Iowa Nurses Association | Legislative Connection, Volume 4, Number 17, May 4, 2001

LEGISLATIVE CONNECTION

a communication of the Iowa Nurses Association

Volume 4, Number 17
May 4, 2001

TOP STORIES OF THE WEEK

Governor Signs Death Pronouncement Bill

On May 3 the Governor signed an Iowa Nurses Association priority bill, House File 354 which legalizes the pronouncement of death by a registered nurse, licensed practical nurse and a physician assistant. Thanks to all members who made calls to legislators and the Governor urging support.

End of Session Soon?

Republican leaders are predicting that they can wrap the session up next week; Democrats are predicting that the session will take two weeks to finish. Senator Iverson said that the Republicans are meeting with the Governor and are making progress. He said that he believes that the parties can resolve their budget differences by next week. Iverson said that controlling spending would remain the most important goal for the Republicans. He said, "Iowans elected Republicans to run a balanced budget" and said "raising taxes is not an option."

Democrats said that this is the worst session for education since 1981, when the state cut state education by $40 million. House Minority Leader Myers said that the state does not lack the money to fund education but that the Republicans have not made it their top priority. Myers said that the state could easily use the $50 million from the 1% left over from budgeting; Senator Gronstal said that the Governor’s proposal to use money from the Economic Emergency Fund and to spread the necessary budget cuts over two years rather than to make all of the cuts this year is a better practice that will lead to fewer lay-offs and disruptions in state government.

STATUS OF THE INA AGENDA

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

There are budget cuts in appropriations for services of interest to nursing: HF 726 the Health and Human Rights Appropriations bill for public health nursing ($330,000 for elderly wellness), funding to the Board of Nursing and other licensing boards ($400,000 for public protection) and funding for child health specialty clinics ($519,00 for chronic care). HF 732, the Human Services Appropriations bill for HAWK-I, nursing home, hospital, home health and community mental health services.

Language to authorize "securitizing" the tobacco settlement funds is found in SF 532. SF 533 makes revenue transfers between state funds to comply with tax laws. SF 537 appropriates the Tobacco Settlement Endowment Fund and the "Healthy Iowans Tobacco Trust" in the amount of $55 million for various health and human services programs including $1,250,000 for public health nursing and home care aides. It renames the Tobacco Settlement Fund as the Healthy Iowans Trust.

RN and LPN Pronouncement of Death

HF 354 passed the Senate on April 25 on a vote of 47-0. The chiropractor amendment was ruled non-germane since they do not work in the four settings listed in the bill. The Governor signed the bill May 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. Governor signed bill April 30.

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 was signed by the Governor.

Senior Living Trust: HF 740 provides funding for a new methodology of nursing home reimbursement with focus on funds focused on direct care providers. INA gave support due to the increased funds that would be targeted at direct care workers.

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 SIGNED BY GOVERNOR OF INTEREST TO NURSING

HF 354 DEATH PRONOUNCEMENT - 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. (Signed May 3)

SF 242 DOCTORS HOSPITAL ORDERS - Directs the DIA to adopt rules regarding medication and authorization orders that require such orders to be authenticated within 30 days. Sunsets the bill as of 2007. (Signed April 30)

SF 533 TOBACCO FUND II - Makes appropriations to the tobacco settlement trust fund and to the endowment for Iowa’s Health in the tobacco settlement trust fund, contingent on the securitization of the tobacco settlement. (Signed May 2)

BILLS PASSED OF INTEREST TO NURSING
Bills to the Governor:

HF 590 AIDS TESTING - 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. Gives immunity to person or institution that performs or fails to perform the test.

H-1574 by the Senate - Strikes health care providers from the bill. Allows information about a person’s contagious disease to be given over police radio if personal identifiers are omitted.

S-3456 by the House - Language correction.

The Senate CONCURRED with S-3456 & PASSED the bill, 45-4; it goes to the Governor

The House PASSED the Bill, 89-0; it now goes to the Governor.

SF 532 TOBACCO FUND I - 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. Creates a capital projects account and a healthy Iowans account in the Tobacco trust. Requires $55 million annually, with adjustments for inflation to be transferred into the Tobacco Trust and limits the use of those funds. Contains related provisions.

H-1744 by Brunkhorst - Makes it the intent of the legislature to fund capitol projects to the extent possible. ADOPTED, 50-41

The House PASSED the Bill, as amended, 94-0; it now returns to the Senate

S-3568 by the House - Makes it the intent of the legislature to fund capitol projects to the extent possible. Makes it a joint rule for the House and Senate to comply with any law, which requires that, the Legislature act with a 3/5 majority.

