Iowa Senate Democrats

Fighting for a Better Deal for Iowans.

  • Healthy Moms and Babies Act will address growing maternal health concerns

    Iowa Senate News Release

    For Immediate Release: Feb. 19, 2020

    DES MOINES – Senate Democrats have proposed legislation to address the growing maternal health crisis in Iowa.

    “Iowa is facing a maternal health crisis that we simply cannot ignore,” says Senator Janet Petersen, the Senate Democratic Leader. “Iowa’s maternal mortality rate has more than doubled in the past three years, hospital labor and delivery departments are shuttering at record speed, and 66 Iowa counties no longer have a single OB/GYN practicing in their county.”

    The scope of the problem includes:

    • Iowa has lost 37 labor and delivery departments.
      MAP OF OB UNITS | LIST OF CLOSURES
    • Iowa has the lowest number of obstetricians per capita in the country. Two-thirds of rural Level 1 hospitals have no obstetrician on staff.
    • Compared to other states, Iowa has a high rate of cesarean births, an indicator of potential health problems for mother and child.

    “Iowa taxpayers pay for more than 40% all births in our state through Medicaid,” Petersen said. “Governor Reynolds has put a system in place that allows out-of-state companies to make a profit off of labor and delivery services while our rural hospitals are financially penalized for providing care. Iowa’s privatized Medicaid doesn’t cover the full cost of delivering babies, which hurts rural and urban hospitals.” 

    The Healthy Moms and Babies Act (SF 2062), co-sponsored by 18 members of the Iowa Senate, will address the maternal health care crisis by:

    • Adjusting Medicaid rates so that hospitals are adequately reimbursed for the care they provide.
    • Ensuring labor and delivery units use proven practices—known as “safety bundles”—that save lives during delivery.
    • Expanding home visiting services for pregnant women, new moms and babies.

    – end –

    Summary of SF 2062: “Healthy Moms and Babies Act”

    Background

    Maternal health in Iowa is experiencing a crisis.

    Maternal death rates are higher in the U.S. than in any other developed nation, and they are rising.  In Iowa, maternal mortality has more than doubled in three years.

    In addition, moms-to-be are now sicker than in the past, with increasing maternal age, higher levels of obesity and related health complications, and societal problems such as substance abuse and mental health, all playing a role.

    To compound these problems, access to care is diminishing and the provider workforce is shrinking. Iowa has seen 37 labor and delivery units in critical access hospitals close since the year 2000, and Iowa has the lowest number of obstetricians per capita in the country, according to the American College of Obstetricians and Gynecologists.

    • 64% of rural Level 1 hospitals have no obstetrician on staff
    • Iowa ranks 50th out of 50 in the number of OB/GYNs per capita
    • Iowa has a high rate of cesarean births which can lead to future health problems

    As of October 2019, 37 of Iowa’s 118 community hospitals have closed their birthing units since 2000, according to the Iowa Department of Public Health. There were two closures in 2019, down from eight closures in 2018 — the most in a single year. Since then, Mount Pleasant, New Hampton and Muscatine have announced closures.  Most of those closures have happened at smaller facilities. Hospitals are not reimbursed for the cost of the standard of care for labor and delivery so they lose money on every birth.

    About 40% of births in Iowa are Medicaid so making improvements to maternal care in the Medicaid program is key to improving maternal health and birth outcomes in Iowa. Privatized Medicaid doesn’t cover the costs for delivering babies in Iowa when health care providers follow the standard of care.

