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INFONET 2020 Issue #1

Issue 1, January 24, 2020

Articles in This Issue:


GOVERNOR ANNOUNCES PLAN TO FUND MH/DS SERVICES

The Iowa Legislature came back into session on January 13 and is off to a fast start.  Already days are filled with subcommittee meetings, which probably means leaders will be trying hard to make the most of the 100 days that make up the 2020 legislative session.

Governor Kim Reynolds laid out her vision and budget for the coming year in her “Condition of the State” speech on January 14.  Her major new initiative, Invest in Iowa, uses a one-cent sales tax to clean up our waterways, expand funding for “quality of life” projects like trails and parks, lower property taxes and income taxes, and adding more state dollars to the mental health and disability services regional system.  She also renewed her commitment to workforce recruitment and expanding career options for Iowans, including expanding access to affordable childcare options for more Iowa families. 

Over the last two years, the Governor and Legislature have added 27 new services to the regional Mental Health and Disabilities Service system, including new services for adults with complex needs and an array of services for children.  The result was a comprehensive, uniform set of services available to Iowans no matter where they live, no matter what their age.  Missing was a plan to pay for these new services, and the base services available before the expansion.  Legislators do not like to raise property taxes, which the system has relied on for decades. However, they have not wanted to take money away from other programs to fully fund the system.  It was clear to everyone that new money needed to be found to pay for these services.  Here is how the Governor’s plan will work: 

  • Counties will be able to collect $12.50 per person living in the county from property taxes.  That’s what is called a “per capita” levy. Right now, counties collect between $25 and $47.28 per capita, so this is a significant cut in property taxes (about $77 million). The $12.50 per capita tax will bring in about $40 million to the system.

  • The State will give the MH/DS Regions $80 million of the money collected from the new sales tax.  This would be distributed by population, so regions would receive about $25.43 per person (per capita).  The Governor plans to increase this base amount by $15 million over the next two years ($10 million more in 2022, $5 million more in 2023) to help pay for the new services that must be started in those years.

  • Regions are currently spending $112 million on services. This plan will bring in about $40 million in local property taxes and $80 million in state funds, for a total of $120 million. That amount increases to $130 million next year, and $135 million the following year.

While this sounds promising, regions are currently in the process of looking at how this will impact their bottom lines.  There is some concern that it may not be enough money and that regions would be more dependent on state dollars that are not predictable.  There is also concern that the state putting more money into the system would mean the state (not local leaders) would make all the decisions.  So the good news is the Governor has put out a plan to fund services, and has recognized this as a priority.  

Now legislators will need to review this plan and make adjustments to make sure the system is fully funded, and that the funding is reliable and sustainable.   It is clear that the Governor’s proposal is the starting point, so it is important that advocates, regions, providers, and others impacted by the MH/DS regional system contact their legislators to let them know how important it is to fund the system, whether it’s the way the Governor laid out or another solution.  The important thing is to find a solution this year.

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IOWA CAUCUSES ARE JUST DAYS AWAY!

Are you a person with a disability? Are you planning to attend the caucuses on February 3, 2020? Make sure you use our caucus materials to help you prepare:

 

We also want to hear (and publish) your caucus story. If you are interested in sharing your story of the Iowa caucuses, your experience, or just photos of you at the caucus, email us at infonetiowa@gmail.com.  

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GOVERNOR'S BUDGET HIGHLIGHTS

It is important to note that the Governor’s budget increases depend on the new funding coming in from the sales tax. If that does not happen, the increased funding in her budget could be in trouble.

  • $78.3 million increase for Medicaid, for total spending of $1.9 billion. It appears this funding level will underfund service by over $100 million, which means that legislators will have to come back next year and add money to the budget.  They do this every year – it’s hard to guess how much more money MCOs will need, how many more people will be eligible for services, and how much those services will end up costing.  This increase does include:  
     
    • $3.3 million increase for Home and Community Based Services (HCBS) provider rates.
    • $6 million increase for substance use disorder provider outpatient and residential rates.
    • $5 million increase for Medicaid telehealth services.
    • No money was included for any new MCO contract raises.
       
  • $330,000 additional funding for current year to help address issues at Glenwood State Resource Center, which is under investigation by the federal Department of Justice for treatment of residents there. 
     
  • $900,000 increase to train teachers to identify students that may be experience a mental health condition and understand what to do next ($3 million total).
     
  • $82,000 increase for vocational rehabilitation for increases in salaries, but no changes in funding for Independent Living Center grants, independent living services, and the Entrepreneurs with Disabilities program.

You can read the Governor’s message to lawmakers here, and her budget documents here.  The non-partisan Legislative Services Agency has prepared their own review of her budget here and a detailed view of her health/human services budget (including Medicaid) here.  Other parts of the budget can be found here.

