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Graphic - Advocate WEDNESDAY

|MARCH 2, 2016|VOLUME 127| ISSUE 9

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Feds approve Medicaid switch, starting April 1 By Erin Sommers Graphic-Advocate Editor Health care providers and Iowa’s Medicaid recipients now have until April 1 before the state switches the responsibility for running the Medicaid program to three managed care organizations. The Centers for Medicare and Medicaid Services last week pushed the start date back one month to give providers and the managed care companies a little more time to adjust to the switch. Officials also said Iowa had made “significant improvement” in establishing a provider network since December. One more month likely won’t make a big difference for Opportunity Living, where officials said Thursday they are still awaiting answers to most of their questions about the change. The switch may have a significant impact on Opportunity Living, because the Lake City organization provides services to intellectually and physically disabled clientele whose care and treatments are almost exclusively funded through Medicaid. “When you don’t get information, you automatically assume the worst,” Financial Officer Jill Westcott said. One big information gap is what sort of future rates the managed care organizations will pay Opportunity Living. Westcott said she hasn’t gotten those rates, which would take effect July 1, either from state of-

ficials or the managed care groups. Westcott is also waiting to learn if the managed care organizations are going to continuing reimbursing Opportunity Living for a client’s care on a per diem basis – a daily fee that gives Opportunity Living the freedom to adjust services daily as needed – or bill for each type of service separately. The latter is a major deviation from how Opportunity Living and similar care providers have operated for years. Opportunity Living still doesn’t have contracts signed with any of the managed care organizations. “It’s just so very difficult,” CEO David Staver said. “(To) project a future budget, there’s hardly any hard evidence for us to go by.” State Senate Democrats, with a few Republican crossovers, passed a measure last month instructing Gov. Terry Branstad to hold off on implementing the changes. State House leadership have said that bill won’t be heard in that chamber. Branstad, when federal officials announced they would allow the switch in April, said the change would mean better access to doctors. “Here in Iowa, for more than 20 years, portions of our Medicaid population have received managed care,” Branstad said in a statement released on his website Feb. 23. “Now we can work together towards successfully bringing the benefits to all our Medicaid patients. Iowa is ready for a new system that provides access through more doctors and will create a more sustainable Med-

icaid program for taxpayers.” The Des Moines Register, in an article published Feb. 25, noted that other states where Medicaid is now run by managed care companies have begun to record cost increases. In Florida, where at least one of Iowa’s managed care companies also operates, the managed care groups recently requested a 7.7 percent funding increase. The article also noted new proposed federal regulations which would make it harder for states to say no when managed care organizations seek rate increases. State Rep. Mike Sexton, at a meeting Saturday morning in Fort Dodge, said he believes the concerns about the switch have been exaggerated. The managed care companies will make a 2 percent profit on the contracts, Sexton said. “The state of Iowa is holding that 2 percent until the process is done and our people are taken care of,” Sexton said, adding the managed care companies must provide a care that is the same or better quality than clients received when Iowa was managing the Medicaid program. Staver said the governor’s office’s silence on the issues providers have raised creates a feeling among providers that the state is catering to the business interests of the managed care companies while ignoring the medical and physical needs of Medicaid recipients. “We just feel badly for the parents of individuals being served,” Staver said. “They have even less information than we do.”

No change to IUB makeup this legislative session, Sexton says By Erin Sommers Graphic-Advocate Editor The Iowa Legislature won’t be pushing for any changes to the makeup of the Iowa Utilities Board. State Rep. Mike Sexton, who represents a district that includes Rockwell City and Lake City, introduced a bill to expand that board from three to five members. The problem, Sexton said, was that members of the state House committee that would have first heard the bill declined to bring the measure forward. The biggest hurdle, he added, was the price tag associated with the bill. Sexton said he didn’t realize how much the IUB’s three members are paid until he introduced the bill. Board members earn $163,000 annually, with the chairperson receiving another $4,000. “We are looking at any bills (in the House) that increase the state budget,” Sexton said. “Those never made it through the funnel.” Adding two members to the board

