Government : In the Statehouse: Updates from DM on Medicaid and more

Hi Everybody, My apologies for the delay in communicating, but the last couple of weeks have been a blur. We are in the midst of the funnel to winnow down the number of bills in the system. That means, if you don't have your bills done this week, they will not be considered this year or maybe ever. Luckily, my committee chairs blessed me with a number of priority bills to move through committees. Being someone who over prepares, it hasn't been too bad and I'm on the last 4 bills today and tomorrow. Anyway, I'm getting ready to head to the Capitol now and before the day gets away from me, I want to send some state updates and remind you of the legislative meeting on Saturday in Marengo, 10:30 at the Public Library. Senator Kapucian and I will be there for sure. If my memory serves correctly, Representative Maxwell will be able to join us also. Hope to see you there! Have a great day in House District 75! Medicaid Modernization Over 85,866 provider contracts have been signed as of the end of January. This represents over 95% of all possible provider contracts have been signed based on the Iowa Medicaid Fee-For-Service network in the past 12 months (out of 89,883). 95% of the providers have signed with all three MCOs. All four major hospital systems have signed with a managed care organization (Genisis, Mercy, UIHC, UnityPoint) Benefits under managed care do not change, but the managed care organizations will provide over 80+ value-added services Medicaid patients do not currently receive. Patients can switch to a different managed care organization at any time for any reason between now and May 17, 2016. After that date, patients can still switch for good cause (e.g., provider not signed up with a MCO). There will also be an annual open enrollment period in the late fall to choose a different managed care organization or remain. Between January 12 and February 4, Iowa Medicaid member and provider-services hosted day-long road shows in 11 cities across the state. Over 2,300 providers have attended or signed up to attend the training. More trainings will be held based on demand. 34,406 Medicaid patients have actively selected an MCO as of 1-22-16. Medicaid Modernization will create predictability and sustainability in the Medicaid budget. In FY 2017, Medicaid costs will increase $41 million even with managed care. Without it, costs would increase $151 million. Medicaid is the second largest program in state government. Its growth threatens the state’s ability to provide additional funding to schools. According to LSA, state revenue grew by 2.7% between 2006 and 2015. Funding for school grew at 4.3%. While funding for Medicaid grew by 9.1%. If Senate Democrats continued sabotage of Medicaid Modernization succeeds, the Legislature will have to find an additional $121.8 million in the FY 2017 budget to maintain the status quo in Medicaid. K-12 SSA already is received nearly all of the $153 million in projected revenue growth. If Medicaid Modernization isn’t implemented, K-12 schools will likely feel the impact through reduced funding. If you or your family are needing direction on this, I can get you to resources. Please let me know. 2016 Future Ready Iowa Summit Date Announced Gov. Branstad announced this week the first “Future Ready Iowa Summit,” to take place this spring on April 19th. The purpose of the summit is to create a statewide conversation about how to close the skills gap by building on efforts already under way to assure that students and workers have the career opportunities they deserve, and business and industry can hire the skilled employees they need. The spark for this initiative was in the Fall of 2014 when Iowa received a National Governor’s Association grant “to advance innovative education and workforce development initiatives.” The first efforts in this initiative took place last fall, in August 2015, when the Governor held the first of a series of roundtable meetings across the state with the same purpose. This was the beginning of the “Future Ready Iowa” initiative with the focus to find better ways to better align education and workforce initiatives. The roundtable included a panel of students from around the state as well as representatives from Iowa’s universities, community colleges, and high schools. The all-day summit is open to the public, with space for about 1,000. The hope is to attract a broad cross section of Iowans, including business, labor and nonprofit leaders; educators, students and parents; and state and local policy makers. The keynote speaker for the summit is Andreas Schleicher, a global expert on education and skills at the Organization for Economic Cooperation and Development. Other featured speakers include Jamie Merisotis, president of the Lumina Foundation, Mary Andringa, chair of the board of Vermeer Corp., and Byron Auguste, co-founder of Opportunity@Work. Students, educators, business and labor leaders, and entrepreneurs from around the state and nation are among other speakers and panelists. Audience questions and answers will wrap up each session. The summit will take place on Tuesday, April 19, from 9:30 a.m. to 3:45 at Hy-Vee Hall in Des Moines. Registration for the event is open now at https://futurereadyiowa.gov. Also