LEGISLATIVE CONNECTION

Mental Health Parity Bill Moving

On Wednesday, February 16 there was three hours of debate on HF 2080 COVERAGE FOR MENTAL ILLNESS. The bill requires that group health benefit policies include payment for biologically-based mental illness for employers with more than fifty employees, or who meet the guidelines for small employers or for certain public employees. Definitions: Adopts a definition of biologically-based illness which includes schizophrenia, depression, autism, developmental disorders and other illnesses. Effective date January 1, 2001

H-8011 By Commerce - Requires co-payments and lifetime limits for mental health services to be the same as for other medical services. Changes effective dates to January 1, 2001 ADOPTED

H-8035 By Osterhaus - Replaces the bill with the Governor’s proposals which include much of the bill but adds: Requires small group policies to cover mental illnesses. Adds, panic disorders, psychotic disorders and eating disorders. Adds substance abuse. Requires coverage for at least 60 days of outpatient visits. Allows insurance companies a waiver if premium increases are more than 3 percent. Sunsets in 2003. FAILED 44-54

H-8033 By Chiodo - Covers Post-Traumatic Stress Syndrome. FAILED, 44-55

H-8034, H-8016 - WITHDRAWN

H-8022 by Osterhaus - Adds eating disorders to mental illness definition. FAILED, 44-54

H-8019 by Jager - Adds substance abuse but reduces the number of in-patient treatment days to 15 and out-patient treatment days to 15. WITHDRAWN

The House PASSED the Bill 55-44, as amended; it goes to the Senate

Governor Vilsack said that legislators should use part of the tobacco settlement money to expand substance abuse treatment. Vilsack said that substance abuse treatment can save taxpayers the cost of the treatment. Vilsack’s proposal would:

• Increase average length of stay in residential, halfway houses and outpatient environments.
• Expand capacity for juvenile and adult 24-hour facilities.
• Improve quality of treatment by retaining qualified substance abuse professionals in treatment programs.
• Institute treatment best practices.
• Inspire successful recovering people to serve as role models.

Vilsack said that the Legislature should require all group health care plans to offer parity for mental health and substance abuse.

Governor Vilsack and Attorney General Miller said legislators should use part of the tobacco settlement money to offer a comprehensive tobacco program focused on prevention and cessation. They would put $18.6 million in programs geared toward reducing tobacco use in Iowa including community programs, school programs, increased enforcement of tobacco laws, and statewide cessation efforts. Vilsack said that prevention efforts will reduce the $79 million the state spends treating tobacco-related illnesses with Medicaid funds.

Republicans delayed any announcements on spending the tobacco funds. They had planned to make such an announcement Wednesday, February 16.

On February 9, Attorney General Miller and Dr. Stephen Gleason, Director of the Department of Public Health, presented the Governor’s proposed comprehensive tobacco prevention, cessation, and enforcement program to the Health and Human Rights Appropriations Subcommittee. The Governor is recommending $10.o million from tobacco settlement funds be used to implement the program. These dollars, combined with $8.6 million in additional new and existing funds, will enable the Department of Public Health to implement a program based on the Centers for Disease Control.

Dr. Gleason also discussed the Governor’s recommendation to appropriate $11.9 million of tobacco settlement funds for substance abuse treatment. The funding would be used to support treatment programs that would be of longer duration and higher quality than those that can be supported by current funding. Dr. Gleason also discussed the recommendation of $3.5 million for Healthy Iowans 2010 initiatives. Those initiatives include: public health nursing, environmental epidemiology, youth suicide prevention, cardiovascular disease prevention, emergency medical services, and poison control.

Check the Bill Summary for the numerous bills introduced with ideas on how to spend the money.

Rep. Bev Nelson-Forbes introduced House File 2189. This bill requires the State Board of Education to adopt administrative rules incorporating a health services component in the general accreditation standards applicable to school districts. These administrative rules had been in place and were just removed during the summer of 1999 since the Department of Education stated they had no Iowa Code authority for the rules. This bill is a top priority of the Iowa School Nurses Association. It has gone to House Education committee. Calls need to be made to House Education members to get it out of committee.

