a communication of the Iowa Nurses Association

Republican leaders said that they would spend an additional $44.3 million, reducing last week’s gap with Governor Vilsack of $100 million to $55.7 million and then send the budget bills to the Governor. Senator Iverson said that they did not have a deal with the Governor but that this was the best they could do in meeting the Governor this year on spending. The increased spending will be appropriated as follows:

• $40 million to HF 413 TEACHER COMPENSATION FUND. The money to fund this program will come from the Healthy Iowans Tobacco Trust (See SF 537) and will be repaid over two years.
• $8 million to HF 746/SF 541 SALARY BILL. This increases the spending on the salary bill to $79.3 million and is the money formerly earmarked for teacher compensation increases.
• $2 million to SF 531 ADMINISTRATION & REGULATION, to DHS for general administration, from savings discovered elsewhere in the budget.
• $2 million to DHS for general administration, from savings discovered elsewhere in the budget. (Any changes to Health & Human Rights will be in the Standings Bill because HF 726 HEALTH & HUMAN RIGHTS was already sent to the Governor)
• $300,000 to the Department of Education for JAG (Jobs for America’s Graduates) and Americorps

While the teacher's compensation fund increase is coming out of the tobacco settlement monies, it does not have an affect on the appropriations to health programs found in SF 537 (this is where the $1,250,000 for public health nursing and home care aides additional money is) in addition to HF 726 with its Elderly Wellness of $10,602,737

However, a chart has been drawn to show visually the Tobacco Securitization flow of funds from the Master Settlement Payments into the Endowment of Iowa's Health to be eventually $1.1 Billion (yes with a B). The teacher's salary money will flow through the Endowment fund for Iowa's Health.  The Endowment fund is like a foundation corpus and is set up to be funded by the Tobacco Master Settlement originally and now also the General Fund and the Rebuild Iowa Infrastructure Fund (RIIF); the fund for "brick and mortar", i.e. buildings, roads, etc.  If bonds to the public were sold to raise money for the Endowment fund, the bonds would have to generate taxable gains.

The legislative thinking is that people would prefer to buy tax-exempt bonds, which under the Internal Revenue Service can only be sold for capital projects, debt service for buildings, etc.  So state money that would ordinarily be put into the Capital projects account is being sent to the General Fund and RIIF funds which funds the Tobacco Endowment Fund in order to pay for the teachers salary and the Healthy Iowans Tobacco Trust (money for health services.)  

The special session will be in June or July because legislators still need to work out their schedules, to see how much of the budget bills that the Governor will accept (to work out the scope of the special session) and to find a place to hold it as the legislative chambers in the Capitol will be in the midst of a renovation. Siegrist said that the Legislature would let the Governor call them back into session.

Rep. Siegrist and Rep. Rants said that while this session "will be remembered in the short-term for the budget battles", in the long-term "it will be remembered for the impact that we had on education." Siegrist said that he would give the Legislature a B+ this year. Senator Iverson and Senator Kramer listed education and the $40 million teacher compensation package as their top accomplishment. They also said that they had successfully controlled the growth of spending and acted to limit state regulators from imposing costly and unnecessary restrictions on Iowa businesses.

Governor Vilsack said that budget as passed by Republicans is "all pain, no gain" and will "cause hardship." He said that except for the $40 million for teacher compensation, he was disappointed by the session. The Governor now has thirty days to sign or veto bills sent to him in the last few days of the session. It may be June 8 before the status of some bills is known.

1. 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. "Securitizing" means that taxable bonds will be sold to raise the money to secure the future funding stream of tobacco settlement revenues. 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.

2. 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.

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

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

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 bill 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.

HF 680 ABUSE REPORTER TRAINING - Requires job-specific training for mandatory reporters of child and dependent adult abuse. Adds education related employees to list of mandatory reporters. Requires peace officers meet reporter-training directive along with other public employee reporters. Requires the DPH Director to create an Abuse Education Review Panel. Allows a person who makes more than three false child abuse reports to be charged with a simple misdemeanor. Requires licensing boards to training procedures for mandatory reporters. Adds head-start programs. Allows licensing boards to exempts persons who served in the military during the educational training period from having to undergo training.

HR 42/SR 43 AUTISM RECORDS - Asks the Department of Education’s (DOE) Regional Autism Services Program to continue to compile records on autism.

HR 47 PREGNANCY AND INFANT LOSS - Designates October 15, 2001 as Pregnancy and Infant Loss Remembrance Day.

