2019 ISSUE #8
Issue 8, 8/7/2019
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Articles in This Issue:
- WELCOME TO THE INTERIM
- MCO CONTRACTS INCREASED, CHANGES AT DHS
- mCBD BOARD DRAFTS RECOMMENDATIONS
- MEET IOWA'S NEWEST LEGISLATOR
- SENATE COMMITEE CHANGES
- REGISTER FOR MAKE YOUR MARK CONFERENCE
- SHOW OFF YOUR ADVOCACY!
- TAKE YOUR LEGISLATOR TO WORK IN OCTOBER!
WELCOME TO THE INTERIM
Iowa's part-time legislators are only in session for a few months a year, usually January through April. Sometimes they go into May, and very rarely, June. The rest of the year they return to their communities, jobs, and families. This non-session time is called "the interim."
Legislative leaders often take this down time to study issues in more depth, authorizing "interim committees" to take more time to review and discuss issues and make recommendations for legislative action. Some years there are a lot of interims, and other years (like this year), there are very few. This year legislative leaders authorized the following legislative interim committees:
- Fiscal Committee: This is a permanent Legislative Council committee. Duties include examining budget and expenditure matters, directing the administration of performance audits and visitations, and studying the operation of state government and making recommendations regarding reorganization. (Members)
- Tax Expenditure Committee: This is also a permanent Legislative Council committee. Duties include approving annual estimates of the cost of tax expenditures by December 15 each year, and performing a scheduled review of specified tax credits so that each credit is reviewed at least every five years (coordinating with Tax Credit Review Committee listed below). The ninth scheduled review is in 2019. (Members)
- Health Policy Oversight Committee: Another permanent legislative committee under the Legislative Council. Duties include providing continuing oversight for Medicaid managed care, ensuring effective and efficient administration of the program, addressing stakeholder concerns, monitoring program costs and expenditures, and making recommendations. (Members)
- State Government Efficiency Review Committee: Another permanent legislative committee required to meet at least every two years to review state government organization and efficiency options and receive state government efficiency suggestions offered by the public and public employees. The last report was submitted in 2016 and the next report is due in January 2020. (Members)
- Public Retirement Systems Committee: Another permanent legislative committee that is required to review and evaluate all public retirement systems in place in Iowa, including the Iowa Public Employees’ Retirement System (IPERS), the Municipal Fire and Police Retirement System of Iowa (Iowa Code chapter 411), the Department of Public Safety Peace Officers’ Retirement System (PORS), and the Judicial Retirement System. The committee typically meets during the legislative interim of odd-numbered years (like 2019). (Members)
- School Finance Formula Review Committee: A permanent legislative committee required to meet at least every five years to prepare a school finance formula status report and make recommendations on changes to the school finance formula changes. Last report was submitted in January 2015, so the next review would need ot be done this interim. (Members)
- Career and Technical Training Implementation Review Committee: This committee was created by the Legislature in 2016 and is required to study career and technical training and work-based learning program rules and assess the membership of the regional career and technical education planning partnerships to assure that all affected groups have representation. Report due before the start of the 2020 Legislative Session. (Members)
- Fuel Distribution Percentage Formula Review Committee: Another permanent legislative committee required to meet at least every six years to review fuel distribution percentage formulas and make recommendations. The first report from this group is due by January 1, 2020. (Members)
- Tax Credit Review Committee: Legislation passed in 2018 required this committee to evaluate available tax credits and consider new or different tax credits, incentive programs, or tax rate or structure changes. (Members)
While there is not a lot here that may be of interest to advocates with disabilities, the Health Policy Oversight Committee continues to be the only body charged with direct oversight of the Medicaid managed care committee. All meetings of this and other committees are open, but probably won't be held until later in the Fall 2019. Stay tuned to our social media feeds and website for announcements between issues of infoNET.