Senator Boettger said that her committee is working very hard on SSB 3121 LONG TERM CARE, which is Governor Vilsack’s proposal to create a long-term care fund. Boettger said that she expects the Senate Human Resources Committee to approve the bill and for the full Senate to take the bill up. The Governor is attending a national conference on the issue on February 26th through the 29th.

Democrats held a press conference in support of Governor Vilsack’s proposals which include funding the long term care fund with $65 million in federal funds. Only $30 million would be spent in the first year; the fund could receive as much as $210 million over the next four years. The fund would be used to convert nursing home facilities and to help pay for alternative services.

Senator Gronstal said that the trust fund can help the state save money and improve the quality of life for Iowa’s growing senior population.

A bill has been introduced on the Senate side for registration of direct entry midwifery. More on this issue next week.

Here is a short list of the Democrats who are retiring or trying to move to the other chamber. This does not include any legislators who may be considering retiring but have not announced that decision.

Rep. Schrader said that one additional Democrat may leave the House; Senator Gronstal said that he believes the other seven Democrats up for re-election will run.

• Representatives Who Are Retiring
  Jim Drees (District 80)
  Minnette Doderer (District 45)
  Norman Mundie (District 14)
• Representatives Running for Senate Seats
  Roger Thomas (District 32; Seeking Senate District 16--Senator Zieman)
  Jack Holveck (District 72; Seeking Senate District 36--Senator Szymoniak)
• Senators Who Are Retiring
  Elaine Szymoniak (District 36)

Here is a short list of the Republicans who are retiring or trying to move to the other chamber. This does not include any legislators who may be considering retiring but have not announced that decision.

• Representatives Who Are Retiring
  Mona Martin (District 43)
  Gary Blodgett (District 19)
  Danny Holmes (District 40)
  Dave Lord (District 77)
  Rosemary Thomson (District 51)
  Jerry Welter (District 56)
• Representatives Running for Senate Seats
  Sandy Greiner (District 96; running for Senator Hedge’s seat)
• Senators Who Are Retiring
  Kay Hedge (District 48)
  Lyle Zieman (District 16)

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". House File 2105 in Senate State Government Committee.
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. No bill, ongoing discussion. School Health Accreditation Standards bill, HF 2189 in House Education Committee.
3. Support parity in health insurance policies for mental health and substance abuse coverage and appropriate housing. House File 2080 was debated by the House and passed 55-44. It goes to the Senate.
4. Assure nursing supervision of emergency medical services personnel when they work in the non-emergency, non-lifesaving acute care settings. INA desired language was agreed to. House State Government committee recommended passage.
5. Increase funding for public health nursing/core public health functions. Director of Public Health and Governor recommended $1.5 million, recommendations to Health and Human Rights Appropriations Subcommittee. No appropriations bill yet.
6. No support for legal recognition of direct-entry midwives. Senate Study Bill 3154 was introduced.

Robert Campbell, Board of Nursing Examiners

Pauline Taylor, Board of Nursing Examiners

SENATE COMMERCE Voted Out:

SF 2126 CONTRACEPTIVE COVERAGE - Prohibits individual or group insurance policy, or other health benefits plan, from excluding benefits for prescription contraceptives if the policy covers other prescriptions. Prohibits denying coverage to a person because of the use of contraceptive devices. Contains other related provisions.

HF 2205 E-COMMERCE - Provides for the legal recognition of electronic records, signatures, contracts. Provides for means to electronically notarize signatures and documents. Provides procedure for correcting electronic records damaged during transmission. AMENDED: Corrective; clarifies consumer protection provisions.

HSB 580 HMO REGULATION - Establishes capitalization requirements and reporting requirements for HMO’s

SSB 3098 HEALTHY KIDS PROGRAM - Fees & Eligibility: Abolishes the sliding fee scale for family cost sharing. Exempts previously insured children from the six month waiting period if the parent had no control over the loss of the insurance. Duties: Requires the Department of Human Service to perform spot checks of enrollees to in compliance with the HAWK-I program. Requires the HAWK-I board to develop a functional health assessment form.

