When legislators redesigned the Mental Health and Disability Services (MH/DS) system last year, they knew they left alot undone. They set up a Transition Fund to help counties maintain services while the system is redesigned, but they didn't fund it. They created a new equalization formula to get money to the counties that don't raise enough money locally, but they didn't fund it. They required counties to regionalize, but they won't know what the regions will look like for two more months.
Over the last two weeks, several bills were introduced to start checking off that "to-do" list:
You have probably heard alot recently about the "transition" from the old (county-based) to the new (regional) mental health and disability services system. We are currently halfway through the "transition year" - the year when counties have only their local property tax dollars to pay for non-Medicaid services and the several months of Medicaid bills that were received after July 1, 2012.
For some counties, the transition year isn't a problem. They will have plenty of money to get through this year, and will start off on good footing next year. Others have just enough to get through this year, but won't have any money in the bank at the end of the year. Still others say they can't make it through this year without cuts to services. So the Legislature created a Transition Fund to help those counties that need assistance to make it through the transition. The trouble is, people have different thoughts on "need."
Some counties say they need enough to get through the first quarter of the year, until property taxes are paid in October. Legislators say that counties can just move money around and borrow from other funds until their property taxes come in. Either way, the Transition Fund was created to help 1) stabilize county services at current levels; and 2) start counties off on the right foot toward regionalizing.
While there has been a lot of talk about it, the Transition Fund debate has begun, and it got heated at the Capitol this week as legislators disagreed about the amount of money needed to help counties maintain services as the state begins to regionalize its non-Medicaid mental health and disability services system.
Last year, legislators reserved $20 million in federal funds for the Transition Fund, but didn't appropriate it because they wanted to see how much money was really needed by counties. DHS made three recommendations, but none used all of the $20 million. Here are the amounts that the various groups recommended for the Transition Fund:
|Transition Committee||$20 million||32 counties|
|Fiscal Viability Committee||$20 million||32 counties|
|MH/DS Commission||$20 million||32 counties|
|DHS (Option 1)||$11.6 million||26 counties|
|DHS (Option 2) & Governor||$3.8 million||11 counties|
|DHS (Option 3)||$1.5 million||3 counties|
The House Appropriations Committee took up (and eventually passed) House FIle 160, which would distribute $11.6 million to the following 26 counties to help maintain services as the system is redesigned:
Rep. Tyler Olson of Cedar Rapids also defended the $20 million amendment. "Most importantly, this (amendment) makes sure that hundreds and thousands of Iowans continue to receive the mental health services they need. There were a number of counties that applied for funds that were left out of this bill, and (the amendment) goes a long way to make sure the people in those counties continue to receive the services they need. I look at this amendment as the ability to continue services…without it we will see counties cutting services."
Legislators expect to debate House File 160 sometime early next week. When the bill comes up for discussion, we will put a note on our Facebook page, so make sure you have "liked" us and you'll get a notice. You can also listen and watch live debate from your computers at www.legis.iowa.gov.
The Iowa Legislature tabled discussion on two contraversial issues last year, but they are back again this year.
More than 50 organizations came together last week to urge the Iowa Legislature to take action and expand the state's Medicaid program as allowed under the Affordable Care Act. Federal health care reform gives states the option to cover more people using their Medicaid programs. Iowans earning up to 138% of the federal poverty level would be able to receive Medicaid services. Right now, you must have a disability, be elderly, or have a child in the home and earn less than 133% of the federal poverty level in order to qualify for Medicaid services. As an incentive to help states expand their Medicaid programs, the federal government will pay 100% of the costs for three years, then slowly lower the match rate until the federal government pays 90% and the state pays 10%. (Current Medicaid match in Iowa is roughly 40% state, 60% federal).
Governor Terry Branstad has said he will not consider a Medicaid expansion, because the federal government is not a dependable partner financially, and because Medicaid has done little to improve the health status of Iowans (so he would like to see signficant changes in how Medicaid delivers services, so that it focuses on outcomes as well as access).
