Senate Journal: Page 1490: Thursday, April 27, 1995

                           GOVERNORS ITEM VETO MESSAGE

                                                              April 27, 1995

    The Honorable Leonard Boswell

    President of the Senate

    State Capitol Building

    L O C A L

    Dear Mr. President:

         I hereby transmit Senate File 462, an act relating to
    appropriations for the Department of Human Services and the Prevention
    of Disabilities Policy Council and including other provisions and
    appropriations involving human services and health care and providing
    for effective and applicability dates.

         Senate File 462 is, therefore, approved on this date with the
    following exceptions which I hereby disapprove.

         I am unable to approve the designated portions of Section 3,
    subsection 10, paragraph e. These items would require the Department of
    Human Services to implement a plan to pursue reimbursement for pharmacy
    services from third-party payors by May 1, 1996, and to include the
    administrative costs of adopting this new policy in the departments
    proposed FY 1997 budget. While I support asking the department to
    explore the feasibility of a pay and chase policy to recover the costs
    of pharmacy services, it would be premature to direct the department to
    implement the policy before a plan is even developed. Further,
    implementation of such a policy will result in costs to the Medicaid
    program which have not been included in the funds appropriated to the
    department for FY 1996. Also, the requirement that the director include
    the costs of implementing the policy in the departments FY 1997 budget
    requests goes beyond the authority the legislature has in the budgeting
    process, and for that reason cannot be approved.

         I am unable to approve the item designated as Section 3, subsection
    14, in its entirety. This item would require the Department of Human
    Services to seek federal approval to develop a new program to pay
    persons, including relatives, to provide care in their homes for elderly
    individuals who are currently residing in nursing homes. In recent
    years, several very good programs have been established to provide
    alternatives to nursing home care for Iowas elderly. As a result, the
    elderly who are entering nursing homes are doing so only after they have
    become so frail or infirm that alternative services are no longer
    appropriate. I am concerned that because this proposal targets the
    elderly who have already been placed in nursing homes, it has the
    potential of encouraging abuses of the Medicaid program and perhaps even
    of elderly Iowans who are best cared for in the nursing home setting. I
    urge the Department of Elder Affairs to develop alternative services
    that are cost effective and that address the needs of Iowas elderly
    citizens.

    I am unable to approve the item designed as Section 10, subsection 11,
    in its entirety. This item utilizes a budgeting gimmick to shift funds
    from one area of the Department of Human Servicess budget to another,
    the result of which reduces the departments flexibility to design

Iowa General Assembly

Index: Senate Journal (76th General Assembly: Session 1)

© 1995 Cornell College and League of Women Voters of Iowa

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