2019 Legislative Update
| February 9, 2019
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Busy Weeks Despite Winter Weather
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While DC struggles to figure out how to keep the federal government open, the State Legislature in Iowa has kicked into high gear. Neither rain, nor snow and ice can keep the Legislature from its business at hand. As proof, the Iowa Legislature continued with a full day of committee and subcommittee meetings on January 30, despite the US Post Office taking the day off from Iowa deliveries due to the weather.
Last week alone, legislative subcommittees and committees debated the merits (or faults) of the state’s judicial nominating process, legalized sports betting, changes to cannabidiol and cannabis laws, bills guaranteeing all views have the right to free speech on campus property, required citizenship test passage for high school graduation, inserting language that states the rights a person does not have in the constitution (in this case, no right to an abortion), allowing the sale of canned cocktail drinks, permitting oyster mushrooms to be sold in farmers’ markets, opening original birth records to adult adoptees, and much more.
We now have four full weeks under our belts and Monday, February 11, will mark Session Day 29 of the 110-day legislative session. That leaves about one month until the First Funnel, a deadline by which any policy bills need to have been approved by their originating committee in order to stay alive.
The funnel week is typically preceded by about 10-12 intense days filled with subcommittee and committee meetings. However, insiders will tell you that the pace of this past week felt a lot more like the week before funnel week than the fourth week of session. Case in point, there were a total of 117 subcommittee meetings on bills this past week. Lobbyists were triple and quadruple booked most days, which meant running from one subcommittee to another and doing as much preparation ahead of time with legislators on subcommittees as is possible.
While all this is going on, bills are being introduced at a maddening pace and we can’t take our eye of these emerging legislative proposals, since they are introduced one day, and debated the next. As of Friday, 868 bills had been introduced, 381 by the Iowa Senate and 487 by the Iowa House. Since the first funnel is still four weeks away, we have no reason to believe that we are nearing the end of the bill introductions for this year. Make sure you keep your eye on your
bill tracker
for these new bills – we update it daily!
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Forecast for Week Ahead...More Controversy
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The fast pace of subcommittee and committee meetings is expected to continue this week, but the Chambers will start to plug in some debate as well. The House is expected to take up school funding Monday night. The Legislature is required to complete school funding within 30 days, so the Senate will likely take up the House’s bill shortly thereafter and send it to the Governor.
Both the House and the Senate appear settled on providing a 2.06% increase to schools. This equates to about $89.3 million in new funds in the
Fiscal Year (FY) 2020, with $78.6 million going into supplemental state aid, $2.9 million going into state per pupil funds, and $7.8 million being allocated toward offsetting transportation inequities to school districts.
Other issues beginning to suck up a lot of oxygen in the Capitol, as of last week, include whether or not (and how) to add sports betting, whether to change the method by which judges are selected in Iowa, and whether to amend the Iowa Constitution to address abortion rights, gun rights, term limits and Gubernatorial succ
ession.
And there still remains a lot of controversy. A House subcommittee will look at an emerging issue to criminalize female genital cutting, a 1000-year-old cultural practice that some in the African/Asian/Middle Eastern refugee communities still practice. A Michigan court struck down a federal criminal law on constitutional grounds, so many states are rushing to criminalize, despite the refugee community asking for a more thoughtful, non-legal approach to change behavior (fearing that communities will not deliver babies in hospitals, seek prenatal care, or take children to doctors if they think someone will report them). Nuanced and tough - one of those "no easy answer" issues that lawmakers have to address each year.
A subcommittee hearing held this week failed to move a bill that would have eliminated the certificate of need process for some new services, and efforts to prohibit the Boards of Social Work and Behavioral Health from setting limits on the number of CEUs that can be obtained online also failed. However, lawmakers did forward a bill out of subcommittee that would license music therapists. We are on the lookout for other professional licensure board changes, and efforts to limit the types of mental health professionals can supervise temporarily licensed mental health counselors and marital and family therapists. We know they're coming. In addition, we'll be keeping an eye on these emerging issues over the next two weeks:
- Medication switching for medically-stable patients (HF 204)
- Anti-vaping efforts (SF 66)
- Multiple (therapy) procedure reductions in Medicaid (SF 147)
- Medication Assisted Treatment prior authorization for addictions (SF122)
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Department of Public Health Presents to Senate
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In the wake of the Washington state measles outbreak, more legislators are starting to ask about Iowa's immunization laws, and whether state law is adequate to protect vulnerable populations from a similar outbreak. During Iowa Department of Public Health Director Gerd Claybaugh's presentation to the Senate Human Resources Committee, Sen. Liz Mathis (D-Linn) asked about the state's immunization rates.
