LEGISLATIVE CONNECTION
A communication of the Iowa Nurses Association
Volume 4, Number 31 April 5, 2002

BIRTH CENTER CODE REQUIREMENTS REMOVED

SF 2325 was passed on Thursday 43-5. It is a bill that reorganizes the Department of Inspections and Appeals and several other state agencies. In a surprise move, Sen. Redwine (R-Sioux City) reversed his position and agreed to a change in Iowa Code Section 135G by striking the section from the Iowa Code. As a compromise gesture, Sen Neal Schuerer (R-Amana) signed onto Sen. Redwine's amendment to strike 135G. This meant that Sen. Schuerer dropped his proposal supported by the Iowa Chapter ACNM for substituting standards adopted nationally by the National Association for Childbearing Centers (NACC), which he had developed last fall. The change 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. It goes to the House for consideration.

Efforts continue to persuade legislators to include an additional $181,000 in the state budget to supplement the Board of Nursing to restore funds for a full-time investigator. Contacts with legislators are needed.

Governor Vilsack met with Republican leaders and has agreed to narrow the difference between his position and that of legislators by reducing his spending proposal by $25 million. Rep. Rants said that legislators would not spend more than $4.571 billion, which is still $150 less than the Governor's position. The Republicans and the Governor also disagree about the state of the economy. Governor Vilsack said that the state has ample reserves and should spend money out of the reserve fund to protect human services program and education. Vilsack said that nationally, the economy seems to be turning around, and he said that the passage of SF 2318 INSURANCE PREMIUM TAX, which will result in a $73 million tax cut several years from now, indicates that the Republicans also expect the state economy to pick up.
Governor Vilsack said that the Republicans are under-funding human services in their budget. The Governor said that parts of the Republican plan are unacceptable, including:
Reducing the number of children on HAWK-I by 3,000, to a total of 10,000.
Reducing funds for child abuse training and for some social work programs. The Governor said, "the Republican proposal devastates child protection efforts".
Increasing the co-payment on prescription drugs for Medicaid patients to $2. The Governor also said that he did not support requiring higher payments for Medicaid patients with brand-name prescriptions instead of generic prescriptions.
The Governor said that legislators should consider using the sales tax generated from the sale of new cars to fund essential state programs along with using funds from the Economic Emergency Fund.
Republican leaders said today that the state has already paid out $135 from the Economic Emergency Fund this year and that the state needs to maintain a $100 million balance in the fund to protect education from additional cuts in spending if the state suffers additional revenue shortfalls next year. They said that the Governor's budget will leave less than $25 million in the Economic Emergency Fund. Speaker Siegrist said that the state does not have any additional revenues it can put into the FY 2003 budget.
Rants said that the budget bills and SF 2293 are the only "must-do bills for the House, but he said that he expects the House to take up SF 2318 INSURANCE PREMIUM TAX.

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.

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.
New Websites
Republicans and Democrats have new websites for you to visit. Those are
http://iowasenaterepublicans.org;
http://iowasenatedemocrats.org;
http://iowahouserepublicans.org;
http://iowahousedemocrats.org;


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.

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, SF 2326. As a result Board of Nursing will suffer a further reduction in staff and services. Democrats have offered an amendment to increase the Board of Nursing by $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. If you have not done so yet, please CONTACT YOUR LEGISLATOR!

2. Award Funds through the Iowa College Aid Commission (Support): SF 2323 was passed by the Senate. It was amended to strike that the loan repayment is for rural shortage areas only. It awaits House debate. Legislators are discussing whether there are any state funds to fund this year. House File 2036 is different version with $500,000 from tobacco monies and remains in House Appropriations Committee. Contact your legislator to support. No opposition expected.

3. Mental Health Parity (Support): In a surprise vote March 28, the Senate adopted an amendment to SF 2322 restore the language previously seen in SF 2289 which was a mandate for mental health parity with co-morbid substance abuse, broader coverage for children and adolescents and studies of the system in Iowa and rejecting tax credits that could total $7 million and weaker language. Senator Kramer said that she deferred on the amended SF 2322 because she needed to talk to her caucus about the mandated insurance coverage in the amendment. Kramer said that the mental health tax credit bill is important but is not a "must-do." The Governor has indicated he wants a stronger bill like the current amended SF 2322 before he would sign an insurance premium tax cut worth $50 million in the years ahead.

