Legislative News

The Iowa Mental Health Counselors Association follows and reports on new legislation and updates to current legislation affecting mental health counselors in Iowa. To learn more about the current issues facing the general assembly, visit the Iowa Legislature General Assembly.

You can read the last 12-18 months of legislative updated below, in order of most recent updates to oldest updates. For older archived legislative updates, they can be found among the general News Items.

 

Legislative Update – April 25, 2017

Reflections on the 2017 Session

The 2017 legislative session concluded early Saturday morning after a marathon all night session.   At the end of the day, the issues of medical cannabis oil and water quality threatened to hold up the conclusion of the legislative session. Legislators successfully reached agreement on the first but could not find common ground on the two water quality proposals.   This session marked the first time in twenty years that all three branches of government were controlled by Republicans.   Republicans pushed through major policy initiatives over the strong objections of Democrats, creating a somewhat acrimonious environment.   In addition, Republicans faced a worsening budget situation and were forced to make reductions in the current year’s budget.   The budget picture for FY 18 was no better and many programs saw reductions to stay within the statutory spending requirements.

Perhaps the biggest success for IMHCA and the other targeted professions is the defeat of legislation to eliminate licensure.   These proposals emanated from the governor’s office. The defeat of this legislation is a shining example of the power of grassroots.   As we transition to a new governor, it will be incumbent upon us to determine if she carries the same opinion that Governor Branstad held.   One thing is clear – legislators do not share his desire to eliminate licensure for marriage and family therapists, mental health counselors and social workers.

FY 18 Health and Human Services Budget

This budget, like all others, was not immune to reductions to adapt to the lowered revenue estimate.   Some key provisions impact mental health services:

  • Eliminate the program to train psychiatric physicians’ assistants at the Cherokee mental health institute ($8,000)
  • Eliminate the University of Iowa hospital primary care model for mental health treatment ($78,309)
  • Suspend the medical residency program targeted at psychiatry ($2 million)
  • Reduce funding to the autism/ABA program ($1.05 million)

Bills that Survived

HF 215: This bill requires state-regulated insurance plans to provide coverage for ABA treatment for autism consistent with the requirements already imposed on the state employee’s plan.   IMHCA is registered in support of this bill. Governor Branstad signed the bill into law on March 30.

HF 593: This bill gives mental health providers the authority to perform examinations and to involuntarily commit someone with a substance abuse problem.   The authority is limited to the scope of licensure and authorization of each individual practice area. IMHCA is registered in support of the bill. Governor Branstad signed the bill into law on April 7.

SF 504: These bills address inequities in the county mental health property tax levy by evening out the levies for counties within one region. The bill also requires counties to spend down their ending fund balances and continues the study of the complex needs population. IMHCA is registered as undecided on the bill because it does not address the underlying need to provide an increase in the mental health levy rate for all counties. The bill passed both chambers and will be sent to the governor for his signature.

Bills that Failed

SF 192: ABA licensure

SF 254: provider ask about gun ownership

SF 255: provider ask about anything other than health and insurance

SF 286: restore reimbursement cut to community mental health centers and others

SF 453: duty to warn law enforcement

SF 477: Medicaid claim payment

SSB 1071: health care worker attraction and retention workgroup

SSB 1160: telehealth insurance coverage

SSB 1168: telehealth insurance coverage

HF 106: establish a mental health workforce center

HF 170/HF 178: placement of elderly people with aggressive or psychiatric behaviors

HF 180/SF 169: evidence based depression screening for elderly people

HF 317: telehealth reimbursement for mental health services

HF 319: mental health providers can do substance abuse commitments

HF 342: mental health levy rate increase

HF 343: mental health levy rate increase

HF 348: telehealth insurance coverage

HF 352: school suicide, trauma informed care training

HF 361: children’s mental health advisory & disability services council

HF 362/SF 262/SF 325: alternative transportation options for mental health patients

HF 380/SSB 1212: music therapist licensure

HF 404: telehealth reimbursement

HSB 138: certificate of need/hospitals, licensure bill

HSB 174: certificate of need/licensure study

 

Legislative Update – March 31, 2017

Under the Golden Dome

The Legislature concluded its second funnel week, a time when all policy bills must have passed one chamber and a committee in the opposite chamber to remain alive.   This does not apply to budget and tax bills. And, as is always possible in the legislative world, procedures exist for bills or bill language to be resurrected. Nothing is truly dead until the legislature adjourns for the year.