S-3573 by Lamberti - Strikes the 3/5 majority provision. ADOPTED

The Senate CONCURRED in S-3568 & PASSED the bill, 47-3; it returns to the House

The House CONCURRED in S-3573 to S-3568 & PASSED the bill; 97-0; Motion to Reconsider - Brunkhorst

SF 537 TOBACCO SETTLEMENT - Makes the appropriations from the tobacco settlement. Total: 57.2 million. DHS Reimbursements: Total 32.5 million. Non-institutional Medicaid Providers ($11.6 million); Medicaid ($4 million); Dentists ($3.8 million); Rehab treatment & providers ($3.2 million); Hospitals ($3.0 million); Home Health Care providers ($2.1 million); Respite care providers ($1.1 million); Other DHS service providers ($546,000); Adoption, independent living, care shelters ($469,000); Breast and cervical cancer care ($250,000); Children’s Health Insurance Program ($200,000); Service care providers ($147,000). DPH: Total $23.8 million. Substance Abuse Treatment ($11.3 million); Tobacco Use Prevention & Cessation ($9.3 million); Healthy Iowans ($2.6 million, including $2 million for a substance abuse treatment facility for persons on probation). DOC; $609,000 for CBCs. Other: Changes the name of the Tobacco Settlement Trust to the Healthy Iowans Tobacco Trust. Directs that $75,000 of the substance abuse funding go to free clinics across the state to help persons quit smoking.

H-1830 by Seng - Eliminates the $75,000 appropriation for smoking cessation products and transfers it to substance abuse treatment. ADOPTED

H-1801 by Heaton - Corrective. ADOPTED

The House PASSED the Bill, as amended, 93-0; it now returns to the Senate

HF 726 HEALTH AND HUMAN RIGHTS APPROPRIATION - Appropriates to health and human rights agencies: Total (from the GF): $84 million;

AMENDMENTS TO HF 726

S-3550 by Appropriations - Increases the appropriation to the Veteran’s Home by $1.7 million from the gambling treatment fund. Requires the Veteran’s Home to report to the fiscal committee by December 2001 on its funding.

S-3566 to S-3550 by Bolkcom - Increases the appropriation from the GF. FAILED, 20-27

S-3553 by Bolkcom - Increases the appropriation to the Civil Rights Commission by $120,000. FAILED, 20-27

S-3550 - ADOPTED

S-3560 by Soukup, et al - Increases the appropriation to the Department of Elder Affairs by $573,000. FAILED

S-3552 by Bolkcom - Increases the appropriation to DPH for addictive disorders by $900,000. FAILED, 20-28

S-3562 by Holveck, et al - Increases the appropriation to DPH for chronic care by $519,000. .FAILED, 20-28

S-3569 by Hammond - Increases the appropriation for elderly wellness by $330,000. FAILED, 20-28

S-3554 by Bolkcom - Increases the appropriation to DPH for public protection by $400,000. FAILED, 20-28

S-3565 by Hansen - Increases the appropriation for community grants by $770,000. FAILED, 20-28b

S-3564 by Tinsman - Decreases the number of positions at the Veteran’s home. ADOPTED, 29-20

S-3561 by Dvorsky, et al - Appropriates $9.5 million for LIHEAP from the unassigned revenue fund administered by the UST board. FAILED, 20-28

The Senate PASSED the bill, 28-20; it now returns to the House

H-1763 by the Senate - Increases the appropriation to the Veteran’s Home by $1.7 million from the gambling treatment fund. Requires the Veteran’s Home to report to the fiscal committee by December 2001 on its funding. Decreases the number of positions at the Veteran’s home.

The House CONCURRED & PASSED the bill; 57-38.

S-3601 to H-1763 by the House - Increases the number of positions at the Veteran’s Home.

The Senate CONCURRED & PASSED the bill; 29-20; it now goes to the Governor

HF 740 SENIOR LIVING TRUST FUND - Appropriates money from the Senior Living Trust Fund for several programs. Appropriates $5.3 million from the Trust Fund to the Department of Elder Affairs for administrative costs; $20 million for Grants to nursing facilities for converting to assist living programs or to provide long-term care alternatives and to development of long-term care alternatives; $1.7 million to supplement the Medical Assistance Appropriation and for reimbursement to eligible persons for health care services and rent through the Home and Community Based Services Waiver and the State Supplementary Assistance Program; $24.75 million for Nursing Facility Provider Reimbursement based on case-mix reimbursement methodology. Directs all unencumbered and unobligated fund be retained in the Trust Fund.

