2021 INFONET: Issue #6
Issue 6, 04-05-2021
Articles in This Issue:
- Second Deadline Passes, Legislators Prepare for Final Month
- Massive Tax Bill Buys Out Regional MH/DS Services
- Senators Talk About Managed Care in Morning Comments
- Adult Changing Stations: A Surprising Way to Win
- ABLE Account Bill Survives Funnel
- HCBS ACCESS ACT: Input Requested!
- Get Out the Vaccine - #GOTVaccine
- Iowa DD Council State Plan Feedback
- INFONET Gets Facelift
- Bill Tracker, Take Action, Go to a Forum & More
- Final Capitol Chat!
Second Deadline Passes, Legislators Prepare for Final Month
The Iowa Legislature is now in it's final month of session; at least the final paid month. Legislators receive expense checks to help offset their costs of moving to Des Moines during the 110 days of the legislative session; those checks end on April 30. While legislators can and do go longer, this year they are working hard to finish up before that deadline hits. They have a lot of work ahead of them, including passing the ten bills that make up the state budget and finishing work on the Governor's bills that expand high-speed "broadband" Internet and increase access to childcare. Legisators have their own priorities as well, including some major tax reforms and expanded "school choice" options that allow for easier open enrollment and charter schools.
Bills that did not make it (died in funnel):
- Requiring adult changing tables to be installed in all modern Interstate rest areas (read article on this for good news).
- Addressing loopholes in older and dependent adult abuse to make financial exploitation a crime.
- Requiring Department of Education and local schools provide resources on language development and set milestones for students who are deaf or hard-of-hearing.
- Protections against non-medical switching (when insurers require a person to switch to a cheaper drug against medical advice).
- Starting the development of a public direct care worker database and expanding the current direct care worker registry to help families connect with direct service professionals.
- Emergency precription drug refills without doctor okay.
- Caps on insulin prescription cost-sharing ($100/month).
- Paying equally for mental health and other health care visits done virtually and in-person (virtual visits are usually reimbursed at 50-70% of an in-person visit, but have been 100% during COVID).
- Constitutional amendment restoring felon voting rights.
- Ending tenure at state universities.
- Penalties for cities and counties that defund the police.
- Stopping employers from requiring COVID-19 vaccinations (and all other bills weakening Iowa vaccine laws).
- Allowing college athlete to earn money through sponsorships and use of their name.
- Taxpayer-funded scholarships for private schools (school vouchers).
- Added protections for mobile home residents.
- Banning speed and red-light cameras.
- Punishing companies like Facebook and Twitter for restricting what people can say online.
- Access to birth control without a prescription (for up to one year).
- Add more public assistance oversight with new asset tests and for frequent eligibility checks for those receiving Medicaid, food assistance, and family support.
Bills that survived and are still alive:
- Allowing older trusts to be converted into more flexible Iowa ABLE accounts.
- Permiting landlords to move a person requesting accommodation for a service animal, if they are accommodating another resident.
- Allowing landlords to discriminate against people using federal housing choice vouchers (this is in Governor's hands now - you can take action on this here).
- Allowing only county elected officials on regional MH/DS boards to vote on spending tax dollars (advisory committees still in place, can still vote on other matters).
- Reviewing all boards that license professionals, ending them automatically if future legislatures do not take action to continue them.
- Occupational Therapy (OT) licensing compact that would allow for OTs to cross state borders without needing additional licensure.
- Requiring interpreters/translators be present during any legal proceeding involving someone who is deaf or hard-of-hearing.
- Allowing charter schools (determined by Board of Education, not local school boards).
- Constitutional amendment stating Iowans do not have the right to an abortion.
- Bottle bill changes to allow grocery stores to stop taking cans.
- Governor’s bills to expand affordable housing options and access to high-speed Internet throughout the state.
- Required first amendment (right to free speech) training for school/university students and employees.
- Stopping schools from teaching and discussing "divisive concepts" such as racism and sexism.
- deductions in unemployment benefits.
- Half of the Governor's eight child care bills.
Remember that “dead” bills can still be turned into amendments and attached to other bills that are still alive and moving. If you see a bill that you are disappointed did not make it, you can ask your legislators to amend it to a budget bill or another bill. The infoNET Bill Tracker is updated frequently, so you can check in on the progress of the bills important to you at infonetiowa.org/bill-tracker/.
