December 5, 2018
Medicaid Audit Incomplete; Still Shows Disappointing Results
Medicaid Audit Incomplete; Still Shows Disappointing Results
A new audit on Medicaid completed by the State Auditor found misleading claims from state officials and less than expected savings from Medicaid privatization.
While the auditor said the report was complete, many Iowans expressed concern that the audit was incomplete because it failed to account for non-payment or lower payments to providers and Iowans who were denied services. Lawmakers have heard from providers who are still not being paid, members that are getting their services severely cut, and some clinics have had to close their doors altogether. In fact, the most recent State Ombudsman report shows there has been a 157% increase in Medicaid-related problems reported to the agency in 2017. There was also a big raise the for-profit Managed Care Organizations (MCOs) recently received-to the tune of $102.9 million or a 7.5% increase-to take into account.
While the audit showed some savings to the state, the final number was far below the estimated savings of $234 million that the Reynolds Administration released last year. The audit also determined that the state officials did not establish a reliable method for calculating cost savings when they unilaterally decided to privatize Medicaid. So, it is almost impossible to calculate true savings, if there are any.
This audit process was only initiated because a Democratic lawmaker requested a review of the Medicaid program due to all the inconsistent data being released by DHS. Medicaid provides health care to 600,000 Iowans, including those in nursing homes. According to recent estimates, about 70% of Medicaid dollars are used for the elderly, severely disabled, and poor. Because this affects our most vulnerable population, it is imperative we understand the true impact privatization is having on our state.
Utility Deregulation Slashes LIHEAP Funding
Now that the cold weather has arrived, many people are getting their furnaces tuned up for the winter months, and some are concerned with the rising cost of the heating bills. Beginning November 1, residents can apply to receive assistance through the Low Income Home Energy Assistance Program (LIHEAP). Households that qualify are protected from natural gas or electric service disconnection between November 1, 2018 and April 30, 2019.
To qualify for LIHEAP, the total household income must be at or below 175% of the federal poverty level. Persons interested in applying should contact the Low-Income Home Energy Assistance Program in the Department of Human Services at 515-281-0859 or their local community action agency, which can be found online at https://humanrights.iowa.gov/dcaa/where-apply.
According to the Iowa Department of Human Rights, 1,200 homes were weatherized and 82,932 Iowa households, 192,919 individuals, received LIHEAP heating assistance benefits between 2017 and 2018 winter months. The program received additional $4.9 million from the Department of Energy and $6 million in aid from Iowa Investor-Owned Utility companies.
Last session, Iowa Republicans enacted legislation to deregulate Iowa investor-owned utilities. Due to those changes, it is estimated that LIHEAP will receive a 50% decrease in aid from utility companies this year.
Iowa Universities Could See Tuition Increases Again
Regent President Mike Richards announced at the November Board of Regents meeting that resident undergraduate tuition at the University of Iowa (U of I) and Iowa State University (ISU) will increase by at least 3% per year over the next five years. That amount could be higher if the Legislature does not fully fund their appropriations request.
If no increase in state funding is approved next session, the resident undergraduate tuition rate will increase by 3.0% plus the projected increase in the Higher Education Price Index (HEPI). For the upcoming budget year, the HEPI is projected to be 2.0%.
The tuition rates for the three universities will no longer be tied together as it has been in the past. This will allow the University of Northern Iowa (UNI) to be competitively priced with other Midwest universities. The Board will continue the practice of a first reading of the tuition rate proposal in April, with a final reading in June after State appropriations have been set. Waiting until June aims to reduce the likelihood of a mid-year tuition increase.
For Fiscal Year 2019, the Regents have requested a $7 million increase for ISU and the U of I each; which would be designated for student tuition assistance. The Regent’s request for UNI is a $4 million increase. Over the last two years, the Legislature has approved budget cuts to the universities that total over $30 million.
Internet Retailers Required to Collect Sales Tax Starting January 1
Changes made during the last legislative session to Iowa’s sales taxes will impact certain retailers starting January 1st. Approved by Republican lawmakers Senate File 2417 expanded the types of businesses that are required to collect state and local sales tax.
Starting on January 1st remote sellers and marketplace facilitators will have to collect Iowa sales tax. Remote sellers are anyone that makes sales into Iowa but does not have a physical presence in the state. Remote sellers are required to collect Iowa sales tax if the seller has $100,000 or more in gross revenue from Iowa sales or makes 200 or more separate sales transactions into the state.
A marketplace facilitator is a business that facilities retail sales by providing infrastructure or support for retail sales into the state and collects the sales price, processes payments, or receives compensation for the retail sale. Examples of marketplace facilitators include auctions, online marketplaces, or consignment stores; for example EBay and Etsy.
A comprehensive webpage on the Iowa tax reforms is available at https://tax.iowa.gov/iowa-tax-reform. In addition, the Iowa Department of Revenue has detailed websites explaining which remote sellers are required to collect Iowa sales taxes at https://tax.iowa.gov/remote-sellers and a detailed description of marketplace facilitators available at https://tax.iowa.gov/marketplace-facilitators.
Grants Used for School Bus Upgrades
Over $3 million in grants will be given out to Iowa’s school bus fleets for upgrades to more environmentally friendly buses. Administered by the Iowa Department of Transportation (DOT), the money came available after a federal court ruled that Volkswagen (VW) must pay $2.8 billion to states to reduce diesel standards after admitting to cheating emission standards.
