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  The Capitol Connection
a publication of the League of Women Voters of Iowa

Funnel Deadline Hits as Session Enters Second Half.

As we prepared to "spring ahead" and set our clocks for daylight savings time this weekend, the Iowa Legislature was also moving into a new phase of the legislative session.  Friday (March 8) was the first legislative funnel deadline. To survive, bills had to be voted out of their committee of origin before the Friday deadline.  Bills left behind in committee are no longer eligible for debate.    

Of course, there are always exceptions.  Bills that spend money (Appropriations), deal with taxes (Ways & Means), or are sponsored by the Government Oversight Committee or legislative leaders are "funnel-proof" and can be debated at any time.  Bills that died in the funnel can be revived in these committees, or gain new life as an amendment to another bill.  As a good friend of ours always says - "know the rules, so you know how to break them." 

 

Saturday (March 9) wasn't only the day we moved our clocks ahead, it was also the 55th day of the 110-day legislative session.  While the session is now halfway through, the Governor has only received and signed three bills into law (two bills changing Iowa law to match new federal laws, and one bill addressing pipeline safety violations).  If you think things will pick-up now that we're in the downhill side of session, think again!

 

This year, the close 53-47 Republican margin in the House and the closer 26-24 Democrat margin in the Senate are creating some problems with floor work, particularly in the Senate. Senator Tom Courtney of Burlington had emergency surgery two weeks ago, and has been out on medical leave.  He is expected back at the Capitol sometime this week, but on a very limited basis. The Senate needs 26 votes to pass a bill, so one person's absence can really slow down the workings of the Iowa Legislature.  As we understand it, Senate leaders have come to an agreement to work on those things where they can find consensus, and leave the more controversial bills for days when Senator Courtney is able to join them.  

 

The Administrative Rules Review Committee waived its in-person voting rules on Friday, allowing Sen. Courtney to vote from his hospital bed via telephone.  The Committee was voting on the Secretary of State's new rules that take suspected non-citizens off voter roles, rules which Senator Courtney has strongly opposed.  While committees can waive their in-person voting rules, Senate rules require legislators be present for any vote taken on the floor.

 

The Legislature has already begun to switch focus and look toward the second legislative funnel deadline on Friday, April 5. For a bill to survive the second funnel, it must be approved by one chamber and voted out of committee in the opposite chamber.  Legislators spend the majority of this four-week period between the funnels on the floor, debating bills.  You can watch live debate in both the House and Senate now from your computers - just click here.  


Funnel Survivors....and the bills you can safely recycle.

Clean-up after a funnel deadline is like clean-up after a funnel cloud - there is a lot of scattered debris and it takes some time to pick through all the pieces to find out what can be saved.  We hope to have our online Bill Tracker caught up and current by the end of next week, so please be patient with us as we work to make sure our list is accurate and complete.  

 

We have a new feature in our Bill Tracker this year - at any time you can go back and look at the "dead bills" that didn't make it through the funnel deadline.  Simply select "inactive" and you'll get a list of those bills that didn't make the cut this year. 

 

The House and Senate majority party caucus staff always prepare excellent reports post-funnel that list all the bills that survived the funnel.  Since we are only tracking issues related to our priority issues, we thought you might like to see the entire lists so you can find issues that may be local league priorities or important to you individually.

  • Click here for the list of House bills that survived the funnel.
  • Click here for the list of Senate bills that survived the funnel.
  • Click here for the LWVIA Bill Tracker. 

Here are a few of our priority issues that survived the funnel: 

  • Medicaid Expansion - Senate File 296 expands Medicaid to 138% fpl.  This is a top priority for the LWVIA this year. 
     
  • Mental Health & Disability Services Redesign - Senate File 415 and House 160 begin the process of making the needed appropriations for the regional non-Medicaid system.  This is and has been a top LWVIA priority for many years. 
     
  • Mental Health AdvocatesSenate File 406 makes the state's mental health advocates (which are currently county-based) state employees overseen by the Department of Inspections and Appeals.   The bill also requires a person who is being involuntarily committed for substance use or mental illness be informed of their right to have a pre-application screening to determine the need for the commitment, and requires DHS to develop a bed tracking system so the courts and law enforcement officers can have access to real-time data on the availability of hospitalization beds (and not have to spend all their time calling around for placements).  It is likely the bill will continue to be worked on, as the House killed their version of the bill this week.  Some legislators would like to see the Mental Health Advocates be placed under the Judicial Branch, but that is met with resistance due to funding issues.
     
