April 25, 2015

Nurses discuss ‘gold star’ of accreditation at MHIs

Employees at the state-run Mental Health Institutes in Clarinda and Mount Pleasant that are being closed say the hospitals have provided high-quality care, even if the facilities do not have the “gold star” of accreditation.

Cindy Fedler, a nurse clinician, was hired at the Mental Health Institute in Mount Pleasant in 2007 — to prepare for the tests required for the accrediting process.

“That plan was aborted due to financial reasons,” Fedler said.

Fedler worked at the MHI in Mount Pleasant until April 6, when she was laid off.

“The accreditation would not have changed the way we admitted folks,” she said this week. “It would not have changed the way those who had payment, insurance — the way they paid, it would not have changed that.”

And Fedler said Mount Pleasant’s MHI met all the Centers for Medicare and Medicaid Services “best practices” guidelines.

“The accreditation we keep hearing in the media, I want the truth to be known that that would have affected us not at all,” Fedler said, “other than a nice little title and a gold star behind our name.”

Governor Terry Branstad has said the two MHI’s are being closed because they’re antiquated and are not accredited. Ann Davison, a nurse clinician at the Clarinda Mental Health Institute, was hired in 2005 to prepare for the accreditation process there — but state officials decided not to spend the money.

“So no, we can’t get accredited if we don’t get a chance to do the test,” Davison said this week.

According to Davison, only half of Iowa’s private hospitals have paid the money and gotten accreditation.

“Are you all that concerned we’re not accredited and that’s why you’re shutting us down?” Davison asked during a senate committee meeting. “Please think about that.”

Davison and Fedler made their comments this week during testimony before the Iowa Senate Government Oversight Committee.

A spokeswoman for the Iowa Department of Human Services says the accreditation fee is in the range of $8,850 to $11,850 per year.

GOP leader suggests Regents can shuffle budget to accommodate tuition freeze

Kraig Paulsen

Kraig Paulsen

The budget plan House Republicans released this week does not include the extra money officials who govern the three state universities requested in order to maintain a tuition freeze.

“You know I’m not so sure they’re not in a position to do a tuition freeze regardless of whatever the state appropriation is,” House Speaker Kraig Paulsen of Hiawatha, the top Republican in the legislature, told reporters Thursday.

In December, the board that governs the University of Iowa, Iowa State University and the University of Northern Iowa voted to keep next year’s tuition for in-state students at the same rate it’s been for the past two years — if legislators provide a 1.75 percent increase in state taxpayer support of the three universities. Paulsen suggests university officials can rearrange spending priorities and keep tuition rates low on their own, without additional state resources.

“I understand that the momentum of a tuition increase being tied to what we do here in the General Assembly,” Paulsen said. “They seem to be linked a whole lot.”

The Board of Regents proposal to base state taxpayer support of Iowa, Iowa State and UNI on a “performance-based formula” isn’t being embraced by Republicans or Democrats in the legislature, either. The board made the proposal, in part, to direct more money to the University of Northern Iowa and Senate Majority Leader Mike Gronstal of Council Bluffs, the top Democrat in the legislature, said UNI is likely to get a funding boost, even if legislators reject the performance-based formula.

“There is broad recognition that UNI, because of its greater number of in-state students, is much more dramatically impacted when it comes to a tuition freeze than the other two institutions,” Gronstal said during an interview. “…There’s a consensus in the legislature that we need to deal with that inequity.”

Under the decades-old formula for distributing state funding, the University of Iowa gets 46 percent, Iowa State gets 36 percent and UNI gets 18 percent.

Governor Branstad’s anti-bullying bill in jeopardy

Chris Hall

Chris Hall

A bill that has been one of Republican Governor Terry Branstad’s priorities in each of the past three years is in limbo in the Iowa House. A bill designed to address concerns about bullying in Iowa schools cleared the Iowa Senate nearly a month ago on a 43-7 vote, but it hasn’t been considered in the Republican-led House.

“I have concerns about whether or not we’re inducing more risk of lawsuits and liability with the way it’s written right now,” House Speaker Kraig Paulsen, a Republican from Hiawatha, said Wednesday.

Democrats in the Iowa House tried to force Paulsen to bring the bill up for debate yesterday and were joined in the effort by the Republican chairman of the House Education Committee, but Paulsen and 51 other Republicans in the House united to block the move. Representative Chris Hall, a Democrat from Sioux City, said it’s important to draw attention to the impasse.

