IPA Legislative News

March 12, 2022

2022 Legislative News

It's Funnel Week...And the Budget Process Has Begun

We have reached the end of the ninth week of the session; Monday marks session day 64 of the scheduled 100-day session. Inside the Capitol, it is beginning to feel like the pieces are coming together for them to complete the session on time (more likely early) depending on what priorities they decide to throw overboard. With many legislators getting to know newly drawn districts and some legislators facing primary elections against fellow colleagues, you get the sense that legislators would like to wrap up the session and get home to their districts sooner rather than later.

Second Funnel. The Legislature will spend this week moving bills through the second funnel deadline. Any policy bill that does not emerge from committee by Friday, March 18 will die for the year and need to be re-introduced in next year if it is to be reconsidered. Other than the Appropriations, Ways & Means, and Government Oversight Committees, the second funnel deadline also marks the end of the year for committee work. After this week, all legislative action now shifts to tax and spending bills and debating remaining policy bills in the full chambers. This means its a good time to connect with your legislators - they'll be at their desks (and computers) for much of the remaining weeks of session.

REC. The Revenue Estimating Conference (REC) met Thursday to revise budget projections for Iowa for Fiscal Year (FY) 2022 and 2023. You can view the one pager here or watch a recording of the meeting here. As expected, the REC’s FY 2022 estimates were revised upward, in this case by $110.5 million over the December estimate. This estimate reflects an overall increase in FY 2022 revenues of $370.5 million, or 4.2%, over FY 2021.

This March REC estimate accounts for the tax relief bill recently enacted by the Governor and Legislature. The REC predicts that FY 2023 revenues, on the other hand, will actually fall by 0.2 percent or roughly $14.8 million over FY 2022. That leveling off of revenue growth will caution legislators to be careful in their budgeting this year, most likely looking at status quo with a small cost of living growth factor added.

Budgets. Since the Legislature must use the lower of the December and March estimates, that means that work behind the scenes over the past several weeks to set a budget based on the December REC numbers can continue as planned. The House rolled out the first o their budget bills on Thursday – Agriculture & Natural Resources, Judiciary, Justice, and Transportation.

Before they can lock down final versions of the ten budget bills, they’ll need to come to agreement on total overall numbers. Right now, the House and Senate are $72 million apart in their targets. The House’s overall budget rings in at $8.2738 billion while the Senate would prefer to allocate $8.2107 billion. Much will depend upon the decision made on another tax adjustment - the state's takeover of the one-cent local option sales tax, making it statewide, and allocating funds for the outdoor recreation fund as passed by voters almost a decade ago.

Filing Deadlines. In addition to March 18th being the second funnel deadline, it is also the deadline for candidates to file their paperwork for the June primary. As such, we are monitoring dozens of announcements about legislative retirements, matchups, and new candidates. As of today, there are at least 18 retirements in the House and 9 in the Senate, with another ten legislators in head-to-head challenges (redistricting put them in same district). Here's a quick rundown:

Retiring Senators: Bolkcom (D), Carlin (R), Goodwin (R), Hogg (D), Mathis (D), Nunn (R), Ragan (D), R. Smith (R), Williams (R)

Retiring Representatives: Anderson (D), Baxter (R), Bohannan (D), Brink (R), Dolecheck (R), Hunter (D), Kerr (R), Klein (R), Mascher (D), McConkey (D), Oldson (D) Paustian (R), Prichard (D), Smith (D), Sunde (D), Williams (D), Wolfe (D), Worthan (R)

Contested Primaries: Rep. Maxwell (R) vs. Rep. Fisher (R); Rep. Mitchell (R) vs. Rep. Shipley (R); Rep. Hein (R) vs. Rep. Bradley (R); Rep. Thorup (R) vs. Sen. Rozenboom (R); Sen. Trone-Garriott vs. Sen. Chapman.

We will have more on this later, but we anticipate this election will usher in the largest number of new Senate and House members we have seen in quite a long time. This means it’s a great time for you to get out there this summer and fall and meet your local candidates! Offer to knock on some doors, make a few phone calls, or join them in tossing candy at a parade.

