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LEGISLATIVE CONNECTION Upmeyer Introduces Whistleblower Protections INA has worked with Rep Linda Upmeyer on whistleblower protection bill that has just been introduced, HF 2375. Drake University graduate nursing students did the background research for this issue in 2002. There is very minimal protection currently in Iowa law. A nurse is protected for reporting another nurse, but not another health professional, i.e. a physician. State employees are protected if they report, but no other private or public employees are protected from retaliation if they raises concerns about patient safety. Mental Health Parity Recommended for Passage One of INA's long-standing agenda issues inched closer to passage on Wednesday, February 25. With a few comments about the need for coverage by the committee chair, Rep Dan Boddicker and a few words of support from the Ranking Member, Rep Mark Smith, the bill passed out of committee 20-0. The bill is not as comprehensive as health providers would like, but it does provide a vehicle for continued discussion of the issue this session. Direct Loan Nursing Schools Left out of New Nursing Loan Program A number of Iowa nursing schools will not be eligible to participate in the new program unveiled February 16 by the Vilsack Administration and the Iowa Student Loan Liquidity Corporation, which identified $8 million for nursing student loans and scholarships. There are two programs that provide loan money for students: Federal Family Education Loan Program (FFELP) and William D. Ford Federal Direct Loan Program (Direct). It is understood that meetings are occurring to sort through how the "Direct Loan" schools can have funds identified for use. Republicans Offer Senior Care Plan Republican leaders have developed a plan to create tax incentives for Iowans to invest in long-term care insurance. Under the plan, individuals who purchase qualified long-term care policies will receive a state income tax credit of up to $500 for a portion of the cost of their premium. Iowans purchasing long-term care policies that meet certain standards can have some, if not all, of their assets protected, rather than having to use up assets in order to meet eligibility for Medicaid. Rep Eichhorn said that the Republicans want to encourage seniors to purchase long-term care insurance as a way to protect their assets. Legislators will also develop a task force to review of long-term care services, such as home-based services using home health aides, community-based services such as hospice and respite care, assisted living facilities and nursing homes. The Republican plan also would establish a prescription drug assistance program through the Insurance Commissioner's office. The program would include a telephone hotline Iowans could call to learn if they are eligible for various free and discounted prescription drug offers from pharmaceutical manufacturers. Callers would also be able to receive information on pharmacies and health-care providers. Rep. Heaton said that the "goal is to establish a clearinghouse that assists Iowans in accessing manufacturer-sponsored discounts." Bills that came out (SF 2163 LONG-TERM CARE INSURANCE) earlier in the session and Senator Johnson's introduction of SF 2016 PRESCRIPTION DRUG ASSISTANCE would require the Insurance Commissioner to help Iowans find prescription drug cost assistance. Democrat's Response Democrats said that Republicans have failed to help Iowa seniors in a number of areas, including letting the case load of the Long-Term Care Ombudsman's Office get too large (19,5000 per ombudsman) and using money from the Senior Living Trust Fund to balance the General Fund budget. The Democrats said that the legislature also needs to increase the funding for the Department of Elder Affairs. SEIU Nurse Rally at Capitol Iowa for Health Care nurses met with legislators at the Capitol in support of HF 2290 HEALTH FACILITY STAFFING which sets direct-care nurse-to-patient ratios for specific units, including the operating room (one nurse to one patient), emergency room (one nurse to three patients), and labor and delivery (one nurse to two patients), prohibits mandatory overtime and prohibits retaliation for reporting violations or suspected violations. Iowa for Health Care is a project of the Service Employees International Union. The bill was sponsored by Rep. Murphy, and is currently in the House Human Resources Committee. The SEIU nurses said that the Legislature need to act to protect patients. They said that a report in the Journal of the American Medical Association said that each additional patient per nurse is associated with a 7% increase in the likelihood of death of one of the nurse's patients within 30 days of admission and a 7% increase in the odds of failure-to-rescue. Each additional patient per nurse was also associated with a 23% increase in the odds of nurse burnout and a 15% increase in the odds of job dissatisfaction. American Cancer Society The American Cancer Society was at the Capitol Thursday, and asked for support on a number of issues, including
