a communication of the Iowa Nurses Association

HOUSE FILE 726 Health and Human Rights Appropriations Bill

Section 5, subsection 6. Elderly Wellness        Republican Cut: $330,000
Public health nursing contracts to local agencies would be reduced.  This would result in the inability of our public health nurses to make an estimated 5,648 home visits to elderly and disabled Iowans.

Talking points:

Public Health has been under-funded in Iowa for many years.  Further reductions will seriously erode our ability to protect, promote and enhance the health of Iowans and broadens the health disparities for those most vulnerable in our communities.  When people in a society are not healthy, it impacts the whole community - particularly the economic, educational, social and cultural sectors.

PHN funding cut comes at time when the need for community-based services to maintain citizens in their home instead of a nursing home is increasing. 

PHN funding has been level funded since 1979 with the only change being due to a 3% across-the-board funding cut in the early 80s.

Section 5, subsection 10 Public Protection       Republican Cut: $400,000
Reduces funding for the licensing and regulation of health professions. Although the fees that these professionals pay into the general fund would not change, the budgets of each of the 22 examining boards would be reduced. These cuts are expected to affect the boards’ ability to investigate complaints of incompetent care that pose a risk to the public’s health and safety, and delay the processing of new license applications and the renewal -of current licenses.

Talking points:

To make a cut in this appropriation is to negate the intent of Section 5, subsection 10 g. which states that the licensing boards shall prepare estimates of projected receipts…and administrative costs and rental expenses … and adjust its schedule of fees as nearly as possible.

Cuts to this budget line subsidize shortfalls in other parts of the budget when 86% of the budget goes for salaries. To take a further cut means a reduction in staff for the Board of Nursing when fees have been set "as nearly possible to reflect projected expenses".

This bill has cuts in the HAWK-I program, which would cap the number of children that can be enrolled to 1600. Cuts in the budget would also not provide any additional monies for additional child protective workers to work with troubled families and at-risk children.

The reimbursement rate for nursing facilities will be determined using a case mix system. The reimbursement for inpatient and outpatient hospital services will remain at the rate in effect June 30, 2001. The rates to home health agencies and community mental health centers will be reduced by 3% for rates in effect June 30, 2001.

Renames the Tobacco Settlement Endowment fund the Healthy Iowans Tobacco Trust. Authorizes the state’s share of the tobacco settlement to be "securitized" and allows the tobacco settlement authority to sell bonds for capital projects. Requires $55 million annually, with adjustments for inflation to be transferred into the Tobacco Trust and limits the use of those funds.

Calls to legislators should indicate support for this effort.

The Budget Bills & Redistricting

Governor Vilsack and the Republicans are still meeting on budget issues, and are making some progress towards a budget, despite the sometimes harsh rhetoric from both sides. Rep Rants said that they are close on six of the budgets. He said that the Governor and the Legislature are farthest apart on SF 535 EDUCATION APPROPRIATIONS and HF 732 HUMAN SERVICES APPROPRIATIONS. Legislators do have most of the budget bills moving. Rep. Siegrist said that he hopes that the Legislature can get agreements on a couple of the smaller budgets and send them down to the Governor so that legislators will have a better idea of how much can be spent in the disputed areas.

Rep. Siegrist said that he expects the Legislature to need at least one additional week to finish up the budget work for the year. The 110th day (the end of per diem payments) is April 27th, the same day the vote on the first redistricting plan is due. If the Legislature rejects the first plan, the redistricting issue can’t be settled until the end of May. Speaker Siegrist said rejecting the plan would mean a special session.

Governor Vilsack, Senator Gronstal and Rep. Myers have indicated that the Democrats will support the redistricting plan that is now before the Legislature. The House Republicans are still waiting to hear from the public response from the open hearings. Rep. Rants said that his impression is that public opinion on the plan is split. Senator Iverson said that the Senate Republicans would make a decision by the middle of next week.

1. Health Care Funding: All tobacco settlement money for health care purposes.

Large budget cuts in appropriations for services of interest to nursing: HF 726 for public health nursing and funding to the Board of Nursing. HF 732 for HAWK-I, nursing home, hospital, home health and community mental health services. Calls to legislators are needed.

Language for "securitizing" the tobacco settlement funds is found in SF 532 and SF 533. Tobacco Settlement Fund is renamed the "Healthy Iowans Tobacco Trust".

2. RN and LPN Pronouncement of Death

The bill is in jeopardy of reaching final passage due to the heavy lobbying of chiropractors. The bill may not be called up for debate and final passage due to the chiropractor issue. Calls to legislators are needed.

3. No support for Direct-Entry Midwives (non-nurse midwives)

HF 200 died in the funnel. It is eligible for consideration next January.

Other Bills on Issues on Watch:

Mental Health & Substance Abuse Parity: None of the bills made the first funnel. The reason given primarily is due to the large premium increase many Iowa employers received. The business community actively worked against all the bills citing large premium increases and their desire for no mandated coverage.

Verbal Orders: SF 242 would extend the length of time for a prescribing practitioner to sign a verbal order from 72 hours to 30 days after discharge. Amended to "sunset" in six years (two cycles of JCAHO reviews) to be evaluated again. INA membership is both for and against the bill.

Repeal of Code for Birth Centers: SF 390 would repeal the Code to regulate birth centers. The bill has been referred back to committee for further work. Legislators intend to work on the issue this summer. INA members are both for and against the issue.

Safe Havens: SF 355 allows fourteen days for a child to be left at a facility if the mother/parents do not want to keep the child. This bill has gone to the Governor.

Governor’s Office 515/281-5211

Iowa House of Representatives at 515/281-3221

Iowa Senate at 515/281-3371