MCO CONTRACTS INCREASED, CHANGES AT DHS
If you read the newspapers, you know it has been a very news-worthy summer for Iowa's Department of Human Services. First, DHS Director Jerry Foxhoven was asked to resign in July because Governor Reynolds has decided to "go in a different direction." Iowa's Department of Public Health Director Gerd Claybaugh has been asked to be the interim DHS Director. Claybaugh will continue to be IDPH Director, overseeing both departments until a permanent replacment can be hired.
With the changes at the top of DHS, Mental Health and Disability Services Division Director Rick Schults has decided to delay his planned July retirement until things stabilize in the department. He will continue to oversee the work in the MH/DS regions, including the roll-out of new Access Centers and other core services, and the planning for the addition of children's services.
Finally, the two private health care companies that manage Iowa’s $5 billion Medicaid program are getting a funding boost. But don’t call it a raise, the state’s Medicaid director said in a mid-July press conference. Contracts signed in July by the state include an 8.6% increase in state and federal funding for Amerigroup Iowa and Iowa Total Care, the two insurers that provide health coverage for more than 600,000 disabled and low-income Iowans on the Medicaid program. That means about $115 million more will be going to Iowa's two managed care organizations (MCOs), without any requirement that it trickle down as raises to the providers of those services.
mCBD BOARD DRAFTS RECOMMENDATIONS
The Iowa Legislature passed a medical cannabidiol (mCBD) bill earlier this year that would have expanded access to those with severe and chronic pain, to those living in rural or underserved areas by allowing nurse pracitioners and physician assistants to certify use, and to those needing higher levels of THC (the stuff that makes people "high") by allowing up to 25 grams of THC over 90 days. That THC change would have replaced current law that puts a 3% THC cap in each dose. It was the THC level change that caused Iowa's mCBD Advisory Board to request a veto of the bill. The Governor followed that advice, and vetoed the bill, asking that the stakeholders in this issue work together over the summer to come up with a compromise.
The mCBD Board met on August 2 to begin this process, and after nearly three hours of public comment and several votes on petitions to expand access, the Board came up with an initial set of recommendations to forward to the Legislature. These recommendations are in draft form, and will be discussed and voted on at the next (November 1) meeting:
- Eliminate 3% THC cap.
- Restrict THC limit to 4.5 grams/90 days.
- Allow waiver of THC limit for those that are terminally ill (less than one year to live).
- Include methodology on how to measure total THC (THC vs. THCA which is not intoxicating).
- Remove felony disqualifiers for both patient and primary caregiver (HF 732 only eliminated for patient).
- Allow PAs, ARNPs, and podiatric doctors to certify use.
- Mandate dispensaries have a pharmacist or pharmacy tech under a pharmacist supervision on site (HF 732 permitted but did not require it; Board wanted someone that understands med-to-med interactions onsite).
- Allow physician and others who can certify use to access to the patient registry.
- Allow certified use of mCBD products in long term, acute care, and school settings.
- Require more research.
- Remove “untreatable pain” and replace with “chronic pain.”
- Eliminate Department of Transportation in the registration process (currently people must go to the DOT office to get their mCBD card, an extra step in the process; instead the Iowa Department of Publci Health will issue cards when they receive a patient's paperwork).
- Eliminate the restriction on the number of times the mCBD Board can meet, and instead change to meeting a minimum of 4x/year (this board may be the only one in state government limited to a number of meeting times; most boards use a minimum # of times to meet, not a maximum).
- Change the name of the Medical Canniabidiol Advisory Board to the more accurate Medical Cannabis Advisory Board.
The Board, which has been innundated with petitions requesting conditions be added, also decided to set up a subcommittee to review each petition in more depth, hear public testimony, and review medical literature. They would then make a recommendation to the full board. The Board agreed these petitions would be discussed quarterly, and petitions could only be re-submitted every six months. The Board rejected two petitions, one adding a large group of conditions (PTSD, social anxiety disorder, obsessive-compulsive disorder (OCD), schizophrenia, anxiety, and more), general anxiety disorder and opioid tapering. They did request that a review of adding PTSD be reviewed by this newly created subcommittee, for discussion at the November 1 meeting. If it is approved as an additional condition, it will be added to the legislative recommendations.
