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Recent editorials published in Iowa newspapers

January 8, 2018

Des Moines Register. January 5, 2018

Our hopes for the Legislature: Raise revenue and create a better Iowa

The new year provides an opportunity for people to chart a better course going forward. Iowa’s elected officials are no exception. Their priorities affect the lives of all residents.

This is why early each January the Des Moines Register editorial board offers suggestions for where lawmakers should focus their energies in the upcoming legislative session. We are doing this again today. The goal, as always, is to make Iowa a better place to live.

Though specific priorities are outlined below, it would be remiss not to recognize the state’s current financial difficulties. One cannot honestly advocate investing in the environment or better protecting vulnerable children, for example, when the money is not there to accomplish those goals.

And the money is not there — largely because previous legislative priorities included tax cuts, corporate giveaways and a refusal to generate new revenue. Again last year, tax collections failed to grow as predicted. Iowa was forced to make mid-year cuts and dip into reserves.

Now the state’s roughly $7.2 billion budget faces a shortfall of $45 million to $90 million.

The top priority of this Legislature, which convenes Monday, must be raising revenue.

Cutting taxes and reducing the size of government is not a vision for the future. It is a philosophy, and one that has devastated other Republican-controlled states like Kansas and Louisiana. Instead of economic growth, those states realized canceled college graduations, abused children sleeping in government offices, depleted trust funds and abrupt tax increases to rescue the state from total fiscal disaster.

Yet Iowa seems to be gradually following in their footsteps. In recent years, thousands of employees have been cut from the state workforce. As few as five troopers have been on duty overnight to patrol the entire state. Families are waiting weeks for a loved one’s remains due to a backlog of autopsies at the Iowa Office of the Medical Examiner. Institutions for the mentally ill have been shuttered.

If lawmakers refuse to raise revenue, things will only get worse. Taxes are not evil. They are an investment in the quality of our daily lives and future. Making that investment requires making revenue a priority.

Here are some other priorities for lawmakers:

Demand answers about privatized Medicaid

Former Gov. Terry Branstad’s privatization of Iowa’s $4 billion health insurance program has resulted in vulnerable Iowans losing in-home services. Health providers have closed their doors because private insurers didn’t pay them.

Under Gov. Kim Reynolds’ leadership, these companies have received more public money. One abandoned a contract with the state, leaving Iowans with no options in insurers. The legislative branch has a responsibility to intervene.

Lawmakers should refuse to appropriate a single penny for Medicaid until Iowans have objective, recent information about the costs of privatization — which appear to be more than state-run Medicaid for a model that erodes, instead of improves, access to health care in this state.

Improve mental health care

A Des Moines Register/Mediacom Iowa Poll in December shows that 64 percent of Iowans disapprove of how state leaders are handling mental health issues. That should be a signal to lawmakers, if recent tragedies weren’t enough evidence of a crisis.

But solutions won’t come easily. Simply reopening one of the mental health institutes or adding beds isn’t necessarily the right answer. Iowa needs to create more community-based approaches that include several types of beds: acute, transitional and long-term. It needs to create a system that serves children. It needs to attract more mental health providers. Perhaps the Legislature’s first action should be lifting a state law that caps the amount of property taxes that counties can collect to pay for mental-health services. The cap is stuck at 1996 levels, even though some counties have seen large population increases since then.

Help public schools (or at least don’t hurt them)

Gov. Kim Reynolds says she wants to avoid cuts to K-12 school funding this year. She’s also encouraged the Legislature to revise the inequitable and complex school-funding formula. Lawmakers can also give districts more flexibility in deciding how to spend their cash reserves. All that would help cash-strapped districts. And here’s what lawmakers absolutely should not do: Create Education Savings Accounts or other expensive “school choice” schemes that take per-pupil state money and essentially give it to parents to spend on private schools.

Examine tax credits and end corporate welfare

This should finally be the year that lawmakers undertake a comprehensive review of special-interest tax breaks. Every year brings a new crop of outrageous giveaways doled out by the Iowa Economic Development Authority. This year’s winner was the $213 million in state and local incentives given to Apple in exchange for building a $1.375 billion data center in Waukee — a deal done without any public notice or debate.

The value of tax credits has ballooned by 180 percent since 2005, from $153 million to an expected $427 million this year.The most lucrative business tax credit program remains the highly controversial Research Activities Credit. The program allows major corporations with annual profits of more than $1 billion to not only avoid taxes, but sometimes collect a check from the state as “compensation” for the credits they can’t use.

Lawmakers need to get serious about rethinking a tax code that’s riddled with worm holes and favors out-of-state corporations over Iowa-based businesses.

