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.

State Auditor Mary Mosiman continues to defend her failure to ask tough questions as an ex officio member of the board that was supposed to oversee the scandal-plagued Iowa Communications Network.

Mosiman had a spotty attendance record for meetings of the Iowa Telecommunications and Technology Commission, which didn’t notice “misspending, cronyism and self-dealing” at ICN for years. Whistleblowers came forward last summer, prompting a special investigation that led to the firing of three top officials.

During a recent meeting with state lawmakers, Mosiman contended she had no reason to believe the ICN was being mismanaged and indicated she didn’t see her board role as relevant to her job as state auditor. She also revealed she hadn’t been aware that voting members were paid to serve on the technology commission, even though their salaries were written into Iowa Code.

A personal commentary by Matt Chapman to coincide with the “Day on the Hill” for our state’s National Alliance on Mental Illness chapter. NAMI Iowa’s “mission is to raise public awareness and concern about mental illness, to foster research, to improve treatment and to upgrade the system of care for the people of Iowa.” -promoted by desmoinesdem

In the last few years I have found myself politically active and seem to be trying to make up for years of not having the right to vote and taking it for granted when I did participate. I would like to share where my focus is and relate how I came to feel so intensely about these issues. You never know when you may find your voice, and if it took me until my 50s, so be it.

Doctors affiliated with Mercy Cedar Rapids and The Iowa Clinic are refusing to sign paperwork their patients need to register for the Iowa Department of Public Health’s medical cannabis program. Iowa law requires applicants to obtain their doctor’s signature attesting that the patient has a “qualifying debilitating medical condition.” But the law stipulates that health care practitioners have “no duty to provide” written confirmation of the patient’s diagnosis.

Mercy Cedar Rapids appears to have instructed its 503 physicians not to sign the IDPH paperwork, according to two sources with qualifying conditions, who receive health care at different facilities in that network. Most if not all of the 250-plus health care providers at The Iowa Clinic, a doctor-owned group in the Des Moines area, are also refusing to sign medical cannabis card applications.

Without cooperation from a primary care provider, Iowans cannot start the process of receiving authorization to use cannabidiol legally. The number of patients affected by their health care group’s policies is unknown but potentially large. Mercy Cedar Rapids handled 451,400 outpatient visits last year at offices around Iowa’s second largest metro area. The Iowa Clinic averages 450,000 visits annually, serving about 148,000 unique patients across its central Iowa locations.

A majority of Iowans think mental health services, student loan debt, child welfare services, state university tuition, and the state budget are either a “crisis” or a “big problem” for Iowa, according to the latest Selzer poll for the Des Moines Register and Mediacom. Among nine issues tested in the survey of 801 Iowa adults in late January, mental health services registered as the top concern: 35 percent of respondents described the situation as a crisis, 38 percent as a big problem. No other topic registered above 20 percent for “crisis.”

The attorney Connie Schmett retained for a recent ethics inquiry is a partner in the BrownWinick law firm, which represents clients at most meetings of the state’s Health Facilities Council. Schmett has served on that board since 2013.

Staff for the Iowa Ethics and Campaign Disclosure Board (IECDB) found no evidence Kim Schmett or Connie Schmett violated state laws on lobbying or conflicts of interest through their outside work as consultants, according to a document prepared by IECDB Executive Director Megan Tooker. However, a review found several omissions on the government officials’ annual personal financial disclosure forms, for which board members approved a reprimand and $250 fine for Connie Schmett. Although staff suggested that the board direct Connie Schmett to stop making campaign contributions under the surname she used during her previous marriage, after a lengthy discussion the board voted that Connie Schmett did not violate state law by donating to candidates and political committees as Connie Russell.

Governor Kim Reynolds requested the review of the Schmetts’ activities in November, following an Associated Press report on the state officials’ work as registered foreign agents lobbying for Saudi Arabia. The board discussed the matter for more than two hours during a January 25 meeting. Following minor revisions, IECDB chair James Albert will sign a letter to Reynolds outlining the board’s findings and recommendations. Tooker distributed a draft letter to reporters during the meeting; I will post the final version as soon as it is available. UPDATE: Enclosed below the letter to the governor, with supporting documents.

Following a public outcry, the Iowa Department of Natural Resources has abandoned an effort to weaken the state’s E. coli water quality standards.

Officials had designed the change with the explicit goal of reducing the number of Iowa waterways deemed impaired. Environmental advocates had warned public health would suffer if the DNR assessed waterways based on average readings of E. coli levels, rather than the highest single measurement of the bacteria.

The American Civil Liberties Union of Iowa has filed a second lawsuit charging that state government violates the civil rights of transgender Iowans. Plaintiff EerieAnna Good is a Medicaid recipient who has been denied coverage for transition-related surgical care, because Iowa Department of Human Services administrative rules exclude Medicaid coverage for surgery related to “Sex reassignment.”