    Division I:  Medicaid Maternal and Child Health Improvements

    DHS is directed to adopt rules under both fee-for-service and managed care Medicaid, amend any managed care contracts, and apply for any Medicaid plan amendments or waivers necessary to improve care for moms and babies in all the following ways:

    1. Provide reimbursement in an amount that appropriately covers the entire standard of care costs for labor and delivery;
    2. Provide the same reimbursement for maternal-fetal medicine services and comprehensive maternity care when provided in person or via telehealth (covering both facility and professional fees);
    3. Allow continuous Medicaid eligibility for a woman for a 12-month postpartum period (compared to 60 days currently);
    4. Provide comprehensive maternity care which includes the basic number of prenatal and postpartum visits recommended by ACOG (American College of Obstetricians and Gynecologists), any additional prenatal or postpartum visits that are medically necessary, necessary laboratory, nutritional assessment and counseling, health education, personal counseling, managed care, outreach and follow-up services, and treatment of conditions which may complicate pregnancy;
    5. Provide reimbursement for doula care;
    6. Reimbursement for breastfeeding supports, counseling, and supplies including the standard cost of breast pumps and electronic breast pumps;
    7. Reimbursement for transportation to all prenatal and postpartum care appointments; and
    8. Reimbursement for all postpartum care products such as breast pads, period pads, comfort products, pain relievers, and other similar products.

    Division II:  Maternal Best Practices/Safety Bundles and Hospital Requirements

    Licensed hospitals that provide labor and delivery services shall be required to do the following:

    1. Adopt and implement the current best practices or safety bundles recommended by ACOG and the Alliance for Innovation on Maternal Health; details here https://www.medpagetoday.com/obgyn/pregnancy/74631

    These maternal safety bundles include action measures for:

    • Obstetrical Hemorrhage
    • Severe Hypertension/Preeclampsia
    • Prevention of Venous Thromboembolism
    • Reduction of Low Risk Primary Cesarean Births/Support for Intended Vaginal Birth
    • Reduction of Peripartum Racial Disparities
    • Postpartum care access and standards
    1. Provide information to the public, including but not limited to maternity and neonatal level of care status and the meaning of that status;
    2. Provide cesarean birth statistics;
    3. Provide statistics on the number of vaginal births after cesarean (VBAC) and vaginal births after two cesareans (VBA2C);
    4. Provide rate of exclusive breastfeeding upon discharge;
    5. Provide all moms and babies receiving labor and delivery services with information and assistance in applying for services and health care coverage including but not limited to Medicaid; AEA agencies; WIC; and home visiting programs; prior to discharge from the hospital; and
    6. Have a comprehensive labor and delivery unit closure plan in place that includes a plan for future births and pregnancies and the capacity of other providers to absorb the services in case of unit closure.

    Division III:  Expanded Home Visiting Services

    DHS is directed to seek federal approval for any state plan amendment or waiver necessary in order to collaborate with the Department of Public Health and the Department of Education to expand maternal and infant home visiting services under Medicaid that:

    • promote healthy pregnancies;
    • positive birth outcomes; and
    • healthy infant growth and development.

    The departments shall design a home visiting approach that maximizes coordination and blending of programs and funding, reduces duplication of efforts and ensures that the services provided meet federal evidence-based criteria. Home visiting should start prenatally and include mental health services.

  • Iowans bring fight for their homes to Capitol

    Iowa Senate News Release

    WHAT: News Conference with the Iowa Manufactured Home Resident’s Network
    WHERE: Room 315, Iowa State Capitol
    WHEN: 11 a.m., Wednesday, February 19, 2020
    WHO: Manufactured home residents from around the state

    (DES MOINES) – Residents from manufactured home parks from across the state will meet at the Capitol in Des Moines on Wednesday to continue the fight for their homes by sharing their stories with Iowa lawmakers.

    The Iowa Manufactured Home Resident’s Network is a coalition of residents and allies who are committed to providing a voice to residents of manufactured home communities across the state.

    This week some of those residents will be raising those voices in Des Moines, as important legislation works its way through the Iowa House and Senate.  The bill (SF 2238/HF 2351) is an important first step toward providing checks and balances in a currently one-sided system, a system that is attracting unscrupulous private equity firms to the state as it drives Iowans out of their homes.

    The residents will hold a press conference at 11 am in Room 315 at the Iowa Capitol. Speakers will include manufactured home residents from around the state.

