Iowa Ideas
Iowa Ideas

To provide a nonpartisan, statewide learning experience

designed to explore the key questions and big ideas that will shape the future of Iowa.

Iowa Ideas

From Medicaid to MeToo: Giving voice to critical issues

Dec 18, 2018 at 4:30 pm
    Panelist Chris Espersen of Chris Espersen Consulting (left) answers about how healthcare can underserve minorities during a session titled Slipping Through the Cracks at the Iowa Ideas conference at the DoubleTree by Hilton Hotel Cedar Rapids Convention Complex in downtown Cedar Rapids on Thursday, September 20, 2018. (Cliff Jette/The Gazette)
    During the first morning of The Gazette’s two-day 2018 Iowa Ideas conference, a panel of health care experts observed that a worker shortage in the state’s direct care industry is reaching a crisis level.

    But, the panelists noted, even as more Iowans are aging and requiring long-term care services, the issue doesn’t seem to get much traction at the legislative level.

    “We have to do a better job marshaling the voices of people who are concerned about this issue,” panelist John Hale said during that discussion. “We need to generate more of a critical mass so the issue gets the attention it deserves.”

    Hale, who is co-founder and president of the Hale Group, an Ankeny-based consulting business focused on aging, disability and caregiving, later reflected on how Iowa Ideas provides a voice to critical issues such as the direct care worker shortage.

    “The Iowa Ideas conference allows issues that otherwise don’t get talked about to be discussed in a significant public policy forum,” Hale said. “The conference brings people together to listen and learn — including people who are in a position to do something about it.”

    From children’s mental health to affordable housing to the future of energy-efficiency programs, the second-annual Iowa Ideas conference offered a platform for discussing scores of issues impacting the state and its residents.

    The conference took place September 20-21 in Cedar Rapids at the DoubleTree by Hilton Hotel Convention Complex.


    Designed to be a nonpartisan, statewide learning experience to explore opportunities and challenges facing Iowa, the event led off with remarks from Gloria Cotton, senior partner for inQuest Consulting, who also delivered the Diversity Forum keynote.

    Thereafter, over the next day-and-a-half, approximately 550 participants were able to pick from dozens of panel discussions in eight topic tracks — agriculture, education, energy and environment, workforce, health care, human and social services, policy and regional development.

    Tracks also were available for Diversity Forum, in partnership with the Employee Resource Group Consortium, and the NextGen Summit, in partnership with ImpactCR and EPIC.

    Some 180 speakers — industry leaders, lawmakers, educators and policy experts, among others — discussed key issues and big ideas in their respective areas of subject matter expertise.

    One attendee, Mario Fenu, who serves as Iowa business development manager for Houston Engineering Inc., an engineering and environmental consulting company, said he was most interested in topics related to the Iowa Nutrient Reduction Strategy, a water quality initiative, and the Iowa Watershed Approach, a program to address flooding, because of their relevance to HEI’s business strategies.

    He found what he was looking for in the first panel discussion in the energy and environment track, entitled “Water Quality: Next Steps.”

    “It really touched on and described Iowa’s ‘wicked problem,’” Fenu said. “That’s a term of art for a problem that doesn’t have a solution but is a series of issues that need to be managed.”

    Fenu noted how issues tend to intersect multiple topic areas.

    “You can’t talk about water quality and soil health without talking about agriculture, too,” he noted.


    That intertwining of issues and topics was perhaps no more apparent than at the lunchtime keynote panel on the first day of the conference.

    For that panel, Iowa Economic Development Authority Director Debi Durham joined with Iowa Department of Education Director Ryan Wise and Iowa Workforce Development Director Beth Townsend to discuss Future Ready Iowa, the state’s skilled workforce development initiative.

    As the trio outlined strategies for recruiting adults and students into training programs for high-demand jobs, they touched upon many issues that had and would be voiced during other panel discussions throughout the conference.

    For example, in an earlier education panel discussion about the affordability and accessibility of college in Iowa, Rob Miller, president of Iowa College Access Network, addressed Free Application for Federal Student Aid, or FAFSA, filings, a necessary first step in applying for federal student aid such as federal grants, work study, and loans.

    “FAFSA completion in the state is at 60 percent now and is going down,” Miller said.

    The topic came up again during the Future Ready Iowa panel.

