2014 INFONET #4

Issue 4, 3/8/2014

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Funnel Ahead & Budget Work Begins

The Iowa Legislature has hit the halfway point in the legislative session, and the Republican-controlled House and the Democratic-controlled Senate are working together to prioritize bills and put together budgets so they can be done with their work on or near their 90-day goal (April 12).  

At the moment, all signs point to the Legislature being done by mid-April.  A safe bet would be that the Legislature, without any major hiccups, should be able to finish the session slightly before Easter (April 20).  Only one thing has to happen before the Legislature can adjourn - they must pass a budget for the state budget year that begins July 1, 2014 and ends on June 30, 2015.

Before legislators can pass a budget, they must know how much they are able to spend. This is called a "target."  This week, the House and Senate reached agreement on budget targets.   To the average Iowan, this statement has little meaning. But to the legislators, lobbyists and Iowans who follow the budget process,, this is very exciting news!  Targets are the first major step in the budget process - when the majority party in each chamber makes the decision on how much to spend, and then divides that number up among the seven appropriations subcommittees. 

In a "normal" year (if there is such a thing), the Republican House and Democratic Senate have different targets that are milions apart.  Each chamber puts their own budget together, and they start going through the process of passing budgets that they know won't look the same once an agreement is made. First one chamber passes their version, then the other replaces it with their version, and then the other chamber makes changes, and utlimately you end up in conference committee.  It's a lot of work, and the final decisions are usually made at a very high level (legislative leaders) after a very long negotiation process.

The significance of joint targets to the budget process is that the House and Senate, for the first time in over a decade, have agreed on the overall amount they will spend next year, and the amount each of the seven budget subcommittees will get to spend. This means that the House and Senate will both spend the same amount in their budget bills, but how they spend it could still (and probably will) be different.  So the negotiations won't be on how much to spend, but how that money is spent.  While this could still be controversial, it’s less likely to be as time-consuming as the "normal" budget process.  You can read more about the actual targets in the next article.

While the announcement of budget targets usually means budget work is full speed ahead, legislators will hit the pause button briefly on budget work in order to turn their attention to next week's March 14 funnel deadline.  This second and final funnel requires all bills to have been passed by one chamber, and then be out of committee in the other chamber.  So any bill that wants to continue its path to becoming law must have passed the House/Senate - and be voted out of the other chamber's committee (so House Files need to have passed the House, and be voted out of a Senate Committee; Senate Files will need to be voted out of the Senate, and pass out of a House Committee). 

Once this final deadline passes, the only committees that will still be working on bills are those that deal with taxes (Ways & Means), spending (Appropriations), and government operations (Government Oversight).  All other committee work will be done, and your lawmakers will spend the majority of their time debating.  You can watch or listen to live debate, and go back and watch archives of these debates.  Just follow the links below!

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Budget Target Details

The House and Senate have agreed to spend a total of $6.972 billion in the fiscal year 2015 (which begins July 1, 2014). That amount would represent a 7.4% increase (or $480 million) over the current budget.  That $480 million is mostly used in four places – a 4% increase in allowable growth for education ($170 million), education reforms passed last year ($54 million), property tax reform “backfill” to reimburse local governments for revenue losses ($120 million), and to pick up a larger share of the state’s Medicaid obligation that is not covered by the federal government ($86 million). 

This agreed-to level is about $29 million less than the Governor's proposed budget, and does not spend all available revenues.  By law the Legislature is allowed to spend 99% of the funds the state collects in taxes.  The rest goes into a "rainy day fund" that the state needed when the economy hit rock bottom.  Now that fund is full again, and is approaching $1 billion.  The budget targets do not spend all of the 99% allowed, but that gives legislators a little bit of wiggle room if they agree to add more funding later in order to get to a budget agreement.

Below is a chart of the targets by budget subcommittee.


As you can see, the Health/Human Services Budget will receive $950,000 less than the Governor recommended.  The Governor didn't make many changes in his proposed budget, with most of the additional dollars going to fill the hole in Medicaid to replace federal funds when the state/federal match rate changed.  However, it is important to note that the Governor did not fully fund Medicaid.  So even if the Legislature had passed the Governor's budget, Medicaid would likely need a supplemental (additional) appropriation early next year.  That used to be common practice - the state would underfund Medicaid in order to fit their budget to the target given to them, and then come back the next year and give Medicaid extra money.  But it's not a great budget practice, and legislators have tried to pass budgets that are realistic. That may be very tough this year. 

Watch our website and Facebook page for announcements on budget progress.  As the HHS Budget Subcommittee begins to make decisions, we'll let you know through Facebook posts and "Breaking News" alerts on the website.

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Tempers Flair During CDAC Vote

It's been a very quiet session.  Not much politics, which is a bit surprising since half of the Iowa Senate and all of the Iowa House of Representatives face elections again this November.  But the Senate debate over the Consumer Directed Attendant Care (CDAC) program was anything but quiet.