SSB 3159 SENIOR LIVING PROGRAM - Creates a Senior Living Program and a Senior Living Trust Fund to assist senior citizens. Appropriates from the trust fund $80 million to DHS over a five year period, $20 million in FY 2001, to convert nursing home space and develop long term care alternatives; $2.2 million for medical and living assistance; $176.8 million for nursing home reimbursement; to Elder affairs, $4.2 million for FY 2001 to develop a comprehensive senior living program; Requests an Interim Study of long term care insurance. Effective on enactment. AMENDED: Raised the DHS appropriation from $65 million over five years and $15 million for FY 2001 to $80 million over five years and $20 million for FY 2001.

SSB 3059 PHYSICAL THERAPISTS - Prohibits persons from claiming to perform physical therapy unless the person is a licensed practitioner. makes appropriates language changes in regards to the scope of practice for chiropractors. AMENDED: A Strike and Replace.

SSB 3076 HEALTH CARE FACILITY INSPECTIONS - Requires unannounced inspections of health care facilities to at least once every 30 months. Does not require that a complaint-based inspection be limited to the complaint. Establishes a quality-based complaint system which requires the DIA to report to the budget subs.

HF 2189 ACCREDITATION STANDARDS - Nelson-Forbes (C), Boal, Cohoon

HF 2006 POWER-OF-ATTORNEY WITNESS - Allows a religious or social worker employed by a health care provider to act as a witness for a durable power of attorney regarding health care or life-sustaining procedures. AMENDED

HSB 512 CRSU ORDERS & EXPENSES (Human Resources) Allows the CRSU to send a notice to a parent’s employee to enroll a child for insurance purposes. Allows CRSU or a parent to file foreign health insurance order with district court. Allows the CRSU to carry certain costs forward for one year only.

HSB 609 FAMILY INVESTMENT PROGRAM - Expands eligibility of FIP for two-parent families. AMENDED

HSB 616 MEDICAL ASSISTANCE - Expands eligibility to children in the guardianship program and added two categories of Medicare beneficiaries to coverage eligibility. Considers disclaimers of inheritance and failure to elect against a will as a transfer of assets in determining eligibility.

HSB 623 CHILD ABUSE INFORMATION- Provides that requests to correct or expunge child abuse information shall not be made public until the conclusion of the proceedings. Allows providers of adult home care, health care or placement facilities to check employment records of future employees. AMENDED: Allows a region to exceed its group foster care budget by fifteen percent.

HSB 593 CONTROLLED SUBSTANCES - Conforms the Iowa Controlled Substances Act with the Federal Uniform Controlled Substances Act. Moves various controlled substances from one schedule to another. Expands the list of precursor substances to match the Federal list.

HF 392 Emergency Medical Services-

House Passed:

HCR 106 MEDICARE FUNDING - Demands Congress address the inequity in funding of the Medicare program by the Federal Government.

Senate Passed:

HF 686 DENTAL ASSISTANTS - Allows the Dental Examiners to adopt education and examination requirements for registering dental assistants and to establish the scope of practice. Gives persons who are working as dental assistants until July, 2000 to have a registration certificate, and persons who start after that date 60 days to get a registration certificate. Specifically distinguishes between dental assistants and nurses in the scope of practice definitions. Requires that the rules to implement this bill be adopted by January 1, 2000 rather than effective by that date.
S-5005 by State Government - Changes relevant dates to 2001. Prohibits administrative rules which allow the administration of local anesthesia, the placement of sealants or the removal of any plaque or other material except with a toothbrush, floss or rubber cup coronal polish. ADOPTED

The Senate PASSED the Bill, as amended, 45-1; it returns to the House

BILL SUMMARY (For more information check www.legis.state.ia.us)