“It’s reaching the point of absurdity, folks,” Hall said just before the House adjourned Thursday. “Most of us agree that legislation cannot and will not resolve each and every issue of bullying, but we can also agree that our updates…can help.”

Back in January, Governor Branstad got a standing ovation from legislators during his “Condition of the State” speech when he called for passage of the anti-bullying bill. Branstad has said he and his staff have worked to address concerns raised in the past two years and the “time has come” to pass the legislation. Paulsen, the legislature’s top Republican, said the bill still has flaws.

“By us creating new standards and requirements for the schools, I’m not sure they have complete control over that side of the equation,” Paulsen told reporters.

Representative Hall, the Democrat who led the effort to try to force debate on the bill in the House, said House Republican leaders are “doubling down” on irresponsibility.

“House leaders have caved to Bob Vander Plaats and the far right fringe,” Hall said. “Perhaps it’s time to accept the reality that compromise won’t come from this chamber and kids won’t be a top priority within this House.”

Bob Vander Plaats — a Republican candidate for governor in 2002, 2006 and 2010 — is president of The Family Leader, a conservative Christian organization. The group is registered as opposed to Governor Branstad’s anti-bullying bill. The American Civil Liberties Union of Iowa and the Iowa Faith and Freedom Coalition are also registered opponents of the bill. Groups that represent Iowa educators and school boards support it.

MHI workers dispute the ‘antiquated’ label attached to the facilities

Four employees at the state-run Mental Health Institutes in Clarinda and Mount Pleasant testified before the Iowa Senate Oversight Committee Wednesday, disputing the governor’s assertion that their facilities are antiquated.

Sue Rehwaldt-Hays is an occupational therapist who has worked at the Clarinda MHI since 1984. She said, just like the Iowa statehouse, the facility in Clarinda has been updated with recent renovations like new windows, new furniture and a fire alarm system that’s still being installed.

“You can do a lot of treatment and you can care for a lot of people in an old building and you can make a lot of decisions in an old building,” Rehwaldt-Hays said.

Anna Short worked as a drug abuse counselor at the Mount Pleasant MHI until she was laid off last week. Many of her former patients who’ve made a success of their lives after treatment there called after learning the place was closing.

“None of those success stories when they all called to tell me how well they were doing mentioned anything about an old building that they had to reside in during their stay,” Short said. “They seemed to be more concerned about the care that they received while they were there.”

Short said the facility was actually built in the 1960s and, in the past year, it got brand new, specially made furniture that was bolted to the floor in the psych ward; a new, million dollar elevator and a new security system.

“If I didn’t know better, you’d think it was prepping for the new owner,” Short quipped.

Cindy Fedler, a nurse clinician, worked her last day at Mount Pleasant on April 6th. Fedler and the others argued the services of the mental health institutes are a crucial last resort for patients suffering from an acute mental illness who have failed in other settings.

“I think we’re all very well aware that…really, we have a mental health crisis in Iowa right now,” Fedler said.

A woman from Shenandoah who gave her name as Christina spoke briefly as well, telling legislators her outpatient treatment elsewhere hadn’t worked and it was “vital” to be admitted for a month at Clarinda.

“I wouldn’t be here today if it wasn’t for that place,” she said. “…My illness was that bad that I needed that long stay.”

She is now working full-time.

The Branstad Administration’s plan is to close the two mental health institutes in southern Iowa by June 30, but keep the MHIs in Cherokee and Independence open. A spokesman for the agency in charge says there will be 30 more beds available after July 1 for in-patient treatment of acutely mentally ill patients in the two facilities than had been available when all four Mental Health Institutes were operating at full capacity.

Republicans in Iowa House release proposed spending outline

Republicans in the Iowa House have released their overall state budget outline for the next fiscal year and it calls for spending about $170 million less than Governor Terry Branstad, a fellow Republican, and Democrats in the Iowa Senate have proposed.

“House Republicans are serious and we’re committed to balancing ongoing revenue with ongoing expenses,” House Speaker Kraig Paulsen, a Republican from Hiawatha, told reporters this morning.

House Republican Leader Linda Upmeyer of Clear Lake said it is “not surprising” the House G-O-P has a goal of spending less than the governor and Democrats in the senate.

“Then we work together and we come to a solution and get it done,” Upmeyer said.

But Paulsen indicated Republicans in the House will resist using the more than $400-million in unspent money from the present budgeting year, unless it’s used for “legitimate one-time expenses” like paying off state bonding debts or financing infrastructure projects.