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FIRST DEADLINE PASSES AT END OF WEEK 2

Legislators just started session, but already one deadline has passed.  January 24 was the last day for a legislator to request a bill.  Committee chairs can still request “study bills,” but legislators who wanted to sponsor a bill needed to get their request in by the end of the second week.  There are a few other deadlines coming up to get on your calendars: 

  • Friday, February 21 is the first “funnel” deadline.  Bills need to be voted out of committee to stay alive.  That means House bills must be voted out of their assigned House committee, and Senate bills out of a Senate committee.  Bills that involve a tax or spending are exempt from the deadline – and can be debated at any time during the session.

  • Friday, March 20 is the second and final “funnel” deadline.  By this date, a bill must have passed one chamber (House or Senate) and have made it out of committee in the opposite chamber.  So House bills need to be voted out of Senate committees, and Senate bills out of House committees.  Any that don’t make this deadline will no longer be discussed.

Legislators are working hard to keep up the pace so they can end on time, on or around April 21, 2020.  Doing so with a major tax plan on the table may be pretty difficult, so advocates may not want to wait too long to let their legislators know which issues are important to you this year.  You can contact your legislators at: http://www.infonetiowa.org/take-action/

 

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SEVERAL BILLS TO WATCH

We update our Bill Tracker daily, so you can keep track of new bills introduced between issues of INFONET easily at www.infonetiowa.org/news/bill-tracker/. Here are a few new bills that were introduced in the first two weeks that may be of interest to you.   

  • HF 2007 - This bill requires Medicaid to contract with an independent third party to administer intensity scale assessments.  (Status: House Human Resources Committee)
     
  • HF 2030 – This bill requires DHS to verify a person’s income eligibility four times a year to make sure they remain eligible for public assistance, including Medicaid, childcare, food assistance, and the family investment program. (Status: House Human Resources Committee)
     
  • HF 2038 - This bill allows drivers with light sensitivity to operate a vehicle with excessively dark tinted windows. (Status: House Transportation Committee)
     
  • HF 2049 & HF 2090 – This bill requires school districts to adopt protocols for children's mental health supports based on nationally recognized practices for all grade levels. (Status: House Education Committee)
     
  • HF 2073 – This bill requires Medicaid to apply for a new waiver to allow coverage for services provided in Institutions for Mental Disease (IMD) for persons with serious mental illness and serious emotional disorders as a part of the continuum of care and an integrated behavioral health care delivery model. Currently IMDs are 100% state funded; this would allow for federal match, saving state dollars.  (Status: House Human Resources Committee)
     
  • HF 2097 – This bill requires the Department of Transportation to install and maintain adult changing stations at some highway rest areas.  (Status: House Transportation Committee)
     
  • HF 2107 – This bill allows a parent or stepparent of a Medicaid member under the age of 18 to provide and be reimbursed for consumer directed attendant care (CDAC) services.   (Status: House Human Resources Committee)
     
  • HF 2108 – This bill requires Medicaid to pay the daily rate for supported community living services provided to adult Medicaid members living in the home of their family, foster family, or guardian.   (Status: House Human Resources Committee)
     
  • HF 2117 – The bill sets up a committee to develop a phased-in plan for a statewide centralized database of direct care workers, with recommendations due by June 30, 2021.  The Iowa Developmental Disabilities Council is one of the members of the work group. (Status: House Human Resources Committee)
     
  • HSB 501 - This bill caps insurance copays for insulin prescriptions and requires insurance companies use same copay structure that they do with other medications.  (Status: Passed House Human Resources Committee and is now on the House Floor ready for debate).

  • HSB 531 - This bill changes the behavior analyst grant program to a program that provides stipends for behavior analysts after providing services in Iowa for at least six months.  (Status: House Human Resources Committee)

  • SF 2003 - This bill requires prosthetic device replacement be covered under the workers' compensation program. (Status: Senate Commerce Committee)

  • SF 2017 – This bill requires Medicaid to create and maintain a list of Consumer Directed Attendant Care (CDAC) and Community Choice Option (CCO) providers, so that Medicaid members know who provides these services in their area.  (Status: Senate Human Resources Committee)

  • SF 2051 – This bill allows some commercial buildings to not have elevators (only if the commercial space is on the ground floor and apartments are on the upper floors).  (Status: Senate Local Government Committee)

  • SF 2056 - This bill requires schools that have an enrolled student with epilepsy or seizure disorder to have an individual health plan and a seizure action plan. Beginning July 1, 2020, at least one staff member at the school must be trained to recognize the signs and symptoms of seizures and be prepared to take appropriate action as outlined in the plan.  (Status: Senate Education Committee)

  • SF 2064 - This bill prohibits insurance plans from considering preexisting conditions when deciding whether to cover a person and does not allow them to charge more for insurance because of a pre-existing condition.  This is a part of the federal Affordable Care Act protections, but legislators want to do this in case the federal law is ruled unconstitutional by the courts.  This bill has more extensive coverage than a similar bill, SSB 3033. (Status: Senate Commerce Committee)

