LEGISLATIVE CONNECTION
A communication of the Iowa Nurses Association
Volume 4, Number 30 March 29, 2002

MENTAL HEALTH PARITY ADOPTED BY SENATE

SF 2322 was taken up for debate on Thursday, the day after it was introduced and discussed in Senate Ways & Means Committee. The bill offered small businesses and individuals an incentive to carry mental health coverage. In the two-hour floor debate, many personal stories were told by Senators of the impact of the effects of substance abuse on family members. In a surprise move, five Republican Senators voted with twenty Democrats and voted to amend the bill and restore the language of SF 2289 that calls for coverage of substance abuse when it is co-morbid with mental illness. Also coverage was extended to children and adolescents with the addition of the ADHD and related disorders and Disorders identified in childhood and adolescence.

Majority Leader Stu Iverson voted with the prevailing side making the vote 26-22 with two Senators absent. Senator Iverson has been a vocal opponent of mandated coverage, so his move would allow him to control further action on the bill. The bill was deferred for further action on Thursday.

Voting for the amendment to restore SF 2289: (26) Black, Bolkcom, Connolly, Dearden, Deluhery, Dvorsky, Fiegen, Fink, Flynn, Fraise, Gronstal, Hammond, Hansen, Harper, Holveck, Horn, Iverson, Kibbie, Lundby, Maddox, McCoy, McKean, Ragan, Redfern, Shearer and Tinsman

Voting against: Angelo, Behn, Boettger, Drake, Freeman, Gaskill, Greiner, Houser, Jensen, King, Kramer, Lamberti, Lord, McKibben, McKinley, Miller, Redwine, Rehberg, Rittmer, Schuerer, Sexton, Veenstra

Absent: Soukup and Zieman

Please contact and thank your Senators for their vote.

BIRTH CENTER AMENDMENT ADOPTED IN COMMITTEE

Members of the Senate Appropriations Committee accepted amendments making adjustments in 135G, the Birth Center Code, to SSB 3193, a bill that reorganizes the Department of Inspections and Appeals and several other state agencies on Wednesday. While the three medical societies lobbied hard to resist adoption of the amendment, Senator Neal Schuerer successfully amended SSB 3193. The amendments will facilitate the opening of birth centers in Iowa and remove excessive restrictions that have made it difficult for certified nurse midwives to establish and operate alternative settings to hospitals and private homes for births.

Voting in support of the amendment were: Kramer, Flynn, Bolkcom, Deluhery, Dvorsky, Jensen, King, Lundby, McKinley, Rehberg, Schuerer, and Tinsman.

Voting against were: Lamberti, Angelo, Connolly, Fiegan, Gaskill, Horn, McKibben, and Veenstra

Pass: Hammond

Absent: Black, Redfern, Soukup and Zieman

Please thank your Senators that supported the Certified Nurse Midwives in their effort to offer a birthing alternative.

TWO WEEKS OF SESSION REMAIN

In order to minimize the state expenditures, legislators have cut this second session by ten days. The funds to support legislators for serving will terminate on April 13.

Omnibus Appropriation Bill

The Legislature will work off an omnibus appropriations bill this year for eight of the budget subcommittees. The Transportation, Infrastructure & Capitals bill and the Salary bill will remain separate. The budget subcommittees will produce study bills, but those bills will be rolled into one budget bill.

To call your representative: 515/281-3221; to call your senator 515/281-3371. Find your legislator's email by going to http://www.legis.state.ia.us "Find Your Legislator" by typing in your home address.

INA LEGISLATIVE AGENDA AND BILLS OF HIGH INTEREST

ACTIVE BILLS

1.Safeguarding the Board of Nursing (Support): Appropriations chairs Lamberti and Millage stated they are reluctant to allow for fee increases in the Appropriations bill (no bill number yet). As a result Board of Nursing will suffer a further reduction in staff and services. Rep. Don Shoultz of Waterloo offered an amendment to restore funding to the Board of Nursing up to 90% of fees generated or $181,000. The amendment was supported by the Democrats and rejected by the Republicans. CONTACT YOUR LEGISLATOR!

2.Award Funds through the Iowa College Aid Commission (Support): Senate Study Bill 3187 was recommended for passage by Senate Appropriations and reintroduced as SF 2323; House File 2036 is different version with $500,000 from tobacco monies and is in House Appropriations Committee. Contact your legislator to support. No opposition expected.

