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.”

The rumors were true: Drake University Law Professor Jerry Foxhoven will be the new Iowa Department of Human Services director, effective tomorrow.

The May 31 press release announcing Chuck Palmer’s retirement linked to a job listing for the DHS director position, to close on June 11. I would be surprised if Governor Kim Reynolds interviewed or seriously considered anyone else for this job, given the rapid turnaround. I never heard a rumor about any candidate other than Foxhoven.

I enclose below the full text of today’s announcement, including background on the new director. Foxhoven has a lot of relevant experience for the job, and I wish him the best of luck as he attempts to lead a department where big mid-year spending cuts will give way to even lower funding levels for the next fiscal year. Morale is reportedly poor among DHS workers, in part because of too-large caseloads. Medicaid privatization has proved disastrous for many vulnerable Iowans and service providers.

Speaking of which, Disability Rights Iowa filed suit yesterday against Reynolds and former DHS Director Palmer, seeking “to halt discriminatory cuts in services to 15,000 Iowans with serious disabilities,” Tony Leys and Jason Clayworth reported for the Des Moines Register. Roxanne Conlin is helping the plaintiffs, who will seek certification for a class action.

UPDATE: Lee Rood and Tony Leys interviewed Foxhoven for the Des Moines Register. I posted excerpts below, but you should click through to read the whole thing.

Promising to stand up to powerful interests and raise her voice for those who are hurting, small business owner Cindy Axne announced this morning that she will run for Congress as a Democrat in Iowa’s third Congressional district. Her campaign is online here as well as on Facebook and Twitter. A Des Moines native, Axne runs a digital design firm with her husband. From 2005 to 2014, she worked in state government for the Department of Administrative Services, Department of Management, and Department of Natural Resources.

I enclose below more background on the candidate and today’s news release. Axne has never run for office before, but she has attended Democratic events around the state this year as a surrogate for gubernatorial candidate Rich Leopold.

Governor Kim Reynolds promised today not to “stop working until every Iowan, no matter where they live, has the same opportunity to succeed, have a satisfying career, raise a family and have a great quality of life.”

Judging by her first speech in her new role, Reynolds has some major blind spots about her own record and the challenges facing Iowans.

Disappointing but not surprising: the Iowa Senate on April 10 confirmed Geri Huser as chair of the Iowa Utilities Board by 44 votes to four. Senators delayed consideration of Huser’s nomination in late March, after Ryan Foley reported for the Associated Press that she “has maintained a busy and profitable private legal practice” during her first two years as board chair.

Iowa Code 474.8 stipulates that each utilities board member “shall devote the member’s whole time to the duties of the office.” For decades, every other attorney appointed to that board halted his or her legal practice during the term of service. For some reason, Huser decided those standards need not apply to her. She has also given out conflicting information about her work for the Skinner Law Office. Although she has claimed not to receive any income from that firm, she appears to work out of their office, as Bleeding Heartland discussed near the end of this post.

Only four senators–Democrats Tony Bisignano, Kevin Kinney, Bob Dvorsky, and Herman Quirmbach–found Huser’s outside legal work concerning enough to oppose giving her two more years of greater administrative responsibility and higher pay as the board chair. Most Iowa Senate confirmations are unanimous, so four votes against Huser indicates unusually strong discomfort with her conduct.

On the other hand, the 44 senators who supported Huser on Monday sent a clear message to Iowans. If state law on devoting one’s “full time” to public service gets in the way of a earning a side income, sometimes during regular business hours, powerful and well-connected officials don’t need to follow that rule.

Huser’s ongoing legal practice isn’t her only unprecedented behavior as Iowa Utilities Board chair. Less than six months into her term, she withheld funding for energy centers affiliated with state universities. That inappropriate exercise of her authority was disruptive to the centers and possibly illegal. At the time, a former lawmaker who helped create the energy centers described Huser’s interference as “way out of line.”

