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House approves $2 billion budget for health, human services

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Timi Brown-Powers


DES MOINES — A health and human services budget that Democrats called the best they could recall in several years, was approved largely without their support, 54-35, by the Iowa House on Monday.

There were parts of the massive budget Democrats liked.

“As with all bills, there are things that are good, and there are things you may not think are good or you could do a better job on,” Rep. John Forbes, D-Urbandale, said about House File 891.

“My caucus has tried to take a bill and make it better. A lot of amendments we asked for do cost money, and we think we have the ability to fund these priorities if we wanted. Unfortunately, the majority party did not agree.”

Health and Human Services Chairman Joel Fry, R-Osceola, liked many of the Democrats’ proposals but said they should be rejected either because of the cost or because the cost was unknown.

His rough math showed the Democratic amendments would have added at least $76 million to the $2 billion-plus budget that funds the Departments of Aging, Human Services, Public Health and Veterans Affairs.

“It would be very irresponsible to increase the budget in that way without understanding where that money would come from or how we would pay for it in future years,” Fry warned.

The ranking Democrat on the House Appropriations Committee, Rep. Chris Hall, D-Sioux City, pointed out the March Revenue Estimating Conference projected Iowa will increase revenues by more than $300 million in each of the next two years. The federal government will pick up an additional $450 million in Medicaid costs over the coming years.

That’s $1.2 billion in new revenue or dollars made flexible by federal assistance, Hall said.

Some of that money — $15 million — would be well spent to provide funding for children’s mental health services, said Rep. Timi Brown-Powers, D-Waterloo.

“It’s time for this state to actually put our teeth, or better yet, some money, in the policy we all worked very hard to pass for child mental health,” she said.

The Legislature approved the framework for a children’s mental health system but has not funded it, she said. County supervisors say they don’t have adequate funding and if they add children’s services, they may have to cut adult services.

Although Gov. Kim Reynolds and Senate Republicans are proposing a sweeping tax bill that includes the state takeover of mental health funding, Brown-Powers was skeptical it would improve or expand those services without additional funding.

The HHS budget is agreed-to with the Senate, Fry said, but Brown-Powers noted House and Senate Republicans are not in agreement on the tax bill.

In both cases, their amendments were ruled non-germane to the budget bill.

Democrats also offered amendments to:

  • Add nearly $300,000 for county veteran commission offices.
  • Transfer $15 million from DHS to the mental health regions, a proposal by Gov. Kim Reynolds.
  • Increase funding for the state’s three mental health institutes by $3 million.
  • Budget an additional $30 million for Medicaid providers.
  • Institute a $5 million cost adjustment for critical access hospitals.
  • Increase foster family pay an additional $5 per day, with a $1,000 annual retention bonus.
  • Add the language from HF 692 to expand the direct care workforce registry.

In the end, Democrats Forbes, Brown-Powers and Dave Williams of Cedar Falls, voted for HF 891. Two Republicans, Reps. Jon Jacobsen of Council Bluffs and Mark Cisneros of Muscatine, joined Democrats in voting against it.

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