HF 2229 ABORTION INFORMATION & REPORTING (Boddicker et al) Requires the Dept. of Public Health to prepare printed materials which show fetal development, describe adoption and pregnancy and child birth assistance services and how to contact those agencies. Requires abortion providers to inform patients about the availability of care to carry the pregnancy to term, the medical risks of abortion, the liability of the father for support and the availability of the printed DPH materials. Requires the physician to make reports. Makes it a Class C felony to knowingly perform an abortion in violation of the reporting procedures and a simple misdemeanor to knowingly submit a false report. Gives the patient or the father a cause of action against the physician if an abortion is performed which doesn’t comply with the provisions of this bill. (Human Resources)

HF 2206/SF 2116 ADMINISTRATIVE RULES WAIVER (Administrative Rules) Allows an agency to waive an administrative rule if undue hardship results, does not prejudice others, and not mandated by statute. (State Government)

HF 2214 ADULT ABUSE ALTERNATIVE HOUSING (Schrader) Requires the Adult Protective Advisory Council to develop a plan to provide services to victims of dependent adult abuse including alternative housing. Directs the Department of Elder Affairs to include in its budget request funding for alternative housing for victims of dependent adult abuse (Human Resources)

SF 2125 ADULT ABUSE REPORTERS (Kibbie) Includes full-time, part-time or contract workers in the designation of mandatory dependent adult abuse reporters for jobs which are mandatory reporters.

HSB 670 CAMPAIGN FINANCE (State Government) Defines "electronic filing" and the "internet." Requires daily electronic reporting by candidates for statewide office and the General Assembly. Requires the disclosure of certain information at the end of phone calls by persons acting on the behalf of a candidate and makes the failure to do so punishable by a fine of $1,500 or one year in jail. Requires candidates to document the truth of advertisements and punishes false advertising by candidates. Establishes public funding for the gubernatorial race. Gipp (C), Arnold, Chiodo, Jager, Jochum, O’Brien, Van Engelenhoven

HSB 670 CAMPAIGN FINANCE (State Government) Defines "electronic filing" and the "internet." Requires daily electronic reporting by candidates for statewide office and the General Assembly. Requires the disclosure of certain information at the end of phone calls by persons acting on the behalf of a candidate and makes the failure to do so punishable by a fine of $1,500 or one year in jail. Requires candidates to document the truth of advertisements and punishes false advertising by candidates. Establishes public funding for the gubernatorial race. Gipp (C), Arnold, Chiodo, Jager, Jochum, O’Brien, Van Engelenhoven

HSB 662 CHILD ABUSE INFORMATION (Human Resources) Gives the Governor and the leadership of the General Assembly access to records held by the Department of Human Services regarding child abuse. Imposes penalties for unauthorized dissemination of information. Boddicker (C), Carroll, Foege

SSB 3135 CIVIL COMMITMENT - DANGEROUS CRIMINALS (Judiciary) Establishes a Civil Commitment procedure, similar to that for sexual predators, for the dangerously violent. Requires DHS to cover the costs of assessment, control, care and treatment.
McKean (C), Hammond, Maddox

HF 2244 COMPREHENSIVE PERSONAL ASSISTANCE (Dix, et al.) Establishes home and community based services program for elders and individuals with disabilities under the direction of the DHS (Human Resources)

SF 2126 CONTRACEPTIVE COVERAGE (Johnson, et al) Prohibits individual or group insurance policy, or other health benefits plan, from excluding benefits for prescription contraceptives if the policy covers other prescriptions. Prohibits denying coverage to a person because of the use of contraceptive devices. Other related provisions.

HF 2205 E-COMMERCE (Jacob) Provides for the legal recognition of electronic records, signatures, contracts. Provides for means to electronically notarize signatures and documents. Provides procedure for correcting electronic records damaged during transmission. (Commerce)

HF 2259 HAWK-I EMPLOYER COVERAGE ENDS (Reynolds) Allows participation in the healthy and well kid in Iowa Program if applicant’s employer coverage ended less than six months prior to eligibility. (Commerce)

HF 2237 HAWK-I FEDERAL WAIVER (Murphy) Directs the DHS to seek a waiver from the federal government in order to purchase family coverage for HAWK-I families. (Human Resources)

SF 2151 HOME HEALTH CARE/DAY CARE ( Judge, et al) Appropriates $6 million of the tobacco settlement money to DHS for home health care service and habilitive day care for children with special needs and the expansion of respite services. Requires that the tobacco settlement money be deposited into the general fund but only used for health care related expenses.

