Health care issues challenging the nation are impacting communities across our state – a shortage of doctors and nurses, rising costs of care, and the need to improve access to services in rural and underserved areas. We have a responsibility to protect the health and well-being of all Iowans. Leveraging our strong public-private partnerships, we will continue to confront these challenges head on.
Governor Reynolds proposes:
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Increasing support for pregnant women and promoting the importance of fatherhood.
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Establishing a Family Medicine Obstetrical Fellowship program to support maternal health services in rural and underserved communities.
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Promoting preventative care by improving access to hormonal contraceptives.
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Providing state employees paid parental leave for the birth or adoption of a child.
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Increasing reimbursement for allowable expenses related to adopting a child.
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Improving the affordability of child care through property tax parity for commercial and in-home providers.
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Supporting post-secondary educational opportunities for foster care students.
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Increasing funding for Regional Centers of Excellence to improve access to medical specialties in rural and underserved communities.
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Limiting liability for medical malpractice cases.
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Ensuring the availability of emergency medical care in rural communities.
MOMS Program – More Options for Maternal Support
In 2020, 85% of women who had an abortion in Iowa were unmarried and 57% were age 20-29. Protecting the unborn means providing care and support for women experiencing an unplanned pregnancy and promoting fatherhood to strengthen all families. Doing so will help foster a strong culture of life in Iowa.
Launched in 2022, MOMS is a statewide program that provides personalized support to pregnant women and stabilization for families. It aims to reduce abortions and improve pregnancy health outcomes, child health and development, and family economic self-sufficiency.
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Increase program funding for a total investment of $2 million.
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Create and maintain a virtual clearinghouse to help pregnant women understand their options and access resources available to support them.
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Establish fatherhood engagement grants for non-profit organizations that assist men with finding jobs, managing child support obligations, accessing health care, understanding child development, enhancing parenting skills, and more.
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Establish a grant program to support organizations that provide mentoring and social and academic support for at-risk male students in elementary, middle, and high school.
Family Medicine OB Fellowship Program
Over the last two decades, more than 40 Iowa hospitals have closed maternity departments, mostly impacting rural communities. Establishing a new state-sponsored obstetrics fellowship for family medicine physicians will help ensure more Iowans will have access to maternal health services nearby.
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Invest $560,000 to fund four one-year obstetrics fellowships for family medicine physicians who commit to practicing in rural and underserved communities for no less than five years upon completion of the program.
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Specialized training will ensure competency in managing pre- and post-natal health care, including for women with complex medical conditions and performing surgical procedures.
Preventative Care
Barriers to access can prevent the regular use of birth control. According to the American College of Obstetricians and Gynecologists, over-the-counter access to hormonal contraception has the potential to decrease unintended pregnancy.
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Allow pharmacists to dispense self-administered hormonal contraceptives to patients 18 years and older without a prescription.
Paid Parental Leave
Currently, state employees utilize the Family Medical Leave Act, or FMLA, to take unpaid time off following the birth or adoption of a child. As an additional benefit to better support our workforce and their families, paid maternity and paternity leave are proposed.
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Provide four weeks paid maternity leave for mothers and one week paid paternity leave for fathers.
Adoption Subsidy Program
Currently, Iowa reimburses adoptive parents for allowable non-recurring legal fees related to the adoption process at a lower rate than other Midwest states. Increasing the reimbursement amount will provide additional support for new families.
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Increase the reimbursement for allowable legal expenses from $500 to $1,000 per adopted child.
Child Care Affordability
The cost of running commercial child care centers are much higher than those of residential options due to additional overhead expenses. Commercial centers are considered commercial property for state property tax purposes, whereas in-home noncommercial child care operations are taxed as residential property. Lowering the tax burden for commercial centers may encourage growth and improve affordability for families.
Educational Access for Students Formerly in Foster Care
According to the National Youth in Transition Database, only 19% of 21-year-olds formerly in foster care in Iowa were enrolled in high school, GED classes, post-secondary classes, or college; 4% reported receiving a vocational certificate/license, associate’s or bachelor’s degree; and 30% had experienced homelessness in the last two years.
Educational attainment is a key factor in long-term financial stability and well-being. The All Iowa Opportunity Scholarship is available for students who age out of Iowa’s foster care system or are adopted after age 16. However, current eligibility requirements may create barriers for some students.
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Change the statutory provision that requires foster care students to begin enrollment within two years of graduating high school or receiving a diploma.
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Change the requirement of scholarship recipients to maintain attendance for consecutive semesters, allowing intermittent semesters.
Regional Centers of Excellence
Improving access to specialty health care in Iowa’s rural communities requires innovation and collaboration among regional providers. By maintaining primary care locally and partnering regionally to develop Centers of Excellence that focus on medical specialties such as maternal health, surgery, or cancer treatment, Iowa can ensure high quality care is accessible statewide. Grants will be awarded to two proposals that meet the targeted medical needs of local and regional residents and establish partnerships between rural hospitals and health systems to leverage resources and develop a sustainable care model.
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Invest $575,000 to fund two additional regional Centers of Excellence, increasing the total number to four.
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State grants will be supplemented by community investments.
Tort Reform
Iowa’s health systems must be able to recruit and retain medical professionals. Current medical malpractice laws in our state make it difficult. Excessive damages have directly affected maternity department closures and the low number of OB/GYNs in Iowa compared to neighboring states. When accidents or mistakes occur, providers should be held accountable, but tort litigation must be handled responsibly and reasonably to avoid far-reaching consequences.
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Limit liability by establishing a hard cap on non-economic damages in cases of medical malpractice.
Rural Emergency Hospital Designation
We need solutions that maintain emergency medical care in rural communities. The Centers for Medicare and Medicaid Services (CMS) will implement a new Rural Emergency Hospital (REH) designation in January 2023, allowing rural and Critical Access Hospitals to avert potential closures and treat patients for emergency medical situations, observation care, or other outpatient services for up to 24 hours.
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Establish a new category of hospital licensure to enable certain rural and Critical Access Hospitals to receive federal health care reimbursement as Rural Emergency Hospitals.
Rural EMS Pilot Program
The Governor’s Empower Rural Iowa Initiative will provide grant funding to pilot a new delivery model of emergency medical services in two rural counties. The grant program aims to decrease emergency response times by notifying the nearest volunteer responders to stabilize victims until an ambulance arrives.
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Grantees will receive $50,000 each to support volunteer recruitment and training, and purchase lifesaving equipment for each volunteer.
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Grant recipients will also get access to technology which allows emergency dispatchers to alert the nearest volunteers through an app on their phone.