The Cancer Society supports increasing the tax on cigarettes to reduce smoking rates, keep kids from starting, reduce health care costs and to increase state revenues. The Cancer Society also believes that the cigarette tax needs to be raised regularly since it is set as a specific amount, rather than as a percentage of cost. The tax has not been raised since 1991; Vilsack's proposal would raise $108 million; the Cancer Society's rate would raise $156 million. Health Freedom Act Citizens are requesting a bill that would change the general frame of reference for physician scope of practice so that modalities that are non-invasive would not be considered "practicing medicine without a license". Currently no unlicensed individual can legally perform non-invasive healing modalities without being licensed. HF 477 would provide that protection. A lengthy subcommittee meeting was held with interested parties on Wednesday. INA's position is to monitor. INA did ask for clarification in the bill for addressing health professionals who have lost their professional license and how they would be handled. INA also suggested that perhaps these practitioners need the same background checks as is currently required of licensees, nurse aides, teachers, child workers, etc. The medical societies are opposing passage of the legislation. INA Legislative Agenda and Bills of Interest to Nursing in 2004 To learn the most current status of the bill, go to www.legis.state.ia.us Under "Popular Links", click on "Bill Book" and put in whether it is a Senate File or House File and the bill number.
Other Issues of Importance
House Resolutions HR 120 DIVERSITY IN CURRICULUM FOR MEDICAL STUDENTS (Ford & Huser) Urges the University of Iowa and the Des Moines University Osteopathic Medical Center to develop medical school curriculums that ensures that physicians receive explicit training in the problems of racial bias and that they learn methods to ensure that treatment and therapies are recommended equitably.
Senate Floor Action The Senate delayed action on these bills and sent them back to committee for further work. The Senate considered substituting HF 2187 for SF 2076, and then passing the bill in the same form as the House. That action would have sent the bill down to the Governor. House Committee Action
House Commerce House Education HF 418 OBESITY MEASUREMENT - Requires the Department of Public health to maintain records on the height, weight and body mass index of students from K-12 schools in an obesity measurement program. Does not require schools to be in the program, or for students to participate. Requires the DPH to develop ways to share the data while protecting the identify of students. The House Education took this bill up in committee, but deferred on further action until at least next week. House Human Resources HF 2074 BIRTH DEFECTS INSTITUTE - Renames the Birth Defects Institute to the Center for Congenital and Inherited Disorders. Expands the scope of study of the institute to all the cause and prevention of all birth disorders, including stillbirths. Makes the identifiable information collected by either the DPH or the Center confidential. AMENDED & PASSED 20-0 FM: Upmeyer See HF 2362 HSB 660 DEPENDENT ADULT ABUSE - Makes various changes regarding dependent adult abuse. Makes funeral directors mandatory reporters. Creates the offense of Dependent Adult Endangerment. AMENDED & PASSED 20-0; FM: Upmeyer HF 627 BIOLOGICALLY BASED MENTAL ILLNESS - Requires group health insurance, HMOs, and third-party payer of employers of 50 or more to pay biologically based mental illness claims. PASSED 20-0; FM: Boddicker Senate Committee Action Senate Business & Labor Committee SSB 3098 DRUG TESTING - Defines "sample" as either from urine, saliva, breath, or blood. Requires the presence of the employee giving an oral liquid sample during testing. Requires collection of enough material to conduct a second test and requires holding the second sample for 45 days or until the first test returns as negative. PASSED, FM: Schuerer See SF 2173 Senate Commerce Committee SF 2163 LONG TERM CARE INCENTIVES - Establishes an asset disregard program. Gives a person who purchases long-term care insurance coverage the opportunity to have other assets disregarded for purposes of Medicaid eligibility. Authorizes a $1 for $1 disregard if the insurance coverage is at least $100,000. Allows certain individuals who purchased insurance coverage before 1998 to qualify for a complete asset exclusion. Directs the Insurance Division to give information to persons who are interested in participating in this program. PASSED, FM: Schuerer See SF 2183 Senate Education Committee SSB 3109 BULLYING POLICIES - Requires schools to adopt a policy prohibiting bullying, and to review the policy every year. Requires the policy to include strategies for preventing bullying and definitions of bullying. Requires schools to include participation from students, teachers, parents and others. PASSED, FM: Boettger See SF 2176 SF 2129 ASTHMA MEDICATION - Requires schools to allow a student to have and self-administer asthma medication if the student's parent submits written authorization, along relevant information. Requires the parents to release the schools from liability. Requires the information to remain on file with the school nurse or administrator. Contains related provisions. PASSED, FM: Ward See SF 2177 Senate Human Resources Committee SSB 3065 LONG TERM CARE - Creates a long-term care task force to report on strategies and related matters for implementing long-term care system. Requires a report to the Legislature by December 2004. PASSED, 13-0; FM: Tinsman See SF 2190 SSB 3070 MERCURY/THIMEROSAL BAN - Bans vaccinations which use preservatives, such as thimerosal, which contain mercury or other heavy metals as of January 2005. The Human Resources Committee amended, and then deferred on this bill.