On Tuesday (March 5) the Senate unanimously passed Senate File 2320, which reverses changes made to the CDAC program by the Iowa Legislature last year.  Last year, the Iowa Legislature directed the Department of Human Services to implement "cost saving measures" to the CDAC program.  The Department filed rules that required CDAC providers to be affiliated with an agency (while continuing to allow people to self-direct their care with independent providers through the Consumer Choices Option) and did not allow legal guardians to be paid to provide CDAC services.  Hundreds of providers, families, and people using CDAC services contacted the Department in opposition to the rules.  The Department decided to pull the rules, and ask the Legislature for direction.

Senator Tom Courtney and Senator Mark Chelgren both had bills this year to fix this issue.  Senator Chelgren's bill would have reversed last year's decision, and returned the program to the way it was before.  Senator Courtney's bill (which is the one being debated) delays the changes by two years (July 1, 2016) and makes them only apply to new contracts (so all existing CDAC providers may remain independent).  The bill also clarifies that people still have the option to self-direct care independently using the Consumer Choices Option (CCO) and allows a person to be a legal guardian and provide CDAC services.

But it wasn't the merits of the bill that caused the fight to break out.  During the debate, Senator Chelgren said that Senator Courtney did not respond to an Ottumwa woman's concerns when she called him.  He told Senator Courtney to "not let that happen again."  Senator Courtney shot back, saying he also had heard from people who had called him (Senator Chelgren) and that he seemed uninterested in their concerns.  Senator Chelgren immediately jumped up and accused Senator Courtney of attacking his charachter.  Senator Courtney responded with, "You started this, pal."

Lets just say that it didn't end there. Senate Majority Leader Mike Gronstal quickly called a lunch break "so some Senators can regulate their blood sugar levels."  While this was an unusally dramatic event in a mostly dull session, the good news is the Senate File 2320 passed 49-0 out of the Senate and is on track to get out of the House Human Resources Committee before next week's funnel deadline.

It looks like smooth sailing for CDAC!

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Accessible Fuel Pump Surprise

There was a pleasant surprise at the end of the first funnel - a bill held-over from last year suddenly emerged from the Senate Agriculture Committee.  Senate File 2284 requires Iowa's gas stations to be accessible, and provide assistance to Iowans with disabilities in pumping gas.  Interests like Hy Vee and the Iowa Grocery Industry Association are opposed.  But they may not be a match for the small but powerful dynamo behind this law change - ID Action's 2013 Advocate of the Year Angie Plager.

The former Ms. Wheelchair has a very busy schedule and drives herself to meetings around the state, but cannot refuel her car.  The buttons on the fuel pumps are too high, the credit card slots are out of reach, the metal fuel pump can be too heavy, and often there is no way to call for assistance.  Some convenience store employees are not well-trained and do not know they are legally obligated to help Iowans with disabilties refuel their vehicles.  So that spurred Angie into action, and last year she made some progress with her bill, but it ultimately didn't make it out of the Senate.

It was pretty quiet until a few days before the first funnel - no one expected this bill to move.  But during the last Senate Agriculture Committee before the deadline, Senator Joe Seng (Davenport) called up the bill, and Senator Rita Hart (Clinton) moved its passage.  It passed, and is now on the Senate Calendar ready for debate.  It must make it out of the Senate, and then out of the House Transportation Committee before next Friday, or it will again be dead.

Senate File 2284 makes three basic changes:

  • Gas stations and convenience stores must offer refueling assistance if requested, and display a sign that shows the hours when fueling assistance is available.

  • Gas stations and convenience stores must offer at least one pump with an accessible call button that can be reached from a car and can be activated with a closed hand. 

  • Stores cannot charge for providing assistance to someone with a disability.

Seems simple, but with the industry against it, the battle will be tough.  One advocate can do a lot, but more advocates makes the job easier.  So if this is something important to you, do not wait.  Call or email your legislators now. You can email your legislators quickly here.

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MH/DS Redesign Update

There is a lot going on with mental health and disability services (MH/DS) redesign - and not alot.  On the surface, it looks like there isn't much going on. But dig deeper and you will see that lots of meetings are happening, just not publicly. The Department of Human Services has met with key legislators to talk about the "savings" counties will see because so many Iowans are now signing up for health insurance, particularly the new Iowa Health and Wellness Plan.  Counties are meeting with the same legislators to explain why they think that the Department's guess on the amount of savings counties will see is wrong.  Those same legislators are meeting with their budget chairs, the Governor, and their leaders to talk strategy.

But no one really knows what to do.  It's a game of "he said - she said" - and it's anyone's guess as to who will be believed.  So to cut through all the back and forth going on at the Capitol, here are a few things you should know:

  • DHS says counties will save about $30 million, of which they will have to pay back 80% beginning next year.  That "savings" goes into a pot that the Legislature gets to decide how it will be spent.