  • Maternal Health of Pregnant Inmates.    Senate File 399 (successor to SF 134) is the formerly titled "shackling bill."   The bill represents the "agreed-to" compromise language with local law enforcement organizations by giving local law enforcement the ability to use restraints if the woman poses an "imminent security risk" and the officer documents his reasons for doing so within 10 days.  There still may be some trouble with this top tier LWVIA priority in the House.    
  • Reasonable Accommodations for Pregnant Workers.  Senate File 308 requires employers to make reasonable accommodations for pregnant workers, if such changes to workload or work environment are ordered by a doctor and have a medical basis.  This falls under the LWVIA's policy position on women's health.  
  • Juvenile Lifers.  House Study Bill 105 prohibits the court from sentencing a juvenile to life in prison without the possibility of parole for first degree murder.  A US Supreme Court ruling forced Iowa to change its sentencing guidelines; this bill allows for life with the possibility for parole after a minimum of 45 years served.  Many groups supported a much lower threshold, such as 15, 20 or 25 years, but law enforcement felt that was too short. This bill will be getting a new number before it is placed on the calendar. 
  • Compulsory Education for Enrolled Preschoolers.  Apparently some parents were treating the state-funded four-year-old preschool program like a drop-in babysitting service, sometimes showing up, and other times not.  With waiting lists growing for these programs, schools wanted to make sure parents were responsible for taking their enrolled four year old to class, so House File 351 makes these kids subject to the compulsory education law. Preschool is a priority for the LWVIA, so we are tracking this, but it does not affect the program and funding itself. 
Now for the more nefarious of the survivors:
  • House File 81 requires a sheriff to keep the list of weapons permit holders private. LWVIA supports sensible gun control measures, and government transparency. 
     
  • House File 167 makes it a felony for a woman to give birth with an illegal drug in her system. Medical groups and child protection groups feel this is a very dangerous piece of legislation, forcing women who suffer from substance use disorders to go underground and not seek proper medical and prenatal care. They also worry that more people will have their children and abandon them for fear of being charged with a felony. 
     
  • House File 268 repeals Iowa's smart planning principles, which cities and counties are to consider when developing their comprehensive plans.  Supporters of the ten planning principles that local governments are to consider (but don't have to enact) say this is a part of the UN's globalization effort. I'm not sure what other comment I can make without sounding biased.
  • House File 485 is the Voter ID bill proposed by the Secretary of State (the successor to HSB 23). The Iowa Senate says the bill is "dead on arrival" if it comes over, so prospects aren't good.  Rep. Dawn Pettengill of Mt. Auburn is the bill's floor manager.    

Governor Announces Medicaid Expansion Alternative
Total cost to the state is $160 million and would depend on federal approval.

Medicaid Expansion got a new number (Senate File 296) when it came out of committee this week (beating the funnel).  The bill expands Medicaid to individuals earning up to 138% of the federal poverty level regardless of whether they have children  (that's $25,571 for a family of three). It also sets up a new model of care, where services are integrated and the focus is on making sure the person stays healthy and gets the services they need, when they need them.  Providers are then rewarded for improving the health of their patients.   

 

The state's limited benefit IowaCare plan would expire on December 31, with the expansion taking its place on January 1, 2014.  The federal government has already appropriated the funds needed to pay for 100% of this expansion, which will eventually phase down to 90% federal share in 2020 and thereafter.  

 

Republicans have been uncommitted as they waited to hear what alternative the Governor might propose.  Many share the Governor's concerns that just expanding Medicaid doesn't mean Iowans will get healthier.  They would like to include some element of personal responsibility (co-payments and deductibles), and want to make sure the program improves health not just pays for "Cadillac services." 

 

The Governor proposed his Medicaid expansion alternative last week - called the Healthy Iowa Plan.  it would replace the current IowaCare waiver, but still requires federal approval and an additional federal appropriation (while the Medicaid expansion is paid for already, this waiver would require additional federal funding and would be a traditional split with the federal government picking up only 58% of the cost).   

 

The Governor's plan continues with a limited benefit plan (although not as limited as IowaCare), and would require co-pays and deductibles that would be waived if a person agrees to certain prevention measures (like an annual health assessment).  The cost to the state is $160 million - and the cost to the federal government is $227 million.  Again, the federal government would have to approve the waiver, and then appropriate the new money requested (which opponents of this plan say adds to the national deficit).

