Meeting Public Comments

Di Findley [Iowa CareGivers]

HF402 is an important direct care workforce infrastructure bill and is long overdue. The current system is based on laws that were written over 40 years ago when nursing homes were the only option for extended care. Early law required all states to establish direct care worker (nurse aide) registries to house the names of only certified nurse aides (CNAs) who were eligible to work in nursing homes. Eligibility meant they completed a federal minimum of 75 hours of training and were free of abuse or criminal backgrounds. Fortunately, today Iowans have many options for care and community supports, including nursing homes, in which home care and hospice aides, personal assistants, universal workers, direct support professionals and others are employed. The antiquated system has not kept up with the new ways of delivering health and long term care services (LTSS). These essential direct care workers are wrongly defined by the population they serve or the settings within which they work which leads to fragmentation. The bill also calls for a public portal where consumers and employers could access qualified direct care workers. An expanded direct care worker registry to include the entirety of the direct care workforce would benefit direct care workers, people with disabilities, older Iowans, family caregivers, LTSS employers, and the state. This kind of workforce database/infrastructure would also strengthen Iowa's emergency response capacity. Thank You.

Gloria Vermie

The pandemic revealed the States inability to locate, mobilize, & determine capabilities of our large direct care work force. HF 402 can initiate the electronic infrastructure needed. My career as an RN, MPH in public health began as an aid in skilled care gives me perspective on the importance of a central database with accessible records, & credentials for care workers, employers & the State. I support this important legislation.

Mr. Fran Mancl

I have worked in Iowa as a Certified Nursing Assistant for over thirty years and experienced my share of both the heartfelt joys and challenges of caregiving, mostly in longterm care. I ask that you wholeheartedly support HF 402, which would expand the direct care workforce registry. There are no continuing education standards to maintain credentials and eligibility to work for those in direct care. Without a central database, direct care workers' credentials are not portable. That places a burden on workers, employers, and those persons served when credentials do not follow the direct care worker. Expansion of the registry would create an excellent resource for those in need of service and for family caregivers who need to find a caregiver with specific training and skills. Recruiting and retaining direct workers in more evident now than ever.

Arlinda McKeen [Family Member]

I strongly support this bill. It is time that these important workers have a system that shows earned credentials/training, streamlines need for oftenrepeated training, and gives the workers a source of record of their education and training. Since 2012 I have had both parents in need of direct care services from long term, home care, and specialized dementia care settings. I can attest to the confusion that exists when a consumer/family member needs assurance that the people caring for them/their loved one has the right training. Please pass this legislation.

Kay Marcel [Family member]

I urge you to support House File 402, which will expand the Iowa Direct Care Worker Registry. Individuals with disabilities, like my adult son, and older Iowans rely on direct support workers to live in their own homes and remain active in their community. Direct support workers assist people with disabilities to obtain and maintain employment; to learn independent living skills; to learn social skills; to maintain good health; and many other activities of daily living that many of us take for granted and that provide the quality of life needed to ensure ones wellbeing. Existing State data systems housed in various State departments (Inspections and Appeals, Human Services, Public Health, and Education) specific to the health and longterm services and supports (LTSS) workforce do not connect or align in ways to track and retain valuable data on the current workforce in order to better prepare and support a strong health and LTSS workforce of the future.The direct care workforce and those who rely on it have been functioning for years in a fragmented system that has no foundation. Now is the time to construct that infrastructure.Your support of House File 402 is needed and will be greatly appreciated.

Julie Russell-Steuart [the Disability Caucus of the Iowa Democratic Party]

My name is Julie RussellSteuart from Reinbeck and I'm the Chair of the Disability Caucus of the Iowa Democratic Party.HF 402 would streamline the LTSS workforce with benefits like portable credentials so they dont lose time retraining. They can get right into a new position without delay. This will immediately help those that need direct care, especially home care. I have listened to members of the Disability Caucus talk about how tough it is to organize their care, even with an agency looking for them. That agency needs the resource of an uptodate registry with credentials to find the right help for their clients. Not only that, but what about when a care worker calls in sick? Or has to take a week off? If the database were expanded with home care workers, the agency could cover that a lot more quickly. No one should be without the care they need, but it happens too often in this current system. Please support HF402.

michelle Soyer

Michelle Soyer Family memberYour support of House File 402 is needed to expand the Iowa Direct Care Worker Registry. I am among many Iowans who have adult children and parents with disabilities. These Iowans rely on direct support workers so they can experience the quality of life needed to ensure ones wellbeing by living safely in their own homes and remain active and included in their community, in jobs that are suited for their talents and abilities. The current system is not functioning efficiently to serve Iowans in need or prepare and support Long Term Support Services workforce. My family and so many like ours urge you to support House File 402.

