Hometown Health: the Challenges and Opportunities Facing Rural Hospitals and Care

May 2020

HOMETOWN HEALTH: THE CHALLENGES AND OPPORTUNITIES FACING RURAL HOSPITALS AND CARE

ASHLEY THOMPSON, Director of government and external affairs, UnityPoint Health 2 Business Record IOWA | May 2020 IOWA ASSOCIATION OF BUSINESS AND INDUSTRY “Trust inTomorrow.”andthe“Grinnell Mutual”areregisteredtrademarksofGrinnellMutualReinsuranceCompany. ©GrinnellMutualReinsuranceCompany,2020. grinnellmutual.com and yourbusiness,fromcyberthreats. with itsownrisks.OurCyberLiabilityandBreachResponsecoveragecanprotectyou, The bestthingwecandorightnowistostayathome,butworkingfromhomecomes THIS TIME OF TIME UNCERTAINTY THIS TRUST US IN AUTO AUTO | HOME | FARM | BUSINESS A CUSTOM PUBLICATION FORABI Trust inTomorrow. ® Talktoustoday. A CUSTOM PUBLICATION FOR ABI

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MAY 2020 Assisting Members is ABI’s Focus VOLUME 10 | NUMBER 5 The global pandemic known as COVID-19 conference until much later in the year or hosting has changed the world in which we all live and a virtual event. In the end, the option with the conduct business. It has led to a major change at least uncertainty and the least negative impact on ABI as well. ABI members and the association itself was to Last month, the ABI Executive Committee cancel the event. and Board of Directors made the unprecedented Now is not the time to be taking members

decision to cancel the 2020 ABI Taking Care of away from their businesses. Now is the time for INDUSTRY AND BUSINESS OF ASSOCIATION IOWA Business Conference. That event, which would ABI to focus on providing assistance to members have been ABI’s 117th annual meeting, was sched- in any way possible. uled to be held in my adopted hometown of Ce- I am so very disappointed I won’t have the dar Rapids in June. Everyone here in eastern Iowa opportunity to welcome you to Cedar Rapids. was excited to host hundreds of Iowa’s best busi- But if there is light at the end of this tunnel, it’s Cindy Dietz ness leaders for three days of terrific program- that I am sure to see many of you in Iowa City/ The Iowa Association of Business and Industry (ABI) is the voice ABI Chair of Iowa business. It is Iowa’s oldest and largest business network, ming, networking and fun. But, that is not to be. Coralville for ABI’s 2021 conference! In the representing 1,500 businesses that employ more than 333,000 Collins Aerospace The decision to cancel the conference was not meantime, and perhaps now more than ever, Iowans. ABI benefits members by advocating on their behalf Cedar Rapids at the statehouse, connecting them with decision-makers to made lightly and, in fact, several options were ex- thank you for your support of ABI. n share ideas and services, offering solutions and best practices for issues that affect their businesses and developing our state’s plored. The committee looked at postponing the business and civic leaders.

President Michael Ralston

Executive Vice President Nicole Crain Vice President, Public Policy JD Davis ABI Foundation – Vice President Rebecca Coady Director, Public Policy Brad Hartkopf

Communications Manager David Hildahl Membership Coordinator Dorothy Knowles Member Programs Director Holly Mueggenberg ABI Foundation – Director, Programs Jessi Steward ABI Foundation – Marketing & Engagement Coordinator McKenzie Kielman ELEVATE IOWA Executive Administrative Assistant Michelle Vollstedt ABI Foundation – Administrative Assistant Jane Galloway Membership Development Services Gary Nash, Kerry Servas Iowa Association of Business and Industry Manufacturing: Not Dirty Jobs 400 East Court Avenue, Suite 100 Des Moines, IA 50309 515-280-8000 or 800-383-4224 Email: [email protected] When people think of advanced manufacturing in a project-based or virtual environment. Web: www.iowaabi.org ing, they think of dirty environments. They think it During this challenging time, most face-to-face is unsafe and has limited potential, but that simply interactions with students have been cancelled or isn’t true. “All you have to do is walk into one of postponed. these great Iowa manufacturers to see the technol- Other resources employers should keep in ogy and opportunities,” says Mike Ralston, presi- mind are the career pathways and work-based dent of ABI. “Not to mention, products made in learning toolkit projects Elevate Advanced Manu-

