2018 Issue #2

Issue 2, 2/4/2018

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Iowans with disabilities are being heard loud and clear at the State Capitiol this year.  Legislators have introduced several bills to protect integrated health homes, require providers be paid better by MCOs, pull long term supports and services out of managed care, prevent insurers from switching medications on people who are doing well on them, and provide options for home delivered meals and home modification.  

These bills are getting a lot of attention, and subcommittees have already spent time working on several of these bills.  But time is running out.   Bills have to move out of committee before February 16, or they die for the year.   Only budget and tax bills are exempt from this deadline.  

There are a lot of things you can do to make sure your priorities get a good hearing at the Capitol.  

  1. Check out the Bill Tracker here - is there something there you want to see passed?
  2. Use social media to get your point across - use our new Action Center to tag your elected officials here.
  3. Call or email your legislators here.
  4. Use your smartphone to videotape your advocacy message and send it to your legislators. Click here for emails.
  5. Get a group togehter and host a Capitol Day.  ID Action has grants to help with that (click here for more info).
  6. Done all this? Then recruit others to do the same!
  7. Share what you are doing with us!  Email us at infonetiowa@gmail.com.

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There is only one thing that the Legislature has to do every session - pass a budget.  Unfortunately, our state legislators have been passing budgets that spend more than the state actually collects, forcing mid-year cuts called "deappropriations."  While the policy committees are racing toward the funnel deadline, House and Senate leaders have been meeting with the Governor to work out a deappropriation deal that will trim between $30-50 million out of the current year budget, which ends June 30, 2018.  
As you may remember, the Governor recommended cutting $27 million in spending out of the current budget year, but the Senate moved its version that cuts $50 million out of committee .  We are waiting to see what the House proposes. The Senate bill (SF 2117) is a bit different than the Governor's recommendations. 
  • The Senate cuts state universities and community colleges by $20 million. It's the same 2.7% cut that other areas of the budget get, but the Governor had recommended just under $7 million in cuts for these two areas.
  • The Governor recommended $10 million in cuts to Medicaid.  The Senate did not touch Medicaid spending but instead redirected these cuts to other areas of the Health/Human Services budget, including $255,000 cut in autism support,  $250,000 from State Supported Assistance (SSA) that helps persons with disabilities live independently, and $6.6 million from DHS' field staff and general administration.
  • The cuts to the Department of Public Health and Department on Aging are tripled. Because these cuts are unassigned in the Senate bill, the Departments have the ability to go after any funds not yet spent. 
  • Vocational rehabilitation is cut dramatically in the Senate budget ($164,000 vs. the Govenror's recommendation of $54,000).  Cuts to vocational rehabilitation often threaten the state's "maintnenance of effort" - the minimum amount of money the state has to put up in order to keep federal funds. So these cuts mean Iowa will be leaving federal funding for job training and education for individuals with disabilities on the table.
So what's with the Senate cuts?  The Senate wants to cut more to be safe; Iowa's farming economy continues to struggle and the state is not collecting as much in taxes as it does in good farming years.  That means less money to spend.  Since lawmakers have to guess at how much money they have to spend each year, mistakes in those guesses leads to mid-year cuts like those above.  The last thing legislators want to do is have a second round of cuts later in the session or have to come back for a special session right before the November elections to cut more programs and services.  
So legislators want to cut enough now, and be careful in developing next year's budget.  For the most part, the cuts made now will continue into fiscal year 2019's budget.  Local schools will get an increase this year - an agreement has been reached for an extra 1% in growth for K-12 education (cost to the state is $38 million).
The state's panel of tax experts will meet again in March to rebalance the state's checkbooks, and at that time we'll have a better picture of our state's spending options.  Even if the numbers look good in March, there are several legislators who would rather cut taxes than reinstate funding cuts.  So let your legislators know what your priorities are!

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Iowans needing hearing aids and other adaptive technology know that the costs are often very high and not covered by private insurance, particularly for growing kids who may need them replaced more frequently.  Rep. Norlin Mommsen of DeWitt has introduced a bill (HF 2178) that requires insurance companies to pay for pediatric hearing aids, including fittings and ear molds. The coverage is limited to one new hearing aid every three years, but insurers cannot set higher copays and deductibles.  

Several legislators introduced another bill (HF 2141) aimed at providing more consumer protection and information on telecoil devices that work with hearing aides.  Telecoils are also called "T-Switches" or "T-Coils"; they are compatible with the Assistive Listening Systems that churches, movie theaters, auditoriums, and sports stadiums use to comply with the American with DIsabilities Act (ADA). So if you have a telecoil equipped hearing aid, then you can hear the magnetic signal in these venues, and can hear a lot better than traditional sound systems.  

Senator Rob Hogg of Cedar Rapids has also introduced legislation to help identify kids with hearing impairments earlier, and provide parents with resources to address their needs. His bill (SF 2076) requires the Department of Education, Department of Public Health, and the Iowa School for the Deaf to develop language milestones for kids with hearing impairements, select assessement tools, require interventions and education plan changes when a child fails to meet milestones, and requires the development of a parent resource to help in understanding and implementing the child's individualized education plan (IEP).  

