S.F. _____ Section 1. FINDINGS AND INTENT. 1 1. The general assembly finds all of the following: 2 a. The majority of aging Iowans and individuals with 3 disabilities want to live as independently as possible in their 4 own communities for as long as possible. 5 b. The increasing number of aging Iowans and individuals 6 with disabilities requires a greater supply of health and 7 long-term care workers. 8 c. The safety and well-being of Iowans is dependent upon a 9 stable health and long-term care workforce to serve their needs 10 when and where such needs arise. 11 d. The direct care workforce is America’s fastest growing 12 profession, with the need estimated by the state direct care 13 workforce initiative in Iowa to be 20,000 new direct care 14 positions by the year 2020. However, the number of individuals 15 who typically fill these positions, typically women between the 16 ages of 18 and 44, is dwindling, while those working in the 17 field experience an average annual turnover rate of between 40 18 and 60 percent. 19 e. High staff turnover cost taxpayers and the state millions 20 of dollars, annually, but more consistent and reliable data on 21 supply, demand, turnover, turnover costs, staffing levels, and 22 various data correlation and other analyses of this critical 23 workforce is needed. 24 f. Extensive work has already been done to study the issues 25 impacting the direct care workforce and other providers of 26 health and long-term care with significant public and private 27 sector investment, including: 28 (1) The direct care worker compensation advisory committee 29 which submitted recommendations for consideration by the 30 general assembly in the 2009 legislative session regarding 31 wages and other compensation paid to direct care workers in 32 nursing facilities. The recommendations included strategies 33 to improve wages and benefits paid to direct care workers 34 employed in Iowa’s nursing facilities that, in time, would help 35 -1- LSB 1487XC (1) 86 pf/nh 1/ 6

S.F. _____ to bridge the wage gap for direct care workers in home and 1 community-based and other settings if implemented. 2 (2) The various initiatives undertaken by the department of 3 public health including the direct care worker task force, the 4 governor’s task force on the nursing shortage, the Alzheimer’s 5 disease task force, the direct care workforce initiative, 6 and the personal and home care aide state training (PHCAST) 7 project undertaken through a federal grant awarded to only six 8 states in the country to develop and pilot a gold standard of 9 education and training for direct care workers. 10 (3) The development of a strategic plan for health care 11 delivery infrastructure and health care workforce resources by 12 the health and long-term care access advisory council released 13 in 2010. 14 (4) The accumulation of relevant data by various state 15 agencies regarding issues impacting the health and long-term 16 care workforce and the impact of not having a quality and 17 stable workforce. 18 g. All of these studies and initiatives and all of the 19 data collected have demonstrated consistent results, with the 20 overriding recommendation being that a point of coordination 21 should be established to address health and long-term care 22 workforce concerns. 23 h. (1) Iowa Code section 135.163 directs the department 24 of public health to coordinate public and private efforts 25 to develop and maintain an appropriate health care delivery 26 infrastructure and a stable, well-qualified, diverse, and 27 sustainable health care workforce in this state to address 28 the broad spectrum of health care needs of Iowans throughout 29 their lifespan including long-term care needs. At a minimum, 30 the department is to develop a strategic plan for health care 31 delivery infrastructure and health care workforce resources 32 in this state; provide for the continuous collection of data 33 to provide a basis for health care strategic planning and 34 health care policymaking; and make recommendations regarding 35 -2- LSB 1487XC (1) 86 pf/nh 2/ 6