The next serious work for the legislature will be developing a budget to accommodate the reduced revenue available for the current fiscal year (FY 17) and the upcoming fiscal year (FY 18).   The legislature will transfer funds from the cash reserve fund to balance the budget for FY 17. However, the statute requires this fund to be “replenished” in the next fiscal year.   Governor Branstad has proposed doing this over a two-year period to reduce the pressure on an already dismal budget situation. As required by law, he submitted his revised budget proposal for FY 18 to reflect the lower revenue estimates announced two weeks ago. Legislative leaders are faced with a difficult task of finding reductions and have yet to release their own revised budget targets.

Bills that Survived – 2nd Funnel

HF 215: This bill requires state-regulated insurance plans to provide coverage for ABA treatment for autism consistent with the requirements already imposed on the state employee’s plan.   IMHCA is registered in support of this bill. Governor Branstad signed the bill into law on March 30.

HF 593: This bill gives mental health providers the authority to perform examinations and to involuntarily commit someone with a substance abuse problem.   The authority is limited to the scope of licensure and authorization of each individual practice area. IMHCA is registered in support of the bill which has been sent to the governor for his signature.

Bills that Failed

SF 453: duty to warn law enforcement

SF 477: Medicaid claim payment

SSB 1071: health care worker attraction and retention workgroup

Legislative Update – March 3, 2017

Under the Golden Dome

The Legislature concluded its first funnel week, a time when all policy bills must have passed a committee in one chamber to remain alive. One of the most controversial bills, HSB 138 died a quick death after marriage and family therapists, mental health counselors and social workers, among others, raised serious objections to the elimination of their licensure.

HSB 174 was quickly introduced to place a one-year moratorium on new licensure categories and establishing a licensure review work group. This bill also failed to move through the process. However, legislators amended HF 229, originally a bill about electrician licensure, by striking the underlying language and inserting most of the language from HSB 174. However, HF 229 did not pass the House State Government Committee and the issue is dead for now. Keep in mind that reduction of licensure and oversight boards appears to be a priority for this governor. Until the legislature adjourns, nothing is officially dead.

IMHCA Day on the Hill-March 13

Are you attending the legislative day for mental health counselors on March 13? If not, please consider attending. This is a perfect opportunity for you to talk with legislators about your profession, the importance of a strong oversight and licensure program and how you serve mental health needs of Iowans. The day begins at 2:00 p.m. in the Legislative Dining Room at the Capitol with a briefing on the mechanics of talking to your legislator and the issues of the day. More information is available at https://imhca.net/upcoming-events/.

Bills that Survived

SF 75: This bill gives mental health providers the authority to notify law enforcement to protect the health and safety of a patient or a clearly identified victim. It also provides immunity protection for mental health professionals who do not provide this notice. IMHCA worked with the subcommittee to draft an amendment to clarify the situations in which such notification could occur and to provide immunity. IMHCA is registered as neutral on the bill. The Senate Human Resources Committee approved the bill.

SF 342: This bill allows a 1 ½ % penalty to apply to all clean claims submitted to Medicaid for reimbursement that are past 90 days. Clean claims is defined as “all information required for processing the claim is included”. The bill was also amended to include language from SF 343 that allows up to one year to file Medicaid claims. IMHCA is registered in support of the bill. The Senate Human Resources Committee approved the bill.

