(Radio Iowa) – Mental health experts say Iowa is facing a critical shortage of providers, especially during the stressful holiday season, though some patients are turning to telehealth for care. Tarrah Holliday, a board-certified psychiatric nurse practitioner, treats up to 30 patients daily at Zion Integrated Medical Services in Atlantic. Holliday says there are only about 300 psychiatry providers statewide. “There are lengthy wait lists,” Holliday says. “Some offices you can get in within three months. Some, it takes up to six months.” As a solution, Holliday says 75-percent of her clients are turning to telehealth, and some even live three hours away.

“Many patients really prefer and feel more comfortable in their own environment,” she says, “and that has been extremely beneficial for them.” The I-S-U Extension reports Iowa is 45th in the nation for mental health care providers per capita. “Oftentimes, especially this time of the year, my colleagues and I are working extra hours and overbooking ourselves to ensure that patients get in and are able to be seen and their needs met,” Holliday says, “because this is a difficult time of year for them.”

According to the U.S. Department of Health and Human Services, about 60-percent of Iowa communities experience a shortage of mental health care. To be considered a Health Professional Shortage Area the population-to-provider ratio must be at least 30,000-to-one.

(Radio Iowa) – The state’s top economic development official says if lawmakers create a tax credit for production of sustainable aviation fuel, Iowa could land a refinery. There are already refineries in Georgia, North Dakota and Montana producing the renewable fuel for airplanes, but Iowa Economic Development Authority director Debi (like “Debbie”) Durham says there’s a market for several more around the country.

“We believe Iowa’s the perfect place to do that and actually there’s a lot of interest from the private sector to do that, based on our lead activity,” Durham says. “When you look at our overall competitive nature of our taxes, when you look where the supply is from a transportation point of view, when you look at what we’re proposing, just simply having a conversation around a production tax credit would be, I think, just stuff to move the needle a little bit because there is plenty of room in this marketplace for growth.”

Durham says the governor will reveal the specifics on tax-related recommendations in January. Durham suggests some long-standing tax credits the state has offered businesses are up for a potential overhaul. “We’ve done research on other states, the states we compete with,” Durham says, “because we want to make sure we’re not outliers in doing something.” Durham says the state tax credit for research and development is critical, but can be adjusted.

However, Durham says change is needed in the state’s 20-year-old High Quality Jobs Program. It has provided tax breaks to Iowa businesses expanding their operations here and to out-of-state companies launching an Iowa location. Durham says the program’s tax credits and exemptions were created to buy down Iowa’s corporate tax rate, which was among the highest in the country.  “Even at a 7.1% corporate flat rate now, or a two tier, getting to a goal of 5.5% with single factor — all of just makes us pretty competitive and so those incentives are not as meaningful,” Durham says. “…We don’t need as many tax incentives, we don’t need as much tax incentives, but they need to look differently and they need to function differently.”

Durham has been Iowa’s top economic development official since 2011.

(Radio Iowa) – Iowa Senator Joni Ernst is not yet ready to say how she’ll vote on President-elect Trump’s pick to head the Pentagon. During an appearance on Fox News, Ernst indicated she has not gotten to yes on Pete Hegseth’s nomination to be U-S Secretary of Defense. Ernst says she had a very thorough discussion with Hegseth on Wednesday about allegations that have been made against him.

Ernst, the first female combat veteran elected to the U-S Senate, is a sexual assault survivor. Ernst says a number senators want to make sure that any allegations against Hegseth have been cleared before his confirmation vote.

Ernst indicated the vetting of Hegseth will continue for the next month or so, until his confirmation hearing before the Senate Armed Services Committee. Ernst is a member of the panel. Another Republican on the committee praised Hegseth after meeting with him today (Thursday). However, South Dakota Senator Mike Rounds says he wants Hegseth to be able to respond publicly to the accusations against him at the committee’s confirmation hearing in January.

(Radio Iowa) – Leaders of the State Dental Association want Iowa lawmakers to address a critical shortage of dentists who accept Medicaid patients. Carroll dentist Chris Bogue, is the president of the organization.  “The reimbursement rate is one, and then the secondary is we don’t have the staff to help us see a lot of these patients,” he says. “We kind of have a double whammy and both of those issues are kind of our legislative priorities this year.” Dr. Bogue says Medicaid reimbursement rates have stayed stagnant for almost 20 years.

“It is hard and that’s the struggle. As dentists, we wanna do everything we can to help when we actually see the patients. We’re probably getting paid 20 to 30 cents on the dollar. And that doesn’t even cover overhead for a lot of the cases,” Bogue says. Tracy Gotto of the Buena Vista County Health Department says none of the five dentists in Storm Lake accepts Medicaid patients, and the local health center is the only option.

“Dentists are just saying that they can’t do it based on the reimbursement, and I think we’re just having this crisis all over. We were sending kids to Fort Dodge at one point, and now Fort Dodge is saying they can’t take any more kids either,” Gotto says. Dr. Bogue also wants the legislature to address a severe shortage of dental hygienists and assistants.

The need for Medicaid providers is so great that a free “Mission of Mercy” clinic in Sioux City in October treated one thousand people – but was forced to turn down another thousand who officials say exhausted all other options for care.

(Radio Iowa) – Governor Kim Reynolds is suggesting the tax and budget cutting formula she’s used over the past seven years could be the model for Republicans who will be in control of congress and the White House next year.  “As Washington prepares for taxes to take center stage in the next administration, there’s a new growth oriented, fiscally conscious model to look to in the heartland,” Reynolds says.

Reynolds, a Republican who’s a former county treasurer and state senator, took over as governor in mid-2017. She has signed five separate tax reduction plans into law. Next month, Iowa’s personal income tax will shrink to a single rate of three-point-eight percent. The state income tax for corporations has been reduced as well.  “Iowa’s journey to tax competitiveness — it wasn’t a matter of a few modest tweaks,” Reynolds says. “It was a complete, top-to-bottom transformation.” Reynolds also spearheaded a reorganization plan for state government in 2023. It consolidated 37 state agencies into 16.

Earlier this year Reynolds signed the law that has eliminated dozens of state boards and commissions. Reynolds says her budget trimming is required in order to cut taxes responsibly. “Fundamentally the story of Iowa’s transformation was less about implementing clever policies and it was more about unleashing the energy and creativity in Iowans and in our communities,” Reynolds syas. “It was truly the triumph of simplicity over complexity, growth over spending and bottom up energy over top down management.”

Reynolds reviewed these and other policies of the past during remarks at the Iowa Taxpayers Association’s annual symposium, but did not reveal what tax or spending ideas she’ll ask legislators to implement in 2025. Reynolds received the annual Iowa Taxpayers Association’s award for advancing business-friendly tax policies. The national Tax Foundation gave Reynolds its annual distinguished service award last month.