The board also heard a few updates on the program:
- 16.4% of patients have an associated primary caregiver (someone who gets the medication for them through a primary caregiver card; these are typically people who have transportation barriers or are children).
- 72% are certified to use for a pain-related condition.
- 40% qualify for reduced fee (Medicaid, SSI, SSDI).
- Gender breakdown is about 50-50 male/female.
- DIspensaries surpassed $1 million in sales this summer; average purchase is $142.70.
- About 3/4 dispensed are high THC or high CBD (split evenly); the rest is balanced.
- Patients by dispensary location: Polk (882), Black Hawk (249), Woodbury (200), Pottawattamie (160), Scott (152)
Two legislators that called for a special session to override the Governor's vetoes (Sen. Joe Bolkcom of Iowa City and Rep. John Forbes of Urbandale) spoke during the public comment period and passionately expressed concern about limitations impacting the quality of life for many Iowans. Sen. Bolkcom urged the board to overcome their "misplaced obsession with THC" and Rep. Forbes (who is a pharmacist) talked about the patients he has worked with who are now pain-free and off dangerous opioids with the help of mCBD. Several people speaking talked about Illinois' passage of recreational marijuana, which will begin January 2020.
What are your opinions? Take our quick poll here.
- If this issue is important to you or someone you love, contact your legislators now and let them know what you think. The 2020 Legislature will address this issue when it returns in January.You can do that through our grassroots action center here.
- Also consider submitting your comments, in person or in writing, to the mCBD Board before their November meeting. You can do that onine here. The November 1 meeting will be held at 10 am - 12:30 pm at the Iowa Laboratory Facility on the DMACC Campus (2240 DMACC Blvd., Ankeny, Iowa). Public comment period is usually at the beginning of the meeting (stay tuned at www.infonetiowa.org for agenda once published).
MEET IOWA'S NEWEST LEGISLATOR
Lisa Heddens is well-known in disability policy circles, as a parent of a son with an intellectual disability, for her work with NAMI Central Iowa and the ASK Resource Center, and as a State Representative who served as ranking member on the Health and Human Services Budget Subcommittee. Earlier this summer, she left her job in the Iowa Legislature and was appointed to the Story County Board of Supervisors, making it the first all-woman board of supervisors in Iowa.
Because she resigned in the middle of her two-year term, the Governor called a special election for Tuesday, August 6. The Republicans did not field a candidate in this heavily Democratic district. That mean Iowa State Extension Service associate program director and diversity officer and former Iowa City Mayor Ross Wilburn easily won the election and will become Iowa's newest State Representative. His election does not change the control of the Iowa House of Representatives (53 Republicans, 47 Democrats).
When asked why he ran, Rep. Ross Wilburn said “service to others is an important part of community," something he learned from his father, who was an auto worker and active union member. Wilburn served on Iowa City’s council for twelve years and was the community’s first African-American mayor during part of that time. He moved to Ames in 2014, and ran for Governor in 2018 (only getting 2% of the statewide vote in the June primary). Rep. Wilburn said one of his priorities would be Medicaid, saying “Iowa’s privatized Medicaid experiment continues to be harmful to Iowans.” He grew up in Davenport, served in the National Guard while attending University of Iowa, and volunteered answering calls for the Johnson County Crisis Center.
Rep. Ross Wilburn's committee assignments will be announced soon, but it is unlikely that he will be the next HHS Budget Ranking Member. Leadership has indicated they plan to look for another member that has more experience on the issues to take that position. Stay tuned!
