IMS federal advocacy is closely linked with that of the AMA, which retains an army of federal staff to advocate on behalf of American physicians. There are times, however, where Iowa physicians may disagree with an AMA position or an issue uniquely impacts the practice of medicine in our state. In those moments, it is critical that Iowa physicians have established relationships with Iowa’s Congressional Delegation and federal Executive Branch Agencies.
In 2018, the IMS Board of Directors recognized the importance of establishing a broader, more sustained federal presence with the formation of the IMS Federal Policy Council. Comprised of the eight members of the Iowa AMA Delegation, this group draws upon the federal experience and close working relationships its members have honed after years of participating in federal policy discussions at the AMA House of Delegates.
This group meets once a year in conjunction with the AMA’s fall Interim Meeting to formalize recommendations to the IMS Board of Directors for federal policy priorities for the coming year. The group also consults on an ad hoc basis throughout the year as issues arise to help guide IMS federal advocacy efforts. In February of each year, a group of IMS physician leaders and staff travel to Washington, DC, to participate in the AMA’s National Advocacy Conference. This annual event is an opportunity for Iowa physicians to carry the IMS Federal Priorities to members of our congressional delegation and to learn the latest updates from the AMA’s federal advocacy staff.
The IMS Federal Policy Council met on November 14 to formalize recommendations for the 2022 IMS Federal Policy Priorities. These recommendations will now go to the IMS Board of Directors for approval at their December 16 meeting.
The COVID-19 pandemic continues to challenge Iowa practices. Federal action provided much-needed financial support to help offset reduced clinic volume and mandatory clinic shutdowns, and to ensure regulatory flexibilities to help physicians adapt to the changing practice environment. With the pandemic still unfolding, practices continue to need flexibility to appropriately respond. In 2022, IMS will work with our federal partners to critically evaluate temporary policy flexibilities to determine where it is appropriate to make temporary policies permanent. Recognizing the ongoing financial strain practices have sustained as a result of the pandemic, IMS will push our federal partners to forgive provider payment advances and for additional time to repay payment advances where forgiveness is not possible.
Addressing Medicare Payment Geographic Disparity
For nearly 30 years, IMS has fought to correct the geographic disparity in Medicare payment rates as a result of the geographic practice cost index (GPCI) calculations. The temporary 1.0 Physician Wage GPCI floor, which expires December 31, 2023, protects physicians in rural states like Iowa from inappropriate payment adjustments that would further reduce payments to Iowa practices by more than $69 million a year. In 2022, IMS will continue to pursue a long-term solution to this problem including addressing the flawed data sources used in these calculations, making permanent the protections of the GPCI floors, and thinking creatively about new payment models that accurately reimburse for the quality of care delivered to Medicare members.
Expanding Physician Workforce
Over the past year and a half, IMS has led a large coalition of stakeholders who helped author the Iowa Rural Healthcare Workforce Strategic Action Plan – our state’s first-ever comprehensive, coordinated strategic plan to address the provider workforce shortage. In 2022, IMS will push for federal action to implement the policy elements of this action plan. These include expansion of recruitment initiatives like the Conrad 30 program, which waives the Visa waiting period for international students who attend an American medical school and agree to practice in workforce shortage areas. This also includes addressing the limitations on funding for graduate medical education (GME) to help increase the availability of sustainable residency positions in our state.
Increasing Rural Access to Case
The rapid, widespread expansion of telehealth services during the COVID-19 pandemic has helped increase access to care and demonstrated the potential for greater technological solutions to rural access and workforce shortage concerns. Temporary measures, including coverage for audio-only telehealth and easing of site restrictions during the public health emergency (PHE) helped unleash the rapid expansion of telehealth services. In 2022, IMS will continue pushing to make permanent those temporary measures that have proven so critical during the PHE and for congressional action to ensure telehealth payment parity for ERISA-governed commercial insurance plans. IMS will work with our federal partners to ensure strategic allocation of newly-authorized funding to sustain broadband expansions, which will help foster greater telehealth utilization, and support improvements to other rural infrastructure including EHR upgrades to improve integration and functionality.
For more information on IMS federal advocacy efforts, please contact Dennis Tibben with the IMS Center for Physician Advocacy.
