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HHS Budget Passes Senate

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The Senate passed a budget that spends $2.3 billion on various health and human services programs, including Medicaid.  That's an increase of about 10%.  Because the budget increase was larger than Senate Republicans wanted, they all voted against it.  So the vote was along party lines (26 Democrats voting for, 22 Republicans voting against with 2 Republicans absent).  Here are some of the highlights of the bill:

  • $333.4 million increase for Medicaid, including:
    • $11 million to eliminate or reduce Medicaid waiver waiting lists. 
    • 3% provider rate increase for Home and Community Based Services (HCBS) providers.
    • 1.5% provider rate increase for most other providers (targeted case managers and consumer directed attendant care providers are not included).
  • $3.3 million for a new autism support program to provide Applied Behavior Analysis and other treatment for children who do not qualify for Medicaid or private insurance autism coverage.
  • $400,000 increase for the Regional Autism Service Program to create autism support programs in Child Health Specialty Clinics.
  • $410,000 increase for brain injury services, including resource facilitators.
  • $50,000 increase for epilepsy education and support.

  • $55,000 increase for the Direct Care Worker Council and a new appropriation of $184,530 to establish a Board of Direct Care Professionals in the Department of Public Health.

  • $25,000 new appropriation for the Children's Mental Health Cabinet if established in the MH/DS Redesign Bill (SF 440).

  • $25,000 increase for the Prevention of Disabilities Council ($63,543 total).

  • $1.6 million increase each for Glenwood State Resource Center and Woodward State Resource Center (but this just replaces lost federal funds when the Medicaid match rate went down this year).

  • No change in funding for the following programs:
    • Audiological Services to Children ($162,768)
    • Youth Suicide Prevention Program ($50,000)
    • Childhood Lead Poisoning, which is a preventable cause of intellectual disabilities ($537,750)
    • Four Oaks Autism Spectum Services ($25,000)
    • Dubuque County Autism Spectrum Services ($25,000)
    • Polk County Systems of Care Program ($327,947)
    • Cerro Gordo and Linn County Systems of Care Programs ($160,000)
    • Connor Decree Training ($33,622)

Other changes include:

  • Implements the standardized assessment (Supports Intensity Scale) for persons on the Intellectual Disability (ID) waiver (estimated to save $8.5 million).
  • Requires the Department of Human Services to continue to administer the state Balancing Incentives Payment (BIP) Program, which requires the state to rebalance its long-term care system so that the state spends more money to support people in their own homes and communities, and less on nursing homes and other institutional care settings.
  • Renames the Ill and Handicapped Waiver to the Health and Disability Waiver (but doesn't change who is is eliglble).

  • Establishes in Iowa Code the Youth Suicide Prevention Program that requires teachers be certified in trauma informed care and suicide prevention, and the Applied Behavior Analysis Program for children with autism that do not qualify for Medicaid or have private insurance coverage.