Senate State Government Committee NEW BILLS INTRODUCED Note -- House Files and Senate Files which have a floor manager listed at the end of the bill (FM) have been passed by one committee and should be eligible for floor debate. House and Senate Files with a Committee listed at the end must go through that committee before being eligible for floor debate. Study Bills must always go through committee (the numbers are changed when the bill is approved). Several of the bills in this list are in twice, first with the original introduction number, and then with the successor number that was assigned after committee passage. House Files HF 2336 COMMITMENT TEAM (Jones) Authorizes the DHS to create an expert mobile team and specialized treatment unit to deal with adults who have a developmental disability and who pose a severe and persistent threat to themselves or others. Requires the unit to be a secure unit. Includes definitions and establishes procedures. Limits the duration of an initial commitment order to 18 months. Requires the creation of a transition plan for persons leaving treatment. Exempts the bill from state mandate funding. (Human Resources) HF 2339 DEPENDENT ADULT ABUSE (Ford) Expands the list of persons who can commit dependent adult abuse to include any person who willfully or negligently acts or fails to act in a certain manner rather than just caretakers. Gives the Dependent Adult Abuse Advisory Council additional notification requirements. HF 2345 DPH PROGRAMS (Human Resources; Successor to HSB 618) Transfers administration of the annual grant program relating to private water supply wells from the DNR to DPH. Requires the DPH to maintain a list of lead abaters and lead inspector training programs. Has other lead abatement provisions. Allows DPH to impose a fee for transporting radioactive material to cover emergency response programs. Allows a audiologist license applicant to hold certain degrees other than a audiology Master's degree. Defines "electronic signature" for prescriptions drug orders. Prohibits Boards of Medical Examiners and Dental Examiners from canceling temporary certificate to practice or a temporary permit without due process. FM: Granzow HF 2355 OUT OF STATE WORK INJURIES (Elgin) Directs, under qualifying conditions, that if an employee is injured while working out of the state, the employee or dependents are entitled to the same worker comp benefits as if the injury occurred in the state. Requires the employer have a business location in the state and the employee regularly works at or from that location, or the employment contract was made in the state with the employee spending a substantial amount of time in the state. Has other conditions. (Ways & Means) HF 2362 BIRTH DEFECTS INSTITUTE (Human Resources; Successor to HF 2074) Renames the Birth Defects Institute to the Center for Congenital and Inherited Disorders. Expands the scope of study of the institute to all the cause and prevention of all birth disorders, including stillbirths. Makes the identifiable information collected by either the DPH or the Center confidential. (Calendar) HF 2364 EMERGENCY COUNSELORS (Smith) Gives volunteer critical incident stress team members who give services to emergency service workers, an exemption from liability, except in cases of negligence. (Judiciary) HF 2369 MEDICAL PROFESSIONAL INSURANCE (Murphy) Requires 120 days notice before canceling of professional insurance coverage for various medical professions. (Commerce) HF 2375 HEALTH CARE WHISTLEBLOWER PROTECTIONS (Upmeyer) Prohibits reprisals against a health care worker who discloses information to various federal and state agencies, departments, commissions, law enforcement agencies. Requires the worker to take reasonable efforts to allow the correction of a violation and requires that the disclosure not be against state or federal law. Creates a presumption that a worker who is fired or punished after a disclosure of a violation of health or safety laws was punished in contravention of these provisions. Allows for a private cause of action. (Human Resources) HF 2376 WORKER COMP CHANGES (Connors) Makes certain records filed with the Worker's Compensation Commissioner confidential public record under the Open Records Law. Makes certain uncovered employees covered under Workers' Comp if the employers insurance policy does not specifically exclude those employees. Has related matters. (Commerce) HF 2379 WORKER COMP INJURIES (Commerce; Successor to HSB 554) Requires