    One attendee asked if that FAFSA statistic presented the reason for the panelists’ concern. Are students perceiving that college is too expensive and too out of reach and not even bothering to file a FAFSA? How will that perception affect Future Ready Iowa’s goal to have 70 percent of the workforce receive education or training beyond high school by 2025?

    “I’m not discouraged by the statistic,” Durham responded, stating that a four-year degree program isn’t necessary for everyone.

    She added that the state could do a better job tracking students who drop out of four-year college programs and then recruiting those students into apprenticeships and specialized training programs.

    The Future Ready Iowa panelists also were asked to comment on the direct care worker shortage.

    Does the state have a plan to meet that need?

    Townsend, of Iowa Workforce Development, noted that while health care is one of the high-demand careers targeted by the workforce initiative, nurse aides and in-home caregivers — who make up a large part of the direct care industry — don’t qualify for Future Ready Iowa funding because those positions don’t require specialized training.

    “We will address (direct care), trucking and other noncredit programs in the second round of funding,” Townsend said. “We have to prioritize, so we’re starting with credit programs.”


    “I think what’s at stake is our future, to be quite honest,” Durham said. “... When I started in this business, it was all about location, location, location, and so now everything is turned upside down. Site selectors are saying that they start with labor.”

    The costs of MEDICAID

    During a Thursday panel discussion on Iowa’s privatized Medicaid managed-care program, Department of Human Services Director Jerry Foxhoven said he remains “confident it’s going to show there was a savings. I think the question is not, does it save money, the question is how much.”

    But another panelist, Kirk Norris, president and chief executive officer of the Iowa Hospital Association, said association members are “still dealing with first-day issues that they were dealing with two years ago,” when most Medicaid enrollees were shifted from the state’s care to managed-care organizations.

    Hospitals, he said association members tell him, now spend $3 to process claims, whereas before it cost them $1 to do so.

    “Our argument is what we’re doing now is not sustainable,” Norris continues. “... We’re not getting any value for the money we’re spending.”


    During a Friday discussion titled “Iowa After #MeToo,” Jill Zwagerman, the lawyer who successfully represented Jane Meyer and Tracey Griesbaum in their gender discrimination lawsuit against the University of Iowa Athletics Department, said she didn’t believe “we’re going to see real change. ... We have to retrain all of our brains and start training our children to think differently about the roles of men and women.

    “Once we do that, we will see real change.”


    “I see sexual violence as part of a social justice movement,” remarked Katryn Durate, assistant director of sexual assault services at the Rape Victim Advocacy Program in Iowa City. “It’s not just men. It’s when someone is in a position of power, and they want to take from someone else.”

    Durate contended that “it’s not about us-versus-them. It’s about how can we come to solutions together.”


    The importance of marshaling voices on critical issues also came up during a policy panel discussion about whether unions still matter after sweeping changes to Iowa’s collective bargaining law.

    Panelist Coy Marquardt, associate executive director for field services of the Iowa State Education Association, said unions matter more than ever.

    “Because of the change in the law, it’s vitally important for our members to speak together as a collective voice,” he said. “When the voice is louder, you have to pay attention to it.”

    Other panels discussed the importance of giving voice to all segments of the community.


    “Everyone needs to be asked — including immigrants, the disabled and young people,” said Bill Menner, executive director of the Iowa Rural Development Council, during a regional development panel entitled “Leveraging Your Community’s Economic Engine.”

    “Make sure to engage the community as much as possible by sharing experiences and cultures,” said Stephanie Moris, coordinator for Refugee Alliance of Central Iowa, on gaining acceptance and engagement of immigrant and refugee populations during a policy and diversity panel.

    “Never too much time”

    For some attendees, the Iowa Ideas conference was an opportunity to hear other perspectives on issues that are important to them.


    “I’m curious about what other people are saying about the things I’m engaged in,” Mary Jane Cobb, executive director of the Iowa State Education Association, who attended the inaugural Iowa Ideas conference in 2017, said she came back this year “to stay abreast of the discussion about education, workforce planning and our communities.”

    For other attendees, the informal conversations and networking that occurred during the conference were just as important as the panel presentations.

    “You can never have too much time to talk and exchange ideas,” Fenu said after an impromptu discussion with industry colleagues between sessions.

    Gazette reporters Rod Boshart, Alison Gowans and Dan Mika contributed to this article.

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