SENATE COMMITEE CHANGES
Sen. Randy Feenstra (R-Orange City) will be running for Congress in 2020, hoping to take the seat from US Rep. Steve King. He will run in the primary, and does not plan to return to the State Senate, whether successful or not. Earlier this summer, he decided to step down as Chair of the powerful Senate Ways & Means Committee so he can focus on this primary challenge. That prompted the Senate Republicans to reorganize their committee memberships:
- Sen. Jake Chapman, R-Adel, will chair the Senate Ways and Means Committee.
- Sen. Dan Dawson, R-Council Bluffs, will chair the Senate Commerce Committee.
- Sen. Jim Carlin, R-Sioux City, will serve as chair of the Senate Veterans Affairs Committee.
- Sen. Julian Garrett will serve as the vice chair of the Senate Judiciary Committee.
- Sen. Ken Rozenboom will replace Senator Dawson on the Senate State Government Committee.
Updated Republican committee members are below (Democratic members remain unchanged). All changes are effective immediately and other committee assignments are unchanged. Our 2019-2020 Guide to the Iowa Legislature has been updated to reflect these changes, and the resignation of Rep. Lisa Heddens (click here).
Ways and Means
- Chapman, Chair
- Dawson, Vice Chair
- Dawson, Chair
- Koelker, Vice Chair
- Zaun, Chair
- Garrett, Vice Chair
- Smith, Chair
- Johnson, Vice Chair
- Carlin, Chair
- Miller-Meeks, Vice Chair
REGISTER FOR MAKE YOUR MARK CONFERENCE
You do not want to miss this year's Make Your Mark! conference. Sessions this year are focused on developing your leadership skills. And because Iowa leads the way in selecting Presidential candidates with its first-in-the-nation caucus, Friday's session will include a mock caucus with our favorite expert Dave Price!
Iowans with Disabilities in Action is excited to again offer FREE registration to individuals with disabilties and family members and direct care support professionals accompanying the participant. However, don't wait to register, as we are limiting registration to the first 150 people (and we're halfway there already!).
SHOW OFF YOUR ADVOCACY!
People often think that advocacy is for someone else. They think it's hard, or you need special skills. Little do they know that all you need is your story, and the desire to help make change happen!
We want to share your advocacy stories in INFONET to help inspire others to take action. Maybe you went to a community meeting, or had coffee with your legislator, or got a selfie with a Presidential candidate. Maybe you're volunteering on someone's campaign, or talking to your board of supervisors about a curb cut.
If you know of an Iowa advocate with a disability who has taken action, let us know! Contact us at email@example.com or by phone at 515.554.5838. We'd love to share your advocacy with others - and show you leading the way!
TAKE YOUR LEGISLATOR TO WORK IN OCTOBER!
October is National Disability Employment Awareness Month and throughout the month, Iowans with Disabilities in Action will conduct the Take your Legislator to Work Campaign. This campaign is intended to increase awareness that every Iowan with or without a disability should have opportunities and choices to have meaningful employment in the community.
Iowans with Disabilities in Action is interested in working with people with disabilities who would like to take their Legislator to Work! The visit will typically last between 30-45 minutes and it is your opportunity to share with your legislator(s) what you do at work and why it is important in your life.
Who Can Participate:
- This campaign is open to any Iowan with a disability who is working in any type of employment. Before you decide to participate, you need to ask yourself two very important questions:
- Do I have great things to say about my job and the impact it has on my life?
- Do I have a message I want to share with my legislator(s)?
If you can answer yes to both of those questions, then you should consider participating in the Take Your Legislator to Work Campaign. Here's how it works:
- The campaign will take place throughout the month of October. To get started, go to the Iowans with Disabilities in Action website www.idaction.org and download the information form. Send the form back to us by September 12 and we can get started. You will be responsible for talking with your employer to get approval, determining the best times for a visit and contacting your legislator to invite them to participate.
- Iowans with Disabilities in Action will provide you with assistance throughout this process.
- If you have any questions, please contact us at 866-432-2846 or firstname.lastname@example.org.
If you are a legislator and interested in being a part of this, let us know as well through the contact information above.