BPC Chairman Connie Wimer Iowa have global reach—now more than ever!” facturing, ABI and the Department of Educa- BPC President Suzanna de Baca Over the past couple months, the Elevate tion collaborated on for you to use as a reference. Publisher & Executive Editor Chris Conetzkey Advanced Manufacturing team, along with ATW Visit the Elevate Iowa website to find these tools BPC Vice President Jason Swanson Training Solutions and in partnership with all 15 or reach out to Michele Farrell at mfarrell@mea- Business Manager Eileen Jackson Iowa community colleges, have been working on suredintentions.com. Accounting Specialist Becky Hotchkiss Michele Farrell short video episodes to highlight this exact mes- Office Manager Laura Stegemann Program Manager, Elevate Inside Sales Representative Alison Damon sage—these are not dirty jobs! Video has been Advanced Manufacturing chosen because it has proven to be the best way Creative Director Joe Crimmings [email protected] Creative Associate Lauren Burt to reach our target audience of 15- to 18-year-olds. Please engage with us! Photographer Duane Tinkey These episodes will be featured on Elevate social Copy Editor Kurt Helland media and will be available for employers to use Facebook.com/ElevateIowa Director of Advertising Sara Brown as a resource.

Instagram @IAElevate 2020 May Senior Account Executives Lori Bratrud, Kristi Edwards Currently production has been halted due to Account Executive Laura Stapes, Mallory Hughes | current COVID-19 safety measures, but we still Twitter @ElevateIA plan to release these this summer! In the mean- #elevateiowa time, keep your eyes on our social media accounts #madeiniowa Business Record® (USPS 154-740, ISSN 1068-6681) is published by for episode teasers (and Elevate scholarship win- Business Publications Corporation Inc., The Depot at Fourth, 100-4th #notadirtyjob Street, Des Moines, Iowa 50309, (515) 288-3336. Contents © 2020 ners)! Business Record. Published weekly. Annual subscriptions $69.95. We also recommend employers reach out Single copy price is $1.75. Copies of past issues, as available, may be purchased for $4.50 each. Periodicals Postage Paid at Des Moines, to their local work-based learning intermediary

Iowa. POSTMASTER: Send address changes to Business Publications, or the new Iowa Clearinghouse for Work-Based IOWA Record Business The Depot at Fourth, 100-4th Street, Des Moines, Iowa 50309. Learning to explore options for work-based learn- 3 4 Business Record IOWA | May 2020 IOWA ASSOCIATION OF BUSINESS AND INDUSTRY CULTIVATING IOWA’S TALENT CONTINUUM State Respond to COVID-19 Iowans Helping Iowans: How Leaders Across the [email protected] ABI Foundation Engagement Coordinator, Marketing & McKenzie Kielman extraordinary effect.” believer intheideathat ordinary peoplecandoordinary things to also includethose self-employed, first responders andessential workers. restaurants. hasexpanded Those beyond eligible theunemployed to [email protected]. account (@RobSandIA). To donate, Venmo @IowaHi orPaypal asapersonal initiative.fund hisown salary,started withamonthof hecreated acoronavirus aid Conceptualized onabike ride, developed withaconfidantand asjustaperson, hefoundinspiration. himself Sand thought of Des Moines Alumnus ofLeadership Iowa, Class of2013-14 Rob Sand,Iowa State Auditor SUPPORT LOCALLY OWNED RESTAURANTS CREATED AFUND TO FEEDIOWANS AND the bestthey have to offer. our communities.Theseleaders, amongst many others, helpwith do not recognize theefforts beingmadewithinour state andwithin so oftentheinformation amplifiednationwide and worldwide, we but nonesoimportant ashow to approach apandemic.We emphasize “Think global, actlocal”isaphrase appliedto many circumstances, For support, instructionscanbefoundonhisTwitter The fund giftsorreimbursesThe fund mealspurchased from locally owned “Let ushelpyou helpothers,” saidSand.“Iamastrong While titlesmay indicate acallto service, itiswhen Rob A CUSTOM PUBLICATION FORABI Research andService(CIRAS). organizations by Iowa State University's Center forIndustrial those who are,” saidVarangkounh. “We’re allneededrightnow.” were eager to contribute. determined and materials supplied,employees already cross-trained understood they would needto take action.Process created, patterns protective equipment (PPE) supplies dwindling, Hy-Capacity heavy-dutymanufacturing tractor parts. her multi-generational owned family businessthat isknown for Varangkounh offered thesewing feature onthemachineryusedin Humboldt Alumna ofLeadership Iowa, Class of2017-18 Molly Varangkounh, PERSONAL PROTECTIVE EQUIPMENT SUPPLEMENTED OPERATIONS TO SUPPLY The gowns and face masks areThe gowns directed andface to therecipient “While I’mnot skilledto beonthefront lines,Icansupport As thepandemicprogressed personal andnews of surfaced In response to emergency resources available, Molly Hy-Capacity A CUSTOM PUBLICATION FOR ABI

