a communication of the Iowa Nurses Association

Volume 3, Number 29 March 31, 2000

House Majority Leader Rants said that if the Governor and the Legislature are only $13 million apart, then he will meet the Governor’s budget half-way by increasing General Fund spending by $7 million.

Governor Vilsack is out of town, but John Cacciatore, the Governor’s policy director, said that the real difference between the Governor and the Legislature is not in the $13 million difference in how much money is spent, but in the $73 million in different spending priorities. He said that the Governor wants to spend more of the tobacco settlement now and to use emergency fund monies for emergencies rather than GF money. Cacciatore said that the Governor and the Legislature have spending differences in every budget bill.

Significant differences include:

• Spending $28 million for tuition replacement (local school infrastructure) from the General Fund for the House and from RIIF for the Governor;
• Spending $8.3 million more in substance abuse treatment by the Governor;
• Keeping $9 million in a tobacco settlement reserve fund by Republicans (the Governor does not create a reserve fund) and
• Appropriating $10 million for the Appeal Board Claims Fund from the Economic Emergency Fund by the Governor (the Republicans do not shift these funds).

House File 2474, the School Accreditation Standards for school health services, awaits debate by the Senate. An amendment and an amendment to the amendment have been filed by Sen. Connolly (D-Dubuque) to reinstate standards for media specialists, guidance counselors and registered nurses providing school health services in Iowa. Contact your Senators to discuss the need to assuring school health services are offered in Iowa school districts.

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 has been signed by the Governor.
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. House Study Bill 781 appropriates $24.3 million.
3. School Health Accreditation Standards bill, HF 2474 is on the Senate debate calendar. House File 2411 would provide the Medicaid state match for direct school nurse services provided to Medicaid children in the schools.
4. Support parity in health insurance policies for mental health and substance abuse coverage and appropriate housing. House File 2080 is awaiting Senate debate. The bill is very limited in coverage.
5. 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 File 2333 was signed by the Governor.
6. Increase funding for public health nursing/core public health functions. Director of Public Health and Governor recommended $1.5 million. Republicans have recommended $400,000 increase from unspent Gambling Treatment Fund and $300,000 from tobacco settlement.
7. No support for legal recognition of direct-entry midwives. House File 2498 did not survive the second funnel.

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.

HF 2351 SALES TAX HOLIDAY - Authorizes a sales tax exemption on shoe and clothing purchases on the first Friday, Saturday, and Sunday of August each year. Does not include athletic clothes, jewelry, or item priced over $100. Applies to local option taxes without exception.

HF 2545 ADMINISTRATION AND REGULATION APPROPRIATIONS - Appropriates from the General Fund for the offices of the Governor and Lt. Governor, the Dept. of General Services, Dept. of Appeals & Inspections, Dept. of Management, Dept. of Personnel and other regulatory and administrative agencies. Total: $88.1 million; The House PASSED the Bill, as amended, 55-43; it now goes to the Senate

HF 2549 EDUCATION APPROPRIATIONS (Appropriations; Successor to HSB 769) Appropriates funds to the Dept. of Education. The College Student Aid Commission, the Dept. of Cultural Affairs, the Board of Regents and Regent’s schools. GF: $988.5 million Empowerment Fund $14.9 million, UI: $305.6 million (Total); $242.7 million (salaries & support); $32.5 million (indigent medical services); $8.2 million (psychiatric hospital); $7.3 million (hospital school); $3.2 million (Oakdale); $4.1 million (State hygienic lab); $2.4 million (Family Practice); $655,000 (Child Health Care); $280,000 (Agricultural Health & Safety); $214,000 (Cancer Registry); $76,000 (Substance Abuse); $1.1 million (Biocatalysis); Primary Health Care $901,000; Public Health Initiative $1.9 million. Requires the University Hospitals to utilize telemedicine in treating the indigent and to report on their efforts to the Legislature. The House PASSED the Bill, as amended, 73-21; it now goes to the Senate.

