Mainstream Living

Iowa Providers Advocate for Change

March 10, 2021

The Iowa Association of Community Providers submitted letters to local media, advocating for legislative support in the current cycle.  The current IACP Board of Directors is led by Mainstream Living President/CEO Bill Vaughn.  Below is the text of the board's letter. 


Iowa community providers support people in our communities who need mental health and disability services. Even before the COVID-19 pandemic turned our state upside down, community providers faced a crisis-level workforce shortage. Community providers were grateful that Gov. Reynolds recognized the crisis and included much needed financial support in the budget she proposed in January. We know that state legislators on both side of the aisle, including Health and Human Services Appropriations Chairs Rep. Joel Fry and Sen. Mark Costello, understand the challenges facing community providers in Iowa. We urge the Legislature to support the home and community-based services, habitation care and intermediate care facility/intellectual disability services funding included by Gov. Reynolds in her proposed budget.

The direct support professional employed by Iowa community providers deliver mental health and disability support and services. They are a lifeline for many Iowans. Their support allows people to stay in their homes, as opposed to state institutions. In addition to providing what people think of as standard care, these professionals often assist with cooking, cleaning, budgeting, shopping, banking, job development/coaching, transportation, and community activities. 

For Iowans who depend on these services, Medicaid provides the financial support for their care. Medicaid exists to serve the disability populations. As a result, community providers’ ability to recruit and retain direct support professionals is based almost entirely on Medicaid reimbursement rates for services. And unfortunately, these reimbursement rates are not keeping up. Since 1993, the reimbursement rate for these services is only 76 percent of what it would be if it had kept up with inflation.

While community providers understand the state government has a responsibility to be a good steward of taxpayers’ money, state leaders must also consider the real life consequences the lack of financial support is having on our ability to care for Iowans. A community provider’s ability to pay a competitive wage for direct support professionals is tied directly to Medicaid reimbursement rates and as a result, providers are struggling to keep these professionals from leaving the field for other jobs. As a result, nearly every community provider in Iowa reports they are struggling to hire direct support professionals.

Governor Kim Reynolds recognizes this is a problem and included funding in her January budget proposal to support these communities. We think this is a crucial step and urge state legislators to include funding in the final state budget to support the home and community-based services, habitation care and intermediate care facility/intellectual disability services delivered by Iowa community providers.

Signed by:

Bill Vaughn
CEO, Mainstream Living
Chair, Iowa Association of Community Providers Board of Directors
Steve Muller
CEO, Balance Autism
Chair, Iowa Association of Community Providers Government Relations Committee

Shelly Chandler
CEO, Iowa Association of Community Providers

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