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Legislature advances health budget with funding increases for nursing homes, mental health

Natalie Krebs
IPR file
Iowa lawmakers advanced a $2.1 billion health and human services budget Thursday.

A $2.1 billion health and human services budget that would increase funding for nursing homes, mental health and substance use disorder treatment was passed by the Iowa Senate Thursday and advanced by a House committee.

“I am thrilled to have this budget before us with the priorities of the House…with mental health, substance abuse, and nursing home funding,” said Rep. Joel Fry, R-Osceola.

The budget would add $15 million for nursing homes in response to a wave of nursing home closures in Iowa.

Matt Hinch, lobbyist for Iowa Health Care Association, said nursing homes appreciate the state’s support this year and in previous years.

“With all of the turmoil that we’ve experienced and with the economy over the last several years, but not for your investment, we would be in a very terrible place right now,” he said.

Rep. Timi Brown-Powers, D-Waterloo, said she wanted to see more money for nursing homes.

“I know the need, and I know that it’s great, and I also know that more nursing homes are closing,” she said. “I’m frustrated that we couldn’t get our partners to come on board for that.”

Fry agreed. He said House Republicans had initially proposed a $25 million increase for nursing homes, but that got brought down to $15 million in negotiations with the Senate.

Groups representing health care interests and advocates praised lawmakers for increasing funding by $10 million for mental health care and by $3 million for substance use disorder treatment.

Jon Murphy, a lobbyist for the Coalition for Family and Children’s Services in Iowa, said that builds on work done in prior years.

“From the coalition’s perspective, there’s a very solid positive trajectory going on in the services that our members provide Iowans across the state,” he said.

In the Senate, Democrats proposed amendments to expand Medicaid coverage for mothers to a year postpartum instead of the current 60 days to help reduce maternal deaths. They also proposed expanding eligibility for child care assistance to help more Iowans pay for daycare.

Republicans rejected those amendments.

Sen. Janet Petersen, D-Des Moines, said the state has also failed to raise reimbursement rates for labor and delivery centers, leading to closures of labor and delivery departments at hospitals. She said the budget is heartless.

“I think we’re going to see more closures of daycares, more closures of nursing homes, more women dying after giving birth, and probably more babies dying as well,” she said.

The budget would fund Republican Gov. Kim Reynolds’ proposal for family medicine/obstetrics fellowships. It would cover four fellowships every year, and the doctors would have to stay in Iowa for five years after the fellowship.

It would also increase state funding for anti-abortion pregnancy centers by $500,000, bringing the total cost of the program to $1 million. Reynolds proposed spending $2 million.

Democrats said that money should instead go to family planning clinics that are required to have licensed medical providers.

Republican lawmakers did not advance Reynolds’ proposal to fund programs that promote the involvement of fathers in their children’s lives.

Blank Children’s Hospital lobbyist Chaney Yeast thanked lawmakers for a $250,000 increase to the poison control center.

“They have seen incredible increases in volumes of calls since the pandemic, and those continue specifically linked to youth mental health and some of the suicide attempts that are occurring,” she said.

Yeast also asked lawmakers to prioritize postpartum Medicaid expansion next year to improve the health of mothers and babies.

The bill would also create a “public assistance modernization fund” to be used for IT improvements to begin implementing the separate bill that would put new limits on food and health care assistance.

Sen. Mark Costello, R-Imogene, said he feels it’s a good budget that meets Iowans’ needs.

“Senate Republicans are being responsible with Iowa’s tax dollars, and we’re not willing to drain all of our resources in one year for ongoing costs,” he said. “This budget is expansive, it’s sustainable, and will allow departments to do their work for Iowans.”

The Republican-led legislature is once again spending far less money than they expect to take in through tax revenue in order to pay for income tax cuts that began phasing in this year.

The 988 Suicide and Crisis Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a trained listener, call 988. Visit 988lifeline.org for crisis chat services or for more information.

Katarina Sostaric is IPR's State Government Reporter