From 4/30H-1755 by Heaton - Adds 13 employees to conform with previous years appropriations. Makes existing nursing homes eligible for the conversion funds before new facilities. ADOPTED

H-1747 by Osterhaus - Add $5 million to the assisted living funding program. FAILED

5/1H-1746 by Osterhaus - Prohibits DHS from using a geographic wage index adjustment in determining the modified price-based case-mix reimbursement rate for nursing facilities. FAILED 36-58

H-1765 by Smith - Emphasizes pay for direct care workers ADOPTED

H-1764 by Osterhaus - A strike & Replace Uses the DHS plan. FAILED 24-70

H-1772 by Osterhaus - prohibits location based wage index. ADOPTED

The House PASSED the Bill, 94-4; it now goes to the Senate.

AMENDMENTS TO HF 740

S-3622 by Hammond - Requires calculations using 85% occupancy rate for the modified price-based case mix reimbursement rate to begin in 2002 instead of 2003. FAILED

S-3624 by Hammond - Allows any excess payment allowance realized from the direct care cost to of the case-mix reimbursement to be used to pay workers more or increase the ratio of care workers to residents. ADOPTED

S-3625 by Hammond - Makes existing nursing homes eligible for the conversion funds before new facilities as July 2002. Strikes the changes to affordable room board and amenities. ADOPTED

S-3636 by Hammond - Requires DHS to implement a monitoring and reporting system to assess compliance with the changes regarding case-mix adjusted costs. ADOPTED

The Senate PASSED the Bill, 50-0; it now returns to the House

The House CONCURRED in H-1979 & PASSED the Bill 85-7; it now goes to the Governor.

HF 732 HUMAN SERVICES APPROPRIATION Makes appropriations to DHS. Total from the General Fund: $778.25 million.

AMENDMENTS to HF 732

S-3581 by Hammond, et al - Strikes the Iowa marriage Matters program and increases the appropriation for child abuse prevention by $500,000. FAILED, 21-28

S-3589 by Veenstra - Technical corrections. Makes a language correction to change a reference in the Marriage Matters from faith-based leaders to persons authorized to solemnize a marriage (judges and ordained religious leaders.) Adds additional language on TANF reporting. ADOPTED

S-3577 by Hammond, et al - Increases the appropriation for HAWK-I by $1.7 million. FAILED, 19-30

S-3576 by Tinsman & Hammond - Allows $700,000 of the Child and Family Services appropriation to be used for aftercare services for juvenile females. ADOPTED

S-3574 by Dvorsky & Hammond - Appropriates $121,000 from the GF to DHS for mental health services for the homeless. Requires DHS and IFA to continue financing existing community-based facilities and affordable community-based housing facilities. FAILED, 19-30

S-3578 by Hammond, et al - Increases the appropriation for DHS field operations by $2.5 million and adds 54 positions. FAILED, 20-28

S-3578 by Hammond, et al - Increases the appropriation for DHS field operations by $4.8 million from the Economic Emergency Fund and adds 44 positions. Appropriates $573,000 for child and family services from the EEF. FAILED, 20-28

S-3579, S-3587 - WITHDRAWN

S-3593 by Veenstra - Changes the allocation of the MH/DD growth factor to increase the percentage of the pooled funds that go to counties with low reserves. ADOPTED

S-3582, S-3586, S-3589, S-3594 - OUT-OF-ORDER

The Senate PASSED the Bill, as amended, 28-19; it returns to the House

H-1855 by the Senate - Makes a language correction to change a reference in the Marriage Matters from faith-based leaders to persons authorized to solemnize a marriage (judges and ordained religious leaders.) Adds additional language on TANF reporting. Allows $700,000 of the Child and Family Services appropriation to be used for aftercare services for juvenile females. Changes the allocation of the MH/DD growth factor to increase the percentage of the pooled funds that go to counties with low reserves.