Status of Policy Priorities & Other Bills Tracked

The IPA bill tracker is the best place to look for updates on bills; we update them daily and the bill status box pulls from the Legislature's website twice a day. Bills that have not passed at least one chamber by now are going to have a really tough time getting through the funnel.

Reminder - you can watch or speak in a Senate subcommittee meeting via zoom, but you have to be in person at the Capitol to speak in the House (but you can still watch House subcommittees live via Webex).

Policy Priorities

HF736: Medicaid Recoupment: Gives Medicaid (fee for service & MCO) two years to identify a non-fraud overpayment (currently it is five years). The Senate subcommittee is scheduled for Monday at Noon and is considering an amendment to narrow this to allow recoupments within 12 months for those who were deemed eligible at the time of service, but later found to be ineligible (as long as the provider checked and documented eligibility through the secure web portal or eligibility phone line).

HF2137 & SF2195: Mental Health Provider Loan Repayment: Establishes a mental health practitioner loan repayment program for both prescribers and non-prescribers, including psychologists (who would be eligible for up to $8,000/year - up to $40,000 total) who serve in mental health shortage areas. The House and Senate bills are a bit different, but they are funnel-proof because they appropriate $1.5 million for the program. At issue is the service commitment area: the House wants them to contribute $20,000 to be eligible as a service area for any provider; the Senate only wants that contribution if it is a psychiatrist (that is IPA's position as well).

HF2197: Concussion Professionals: Adds neuropsychologists with training in concussion protocols to do school sports concussion assessments. This is IPA's bill, we support. However, it is unlikely that this will make it through the process at this point.

HF2246: Provisional Psychologists: Allows a doctoral psychology student to be issued a two-year provisional license during the student’s internship. (Passed House 95-1 & Passed Senate Human Resources Committee unanimously - it's safe from funnel and only a Senate vote away from being sent to the Governor!)

HF2386: Psychological Testing Disclosures: Allows the disclosure of "psychological testing materials" to defense counsel (to lawyers not just expert witness). The Senate bill failed to make the funnel, but the House bill moved out of committee. Thanks to those of you that sent emails (63 emails sent to 47 legislators) and the work of the IPA Advocacy Committee members with key legislators, we were able to successfully get this pulled off the debate calendar five times over the last two weeks! Let's hope it stays off the calendar this week as well.

Other Bills of Interest

HF2546 & SF2331: Tiered Psychiatric Reimbursements: Requires DHS to implement a tiered reimbursement methodology for Medicaid psychiatric intensive inpatient care, based on the patient's acuity. Both bills are on their respective chamber calendars, so are funnel-proof. A fiscal note estimates the cost to be $1-4 million if not done in revenue-neutral way, depending on utilization rates.

HF2167: Autism Definition: Updates definition of autism to match DSM, and defines as mental health condition so parity laws apply. The House passed this 95-0, and the Senate Commerce Committee voted it out of committee last week, so it is safe from the funnel.

HF2543: School Dyslexia Specialists: Allows independent contractors to serve as school dyslexia specialists. This has not yet passed the House (but has been on debate calendar for several days).

HF2245: Mental Health via Telehealth: Prohibits insurers from excluding out-of-state mental health professionals from providing services via telehealth. This bill passed the House last week 91-0 and was sent to the Senate Human Resources Committee.

HF2297: Medicaid MCO Regulation: Exempts Iowa Medicaid and its managed care organizations (including hawk-I) from insurance regulation (including mandates), unless legislation specifically requires them to be covered. This bill is safe from the funnel, having passed the House (97-0) and out of the Senate Human Resources Committee).

HF2298: COVID-19 Immunization Requirements: Prohibits requiring COVID-19 immunization to enroll in a child care center or school. This bill passed the House 57-36 and is now in the Senate Judiciary Committee (Schultz, Zaun, Bisignano)

HF2323: Opioid Antagonist Medication Fund: Creates an Opioid Antagonist Medication Fund to assist first responders with the cost of opioid antagonists. An amendment offered in the House Appropriations Committee puts all opioid settlement funds into a separate account that only the Legislature can determine how it is spent (currently spending is at sole discretion of Attorney General). This is on the House floor, but it's funnel-proof because it involves appropriations.