Chris Adcock

I have worked as a direct care provider through an agency in the past in rural Southwest Iowa. While the agency was required to provide care coverage if I or my coworkers were unable to get to their shifts. I know there are many people making their own arrangements for care and the idea that there is not a substantial and reliable database of providers from which to seek help is frightful. In urgent and unforeseen situations, the inability to access and arrange prompt and reliable care can mean possible injury or death. Please help empower Iowans get the care they need when they need it. I support HF402 and ask that you do, too. Thank you, Chris Adcock, Page County HD24

Dawn Francis [Disability Rights Advocate]

Dear Subcommittee Members,I have AT LEAST FOUR different good friends from ALL ACROSS IOWA who are ALL quadriplegic which means they CANNOT walk and MUST have caregivers in their homes several times a day, 7 days a week, 365 days per year. At a minimum, they need someone in their home twice a day, once in the morning to help them get up out of bed and dressed, and once at night to help them get into bed. They also need someone to help them shower at least every other day, and assistance with other daily care needs such as toileting and stretching, to name a few.ALL FOUR of these folks live INDEPENDENTLY in their OWN HOMES, and do NOT live with family.THREE of these folks are GAINFULLY EMPLOYED.ALL FOUR of these folks CONTINUE to face the THREAT of being forced to move into a congregate setting, such as a nursing home, simply because they CONSTANTLY struggle with finding regular caregivers to come into their homes on a daily basis to help them with their caregiving needs.NO ONE should be forced to move to a congregate setting and give up their jobs and independence simply because they cannot find adequate inhome caregivers to help them with the basic needs they have to remain living independently and working.I also have a FIFTH good friend who DIED because he could not find caregivers to help him in his home. He got sick, went into the hospital, and was then in a nursing home to recover. When he was well enough to return home, he could not find caregivers to help him in his home. HE JUST GAVE UP AT THAT POINT! He refused further treatments he needed to stay healthy, as he REFUSED to continue to live the rest of his life in a nursing home and so he passed awayThe caregiver workforce shortage is a DESPERATE CRISIS for the disability community!!!We NEED this direct care workforce registry as a first step in providing the supports that individuals with disabilities need to remaining living and working independently, and not be forced to live in institutions, such as nursing homes, which are MUCH more costly in the long run that providing the supports folks need to remain in their own homes.I STRONGLY URGE YOU to move forward and pass HF402!Thank you for your serious consideration of these comments.Dawn E. FrancisDisability Rights AdvocateAdel, Iowa

Mary Kahl [Iowa Citizen Action Network]

Iowa needs to support in home careworkers especially during a pandemic. Our healthcare infrastructure is in desperate need of repair.

Mickey Rottinghaus

This bill would address an issue that has been a problem for years. The frustration my son and I experienced after his initial injury left him with quadriplegia can't be overstated. The agency we worked with would send new staff each weekend: a new one on Saturday, and another on Sunday. I would provide specific training in terms of transfers, bathing, dressing, etc. as the health care worker observed. For six months this happened each weekend. The agency asserted they didn't have a deep enough pool of workers to ensure we would see the same staff on a regular basis. Over the past few years, three or four different agencies declined to provide services, claiming worker shortages. As I tried to negotiate having them solicit supplemental staff from other agencies when someone called in sick. The issue of liability reared its ugly head. There were question regarding unequal training from one agency to another.HF 402 will address this. Another aspect it would address is redundancy in training which gets in the way of a new hire being trusted to have the training necessary to provide quality care to their clients. Our health care industry is in a pinch. Please pass this bill to support those dependent upon personal care as they endeavor to stay in their own homes. Mickey Rottinghaus

Tammy Nyden [fammily member]

As a widowed parent of a child with serious mental illness, I have depended on direct care workers for the health, safety and financial viability of my family. Without the direct care workforce, single parents like me are completely unable to support our families. Even so, it has been a struggle because of the high turnover of workers, many parents end up losing their own employment due to the constant care giving disruptions. It has always been difficult to find new caregivers, as there are usually long waiting lists. Having a registry of workers will help make this easier. We also need to build and keep this workforce by paying them the living wage they deserve. We need to improve the infrastructure of care in Iowa. Please support HF 402 and continue to work to build this important foundation of our community.

Jesse Schwartzman [Disability Advocate ]

As a person with a disability and as advocate we need to do better to support people with disabilities. This continues with the direct care registry. We deserve dignity and the ability to live our best lives in our OWN homes with or without direct care. I hope this is just the start of much more reforms that are needed.

Margaret Whiting

Please support HF 402. We need an up to date database system for caregiver information. People in Iowa are having trouble getting the care they need.

Maribel Slinde

I am writing to urge the committee to support HF 402. As someone who has worked with DCW in the public health and home care arena for more than 35 years, I have witnessed first hand the continued fragmentation of information/data regarding members of this workforce. This bill will lay a foundation upon which to expand the infrastructure needed to support DCW, employers and consumers. As we have so recently witnessed, Iowa is clearly far behind where it needs to be in support of all these essential workers. Please take this important step in not only support of DCW but all Iowans who depend on them for daily life giving support and services. Thank you.

Amanda Lovan [Family Member]

Hello, my name is Amanda Lovan. I am kindly asking you to advocate for HF 402. Direct care workers are essential. COVID19 has made us realize that we can make working from home normal if we are forced to do it. But what about the people who weren't able to leave their homes to begin with? They need to know their caregiver hasn't been exposed. Iowa has step it up and have a wellmaintained and accessible direct care workforce registry.

Greg Fier [Quadriplegic - Medicaid member ]

As a quadriplegic for the past 11 years who requires assistance for every activity of daily living, I have found myself in need of finding a direct care provider on short notice more times than I can remember. It has always been extremely difficult to find a qualified provider even when I have months in which to make a hire. Finding someone to fill in on short notice is not only extremely difficult, but can be very dangerous. I have had to sleep in my wheelchair on several occasions. On a number of occasions, I have had to hire someone who is not CDAC certified. On three of those occasions, I selected helpers who wound up being found as having serious drug problems. An expanded and detailed list of available direct care providers is sorely needed for the safety and wellbeing of Iowa's most vulnerable population.