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JANUARY 15, 2024
Good morning, Fearless readers:

Today is Martin Luther King Jr. Day. What will you do to serve others?

In this week’s Fearless e-newsletter, you will find:

  • A news story about the state likely expanding Medicaid coverage for Iowans who have just given birth. However, a possible change to income requirements could reduce the number of women who qualify.
  • A column by Suzanna de Baca, president and CEO of Business Publications Corp., about how to be a more fearless leader in 2024.
  • A short story about April Schmaltz, who was named the CEO and president of Delta Dental of Iowa.
  • In the headlines: A state law requiring gender balance on Iowas top judicial nominating commission may have been appropriate when approved in the 1980s but no longer passes constitutional muster and cannot be enforced, a federal judge ruled Thursday.
  • In case you missed it: Dr. Tammy Chance has been named chief medical officer of Broadlawns Medical Center.
  • Lots more!

– Nicole Grundmeier, Business Record staff writer

Plan would expand postpartum Medicaid coverage for some Iowa women
Getty Photos.
Republicans who control the Iowa Legislature and governors office are signaling their intent to allow some pregnant women covered by Medicaid to keep coverage for 12 months after the end of pregnancy.

In her Condition of the State address Tuesday evening, Iowa Gov. Kim Reynolds said she is proposing lengthening Medicaid coverage for moms who make less than a certain amount. The governors website says the cutoff would be set at 215% of the federal poverty level. Thats about $64,500 for a family of four.

Lets do more to help moms, babies and their families get off to a good start, Reynolds said in her address.

Only three states, including Iowa, have not extended postpartum Medicaid for a full year; currently, Iowa law allows for 60 days of coverage after a pregnancy ends. Similar legislation has advanced in recent years but has never made it to Reynolds’ desk.

The day before Reynolds address,
House Study Bill 500 was assigned to a subcommittee; that bill would also extend postpartum coverage to 12 months but does not mention unique income restrictions. No legislation to implement the governor’s proposal had been introduced as of late Friday.

State Rep. Beth Wessel-Kroeschell, D-Ames, said in an email message to Fearless that Reynolds plans for a stricter income eligibility threshold would keep thousands of pregnant Iowans each year from getting the coverage extension. This is a great program made bad by this change, she said. Wessel-Kroeschell is a member of the subcommittee on House Study Bill 500. She frequently speaks about policies that affect women, their families and the economy.

Reynolds office did not immediately reply to an emailed request for comment Friday afternoon.

Advocates say that longer coverage would help thousands of Iowa women annually to manage postpartum complications and other issues.

Medicaid is a critical source of health insurance coverage for half of mothers in Iowa, said Brittney Haskins, president of the Iowa chapter of Postpartum Support International, also known as PSI. Haskins said extending postpartum Medicaid coverage for women is PSI Iowas top legislative priority this year.

Maternal health emergencies can occur long after a birth

Haskins said that mothers can experience major health problems long after 60 days postpartum, including ongoing cardiac issues, mental health disorders and more.

Removing Medicaid coverage leaves women unable to pay for medical expenses and less likely to seek treatment, which leads to higher rates of morbidity and mortality, Haskins said. This has a ripple effect on the family system, as mothers are often the primary caregivers.

Mary Nelle Trefz is the advocacy network director of Iowa ACEs 360. Trefz said that some of the most dangerous pregnancy-related complications, such as certain forms of eclampsia, cardiomyopathy and strokes, may not surface until months after a delivery.

If a new mom loses health insurance coverage shortly after giving birth, these complications are unlikely to be identified or treated,” Trefz said.

The same is true for perinatal or
postpartum mood and anxiety disorder, also known as PMAD, which are some of the most common conditions identified during pregnancy and postpartum, Trefz said.

Losing coverage just 60 days after giving birth makes it difficult to identify and manage these conditions,she said.

Consequences of poor postpartum health include generational trauma, health problems for offspring

Left untreated, maternal mental health conditions are costly and have multigenerational consequences, both Trefz and Haskins emphasized to Fearless.

The costs come not just from health care services for mothers, but also in lost workforce productivity and increases in child developmental and behavioral disorders,” Trefz said.

Moms with Medicaid coverage are 25% more likely to have symptoms of postpartum depression compared with mothers covered by private insurance, Trefz added.

Women who live with untreated postpartum depression have children with a higher ACES [Adverse Childhood Experiences] score later in life, Haskins said.

The higher a persons ACES score, the more at-risk that person is for major health complications over a lifetime, including cancer, heart disease, diabetes, depression and more, according to the Centers for Disease Control and Prevention. People with high ACES scores are also more likely to be the victims of a crime and more likely to struggle with finances and jobs, according to the CDC.

Extending the length of Medicaid coverage provides access and funding to resources and treatment for doctors visits, cancer screenings, postpartum mental health medication and sometimes therapy, Haskins said.

Healthy mothers are better able to bond with their children, create secure attachments with their babies, are more likely to attend their childrens well-visits, and are less likely to call into work sick or quit their jobs, Haskins said. Extending Medicaid coverage beyond the current 60 days postpartum is not only basic health care for women, but will have positive effects for their families, communities and the economy.