HF 2193 HOME HEALTH REIMBURSEMENTS (Dotzler) Directs the Department of Human Services to offer reimbursement to home health care agencies that are certified under Medicare, in the lesser of the agency’s audited costs or current Medicare standard.. (Human Resources)

HF 2213/SSB 3121 LONG-TERM CARE PROGRAM (Schrader, et al.) Creates the Iowa Long-Term Care Program along with the Trust Fund under the direction of the Department of Human Services. Appropriates from the Fund up to $65 million over five years for conversion of nursing facility space. (See HSB 643) (Appropriations)

SF 2169 LONG-TERM CARE (Deluhery, et al) Creates the long-term care trust fund. Appropriations: makes appropriations to DHS and DEA to implement long-term care services, including the conversion of nursing home care to other alternatives. Administration: Requires DHS to adopt rules for the administration of the fund. Requires the State treasurer to report quarterly on the fund. Other: Other related provisions.

SSB 3095 MEDICAL ASSISTANCE ELIGIBILITY (Human Resources) (See HSB 616) Expands eligibility to children in the guardianship program and added two categories of Medicare beneficiaries to coverage eligibility. Considers disclaimers of inheritance and failure to elect against a will as a transfer of assets in determining eligibility. (DHS) Miller (C), Hammond, Tinsman

SSB 3154 MIDWIFERY (Human Resources) Provides registration requirements for individuals engaged in the practice of direct entry midwifery and establishes a midwifery advisory council. Redwine (C), Boettger, and Hammond

HF 2208 MINIMUM WAGE (Jacobs) Sets state minimum wage at 150 percent of federal poverty level for a family of one. Allows $4.25 per hour minimum wage for employees under 20 years old and having less than 90 days of employment with employer. (Labor)

HF 2203 ORGAN DONOR REGISTRY (Blodgett) Establishes a statewide organ donor registry and appropriates $75,000 to the Department of Public Health to run program. (Human Resources)

SSB 3134 OWI IN-PATIENT TREATMENT (Judiciary) Requires OWI offenders placed in institutional programs to be so placed within sixty days or as soon as possible. Allows an offender already in an institutional program to enter a community based residential program at the same point as they were in the other program rather than start from the beginning. McKean (C), Hammond, Maddox

SSB 3138/HSB 683 PHYSICIAN ASSISTANT LICENSING (State Government) Adopts rules concerning the licensing of Physician’s Assistants. Adds two members of the profession to the Board, Requires a person applying for a license after July 1, 2001 to have graduated from an accredited program; grandfather’s those with a license before July 2001. Maddox (C), Kibbie, Rittmer Lord (C ), Boddicker, Reynolds

SF 2180 PHYSICAL THERAPISTS (State Government,successor to SSB 3059) Prohibits health care providers from claiming to perform physical therapy unless the person is a licensed physical therapist. Allows chiropractors to advertise that they perform chiropractic physiotherapy. Establishes civil penalties.

HSB 663 PROFESSIONAL LIABILITY CONFIDENTIALITY (Judiciary) Requires that professional liability cases be treated confidentially by the parties and the court until the certification of expert witnesses. Shey (C), Kettering, Holveck

HF 2276/SF 2193 SENIOR LIVING (Martin, et al.) Creates the Iowa Senior Living Program within the Department of Elder Affairs. Creates Senior Living Trust Fund under the Department of Human Services. Allocates from the trust fund up to $65 million over five years for the conversion of existing nursing facility space and development of long-term care alternatives. (Human Resources)

SF 2120 TOBACCO SETTLEMENT- ANTI TOBACCO EDUCATION (Bolkcom) Appropriates $21.4 million from the tobacco settlement to a tobacco settlement fund for anti-tobacco programs, education and enforcement.