HF2399: Prior Authorization Reimbursement: Prohibits a utilization review committee from limiting or revoking a prior authorization after the health care service has been provided (except for prescription drug utilization reviews). (Passed House 97-0 and is in Senate State Government Committee, assigned to Sens. R.Smith, Bisignano, Johnson).

HF2438: Public Assistance Program Integrity: Requires a person set up some identity verification questions when applying for public assistance (mother's maiden name, pin number, etc). This bill was made funnel-proof by being sent to the House Appropriations Committee (where a subcommittee decided to advance it last week).

HF2497: Palliative Care: Amends the definition of palliative care and palliative care team. The bill previously only included social workers, but at IPA's request was amended to include psychologists (then other groups had others added as well).

HF2521 & SF2210: Healthcare Employment Agencies: Requires healthcare employment agencies (like traveling nurses) to register with the Department of Inspections and Appeals (and pay a fee) and prohibits non-compete clauses. The House passed this bill 99-0, and since there was a companion bill on the Senate Calendar, they were able to attach them (thus they are now safe from the funnel).

HF2529: Psychiatric Residency Programs: Requires the University of Iowa Hospitals and Clinics to administer a psychiatric residency program jointly with Cherokee and Independence mental health institutes, Oakdale Classification Center, and the State Resource Centers. The program would add 12 new residencies. This has not passed the House yet, but it's an appropriation bill so is exempt from the funnel.

HF2533: Functional Family Therapy: Adds functional family therapy and multi systemic therapy for youth as covered Medicaid services. This has not yet passed the House; a fiscal note estimates cost in FY23 at $1.8 million and FY24 at $3 million. For the first time, this fiscal note estimates return on investment (estimated at 5.62). Bills like this are sometimes held and added later into budget bills.

HF2545: Medical Privacy and Freedom Act: Strikes prohibitions against businesses requiring proof of COVID immunizations passed in the special session, and prohibits a business, school, organization, or governmental agency from requiring any type of immunization. Far reaching bill, unlikely to move but a "skinny" version of this (only applying to COVID-19 vaccinations) was added to the "compromise" amendment on the Tort/Unemployment Reform Bill (HF 2279). House Republicans still do not have the votes to pass HF 2279, and the addition of the amendment didn't add any from the anti-vaccination caucus.

SF513: MH/SA Police Report Confidentiality: Requires law enforcement crisis intervention reports about a person experiencing a mental health, substance-related disorder, or housing crisis to be kept confidential (but allows sharing with health professionals). This bill passed the Senate last year; there is a subcommittee scheduled for this bill on Tuesday at 8 am.

SF2216: Intensive Psychiatric Units: Establishes intensive psychiatric units at the state MHIs. This passed the Senate (47-0) and was assigned to House Human Resources Committee (to Reps. A. Meyer, Fry, Brown-Powers).

SF2292: Social Worker Assault: Adds social workers under assault protections for health care workers. This has not yet passed the Senate.

SF2307: Professional Licensing Requirements: Prohibits professional licensing boards (other than Board of Nursing & Board of Medicine) from requiring applicants to submit official transcripts or diplomas. This passed the Senate (37-10) and is in the House State Government Committee assigned to Reps. Lundgren, A. Meyer, Winckler.

SF2314: MHDS Cash Reserves: Increases the amount of cash reserves a mental health and disability services region may have before payments are reduced. This passed out of a Ways & Means (funnel-proof) subcommittee.

SF2359: Technology Impact Study/Cognition: Requires the Department of Education to convene a workgroup to study the impact of technology on learning, cognition, and recommend best practices by December 2022. This passed the Senate (46-0), and is in the House Education Committee.

SF2361 & HF 2527: Governor's Workforce & Regulatory Bill: There is a lot of miscellaneous things in this bill (county zoning, work-based learning, health care loan repayment cleanup to allow part-time and expand to neurology, professional licensing reform for military spouses, EMS certificates for National Guard, lifetime military hunting and fishing licenses, military service property tax credit increase, temporary licenses for insurance producers, state building code updates). Both bills are in the funnel-proof Ways & Means Committees in their respective chambers.