Update from State Rep. Thomas Gerhold

Census Proves Agriculture is Vital to Iowa’s Economy

On Thursday, April 11, 2019, the Iowa Department of Agriculture and Land Stewardship (IDALS) issued a press release in which Iowa Secretary of Agriculture Mike Naig commented on the USDA NASS 2017 Census of Ag report 

Census Overview 

The U.S. Department of Agriculture (USDA) National Agricultural Statistics Service (NASS) released the 2017 Census of Agriculture results, sharing a wide range of information about Iowa’s farms and ranches and those who operate them, including new data about on-farm decision making, down to the county level. Information collected directly from producers tells us both farm numbers and land in farms have small percentage declines since the last Census in 2012, and the average age of all farmers and ranchers continues to rise. The Census information will be used by farmers, ranchers, local officials, agribusiness, commodity groups, and others to guide future decisions, in evaluating and implementing policies, and to educate consumers, which will provide a return on the investment made by the thousands of farmers who completed their Census form. 

The 2017 Census of Agriculture data show the following key trends for Iowa: 

• There are 86,104 million farms (down 2.9 percent from 2012) with an average size of 355 acres (up 2.9 percent) on 30.6 million acres (down 0.2 percent). 

• The value of agricultural products sold by Iowa farmers totaled $29.0 billion, down 6 percent or $1.87 billion from 2012. Crop sales accounted for $13.8 billion of the total, down 20 percent from 2012, while livestock sales accounted for $15.1 billion, up 12 percent from 2012. 

• Iowa ranked 2nd nationally for the total value of agricultural products sold and livestock sales in 2017 with Iowa’s crop sales ranking 3rd highest. 

• Farmers in Sioux, Lyon, Plymouth, Washington, and Kossuth counties had the largest value of sales in Iowa for 2017. 

• Farmers spent a total of $23.5 billion on production expenses in 2017, down 1 percent from the $23.7 billion in 2012. 

• Farmers harvested crops from 24.3 million acres in 2017 with no-till practices used on 8.20 million acres (up 18 percent from 2012) and reduced (conservation) tillage practices used on 10.1 million acres (up 16 percent). 

• Farms with internet access rose from 74 percent in 2012 to 80 percent in 2017. 

For the 2017 Census of Agriculture, NASS changed the demographic questions to better represent the roles of all persons involved in on-farm decision making. As a result, in 2017, the number of Iowa producers is up nearly 11 percent to 143,447, because more farms reported multiple producers. Most of these newly identified producers are female. While the number of male producers fell 3.2 percent to 94,382 from 2012 to 2017, the number of female producers increased by nearly 53 percent to 49,065. This change underscores the effectiveness of the questionnaire changes.

Other demographic highlights include: 

• The average age of all Iowa producers is 57.4, up 1.8 years from 2012. 

• There are 14,986 young producers age 35 or less on 11,136 farms. Young producers are more involved in making decisions regarding livestock than any other age group. 

• Just over one in five producers is a beginning farmer with 10 or fewer years of experience and an average age of 43.7. 

• The number of Iowa producers who have served in the military is 12,829, or 9 percent of all producers. They are older than the average at 70.1 years of age. 

• Thirty-four percent of all Iowa producers are female with the largest percentage of female producers involved in record keeping and financial management along with day-to-day decisions. 

April Enhance Iowa Boards Awards 

Last week, the Enhance Iowa Board awarded $675,000 in Community Attraction and Tourism (CAT) grants to a YMCA in Davenport, public garden in Des Moines, and a city park in Milford. 

Regents Free Speech Policy Revision Comes before the Board 

The Board of Regents is considering a revision to its “Free Speech” policies at the next Board meeting that occurs this week. The agenda item will consider, as a first and final reading, the proposed revisions. 

It comes as a result of the legislature passing and the governor signing SF 274 in March. The new law prohibits public universities and community colleges from adopting speech codes that violate the First Amendment. With the bill, public universities and community colleges in Iowa are required to add policies that acknowledge intellectual freedom and free expression are essential on campus. The bill also prevents a campus from having limited free speech zones in outdoor areas. It gives schools the ability to still implement reasonable time, place and manner restrictions to activities, including assemblies, protests, speeches, petitions, and recordings. 

The bill is in response to an unconstitutional policy at the University of Iowa. College campuses used to be generally understood as places that welcomed the free exchange of ideas, however, that has unfortunately changed significantly in the past several years. Free speech zones, arbitrary restrictions on student-funded groups, disallowing of certain speakers, and the removal of signs have all become commonplace on college campuses. 

The bill passed the House 52-44 without a single Democrat supporting free speech on campus, despite having received bipartisan support in the Senate. 

