Elizabeth Matney, who has led the Iowa Medicaid Bureau of Managed Care since the state began privatizing nearly the whole program in 2015, is leaving the Department of Human Services to become Governor Kim Reynolds’ health policy advisor, Matney’s LinkedIn profile shows. Her starting date is unclear; the governor’s office has not announced Matney’s hiring or responded to Bleeding Heartland’s inquiries on the subject. A DHS organizational chart dated June 17 still shows Matney as bureau chief for MCO Oversight & Supports, the state’s leading official for overseeing the private companies picked to manage care for more than 600,000 Iowans on Medicaid.

When the new fiscal year begins on July 1, the governor’s office will receive additional funding for staff, so Matney’s work for Reynolds may formally begin at that time. The governor’s previous health policy advisor, Paige Thorson, appears to be staying on as deputy chief of staff, meaning that new funds would be needed to pay Matney (the governor’s staff have not clarified that point).

Jerry Foxhoven has resigned as Iowa Department of Human Services director, effective today, Governor Kim Reynolds’ office announced on June 17. The news release did not give a reason for Foxhoven’s departure. Staff for DHS and the governor did not immediately respond to questions including:

Two Iowa state agencies announced on May 31 an intent to award Planned Parenthood of the Heartland sex education grants for the fiscal year beginning on July 1.

Republican lawmakers approved and Governor Kim Reynolds signed legislation seeking to deny Planned Parenthood access to the federally-funded Community Adolescent Pregnancy Prevention and Services Program (CAPP) and the Personal Responsibility Education Program (PREP) grants. However, a Polk County District Court put that provision on hold this week, saying Planned Parenthood was “likely to succeed on the merits of its equal protection claim” under the Iowa Constitution.

Carl Olsen has been a leading advocate for medical cannabis in Iowa for many years and closely follows legislative happenings related to the issue. -promoted by Laura Belin

In a highly unusual move, the Iowa Department of Public Health (IDPH) announced on the afternoon of April 12 that the Medical Cannabidiol Advisory Board had rescheduled its planned meeting. Instead of convening for two and a half hours on May 3, the board would meet for one hour on April 16.

Members called the shorter, rushed meeting in order to discuss recommendations on the tetrahydracannabinol or THC cap and purchase limits in a bill the Iowa House approved last month.

John Morrissey is a longtime Des Moines resident who has investigated state spending increases, financial anomalies, and payment disruptions associated with Medicaid privatization in Iowa. -promoted by Laura Belin

The “he said/she said” controversy between an insurance company CEO and Iowa’s governor about why UnitedHealthcare decided to leave the state’s Medicaid program might make entertaining copy, but it doesn’t address who is going to manage the care of 420,000 Iowans left in the lurch.

Nor does it address whether the remaining company (Amerigroup) is adequately prepared to handle more members, and whether a new player poised to enter our state’s Medicaid market (Iowa Total Care) has the expertise to handle special populations in Iowa such as the elderly, disabled, and very ill.

It also doesn’t consider whether the state’s traditional fee-for-service Medicaid offering has the financial wherewithal to shoulder an even larger share of the enrollment and cost. Fee-for-service was held over from the old state-run program when most of the Medicaid program was privatized in 2016. The fee-for-service program pays the claims of Iowa’s sickest and most frail Medicaid members, which the for-profit managed care organizations (MCOs) don’t want or can’t handle.

The Iowa Deparment of Human Services (DHS) did not respond to a request for comment on these issues.

When a government press release arrives at 4:45 pm on a Friday, you know it’s not bearing good news. UnitedHealthcare will soon pull out of Iowa’s Medicaid program, the governor’s office announced on March 29. The company “manages health care for more than two-thirds of Iowans on Medicaid,” at least 425,000 people, Tony Leys reported for the Des Moines Register.

The official spin portrayed Governor Kim Reynolds as a hero who resisted a for-profit insurer’s “unreasonable” and “unacceptable” demands.

The real story is that nearly three years into our costly Medicaid privatization experiment, Iowa’s dominant managed-care organization (MCO) still can’t handle normal business practices like paying health care providers on time.

Paul Deaton: “It’s easy to say we should balance our politics and policy. I’m not sure about that. A better approach is to recognize there is political bandwidth and tune in.” -promoted by Laura Belin

The 2020 general election will be challenging for a lot of reasons, not the least of which for me is deciding whether policy or politics is the most important part of it.

Politics is the art of what’s possible. I’m over the naive notion that policy matters more than politics, although the art of what’s possible has produced some problems.

Matt Chapman has closely followed this year’s legislative proposals targeting Iowans on public assistance. -promoted by Laura Belin

A bill requiring more frequent reviews of Iowans’ eligibility for public assistance programs would cost the state an additional $40 million during the first two years alone, according to analysis by the nonpartisan Legislative Services Agency. The federal government would be on the hook for an additional $35 million during the same period.