CULTIVATING IOWA’S TALENT CONTINUUM IOWA ASSOCIATION OF BUSINESS AND INDUSTRY AND BUSINESS OF ASSOCIATION IOWA

FACILITATED ETHANOL PLANT’S ABILITY TO PRODUCE MEASURED BUSINESS NEEDS FOR STATE AND FEDERAL HAND SANITIZER RESOURCES TO BE PROVIDED

Justin Schultz, Southwest Iowa Renewable Energy and Pottawattamie Drew Conrad, Institute for Decision Making at the University County Board of Supervisors of Northern Iowa Alumnus of Leadership Iowa, Class of 2018-19 Alumnus of Leadership Iowa, Class of 2005-06 Council Bluffs Cedar Falls

Justin Schultz’s day-to-day changed quickly with an early COVID-19 case in It all begins with a call, and it was Drew Conrad who answered. the region. When community leadership was alerted to the depletion of personal Within 36 hours, an instrument to understand the impact of COVID-19 on Iowa protective equipment (PPE) at the local hospital, the who, what, when and where it businesses was created and released. Updates were provided to the Iowa Economic was needed quickly became clear. Development Authority twice a day. Nearly 14,000 respondents required seven Schultz navigated permits and federal agencies, garnered support from Senators straight days to analyze. The data confirms that this crisis is impacting all of the Joni Ernst and Chuck Grassley’s staff and monitored need while colleagues engineered industry sectors in Iowa. the operation. Following guidelines of the World Health Organization, they produce a Metrics collected are used by state and federal agencies and lawmakers to determine liquid anti-microbial substance dubbed “SIREtizer.” governmental aid and other support evidenced as needed to be made available. The supply’s first priority is hospitals, clinics and first responders. Other “One of the things that has made me proud of our work in Iowa has been the recipients, at cost, are Pottawattamie County and area communities through local number of other states who have reached out to us,” said Conrad. “They say they businesses to offer with orders. need what we’ve done, which we willingly provide to them.” “None of what we have been able to accomplish so far could have been done without the support of others on my team,” said Schultz. SIRE has also provided alcohol to other entities for other operations to multiply the output of the needed resource.

GET TO KNOW Meet Our Newest Members

Visit our newest members’ websites, and see what they’re up to: Braun Intertec | www.braunintertec.com Geater Machining & Mfg., Co. | www.geater.com Mount Mercy University | www.mtmercy.edu

Learn more about how ABI membership could benefit your company by visiting www.iowaabi.org/membership/why-abi. Business Record IOWA Record Business

5 6 Business Record IOWA | May 2020 IOWA ASSOCIATION OF BUSINESS AND INDUSTRY ASHLEY THOMPSON, Director of government and external affairs, UnityPoint Health A CUSTOM PUBLICATION FORABI RURAL HOSPITALS ANDCARE OPPORTUNITIES FACING THE CHALLENGES AND HOMETOWN HEALTH: A CUSTOM PUBLICATION FOR ABI

