LEGISLATIVE CONNECTION
A communication of the Iowa Nurses Association
A benefit of membership
Volume 5, Number 25 March 12, 2004

Asthma Medication Amended by INA

On behalf of the Iowa School Nurses Organization, Iowa Nurses Association successfully amended SF 2177 to add ARNPs as recognized prescribers and that students could possess and self-administer asthma "and other airway constricting disease" medications. The Iowa State Education Association also sought a minor modification with protection from liability for the schools and its employees for "unauthorized administration". This bill was floor managed by new Senator Pat Ward-West Des Moines. For those who might have heard the floor debate, she incurred the Senate tradition of "hazing" new senators handling their first bill with numerous unrelated questions being asked.

Development of a Drug Repository Program
The House Committee on Human Resources has had introduced a resolution, HCR 119 as a successor to House File 2191, to request the Legislative Council form a committee to make recommendations regarding the development of a drug repository program. This initiative started out as a cancer drug repository and has broadened. Five members will be appointed from the Senate and the House. Organizations will be contacted to conduct the study. INA members who are interested in providing input once the committee is formed are urged to contact the INA office and express their interest in being notified.

Non-Economic Damages Awards
On a vote of 53-47 the Iowa House of Representatives passed HF 2440, a bill that would cap jury awards for "pain and suffering" in medical malpractice suits at $250,000. About 400 physicians held a demonstration at the Capitol Building on March 4 calling for this legislation Rep. Linda Upmeyer did have an amendment adopted that would include ARNPs in the bill. INA is aware that physicians have requested the support of ARNPs to pass this bill. The Iowa Medical Society has requested that since ARNPs are now in the bill that calls be made to legislators to encourage passage in the Senate. Members are encouraged to contact their Senators with your comments about the bill. The bill is controversial and there is some expectation that the Governor will veto the bill.

Criminal History Background Checks
INA membership adopted a resolution in support of the Iowa Board of Nursing seeking authority for conducting criminal history background checks from the FBI (national). There was a bill introduced in 2003 that passed the Senate, but the bill got held up in the House. INA worked to move the process along. Since then, the FBI has stated that federal legislation for child protection should be acceptable authority for the Board of Nursing and that state legislation will not be needed. The Iowa Board of Nursing awaits that written statement, but anticipates that rule-making will begin in June with an effective date in 2005.

CNMs meet with DHS Staff to Discuss Back Payments Owed
Rep Dan Boddicker convened a meeting of the certified nurse midwives who operate independent clinics and birth centers with the Department of Human Services staff and ACS staff on Thursday, March 11. Rep Boddicker introduced the legislation to assist in removing the barriers for CNMs to practice independently in the state in birth centers and with Rep Linda Upmeyer, introduced legislation to authorize ARNPs to be Medicaid primary care providers. To date no payment has been received for Medicaid births from February 2002 to September 2003. This meeting was held to resolve issues of lack of payment of CNMs in the earlier time period as well as the 99 percent denial rate for claims since implementation of last year's legislation. There have been problems with "edits" for regular Medicaid and Medipass, as well as problems with payment from Iowa Health Solutions. Gene Gessow, Medicaid Director resolved to look into the issues raised.

Budget Targets Next Monday
Rep. Dix, the House Appropriations chair, said that budget targets will be out on Monday. Dix said that the Legislature will fund property tax credits at the same level as last year ($160 million).

Speaker Rants said that schools can proceed with their budgets because the Legislature will fund Allowable Growth at 2% for the next school year. Rants also said that the Republicans will follow the Governor's lead and not put $70 million in salaries for state employees. He said that this might lead to lay-offs, but that lay-offs could have been avoided if the AFSCME had agreed to take reductions in the current contract.

Rep. Gipp said that some schools will be receiving less money next year, despite the increase in Allowable Growth, due to enrollment declines. Rants said that school districts with budget problems may need to look at having employees carry more of the cost of health care benefits.

