LEGISLATIVE CONNECTION
A communication of the Iowa Nurses Association
A benefit of membership
Volume 5, Number 5, February 14, 2003

Connecting with Nurses on Health Issues

Vilsack Proposes Budget
Governor Vilsack submitted his FY 2004 budget to the Legislature today, which he said was a "status quo budget" with some additional funds for education, health care and the environment. Vilsack said that the important work facing the Legislature this year is not the budget but the work in transforming the economy. He said that unless the state actively works to create jobs that require college graduates as employees, the state will never be able to make significant advances. Vilsack said that if the state can create enough jobs for 100,000 college graduates, those graduates would add $175 million to the state budget in increased tax collections. He said that it is vital for the Legislature to move forward with his Iowa Values Fund, which will invest money raised through bonds in biotech and other economic initiatives. He said that the Legislature needs to move forward in removing regulatory barriers and in increasing the minimum wage by $1.

Increases for Education, Environment, Health Care
Vilsack's budget calls for a 2% allowable growth rate, no decrease in the support for the class size reduction, $4.7 million for other teacher programs, reinstating the work-study program to help students earn money for college, increasing the Iowa Tuition Grants by $300,000, full funding for salaries at the Regent schools, and increasing community college funding with $1 million for technology and $4 million for career education.

Vilsack said that the state needs to expand programs like HAWK-I and to take advantage of a new federal initiative on Medicaid. The new program will allow states more flexibility in solving funding problems and will have incentives for effective programs. Like legislative leaders, the Governor has said that the federal government should pay a higher reimbursement rate to the state. He also said that he has talked to Senator Kramer about the federal Medicaid changes and that he expects the Legislature to take advantage of the new rules. His budget also includes about $40 million in a Medicaid Supplemental bill. The Legislature has already approved one supplemental in his budget (SF 36) with health and safety spending.

Financial Highlights
The Governor's budget calls for $4.611 billion ($4.599 billion after expected reversions), which is an increase of 1.8% over FY 2003. The state reduced spending in FY 2003 and the proposed FY 2004 budget returns the state to the FY 2002 spending level. The GF ending balance is expected to be $128 million, which the Governor expects to take care of any increases from the collective bargaining agreement still being negotiated. Overall, his budget shows an increase in the Cash Reserve fund from $226 million to $304 million. The ending balance of the Economic Emergency Fund is unchanged at $3.3 million.

The Governor's budget expects to receive $25 million this year in increased sales tax collections, due to the adoption of the streamlines sales tax act, $25 million from a one-time source by requiring lost property to be turned over to the state after one year instead of three and $25 million this year by requiring corporations to file combined income tax reports.

The $64 million in one-time money in the budget comes from the Tobacco Fund ($34 million), RIIF ($20 million) and the Underground Storage Tank Fund ($10 million). In addition to the call for full funding of the Environment First Fund, Vilsack's budget projects that about $55 million will be available to the RIIF.

The Governor also hopes to save $88.5 million by what he calls "statutory reinvention"--changes the state can implement, such as sharing health insurance savings with the employees who create those savings.

Fiscal Management and One-Time Funds
Vilsack said that his financial planning priorities include keeping Iowa's bond rating at AA+ and keeping the cost of government low. He said that the price of state services, as measured by the percentage that state taxes take of personal income, was the lowest it has been in 30 years.

He said that state reserves will be above 5% and nearly double the national average. His budget calls for the use of reserve funds during the year, but those funds are replaced by year's end.

Vilsack said that the budget will reduce the use of one-time funds from $211 million to $64 million. He said that does not include the $100 million from the Senior Living Trust fund which is likely to be used to make up Medicaid shortages.

Taxes
Vilsack said that he will not ask for tax increases, and that his major initiative will be to try to move Iowa to collecting its share of sales taxes for internet purchases. Vilsack said that if the state approves streamlined tax rules, it is quite possible that a number of major internet and catalog retailers will begin to voluntarily collect the sales taxes and remit them to states like Iowa. Vilsack is hoping for $25 million in collections this year from internet sales. He said that he wanted to stress that this is not a new tax. Internet purchases are usually subject to the use tax if the state fails to have sufficient nexus to require the retailer to collect the tax, but in practice, those use taxes are rarely paid.

