a communication of the Iowa Nurses Association

Volume 3, Number 31 April 14, 2000

HF 2565 TOBACCO USE CONTROL (Companion to SF 2449) Creates the Tobacco Use Prevention and Control Division (TUPC) within the Department of Public Health with 15 voting members appointed by the Governor and confirmed by the Senate. The Commission also has 5 ex officio non-voting members. Establishes the Tobacco Use Prevention and Control Initiative to attain specified results of reducing smoking by youths, pregnant women, etc. and encourage community based partnerships with schools and others to reducing tobacco use. Directs the Commission to implement a statewide system for the equitable funding of initiative programs based on the school-age population along with other criteria. Effective upon enactment. AMENDED

SENATE APPRORIATIONS Voted Out:

SSB 3231 STANDINGS APPROPRIATIONS Appropriations: From the General Fund: Mental Health Growth: Total $25.8 million ($12.0 million for inflation; $9.8 million for per capita target pool; $2.0 million for the incentive pool; $2.0 million for the risk pool); Education: $80.9 million to Dept. of Education for teachers salaries. (reduction of $2 million) From the Tobacco Fund: $64.4 million to the General Fund. (for cash flow purposes only.) Statutory: Creates a Microsoft Settlement Fund for any money the state may get from litigation against Microsoft. Allows the UNI Waste Reduction Center to use reversions of their FY 2000 Supplemental Appropriation of $2 million in FY 2001. Corrective Amendments to 2000 Bills: HF 2105, HF 2148, HF 2316, HF 2317, HF 2331, HF 2362, HF 2435, HF 2442, HF 2492, SF 182, SF 421, SF 2145, SF 2193, SF 2194, SF 2248, SF 2254, SF 2300, SF 2344, SF 2371SF 2373 & SF 2411 (See HSB 785/HF 2572) (This bill includes technical corrections for the Nurse Licensure Compact, HF 2105)

SF 2126 CONTRACEPTIVE COVERAGE - Prohibits all insurance policies, or other health benefits plans, from excluding benefits for prescription contraceptives if the policy covers other prescriptions. Authorizes the use of generic drugs. Prohibits denying coverage to a person because of the use of contraceptive devices. Effective after July, 2000. Contains other related provisions.

H-8477 by Boddicker - Requires the devices prevent conception. ADOPTED

H-8740 & H-8768 - WITHDRAWN

SF 2435 HUMAN SERVICES APPROPRIATIONS - Makes appropriations to DHS. Total from the GF: $797.8 million; $134.7 million (Operations); $641.9 million (Grants); $21.3 million (Standings). Economic Assistance: ($42 million Total) FIP: $35.5 million; Emergency Assistance: $10,000; Child Support Recovery: $6.5 million. 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; Supplementary Assistance: $20 million. Adult Child & Family Services: ($132.8 million Total); Child Care: $5.1 million; Toledo Home: $6.3 million; Eldora School: $10.4 million; Child & Family Services: $108.8 million; Community Based Services: $280,000; Family Support Subsidy: $2 million. MM/MR/DD/BI: ($103.5 million Total); Institutions - Cherokee: $12.8 million; Clarinda: $7.2 million; Independence: $17.5 million; Mt. Pleasant: $5.4 million; Glenwood: $2.5 million; Woodward: $1.7 million; Other MH: Conners Training $46,000; Special Services $121,000; DD Special Needs: $53,000; State Cases: $13.8 million; Community MH/MR Fund $19.6 million; Personal Assistance: $364,000; Sexual Predator Commitment: $1.8 million; MH Allowable Growth: $21.3 Million. DHS Administration: Field Operations: $44.2 million; Regional Offices: $5.7 million; General Administration: $13.4 million. Other Funds - TANF: Total: $141.9 million Administration: $5.4 million; Field Operations: $12.9 million; Child & Family Services: $23.6 million; FIP: $44 million; Day Care: $20.6 million; Promise Jobs: $20 million; 5 & Under Children: $3.2 million; MH/DD Community Services: $4.6 million; Emergency Assistance: $2.8 million; Pregnancy Prevention: $2.5 million; Other: $2.3 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. 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. 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.

AMENDMENTS TO SF 2435

H-8786 by Jochum & Foege - Increases Child Care Assistance by $4.1 million. FAILED

H-8801A by Heaton - Requires child care assistance grants get local matching support. Makes Medical Assistance waivers needs based. Strikes the pilot project. Requires MH and substance abuse dual diagnosis be done at Mt. Pleasant. Requires $50,000 from Medical Contracts be spent on getting and keeping nurses aides. Adds $8,000 for the Toledo Home, $24,000 for Eldora. Cuts $8,000 from Child & Family Services. Retains Title IV-E funds efficiencies. Increases Clarinda, Independence and Woodward funding by a total of $11,000. Cuts $120,000 from regional offices. Cuts $93,000 from DHS administration. Cuts $600,000 from MI/MR/DD Cases and puts $300,000 for MR intermediate care. Appropriates $25,000 to the Dept. for the Blind for newsline access. Adds $148,000 to field operations for child abuse staff. Appropriates $210,000 for State-County Assistance Functions. Requires the Prevention of Disabilities Council to report on itself and its need to continue.

