State Capitol Report

April 15, 2024

This will be your final scheduled report for the 2024 legislative session; your next report will be the final session wrap-up. Today is tax day, and as they say in Raising Arizona, "the government do take a bite, don't she?" It is not a coincidence that today you will most likely see the Senate's property tax bill.

We're quickly approaching the end of the 2024 Legislative Session, with only one day left until the scheduled conclusion on April 16th, the 100th Session Day. Come that day, legislators will lose both their per diems and their clerks. Despite the unlikelihood of wrapping up on Tuesday, there's considerable pressure to expedite proceedings, which gives us a decent chance of them wrapping up business by the end of the week or early next week.

In the past two weeks, the House has seen a slowdown in legislative activity, passing only 31 bills. In contrast, the Senate has doubled that, passing 71 bills during the same period. Part of this stems from the House passing a higher number of bills over to the Senate last month; they are simply running out of policy bills as the focus shifts to the budget and taxes.

As we get closer to adjournment, focus remains on finalizing the FY 2025 budget and agreeing on a tax bill (or not agreeing on one and deciding to let the surplus grow until a bigger tax bill can be passed next year). The Senate has made significant progress by sending all of their budget bills to the floor for debate, and the House has been slower about rolling out their budget bills. Both chambers and the Governor still need to confer among themselves to nail down identical numbers they can agree on. 

Confirmations

Last week, the Senate undertook confirmation proceedings for the Governor's appointees to lead state agencies and serve on state boards and commissions. While most appointees received bipartisan support, contentious party-line votes marked confirmations for Douglas Hoisington, Catherine Lucas, and McKenzie Snow. HHS Director Kelly Garcia got near-unanimous approval, with only Democratic Sen. Herman Quirmbach of Ames voting against her confirmation.

Senate confirmations require an affirmative vote of two-thirds of the Senate, or 34 Senators voting in favor. At the end of the day, since Republicans control the Senate 34-16, the majority party has the votes needed to pass any confirmation without support from the minority party. 

Budgets Take Shape

While the House, Senate and Governor make a decision about whether to push a late tax bill through this session, the House and Senate are advancing their own version of the 10 budget bills they will need to pass before adjournment to enact the FY 2025 budget. 

In past years, the chambers split the budgets up and rotated who started each of the budgets. Over the last couple of years, as one party has the trifecta of control, each chamber has created their own set of the budgets rather than go through the arduous process of amending and bouncing bills between the chambers. This year, the Senate has 9 of the 10 budget bills through committee and ready for debate, while the House has several of them in committee but only two ready for debate (transportation & infrastructure). None of the House and Senate bills are identical yet, so negotiations will be intense over the days ahead. 

Before I review details, I wanted to again show the spending allowed and where each chamber and the Governor are with targets. As the Senate moves its target up to meet the House, they will likely be swapping money for policy and tax bills that they want to move. The final decision on spending (or not spending) opioid settlement funds is also tied up in the end of session horse trading. Right now decisions are at the highest levels in leadership.

For those of you wanting to dig into the budget documents, our fabulous intern Chloe has put together a budget bill tracker that shows spreadsheet (if available), non-partisan fiscal staff write-ups called a “NOBA” (if available), and the links to the budget bills, along with their status. We will be updating this as the bills move forward, so save the link. Few items to note:

• The House includes all the Governor’s Medicaid provider rate increases (including occupational therapists, physical therapists, psychologists, community mental health centers, medical supplies, pharmacists) and an additional $2,251,436 for behavioral health rate increases (where that goes is not yet decided). The state share for the psychologist rate adjustment is only $32,832 and the CMHC state share is $276,947.

• The House also has $369,000 to bring in a new PMIC (psychiatric medical institution for children) to the state to address children with complex and aggressive behaviors, including sexualized behaviors.  Some legislators have noted that recent rate increases have not led to more Iowa-based PMICs taking these kids, who are often placed at a higher cost out of state. Others are upset about spending tax dollars on an out-of-state provider.

The spending of opioid settlement funds is still up in the air. SF 2395 is the Senate-passed bill that gives 75% of the funds to HHS and 25% to the Attorney General to spend at their own discretion. The House will amend this bill to create a task force to advise HHS on how to spend the funds and prohibit any spending without legislative approval (so all spending put off at least one more year). The House Amendment (H-8314) has no earmarks.

The advisory committee includes two addiction treatment providers and one opioid addiction specialist. The Senate has been absolutely opposed to an advisory group but may agree to this if HHS is allowed to spend the funds without waiting for legislative approval (since their position has been that HHS and the Attorney General know the system needs best).

Bills of Interest to IPA Members

• HF 2302 - enhancing penalties for health care worker assaults (and adds spitting) has been on the debate list off and on, but never brought up. Democrats have two amendments - 1) to add juvenile detention; and 2) to add sports officials (referees). Neither seem like things that would kill the bill, so not sure why there is a hold up.

• HF 2397 is scheduled for debate today in the Senate; it requires Medicaid coverage for ambulances taking a person to an Access Center.

• HF 2512 finally passed the Senate last week, sending this bill adopting the Social Work Compact to the Governor.

• HF 2515 also passed the Senate and is on its way to the Governor. It prohibits the Board of Behavioral Health and Board of Social Work from requiring supervised clinical experience to include live or recorded direct observation of client interaction and streamlines licensing of out-of-state professionals.

• HF 2586 is the "school safety" bill and provides schools with grants to pay for school resource officers or security firms and allows properly trained school employees to carry firearms at school (concealed only). It passed the Senate, which stripped the grant fund out and left only the arming of teachers. The decision is in the House's hands now.

• HSB 743 is the new prior authorization bill that prohibits Medicaid/MCOs from recouping money from a provider that provided a service after getting prior authorization. This includes a ban on offsets or other forms of collection.  A subcommittee passed it last week, but there has not been a Ways & Means Committee meeting since subcommittee passage. Likely this is on the House's list for budget bill language.

• SF 2251 - expanding postpartum coverage for 12 months (reducing to 215% FPL) passed and is awaiting the Governor's signature.

Your Bill Tracker

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Town Halls & Public Forums

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