Dbq Cty Board of Supervisors-Dubuque County Legislative Priorities 2001 SessionPHONE: 319-589-4441
FAX: 319-589-4478
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DUBUQUE, IOWA 52001-7053
DUBUQUE COUNTY LEGISLATIVE PRIORITIES
2001 SESSION
Presented November 29, 2000
1. Local Option Tax
DONNA L. SMITH
ALAN R.MANTERNACH
JIM WALLER
During the last session of the legislature, you authorized implementation of the Local
Option Sales Tax legislation to deduct $400,000 in local option sales tax revenues by the
Department of Revenue and Finance for administrative costs associated with the
collection and distribution of revenues.
We also learned in investigating this matter, that interest earned on local option sales tax
from the time it is collected until it is distributed is deposited in the State's General Fund.
We believe that interest earned should be apportioned to the local governments for whom
the tax is collected, especially in light of the decision to utilize a portion of the monies
collected as a result of local referenda, which designated the funds for specific uses.
2. County Budgeting Process
We as a Board continue to oppose any constitutional or statutory spending limitations on
local governments believing that local elected officials have the same status with the
electorate as state elected officials.
The Iowa State Association of Counties will be proposing the Local Government Fiscal
Reform Act described in an attachment to this presentation, as an proactive alternative to
any proposal for spending limitations.
3. Public Health Funding
During the 2000 session, the Iowa Legislature appropriated the first year payment of the
tobacco settlement to health -related programs. Since this was a non -standing
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appropriation, we are encouraging you to strictly devote the payments from the tobacco
settlement to health -related programs.
We further recommend that this additional funding be funneled to single county contract
designees (boards of supervisors or boards of health) for environmental and public health
nursing programs within local health departments, and that the priorities for its use be
those established at the local level.
Dubuque County has participated in the Iowa Department of Public Health's Community
Services Bureau Single Grant contract since its inception. Under this program, Dubuque
County in fiscal year 2001 receives $200,664 for the Home Care Aide program, $15,000
for the court -ordered Home Care Aide program, $59,960 for the Public Health Nursing
and $8,392 for the Senior Health Program. These amounts are static from those received
in fiscal year 2000. We contract these services with the Visiting Nurse Association
through the County's Board of Supervisors..
However, Dubuque County also spends $15,000 for public health nursing services to
persons in need who do not necessarily meet the criteria for the state's public health
nursing program and an additional $80,000 to pay for additional necessary public health
nursing services.
Because of new federally -imposed restrictions on Medicare and Medicaid funding for
home health services, Dubuque County has reached a crisis point in providing those
services. The Visiting Nurse Association reports that Visiting Nurse
Association Finley Home Health Care and Mercy Home Health Care are making referrals
to the programs funded through the State of Iowa Single County Grant and County
Property tax much sooner because Medicare, Medicaid and private health insurance
funding have been exhausted.
As a result, fewer clients are being served with the state and local monies. This issue
must be addressed statewide. We are asking that a significant funding increase in the year
2002 would achieve a 50% state -county partnership in funding for Public Health Nursing
and Home Care Aide programs.
4. Abandoned Wells
The Water Well Grants -to -Counties program from the Department of Natural Resources
has been decreased from $21,500 to $15,000 per county, at the same time that the DNR is
mandating that all abandoned wells be closed. It is estimated that there are 30,000 more
abandoned wells in Iowa that need to be closed. Rehabilitation of wells has also been
added as an eligible category for the grants.
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We are asking that the grants be restored to at least the $21,500 figure in order to
encourage property owners to close abandoned wells.
5. Environmental Health & Zoning Issues
We ask that the legislature insert a definition of a "farm" for zoning purposes.
The legislature must determine under what circumstances corporate commercial animal
confinement facilities fit within the agricultural exemption for zoning purposes. The
legislature must also determine definitions counties can utilize when rural properties are
sub -divided and precisely under what circumstances these developments fit within the
agricultural exemption
6. State Papers
The Dubuque County Board of Supervisors continues to be supportive of the partnership
between the University of Iowa Hospitals and Clinics, the State, and counties for the
medical care of the indigent. During fiscal year 2001 (the current year), we had utilized
114 of our quota of state papers by November 1, leaving a balance of 44 papers for the
remaining 7 months of the year.
With the increasing number of uninsured or under insured adults, it may be time to
reevaluate increased availability of state papers for needy people.
