INA Lobby Days February 27

Dr. Michael Flaum, Uof I College of Medicine spoke to 36 legislators and numerous representatives of the Alliance for the Mentally Ill and professional societies. He discussed that the Uof I is where biological psychiatry is being researched and that many conditions are truly biologically based. Substance abuse will likely eventually be known as biologically based. He said that the Mental Health and Developmental Disabilities Commission found that the number one issue was that Iowa needed to restructure its mental health authority. Iowa used to have an asylum model of treatment and while policies don't reflect that, there are still four mental health institutes in Iowa. Legal settlement is 150 years old. There is nothing more fragmented than children services in Iowa. There is a great maldistribution of psychiatrists with 25% of them in Iowa City; 55% in four counties and two-thirds in 6 counties. The community mental health centers are failing. There has been a tremendous amount of cost shifting of the cost of services and there are still big gaps in coverage of physical and mental health services in states that have passed parity.

The Legislature will not hold a session on Monday, February 11, due to local caucuses.

Governor Vilsack also announced February 1 that the state will receive nearly $13 million to prepare for attacks and other public health emergencies resulting from bioterrorism. The Iowa award is part of over one billion dollars being allocated by the U.S. Department of Health and Human Services.

Governor Vilsack said that he will make further cuts in this year's budget because of the declining revenues and the Medicaid shortfall. Vilsack said that the state needs to set its priorities and act accordingly.

For Medicaid, the Governor said that his four priorities are to preserve the program for the medically needy, to begin to prepare for additional shortfalls next year, to ensure that the Senior Living Trust is not "unduly used", and to give Medicaid service providers as much notice of the cuts in reimbursement levels as possible.

Speaker Siegrist said that the state needs to find a solution to the Medicaid shortfall at the state level. Siegrist said that "there aren't a lot of resources available," to the state for a solution. Siegrist said that the Medicaid problem has been made worse. He said: "DHS failed to act when Governor Vilsack ordered his across the board cut in November. On top of that, they are way over budget in Medicaid expenses.

Republican legislators released their proposals for dealing with the FY 2002 Medicaid shortfall. Senator Kramer said that the Republicans are waiting until farther into the appropriations process before making decisions about FY 2003. Senator Lamberti said that he supported waiting before making FY 2003 decisions because he believes that the FY 2003 shortfall could be closer to $114 million rather than $93 million.

Both Kramer and Lamberti said that it was possible that the federal government would step in and help the state with the shortfall. Lamberti also said that Governor Vilsack had expressed concerns about the amount of funds coming from the Senior Living Trust, but he said that he believed the two sides were reasonably close.

SCR 107 MEDICAID RESOLUTION (Kramer, et al) Urges the President and Congress to help control the costs of Medicaid.

LSB 6667 MEDICAID FUNDING -Appropriates for the Medicaid Program:
FY 2002 Supplemental: Senior Living Trust $48.5 Million. Hospital Trust Fund $7 million Tobacco Settlement: $7 million. Creates a procedure for crediting funds back if unanticipated federal funds are received. Other: Requires co-payments between $1 and $3 on drugs. Limits adults to preventive care services. Requires dual certification under Medicare and Medicaid for nursing homes. Requires DHS to form a joint legislative-executive branch advisory group to make recommendations. PASSED, 14-8; Floor Manager: Jacobs Same as SSB 3111, introduced in the Senate.

HF 2211 NURSING DATABASE - Tymeson (C), De Boef, Witt

HF 2120 PRESCRIPTION DRUG STUDY - Directs the DPH, along with the DHS, DEA, DOM, and DOP, to study the feasibility of establishing an interstate prescription drug purchasing co-op with other Midwestern states and report to the Legislature and Governor by December 15, 2002.