Democrats Predict Budget Problems
Senator Gronstal said that the Republicans face a $340 million budget problem that could grow to $650 million in their FY 2005 budget if they win their lawsuit against the Governor on the item vetoes. That decision is not expected to be out until after the session. Gronstal and Murphy said that Republicans have also pledged not to raise taxes, use the reserve funds or approve across the board cuts, in addition to the pledges on Allowable Growth, on property tax credits and to the Regents, and that Democrats believe that this could lead to severe cutbacks in health care, community colleges and public safety.

Rep. Murphy said that both parties need to work together to avoid a "budget trainwreck."

April 9th To Adjourn?
Legislators have named April 9th as their target date for finishing up this year. Legislators hope that by April 9th, they will have finished work on school Allowable Growth by then (2% approved by the Legislature; 6% requested by the Governor), other budget spending (targets should be out soon as the REC has its March meeting scheduled shortly), on the gambling bill (HF 2302, currently in the Senate), and hope to have word back from the Iowa Supreme Court on the item-veto lawsuit.

Other Issues of Importance

1. Criminal History Felony Background Checks (SF 235; HF 2164; Authority granted under federal legislation for Child Protection)
2. Funding for Center for Workforce Planning (federal funding renewed)
3. Funding for Iowa Board of Nursing (awaiting Appropriations bill)
4. Adequately Fund Schools to assure school nurses are employed (Conversations about Medicaid Direct Claiming for special education students)
5. Remove Certificate of Need for Birth Centers (SF 206 died)
6. Assure Hospital Privileges for ARNPs (being researched)
7. Fund Adequately Public Health Nursing services (awaiting Appropriations bill)
8. Pass the tobacco reduction initiative (multiple bills, none with $1 tax increase)
9. Adequately fund Medicaid and HAWK-I (awaiting Appropriations bill)
10. Support changes in Assisted Living to provide dementia-specific care (HF 2421 awaiting House)
11. Support Child Restraints in motor vehicles (SF 2066-in House Transportation)
12. Update Nurse Practice Act (Public Health Programs-Sec9) (HF 2492 awaiting debate)

    ADDITIONAL BILLS

13. Asthma Medications in Schools (SF 2177 awaiting Senate debate; Bullying policies SF 2176)
14. Ban on Thimerosal in Vaccines (SF 2209-awaiting Senate debate)
15. Drug Repository Program (HF 2191 recommended; HCR 119 filed)
16. Prescription Drug Assistance- (SF 2016, now SF 2229 awaiting Senate debate)
17. Pharmacy Benefit Manager Regulation- (SF 2283-awaiting Senate debate, amendment filed)
18. Long Term Care Insurance Incentives- (SF 2163- passed Senate Mar 10)
19. Long Term Care Plan- (SF 2190-awaitng Senate debate)
20. Elderly Programs- (SF 2132-Government Oversight Committee)
21. Dependent Adult Abuse- (HF 2391-awaiting debate)
22. ICN Terms and Conditions of Sale (HF 2536 recommended)
23. Unborn Child Protection Act (SF 2254-awaiting Senate debate)
24. Involuntary Hospitalization (HF 2354-awaiting House debate)
25. Health Provider Discrimination Prohibition- (SF ???? )
26. Uniform Electronic Transactions (HF 2490-House passed)
27. PT Advertizing (HF 2496-House passed)
28. Remove Certification requirement on Dental Assistants- (HF 2187 to Senate State Government)
29. Obesity Measurements (HF 418-died)
30. RN Surgery First Assistants Payment Mandate- (HF 2184 died)
31. PA as Medicaid Primary Care Provider- (HF 2260,SSB 3011/SSB3111-died)
32. Health Freedom Act- (HF 477 died)

House Floor Action

HF 2201 MASSAGE THERAPY EXEMPTION - Exempts a number of professional license holders from massage therapy licensing requirements, including M.D.s, D.O.s, surgeons, chiropractors, podiatrists, cosmetology license holders. Exempts athletic trainers, technicians, nurses, occupational therapists, or physical therapists who work under the supervision of a medical professional. Exempts persons licensed in another state or country who are in Iowa to teach massage therapy. Exempts supervised massage therapy students completing clinical graduation requirements and most out-of-state emergency personnel. Exempts other professional who use touch as part of practice and lists various approved methods of touch.