SF 400/HF 215: These bills require state-regulated insurance plans to provide coverage for ABA treatment for autism consistent with the requirements already imposed on the state employee’s plan. IMHCA is registered in support of both bills. The Human Resources Committees in each chamber approved these bills.

SSB 1071: This bill directs the Department of Public Health to convene a workgroup and make recommendations on health care worker attraction and retention. IMHCA is registered in support of the bill. The Senate Human Resources Committee approved the bill.

Bills that Failed

SF 85: art therapist licensure

SF 192: ABA licensure

SF 254: provider ask about gun ownership

SF 255: provider ask about anything other than health and insurance

SF 286: restore reimbursement cut to community mental health centers and others

SSB 1160: telehealth insurance coverage

SSB 1168: telehealth insurance coverage

HF 319: mental health providers can do substance abuse commitments

HF 342: mental health levy rate increase

HF 343: mental health levy rate increase

HF 348: telehealth insurance coverage

HF 352: school suicide, trauma informed care training

HSB 138: certificate of need/hospitals, licensure bill

HSB 174: certificate of need/licensure study

 

UPDATE ON HSB 138-Dead! – Feb. 28, 2017

HSB 138 is officially dead! Thanks to all of you who emailed, called and attended the subcommittee.  Today, HSB 174 was introduced and includes a ban on any new licensure programs and establishes a licensure board programmatic review committee. It does not impact licensure for marriage and family therapists, mental health counselors or social workers. It does establish a committee to review and make recommendations for all professions that are required to have licensure. This is an opportunity for mental health providers to be involved in that process, and IMHCA will ensure its members are represented at that table! Know that your voices will continue to be heard!

 

UPDATE ON HSB 138; Feb. 24, 2017

There has been a flurry of activity related to the proposal to eliminate licensure for social workers, mental health counselors and marriage and family therapists. This move calls into question insurance and Medicaid reimbursement issues that could reduce access to mental health services, puts the professions at risk of having no oversight or restrictions on who can practice and is a shortsighted effort to reduce the size of government. The main reason being used for the somewhat eclectic compilation of boards that would be eliminated is that these boards are not financially self-sustaining. Thus, it wasn’t about the reasons for the licensure but about the cost.At this point, our understanding is that HSB 138 is not going to move as written. The emails and phone calls by those impacted have had an impact. However, the bill is scheduled for a subcommittee meeting on Monday at 2:00 p.m. It is our understanding, again, that the bill will not move forward in its current form. Should you wish to attend and either listen or speak, you are certainly welcome to do that. Our lobbyist, Emily Piper, is in close contact with key legislators about this legislation and will also be communicating our opposition.

If you have specific questions about what is happening on the bill, please refer those to government@imhca.net.Your voice is being heard — thank you for standing up for our profession!
Donald Gilbert MS, PhD, LMHC, BCPC
IMHCA President
225 NW School St, Ankeny, IA 50023
515-964-5003
515-225-4006
fx 515-225-4016

NOTE: Please do not contact our lobbyist, Emily Piper about this bill at this point. She has been swamped and is working very hard on our behalf. Please contact you representatives, and send questions or comments about HSB138 to government@imhca.net.

One of our members offered the following list of emails if you would like to email the representatives on the relevant committee: (These were not confirmed by IMHCA, we are just passing them along from a member)

Ken.Rizer@legis.iowa.gov,
kevin.koester@legis.iowa.gov,
mary.mascher@legis.iowa.gov,
rob.bacon@legis.iowa.gov,
chip.baltimore@legis.iowa.gov,
Michael.Bergan@legis.iowa.gov,
dennis.cohoon@legis.iowa.gov,
peter.cownie@legis.iowa.gov,
lee.hein@legis.iowa.gov,
jake.highfill@legis.iowa.gov,
bruce.hunter@legis.iowa.gov,
bobby.kaufmann@legis.iowa.gov,
vicki.lensing@legis.iowa.gov,
Tom.Moore@legis.iowa.gov,
Amy.Nielsen@legis.iowa.gov,
jo.oldson@legis.iowa.gov,
dawn.pettengill@legis.iowa.gov,
Mike.Sexton@legis.iowa.gov,
sharon.steckman@legis.iowa.gov,
todd.taylor@legis.iowa.gov,
ralph.watts@legis.iowa.gov,
cindy.winckler@legis.iowa.gov,
Louie.zumbach@legis.iowa.gov

ACTION ALERT! Feb. 23, 2017

Attention Providers!