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laybaugh responded that state immunization rates were still high (96-97%), but added that in Polk County both religious exemption requests and overall immunization rates were rising. Claybaugh said that his department's work in assessment helps him see trends, and said he would be happy to provide more information on trends to help inform their policy deliberations. Sen. Mathis encouraged him to look at state statutes to make sure "we haven't gotten too loose in granting these exemptions."
Other issues discussed during Director Claybaugh's presentation include:
- Childhood Obesity: Claybaugh reported that the program has received a great response and has the support of the Councils of Government and the Iowa Medical Society, which helped engage more than 1,500 children in the program. He reported this as one of his Department's two biggest challenges (substance use being the other). "We are 4th in the country for childhood obesity...and we continue to get worse," reported Claybaugh. He said while this is a good long-term investment, something needs to be done to address adult obesity as well. In response to a question by Sen. Jeff Edler (R-Marshall) about his biggest challenges in this area, Claybaugh said they do not have good data to develop a risk profile for kids, but said activity levels and better eating are the biggest issues. He added that parents need to be more involved in healthy eating choices.
- Substance Use: Claybaugh pointed to substance use as his second biggest challenge, and said that it goes well beyond opioids, with methamphetamine still on the rise and alcohol being the number one cause of substance use death in the state. he also pointed to rising rates of marijuana addiction in youths. Sen. Herman Quirmbach (D-Ames) asked about the current allocation for tobacco prevention ($4 million) and commented on its inadequacy (CDC recommends $36 million).
- Workforce: Claybaugh touted the work on the medical residency program and the new expansion recommended by the Governor to add four more psychiatric residencies. "Research shows that where physicians do their residences is typically where they end up staying," said Claybaugh. He said they are "very invested in workforce" and will be evaluating the department programs regularly. He said this was a critical investment, but there was so much more to do. Overall IDPH licenses more than 150,000 health professionals through 19 boards within the bureau, four large boards outside the bureau (dentistry, pharmacy, medical, nursing) and about 20 more professions that are licensed without boards. Sen. Mathis asked about follow-up on a 2016 workforce program report, and asked if any programs had been eliminated or consolidated based on that report. Claybaugh said that he would get back to them with a more complete answer, but that PRIMECARRE program was very important to the department. Over the program's 20 year tenure, it has served 92 individuals, of which 72 remain in the state. He said that shows the program has a high return on investment, and funds are matched by the federal government. He didn't mention IPA's psychologist training program, but the 2016 report shined a great light on our successes!
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Medicaid "Work Requirements" Coming
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There have been a handful of bills that proactively address some of the administrative complexities of the Medicaid managed care program, but none have much chance of passage. Bills include:
- HF 60 - directs greater standardization, streamlining, and simplification.
- SF 148 - requires uniform prior authorization process, forms, requirements, time frames.
- SF 211 - requires an external review process for appeal denials.
- HF 135, SF 143, SF 211 - pulls long term supports and services out of managed care.
Work requirements for people receiving benefits from Medicaid and other public assistance programs is going to be a hot topic this year, and we know it's coming. A few bills were released over the last two days that start to bring this issue up:
- SSB 1131 - DHS must contract out for eligibility verification system for public assistance programs.
- SSB 1109 - Requires child support order compliance in order to receive SNAP assistance.
- SSB 1108 - Requires DHS assign a person to a workfare program to maintain SNAP eligibility.
- SSB 1134 - Requires DHS to submit a waiver request to CMS to require, as a condition of eligibility, Iowa health and wellness plan members participate in community engagement activities.
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Your Bill Tracker
Click above to see status of important bills, or create your own report with our custom download.
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Town Halls & Public Forums
Find a local event with your state or federal elected officials here. Three weeks are shown at a time on this website.
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Your Legislative Team:
Your Advocacy Toolkit:
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