The Iowa Medical Society Foundation (IMSF) is the giving arm of the Iowa Medical Society (IMS). The foundation is a voluntarily organization that uses contributions from physicians and friends of medicine to carry out its mission to inspire, facilitate, and expand the educational and philanthropic endeavors of IMS – ultimately supporting more than 6,000 physicians, residents, and medical students throughout the state.
Through support of the IMSF, Iowa physicians have access to a variety of professional development and leadership opportunities, such as the Physician Business Leadership Certificate Program, a collaborative program designed to help physicians gain knowledge, skills, and tools to become successful leaders in today’s complex healthcare environment. In addition to supporting the program as a whole, IMSF provides direct scholarships for a number of physician participants each year.
IMSF is also a key sponsor of IMS’ expansive offering of education events, conferences, trainings, and meetings. The robust burnout and physician wellness programming, inclusive of the Awareness and Professional Residency programming with Tammy Rogers, the Recognize, Recover, Rebuild programming with Dr. Charles Keller, and the Crucial Conversations FOCUSED workshop, are made possible through IMSF support. Continued support will be crucial to the next generations of educational programming from CANDOR to diversity, equity, and inclusion
As Iowa physicians have responded to the COVID-19 pandemic, navigating the complex and rapidly-evolving public health emergency, the IMSF has been there to help stand up real-time resources - launching business resources for clinics facing temporary closure and staff layoff, preparing public health communications and clinical guidance resources, and the weekly then monthly COVID-19 Quick Connect webinars to keep Iowa physicians in the know with the latest information as it was known.
Supporting the next generations of physicians is a core function and goal of the foundation. Each year, IMSF purchases the white coats worn by incoming medical students and awards a number of scholarships to Iowa students attending medical school at Des Moines University College of Osteopathic Medicine and the University of Iowa Carver College of Medicine. These scholarships provide funding support to Iowa medical students throughout their medical education experiences both here at home and globally through international health study rotations.
IMSF and the incredible work it supports is made possible through the generosity of physician partners, just like you, who want to invest in the future of their profession and in their peers. The need and desire to lift each other up and to champion physicians has never been greater than after enduring two years of pandemic, political, and personal pressures. Recent data shows that people are highly motivated to give in 2021, and are giving more in response to needs in their community and for causes they care about.
This year, IMSF is participating in GivingTuesday, a global day of generosity that will take place on November 30, 2021. If you support the work of IMSF, please consider contributing to IMSF. All donations to IMSF are tax-deductible and are made easy through our online donation page.
Donate today. Support tomorrow.
For more information on IMSF contributions or to get involved, contact Kady Reese at IMS.
Established in 2014, the IMS Policy Forum replaced the IMS House of Delegates as the primary policy-setting body for the Iowa Medical Society. This model is designed to ensure a more transparent and inclusive model for IMS members to call for organizational action. This model offers multiple opportunities for members to provide input in-person during live Policy Forum meetings; electronically via online discussion boards or submitted video testimony; and anonymously via secure email submissions.
Since transitioning to the Policy Forum model, IMS has seen record member engagement and members have seen results. In 2018, the governor signed into law telehealth commercial coverage parity legislation, which was a direct result of PRS 17-2-04 – a Policy Forum submission from a group of University of Iowa medical students and physicians calling for such action.
Policy Request Statements (PRS) are the formal requests submitted for consideration during the Policy Forum process. A PRS may seek to do any of the following:
A PRS may be submitted at any time throughout the year, however, it will only be considered during the official Policy Forum periods each spring and fall. A sample PRS is available to guide authors in development of their requests. Staff and Board Liaisons are also available to assist in developing the strongest possible request for consideration.
The official “Call for Action” period begins seven weeks prior to each scheduled Policy Forum meeting and lasts for two weeks. During this time, members are invited to submit their ideas for a Policy Request Statement. Individuals interested submitting an idea should contact staff to begin the process. The Policy Forum Speaker will assign a Board Liaison to each PRS author, based upon the content of the request and individual board members’ areas of expertise. Board Liaisons and staff will work with the PRS author during this phase to develop the strongest Policy Request Statement possible.
The second phase is the Testimony Forum, which begins five weeks prior to each scheduled Policy Forum meeting. PRSs received during the Call for Action period are published on a secure page of the IMS website. Members have two weeks from the opening of the Testimony Forum phase to contribute testimony via members-only discussions on the IMS website or submit feedback privately via email. Members may also submit video testimony to be shared on the Testimony Forum discussion boards or at the Policy Forum meeting.
