DES MOINES, Iowa (AP) — Iowa Gov. Kim Reynolds focused on education and health care in an expansive agenda laid out for legislators Tuesday evening, calling for substantial revisions to how special education is provided in schools and how mental health and substance use are treated across the state.

The proposals may bring systematic changes to services across Iowa but are drawing early concerns about disparities in care in the state, especially for rural communities.

Reynolds began her annual Condition of the State address reflecting on last week’s high school shooting in Perry, about 40 miles (65 kilometers) northwest of Des Moines and thanking first responders, some of whom were in the audience.

She made no mention of gun laws, which brought high school and college students to the Capitol rotunda Monday to advocate for gun control legislation.

Other news DeSantis and Haley go head to head: How to watch the fifth Republican presidential debate DeSantis targets New York, California and Biden in his Florida State of the State address How an animated character named Marlon could help Trump win Iowa’s caucuses

On education, Reynolds spoke about “troubling” performance metrics for students with disabilities despite funding levels for special education that are higher than the national average. Reynolds will target the nine regional agencies – called Area Education Agencies — responsible for providing special education services in Iowa, instead recommending that schools can decide for themselves whether their funding goes to those agencies, as is the case now, or whether they seek out other providers.

Hints of reform to the agencies has already drawn some concern, prompting Reynolds to include a clarifying message to families “who have been told that we’re planning to end the AEAs or even cut services their families depend on.”

“This claim is categorically false,” she said.

Senate Minority Leader Pam Jochum expressed concern that the potential for increased privatization of education services will have an outsized impact on rural Iowa.

Most of what Reynolds proposed in last year’s condition of the state crossed the finish line after a robust re-election win in 2022, which also padded her party’s majorities in the Legislature. She celebrated some of those policies Tuesday, including her signature school choice legislation to create publicly funded educational savings accounts that families could use for private school education.

“There are those who said we did too much, too fast. That change wasn’t necessary or that it would make us worse off,” Reynolds said. “But when I look at the result of our hard work, I know we made a difference. And it drives me to do it again; to work even harder this session.”

Reynolds’ address ran the gamut, pledging to cut taxes, expand work-based learning programs, protect minors from online pornography and to bolster enforcement of foreign ownership of land in Iowa.

Reynolds also identified mental health and substance use as priorities for the Legislature this year, investing $20 million of Iowa’s settlement award money from opioid-related lawsuits and streamlining the state’s administration of behavioral health.

Democratic House leader Jennifer Konfrst criticized what she sees as diminished — not expanded — mental health care in Iowa, saying she’s not optimistic that the administrative revisions will lead to substantive benefits.

“I have a constituent who recently spent three days in the E.R. waiting for a mental health bed and had to go out of state because there we no beds available,” she said.

Reynolds again asked the Legislature to extend postpartum Medicaid coverage for moms earning less than $42,000 a year, from 60 days to 12 months. It earned applause from Republicans and Democrats in the chamber, though it was not as expansive as legislation Democrats have previously proposed to expand the benefit for all moms on Medicaid.

She also called for a select few health care proposals that tend to be supported by Democrats but failed to win over some Republicans, including over-the-counter contraception and parental leave for state employees.

House Speaker Pat Grassley said he wouldn’t commit at this point to the legislation passing a majority of his caucus, but he acknowledged it’s something “we can’t just ignore.”

Konfrst said she hopes House Democrats and Republicans can talk about solutions to address those priorities they have in common, saying Democrats will look to the specifics of Reynolds’ proposals and “bipartisanship isn’t — we vote for the bills Republicans bring to the table.”

“We are hopeful. I’m going to hope we’re going to be bipartisan and work together,” she said. “Democrats stand ready to have those conversations. The question is, will Republicans include us in this conversation or not?”