Iowa Nurses Association | Legislative Connection, Volume 4, Number 7, February 23, 2001

LEGISLATIVE CONNECTION

a communication of the Iowa Nurses Association

Volume 4, Number 7
February 23, 2001

TOP STORIES OF THE WEEK

INA Priority Bill Gets New Number and Debate Time

INA’s priority legislation was assigned a bill number on Wednesday. It has changed from House Study Bill 59 to House File 354 . It has gone to the House debate calendar and in conferring with the House Majority Leader, Christopher Rants (R-Sioux City), he has agreed to schedule it for debate the afternoon of February 28 when there will be a number of nursing students and members present at the Capitol. If you are not attending Lobby Days, please contact your representative and ask for their support of this "practical

bill which legalizes current activity but clarifies the action for those who have question."

INA Seeking Input on Senate File 242

Senate File 242 provides that administrative rules would be directed to be rewritten stating that a practitioner’s order in the hospital does not need to be authenticated until thirty days after discharge of the patient. This is being requested by the physician community which states that with some large group practices and rotations of physicians going to see patients that it is sometimes difficult to get back to the hospital to sign the verbal orders. The lobbyists for the Iowa Nurses Association are seeking comments from staff nurses as to whether this would be a problem in providing patient care and the quality of the care provided. In research, the Medicare Conditions of Participation state that verbal orders should be used infrequently and signed as soon as possible. This bill would appear to lengthen that time in Iowa. Senator Merlin Bartz (R-Grafton) is floor manager of the bill and INA has asked him to give the Association some time to research whether this is a good bill for nursing care and ultimately the patient.

Republicans Propose Budget Cuts of $40 Million

Republican lawmakers announced cuts of $40 million from the current budget because state receipts are down $170 million from estimates, and down $2 million over the first seven months of the current fiscal year. Legislators identified five areas--public schools, the state Veteran’s Home, prisons, property tax replacement payments and health care payments for the poor--that will not be cut, leaving about $2 billion of the state budget from which to make cuts. The Republicans said that it would be irresponsible to use the ending balance for FY 2001, once estimated at $130 million, to cover the shortfall rather than make cuts now, as Governor Vilsack suggested. Senate Majority Leader Stu Iverson said that if the state uses the ending balance to cover the revenue shortfall this year, then the Legislature will need to make even bigger cuts in the FY 2002 budget.

Speaker of the House Siegrist said that the state is experiencing budget problems and even with the cuts for FY 2001, the Legislature will continue to look at spending cuts for the FY 2002 budget. The House Appropriations Committee passed the bill Wednesday afternoon. The $40 million cuts include nearly $10 million from the three state universities and the community colleges and $8.5 from the Department of Human Services.

Governor Vilsack said that the Republicans are overreacting to the lower than expected revenues in order to make spending cuts that will be used to pay for tax cuts later. The Republicans said that they have put any more tax cuts on hold this year. Vilsack said that it makes more sense to use the ending balance for FY 2001 rather than make cuts late in the fiscal year.

House Majority Leader Rep. Rants said that the Legislature would not have budget targets until after the March 15 meeting of the Revenue Estimating Council.

Governor Vilsack said that he has only made a limited review of the Republican proposal but he is convinced that the state has enough funds for this year’s spending. He said that parts of the plan would eventually cost more than they save. He said that the cuts to public safety (nearly $2 million) and to Community Based Correction’s ($1.1 million) will endanger the public, that the cuts to child support recovery ($1 million) will hurt efforts to ensure parents pay their financial obligation to their children and that the cuts to the University of Iowa, Iowa State, and UNI ($8.5 million) are a bad idea. He also said that the bill cuts more than $600,000 from the Iowa Veterans' Home.

Budget Cut Hearings

Republican lawmakers will hold budget hearings on SF 267 DEAPPROPRIATIONS on Monday night at 6:00 p.m. The Senate Appropriations Committee passed the bill Thursday, with many amendments. Senate Democrats intend to hold their own hearings on Monday.

Youth Employees in Health Settings

SF 170 MINOR HEALTH CARE WORKERS (Business & Labor; Successor to SSB 1120) This bill was amended to remove 14 and 15 year-olds to work as aides in hospitals, health care facilities and assisted living programs if the person receives training regarding exposure to biohazards. It allows persons under 18 to enroll in training programs for nurses, nursing assistants or aides and to be employed in those positions following the completion of the program. Thoughts on this issue should be directed to the floor manager, Senator Schuerer (R-Amana) and other senators.