HCR 38 MH/DD TASK FORCE FOCUS (Heaton) Request the Mental Health and Developmental Disabilities Restructuring Task Force give particular attention to financing issues such as securing more federal dollars, the adult decategorization pilot project and equity in financing capacity.

Bills to the Governor

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 theTobacco Settlement Trust to the Healthy Iowans Tobacco Trust.

S-3645 by the House - Transfers the $75,000 for stop smoking products to the substance abuse program.

H-2027 by the Senate - Strikes the transfer.

The House CONCURRED in the Senate Amendment and PASSED the Bill, as amended, 87-0; it goes to the Governor.

HF 413 TEACHER COMPENSATION FUND - Appropriates $40 million from the Tobacco Settlement Trust Fund to the DOE for the Teacher Quality Program. Directs that the surplus from the Economic Emergency Fund be transferred to the General Fund. Allows participating school districts to receive up to $1,300 per teacher. Makes conforming changes to SF 476 TEACHERS’ COMPENSATION. Makes participation in the compensation plan contingent on funding. Lets the Department use some of the funds for administrative costs.

The Senate PASSED the Bill, 39-5; it goes to the Governor

HF 755 STANDINGS BILL Appropriates or reduces appropriated money for various state agencies. General Fund Appropriations: Dept. of Human Services - $14.9 million for distribution to counties for MH/MR/DD allowable growth purposes; State Treasurer - ICN Debt Service : $9.9 million; Tobacco Settlement Fund: Board of Regents - Tuition Replacement : $600,000 (if SF 535 is enacted); State Treasurer - ICN Debt Service : $1.5 million; Prison Infrastructure Bond payment : $5.2 million; million (if SF 532 is enacted); Tobacco Settlement Litigation Fees : $10.6 million (if SF 532 is enacted). Deappropriations: General Assembly : $1.55 million; Executive Council : $1 million; Appeal Board Claims : $2 million; Sec. Of State - Public Measures : $2,565; Area Education Agencies : $7.5 million; Nonpublic School Transportation : $$505,000 and directs fund be prorated if reimbursement claims that appropriated amount. Early Intervention Block Grant : $10 million; School Improvement Technology : $10 million; At-Risk Children : $1 million; Educational Excellence : $2 million; Public Transit Assistance : $505,000; Indian Settlement Officer : $25,000; Special State Cases Court Costs : $66,000, if SF 514 PROPERTY TAXES becomes law. Allows a city to certify to a school district the amount of money needed through the physical plant & equipment property tax levy for bonds. Requires the school to pay the PPEL on May 1 and November 1. Requires that a city have certified an amount during FY 2001 in order to certify an amount in subsequent years. Prohibits the municipality from certifying a larger amount in subsequent years. Corrective Amendments: HF 179 BITING POLICE DOGS; HF 259 NOTARIES; HF 643 EDUCATION CODE CHANGES; HF 654 RETIREMENT PLAN CONTRIBUTIONS; HF 656 MOBILE HOMES, SF 63 CHILD ENDANGERMENT; SF 185 MANUFACTURED HOMES (if HF 656 is enacted); SF 209 JOHNE’S DISEASE CONTROL; SF 276 LICENSING INSURANCE PRODUCERS; SF 350 DOT CORRECTIVE CHANGES; SF 453 COUNTY OFFICER POWERS; SF 458 JUVENILE SERVICES; SF 473 SECURITY LEGISLATION; SF 479 WASTEWATER ASSISTANCE FUND; SF 500 INSURANCE CODE CHANGES.

H-2039 by the Senate - Appropriates $2 million (DHS--General Administration); $300,000 (JAG & Americorps). Requires that textbooks be made available to non-public schools to the extent that the Legislature appropriates money for those textbooks. Requires the DOE to determine the amounts that a school district must use for non-public schools. Technical corrections made to tobacco securitization bond language. Specifically includes psychiatry services for coverage under certain programs. Corrects dates concerning the PPE levy. Makes the effective date for HF 259 NOTARIES January 1, 2002. The House CONCURRED & PASSED the bill, 51-44; it goes to the Governor

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. Requires local MH and DD Service to use accepted accounting practices for the two previous years Establishes procedures for settling disputed billing of services. 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. Makes other changes.

The Senate PASSED the Bill, 47-0; it goes to the Governor

This will be our last Legislative Bulletin of the 2001 Session. We will keep you up to date if there is Interim action of interest to nursing. Look for our summary of activity on the INA website at www.iowanurses.org after the Governor’s thirty days to consider bills has concluded in mid-June. Call the INA office if you have any questions about any of these bills.