Your license to practice is currently under attack!

The Iowa Mental Health Counselors Association (IMHCA) has issued a call to action in opposition of HSB 138, a House Study Bill proposed by Governor Branstad that would take away a protection for Iowans as well as put Iowa last in the nation by removing licensure for the profession and eliminating the Board of Behavioral Sciences and the Board of Social Work.

Below are several talking points for you to refer back on as you join IMHCA in reaching out to lawmakers and expressing your concerns for HSB 138.

  • Mental Health Counselors are licensed, not registered, in all 50 states as well as the District of Columbia.  This provides us with the right to practice.  One of the many challenges that professionals would face under this bill is the ability to move from this state to another without a license, and still be allowed to practice.  Removing licensure would undoubtedly prevent the providers impacted by this bill from getting licensed in other states.
  • Insurance companies and employers have requirements that mental health professionals are licensed.  Tricare and the VA require Mental Health Counselors to be licensed at the highest level in their state.  Getting rid of licensure will reduce the number of practitioners eligible to serve our veterans and other Iowans.
  • Iowa already suffers from a shortage of mental health professionals.  It is imperative that we continue to ensure access to qualified mental health professionals, including Licensed Mental Health Counselors, Licensed Marriage and Family Therapists, and Licensed Master’s and Independent Social Workers.
  • Regulatory boards, such as the Board of Behavioral Science and Board of Social Work, have the primary goal of ensuring protection of the public through setting and enforcing rules related to education, ongoing training, and upholding ethical standards.  Numerous complaints are made annually regarding concerns from vulnerable Iowans about potential ethical violations ranging from professionals breaking trust by betraying confidentiality, taking advantage of someone financially, lying about claims, to having sexual relationships with clients.  Licensure boards provide accountability for the profession as well as protection by ensuring those who commit violations are not able to practice or get additional training to demonstrate improvement.

IMHCA is urging you to contact Governor Branstad, Lt. Governor Reynolds, House leaders and your local legislators and ask them to carefully consider the ramifications of this study bill.  Demand that they continue to keep Mental Health Counselors, Marriage and Family Therapists, and Social Workers licensed under their respective boards.

Go to:  https://www.legis.iowa.gov/legislators/find if you are unsure who is serving your legislative interests on the hill. Contact information may be found on each legislator’s office site. To contact the Governor’s office, please use the following information:

1007 East Grand Ave.
Des Moines, Iowa 50319

Phone: 515-281-5211

For more information on how you can get involved in IMHCA’s legislative efforts, click on ‘Events’, or send an email to government@imhca.net and let us know you would like to help!

Respectfully,

Kacey M. Peterson, MS, LMHC

 

Feb. 18, 2017; Day on the Hill Advocacy Event

Join us at the capital on Monday, March 13th, 2017, starting at 2 PM! See additional details on our event page: https://imhca.net/events/day-on-the-hill/

 

Legislative Update – February 3, 2017

Under the Golden Dome

We are four weeks into the legislative session that has largely been defined by divisive issues, lack of civility and general inability to come together for the good of Iowa.   It is only destined to get worse as legislators settle school funding, make changes to collective bargaining and debate educational vouchers.

The pace of work on other, less controversial, legislation, has been slow.   Committees are routinely cancelled and the pace of bill introduction lags behind prior years.   Legislators did resolve the necessary reductions in the current year’s budget to accommodate for a reduction in projected revenue growth.  And, the Republican leadership in the two chambers reached agreement on school funding.  This allows legislative leaders to move forward to put the FY 18 budget together.   Revenues are also projected to be tight for FY 18 with approximately $178 in new revenue available after accounting for the built-in increases in the budget.

