What a difference a couple of makes. Global pandemic is not exactly something I anticipated we, as a child advocates, would be writing about. But here it is, and it's certainly put our policy agenda in an larger, scarier, context.
Over the next weeks, we'll aim to keep you updated on how this is playing out for Iowa children and families. Below are COVID-19 updates related to the Iowa legislature and our state's Medicaid and Child Care Assistance programs.
Iowans are facing challenges times. Let's take care of each other. Be well, all.
Anne Discher, executive director
COVID-19: Legislature responds, strengthens Medicaid and child care supports
The Iowa legislature met this Monday, March 16 to pass an emergency appropriations bill and pause the legislative session until April 13. The bill, which passed with bipartisan support, appropriated additional dollars for Medicaid, Hawki, Glenwood and the state hygienics lab. Lawmakers also appropriated funds for the first couple of months of the upcoming fiscal year, which starts July 1, 2020, in case their return to the Capitol is delayed. The bill gave the Governor authority to move money around as needed in the interim to deal with COVID-19. And, finally, the bill waived the requirement for schools to make up the four weeks of school that students will miss because of mandatory school closures.
Here’s some additional state and federal updates related to two important supports for Iowa families: child care and Medicaid.
Of course, all this is putting a strain on families — especially those families with limited resources and families that rely on child care. It’s also straining child care providers. Some child care centers have shut down already. Many are remaining open to ensure that those that need to work (health care professionals, for example) are able to do so.
The Iowa Department of Human Services is already moving on some responses. Current Child Care Assistance billing policies limit absent day billing to four days per month per eligible child. Effective March 9, 2020, DHS will not limit the amount of absence days paid per month. Providers must still follow absence billing policies and only bill absences for times the child was scheduled to be in their care. We understand that state officials are working on other ways to address the current crisis – and we hope they do.
In addition, the federal government is at work on a relief package. We support the recommendations our federal partners have made to Congress and the President. Congress should provide robust flexible emergency funding that does not require a state match to help families and providers address the impacts of COVID-19. Allowable uses of this funding should be based on what providers and parents need in their community, and should at a minimum include:
Direct assistance to programs based on enrollment, not attendance
Payments to programs and workers during COVID-19 related closures, including back-up care
Payments to programs to continue to serve children when parents or caregivers experience an inability to make co-payments or pay tuition
Covering the cost of substitute educators
Purchasing additional supplies or services necessary to keeping centers and homes safe and sanitary and provide necessary training for staff in all relevant languages
States have enormous flexibility to adapt their Medicaid programs to address COVID-19. They can expand eligibility and benefits and take steps to make it easier for people to enroll and stay enrolled. To soften the financial burden, Congress just passed a temporary increase to states’ federal matching assistance percentages (FMAPs). The Families First Coronavirus Response Act includes a temporary 6.2 percentage point FMAP increase, which means the federal government will pay for about 68 percent of Iowa’s Medicaid costs. In addition, the Centers for Medicare and Medicaid Services (CMS) has issued guidance on waivers that states can apply for to get permission to skip steps normally required to enroll people in Medicaid, make it easier for them to stay enrolled and bring more health providers into the program. Yesterday, Iowa DHS announced the state will apply for several of these waivers to help ensure access to critical services during the COVID-19 pandemic. The state seeks to:
Waive co-pays and premiums for Iowa Health and Wellness Plan (IHAWP), Medicaid for Employed People with Disabilities, Hawki and Dental Wellness Plan members
Pause all dis-enrollments for medical assistance programs
Continuous eligibility for adults
Enroll CHIP kids who age out in IHAWP
Equip hospitals to determine presumptive eligibility for categorically eligible members
Provide home-delivered meals for non-waiver members who are homebound
Provide home-delivered meals for waiver members where the waiver does not have meals as an allowable service
Allow additional flexibility for home- and community-based services (HCBS) providers to continue to meet member’s needs throughout the disaster proclamation.
DHS is requesting the waivers be effective March 13, 2020, in alignment with the President’s national emergency proclamation.
These are good steps. Iowa’s Medicaid and human services agencies are short-staffed and dealing with multiple aspects of COVID-19. Many of these actions would simplify their processes and reduce workload. However, it will be critical for the state to expand public awareness, outreach and enrollment assistance to maximize Medicaid’s reach and make sure people can immediately obtain the care they need.