Massive Tax Bill Buys Out Regional MH/DS Services
Leaders in the Iowa Senate rolled out a huge tax reform bill that takes $152 million in property tax replacement dollars from cities and counties, ends tax credits for those that donate their land to conservation, and limits who can avoid property taxes by putting their land for forestry reserves. The biggest part of this bill (Senate File 587) addresses funding for the state's mental health and disability services system that is currently funded entirely by property tax dollars. Instead, this bill will get rid of these local funds and replace them with state funds. Whether these funds are enough to maintain services and add new complex needs and children's services coming on line this July 1 is not known. The bill's complex formulas for growth and repayments from regions with fund balances make it difficult if not impossible to predict how much funding will be available from year to year.
Many groups are registered in opposition to this bill, while others have stayed "undecided" as they work through these details. Those in favor include Farm Bureau, Americans for Prosperity, Iowans for Tax Relief and Iowa Taxpayer's Association. Many advocates see both good and bad in the bill, but the common theme is uncertainty, something that has plagued the system from the beginning of the state-county partnership late 1990s. You can read more in the nonpartisan staff review of the bill here.
Mental Health/Disability Service (MH/DS) Regions
- Regional boards would remain the same, and still vote on all the budgets and plans for the region.
- No change is made to the regional advisory boards; they continue to be an important part of the planning process.
- All regions would have to put their money into a single bank account (by July 1, 2021).
- The unelected regional administrator (called a CEO, for chief executive officer) would be responsible and accountable for the funds, instead of the elected county auditors.
- Regional requirements and core services do not change.
- Regions are encouraged to spend down their fund balances (fund balances are like a savings account - it's the amount of property tax dollars left unspent at the end of the year).
- No other county tax dollars could be used to pay for services or staff (although an exception is made for three years to allow the continued shared funding/donated services agreement between Broadlawns and the Polk County Region).
County MH/DS Property Taxes
- We use the term "per capita" when talking about funding for the regional MH/DS system. It means "per person" living in the region.
- Currently regions are allowed to use up to $47.28 in property taxes for services (although several regions were locked in at a lower rate).
- Year 1 would change that to $21.14. (FY 2022 - which starts in just a few months on July 1, 2021).
- Year 2 the property tax for MH/DS services is eliminated. The system becomes entirely state-funded.
- After the first year, there are no longer county dollars in the system.
State Regional Supplement Fund
- For Year 1 (FY 2022) state funding for regions is $15.86 per capita (for total of $37 per capita).
- For Year 2 (FY 2023) state funding for regions is $38 per capita (there are no longer county dollars in the system).
- For Year 3 (FY 2024) state funding goes up to $40 per capita.
- For Year 4 (FY 2025) state funding increases to $42 per capita.
- For Year 5 (FY 2026) & after, the state would add cost of living increase (called an allowed growth rate) up to 1.5% (based on a formula that is dependent on sales tax increases).
- In Year 5, if the growth rate is the maximum of 1.5% - that is a per capita increase of just 63 cents - so up FY 2026 would be at most $42.63.
- At this rate, it would take until FY 2033 to get back up to $47.28 per capita (the current rate). That's 12 years!
- Regions are sent state funds in four even quarterly payments (July, October, January, April).
Regional Risk Pool
- A new risk pool is created to help regions for which the per capita rate is not enough to cover costs.
- The risk pool board includes providers, county supervisors, county auditors, regional MH/DS administrators, and other stakeholders.
- Risk pool applications are due October 31, decisions are made by December 15, and funds sent to the regions on January 1.
- Regions who have over 40% fund balance in Year 1, 20% in Year 2, and 5% in Year 3 and after are not eligible for risk pool funds.
- Lists how risk pool funds can be used (core services, "critical services," avoiding cuts that put someone's safety and health at risk, and assistance in to "maintain consumers in a community setting.")
Regional Risk Pool Funding
- Funds risk pool with $9,960,590 in Year 1 (FY 2022) and $5,170,340 in Year 2 (FY 2023).
- Starting in Year 3 (FY 2024), there is an annual increase (called the risk pool growth factor), up to 3.5% (also based on sales tax increases).
- Regions that have fund balances over the allowed limits would have to pay back the state for the amount they are over the fund balance limit. Those repaid funds go into a Risk Pool. (Reminder: regions are allowed 40% fund balance in Year 1, 20% in Year 2, and 5% Year 3).
- Total risk pool funds available each year is not known since we do not know if sales taxes will increase (and by how much) and how many regions will be required to repay the state.
