HF 106 (LSB 1487YH (4) 86)

HOUSE FILE 106

BY  STAED, WINCKLER, WESSEL-KROESCHELL, HEDDENS, ANDERSON, BERRY, THEDE, BROWN-POWERS, McCONKEY, GASKILL, SMITH, ABDUL-SAMAD, STECKMAN, KEARNS, OURTH, HANSON, HUNTER, MEYER, MASCHER, LENSING, WOLFE, FORBES, GAINES, KELLEY, OLSON, DUNKEL, PRICHARD, OLDSON, and RUFF

A BILL FOR

An Act relating to the establishment of a health workforce center.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  FINDINGS AND INTENT.
   1.  The general assembly finds all of the following:
   a.  The majority of aging Iowans and individuals with disabilities want to live as independently as possible in their own communities for as long as possible. 
   b.  The increasing number of aging Iowans and individuals with disabilities requires a greater supply of health and long-term care workers.
   c.  The safety and well-being of Iowans is dependent upon a stable health and long-term care workforce to serve their needs when and where such needs arise.
   d.  The direct care workforce is America’s fastest growing profession, with the need estimated by the state direct care workforce initiative in Iowa to be 20,000 new direct care positions by the year 2020. However, the number of individuals who typically fill these positions, typically women between the ages of 18 and 44, is dwindling, while those working in the field experience an average annual turnover rate of between 40 and 60 percent.
   e.  High staff turnover cost taxpayers and the state millions of dollars, annually, but more consistent and reliable data on supply, demand, turnover, turnover costs, staffing levels, and various data correlation and other analyses of this critical workforce is needed.
   f.  Extensive work has already been done to study the issues impacting the direct care workforce and other providers of health and long-term care with significant public and private sector investment, including:
   (1)  The direct care worker compensation advisory committee which submitted recommendations for consideration by the general assembly in the 2009 legislative session regarding wages and other compensation paid to direct care workers in nursing facilities. The recommendations included strategies to improve wages and benefits paid to direct care workers employed in Iowa’s nursing facilities that, in time, would help to bridge the wage gap for direct care workers in home and community-based and other settings if implemented.
   (2)  The various initiatives undertaken by the department of public health including the direct care worker task force, the governor’s task force on the nursing shortage, the Alzheimer’s disease task force, the direct care workforce initiative, and the personal and home care aide state training (PHCAST) project undertaken through a federal grant awarded to only six states in the country to develop and pilot a gold standard of education and training for direct care workers.
   (3)  The development of a strategic plan for health care delivery infrastructure and health care workforce resources by the health and long-term care access advisory council released in 2010.
   (4)  The accumulation of relevant data by various state agencies regarding issues impacting the health and long-term care workforce and the impact of not having a quality and stable workforce.
   g.  All of these studies and initiatives and all of the data collected have demonstrated consistent results, with the overriding recommendation being that a point of coordination should be established to address health and long-term care workforce concerns.
   h.  (1)  Iowa Code section 135.163 directs the department of public health to coordinate public and private efforts to develop and maintain an appropriate health care delivery infrastructure and a stable, well-qualified, diverse, and sustainable health care workforce in this state to address the broad spectrum of health care needs of Iowans throughout their lifespan including long-term care needs. At a minimum, the department is to develop a strategic plan for health care delivery infrastructure and health care workforce resources in this state; provide for the continuous collection of data to provide a basis for health care strategic planning and health care policymaking; and make recommendations regarding the health care delivery infrastructure and the health care workforce to assist in monitoring current needs, predicting future trends, and informing policymaking.
   (2)  Iowa Code section 135.11, subsection 27, directs the department of public health to establish and administer, if sufficient funds are available, a program to assess and forecast health workforce supply and demand in the state for the purpose of identifying current and projected workforce needs. The program may collect, analyze, and report data that furthers the purpose of the program. The program shall not release information that permits identification of individual respondents of program surveys.
   2.  Given that the recommendations of all of the initiatives and studies have consistently called for the establishment of a point of coordination and given the leadership demonstrated by the department of public health and the directives to the department relating to the health and long-term care workforce, it is the intent of the general assembly that an Iowa health workforce center be established within the department of public health to act as the state’s coordination point to address health workforce concerns.
   a.  It is the intent of the general assembly that the center provide a home for direct care and other health workforce initiatives across state government, charged with ensuring a more coordinated effort to identify and address various needs and solutions to workforce stability, and focusing on the advancement of a significant body of research, programming, and services proven to be effective in bringing more stability to the health and long-term care workforce. 
   b.  It is the intent of the general assembly that the investment in existing and new strategies funded by the state and the private sector, and carried out by the department, will result in a return on investment through improved utilization of tax dollars which has the potential to result in health care cost containment and reduce Medicaid and other costs related to poor quality of care and staff turnover.
   c.  It is also the intent of the general assembly that the center provide an opportunity to demonstrate Iowa’s continued leadership in the nation as a model in providing quality of life for all of its citizens.
    Sec. 2.  NEW SECTION.  135.164A  Iowa health workforce center —— established.
   1.  The department shall establish an Iowa health workforce center to coordinate public and private health and long-term care workforce efforts in the state.
   2.  At a minimum, the center shall do all of the following:
   a.  Provide for continuous data collection, management, and analysis to ensure a basis for health care strategic planning and health care policymaking, and for the making of recommendations to assist in monitoring current needs, predicting future trends, and informing policymaking.
   b.  Build a cohesive, collaborative, and comprehensive network of public and private partnerships with a common mission of ensuring a stable health and long-term care workforce prepared to provide quality care and support to Iowans and to provide the basic infrastructure and capacity to advance existing bodies of work developed through these efforts.
   c.  Examine the health care workforce from a systems-based approach and find solutions to the problems the health care system faces by bringing together stakeholders from education, health professions, hospitals, and government to build sustainable programs that solve the problems facing health care workers and employers through health care workforce innovations. 
   d.  Coordinate recruitment, training, and retention efforts and serve as an incubator for new recruitment, training, and retention initiatives.
   e.  Undertake other activities as necessary to assist in developing and maintaining a stable, well-qualified, diverse, and sustainable health care workforce which may appropriately address the broad spectrum of health care needs of Iowans across their ability level and throughout their lifespan.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill provides findings and intent of the general assembly relating to the establishment of an Iowa health workforce center.
   The bill establishes the Iowa health workforce center in the department of public health to coordinate public and private health and long-term care workforce efforts in the state. At a minimum, the center must provide for continuous data collection, management, and analysis to provide a basis for health care strategic planning and health care policymaking, and to make recommendations to assist in monitoring current needs, predicting future trends, and informing policymaking; build a cohesive, collaborative, and comprehensive network of public and private partnerships with a common mission of ensuring a stable health and long-term care workforce prepared to provide quality care and support to Iowans and provide the basic infrastructure and capacity to advance existing bodies of work developed through these efforts; examine the health workforce from a systems-based approach and find solutions to the problems by bringing together stakeholders from education, health professions, hospitals, and government to build sustainable programs that solve the problems facing health care workers and employers through health care workforce innovations; coordinate recruitment, training, and retention efforts and serve as an incubator for new recruitment, training, and retention initiatives; and undertake other activities as necessary to assist in developing and maintaining a stable, well-qualified, diverse, and sustainable health care workforce which may appropriately address the broad spectrum of health care needs of Iowans across their ability level and throughout their lifespan.