Des Moines Register. March 9, 2017
Licensing board secrecy fosters free-for-all.
When Iowans have complaints about doctors, therapists, teachers, barbers or numerous other professionals, they may contact the state board that oversees that worker. Anyone filing a grievance likely expects it to be taken seriously by the licensing board ostensibly created to protect the public from incompetent or unscrupulous workers. One would expect a clear process to objectively handle and investigate allegations of wrongdoing.
But that might be expecting too much.
The state boards that license thousands of Iowans in dozens of professions operate in secrecy and are unaccountable to the public, according to a recent report by the Iowa Office of Ombudsman. The lack of transparency fosters “lackadaisical investigations, apathetic board members, poor documentation of deliberations, and questionable outcomes,” the independent agency concluded.
Sadly, this is not necessarily a surprise.
The Register editorial board has repeatedly written about problems related to job licensing in this state. Among them is the structure of licensing boards, which encourages a greater focus on protecting workers than public health. Members are from the private sector and frequently employed in the profession they’re charged with regulating. Appointed by the governor, they are given broad responsibility and unchecked authority under Iowa law.
Boards can strip fellow workers of licenses and livelihood. Meanwhile, consumers and patients depend on boards to sanction bad actors in industries.
So the ombudsman’s report raises significant concerns.
In response to Iowans who said their complaints about licensees had been closed with no explanation, the ombudsman investigated four boards. Unfortunately, the final report does not identify the boards, but it does provide a glimpse of the secrecy, shenanigans and conflicts of interest that plague them.
First, it took years and a change in state law for the ombudsman to even access minutes, audio recordings and information from closed-session board meetings. When the office finally obtained the spotty information that existed, it found unprofessional conduct and weak investigations into complaints about licensees.
In one case, the board did not interview the individual being investigated for possible sanctions. In another, a board member worked for the licensee who was the subject of a complaint. She stated under oath she had recused herself from proceedings, but records from the meeting reveal otherwise.
The ombudsman found one complaint of wrongdoing was directed at the chairman of a licensing board. That raised questions about whether the group could perform an objective investigation and evaluation.
Then there was the behavior of board members who made remarks in meetings the ombudsman’s report characterizes as “derogatory, inappropriate, and quite frankly, appalling,” leaving the impression board members had a bias that could influence their decisions in handling a complaint.
This legislative session, Iowa lawmakers seem to have finally taken an interest in this state’s overzealous licensing of workers. They should also address the structure and operations of the licensing boards charged with responding to complaints from consumers and patients.
. And speaking of secrecy
The Iowa Office of Ombudsman investigated four of the 36 state licensing boards that oversee workers. Which boards? Good question. The office said it could not identify them or the workers interviewed “due to state laws that consider boards’ investigative files and their closed-session meetings confidential.”
It is hard to imagine the state auditor, for example, issuing a 17-page report about a few state agencies engaging in wrongdoing but leaving the public to guess which agencies it had examined.
Such lack of information not only leaves the public in the dark, it casts suspicion on all boards, including those which may be operating properly.
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Waterloo-Cedar Falls Courier. March 9, 2017
Casino audits should remain public record.
Like many states today, revenue from casinos around Iowa has become a substantial component of the state’s economy.
In 2015, Iowa’s casinos paid more than $312 million in gambling taxes and contributed nearly $40 million to charities.
That’s true around the Cedar Valley, as well. Since 2007, the Black Hawk County Gaming Association has awarded millions of dollars to hundreds of projects across the Cedar Valley. It has been an incredible infusion of funding for a variety of recipients, and we are fortunate to have this supplemental funding source.
Voters around the area gave their approval to a casino in the Cedar Valley, and we supported it. We have praised the benefits ever since.
That was always with the understanding audit reports from state-licensed casinos were available to the public.
There’s a chance that could be changing.
Last year, a group of Iowa casinos, including the Isle Casino Hotel Waterloo, filed a lawsuit to keep documents from being released. The action was intended to block their proprietary information from being released to competitors.
At that time, Iowa Gaming Association President Wes Ehrecke said the audits include trade secrets that shouldn’t be publicly released. However, the reports have been public in Iowa for almost 30 years., and they are relied upon to gauge the health of the industry.
A decision is still pending in that case. In the meantime, bills making their way through the Iowa House and Senate would allow audit reports to the Iowa Racing and Gaming Commission to be kept confidential.
We don’t believe that’s what we signed up for.
Iowa citizens expect and deserve transparency in all areas of government and in all government agency dealings. In 1983, Gov. Terry Branstad signed a law requiring the audits of gambling licensees’ “total gambling operations, including an itemization of all expenses and subsidies.”
The law also states books and records kept by the licensee are a public record.
Currently, the media is able to make a request to the IRGC to obtain an audit report. The IRGC then contacts the casino and it has 20 days to respond by either providing the audit or filing a court injunction.
It is our hope our state leaders unite against this potential erosion of transparency at a time when more transparency is needed in all government dealings.
Passage of these bills would do away with transparency we have had here for more than three decades. The loss of transparency is not the direction we want to go.