A new dark money group is threatening clean energy progress in Iowa. Mark Langgin digs into the social media advertising campaign that emerged a few days ago. -promoted by Laura Belin

Looks like the utilities and electric cooperatives are up to no good. A new “dark money” organization just launched ads on Facebook.

The “REAL” Coalition began advertising on Facebook on March 1, arguing for legislation that would undermine net metering. The REAL Coalition is doing this under the guise of promoting renewable and clean energy.

Governor Kim Reynolds appointed former Iowa House Speaker Kraig Paulsen as director of the Iowa Department of Revenue on February 22, only six weeks after she had named Adam Humes to lead the agency. A late Friday afternoon news release did not explain the reason for the change, saying only that Humes “has decided to pursue other opportunities.”* Paulsen will start work this coming Monday. Leadership transitions at state agencies typically are weeks or months in the making.

Humes’ predecessor, Courtney Kay-Decker, also left under odd circumstances. Appointed by Governor Terry Branstad in 2011, she sounded excited to continue to lead the department after the 2018 election. But in early December, Kay-Decker announced her resignation, effective at the start of the new year.

Catherine Gayle Williams passed away on May 20, 2020. Original post follows.

Democratic State Representative Marti Anderson delivered these remarks in the Iowa House on February 4. -promoted by Laura Belin

The Iowa House of Representatives on February 4, 2019 begins to observe Black History Month. The ancestors of African Americans did not immigrate to the United States of their own free will like most of our families. They were trafficked to America to work the fields, build our communities and help create our nation’s history.

Beginning today and for the next month, you will hear inspirational stories of Black Americans and you will be moved by their lives of hard work and persistence to make America a better place for their children.

I am thrilled to open this special month of American history by honoring the Iowa grit and American spirit of my friend and shero, Catherine Gayle Williams of Des Moines. Ms. Williams has had two primary careers in her 104 rich years of life, and I would like to weave her story of accomplishment for you.

A divided state board has approved settlements worth a combined $4.15 million to two women who reported extensive, appalling sexual misconduct by former Iowa Finance Authority Director Dave Jamison. Under the agreements posted in full below, $2.35 million will go to the agency’s former business development director Beth Mahaffey, and $1.8 million will go to the agency’s communications director Ashley Jared. Attorney’s fees for both women will come out of those payments.

The settlements bring closure to women who endured a horrific workplace environment. But they also ensure that oversight failures at the finance authority will never be fully explored in litigation.

Rejecting a leading Republican talking point from the 2018 campaign, the board that regulates the accounting profession in Iowa has confirmed State Auditor Rob Sand can do the job Iowans elected him to do.

Catching up on news from last week: State Auditor Rob Sand announced on January 22 that energy efficiency recommendations will be part of every audit his office produces of a municipal, county, or state government entity.

The Iowa Ethics and Campaign Disclosure Board has a new website that is easier to navigate and complies with its own transparency rules. The board announced the site launch on January 15, a week before the next deadline for Iowa campaigns to report on their fundraising and spending.

Clive native T.J. Foley is a Harvard College undergraduate. -promoted by Laura Belin

As shutdowns abound and federal workers around the country continue to celebrate the holidays without their paychecks, the fiscal practices of our state and federal government continue to destabilize economic outlook. Day after day, elected officials in Washington bicker about spending cuts and public expenditures with no end in sight, all from the supposed guardians of fiscal responsibility.

Republicans in Wisconsin and Michigan responded to recent election losses by limiting the powers of some Democratic statewide officials. GOP lawmakers are rumored to be considering similar legislation in Iowa, where Rob Sand just took office as the first Democrat to serve as state auditor in more than 50 years.

But Republican State Representative Bobby Kaufmann, who chairs the Iowa House State Government Committee, told Bleeding Heartland he has no interest in revoking or curtailing the subpoena power of Sand’s office.

The first Democrat to serve as Iowa’s state auditor in more than 50 years has hired a “tri-partisan leadership team” to help run the office.

Iowa has long been one of the worst states for racial disparities in the criminal justice system. Gwen Hope reviews some depressing relevant data. -promoted by desmoinesdem

If you’ve been convicted of falling short of the law in Iowa, it pays to be white. This is nothing new, racial bias nationwide has long been a known and understood problem rooted in the prejudices of the past and present. How much bias, however, might surprise some people.

This is nearly 2019, after all, many white Americans live as if racism is a thing of the past no longer dealt with in their illusory post-racial modern world. In 2018, the evidence here in Iowa shows the continuation of one of the longest, most abhorrent trends in US history – white privilege, black punishment.

For weeks this fall, the Iowa Department of Human Services stonewalled a journalist’s request for easily accessible public records that would have cast an unflattering light on management of the state’s Medicaid program.