    Senator Wahls speaks in the Chamber about need for reforms

    News conference speakers and video of remarks

    Candi Evans, Golfview Residents Association, North Liberty

    • Park purchased by Havenpark in 2019 – I found out from notice taped to my door of rent increase …
    • Who’s in our community / we are real people
    • Our journey in the past year: from outrageous rent increases, to finding out Havenpark is private investor group from Utah, to first meeting of residents to months of work to get our voices heard, to a bill now under discussion to finally create some of the protections all Iowa manufactured homeowners should have had a long time ago
    • Why we need this bill … we have residents here from at least 7 different parks across Iowa who will share part of their stories with us today

    Angela Smith, Park Plaza Manufactured Home Park, Muscatine

    • Park purchased by Impact in 2019
    • Major rent increases and water overcharges (example) – then because we started to speak up and got help from our city and our municipal utility, the owners are starting to refund the overcharges
    • I’m worried it will happen again unless we get legal protection
    • We need this bill to protect all Iowa residents against fraud and unfair utility charges

    Jenny Heishman, Grinnell Manufactured Home Park, Grinnell

    • Story of trailer purchase and grandparents’ living situation
    • Park purchased by Impact in 2013
    • Since then, our lot rent has increased over 200%
    • We need this bill to protect proud, hardworking Iowans like my grandparents

    Carrie Presley, Table Mound Residents Association, Dubuque

    • Park purchased by Impact in 2017

    Margarita Rodriguez, Forest View Residents’ Association, Iowa City

    • Park sold to developer in 2016
    • With developer as our park owner, there is now no maintenance of park anymore; conditions deteriorating and unsafe
    • Sewers aren’t repaired. Potholes aren’t fixed. And there is no one for us to turn to.
    • We need this bill to create a way for residents to hold owners accountable for safe conditions in our parks, no matter who owns our parks in the future.

    Matt Chapman, Midwest Country Estates, Waukee

    • Waukee residents facing rent increases / who lives in my park
    • Park purchased by Havenpark in 2019
    • Part of national trend, private equity groups taking advantage of residents
    • Who are these owners who are trying to keep us from getting this bill passed?
    • The Iowa Manufactured Homes Association is one of the only opponents to this bill. They have “Iowa” in their name, but they are choosing to represent Havenpark and other out-of-state park owners against the interest of Iowans. In fact, we now know that Impact CEO Frank Rolfe sits on their board. Impact is headquartered in Colorado and now owns at least 23 parks in Iowa. Their CEO Frank Rolfe is the same man who famously told investors that a mobile home park “is like a Waffle House where the customers are chained to their booths.”
    • We need this bill to prevent the Frank Rolfe’s of the world targeting Iowa residents as easy marks for their quick profits.

    State Senator Zach Wahls, D-Coralville

    Senator Wahls offered an update on the current status of manufactured housing legislation traveling through both chambers. The House and Senate have introduce bipartisan bills intended to protect manufactured home owners. He clarified that this is not an issue of parks being sold for redevelopment. Out-of-state owners are eyeing mobile home parks as an opportunity to profit from the vulnerability of disabled or low-income people.

  • Rural Iowa’s Maternal Health Crisis: A Doctor’s Perspective

    By Senate Intern Kylie Spies, University of Iowa MSW student

    Women in Henry County soon will have to travel an hour to Iowa City or Ottumwa to give birth. In labor and delivery, every minute can be critical. Sarah Ledger of Mount Pleasant, a physician with Henry County Health Center, talks with State Sen. Rich Taylor about the consequences of closing obstetrics units in rural Iowa.

    Rural Iowa hospitals are struggling to keep their doors open, and family practice doctors are on the front lines. Dr. Sarah Ledger, D.O., visited the State Capitol to tell legislators about the challenges Iowa families and doctors are facing.

    Dr. Ledger provides prenatal care to southeast Iowa women at Henry County Health Center in Mount Pleasant. HCHC will close the doors to its maternity unit in June, leaving another Iowa community without a safe place to have a baby.

    Henry County Health Center is a Top 100 Critical Access Hospital in the United States. Critical Access Hospitals are small rural hospitals at least 35 miles from another facility. They have 25 beds or fewer, and must offer 24/7 emergency services. In rural Iowa, these hospitals may be a matter of life and death in a crisis.

