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More on Education

In addition to SSB 1065 that I described last week, we have proposed a bill that did not get much attention, SSB 1159. It provides an additional $45.2 million for K-12 education, in addition to the nearly $3.5 billion that we provided last year. Because of the coronavirus, K-12 enrollment decreased by about 6,000 students this school year, as parents kept their students home for various reasons including health concerns for their children or a family member. Because of this, the normal way of calculating school funding for next year could mean a decrease in funding for some schools. SSB 1165 provides a one-time increase of $65 per pupil for next year. The total is $29.4 million to cushion the effect of the decrease in student numbers. Also, there is an additional $10 million to continue to address per pupil and transportation inequities. The total in new funding comes to $45.2 million.      

Direct Primary Care for Medicaid Patients

I am again working on a bill to ask the Department of Human Services to establish a pilot program using Direct Primary Care for Medicaid participants. Under this model, health care providers are paid a monthly fee and they then provide basic medical services. There is a contract setting out what services are covered. An insurance policy covering “catastrophic” health problems is needed to cover the big-ticket items. The monthly fee can be from about $100.00 to $200.00 per month, depending on things like age, and whether it covers an individual or a family. We are spending around $4 billion, in state and federal money on our Medicaid program, so reducing the cost could result in huge savings, while providing better care. Under a Direct Primary Care model, the doctor may have around 800 patients. Under our current models, they may have 1,200 or more patients. The reason for the difference is that there is much less paperwork. Many doctors complain that they spend too much time on paperwork instead of helping patients.

I floor managed a bill several years ago to permit Direct Primary Care in the private sector and it is growing slowly. A new facility is opening up in West Des Moines. DPC is growing in the Omaha-Council Bluffs area also. I understand that there are a few other areas of the state where DPC is offered.

This model gets complicated in the Medicaid area because of the fact that both state and federal governments are necessarily involved. In Iowa, we are serving several hundred thousand people, at a cost as I said above, of $4 billion or so. Because of existing laws and rules, we might need a “waiver” from the federal government to try this for Medicaid participants.

Obviously, there would be a cost in setting up even a pilot program, but given the potential savings I believe this idea is worth pursuing. I believe most, if not all, the Republicans on the Senate Human Resources Committee support my bill. We all recognize that this is a long term project.

Allowing Young People to Drive to and from Farm for Work

One of the bills we passed is Senate File 231, allowing a person holding a special minor’s driver’s license who resides on a farm or is working on a farm in Iowa to operate a motor vehicle between 5 a.m. and 10 p.m. to get to and from the location where he or she needs to be to do the farm work, up to a distance of 50 miles.

Author: Julian Garrett