Three days after Governor Kim Reynolds won the election, the department sent a copy of one key document to Ryan Foley of the Associated Press. DHS released other relevant files on December 6, allowing Foley to confirm Director Jerry Foxhoven had cut a deal in April allowing UnityPoint Health affiliates to keep nearly $2.4 million they had been overpaid for services provided to Medicaid patients.

The settlement agreement came shortly after UnityPoint agreed to remain part of the network for Amerigroup, one of the private companies DHS picked to manage care for Medicaid recipients.

Privatizing Medicaid saved the state of Iowa about $126 million during the fiscal year that ended June 30, according to a report State Auditor Mary Mosiman released on November 26.

I put low odds on that estimate holding up after a more diligent auditor takes office.

Even if it did, this review of “savings” was too narrow to reveal whether turning Medicaid over to for-profit companies was a good deal for Iowans.

Leslie Carpenter is an advocate for improving the treatment of people with serious mental illnesses in Iowa and across the country. -promoted by desmoinesdem

While speaking at the National Alliance on Mental Illness Iowa Annual Conference on November 16, Iowa Department of Human Services Director Jerry Foxhoven advised the attendees that it was a good thing that two of the state’s four in-patient mental health institutions (MHIs) were closed, and that we have moved to community-based care. He further shared that it was a good thing to go from more than 700 beds to the current level of 64 beds for adults in the whole state.

We should recall that this reduction of state-operated acute care beds has caused Iowa to be ranked 51st by the Treatment Advocacy Center.

Iowa’s two largest public sector unions have defeated Republican efforts to diminish their power for a second straight year.

John Morrissey investigates anomalies in financial reports filed by AmeriHealth Caritas, which left Iowa’s Medicaid program last year. -promoted by desmoinesdem

A managed care company that left the Iowa Medicaid program last November financially engineered its first quarter report to state regulators this year, even as it dragged its feet in paying Iowa medical providers for claims that were then more than 90 days old.

AmeriHealth Caritas Iowa, Inc. claimed in its calendar first quarter filing with the Iowa Insurance Division (IID) that general administrative costs to run its Iowa operation totaled $20 million. But at the end of June, the company reduced that expense to $6 million without explanation.

Carl Olsen is a longtime advocate for expanding access to medical cannabis in Iowa and maintains the Iowans for Medical Marijuana website. -promoted by desmoinesdem

On Thursday, September 20, the Iowa Board of Pharmacy moved to dismiss my petition for the religious use of medical cannabidiol, in Olsen v. Board of Pharmacy, No. CVCV056841 (Iowa District Court, Polk County).  The Board says the petition should have been filed with the Iowa legislature instead of the board.

The problem with the board’s position is that the legislature has given the board the duty of recommending changes in the schedules of controlled substances and medical cannabidiol is a controlled substance in Iowa.  There is also an existing exemption for the religious use of peyote, a Schedule 1 controlled substance.  Iowa Code § 124.204(8) (2018).

John Morrissey delved into a little-noticed financial report by AmeriHealth Caritas. -promoted by desmoinesdem

Although it left the Iowa Medicaid program more than seven months ago, AmeriHealth Caritas Iowa, Inc. continues to string along claims payments due to Iowa providers.

AmeriHealth – which is owned by Independence Blue Cross of Philadelphia – reported $14.6 million in unpaid liability for claims submitted last year by Iowa Medicaid providers, according to the company’s most recent quarterly financial filing with the Iowa Insurance Division. Meanwhile, the managed-care organization has racked up more than $6 million in administrative costs so far this year to manage the now-closed operation.

Carl Olsen is a longtime advocate for expanding access to medical cannabis in Iowa and maintains the Iowans for Medical Marijuana website. -promoted by desmoinesdem

I attended the seventh meeting of the state Medical Cannabidiol Advisory Board on August 3 at the Iowa Laboratory Facility on DMACC’s Ankeny Campus. Current law names nine “debilitating medical conditions” which can legally be treated with cannabidiol. See Iowa Code § 124E.2(2) (2018). The board considered three petitions to expand the list. Board members denied one, deferred one, and granted the petition to add ulcerative colitis.

My observations about these rulings may help advocates lobbying officials to allow medical cannabis for other diseases or chronic health conditions now excluded under Iowa law.

John Morrissey is a native Iowan and longtime Des Moines resident. -promoted by desmoinesdem

Despite promises of huge annual cost savings resulting from Medicaid privatization, Iowa’s medical assistance programs spent more in eleven months of the current fiscal year than during all of the previous fiscal year.