The bar chart below shows how much regions will receive in county property tax dollars (orange) and state funds (blue). The first fully-orange bar is current law, allowing regions to collect up to $47.28 per capita from their property tax levies. The second year, noted as FY 2022) is when the bill takes effect, reducing county taxes and adding in state funds. Since we do not know how much will be in the risk pool or how much growth will be, they are noted with question marks. We have more information on this bill available at infonetiowa,org.
The bill is on the Senate Debate Calendar already, so it could come up any day now. Some of the things advocates have been saying:
- It's not a Mental Health System - it's a Mental Health and Disabiity Services System. Legislators and some organizations have started to refer to the regional system as "mental health regions." People are starting to forget the DISABILITY SERVICES side of MH/DS regions and the importance of those services to individuals with intellectual and developmental disabilities. As a reminder, Iowa law only requires regions to serve individuals with an Intellectual Disability (ID) diagnosis; serving individuals with Developmental Disabilities (DD) is optional for regions and entirely dependent on the region having extra funding available. If state funding is not sufficient, non-mandated populations like those with a DD diagnosis may face service cuts.
- Funding is ramped up over time and includes a growth factor. However, the growth factor is connected to sales tax growth, so if the economy goes down, the state's funding for mental health does as well (even though demand for mental health services goes up during times of economic uncertainty). In addition, the growth factor is based on two-year old data to improve predictibility (but that's a big lag for a service system). The growth factor does not take into consideration growth in the overall state's population; if more people are served, more than a cost-of-living increase is needed.
- Property taxes are reduced, addressing an unfair system that has led to "have" and "have not" regions. Scott County almost got kicked out of their region because they were unable to contribute their fair share to the regional budget (their property taxes are capped too low). Polk County's property taxes have only funded half of their budget since the 2015 "equalization formula" was abandoned (when the state stopped contributing $30 million to the regional system). While this bill removes one barrier, it does not address the core problem that some regions will have to forever rely on the state risk pool to maintain services.
- Funds can be allocated where they are needed, not where the property tax dollars can be generated. One of the problems with the old freeze on property taxes is that it froze the amount a county could collect, so counties are allowed to collect the same amount from property taxes this year (Fiscal Year 2021) as they did when the state started partnering with counties in 1998. Since that time there have been two censuses and population has shifted. Iowa's urban counties have grown significantly since that time: Story County added 25,000 residents, Linn County and Johnson County combined serve 100,000 additional residents, and Polk County increased its population by 140,000. Some regions have more than enough money from property taxes, and could even tax more, but the state cannot take those funds and give them to other areas of the state in need. With an entirely state-funded system, the state could do this.
- There are several operational issues with the structure of the new system. First, no region can operate on zero fund balance. Imagine your bank account going to zero at the end of each month and trying to pay rent, car payments, and groceries during that first few weeks of the next month. Regions need some money in the bank to pay providers, or provider payments will be delayed or service authorizations slowed. Second, most (if not all) regional staff are county employees or the county pays their salaries. Without a levy and with the prohibition on any other funds being used to pay for those salaries, this would cut into service dollars. Third, a non-elected person is the new administrator of the funds (no longer county auditor, now regional administrator). Other issues include uncertainty in risk pool dependent areas, lack of definition in the risk pool criteria, absence of a children's provider representative on the risk pool board, fast implementation date (starts less than two months if bill passes and is signed), and prohibits some sharing of resources.
- The state has not been a reliable partner. This is not an opinion; it's fact. The state has rarely lived up to its promises in funding their part of the MH/DS regional system and regions have relied on local property tax dollars to fill in those gaps. Local funding means local input into the process, and a degree of responsiveness that you do not see in other state funded systems. Without some reliable locally-controlled funding source, regions are entirely dependent on the Governor, DHS and the 150 state legislators to fund the system. As a person with a disability, instead of going to your local county supervisors for help, you will need to go to your two legislators and DHS to make your case. That all said, the Senators writing this bill fully intend to retain local control, but that may or may not be possible without local dollars in the system.
The bill moved fast through the Senate; one week from it's introduction the bill has gone through two committees and subcommittees, and was voted out of the Senate on Tuesday, April 6. Democrats voted against; Republicans voted for. It now moves to the House - so if you have concerns, comments, thoughts, or suggestions, talk to your State Representative (you can take action here). If it does not pass this year, advocates will need to talk to their legislators about this bill and other approaches to funding the state's MH/DS regional system so that it remains accountable to the taxpayer and responsive to the person relying on the services and sustainable for those providing the services.