Professional associations representing doctors, psychologists, psychiatrists, and social workers support transition-related care as medically necessary, and more than a dozen states prohibit transgender exclusions in private health insurance or Medicaid.

In a news release enclosed in full below, ACLU of Iowa legal director Rita Bettis noted that “Iowans who are not transgender routinely receive coverage for a medically necessary mastectomy—but a transgender Iowan would be banned from coverage for the same care to treat gender dysphoria regardless of medical need. That’s a violation of the Iowa Civil Rights Act and equal protection under the Iowa Constitution.” (Since 2007, the Iowa Civil Rights Act has prohibited discrimination on the basis of gender identity.)

A second transgender Iowan, Carol Ann Beal, will likely join this lawsuit after the Iowa DHS finishes processing her appeal of Medicaid’s denial of coverage, the ACLU said.

Last month, the ACLU filed suit on behalf of a former Iowa prison nurse, who “was continuously denied the use of restrooms and locker rooms consistent with his gender identity, because he is transgender,” and also denied “the same level of health care benefit coverage” the state plan provided to employees who are not transgender.

A former prison nurse has filed Iowa’s first transgender rights case since state lawmakers and the governor added gender identity protections to the Iowa Civil Rights Act in 2007, the American Civil Liberties Union of Iowa announced today.

Jesse Vroegh is suing the Iowa Department of Corrections, the Iowa Department of Administrative Services, the insurance company Wellmark Blue Cross/Blue Shield of Iowa, and State Penitentiary Warden Patti Wachtendorf on four counts of discrimination on the basis of gender identity and sex. The plaintiff charges that while employed at the Iowa Correctional Institution for Women in Mitchellville, he “was continuously denied the use of restrooms and locker rooms consistent with his gender identity, because he is transgender.”

In addition, the Department of Corrections “denied transgender employees the same level of health care benefit coverage that it provided to non-transgender employees,” while the Department of Administrative Services “was involved in the decision to select and offer to employees of the Iowa Department of Corrections only employer-sponsored health care plans which discriminated against transgender employees.”

Vroegh claims the state’s actions violated the Civil Rights Act and provisions in the Iowa Constitution that prohibit discrimination on the basis of sex and require equal protection for historically disfavored groups. I enclose below the plaintiff’s initial court filing and a press release providing more background on the case.

Although he no longer works for the Department of Corrections, Vroegh said in a statement he is proceeding with the lawsuit “because I feel I need to fight for the rights not only of transgender people who work for the state but for other Iowa workers as well. I’m not asking for any special treatment of myself or any other transgender person. All I’m asking for is that transgender people be treated the same way as people who are not transgender.”

The ACLU of Iowa noted, “The first transgender employment discrimination case, Sommers v. Iowa Civil Rights Commission, was decided in 1983. But today’s action is the first case we’re aware of to be filed in Iowa District Court that asserts gender identity discrimination in employment since the Iowa Civil Rights Act was amended in 2007 to include gender identity and sexual orientation.” A few state House and Senate Republicans joined almost all of the Democratic lawmakers to approve the new civil rights language during the first year Democrats had controlled both chambers of the legislature in more than a decade. Governor Chet Culver signed the bill into law.

Are Iowa Democrats more likely to support a successful businessman who is not a politician? Are they sympathetic to the argument that a self-funding candidate for governor is less susceptible to influence by special interests? Are they more impressed by private- or public-sector jobs Fred Hubbell has held, or by his charitable giving to causes like Planned Parenthood?

A recent survey of Democratic voters appears to be the Hubbell campaign’s first attempt to answer those and other questions.

First-person accounts of political events are welcome at Bleeding Heartland. The Norris campaign is online here. -promoted by desmoinesdem

Last weekend I was able to attend John Norris’ gubernatorial campaign kickoff at Living History Farms in Urbandale. As someone who is relatively new to Iowa politics, I was pleasantly surprised to see about 200 people out for this campaign potluck event.

As a lifelong Democrat, Norris certainly impressed me with his campaign speech, and spoke about many issues that I, and many other Democrats, are passionate about.

Governor Kim Reynolds has said many times that she was a “full partner” in former Governor Terry Branstad’s administration. Other well-placed Iowa Republicans likewise have attested to Reynolds’ role as a “full partner” or “active partner” in running state government during nearly six and a half years as lieutenant governor.

But when Democratic State Representative Chuck Isenhart recently requested communications with the governor’s office pertaining to the Leopold Center for Sustainable Agriculture at Iowa State University, staff for Reynolds informed him that “our office cannot reach back and review and release records from the previous administration.”