a communication of the Iowa Nurses Association

Volume 3, Number 28 March 24, 2000

Governor Vilsack said that the difference is between his budget and the Legislature’s budget is only $13.5 million and that the real disagreement is in how to spend the money. Vilsack said that he wants to move the $20 million for tuition replacement into the RIIF because those funds are typically spent on school buildings. He said that the state does not need to appropriate $18 million on a Capitol parking ramp and on a new judicial building this year. Rather than spend the money on that, he said that the Legislature is underfunding the community colleges by $2.5 million and that the tuition at Iowa’s community colleges is already too high and the staff are older, fewer and lesser-paid. Vilsack said that his budget has $65 million in cuts and reallocations over the next two fiscal years.

Republicans said that they will not raise fees or otherwise agree to bad budgeting practices. They said the Governor’s budget spends too much--$86 million more than their budget--and makes too many transfers. They said that they are taking care of all the priorities in Iowa without creating the potential for a deficit two years from now.

According to estimates from the Legislative Fiscal Bureau, the Republican budget, without considering any tax cuts, would end with a $70 million ending balance; the Governor’s budget has a $53 million ending balance.

Funding for public health nursing and home care aides is spread throughout four budget items: elderly wellness, community capacity, child and adolescent wellness and adult wellness. Therefore it is more difficult to track INA’s priority for increasing the funds. The General Fund appropriation remains constant, but there is an $8 million cut in addictive disorders, i.e. substance abuse funding. It is unclear whether tobacco settlement funds will be used to fund these services.

PLEASE CONTINUE TO MAKE CONTACTS WITH YOUR LEGISLATORS TO DISCUSS THE NEED FOR FUNDING OF THE MIDDLE INCOME IOWAN IN NEED OF HOME AND COMMUNITY BASED SERVICES. Tobacco settlement monies should be spent on health care.

House File 2474, the School Accreditation Standards for school health services, awaits debate by the Senate. An amendment has been filed by Sen Connolly (D-Dubuque) to reinstate standards for media specialists and guidance counselors, but it does not address school health services by registered nurses in Iowa.

There was debate about SF 2314 this week. Senator John Redwine (R-Sioux City) had removed the religious exemption for immunizations. The House in floor debate restored it to the current code. From comments in floor debate there are many parents who increasingly do not want to have their children immunized. Floor manager, Rep. Dan Boddicker (R-Tipton) said that this issue is a First Amendment Right for freedom of religion. It is also a parental control issue to allow for the religious exemption.

HOUSE APPROPRIATIONS - Voted Out:

SF 2302 PUBLIC HEALTH DUTIES There are a number of provisions including a needle regulation study by the Dept. of Public Health. (AMENDED)

SF 2367 PREGNANCY INFORMATION - Requires the reporting of various medical information regarding the termination of a pregnancy, the county, the type of procedure, the name of the doctor and the name of the person completing the report, the confidential identifier of the patient, the ancestry and history of other births and the time of the patient’s last period. Deletes requirements that spontaneous terminations be reported. AMENDED: Uses maternal regions instead of counties.

HF 2514 PHYSICIAN ASSISTANTS - Allows a PA to be licensed independently of a physician. Adds two members of the profession to the Board of Physician Assistants Examiners. Requires graduation from an accredited program after July 2001 and grandfathers in those already with a license before July 2001. Committee decided to not take up the bill since administrative rule changes could address the reason why the bill was brought forward.

HF 2229 ABORTION INFORMATION & REPORTING - Waiting Period: Requires that a doctor give a woman information regarding abortion and options at least 24 hours before performing the abortion. Allows for immediate abortions if a delay would create a serious risk of substantial and irreversible impairment of a major bodily function. Information: Requires the doctor to inform the patient of available prenatal care, Medicaid benefits for childbirth and neonatal care, the financial responsibility of the father, available public and private agencies that offer adoptions or other options, the anatomical development of the fetus, the medical risks of an abortion, among others. Requires the patient to certify that the physician has given the required information. Requires the doctor to file a copy of the information with the DPH and for that information to be accessible by October 1, 2000. Penalties: Makes the violations of bill, or the release of confidential information, a simple misdemeanor. PASSED, 7-0

HF 2206 WAIVER OF ADMINISTRATIVE RULES - Allows an agency to waive an administrative rule if undue hardship results, does not prejudice others, and not mandated by statute. Requires the variance be consistent with the applicable law.