Rural health care is deeply personal for Ashley Thompson. Her physicians to practice and take care of the large elderly population in great-grandmother, Irma Bergeson, was a nurse in a rural hospital in rural areas. It’s a big part of why Iowa’s rural hospitals are struggling northwest Iowa and was the first district vice president of the Iowa — both financially and in recruiting physicians. Nurses Association. Thompson’s husband, Nate, grew up in rural Steve Cassabaum of 21st Century Rehab knows that story all too

Iowa and is CEO of the Story County Medical Center in Nevada. well. His organization provides physical, occupational and speech INDUSTRY AND BUSINESS OF ASSOCIATION IOWA Many of her immediate and extended family members work in the therapies in addition to sports medicine and occupational health field. services. It operates several clinics, but also provides services to rural Thompson works in health care as well — as the director of hospitals across Iowa. government and external affairs for UnityPoint Health — and plays a He has noticed reimbursements from all types of providers — key role in shaping the rural health system. Thompson supports advo- Medicare, Medicaid and private insurances — declining across the cacy, legislative and policy efforts that affect patients and health care board. That puts hospitals in a precarious spot. providers in Iowa, particularly UnityPoint’s critical access and rural “It’s a big part of [the financial hardships],” Cassabaum said. “I hospitals, rural health clinics and community mental health centers. think the health care system in general is not well run. I think they She sees firsthand the challenges and opportunities these areas face. give incentives for the wrong reasons, but most of the problems come “While our health care providers and professionals are needed from reimbursement. It’s had a big impact on rural hospitals.” now more than ever, and they are delivering high-quality essential ser- Another big challenge in recruiting workforce has been the vices to our rural communities, the challenges we face are significant continuing divide between Iowa’s urban and rural areas. Many skilled and increasingly so,” Thompson said. “Delivering health care in our workers are moving to the state’s most populated areas, which creates rural communities is distinct from how we provide care in our metro a shortage in rural hospitals. areas and in other parts of the country.” There’s work being done to address this shortage, from the state From physician recruitment to a precarious financial situation and all the way to the local levels. Thompson said the key will be helping the unprecedented COVID-19 pandemic, the rural health care system rejuvenate rural towns and areas to help make them a more attractive does face daunting challenges. But there are opportunities as well. place to live and work. Seizing them will help provide critical services for our state’s rural “Oftentimes, when we are recruiting a new health care profes- areas, where about 1 in 3 Iowans live. sional to one of our rural hospitals or clinics, they have a spouse who is also looking for employment opportunities in our towns and TOUGH SELL children who would be enrolling in our local schools,” Thompson Iowa doesn’t have the grand allure of mountains, oceans, big said. “So having a vibrant, family-friendly community with housing sports or large cities. The large majority of the state is considered options, a good job market, excellent schools and social opportunities rural. Those factors can make it hard to recruit high-quality and is essential to growing our rural workforce.” talented doctors to practice in the state. Iowa ranks 42nd in the na- There is also a push for Iowa to grow its own generation of doc- tion for the number of physicians per 100,000 people, according to tors and health care providers, which would help bolster workforce a January 2020 report from the University of Iowa Carver College of over the long term, Thompson said. Medicine. But there are many other factors beyond geography that hinder DAMAGES ADD UP Iowa. The tough financial situation for rural health care is exacerbated “We struggled to get doctors to come to Iowa to begin with, and, by Iowa’s outdated malpractice laws. The Iowa Medical Society, a yes, the rural areas even struggle more than Des Moines, Iowa City, statewide professional association representing Iowa physicians, resi- Cedar Rapids and more,” said Dr. Christina Taylor, chief quality dents and medical students, goes so far as calling it a crisis. officer at The Iowa Clinic. “And now with Iowa being so incredibly According to figures from the Iowa Medical Society, Iowa has far behind all of the other states, even our own ‘sons and daughters seen a substantial jump in high-dollar malpractice awards against of Iowa’ that are going off to medical school are not easily returning physicians and facilities. In the past three years, five cases alone have because of the malpractice [insurance] and inability to afford it and resulted in $85 million in damages. Many of the surrounding Midwest make a living.” states put a cap on noneconomic damages — damages associated with Iowa’s reimbursement for Medicare payments is extremely poor. pain, suffering, inconvenience, physical impairment, mental anguish The state ranks 51st among states and territories for Medicare reim- and more nontangible effects. These damages can often push up the bursement, falling behind Puerto Rico. That can make it harder for reward of lawsuits into the tens of millions of dollars. May 2020 May | |