SF 2091 NURSE RECRUITMENT - McKinley (C), Boettger, Harper

SF 2094 ANATOMICAL GIFT - Boettger (C), Dvorsky, Redwine

SF 2114 MH/MR/DD SERVICES - Hammond (C), Behn, Tinsman

SF 2046 CLONING BAN - Prohibits human cloning or doing destructive research on human embryos. Establishes criminal penalties. PASSED, 9-4; Floor Manager: Redwine

SF 2090 REFLEXOLOGY LICENSING - Schuerer (C), Connolly, McKean

SCR 107 MEDICAID RESOLUTION -; Urges the President and Congress to help control the costs of Medicaid. PASSED, 9-0

HF 2176 PHARMACY QUALITY IMPROVEMENT (Osterhaus) Requires each licensed pharmacy to set up a Continuous Quality Improvement Program to reduce medication errors and improving customer use of medications. (Human Resources)

HF 2188 HMO EARLY DISCHARGE (Connors) Defines an organized delivery systems as insurance and makes telling a patient that they must leave a hospital before they are released by their doctor an unfair insurance practice. (Commerce)

HF 2192 INTERSTATE PRESCRIPTION DRUG STUDY (Human Resources; Successor to HF 2120)
Directs the DPH, along with the DHS, DEA, DOM, and DOP, to study the feasibility of establishing an interstate prescription drug purchasing co-op with other Midwestern states and report to the Legislature and Governor by December 15, 2002.

HF 2209 HAWK-I COVERAGE (Osterhaus, et al.) Allows presumptive eligibility to HAWK-I and the Medical Assistance Program. Shifts responsibility for the DHS to the Hawk-I Board of setting the family cost sharing sliding fee scale. Adds benefits to the HAWK-I benefit package. Makes other changes. (Commerce)

HF 2211 NURSING DATABASE (Tymeson & Reynolds) Directs the DPS to create a nursing workforce database. Allows various public and private agencies to access the database. (Human Resources)

HF 2222 DETERMINATION OF DEATH (Murphy) Allows for the determination of the time of death by an advanced registered nurse practitioner. (Human Resources)

HF 2237 HEALTH FACILITIES STAFFING (Mascher) Sets staffing requirements for acute care hospitals, outpatient surgical facilities, or psychiatric hospitals regulated by the DIA. Set maximum duty hours and prohibits mandatory overtime making exceptions for state of emergency. Allows private actions by a nurse if the provisions are violated. Makes violation an aggravated misdemeanor. (Human Resources)

HF 2245 MEDICAL ASSISTANCE PROGRAMS (Appropriations) Add contingency language to the Hospital Trust Fund if federal funds are not received. Requires applicants or recipients of medical assistance to report any changes in income or resources to the DHS. Allow adults receiving dental services under the Medical Assistance Program to receive only preventive care. Directs the DHS to require recipients of medical assistance to co-pay of covered drug prescriptions including refills. Allows for emergency rule making. Requires after October 1, 2002 licensed nursing facilities be certified under both the federal Medicare Program and the Medical Assistance Program in order to participate in the Medical Assistance Program. Effective upon enactment. (Appropriations calendar)

SF 2114 MH/MR/DD SERVICES (Houser & Hammond) Requires that the providers of mental health, mental retardation and developmental disability services who are under contract with DHS to provide Medicaid services must use the standards for case management that are developed by the Mental Health and Developmental Disabilities Commission. Includes providers who offer case-management services for MH/DD/MI as cost-based providers. Makes the county of legal settlement responsible for 100% of the non-federal share of the costs of the services for persons with chronic mental illness for Medicaid rehabilitation services, and the state responsible for persons with no county of legal settlement. (Human Resources)

SF 2118 CLONING BAN (Human Resources; Successor to SF 2046) Prohibits human cloning or knowingly doing destructive research on human embryos, or knowingly transferring a human embryo that will be subjected to destructive research. Makes violations an aggravated misdemeanor. Floor Manager: Redwine

SF 2126 HOSPITAL STAFFING HOURS (Bolkcom) Establishes staffing requirements for acute care hospitals, outpatient surgical facilities and psychiatric hospitals or units that are regulated by the DIA. Specifies the maximum hours that can be required and prohibits mandatory overtime. Authorizes a private right of action by a nurse for violations. Contains related provisions. (Human Resources)