would add about $350,000 to the state’s $7 billion budget. Sexton said he isn’t ready to give up on the idea of adding more members to a board, particularly because he has concerns about allowing just three people to decide whether businesses can use eminent domain to seize private property. “I’m going to keep working this summer and keep digging into this,” Sexton said. “Maybe we can cut their wages.” Sexton credited his constituents with pressuring Gov. Terry Branstad to reconsider his stance on the federal tax coupling issue. Typically, Sexton said, Iowa legislators vote to couple, or adopt, the federal tax code. This year, Branstad said he wasn’t going to couple Iowa to the federal tax rules, which would have added about $93 million in taxes, Sexton said. “If we don’t couple, it’s a tax increase on agriculture and small business,” Sexton said. “If we don’t couple, we’re balancing the budget on the backs of these people.” The move seemed to offset some of

Firworks are seen on display during the 2015 Calhoun County Expo. Iowa legislators are moving ahead with a measure that would legalize more fireworks use in the state. GRAPHIC-ADVOCATE PHOTO/ERIN SOMMERS

State Rep. Mike Sexton said Saturday a bill that would legalize fireworks use in Iowa was still alive and progressing through the state Senate. The state House approved the measure last year. Here, fireworks are seen during the 2015 Calhoun County Expo. GRAPHIC-ADVOCATE PHOTO/ ERIN SOMMERS

the commercial property tax credits Branstad instituted, Sexton said. Sexton, in his weekly email to constituents, urged people to call Branstad and legislators to express their support for coupling. “(That) convinced him this is a big deal for us,” Sexton said. A meeting attendee asked what Branstad’s motivation was for the move. “His motivation is $93 million,” Sexton said. “He needs $93 million to do supplemental state aid at 2.45 percent. To get to 2.45 percent, he needs that $93 million.” The legislature is making progress toward legalizing more fireworks. Sexton said the bill is written to still allow cities and counties the authority to limit or ban fireworks use. Though opponents of fireworks legalization often cite worries about injuries resulting from using the explosives, “there’s a whole list of things that are a lot more dangerous than fireworks,” Sexton said. The House passed the bill last year. The Senate passed it out of a committee last month, Sexton said.

Main Street in Lake City is seen Friday. A business development specialist spoke with Lake City Betterment Association members Thursday to talk about how to promote their businesses. GRAPHIC-ADVOCATE PHOTO/TONI VENTEICHER

State development specialist talks marketing with Lake City businesses By Erin Sommers Graphic-Advocate Editor Small town businesses should stop waiting for the customers to come to them and work to find out what customers are leaving town to buy, a business development specialist said Thursday. Jim Thompson, who works for the Iowa Economic Development Authority, said he sometimes hears from business owners who think they can just open their doors in the morning – or worse, with severely limited hours if the owner is running the shop as a hobby business – and customers should just walk in. “We earn our customers one at a time,” Thompson said. A good first step for Lake City, where the Betterment Association has been working with Thompson and Main Street Iowa, a program within the development authority, would be an online survey, distributed through social media and with a link on any electronic documents city residents get, such as bank statements, that gathers information about residents’ shopping habits. The responses might show products that town residents say they just can’t find in town but they would buy if the items were available, Thompson said. Or, the responses may reveal that residents don’t know what products are available, and business owners can then do a better job of spreading that information to the community. “People spend money the way they like to, and sometimes the way they need to,” Thompson said. “We have to make sure our businesses are meeting those needs. They’re still