3.Mental Health Parity (Support): SF 2322 was taken up by Senate Ways and Means and recommended for passage on Wednesday. Thursday morning the bill was brought up for debate. In a surprise vote, the Senate adopted an amendment to restore the language of SF 2289, a mandate for mental health parity with co-morbid substance abuse, broader coverage for children and adolescents and studies of the system in Iowa, rejecting tax credits that could total $7 million as incentives for small business and individuals to offer mental health coverage (no substance abuse) to their employees. The bill has been deferred.

4.ARNPs as Medicaid Primary Care Providers (Support): HF 2382 died in the funnel. There is a continuing effort to include such language in the Medicaid appropriations language. Strong opposition from physician organizations who believe Medicaid patients are too complicated for ARNPs to see. CONTACT YOUR LEGISLATOR!

5.IPERS (Support): HF 2532 was taken up by the House to consider the Senate amendment. The House voted to restore that "if employment is not full-time employment until the participating member receives remuneration in an amount in excess of $40,000 (reversing the Senate action of $25,000) for a calendar year, or an amount of remuneration permitted for a calendar year for persons under sixty-five years of age before a reduction in federal social security retirement benefits is required, whichever is higher. Effective the first of the month in which a member attains the age of sixty-five years, a retired member may receive a retirement allowance without a reduction after return to covered employment regardless of the amount of remuneration received." The bill returns to the Senate for concurrence in the restoration.

6.Department of Public Health Bill: HF 2547 was amended to leave disciplinary fees established by licensing boards at $75 for actions filed.

7.School Nurses Recognized in Teacher Pay Plan (Support): HF 2549 Student Achievement and Teacher Quality Plan in Section 19 includes language for a study of inclusion of school nurses in the teacher pay plan. The bill is continuing to proceed through the process.

8.Organ Donor Network (Support): SF 2195 passed the House and was sent to the Governor.

9.Birth Centers (Support): SF 390 now included in SSB 3193; a state agency reorganization bill.

10.Cloning/Stem Cell Research (Monitor) SF 2118: House adopted an amendment to allow research on embryos not used in in-vitro fertilization on a vote of 50-47. Likely stops further consideration.

11.Funding the Fiscal Year 2003 Budget: Appropriations Subcommittee reduced the funds for Elderly Wellness by $144,000 due to raising the age of eligibility to 60 years of age. The committee turned down an amendment to allow the Board of Nursing to retain fees in the amount of $181,000 to assure that they receive 90% of fees generated. After two rounds of budget cuts, the Board of Nursing is funded at 78% of fees collected.

For a subject listing of all bills of interest to nursing, check out the webpage http://www.iowanurses.org or call the INA office at 515/225-0495.

NO LONGER ACTIVE THIS SESSION</P>

12.Assure Collection of Nursing Workforce Data (Support): HF 2211, SF 2132. Bills not recommended.

13.Assure Accountability in Patient Care (Support): Bills not recommended.

14.Mandatory Overtime (Support): SF 2127 similar to ANA model language and bill passed in New Jersey, Maine, Oregon, Minnesota and Washington State. Bill not recommended.

15.ARNPs Sign Death Certificate (Support): HF 2222 failed to come out of committee.

16.Child Drug Treatment: HF 2318 died in the second funnel.

17.HIV Transmission (Oppose): SSB 3078 and HF 2283 would allow individual names to be transmitted over radio-based communications systems. Failed to come out of committee.

PASSED AND SIGNED BY THE GOVERNOR

1.Medicaid Shortfall Funding (Support): HF 2245 passed and sent to Governor. Governor signed and itemed vetoed sections of the bill.

2.Funding the Fiscal Year 2002 Budget: Senate File 2304 was signed by the Governor on March 1. The $120 million FY02 shortfall was funded in part by using the Cash Reserve Funds (Rainy Day funds). The Elderly Wellness portion of the Dept of Public Health budget (funds elderly wellness clinics, local public health nursing and homemaker aides) will be cut by $101,000 in FY 02 and FY 03. Medicaid was protected from cuts. State employees will be furloughed.

3.HF 2340 Well Being Visits- 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.

4.HF 2345 Violence Against Women- Allows the Department of Justice, Victim Assistance Program to administer the Violence Against Women program and grants from the federal Violence Against Women Act.

5.HF 2487 Children's Hospital- Directs the DHS to designate a children's hospital meeting the criteria for a voting member of the National Association Of Children's Hospitals And Related Institutions as qualifying member for the receipt of disproportionate share hospital payments under Medicaid. Directs the DHS to seek a waiver.