    Dr. Ledger says that because of the way Medicaid providers pay hospitals for maternity services, they are sometimes forced to close their labor and delivery units to keep the rest of the hospital afloat. It takes a lot of staff and hospital resources to be ready to deliver a baby at any time. If Medicaid payments don’t cover the costs or aren’t made quickly, rural OB units suffer.

    Critical Access Hospitals are supposed to receive higher rates of payment for their services because they are so vital to the community. But profit-driven private Medicaid providers have squeezed hospital budgets so tightly that they can no longer serve Iowans.

    “You abandon OB to keep your hospital open,” says Dr. Ledger. “We’re running into the same thing with our EMS services. We run into the same thing with some of our inpatient care units. You have to cut back on the services that you provide to keep your hospital open. And we’re seeing hospitals that are still closing.”

    Dr. Ledger says women are at higher risk of health problems like high blood pressure and premature births than they were 20 years ago. She sees patients living with violence and hunger, and many without a vehicle for traveling to appointments.

    Good prenatal care is crucial for the health of moms and babies. Regular appointments during pregnancy allow doctors and midwives to monitor patient health, educate moms, and prepare them for labor and newborn care. Without access to prenatal care, Iowa women and their babies face serious health risks.

    “These women come in and we have no idea what the potential complications are going to be. It increases the cost of health care overall because we’re not prepared. We haven’t taught these moms how to take care of their babies. We haven’t taught these moms how to take care of their bodies. You see more complications with that.”

    Women in Henry County soon will have to travel an hour to Iowa City or Ottumwa to give birth. In labor and delivery, every minute can be critical.

    “It is much safer to deliver these babies in a stable OB unit with a trained OB clinician, rather than an ER, in the back of an ambulance, or in a personal vehicle on the side of the road,” says Dr. Ledger.

     The shortage of maternity units in rural Iowa puts moms and babies at risk.

    Iowa ranks 50th out of the 50 states in the number of OB-GYNs per capita. Two-thirds of Iowa counties don’t have a single OB. Combined with the 34 closures of rural Iowa maternity units since 2000, Iowa has a serious care crisis. Dr. Ledger is asking the Legislature to fix Iowa’s Medicaid mess to protect rural hospitals.

    “We need more support with our Critical Access Hospitals. We need more money, unfortunately we need higher reimbursement,” she says.

    “We pay a lot of money to these private MCOs, and we are getting less and less.”

    Sources

    www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Health-Disparities-in-Rural-Women?IsMobileSet=false

    www.hchc.org/

    www.ruralhealthinfo.org/topics/critical-access-hospitals

    www.arcgis.com/apps/webappviewer/index.html?id=52284a7453eb46b79149c1571d2d5e1b

  • Report investigates death of Natalie Finn

    Another tragedy like the death of teenager Natalie Finn could happen unless Iowa’s child-protection workers are given the resources and support they need, the State Ombudsman announced today in a report on how the Iowa Department of Human Services handled child-abuse reports.

    The 16-year-old girl was emaciated when emergency responders were called to her adoptive family’s West Des Moines home in October 2016. She died a few hours later at a local hospital.

    Let’s ensure no child suffers like this again!

    Read the news release from the Ombudsman’s Office.

    Read the Ombudsman’s report, “A Tragedy of Errors: An Investigation of the Death of Natalie Finn“

  • Senate Republicans vote to take away women’s rights

    TRANSCRIPT:

    Ladies and Gentleman of the Senate, on the opening day of the Legislative Session, I said,

    “Iowans shouldn’t have to worry that their human and civil rights are on the line when the Legislature is in session.”

    But here we are…

    Today, Senate Republicans, under the leadership of Senator Schneider and Senator Whitver, are pushing a Constitutional Amendment designed to strip away the freedom of Iowa women, girls and their families.

    President Schneider and Leader Whitver – this debate calendar for today is one for the history books – one you will both be remembered for.

    First, you celebrate the 100th anniversary of women’s right to vote.