SF 2137 TOBACCO - ANTI SMOKING (Gronstal et al) Appropriates $9.3 Million for Anti Smoking programs and requires that Tobacco Settlement funds, after legal costs, only be used for health care related programs.

SF 2296 TOBACCO SETTLEMENT- CESSATION PROGRAMS (Schrader, et al) Appropriates $9.3 million of the tobacco settlement money for various smoking cessation programs. (Appropriations)

SF 2135 TOBACCO - CHILDRENS HEALTH (Gronstal et al) Appropriates $1.2 Million for a medical assistance program for those under 19 and requires that Tobacco Settlement funds, after legal costs, only be used for health care related programs.

SF 2136 TOBACCO - CHILDRENS HEALTH (Gronstal et al) Appropriates $7.5 Million for a medical assistance program for those under 19 and requires that Tobacco Settlement funds, after legal costs, only be used for health care related programs.

SF 2162 TOBACCO ENDOWMENT FUND (Schuerer, et al) Changes the tobacco settlement fund into an endowment fund and allows only earnings from the fund to be spent.

SF 2128 TOBACCO - ENVIRONMENTAL HEALTH (Dvorsky, et al) Appropriates $503,000 for an environmental epidemiology program. and requires that Tobacco Settlement funds, after legal costs, only be used for health care related programs.

SF 2140 SF 2128 TOBACCO - FOOD SAFETY (Hammond, et al) Appropriates $45,000 Food Safety measures and requires that Tobacco Settlement funds, after legal costs, only be used for health care related programs.

SF 2139 TOBACCO - HEART DISEASE (Fraise, et al) Appropriates $250,000 for Cardiovascular Disease prevention and requires that Tobacco Settlement funds, after legal costs, only be used for health care related programs.

HF 2286 TOBACCO SETTLEMENT - HOME HEALTH CARE (Schrader, et al.) Appropriates $1.5 million of the tobacco settlement money to the DPH for home health care and public nursing services to enhance disease and injury prevention. (Appropriations)

SF 2129 TOBACCO - POISON (Bolkcom, et al) Appropriates $438,000 a poison control center and requires that Tobacco Settlement funds, after legal costs, only be used for health care related programs.

SF 2131 TOBACCO - PRESCRIPTIONS (Bolkcom, Szymoniak, Shearer et al) Appropriates $10 Million from the Tobacco Settlement funds for a Pharmaceutical Assistance Program for those over 65 years of age with an income of less than 250% of the poverty level.

SF 2152 TOBACCO -PUBLIC HEALTH (Judge, et al) Appropriates $1.5 million from the tobacco settlement for core public health care functions, including home health care and public nursing. Requires that the tobacco settlement money be deposited into the general fund but only used for health care related expenses.

SF 2302 TOBACCO SETTLEMENT- SCHOOL SUPERVISION OF KIDS (Schrader, et al) Appropriates $650,000 of the tobacco settlement money to the DHS to fund school based supervision of children. (Appropriations)

SF 2138 TOBACCO - SUBSTANCE ABUSE (Gronstal, et al) Appropriates $11.9 Million for a Substance Abuse Treatment program. and requires that Tobacco Settlement funds, after legal costs, only be used for health care related programs.

HF 2230 TRANSPLANT INSURANCE (Scherrman) Directs the Insurance Commissioner to increase the benefits for organ transplants to at least 80% of $250,000 in the standard health plan. (Commerce)

SF 2161 TRAUMA/EMS (Soukup, et al) Appropriates $505,000 from the tobacco settlement for a trauma and EMS system . Requires that the tobacco settlement money be deposited into the general fund but only used for health care related expenses.

SF2307 UNIVERSITY HOSPITALS PRESCRIPTIONS (Frevert) Requires the University Hospitals and Clinics to establish guidelines to provide prescription and non-prescription drugs to indigent patients in remote or alternative locations. (Human Resources)