Help Mother Nature and water quality

Gov. Kim Reynolds has said the first bill she wants to sign in 2018 is one seeking to improve water quality in this state. But Iowa does not need a new law on this issue and does not have the revenue to fund one. Lawmakers should raise the sales tax a fraction of a penny to provide revenue to the voter-approved Natural Resources and Outdoor Recreation Trust Fund, created by voters in 2010. Then we could start cleaning up our filthy waterways.

Eliminate the child care cliff

Instead of gradually reducing subsidies as a family’s income increases, Iowa’s Child Care Assistance Program cuts off all aid when a recipient’s income hits 145 percent of the poverty level. According to United Way of Central Iowa, a raise as small as 15 cents an hour can disqualify a family and lead to a net loss of $4,221 a year. This discourages workers from pursuing raises that would make them less financially dependent on the state, and costs the state more money. There’s no reason Republicans, who now control the House, Senate and governor’s office, can’t address this problem.

Reform job licensing laws

Conservatives frequently advocate the elimination of burdensome government regulations they say stifle economic growth. A Republican-controlled Iowa Legislature should be scrambling to reform the state’s job-killing occupational licensing laws.

As this editorial board has repeatedly written, Iowans should not need 2,100 hours of training and a government license to cut hair. Or permission from the state to file a fingernail, interpret sign language, pluck an eyebrow or be a “milk sampler.”

One-third of Iowa’s adult workforce now must obtain government permission to earn a living — a higher percentage than in any other state, according to a 2015 White House report.

Last legislative session, lawmakers hastily cobbled together a licensing reform bill that lacked any coherent principles about which workers should be licensed and raised more questions than it answered. They should craft a thoughtful bill requiring government oversight only for workers who may put public health and safety at risk.

Reduce drunken driving’s toll

Iowa has made little or no progress in reducing fatal crashes involving alcohol or lessening the percentage of intoxicated drivers who are repeat offenders. A statewide coalition has made 66 recommendations for stopping impaired driving. Only one has been adopted: a 24/7 sobriety program, which requires offenders to undergo twice-a-day alcohol testing. The Legislature passed that last session, but the version is weak. Lawmakers can strengthen that program as well as tackle other recommendations, such as examining penalties for repeat offenders, revamping treatment programs and implementing the Place of Last Drink program, which requires that OWI offenders disclose where they were served their last drink.

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Waterloo-Cedar Falls Courier. January 3, 2018

VA hospitals need real reform

While Congress tries various remedies to fix what ails Veterans Affairs hospitals, it may be time to admit this patient can’t be cured in its current incarnation.

In 2017 the Veterans Health Administration accounted for 38 percent of the $182.3 billion Department of Veterans Affairs budget, serving 9 million of the 22 million veterans at 144 hospitals, 1,200 outpatient sites and 300 mental health centers. Most veterans rely on private insurance, Medicare or Medicaid.

In 2014 the VA’s required wait time of 14 days for new enrollees and 14 to 30 days for others was ignored at 42 medical centers to improve performance records. The VA inspector general reported more than 120,000 veterans waited an extended period or were denied care.

An estimated 1,700 veterans were relegated to a “secret list” to improve performance records in Phoenix, where wait times averaged 115 days and 35 deaths occurred awaiting treatment.

Congress subsequently approved legislation to address staffing shortages and remove problem personnel.

Yet USA Today and other media report incompetence remains pervasive. The VA has hired medical personnel with numerous malpractice claims. When problem doctors depart, it frequently fails to flag them in the National Practitioner Data Bank.

USA Today reported the Iowa City VA hired neurosurgeon John Henry Schneider despite numerous malpractice claims, including four settlements for surgical mistakes leaving patients “maimed, dead or paralyzed.” His license was revoked in Wyoming, but not Montana.

In Iowa City, he performed four brain surgeries within four weeks on a 65-year-old veteran who died in August from an infection, and three spine surgeries on a 77-year-old veteran — two to clean up an infection from the first. He resigned before being fired.

A 1999 federal law prohibited the VA from hiring medical workers with revoked licenses. Yet in 2002 the VA told local hospitals they could be hired after consideration “of all relevant facts surrounding” if they retained a license in one state.

An Oklahoma VA hospital hired a psychiatrist sanctioned for sexual misconduct who would later sleep with a patient.

Among those not flagged in the national database was podiatrist Thomas Franchini, who made mistakes in 88 cases harming veterans at its Maine hospital but now practices in New York City. The VA stated the database was only for medical doctors and dentists.

USA Today examined confidential VA records from 2014-15 and found 230 secret settlements (some involving whistleblowers) costing $6.7 million. Worker mistakes or misdeeds meriting dismissal accounted for 126. In 70 instances, workers were banned from VA facilities for years or life, but without specific reasons.

