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February 20, 2021
2021 Legislative News
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The pace at the Capitol continues to accelerate as lawmakers head toward the halfway point and first legislative deadline in two weeks. The March 5th funnel will mark the end of the road for any bills that fail to be voted out of committee (except tax and spending bills). The deadline will be a welcome relief from the waves of bills that still continue to be introduced (we're up to 1,536 if you were wondering). Many of the highly controversial bills (aka "message bills") will have done their work and be laid to rest when the committee doors close on March 5.
Legislators seem to like the newly blocked subcommittee time schedules, but it proves challenging for lobbyists who toggle between the Senate's entirely zoom meetings and House's entirely in-person meetings, all crammed into the same two hour blocks. Committees will continue to work late to get priority bills out, so you might see a lot of what they call "works in progress" as time runs short to negotiate amendments. Like all of these reports; we have some good news and some bad news.
Medicaid Recoupments: Rep. Ann Meyer of Fort Dodge has filed a bill (HSB 225) that no longer allows Medicaid and the MCOs to go back more than 12 months to recoup payments made in error, including any withholding of future payments. This language is similar to what is in law in Missouri, and aligns with the 12-month window providers have to submit claims. Some providers have been hit with recoupments dating back five years to the early days of managed care. Rep. Brooke Boden of Indianola, Rep. Tom Moore of Griswold and Rep. Timi Brown-Powers have called a subcommittee on the bill for Tuesday at Noon in the Supreme Court Chamber. Any IPA member with a story to tell on this is more than welcome to attend but House subcommittees are in-person only. If you want to share the details of your recoupment saga - you are highly encouraged to submit written comments here, or you can share them with your lobbyist (amy@ialobby.com) & your State Advocacy Chair (paulascheman@gmail.com).
School Sport Concussions/Provider Expansion: A new bill (SF 328) has been filed to expand the providers who can determine if a student is able to continue to participate in sports or return to play after getting a concussion or brain injury. The bill adds OTs to the list that includes PTs, PAs, ARNPs, nurses, athletic trainers, physicians and chiropractors. IPA will be attending the subcommittee on Tuesday at 12:30 p.m. to ask that psychologists be added, specifically psychologists with training in neuropsychologists (but we'll be asking for any psychologist practicing within their scope). If you know any of the Senators on this subcommittee, or you live in their district, please send them an email asking for this: Sen. Brad Zaun of Urbandale (brad.zaun@legis.iowa.gov), Sen. Sarah Trone Garriott (sarah.trone.garriott@legis.iowa.gov), and Sen. Tim Goodwin of Burlington (tim.goodwin@legis.iowa.gov).
Telehealth: No movement yet on the mental health telehealth payment parity bill (HF 294) but it is safe from the first funnel and will be eligible debate through April 2, at which time it needs to have made it out of the House and through a Senate committee (the latter of which may be difficult). The House did unanimously pass the bill that requires all state health licensing boards to include audio-only delivery of service as an accepted modality in their standards of care (HF 431). That bill is in the Senate Human Resources Committee now, but has not yet been assigned a subcommittee.
Defrauding Drug Tests/Referral to Treatment: The Legislature completed their work on HF 283, which criminalized the use of synthetic urine or other methods of defrauding alcohol and drug tests. The bill had originally only included criminal penalties (simple misdemeanor for first offense, serious misdemeanor for all subsequent), but Rep. Brian Lohse of Altoona and Sen. Waylon Brown of Osage accepted an amendment from the provider community to allow a judge to order a substance use evaluation and treatment in addition to or in lieu of the penalties. The bill passed the Senate 32-16 and the House 61-30.