that a worker's compensation injury be characterized as either traumatic or cumulative and defines both. Sets requirements for determining if either a traumatic injury or a cumulative injury is work related. Requires that employment activity be the most significant factor in causing or aggravating the injury before such an injury is work-related. (Calendar) FM: Horbach House Study Bills HSB 686 STATE PENSION PLANS (State Government) Makes numerous changes to PORS, IPERS, Statewide Fire and Police Retirement System (SFPRS) and the Judicial Retirement System (JRS). PORS: Allows for certain members to have service credited city fire and police retirement system before consolidation. IPERS: Directs the a member's the greater of the member's three-year average covered wage retirement allowance will be calculated based upon calculated on June 30, 2004, or the member's five-year average covered wage. Increases employer contribution to 6.2 % for FY 2009 and to 6.7 % for FY 2010. Increases employees contributions by .5 % per year until the contribution is 6.7 %. Changes calculation method after 2010 and directs how the calculation is to be made. Establishes new alternative retirement benefits for IPERS member who are teachers, and municipal and county hospitals employees. Sets requirements for the alternative system. Allows for certain employees who has previously elected not to participate in IPERS to elect to so do under certain conditions. Adds new employees to the IPERS eligible employees. Has other provisions related provision related to disability and early retirement. SFPRS: Creates a rebuttal presumption a heart attack is work related. Allows for the annual adjustment for all members. Changes method of calculating determining the normal contribution rate for cities. Requires work related hospitalization be paid by the city with no cost to the member. Has other provisions. Drake (C), Connors, Elgin, Jones, Lykam HSB 689 VOLUNTARY DRUG DONATIONS (Human Resources) Directs the DPH to create a voluntary program to accept donated drugs by UI Hospitals and Clinics for use and distribution to indigent care program or DOC patients. Requires the drug in the original unopened, sealed, and tamper- evident packaging. Prohibits acceptance is the expiration date is less than 6 months from the donation date. Establishes requirements for medical professional who accept donations. Limits liability of manufactures and other donors. Directs the DPH to create rules to carry-out program. Carroll (C), Upmeyer, Jacoby Senate Files SF 2161 COMMITMENT TEAM (Houser) Authorizes the DHS to create an expert mobile team and specialized treatment unit to deal with adults who have a developmental disability and who pose a severe and persistent threat to themselves or others. Requires the unit to be a secure unit. Includes definitions and establishes procedures. Limits the duration of an initial commitment order to 18 months. Requires the creation of a transition plan for persons leaving treatment. (Human Resources) SF 2162 IPERS MEMBERS (Gronstal) Adds jailers and detention officers as members in a protection occupation for the purposes of IPERS. (State Government) SF 2163 LONG TERM CARE INCENTIVES (Schuerer) Establishes an asset disregard program. Gives a person who purchases long-term care insurance coverage the opportunity to have other assets disregarded for purposes of Medicaid eligibility. Authorizes a $1 for $1 disregard if the insurance coverage is at least $100,000. Allows certain individuals who purchased insurance coverage before 1998 to qualify for a complete asset exclusion. Directs the Insurance Division to give information to persons who are interested in participating in this program. (Commerce) SF 2164 INSURANCE PREMIUM PROHIBITIONS (Warnstadt) Prohibits long-term care insurance policies from containing provisions which require an insured to pay premiums which in total would exceed the lifetime maximum benefit. Requires that existing policies be amended to increase benefits to at least equal to the premiums paid. (Commerce) SF 2173 DRUG TESTING (Business & Labor; Successor to SSB 3098) Defines "sample" as either from urine, saliva, breath, or blood. Requires the presence of the employee giving an oral liquid sample during testing. Requires collection of enough material to conduct a second test and requires holding the second sample for 45 days or until the first test returns as negative. FM: Schuerer SF 2175 WORKERS COMP (Business & Labor; Successor to SSB 