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7 8 Business Record IOWA | May 2020 IOWA ASSOCIATION OF BUSINESS AND INDUSTRY PANDEMIC BRINGSISSUES TO LIGHT the healthcare andsocialassistancespaces,according to a2019 work- different specialties. More than 8,000 job vacancies are estimated in MedicineCollege foundIowa of isshort 361physicians across eight spring. already aproblem before facing theillnessswept thenation inearly workers are essential inthefight against thepandemic, but Iowa was above, particularly theworkforce shortage. Front-line healthcare But dueto COVID-19, thebill hasbeenputonpause. affect economicdamages awarded forlost wages orhealthcare costs. a jurycouldaward fornon-economicdamages. Thecapwould not mittee level. Thebillwould make $250,000 themaximumamount awarded inmedicalmalpractice lawsuits was proposed at thesubcom- liability insurance,” Schweiger said. recruit physicians inIowa becauseithasastronomically increased state. malpractice damages, physicians practicing inthe mightbewary of and asahealthsystem to bringawareness to theneedfortort reform.” don’t have options. We’re alot of tryingto cometogether asastate for Iowans, especially when they’re outintheserural areas. They Schweigerfall,” said.“We’re seeingthat problems it’s causingalot of health servicesdirector at TheIowa Clinic. << CONTINUED FROMPAGE 7 In astudy released inJanuary, theUniversity Iowa of Carver COVID-19 hasbrought totheproblems lightmany stated of In February, damages a bill that would put a cap on the amount of “We’re alsoseeingthat thismakes iteven more difficult toactually The problem extends to recruitment as well. Without acapon “It’s really inafinancialpit- placing thesesmallrural facilities Iowa hospitals have feltthe blow, said Jodi Schweiger, employer “DELIVERING HEALTH CAREINOURRURAL WE PROVIDE CAREINOURMETROAREAS AND INOTHER PARTS OFTHECOUNTRY.” Ashley Thompson, Director ofgovernment andexternal affairs, UnityPoint Health COMMUNITIES ISDISTINCT FROMHOW A CUSTOM PUBLICATION FORABI Hospital Association andtheIowa Rural Health Association to moni- HealthPublic andimportant state association partners like theIowa are working closely withthegovernor’s office, of Iowa Department organizations COVID-19 to monitor theeffectof onrural hospitals. Iowa’s most-populated areas —to focusonCOVID-19 capacity. forced to shutdown almost 20 outreach clinics—located outsideof it difficult todoanaudioorvisualvisit.The Iowa Clinichasbeen video chat. Butinrural areas, accessto internetcanbespotty, making now.” the emergency room, which isthelastplacewe want themgoingright they don’t, theirconditionscouldworsen, andthat couldlandthemin continue to have theirfollow-up appointmentswiththeirdoctors. If not good,”Taylor said.“Patients withchronic conditionsneedto told to do, butpatients are alsoneglectingtheirhealth,which is crisis. might beafraid to seekhelpinthistimeof that’s helpedcapacity, butithasalsoputaburden onpatients who it’s adire emergency. Many elective surgeries have beencanceled.And VID-19 patients,” hesaid. side becauseother beds insomehospitals are beingheldforCO - are busierthannormal,puttingastrain ontheworkforce. themetro areaplaces outsideof forcare. That meansrural hospitals COVID-19of patients, meaningmany peopleare beingreferred to force needs assessment by Iowa Workforce Development. “UnityPoint Health andourfellow healthsystems across thestate UnityPoint Health saiditwas working incooperation withother Taylor saidmany patients are takingadvantage virtual visits via of “In general, patients across Iowa are staying home like they are For themost part, peoplehave stayed away from hospitals unless “Some rural hospitals have becomevery busy ontheinpatient Cassabaum saidmany urban hospitals are bracing foraninflux CONTINUED ONPAGE 10>> A CUSTOM PUBLICATION FOR ABI IOWA ASSOCIATION OF BUSINESS AND INDUSTRY AND BUSINESS OF ASSOCIATION IOWA May 2020 May | | Business Record IOWA Record Business