H-8017 by Greiner- Adds physician assistants to the list of exemptions. ADOPTED
The House PASSED the Bill, as amended, 98-0; it now goes to the Senate

HF 2328 CHILD PROTECTION INFORMATION - Makes changes to access to information regarding confidential child abuse information. Allows releases of additional information in child abuse fatality, or near fatality, cases. Allows dissemination of information to legislators in confidential meetings, and allows the Governor to designate someone to receive child abuse information. Gives the DHS more ability to make general comments about cases. Allows the Director of the DHS to inform a member of the public if a child abuse assessment is occurring. Makes corrective changes. The House PASSED the Bill, 97-0; it now goes to the Senate

HF 2262 IPERS/PENSION BILL - Makes changes to IPERS, PORS, and the Statewide Fire and Police Retirement system. IPERS: Requires a member who is retiring to designate their first intended first month of entitlement. Excludes from the definition of service any temporary employment during any quarter the member is on an unpaid leave of absence (other than family leave). Delays the date in changing the three-year calculation method to July 1, 2008. Prohibits an inactive member of IPERS from becoming vested just by turning 55. Allows certain wages received after retirement to be covered wages and excludes wages received in an employment dispute. Allows IPERS to waive the collection of old benefit overpayments. Makes changes regarding the determination of wage distortions. Allows IPERS to charge an administrative fee for certain costs if the cost is more than de minimis. Allows IPERS to charge for issuing paper checks instead of making an electronic deposit. Allows IPERS to refer fraud matters to the State Auditor and to law enforcement agencies.

H-8048 by Drake - Excluding HIV testing from certain medical tests for the Statewide Fire and Police system. ADOPTED
H-8040 by Drake - Language change. ADOPTED
H-8155 by Drake - Lowers city population limits to 30,000 for board membership. ADOPTED
The House PASSED the bill, as amended, 99-0; it now goes to the Senate

HF 2304 WORKER COMPENSATION CHANGES - Makes confidential information provided to the Workers Compensation Commissioner confidential public records under the public records law. Prohibits third party insurance from denying coverage because the employer has denied worker comp liability. Requires the Insurance Commissioner to determine security deposited for self-insured employers and is to be held in trust. Makes other changes related to self-insured workers comp employers.

H-8109 by Horbach - Sets method for calculating weekly gross earnings in cases of wage payments that are not paid over the course of a year. ADOPTED

H-8173 by Huser - Allows a prevailing employee to collect reasonable attorney fees and costs. FAILED

H-8185 by Eichhorn, et al. - Requires hearing be held within 14 months of the original filing. ADOPTED

H-8174 by Huser - Directs the Workers' Comp and Insurance Commissioners to study inflationary factors related to medical services and prescription drugs. FAILED

The House PASSED the bill, as amended, 56-43; it now goes to the Senate

HF 2440 PUNITIVE DAMAGE AWARDS - Creates the Non-economic Damage Awards Against Health Care Provider Act. Limits such damages to $250,000 unless a finding of actual malice by the defendant. H-8213 by Upmeyer - Adds advanced registered nurse practitioner to the list of health care workers. ADOPTED

H-8188, H-8196 - RULED NOT GERMANE

H-8182, H-8187, H-8189, H-8194, H-8197, H-8199, H-8217 - WITHDRAWN

The House PASSED the bill, as amended, 53-47; it now goes to the Senate

HF 2468 ADMINISTRATIVE RULES - Limits the effective period for any administrative rules adopted without public input to 180 days.

