Article Comment Submission Form
|4/17/2013 ||Email this article Print this article |
Health care dominates discussion at legislative forum
|Sen. Rita Hart
|Rep. Mary Wolfe
By Jeremy Huss
Reform of the state's mental health care system and the possible expansion of Medicaid services dominated the discussion at the April 13 legislative coffee at the DeWitt Community Center.
Sen. Rita Hart (D-Wheatland) and Rep. Mary Wolfe (D-Clinton) heard concerns from a group of around 20 constituents and updated attendees on the legislature's progress and lack thereof. Rep. Steve Olson (R-DeWitt) was unable to attend.
The forum began with a question from DeWitt resident Todd Noack, who works for the Iowa Office of Consumer Affairs.
Noack spoke about the importance of peer support training for use in integrated home health care sites, and he asked when the local mental health region will begin training for peer support.
Hart said she doesn't know when it will happen, but the model for all of the state's mental health regions is a group in northwest Iowa led by Floyd County administrator Bob Lincoln.
She said the legislature is making progress on funding for the transition to a regionalized mental health care system.
"Once we get that down, I feel those pieces will start to fall into place," Hart said.
She referred the question to Clinton County supervisor Brian Schmidt, who is representing the county in the local mental health region. The region includes Clinton, Jackson, Jones, Muscatine and Scott counties.
Schmidt said the region has contracted with a consultant to determine how best to proceed in the regionalization process. Counties are waiting for the legislature to finalize funding so they know where they stand before moving forward.
"We're still struggling with the monies we're going to be working with and the things we're going to do," Schmidt said. Hart said the Senate appropriations committee has passed a mental health funding bill that will be going to full debate this week.
DeWitt resident Lou Behrend asked the legislators to discuss differences between the expansion of Medicare under the federal Affordable Care Act and Gov. Branstad's alternative health care proposal.
Wolfe said the federal health care law requires states to have a program in place by October to serve residents whose income falls within 130 percent of the poverty guideline.
"If we don't have anything, we're not eligible for hundreds of millions in federal funding," she said.
Wolfe said the governor's plan hasn't been approved by the federal government, and she is concerned it won't meet federal criteria because of the conditions it puts on low-income individuals.
"I think there's going to be a compromise hybrid of Medicare expansion that incorporates aspects of the Health Iowa plan," Wolfe said.
"The point is, we're going to be in big trouble if we don't put something together the Feds approve," she stated.
She said the legislature is holding a public hearing on Branstad's Healthy Iowa proposal at 5:30 p.m., Wednesday, April 17, that will be streamed live on the legislature's website. Residents also have the opportunity make online comments about the proposal.
Hart and Wolfe were asked how they intend to vote on the issue.
"I definitely favor Medicare. I don't see how the finance works otherwise. It would be the fiscally responsible thing to do," Hart said.
Wolfe agreed. "It's considerably less time and money to do Medicare. It serves more people, and the system is already in place," she said.
Joe Dierickx of DeWitt asked about funding and if there is a contingency plan in the event federal funding disappears.
Hart said the federal government will fund 100 percent of the cost of the expansion for three years and 90 percent of the cost thereafter, but the Senate bill has an opt-out feature if the federal money isn't forthcoming.
"Like any other federal money we rely on, if the money's not there, we have to come up with a plan B. That doesn't stop us from getting involved in the myriad of federal programs we're involved in," she said.
Wolfe said Iowa treasurer Michael Fitzgerald has pointed out the governor's plan actually requires more federal money than the Medicare expansion. Branstad would disagree, she said, but the governor's plan still uses federal funding.
Wolfe said Branstad's plan also relies on counties providing additional money for mental health care, which is a concern since there already are problems with mental health care funding.
"It's hard to defend the governor's plan when it would increase property taxes," Hart said.
An audience member expressed concerns people are abusing the state's social service system and the oversight is poor.
"Point well taken. There's always abuses in the system. We're all aware of holes in the system, and we need to work on it," Hart said.
Keith Dexter of Lost Nation asked the legislators to keep in mind the state loses local accountability when it gets involved in federally-funded programs.
"There's less I feel we can do on a local level when a plan goes to (Washington) D.C. rather than Des Moines," he said.
Wolfe said she thinks the current IowaCares system for low-income individuals is sub-par. She said the state still will be administering the Medicare system if the expansion is approved.
"If the legislature agrees, the state would be pulling the strings," she said.
Dierickx asked about a bill that would limit liability for property owners who allow their property to be used for recreational purposes.
The bill, House File 605, is in response to a recent court ruling that found a farmer liable for injuries sustained by a woman who fell through a hole in a hayloft while she was accompanying a school group on a farm tour.
The bill broadens the definition of recreational activity and the definition of what land and water areas are included in the limitation of liability.
She said the bill is a compromise between bills supported by the Iowa Farm Bureau and trial lawyers.
The bill could be dead if the Farm Bureau doesn't agree to compromise, Wolfe said.
Jane Schmidt of Delmar asked about allowable growth for schools and a proposal to provide 4 percent allowable growth if the governor's school reform package is approved.
"If it's such a good plan, why can't it stand alone?" Schmidt said, adding schools have been "cut to the bone" in recent years.
Hart said the "funny thing" about the proposal is it uses one-time funding to provide half of the allowable growth, something Republicans have opposed elsewhere.
"I don't understand why all of a sudden it's OK now to use one-time funding for ongoing expenses," she said.
The proposal also pulls money from an early intervention program meant to keep class sizes low, which means it is effectively a 1 percent increase rather than 4 percent, she said.
Hart compared the education reform effort to a farmer raising livestock that aren't finishing well.
"To do this is like saying we want a better result, but we're going to keep our feed budget the same," even though costs have gone up.
It makes no sense when the state is sitting on a healthy budget surplus, Hart said.
Workforce, property tax issues
Wolfe noted she voted in favor of a bill to allow use of ATVs on secondary roads after hearing from many constituents in favor of the change.
Hart said the Senate has passed a bill for historic preservation tax credits that "really puts a lot of investment into Main Streets" and should benefit the city of Clinton.
The House still must vote on the bill.
The Senate economic development subcommittee added a provision that would re-open workforce development offices closed by Branstad in favor of a computer-based system, Hart said, but the House has removed it from its version.
Hart said the kiosk system and cuts in workforce development staff have created obstacles to many job seekers.
She said the fate of commercial property tax reform and the state gas tax is in the hands of party leaders.
"That may be one of the last things that gets tackled, and it's going to depend on leadership," she said.
Hart said she expects the legislature to remain in session past May 3, the last day legislators receive per diem payments.