Drug Paraphernalia/Specialty Court Fund: The Senate unanimously passed SF 363, intended to put a stop to the widespread sales of glass and metal pipes used to smoke illicit drugs. Billed as tobacco smoking devices, they are sold at convenience stores and pop-up retail locations. In addition to adding new permitting fees and prohibiting sales to youth under 21, the bill directs the new revenues to a new Specialty Court Fund under the direction of the Governor's Office of Drug Control Policy to support specialty courts "to address underlying substance use disorder-related and mental health-related issues that contribute to the contact of individuals with the justice system." The Office will develop criteria for approval of a request for specialty courts program funding annually by May 1; this is the first time there has been a fund established for specialty courts of any kind.
Professional Licensure: Social workers will be able to have virtual supervision permanently (not just during a public health emergency) under HF 485, which has moved to the House Floor. The bill was amended in committee to allow a LMFT or LMHC to supervise social workers who are working to obtain their LISW (associations representing social workers, marital/family therapists, and mental health counselors all support this bill; previously NASW Iowa had opposed the cross-supervision piece).
MH/DS Regions & Crisis Services: Rumor is Sen. Jeff Edler of State Center is working on a bill to revise requirements for Access Centers to require them to be locked and allow them to hold people without court order; he would do this by opening up Iowa Chapter 229 (mental health commitments). Those of you that have been around for a while know what type of sticky wicket that will be. Much of this is stemming from a desire of the county sheriffs to have a more secure option than the current Access Centers. Setting that aside, a new bill (SF 395) was introduced this week by Sen. Dan Dawson of Council Bluffs. It will makes law enforcement reports about a person experiencing a mental health, substance use, or housing crisis confidential if it is used for crisis intervention and conflict de-escalation. Sen. Dawson will chair the subcommittee on Monday at 4:30 p.m., along with fellow (now former) law enforcement officer Sen. Kevin Kinney of Oxford and freshman Senator Jeff Taylor of Sioux Center.
Broadband: Broadband was called out as a foundational issue to almost every single industry in the state, to our health care system as well as our educational system. It may very well be as close to a universal policy priority as you can get. A number of bills dealing with various elements of broadband are making their way through the legislative process. Most attention though is on the Governor’s expansion proposal (SF 390 & HSB 133). Some level of contention has arisen between providers over the bill’s requirement of 100 megabytes for upload and download to be eligible for the grants, however most groups are in agreement about the goals of the bill. SF 390 has been passed by the Senate Commerce Committee and is awaiting either full Senate debate or referral to another committee. HSB 133 will be voted out of the House Information Technology Committee next week. It’s important to note that the Governor’s request of $450 million over three years for these grants is not yet in these bills, and will be addressed either at the bill’s next committee stop or in separate legislation. It’s clear that the $450 million price tag is not a slam dunk with legislators yet; advocates for this legislation still have some work to do.
Public Assistance Oversight: Despite DHS warnings that the bill will cost more than it saves and will duplicate ongoing efforts to streamline income verification, the Senate Labor Committee moved the public assistance program oversight bill (now SF 389) forward. The bill will likely get a fiscal note before Senate debate. DHS noted that this bill, which requires they hire a private company like Equifax to verify income and assets "periodically" for anyone receiving food assistance (SNAP), family support (FIP), or Medicaid. We predict this will not be acceptable to the House; DHS is already planning to join a national income verification system, a system that will be free to states and has the same goals as the bill.
Just Plain Bad Bills: IPA has joined the growing list of groups to oppose the University Tenure (or more appropriately NO university tenure bill). HF 496 eliminates tenure in our public university system; it is safe from the first funnel and ready for debate on the House Floor. Its floor manager (Rep. Skyler Wheeler of Orange City) is one of the leading voices behind the anti-LGBTQ+ bills circulating and the anti-1619 educational curriculum legislation. Fortunately, the business community is firmly behind all of these types of bills, including the so-called "bathroom bills," making economic arguments to shut these discussions down. But like many have said, businesses and young people pay attention to this stuff and it does impact decision making. One lobbyist who knows physician recruitment well said that recruitment of OB/GYNs to the state is really tough because many young specialists are unwilling to locate to states with more severe reproductive rights laws. Legislators don't seem to make these connections when sending out their "messages."