at the website are a link to the agenda and additional information about the event, including info on the presenters. Source: https://governor.iowa.gov/2016/02/branstad-reynolds-announce-governor%E2%80%99s-2016- future-ready-iowa-summit. DNR Announces that Livestock Master Matrix Adopted in 88 Counties On Thursday, February 4, 2016, the Iowa Department of Natural Resources (DNR) published in electronic newsletter “EcoNewsWire” which contained an article announcing that once again, 88 of 99 Iowa counties notified DNR in January that they plan to evaluate construction permit applications and proposed locations for animal confinements by using the master matrix. Animal producers in these counties must meet higher standards than other confinement producers who also need a construction permit. They must earn points on the master matrix by choosing a site and using practices that reduce impacts on air, water and the community. With 11 exceptions, all counties will use the matrix during the next 12 months. The following counties will not use the matrix in 2016: Decatur, Des Moines, Fremont, Keokuk, Lee, Mahaska, Osceola, Plymouth, Wapello, Warren and Washington. Counties that adopt the master matrix can provide more input to producers on site selection, the proposed structures and proposed facility management. Participating counties score each master matrix submitted in their county and can also join in DNR visits to a proposed confinement site. While all counties may submit comments to DNR during the review process for permit applications, counties that adopt the master matrix can also appeal approval of a preliminary permit to the state Environmental Protection Commission. The deadline for enrolling in the program is Jan. 31 of each year. Producers and citizens can obtain more information and view a map of participating counties by looking for preconstruction requirements for permitted confinements at www.iowadnr.gov/afo. Only producers who must get a construction permit for a confinement are affected by the master matrix. Generally, these include proposed construction, expansion or modification of confinement feeding operations with more than 2,500 finishing hogs, 1,000 beef cattle or 715 mature dairy cows. Confinements are totally roofed facilities. Prescription Authority Granted to Certain Psychologists This week, the House Human Resources Committee passed HSB 503. This bill grants prescription authority to certain licensed psychologists. These prescribing psychologists must complete many additional requirements that a traditional psychologist does not. During the subcommittee for this bill, the physicians asked for a few additional items to tighten up and clarify the language in the bill. The amendment that was created as a compromise does the following:  The amendment requires a prescribing psychologist to have a signed collaborative practice agreement with a physician as a condition of certification. The bill already includes very strong language requiring a prescribing psychologist to collaborate regularly with their patient’s primary care provider to “ensure that necessary medical examinations are conducted, the psychotropic medication is appropriate for the patient’s medical condition, and significant changes in the patient’s medical and psychological condition are discussed.” This amendment builds on what is already in the bill by requiring this agreement. This is to ensure patient safety while improving access to mental health providers across the state.  The amendment clarifies that the only medications to be prescribed by the prescribing psychologist are for the treatment of mental health disorders. This specifically prohibits prescribing psychologists from prescribing narcotics.  The amendment requires prescribing psychologists to have two years of supervision by a physician before they can prescribe independently.  The amendment requires the Board of Medicine and Board of Psychology to collaborate on the development of rules to implement this change. The bill already stipulates that the Board of Medicine has authority to develop rules on the supervision and discipline of physicians overseeing psychologists. Many people living in rural Iowa face challenges with access to mental health providers. This bill takes Iowa one step closer to having a larger mental health workforce and better access to care. The bill passed 14-6 in committee. Combating the Global Crime of Human Trafficking While Americans were watching football and enjoying a tailgate party on Sunday, peace officers in California were focused on a much darker issue, rescuing human trafficking victims from those who seek to do them harm. Large sporting events bring out the best in people, but unfortunately, it normally means an influx of human traffickers and their victims. This was the case around Santa Clara, California the home of Super Bowl 50. According to the Santa Clara County Sheriff’s Office there were 42 potential human trafficking victims identified and as of last report, more than 20 of them have been put in touch with social workers to receive additional assistance. Officers also arrested 30 men for soliciting prostitution. In the week leading up to the Super Bowl, Ryan Murphy, a member of the Denver Broncos practice squad was stopped and questioned in a