9 10 Business Record IOWA | May 2020 IOWA ASSOCIATION OF BUSINESS AND INDUSTRY THE PATH FORWARD Thompson said. to ensurefor funding sustainability duringtheunprecedented crisis,” COVID-19tor theimpactof onrural hospitals inIowa andadvocate the amount of surgeriesthe amountof andtestingneededafteraninjury. conservative care provides enormousbenefitsandcanactually reduce system looksat care. Asaphysical therapist, hesaidpreventive and ensure accessto care forallIowans, nomatter where we live.” whether they are doingsoinperson orthrough telehealth—willhelp doctors andhealthcare providers are paidthesameforproviding care telehealthparityThompson said.“Supporting—meaningour full health care providerslack of in a communitywork,” or taking time off care needs while addressing transportation, barriers suchaslackof remotely. better tapinto videoorphoneservices,peoplemay beableto get care which makes in-person treatment anecessity. thestate could Butif technology. Broadband canbehard to accessinmany rural areas, are opportunities to grow. << CONTINUED FROMPAGE 8 The problem care isthat type isn’t of financially lucrative enough, Cassabaum seesanopportunity inchangingtheway thehealth “Technology isatool thatuswithourhealth canhelpmany of Thompson believes improvement thebiggest areas of oneof is Amid thehardships Iowa’s rural healthcare systemthere faces, dedicating our lives to taking care of yours // ofyours care taking to our lives dedicating 515.875.9855 // iowaclinic.com exceptional. A CUSTOM PUBLICATION FORABI One day. Onebuilding.life. of Executive Healthexperience. are theonlyprogram inthestatetooffer thistype conveniently doneinoneday atonelocation. We All ofthenecessaryappointmentsandtestingare a program streamlinedintoa6-7hourtime frame. provides apersonalized conciergeexperience and We understand your timeisatapremium.Ourstaff Iowa to improve ouroverall healthandcare,” shesaid. leaders andeveryday Iowans who are working to pave theway for the path forward, Thompson said. sionate aboutimproving patient care. Ultimately, they willhelplead affect the whole state.” to recruit physicians to Iowa. affects everything fromof hospitals totheability thefinancialviability damages allowedamount of inamalpractice lawsuit. Shesaidthat caretype forallpatients.” of they should.There needs to be incentives inplacesowe canhave that sets upthesystem formore forspendingmore failure money than services. other types of meaning hospitals, which may already bestruggling, usually choose “We have somany passionate healthcare providers, advocates, Iowa’s innovative healthcare system of isfull peoplewho are pas- “Tort reform isahuge, huge issue,” Schweiger said.“It really does Schweiger theneedfortort emphasized reform, andlimitingthe “The savings are astronomical,” hesaid.“Theway it’s setupnow EXECUTIVE HEALTH EXECUTIVE A CUSTOM PUBLICATION FOR ABI

CAPITOL BUSINESS

Health Care Policy Impacts of COVID-19

As of this writing, the Iowa legislative session remains suspended and poli- health care. cymakers are at home. The state has yet to reach our projected peak number of ABI staff will represent our members to ensure that these new efficiencies coronavirus infections. Many non-essential businesses remain shuttered. Front in the delivery of care are shared equitably between those who deliver that care