“That’s one boundary we’ve laid out for several years now and we’re very serious about it,” Paulsen said.

Paulsen often refers to the unspent money left over at the end of the state budgeting year on June 30th as the “overpayment” of taxes.

“We’ve been pretty clear,” Paulsen said today. “We’d love to leave more money in the taxpayers’ hands.”

Senate Democratic Leader Mike Gronstal of Council Bluffs said the tax-cutting ideas Republicans favor would provide only “peanuts” to most Iowans.

“They want to save money for a giant tax cut for their wealthy contributors,” Gronstal told reporters this morning.

And Gronstal said the lower state spending level House Republicans propose would cause “significant problems.”

“People’s phone calls will go unanswered,” Gronstal said. “…It will take longer to process permits…I think it has a very significant impact on state services.”

The spending level Senate Democrats and Republican Governor Branstad have proposed is “fiscally prudent,” according to Gronstal. Jimmy Centers, a spokesman for the governor, said Branstad and his staff will continue to work with both the Iowa House and the Iowa Senate to try to find an agreement.

“The governor’s priority, as it has been since he took office in 2011, is to provide stability and predictability in the budgeting process, something that he believes the taxpayers deserve,” Centers said this morning.

Republicans and Democrats at the statehouse remain at odds over one key spending decision: how much state aid to direct of Iowa’s public school districts. That difference is reflected in the general budget outline House Republicans released today. House Democrats said 153 of Iowa’s superintendents have responded to a survey asking how they’ve responded to the “education spending crisis” and indicating they have collectively issued 298 “pink slips” to teachers and will not fill 405 positions for the fall semester. Over 100 of the superintendents said they plan to raise local property taxes to balance their school budgets.

Senate votes to combine crime bills into one package

The Iowa Senate has unanimously voted to combine a series of crime-related proposals into one bill. Senator Janet Petersen, a Democrat from Des Moines, opened the debate with a reference to the Urbandale woman who authorities believe was killed by her boyfriend this weekend.

“She has a kindergartener who will be saying goodbye to his mom today,” Petersen said, her voice breaking with emotion. “Our role in the legislature is to do all we can to protect Iowans from violence and to ensure our laws are written clearly so that perpetrators don’t get away with sexual exploitation, abuse, tormenting or violence because of gaps in our criminal code.”

Increasing the penalty for human trafficking to a forcible felony was one of the proposals included in the package, along with enhanced penalties for abuse that occurs between two people who are dating.

“Our criminal code does not recognize that violence in dating relationships is often as dangerous as violence in married or cohabitating relationships,” Petersen said. “These abusers should be penalized similarly.”

The bill, when it passed the Iowa House, expanded Iowa law so any school employee or volunteer at a school activity can be charged with sexual exploitation of a student. Under current Iowa law teachers, administrators, coaches and counselors can be charged with that crime. House members must now decide whether to accept senators’ decision to expand the bill to cover additional subjects.

Iowa House passes broadband bill on 89-5 vote

The Iowa House has passed a bill that would set up a state-run grant program to expand broadband access in Iowa, although no state money is committed and the program will only get going if the state gets federal tax dollars for it. The bill would set up a new, 10-year-long property tax exemption for companies that extend high-speed broadband service in “unserved or underserved areas” of the state.

Representative Peter Cownie, a Republican from West Des Moines, has been trying for the past couple of years to craft some sort of state effort to expand broadband.

“I think this bill is a first step and a good step in the right direction,” Cownie said Tuesday during House debate of the plan. “…The internet is a way of life for Iowans and for Iowa to reach its full potential, we need better connectivity to it.”

Representative Jo Oldson, a Democrat from Des Moines, supported the bill, but hopes the property tax exemption can be tightened by the senate.

“So that we truly are focused on making sure that we are providing incentives to get broadband out to areas that have no broadband whatsoever,” Oldson said.

Representative Dave Jacoby, a Democrat from Coralville, was among the overwhelming majority of House members who voted for the bill.

“Extending broadband to all reaches of the state is so important for our economic future,” Jacoby said.

The property tax break outlined in the bill would only be for expanded broadband service that is fast enough to deliver HD quality video and for conducting “telemedicine” activities. Representative Josh Byrnes, a Republican from Osage, said the bill will hopefully address the “inconsistencies” in broadband speeds.

“I live in a part of Mitchell County where I actually get better connectivity to my barn than I get here at the state capitol,” Byrnes said.

Legislators wrestled with this same issue last year, but failed to pass a bill.