Vilsack said that ultimately the state could expect $80 to $100 million extra in sales tax collections. He said that collecting the sales tax on internet purchases is also an issue of fairness for local businesses who must collect the sales tax.

Vilsack said that he will continue with efforts to simplify Iowa's personal income tax and to replace the property tax. He also said that he supports requiring combined reporting from large corporations, which he said would close a loophole used by corporations to avoid Iowa taxes by using out of state corporations to lower tax liability and replace the property tax system.

The Governor said that his budget anticipates no reduction in gaming revenues, whether that is from a successful suit to the Supreme Court or through a negotiated solution between the state and the racetracks.

Response to Governor
Senator Gronstal said that the federal government needs to fund more of the obligations of the "No Child Left Behind" act. Republican legislators said that they needed to study the Governor's budget in greater depth before deciding how much of it they could support. Rep. Rants said that they have concerns about some of the details, particularly in how the Governor expects to save $88 million through "government reinvention". Rants said that he expects the Governor to supply them with more details shortly so that the budget subcommittees can examine the savings proposals. Rants said that the Legislature needs to begin serious work on the budget as this is already the fourth week. Senator Iverson said that the Republicans still have more questions than answers about the budget.

Senator Iverson said that the Governor needs to come out with more details on how his combined corporate reporting proposal will work. The Governor hopes to raise $25 million by requiring more detailed tax returns from corporations. Governor Vilsack said that this proposal is simply closing a loophole. Iverson said that he needs further information from the Governor or from the DRF before he can support the idea. Iverson also said that his caucus is still reviewing the idea of adopting a simplified sales tax. The sales tax proposal is part of a national initiative to get internet and catalog retailers to collect the sales tax. In past sessions, Republicans have not supported the idea, but Vilsack hopes to collect $25 million in sales tax this year on internet sales. The proposal requires a sufficient number of states to adopt model legislation that will simplify the reporting requirements; if that happens, a number of large internet and catalog retailers have agreed to begin collecting the sales tax.

State Finances

Year-to-date state finances for FY 2003 are running above the REC revenue estimates. The state is currently about $46 million above FY 2002 in a year-to-date comparison, or a 1.7% increase. Overall, the REC estimated growth at only 0.3%, or about $18 million in growth in FY 2003 over FY 2002.

The state has done significantly better than projected in corporate income tax collections, and sales and inheritance tax collections have not fallen off as much as projected. The insurance premium tax, for which the Legislature accelerated the schedule of estimated payments, is also coming in at a higher than expected level.

ARNP Signing Death Certificates
There will be a meeting Monday, February 10 in the House Lounge on House File 87 ARNP signing of death certificates with Reps. Rasmussen, Gaskill and Roberts. Please contact Linda Goeldner at 515/225-0495 or 515/249-4038 if you would like to participate in the discussion.

Contact your Legislator
Find your legislator, current legislation, bill history, publications, Iowa laws, legislative agencies, and more by going to the legislative web site: www.legis.state.ia.us. The INA Legislative Connection will give you the bill numbers, legislator names and committee names to assist you in locating information more quickly. On the legislative website, click on "Track Legislation", "Information by Bill", "Display a Bill and Amendments" to see what the bill proposes. Click on "Bill History" to follow the progress of a bill.

Register for Lobby Day-February 20, 2003 Today!
Go to the INA website at http://www.iowanurses.org and sign up for the INA Lobby Day. The morning will be time to contact your legislator about nursing issues. From 10-1 there will be display tables from nursing specialty organizations to speak with and answer questions of legislators. We encourage some interactive activity, like taking blood pressures, advocating for "Lighten Up Iowa", whatever preventive health measure you would like to offer. The afternoon program is continuing education on delegation for 3 hours at the State Historical Building, East 6th and Grand. It has been ANCC and IBON approved. Check the website for the CE program agenda. Early Bird Registration ends after February 8. Schools of Nursing are encouraged to submit one list with all student names and one check for speedy processing.

