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Recently, Governor Branstad completed action on the 2016 session by signing the final bills from this year. This year the Governor signed all the bills that came across his desk.  No bills were vetoed.  The Governor did line-item veto a few things from budget bills.  In Iowa, our Governor is allowed to veto parts of a budget bill, but sign the rest into law.  The Governor vetoed:

  • An attempt to stop changes to Medicaid physician reimbursement (called "cross-over claims").
  • Reporting on all cost-saving measures implemented by Department of Human Services (DHS) during the year.
  • Duplicative language about Medicaid rate floors (see note below).
  • Requirement that DHS look for alternatives to the hospital assessment (the so-called "Hospital Provider Tax" that brings in an additional $30 million in federal Medicaid funds).

It is important to note that the Governor line item vetoed language that required Managed Care Organizations (MCOs) to honor reimbursement methodology changes or rate increases for fee-for-service included in the budget.  This does not affect the 1% increase in HCBS provider reimbursement (as we had previously reported).  So the 1% HCBS provider rate increase will go into affect, and will apply to MCO contracts! 

All other items noted in our End of Session report were signed into law, including:

  • Changes to expand and ease access to the state's autism support program (read more here).

  • All parts of the agreement on Medicaid managed care oversight (read more here).
  • $100,000 increase for an additional long-term care ombudsman to provide assistance and advocacy to persons receiving Medicaid waiver services.

  • $150,000 increase for the Department of Public Health's brain injury program for brain injury resource facilitator services and brain injury service provider recruitment and training (total $1.04 million).

  • $86,000 increase to the Children at Home program for expansion to new service areas (the Family Support Subsidy is reduced by $4,650 as the program continues to phase out and transition to the Children at Home program).

  • $1 million to increase HCBS provider rates by 1%, and $1 million to increase home health agency rates by 1%.

  • $200,000 for a new contract with the College of Direct Support to provide internet-based training for mental health and disability services providers.

  • $2 million to reduce HCBS waiver waiting lists.  DHS is required to report on the impact of changes in the HCBS waiver supported employment and prevocational services (report due 12/15/16).

  • $500,000 for Eastern Iowa Mental Health Region (Scott County) & $2.5 million for Polk County Mental Health Region. DHS is required to report on the progress of MH/DS redesign, including identifying any challenges facing redesign; governance, management, and administration; best practices, including evidence-based practices; availability of, access to, and provision of initial core services and additional core services to and for required core service populations and additional core service populations; and the financial stability and fiscal viability of the redesign.

  • $300,000 for the development of children's mental health crisis services, and establishment of "learning labs" to review emerging collaborative efforts that improve the well-being of children with complex needs and their families.  The bill also creates the Children's Health & Well-Being Advisory Council within the Department of Human Services to continue the work of the same-named work group.

  • $100,000 new appropriation to Department of Public Health to to develop recommendations for a broader, more systematic and strategic workforce initiative, which may include a comprehensive study of workforce program needs and the establishment of an advisory workgroup (due 12/15/16).

  • $2 million in funding for the Autism Support Program, any funds unspent at close of fiscal year can stay in the program to be used next year, and program eligibility is revised to expand access.

Make sure you thank your legislators for their work this session, and ask them what their priorities are for next year. Make sure you share YOUR priorities with them as well.  You never know what makes its way into law!