Bills Of Interest 

Complete text of bills can be accessed at the following link: https://www.legis.iowa.gov

SF 75:  This bill requires a physician to notify law enforcement of a potential dangerous situation with a patient with a mental health condition.  IMHCA is registered as neutral on the bill and has raised concerns about what this is intended to accomplish and the potential to violate patient privacy.  The bill was referred to the Senate Human Resources Committee.

SF 85:  This bill establishes a licensure procedure for clinical arts therapists and places them under the purview of the board of behavioral science.   IMHCA is registered as neutral on the bill.   The bill was referred to the Senate Human Resources Committee.

SSB 1043/HSB 41:  These bills expand the state employee insurance coverage for applied behavioral analysis for autism treatment.  IMHCA is registered in support of both bills.  The House Commerce Committee approved HSB 41.  SSB 1043 was referred to the Senate Commerce Committee.

 

IMHCA Government Relations Committee Update; March 2016

See the picture from our “Day on the Hill” and read this update in a nice format by clicking the link to the PDF at the bottom of this article!

Summary of Public Policy and Mental Health Awareness Efforts

March was a busy month for the Government Relations Team! On Monday, March 7th 2016, the Iowa Mental Health Counselors Association held its 8th annual “Day on the Hill” advocacy event at the Capitol in Des Moines. With increasing interest and concern about the current state of Iowa’s mental health delivery system, the event has steadily grown in popularity since its inception during the 2008 Regular Session. This year we welcomed the highest number of attendees to date, consisting of mental health counselors, marriage and family therapists, and over a dozen students from Drake University’s Mental Health Counseling and Rehabilitation Programs. Numbering over twenty, participants gathered for a short briefing by IMHCA and IAMFT state lobbyist, Emily Piper, to review the afternoon agenda and hear the latest legislative update before heading upstairs to meet individually with Senators and Representatives from both sides of the aisle.

Focusing on members of the Senate and House Human Resources Committees, Majority and Minority Leaders, and a small number of legislators from various participant districts, our emphasis this year was placed on educating session leaders from both chambers by summarizing key legislative efforts, communicating individual and collective experiences related to the privatization of Medicaid services in Iowa, and showing appreciation for supported efforts and/or movement on IMHCA monitored legislation.

As is sometimes the case (these things are often difficult to predict), many of our meeting requests were met with disappointment as attempts to successfully navigate around caucuses in both chambers proved difficult. In spite of the unforeseen barriers and unusually quiet Senate and House floors, attendees were able to speak at length with House Representatives David Heaton (R), Beth Wessel-Kroeschell (D), Zach Nunn (R), and John Forbes (D) along with Senate Republican Leader Bill Dix. Each was receptive and willing to listen openly to the group’s concerns, and although there were a few spirited disagreements about the handling of Iowa’s Medicaid privatization efforts, there seemed to be bi-partisan agreement that a certain level of DHS and IME oversight would be necessary as the state forges ahead with a looming April 1st implementation date.

It was refreshing to see folks come together once again to rally for quality mental health services, higher industry-wide standards, and accountability by our leaders as we face an ever-changing mental health delivery system in Iowa. A special thank you to Emily Piper for her continued efforts on our behalf, fellow IMHCA board members who took time out of their day to join in our efforts, our colleagues at the Iowa Association of Marriage and Family Therapists, the instructors at Drake University for relaying to graduate students the importance of becoming active in local public policy and advocacy efforts, and the providers who were willing to come to the capitol and share their stories in an effort to help make our 2016 Day on the Hill a success! Finally, to the IMHCA members and conference goers whose contributions make our lobbying efforts possible, we could not do this year after year without you.

