House File 106 - Introduced HOUSE FILE 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 1 An Act relating to the establishment of a health workforce 2 center. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 1487YH (4) 86 pf/nh PAG LIN 1 1 Section 1. FINDINGS AND INTENT. 1 2 1. The general assembly finds all of the following: 1 3 a. The majority of aging Iowans and individuals with 1 4 disabilities want to live as independently as possible in their 1 5 own communities for as long as possible. 1 6 b. The increasing number of aging Iowans and individuals 1 7 with disabilities requires a greater supply of health and 1 8 long=term care workers. 1 9 c. The safety and well=being of Iowans is dependent upon a 1 10 stable health and long=term care workforce to serve their needs 1 11 when and where such needs arise. 1 12 d. The direct care workforce is America's fastest growing 1 13 profession, with the need estimated by the state direct care 1 14 workforce initiative in Iowa to be 20,000 new direct care 1 15 positions by the year 2020. However, the number of individuals 1 16 who typically fill these positions, typically women between the 1 17 ages of 18 and 44, is dwindling, while those working in the 1 18 field experience an average annual turnover rate of between 40 1 19 and 60 percent. 1 20 e. High staff turnover cost taxpayers and the state millions 1 21 of dollars, annually, but more consistent and reliable data on 1 22 supply, demand, turnover, turnover costs, staffing levels, and 1 23 various data correlation and other analyses of this critical 1 24 workforce is needed. 1 25 f. Extensive work has already been done to study the issues 1 26 impacting the direct care workforce and other providers of 1 27 health and long=term care with significant public and private 1 28 sector investment, including: 1 29 (1) The direct care worker compensation advisory committee 1 30 which submitted recommendations for consideration by the 1 31 general assembly in the 2009 legislative session regarding 1 32 wages and other compensation paid to direct care workers in 1 33 nursing facilities. The recommendations included strategies 1 34 to improve wages and benefits paid to direct care workers 1 35 employed in Iowa's nursing facilities that, in time, would help 2 1 to bridge the wage gap for direct care workers in home and 2 2 community=based and other settings if implemented. 2 3 (2) The various initiatives undertaken by the department of 2 4 public health including the direct care worker task force, the 2 5 governor's task force on the nursing shortage, the Alzheimer's 2 6 disease task force, the direct care workforce initiative, 2 7 and the personal and home care aide state training (PHCAST) 2 8 project undertaken through a federal grant awarded to only six 2 9 states in the country to develop and pilot a gold standard of 2 10 education and training for direct care workers. 2 11 (3) The development of a strategic plan for health care 2 12 delivery infrastructure and health care workforce resources by 2 13 the health and long=term care access advisory council released 2 14 in 2010. 2 15 (4) The accumulation of relevant data by various state 2 16 agencies regarding issues impacting the health and long=term 2 17 care workforce and the impact of not having a quality and 2 18 stable workforce. 2 19 g. All of these studies and initiatives and all of the 2 20 data collected have demonstrated consistent results, with the 2 21 overriding recommendation being that a point of coordination 2 22 should be established to address health and long=term care 2 23 workforce concerns. 2 24 h. (1) Iowa Code section 135.163 directs the department 2 25 of public health to coordinate public and private efforts 2 26 to develop and maintain an appropriate health care delivery 2 27 infrastructure and a stable, well=qualified, diverse, and 2 28 sustainable health care workforce in this state to address 2 29 the broad spectrum of health care needs of Iowans throughout 2 30 their lifespan including long=term care needs. At a minimum, 2 31 the department is to develop a strategic plan for health care 2 32 delivery infrastructure and health care workforce resources 2 33 in this state; provide for the continuous collection of data 2 34 to provide a basis for health care strategic planning and 2 35 health care policymaking; and make recommendations regarding 3 1 the health care delivery infrastructure and the health care 3 2 workforce to assist in monitoring current needs, predicting 3 3 future trends, and informing policymaking. 3 4 (2) Iowa Code section 135.11, subsection 27, directs 3 5 the department of public health to establish and administer, 3 6 if sufficient funds are available, a program to assess and 3 7 forecast health workforce supply and demand in the state for 3 8 the purpose of identifying current and projected workforce 3 9 needs. The program may collect, analyze, and report data that 3 10 furthers the purpose of the program. The program shall not 3 11 release information that permits identification of individual 3 12 respondents of program surveys. 3 13 2. Given that the recommendations of all of the initiatives 3 14 and studies have consistently called for the establishment of 3 15 a point of coordination and given the leadership demonstrated 3 16 by the department of public health and the directives to the 3 17 department relating to the health and long=term care workforce, 3 18 it is the intent of the general assembly that an Iowa health 3 19 workforce center be established within the department of public 3 20 health to act as the state's coordination point to address 3 21 health workforce concerns. 