NOTE TO ADVOCATES: In 2020, the Governor Reynolds submitted her plan to use a part of a sales tax increase to reduce property taxes and add more state funding. This year, we have the Senate plan. Next year there may be another plan. The good news is that everyone is talking about a better way to fund regional mental health and disability services. Every person working on this has mental health and disability services as a priority, they all just have different ways to fund them. So far, no plan has been perfect. As they say, the devil is in the details. If it were easy, it would have been fixed a long time ago. So if you talk to your legislators about this, make sure you start out by thanking them for making mental health and disability services funding a priority.
Senators Talk About Managed Care in Morning Comments
At the beginning and end of each day during the legislative session, your state legislators are allowed to talk about anything on their minds during "points of personal privilege." This is basically just an open time when a legislator may make an announcement (birthday, anniversary, bragging about a team in their district winning state championships, or talking about an issue that has them concerned or excited). Usually these are pretty boring, but they sometimes get animated and focus on a policy area that may be overlooked during the session. That's what happened on Wednesday, March 31, on the eve of the fifth anniversary of the state's move to Medicaid managed care.
Sen. Janet Peteresen (D-Des Moines) honored the five-year anniversary of the transition saying it has been "a complete mess that's cost taxpayers millions of dollars, stripped health care away from Iowans, and ripped off Iowa health care providers." Here are the rest of her comments:
Out-of-state private managed care companies have a lot to celebrate, and boy could they throw one whopper of a party with the amount of money they've taken out of Iowa with cushy contracts while giving Iowa's health care infrastructure a big power flush down the drain. So where do these profits come from? YOU. That's right YOU, the taxpayers of Iowa.
These out-of-state for-profit companies have gotten big, fat raises courtesy of Gov. Kim Reynolds. In fiscal year 2019, they received an 8.4% increase. In fiscal year 2020, they got an 8.6% increase. Even in fiscal year 2021, they are expecting another raise. What’s disgusting is how big their raises have been while public servants protecting Iowans in our prisons, teaching our kids, and caring for older Iowans haven’t seen a raise anywhere close to that amount for more than a decade.
And, unlike a publicly run system with sunshine and accountability, (Governor) Reynolds’ team of MCOs raked in the profits. After asking for years, we recently received data on the amount of profit being earned by private managed care organizations. Amerigroup earned $81.8 million in profits in calendar year 2019 and $146 million to date in calendar year 2020 (as of September 30, 2020). Iowa Total Care's profits in calendar year 2019 was $15.2 million and, to date through September 2020, $14.1 million.
Looking back to the beginning of the privatized program and including the beginning when all MCOs experienced losses because of the rushed, botched implementation, the overall profit for Amerigroup was $60.7 million and Iowa Total Cares' total profit was $29.4 million. What else did Governor Reynolds promise Iowans?
Reynolds and Republican lawmakers said the Medicaid budget would be stable and more predictable. Guess what? Not true. Costs have gone up almost 9% for two straight years, in FY 2019 and 2020. That’s three times higher at least than any growth we saw when our system was publicly managed, when Iowans were running the system. Iowans were promised savings, better access to service, and healthier Iowans. But instead, we got:
Cuts and delays in payments to health care providers that offer critical services to hundreds of thousands of Iowans. Some cuts and delays were so bad that providers shuttered.
Hoops and hurdles for Medicaid recipients to get the health care they need.
Less money for our schools, public safety and other priorities Iowans care about. Why? Because Governor Reynolds has to feed the privatized Medicaid beast sending more of our money out of state to for-profit MCOs.
Yes, it's been five long years since Governor Reynolds started digging this hole, and she has a firm grip on her privatized Medicaid shovel with Republican lawmakers helping her continue to dig this hole. While she claims it has been modernized, Iowans know better. Our Medicaid system has been more like “slaughterized.” And instead of facing the problem, statehouse Republicans stick their heads in the sand and claim it’s working, while a $6 billion health care system crumbles.
The for-profit corporations running Medicaid are denying services to disabled, elderly and vulnerable Iowans, and not properly reimbursing health care providers. In turn, health care providers are refusing to treat Medicaid patients, and some have been forced to close up shop. All the while, Iowa taxpayers are forced to shake more money from their pockets for less care. Two of the private, for-profit managed care companies abandoned Iowa and their customers. MCOs coming and going has made our Medicaid system unstable, and once again another new company is being added, so more upheaval is on the horizon.