H-1934 by Heaton - Technical changes. ADOPTED

H-1982 by Carroll - Technical adjustments to the MHMRDD formula ADOPTED

The House CONCURRED in H-1855 & PASSED the Bill 54-41; it now returns to the Senate

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 Committee: Voted Out:

SF 537 TOBACCO SETTLEMENT - Makes the appropriations from the tobacco settlement. Total: 57.2 million. DHS Reimbursements: Total 32.5 million. Non-institutional Medicaid Providers ($11.6 million); Medicaid ($4 million); Dentists ($3.8 million); Rehab treatment & providers ($3.2 million); Hospitals ($3.0 million); Home Health Care providers ($2.1 million); Respite care providers ($1.1 million); Other DHS service providers ($546,000); Adoption, independent living, care shelters ($469,000); Breast and cervical cancer care ($250,000); Children’s Health Insurance Program ($200,000); Service care providers ($147,000). DPH: Total $23.8 million. Substance Abuse Treatment ($11.3 million); Tobacco Use Prevention & Cessation ($9.3 million); Healthy Iowans ($2.6 million, including $2 million for a substance abuse treatment facility for persons on probation). DOC; $609,000 for CBCs. Other: Changes the name of the Tobacco Settlement Trust to the Healthy Iowans Tobacco Trust. PASSED, 25-0

House State Government Committee: Voted Out:

HSB 260 REDISTRICTING PLAN - Sets the Legislative Service Bureau’s first redistricting plan Congressional and legislative districts. PASSED without RECOMMENDATION, 19-2;

Senate Committees

Senate Commerce Committee: Voted Out:

SCR 22 PRIVACY STUDY - Senate Rules Proposes that the Legislative Council extend the time for the personal privacy issues study committee.

SSB 1275 HIGH-PAYING JOBS - Urges Iowa’s leaders to gather information to help create high-paying, high technology jobs.

Senate State Government Committee: Voted Out:

SSB 1272 REDISTRICTING - Establishes the first redistricting plan for 2001.

PASSED, without RECOMMENDATION See SF 540

Senate State Government Committee: Voted Out:

SR 50 REDISTRICTING MESSAGE - Advises the LSB of the rejection by the Senate of the first plan and resolves the LSB to improve the population variances, the compactness of districts and to eliminate the regionalization of US Congressional districts.

Senate Ways & Means Committee: Voted Out:

HF 727 MH AND DD SERVICES - Makes changes to Funding Pools within the Property Tax Relief Fund used to make payments to counties for MH/DD services. Increases the statewide per capita expenditure target amount for county MH/DD service to 100% for FY 2002. Changes the eligibility requirements for the per capita expenditure target pool. Makes other changes. Requires local MH and DD Service to use accepted accounting practices for the two previous years. Sets procedure for settling disputed billing of services. Establishes notice and hearing procedures. Directs that the individual receive "appropriate" alternative treatment. Changes reporting requires to the DHS from the DRF. Allows the state to set standards of service for licensing of mental health providers if no other standard is set.

BILLS INTRODUCED OF INTEREST TO NURSING

SR 46 WOMEN’S’ HEALTH CARE - Urges state agencies and private groups to recognize inequalities in the treatment of women.

SCR 22 PRIVACY STUDY - Proposes that the Legislative Council extend the time for the personal privacy issues study committee.

S-3647 by Gronstal, et al - Commends the LSB for its work on the first redistricting map. FAILED, 21-29

S-3648 by Dvorsky, et al - Requires the Temporary Redistricting Commission to hold hearings again. FAILED, 21-29

ADOPTED by the Senate, 21-29

HF 740 SENIOR LIVING TRUST FUND (Appropriations; Successor to HSB 258) Appropriates money from the Senior Living Trust Fund for several programs. Appropriates $5.3 million from the Trust Fund to the Department of Elder Affairs for administrative costs; $20 million for Grants to nursing facilities for converting to assist living programs or to provide long-term care alternatives and to development of long-term care alternatives; $1.7 million to supplement the Medical Assistance Appropriation and for reimbursement to eligible persons for health care services and rent through the Home and Community Based Services Waiver and the State Supplementary Assistance Program; $24.75 million for Nursing Facility Provider Reimbursement based on case-mix reimbursement methodology. Directs all unencumbered and unobligated fund be retained in the Trust Fund. Sets the rate determination formula for Modified Price-Based Case-Mix Reimbursement.

HF 748 REDISTRICTING PLAN (State Government; Successor to HSB 260) - Sets the Legislative Service Bureau’s first redistricting plan Congressional and legislative districts.

HF 750 CHILDREN’S MENTAL HEALTH (Foege) Creates the Children’s Mental Health Planning Group consisting of the Directors of Human Services, Public Health, Education, and the Attorney General to consider issues concerning children’s mental health.

SF 540 REDISTRICTING (State Government; Successor to SSB 1272) Establishes the first redistricting plan for 2001.

FM: King

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