Fearless will continue to cover this issue as the legislative session continues.

Leading Fearlessly: How to be a more fearless leader in 2024
As the new year approached, I reviewed my resolutions from last year and was shocked to realize I’d met the personal and professional goals I had set for myself. Why the surprise? Over the last year I experienced a great deal of change and loss, and in the midst of struggling to maintain balance, I didn’t notice that I was actually moving forward. Upon reflection, I attributed my ability to carry on to caring less and less what anyone thinks of me, letting go of other people’s issues, and having confidence that ultimately everything will work out. As a result, this year I decided to make New Year’s goals that are less about specific actions and more about continuing to cultivate confidence and fearlessness – both personally and professionally.

With that in mind, I decided to turn to other leaders to ask them about their own goals for the new year. I posed this question: “What is one way you plan to be fearless as a leader in 2024?”

Kate Banasiak, president and CEO, Diversified Management Services:

My chosen word for the year is “empower,” reflecting my commitment to granting authority and strength. In the evolving backdrop of the last three years, I’ve observed both the positive and negative impacts when individuals feel secure expressing their truths and ideas. As a leader, my goal is to exemplify attentive listening, responding with curiosity and empathy. Through this approach, I aim to create an environment where people are empowered to actively contribute to positive change in both their personal and professional lives. I believe that fostering empowerment not only enhances individual confidence but also cultivates a collective force for meaningful improvement.

Deidre DeJear, owner, Caleo Enterprises:

In 2024, my leadership journey is characterized by fearlessness as I wholeheartedly embrace authenticity. Fear will be a companion, not an obstacle, as I navigate challenges with resilience and enduring strength. Each setback transforms into an opportunity to refine and rebuild, emerging even stronger. Every pause grants moments for reflection and recalibration.

Fostering a spirit of inclusion, I graciously welcome the authenticity of others, acknowledging the power of diverse perspectives. Committed to fearlessly accepting every aspect of my being, I establish a leadership environment where fellow women can do the same. I actively amplify the voices of authenticity, reshaping the leadership narrative with courage, compassion and unwavering self-love.

My mission is to inspire women to boldly embrace their true selves, cultivating a culture of resilience, empathy and genuine connection within our community. Together, we define success on our terms, fearlessly navigating the beautiful complexity that defines us.

Katherine Harrington, president and CEO, West Des Moines Chamber:

I’m driven by the profound words of the great philosopher Taylor Swift: “Being fearless isn’t being 100% not fearful. It’s being terrified, but you jump anyway.” As a leader, embracing fear is paramount for personal and organizational growth.

Recognizing our strengths and areas for improvement is essential. Instead of avoiding fear, we must view it as a catalyst for development. Understanding our individual and collective strengths empowers us to unlock our full potential, while acknowledging growth areas allows us to confront fear with confidence.

In the pursuit of fearless leadership, I’m dedicated to fostering an environment that encourages self-awareness, team collaboration and continuous improvement. By embracing fear as a path to progress, we’ll not only overcome challenges but also inspire growth and resilience in our organization and community.

2024 marks a year of transformative leadership, where we jump into the unknown with determination and unity, fueled by the belief that fearless leaders are the driving force behind success.

Dana James, publisher and founder, Black Iowa News:

By letting go. 

I’m rejecting the notion that because I can do many things well, I must do everything myself. I’m surrendering control of the narrative. I’m firing the internal critic who over-amplifies my mistakes and downplays my achievements. I’m silencing the replay of negative conversations, insults and microaggressions. I’m relinquishing the need to prove my worth to anyone. I’m forgiving myself for time wasted in the wrong places with small-minded people. I’m freeing myself from worrying about the things I can’t control. I’m abandoning spaces — and people — that negatively affect my outlook and spirit. I’m overcoming the urge to people-please, over-apologize and remain polite in the face of abuse or mistreatment. I’m jettisoning the baggage to fulfill my purpose, poised with new self-awareness and acceptance.

Jenna Knox, foundation director, Mission Cancer + Blood:

Focus my energy on action. A fearless leader gets things done and delivers outcomes. As a woman who wears many hats, it is easy for me to become overwhelmed with a never-ending to-do list, or to feel like I am not meeting all the expectations. My goal for 2024 is to push past self-doubt or analysis paralysis and ground myself in a commitment to act. Simple, often-small actions, such as adding my thoughts to a conversation, starting a project I’ve been meaning to tackle, or showing up for a cause I care about, will culminate into meaningful impact.

Delta Dental of Iowa names April Schmaltz as its new CEO, president
April Schmaltz has been named CEO and president of Delta Dental of Iowa, the company announced. The announcement comes after the completion of a national search.

Schmaltz replaces Jeff Russell, who left the company in May to become president and CEO of Blue Cross and Blue Shield of Nebraska. Schmaltz was Delta Dental of Iowa’s interim co-CEO and senior vice president of sales and marketing during the national search for a new CEO and president.

“April’s strong track record of providing strategic leadership, along with her experience in the health care and financial services industries made her the unanimous choice of the board,” Rowena Crosbie, chair of Delta Dental of Iowa’s board, said in a prepared statement. Schmaltz’s “background provides a unique perspective of understanding the needs of members, providers, brokers and employers.”