6.Senate File 374 Optometry Treatments- Modifying the qualifications and authorization of therapeutically certified optometrists engaged in the practice of optometry.

BILLS SENT TO THE GOVERNOR

HF 2507 ANTHRAX PENALTIES - Makes the possession of anthrax a Class C felony and the distribution of anthrax a Class B felony. Makes an exception for persons who have anthrax for reasons authorized under federal law. H-8041 by the Senate - Requires the possession or distribution to be knowing.

The House CONCURRED & PASSED the Bill, 87-1; it now goes to the Governor

HF 2075 TOBACCO SETTLEMENT REPAYMENT - Removes the time limit for repayment of Tobacco Settlement money used for the teacher pay program. S-5239 by Schuerer & Flynn. S-5040 - Withdrawn.

The Senate PASSED the Bill, 47-0; H-8417 by the Senate - Adds removal of the time limit for repayment to the Senior Living Trust Fund. The House CONCURRED & PASSED the Bill, 92-0; it now goes to the Governor.

HF 2264 INFORMED CONSENT - 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.

The Senate PASSED the Bill, 31-17; it goes to the Governor

FLOOR ACTION

House Floor Action

HF 2192 INTERSTATE 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. Requires the work group to report to the Legislative Council on a bi-monthly basis and report to the Legislature and Governor by December 15, 2002.

H-8326 by the Senate - Changes the agency work group to a task force and specifies that the task force shall include the DPS, the DHS, the DEA, the DOM, the DOP, the Pharmacy Examiners, the Medical Examiners, a representative of the pharmacy manufacturers, and four members of the Legislature. H-8434 to H-8326 by Osterhaus - Adds certain organizations who may appoint members to the task force. ADOPTEDH-8326, as amended. The House CONCURRED & PASSED the Bill, as amended, 93-0; it now returns to the Senate.

HF 2532 IPERS BILLS - Makes numerous changes to IPERS, PORS, the statewide fire and police retirement system, and the judicial retirement system. Increases the amount that a retiree can earn to $40,000 before losing benefits after returning to work. Contains other technical corrections.

H-8441 by Elgin - Changes the amount a retired IPERS member may earn while collecting IPERS benefits to $40,000. ADOPTED H-8419, as amended.

The House CONCURRED & PASSED the Bill, as amended, 95-0 it now returns to the Senate.

SF 2190 WORKERS COMPENSATION - Keeps records which could identify an injured employee, or the employee's dependent, confidential. Prohibits health care providers from seeking payment for fees from employers when the provider and the insurance company are disputing the fee. Defines a day of incapacity to mean eight hours and allows those hours to be collected over more than three days. Prohibits insurance plans from denying benefits to an employee because of a dispute over the employer's liability. Numerous amendments.

The House PASSED the Bill, as amended, 52-41; it now returns to the Senate.

Senate Floor Action

Individual Confirmations Confirmed

Steven Young, Department of Inspections & Appeals, 48-0

HF 2247 RESIDENT ADVOCATE DUTIES - DIA actions: Eliminates the requirement that the Department of Inspections and Appeals advise the resident advocate committee when the DIA proceeds with an action for receivership or emergency removal of residents based on a denial, suspension, or revocation of a health care facility license. Ends the requirement that the DIA obtain the advice of the resident advocate committee when it determines the health, safety, or welfare of the residents is in immediate danger and orders the removal of residents and judicial review is pending. Requires the DIA to review the complaints that are forwarded to it. Advocacy Committees: Excludes residential care facilities, which treat MR/MI from the requirements to have a resident advocacy committee appointed by the Department of Elder Affairs. Ends the requirement that a copy of the complaint filed with the resident advocate committee or long-term care resident's advocate be forwarded to the DIA but does allow it to be forwarded. Makes other changes.

S-5156 by Human Resources - Strikes the eliminations of some of the reporting requirements and the change to resident advocacy committees for MR/MI facilities. Requires a report from interagency substitute decision makers task force regarding whether resident advocate committees should continue to be used at MI/MR facilities by December 2002.