Other News: The House moved six childcare bills over to the Senate over the last two weeks and both chambers continue to negotiate allowable growth for schools. The Governor’s Housing Bills (SF 295 & HF 582) are making their way now through their second set of committees (Ways & Means); since bills involving tax issues like these are exempt from the funnel deadlines, there is plenty of time to perfect them. While some immunization bills have escaped committee, it's unlikely any real action will be taken to scale back Iowa's immunization laws. Thirty Republican introduced legislation (SF 402) this week aimed at technology companies that censor online content (ending use of state economic development funds and local government incentives for companies that engage in this censorship).
There is a strong effort afoot to make major structural changes to the state's bottle bill to get the redemptions out of grocery stores, and the House and Senate are moving swiftly on a major election reform effort to reign in "rogue auditors" and shorten early voting. Those bills (SF 413 & HF 590) moved lightening fast - introduced on Tuesday, out of subcommittee on Wednesday, then out of committee on Thursday. There is a public hearing scheduled for Monday night in the House, with debate in the Senate planned Tuesday and in the House planned Wednesday. Legislators hope the bill will be signed into law by the end of the week. The bills shorten the timeframe for absentee ballot requests (from 120 days before an election to 70), shorten the timeframe for returning an absentee ballot or voting in-person early (from 29 days before an election to 18), prohibit county auditors from sending out blank absentee ballot request forms (even upon request of the voter), and bar a person from having their neighbors, friends or campaign volunteers return their voted mail-in ballot.
Revenue Estimating Conference: The March meeting of the Revenue Estimating Conference (REC) has been set for 11 a.m. on Friday, March 19. They will review current projections for Fiscal Year 2021 and 2022 and produce a report that will guide the Legislature on their next steps in enacting a budget. The Legislature will be required to use the lower of the March 2021 and December 2020 REC projections. Iowa revenues have been pretty stable compared to other states, and prior REC estimates have showed signs of a slow recovery. This will also be the first REC meeting with newly appointed Iowa Department of Management Director Michael Bousselot (famous for bringing Medicaid managed care to Iowa). Legislators will likely be paying close attention to the gaming revenue projections that end up funding the Rebuild Iowa Infrastructure Fund (RIIF). In addition to challenges created by the casino closures during the pandemic and the efforts to get them back up and running, Nebraska’s recent decision to build casinos will no doubt affect Iowa’s revenues.
Redistricting Update: This redistricting cycle will be one for the record books. Iowa’s Constitution requires the Legislature approve and submit the final plan with the newly drawn political maps to the Governor by September 1, with enactment by September 15. Last week, the U.S. Census Bureau alerted states that they would be delivering redistricting data to states until September 30. If the deadlines in the Iowa Constitution are not met, the Iowa Supreme Court is tasked with drawing the maps. Iowa is definitely not alone in facing an impossible timeline for redistricting. Still, legislators are forging on with the process until they figure out the game plan. Monday was the deadline for the leaders in each chamber to appoint a member of the Temporary Redistricting Advisory Commission. Republicans named former House Majority Leader Chris Hagenow and recently retired Department of Management Director Dave Roederer. Democrats selected Bettendorf attorney Ian Russell and former candidate for Iowa Secretary of State Deidre DeJear. Those four members will meet on Monday at 2:00 p.m. to discuss next steps and select a fifth member to serve as Chair.
Economic Recovery Advisory Council Report. We should have included this in our last issue; two weeks ago the Governor's Economic Advisory Council issued their much-anticipated final report. And yes, it does include a recommendation for making the Governor's telehealth proclamations during the pandemic permanent, including full payment parity and the accompanying flexibilities.
Bill Tracker: The IPA Bill Tracker is updated daily with changes of status. You can see them at: www.ialobby.com/billtracker/ipa/. We will all be happy when the March 5 deadline slices this list in half.
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