3080) Makes confidential information filed with the Workers' Comp Commissioner a confidential public record. Defines confidential information as information regarding an employee's injury or death that would allow identification of the employee or the employee's dependents. Includes various reports but excludes pleadings and other matters related to a settlement. Establishes exceptions for the release of information, including through a waiver, to an agency compiling statistical data or conducting scientific, medical, or public policy research, to the employee or to the agent or attorney of the employee, or to the person or agent of the person who submitted the information, or to the attorney, investigator, or similar agent for the employer. Prohibits using violations as a cause of action. Other: Defines day of incapacity to work to means eight hours of accumulated absence from work. Prohibits insurers from denying benefits to an injured employee on the basis of employer liability if the employer denies liability. Makes changes to filing requirements and security deposits for self-insured employers., for filing claims and other matters. FM: McKibben SF 2176 BULLYING POLICIES (Education; Successor to SSB 3109) Requires schools to adopt a policy prohibiting bullying, and to review the policy every year. Requires the policy to include strategies for preventing bullying and definitions of bullying. Requires schools to include participation from students, teachers, parents and others. FM: Boettger SF 2177 ASTHMA MEDICATION (Education; Successor to SF 2129) Requires schools to allow a student to have and self-administer asthma medication if the student's parent submits written authorization, along relevant information. Requires the parents to release the schools from liability. Requires the information to remain on file with the school nurse or administrator. Contains related provisions. FM: Ward SF 2182 WHEELCHAIR DEFINITIONS (Holveck) Defines a person in a wheelchair as a pedestrian. Excludes motorized wheelchairs from the definition of motor vehicle. (Transportation) SF 2183 LONG TERM CARE INCENTIVES (Commerce; Successor to SF 2163) Establishes an asset disregard program. Gives a person who purchases long-term care insurance coverage the opportunity to have other assets disregarded for purposes of Medicaid eligibility. Authorizes a $1 for $1 disregard if the insurance coverage is at least $100,000. Allows certain individuals who purchased insurance coverage before 1998 to qualify for a complete asset exclusion. Directs the Insurance Division to give information to persons who are interested in participating in this program. FM: Schuerer SF 2190 LONG TERM CARE (Human Resources; Successor to SSB 3065) Creates a long-term care task force to report on strategies and related matters for implementing long-term care system. Requires a report to the Legislature by December 2004. FM: Tinsman Senate Study Bills SSB 3109 BULLYING POLICIES (Education) Requires schools to adopt a policy prohibiting bullying, and to review the policy every year. Requires the policy to include strategies for preventing bullying and definitions of bullying. Requires schools to include participation from students, teachers, parents and others, Boettger (C), Connolly, Ward SSB 3111 PHYSICIAN ASSISTANTS (Human Resources) Allows Physician Assistants to be regarded as approved providers of health care services, including for primary care, for the purposes of managed care or prepaid services contracts under Medicaid. Boettger n, Seymour, Ragan (See HF 2260) SSB 3119 HEALTH CARE WHISTLEBLOWERS (Judiciary) Creates a private cause of action against a person or agency that discloses the identity of a person who files a complaint against a health care facility. Requires a minimum award of $100 plus court costs and attorney fees. Boettger (C), Horn, Ward SSB 3129 COLLEGE MENINGITIS (Education) Requires colleges with dormitories to give students information about meningococcal disease and vaccinations in student health forms. Requires the forms to ask whether a student has received the vaccination, and to include recommendations by the National Centers for Disease Control and Prevention regarding the disease. Requires the data to the Department of Public Health, in a manner that prevents the identification of individuals. person can be identified. Boettger (C), Dvorsky, Rehberg © 2008 The American Nurses Association, Inc. All Rights Reserved
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