The final phase is the Policy Forum meeting. At the meeting, all PRSs and accompanying Testimony Forum comments are considered by the Policy Forum. All IMS members are invited to attend the Policy Forum to engage in discussion and offer testimony, either live or via video, regarding the PRSs under consideration. Authors are invited to present their PRS to the Policy Forum members either live or via video, and answer members’ questions about their request. Following the Public portion of this meeting, the Policy Forum members will convene in closed session to deliberate on each PRS and take action. PRS authors are notified of the Policy Forum’s decision following the meeting.
While Policy Forums must be held at least once a year, they are regularly scheduled to be held once in the spring in conjunction with the Presidential Installation and again in the Fall. In addition, special sessions of the Policy Forum may be called as needed.
The Policy Forum may take the following actions with a Policy Request Statement:
Recognizing the sensitive nature of some Policy Request Statements and the possibility that a member may not feel comfortable publicly raising an issue for consideration, in 2020 the IMS Board of Directors approved the development of an anonymous Policy Forum submission process. PRS authors wishing to anonymously submit an issue for consideration may select to have an IMS Board member or an IMS staff member serve as their public proxy during the Policy Forum process. Based upon the member’s preference, the Policy Forum Speaker will assign a board member or staff member to work privately with the author to develop his or her PRS. Staff proxies will coordinate with the Board Liaison assigned to that Policy Request Statement. Board proxies will also serve as the PRS Board Liaison.
In 2020, the IMS Board of Directors approved the designation of Board Liaisons to work with PRS authors throughout the Policy Forum process. Board Liaisons are assigned by the Policy Forum Speaker, based individual board members’ areas of expertise and the subject of the individual PRS. The Board Liaison will work with the PRS author to craft the strongest possible request, answer questions about the process, and advocate on the author’s behalf during the Policy Forum’s consideration.
To learn more about the Policy Forum process and submit your ideas for organizational action by visiting the Policy Forum page on the IMS website.
Combatting the growing opioid epidemic has long been a priority of the Iowa Medical Society (IMS). From working to pass the legislation that improved access to naloxone in 2015, the enactment of the Good Samaritan Law protections in overdose situations in 2017, expediting Prescription Drug Monitoring Program (PDMP) dispensed medication reporting and enhancing usability of the PDMP, championing the removal of regulatory burdens to ensure continued access to treatment for incarcerated persons following release, through leading the charge which eliminated Medicaid prior authorization barriers to Medication Assisted Therapy (MAT) in 2019, IMS is committed to ensuring access to prevention and treatment services for all Iowans.
The IMS commitment goes beyond policy and legislative charges. In 2019, IMS hosted an Opioid Summit in Dubuque. This educational event, held in partnership with the Iowa Behavioral Health Association (IBHA), provided a much-needed training opportunity for healthcare providers in an area especially hard hit by opioid use disorder (OUD). IMS has also hosted training events tailored to prevention through education on appropriate prescribing of opioids as recommended by the Centers for Disease Control and Prevention (CDC).
Contrary to common misconceptions, the opioid epidemic of misuse, abuse, and addiction is not simply a “big city problem”. The opioid dilemma in Iowa has unique application as a rural state with eight of the top 10 counties most vulnerable to opioid overdoses rural counties – a situation that has only been exacerbated by the effects of the COVID-19 pandemic.1
Since 2019, IMS has served as a lead consortium member as part of a targeted effort to address OUD in our rural communities. The Rural Communities Opioid Response Program (RCORP) is a multi-year Health Resources and Services Administration (HRSA) initiative aimed at reducing the morbidity and mortality of substance use disorder (SUD), including OUD in high-risk rural communities. Helmed by the Iowa Healthcare Collaborative, a long-time IMS partner, the RCORP initiative utilizes a multi-stakeholder approach to collectively address OUD through evidence-based best practices from prevention through treatment and recovery.
In this work, IMS leads the physician engagement and education efforts to amplify local community readiness to address opioid use/misuse. From this effort, IMS has and will continue to provide:
Through these efforts and more, IMS is equipping healthcare providers with the knowledge, tools, and support they need to address opioid addiction and care for patients who use opioids – from prevention and appropriate prescribing to treatment and long-term recovery.
