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University Avenue work to resume soon in Cedar Falls

CEDAR FALLS — City officials believe they’re about to enter the final turn and head down the homestretch of the University Avenue project.

They’ll detail the construction schedule at a public information meeting from 5 to 7 p.m. Thursday in the cafeteria at Peet Junior High School, 525 E. Seerley Blvd.

Community Development Director Stephanie Houk Sheetz said the meeting is expected to last about 20 minutes.

“But really, it’s to be available for one-on-one questions about, ‘What’s happening with my driveway?’ Or, ‘I’m concerned about this.’”

City staff and engineering consultants Foth Infrastructure & Environment, headquartered in Wisconsin with offices in Des Moines, will be on hand to answer questions.

Construction is anticipated to resume about March 19, Sheetz said. The project’s third and final phase is generally between Grove and Main streets under the Iowa Highway 58 interchange, including a double roundabout at that interchange.

That work would get underway while work continues on the second half of the project’s second phase between Veralta Drive and Waterloo Road. Some additional work also remains around a new roundabout at University and Cedar Heights Drive.

The third phase of University reconstruction is the shortest stretch in terms of road miles, officials said. It would be constructed in two phases, the north half first. University will remain open with one lane of travel in each direction throughout construction.

Some work would be required on the Highway 58 on- and off-ramps to accommodate the double roundabout, staff said. The northbound exit ramp from Highway 58 would remain open throughout construction. It is hoped that will accommodate businesses in the area and provide motorists an alternative to detouring onto Greenhill Road and South Main Street to get to College Square mall.

The Highway 58 on-and off-ramps on the north side of University will be closed during the first part of construction, though the highway will remain open to through traffic. To access University Avenue from southbound 58, traffic coming from the northern part of Cedar Falls would be detoured off 58 to Waterloo Road, which could take drivers to the College Square area.

When construction shifts to the southern portion of the road, the 58 on- and off-ramps on the north side of University would be open but the southbound on-ramp from University onto 58 will close.

The third phase of University would be coordinated with the second phase of the ongoing Dry Run Creek sanitary sewer project, building a new, larger sewer serving most of the southern part of the city.

Peterson Contractors Inc. of Reinbeck is the general contractor for both the second and third phases of the work.

'Shape of Water' triumphs at an Oscars full of change

LOS ANGELES — Against all odds, love won out at the 90th Academy Awards.

Guillermo del Toro's lavish, romantic monster fable "The Shape of Water" swam away with best picture at an Oscar ceremony flooded by a sense of a change for a movie business confronting the post-Harvey Weinstein era.

The ceremony, held Sunday at the Dolby Theatre in Los Angeles, exorcised some demons — like last year's envelope fiasco — and wrestled with other, deeper problems in Hollywood, like gender equality and diversity.

"The Shape of Water," which came in with 13 nods, took a leading four awards, including best production design, best score and best director for del Toro. He became the third Mexican-born filmmaker to win the award, joining his friends and countrymen Alejandro Inarritu and Alfonso Cuaron — who once were dubbed "the Three Amigos."

"The greatest thing that art does, and that our industry does, is erase the lines in the sand," said del Toro.

Jordan Peele won for his script to his horror sensation "Get Out," becoming the first African-American to win for best original screenplay. Peele said he stopped writing it "20 times," skeptical that it would ever get made.

"But I kept coming back to it because I knew if someone would let me make this movie, that people would hear it and people would see it," Peele said. "So I want to dedicate this to all the people who raised my voice and let me make this movie."

In a year lacking a clear front-runner the awards were spread around. Christopher Nolan's World War II epic "Dunkirk" landed three awards, all for its technical craft: editing, sound editing and sound design.

Things went expected in the acting categories, where Frances McDormand won her second Oscar for her performance in "Three Billboards Outside Ebbing, Missouri." McDormand asked all the attending female nominees stand up in the theater.

"Look around, ladies and gentlemen, because we all have stories to tell and projects that need financing," McDormand declared. "I have two words to leave with you tonight, ladies and gentlemen, Inclusion Rider."

Subbing for last year's best-actor winner, Casey Affleck, in presenting the best-actress award were Jodie Foster and Jennifer Lawrence. "It's a new day in Hollywood," Lawrence said.

Three widely admired veteran actors won their first Oscars. Gary Oldman won for his Winston Churchill in "Darkest Hour," Allison Janney ("I, Tonya") took best supporting actress, and Sam Rockwell ("Three Billboards") won best supporting actor. Oldman thanked his "99-years young" mother. "Put the kettle on," he told her. "I'm bringing Oscar home."

But many of the show's most powerful moments came in between the awards. Ashley Judd, Anabella Sciorra and Salma Hayek — who all made allegations of sexual misconduct against Weinstein — together assembled for a mid-show segment dedicated to the #MeToo movement that has followed the downfall of Weinstein, long an Oscar heavyweight. They were met by a standing ovation.

"We work together to make sure the next 90 years empower these limitless possibilities of equality, diversity, inclusion and intersectionality," Judd said. "That's what this year has promised us."