HF 2461 REDISTRICTING POLITICAL DISTRICTS - Requires if the number of congressional districts is evenly divisible by the number of State House and Senate districts then the State House and Senate boundaries shall be wholly contained within the congressional district. Requires if the number of school board directors exceeds the authorized number after redistricting each of the affected directors’ term of office ends after the organizational meeting of the school board.

HF 2162 PMIC STUDY - Requires the Department of Public Health to study the methodology used in reimbursing Psychiatric Medical Institutions for Children. Requires the Department to report findings to the Legislature.

The House PASSED the Bill, 92-0; it now goes to the Senate.

SF 2314 INFECTIOUS DISEASES - Combines the various Code sections on communicable diseases, venereal diseases and exposure of emergency workers into the Communicable & Infectious Disease Reporting and Control Act. Strikes the requirement for syphilis testing of pregnant women and requires the DPH to adopt national standards in regards to prenatal testing. Requires that knowingly exposing a child to a communicable disease be done with the intent to cause disease in order to be punishable. Adds penalties for persons who repeatedly fail to file reports under this bill. Makes language changes, including venereal diseases to sexual transmitted diseases and other related changes. Deletes the religious exemption from immunization for children.

H-8340 by Human Resources - Restores the religious exemption from immunization. ADOPTED

H-8352 by Blodgett - Adds "acting reasonably" to good faith in filing required reports language ADOPTED

H-8353 by Blodgett - Requires health care providers to notify emergency care providers of contagious or infectious diseases if called by the health care provider. Allows the local Board of Health to pay for the quarantine costs of individuals unable to pay for such. ADOPTED

H-8352 by Blodgett - Establishes a post-secondary immunization task force. ADOPTED

The House PASSED the Bill, as amended, 98-1; it now goes back to the Senate.

HF 2533 FEDERAL BLOCK GRANT - Appropriates Federal Block Grant money for the FY 2000-2001. Prohibits utility disconnection if Governor declares there is not enough money in the Low-Income Home Energy Assistance Program.

H-8175 by Grundberg - Directs the DHS to seek bids for grants to assist homeless individuals. ADOPTED

The House PASSED the Bill, as amended, 91-0; it now goes to the Senate.

HCR 111 OSTEOPOROSIS PREVENTION - Encourages health care workers, among others, to inform the public of the causes of, and prevention of osteoporosis.

ADOPTED by the House

SF 2344 CHILD AND FAMILY SERVICES - 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.

H-8474 by Carroll - Requires documentation of procedures taken when it is determined a child in foster care cannot be return home. Set time limits to file petitions regarding temporary removal of a child from his/her home. Establishes a Child Care Assistance Program within the DHS to aid families needing child care services. ADOPTED

The House PASSED the Bill, as amended, 97-0; it now returns to the Senate

HF 2365 INVESTIGATING CHILD DEATHS - Requires the child death review team to review all deaths of children up to the age of eighteen.

HF 2321 MEDICAID ELIGIBILITY - Expands eligibility to include children in the guardianship program and adds 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.

S-5184 by Tinsman - strikes the inclusion of the guardianship in the eligibility guidelines. ADOPTED

The Senate PASSED the Bill, as amended, 49-0; it now returns to the House

SF 2203 HEALTH INSURANCE PAYMENTS - Requires that an insured person to be allowed the option from the carrier to assign payments to the health care provider.

HF 2385 ORGAN DONOR REGISTRY - Establishes a statewide organ donor registry and appropriates $75,000 to the Department of Public Health to run program. Directs the DPH to create a public awareness campaign.

The Senate PASSED the Bill, 47-0; it now goes to the Governor

SF 2048 HOSPITAL BOARDS - Regulates the terms of new members of a public hospital board when the board expands its membership. Allows boards to establish five-member or seven-member boards and establishes a schedule for staggering the terms of new members.

The House PASSED the Bill, 92-0; it now goes to the Governor

SF 2429 HEALTH AND HUMAN RIGHTS APPROPRIATION (Appropriations; Successor to SSB 3216)- Appropriates to health and human rights agencies Total (from the GF): $87.6 million; Operations $73.6 million; Grants: $14 million Appropriations: Dept. of Elder Affairs $5.1 million;Governor’s Alliance on Substance Abuse $506,000; Dept. of Public Health Total - $29.8 million. Other Funds DPH Total $3.8 million; Gambling Treatment Fund $2.2 million; Addictive Disorders & Home Care $1.6 million. Retained Fees: Allows the Dental Board, Pharmacists Board, Nursing Board and the Medical Board to use $263,000 from fees for moving expenses. Allows Public Health to keep $100,000 in fees from the Medical Board to improve licensing functions.