The Governor's plan is paid for with $160 million from several new and existing appropriations:

  • $42 million Broadlawns Polk County property tax levy
  • $43 million county mental health property tax levies 
  • $12 million state appropriation now going to the University of Iowa Hospitals & Clinics
  • $24 million new general fund appropriations
  • $34 million in Medicaid "savings" reinvested in the program
  • $7 million in participant premiums reinvested in the program

The Governor plans to use one-third of the existing $125 million of MH/DS levies, but the mental health benefits in the plan would likely be limited.  Counties were quick to point out that they need every bit of their levies to pay for the existing demand for services, and are in the middle of a major redesign of service delivery.  In addition, many county levies pay for services delivered to people earning from 150%-200% of the federal poverty level (whereas the Governor's plan only goes up to 100% of the federal poverty level).  Conversely, Medicaid expansion is estimated to result in $40-60 million in savings to counties/regions when some of those receiving non-Medicaid services become eligible for Medicaid services.   

 

We don't know if the program would be capped (that is, would only be available until funds ran out, as it is with the IowaCare waiver). So the Legislature is faced with the following choice:

  1. Expand Medicaid to those earning up to 138% of the federal poverty level, which covers as many as 150,000 Iowans at no cost to the state (and limited costs after the first three years).  This option would include mental health and substance use treatment funding, and is already paid for by the federal government.   This option is also consistent with the ongoing MH/DS redesign, and is a top priority of the LWVIA this year. 

    OR 
     
  2. Request the federal government approve the Healthy Iowa Plan waiver proposed by the Governor, which covers half the people (89,000) at a state cost of $160 million. The plan includes a limited benefit package that may include some mental health services, and takes $43 million away from the ongoing redesign of the mental health and disability services system.  The plan would be subject to federal approval, and would require an additional federal appropriation of $227 million (adding to the federal deficit).

You can see a side-by-side comparison of the two plans developed by legislative staff here.  

     

MH/DS Redesign Update

The Legislature is making quite a bit of progress on many of the unresolved issues around the redesign of the state's mental health and disability services (MH/DS) system.  Here's a quick review.

  • Transition Fund.  The Senate Appropriations Committee will take up House File 160 early this week. The bill distributes $11.6 million to 26 of the 32 counties that applied for Transition Funds to help them make it through the current fiscal year without cutting services or starting waiting lists.  The transition funds were meant to stabilize the system as the state moved from a county based system to a regional one. Last year the state took all money that had been going to counties, but also assumed the responsibility of paying for the non-federal share of all Medicaid services.  This "Medicaid Lift" helped some counties, but without state funds, other counties found themselves in trouble. Six counties that had applied for transition funds will not get money from this bill because they are projecting ending fund balances.  The 26 counties that would receive funds from this bill only get enough to land at "zero" this year - so they and other counties continue to have cash flow issues. If the Senate does not amend the bill, it will go straight to the Governor for signature.  Senators are considering an amendment that would change the source of the funds (from federal to state), so counties would not run into trouble spending the money and could use it to pay off Medicaid bills still owed to the state.     
  • Transition Plus. Rep. Megan Hess of Cherokee has introduced a bill (House File 399) that allocates $750,000 to pay off a portion of the Medicaid bills owed by counties that didn't receive transition funds. Five of the six counties that applied for transition funds and were not included in the transition fund recommendations have outstanding Medicaid bills. This doesn't cover all of the obligations out there.  The bill is in the House Appropriations Committee, where it is not subject to funnel deadlines.   
     
  • Per Capita Equalization.  The legislators serving on the Fiscal Viability Committee made several recommendations for changes in the redesign law, including passage of the $29.8 million needed to equalize funding for regionally delivered, county funded non-Medicaid core services.  This $29.8 million equalization fund makes sure that every county has $47.28 per person living in their area to spend on mental health and disability services.  The money goes out to counties that raise less than $47.28 per person living in their county; counties raising more than that amount locally must cut their property taxes and will not receive money from the state.  Senate File 415 passed out of committee this week, and is in the Senate Appropriations Committee. The bill as amended does a number of things:
    • Appropriates the $47.28 equalization funds ($29.8 million) promised last year to help pay for core regional services to people not eligible for Medicaid or for core services not covered by Medicaid.       
    • Allows county mental health programs to pay for services to people in community-based corrections if funds are appropriated.     
       
    • Directs the MH/DS Commission to make recommendations on ways to better coordinate substance use disorder and mental health funding.     
       
    • Establishes a children's cabinet to address the mental health needs of children (systems of care approach) and creates a Center for Child Health Innovation and Excellence to provide a policy forum for efforts to improve overall child health (subject to funding).     
       
    • Grandfathers in non-target eligibility groups currently served (regions are only required to pay for the "targeted populations" of individuals with intellectual disabilities and mental illness, even though some counties serve people with other developmental disabilities, people with brain injuries, and children with mental illnesses; this allows counties to continue to maintain this level of service).