Iowa's privatized Medicaid mess is stressful, even frightening, for many Iowans. Imagine being pregnant now in this state. Reynolds has kept reimbursement rates so low for labor and delivery in this state that we have seen 17 hospitals shut off services to pregnant moms since her privatized Medicaid program began. You don't ahve to be a mom relying on Medicaid to realize how dangerous it is to have that many hospitals closing their doors to all care, to all women, even if they are private pay. Reynolds has created a labor and delivery care desert in our state. Hospitals aren't even reimbursed to transport pregnant moms however far they need to go to safely delviery a baby. And we know more hospitals are preparing to cut more services, they were planning to do so even before the pandemic, like ICU departments and mental health services.
Here's the bottom line. Reynolds' privatized Medicaid program isn't saving money. There is no evidence Iowans are better off. We have no data to show Iowans are healthier. If Iowans truly are healthier, we should have known that by now. For profit Medicaid has been a disaster for Iowa's families and health care providers. It is proving to be an even bigger disaster for our state budget and Iowa taxpayers. Governro Reynolds and legislative Republicans should reverse course and join legislative Democrats in supporting a return to a more efficient, publicly managed system that is not based off of making a profit on the backs of Iowa taxpayers.
Responding to these comments, Sen. Jeff Edler (R-State Center), who chairs the Senate Human Resources Committee and was not in the Senate when managed care was introduced, said the following:
I appreciate (Sen. Petersen) leading in with the outcome discussion. But I will say also, when I first started I had a pretty high share of MCO complaints; those do not exist anymore. One provider that I had worked with, I actually spoke with them this morning, and I asked them specifically about the MCO reimbursements.. While there are still some issues because of Code changes, things are going pretty well. Also, as far as the saving money, we were just given a document recently from the department that showed those savings. Senator Petersen I'd be more than happy to sit down with you and go over that and field any concerns you have."
If you are interested in telehealth payment parity (paying providers equally for virtual and in-person visits, instead of a lower rate for virtual visits), you might want to keep listening as Sen. Edler brings up the hundreds of calls and emails he has been getting on the subject and the need for more providers to understand what Wellmark is offering (see attached PDF with a plan to allow providers to "earn up" to 90% payment for virtual visits).
You can watch or listen to the exchange (closed captioning is not available on the legislative website) here - but you will want to forward it to the time stamp 9:13:30 unless you want to hear the morning prayer, pledge of allegiance, and comments about a Senator's retiring from military service.
Adult Changing Stations: A Surprising Way to Win
People always think the only way to win an issue is to get a bill passed, but sometimes there are other ways to come out a winner. Legislation is often introduced to keep an agency's feet to the fire, or to push for an issue to be addressed. Sometimes agencies agree to do it voluntarily, so passing a bill isn't required. That is what happened with House File 492, the bill that requires the Department of Transportation (DOT) to install adult changing tables in modern Interstate bathrooms. The bill didn't make it off the House Floor because it's lead sponsor, Rep. Ann Meyer (R-Fort Dodge) was able to get agreement from the DOT to do this without legislation, and to build it into their budget for the next year.
As Rep. Meyer reported in her weekly newsletter, "This bill will not be advancing, but that is NOT bad news! The DOT has shared that they will be voluntarily installing several changing tables in certain rest stops, primarily in new constructions as that is the most cost effective. The first one is under construction in Victor, Iowa (I-80 between Des Moines and Iowa City). They have been working with Changing Spaces advocates. The DOT was committed and had made the decision to incorporate adult changing stations because they felt it was the right thing to do. Here's an example of what can be done with collaboration and not government mandates!"
This is great news for advocates - and a great example of how a parent advocate (Amanda Milham) connected with her State Representative (Ann Meyer) to get an issue addressed. It's also a great example of how a state agency (DOT) can work with local advocates (Changing Spaces Iowa) to make sure our state is accessible to all who live here or visit. Congratulations to all who worked on this issue!
DID YOU KNOW? You can sign up to receive any legislator's newsletter from the legislative website. You can sign up for your Representative or Senator - or add in others that you want to follow (but remember, you'll get them in your inbox and you may not want 150 each week!). If you don't know who your Representative or Senator are, you can find out here. At the bottom of the legislator's page, you will find a "Subscribe to Newsletter" link.