SF 2127 HOSPITAL OVERTIME (Bolkcom) Prohibits mandatory overtime for certain health facility employees. Requires the labor commissioner to adopt rules and establishes penalties. (Human Resources)

HSB 596 DEATH & MEDICAL EXAMINERS (Human Resources) Increases form one to three days the time by which a death must be certified. Increases from one to three days the time a medical examiner has to determine cause of death. Eliminates religious exception for cremation permit and raises the fee for a cremation permit from $35 to $75. Allows medical examiners to perform private autopsies for a fee so long as they don't compete with autopsy services. (Dept. of Public Health) Roberts (C), De Boef, Tremmel

HSB 597 WELL-BEING VISITS (Human Resources) Authorizes the DHS to conduct well-being visits to families, which have lost their cash assistance under FIP, if funding is available, on an optional basis. Effective immediately. (DHS) Boal (C), Tymeson, Reynolds

HSB 598 ELDER AFFAIRS CHANGES (Human Resources) Updates Elder Iowans Act to conform with federal definitions and changes several elder and senior programs. Eliminates the Elder Law Education Program and the Representative Payee Projects. Repeals the code chapter relating to Elder Family Homes. Creates enforcement provisions related to Certified Assisted Living Programs. Makes certain records maintained by the Long-Term Care Resident's Advocate Program confidential. (Elder Affairs)

Broers (C), Wilderdyke, Ford

HSB 599 WORKERS COMP CHANGES (Labor) Makes certain records regarding the identify of injured workers confidential. Establishes procedure to subrogate employer claims from third parties. Prohibits health care providers from seeking fees in dispute with the insurance carriers from the employer. Makes the employer liable for medical treatment fees if the treatment was at the employer's direction. Prohibits collection action against an employer pending contested cases. Prohibits nonoccupational, individual, or group health insurance plans from denying payment to the employee based on unresolved employer's contesting payment. Makes other changes. Horbach (C), Millage, Dotzler

HSB 607 MENTAL HEALTH SERVICES (Local Government) Establishes definition for "case management services." Makes changes as to reimbursement of noninstitutional mental health providers. Effective upon enactment. Carroll (C), Van Engelenhoven, Peterson

HSB 612 VIOLENCE AGAINST WOMEN (Judiciary) Allows the Department of Justice, Victim Assistance Program to administer the Violence Against Women program and grants received under the federal Violence Against Women Act. (Governor) Grundberg (C), Kettering, Jochum

HSB 615 PHYSICAL THERAPISTS (State Government) Prohibits the use of titles or other abbreviations indicating that physical therapy or other physical services are available at a business unless the services are provided by a licensed physical therapist. Does not restrict another licensed person who practices pursuant to that profession if the person does not claim to be a physical therapist or hold a related license. Strikes current Code provisions concerning an exemption for massage therapists. Metcalf (C), Bradley, Reynolds

HSB 617 LOBBYIST REPORTS (State Government) Harmonizes lobbyist filing rules for both the Legislature and the Ethics and Campaign Board. Reduces the number of filings. Requires the lobbyist to report certain information now filed by the client. Contains other provisions. Gipp (C), Garman, Jochum (Campaign Board) See SSB 3093

HSB 623 OUT OF HOSPITAL DO NOT RESUSCITATE (Human Resources) Directs the DPH to develop a standard form and personal identifier for Do Not Resuscitate Orders outside a hospital setting. Makes a serious misdemeanor to destroy, withhold, or conceals such orders without the maker's consent.
Hoversten (C), Roberts, Reynolds

HSB 624 HEALTH PROFESSION FEES (Human Resources) Requires that 10 percent of the licensing fees collected by various health licensing boards be deposited in the General Fund and the remaining 90 percent be deposited in a special fund for the respective board. Hoversten (C), Boal, Smith

SSB 3078 HIV INFORMATION (State Government) Allows a police officer to release information related to a person's HIV status over the police radio if the officer is acting within the scope of their employment. Jensen (C), Lamberti, Kibbie