We commend the Department for taking swift action to make it easier to access and maintain health care services during this critical time — and hope for similar efforts for other safety-net programs, which we understand to be forthcoming.
About our safety net
Center staff have spent much of the legislative session arguing for protecting — and where we can, strengthening — our safety net. The last couple of weeks has made even clearly why this is so important. Good health insurance so folks can get the testing and care they need when they're sick. SNAP so when families suddenly find themselves laid off they can still put food on the table. Paid sick leave so they can stay home and take care of themselves and their families when they feel sick.
There’s no good news from this crisis, but we can hope it shifts our priorities away from punitive rules that not only harm individual Iowans, but the health of whole communities. Here's one example: One bill we've been fighting would ban the state from applying for a waiver of SNAP work requirements during economic downturns, natural disasters, and yes, global pandemics.
Federal SNAP rules already limit most working-age adults not raising children to three months of food assistance out of every 36 months unless they are working at least 20 hours a week or otherwise exempt. But states can seek temporary waivers from the time limit for higher-unemployment areas in periods when it is harder to find a job. Since the late 1990s, Iowa has requested a waiver for only three years: 2011 through 2013, the aftermath of the Great Recession. Another recession could well be in the cards — we should not pass up federal help when we need it the most.
Census 2020 It's time to #CountAllKids
2020 is a census year, and much is at stake. Census results not only determine representation in Washington, D.C., but also how federal funding is allocated among states and communities. The 2010 Census missed 2.2 million U.S. children under the age of 5 (10 percent of the young child population). This time around, research shows, the number of parents who may not count these kids could reach 1 in 5, double the share missed ten years ago.
Message research has also identified the top reasons parents and caregivers might not include young children in their Census responses:
Unfamiliarity with how the Census can help their children and households
Lack of understanding about who to include in the household
Personal fears related to immigration status, overcrowded housing and privacy
Help us spread the word to prevent an undercount in Iowa! Talk with parents and caregivers in your circles about the importance of counting every baby and child in the census. Engage your networks and partner organizations to spread the word.
Here are main ideas to share:
Count ALL kids living at your address on Census Day (April 1, 2020) — including babies, nieces, nephews, grandchildren, foster children, and people not related to you (like a friend and their child).
Filling out the Census is important because it helps decide how much money your community will get for schools, child care, health insurance and medical care, early intervention and home-visiting programs, food assistance, foster care, housing assistance and many other important services.
The Census only happens once every 10 years. So, if all the children living at your address aren’t counted in 2020, they will have fewer services for the next decade.
The Census has the strongest confidentiality guarantees in the federal government. By law, the information you share through the Census cannot be released for 72 years.
For additional resources, check out this comprehensive toolkit on the "Count All Kids" campaign from the Annie E. Casey Foundation. It includes helpful resources on messaging, identifying at-risk communities in Iowa, social media posts, fact sheets and outreach tools.
Governor's proposed tax bill flouts constitutional amendment Iowaopoly
Prior to session being postponed, the legislature was considering significant changes to taxes in Iowa. Governor Reynold's proposed tax bill (SSB 3116) is the wrong approach to generating revenue, and many Iowans, especially low-income families, would be hurt. We hope the bill doesn't resurface when the legislature reconvenes — here's why:
The governor's bill would raise Iowa's sales tax to fund water quality and mental health efforts, while simultaneously cutting income taxes for wealthy individuals. This proposal flies in the face of a constitutional amendment passed in 2010 by a large majority that sets aside three-eighths of a cent sales tax increase to fund environmental initiatives. It would change the rules on several fronts, leaving promises made to Iowans a decade ago only half-kept.
Funding things Iowans value — mental health, water quality, parks and trails, education, health care — shouldn't be a zero-sum game. A decade later, we need a tax plan that remains true to that vision.
On the podcast. In our latest podcast episode, Anne talks with Peter Fisher from Iowa Policy Project in Iowa City about the governor's tax proposal, including what it means for Iowa and better alternatives legislators should consider.
Not sure who represents you? With 50 senators and 100 representatives, it can be hard to keep tabs. Visit our Legislator Lookup tool to find out who represents you in the state house and senate, biographical information about each one and a link to their legislative websites, which list contact information and committee membership. All you need to do is enter your home address and zip code.
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