House Republican Passes Medicaid Solutions 

Last week, the House passed the Fiscal Year 2020 Health and Human Services Budget, which included many solutions related to Medicaid managed care. Importantly, this budget included suggestions from providers to ensure a smooth transition with the exit of UnitedHealthcare, as well as a significant increase to right-size the Medicaid program in the current fiscal year. 

Medicaid managed care in Iowa was approved by President Obama’s CMS administration with flawed capitation rates. This appropriation includes an additional $105.9 million to finally have actuarially sound rates in Iowa based on the actual experience of our program. These rates cover the 354 Exceptions to Policy granted by Iowa Medicaid Enterprise to serve our most vulnerable Iowans with the care they need, as well as the increased membership in the state. Last year, Medicaid expansion enrollment grew by an unanticipated 9.8%. 

This budget included many solutions related to the transition with United exiting while Iowa Total Care joins the Iowa Medicaid program. House Republicans are focused on ensuring a smooth transition for Medicaid members and providers. The budget includes: 

• Requiring United to expedite claims disputes for all outstanding claims with providers after they leave in July. 

• Requiring United to report on a monthly basis for 2 years’ outcomes of all claims with providers. 

• Requiring Amerigroup and Iowa Total Care to have a uniform prior authorization process in place by October. 

• Requiring attendance at the Medicaid oversight committee, called the Medical Assistance Advisory Council (MAAC), to ensure an effective, managed care oversight entity. 

The provisions above build on the work House Republicans have included in the past. Last year, based on feedback from constituents, House Republicans pushed the Governor to sign legislation related to holding managed care organizations accountable to providers and members and passing even stronger oversight of the Medicaid system. That legislation included requirements on the timeliness of payment and appeals, level of care determinations, health homes, credentialing, and an audit. 

Don’t let the House Democrats fool you into thinking that nothing has been done or that they have any sort of plan. Iowa has some of the strongest oversight of managed care of any state in the country, and House Republicans continue to provide solutions. House Democrats, if their comments are an accurate indication, simply want to trash the current system and go back to the flawed and unsustainable program. 

House Republicans are dedicated to assisting any Medicaid member or provider that is having issues navigating the managed care program. The MCOs are contractors for the state, and they should be held accountable if they are not fulfilling the obligations to the state and those it serves. Please contact me if I can assist in any way. 

Medicaid Provider Trainings to be Held Across the State 

Beginning in May, the Iowa Medicaid Enterprise (IME) and representatives from current and future managed care companies (UnitedHealthcare, Amerigroup, and Iowa Total Care) will be hosting 18 Provider Training Sessions at 9 locations throughout the state. The trainings will include an update from IME, updates from the MCOs, a panel question and answer, and a breakout where specific questions can be asked of all entities. For information on how to register, click here. 

A Shocking Debate on Stun Guns and Campus Safety 

Safety on college campuses is an important issue for all Iowans, but especially for students and their parents. A 2017 University of Iowa survey found spikes in sexual misconduct during the first year on campus. During the first ten weeks on campus, 17% of female students reported unwanted sexual contact. These numbers are deeply concerning and the legislature has been looking at ways to help students protect themselves and end this type of violence. Senate File 188 is a major step to ensuring persons on campus can decide how best to defend themselves. 

SF 188 simply prohibits Regents Universities and Community Colleges from banning stun guns on campus. This bill, coupled with a code change from last year, will ensure people over the age of 18 can carry stun guns on campus without interference. Under current law, and the proposed bill, the stun gun cannot have projectiles, meaning a person must touch their attacker with the stun gun. House Republicans agreed to one Democrat amendment to clarify that convicted felons could not carry these stun guns on campus. 

During the debate, multiple House Democrats stood up to oppose the legislation. They highlighted safety features in and around campus that students could use, including phone apps, campus escorts, rape whistles and letting others know where you’re going and who you’re with. While each of these are important and effective to varying degrees, none of them can necessarily help when seconds count. A stun gun is a simple and effective way to stop an attacker immediately. Others who opposed the bill talked about the necessity of a culture change and instead of arming students, recommended we teach others not to commit violent acts. In an ideal world, that may work as a long term solution. But in the short term, it doesn’t stop a violent attack. It doesn’t help the student walking across campus at night. That student should not be forced into the vulnerable situation of being unable to defend themselves. Hoping everyone is nice, is a poor defense strategy and isn’t realistic. Everyone has a right to defend themselves. 

Some on the floor went so far as to suggest that women shouldn’t have the opportunity to defend themselves because a stun gun might not always stop the attacker. Instead, they recommended the woman should only take a basic self-defense class and hope that is good enough. While House Republicans agree self- defense classes can be important but they are not a substitution for an easy to use stun gun carried for safety. 

Democrats offered several amendments, including one to have a study committee on campus violence, one to keep the current law in place, and one to ban felons from having stun guns on campus. House Republicans agreed that keeping felons with stun guns off campus is good policy. The rest of the amendments were defeated. 