STATUS OF 2003 LEGISLATIVE AGENDA

1. FUNDING THE BOARD OF NURSING: Appropriate funds to reflect funding of the Board of Nursing with 100% of license and renewal fees collected.

2. TOBACCO REDUCTION INITIATIVE: Pass an increase of the cigarette excise tax by $1.00 per package to reduce tobacco use by Iowa's youth and strengthen the state tobacco use prevention and control program. (Seeking legislative sponsors)

3. FUNDING OF NURSE RETENTION AND RECRUITMENT PROGRAM: Appropriate funding for the College Aid Commission to support registered nurses increasing their education to become nursing faculty and to support recruitment.

4. MANDATORY OVERTIME: Pass legislation similar to that passed in Maine, Maryland, Minnesota, New Jersey, Oregon, Texas and Washington State which bans or severely limits the use of mandatory overtime as a staffing measure and which is defined as being compelled or forced to work hours beyond agreed upon assignments by threat of discrimination, dismissal, licensure discipline and/or other sanctions. (Bill being drafted.)

5. MENTAL HEALTH PARITY: Pass legislation providing for parity in health insurance for mental health to be no different than physical health coverage, with recognition for children and adolescents including services for chemically dependent and appropriate housing for individuals with persistent mental illness. ( HF 63,HSB 48 introduced; SF 58 )

6. ASSISTED LIVING. Pass legislation that assures that registered nurses are available and utilized to provide services at their level of education to assess and evaluate residents and participate in policy-making discussion about the tenant's choice to stay in assisted living as long as they meet the criteria for the level of care; not forcing tenants to a higher level of care by unduly restrictive state regulations. (Bills being introduced)

Public Policy Priorities
1. Support adequate funding of Medicaid and Hawk-I program. Appropriate sufficient resources for programs that provide services to the poor. (Governor's Budget; HF 49)

2. Recognize ARNPs as Medicaid Primary Care Providers. Pass legislation that recognizes advanced registered nurse practitioners (ARNPs) as primary care providers under the Medicaid Managed Care Program which covers 85% of the Medicaid enrollees. (HF 60)

3. Medical Privacy: Pass legislation that modifies Iowa Code Section 622.10 to prohibit the release of medical records as "evidence". (Bill draft circulating)

Committee Assignments

House Appropriations: Assigned to Subcommittee:

House Commerce: Assigned to Subcommittee:
HF 86 PUBLIC EMPLOYMENT RETIREES - Horbach (C), Kurtenbach, Murphy
HF 92 HEALTH INSURANCE PAYMENTS - B. Hansen (C), Osterhaus, Sands
HF 97 MAMMOGRAPHY COVERAGE - B. Hansen (C), Petersen, Sands

House Human Resources: Assigned to Subcommittee:
HF 57 CLERGY CHILD ABUSE REPORTERS Boddicker (C), Roberts, Smith
HF 111 FAMILY PLANNING GRANTS - Roberts (C), Smith, Tymeson

House Judiciary: Assigned to Subcommittee:
HF 74 PRISON MENTAL HEALTH - Heaton (C), Foege, Schickel
HF 116 BURN INJURY REPORTING - Baudler (C), Dennis, Lensing

House State Government: Assigned to Subcommittee:
HF 73 IPERS ASSIGNMENT - Drake (C), Connors, Elgin, Jones, Oldson
HF 87 SIGNING DEATH CERTIFICATES - Rasmussen (C), Gaskill, Roberts

House Transportation: Assigned to Subcommittee:
HF 100 CHILD RESTRAINT FINE - Klemme (C), Miller, Rasmussen

Senate Committee Reports

Senate Commerce: Assigned to Subcommittee:

Senate Human Resources: Assigned to Subcommittee:
SF 59 COUNTY CHILD PROTECTION ASSISTANCE TEAMS - Ragan (C), Hatch, Tinsman
SF 87 PUBLIC SMOKING BAN - McKinley(C), Behn, Horn