4. ARNPs as Medicaid Primary Care Providers (Support): HF 2382 died in the funnel. There is a continuing effort to include such language in one of the appropriations bills. Opposition from physician organizations continues because they believe Medicaid patients are too complicated for ARNPs to see.

5. IPERS (Support): HF 2532 has gone to conference committee to resolve the differences between the House and the Senate over how much IPERS retirees should be able to earn before losing any benefits.
The Senators are: Rittmer, Drake, Sexton, Kibbie, Connolly
The Representatives are Elgin, Gipp, Larkin, Metcalf, & T. Taylor.

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

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 was signed by the Governor.

9. Birth Centers (Support): SF 390 now included in SF 2325; 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. Rep Rants said that he did not believe that SF 2118 would come back up for debate this year.

11. Funding the Fiscal Year 2003 Budget: SF 2326 is the Omnibus Budget bill for state agencies and the judicial branch. Funding was reduced for Elderly Wellness and the Board of Nursing is still insufficiently funded.


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
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.

18. Medicaid Shortfall Funding (Support): HF 2245 passed and sent to Governor. Governor signed and itemed vetoed sections of the bill.
19. 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.
20. 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.
21. 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.
22. 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.
23. Senate File 374 Optometry Treatments- Modifying the qualifications and authorization of therapeutically certified optometrists engaged in the practice of optometry. Allows therapeutically certified optometrist to use all diagnostic and therapeutic agents for the treatment of the eye or adnexa and to prescribe steroids for up to 14 days without referral to a primary care physician. Limits the use of injections except for anaphylactic shock. Allows the Optometry Board to adopt emergency rules.
24. HF 2507 Anthrax Penalties.
25. HF 2075 Tobacco Settlement Repayment- Removes the time limit for repayment of Tobacco Settlement money used for the teacher pay program.
26. HF 2138 College Student Aid Waivers - Allows the College Student Aid Commission to waive or to modify statutory or regulatory provisions if the President declares a national emergency due to a terrorist attack. Retroactive to September 11, 2001.
27. SF 2167 Health Insurance Administration Fund - Establishes the Health Insurance Administration fund in the Treasurer's office to pay health insurance administration costs. Establishes a management surcharge. Contains related provisions.
28. SF 2231 Hospital Checks - Authorizes hospitals to have access to the abuse registries for the purpose of employment checks. Allows a hospital to establish a single contact repository.
29. SF 2260 AEA Reorganization - Makes changes in the procedures and deadlines for reorganizing or dissolving an Area Education Agency.
30. HF 2488 Elder Affairs Changes- Updates Elder Iowans Act to conform with federal names. Changes references as necessary.

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.

HF 2582 FEDERAL BLOCK GRANTS - Appropriates federal Block Grants for various programs. Includes procedures for adjusting the grants if the grant amounts increase or decrease.
The Senate PASSED the Bill, 48-0; it now goes to the Governor

HF 2547 PUBLIC HEALTH - Makes various changes to certain programs and public health issues.
S-5284 by Tinsman - WITHDRAWN
The Senate PASSED the Bill 48-0; it now goes to the Governor

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.
H-8448 by the Senate - 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.
The House REFUSED to CONCUR with the Senate amendment; it now returns to the Senate

HF 2613 SENIOR LIVING APPROPRIATIONS -
H-8508 by Heaton - Allows DHS to decide how to distribute nursing home inflation funding. ADOPTED The House PASSED the Bill, as amended, 80-12; it now goes to the Senate

