Recap of Week 14
On Tuesday, the Iowa Cattlemen’s Association visited the Capitol. I always enjoy meeting with the Cattlemen as they are important to Iowa’s Agriculture community. Beef production is an important part of Iowa’s economy and the Cattlemen work hard to promote the quality of beef coming from the state.
This week I sat on the subcommittee for SF 2322, which would give a $50 tax credit to volunteer EMS and Fire Fighters. The bill passed out of the Ways and Means committee and will come to the floor for a vote sometime next week.
The House passed HF 2462 this week. The bill requires public schools to begin the school year no earlier than the 4th Monday in August, starting with the 2013/2014 school year. I supported this bill and sponsored an amendment that would include Community Colleges and the state universities. Currently there are many Community Colleges and higher education schools that offer classes to high school-aged students for college credit while still in high school. Moving the starting date for public schools without including Community Colleges and universities would make the partnership difficult.
I was appointed to the Infrastructure Conference Committee to help negotiate the differences between the House and Senate versions of the Infrastructure Appropriations bill. Currently, the Senate version includes funding to help rebuild the Lake Delhi dam, but the House version does not. The Conference Committee will work to compromise on the $8 million difference between the House and Senate versions. My hope is that the final bill will contain funding for Lake Delhi.
Buying Out Mental Health Services Paid for by Medicaid
Two sessions of work on redesigning Iowa’s mental health system are nearing completion, as the House continues to perfect an amendment to Senate File 2315. While much of the policy issues have been settled on a new system going into effect in FY 2014, the question of funding remains under discussion with the focus being on the issue of who will pay for those services funded by Medicaid.
Over the past several years, the Department of Human Services has discussed the idea of “buying out” those mental health services that are funded through Medicaid. This would mean the state would assume the responsibility to pay for Medicaid services, instead of the county.
Under the current system, the state provides counties with a variety of payments including allowed growth in the system, replacing property tax dollars, and other service money. A county combines these funds with the money it raises from its mental health property tax levy. When a person needs mental health services, they would go to the county Central Point of Coordination office which then arranges for the services to be provided.
Most mental health services are not eligible for Medicaid funding, and thus the county simply pays the bill for the service. But, the situation is different for intellectual disability services. Many of these are eligible for Medicaid, and payment for these services is much more complicated. Much of the non-federal share of the payment is state money that has been distributed to the counties and then sent back to the state.
DHS estimates that in FY 2013, the cost of these services will be about $231 million. The expected cost of the non-Medicaid services is projected at $141 million. What DHS has suggested as part of its mental health redesign plan that the state assume responsibility for the Medicaid costs beginning in FY 2013. To pay for these, the state would retain the state funds that had been distributed to counties. This is projected to require an additional $40-42 million in state funding beyond the current state mental health funding. To cover the cost of the non-Medicaid services, counties would use their mental health levy revenue (approximately $125 million statewide) and what the state receives in the Social Services Block Grant for mental health ($12 million).
For many counties, this has the potential to be a good deal. Because the Medicaid services are generally covering long-term intellectual disability services, these costs remain with a county for years and go up over time. The growth in these Medicaid costs can be higher than any increase in state funding for a year. This forces some counties to reduce what they offer for non-Medicaid services in order to meet their obligation for the Medicaid services. Making the switch would allow them to preserve and possibly improve the mental health services they provide.
Other counties indicate that they would have trouble with this idea. There are a number of counties who currently receive more state funding than what they spend on Medicaid services. The excess funds are used to provide non-Medicaid services. These counties are asserting that making the switch will leave them short of funds to pay for non-Medicaid services. Another complicating factor is that a county may be the actual provider of the Medicaid services. A county could have its own staff to provide case management services, which are payable by Medicaid. The funds generated by this service are then used to pay for other services.
Both the House and Senate continue to work with DHS and other parties to get a better picture on the impact of this proposal. The issue is likely to be determined as part of the Health and Human Services budget bill discussions.
Senate Passes Their Version of Education Reform
The Senate passed its own version of education reform on Monday on a party-line vote. It shares some similar language with the House version, but differs considerably on many points.
The areas where the bills agree are mainly around competency-based learning and the Iowa learning online initiative.
What’s missing that the House language included are areas that will help:
– provide increased local control through home rule
– parental choice in education through improved charter school language and increased online learning opportunities,
– a way to foster innovation through a competitive grant process meant to boost student achievement
– value-added assessments that assess student performance based on how a student’s level of achievement has increased and not just based on where they are in relation to an arbitrary bar determined by their age and grade level
– the ability to retain the best teachers by disallowing schools to make reduction decisions based on seniority rather than performance and the needs of the school
– allowing the pool of available teachers to increase and bring in new talent by allowing for alternative pathways to licensure, so professionals in other fields can enter the teaching profession and bring their career experience with them into the classroom
– protect religious schools from having to abide by state mandated curriculum requirements which may conflict with their religious tenets
– the development of a meaningful evaluation system to be conducted annually which would help teachers improve
– an accountability system for schools which would allow the local community to know how their local schools are doing and providing the pathway for schools that are doing outstanding jobs to be left with further autonomy
– a literacy initiative which recognizes that beyond third grade students are no longer learning to read, but should be reading to learn and would prevent students from being passed on from grade to grade when they aren’t reading at an appropriate level for success.
The difference between the bills will mean a difficult process of conciliation that will result in either a meaningful step forward in education reform in the state, or simply a minor change for the good with a few agreed upon issues making the cut.
If you have any questions, comments or concerns about these topics or any others please feel free to contact me by e-mail at email@example.com or by phone at (515) 281-7330.