Democratic State Senator Joe Bolkcom works at the Center for Global and Regional Environmental Research at the University of Iowa, which got caught up in Huser’s power play, even though the Iowa Energy Center at Iowa State University was her primary target. I am seeking comment from Bolkcom on his vote to confirm Huser and will update this post as needed.

Real-world data don’t match figures Governor Terry Branstad and Lieutenant Governor Kim Reynolds released yesterday in order to demonstrated the alleged “continued success of modernizing our state’s Medicaid program.”

April 1 marked a year since Iowa allowed three private insurance companies to manage care for more than half a million Medicaid recipients. The shift was disruptive for thousands of Iowans as well as for caseworkers and service providers, some of which went out of business. Reimbursement problems and cutbacks to care are still affecting many people, Chelsea Keenan reported in this retrospective on the first year of the policy.

Although privatization was supposedly designed to save money and bring predictability to the state budget, the Branstad administration agreed last fall and again in February to hand over millions more state dollars to the managed-care organizations (MCOs), unlocking some $225 million in extra federal funding for the corporations, which have much higher administrative costs than Iowa’s state-run Medicaid program did.

I enclose below the latest deceptive official statements about the “modernization,” along with a demolition fact-checking job by Democratic State Senator Liz Mathis. I’ve also included independent State Senator David Johnson’s reaction to what he called a “lousy, lousy” press release. While still a member of the Republican caucus during the 2016 legislative session, Johnson worked with Democrats trying to halt Medicaid privatization or at least provide stronger legislative oversight of the program.

The Iowa Hospital Association can’t substantiate the Branstad/Reynolds claims on hospitalization rates, Tony Leys reported yesterday for the Des Moines Register. Excerpts from that story are at the end of this post.

On a related note: thousands of Iowans who follow this issue closely are mourning Rhonda Shouse, who died unexpectedly in late March. I never met Rhonda in person, but we communicated through social media, and I admired her relentless advocacy on behalf of those adversely affected by Medicaid privatization. Keenan marked her passing in the Cedar Rapids Gazette, and Leys did so in the Des Moines Register. May her memory always be for a blessing.

State senators will soon decide whether to confirm Geri Huser to another two years as chair of the Iowa Utilities Board.

The vote presents an opportunity to affirm that even the most powerful and well-connected state officials must follow the law.

Don’t count on senators seizing that chance.

Governor Terry Branstad’s staff have rebuffed repeated efforts to obtain a list of those invited to watch the governor sign sweeping changes to Iowa’s collective bargaining law last month.

Going against longtime standard practice for high-profile legislation, Branstad excluded reporters from attending what staff called a “private” event. Drew Klein, state director for Americans for Prosperity, later posted a picture of himself shaking the governor’s hand at the bill signing. The large number of pens on the governor’s desk suggest that many others celebrated the historic move to take rights away from an estimated 180,000 public workers.

Jodie Butler was determined to find out who else was in that room.

Iowa’s Revenue Estimating Conference delivered bad news yesterday. Revenues are lagging so far behind projections that even after enacting huge spending cuts in February, the state is on track to have a shortfall of $131 million at the end of the current fiscal year. Next year’s revenues are being revised downward by $191 million as well.

Governor Terry Branstad, Senate Majority Leader Bill Dix, and House Speaker Linda Upmeyer quickly announced plans to use the state’s cash reserves to cover the gap. Dix’s written statement explained, “We must not cripple our schools, public safety and many other essential services with further cuts this year. Our savings account exists for moments such as this.”

Two months ago, many Democratic lawmakers advocated dipping into “rainy day” funds as an alternative to the last round of painful reductions to higher education, human services, and public safety. At that time, Republican leaders portrayed such calls as irresponsible. A spokesperson said Branstad “doesn’t believe in using the one-time money for ongoing expenses.” Now, the governor assures the public, “Iowa is prepared,” thanks to hundreds of millions of dollars in the state’s cash reserves, and Dix boasts about the supposedly strong GOP leadership that filled those reserve funds.