The House PASSED the Bill, 63-28; it now goes to the Senate
HF 2490 UNIFORM ELECTRONIC TRANSACTION - Strikes definitions "consumer," "consumer transaction," and "digital signature" from the Uniform Electronic Transaction Act. Changes definition of "transaction" to exclude consumer actions related to consumer affairs. Strikes the requirement that the Regents institutions conform with electronic signature standards. Has a severability clause. Contains other provisions.

The House PASSED the Bill, 90-0; it now goes to the Senate
HF 2496 PHYSICAL THERAPY ADVERTISING - Prohibits the use of titles that indicate that services from a person or business is from licensed physical therapist unless the services are performed by or under the supervision of a therapist. Makes violations a simple misdemeanor. Makes language corrections. The House PASSED the Bill, 93-0; it now goes to the Senate

HF 2497 STATE EMPLOYEE INCENTIVES - Establishes a sick leave and vacation incentive program for eligible executive branch employees including DOJ employees not covered by collective bargaining. Allows a incentive benefit equal to the employee's unused vacation plus the lesser of an amount equal to 75% of the employee's regular annual salary or an amount equal to 75% of the value of the employee's sick leave. Sets other requirements. Effective upon enactment.

H-8224 by Elgin - Adds employees covered by collective bargaining. ADOPTED
H-8220 - WITHDRAWN
The House PASSED the Bill, as amended, 91-2; it now goes to the Senate

Senate Floor Action

SF 2202 COLLEGE MENINGITIS - Requires colleges with dormitories to give students information about meningitis 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 be submitted to the DPH, in a manner that prevents the identification of individuals.

S-5046 - by Quirmbach - Requires the form to state that the student does not have to give information on being vaccinated, and makes the form a confidential record. FAILED

S-5044 by Boettger - Requires the DPH The department shall to review this program at least every five years, and to submit recommendations to the Legislature.

The Senate PASSED the bill, 41-4; it now goes to the House

SF 2235 UNIFORM MEDIATION ACT - Establishes the Uniform Mediation Act. Adopts rules for most mediations with exceptions for some court and school hearings, at reform schools, and for some collective bargaining situations.

S-5040 by Redfern - Language correction. ADOPTED

The Senate PASSED the bill, 46-0; it now goes to the House

SF 2177 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.

S-5057 by Ward - Adds language to include other airway constricting diseases. ADOPTED The Senate PASSED the bill, as amended, 49-0; it now goes to the House

SF 2190 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. The Senate PASSED the bill, 49-0; it now goes to the House

SF 2173 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.

S-5070 - by Schuerer - Allows FDA standards for the measuring instrument to be used if nationally accepted standards have not been adopted. Establishes standards for taking samples, including requiring that a person of the same sex monitors and that samples be taken in a sanitary manner and with regards to the person's privacy. Strikes certain provisions regarding emergency rules. ADOPTED The Senate PASSED the bill, as amended, 47-2; it now goes to the House

SF 2175 WORKERS COMP - 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.

S-5033 by McKibben - Makes a language correction and other changes regarding the recovery of benefits which should not have been paid to an employee. ADOPTED

S-5032 - WITHDRAWN

The Senate PASSED the bill, 49-0; it now goes to the House

SF 2183 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.

S-5083 by Quirmbach - Makes the provisions of this bill effective only for policies issued after July, 2004. FAILED

S-5006 by Schuerer - Requires the DHS and the Insurance Division to adopt rules on this program, rather than just giving them the authority to do so. ADOPTED

S-5081 by Schuerer - Makes changes in regards to the eligibility of older policies. ADOPTED

The Senate PASSED the bill, as amended, 33-15; it now goes to the House

Bills Assigned to House Committees
House Judiciary Committee: Assigned to Subcommittee
SF 2191 UNIFORM ARBITRATION ACT - Maddox (C), Jochum, Paulsen
SF 2235 UNIFORM MEDIATION ACT - Maddox (C), Jochum, Reasoner