STATUS OF THE INA AGENDA

Health Care Funding: All tobacco settlement money for health care purposes.
Appropriations Committees continue to meet. Deappropriations bills are a concern.
RN and LPN Pronouncement of Death
House Study Bill 59 was amended and introduced as House File 354. The bill is scheduled for floor debate Wednesday, February 28.
No support for Direct-Entry Midwives (non-nurse midwives)

HF 200 has been introduced and assigned to an unfavorable committee, Commerce and Regulation. It is not expected to move.

Other Bills on Issues on Watch:

Mental Health & Substance Abuse Parity: House File 107/Senate File 137 covers neurobiological conditions and calls for a substance abuse study, House File 113/Senate File 136 covers state employees with mental health and substance abuse coverage; House File 153/Senate File 132 covers children only for mental health and substance abuse; Senate File 131 appears to be very similar to last year’s House passed bill HF 2080 which died in the Senate. The Governor’s bill, Senate File 177 covers serious mental illnesses and substance abuse. HF 72/SF119 (Jochum and Connolly) cover all mental conditions in the ICD and substance abuse and are full parity, but unlikely to be considered by the Republican majority party.

The INA Public Policy Committee has recommended support of HF 107/SF 137 because the conditions listed are diagnostic categories and driven more by clinical insight and are clinically consistent with proven efficacy and effectiveness of treatment.

MAKING CONTACT

Attend local town hall meetings evenings or on Saturdays as locally scheduled.

Phone Numbers for leaving a message:

Governor’s Office 515/281-5211

Iowa House of Representatives at 515/281-3221

Iowa Senate at 515/281-3371

Website Contacts for sending emails or regular letters:

www.state.ia.us/governor On the "Office of Governor" page, go to "Desk Tops" on left side and hit "Comments", this brings up the "Comments Desk" and #3 is the email hot button.

www.legis.state.ia.us On the "Welcome to the Iowa General Assembly" page, go to "Members", then "Find Your Legislator" and you can type in your street address, city and zip code to get to your Congressional and state senator and representative names, phone numbers and email addresses.

Deanna McCallum and Linda Goeldner are the INA registered lobbyists. To learn more about the nursing agenda or nursing issues, call the INA office at 515/225-0495 or email either at DmcCall34@aol.com or Lkgoeld@aol.com.

BILLS PASSED OF INTEREST TO NURSING

Senate Debate

Bills to the House

SF 186 COUNTY HOSPITAL TAX LEVY - Increases the maximum property tax levy for the county hospital fund in Polk County to $2.05 per $1,000 in assessed value.

The Senate PASSED the bill, 45-0; it now goes to the House

SF 258 TOBACCO SETTLEMENT - Extends the existence of the Tobacco Settlement Authority Act until December 31, 2001.

The House PASSED the Bill, 46-0; it now goes to the House

BILLS IN COMMITTEE OF INTEREST TO NURSING

Use the website address above to find 1) the bill language and 2) the email address for the legislators listed below. Legislators serving on the following subcommittees are the individuals to whom comments should be initially made. Legislators give first priority to those living in their House or Senate District. Make sure the legislator knows you are a registered nurse.

House Appropriations: Voted Out:

LSB 2836 DEAPPROPRIATIONS & Transfers De-Appropriations: $34.70 million By Subcommittee: Administration & Regulation ($2.83 million); Agriculture & Natural Resources ($1.3 million from soil conservation and water quality); Economic Development ($1.1 million); Education ($12.2 million Total. Regents: $8.7 million; Community Colleges: $1.7 million; Aid Commission: $950,000) Health & Human Rights ($697,000); Human Services ($8.67 million Total. Administration $2 million; Mental Health $1.1 million; Child Health $1.3 Million; Mental Health $1,1 million; Child Support Recovery $950,000); Justice Systems ($5.40 million Total. Corrections: $1.4 million, $1.2 million from CBC; Public Defender: $1 million; AG $374,000; Judicial Retirement $422,000; Public Safety & Defense $5.4 million); Transportation ($100,000 from rail and aviation) LEGISLATIVE Branch ($1.4 million) Transfers: State Strategic Plan ($82, 645), Enhanced Court Collections ($4 million); Jury Witness Fund ($598,000); Pooled Technology ($700,000)

PASSED, 14-11; Floor Manger: Millage

House Commerce Voted Out:

HSB 49 HAWK-I PROGRAM - Abolishes the requirement that the Department of Human Services establish a sliding fee scale for HAWK-I. Allows HAWK-I Board to establish cost sharing amounts. Requires periodic random reviews of enrollee applications. Eliminates the outreach media campaign requirements. Directs administrative contractor to forward names of children that appear to be eligible for heath insurance coverage to local DHS office. Eliminates the requirement that the administrative contractor make applications available via mail, schools, local health departments, and local DHS offices. Allows for cost sharing based on family income levels at or below 150% federal poverty level. PASSED , 18-0 Floor Manager: Hansen

House Human Resources: Assigned to Subcommittee:

HF 308 MEDICAL ASSISTANCE PROGRAM - Tymeson (C), Atteberry, Grundberg

HF 331 AIDS TESTING - Carroll (C), Hoversten, Murphy

HF 338 CHINA ASSISTANCE REQUIREMENTS - Boddicker (C), Hoversten, Reynolds

HF 341 INFORMED CONSENT - Hoversten (C), Barry, Boddicker, Kreiman, Reynolds

HF 344 CHILD PROTECTION CENTER - Hoversten (C), Boddicker, Foege

House Human Resources: Voted out:

HF 116 PREGNANCY TERMINATION REPORTING - Requires health care providers to report spontaneous and induced abortions, along with estimated gestation age, and the county in which the patient resides. AMENDED & PASSED , 11-9 Floor Manager: Boddicker

Senate Appropriations: Voted Out: (1)

AMENDED & PASSED, 14-9; Floor Manger: Lamberti See SF 267

Senate Judiciary: Voted Out:

SSB 1153 TOBACCO SETTLEMENT - Extends the existence of the Tobacco Settlement Authority Act until December 31, 2001. PASSED, 12-0 Floor Manager: Lamberti

Senate Business & Labor: Voted Out:

SSB 1120 MINOR HOSPITAL WORKERS - Allows 14 and 15 year-olds to work as aides in hospitals, health care facilities and assisted living programs if the person receives training regarding exposure to biohazards. Allows a person under 18 to enroll in training programs for nurses, nursing assistants or aides and to be employed in those positions following the completion of the program. PASSED

Senate Commerce: Assigned to subcommittee:

SF 119 SUBSTANCE ABUSE COVERAGE - Johnson (C), Deluhery, Schuerer

SF 131 NEUROBIOLOGICAL COVERAGE - Johnson (C), Hansen, Maddox

SF 132 NEUROBIOLOGICAL COVERAGE - Johnson (C), Hansen, Maddox

SF 232 PRESCRIPTION DRUG CARDS - Redwine (C), Deluhery, Freeman

Senate Human Resources: Assigned to subcommittee:

HF 178 DRUGS AND CHILD ABUSE - Boettger (C), Holveck, Miller

SF 145 PREGNANCY TERMINATION INFO - Bartz (C), Behn , Shearer

SF 187 CHILD ABUSE REPORTING - Miller (C), Dvorsky, Veenstra

SF 201 PERSONAL NEEDS ALLOWANCE - Veenstra (C), Harper, Schuerer

SF 212 SENIOR ADULT EMPOWERMENT - Schuerer (C), Harper, Miller

Senate Human Resources: Voted Out:

SSB 1079 PRACTITIONER HOSPITAL ORDERS - Directs the DIA to adopt rules regarding verbal orders in hospitals that are consistent with federal law and regulations. Bars the DIA from requiring that the orders be signed within a certain time unless the federal rules also have that requirement. AMENDED & PASSED , Floor Manager: Bartz

SSB 1126 RESUSCITATION ORDERS - Creates new code section on "Resuscitation Status Orders Act." Allows a doctor to issue written orders withholding or withdrawing life-sustaining procedures outside a hospital setting. Requires consent of the patient or patient’s representative. Validates preexisting resuscitation orders. Grants immunity to persons acting in good faith in carrying out resuscitation orders. PASSED , 12-0; Floor Manager: Schuerer

Senate Ways & Means: Assigned to Subcommittee:

SF 255 SENIOR LIVING CARE CREDIT - McKinley (C), Connolly, Maddox

BILLS INTRODUCED OF INTEREST TO NURSING

Resolutions Introduced

HCR 16 COLORECTAL CANCER MONTH (Hansen, et al.) Requests the Governor annually designate March as Colorectal Cancer Awareness Month.