For more information about IMS’ opioid initiatives, please contact Kady Reese, firstname.lastname@example.org.
1 Iowa Department of Public Health. Bureau of HIV, STD, and Hepatitis. Iowa County-level Vulnerability Assessments for Risk of Opioid Overdoses and Rapid Dissemination of HIV and Hepatitis C. December 2019.
In 2016, the IMS Board of Directors approved the formation of an ad hoc task force to determine how IMS might best support physicians at risk of or currently experiencing professional burnout. Their recommendations, contained in the Steenblock Report, kicked off five years of statewide work to provide individual and organizational burnout and professional wellness resources to physicians and clinicians across our state. The COVID-19 pandemic has only worsened the strain on the healthcare community and is now leading to a concerning explosion of professional burnout. IMS is here to help.
Physician Wellness Resource Page
Following the adoption of the Steenblock Report in the summer of 2017, IMS launched the first of several resource pages, which have evolved over the years to meet the changing needs of the physician community. The current resource page includes an anonymous self-assessment tool to allow individuals to gauge their level of burnout in a secure and private manner. Since early in the pandemic, IMS has operated a second COVID-19 Wellness Page, which included a number of pandemic-specific tools to help support individuals and practices. Many of these resources have been migrated to the newly relaunched Physician Wellness Resource Page so all of our burnout and wellness resources are now available on a single site.
In 2018, IMS hosted the first-ever statewide, multidisciplinary conference on professional burnout. Co-hosted by eleven provider and clinic administration organizations, this conference represented an acknowledgement that burnout impacts all members of the care team and successfully addressing the problem will require buy-in from administrative leadership. The program included sessions on recognizing burnout, critically evaluating clinical systems to improve the culture leading to burnout, and learning new techniques to respond to professional stress. In 2019, IMS partnered with the Iowa Pharmacy Association to bring these valuable resources to more Iowa communities, hosting a series of 13 local wellness programs that connected area clinicians with subject matter experts on burnout and professional wellness.
The COVID-19 pandemic forced a reimagining of our physician wellness programs, with IMS shifting to offering several virtual programs. Recently, IMS was able to resume its in-person programming in a local, small-group format. Working with leadership at a clinic in Northeast Iowa, IMS helped facilitate two evenings of extensive, peer-guided reflection and discussion. These allowed first their physicians and then their advanced practice providers to discuss their individual and collective experiences throughout the pandemic, opportunities for clinic-wide improvement, and new techniques to maintain professional wellness in the face of these ongoing challenges.
The ongoing strain COVID-19 has placed on Iowa physicians has renewed the Iowa Medical Society’s commitment to physician wellness. The IMS Programming Committee and staff are in the process of critically evaluating the resources, programming, and support we offer, with an eye toward identifying additional unmet needs. In 2022, IMS also hopes to build upon the success of our recent local self-evaluation events in Northeast Iowa by making similar opportunities available to more practices across our state. If you have ideas for how IMS can help support you or your clinic, we want to hear from you. Please contact Autumn McGill with IMS for more information on our physician wellness efforts or to share your ideas.
The FDA has amended the Emergency Use Authorizations (EUAs) for both Moderna and Janssen/Johnson & Johnson (J&J) to allow for a single booster doses for both COVID-19 vaccine products.
The Moderna COVID-19 vaccine is authorized for booster dose administration at least six months after completion of primary series for individuals:
The use of a single Janssen/J&J booster dose is authorized for administration at least two months following completion of the primary dose for individuals age 18 years and older.
The EUA amendments also allow for use of any of the available COVID-19 vaccines as a booster dose in heterologous or mix-and-match administration.
The CDC Advisory Committee on Immunization Practices (ACIP) voted unanimously to endorse the booster dose recommendations for Moderna and Janssen/J&J COVID-19 vaccines and will issue additional clinical guidance recommendations to aid in appropriate dosing and administration.
Additional details on the most recent FDA authorizations are available in the FDA News Release.
The COVID-19 pandemic has transformed telehealth utilization here in Iowa and around the country. Thanks to a significant influx of funding, an expansion of coverage, and an easing of long-standing regulatory barriers, more clinics in our state are providing a greater variety of telehealth services than ever before. In this week’s IMS Close-Up, we look at a new IMS project to help support and sustain these telehealth expansions, and how this new work builds upon years of IMS advocacy in this area.