If you are interested in these bills, let your legislators know! The first two are assigned to the House Human Resources Committee; the last is assigned to the Senate Education Committee.   Since they have been recently introduced, they do not yet have a subcommittee assigned to them. 

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United announced it would take over the care coordination for some Iowans with serious and persistent mental illness (SPMI) in integrated health homes (IHH), giving providers and members only two weeks notice.  After legislative, provider, and member outrage over the change, DHS announced last week it would "pause" any changes to the Health Home program for six months.  

Over the next several months, DHS will work with MCOs, providers, and members to review the health home program, review data, find out what is working, and work on areas that are not performing as expectred. DHS said its goal is to leave those programs that are meeting expectations alone, but put those not doing well on notice to improve.

But this six-month pause might not be enough for some Senators.  Mike Randol, the state’s new Medicaid director, faced tough questions from several committees and subcommittees last week.  Sen. Mark Chelgren (R-Ottumwa) and Sen. Amanda Ragan (D-Mason City) decided to pass and amend Senate File 2092, which does not allow MCOs to do health home care coordination on their own and gives Medicaid members the opportunity to choose their health home.  

Senators Chelgren and Ragan amended the bill during subcommittee to prohibit any changes to the health home program for one year, giving legislators time to review any changes before they are made.  The bill should be ready for committee action sometime in the coming week.

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The Governor’s health policy staff called a meeting of stakeholders together this week to discuss the complex needs legislation being drafted by Senator Jeff Edler (R-State Center) and Rep. Shannon Lundgren (R-Peosta).   The bill (which has not yet been introduced) will model the recommendations of the work group held this summer (www.legis.iowa.gov/docs/publications/DF/865801.pdf).  

Mental health and disability services (MH/DS) regions will be asked to use their fund balances to help develop the expanded array of services recommended in the bill, including “access centers” that would include subacute beds to keep Iowans in a mental health crisis out of hospitals and jails.  The report also calls for intensive residential serivce homes (nicknamed "IRiSH"), a stronger continuum of crisis services, and more psychiatric inpatient beds access.  

Of course the pricetag on this will be large, so lawmakers may have to prioritize their wish list before the session ends.   Look for these to come down in the next week.

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After last year's crowds and demonstrations, it's pretty quiet at the Capitol.  This year is a perfect time to organize a group and have your own Capitol Day! 

ID Action will provide eight (8) Capitol Day grants up to $500 each for advocacy training and support to local advocacy groups who are interested in meeting with their legislators and advocating on behalf of disability related issues at the Iowa State Capitol .  There are a few rules - your group must:

  • Consist of at least 10 people with a disability (no more than 20)  
  • Advocate for disability related issues  
  • Schedule a Capitol Day on either Tuesday or Wednesday now through April
  • Participate in an advocacy training at the beginning of the Capitol Day  
  • Set appointments with your legislators (ID Action can assist)  
  • Provide a written recap of your Capitol Day within two weeks after your visit

While not required, we encourage groups to do the following while at the Capitol:

  • Watch a floor debate  
  • Attend a committee meeting  
  • Meet with other state agencies  
  • Meet with ID Action or Iowa Developmental Disabilities Council staff  
  • ID Action Capitol Day Grants cannot be used to attend other organization's lobby days.

To apply for an ID Action Capitol Day grant, please fill out the grant application.  Call 866-432-2846 or email us at contactus@idaction.org with any questions. Grants are available on a first come, first served basis for eligible groups.


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We have ramped up our resources for you this session including a brand new (hot of the presses) 2018 Guide to the Iowa Legislature.  If you are an infoNET subscriber, you will receive a copy in your mailboxes soon.  It's always available here.

If you have not tried out our new Advocacy Center, you should give it a whirl!  You can easily send a message to your elected officials - state legislators, Congress, Governor, or President.  You can also call them, or use our system to post to your elected officials' social media sites.  Or try sending photos and messages using the new #IamMedicaidIowa.  It's really cool - try it out here.

And don't forget - you get points for every action you take in our Advocacy Challenge.  So get started now and improve your chances of winning!

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We work hard to make sure you know the issues your legislators are working on each year at the State Capitol.  There are a number of issues we know that our readers care about - transportation, Medicaid, community-based services, access, and more.  Click here to look at the new bills introduced (so far) in the 2018 session.   

To stay alive, bills must get out of their first assigned committee before Friday, February 16.  So take action if you see something you like, dislike or want changed.  You can use our Advocacy Center to let your legislators know!

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Do not miss out on the best way to advocate - in person, in your own area.  Iowa's elected officials are really good about getting back to their districts and talking to the people they represent.  That goes for our members of Congress as well as your state legislators, and Governor Kim Reynolds, who is continuing the Branstad tradition of getting to all of Iowa's 99 counties each year.

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Click here to get this issue in PDF format.

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