The Government Relations Committee looks forward to getting your feedback at the IMHCA conference in April! We also encourage you to check out the mental health observance reminders coming up for the month of April!

Respectfully,
Kacey M. Peterson, MS, LMHC
Government Relations Committee Chair
government@imhca.net
Mental Health Awareness Calendar Reminders
March Re-cap:
American National Nutrition Month;
Employee Spirit Month; Developmental Disabilities Awareness Month;
National Sleep Awareness Week® (Mar. 6-13); Brain Awareness Week (Mar 14-20)
April Observances
National Autism Awareness Month; Alcohol Awareness Month;
National Stress Awareness Month; Premenstrual Dysphoric Disorder (PMDD) Month;
National Minority Mental Health Month; National Counseling Awareness Month;
World Health Day (Apr. 7)
Sign up now for the 2016 IMHCA Conference! (April 11th and 12th)

IMHCA Committee March Update

 

Legislative news – 02/03/2016

Managed Care Organizations

Quick Update From Our Legislative Lobbyist

Wednesday, Feb. 3, we made some progress in working with IME on issues related to timely reimbursement and to credentialing. We are told that as of today, everyone should be up to date on reimbursements and that the “bugs” in the credentialing process are fixed.

Also, we have been told that for issues with the IME management of behavioral health to directly contact the individuals listed below:

For reimbursement issues: Sean Bagniewski: sbagnie@dhs.state.ia.us

For credentialing issues: Paige Thorson: pthorso@dhs.state.ia.us

Legislative news – 01/26/2016

Under the Golden Dome

The second session of the two-year legislative cycle is largely focused on quickly resolving school funding for the next fiscal year. The resolution of this issue is critical to determining the other parts of the state’s budget. Committees are beginning their work to move legislation forward in anticipation of the first legislative funnel deadline, February 19. By this time, a bill must have passed a committee in one chamber to remain alive. This deadline does not apply to budget or tax bills.

The Governor’s budget for FY 2017 recommends $1.3 billion budget for Medicaid, a $23.4 million increase over FY 2016’s estimated costs. This includes a supplemental of approximately $40 million for FY 2016 to fully cover all costs. The delay in the implementation of Medicaid managed care is reducing the amount of “savings” that were projected for the current fiscal year. The legislature based the FY 2016 budget on a $51 million savings from the move to managed care. However, that number is continually being reduced as implementation is delayed.

Medicaid Managed Care Update

At this point, the program is scheduled to be implemented beginning March 1. Wellcare has had its contract cancelled by the state, leaving three remaining companies. While the delay has not negatively impacted reimbursements for physical health claims, it is causing sizable problems for behavioral health claims. Legislators appear to be more focused on the “bigger picture” and lost in that is the impact that the lack of reimbursements have on those who serve patients.

We need to shift the focus on this so that legislators help us “push” DHS and IME to resolve this problem quickly. Please consider sending an email to your House and Senate members. Make these key points in your email:

1. Identify yourself as a constituent and mental health provider in the subject line of the email.

2. Outline the problems and delays you have experienced in receiving reimbursement from IME.

3. Outline what impact this could have on your ability to continue serving clients on Medicaid and on your business as a whole.

4. Ask that your legislator raise this issue with IME and push for a quicker response time with respect to reimbursement.

To find your legislators by using your address, use this link: https://www.legis.iowa.gov/legislators/find

Bills of Interest

HSB 502: This bill would require coverage for telehealth services (distinct from coverage of telemedicine) for employees on the state’s health insurance. Telehealth may include situations in which there is a cost incurred for the service but does not involve direct care of a patient by a medical provider. IMHCA is registered in support of this bill which is in the House Human Resources Committee.

SF 2032: This bill creates a process to allow mental health providers to more easily share mental health records with other providers. The goal is to more easily allow access by physical health providers of these records when treating patients. HIPPA protections are maintained. IMHCA is registered in support of this bill which is in the Senate Human Resources Committee.