Category: View Point

ViewPoint: Repeal of Iowa law Could Threaten Access to Health Care

By Mike Riege, Administrator, Virginia Gay Hospital and Clinics
Iowa has one of the highest quality, lowest cost health care systems in the United States. And at the heart of that system are 118 community hospitals that stand ready, every day and every night, to serve everyone, regardless of their ability to pay. A move is underway in Des Moines to change an Iowa law, the Certificate Of Need legislation, that we think might threaten rural health care. The law, enacted in 1977, was designed to avoid duplication of medical services to keep costs down for patients. In Iowa this law, requiring approval of new facilities costing $1.5 Million or more, has worked very well.
Critics of the law are now saying it “stifles competition” and eliminating the law would lead to private investment in new medical facilities providing more choices, and therefore, lower costs. We think those critics fail to understand the realities of living in rural Iowa.
What’s most important for rural communities isn’t the opportunity to go shopping for doctors or surgeries like critics imagine, it is an emergency department close-by and staffed to respond when needed. What’s important is a relationship with a primary care provider and access to the technology needed to provide for your health. What’s at stake is the future of rural Iowa and the health of rural Iowans.
The new facilities built without oversight won’t be located in small towns. They will be in urban communities and using their services will require rural patients to travel, which is especially difficult for the elderly and those of lesser means. What we fear is what has already happened in states where Certificate Of Need requirements have been repealed; the small number of patients hospitals in rural communities lose will spell the difference between keeping the doors open or closing them for good.
This might be an acceptable economic or medical outcome if our small hospitals provided services at inflated costs, or if patient outcomes failed to be at the same level of quality as larger hospitals. The data says, and our patients agree; we provide high quality services at comparable or lower costs.
There is one additional factor to consider. Community hospitals are an engine of economic growth. Virginia Gay Hospital provides employment for more than 200 people and has a total economic impact to the communities we serve estimated at $37 Million, and generates retail sales of $4 Million. Those retail sales in turn generate $240,000 in sales tax revenue to help support our state, our communities and our schools.
Requiring a Certificate Of Need before constructing new medical facilities is a proven, fair, and reasoned process of approving medical expansions based on patient need rather than on marketing hype. If you are concerned that repealing the Certificate Of Need requirement might jeopardize your access to health care, let your state legislators know how you feel.

ViewPoint: District 72 Update – January 25, 2017

By Dean Fisher
We are now finishing up our second week in session. Bills are being filed and committee work is underway. Here is a brief look at some of the bills beginning to work their way through the legislative process:
House Joint Resolution – Right To Hunt, Fish, and Trap: This bill seeks to amend the Iowa Constitution to not only guarantee our right to engage in these sports, but also to use traditional methods into the future. As the population continues to shift to urban areas the necessity for this amendment increases. The amendment language is similar to what has passed recently in several other Midwestern states.
House File 29 – Shared Operational Functions: This bill was suggested by school superintendents in my district. It deals with continuing a program of financial incentives to smaller school districts to share personnel in several functions such as school counselor, curriculum director, superintendent, business management, etc.. For example, two school districts might share a school counselor to save on salary expense, this program provides additional funds to both districts for that sharing. This bill adds principal to the list of shared functions, and it removes the 2019 sunset provision so that our smaller school districts can continue to benefit from this program.
House File 16 – Supervision of Apprentice Electricians: This is a bill requested by electrical contractors in my district. An apprentice must work for four years before they can become a Journeyman Electrician. Current law requires that apprentice to have a supervising electrician at the job site 100% of the time. This requirement places an undue burden on our rural and small town electricians. For example, the supervisor, typically the business owner, can’t legally leave the job site to answer a furnace repair call and let the apprentice continue performing routine tasks while the supervisor is away. This bill reduces the requirement from 100% to 25% of the day, giving the contractors flexibility and, ultimately, reducing cost to the customers.
House File 1 – Five Year Program Review and Repeal: This bill, sponsored by the House leadership, requires that all current and future programs implemented by the legislature be subject to automatic repeal over a period of five years, based on a staggered schedule. All future programs, whether new or reauthorized, would also be subject to the five year review and repeal. This is to ensure that each program created by the legislature continues to remain effective and efficient. The schedule of review will be set by legislation from the State Government Committee.
House File 28 – High School Financial Literacy: This bill requires high schools to teach financial literacy courses that promote important skills and concepts for adult life like money management, college planning, savings and investments, credit and debt, and insurance coverage. One example of the benefits of teaching financial literacy can be found at the University of Northern Iowa, where such a course has been credited with lowering the student debt levels.
House Joint Resolution 1 – Electronic Communications Protection: This bill seeks to amend the Iowa Constitution so that the privacy of Iowans electronic communications is protected from search and seizure unless a search warrant is issued.
As always, please feel free to contact me by calling 641-750-3594, or via email at dean.fisher@legis.iowa.gov.

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