- Associated Press - Monday, January 18, 2016

The Des Moines Register. Jan. 12, 2016

Wellmark ruling reveals patient struggles.

Iowa’s largest health insurer searched for any way to justify not reimbursing an Iowa City pharmacist for drugs he dispensed to hemophilia patients. Wellmark Blue Cross and Blue Shield ultimately breached its contract with Michael Stein by not honoring 114 claims for drugs dispensed to 24 patients, according to a decision issued last month by the Iowa Court of Appeals. If the ruling stands, the insurer may owe an estimated $9 million.

Stein, who lost his business due to the long-running legal dispute, called the outcome “a victory for pharmacy and a victory for patient advocacy.” But the average person who sits down with the 32-page decision likely doesn’t feel much satisfaction. That’s because the most troubling aspects of this case can’t be sorted out by a court.

Beyond a claims dispute, this is a story about the outrageous cost of life-saving drugs in this country, an insurer’s frustration with the expense and, most important, the average people caught in the middle. These include parents simply trying to keep their children alive.



One of those children was a young Iowan with hemophilia identified by the court as “A.K.” In need of so-called “factor” drugs to prevent the 5-year-old from bleeding to death in 2008, the family found Pharmacy Matters, a home-infusion therapy provider owned by Stein. Not long after, the family was dragged into a dispute between the child’s health insurer and the pharmacy.

As part of an investigation into Stein, Wellmark wanted the child’s medication logs. Though the family had agreed to mail them, the insurer insisted on an in-home visit. A company investigator, along with two investigators from the federal government, traveled to their southeast Iowa home. Though the parents accounted for every shipment of drugs they had received, the insurance investigator felt compelled to personally warn them they were “getting really close” to their lifetime cap on their coverage. (The father later testified this was not true and their son had used only about 10 percent of the limit). The worker viewed the father as “a bit hostile” during the visit, according to court records.

A bit hostile. Imagine that.

These are the parents of a child with a rare blood disorder that impairs the body’s ability to control blood clotting. They know the only thing standing between him and death are drugs that cost about $1 million a year. Their income was low enough to qualify the child for a Medicaid insurance program administered by the private insurer. The policy’s “covered benefits” included the infusion therapy the child needed. These parents regularly spent hours with hemophilia specialists and struggled to locate veins on a little boy to administer drugs. They searched the country for help. They tracked down an approved pharmacy to provide the drugs.

As if they don’t have enough to worry about, they are then subjected to a three-hour visit from strangers - including a company investigator they will later find out had been promised a free lunch if she could convince the family to change pharmacies. Soon after, the supplier of their child’s drugs goes out of business.

So feeling a bit hostile is certainly understandable.

While a pharmacist and insurer worked through a court dispute, what happened to this family and this child? And are they now among the thousands of Iowans whose health insurance coverage has been disrupted by Gov. Terry Branstad’s quest to privatize Medicaid? The government insurance program for children that the parents were relying on a few years ago has been left in limbo.

While insurers, providers and politicians work to protect their financial and political agendas, we cannot forget the lives of vulnerable Iowans are really what’s at stake.

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The Waterloo-Cedar Falls Courier. Jan. 13, 2016

Full speed ahead for Single Speed Brewery.

Last week it was announced Single Speed Brewing Co. had received the deed to the old Hostess Bakery building from the city of Waterloo.

That’s great news for those supporting the project of renovating the old Hostess Wonder Bread building and placing a viable business at the site - which includes a production brewery, restaurant and retail space. Sidecar Coffee also is set to locate in a portion of the building.

“People are stoked,” said Dave Morgan, Single Speed founder.”It’s gone slightly quiet because nothing’s been happening while we waited to get the deed.”

While the building has already received a local historic designation, Single Speed is pursuing its listing on the National Register of Historic Places. Some work will be waiting on historic reviews.

Single Speed has fit in nicely in its Cedar Falls location, quickly becoming a successful and complementary business to the merchants, bars and eateries downtown.

Last spring it became known Single Speed was looking at expanding its operation and was looking at the building at West Third and Commercial streets in Waterloo.

It’s a site that intrigued Morgan. It’s in the heart of the city’s Riverfront Renaissance project near the RiverLoop Expo Plaza and Amphitheatre, Center for the Arts, Cedar Valley SportsPlex and Young Arena.

We believe the project currently moving forward can add a quaint and enjoyable atmosphere to that particular area, which will blend well with the redevelopment of Waterloo’s downtown - efforts that have been years in the making and many that have come to fruition.

Initially, there had been some question if the city should keep a one-story building on that location.

In 2014, a proposal to build a 58-unit apartment building near the former bakery fell though after it failed to receive the $3 million federal community development block grant.

After reviewing, the city saw the Single Speed proposal as a legitimate one. It’s an established business that will fit in well downtown. It’s a way to encourage economic development as well as historic re-use. And, it’s all in an area the city has set up as a social hub that is friendly to foot traffic.

Around the country, former Wonder Bread plants have found new life as shared work space offices, breweries and restaurants. In Waterloo, the old bakery is in a key location. That’s why the city purchased it - to be able to control what was ultimately placed there. It was a good strategy

This will add another destination point for downtown Waterloo. We thank Morgan and others who have been pushing for this project, and we thank city leaders and officials who worked with them

We’re looking forward to having this new neighbor in downtown Waterloo.

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The Mason City Globe Gazette. Jan. 14, 2016

Mitchell County Habitat for Humanity could use a big hand.