Schmaltz worked at Delta Dental of Iowa since 2014, leading sales, marketing and product development. She has more than 25 years of experience in executive leadership, strategy and new business growth. Schmaltz has a bachelor’s degree from St. Mary’s University and a master's of business administration from Iowa State University.

Getty Photos.
In the headlines
Iowa doctors say proposed new abortion rules might limit women’s access to health care: New proposed rules for Iowa doctors who perform abortions might further reduce the state’s number of women’s health care providers — which is already the lowest per-capita in the country — according to several doctors. “As a obstetrician-gynecologist practicing in a rural area, I consider myself scarce — I’m a rarity,” said Dr. Emily Boevers, an OB-GYN at the Waverly Health Center in northeast Iowa. Boevers provided the comments to the Iowa Board of Medicine on Jan. 4 during a public hearing that was meant to elicit feedback on new rules it is considering for the state’s physicians to implement abortion restrictions signed into law last summer. The rulemaking process is continuing even while the law is on hold as the courts consider its constitutionality. No one testified Jan. 4 in support of the rules as written, according to this news story in the Iowa Capital Dispatch.

Iowa law requiring gender balance on judicial commissions struck down as unconstitutional: A state law requiring gender balance on Iowa's top judicial nominating commission may have been appropriate when approved in the 1980s but no longer passes constitutional muster and cannot be enforced, a federal judge ruled Thursday. The ruling could have wide-reaching implications for Iowa women. The lawsuit was spearheaded by lawyers from the California-based Pacific Legal Foundation, who challenged the law governing the makeup of the commission that recommends to the governor candidates to fill vacancies on Iowa's appellate courts. Eight of the 17 commissioners are elected by lawyers; state law requires that each congressional district elect two commissioners "of different genders." The state failed to persuade the judge that the law is justified by important government interests, according to this news story in the Des Moines Register. Here is previous Fearless coverage of Iowa's broader gender balance law.

Her husband, in same Iowa state job, was paid much more. So she sued ― and won. A woman hired for her husband's former state government job, only to be paid much less than he and his remaining male colleague, will receive a six-figure settlement in her ensuing sex discrimination lawsuit, according to this news story in the Des Moines Register. Ellen McComas, who works as a "Disability Examiner Specialist Advanced" for Iowa Vocational Rehabilitation Services, is one of two state employees who hear appeals contesting determinations of whether people receiving federal benefits are legally disabled. Both people who held those posts as of 2021 have sued the state, and on Tuesday, the State Appeal Board approved a $277,000 settlement to resolve McComas' case.

This Latina immigrant is betting on rural western Iowa newspapers, in Spanish and English: Nestled in an airy loft reachable by steep, creaky wooden steps above the Donna Reed Theatre in Denison is a hive of journalism energy, where reporters work for La Prensa Spanish Iowa Newspaper and the newly launched Denison Free Press. Both publications churn out stories on a region defined by a rich agricultural history and the collective optimism of thousands of immigrants, most from Mexico and Central America. The Free Press and La Prensa are defying national trends, outrunning the Great Newspaper Armageddon by publishing once a week and getting their papers into the local Hy-Vee grocery store and the El Michoacano Tienda y Taqueria and other distribution points. At the helm of these resilient community newspapers is their restless publisher and editor, Lorena López, a Nicaraguan immigrant intent on keeping local news alive, according to this business story in the Des Moines Register.

Worth checking out
Women always had hot flashes at work. Now they’re done hiding menopause. (Los Angeles Times/Bloomberg). Polk County seeks to participate in Summer EBT program, despite state of Iowa’s refusal (Des Moines Register). An American girlhood in the Ozempic era (the Cut). How a millennial Estée Lauder built a widely popular beauty brand (New York Times). Can family doctors deliver rural America from its maternal health crisis? (the 19th). As Kim Reynolds pitches special education changes, Department of Education posts 29 new jobs (Des Moines Register).
Broadlawns announces new chief medical officer
Dr. Tammy Chance has been named chief medical officer of Broadlawns Medical Center, succeeding Dr. Jason Kruse. Kruse will remain in a leadership capacity as interim CEO.

Chance, who has 22 years of experience as a family physician, most recently served as the medical director of rural health and quality initiatives for Boone County Hospital.

“Dr. Chance brings a wealth of knowledge and commitment to serving Central Iowa,” Kruse said in a prepared statement. “Dr. Chance will play an important role in providing accessible, cost-effective and high-quality patient care for all.”

Chance has served as chair of the American Hospital Association’s State Hospital Association Physician Executives, chaired the Physician Leaders Forum/CMO workgroup through the Iowa Hospital Association and recently completed two terms as a trustee of IHA.

Be fearless with us
At its core, Fearless exists to help empower Iowa women to succeed in work and life. We believe that everyone has a story to share and that we cannot progress as a society unless we know about one another. We share stories through featuring women in our reporting, featuring guest contributions and speakers at our events.

We are always looking for new stories to share and people to feature. Get in touch with us!

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