The following groups have come out in support of a Medicaid expansion:
American Cancer Society Cancer Action Network
AFSCME Iowa Council 61
Alzheimer's Association of Greater Iowa
American Heart Association
AMOS (A Mid-Iowa Organizing Strategy)
Brain Injury Alliance of Iowa
CAFE Iowa CAN
CHAIN (Community HVI/Hepatitis Advocates of Iowa Network) Community Health Charities Iowa
Communications Workers of America Iowa State Council Easter Seals Iowa
Epilepsy Foundation of Iowa
Every Child Counts (Child and Family Policy Center Initiative) HCI Care Services (formerly Hospice of Central Iowa)
Family Planning Council of Iowa
Hospice & Palliative Care Association of Iowa
Iowa Alliance for Retired Americans
Iowa Alliance in Home Care
Iowa Annual Conference of the United Methodist Church
Iowa Association of Area Agencies on Aging
Iowa Care Givers Association
Iowa Catholic Conference
Iowa Citizen Action Network (ICAN)
Iowa Community Action Association
Iowa Developmental Disabilities Council
Iowa Federation of Labor, AFL-CIO
Iowa Hospital Association
Iowa Human Needs Advocates
Iowa Medical Society
Iowa Mental Health Planning Council
Iowa Nurses Association
Iowa Occupational Therapy Association
Iowa Olmstead Consumer Task Force
Iowa Public Health Association
Iowa Primary Care Association
Iowa Psychological Association
Iowa Statewide Independent Living Council
League of Women Voters of Iowa
Leukemia and Lymphoma Society, Iowa Chapter
Mercy Health Network
NAMI (National Alliance on Mental Illness) Greater Des Moines National Association of Social Workers, Iowa Chapter
National Multiple Sclerosis Society, Upper Midwest Chapter Polk County
Planned Parenthood of the Heartland
Progressive Action for the Common Good
Results (The Power to End Poverty)
South Central Iowa Federation of Labor, AFL-CIO
Visiting Nurse Services of Iowa
Two bills have been introduced to expand Medicaid - House File 83 and Senate File 71. The first subcommittee meeting on Senate File 71 will be on Monday, February 11 at 10 a.m. in Room 22 at the State Capitol. Sen. Pam Jochum is chairing the subcommittee, which also includes Sen. Jack Hatch of Des Moines and Sen. Nancy Boettger of Harlan.
Learn more about Medicaid Expansion in ID Action's upcoming "Perspectives in Policy." Let your legislators know what you think about expanding Medicaid using our Grassroots Action Center.
The Iowa Developmental Disabilities Council, ID Action and Polk County Health Services invite you to participate in Advocating for Change Day 2013.
Advocating for Change Day is a day specifically for Iowans affected by disability to become skilled at communicating with their legislators and other elected state officials. As a participant you will have the opportunity to learn how to develop and deliver an effective message, visit with available legislators and other elected officials and lobbyists, and watch the legislative process from the galleries (when the Senate and/or House are in session). The event is free, and a free lunch will be available for all registered participants.
Fill out the online form to get registered for the event. Register to attend by March 13, 2013 to guarantee your free lunch. You can register up to 30 people per form. If you need to register more please contact ID Action email@example.com or 866-432-2846.
infoNET has added a new tool to your advocacy toolbox - the Grassroots Advocacy Center. You do not need to know the names of your legislators, the Governor, or the people that represent you in the US Congress. If you know your address, our Grassroots Advocacy Center will match you to your elected officials, and automatically find their emails for you. All you need to do is write your message and hit "send." It's just that easy. So try it out - click here to get started.
If you need more help in crafting your message, make sure you check our new infoNET website for more information (www.infonetiowa.org) and ID Action's new Advocacy University website (www.advocacyuniversity.org). You will find lots of useful information and videos other advocates have made to help you get started.
Local advocacy is the best advocacy. Your legislators come home to their legislative districts on Fridays-Sundays during the legislative district, and many hold open public forums during that time. They call them by many names - public forums, town hall meetings, listening posts, Eggs & Issues, Pizza & Politics, legislative breakfasts, legislative forums. But they all give legislators a chance to talk to the people they represent, answer their questions, and hear their concerns. They are great and highly effective ways to advocate.