The Telehealth Initiative
This past June, IMS received notification of selection to participate in the second cohort of The Telehealth Initiative (TTI), a program created in collaboration between The Physicians Foundation and the American Medical Association (AMA) to bolster implementation support at the state-level by equipping state medical societies with telehealth programming that can further support physicians and practices in implementation and optimal use of telehealth. Components of TTI participation include:
Through this initiative, IMS will be able to offer greater educational resources to all Iowa practices, as well as targeted technical assistance to a handful of practices looking to expand their telehealth offerings or considering making permanent some of the telehealth services they stood up during the pandemic. In partnership with the AMA, IMS will assess physicians’ experience with telehealth during the pandemic and work to identify additional barriers to sustainable utilization moving forward.
For more information on The Telehealth Initiative and how your clinic can take advantage of these resources and support, please contact Kady Reese with IMS.
Support for expanded telehealth utilization has long been an advocacy priority for the Iowa Medical Society. In 2015, IMS worked in partnership with the Iowa Board of Medicine to stand up Iowa’s first telehealth practice standards, which were based in part upon guidelines from the AMA and other national experts. These board rules were intentionally designed to allow for an evolution of technology and utilization practices, while still ensuring minimum standards for appropriate telehealth services in our state. That same year, IMS successfully pushed for enactment of Medicaid coverage and payment parity to ensure that telehealth services provided to Medicaid patients were covered at the same rate as in-person services.
In 2017, a group of IMS member physicians and medical students submitted a request to the Policy Forum for IMS to pursue commercial telehealth parity legislation the following year. This policy request resulted in a successful 2018 legislative push to enact commercial coverage parity to further extend the policy underpinnings to support greater telehealth utilization. This also marked the beginning of a multi-year push for commercial telehealth payment parity to extend the same payment equity now in place under the Medicaid program.
In 2019, IMS partnered with the Iowa Association of School Boards to craft legislation to enact a regulatory framework to allow for an expansion of behavioral health services delivered via telehealth in a school-based setting. This nontraditional service delivery model represents a larger commitment to creatively approaching both Iowa’s provider workforce shortage and broadband access problems. By building upon the ICN fiber optic network that is connected to every Iowa school and ensuring appropriate safeguards to utilization, this legislation, which took effect in 2020, further expanded the number of sites in rural Iowa that are now able to offer pediatric behavioral health services.
With the onset of COVID-19, IMS worked closely with the Governor’s Office to successfully push for the inclusion of numerous telehealth expansion and flexibility measures, including enactment of temporary full commercial payment parity. IMS also worked with Iowa’s Congressional Delegation and our federal agency partners to push for telehealth policy flexibilities including coverage for audio-only telehealth services and an easing of site restrictions, as well as an expansion of covered services. As Iowa practices demonstrated the true possibility of expanded telehealth services, we also built the case for making permanent several of these temporary measures. This has included two successive years of CMS expansions of permanent telehealth coverage options as part of the Physician Fee Schedule payment rule and legislative action earlier this year to enact full commercial payment parity for behavioral health services delivered via telehealth.
Our advocacy work in support of greater telehealth utilization is not done. IMS is working now with the Iowa Board of Medicine to update their telehealth practice standards to recognize the important role audio-only telehealth can play as a service delivery option. We continue to pursue commercial payment parity for physical health services and we continue to explore options to make permanent the temporary policies and flexibilities that have proven so critical during the pandemic. In addition, IMS is working closely with our federal partners to ensure the billion in new funding to support telehealth infrastructure is awarded in such a manner so as to maximize its impact on telehealth access across our state.
For more information IMS advocacy efforts in support of telehealth, please contact Dennis Tibben with IMS.
The physician leaders of the Iowa Medical Society drive everything we do as an organization. Engagement with organized medicine helps develop both personal and professional leadership skills and IMS offers a host of options to do so. Opportunities extend beyond simply serving on the IMS Board of Directors to also include service as an Iowa representative to the AMA House of Delegates, service on two IMS-affiliated boards, and service on one of nine IMS standing committees.