Senate Rules: Voted Out:
SCR 1 IOWA MEDICARE MEDICAID - Urges Congress to give Iowa more Medicare money. 9-0 Floor Manager: Iverson

Bills Introduced of Interest to Nursing

Find the bills at http://www.legis.state.ia.us

"Track Legislation" -- House Files

HF 92 HEALTH INSURANCE PAYMENTS (Foege) Requires group health insurance and HMOs' to compensate optometrists, chiropractors, nursing, and podiatrists at the same level as allopathic and osteopathic physicians for the same type of treatment. (Commerce)

HF 97 MAMMOGRAPHY COVERAGE (Huser, et al.) Requires health insurance plans and HMOs' to pay for a physician recommended mammograms every six months for women with a family history of breast cancer. (Commerce & Regulation)

HF 98 LONG-TERM CARE CREDIT (B. Hansen) Gives an income tax credit of 50% of long-term health care insurance premiums. Limits credit to $500. (Ways & Means)

HF 100 CHILD RESTRAINT FINE (Smith) Increases the under six child restraint fine from $25 to $500. (Transportation)

HF 104 OVARIAN CANCER TEST COVERAGE - (Murphy & Frevert) Requires health insurance coverage to pay for screening tests for ovarian cancer. (Commerce & Regulation)

HF 111 FAMILY PLANNING GRANTS (Alons, et al) Requires the DPH, DHS and other state agencies that give grants under the federal family planning act to give priority in awarding such grants to the organizations that engage in the fewest of the following activities: performing abortions or making abortion referrals, advocating for abortion rights or including access to abortion as a family planning measure. Establishes exceptions. (Human Resources)

HF 116 BURN INJURY REPORTING (Maddox) Requires doctors to report certain burn injuries to the State Fire Marshal. Makes failure to report a simple misdemeanor. (Companion to SF by Redfern) (Judiciary)

HF 118 CHILD DEPENDENT CARE CREDIT (S. Olson) Allows persons making between $40,000 and $50,000 to receive a state tax credit equal to 30 percent of the federal Child or Dependent Care Tax Credit. Allows persons with net incomes between $50, 000 and $60,000 to receive 20 percent and persons $60,000 and $70,000 to receive 10 percent of the tax credit. (Ways & Means)

HF 119 FAMILY LEAVE (Petersen, et al.) Makes it an unfair employment practice under the Civil Rights Act to discriminate against an employee or applicant because the person exercised rights under the federal Family And Medical Leave Act. (Commerce)

HF 123 SEPSIS REPORTING (Mertz) Directs the DPH to create a centralized reporting and education program concerning sepsis. (Companion to SF 90 by Tinsman) (Human Resources) HF 127 GOVERNANCE BOARDS MEMBERSHIP (Bell) Requires program governance boards overseeing a county program for decategorization of child welfare funding to include representatives of individuals and agencies providing services or funding to address the needs of children. (Human Resources)

HF 128 RUNAWAY CHILDREN (Connors) Directs that in counties without an approved runaway treatment plan or the child is not a chronic runaway, the child and parents participate in counseling sessions at a shelter care facility or any other location. (Human Resources)

HF 130 DEMENTIA ADMISSIONS (Connors) Allows for the next of kin of a person suffering from severe dementia or a dementia relate illness to voluntarily admit that person for inpatient psychiatric care. (Judiciary)

House Study Bills

HSB 48 MENTAL HEALTH COVERAGE (Judiciary) Requires health insurance plans to cover neurobiological disorders and based on rates, terms, and conditions that are no more restrictive than the coverage for other conditions under the plan. Requires the DPH to conduct a two-year study on the delivery of mental health coverage to be presented to the Legislature by November 1, 2005. Requires the Insurance Division and the Auditor to conduct a joint study on the costs, to be completed by January 30, 2006. Maddox (C), Heaton, Jochum