    Then, on the same debate calendar, the only other piece of legislation you put forth is a Constitutional Amendment to strip women and girls of their basic human rights.

    You’ve chosen today to push an extreme agenda with the ultimate goal of an all-out abortion ban in Iowa –with no exceptions granted under any circumstances, instead of focusing on real problems facing young Iowa families in our state.

    Iowa women and girls need MORE access to safe health care close to home, NOT LESS.

    But that doesn’t seem to faze you.

    Never mind that Iowa is facing a maternal health crisis facing our state.

    Never mind that Iowa’s maternal mortality rate has more than doubled in the past three years.

    Never mind that 66 Iowa counties don’t even have a single OB/GYN.

    Livestock in our state has better access to doctors than Iowa women and girls, but I guess that doesn’t matter to you.

    Never mind that Iowans are losing labor & delivery departments and safe places to go for decent reproductive health care at a dangerous and deadly pace.
    ¬
    Iowa families represented by Senator Sinclair have lost three labor & delivery departments in Chariton, Knoxville and Leon.

    The families Senator Miller-Meeks represents have lost three labor & delivery departments in Bloomfield, Keosauqua, and Fairfield.

    Moms-to-be in Senator Rozenboom’s district lost their labor & delivery department in Centerville.

    Young families who are represented by Senator Segebart lost access to three labor & delivery departments in Audubon, Manning, and Sac City.

    Senator Waylon Brown – young families in your district had already lost labor & delivery services in Osage. Now you can add New Hampton to the list of places that won’t serve moms-to-be in your district anymore.

    Moms-to-be represented by Senator Johnson no longer have a labor & delivery department to deliver their babies in Oelwein and Independence.

    Senator Johnson was assigned the Healthy Moms and Babies Act to help address the maternal health crisis facing Iowa. But Senator Johnson hasn’t scheduled a subcommittee on the bill yet.

    Senator Edler: you promised the families in your district more access to health care. But Marshalltown because the Iowa community to lose a Level 2 labor and delivery department.

    Iowa parents-to-be that Senator Costello represents no longer have labor & delivery departments in Clarinda and Hamburg.

    Families Senator Sweeney represents lost labor & delivery departments in Iowa Falls and Eldora.

    Families Senator Whiting represents lost labor & delivery departments in Sibley and Rock Rapids.

    Parents-to-be and families living in Anamosa, Corning, Dyersville, Estherville, Guttenberg, Hampton, Humboldt, Ida Grove, Jefferson, Keokuk, Maquoketa, Washington, Webster City – all lost labor and delivery departments.

    Mount Pleasant is soon to shutter its labor and delivery program. And NONE of these hospitals that closed their labor and delivery departments are required to make sure other communities can take on the additional patient load, or that women have safe transportation to get to distant hospitals.

    So, even if your senate district hasn’t lost a labor and delivery department, your constituents health care is compromised as well. Access to a labor and delivery room matters.

    And the problem is getting worse.

    We know we’re likely to see an additional 10 labor & deliveries close down in the near future. A significant number of OB/gyns and family practitioners are planning to retire soon. And, we are starting to lose family practice residency programs in the state.

    These, my friends are real issues.

    BUT instead of making Iowa a safer place to have a baby, or help women get health care to regulate problematic periods, and address period health care issues that impact their ability to go to school and work, or improving access to family planning services so parents can choose when to have kids, and safely space their pregnancies, or choose not to have kids.

    Instead government is intruding on their lives.

    You have chosen to take away freedoms from Iowans.

    Instead of dealing with real problems that can truly be life or death problems for women and girls in our state, you have chosen to ram your power into women’s bodies once again.

    Wasn’t it enough, when you banned thousands of Iowa women from getting their reproductive health care from Planned Parenthood, Unity Point and the University of Iowa Hospitals and Clinics…while you still enjoyed your taxpayer funded health insurance that allowed you, your spouses and your kids to access those providers and even get the same services you denied to the women you represent?

    Women are getting tired of you making your political statements with our uteruses.

    It’s time to quit punching women and girls in the uterus with your policies, and pretending it’s for our own good.

