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Thorup prioritizes mental health, Medicaid changes in first leg session

Newton Daily News - 12/27/2018

Dec. 27--Weeks before the Iowa Legislature convenes for its 2019 session, incoming Iowa House District 28 Rep. Jon Thorup enjoyed a more relaxed approach to discussing politics in an interview with Newton Daily News on Dec. 21. But when the gavel drops Jan. 14 in the Iowa House, the rural Knoxville Republican will be forced to put on a suit and tie.

Exchanging his blazer for a baggy Iowa Hawkeye sweatshirt, the statehouse newcomer reclined back in his seat in the dining section of a Casey's General Store in Monroe and sipped a cup of soda while going over his list of priorities and goals leading into his first term. Of note are his continued concerns over the state's mental health crisis, problems with Medicaid services and increasing public safety.

Thorup said his legislative priorities are largely influenced by the comments he has received from constituents.

Mental health

Conversations with voters on the campaign trail convinced Thorup mental health is not only a top priority for Iowa lawmakers but a top priority in his district.

People in HD 28, which includes Lynnville, Sully and Monroe in Jasper County, are very concerned about the issue and often are either directly or indirectly affected by mental illness; very rarely does Thorup come across someone "who doesn't have a brother or a child or a best friend that struggles with mental illness or did struggle with mental illness," he said.

Citing a mostly bipartisan mental health bill signed into law by Gov. Kim Reynolds in July, Thorup agrees improvements have been made

but there is still room to enhance services and other factors relating to the subject. For instance, Thorup said he has a particular interest in addressing children's mental health situations. Identifying those issues early on in a person's life, he said, offers "a much better chance for them to have a long and productive future ahead of them."

By no means is it the only area Iowa needs to focus, Thorup added, but a better understanding of mental illness detection in youth is something the Iowa Republican would like to see developed further, including how to detect a problem, what to educate others to look for and finally administer some form of sustained help.

Thorup also has concerns about patients who are "very hard to place in a facility," especially those with potentially violent or at risk behaviors. He said these particular individuals often find themselves "bouncing around the system" or have no place to turn to for help.

"A lot of times those people end up maybe going to jail for a while or get released and then they're back out on the street and the cycle continues," Thorup, a career state trooper, said. "That would be something that I'm particularly interested in figuring out what to do and then putting that into some kind of bill."

Medicaid oversight

In October, Thorup told the Newton Daily News he would be in favor of restoring Medicaid to a state-led system, splitting with most of his Republican colleagues, although he prefaced his stance stating "it's not going to be as easy as flipping a light switch."

Two months later, during his Dec. 21 interview with the NDN, Thorup maintains that same viewpoint but is "open to several different methods" to fix the current Medicaid system. Thorup said he is beginning to see details on a plan to increase oversight and make sure recipients are getting the services they need.

"There's also discussion about removing some of the LTSS or long-term support services," Thorup said. "Medicaid recipients that are in that classification, there's talk about maybe carving them out. But it's super early. I guess anything is on the table at this point."

Thorup said discussions with his constituents the two major problems with the Medicaid Managed Care Organizations are lack of services or lack of reimbursement for services accessible prior to the privatization two years ago. In a lot of cases, he said, the assistance people need is "not unreasonable." Not a single person, Thorup claims, approached him during the campaign or since who "discussed a service they had been denied now that was out of the realm of reason."

Thorup said he would also like to see more patient advocacy, whether it come from the Iowa Department of Human Services (DHS) or from a position at the MCOs. Based upon the complaints he has personally received, Thorup said a lot of people are frustrated and "beating their heads against the wall because they don't know who to turn to or what to do."

"Getting them services is a lot easier if people know there is a problem with that recipient," he said.

Public safety

One of Thorup's personal legislative priorities is concerns involving public safety; a topic, Thorup admitted, "means a whole lot of things." The HD 28 rep claims the scope of violence in Des Moines, particularly homicides and gang activity and "gunplay," is at a level "we haven't seen in a long time." When working as an Iowa State Trooper, he said "there's very rarely a night that goes by that there's not a call in Des Moines of shots fired or (a) drive-by (shooting)."

Thorup also highlighted concerns involving human trafficking and the shipping of narcotics across state lines. The state, he said, does not have criminal enforcement team anymore that "goes out proactively on the highways and tries to find that type of activity."

Drawing attention to the opioid epidemic, Thorup worries the type of heavy opioid-related activity in Ohio -- which the National Institute of Drug Abuse reported in February is "among the top five states with the highest rates of opioid-related overdose deaths" -- would spread to Iowa, advocating for precautionary barriers to combat the dissemination. However, the 2019 Governor's Office of Drug Control Policy reported opioid-related deaths in Iowa were down 35 percent during the first eight months of 2018 compared to the same time period one year ago.

Thorup said he'll also push for more funding for Iowa law enforcement agencies to solving unsettled and unresolved homicides. Thorup sees the recent arrest of a Manchester man charged with the first-degree murder of Michelle Marie Martinko 39 years ago in Cedar Rapids, as an example of using new techniques in DNA technology to help reopen cases and may have helped investigators in Cedar Rapids find the victims alleged killer.

If the technology has improved and costs have decreased, Thorup said Iowa has an opportunity to solve "a lot of old homicides," as well as sexual assault cases. The challenge ahead, he explained, is the lack of personnel available to conduct open more cold cases, or cases more than 1 year old.

"I'd like to see some of those high level, really serious violent crimes investigated further," Thorup said. "...To me there's nothing more important than preventing more homicides because a lot of times these people will kill again. If they get away with it once, what's to prevent them?"

Describing himself as someone who is open to any kind of positive reform, Thorup said he is always willing to add improvements to programs and bills so long as there are good ideas to support the action. When it comes to Gov. Reynolds' openness to automatically restore voting rights to Iowa felons, Thorup, too, is open to the idea; however, he said it ultimately depends on the details of the bill, deciding to not make an informed judgment until he sees a bill firsthand.

Contact Christopher Braunschweig at 641-792-3121 ext. 6560 or cbraunschweig@newtondailynews.com

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(c)2018 the Newton Daily News (Newton, Iowa)

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