Republican hypocrisy on state budget practices is irritating and all too predictable. But that’s not my focus today.

While transferring funds from cash reserves will solve the immediate problem, it won’t answer some important questions about how we got into this mess.

Mary Dyer, an advocate for Iowans with hearing loss, sounds the alarm about an imminent threat to deaf services. The Department of Human Rights has been forced to cut about $90,000 from its budget before the end of the current fiscal year on June 30. -promoted by desmoinesdem

RE: Cuts to Deaf Services Effective March 31

I was notified Monday, March 6, by Monica Stone, Deputy Director of the Iowa Department of Human Rights, that Stephanie Lyons, the full-time disabilities consultant with the Department of Deaf Services, is being terminated at the end of the month due to “necessary” budget cuts. This leaves one staff member working one-third-time for the entire department of Deaf Services, plus support staff. This is for the entire state of Iowa.

If you are someone with typical hearing, you have probably not thought of the challenges and limitations of having hearing loss. I learned about this the hard way.

Republicans have already inflicted immeasurable harm on Iowans during the 2017 legislative session, taking rights away from more than 180,000 workers, slashing funding for higher education and human services, and approving the third-smallest K-12 school funding increase in four decades. The worst part is, they’re nowhere near finished.

Iowa Senate Minority Leader Rob Hogg has flagged twelve of the most destructive bills still alive in the GOP-controlled House and Senate. Any Iowan can attend public hearings scheduled for March 6 or 7 on four of those “dirty dozen” bills. Those who are unable to come to the Capitol in person can submit written comments on the legislation or contact Republican state representatives or senators directly by phone or e-mail.

Here’s what you need to know about the four bills most urgently requiring attention.

A new bill that would have named a task force to study licensing requirements in Iowa will not move forward this legislative session, Republican State Representative Dawn Pettengill told representatives of the National Association of Social Workers Iowa chapter. House Study Bill 174 replaced an earlier proposal from Governor Terry Branstad, which would have eliminated licensing requirements for numerous professions. During the past week, House Study Bill 138 generated as many constituent contacts to Iowa lawmakers as the bill passed earlier this month to destroy collective bargaining rights. Among other things, the governor’s licensing bill would have reduced insurance coverage for mental health care services. On February 27, an Iowa House State Government subcommittee voted not to move that bill forward.

House State Government Committee Chair Ken Rizer introduced the replacement licensing bill on February 28. In addition to changing regulations in several other areas, House Study Bill 174 called for a new task force to review Iowa’s licensing requirements and report back to the legislature by the end of 2017.

Although Rizer’s bill would not have immediately affected marriage and family therapists, mental health counselors, or social workers, the leading association representing Iowa’s social workers expressed concern that “the taskforce as outlined would mostly be selected by the Governor, who has demonstrated that he wants to de-professionalize many different important professions that serve some of our most vulnerable populations.” (You can read the task force membership provisions on on page 37.) The social workers group was seeking an amendment to give licensed professionals greater influence over the task force membership. But last night, Pettengill–one of two Republicans on the subcommittee where the new bill was assigned–said House Study Bill 174 was dead.

Most non-appropriations bills must be approved by at least one Iowa House or Senate committee by March 3 in order to stay alive for this year. Bills need to clear a subcommittee before coming up for a full committee vote.

Whether the licensing task force language led to the new bill’s demise is not clear. The lobbyist declarations on House Study Bill 174 show substantial opposition, presumably related to other provisions on regulating hospitals and electricians.

P.S. Attention-seeking State Representative Bobby Kaufmann could have let the governor’s original licensing bill die quietly by not scheduling a subcommittee hearing, as is normal practice in the Iowa legislature. Instead, the publicity hound wasted a lot of people’s time before drawing cheers as he ripped up the bill’s cover sheet. Alas, television cameras had already left the meeting room before Kaufmann’s dramatic gesture. The young Republican lawmaker was literally not ready for prime time.