prostitution sting near Santa Clara. Human trafficking is the second largest criminal industry in the world, according to the Department of Health and Human Services, this crime generates $32 billion. The U.S. Department of Justice’s estimates that a child is between the age of 12 and 14 when they are first used in commercial sex trafficking. These numbers show how truly dangerous human trafficking is in Iowa and around the world. Victims of sex trafficking are overwhelmingly female (93%), according to the National Human Trafficking Resource Center. A majority of these victims, 53%, are under the age of 17. It is estimated that over 76% of the suspects charged with human trafficking are male. There is no doubt that human trafficking is a serious problem around the country. House Republicans have several bills proposed to focus on training law enforcement and the general public on how to recognize human trafficking and the best ways to help victims. ATV and Fishing Bills Move in Natural Resources Over the past week, the House Natural Resources Committee has passed two bills. The first, House File 2066, allows a person to carry a weapon while on an ATV or snowmobile. Under current law, this was prohibited. Additionally, the bill clarifies that a person on their own land does not have to have a permit to carry a weapon on an ATV or snowmobile. However, this bill does not allow a person to fire a weapon from an ATV when hunting game or a protected species. This bill passed with 17 ayes and one nay, Democrat Lisa Heddens. The second bill was House File 2046. HF 2046 allows a person to fish without a license on private lakes and ponds with consent from the landowner. If you violate this provision, you are subject to a $25 fine. The bill passed committee with a vote of 12-8. Participate in the DOT Survey! Currently the DOT is the process of updating their long-range transportation plan. This is a practice that the DOT engages in every 5 years, as required by Iowa law. The current long-range plan extends transportation planning to 2045. As part of this process, the DOT is asking for public opinions. The DOT engages in creating a long-term transportation plan, as transportation infrastructure can take several years to develop and several changes can occur that would affect infrastructure. Some of the changes that the DOT expects to occur by 2045 include: Iowa gaining half a million people, a changing economy where jobs shift from agriculture to health care, increases in agricultural productivity, increased freight movement, and increasing use of technology which could lead to self-driving vehicles. Economic, technology, demographic, and population changes are important for the DOT to anticipate and plan for because these changes shall ultimately impact aviation, highway travel, public transit, railways, and pedestrians. If the DOT fails to plan appropriately, this could result in an ineffective and inefficient transportation system. The last long-range transportation plan was initiated in 2010 and stemmed out into 2040. The 2015 longterm plan will likely mirror the structure of the 2010 plan. This 2010 long-range plan concluded that the state needs to “efficiently manage the transportation system through a philosophy of stewardship”, that there is a funding shortfall that if not properly fixed with new incomes could worsen overtime, and “that action must be taken immediately to ensure the future viability of the transportation system”. Since the transportation system affects present and future Iowans, it is important to take the time to complete the survey. Public opinion will help the DOT create a better Iowa. The survey can be found at https://iowainmotion2045.metroquest.com/. The survey includes questions related to investment areas, best practices, ineffective practices, and strategies. Some of the questions ask Iowans their opinions about the future, while other questions ask Iowans questions about the present. There are multiple choice questions, as well as questions that permit a written answer. Spring Agent Orange Symposium Announced Iowa Department of Veterans Affairs Director Col. King has announced that Vietnam Veterans of America are planning a symposium aimed at addressing the birth defects, diseases, and learning disabilities affecting the children and grandchildren of our nation’s veterans affected by Agent Orange. The Faces of Agent Orange Symposium will be held Saturday, April 23rd at Hy-Vee Hall in Des Moines. The goal of the symposium is to bring attention to the Agent Orange situation and to encourage the government to assist the medical profession in finding ways to diagnose and treat these birth defects. War Veterans are often subjected to various contaminates unknowingly and without knowledge of the possibility of birth defects for future generations. Veterans who may have been exposed to any hazardous substances are encouraged to attend the symposium. Vietnam Veterans of America, Inc. is a national non-profit corporation founded in 1978 committed to serving the needs of all veterans. It is self-funded and receives no money from any level of government. The Vietnam Veterans of America’s (VVA) founding principle is “Never again will one generation of veterans abandon another.” Information on the VVA can be found at: http://www.vva.org