SF 2369 JUVENILE RECORDS/CHILD ABUSE INFORMATION - Allows for the schools and juvenile justice agencies to enter agreements to share information regarding juvenile court records. Allows child abuse information from DHS to be shared if DHS approves and sharing the information is necessary to the disposition of the case.

H-8519 by Boddicker - Allows the DHS to release confidential information in certain circumstances. ADOPTED

The House PASSED the Bill, as amended, 90-0; it now returns to the Senate

SF 2429 HEALTH AND HUMAN RIGHTS APPROPRIATION

Appropriates to health and human rights agencies Total (from the GF): $87.6 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 the Department of Public Health to keep $100,000 in fees from the Medical Board to improve licensing functions and to retain autopsy fees. Allows the Veterans Home to keep $900,000 in VA drug reimbursements for pharmacy related expenses. Statutory Changes: Creates an Assisted Living Certification Fund controlled by Elder Affairs retroactive to the beginning of FY 2000. Continues the Scope of Practice Review Project until 2002.

S-5214 by Szymoniak - Requires the Department of the Blind to use $25,000 of its appropriations for the Iowa reading information service. FAILED

S-5231 by Gronstal - Creates a pharmaceutical assistance program for the elderly if the federal government fails to act. Applies to single individuals making less than $16,000 AGI, and $25,000 AGI in FY 2001. FAILED, 22-28

S-5230 by Bolkcom - Increases the appropriation for substance abuse treatment by $8.3 million. FAILED, 21-28

S-5229 by Judge - Strikes the language allowing the Veteran’s Home to retain the $900,000 for drug reimbursements and appropriates an additional $1.3 million for the Veteran’s Home. FAILED, 22-28

S-5232 by Deluhery – Provides for mental health and substance abuse coverage. RULED NOT GERMANE

SF 2435 HUMAN SERVICES APPROPRIATIONS (Appropriations; Successor to SSB 3222)

Makes appropriations to DHS. Total from the General Fund: $797.8 million; $134.7 million (Operations); $641.9 million (Grants); $21.3 million (Standings). Medical Services: ($456.1 million Total) Medical Assistance: $422.5 million; Health Insurance: $401,000; Child Health Insurance: $5 million; Medical Contracts: $8.3 million; Other Provisions: Requires DHS to develop a pharmaceutical case management study. Raises to 200% of poverty eligibility requirements for Medical Assistance for pregnant mothers. Gives family planning services for two years to women who were on medical assistance when their pregnancy ended. Require DHS to seek a federal waiver to set up a pilot program providing continuous eligibility for children in HAWK-I.

S-5276 by Hammond - Authorizes the expansion of eligibility for state day care if DHS can do it without instituting waiting lists. Increases FIP and other appropriations. FAILED, 20-30

S-5255 by Miller - Makes the highest priority for pregnancy prevention grants for areas with the highest percentage of unplanned pregnancies for girls between the ages of 13 and 18. ADOPTED

S-5267 by Hammond - Increases the appropriations for a number of DHS positions. FAILED

S-5266 by Hammond & Szymoniak - Increases the appropriations for a number of DHS positions. FAILED, 19-30

S-5254 by Hammond - Strikes the continuous eligibility for HAWK-I pilot program and the requirement for DHS to seek a waiver. FAILED

S-5258 by Deluhery - Raises the eligibility level for HAWK-I to 200%. FAILED, 19-30

S-5253 by Hammond - Increases the appropriation for state supplementary assistance by $200,000. FAILED

S-5291 by Tinsman - Authorizes waiting lists for child care only if authorized and requires DHS to notify members of the joint appropriations committees regarding child care expenditures from federal funds. ADOPTED

S-5265 by Hammond - Increases the appropriation for operating various state DHS facilities. ADOPTED

S-5268 by Hammond - Increases the appropriation for PMICs by $205,000. FAILED, 19-30

S-5270 by Tinsman - Increases the support for DHS administration by $200,000 and decreases the support for MI/DD/MR state cases by $200,000. ADOPTED