3 22 a. It is the intent of the general assembly that the center 3 23 provide a home for direct care and other health workforce 3 24 initiatives across state government, charged with ensuring a 3 25 more coordinated effort to identify and address various needs 3 26 and solutions to workforce stability, and focusing on the 3 27 advancement of a significant body of research, programming, and 3 28 services proven to be effective in bringing more stability to 3 29 the health and long=term care workforce. 3 30 b. It is the intent of the general assembly that the 3 31 investment in existing and new strategies funded by the state 3 32 and the private sector, and carried out by the department, will 3 33 result in a return on investment through improved utilization 3 34 of tax dollars which has the potential to result in health care 3 35 cost containment and reduce Medicaid and other costs related to 4 1 poor quality of care and staff turnover. 4 2 c. It is also the intent of the general assembly that the 4 3 center provide an opportunity to demonstrate Iowa's continued 4 4 leadership in the nation as a model in providing quality of 4 5 life for all of its citizens. 4 6 Sec. 2. NEW SECTION. 135.164A Iowa health workforce center 4 7 == established. 4 8 1. The department shall establish an Iowa health workforce 4 9 center to coordinate public and private health and long=term 4 10 care workforce efforts in the state. 4 11 2. At a minimum, the center shall do all of the following: 4 12 a. Provide for continuous data collection, management, 4 13 and analysis to ensure a basis for health care strategic 4 14 planning and health care policymaking, and for the making 4 15 of recommendations to assist in monitoring current needs, 4 16 predicting future trends, and informing policymaking. 4 17 b. Build a cohesive, collaborative, and comprehensive 4 18 network of public and private partnerships with a common 4 19 mission of ensuring a stable health and long=term care 4 20 workforce prepared to provide quality care and support to 4 21 Iowans and to provide the basic infrastructure and capacity 4 22 to advance existing bodies of work developed through these 4 23 efforts. 4 24 c. Examine the health care workforce from a systems=based 4 25 approach and find solutions to the problems the health care 4 26 system faces by bringing together stakeholders from education, 4 27 health professions, hospitals, and government to build 4 28 sustainable programs that solve the problems facing health 4 29 care workers and employers through health care workforce 4 30 innovations. 4 31 d. Coordinate recruitment, training, and retention efforts 4 32 and serve as an incubator for new recruitment, training, and 4 33 retention initiatives. 4 34 e. Undertake other activities as necessary to assist in 4 35 developing and maintaining a stable, well=qualified, diverse, 5 1 and sustainable health care workforce which may appropriately 5 2 address the broad spectrum of health care needs of Iowans 5 3 across their ability level and throughout their lifespan. 5 4 EXPLANATION 5 5 The inclusion of this explanation does not constitute agreement with 5 6 the explanation's substance by the members of the general assembly. 5 7 This bill provides findings and intent of the general 5 8 assembly relating to the establishment of an Iowa health 5 9 workforce center. 5 10 The bill establishes the Iowa health workforce center in the 5 11 department of public health to coordinate public and private 5 12 health and long=term care workforce efforts in the state. 5 13 At a minimum, the center must provide for continuous data 5 14 collection, management, and analysis to provide a basis for 5 15 health care strategic planning and health care policymaking, 5 16 and to make recommendations to assist in monitoring current 5 17 needs, predicting future trends, and informing policymaking; 5 18 build a cohesive, collaborative, and comprehensive network 5 19 of public and private partnerships with a common mission of 5 20 ensuring a stable health and long=term care workforce prepared 5 21 to provide quality care and support to Iowans and provide 5 22 the basic infrastructure and capacity to advance existing 5 23 bodies of work developed through these efforts; examine 5 24 the health workforce from a systems=based approach and find 5 25 solutions to the problems by bringing together stakeholders 5 26 from education, health professions, hospitals, and government 5 27 to build sustainable programs that solve the problems facing 5 28 health care workers and employers through health care workforce 5 29 innovations; coordinate recruitment, training, and retention 5 30 efforts and serve as an incubator for new recruitment, 5 31 training, and retention initiatives; and undertake other 5 32 activities as necessary to assist in developing and maintaining 5 33 a stable, well=qualified, diverse, and sustainable health care 5 34 workforce which may appropriately address the broad spectrum 5 35 of health care needs of Iowans across their ability level and 6 1 throughout their lifespan. 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