ABLE Account Bill Survives Funnel
In 2014, Congress passed and President Obama signed the Achieving a Better Life Experience (ABLE) Act to give individuals with disabilities and their families more options to save for future expenses that are not covered by Medicaid or Social Security Income (SSI). Before that, families could set up Special Needs Trusts or Supplemental Needs Trusts to help pay for these expenses, but they require a court visit for even the smallest of expenses. While there is more oversight for these accounts, they make it difficult for families that cannot retain a lawyer everytime they want to use these funds. ABLE Accounts, which have been available in Iowa for five years now, are more flexible and allow individuals or their designees to withdraw funds to help pay for unreimbursed expenses related to work, living, or school.
The Iowa Legislature wants to make sure more Iowans can take part in these savings account by saving House File 835 from the funnel. The bill, which allows people to transfer funds from older trusts into an ABLE account and protects the funds from being recovered by Medicaid upon the death of the account owner, is now ready for Senate debate. If it passes the Senate without amendment, it will go straight to the Governor. If it is amended in the Senate, it will go back to the House (which can agree to the change, make more changes, or insist on their version). The bill passed the House unanimously last week, despite a fiscal note saying it may cost the state millions if the state cannot recover Medicaid expenses from the estate of an ABLE account owner. Sen. Mark Costello (R-Imogene) is the Senate floor manager, which means he will be the lead in getting the bill passed in the Senate.
On March 25, the State Treasurer of Iowa Michael Fitzgerald announced that Iowa now has 1,000 individuals with disabilties saving with Iowa ABLE. "I am pleased to see more Iowans with disabilities and their families who are saving with IAble to pay for qualified expenses while maintaining their essential benefits. As we reach this milestone, it makes me more committed to ensuring individuals with disabilities use the program to achieve their version of a better life experience."
Individuals with IAble accounts can save above the $2,000 resource limit without risking their eligibility for SSI and Medicaid. Account owners can safe for expenses such as housing, food, assistive technology and transportation. Family, friends, and others that contribute to the account for the individual can deduct up to $3,474 in contributions in 2021 (this amount changes each year) - but they can put more in without the deduction. The average IAble account is $8,480 and the total saved by these 1,000 account holders is over $8.7 million!
"I wish I could individually congratulate each of the 1,000 account owners for taking the step towards financial freedom," said Fitzgerald. "We're only scraping the surface of the opportunities IAble can provide for an individual with a disability, and I look forward to celebrating more accomplishments from the plan as we continue to grow."
For more information about setting up or contributing to an account, go to IAble.gov or call (888) 609-8910. You can watch for updates and more information by following the Treasurer's posts on Facebook and Twitter.
HCBS ACCESS ACT: Input Requested!
There is a lot going on in our nation's Capitol right now as well. Iowa is represented by seven people in the United State Congress - two US Senators representing all of Iowa, and five US Representatives who each represent a different part of Iowa. They have been busy at work with COVID-19 response and their own budget-setting process. A group of federal legislators from other states have started working on an exciting new bill to expand access to home and community based services (commonly called HCBS), a proposal they are calling the HCBS Access Act.
Many people do not realize that services that help people stay in their own homes and communities are currently optional services that state Medicaid programs can provide. They are not required, so states wanting to provide these less expensive, higher demand services through a waiver process that allows waiting lists to be created if the state does not budget enough funds to meet demand for the services. Iowa currently has more than 15,000 people on its combined HCBS waiver waiting list.
In fact, Medicaid is only required to pay for institutional services like those in nursing homes, mental health institutes, and state resource centers without waiting lists. This has not changed since Medicaid was first created by Congress in 1965, when institutionalization was the only option for people with disabiities. Thank goodness times have changed, but the federal law has not changed with the times. That is why lead sponsors Senator Sherrod Brown (D-Ohio), Senator Margaret Wood Hassan (D-New Hampshire), Senator Robert Casey (D-Pennsylvania) and Representative Debbie Dingell (D-Michigan) are working on the HCBS Access Act and are asking for input from stakeholders like you!
The proposal upends Medicaid, making HCBS services mandatory and eliminating waiting lists for these important, less costly services. The Act would also permanently increase Medicaid funding for HCBS, and provide additional grant funding to help states build the capacity to serve all people who need HCBS. Sponsors hope the changes proposed will also improve the quality of the direct care workforce and address the decades-long workforce crisis by ensuring that the workers that support people with disabilies and older adults (who are disproportionately women of color) are fairly paid. These changes will also allow people with disabilities and their families to move from state-to-state and still be able to access crucial HCBS services. Finally, the Act will provide the federal Medicaid resources necessary to fulfill the promises of the Americans with Disabilies Act and the Supreme Court’s Olmstead decision so that people with disabilies and older adults can live the lives they want in their homes and communities.
