The CAPITOL Beat
Bipartisan bills are in short order this year - only 32 of the nearly 1,000 bills that have been introduced to date. That’s only about 3% of the bills introduced this year. These bipartisan bills eliminate the state building code requirement for sprinklers, allow choice in auto repair when insurance is picking up the cost, providing state funds for private school textbooks, changing "mental retardation" references to "intellectual disability" in the Iowa Code, creating a non-profit institute for public policy, making changes to property taxes, providing a sales tax exemption for head hunter services, requiring campaign finance reporting to be electronic, and creating a tax credit for regenerative medicine (stem cell) researchers.
The Iowa Senate unanimously confirmed two of the Governor’s new department heads – Charles Krogmeier (Department of Human Services Director) and Bret Mills (Department of Economic Development Director). After the last few years, this is a major victory for the Culver Administration, which saw several appointments fail to get the needed 2/3 vote of the Iowa Senate to be confirmed.
This week (Friday, February 12) is the first funnel deadline. Bills will die if they do not get voted out of committee by the end of the day. Believe it or not, we are nearing the halfway point of legislative session – February 19 is day 40 of the 80-day session.
So let your legislators know if you want to see a bill become law – time is running out, even though we are only wrapping up week four!
ISSUE BRIEFING
Updates on the issues of importance to persons with disabilities.
Insurance Coverage for Autism
Families of children with autism flooded the Capitol last week to show their support for two bills introduced last year - SF 1 and HF 1. These bills require insurance plans to pay for up to $36,000 annually for the diagnosis and treatment of children with autism (and no limit on the number of visits).
A national expert attended the meeting to discuss the experience of the 15 states that currently have autism insurance mandates. Based on an independent analysis of 11 of those states, insurance premiums increased by less than 1%. Based on this finding, the report estimated that Iowans would pay about $1 more per month if these bills were to pass.
Considering one in every 71 boys is diagnosed with autism, advocates say this is a good deal for Iowa families and the state. "You have to be impoverished to get help," acknowledged one parent testifying before the Senate subcommittee reviewing SF 1. "We have been through bankruptcy twice, but when it comes to the health and safety of your child, you will do anything."
If the Iowa Legislature passes this legislation, Iowa will join Arizona, Colorado, Connecticut, Florida, Illinois, Indiana, Louisiana, Minnesota, Montana, Nevada, New Jersey, New Mexico, Pennsylvania, South Carolina & Texas in mandating health coverage for autism diagnosis and treatment.
The bills chances do not look very promising at this point, despite the advocacy of the Senate bill sponsor Sen. Daryl Beall, who is a grandparent of a child with autism. If you care about this issue, contact your legislators and the subcommittees working on these bills: Sen. Tom Rielly of Oskaloosa, Sen. Bill Heckroth of Waverly, Sen. David Hartsuch of Bettendorf, Rep. Beth Wessel-Kroeschell of Ames, Rep. Bruce Hunter of Des Moines, and Rep. Greg Forristall of Macedonia.
- Advocacy Tip: One reason given by those opposing this mandate is that it does not apply to all insurance plans, only those that are regulated by the state (since federal law does not allow the state to regulate self-insured plans). This limits the reach of the legislation to only about 25% of the state's health plans. However, one advocate used a great analogy: if you were on a dock with two life jackets, and there was a sinking ship with ten people on the boat, do you keep the life jackets with you because there aren't enough to go around, or do you throw them out and hope at least a couple people are saved?
Mental Health Parity
The mental health parity bill (HF 234) continues to sit on the House Calendar, but do not get concerned about its lack of movement right now. Rep. Beth Wessel-Kroeschell, the legislator who will lead the debate in the House (called a "floor manager"), has been hosting a series of input meetings with insurance companies and the business community to see if any reasonable changes could be made to address concerns without gutting the bill. If you want all state-regulated insurance plans to be required to pay for the costs of any mental illness or substance use disorder, contact your State Representative now.
Others on the fence: Rep. Brian Quirk of New Hampton, Rep. Doris Kelley of Waterloo/Cedar Falls, Rep. Dolores Mertz of Algona, Rep. Mike Reasoner of Creston, Rep. McKinley Bailey of Story City, Rep. Larry Marek of Riverside, and Rep. Geri Huser of Altoona.
