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BUDGET END GAME

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There is no other way to say it - the budget this year is painful.  Legislators had little choice but to make deep cuts to the state's budget. Early in session, they cut the current year budget by $130 million, but it wasn't enough.  Legislators borrowed $131.1 million from the state's "emergency fund" to fill the growing hole in March.  Leaders decided they needed to be careful in spending funds this year, just in case they end up in the same position next year.  The result is a bare bones budget with a lot of cuts, and a lot of pain to spread around.  

As a wise friend said to me, "Sometimes you measure success by what you didn't lose."  Only you can be the judge! 

  • No change in funding for rental assistance to help those that qualify for HCBS waiver services or Money Follows the Person to live in the community ($658,000).
     
  • Eliminates the funding for the Newsline for the Blind ($52,000) and cuts the Department for the Blind by another  $86,000.
     
  • Cuts vocational rehabilitation funding by $116,958 - because this is matched with federal dollars the actual cut totals almost $550,000.  These are funds that help Iowans with disabilities get or keep a job. 
     
  • Cuts the Entrepreneurs with Disabilities Program, Centers for Independent Living, and independent living services by 5%, and keeps funding the same ($130,000) for the Easter Seals' Farmers with Disabilities program.
     
  • Cuts funding for Aging and DIsability Resource Centers by 20% (leaving $750,000).
     
  • No change in funding for donated dental services to individuals with disabilities, audiological services for kids, youth suicide prevention, Adverse Childhood Experience (ACES) study, brain injury programs, epilepsy education, and regional autism assistance program.  There is no change in funding for the medical cannabidiol administration - but $22,000 won't be enough for the Department of Public Health to manage the newly expanded program.  
     
  • Increases Medicaid funding by only 1%, but includes $35 million of "cost containment" measures that will make changes in the way providers get reimbursed, which could impact access to services.  These changes include:
    • Eliminating some consultation codes physicians use ($500,000 savings).
    • Increasing use of pharmaceutical drug rebates ($1.2 million savings).
    • Reducing reimbursement significantly for services performed in a hospital that are more appropriately done in a medical clinic ($2 million savings).
    • Reducing anesthesiologist reimbursement, which is much higher than in other states ($3.1 million savings).
    • Paying primary care providers at normal rate, not the federally-required enhanced rate that expired several years ago (savings $5 million).
    • Limiting the extra payment to providers for people who are eligible for both Medicaid and Medicare (called "cross over claims" - saving $7.7 million).
    • Changing reimbursement to hospitals for high-cost cases (saving $10 million).
    • Limiting payment for some services that were incurred prior to applying for Medicaid ($4.3 million savings).
    • Finding another $1,908,857 in savings (called "perfomance improvement").
       
  • Adds $60,000 to the Family Support Subsidy/Child at Home program to keep up with demand.
     
  • Reduces funding to the State Treasurer for the ABLE Savings Account administration by $50,000 ($200,000 available next year for the program).