Des Moines Register. March 7, 2019
Addressing problems with privatized Medicaid should transcend politics
A rose to Democratic state Sens. Liz Mathis of Hiawatha and Amanda Ragan of Mason City for introducing a common-sense bill on Medicaid.
Senate File 156 attempts to address some of the many problems created by the Republican-led experiment of privatizing the $6 billion health insurance program.
The bill would, among other things, return Iowans with complex medical needs to state management, end prior authorization for substance abuse treatment, encourage private insurers receiving billions of public dollars to work toward expanding the health care workforce in Iowa, and make it easier for Iowans to change insurance companies.
Handing over the taxpayer-financed Medicaid to for-profit insurers has caused numerous problems for Iowa patients and care providers. Gov. Kim Reynolds and Republican lawmakers continue to insist that privatization will save money and improve care. Since they are determined to continue with privatization, they should at least support efforts to improve it.
Management of the state’s Medicaid system directly affects the health and well-being of 600,000 poor or disabled Iowans. This is an issue that should transcend politics.
A rose to the Harkin Institute for Public Policy & Citizen Engagement for a planned $8 million expansion at Drake University in Des Moines.
The nonpartisan organization is using private donations to fund a new 16,000-square-foot building near the southwest corner of 28th Street and University Avenue - an area Drake has been working to improve.
The Institute was established in 2013 to conduct public policy research and analysis of issues important to retired U.S. Sen. Tom Harkin. These include labor and employment, the needs of people with disabilities, retirement security and nutrition. The institute focuses on education and outreach with the help of six full-time employees, 15 undergraduate student workers and five research fellows. The institute is good for Drake, Des Moines and all of Iowa.
A thistle to the Iowa Environmental Protection Commission, a name the entity does not deserve. It rejected a proposal from environmental groups to finally get to work cleaning up Iowa’s nearly 160 recreational lakes.
Iowans have stood on the banks of contaminated water after the closure of beaches nearly 200 times over 12 years. Microcystins tied to harmful algae blooms are dangerous to people, pets and livestock. Last year, the city of Greenfield asked residents to use bottled water following a toxic blue-green algae outbreak on a nearby lake that’s used for drinking water. Dozens of Iowa cities and towns rely on at-risk waterways to source drinking water.
The commission’s rationale for rejecting the environmentalists’ proposal: It would cost local governments about $205 million.
Yes, cleaning up Iowa’s filthy and dangerous waterways is going to cost money. And the state could pitch in.
In fact, there would be a big chunk of money for this endeavor if the GOP-controlled Iowa Legislature would finally raise the state sales tax a fraction of a penny to provide money to a conservation and recreation trust fund created by voters nearly a decade ago. The trust does not contain a single penny while our environment continues to deteriorate.
A rose to Kenneth Quinn for being recognized by a British humanitarian organization working to prevent genocide.
Quinn, president of the World Food Prize Foundation, is receiving the Steven Krulis Champion of Humanity Distinguished Service Award in recognition of his contributions to ending Cambodian genocide. The Iowa native is widely recognized as the first person to write about the atrocities of the Khmer Rouge, a violent extremist regime in Cambodia.
“My Iowa values. didn’t allow me to turn my back when people are suffering,” he said. Those same values have led to many other awards and, more important, lives saved around the world.
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Dubuque Telegraph Herald. March 6, 2019.
School nurses, librarians play key role
It sounds positive when state lawmakers talk about giving school districts more flexibility in spending and shifting decision-making toward more local control.
But legislators are tasked with looking out for the greater good for everyone, and there are times that ceding responsibility to lower levels of governance isn’t necessarily in citizens’ best interest.
That’s particularly concerning when the citizens in question are children.
A measure advancing in the Iowa Senate would eliminate the requirement that school districts employ full-time school nurses and librarians.
Bill sponsor Amy Sinclair, R-Allerton, said she brought the legislation forward after hearing from constituents who said, “We don’t need regulations telling us to do what’s best for these kids.”
Giving local government more control is one thing, but this legislation goes a bit far. After all, we certainly do believe that some state regulations about what’s best for kids are necessary. It’s just a question of which ones.