IMS Elected & Appointed Leadership Roles
IMS Standing Committees
Each of the IMS standing committees focuses on a different aspect of the work of the organization. Appointments and reappointments are made annually by the new IMS President, with meeting frequency and timing varying by committee. For more information about the individual committees, please visit the
IMS Leadership Development Committee
At its September 2021 meeting, the IMS Board of Directors voted to recommend the formation of a new standing IMS Leadership Development Committee. This group is intended in part to replace the IMS Nominating Committee, which annually slates candidates for the elected leadership positions of the organization. It is also charged with providing an ongoing, holistic review of IMS leadership recruitment and selection processes, as well as providing additional opportunities for greater member engagement at every level of the organization.
Committee membership will consist of a representative of each of the nine standing IMS committees, confirmed by the IMS Board of Directors, and the IMS President-Elect as committee chair. Initial appointments to the new Leadership Development Committee will be confirmed at the December Board of Directors meeting. Because transitioning from the Nominating Committee to the Leadership Development Committee will require amending the IMS Bylaws, the Board of Directors voted in September to recommend these bylaws amendments at a special Policy Forum meeting, which will be held in conjunction with the December board meeting to ensure the new committee is seated in time to help slate candidates for the 2022 IMS leadership elections.
Initial 2022 Legislative Priorities
At their September 17 meeting, the IMS Board of Directors voted to approve recommendations from the Committee on Legislation for our initial 2022 Legislative Agenda. These priorities are as follows:
Medical Liability Reform
Combatting Vaccine Hesitancy
Protecting Safe Medical Care
Reducing Administrative Burden
Read the full Initial 2022 Legislative Priorities
These priorities represent the top focus areas for the organization as we prepare for the next legislative session, however, this is by no means an exhaustive list. Each session, IMS engages on hundreds of pieces of legislation to ensure the voice of Iowa physicians is a part of the policy discussions that impact medical practice in our state.
IMS Legislative Planning
Early each fall, the IMS Committee on Legislation meets to establish recommendation to the Board of Directors for the organization’s Legislative Agenda for the coming year. Ideas for these priorities come from a host of source. A member might submit a legislative request through the Policy Forum process, staff flag trends in issues that they hear from member contacts throughout the year, and partner organizations regularly contact IMS to request that we partner to work on a legislative idea.
Regardless of its source, an idea for legislative action follows the same path. Staff review the issues and work to identify potential legislative and non-legislative solutions, including legislation that has been proposed in other states to address the problem. This information is then shared with the IMS Committee on Legislation – a diverse group of physicians from various specialties, practice settings, and areas of the state, as well as representatives from both medical schools. This group finalizes the recommended priorities to the IMS Board of Directors for approval at their September meeting.
Once approved, these initial priorities are shared with the membership, the impacted IMS standing committees that meet throughout the fall, and other key IMS partners for feedback and additional insights. This input is brought back to the Committee on Legislation when it reconvenes in late fall to determine if any refinements or additions should be made to the IMS Legislative Agenda. If adjustments or additional priorities are recommended, these are approved by the IMS Board of Directors at its December meeting.
For more information on the IMS legislative priority development process, to share your thoughts on the initial 2022 Legislative Agenda, or to get more involved in this work, please contact Dennis Tibben with the IMS center for Physician Advocacy.
Through a contract with the Iowa Department of Public Health (IDPH), IMS has worked over the past year to lead a multi-disciplinary workforce project team that included the Iowa Hospital Association, the Iowa Pharmacy Association, and the Iowa Primary Care Association. This group has collaborated to establish a comprehensive statewide strategy to address the workforce barriers in Iowa. This initiative brought together healthcare leaders and stakeholders from the business, payer, and educational communities. It built upon the work initiated in 2018 with the formation of the IMS Physician Workforce Committee and the fall 2019 Physician Workforce Stakeholder Meeting that included many of these same stakeholder groups meeting for the first time across industries for a frank and comprehensive discussion about our state’s provider workforce needs at all levels.
Over the past year, the project team has conducted a series of townhall-style focus groups and surveys to identify needs, barriers, and opportunities, which helped to inform a stakeholder task force that jointly crafted the Iowa Rural Healthcare Workforce Strategic Action Plan – Iowa’s first-ever comprehensive, statewide provider workforce strategic plan. This report has been submitted to IDPH and IMS has been tapped to lead year two of this work, which now pivots to implementation of the recommendations included in the plan.
The Iowa Medical Society is a 501(c)6 non-profit organization. 515 E Locust St. Ste. 400 50309