HF 2615 TOBACCO APPROPRIATION - Appropriates $65.2 from the Healthy Iowans Tobacco Trust for various health related programs. DHS: Total: $44.9 million; MEDICAL SERVICES: Non-Institutional Medical Assistance Providers: $8.0 million; Dental Providers: $3.8 million; Hospital Providers: $3.0 million; Home Health Care Providers: $2.1 million; Critical Assess Hospitals: $250,000; Home Health Daycare: $1.95 million; Respite Care Expansion: $1.1 million; CHIP Expansion: $200,000; Breast Cancer Treatment: $250,000; Medicaid Medical Assistance Supplement: $17.5 million; HIPAA Implementation: $2.1 million; CHILD & FAMILY SERVICES: Rehabilitative Treatment & Support Services COLA: $3.2 million; Adoption/Independent Living/Shelter Care COLA: $469,000. MH/MR/DD/BI: Property Tax Relief: $147,000. DOE: Empowerment: $1.2 million. DPS: Tobacco Use Prevention: $5.0 million; Substance Abuse Prevention: $10.0 million; Healthy Iowans 2010: $2.4 million; Smoking Cessation Products: $75,000; Substance Abuse Treatment: $1.1 million. DOC: Total: $610,000; District II: $127,000; District III: $35,000; District IV: $192,000; District V: $256,000.
H-8504 by Mascher - Increases funding for Tobacco Use Prevention to $9.3 million FAILED, 44, 52
H-8500 by Brunkhorst - Requires at least 80 percent of money appropriated for Community Partnerships be used in FY 2002. ADOPTED, 48-42
H-8505 by Smith - Increases funding for Substance Abuse Treatment to $11.8 million. FAILED
The House PASSED the Bill, as amended, 54-44; it now goes to the Senate.

SF 2317 TOBACCO SETTLEMENT-Implements provisions in the master Tobacco settlement. Requires that a tobacco manufacturer be part of the master settlement in order for a tobacco distributor to distribute brands from that manufacturer. Requires manufacturers to certify compliance with the master settlement. Authorizes the Attorney General and the Department of Revenue & Finance to share information for compliance purposes. Requires a tobacco manufacturer to maintain a registered agent in the state in order to make sales in the state.
S-5373 by Lamberti - Specifies that distributors can be subject to civil penalties. ADOPTED
The Senate PASSED the Bill, as amended, 48-0; it now goes to the House

Deferred On: (Full report of last week's action):
SF 2322 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.
S-5275 by Fiegen, Lundby, et al - A Strike & Replace: Mandates coverage for neurobiological disorders including schizophrenia, affective disorders, anxiety disorders, developmental disorders, ADD, and other disorders including adolescent disorders. Requires a joint study by the Insurance Division and the State Auditor of the costs. S-5277 to S-5275 by Shearer, et al - Includes substance abuse coverage. FAILED, 20-28
S-5275 - ADOPTED 26-22; MTR filed by Iverson Senator Kramer deferred on the bill.

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.
The Senate PASSED the Bill 47-0; it now goes to the House

Deferred On:
SF 2190 WORKERS COMPENSATION - Keeps records which could identify an injured employee, or the employee's dependent, confidential. Includes exempt household and agricultural workers under workers' compensation if those workers are covered by a workers' comp insurance policy. Establishes new subrogation procedures and allows an employer to subrogate the recovery of an injured employee. Prohibits health care providers from seeking payment for fees from employers when the provider and the insurance company are disputing the fee. Prohibits debt collection against an employer during a contested case proceeding. 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. Eliminates the requirement to present a certified copy of a decision in order to enforce it. Allows the Workers Compensation Commissioner to require employers to submit proof of liability insurance.
S-5293 by Fiegen to S-5272 - Requires that compensation for permanent partial disability to be paid for the worker's lifetime rather than only for 500 weeks. Allows for a reduction in benefits for a worker who was previously injured but requires the employer to show that an employee who was previously paid for FAILED, 21-26
S-5292 by Dearden to S-5272 - Requires that any savings that results as a reduction of compensation to be passed on to the employer. FAILED, 19-29