H-8819 B by Dix & Heaton - Establishes home and community based services program for elders and individuals with disabilities under the direction of the DHS. Effective July 1, 2002. (Incorporates HF 2380 COMPREHENSIVE PERSONAL ASSISTANCE) ADOPTED

H-8815A by Heaton - Raises funds for Independence another $40,000. ADOPTED

H- 8833 by Heaton - Changes language for head injury qualification. ADOPTED

H-8837 by Blodgett - Adds $25,000 to the Dept. for the Blind for news access by Iowa radio reading service. ADOPTED

H8832 by Murphy Strikes cut in Child Protection and increases it by $19,000. FAILED 44-51

H-8834 by Jochum- Restores cut from regional offices and adds $310,000. FAILED 44-54

H-8826 by Jochum - Strikes the cut to DHS administration and adds $280,000. FAILED

H-8803 by Blodgett - Raise the PMICs daily rate cap by $1.46. ADOPTED

H-8822B by Osterhaus & Heaton - Appropriates $414,000 for a Pharmaceutical Case Management Study. ADOPTED

H-8820 by Foege - Adds $69,000 for PMICS, FAILED

H-8814B by Greimann - Adds an additional $69,000 for Independence FAILED

H-8801A, as amended, ADOPTED

H-8788 by Foege - Shifts $731,000 to prevent child abuse from FIP to the FSSP. FAILED

H-8841 by Heaton - Provides for state funding for federal matching funds for state cases. ADOPTED

H-8825 by Hansen - Lets people opt for Hawk-I instead of Medicaid. ADOPTED

H-8850 by Jochum - Strikes bar on a child care assistance waiting list. ADOPTED

H-8787 by Foege - Changes the priorities for the juvenile female aftercare program. ADOPTED

H-8821 by Blodgett - Technical. ADOPTED

H-8812 by Jochum - Increases Family Support Subsidy Program by $190,000. FAILED

H-8794 by Heaton - Directs DHS to continue reviewing reimbursement policies but prohibits changes without legislative approval. ADOPTED

H-8840 by Heaton - Requires Nursing homes owned by one company to include central administrative costs and to use the same accounting dates ADOPTED

H-8856 by Heaton - Cuts $422,000 from medical assistance. ADOPTED

H-8854 by Reynolds - Allows direct reimbursement to an independent nurse practitioner. ADOPTED

H-8855 by Osterhaus - Appropriates $127,000 to fund infant medical assistance at 200% of the poverty level. FAILED

WITHDRAWN: H-8751, H-8758, H-8779, H-8785, H-8789, H-8792, H-8793, H-8797, H-8798, H-8801B, H-8808, H-8809, H-8811, H-8814A, H-8815B, H-8816, H-8819A H-8822A, H-8827, H-8838, H-8839, H-8843, H-8851. OUT OF ORDER: H-8790, H-8791, H-8808, H-8814B

SF 2113 MASSAGE THERAPY - Requires persons to have appropriate certification and training to act as a massage therapist and prohibits the unlicensed persons from practicing massage therapy of from falsely claiming certification. Authorizes civil penalties for persons who violate the provisions of this bill.

S-5335 by the House - Defines practices of Massage Therapy.

The Senate CONCURRED with the S-5335.

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.

S-5272 by the House - Allows the DHS to release confidential information in certain circumstances.

The Senate CONCURRED with the S-5272.

HF 754 COVERAGE OF DENTAL CARE - Requires that health benefit coverage include coverage for anesthesia and other hospital charges related to dental care for children, the developmentally disabled or a person with a condition that requires hospitalization and treatment. Allows prior authorization requirements.

SF 2408 COVERAGE OF DENTAL CARE - WITHDRAWN

SF 2360 BACKGROUND CHECKS - Makes technical changes to the code regarding background checks of state employees. Allows background checks of employees and volunteers who have direct contact with clients in county cluster offices. Allows the consideration of the criminal offenses in determining if that person should continue service. Changes the name of the state hospital schools to state resource centers.