7. Mental Health Parity
Iowa does not currently require that health insurance policies cover treatment of inpatient
and outpatient mental illness and chemical dependency at the same level and with the
same annual and lifetime limits as physical illnesses. The discrepancy in the law is
discriminatory and needs to be corrected. The State should amend the Code to adopt an
insurance parity law that requires insurance carriers to use the same co -pays, deductibles
and annual and lifetime limits for mental health and chemical dependency treatment as
for treatment of other physical illnesses.
8. Substance Abuse Funding
Inadequate funding for substance abuse treatment has created a fragmented system with
statewide inequities to the access for treatment.
First, the State must appropriate monies to pay for the actual cost of detoxification, and
then, in a separate fund, the State must appropriate monies to pay for treatment and
follow-up services.
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The State should also appropriate funds to increase the number of community -based
treatment facilities to appropriately treat substance abusers.
9. Mental Health Issues
A. Growth in MH/MR/DD Fund
The best possible solution to the Iowa dilemma for services for the Mentally Ill,
Mentally Retarded and Developmentally Disabled is for the State to assume
responsibility for this entire system. One way that this could perhaps be done is
for the state to assume the system and abolish the concept of legal settlement so
that clients could more freely move and be placed in appropriate settings closer to
home. Perhaps the State could assume that responsibility sooner if counties
would agree to pay to the state an amount based on current expenditures, which
would decrease each year for a period of years, at the end of which the county
responsibility would be completely gone.
There is a proposal from the Department of Human Services and the Central Point
of Coordination Restructuring Task Force to abolish the legal settlement concept
and substitute residency for it. This proposal is based on a principle of equitable
service access, and ideals that require funding to follow consumers wherever they
choose to live. Unless that goal is established first, legal settlement cannot be
abolished, because counties like Dubuque, which offer a rich array of services,
will be magnets for disabled persons from other counties.
The various counties will have individual, unique situations in that fund, too. For
example, in our budgeting process in fiscal year 1998 in that fund, a credit from
the State of Iowa for state cases resulted in our lowering the levy, despite the fact
that the needs in that fund are substantial. The lower levy does not reflect
decreased need; it reflects a substantial unusual revenue source, so we urge you
not to tie growth allocation to the levy rate in the MH/MR/DD fund.
Fund balances in the MH/DD Fund have also become an issue during the past two
years. While Dubuque County enjoys a large fund balance in this fund, we
remind you that there continues to be confusion with billings from the Iowa
Department of Human Services for expenses at the Mental Health Institutes and
for Medicaid payments.
B. Medicaid Rehabilitation Option for Mentally I11.
We have hopes that utilization of the Medicaid Rehabilitation Option recently
implemented by the Iowa Department of Human Services will provide sorely
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needed services for the chronically mentally ill. We thank you and the
Department for your work in formulating this option for services for that
population.
C. Property Tax Relief
The State of Iowa has not yet reached the 50% of the county base the legislature
projected when the mental health reform began.
The non-federal share of the ICF/MR and HCBS Waiver Services for children
should be paid from funds other than the property tax relief fund which would
result in further property tax relief for Iowa's people. We also have seen no
improvement in the State's billing system for the Medicaid programs, i.e., Case
Management, ICF/MR, HCBS Waiver.
Beginning in fiscal year 2002, the Social Services Block Grant monies will no
longer be able to be supplemented with Temporary Assistance to Needy Families
funds from the federal level. Please appropriate state funds to replace the SSBG
funds that are currently being utilized for local purchase allocation to counties.
D. Managed Mental Health Care
Concerns about the State's managed mental health and substance abuse provider
continue with providers of service. We are concerned that services for "state
cases" managed by the provider have equal access to services, in accordance with
the county management plan of the county in which the individual needing
services lives.
Dubuque County is particularly sensitive to the "state case" issue because of our
location, and because of the county's continued responsibility to pay for
commitment costs for "state case" clients from Wisconsin and Illinois who are not
actually committed to a state institution.
We suggest that the contractor's responsibility be expanded to include the
commitment costs for both mental health and substance abuse.
E. Long Term Nursing Care for Geriatric MH/DD Clients (ICF/PMI)
There are no monies available to develop specialized intermediate care facilities to
care for elderly and/or physically ill persons who have been diagnosed with
mental illness and cannot be managed in the traditional nursing home setting.
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The legislature must direct the Medicaid program to develop a per diem rate for
residents based on the type of care provided, and appropriate funds to cover 100%
of the non-federal share of the cost.