The DOT chose to use the money to upgrade bus fleets after it was one of the more popular choices of a public survey completed by the DOT. The grants will be available to private organizations, school districts, public transit system operators, cities, and counties.
Applications will be accepted until January 18th and those receiving the grant can receive up to $25,000 or 25% of the cost of the vehicle, whichever is less. In total the state will receive $21 million over 10 years to help reduce nitrogen oxide omissions.
Iowa Deer Hunting Season Begins
Deer hunting season is in full swing with over 100,000 hunters expected to participate in the two shotgun seasons. There is still time to purchase deer licenses from over 750 vendors across the state. To ensure hunters have a successful hunt, the Iowa Department of Natural Resources (DNR) has the following safety tips:
• Treat every gun as if it is loaded
Hunters must report harvested deer before midnight the day after the deer is tagged. Hunters can report their harvest online at www.iowadnr.gov/hunting and click on the orange ‘Report Your Harvest Online’ button. Harvests can be reported by phone by calling 800-771-4692.
There are a few new things with deer hunting this year. The DNR has created an online portal for hunters who provide samples of deer tissue for chronic wasting disease (CWD) testing. Results take 2-3 weeks and can be found at http://www.iowadnr.gov/hunting. Allamakee, Clayton, and Wayne Counties have deer management zones to test for CWD. Hunters using a management zone license must provide a tissue sample for testing.
There is also an antlerless deer season in Allamakee, Clayton, Wayne, and Appanoose Counties from January 11-27. Over 1,000 licenses will be available in each county. Finally, an unfilled youth deer license can be used in the remaining deer seasons as long as the method of take for the season is followed and the youth is mentored by a licensed adult.
Hunters can donate extra deer to lockers that participate in the HUSH (Help Us Stop Hunger) program at no cost. Lockers then process the meat for the Food Bank of Iowa to distribute to people who need it. To find more information about the HUSH program and to find a locker, go to http://www.iowahush.com.
Trade War Drags On, Hits Iowa Farmers
The Trump Administration’s damaging trade war continues on with little sign of ending. The trade fight with America’s biggest economic partners has depressed crop and livestock prices and led to uncertainty among Iowa producers.
Iowa has been particularly hard hit by the continuing trade disputes. In 2017, Iowa was second nationally in soybean production and soybeans were the top US agricultural export to China. China accounts for nearly 60 percent of the global soybean trade, which accounts for one of every three rows of U.S. soybean production.
Since the beginning of the trade war, China has ceased buying US soybeans, turning instead to Brazil. Soybean exports to China are now down 98% in 2018. The USDA is forecasting that soybean-planted acreage will drop by 6.6 million acres to 82.5 million in 2019, the third largest acreage decline of all time.
To offset some of the losses from the tariff fight, the Trump Administration has approved a bailout for producers who are unable to sell their products. Iowa soybean farmers will receive an estimated $479 million, based on the state's projected harvest. Iowa pork producers would get between $60 million and $70 million. The bailout funds from the federal government do not begin to cover losses for most producers, with some corn growers receiving as little as $25.
According to information from the Federal Reserve, farm bankruptcies are on the rise, doubling in the last year from their low in 2014.
The US Chamber of Commerce estimates that the impact on Iowa could be as much as $977 million. An economist at Iowa State University estimates that Iowa farmers stand to lose up to $624 million because of the tariffs on soybeans alone. After implementation of the Trump tariffs, the trade deficit in June ballooned to the highest level in ten years.
Iowa’s New Statewide Assessment Coming this Spring
This Spring there will finally be a new Iowa assessment administered to K-12 students; it is called the Iowa Statewide Assessment of Student Progress or (ISASP). Last session, the Legislature passed a bill to designate the new test and it ended a long standing dispute in Iowa as to what the new Iowa assessment would be.
Back in 2013, lawmakers required the Iowa State Board of Education to set the new test with core academic indicators by July of 2016. That set in motion a study committee, and then a bid process. Last year a bid award was announced to be a test designed by the American Institute of Research. However, lawsuits followed on the bidding process, and the Legislature nixed that plan with the passage last session.
The ISASP will be a partnership between the Department of Education, which provided the assessment policy development; Iowa Testing Programs at the University of Iowa that developed the assessment; and Pearson, a private company that will administer the test. The test materials are aligned to the Iowa Core, developed by Iowa educators and field tested to Iowa students with test forms unique to each grade level.
As part of the preparation for the test, professional development training is being provided to schools. The test can be delivered in either paper pencil format or on line computer format. By the end of December, school districts in Iowa will need to decide which format that they will use.
Public Input Sought on PE and Health Standards
The Iowa Department of Education is seeking the public’s input on proposed physical education and health standards. The standards, selected by the Physical Education and Health Standards Review Team, would be recommended to schools but are not required.
Feedback on the standards is available through a survey or at public forums which will be held on Dec. 4 and Dec. 6 (details are below). Both forums run from 4:30-6:30 p.m. The survey will be open until Dec. 20. Input from the survey and forums will be incorporated into the team’s final recommendations, and are aimed to go before the Iowa State Board of Education for consideration sometime next spring.
According to the Department, the new standards are an attempt to provide teachers with a framework to strengthen K-12 instruction and to help students with the skills to be healthy for an active for life. Research shows physical activity and good nutrition lessen physical and mental health problems.
Grant Wood Elementary
University of Northern Iowa
Lewis Central CSD