SF 2326 OMNIBUS APPROPRIATIONS: Appropriates $2.7 billion for state agencies and judicial branch. Of the 34 amendments to the bill, the following were of interest to nurses:
S-5305 by Ragan, et al - Appropriates $100,000 for a nurse recruitment program. FAILED, 22-28
S-5301 by Kibbie, et al - Appropriates an additional $4 million for community colleges. FAILED, 23-27
S-5310 by Dvorsky, et al - Appropriates an additional $18 million to the Regents. FAILED, 22-28
S-5304 by Connolly, et al - Restores $1.7 million to the Iowa tuition grant program. FAILED, 18-32
S-5318 by Bolkcom - Appropriates $160,000 for Alzheimer's support. FAILED, 24-26
S-5320 by Ragan - Increases the appropriation for elderly wellness by 155,000. FAILED, 22-28
S-5317 by Bolkcom - Allows the nursing board to retain $181,000 from fees. FAILED, 22-28
S-5319 by Bolkcom - Appropriates $491,000 for the Veteran's Home. FAILED, 22-27
S-5298 by Hammond , et al - Increases the appropriation for HAWK-I by $2.8 million. FAILED, 20-29

The Senate PASSED the Bill, as amended, 29-20; it now goes to the House

House Appropriations: Voted Out
HF 2613 SENIOR LIVING APPROPRIATION - Makes appropriations from the Senior Living Trust Fund to DHS for various programs for senior citizens. PASSED 13-11. Floor Manager: Heaton
HF 2614 TOBACCO, RIIF AND ENVIRONMENT FIRST APPROPRIATIONS - Appropriates money from the Tobacco Settlement Trust Fund to the Regents, DOC, DHS, DOM, DNR, among others for various programs. Appropriates money from RIIF to the Regents, DOC, DED among others for various programs. Appropriates money from Environment First Fund to the DNR and DED among others for various programs. PASSED 16-5. Floor Manager: Brunkhorst
HSB 718 RIIF & TOBACCO SETTLEMENT APPROPRIATION (See SSB 3196) PASSED 14-11. Floor Manager: Gipp

Senate Appropriations: Voted Out:
SF 2326 OMNIBUS APPROPRIATIONS PASSED 13-10. Floor Manager: Lamberti

HF 2613 SENIOR LIVING APPROPRIATION (Appropriations) Makes appropriations from the Senior Living Trust Fund to DHS for various programs for senior citizens.

HF 2614 TOBACCO, RIIF AND ENVIRONMENT FIRST APPROPRIATIONS (Appropriations; Successor to HSB 718) Appropriates money from the Tobacco Settlement Trust Fund to the Regents, DOC, DHS, DOM, DNR, among others for various programs. Appropriates money from RIIF to the Regents, DOC, DED among others for various programs. Appropriates money from Environment First Fund to the DNR and DED among others for various programs.

HF 2615 TOBACCO APPROPRIATION - Appropriates $65.2 from the Healthy Iowans Tobacco Trust for various health related programs. DHS: Total: $44.9 million; MEDICAL SERVICES: Non-Institutional Medical Assistance Providers: $8.0 million; Dental Providers: $3.8 million; Hospital Providers: $3.0 million; Home Health Care Providers: $2.1 million; Critical Assess Hospitals: $250,000; Home Health Daycare: $1.95 million; Respite Care Expansion: $1.1 million; CHIP Expansion: $200,000; Breast Cancer Treatment: $250,000; Medicaid Medical Assistance Supplement: $17.5 million; HIPAA Implementation: $2.1 million; CHILD & FAMILY SERVICES: Rehabilitative Treatment & Support Services COLA: $3.2 million; Adoption/Independent Living/Shelter Care COLA: $469,000. MH/MR/DD/BI: Property Tax Relief: $147,000. DOE: Empowerment: $1.2 million. DPS: Tobacco Use Prevention: $5.0 million; Substance Abuse Prevention: $10.0 million; Healthy Iowans 2010: $2.4 million; Smoking Cessation Products: $75,000; Substance Abuse Treatment: $1.1 million. DOC: Total: $610,000; District II: $127,000; District III: $35,000; District IV: $192,000; District V: $256,000.

SF 2325 DEPARTMENT RE-ORGANIZATION (Oversight/Appropriations; successor to SSB 3193)
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. Birth Centers: Iowa Code Chapter 135G is repealed. Floor Manager: Lundby

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