Mario DeSanctis, the former director of the VA Medical Center in Tomah, Wis., and his lawyers received $163,000. Local police, concerned the facility dispensed dangerous doses of powerful narcotics, called it “Candy Land.”

Radiologist Jorge Salcedo misread dozens of CT scans to detect tumors and blood clots at a Washington state VA. He got $45,000 in leave time and a clean reference.

The VA purged negative records in three-quarters of the cases, providing neutral or positive references to prospective employers, according to USA Today.

Other incompetence included a veteran treated in Memphis to repair broken blood vessels who was discovered to have 10-inches of plastic tube packaging embedded in his leg, which was amputated three weeks later. The VA cited Memphis for 1,000 threats to patient safety.

VA Secretary David Shulkin is now requiring department review of settlements greater than $5,000, while Congress approved the VA Accountability and Whistleblower Protection Act, making it easier to terminate employees for misconduct.

Congress tried to alleviate pressure on an understaffed VA in 2014 with the $16 billion Veterans Choice and Accountability Act, including $10 billion for veterans to receive care outside the VA and $2.5 billion to hire 12,000 more medical personnel.

But hospitals with the longest wait times didn’t get a larger share of funds, and far fewer doctors and nurses were hired than envisioned. In April, the VA had 45,360 vacancies. Attrition is a problem. In 2015, the VA hired 8,528 nurses, but lost 4,966.

And “choice” only occurs when the VA can’t schedule an internal visit within 30 days or the travel distance exceeds 40 miles. A “choice backlog” exists because VA officials have been slow to determine when it’s available. Meanwhile, patient reimbursement is often delayed.

Shulkin has proposed a program to allow veterans to select any private sector physician without restrictions. VA supporters claim that could gut the system, arguing outside practitioners lack experience dealing with such military medical issues as traumatic brain injuries, post-traumatic stress disorder, polytrauma and prosthetics.

The problems within the VA cry out for meaningful reform — not just continually reshuffling existing cards. Veterans must be allowed greater choice in getting timely and competent medical and mental health assistance.

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Sioux City Journal. January 3, 2018

City should end squabble with landowner

We have a suggestion for the city of Sioux City.

End the squabble with local resident Brad Lepper by paying the man $34,000 for land of his City Hall wants to complete a stretch of recreational trail along the Big Sioux River.

As detailed in a Dec. 28 Journal story, the city is using the power of eminent domain to acquire land owned by Lepper in the 800 block of Bruner Avenue for the second phase of the trail. This .75-mile segment of trail will run from the Riverside Pool to Florence Avenue.

The city offered Lepper just under $16,500 for the land. The Woodbury County Compensation Commission said a fair purchase price for the land is $34,000. Lepper is willing to accept the $34,000, but the city appealed the commission decision to Woodbury County District Court.

We don’t believe this is necessary — or necessarily prudent.

First, we see no reason to play hardball with Lepper, who strikes us as a reasonable individual. Second, we like trails, but we won’t argue with anyone who suggests a healthy debate can be had about whether forcing a resident to sell land for a trail is proper use of eminent domain law. Third, the city in the end could spend more for total land acquisition and legal costs than $34,000 by dragging this out in court.

We see no value for anyone in a protracted battle.

In our view, the city’s best move is to pay Lepper the fair purchase price as determined by the commission and move on.

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DNR aids area fire departments. January 6, 2018

Grants will help upgrade key communications capabilities.

Fire protection is crucial no matter where one lives. In small-town and rural America, volunteer fire departments are of vital importance to the well-being of both businesses and residents.

Staffing and equipping these organizations is a challenge both in terms of recruiting a sufficient number of people to become volunteer firefighters and finding the financial resources to pay for the vehicles and multitude of other equipment that firefighters need to do their job effectively and safely.

Fortunately, throughout the region served by The Messenger, it is common for public-spirited individuals to step forward for part-time service as firefighters. Often, however, tight budgets make mobilizing the finances needed to equip and operate a department tough.

That’s why assistance from governmental and private sector grant makers can be of crucial importance to these departments. Consequently, it’s good news that several area volunteer fire departments have been able to improve their communications equipment thanks to the Iowa Volunteer Fire Assistance Grant program of Iowa Department of Natural Resources.

The Otho Volunteer Fire Department was awarded $1,290. The Duncombe Volunteer Fire Department received $1,880. The Dayton Volunteer Fire Department got a grant award of $3,430. The Rockwell City Volunteer Fire Department was awarded $820. The Jewell Volunteer Fire Department is receiving $3,168

The Messenger congratulates these departments on being selected to receive these funds. This DNR program is a worthy undertaking that deserves strong public support. It helps fire departments in rural Iowa do the important jobs on which so many Iowans depend.

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