This need grows consistently as people brought back to our communities through
the MH/DD system age and require nursing care, and as the aging population
grows. Through the 109-bed geriatric unit at Sunnycrest Manor, Dubuque County
has provided care for some of these clients when they met the county's criteria;
however, the county cannot care for all of this population at that facility for
several reasons. One of them is cost; this population requires enormous amounts
of staff time which the regular Title XIX reimbursement does not pay for.
Another is that the facility is not licensed as a PMI and to do so would endanger
the Medicaid money that we do receive for geriatric clients, through the
prohibition on utilizing Medicaid for a "large public mental institution."
The only beds currently providing the appropriate level of care are at Clarinda
MHI, which has been certified to receive a higher level of Medicaid
reimbursement. However, there is a long waiting list there, and persons who are
admitted to the program must leave their own communities.
F. Dual Diagnosis
Approximately 70 per cent of persons with chronic mental illness experience a co-
occurring problem with substance abuse. Treatment for dually diagnosed
individuals is a critical need. The DHS program available for these consumer is
in Mt. Pleasant, where beds are limited and costs are prohibitive; the county's
share of the per diem for the program $428.00. It is critical that the State and its
managed care contractors approach the needs of the dually diagnosed population
in an integrated manner.
G. Services to the Department of Corrections
Counties are being requested to fund MH/DD services to persons who are under
the jurisdiction of the Department of Corrections. This has happened to Dubuque
County in two ways:
(1) Requests for residential placement for persons who have
disabilities and/or have disabilities at the County's expense.
(2) Requests for vocational and/or counseling services for persons
brought to our county under the "interstate compact" to complete
requirements of probation.
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It continues to be our position that persons under the jurisdiction of the
Department of Correctional Services are the responsibility of the State of Iowa.
There has been attention to this situation recently when the Des Moines Register
published a series of articles about the large percentage of people in Iowa's prison
system with a diagnosis of mental illness, and the lack of treatment opportunities
for those people. We continue to be concerned people having diagnoses of mental
illness remain the responsibility of the Department of Correctional Services and
encourage sufficient state funding to provide the services needed by persons
supervised by the department..
H. Civil Court -Ordered Services
In the 1980's the State of Iowa began transitioning the funding and supervision of
court services from counties to the state. This process was never completed and it
is time to do so.
As you study the issue of the employment status of Judicial Advocates, who are
currently actively seeking employment status either through the state or the
counties, consider that the counties meet non of the federal qualifications for
"employer" for these advocates. We do not hire, fire, train or supervise these
people; we should not be their employer for ethical reasons because the county's
interests in any case may be different from the Advocate's. Advocates should
either be paid in the same manner as Court -Appointed Attorneys, or should be
employees of the State of Iowa.
We also ask that court -ordered sheriff's transportation and other fees be paid by
the State, as well as court -appointed attorneys in the commitment process, and
any court -ordered diagnostic evaluation.
I. Brain Injury
Funding for persons with a brain injury is very limited and many of these
individuals need services that they are unable to obtain. Counties do not have
resources available to add a new population group to our management plans.
Therefore, we support the establishment of a state/federal funding stream to
provide services for persons with brain injury.
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10. State Court Administrator's Office and Juvenile Court Services
As the situation currently stands, counties are paying a pro-rata share for space
occupied by State Court Administration in the Black Hawk County Courthouse.
We also provide space in our Courthouse, where space is scarce. We ask that you
amend Iowa Code Section 602.1303(1)(b) to provide only that counties provide
offices for the district court.
We also ask that the mandate that counties provide space for Juvenile Court
Services be transferred to the state, which employs the Juvenile Court Services
staff. It is chaotic for us to be negotiating to rent space for an office that is
staffed by state employees, and where we have absolutely no control over the
numbers of people and therefore the numbers of offices that are necessary.
11. Funding of State Mandates
County budgets are increasingly burdened with the cost of current and new state
mandates. In order to avoid forcing additional spending onto the property tax, any
service mandated by the state must have adequate state funds to pay for it.
The mandate issue is complex. It relates to much of what we do, and in both
direct and indirect ways. For example, Dubuque County has had to employ more
prosecutors and needs more jail space because more people are being charged and
sentenced, although we know that the legislature did not specifically intend to
cause jail overcrowding when the legislation was passed.
Unfunded mandates force additional spending onto the property tax; any service
mandated by state legislation should have adequate state funds to support it.
