On Tuesday evening, Governor Reynolds broke with long-standing tradition and delivered an evening Condition of the State Address, which was carried live across the state. She used her annual address to thank healthcare workers, including IMS President-Elect Tiffani Milless, MD, and Secretary/Treasurer Jessica Zuzga-Reed, MD, who were invited to attend the address as guests of the governor.
The Condition of the State Address and the accompanying release of the governor’s budget recommendations are Governor Reynold’s opportunity to outline her policy and budget priorities for the session. Of interest to the medical community, these included the following:
Governor Reynolds renewed her long-standing support for tort reform efforts, highlighting in her policy priorities the need for passage of a hard cap on noneconomic damages this session. She noted the alarming, ongoing trend of high-dollar malpractice claims and the long-term implications limitless claims will have on the state’s ability to maintain healthcare access. Over the past year, IMS has been working with the Governor’s Office and legislative leadership to expand support for passage of this critical reform this session and partner on educating new members about the need for this reform.
Expanded Broadband Access
One of the governor’s biggest proposals of the evening was a three-year, $450 million push to expand statewide access to affordable, reliable broadband. The governor noted that despite recent efforts to expand availability, a third of Iowa counties are still classified as broadband deserts and statewide broadband speeds are ranked second slowest in the nation. The COVID-19 pandemic has brought renewed focus to the implications of limited broadband access, including the ability to further expand comprehensive telehealth services across the state. In her address, the governor highlighted last year’s IMS-authored legislation, which established a regulatory framework for the provision of behavioral health services via telehealth in a school-based setting, as just one example of the potential for telehealth to expand access to care.
Health Care Centers of Excellence
In her address, the governor applauded how the healthcare system came together to work in a regional manner across systems and clinics responding to the COVID-19 pandemic. In her budget and policy priorities, she proposed utilizing this as a model for rethinking care delivery long-term. The governor is proposing $1 million in FY 2022 to pilot two Health Care Centers of Excellence to test regional care delivery models with the goal of better integrating care delivery, especially for rural communities. The two communities to host these centers would be required to match the state’s $500,000 grants and include in their proposals a five-year sustainability plan. Additional details on this proposal are expected to be released soon.
Increased Mental Health Funding
Governor Reynolds is also proposing increased funding for the state’s mental health systems as a priority focus this session. The state continues to move forward with the Complex Needs behavioral health reforms and the establishment of a Children’s Mental Health System, which were enacted by the legislature in 2018 and 2019 respectively. The governor is proposing to build upon the $40 million in CARES Act funding she allocated to support these reforms and this new system in the current fiscal year, with an additional $15 million in new state funding in FY 2022 and an additional $15 million in new state funding in FY 2023.
Physician Workforce Funding
The governor is also proposing to increase funding for the state’s medical residency grant program as part of statewide efforts to address physician workforce needs. She’s proposing an additional $200,000 for the Psychiatry Residency Training Program, which would fund additional residency slots and bring the annual funding for this program to $600,000. The governor is also proposing a status quo $1.4 million appropriation for the Rural Physician Loan Repayment Program in each of the next two fiscal years. IMS is working with the Iowa Psychiatric Society and the Iowa Academy of Family Physicians to push for increased funding for this popular program, which provides up to $200,000 in loan repayment to new physicians who agree in a rural area for five years following the completion of their residency.
The Governor’s FY 22-23 budget book and a summary of her 2021 policy priorities is available online. A summary of the Governor's health care policy priorities is available here.