S-5236 by Holveck & Boettger - Restores the change to resident advocacy committees for MR/MI facilities. Requires that the Governor's Developmental Disability Council be consulted by the

The Senate PASSED the Bill, 48-0, as amended; it now returns to the House

COMMITTEE ACTION

House Action

House Ways & Means Committee: Assigned to Subcommittee:

HF 2352 FREE HEALTH CLINIC CHECK-OFF - Shey (C), Jochum Larson

Senate Action

Senate Appropriations: Voted Out:

SSB 3187 REGISTERED NURSE PROGRAM - Creates a registered nurse recruitment calendar to be administered by the College Student Aid Commission. Creates a forgivable loan program, a tuition scholarship program, and a registered nurse loan repayment Contains other related provisions. PASSED, 23-0; Floor Manager: Redfern

SSB 3193 DEPARTMENT RE-ORGANIZATION - DIA: Eliminates the Audits Division. Makes changes to the Inspections Division and gives the DIA director the responsibility over social and charitable gaming. Makes other changes. Child Services: Transfers the CASA (Court-appointed special advocate) program into DIA. Adds additional powers and confidentiality duties to the program. Directs the Child advocacy State Board and the Foster Care Review Board to work with CASA to merge that program with the Citizen Foster Care Review process. Requires the Advocacy Board to report on out-of-home placements of children and juvenile courts by December 16, 2002. Renames the State Citizen Foster Care Review Board the Child Advocacy Board. Increases the number of members on the board to 9. DNR: Reorganizes the administrative structure of the DNR. Strikes the current structure and allows the director of the DNR to establish new divisions. Transfers authority over rural water supplies to the DPH. Oversight Committee: Places the Oversight Committee in with the other Legislative Council. Directs the committee to perform annual reviews of judicial and executive agencies. Amended to add changes to Birth Centers Code. PASSED, 23-0; Floor Manager: Lundby

Senate Ways and Means: Voted Out:

SSB 3195 NEUROBIOLOGICAL TAX CREDITS - Authorizes tax credits for small businesses which offer coverage for neurobiological disorders in health plans and to individuals who purchase coverage for neurobiological disorders. Credits: Requires that 50% of an employer's employees accept coverage for the employer to receive the credit. Makes the credit equal to 1% of the premium for individuals and 1% of the premium for the employees who accept coverage. Coverage: Defines neurobiological disorders to include schizophrenia, schizo-affective disorders, bipolar disorders, depressive disorders obsessive-compulsive-disorders, developmental disorders and autism. Adopts other provisions concerning benefit plans. Study: Requires a joint study by the Insurance Division and the State Auditor. PASSED, 8-6; Floor Manager: McKibben (See SF 2322)

Senate Appropriations: Assigned to Subcommittee:

HF 2582 FEDERAL BLOCK GRANTS - Tinsman (C); Bolkcom, Lamberti

BILLS INTRODUCED OF INTEREST TO NURSES

House Study Bills

HSB 715 INSURANCE PREMIUM TAX (Ways & Means) Reduces the insurance premium tax from 2% to 1% over the next four years. Makes adjustments in estimated payment to keep the taxes revenue-neutral until 2007. Hansen (C), Hoffman, Osterhaus (See SSB 3189)

Senate Files

SF 2318 INSURANCE PREMIUM TAX (Ways & Means; Successor to SSB 3189) Reduces the insurance premium tax from 2% to 1% over the next four years. Makes adjustments in estimated payment to keep the taxes revenue-neutral until 2007. McKibben

SF 2322 NEUROBIOLOGICAL TAX CREDITS (Ways & Means; Successor to SSB 3195) Authorizes tax credits for small businesses which offer coverage for neurobiological disorders in health plans and to individuals who purchase coverage for neurobiological disorders. Credits: Requires that 50% of an employer's employees accept coverage for the employer to receive the credit. Makes the credit equal to 1% of the premium for individuals and 1% of the premium for the employees who accept coverage. Coverage: Defines neurobiological disorders to include schizophrenia, schizo-affective disorders, bipolar disorders, depressive disorders obsessive-compulsive-disorders, developmental disorders and autism. Adopts other provisions concerning benefit plans. Study: Requires a joint study by the Insurance Division and the State Auditor. Floor Manager: McKibben

SF 2323 REGISTERED NURSE PROGRAM (Ways & Means; Successor to SSB 3187) Creates a registered nurse recruitment calendar to be administered by the College Student Aid Commission. Creates a forgivable loan program, a tuition scholarship program, and a registered nurse loan repayment Contains other related provisions. Floor Manager: Redfern

Senate Study Bills

SSB 3191 BIRTH CERTIFICATES (Ways & Means) Increases the fees for birth certificates to $20 over two years. Rehberg (C), Maddox, Holveck

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