HSB 57 PUNITIVE DAMAGE LIMIT (Economic Growth) Limits punitive or exemplary damages to the greater of $200,000 or four times the claimant's economic loss. Kramer (C), S. Olson, Miller HSB 83 UNIVERSITY RESEARCH PROGRAM (Economic Growth) Creates the University-Based Research Utilization Program administered by the DED. Sets requirements for businesses that wish to participate in the program. Allows approved businesses and the university employee responsible for technology to development a carry-forward tax credit against personal or corporate income taxes. Makes other requirements for the credit. Jenkins (C), Kramer, Thomas

HSB 89 OWI BLOOD WITHDRAWAL (Public Safety) Allows taking a blood test without warrant if the driver at fault has been arrested for OWI and the accident cost a life or seems likely to cost a life. (See SF 51) Klemme (C), Ford, Sands

Senate Files
SF 71 MASSAGE THERAPY STUDY (Lundby) Directs the DPH and the Board of Massage Therapy Examiners, in conjunction with licensed and unlicensed practitioners, to study the various forms of massage therapy, including forms currently not licensed. Requires a report to the Legislature on what should be included in the practice of massage, including a recommendation on reflexology. (State Government) See HSB 18

SF 87 PUBLIC SMOKING BAN (Dearden ,et al) Bans smoking in public places including restaurants and outdoor bar areas. Makes an exception for tobacco shops, but eliminates other exemptions from the current rules. (Human Resources)

SF 88 REQUIRED BENEFIT PLAN (Dotzler) Makes it a Class "D" felony for an employer to knowingly fail to make payments to a health benefit plan for an employee if the payments are required under an agreement with the employee, or the employer's policies. (Judiciary)

SF 89 DOMESTIC ABUSE SURCHARGE (Dvorsky) Creates a domestic abuse shelter surcharge of $10 to be assessed against persons convicted of domestic abuse. Authorizes the Department of Justice to use the surcharges to run domestic abuse shelters. (Judiciary)

SF 90 SEPSIS EDUCATION (Tinsman) Requires the DPH to establish a centralized reporting system for sepsis and to create an education to improve public awareness. Establishes reporting requirements by hospitals, requirements regarding continuing education and other related matters. Grants immunity from civil and criminal liability for a person who gives the DPH information in good faith due to the provisions of this bill. (Human Resources)

SF 91 VEHICLE FUEL STANDARDS (Warnstadt) Requires that the aggregate fuel efficiency of vehicles purchased by state and local governments must exceed the fuel efficiency standards for the vehicle's model year. (State Government)

SF 92 SCHOOL HEALTH BENEFITS (Connolly & Kibbie) Allows the school district management levy to be used to pay the costs of employee health benefits. (Education)

SF 95 CHOOSE LIFE PLATES (Johnson) Creates Choose Life license plates. Requires the DOT to consult with the Choose Life organization on a design. Establishes an initial fee of $35, over the other registration costs, and an annual fee of $15 for the plate, with personalized plates costing an extra $25 a year. Uses the funds for non-profit adoption agencies. Allows for the funds to be used to support pregnant women and for other adoption costs. Requires annual audits. (Transportation)

Senate Study Bills
SSB 1051 EMPOWERMENT COMMITTEES (State Government) Allows creation of Local Government Empowerment Committees to make recommendations for change of government for a county. Committee consists of three supervisors, three council members from each city of over 25,000 and one council member from each city less than 25,000, and two per legislative district with a majority of population in the county. If the committee recommends a change, it becomes a charter commission. Requires recommendation if new government will partisan or non-partisan. Requires Charter Commissions to say if the new government will partisan or non-partisan. Allows charter to be voted on at a special election. Allows a resident or property owner to challenge the legality of a proposed charter in court; a challenge delays voting on the charter until the challenge is resolved. Shull (C), Drake, Kibbie

SSB 1055 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. Veenstra (C), Boettger, Ragan

Senate Resolutions

Senate Resolutions:
SR 6 FIRST RESPONDERS (Warnstadt) Urges Congress to appropriate $3.5 Billion for state first responder networks per President Bush's request. (Rules)

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