S-5293 by Dvorsky - Allows DHS to keep all of its unreverted funds instead of $250,000

S-5269 by Hammond - Adds $500,000 for DHS Field Operations. FAILED

S-5290 by Szymoniak - Appropriates $65,000 for a Certified Nurses Aide project. FAILED

S-5301 by Tinsman - Appropriates $17.8 million for nursing home medical aid cost reimbursements. ADOPTED

S-5292 by Tinsman - Lets DHS offer its own FIP entrepreneur program. Cuts $500,000 from Juvenile school-based supervision.

S-5246, S-5250, S-5252, S-5273, S-5278, S-5279, S-5297 - WITHDRAWN or OUT-OF-ORDER

The Bill PASSED The Senate 35-14, it now goes to the House.

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.

H-8437 by Senate - Strikes the inclusion of the guardianship in the eligibility guidelines.

The House CONCURRED with the Senate Amendment.

SF 182 ACUPUNCTURE LICENSING - Requires that acupuncturists be licensed by the Board of Medical Examiners.

S-5109 by the House - Requires that the license include a statement that a license to practice acupuncture is not a license to practice medicine.

The Senate CONCURRED in S-5109;

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.

S-5203 by the House - Immunization: Restores the religious exemption from immunization. Directs the DPH to establish a task force to make immunization recommendations for post-secondary students. Other: Adds "acting reasonably" to good faith in filing required reports language. 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.

The Senate CONCURRED in S-5203;

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.

S-5210 by the House - Requires documentation of procedures taken when it is determined a child in foster care cannot be return home. Sets 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.

The Senate CONCURRED in S-5210;

SF 174 MEDICAL REFERENCE - Changes a reference for a membership on the Medical Assistance Advisory Council to the Community Mental Health Centers Association.

SF 2007 GUARDIAN MEDICAL POWERS - Allows a guardian to authorize the use of anesthesia for a ward for professional care, if necessitated by the disability of the ward. Exempts such professional care from the definition of major elective surgery or non-emergency medical procedures.

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.

S-5275 by Soukup - Requires a twenty-four hour waiting period before a vasectomy, except for medical emergencies. RULED NOT GERMANE

S-5281 by Harper - Requires a 24-hour waiting period for all medical procedures performed on women or men, except for emergencies. RULED NOT GERMANE

S-5271 by Hammond - Requires a waiting period for gun ownership. RULED NOT GERMANE

S-5283, S-5284 & S-5285 - WITHDRAWN

HF 2549 EDUCATION APPROPRIATIONS (Appropriations; Successor to HSB 769) Appropriates funds to the Dept. of Education. The College Student Aid Commission, the Dept. of Cultural Affairs, the Board of Regents and Regent’s schools. GF: $969.9 million

HSB 781 TOBACCO SETTLEMENT (Appropriations) Appropriates $24.3 million from the Tobacco Settlement Fund. Dept. of Human Services: Medical Assistance Payment Increases: $6 million (to Doctors - up to Medicare levels) $3.6 million (to Dentists, to 75% of customary rates) $3.1 million (to Physical Therapists and support services by 5%) $2.3 million (to Hospitals by 3%) $2.4 million (to Home Health Care Providers up to Medicare levels) $250,000 (to critical access hospitals up to Medicare levels) $4.4 million (Home Health Care and day care for special needs children. $1.2 million (Respite Care) $550,000 (to DHS service providers by 1%) DHS performance evaluation: $35,000. Dept. of Public Health: Tobacco Prevention & Quitting Program: $9.4 million. Substance Abuse Treatment: $11.9 million Healthy Iowans 2010: $1.8 million Dept. of Corrections: $610,00 for Drug Court and Day Programming. County MH: $2 million to counties with low MH/MD/DD funds to fund increased payment levels. Healthy Iowans Savings Account: $5 million. Assigned to committee of Heaton (C), Nelson Forbes, Murphy