A two-decade-old state administrative rule “clearly discriminates against transgender Medicaid recipients on the basis of gender identity by excluding coverage for medically necessary gender affirming surgery” while covering the same surgeries for non-transgender Iowans, a Polk County District Court ruled on June 7. Chief Judge Arthur Gamble found the rule violates both Article I, section 6 of the Iowa Constitution, which guarantees equal protection, and the Iowa Civil Rights Act, which has prohibited discrimination on the basis of gender identity since 2007.

Iowa Freedom of Information Council executive director Randy Evans reflects on the flawed draft advisory opinion the Iowa Public Information Board’s staff proposed in response to my inquiry. -promoted by desmoinesdem

I sometimes think government officials overlook the important role the public plays in our system of government.

That was my takeaway last week from the monthly meeting of the Iowa Public Information Board.

Continuing a series on Iowa legislative happenings that attracted little notice while the House and Senate were in session.

State officials will be barred from “any outside employment or activity that requires the person to register under the federal Foreign Agents Registration Act,” under a new law that takes effect on July 1. In addition, applicants for state jobs or nominees for any position that requires Iowa Senate confirmation will have to disclose whether they have ever registered as foreign agents.

Iowa lawmakers went home for the year on May 5. In the coming weeks, Bleeding Heartland will catch up on some of the legislature’s significant work that attracted relatively little attention.

Two proposed state constitutional amendments passed both chambers and could appear on the 2020 general election ballot, if the House and Senate approve them in the same form during either 2019 or 2020.

Three other constitutional amendments cleared one chamber in 2017–in one case unanimously–then stalled in the other chamber as lawmakers completed this two-year session. Those ideas may resurface next year. But since changes to the state constitution must be passed by two consecutively elected legislatures before landing on the general election ballot (the last step in the process), Iowa voters would not be able to ratify those proposals until November 2022 at the earliest.

Republican lawmakers made big promises last year that Iowans would have “more access” to family planning services under a new state program that excluded Planned Parenthood.

As anyone could have foreseen, the opposite was true. In the first nine months of the State Family Planning Program’s existence, the number of Iowans enrolled dropped by a third. The number who obtained at least one reproductive health care service fell by more than 40 percent from the first quarter to the second quarter the program was operating. The number of health care providers billing the program also declined by 40 percent during the same time frame.

Republican lawmakers don’t want to hear how poorly the new system is serving their constituents. Even worse, GOP state senators voted unanimously last week to compound the mistake by blocking Planned Parenthood from participating in sex education programs.

UPDATE: On April 26 the governor’s office released a redacted version of the written complaint against Jamison, now enclosed at the end of this post.

Governor Kim Reynolds and her staff continue to withhold details on the “credible allegations” of sexual harassment that ended Dave Jamison’s tenure as director of the Iowa Finance Authority last month.

To hear her tell the story, the stonewalling is all about protecting Jamison’s victims. But Reynolds could provide more details–and comply with state law–without revealing the accusers’ identities.

Secretary of State Paul Pate failed to list two companies he controls on his latest personal financial disclosure form, Ryan Foley reported for the Associated Press on April 17.

Instead of instructing Pate to correct his filing, Iowa Ethics and Campaign Disclosure Board executive director Megan Tooker gave the incomplete form her blessing. She further suggested it would be unfair for her to require more detail from Pate after receiving a “media inquiry.”

Tooker and longtime board chair James Albert just gave every state official reason to believe they will be in the clear, even if watchdogs uncover material omissions on their personal disclosures.

Governor Kim Reynolds fired Dave Jamison as Iowa Finance Authority director “effective immediately” this weekend, due to “credible allegations of sexual harassment.” Communications director Brenna Smith “declined to provide more details about the allegations” than what appeared in the official announcement, William Petroski reported for the Des Moines Register.

“I’m sorry, but to protect the privacy of IFA’s remaining employees, no further comment will be made,” Smith said in an email.

That won’t cut it.

The Iowa Senate confirmed Jerry Foxhoven as director of the Iowa Department of Human Services in an unusually close vote on March 21.

Most of Governor Kim Reynolds’ appointees have won unanimous confirmation, as has typically been the case in Iowa for many years. Foxhoven’s nomination was controversial because of how privatized Medicaid has been managed, along with several tragedies involving abused children. Senate Democrats asked to defer consideration on the DHS director last month “until we can fully assess his leadership.”

Connie Schmett hired Doug Gross to represent her in an ethics investigation within a day of the senior BrownWinick partner arguing a position before the state board on which Schmett serves.

Iowa Department of Human Services Director Jerry Foxhoven “does not have enough votes to be confirmed,” Democratic State Senator Pam Jochum told Bleeding Heartland in a March 4 telephone interview. “He’s in trouble” largely due to concerns over the state’s handling of Medicaid privatization, she explained.

Governor Kim Reynolds will withdraw one of her latest nominees for a state regulatory body after “a mistake was made” that would have upset the partisan balance Iowa law requires.