House Transportation Committee: Assigned to Subcommittee
SF 2066 CHILD RESTRAINT SYSTEMS - Chambers (C), Bukta, S. Olson

Bills Assigned to Senate Committees
Senate Appropriations Committee:
SSB 3053 FEDERAL BLOCK GRANTS - Appropriates the federal block grant money. FM: Seymour

Senate State Government Committee: Assigned to Subcommittee:
SF 2225 NEGOTIATED RULEMAKING - Johnson (C), Ragan, Ward
HF 2201 MASSAGE THERAPY EXEMPTION - Ward (C), Connolly, Shull

Senate Ways & Means:
SF 2232 SPINAL CORD RESEARCH PROGRAM- Miller (C), Connolly, Rehberg
SF 2283 Pharmacy Benefit Managers-Referred to Committee

NEW BILLS INTRODUCED

HCR 119 - Legislative Council make recommendations on Drug Repository Program

House

HF 2487 INSURANCE TASK FORCE RECOMMENDATIONS (Commerce; Successor to HSB 643) Adopts the recommendations of the Individual Health Insurance task force as related to individual health insurance market reforms. Makes changes regarding the eligibility of programs, forms, reinsurance and other matters. FM: Hoffman

HF 2490 UNIFORM ELECTRONIC TRANSACTION (Commerce; Successor to HSB 687) Strikes definitions "consumer," "consumer transaction," and "digital signature" from the Uniform Electronic Transaction Act. Changes definition of "transaction" to exclude consumer actions related to consumer affairs. Strikes the requirement that the Regents institutions conform with electronic signature standards. Has a severability clause. Contains other provisions. FM: Jacobs

HF 2492 PUBLIC HEALTH PROGRAMS (Human Resources; Successor to HSB 626) Creates a Gifts and Grants Fund to accept gifts and grants from any source to be used exclusive use as provided by the gift or grant. Prohibits such money from being diverted to the General Fund. Changes the funding match for the Childhood Lead Poisoning Prevention Grant Program to a dollar for dollar match. Directs the DPH creates programs and adopt rules related to construction standards for radon abatement systems. Prohibits an employer from taking adverse action against an employee subject to a quarantine order by the DPH or local board of health. Amends Nurse Practice Act. Makes various changes or deletions related to physician assistants, hearing aid dispensers, provisional nursing home administrators. Allows the Board of Mortuary Science Examiners to impose civil penalties up to $1,000 for unlicensed practice. FM: Upmeyer

HF 2496 PHYSICAL THERAPY ADVERTISING (State Government; Successor to HSB 130) Prohibits the use of titles that indicate that services from a person or business is from licensed physical therapist unless the services are performed by or under the supervision of a therapist. Makes violations a simple misdemeanor. Makes language corrections. FM: Dennis

HF 2497 PUBLIC EMPLOYYEE INCENTIVES (State Government; Successor to HSB 694) Establishes a sick leave and vacation incentive program for eligible executive branch employees including DOJ employees not covered by collective bargaining. Allows a incentive benefit equal to the employee's unused vacation plus the lesser of an amount equal to 75% of the employee's regular annual salary or an amount equal to 75% of the value of the employee's sick leave. Sets other requirements. Effective upon enactment. FM: Elgin

HF 2506 ELECTRONIC AND FAX PRESCRIPTIONS (Human Resources; Successor to HF 2324) Allows an electronic or fax prescription for schedule II, III, IV, or V controlled substances to serve as the original copy of the prescription, if permitted by federal law. Allows electronic or fax prescriptions under the drugs, devices, and cosmetics the Code. Sets requirements for such prescriptions and makes penalties. FM: Heaton