- Advocacy Tip: Insurance companies say this increase in coverage would force insurance premiums to go up by 5-10%. Advocates say these numbers are extremely inflated, and point to other state experiences, information from the Congressional Budget Office, and independent actuarial studies that show full mental health and substance use coverage increases premiums by less than 1%. In addition, studies have shown that 90% of any premium increase are due to "biologically based mental illnesses" which Iowa law already mandates. Adding all mental illnesses and substance use disorders would have nearly no effect on premiums (that is a potential increase of up to .1%).
Brain Injury Prevention
As the old saying goes: an ounce of prevention is worth a pound of cure. One piece of legislation is being proposed this year to prevent brain injuries (and keep kids safe). SF 2055 requires older youths (ages 11-17) to wear seat belts in both the front and back seats. Right now, seat belts are required only in the front seat for that age group. According to the Iowa Brain Injury Association, this age group sustains the most injuries and death because of motor vehicle accidents (84% of the 1,823 unbelted youth injured in Iowa motor vehicle accidents from 2004-2007 were in the 11-17 year old group; 85% of the 71 unbelted fatalities during the same period were back-seat passengers).
- The Senate Transportation Committee approved this bill unanimously on Tuesday, February 2. If this is important to you, contact your legislators (while this is in the Senate, we hear the House does not have the votes to pass it, so contact your Representative too).
Rights of Persons with Disabilities
The Iowa Department of Human Rights has proposed a bill (HF 2150 & SSB 3183) that cleans up Iowa Code and so that it conforms with the current federal ADA language. The bill eliminates old references to "persons with physical disabilities" and replaces it with the more inclusive "persons with disabilities." The bill clarifies that service animals do not need to be trained by a recognized training facility (since there are none in Iowa). Curb cuts (accessible slopes) are now required on all new or repaired intersection curbs. The subcommittees on these bills met this week, the Senate unanimously passed its bill (SF 2150) out of committee, and the House plans to take action on their bill early next week.
- Rep. Lisa Heddens of Ames and Sen. Joe Bolkcom will floor manage the bill - so you can send your comments or thanks to them directly, as well as to your legislators.
Dependent Adult Abuse
Two years ago, the Iowa Legislature spent many hours working with state agencies, advocates for dependent adults, hospitals, health care providers and nursing homes to determine whether Iowa's definitions of "dependent adult abuse" were good enough, or if they made it too easy for caregivers to be charged with dependent adult abuse.
The discussions produced a bill that created what bill sponsor Rep. Bruce Hunter of Des Moines called a "delicate balancing act." Last summer, the Department of Inspections and Appeals filed their rules implementing the law passed two years ago, but health care providers, hospitals, and nursing homes said the rules went too far and did not reflect the agreement made.
Advocates for persons with disabilities and older Iowans say the rules did exactly as the legislation intended - raise the standard for dependent adult abuse so caregivers were not facing abuse allegations for minor errors, but making sure it was still a standard that protected vulnerable Iowans.
Now legislators are considering a bill filed by the nursing homes, hospitals and healthcare providers to make it even more difficult to prosecute for dependent adult abuse. As Rep. Hunter said recently about the proposed changes, ""It would make it very, very difficult, if not impossible, to prosecute somebody in a nursing home or a hospital," he said. "Yes, we want to make prosecution difficult because dependent-adult abuse is a serious charge, but we don't want to make it impossible."
- At this time, the House has decided to stop all action on their bill (HSB 612), and the Senate plans to amend their bill (SSB 3103) to strike all controversial sections.
Audiology Insurance Coverage
Rep. Janet Petersen of Des Moines did a quick bit of maneuvering this week when she failed to find the votes in the House Commerce Committee (which she chairs) to pass a bill that would require insurance plans to pay for audiological evaluations and hearing aids for children. She quickly had the bill reintroduced in the House Human Resources Committee (HSB 682) and received the necessary support to move the bill out of subcommittee and to a full committee vote next week.
- If you care about this issue, contact your State Representative.