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Quad-City Times. March 10, 2017
Insurance overhaul would cost Iowa, Illinois
As if Iowa’s embattled Medicaid system needed more stress.
U.S. House Speaker Paul Ryan’s pitch to replace the Affordable Care Act is already in trouble. House conservatives are blasting it from the right, dubbing it “Obamacare-lite.” Democrats are decrying the bill’s potential to strip millions of Americans of their health insurance, a claim that will next week be tested when the Congressional Budget Office issues its analysis. President Donald Trump’s enthusiasm is, at best, inconsistent. Powerful lobbies representing the elderly and physicians are lining up against it. And four center-right Republicans in the Senate immediately panned it because it would end federal funding for Medicaid expansion, which 31 states have done since ACA’s adoption.
It’s this last point of contention in which Iowa and Illinois - both states that expanded Medicaid - could end up in dire financial straits. The bill, as it now stands, would end federal matching funds for Medicaid expansion in 2020, replacing them with bloc grants. The rollback is essential to pay for the hundreds of billions in tax cuts that are at the core of Ryan’s bill, which even Fox News admitted would disproportionately benefit the wealthy.
Iowa’s Medicaid program is already in free-fall after last year’s privatization. Recent filings from two of the three providers, showing huge financial losses, is evidence that Gov. Terry Branstad should have listened to federal regulators last year and applied the brakes. The third company has said in the past that Iowa’s payments simply aren’t enough to make it whole.
Medicaid in Iowa is already nearing a tipping point.
And it’s within this ecosystem where Ryan, and to a lesser extend Trump, find themselves. Illinois Gov. Bruce Rauner, a Republican, admitted as much when he immediately panned Ryan’s bill after last week’s rollout. Illinois “won’t do very well,” under the House draft, Rauner told the Chicago Tribune. Rauner’s comments echoed Ohio’s GOP governor, John Kasich, who recently lobbied the White House to salvage the Medicaid funding.
Branstad, who is set to accept a diplomatic job with the Trump administration, was more, well, diplomatic. Branstad, also a Republican, said he wanted to read the bill before commenting.
The fact is, Iowa’s Medicaid system has more than doubled since the state expanded Medicaid to include those making up to 138 percent of the poverty level, or $26,000 for a family of three. About 70,000 relied on the program prior to 2013’s state expansion, a Department of Human Services spokeswoman told us. Now, between 145,000 and 150,000 Iowans are in the program on any given week. That’s 5 percent of the state’s population now relying on Medicaid. In Illinois, 650,000 were added after Medicaid expansion.
Does anyone actually believe that, when the federal funds dry up, the state is going to let those people languish? Lawmakers could, but it would be cruel and politically problematic. And, as that population again flees to emergency rooms over primary care, everyone will pick up the tab.
Ryan and Trump are feeling it from all sides. Both men made huge promises, after Republicans spent years lampooning President Barack Obama’s premier domestic achievement. House Republicans ceremonially voted dozens of times to repeal the law while Obama was in office. And now, House conservatives - especially the Freedom Caucus - are looking to make good on pledges to kill the troubled program once and for all. Meanwhile, the GOP’s center is rightly fretting the human and political costs that could accompany such aggressive and swift action.
A lot has been said about ACA’s shortcomings. A lot was done to assure Obama’s health insurance program failed. A lot has been promised to voters, many of them benefiting from the ACA.
But, as it now stands, states like Iowa and Illinois stand to pay if Ryan gets his victory.
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Sioux City Journal. March 9, 2017
Consider way to minimize impact of bridge project
We understand the essential need for repair of local streets and bridges, but at the same time we sympathize with private businesses negatively impacted by such projects.
When an infrastructure project unavoidably affects private businesses, we believe the city is obligated to communicate with owners of those businesses and at least consider reasonable steps aimed at minimizing the damage to bottom lines. In other words, it shouldn’t ignore private concerns.
In our view, this obligation should apply to planned repair work on the Military Road bridge across the Big Sioux River and reconstruction of Military Road.
On Monday, private business owners and employees from both sides of the bridge - in Sioux City and North Sioux City, S.D. - told city officials and a city consultant closing the bridge for five months (one option under consideration) would be devastating to them.
“I get business from North Sioux, North Sioux gets business from me, and if you close us down we are all going to die - done - we’ll have to find another job,” said Perry Antonopoulos, owner of Harvey’s, a restaurant at 5307 Military Road.
No solution to the dilemma posed by the need for this bridge and road work is perfect because businesses will be affected one way or another, but a 10-month option on the table in which one side of the bridge would remain open while the other side would undergo work strikes us as a potential compromise acceptable to both sides.
We do not wish to see either Sioux City businesses or North Sioux City businesses connected to Sioux City by Military Road close as a result of this work. Even though affected North Sioux City businesses are located in another city and state, consideration within Sioux City government of their concerns speaks to the spirit of tri-state cooperation that is a hallmark of this metro region.
Even though the 10-month option for this project would increase cost of construction from $2.6 million for the five-month plan to $3.1 million, we believe it’s at least worth strong consideration by the City Council.
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