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More than $25 Million for Iowans with Disabilities

Friday, April 1, 2022

You read the title right.  The Iowa House of Representatives is ready to take action on a budget that includes more than $25 million in new money to help give more Iowans with disabilities access to home and community based services. This has been a top issue for the Iowa Developmental Disabilities Council, but it is far from a done deal.  

The House Appropriations Committee has passed out all ten budget bills, but the Iowa Senate has yet to introduce one.  So there is not agreement on these budgets, but there is definitely something to get excited about.  Rep. Joel Fry (R-Osceola), the chair of the Health and Human Services (HHS) Budget Subcommittee, said the budget reflects what he has heard from Iowans: pay the people who provide direct services to Iowans with disabilities better and expand access to mental health services. He also said the bill begins to build up community capacity to give Iowans with disabilities more community living options.  

The Health and Human Services Budget (House File 2578) includes:

  • Full funding for Glenwood and Woodward State Resource Centers to make sure those living there are safe and know their options.
  • $14.6 million increase in Home and Community Based Service (HCBS) provider rates to increase pay going to direct support staff and the supervisors that covered shifts during the pandemic.  This is expected to raise hourly wages by $3/hour, and includes individuals on the Consumer Choice Option and habilitation providers.  
  • $7.4 million more to remove 250 people from HCBS Intellectual Disabilities (ID) waiver waiting list (there are currently over 5,700 people on this waiting list).
  • $4 million increase to expand rural access to home health care providers (so people in rural areas have the same access as those in urban areas, particularly as gas prices are on the rise).
  • $3 million increase for Intermediate Care Facilities to increase direct support staff wages for those who support individuals with intellectual disabilities.
  • $2 million more to raise psychiatric hospitalization rates for more complex patients (also called "tiered rates"), so providers are paid more for people that require lower staffing ratios or need more services.
  • $3 million more for child psychiatric hospitalization rates; this is a 36% increase to help make sure these services remain available and encourage more access.
  • $1.1 million more to increase residential substance use rates.
  • $71 million of new money for full take-over of mental health and disability services (MH/DS) regional funding.
  • 500,000 to clear waiting lists for guardianship services through the Office of Public Guardian.
  • $300,000 to hire three more long-term care ombudsmen.

It should be noted that all Medicaid funds noted above can be matched - every $1 the state puts into Medicaid is matched by about $2 of federal money! So that $25 million in funding to reduce waivers, increase salaries, and improve access is actually closer to $75 million!  The federal match right now is high because it was increased during the pandemic.  You can see what that percentage is regularly, and right now during the pandemic, for each state here.

The House Education Budget (HF 2575) also has some great surprises. The House has already passed this bill on to the Senate, but no action has been taken by Senators as of April 4, 2022.  Some of the things in this include: 

  • $200,000 in new funds for scholarships for post-high-school transition programs at Iowa colleges for young Iowans with intellectual, cognitive, and learning disabilities, if the bill creating this program passes (HF 2495). There are currently two programs in the state - REACH at University of Iowa, and NEXT at Northwestern College.  REACH (Realizing Educational And Career Hopes) are two- and four-year programs that give young adults an integrated college experience within a caring and supportive environment.
  • $4.5 million more for college loan repayments for health care professionals, including $1.5 million for new program for mental health professionals, if the bill creating the program passes (HF 2549). This new loan repayment program will repay college student loans for social workers, marriage and family therapists, mental health counselors, psychologists, prescribing psychologists, psychiatric Advanced Registered Nurse Practitioners, physician assistants working under the supervision of a psychiatrist, and psychiatrists in areas where access to mental health services is lacking.
  • $120,000 increase for vocational rehabilitation services.  Vocational rehabilitation services  provides expert, individualized services to Iowans with disabilities to achieve their independence through successful employment and economic support. These state funds can be matched by federal dollars, adding even more money to their employment efforts.
  • $200,000 increase for school-based mental health at the Area Education Agencies (AEAs).
  • $10,000 increase for Best Buddies to expand into more schools, for a total of $35,000.

  • The State House has put more money into their budget for services and supports.
  • More money means more pay for staff, and hopefully they stay longer.
  • More money also helps providers offer more types of services.
  • Taking people off waiting lists lets more people get the services they need.
  • The Senate may make changes to this budget.
  • To pass, the Senate and House will have to agree on how to spend the money. 

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