- Click here for a one-pager on the HCBS Access Act.
- Click here for the request for comment from the Act's lead sponsors (due April 26).
- Click here to read the proposed bill language (they will introduce after reviewing comments and making changes).
- Click here for the Iowa Disability League's Facebook Live HCBS Access Act Discussion.
- Click here for notes on the "good" and "bad" parts of the bill (from advocates on the Facebook Live discussion).
The Iowa Disability League is hosting a follow-up Zoom conversation on the HCBS Access Act on Tuesday, April 20 at 6:00 p.m. to collectively review areas of concern in the HCBS Access Act draft, discuss changes, and then take action together. To participate you will need to pre-register here. Captioning will be provided (checking on funding for ASL) so please request so we can make sure it is available. Contact Jenn Wolff, firstname.lastname@example.org with any questions.
Get Out the Vaccine - #GOTVaccine
More Iowans are becoming eligible for the COVID-19 vaccine. It’s time to "Get Out the Vaccine!" The Iowa Developmental Disabilities Council and its national organization, the National Association of Councils on Developmental Disabilities (NACDD) have launched GetOutTheVaccine.org to help people with disabilities, their loved ones, and caregivers learn more about the COVID-19 vaccines.
Iowa DD Council State Plan Feedback
INFONET Gets Facelift
It's been over a decade since the infoNET website got a facelift. Sure there were cosmetic changes, but a complete redesign has been needed for some time. Since COVID-19 gave us all a break from "normal" worklife and we have all needed to get information online as much as possible, it seemed like a good time to do that. infoNET still can be found in the same location, with easy access to our Bill Tracker, Action Center, Town Hall Calendar, Advocacy Tools & Legislative Guides, and more. Check us out at infonetiowa.org!
You may also notice a blue circle symbol in the lower left corner of the browser window. That's the new "AccessiBe" icon that makes our new website fully accessible and ADA compliant. We know that our old site sometimes fought with your screen readers, so this was a top priority for our new website. So take a look, try it out, and let us know what you think (email@example.com).
Look for this symbol on infoNET's new website for expanded accessibility.
Bill Tracker, Take Action, Go to a Forum & More
BILL TRACKER: You can find all the current bills being tracked in our online Bill Tracker. It's updated daily, so watch it closely as we start to wind down session.
ACTION CENTER: If you don't see your bills moving, now is the time to take action! You can do it easily with our online Action Center. It's so easy, you just need to know your address and the system will do the rest. Well, you are in charge of your message (but sometimes we help you with that too). Check it out and let us know how it goes.
TOWN HALLS: There are certainly fewer of these during COVID-19 and some have moved online, but you can find out where these are so you can meet or ask your legislators questions, or just listen to what others in your community are asking about. You can find an updated list here (updates are made every Thursday evening).
VIDEO LIBRARY: We're starting a library of videos that can provide tips and resources for advocates with disabilities. Watch for more additions - but you can find videos of our 2020 Fall legislative panel, Feb. 26 virtual town hall, and monthly Capitol Chats there now! Just go to "Resources" on the main navigation page, and click on the video tab.
Final Capitol Chat!
Be sure to join us for our final virtual Capitol Chat on Friday, Friday, April 30. More than 100 advocates have joined us for the first three Capitol Chats - and we've learned a ton from those of you that participated. Thanks to an advocate in our last Chat, we became aware of the HCBS Access Act. You can watch the last three Capitol Chats in our Video Library here.
April Capitol Chat | Friday, April 30 @ 11 a.m.
Click here to register for this Capitol Chat.
If you have registered for another Capitol Chat you do not need to do it again.
The End is Near (Maybe)
There are just two more weeks left until the Iowa Legislature is scheduled to finish its work. April 30 is the 110th day of the 2021 session and the last day...Read more
Budget Bills in Position, Ready for Compromise
The budget is the one thing legislators must do before they leave town in a couple of weeks. The state's new budget year (called a "fiscal year") begins on July 1, 2021 and ends on...Read more
Redistricting the Iowa Way
Every ten years, following a new US Census count, states must redraw their political maps. That means drawing new Congressional and state legislative districts so they are...Read more
It's easy to drift away from advocacy after the legislative session, but that is the biggest mistake you can make! Summer is a great time to gear up for the...Read more
Bill Tracker 2021
Check on the status of the bills you care about in the infoNET Bill Tracker here. Status is updated daily, so check back frequently.Read more
Final Capitol Chat!