The bill passed with bi-partisan support 60-37. It was returned to the Senate with the approved amendment for their consideration. 

Mental Health Care Remains a priority for the U.S. Department of Veterans Affairs 

Mental Health Care has been a main priority for the U.S. Department of Veterans Affairs (VA). As part of their efforts to provide the best mental health care access possible for veterans, the VA is reminding veterans that they do offer same-day access to mental health care at any VA health care facility across the country. 

VA has supported numerous Veterans and has the capacity to assist more. In fiscal year (FY) 2018, 1.7 million Veterans received Veterans Health Administration (VHA) mental health services. These patients received more than 84,000 psychiatric hospital stays, about 41,700 residential stays and more than 21 million outpatient encounters. 

Veterans in crisis – or those concerned about one – should call the Veterans Crisis Line at 800-273-8255 and press 1, send a text message to 838255 or chat online at VeteransCrisisLine.net 

House Gives Final Approval on Mushrooms at Farmer’s Markets 

On Tuesday, April 16, 2019, the House considered and passed Senate File 265 by a unanimous 99-aye vote. The measure was previously approved by the Senate on February 28, 2019 by a unanimous 49-aye vote. The measure will soon go to the Governor for her consideration. Senate File 265 provides for the addition of the ‘wild golden oyster mushroom’ as a type of mushroom that may be offered for sale at farmers markets, according to rules adopted by the Department of Inspections and Appeals (DIA). The DIA adopted the United States Food and Drug Administration food code, which also includes rules for morel mushrooms. The bill allows the Iowa DIA to devise rules concerning the sale of potentially poisonous look-alike morel mushrooms. Vendors must complete a three-hour identification expert course once every three years. This legislation adds a related new subsection to require the Iowa DIA to adopt rules for the sale at farmer’s markets of wild golden oyster mushrooms classified as pleurotus ostreatus, pleurotus populinus, or pleurotus pulmonarious. The bill has an immediate effective date, but it will probably take several months for the three-hour identification course to be developed and offered for interested vendors. 

House Republican Budget Reflects Iowan’s Key Priorities 

With the 110th day approaching, the work of the Legislature is centered around the Fiscal Year 2020 budget. The budget needs to reflect the priorities of the people who fund it. It is clear the budget put together by House Republicans is guided by the priorities of Iowans. 

ISSUE: Access to Quality Health in Rural Iowa – Throughout Iowa, many of the state’s rural community hospitals are critical access hospitals, which limits the services they can provide in exchange for higher reimbursement rates. The program, created in late 1990’s by Senator Grassley, pays these hospitals 101% of their costs for Medicaid services provided. As health care costs increase and competition for providers intensifies, these hospitals are having a more difficult time remaining viable as the additional funding has dwindled since 2013’s Federal budget deal. 

SOLUTION: Restore the 101% cost-based reimbursement for critical access hospitals for Medicaid services. House Republicans have provided $1.5 million in the Fiscal Year 2020 Health & Human Services budget bill to pay for the state share of the 101% cost-based reimbursement for Medicaid services. This will provide needed funds for the 82 critical access hospitals across Iowa as they work to maintain access to health care services in rural and small town Iowa.

ISSUE: Provide Iowans with the necessary job skills to compete in the 21st Century Economy – Across the state, employers of all sizes are faced with one critical issue – the lack of available trained workers to fill open jobs. There is an estimated 55,000 available jobs in Iowa, and the lack of job candidates with the necessary skills is limiting growth in the Iowa economy and the General Fund. 

SOLUTION: Expand access to job skills and training through Iowa’s 15 community colleges. The state’s community college system is charged with being the focal point of the state’s workforce training program. House Republicans committed to increasing these opportunities by providing $14.8 million for the Future Ready Iowa Last Dollar Scholarship program at $14.8 million. The program invests in Iowans by providing financial aid to acquire the skills to enter high-demand careers in healthcare, information technology, advanced manufacturing, and construction. Additionally, the House budget provides an additional $7 million to support the programs of Iowa community colleges. 

ISSUE: Improving Iowa’s mental health system for children – Iowans of all political persuasions have decided that creating a mental health system for our children is a critical priority now. Addressing this will require the state to commit to developing more providers, adding programs that can serve children, and devoting more money to the effort. 

SOLUTION: Provide training for more mental health providers, assist schools to identify mental health issues, and expand access to mental health services for children. House Republicans have made addressing children’s mental health services as a central issue of their FY 2020 budget. The Health and Human Services budget provides $1.2 million to increase the number of children who get needed mental health services via the Children’s Mental Health waiver. That bill also includes money to train additional psychiatrists and other mental health providers and have them do part of their training in rural Iowa. Within the Education budget, $3 million is provided to the Area Education Agencies to help train teachers and other school personnel to identify students with mental health issues, and to develop other programs to help address these kids’ issues.