Senator Grassley discusses variety of matters during Allamakee County visit

by Joe Moses

Iowa Senator Charles Grassley held a Q&A session Tuesday, May 4 at the Waukon Wellness Center’s Community Room as part of his annual 99-County Tour, an effort to hear directly from his constituents about issues affecting Iowans. Over 20 individuals were in attendance representing a cross section of business, industry, health care and economic development within Allamakee County.

CEO Michael Coyle of Veterans Memorial Hospital (VMH) in Waukon began the discussion with Grassley by providing some background relating to the recent opening of the VMH Waukon Medical Clinic. Coyle discussed the Mayo Clinic’s decision to leave that clinic space a year and a half ago, leaving many without a local primary health care provider. Coyle noted that the Gundersen Clinic on the VMH campus has done a great job in serving patients but with the loss of the Mayo Clinic, there was a need for additional providers in this community.

Coyle explained that there are challenges in providing the services of specialists due to the co-mingling restrictions placed on hospital and rural health clinic space. Coyle elaborated that restrictions do not allow rural health care clinic patients and hospital outpatients to see specialists in the same building without separate entrances, nursing staff and reception staff for these separate areas. Grassley replied that he has not heard similar feedback from other health care providers, with Coyle further explaining that many providers are able to operate within these restrictions through the use of separate buildings within or near their campuses for specialists. Coyle added that VMH is land locked as far as space for developing an additional structure for this purpose and that creating a separate entrance with additional staffing within a building is not ideal with there being space within the hospital for additional specialists if these co-mingling restrictions were removed. Coyle suggested these restrictions be reviewed, with Grassley agreeing to further look into the matter.

Later in the meeting, Coyle discussed concerns relating to the State of Iowa not considering Emergency Medical Services (EMS), such as ambulance, as an essential service, which, in turn, creates difficulties in funding this need for small communities.

Steve Bargar, Administrator at Good Samaritan Society-Waukon, added to Coyle’s earlier comments relating to the impact and need of having specialists available in this community on a regular and permanent basis. Bargar advised that nursing home residents require transport to other communities in order to see medical specialists, which financially benefits other communities while creating challenges locally from a staffing perspective. Coyle added that there are some specialists currently available, including a general surgeon once a week and a podiatrist being available once a month.

Bargar transitioned into discussion of the COVID-19 pandemic’s impact upon nursing homes, describing it as being a disease and infection control crisis that is rapidly becoming a financial crisis industry-wide. Bargar explained that decreased occupancy as many choose to delay moving into a nursing facility due to pandemic-related concerns, a reduced number of health care professionals staying in the health care field, staffing shortages and subsequent unsustainable incentive wages for additional shifts, in addition to a lack of rate increases for provider funding through the Coronavirus, Aid, Relief and Economic Security (CARES) Act are contributing to the financial crisis currently felt in the nursing home industry.

Bargar also discussed current challenges in recruiting employees including competition with other health care partners for job candidates while also competing with the rebounding hospitality industry. Bargar also expressed concerns that extended and enriched unemployment benefits may be keeping qualified candidates out of the workforce with several other employers echoing similar comments later in the meeting relating to their respective staffing and recruitment efforts.

Bargar also suggested that there is work to be done in overcoming job candidates’ current fears in working in the health care industry with it being important that the government looks into ways to support the nursing home industry. In response, Grassley said that the additional Federal funding toward State unemployment is scheduled to end in September. Grassley and Bargar discussed occupancy rates for nursing homes with Bargar indicating that the Good Samaritan Society’s occupancy rate is trending upwards slowly and above national trends. Bargar further discussed that improvement is needed relating to the release of funds through the CARES Act and that tuition assistance and programs supporting entry into nursing and CNA training would be beneficial in revitalizing the talent pool for the nursing home industry.

In other discussion, Grassley relayed his concerns relating to the Biden Administration’s $2.6 trillion in spending allocated through the CARES Act. He said that only 25 percent, approximately $600 billion, is designated for traditional infrastructure improvements including bridges, roads and broadband.

Grassley added that the $600 billion in infrastructure funding should have been achieved through a bipartisan agreement rather than the $2.6 trillion in funding approved along party lines.

A variety of other topics were discussed with Grassley by those in attendance. Gail Prestemon, President and CEO of Waukon State Bank, discussed the importance of continuing family farming operations with the economic barriers families face in transferring farms to the next generation of young farmers including capital gains tax, inheritance tax and rising land values preventing expansion for many. Waukon Mayor Pat Stone and Shain Kroenecke, Vice President of Iowa Operations and Sales for Aveka Nutra Processing, discussed matters relating to election security with Kroenecke also discussing the influence of social media. Jane Regan of Upper Iowa Insurance Services discussed challenges related to employee recruitment. Director Ardie Kuhse of Waukon Economic Development Corporation relayed comments and feedback from several business leaders not able to attend this meeting. Executive Director Val Reinke of Allamakee County Economic Development (ACED) provided an overview of the county’s efforts in promoting tourism and job growth.

During the media availability portion of the meeting, Grassley responded to questions from The Standard. Relating to economic development, Grassley discussed infrastructure with improved internet service and broadband being important factors for economic growth in Iowa. As far as current or proposed legislation that will be beneficial to Iowa, Grassley offered the bipartisan Prescription Drug Pricing Reduction Act, co-authored by Grassley and Senator Ron Wyden (D-OR), to reduce prescription drug costs. Grassley also discussed the Cattle Market Transparency Bill, which he indicated will improve markets through competition and transparency while requiring that a minimum of 50 percent of a meat processor’s weekly volume of beef be purchased on the open market through independent negotiated price. Regarding Grassley’s 99-County Tour, the veteran Senator said that five meetings in different counties are taking place during his May 4 visit to northeast Iowa, including Winneshiek, Allamakee, Clayton, Fayette and Jones Counties.