If nothing happens in the near future, Mitchell County residents could miss out on some special smiles.

Smiles like those on the faces of Jackie Levendusky and her family when they were presented the keys to their new Habitat for Humanity home in February 2014. At that ceremony she said her family was “blessed for all the work” done by friends and volunteers, many one in the same.

Unfortunately, county residents might not see those kinds of smiles again, because Habitat for Humanity in Mitchell County is dissolving, and the lack of those kinds of volunteers who helped change Levendusky’s life is the reason.

But maybe there’s one last chance. One chance for volunteers to come forward and make a difference for fellow Mitchell County residents who need good housing.

That’s what happened the first time.

On Jan. 1, 2001, Habitat for Humanity Mitchell County was approved as an official affiliate of Habitat for Humanity International. The idea to seek Habitat affiliation was formed in March 1999 when, according to a story in the Mitchell County Press-News, residents discovered many families in the county needed affordable homes, the kind of which did not exist.

After undergoing training and achieving non-profit status, a fundraising plan was developed.

Ultimately, three homes were built over the years: the first in 2002 for the Connie Morrison family in Osage, the second in 2009 for the Steve and Sara Martinie family in St. Ansgar and the third for Jackie Levendusky’s family in Osage.

As she accepted the keys to the new house in 2014, Levendusky said, “It has been overwhelming at times, and a long journey. I am just so grateful to everyone who helped; it’s just perfect.”

Now, there will be no more such experiences to be had if the organization disbands for lack of willing volunteers. It’s not been for the lack of trying by the current Mitchell County board members, who kept things going as long as they could while they looked for more help.

“It’s not like we didn’t try to find people,” according to board member Neil Hernan. “We advertised many times and just couldn’t find people to commit to be on the board or to even help build.”

Every time they asked why there wasn’t more help to be found, “we just couldn’t come up with any definite reason.”

It’s not easy to find volunteers these days. Many organizations will attest to that. Families are extremely busy and there are many demands on peoples’ times. Plus too many people just don’t see the benefit of volunteering - especially in projects that take considerable work like Habitat for Humanity.

So now, the dissolution papers have been filed. Things aren’t looking good. But Hernan and his group are still holding out hope - hope that people, seeing the need and wanting to see more smiling faces on people given an extraordinary opportunity, will step forward so the group can continue its good work.

As late board member Neil Wubben once said, “Habitat’s mission is to build homes and build hope.”

Here’s hoping volunteers will keep that mission going strong.

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Quad City Times. Jan. 15, 2016

Rauner successfully held the line.

Gov. Bruce Rauner’s first year in office isn’t the “failure” that so many pundits like to call it. On the contrary, Rauner’s oft-derided stubbornness has forced Springfield to face the fiscal pit into which Illinois has fallen.

“Gridlock” has consumed the Capitol, they say. The Republican’s “Turnaround Agenda” is stalled in a Democratic-run General Assembly. He’s “failed” to get a budget passed, an indication that even the most basic function of state government has ground to a halt with Rauner at the helm.

The critics miss the point.

Illinois’s credit rating plunges with the regularity of a sunset. Its roads crumble. Billions of dollars worth of unpaid bills continue to mount. Roughly 20 percent of the general fund goes toward keeping the pension fund solvent. Its largest city, Chicago, is nearing financial ruin.

Rauner has stubbornly clung to the notion that Illinois can’t afford to continue as it has, taxing and spending with no long-term goals or planning. He’s lambasted a legislative leadership so cozy with special interests that operating the state takes a backseat to their party’s political class. Dubbed “anti-worker,” his negotiations with public unions will save the state piles of cash. And his refusal to capitulate to Illinois’s largest public union, the American Federation of State, County and Municipal Employees (AFSCME), is refreshing in a state going broke.

Rauner’s style isn’t elegant. It’s not seasoned. It’s sometimes blunt and unyielding. That’s typically a problem in politics. But Rauner is the exception, thanks largely to Illinois’s sad condition at this point in history.

Former Gov. Pat Quinn probably would have griped if the General Assembly sent yet another budget to his desk with a $4 billion deficit. Quinn would have pushed back here and there. Maybe there would be a line-item veto or two. But, ultimately, he would have signed it.

Quinn would have given in to AFSCME after a few months, when the protesters got too loud and the Legislature too troublesome. Quinn would have blasted the status quo that’s strangling services to pay for handouts. And then he would have maintained it.

Rauner is a different sort. He’s a wealthy CEO who is used to getting what he wants, observers often complain. But a little pigheadedness at the top might be just what Illinois needs right now.

Frankly, Rauner has shown a greater affinity for occasional compromise than the likes of House Speaker Mike Madigan. For example, late last year, he reversed devastating cuts to the state’s child care assistance program. Perhaps the prospect of Republican defectors and a possible veto-override fueled the reversal. Any cynic can see the political damage Rauner would have suffered had General Assembly Republicans rebelled. Regardless, he sat down with Senate Democrats and got the program funded. Just maybe, Rauner realized that the cuts were a counterproductive swipe that drove single mothers from the workforce.

While Madigan and his ilk fight only for a busted status quo, Rauner marches for a necessary shift in paradigm.

There’s no budget. Illinois is still bleeding money. And almost all of Rauner’s “turnaround agenda” collects dust in some committee room.

But the strife that’s infected Illinois precedes Rauner by decades. It’s his unwillingness to cave that has forced Illinois to look into the mirror. And, in Illinois, simply gazing at the ugly reality is, at this point, an accomplishment.

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