Host Jimmy Kimmel opened with a monologue that mixed Weinstein punchlines with earnest comments about reforming gender equality in Hollywood. And of course, Kimmel — returning to the scene of the flub — dove straight into material about last year's infamous best-picture mix-up.

"I do want to mention, this year, when you hear your name called, don't get up right away," Kimmel said. "Give us a minute."

But while Kimmel spent a few moments on the fiasco known as Envelopegate, he expended far more minutes frankly and soberly discussing the parade of sexual harassment allegations in the wake of the revelations regarding Weinstein. Kimmel cited the industry's poor record for female directors and equal pay.

"We can't let bad behavior slide anymore," said Kimmel. "The world is watching us."

Gesturing to a giant statue on the stage, he praised Oscar, himself for keeping "his hands where you can see them." But Kimmel introduced the broadcast as "a night for positivity," and cited, among other things, the box-office success of "Black Panther" and "Wonder Woman."

"I remember a time when the major studios didn't believe a woman or a minority could open a superhero movie — and the reason I remember that time is because it was March of last year," Kimmel said.

Several cinema legends won their first Oscar. James Ivory, 89, won best adapted screenplay for his script to the coming-of-age drama "Call Me By Your Name," becoming the oldest winner ever. After 14 nominations, revered cinematographer Roger Deakins finally won for his photography on "Blade Runner 2049." In the category, Rachel Morrison ("Mudbound") became the first woman nominated for best cinematography.

Pakistan-born comedian Kumail Nanjiani joined Kenyan-born Lupita Nyong'o to salute the so-called Dreamers — immigrants brought to the U.S. illegally as children and here without permanent protection from deportation. "Dreams are the foundation of Hollywood and dreams are the foundation of America. And, so, to all the Dreamers out there, we stand with you," Nanjiani said.

Later, Pixar's colorful ode to Mexican culture "Coco" won best animated film as well as best song for "Remember Me." Best foreign language film went to Chile's "A Fantastic Woman," Sebastian Lelio's drama starring transgender actress Daniela Vega.

"The biggest thank you of all to the people of Mexico," said director Lee Unkrich to loud applause. "Marginalized people deserve to feel like they belong. Representation matters."

Netflix scored its first feature-film Oscar, with best documentary going to "Icarus," Bryan Fogel's investigation into doping in sports, aided by the assistance of Grigory Rodchenkov, the head of the Russian anti-doping laboratory who candidly discussed the doping scheme under Vladimir Putin. Fogel dedicated the award to Rodchenkov, "our fearless whistleblower who now lives in grave danger."

"Darkest Hour" won for best makeup. The period romance "Phantom Thread" won for costume design.

Providers: Medicaid payment changes not sustainable long term

CEDAR RAPIDS — A change in a Medicaid waiver reimbursement system for the state’s special-needs population has left some health providers without enough funding to sustain their services.

Changes to the home- and community-based services waiver — which affects approximately 5,000 Iowans who have traumatic brain injuries, developmental or intellectual disabilities — moved the payment model from a fee-for-service model to a tiered rate system, effective Dec. 1, 2017.

While Iowa Department of Human Services officials say this change will create more stability to the reimbursement system, it leaves some such as Jean Sturtz, who care for those covered by the waiver, concerned for their loved ones’ future.

Sturtz, of Urbana, took over guardianship of her younger brother, Jake Simmons, after the death of their mother. Simmons, who is 55 and has an intellectual disability, receives residential and day habilitation services from local providers who are considering cuts to their services.

Sturtz added that losing his long-term case manager leaves her concerned her brother might struggle to find long-term support in the years to come.

“What if Jake was kicked out, where would he go?” she said.

Instead of receiving a fee for services performed, Iowa’s managed-care organizations and the state now reimburse providers based on a tiered scale administered on a per-member basis.

Tier one is the lesser amount of reimbursement, and tier six the greatest.

Department of Human Services spokesman Matt Highland said in an email there are approximately 423 providers who serve that population.

Medicaid enrollees covered by the waiver were placed in one of these tiers based on his or her level of need.

Highland said the goal of the tiered rates was to stabilize payments to providers by reimbursing more for services to individuals with more-severe disabilities and less to individuals with relatively less-severe disabilities.

“Previously these services were reimbursed using about 5,000 individual rates, exceptions to policy and old county contract rates not necessarily tied to the individuals’ severity of disability,” Highland said in the email. “This was not an effective way to appropriately reimburse providers to meet individuals’ needs.”

But the payments — coupled with client shifts to managed-care organization case management — has been a factor in the closure of Linn County Mental Health and Developmental Disability Services, which shuttered its doors on Thursday.


The new tiered reimbursement rate system implemented in December by the Department of Human Services has resulted in a projected reduction in revenue for departments such as the Linn County agency.

“Linn County, just like any other service provider, lives at the mercy of their reimbursement rates,” Linn County Supervisor Ben Rogers said. “The reimbursement rates we are receiving are so low, the board would have to choose to sustain a program that is losing dollars to the tune of tens of thousands of dollars each month. That’s not something that is sustainable.”

The shift of clients from independent providers to in-house services provided by managed-care organizations also has taken a toll on some case-management organizations.