12. Funding for County Jails
The cost of building and operating county jails continues to consumer an ever-
increasing share of the budget for most counties. One way to fight this is for the
State to guarantee the necessary fund to fulfill its statutory duty to reimburse
counties for holding state prisoners in county jails. The State of Iowa is required
to statute to reimburse counties for the cost of holding parole violators in county
jails, and to reimburse counties for work release violators and some OWI
violators. The current $900,000 appropriation falls short of the estimated $1.5
million necessary for full reimbursement.
The state should pay counties for housing all prisoners under the jurisdiction of
he Department of Corrections held in county jails or other county -paid facilities.
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pieces of bluff, lots which are too small, too steep, or too narrow. Infrequently, a
derelict building is located on one of these lots.
All of this is a liability to the County, particularly resulting from the terrain of
Dubuque County. When the property is sold, proceeds are shared with all taxing
districts.
We suggest that when these properties become delinquent and are ready to
become the property of a public entity, properties within a city become the
property of, and liability of, that city. The County would then assume the liability
and responsibility for the properties in the rural areas. When and if the property is
sold, proceeds would continue to be shared with all taxing districts applicable.
16. Tax Increment Financing
Tax Increment Financing Districts under Iowa Code Chapter 403 should be
changed so that the taxing authority establishing the TIF district can only create
an urban renewal area with the approval of each affected taxing jurisdiction of the
city or county and school that share the TIF base. TIF districts should be limited
to a certain number of years, specifically pertaining to TIF's designated for
eliminating urban slum or blight.
All TIF districts must also be required to prepare a fiscal impact statement prior to
approval.
Two cities in Dubuque County have created such districts for residential purposes;
one of the two created a district which includes almost the entire city, thereby
reducing the amount of money available for county services, although those
services must remain available to those citizens. Therefore, there is an additional
property tax burden on farmers, who are already facing extreme economic
difficulties.
17. Southwest Arterial
We are encouraged by the news that the Southwest Arterial has been included in
the Iowa Department of Transportation's five-year plan for fiscal year 2005.
However, because the Southwest Arterial is such a vital link in Dubuque County's
transportation system, we believe that the project should be accelerated in the
plan.
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2001 Top Legislative Priorities
2001 Top Legislative Priorities
All 99 counties of Iowa are dedicated to the best service at the lowest possible cost for the
citizens and taxpayers they serve. The counties, through ISAC, support the concept of
representative government and encourage the preservation of flexibility for elected officials
to best represent the people who elect them.
in keeping with these principles, Iowa county officials are proud to present their "Top
Legislative Priorities" for 2001. With the prime interest of the citizens and taxpayers in
mind, we respectfully request that the following eight legislative objectives be considered
and approved by the 79'h General Assembly of Iowa and approved by Governor Vilsack.
Iowa Commission on State and Local Taxation - In order to obtain true tax reform, all
elements of the system must be considered. Such effort must include an examination of
state and local income, sales, and property taxes and a comprehensive look at the services
funded by each revenue source. ISAC proposes that an Iowa Commission on State and
Local Taxation be created for these purposes. Commission membership should include
representatives appointed by leadership from both houses of the Iowa General Assembly,
Governor Vilsack, ISAC, the Iowa League of Cities, the Iowa Association of School Boards,
and other interested groups as deemed appropriate. To achieve best results, the
Commission should be adequately funded and staffed by the state. A time frame should
include a preliminary report 12 months from the time of enactment, and a final report by
18 months. The Commission should be retained for a few years to facilitate recommended
legislative changes and implementation of the results. Similar commissions have been set
into place in Colorado and Virginia.
Local Government Fiscal Reform Act - To show that counties are serious about relying on
the Commission for comprehensive tax reforms, we offer the following set of immediate
reforms in good faith:
• Financial Management Plans to use in budget preparation with forms to be approved
by the County Finance Committee in consultation with the Iowa State Association of
County Supervisors and Iowa State Association of County Auditors. This budget tool
(similar to mental health County Management Plans) would be used to assist counties in
identifying budget goals, service and program plans, revenue targets that are self-
limiting, and capital projects;
• 25% unreserved-undesignated fund balance allowance in general and rural funds
beginning in FY03 with a levy reduction formula to offset excess balances in FY04 and
thereafter if needed;
• Strong unfunded mandates protections (HF 2299 from 2000 legislative session); and
• General Obligation Bond Flexibility to allow counties to use debt levy for G.O.
Bonding in areas Tess than county wide for specified projects.
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