  • SF 2067 - This bill requires all public and private schools to excuse students who are unable to come to school because of mental health reasons.  (Status: Senate Education Committee)

  • SF 2070 - This bill allows funds from a medical assistance special needs trust or supplemental needs trust to be transferred to an Iowa ABLE savings plan trust account.  Makes ABLE savings plant exempt from Medicaid recovery. (Status: Senate State Government Committee)

  • SF 2076 - This bill increases the personal needs allowance for Medicaid members living in nursing facilities, psychiatric medical institutions for children, or an intermediate care facility for persons with either mental illness or intellectual disability from $50/month to $60/month. ((Status: Senate Human Resources Committee)

  • SSB 3006 – This bill makes more changes to guardianships and conservatorships, which were changed significantly in 2019.  Changes are made in the powers of a guardian/conservator may have before going to court, changes information to be included in reports, and requires a court-ordered evaluation before petition filed with court. (Status: Senate Judiciary Committee)

  • SSB 3033 - This bill prohibits insurance plans from considering preexisting conditions when deciding whether to cover a person and does not allow them to charge more for insurance because of a pre-existing condition.  This is a part of the federal Affordable Care Act protections, but legislators want to do this in case the federal law is ruled unconstitutional by the courts. (Status: Senate Judiciary Committee)

  • SSB 3038 - This bill makes even broader changes in the opening, administering, and terminating adult and minor guardianships and conservatorships.  (Status: Senate Judiciary Committee)

  • SSB 3068 - This bill requires DHS to request a waiver to require food assistance recipient reviews to eliminate duplication and fraud; requires eligibility verification for all public assistance programs; requires DHS to conduct an asset verification process on every household member of food assistance (SNAP) recipients; requires SNAP recipients to be paid up on child support; and establishes new system and processes for verification of eligibility for all public assistance programs. ((Status: Senate Human Resources Committee)

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FEDERAL GOVERNMENT MAY RESTRICT SUPPORT ANIMALS ON PLANES

The US government may restrict some animals from traveling with their owners on planes, including those that are considered emotional support animals.  The US Department of Transportation has been receiving many more complaints from passengers traveling near some animals, with huge increases in the number of onboard emotional support animals.  They say some animals are not well trained, and roam freely around the cabins, have attacked flight attendants, and have gone after legitimate service animals.  

Airlines are concerned that people are abusing the system by claiming their pets are emotional support animals. The US Department of Transportation has proposed rules that would treat service animals helping people with diagnosed mental illnesses the same as service animals for other kinds of disabilities.  The rules would no longer classify emotional support animals as service animals; they will be considered pets.  The rules require an animal to be individually trained to perform tasks for a traveler with a disability, allow airlines to require more paperwork documenting a service animal’s training and health.  Passengers would have to certify that their service animal is able to avoid relieving itself during the flight (or do so in a way that is sanitary).  That has some advocates concerned that the paperwork may be a barrier to persons with disabilities flying.

The public has two months now to comment; comments are due by March 22, 2020.  So far (as of 1/24/20) there have been 2,613 comments received.  

  • You can find out more here.  
  • You can read the full notice of rules and the new requirements here.
  • You can comment online here.
  • You can also mail/fax your comments to:  

Docket Management Facility
U.S. Department of Transportation
West Building Ground Floor, Room W12-140
1200 New Jersey Ave. SE
Washington, DC 20590-0001
Fax: (202) 493-2251 

 

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JOIN US! FEBRUARY 14th LEGISLATIVE REVIEW WEBINAR & CALL

Friday, February 14 @ Noon

To join by phone: (646) 558-8656  or (669) 900-9128 
When asked, enter the following webinar ID: 781 041 837

To join by computer or iPhone/Android device:
Please click this URL to join. https://capture.zoom.us/j/781041837

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UPDATED 2020 GUIDE TO THE IOWA LEGISLATURE

With the changes in leadership, there were a lot of changes to committees.  We have updated our Guide to the Iowa Legislature. You can find it here.

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ADVOCACY HAS NEVER BEEN EASIER!

The Iowa Developmental Disabilities Council wants to make advocacy easy.  That is why we have created a Grassroots Action Center to take the worry out of communicating with your elected officials.

 You can email the President, your US Senators, your US Representative, the Governor, and your state legislators with the click of a button.  You don’t need to know who represents you – just put in your address and the system will do the work for you.  Type a quick note about your issue and share your story – then click send. It takes no time, so try it out!  

Get started at: www.infonetiowa.org/take-action/.

(And if you really want to go crazy, you can use the easy social media posts in the system…with another click you can send your message via tweet to your elected official, or post a comment on their Facebook page) 

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ADVOCATE LOCALLY @ A FORUM

You can find a list of legislative forums that are held on Fridays and Saturdays near you here.

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GET THIS ISSUE IN PDF

Click here for the formatted PDF version of this issue.

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