HF 2507 PRESCRIPTION DRUG ASSISTANCE (Human Resources; Successor to HF 2216) Directs the Insurance Commissioner to create and maintain Prescription Drug Assistance Program to assist persons in accessing free or discounted drug assistance programs by pharmaceutical manufacturers. Sets requirements for the commissioner and makes a conditional appropriation of $190,000 from the Senior Living Trust Fund. Contains related provisions. FM: Heaton (Appropriations)

HF 2514 DEMENTIA PROJECT (Human Resources; Successor to HF 2421) Directs the DIA in cooperation with the department of elder affairs to implement a pilot project for dementia-specific alternative living. Directs DIA to adopt rules for the project similar to group home living but which complies with life safety codes. FM: Upmeyer

HF 2521 HEALTH INSURANCE STUDY (Commerce; Successor to HSB 701) Requires the Insurance Commissioner to study health insurance premiums and ways of reducing premiums. Requires report by April 1, 2005. Effective upon enactment. FM: Jenkins

HF 2523 AIR QUALITY (Environmental Protection; Successor to HSB 695) Requires the establishment of a health effect advisory panel composed of various public and private interests including regulators, scientific community, animal agriculture, rural residents, and industry. Prohibits the DNR from adopting standards for a health effect level before the panel submits its final report to the general assembly. Establishes a health effect level based on duration and level of expose. Requires the Department conduct a comprehensive field study to monitor the level of airborne pollutants emitted from animal feeding operations for a period of at least three years. Set minimum separation distances for monitoring hydrogen sulfide ammonia, and odor if scientifically possible. Establishes technical standards for equipment to measure airborne pollutants. Has related provisions. FM: Greiner HF 2536 ICN SALE II (Commerce; Successor to HSB 645) Establishes provisions for the sale of the ICN, including selling many of the physical assets and retaining the rights to long-term use of the system. Contains reserved state rights. Specifies the conditions for the sale of the network through an investment bank, and contains other related provisions. Effective upon enactment. FM: Watts

HF 2537 MI/DD/BI SERVICES (Human Resources; Successor to HSB 649) Changes the name of Mental Health and Developmental Disabilities Commission to the to the Mental Health, Developmental Disabilities, and Brain Injury Commission. Changes term "single entry point process" to "central point of coordination." Duties: Changes and adds duties of the Commission. Requires the Commission to identify basic financial eligibility standards for disability services including income levels. Bill of Rights: Creates a bill of rights for persons receiving MI/DD/BI services including quality service standards. Other: Give approval authority to the Commission over county management plan reviews and strategic plans. Makes changes to county and state funding procedures for MI/DD/BI starting July 1, 2006. Repeals property tax relief and repeals the state payment of allowed growth funding. Makes appropriation to the DPH from the risk pool within the property tax relief fund. Effective upon enactment. Exempts the forgoing provisions from state mandate funding requirements. FM: Heaton

Senate Files

SF 2283 PHARMACY BENEFIT MANAGERS (State Government; Successor to SSB SSB 3039) Regulates Pharmacy Benefit Managers. Defines a pharmacy benefit manager as the entity that administers the prescription drug portion of a benefits plan. Requires such managers to get certification from the Pharmacy Examiners every four years. Requires the manager to be licensed by the Insurance Commissioner and to make annual reports. Requires the state agencies to assess the costs of regulating managers against all of the managers in the state. Requires that contracts with pharmacies or pharmacists and the manager to be filed with the Pharmacy Examiners. Contains other related provisions. FM: Zieman

SF 2288 FEDERAL BLOCK GRANTS (Appropriations; Successor to SSB 3053) Appropriates the federal block grant money. FM: Seymour

Senate Study Bills

SSB 3164 HEALTH COVERAGE CREDITS (Ways & Means) Couples the Iowa code with the federal code for purposes of deductions to health savings accounts. Creates a long-term care insurance tax credit equal to 50% of the premiums, up to $500. Applies this credit to tax years starting in January, 2007. Wieck (C), Miller, Seng

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