    This Constitutional Amendment steals the rights away from Iowa women and girls by taking away our ability to make personal decisions about what is best for our bodies, our future, our families, and our pregnancies.

    I can’t think of a single body part that is regulated more than the UTERUS.

    Not a big toe.

    Not eyes.

    Not even the penis, which is responsible for 99% of all rapes and 100% of all unintended pregnancies in our country, according to facts and science.

    To my Senate Republican colleagues – it is time for you to quit treating Iowa women and girls as second-class citizens whose rights and opportunities are inferior to your own.

    I don’t like to be mansplained on what human rights are.

    This constitutional amendment is written with the sole purpose of banning access to safe abortion care in Iowa.

    Don’t let the misleading language in this amendment confuse you.

    This amendment is not designed to protect women.

    The intent of this constitutional amendment, and the politicians behind it, is to make sure Iowa can ban abortion without exception.

    When you take away access to safe, legal abortion care, and maternal health care, you do not protect women and girls – you put their lives at risk.

    That’s why the American Medical Association and the American College of Obstetricians and Gynecologists oppose efforts to ban abortion.

    Iowans – not politicians – should be in charge of our own personal medical decisions.

    Make no mistake about it – this Constitutional Amendment is part of an extreme abortion ban agenda pushed by Republican politicians here in Iowa and across the country – designed to do one thing. End access to safe abortion care, no matter what the cost to the lives of women, girls and families living in our country.

    President Schneider, you chose to use the power of the Senate Presidency to have the Iowa Senate celebrate women’s right to vote today. And then in the very same day, you allowed a debate on an ultra-extreme Constitutional Amendment that strips women and girls of their basic human rights.

    Isn’t it ironic, don’t you think!

    President Schneider, I am glad you don’t have the power to take away women’s RIGHT TO VOTE that our grandmas and great grandmas fought for more than 100 years ago because I know WOMEN intend to use that right.

    I urge a no vote.

  • Mobile Home Bill Filed

    On Wednesday, a bipartisan group of senators filed a bill to protect Iowans who own manufactured homes. Senate File 2238 garnered 30 Senate cosponsors—15 Republicans and 15 Democrats.

    The House filed a “companion” bill (i.e., the same bill). The first public hearing on House File 2351 will be 1 p.m. on Monday, Feb. 17 in room 19.

    The legislation would update Iowa Code Chapter 562B to be fairer and curb predatory practices with four changes to Iowa law:

    1. Eviction: Require “good cause” for eviction.

    2. Rent increases: Mandate 180-days’ notice of rent increases, limit increases to once per year and require an explanation if the increase is more than the rate of inflation.

    3. Enforcement: Give the Iowa Attorney General authority to enforce the mobile home park laws under the Consumer Fraud Act.

    4. Equity: Provide mobile homeowners the same protections afforded apartment renters.

  • Mental Health System Under Threat

    Plan by Gov. Reynolds and Farm Bureau jeopardizes Iowa’s mental health system

    By State Sen. Joe Bolkcom, Iowa City (Senate District 43)

    I have been working for the last three weeks to draw attention to Governor Reynolds’ proposal to undermine stable, core funding of our local mental health system.

    I understand that every major business organization will support this deal, but I was shocked this week to learn that NAMI Iowa has endorsed Governor Reynolds’ destructive proposal. Why is NAMI Iowa joining Governor Reynolds and the Iowa Farm Bureau to hurt our mental health care providers and people that need their services? I don’t understand.

    State Sen. Joe Bolkcom is interviewed Feb. 12 on the Governor’s plan to shift the tax burden onto seniors and low-income Iowans, while undermining stable funding for Iowa’s adult mental health system.

    Here are some details about the Governor’s plan.

    While the main thrust of Governor Reynolds’ tax shift proposal is to give another massive tax cut to wealthy Iowans that will drain hundreds of millions from state priorities, she also proposes to do great damage to our mental health system.

    The Governor’s plan is a disaster. It cuts $80 million in stable, predictable local funding from our mental health system, and replaces it with unpredictable and insufficient state appropriations.