line health care professionals responding to COVID-19 are acting heroically and the patients and businesses who pay for those services. INDUSTRY AND BUSINESS OF ASSOCIATION IOWA and tirelessly over a long response to the virus. Government has recommended social distancing and is asking the sick to stay home rather than to visit their doctor. The adaptations required to respond to COVID-19 in the health care industry are unprecedented and attest to the ingenuity of Iowans. Telemedicine, for instance, has delivered great benefits. Sick patients in rural settings, distant from needed care, are being screened through telemedi- JD Davis cine at greater rates than before. Telemedicine also allows health care profes- Vice President, sionals to screen, diagnose and recommend treatments to a greater number of patients in a shorter amount of time than traditional office visits would Public Policy, ABI Contact the ABI Public Policy Team allow. While telemedicine practices were evolving over time, the advent of [email protected] COVID-19 has accelerated their use. JD Davis, Vice President, Public Policy In response to COVID-19, Gov. Reynolds rightly and temporarily ordered [email protected] | 515-979-1212 that telemedicine services be reimbursed as though the patient were in a doc- Brad Hartkopf, Director, Public Policy tor’s office to spur the use of telemedicine. When we put this pandemic behind [email protected] | 712-249-8589 us—and we will—Iowa policymakers may choose to update public policy to recognize the efficiencies and benefits telemedicine brings to the provision of

GET INVOLVED – MAKE A DIFFERENCE

The Iowa Association of Business and Industry works hard year-round, representing member companies and employees at the Statehouse and in the development of administrative rules and regulations to ensure businesses are treated fairly. Financial contributions to ABI’s political e orts help support candidates who understand the importance of a favorable business climate in Iowa. These contributions are important to ABI’s work in promoting pro-business legislation and stopping proposals that would harm Iowa companies. Learn more about the two programs you can support through your contributions below

Iowa Industry Political Action Committee (IIPAC) Iowans for Jobs Initiative (IFJI)

IIPAC is a way for ABI members to actively participate in the The Iowans for Jobs Initiative is the public policy political process by combining their personal support with education arm of ABI. Its objective is to promote the What is it? other IIPAC contributors. This ampliﬁes the e ectiveness of importance of pro-jobs, pro-business policy for all individual contributions to support candidates who understand Iowans. the importance of fostering a pro-business climate in Iowa.

IIPAC funds provide direct ﬁnancial support to pro-business These funds help educate Iowans and Iowa Democrat and Republican candidates for statewide and lawmakers on issues important to ABI, such as Iowa’s How is the money used? legislative oces in Iowa. Right to Work laws. The funds also allow us to ﬁle amicus briefs standing up for employers in court and also aid get-out-the-vote initiatives.

What types of contributions IIPAC accepts personal contributions. The Iowans for Jobs Initiative accepts both corporate 2020 May are accepted? and individual contributions. | IIPAC is critical to ABI’s ability to support and help elect allies to The Iowans for Jobs initiative plays a critical role in Why is it important? state oces who are committed to fostering a pro-business, helping Iowans understand how the decisions of pro-jobs climate. legislators a ect the paychecks of all Iowans.

How do I contribute? Please contact [email protected]. Please contact [email protected].

Paid for by the Iowa Industry Political Action Committee (IIPAC) IOWA Record Business

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EXPERT ADVICE ADVISORY COUNCIL STEVE CASSABAUM 21st Century Rehab Telehealth to Play Significant Role DENNY FISHER in Future of Rural Medicine Associated Computer Systems (ACS)

Before this past month I was not an expert, like most of us, on what to do when dealing with a pandemic. I do know about rural health, having worked in a rural hospital for the last 25 years. JIM NALLEY Each of the seven rural, critical access hospitals that we serve differ somewhat in the challenges BCC Advisers and opportunities they face. Some fare better than others depending on the local communities, business environment, competition, tax base and leadership available. Many struggle to make ends meet. The struggles have multiplied with this pandemic. INDUSTRY AND BUSINESS OF ASSOCIATION IOWA DREW LARSON Telehealth is one thing that is now being used to serve patients and survive this crazy time. I am BrownWinick Law Firm now, almost, an expert on telehealth, which prior to this pandemic, felt we would rarely or ever use. Surprisingly, we have utilized it much more than anticipated. It not only helps us continue to serve our most vulnerable patients, but allows us to keep ‘the doors open’ a little better. Telehealth may be a large part in determining whether some rural hospitals and clinics survive MIKE O’DONNELL CIRAS Steve Cassabaum, this crisis. Telehealth may also become a significant part of rural medicine in the future, and a part of what keeps these facilities open and continuing to provide the vital service to the rural popula- MSPT, DPT tions of Iowa. President and Founder, 21st Century Rehab PC JUSTIN ZIMMERMAN [email protected] CliftonLarsonAllen