SSB 3079 HEALTH INSURANCE ADMINISTRATION FUND (State Government) Establishes the Health Insurance Administration fund in the Treasurer's office to pay health insurance administration costs. Establishes a management surcharge. Contains related provisions. (DOP) Schuerer (C),Rittmer, Connolly

SSB 3080 MENTAL HEALTH CARE BENEFITS (Commerce) Requires coverage for mental health benefits and for substance abuse in insurance or other third-party coverage. Lundby(C), Jensen, Gronstal

SSB 3093 LOBBYIST REPORTS (State Government) Harmonizes lobbyist filing rules for both the Legislature and the Ethics and Campaign Board. Reduces the number of filings. Requires the lobbyist to report certain information now filed by the client. Contains other provisions. McKean (C), Sexton, King, Dearden, Connolly (Campaign Board) See HSB 617

SSB 3094 ELECTRONIC CAMPAIGN FILING (State Government) Institutes mandatory electronic filing for campaigns the reach a $20,000 threshold, effective January 2003. Requires that electronic data be available to the public. Contains related provisions. McKean (C), Maddox, Dearden (Secretary of State) See HSB 616

SSB 3095 MANDATED INSURANCE COSTS (State Government) Imposes a moratorium on any new mandated health or medical expenses. Requires the Insurance Division to study both the moratorium and current mandates and their effect on insurance costs and treatment availability. King (C), Schuerer, Bolkcom See SF 2112

SSB 3098 VIOLENCE AGAINST WOMEN (Judiciary) Allows the Department of Justice, Victim Assistance Program to administer the Violence Against Women program and grants received under the federal Violence Against Women Act. (Governor) Tinsman, King, Horn (See HSB 612)

SSB 3103 OUT OF HOSPITAL RESUSCITATE (Human Resources) Directs the DPH to develop a standard form and personal identifier for Do Not Resuscitate Orders outside a hospital setting. Makes a serious misdemeanor to destroy or conceals such orders. Schuerer (C), Boettger, Harper. See HSB 623

SSB 3104 FEMALE GENITAL MUTILATION (Human Resources) Makes it a Class C felony to mutilate female genital tissue. Makes exceptions for medical procedures. Prohibits the use of custom as a defense. Requires the DPH to carry on education efforts, and to seek private funds for the work. Boettger (C), Hammond, Tinsman

SSB 3106 WELL-BEING VISITS (Human Resources) Authorizes the DHS to conduct well-being visits to families, which have lost their cash assistance under FIP, if funding is available, on an optional basis. Effective immediately. (DHS) Harper (C), Boettger, Veenstra. See HSB 597

SSB 3109 INFORMED CONSENT (Human Resources) Requires that women be given specific information, to be developed by the DPH, on alternatives by a doctor before an abortion can be performed. Establishes exceptions for emergencies. Establishes criminal penalties. Effective October 2003. Redwine (C), Boettger, Harper

SSB 3110 CHILD PROTECTION CONFIDENTIALITY (Human Resources) Allows for the disclosure of certain information in child abuse cases involving death or near death of the child. Prohibits written information provided to legislative leaders during a confidential meeting regarding a child abuse case from being removed from the meeting room and prohibits the re-dissemination of confidential received at the meeting. (Governor) Miller, Behn, Dvorsky (See HSB 602)

SSB 3111 MEDICAID FUNDING (Appropriations) Appropriates for the Medicaid Program:
FY 2002 Supplemental: Senior Living Trust $48.5 Million. Hospital Trust Fund $7 million. Tobacco Settlement: $7 million. Creates a procedure for crediting funds back if unanticipated federal funds are received. Other: Requires co-payments between $1 and $3 on drugs. Limits adults to preventive care services. Requires dual certification under Medicare and Medicaid for nursing homes. Requires DHS to form a joint legislative-executive branch advisory group to make recommendations. Veenstra (C), Kramer, Hammond