    The strength of our adult system is that it was created and is financially supported by local elected officials, families and mental health providers. It is the backbone of our mental health system. The reason it exists today is that it has NOT had to rely on annually begging the Legislature for resources over the past 50 years. It is successful because local elected officials are accountable for making it work.

    More state control of the system will result in less stable funding, less local accountability for results and more broken promises. Why would the Governor, who says she cares about mental health, propose to take away much of its most secure financial support?

    Because the Iowa Farm Bureau told her too. It has been a Farm Bureau priority for 30 years. Why should Farm Bureau members have to pay for mental health services? “What do social services like mental health have to do with farm fields,” they ask.

    I investigated who pays the dedicated county mental health property tax levy that funds our local providers. Implied in Farm Bureau’s complaint is that they are paying more than their fair share for local mental health services. For the record, agricultural property accounts for 18 percent of the total statewide contribution for our local mental health services. Apparently, they want to pay zero.

    So the Governor and the Farm Bureau want to destroy the most reliable source of funding for our mental health system because Farm Bureau does not want to pay their fair share for mental health services. I don’t understand why NAMI Iowa agrees?

    I wish I had more faith in Iowa state government to keep its word. I don’t aim to be mean, but just look at the GOP’s major health care initiatives over the past five years to see how Republican control of our health care has been amazingly ineffective.  

    Everyone but Governor Reynolds and legislative Republicans still agree that privatizing Medicaid has been a costly disaster. Governor Reynolds’ and Republican’s closure of two state mental health facilities (Clarinda and Mt. Pleasant) resulted in premature death for several vulnerable Iowans and significantly reduced much needed mental health beds.

    The GOP gutted Iowa’s successful family planning programs that have led to a documented maternal mortality crisis and dangerous outcomes for pregnant moms and their babies.

    The GOP’s medical cannabis program is the worst, most bureaucratic, unworkable program in the nation.

    And now the U.S. Department of Justice is investigating the Reynolds’ Administration for its operation of two state resource centers (Glenwood and Woodward) for our most vulnerable intellectually disabled and mental health patients, following an unusual number of recent deaths and serious violations of federal law.

    More state control over Iowa’s local mental health system will lead to serious decline. Please speak up NOW if you care about maintaining and improving Iowa’s mental health system.

  • Nursing students aim to fill health care needs

    By Senate Intern Kylie Spies, University of Iowa MSW student

    Richie Gibbs, Erica Altemeier and Madelynn Rhodes are nursing students at Des Moines Area Community College.

    Students from DMACC’s RN training program were on hand for Career and Technical Education Day at the Capitol. They shared with legislators how their program is helping prepare Iowans for high-demand jobs.

    Iowa is experiencing shortages in OB-GYNs, mental health providers, nurses and other health professions. In 2018, U.S. News ranked Iowa 36th in the nation in overall health care, and 46th in hospital quality.

    State-of-the-art training can help turn things around. The Healthcare Simulation Lab, located on DMACC’s Capitol Center campus, offers high-tech learning opportunities for future nurses and other health care professionals.

    While at the State Capitol, nursing students demonstrated surgical technology, hospital newborn care equipment and a child-sized dummy with a pulse. They take pride in the skills they’re gaining, but are well aware of the challenges facing Iowa’s health care system.

    Take Medicaid, for example.

    Richie Gibbs, Erica Altemeier and Madelynn Rhodes are all in the last semester of their Registered Nurse program. Even before entering the field, the three have witnessed how privatized Medicaid is squeezing providers.

    “We are close to the bottom in pay here in Iowa,” Gibbs said.

    As of 2017, the U.S. Bureau of Labor Statistics ranked Iowa 48th in the nation in average nursing salary—$57,930, or $27.85 per hour. That includes many nurses with decades of experience.

    In addition to the usual college courses, nursing students must take clinicals. Clinicals involve shadowing a practicing nurse to get hands-on experience in the field. DMACC nursing students have seen overworked, underpaid hospital staff that cannot keep up with the demand for care.

