Legislative Update – Final Week 2023

Under the Golden Dome

The legislature adjourned sine die on Thursday, May 4.  This was four days past the scheduled adjournment of April 28.  The legislature passed most of the governor’s priorities including establishment of educational savings accounts for private school students, caps on medical malpractice awards and a $100 million property tax relief package.

Republicans in the legislature also addressed workforce concerns by easing restrictions on licensure for prescribing psychologists, allowing independent practice for physician assistants, and creating licensure for midwives.  On the positive side, the legislature did move to prohibit noncompete agreements for mental health professionals and adopted legislation that grants Iowa’s entry into the counseling compact.  Both provisions will help keep our mental health workforce in Iowa.

The budget process was like nothing I’ve ever seen.  In early April, the Senate passed “shell” budget bills, i.e., the language but no funding.  This means that when the agreement on the budget was reached, there was no opportunity for public input.  The deal essentially cut the lobby and legislators not engaged in budget negotiations out of the process.

IMHCA had three big wins on their priority agenda:

  • Passage of noncompete legislation
  • Passage of legislation allowing Iowa’s entry into the counseling compact
  • $10 million increase in Medicaid reimbursement rates for mental health therapy

The work done over the interim by IMHCA members and your continued focus and advocacy helped to make these three items a reality.  A big shout out to all of you!

 

Bills of Interest

HF 93:  This bill prohibits non-compete clauses for any mental health professional as defined in 228.1, including mental health counselors.  HF 93 passed the House and Senate unanimously and has been sent to the governor for her signature.  The legislation is effective upon enactment AND makes any prior non-compete agreement invalid.  IMHCA is registered in support of the bill.

HF 671:  This bill adopts the national counseling compact legislation, allowing Iowa’s entry into this compact.  The compact authorizes both in-person and telehealth practice by licensed individuals in other member states of the compact.  The House and Senate unanimously approved the bill, sending it to the governor for her signature.  IMHCA is registered in support of the bill.

SF 496:  This is the governor’s “parent empowerment” bill which includes two provisions that IMHCA registered opposed to as single bills in the House.  prohibits schools from providing instruction in gender identity and sexual orientation to students in kindergarten through six grades.  And it prohibits schools from facilitating any accommodation to affirm a student’s gender identity if it is different from the student’s sex listed at birth unless the parent or guardian consents to these accommodations.  Both chambers approved the bill, sending it to the governor for her signature. IMHCA is registered opposed to the bill.

SF 482:  This bill prohibits schools from allowing a person to use a multiple occupancy restroom, changing room or other facility that does not correspond to their biological sex.  It allows districts to make accommodations for any student for any reason whose parent/guardian consents to alternative accommodations.  It is effective upon the governor’s signature.  SF 482 passed the Senate 33-16 and the House 57-39.  Governor Reynolds signed the bill into law on March 22, 2023, and it was effective immediately.  IMHCA is registered opposed to the bill.

SF 538: This bill prohibits any health care professional licensed under Iowa Code 147 from providing any medical or surgery for minors experiencing gender dysphoria.  It does not prohibit mental health counselors from providing counseling services, but it does prohibit them from recommending their client for treatment that is prohibited by this bill.  The Senate passed the bill 33-16 and the House passed the bill 58-39.  Governor Reynolds signed the bill into law on March 22, 2023.  IMHCA is registered opposed to the bill.

SF 560: The education budget includes the following items of interest:

  • $3,383,936 to the area education agencies for children’s mental health training and services (status quo)
  • $520,000 for the mental health loan repayment program (status quo)

The bill passed both chambers and is before the governor for her signature.

SF 561: Health and Human Services budget includes the following items of interest:

  • $306,000 for 24-hour crisis hotline for children’s mental health
  • $384,000 for autism assistance and support provided through the University of Iowa
  • $2.1 million for medical residencies
    • $250,000 to Des Moines University to provide primary care physicians with training to identify mental illnesses
    • $800,000 for rural psychiatry residencies
    • $150,000 for psychiatric training for physicians assistants and nurse practitioners
  • $188,000 for autism assistance and support provided through the University of Iowa
  • $25,000 is directed to a psychiatric medical institution for children (PMIC) which provides school-based services in Linn County (Tanager Place)
  • $300,000 to support the children’s behavioral health system state board
  • Allocates $13 million to Medicaid rate increases for mental health therapy and substance abuse
  • Allows community mental health centers to be reimbursed at 100% of reasonable costs OR the alternative reimbursement rate methodology approved by DHS

The bill passed both chambers and is before the governor for her signature.  IMHCA is registered in support of the bill.

 

Bills that did not survive

HF 19: limits MH loan repayment to those working for agencies

HF 273/SF 210: allows use of the term “brain health” synonymously with “mental health”

HF 151: replaces MH loan repayment with broader program for all mental health practitioners

HF 180: requires parental notification of student request to use different pronouns (included in SF 496)

HF 243: extends age limit/coverage for ABA

HF 244/SF 253: loan repayment program technical corrections

HF 348: no gender identity/sexual orientation K – 6 (included in SF 496)

HF 616: prohibits funds spent at regent’s institutions for DEI

HF 620: prohibits disciplinary action for failure to use chosen pronouns or to require pronouns

HF 692: requires brain health professionals in schools

SSB 1045: classifies occupational therapists as mental health professionals

SSB 1050: expanded autism insurance coverage (see HF 243)

SSB 1106: MH noncompete clauses (see HF 93)

SF 83: prohibits gender or sexual identity curriculum

SF 300: prohibits licensure discipline if don’t follow federal guidelines

HSB 130/SSB 1100: no prior auth requirement if provider was denied at least 80% of time