S.F. _____ the health care delivery infrastructure and the health care 1 workforce to assist in monitoring current needs, predicting 2 future trends, and informing policymaking. 3 (2) Iowa Code section 135.11, subsection 27, directs 4 the department of public health to establish and administer, 5 if sufficient funds are available, a program to assess and 6 forecast health workforce supply and demand in the state for 7 the purpose of identifying current and projected workforce 8 needs. The program may collect, analyze, and report data that 9 furthers the purpose of the program. The program shall not 10 release information that permits identification of individual 11 respondents of program surveys. 12 2. Given that the recommendations of all of the initiatives 13 and studies have consistently called for the establishment of 14 a point of coordination and given the leadership demonstrated 15 by the department of public health and the directives to the 16 department relating to the health and long-term care workforce, 17 it is the intent of the general assembly that an Iowa health 18 workforce center be established within the department of public 19 health to act as the state’s coordination point to address 20 health workforce concerns. 21 a. It is the intent of the general assembly that the center 22 provide a home for direct care and other health workforce 23 initiatives across state government, charged with ensuring a 24 more coordinated effort to identify and address various needs 25 and solutions to workforce stability, and focusing on the 26 advancement of a significant body of research, programming, and 27 services proven to be effective in bringing more stability to 28 the health and long-term care workforce. 29 b. It is the intent of the general assembly that the 30 investment in existing and new strategies funded by the state 31 and the private sector, and carried out by the department, will 32 result in a return on investment through improved utilization 33 of tax dollars which has the potential to result in health care 34 cost containment and reduce Medicaid and other costs related to 35 -3- LSB 1487XC (1) 86 pf/nh 3/ 6

S.F. _____ poor quality of care and staff turnover. 1 c. It is also the intent of the general assembly that the 2 center provide an opportunity to demonstrate Iowa’s continued 3 leadership in the nation as a model in providing quality of 4 life for all of its citizens. 5 Sec. 2. NEW SECTION . 135.164A Iowa health workforce center 6 —— established. 7 1. The department shall establish an Iowa health workforce 8 center to coordinate public and private health and long-term 9 care workforce efforts in the state. 10 2. At a minimum, the center shall do all of the following: 11 a. Provide for continuous data collection, management, 12 and analysis to ensure a basis for health care strategic 13 planning and health care policymaking, and for the making 14 of recommendations to assist in monitoring current needs, 15 predicting future trends, and informing policymaking. 16 b. Build a cohesive, collaborative, and comprehensive 17 network of public and private partnerships with a common 18 mission of ensuring a stable health and long-term care 19 workforce prepared to provide quality care and support to 20 Iowans and to provide the basic infrastructure and capacity 21 to advance existing bodies of work developed through these 22 efforts. 23 c. Examine the health care workforce from a systems-based 24 approach and find solutions to the problems the health care 25 system faces by bringing together stakeholders from education, 26 health professions, hospitals, and government to build 27 sustainable programs that solve the problems facing health 28 care workers and employers through health care workforce 29 innovations. 30 d. Coordinate recruitment, training, and retention efforts 31 and serve as an incubator for new recruitment, training, and 32 retention initiatives. 33 e. Undertake other activities as necessary to assist in 34 developing and maintaining a stable, well-qualified, diverse, 35 -4- LSB 1487XC (1) 86 pf/nh 4/ 6

S.F. _____ and sustainable health care workforce which may appropriately 1 address the broad spectrum of health care needs of Iowans 2 across their ability level and throughout their lifespan. 3 EXPLANATION 4 The inclusion of this explanation does not constitute agreement with 5 the explanation’s substance by the members of the general assembly. 6 This bill provides findings and intent of the general 7 assembly relating to the establishment of an Iowa health 8 workforce center. 9 The bill establishes the Iowa health workforce center in the 10 department of public health to coordinate public and private 11 health and long-term care workforce efforts in the state. 12 At a minimum, the center must provide for continuous data 13 collection, management, and analysis to provide a basis for 14 health care strategic planning and health care policymaking, 15 and to make recommendations to assist in monitoring current 16 needs, predicting future trends, and informing policymaking; 17 build a cohesive, collaborative, and comprehensive network 18 of public and private partnerships with a common mission of 19 ensuring a stable health and long-term care workforce prepared 20 to provide quality care and support to Iowans and provide 21 the basic infrastructure and capacity to advance existing 22 bodies of work developed through these efforts; examine 23 the health workforce from a systems-based approach and find 24 solutions to the problems by bringing together stakeholders 25 from education, health professions, hospitals, and government 26 to build sustainable programs that solve the problems facing 27 health care workers and employers through health care workforce 28 innovations; coordinate recruitment, training, and retention 29 efforts and serve as an incubator for new recruitment, 30 training, and retention initiatives; and undertake other 31 activities as necessary to assist in developing and maintaining 32 a stable, well-qualified, diverse, and sustainable health care 33 workforce which may appropriately address the broad spectrum 34 of health care needs of Iowans across their ability level and 35 -5- LSB 1487XC (1) 86 pf/nh 5/ 6