S-5344 by the House - Allows a county to change its service arrangements with DHS on ninety days notice. Sets Webster and Washington Counties as the Adult MH/MR/DD Decat Pilot Project ADOPTED

The Senate CONCURRED with S-5344

SF 2302 PUBLIC HEALTH DUTIES - Requires Substance Abuse Commission to specifically review initial requests for a substance abuse facility. Broadens inspection authority of substance abuse facilities by the DPH. Adds provisions about electronic filing of records. Makes licensing changes for audiologists, morticians, social workers and others. Authorizes fees for autopsies. Strikes the requirement for the minister to issue a certified copy of the marriage certificate to the couple. Requires county recorders to issue the certified copies of marriage licenses for four dollars. Strikes a provision that requires DALS and the Pharmacy Examiners to purchase condoms for DPH for testing if DPH requests those two agencies to do so. Allows women to breastfeed their own children in public. Makes technical corrections and deletes obsolete references.

S-5353 by the House - Gives a free certified copy of the marriage license to the happy couple. Makes technical change to the breastfeeding provision. Eliminates granting subpoena powers to the medical examiner and deputies. Raises marriage license fees to $35. Makes language and technical corrections.

H-8805 by the Senate - Exempts dietary supplements that contain less than 15% of naturally occurring ephedrine compounds from the schedule of controlled substances.

The House CONCURRED in H-8805.

HF 2316 RISK-BASED HMO REGULATION - Risk-based Capital Reports: Requires a domestic HMO to file an annual report on risk-based capital levels with the Insurance Commissioner of Iowa, and other states that the HMO does business. Defines risk-based capital and when the Insurance Commissioner must take action. Other: Allows an HMO to appeal the Insurance Commissioner’s decision. Allows the Insurance Commissioner to exempt some HMOs from regulation under the bill.

HF 2321 MEDICAID ELIGIBILITY - Adds two categories of Medicare eligibility. Considers disclaimers inheritance and failure to elect against a will as a transfer of assets in determining eligibility.

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

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.

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. Tests & Reports: 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. Immunization: Directs the DPH to establish a task force to make immunization recommendations for post-secondary students. Other: 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. Makes language changes, including venereal diseases to sexual transmitted diseases and other related changes.

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. 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.

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.

HF 2563 NON-PROFIT HOSPITALS (Ways & Means; Successor to HF 2095) Exempts from the sales and use taxes and allows for refunding of taxes paid for construction material used to fulfill written contracts with non-profit hospitals if the following conditions are met: 1) the sales and delivery occurred between July, 1998 and December 31, 2001; 2) the contract was entered in to or bonds for the project were issued before December 31, 1999, and; 3) the items were purchased by the contractor or hospital directly. Limits refunds to an aggregate of $25,000. (Ways & Means Calendar)

HF 2565 TOBACCO USE CONTROL (Rants; Companion to SF 2449) Creates the Tobacco Use Prevention and Control Division (TUPC) within the Department of Public Health with 15 voting members appointed by the Governor and confirmed by the Senate. The Commission also has 5 ex officio non-voting members. Establishes the Tobacco Use Prevention and Control Initiative to attain specified results of reducing smoking by youths, pregnant women, etc. and encourage community based partnerships with schools and others to reducing tobacco use. Directs the Commission to implement a statewide system for the equitable funding of initiative programs based on the school-age population along with other criteria. Effective upon enactment. (Human Resources)

SSB 3231 APPROPRIATIONS CLEAN-UP (Appropriations) Appropriates money to DHS for the county MH/MR/DD allowed growth factor of 1.7 percent. Transfers funds from the tobacco settlement fund to the General Fund. Reduces the appropriation to the education excellence program by $2 million. Protects unspent funds at the Iowa Waste Reduction Center from reverting. Makes numerous corrections to legislation passed in 2000. McLaren (C), Rife, Flynn

HF 2572 STANDINGS APPROPRIATIONS (Appropriations; Successor to HSB 785) Appropriations: From the General Fund: Mental Health Growth: Total $25.8 million ($12.0 million for inflation; $9.8 million for per capita target pool; $2.0 million for the incentive pool; $2.0 million for the risk pool); Education: $80.9 million to Dept. of Education for teachers salaries. (reduction of $2 million) From the Tobacco Fund: $64.4 million to the General Fund. (for cash flow purposes only.) Statutory: Creates a Microsoft Settlement Fund for any money the state may get from litigation against Microsoft. Allows the UNI Waste Reduction Center to use reversions of their FY 2000 Supplemental Appropriation of $2 million in FY 2001. Corrective Amendments to 2000 Bills: HF 2105, HF 2148, HF 2316, HF 2317, HF 2331, HF 2362, HF 2435, HF 2442, HF 2492, SF 182, SF 421, SF 2145, SF 2193, SF 2194, SF 2248, SF 2254, SF 2300, SF 2344, SF 2371SF 2373 & SF 2411