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TOP TIPS MICHAEL TEACHOUT Focus OneSource 4 Employment Laws to Watch MARC WARD in 2020 Fredrikson & Byron

With a new year comes new changes. Already this year we have seen some changes in employment BRIAN CROTTY laws. It’s critical to keep up with these changes. The best way to keep your business in compliance with HDH Advisors federal and state laws is through continuous research. Based on recent hot topics, we predict the following trends may be worth keeping an eye on this year. 1. Marijuana, is it legal? What to watch for: Specific marijuana testing laws in the workplace. Each state addresses JULI JENKINS marijuana differently. Some states allow employers to maintain a marijuana-free workplace. LMC Insurance and Risk While other states do not. Workplace marijuana laws are only applicable to medical mari- Management juana use. Little to no protection is available for employees who partake in recreational marijuana use. LANCE GARDNER 2. Paid Family Leave Principal What to watch for: The Paid Family Leave Act will continue to become more complex as Alaina Riley policies change. Stay up to date on state legislation surrounding parental and medical leave Marketing & Wellness trends. Coordinator CHRIS BURNS 3. Pay Equity [email protected] What to watch for: Changes in legislation that will impact your business. Track what is hap- Shift Interactive pening at the state and federal level. A few current changes include: • Elimination of inquiries on salary-history

• Requirement to provide insight and reasoning on pay discrepancies JODI SCHWEIGER 2020 May • Provide pay transparency to workers The Iowa Clinic | 4. New Salary Threshold What to watch for: Check if your classifications are set correctly based on the 2020 U.S. Department of Labor’s new salary threshold. Dedicate the time to develop a thorough understanding of current national trends. Stay up to CASEY CASON Wells Fargo date on what’s new in legislation, and most importantly, watch the local changes that affect your business directly. Business Record IOWA Record Business

13 14 Business Record IOWA | May 2020 IOWA ASSOCIATION OF BUSINESS AND INDUSTRY SUCCESSION PLANNING When Succession Planning Account for UnseenEmergencies achieve your visionby makingsuccessionplanningakey your organization. componentto successof thefuture always beendoneandevaluate theirprocesses, they alsoneedto reevaluate theirsuccessionplanning. personnel canbeshared intheevent that certain personnel becomeunavailable. that accountsforunseenemergencies theorganization. aswell asthoughtfully of consideringthelong-termfuture does not discriminate based onone’s job title, asCEOs andkey officers are not immune. Companiesneed toadopt asuccessionplan tinuity andsuccessionplanning. term inmy vocabulary. However, duringthispandemic,Ihave learnedakey lessonaboutplanningasitrelates to both businesscon- This pandemic may provide a different lens to view your organization. Use this time to reflect and determine how you can best This pandemichasprovided many organizations anopportunity to adapt, adjustandinnovate. Asthey lookat how things have The planningprocess shouldidentifysuccessors along withinterimpersonnel andhow dutiesandresponsibilities amongexisting In reality, both are essentialto ensure continuity inthemanagement any anddaily operations organization. of Thispandemic Earlier this year, when I signed up to write a short article on my thoughts on succession planning, COVID-19 was an unfamiliar A CUSTOM PUBLICATION FORABI your business reach the next level. Learn more at more IowaEDA.com. Learn level. the reach next business your ready to the ofAnkeny industry, help is city manufacturing hub for the advanced aburgeoning as recognized and of the (2019) Year Administration the by Business U.S. Small I-80.and Celebrated Iowa’s Community as Business Small ofI-35 the near intersection location geographic strategic its from products the store distribute and know-how to build, and the infrastructure workforce, Ankeny brings the Midwest, in city the growing fastest As Moines. minutes away Des from await far. Ankeny in to very look opportunities Exciting There’s need no expansion? fornext your options Considering AnkenyIowa.com [email protected] COO/CFO, Rehab 21stCentury Michelle Cassabaum, FACHE IowaEDA.com , just , just