    For many nursing students, the first career step is as a Patient Care Technician. PCTs are entry-level health care workers who do hard physical labor, like feeding, dressing and bathing patients. Most make only about $13 per hour.

    Rhodes, who works as a PCT in a facility for seniors with dementia, says patients pay more than $100,000 per year at the facility, and that her pay is higher than many of her classmates.

    Altemeier received a grant from Central Iowa HealthWorks to help pay for tuition, books and gas to get to her classes and clinicals. Iowa HealthWorks is a United Way program that helps adult learners reach their health care career goals. Altemeier is grateful for the assistance, and says she wishes more money was available to help Iowans get into the profession. Some of her classmates come from other states to take advantage of DMACC’s program, but always intend to return home where they’ll make more money.

    Altemeier wants to see the state invest in people who are interested in becoming nurses or Patient Care Technicians, as well as competitive salaries that will keep talented nurses here in Iowa.

    Iowa cannot provide adequate health care services to those most in need without a bigger investment. Let’s not continue this race to the bottom.

  • Our children are our future

    By State Sen. Liz Mathis, Hiawatha (Senate District 34)

    There are few things more important than the future of our children. As legislators, I believe we need to reflect that in our work at the State Capitol.

    This year I have introduced several bills about children’s needs. After working on the children’s mental health system design and sitting on the Children’s Behavioral Health System State Board, I have learned from educators and mental health providers about immediate needs and long-term goals for alleviating the crisis and anxiety that kids are experiencing in their lives.

    The bills include creating a grant program using $15 million in Instructional Support Levy dollars to develop and improve mental health services in the schools (SF2042 and SF2071), creating mental health days with follow-up from school mental health staff (SF2067) and making certain the Your Life Iowa crisis line is on school IDs (SF2027).

    Since passing the children’s mental health system bill last year, we are working together on next steps: organizing core services needed at local levels and funding the system. Hard work is ahead to ensure the system is developed and supported.

    Other bills I’ve introduced include expanding pre-school programs and using vacant schools to house pre-schools and daycare centers in urban and rural areas and other legislation to help more pregnant women and new moms for a longer period of time. 

    I’ve signed up as a sponsor to lower the cost of day care for families (SF2110) and to allow for supports for our direct-care workforce (SF2098). This week I joined three other legislators, two across the aisle, to mandate that health insurance includes treatment for a pediatric autoimmune neuropsychiatric syndrome (PANS). 

  • Working together, we can help kids in need

    By State Sen. Nate Boulton, Des Moines (Senate District 16)

    Over the past year, I have had the chance to learn about a serious and heartbreaking illness that affects children who suffer from complications associated with strep infections. While most of us would not panic to hear our child has a diagnosis as common as strep throat, the unfortunate reality is that for some kids, that infection leads to a much more serious condition.

    PANDAS/PANS refers to several neuro-psychiatric conditions that can result from a simple streptococcal infection. Children affected suffer from a variety of problems, some as simple as headaches. Others, however, may become emotionally unstable and even suicidal. The National Institute of Mental Health Treatment describes the symptoms as usually dramatic, come on suddenly, and can include motor or vocal tics, obsessions and compulsions. Otherwise happy and healthy children can get a strep infection that one day causes a “trap door” to be triggered.

    While the condition alone is scary, parents face another frightening reality: treatment can be expensive and some health insurance companies refuse to cover it. To help ease the burden on these families facing a tough road ahead, I drafted legislation that requires coverage for treatment related to a PANDAS/PANS diagnosis.

    I was proud to see that as I spoke with other legislators about the issue, I was joined by Senators Tom Greene of Burlington (R), Liz Mathis of Hiawatha (D) and Mark Segebart of Vail (R) who signed on to co-sponsor the bill. We are making this a bipartisan effort to help families in need. SF 2084 has now been assigned to the Senate Human Resources Committee and awaits review by a Senate Subcommittee.

    Just as pediatric illnesses don’t afflict only Democratic or Republican children, our party labels should not prevent us from getting kids the health care they need when they need it.

    You can learn more about the issue in this short video with two Iowa moms: