Iowa s Disability Policy Resource Time Running Short for Your Priorities 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. [All links in red in this article can be found at http://www.infonetiowa.org/ news/] In This Issue 2 Budget Talks Underway 3 Bill to Help with Hearing Introduced 3 Integrated Health Home Changes Paused 4 Bill Coming on Complex Needs 4 WANTED: People to Respond to Survey! 5 Plan a Capitol Day Now! 5 New Advocacy Resources 6 Bill Tracker 8 Public Forums 2018 Issue #2 February 4, 2018
Budget Talks Underway 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! 2018 Issue #2 February 4, 2018 Page 2
Bill to Help with Hearing Introduced 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. Integrated Health Home Changes Paused 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. 2018 Issue #2 February 4, 2018 Page 3
Bill Coming on Complex Needs 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. WANTED: People to Respond to Survey! 2018 Issue #2 February 4, 2018 Page 4
Plan a Capitol Day Now! 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 at the Iowa State Capitol and advocating on behalf of disability related issues. 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. New Advocacy Resources 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! 2018 Issue #2 February 4, 2018 Page 5
Bill Tracker Here are a few bills that may be of interest. A full list of bills tracked for our readers can be found at www.infonetiowa.org/news/bill-tracker/. HF2001 Service Dogs and Assistive Animals - Allows a landlord to require a person with a disability to remove their service dog or assistive animal from their rental house or apartment under certain circumstances. (House Commerce Committee) HF2014 Hunters with Physical Disabilities - Allows hunters with physical disabilities to use any firearm, bow and arrow, or other hunting weapon authorized for hunting deer. (House Natural Resources Committee) HF2089 Service Dog Mistreatment - Prohibits the mistreatment of service dogs. (House Judiciary Committee) HF2104 Medicaid MCO Contracts- Ends Medicaid MCO contracts and returns Medicaid to the state Fee For Service system. (House Human Resources Committee) HF2141 Telecoil Assistive Devices - Requires telecoil hearing aid dealers to provide written information on the device to the consumer at the time the order is placed. ( (House Human Resources Committee) HF2178 Hearing Aid Coverage for Minors - Requires insurers to pay for pediatric hearing aids (for persons under 18 years of age). (House Human Resources Committee) HF2211 MHDS Funding - Allows MHDS regions to use fund balances to provide services to persons with substance-related disorders and persons with co-occurring mental health and substance-related disorders. (House Human Resources Committee) HF2212 & SF2159 Direct Care Workforce Database - Expands the registry of nurse aides to include a database to maintain the verified education and training records, credentials or certifications, and experience of all direct care workers. HSB516 & SSB 3003 Prescription Drug Coverage - Prohibits an insurer from limiting or excluding person's prescription drug coverage. (House & Senate Human Resources Committees) HSB520 Opiate Prescription Restrictions No longer allows prescriptions for more than a seven-day supply of an opiate. (House Public Safety Committee) HSB598 Health Care Administrative Simplification - Directs the Insurance Commissioner s annual work group to consider ways to bring about greater standardization, streamlining and simplification of health care administrative transactions. (House Commerce Committee) SF169 HCBS Waiver/Home Meals - Includes home delivered meals as a service available under all Medicaid home and community-based services waivers. (Senate Human Resources Committee) SF 2013 & SSB3094 Medicaid MCO/LTSS - Pulls the long-term care supports and services population out of Medicaid managed care, and allows for a 60-day transition back to the Medicaid fee-for-service system. (Senate Human Resources Committee) SF2055 SPMI Integrated Health Homes - Requires existing Medicaid MCO contracts ensure that SPMI integrated health homes are provided in a manner that reflect DHS criteria and meet the specifications of the Medicaid state plan amendment. (Senate Human Resources Committee) SF2075 Retroactive Medicaid Coverage - Reinstates three-month retroactive Medicaid coverage. (Senate Human Resources Committee)...continued on page 7 2018 Issue #2 February 4, 2018 Page 6
Bill Tracker (continued from page 6) SF2076 Language and Literacy Development for Deaf and Hard-of-Hearing Children Requires the development of developmental milestones and parental resources for language and literacy development for children with hearing impairments. (Senate Education Committee) SF2083 Medicaid Provider Reimbursement - Requires Medicaid MCOs to reimburse in-network providers at 100% of the fee-for-service rate and out-of-network providers at 95% of the fee-for-service rate for covered services. (Senate Human Resources Committee) SF2092 Integrated Health Home Services Directs MCOs to follow the state plan amendment for integrated health home services and prohibits them from doing the IHH care coordination themselves. (Senate Human Resources Committee) SF2113 Suicide Awareness & Prevention Training for School Employees - Requires school employees to complete suicide awareness and prevention training. (Senate Floor) SF2117 FY18 Deappropriation - Cuts the current fiscal year (FY18) budget by $50.1 million, about $20 million more than the Governors recommendation. Cuts hawk-i, autism support program fund, Regents universities, community colleges, vocational rehabilitation, autism support program, and human services, (Senate Floor) SF2119 Medicaid Provider Credentialing - Requires uniform credentialing requirements and procedures for Medicaid providers. (Senate Human Resources Committee) SF2120 Medicaid Uniform Billing and Prior Authorization Form - Requires a uniform billing and prior authorization form to be used by all Medicaid managed care organizations. (Senate Human Resources Committee) SF2133 Iowa Family and Medical Leave Act Creates a paid leave program that is funded through employer and employee contributions (similar to unemployment compensation) to allow people to take paid leave for an extended illness in the family. (Senate Labor Committee) SF2140 Medicaid MCO SIS Appeals Process - Requires Medicaid MCOs implement a process to appeal a supports intensity scale (SIS) assessment. (Senate Human Resources Committee) SF2141 Iowa ABLE - Medicaid Recovery - Prohibits DHS from recovering any remaining account balance following the death of an Iowa ABLE beneficiary. (Senate Human Resources Committee) SF2143 Housing for Aging Sex Offenders - Directs DHS and Department of Corrections to address the lack of sufficient housing for aging sex offenders who qualify for release from the custody. (Senate Judiciary Committee) SF2150 Medicaid LTSS/Conflict Free - Requires Medicaid long-term services and supports members receive services in a conflict free manner, including having independent providers performing assessments (SIS) and case management. (Senate Human Resources Committee) SF2157 Medical Cannabidiol Act Eligibility - Adds new medical conditions to the list that can be treated with cannabidiol. (Senate Human Resources Committee) SF2158 Medicaid Eligibility Requirements - Requires people to work, look for a job, or be in school as a condition of receiving Medicaid. (Senate Human Resources Committee) SSB3106 Medical Cannabidiol Act Changes Allows the Medical Cannabidiol Board add to the list of debilitating conditions that can be treated with cannabidiol and allows it to lift the 3% THC limit. (Senate Judicary Committee) 2018 Issue #2 February 4, 2018 Page 7
PO Box 737 Des Moines, IA 50303 [FIRST] [LAST] OR CURRENT RESIDENT [ADDRESS] [CITY], [STATE] [ZIP]-[ZIP4] Representing you in Congress: Sen. Charles Grassley Sen. Joni Ernst Rep. [Representative] Representing you @ State Capitol: Sen. [Name-Senate] Rep. [Name-House] infonet is a free policy resource published by ID Action, with support from the Iowa Developmental Disabilities Council. You can contact us at 866/432-2846 www.idaction.org www.infonetiowa.org. 2018 Issue #2 February 4, 2018 Public Forums 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. The following cities will host coffees with legislators and congressional members over the next two weeks. 02/16/2018, 12:00 PM-1:00 PM - Legislative Forum-Marshalltown 02/16/2018, 12:00 PM-1:00 PM - Legislative Forum - Fort Madison 02/16/2018, 12:00 PM-1:00 PM - Legislative Forum - Cherokee 02/16/2018, 12:00 PM-1:30 PM - Legislative Forum - Anamosa 02/17/2018, 7:30 AM-9:00 AM - Legislative Forum - Fairfield 02/17/2018, 8:00 AM-9:00 AM - Listening Post - Sigourney 02/17/2018, 9:00 AM-10:00 AM - Legislative Forum - Clinton 02/17/2018, 9:00 AM-10:00 AM - Town Hall - Plainfield 02/17/2018, 9:00 AM-10:30 AM - Eggs & Issues - Spencer 02/17/2018, 9:00 AM-10:30 AM - Public Forum - Burlington 02/17/2018, 9:00 AM-10:00 AM - Legislative Forum - Arlington 02/17/2018, 9:00 AM-10:30 AM - Legislative Forum - Newton 02/17/2018, 9:30 AM-11:30 AM - Legislative Forum - Waukee 02/17/2018, 10:00 AM-12:00 PM - Legislative Forum - Washington 02/17/2018, 10:00 AM-11:00 AM - Legislative Forum - Centerville 02/17/2018, 10:00 AM-11:00 AM - Legislative Coffee - Harlan 02/17/2018, 11:00 AM-12:00 PM - Legislative Forum - DeWitt You can see the full list and details of the above meetings at www.infonetiowa.org/calendar/events/.