House Study Bills:

HSB 166 CENTRALIZED CHILD ABUSE REPORTING (Human Resources) Requires the DHS to create a statewide central intake unit for child abuse reporting. Requires the use of a toll-free number and staff trained to take child abuse reports. Hoversten (C) , Boddicker , Smith

HSB 167 SAFE HAVENS (Human Resources) Allows a parent to voluntarily surrender the custody of a child who is four days old or younger at a hospital or other health care facility. Gives the parent immunity from prosecution if the infant is not harmed. Requires the county attorney to proceed with efforts to terminate parental rights as soon as practical. Grants immunity to the individual who receives the child and allows that individual to receive the notice of any hearings.

Barry (C), Boal, Tymeson, Reynolds, Atteberry ( See SSB 1148)

HSB 170 CHILD ABUSE INVESTIGATION TEAMS (Judiciary) Appropriates $500,000 from the General Fund to the Justice Department to train teams to investigate and prosecute child abuse cases and to assist local authorities in establishing such teams. (Attorney General) Millage (C), Kettering , Shoultz

House Files:

HF 296 PRESCRIPTION DRUG PROGRAM (Tremmel, et al.) Appropriates $5 million to the DPH for FY 2001-02 for direct services to participants in the Prescription Drug Program. (Appropriations)

HF 306 LEAD POISONING APPROPRIATION (Ford, Dotzler, & Reynolds) Appropriates $153,000 to the DPH from the General Fund for expansion of the Childhood Lead Poisoning Prevention Program. (Appropriations)

HF 308 OPTIONAL MEDICAL ASSISTANCE PROGRAM (Heaton, et al.) Creates a new category of optional coverage under the Medical Assistance Program for certain women requiring treatment of breast or cervical cancer. (Human Resources)

HF 319 HAWK-I ELIGIBILITY (Osterhaus & Hatch) Allows a presumptive eligibility determination to be made only once per year. Directs that the determination of an applicant’s family income is to be based on the applicant’s self-declaration of income. Requires public schools to provide Hawk-I information and applications at the time of school registration. (Commerce)

HF 331 AIDS TESTING (Baudler) Allows for AIDS testing of individuals receiving assistance from care givers or from persons giving emergency first aid on a voluntary basis and without compensation. (Human Resources)

HF 338 CHINA ASSISTANCE REQUIREMENTS (Baudler) Allows for application of CHINA provisions if a parent, guardian, or other member of the child household refuses to undergo medically relevant testing or provide the results of the medical tests. Requires the court to prohibit the child remaining in the house if the parent or guardian is affected by chemical dependency. (Human Resources)

HF 341 INFORMED CONSENT (Boddicker, et al.) Creates new code section known as the "Woman’s Right to Know Act. Requires informed consent from women including information a doctor is required to provide prior to the medical termination of a pregnancy. Makes a medical emergency exception. Makes it a simple misdemeanor for a doctor to violate informed consent provisions. Effective October 1, 2001. (Human Resources)

HF 344 CHILD PROTECTION CENTER (Foege, et al.) Creates within the DPH the Child Protection Center Grant Program with grants awarded by the state Board of Health. Allows grants in the five DHS regions served by a Child Protection Center (Human Resources)

HF 354 DEATH PRONOUNCEMENT (Judiciary; Successor to HSB 59) Allows a registered nurse, a physician assistant or a licensed practical nurse to declare someone dead if the death occurs in a hospital, health care facility, a Medicare-certified home health agency or Medicare hospice program. (Calendar) FM: Grundberg

HF 365 TOBACCO SETTLEMENT (Heaton)) Extends the existence of the Tobacco Settlement Authority Act until June 30, 2002. ( Different than SF 258) (Appropriations)

HF 369 INCORRECT PRESCRIPTION DRUGS (Fallon) Directs the Board of Pharmacy Examiners to adopt rules for ultimate users remedies who are dispensed the incorrect or inappropriate prescription. (Human Resources)

Senate Study Bills:

SSB 1148 SAFE HAVENS (Human Resources) Allows a parent to voluntarily surrender the custody of a child who is four days old or younger at a hospital or other health care facility. Gives the parent immunity from prosecution if the infant is not harmed. Requires the county attorney to proceed with efforts to terminate parental rights as soon as practical. Grants immunity to the individual who receives the child and allows that individual to receive the notice of any hearings.