  • While MH/DS Redesign passed two years ago, counties do not begin operating as regions until July 1, 2014.  So many regions are not yet fully operational.

  • Counties say they need at least one year of operating as a region to be able to tell Legislators how much it will cost to provide all core services, services to non-mandated populations (DD and BI), and provide core plus services. Until those numbers are available, they ask that the Legislature not take funds away.  They also are asking that any "savings" be reinvested in the system to make progress on full redesign.

  • The MH/DS "Clean-Up" bill (House File 2417) may be more controversial than first expected.  According to several legislators and the Iowa State Association of Counties, the changes made in that bill could seriously affect regional operations and the region's bottom line.  More on this in upcoming issues, but watch for updates on the website.

  • The Crisis Stabilization Bill (House File 2378) passed the Iowa House unanimously this week. It clears the way for new mental health crisis stabilization programs to be developed, giving the Department of Human Services the direction to write rules that would allow regions to move forward in responding to this need to provide a non-hospital level of care to help Iowans experiencing a mental health crisis stabilize safely.  Crisis Stabilization is a core plus service.

  • Funding for MH/DS Redesign was in the Governor's budget ($29.7 million).  It is unknown if the funding is in the joint budget targets issues this week, as that level of detail was not available.

If you are concerned about funding for MH/DS regions, do not worry about details. Talk to your legislator about the services you get from your region, the services you wish you'd get (that might be available if redesign is fully funded), and improvements you want to see in the system.  One thing is apparent - not all legislators understand the value of regional services. They see money going into a system, but don't see how that money is spent, and the value of it.  So let them know!

You can contact your legislator quickly by email here.  Or you can call your legislators during the week at: (515) 281-3221 (Representatives) or (515) 281-3371 (Senators). 

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Share Your Thoughts on Children's Mental Health Services

If you have things to say about the mental health services available to Iowa kids, now is your chance!  The Iowa Department of Human Services has a planning grant to learn more about how to serve families.  Through that grant, the ASK Resource Center will hold meetings to learn about the needs of families and their youth with mental health needs. The meetings are being held in communities across the state, and are for family members and youth.  At these events, you can share thoughts and ideas about how to make services better.  You will also have the chance to connect with other family members and youth.

Focus groups will be held in Ottumwa (March 11), Davenport (March 12), Des Moines (March 25), Atlantic (March 26), Sioux City (March 27), and Cedar Rapids (April 1).  For full details and registration, click here.  Space is limited so please register for these events.

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HCBS Focus Group Volunteers Needed!

Iowa is one of four states selected by the federal Centers for Medicare and Medicaid Services (CMS) to help identify core competencies for direct service providers in community based and long term care settings. Core competencies are basically skill sets that providers should have to best provide home and community based services.

The Department of Human Services has developed these "core competencies" and wants to make sure they are on the right track.  They will hold focus groups on March 24 and March 25 to see what providers, direct service workers, and the receipients of these services think about the core competencies, and what might need to be changed.

If you are a direct service worker or someone that receives HCBS waiver services and are willing to volunteer, please contact LeAnn Moskowitz at lmoskow@dhs.state.ia.us or call (515) 256-4653.  The following information should be included:

  • Name
  • Address, phone number and email address.
  • The type of HCBS services received which may include: Elderly, Developmental Disabilities/Intellectual Disabilities, Physical Disabilities or Behavioral Health services.

 The department currently needs the following slots to be filled, so let them know soon if you are interested:

  • Behavioral Health: 9 direct service workers, 9 HCBS service recipients/family/guardians
  • Intellectual Disability/Developmental Disability - 4 direct service workers, 5 HCBS service recipients/family/guardians
  • Physical Disability - 9 direct service workers, 7 HCBS service recipients/family/guardians

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Legislative Forums - Don't Forget About This GREAT Advocacy Opportunity!

Legislators like to keep in contact with their constituents during the session, but it can be tough to do while they are in Des Moines most of the week.  So on Fridays and Saturdays, they return to their homes and hold public meetings where the people they represent can talk to them about anything on their minds.  These are called "legislative forums" or "public forums" or "town hall meetings" or more creatively "Eggs & Issues" and "Pizza & Politics."  Whatever their name, its the same thing. An excellent advocacy opportunity!

So plan on going to a forum near you. If you don't want to ask a question or make a comment, at least go to meet your legislator and let them know who you are.  Just introduce yourself before or after the forum, and thank them for their service.  Click here for a list of upcoming forums.

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Bill Tracker

Check out disability-related bills that have been introduced so far this year  - click here to go to our Bill Tracker

Status has been updated - all bills that didn't make the first funnel deadline have been made "inactive."  Status is updated daily, so come back often!

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Get This Issue in PDF

You can download a formatted version of this email in PDF by clicking here.

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