Be sure to join us for our final virtual Capitol Chat on Friday, Friday, April 30. More than 100 advocates have joined us for the first three Capitol Chats...Read more
Second Deadline Passes, Legislators Prepare for Final Month
The Iowa Legislature is now in it's final month of session; at least the final paid month. Legislators receive expense checks to help offset their costs of moving to Des Moines...Read more
Adult Changing Stations: A Surprising Way to Win
People always think the only way to win an issue is to get a bill passed, but sometimes there are other ways to come out a winner. Legislation is often introduced to...Read more
ABLE Account Bill Survives Funnel
In 2014, Congress passed and President Obama signed the Achieving a Better Life Experience (ABLE) Act to give individuals with disabilities and their families more...Read more
Massive Tax Bill Buys Out Regional MH/DS Services
Leaders in the Iowa Senate rolled out a huge tax reform bill that takes $152 million in property tax replacement dollars from cities and counties, ends tax credits for those that donate their land to conservation, and limits who can avoid property...Read more
Get Out the Vaccine - #GOTVaccine
More Iowans are becoming eligible for the COVID-19 vaccine. It’s time to "Get Out the Vaccine!" The Iowa Developmental Disabilities Council and its national...Read more
Iowa DD Council State Plan Feedback
The Iowa DD Council hosted a series of listening posts Aprll 6-8 to learn more about their five year plan and get stakeholder feedback. If you missed the...Read more
Senators Talk About Managed Care in Morning Comments
At the beginning and end of each day during the legislative session, your state legislators are allowed to talk about anything on their minds during "points of personal privilege." This is basically...Read more
INFONET Gets Facelift
It's been over a decade since the infoNET website got a facelift. Sure there were cosmetic changes, but a complete redesign has been needed for some time. Since...Read more
Bill Tracker, Take Action, Go to a Forum & More
BILL TRACKER: You can find all the current bills being tracked in our online Bill Tracker. It's updated daily, so watch it closely as we start to wind down...Read more
HCBS ACCESS ACT: Input Requested!
There is a lot going on in our nation's Capitol right now as well. Iowa is represented by seven people in the United State Congress - two US Senators representing all of Iowa, and...Read more
State Revenue Estimates; Time to Start Budgets
Today the state's three-person Revenue Estimating Conference met to revise its estimates, which help state lawmakers develop the budget for the fiscal year that...Read more
President Signs New Relief Package
This week, Congress passed and President Biden signed a $1.9 TRILLION package to help respond to the economic impact of COVID-19. The following information is from...Read more
Funnel Week Ends!
The first legislative deadline is today (March 5) - the date when most bills need to be voted out of a committee. This "funnel" deadline does not apply...Read more
Host a Town Hall Meeting!
The Iowa DD Council wants to help you hold a virtual townhall meeting in your area! In years past, the Iowa DD Council has helped Iowans with...Read more
Special Election Information: January 26
Voters living in Senate District 41 will go to the polls on Tuesday, January 26, 2021 to select a new state senator. We wanted to make sure those of you living in this area had all the...Read more
SPECIAL ELECTION SET: January 26, 2021
Ottumwa physician Mariannette Miller-Meeks has been "provisionally" sworn in as a U.S. Representative, as she awaits the review by a Congressional...Read more
LEGISLATURE STILL PLANS TO MEET
Many of you have asked what the next legislative session will be like. Our answer continues to be - who knows! At this point, we believe the Iowa...Read more
2021 Committees Assigned
Each legislator serves on several committees - standing committees that deal with policy issues in a certain area, and budget (appropriations)...Read more
Revenues Holding Steady, State Economy Looking Good
Every year we talk about the way Iowa budgets. It all starts with the law that only allows the state to spend 99% of the money it collects each year. So if the state...Read more
Legislative Leaders Elected; Looking Ahead at 2021
The majority and minority party members of the Iowa Legislature have picked their new leaders. Committee assignments should be coming out in the next few weeks, so stay tuned. Below are the new leaders - an...Read more
CALL TO ACTION: Contact Congress
Congress has yet to pass a new COVID-19 relief package that will help people who continue to face unemployment, health centers and hospitals caring for those with the virus, and local governments...Read more
Iowans with Disabilities Face Danger, Isolation During COVID-19
The Des Moines Register featured a great article on the challenges Iowans with disabilities face during the COVID-19 outbreak. Titled "Iowans with...Read more