and Senate do).|| $29,820,478
|Same as House.|
|MH/DS Redesign/Medicaid Offset: This is the “savings” that regions are to repay beginning this year for people who became eligible for the Iowa Health and Wellness Plan (IHWP). There is disagreement between House and Senate on how to calculate those savings, and when the offset should begin. Under current law, DHS is to calculate the savings based on enrollments in the Iowa Health and Wellness Plan from January to June of this year. That amount is to be doubled and then counties are to repay 80% of those “savings.” The county auditors are all allowed to review these offset calculations, but there is no process in place if there is a dispute. DHS calculations to date have included all services covered by the IHWP, and all people enrolled, whether or not they were ever served by the county and whether or not they received all the services prior to enrollment. Because of this, counties say these “savings” are too high and not true savings. DHS argues that costs avoided are also savings.||No Change.|| Counties to repay “savings” but calculations are based on actual savings – that is, people that were served by counties, that now have IHWP, and only for services in accordance with the management plan.
Fiscal agent of the region and state auditor review offset. Disputes settled by Administrative Law Judge (ALJ), but DHS Director can override that decision.
| Delays offset for another year; no change in how offset calculated.
Dispute resolution process same as House.
|MH/DS Redesign/Regions: Allows Marion and Mahaska Counties to be a two-county MH/DS region for one year (decision to do so is still left with DHS). This temporary authorization for a region can be extended for a second year, or can be made final if they meet the requirements of a region.||Not included.||Not included.||Included.|
|MH/DS Redesign/Resource Limits: DHS rules this year set resource limits that are far more restrictive than were used by counties prior to redesign. DHS used SSI resource limits, which counties used as a baseline for eligibility. That is, counties wouldn’t set limits lower than these but most had higher limits. The new DHS rules states that they are now the ceiling instead of the floor (that is, regions cannot serve anyone above them anymore). That means families with too many resources (i.e. two cars, some savings, etc.) May no longer be eligible to receive regional services.||No change.||No change.||Changes so it is clear regions can continue to set higher resource limits than in DHS rules.|
|MH/DS Redesign/Ending Fund Balances: This is how much regions are allowed to keep in the bank at the end of the year as an “ending fund balance.” These ending fund balances are used for cash flow purposes, so regions have enough money until property taxes are collected or state dollars are distributed.||No change.||Allows regions, counties to have a 25% ending fund balance, and money beyond that is to be used to meet core services and expand to core plus services.||Allows regions, counties to have an ending fund balance that is sufficient to pay for three months of services. Additional funding is to be used to meet core service and core plus services.|
|MH/DS Redesign/Mental Health Advocates: Last year the Governor vetoed a bill that moved the state’s mental health advocate to the Department of Inspections and Appeals. Currently these advocates assist a person that is going through court commitment processes, but there is no consistency in supervision, qualifications, or work activities. This move is meant to increase consistency, and ensure no conflicts of interest exist. The Redesign Committee recommended this change.||No change.||$250,000 to make advocates DIA employees.||Same as House.|
|Community Mental Health Center (CMHC) Funding: Allows CMHCs to choose to be reimbursed as they are or to use an alternative reimbursement model. Cost reporting can take up to three years before reimbursement is finalized, so CMHCs are waiting a long time for funding. This new reimbursement is cost neutral (so it doesn’t cost the state more) but CMHCs will be able to get funding quicker.||Not included.||Included.||Included.|
|HCBS Technical Assistance to help providers of habilitation services and HCBS waiver services working with adults with disabilities served by Medicaid.||$132,300||$132,300||$150,000|
|Bed Tracking Committee is established to implement a system where people can find psychiatric and substance abuse beds available throughout the state through a live, online system.||Not included.||Included.||Not included.|
|Study of Community-Based Service Options for Persons with Serious Mental Illness, to include a review of services currently available and services that should be developed, and barriers to maintain current community-based services option.||Not included.||Included.||Not included.|
|Start-up costs to implement the Medical Cannabidiol Act (medical marijuana) for can be used by people with seizure disorders.||$0||$0||$25,000|
|Office of Substitute Decision Maker – to help Iowans who are unable to make decisions about their health and finances, and have no other person to do so. This is viewed as important to addressing financial exploitation of vulnerable Iowans.||$0||$0||$325,000|
|Suicide Prevention & Trauma Coordinator to be established in the Department of Education to support school districts in implementing trauma-informed care models and suicide prevention protocols, including training of school personnel. No funds are appropriated, but the Department of Public Health and Department of Education are to use federal grant funds.||Not included.||Not included.||Included.|
There is still time to talk to your legislators about your budget priorities. Your legislators can be your advocate at the Capitol. While your legislator may not serve on the "right" committee for your issue, they still can talk to others that do.
Legislators will have to resolve their differences on budget issues like those above. If you prefer the way the House or Senate is tackling your issue, let your legislator know! Ask them to talk to their friends and colleagues on the conference committee. If they say its too late, ask them to consider fixing it in the Standings bill or any other bill still floating around. Now is the time to act – legislators will be done for the year very soon so call or email soon.
You can check out disability-related bills (including budget bills) that are still under consideration in the infoNET Bill Tracker. We update the status of these bills daily - sometimes more frequently - so check back often. As things move quickly in these final days of session, we will do our best to update descriptions of bills as they change and are amended.
Bills that are not longer eligible for debate have been moved to the "inactive" list. Bills that have been signed by the Governor remain in our "active" list, but work on them has been done and they are now (or will be soon) law.
Most legislators hold public forums and town hall meetings when they are back in their districts on Fridays and Saturdays. These are ways they keep in touch with their constituents. Some of them (like Council Bluffs) are so well-attended, they have been moved to larger venues. Others are small, with only a handful attending. But they are all excellent opportunities for you to meet your legislators, learn from them, and educate them on your priorities. Try one out - a full schedlue is available here.