UnitedHealthcare of the River Valley, one of the state’s managed-care organizations, initially contracted with Linn County for case management while the insurer took on 213,000 members affected by the Dec. 1 exit of AmeriHealth Caritas. AmeriHealth had the largest concentration of special-needs enrollees.

UnitedHealthcare ended its agreement with Linn County — which was signed on an interim basis, said UnitedHealthcare spokesman Jesse Harris — on Feb. 1.

“Those agreements concluded as UnitedHealthcare added approximately 300 new employees to continue to meet the health care needs of our members,” Harris said in an email to The Gazette.

Iowa’s other managed-care insurer, Amerigroup of Iowa, operates with case managers on staff.

With client numbers shrinking and the county’s case-management department struggling to pay the bills, Linn County supervisors were tasked with voting on whether they should retain a few staffers — at a financial loss — to manage the approximately 65 clients still with the department.

In late January, the board voted 4-1, with Supervisor Jim Houser opposed, to not retain any case-management services for Linn County Mental Health and Developmental Disability Services’ clients. The decision took effect March 1.

With that vote, the remaining clients with Linn County case management were shifted to new providers with DHS or Johnson County Mental Health and Disability Service.

Much of the department’s former staff members have found new county positions. Services Coordinator Maggie Beavers will retire this month.

Consistent person

The role of a case manager is to be an advocate for an individual’s needs.

Beavers said some case managers have been with the county as long as 30 years. Beavers herself has been a case manager for about 40 years.

“For a lot of individuals, the case managers have been a consistent person in their life,” Beavers said. “There are a lot of people we work with, a lot of the families that it is very difficult to be looking at making changes to having somebody new.

“It’s not that consistent person anymore.”

It was Jacqueline Hagen, Jake Simmons’s case manager, whom Jean Sturtz said helped her younger brother’s move to a supported living home go smoothly.

Hagen “is very knowledgeable in what she does,” Strutz said. “I think the social workers that are assigned these (clients), it’s invaluable the knowledge that they have. I’m not saying it’s not valuable with privatized case management, but going forward, if someone comes into the middle of something like that, it could have fallen apart.”

No more tiers?

Because of the waiver change, other providers are looking at their own budgets with apprehension.

Under the previous fee-for-service system, the Cedar Rapids-based Linn County Options received $102.32 a day per individual, totaling up to approximately $3,360,500 a year.

Nowadays, Linn County Options Director Jim Fox said his agency is projected to receive $750,000 less in payments this year — a nearly 22 percent decline.

Other area providers have seen a similar shift in payments due to the new system, including Systems Unlimited in Iowa City, which is expecting a $3 million payment decline a year, and the Village Community, the West Branch-based provider that is experiencing a 53 percent cut in its payments.

“It’s been challenging,” said Casey Westhoff, executive director of Systems Unlimited. “We’re trying to minimize any of the impact on those changes, and make adjustments where we can.”

However, Westhoff said cost-cutting initiatives ultimately may come down to more extreme measures.

“We serve people who need 24/7 support. How do we change that?” Westhoff said. “It may force us to consider who we can’t serve.”

Black Hawk County budget set for Tuesday hearing

WATERLOO — A proposed $68 million budget for Black Hawk County government is up for approval this week.

The Board of Supervisors is scheduled to hold a public hearing on the spending plan and property tax rate at 9 a.m. Tuesday in Room 201 of the courthouse, 316 E. Fifth St., in downtown Waterloo.

The proposed budget calls for a $2 million, or 5.4 percent, increase in overall property tax collection for the fiscal year starting July 1.

That boost in taxes is primarily due to a $2 million subsidy of the Country View nursing home, which had been expected to stand on its own financially but has been running operating deficits that exhausted its reserves this year.

While the supervisors have hired a broker and may attempt to sell Country View to a private nursing home firm, county officials believe it’s unlikely any sale would take place before they need to certify next year’s budget.

All other county operations saw a $527,000 increase in tax askings, primarily due to employee raises and health insurance costs. But it’s being offset by the use of $500,000 in cash reserves in the county’s debt service fund.

Under the proposed budget, the urban property tax rate would jump from $6.41 to $6.69 per $1,000 of taxable property value. Property owners in rural Black Hawk County, who do not pay a city tax bill, would see the county’s tax rate increase from $9.62 to $10.19 per $1,000.

The impact of those tax rate changes varies based on the type of property a person owns and whether it is in a city or rural area.

Residential property owners, who saw a state rollback order reduce the portion of their home value available for taxation, will see a smaller tax increase than commercial or agricultural property owners next year.

An urban homeowner would see a 1.92 percent increase in the county’s portion of their overall property tax bill. That’s $7 on a $100,000 home.

That same home in rural Black Hawk County would see its county taxes grow from $548 to $567, or 3.5 percent.

The typical commercial and industrial property would see a 4.3 percent increase in county taxes while an average farm would see a 9.3 percent tax hike based on the proposed tax rates.

The county Board of Supervisors only sets the tax rates for county government, which is typically less than a fifth of the overall tax bill. Cities and school districts collect the largest share of the tax bill and set their own budgets and tax rates.