going to spend the same amount of money. We have to help them determine where they’re going to spend it.” Thompson works with city councils across the state that also struggle with being able to grant businesses’ requests, when those requests violate city codes. Take adding vertical signs or flags in front of businesses, Thompson said. Many city codes prohibit those signs, but Thompson said if those rules can be changed, the signs create an environment that encourages shoppers to walk from store to store in a downtown area. Vertical signage mimics the signs seen in malls, for example, so having that type of signs in place essentially turns the downtown business district into an outdoor mall. Thompson also encouraged businesses to find activities they could do to bring people into nonretail businesses. He told the story of a town that had a walking health clinic, in which attendees visited insurance offices for blood pressure checks. If someone already has insurance, they’re not likely to walk into a new insurance office, so this type of event brings new, potential customers through the front door. From there, he said, it’s the business owner’s job to convert that visitor into a customer. Thompson also encouraged more creative thinking about business design and location. More space inside of a store doesn’t equal more sales, he said. One small Iowa town has a store housing five unique businesses. The owners created a business plan that includes a rotating schedule for store coverage. The businesses are individually doing well, Thompson said, better than if they each had

their own store. The economic downtur n that plagued the east and west coasts never hit Iowa as hard, Thompson said. “If you go into the metro (Des Moines), the economy is alive and well,” he said, adding developers can’t build townhouses fast enough for demand there. In rural Iowa, communities don’t need to create big subdivisions – they can convert the upper f loors of downtown buildings into apartments. Thompson said people 55 and older are clamoring for those types of dwellings, and creating them brings the added bonus of freeing up housing for young families looking to buy in small towns, where inventory is often limited. W hile business ow ners may struggle with technological shifts, not all new technology trends are a problem, Thompson said. While business owners may be frustrated to see a shopper with a smart phone out checking online prices, Thompson said people who use their mobile devices in store are 6 percent more likely to make a purchase. He left the business owners with a few suggestions for new businesses a town such as Lake City could support, and that might bring a few new people to town or keep shoppers here. Easy restaurant additions would be a Chinese or Mexican restaurant. The wine and painting events are “huge” at the moment, and something the town could host. And businesses may also want to consider mobile versions of the shops. Thompson said he’s seen food trucks, which people are familiar with, and wedding dress trucks, which travel from wedding expo to bridal show.

State’s top court denies Trott’s Diocese request for conviction review announces who testified at the trial. Those of- parish changes By Erin Sommers Graphic-Advocate Editor

The Iowa Supreme Court denied last week Corey Trott’s appeal of his 2015 conviction in the shooting death of Rockwell City Police Officer Jamie Buenting. Trott shot Buenting in September 2013 in Rockwell City. Calhoun County Attorney Tina Meth Farrington said the court’s decision was “absolutely” a relief for her and law enforcement officers. Trott’s attorney argued his rights were violated by officers asking him, more than once, if he wanted to make statements. One of those times, Trott consented to be questioned and talked about the shooting. His comments were admitted as evidence in his trial. Buenting’s mother, Janet Sterrett, said she was grateful to see the criminal justice system work. She thanked the law enforcement agents who investigated the shooting and

ficers did their jobs correctly, which allowed the case to be presented as it needed to be, she said. “We’re just very, very proud of the justice system,” Sterrett said Friday. Though she was confident Trott’s conviction would be upheld, “there’s always that one ounce that says we can’t be 100 percent (sure). We can be 99.9 percent. We have to wait for that final yes or no.” Sterrett and several family members attended a December hearing before the Iowa Court of Appeals, which ruled just weeks later that Trott’s rights had not been violated. Sterrett said family members wanted to attend that hearing to represent Buenting. Now, more than two years since Buenting was killed, Sterrett said she is also thankful for all of the community support she has received. “It seems no matter where we go, someone’s got a kind story about Jamie,” she said. “Don’t ever stop telling stories about Jamie.”

Demographic shifts and declining church membership in some rural areas prompted the Diocese of Sioux City to announce a number of changes to parishes, including parish clusters in Calhoun County. Maps provided by the Diocese show the Lohrville and Pomeroy parishes will become oratory parishes, starting in 2017, if the plan proceeds. Two parish clusters in the county will shift, with Lake City, Rockwell City and Lohrville joining together, while Manson and Pomeroy will join with Fonda and Varina. Diocese officials announced the changes Thursday. The Graphic-Advocate will update this story as more information becomes available.


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