The role of the school librarian has evolved to meet 21st century learning needs, including using technology for research and verifying sources of information. That’s a necessary role in today’s educational model. Librarians continue to be champions for reading and to foster students’ love of it. Ask any young adult who loves to read and they probably have a story about a librarian who helped them along the way. These days, librarians also can help students sort through the information that bombards them and separate the accurate from the fake.
The state mandate on nurses is that the role be filled in the ratio of one nurse per 750 students. Nurses address the needs of students with chronic or short-term illnesses, emotional and physical. With a dramatic increase in the number of students with diabetes alone, requiring a nurse in every district is hardly an overreach.
Supporters say eliminating the requirement would allow smaller districts to contract with individuals to perform those duties rather than employ a full-time nurse or librarian. Perhaps the state needs to consider a modification of the law to help out smaller districts. But a broad-brush removal of the requirement goes too far.
Even if the Legislature decides to move forward with the measure, school districts would be wise to tread cautiously. Yes, budgets are tight, but nurses and librarians continue to play vital roles in schools.
For all the elected officials who list education as a top priority, here is an opportunity to show leadership rather than cede responsibility to school districts and risk losing librarians and nurses in some (most likely the poorest) districts.
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Quad-City Times. March 6, 2019
Preventing outbreaks with wise public policy
If you tuned into the U.S. Senate hearing on vaccines and disease outbreaks on Tuesday, you may have gotten a chill listening to Saad B. Omer. It’s easy to see why.
Omer, a professor of epidemiology at Emory University in Atlanta, testified about national measles outbreaks in Europe, including in Italy, Germany and France.
Those national outbreaks haven’t happened here, and there are several reasons for that. Among them, state laws requiring immunization.
“Our school-level mandates work,” Omer said.
However, Omer also noted that, while contained, there have been regional measles outbreaks in the U.S. that are alarming in their size and frequency.
All 50 states require specified vaccines for students. But in certain pockets of the country, parents are increasingly opting out of vaccinations for their kids, and that has had consequences.
Preliminary figures from the Centers for Disease Control and Prevention say there were 372 measles cases in the U.S. last year and, so far in 2019, there have been 206 reports in 11 states (California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New Jersey, New York, Oregon, Texas and Washington.)
In explaining the increases, the CDC pointed to travelers going abroad and returning home with the disease - and pockets of unvaccinated people.
The state of Washington, the home of a large number of anti-vaccination activists, has seen a significant measles outbreak recently.
Iowa has been fortunate. The state has not had a report of measles since 2011, when there was one case, according to the Department of Public Health.
Still, the thought of what’s happened in Washington state, or worse in Europe, is scary.
We should not take our relative safety for granted. The spread of conspiracies about vaccines, much of it on social media - even in the face of overwhelming medical evidence of their safety - is putting all of us at risk.
We are hopeful the consensus continues to hold in Iowa. It appears a Senate bill introduced this year which would have loosened the religious and medical exemptions already in state law has not moved. We are grateful for that dose of common sense, though we would note that the number of religious exemptions to immunizations for schoolkids in the state tripled to 8,740 over the past 10 years.
Some might balk at the idea of requiring vaccinations, but this country has a long history of acting for the public good in this area. The first state law mandating vaccinations goes back more than 200 years, and the U.S. Supreme Court upheld the right to compel vaccination more than 100 years ago, when the disease at issue was smallpox.
Most states, like Iowa, have medical and/or religious exemptions. But they are not, nor should they be, limitless.
There also is a bill in the Iowa House proposing to end the religious exemption, but that doesn’t appear to be moving, either.
During Tuesday’s hearing we heard some ideas worthy of supporting to counteract the conspiracy theories.
One person advocated we put greater resources into trying to discover the cause of autism. So many theories about vaccines center on the idea that they are linked to autism, which numerous studies have disproved.
We also believe, as was proposed, that the government should lend greater support to public education programs. It is impossible, we think, to eradicate all conspiracy theories, but we believe aggressive education is a tonic for the ills that can be so easily spread over the Internet.
As we noted before, we applaud policy leaders who stand in the way of weakening the reasonable laws that bind us together as a people and serve to protect us from the dangers of this world.
Our country has avoided the kind of outbreaks that have so recently afflicted Europe. But we must be vigilant to protect the steps we have taken that contribute to making it so.
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