a communication of the Iowa Nurses Association

Volume 3, Number 18 January 13, 2000

This issue opens the sixth year of the Legislative Connection. This communication is designed to report the legislation introduced in the Iowa General Assembly of interest to the registered nurse to members of the Iowa Nurses Association and other interested individuals, The purpose of the publication is: 1) to share information about bills, committee meetings, floor debates, votes and association activity and positions with the registered nurse membership; and 2) to encourage comment and response from the membership which helps guide and shape INA advocacy with the state legislature and the Governor’s office.

This communication will be published weekly until the anticipated session adjournment April 18^th (the 100^th calendar day). Numbering of the Legislative Connection continues consecutively since the Session is a two year long process

The Legislative Connection is designed to have two sections to the publications: 1) a narrative section which will feature major activities of interest to nursing and background on issues; and 2) a bill summary section which will summarize each bill introduced of interest to nursing.

Contact your representative in the House of Representatives now about the Nurse Licensure Compact. The current bill number is House Study Bill 143. Check the INA web site for suggestions on making comments to your legislator.

There will be a program for legislators on Wednesday, January 26 from 11:30 a.m. to 1:00 p.m. to encourage their support for passage of a bill on mental health and substance abuse parity. It will be in Room 118 of the State Capitol. Please call the INA office if you plan to attend. This activity is being held in conjunction with the Mental Health Advocacy Coalition.

Speeches by legislative leadership highlighted the goals to accomplish this year. There are budget cuts to be made and decisions about how to spend the tobacco settlement money.

The Governor set forth his legislative agenda by identifying a number of health issues.

He calls for Iowa to be a national leader by ensuring access to comprehensive health care focused on the prevention of disease and illness. State government can channel resources toward the goals of:

• Providing access to quality health care services to all Iowans, particularly those with special needs.

• Expand HAWK-I
• Provide 12 month continuous Medicaid eligibility
• Adopt presumptive eligibility for children to be covered by Medicaid.
• Expand coverage for persons with special needs
• Provide supportive employment opportunities under the mental retardation and brain injury waivers
• Help children with special needs remain in their homes by expanding services, including home health care services, respite care, and habilitative day care for children
• Provide funding for 4% allowable growth rate to counties for mental health in FY02 to serve adults

• Develop a comprehensive long term care system that supports independence for all Iowans
• Provide funding for a third Long Term Care Ombudsman
• Adopt system payment changes for human services providers
• Promote parity for mental health and substance abuse treatment by private health plans
• Allow consumers to have a strong voice in Iowa’s health care system.
• Governor’s Task Force on Privacy
• Comprehensive, quality-based long term care inspection program
• Joint Health and Human Services Consumer Advisory Council
• Reduce disease through prevention.
• Anti-smoking programs for youth
• Advertisement campaign on smoking cessation
• Enforcement to reduce sales of tobacco products
• Increase state funding of home health and public health nursing
• Increase funding to coordinated trauma emergency services system
• Increase funding to environmental epidemiological program
• Increase funding to a certified poison control center
• Reduce food poisoning due to improper preparation
• Increase funding to cardiovascular disease prevention program
• Prevent youth suicide
• Increase funding to UI Public Health Initiative for elderly
• Restore Iowan’s health by reducing dependency on harmful drugs.
• 24-hour treatment programs for children
• Extend length of treatment period
• Therapeutic treatment center at a state facility
• Share best practices with substance abuse facilities
• Outcome based funding approach to treatment
• Inspire those successfully recovering from substance abuse to serve as role models

The INA Board of Directors adopted the following legislative agenda at their Board meeting on November 18.

1. Support adoption of an Interstate Compact to facilitate a system of licensure in which a single license allows a nurse to practice in multiple states with a "multistate licensure privilege".
2. Appropriate the tobacco settlement dollars for health care purposes with attention to: 1) school programs to reduce tobacco use and improve health, 2) assuring health services provided by school nurses are included in state school accreditation standards, and 3) programs to reduce school violence.
3. Support parity in health insurance policies for mental health and substance abuse coverage and appropriate housing.
4. Assure nursing supervision of emergency medical services personnel when they work in the non-emergency, non-lifesaving acute care settings.
5. Increase funding for public health nursing/core public health functions.
6. No support for legal recognition of direct-entry midwives.

INA Public Policy Agenda (These are issues which are concerns with state agencies, payors of health services or Congress, or are not of high state legislative priority.)

1. Monitor the proposed regulation of hollow-bore needles.
2. Monitor the need for regulation of telehealth applications.
3. Monitor the implementation of the expanded Medicaid program for children, and implementation of the HAWK-I program and Empowerment Boards.
4. Seek modification of the Medicaid program: 1) evaluate barriers to direct services from advanced practice nurses to Medicaid recipients, i.e. provision of billing numbers, reimbursement of certified nurse midwives (CNMs) and reimbursement of advanced practice nurses for assessment and services in nursing homes and 2) increase reimbursement for basic health services, such as dental care, to recipients.
5. Promote understanding of End-of-Life issues through dissemination of information on advanced directives and living wills, information on treatment choices and documentation and communication of end-of-life options and preferences.
6. Assure reviewers of managed care and third party payor companies have the appropriate educational preparation and judgement needed to evaluate the patient’s conditions being presented.
7. Monitor activities relative to women’s health including research funding, occupational health safety risks, access to health care interventions and consumer protections.
8. Assure electronic privacy to protect the confidentiality of personal and professional online information.
9. Assure Medicare’s long term solvency and universal access for all older Americans and identified disable populations with the current levels of quality, services and eligibility.

Nurse Licensure Compact: HSB 143 and SSB 45

Mental Health and Substance Abuse Parity: SF 83

Emergency Medical Services: HF 392

Midwifery Scope of Practice: a report is expected from HF 402

Needle Regulation: HF 707