While SF 415 passed out of committee, there is more work to be done.  Some Senate Democrats don't like the "per capita equalization formula" that is currently in law, and would like to distribute the $29.8 million in a different (yet to be announced) way.  House Republicans say it's the law, and they plan to live up to their promise to fund the current distribution.  Counties say they've already set their budgets based on the $47.28, and they don't want to change course now.  Seems nothing is ever simple when it comes to MH/DS services reform.

 


Budget Targets Announced
Work on two-year budget begins this week.

State government budgeting is a session-long process. It starts with the Governor presenting his budget requests.  Then each of the seven budget subcommittees meets twice (sometimes three times) a week to learn more about each item in their budget.  Subcommittees hear testimony from experts and interest groups on various issues.  But they cannot really take action until their leaders tell them how much money they will have to spend on their area of the budget.

 

Last week, the House and Senate both introduced their "budget targets"- the amount of money each budget subcommittee will have to spend on programs and services in their area.  But don't expect there to be too much detail in these targets - how the money is divided up is a decision of the budget subcommittee. 

 

House Republicans want to increase spending by 3%; the Governor asked for a 4% increase, and Senate Democrats want 11% more for next year.  

  • Senate Budget Targets can be found here.
  • House Budget Targets can be found here.

The House Appropriations Committee plans to move out their versions of the eight main budget bills this week - Administration/Regulation, Agriculture/Natural Resources, Economic Development, Education, Health/Human Services, Judiciary, Justice Systems, and Transportation.  The Senate plans to do the same with their versions of the budgets.  

 

While both chambers plan to get their bills out onto the calendar soon, don't expect them to be in a rush to do anything with them.  The budget negotiation process is long, so legislators are just getting their initial bills in position so the talks can begin.  Agreement is easy in some areas, while others (like Health/Human Services) always seem to be among the last bills passed in the session.  

 

Of note:

  • The Governor's budget does not expand Medicaid as allowed in the Affordable Care Act, does not include money for non-Medicaid services delivered by the new regional mental health and disability services (MH/DS) system, and has only about half the funding needed to open the new (but yet to be staffed) community based corrections facilities.  The Governor did not add any additional funds for domestic violence and sexual assault programs which are going through a significant reorganization.  
  • House Republicans did not add Medicaid expansion to their targets (they were waiting to hear more about the Governor's alternative plan) but the targets do include $29.8 million to pay for regional non-Medicaid mental health and disability services.  This $29.8 million was promised to counties last year when the mental health and disability services redesign passed.  It funds the "Per Capita Equalization Fund" that ensures each county/region has $47.28 per person to spend on services to people living in their area. We believe the House will stick with the Governor's funding levels for CBC beds. It is not yet known what, if any, of the requested increase for domestic violence/sexual assault is included. 
  • The budget proposed by Senate Democrats expands Medicaid to cover 150,000 low income Iowans, adds sufficient funding to open all existing CBC beds, provides the $2 million needed to regionalize and transition the domestic violence and sexual assault system and adds the requested $6 million in additional funds to put more advocates in the field and serve more victims and survivors, and includes $29.8 million for the regional mental health and disability services system. The Senate plan does not address how that $29.8 million will be distributed - some say they are not thrilled with the "$47.28 per capita distribution formula" and think it was an arbitrary number. In addition, their funds for MH/DS services come from the budget surplus, which could be a challenge for funding in later years.

It's Here - the Sequester

You've heard a lot about it - the "sequester" - those automatic federal budget cuts that went into effect last week because Congress failed to work out an agreement to reduce federal spending and balance the federal budget.  Iowa's top budget official David Roederer held a press conference late last week to outline the impact the "sequestration cuts" will have on Iowa. 

Roederer said education reading programs, public health, and workforce development will be hit the hardest by the $46.5 million cut in federal funding, and initial reviews indicate 236 positions that are funded with federal money could be affected by employee furloughs or permanent layoffs if no changes are made by Congress. He said the cuts affect only about 0.4% of all state spending, which is more than $12 billion when federal funding and state spending are combined.

"We believe we'll be able to handle things without a whole lot of problems," Roederer told reporters this week, but said that the problems could get worse. "This isn't going to be short term," he said. "This is not a good way to run anything, let alone a federal government."

 

The breakdown of current year funding reductions included $14.1 million for education, $8.75 million for public defense, $4.32 million for human rights and $4.25 million for vocational rehabilitation.  Click here for a spreadsheet showing all of the cuts. 


Amy Campbell & Craig Patterson
Lobbyists, League of Women Voters of Iowa
[email protected] * [email protected]
515.554.5838 (Amy) * 515.554.7920 (Craig)



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