Boettger (C), Redwine, Harper

SSB 1149 DEATH STANDARDS (Judiciary) Establishes a uniform standard to declare a person dead. Conforms with the Uniform Declaration of Death Act drafted by the National Conference of Commissioners on Uniform State Laws.
Redfern (C), King , Horn

SSB 1153 TOBACCO SETTLEMENT (Judiciary) Extends the existence of the Tobacco Settlement Authority Act until December 31, 2001.

Lamberti (C), Boettger, Fraise

SSB 1154 STUDENT SUPERVISION OVER ICN (State Government) Allows for supervision of K-12 student receiving instruction over the ICN by a licensing teacher at the site of origination or by the school receiving the curriculum.
McLaren (C) , King , Bolkcom

SSB 1155 OPTOMETRIST TREATMENTS (State Government) Allows therapeutically certified optometrist to use all diagnostic and therapeutic agents to treatment the eye. Makes exceptions.
Jensen (C), Rittmer , Connolly

Senate Files:

SF 210 LOW-INCOME DRUG PLAN (Human Resources; Successor to SSB 1069) Directs the Department of Public Health and the Department of Human Services to develop a proposal for a prescription drug program for low-income seniors and low-income persons with disabilities in specific circumstances. FM: Boettger

SF 212 SENIOR EMPOWERMENT (Schuerer) Includes senior adults, defined as adults over the age of sixty, in the community empowerment initiative and allows empowerment boards to address their needs. (Hum Res)

SF 232 PRESCRIPTION DRUG CARDS (Johnson & Hammond) Requires the use of a uniform prescription card by providers of third-party payment or by prepayment of prescription drug expenses. (Commerce)

SF 242 PRACTITIONER HOSPITAL ORDERS (Human Resources; Successor to SSB 1079) Directs the DIA to adopt rules regarding verbal orders in hospitals that require such orders to be authenticated within 30 days. (Calendar) Floor Manager: Bartz

SF 247 HIV RADIO TRANSMISSIONS (King) Allows a law enforcement agency to transmit the HIV status of a person over the radio if the employee is acting within the scope of their employment. (Judiciary)

SF 255 SENIOR LIVING CARE CREDIT (Tinsman) Creates an income tax credit on long -term care insurance contracts of 50% of the premium up to a total credit of $350. Allows credits for the taxpayer, their spouse or dependent and their or their spouses parents or grandparents. (Ways & Means)

SF 258 TOBACCO SETTLEMENT (Judiciary; Successor to SSB 1153) Extends the existence of the Tobacco Settlement Authority Act until December 31, 2001. Floor Manager: Lamberti

SF 264 RESUSCITATION ORDERS (Human Resources; Successor to SSB 1126) Creates the Resuscitation Status Orders Act. Orders: Allows doctors to issue written orders withholding or withdrawing life-sustaining procedures outside a hospital setting. Authorizes the DPH to establish rules regarding the form of such orders and the necessary information in such orders. Consent & Revocation: Requires consent of the patient or patient’s representative. Establishes provisions for the revocation of an order. Other: Validates preexisting resuscitation orders. Grants immunity to persons acting in good faith in carrying out resuscitation orders. (Calendar) Floor Manager: Schuerer

SF 267 DEAPPROPRIATIONS (Appropriations) De-Appropriations: $34.70 million By Subcommittee: Admin & Reg ($2.83 million); Agri & Nat Res ($1.3 million from soil conservation and water quality); Economic Development ($1.1 million); Education ($12.2 million Total. Regents: $8.7 million; Community Colleges: $1.7 million; Aid Commission: $950,000) Health & Human Rights ($697,000); Human Services ($8.67 million Total. Administration $2 million; Mental Health $1.1 million; Child Health $1.3 Million; Mental Health $1,1 million; Child Support Recovery $950,000); Justice Systems ($5.40 million Total. Corrections: $1.4 million, $1.2 million from CBC; Public Defender: $1 million; AG $374,000; Judicial Retirement $422,000; Public Safety & Defense $5.4 million); Transportation ($100,000 from rail and aviation) Legislative ($1.4 million) Transfers : State Strategic Plan ($82, 645), Enhanced Court Collections ($4 million); Jury Witness Fund ($598,000); Pooled Technology ($700,000)(Calendar) Floor Manger: Lamberti

SF 271 JUDICIAL HOSPITAL REFEREES (Fiegen) Appropriates $160,000 to pay for judicial hospitalization referees.

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