Human Resources Committee –All-Bill Summary 2017

The following bills were passed by the Legislature and signed into law by the Governor.

SF 51—Cytomegalovirus (CMV) awareness and screening
SF 250—Breast density notifications
SF 419—Nurse Licensure Compact
SF 471—Prohibits abortions after 20 weeks with limited exceptions
SF 479—Dental hygienists perform educational activities without supervision of dentist
SF 484—Board of Pharmacy Omnibus bill
HF 232—Death pronouncements by nurses and physician assistants
HF 233—Step therapy protocol process and exceptions
HF 234—Mental Health Advocate reporting
HF 305—Allows dispensing of biological and biosimilar products
HF 306—Certified nursing assistant on-line training
HF 393—Iowa Department of Public Health Omnibus bill
HF 396—Defines relative foster care
HF 524–Medical Cannabidiol
HF 531—Requires DHS to report on asset verification system
HF 534—Exceptions from child care facility licensing requirements
HF 543—Changes to drug endangered child definition
HF 544—Expands definition of dependent adult abuse to include personal degradation
HF 545—Aligns state law to federal law regarding child fatalities and near-fatalities
HF 547—Background checks for employees or vendors if they have access to confidential information
HF 548—Promotes stroke care quality improvement
HF 576—Background checks for health care temporary staffing
HF 577—Alternative treatments for Lyme disease
HF 591—Physician Assistant Board reporting to Board of Medicine
HF 593—Mental Health professionals decision making re: hospitalization, committals

 

SF 51 creates a new initiative within the Center for Congenital & Inherited Disorders to raise awareness of Cytomegalovirus (CMV) and congenital Cytomegalovirus (cCMV) among women who may become pregnant, expectant parents, parents of infants, attending health care providers and others. The Center will publish information to be distributed to health care providers, who would provide it to pregnant women and child care providers. If a child fails the newborn hearing screening, the child will be tested for CMV or cCMV within 21 days, and the parents will be provided information regarding the birth defects caused by CMV.
[3/22: 49-0 (Shipley excused)]

 

SF 250 requires the Department of Public Health to adopt rules requiring that facilities performing mammograms include information on breast tissue density in reports sent to all mammogram patients. For patients with dense breasts, or an equivalent determination by a nationally recognized density graduation system, the report must include information on dense breast tissue, risks associated with dense breast tissue, and the effects of dense breast tissue on screening mammograms.
[3/14: 49-0 (Horn excused)]

 

SF 419 is the Nurse Licensure Compact. It is an interstate compact that allows a nurse to have one multistate license and practice in other member states both physically and electronically. This increases access to care while maintaining public protection. These 10 states have adopted the compact so far: Arizona, Florida, Idaho, Missouri, New Hampshire, Oklahoma, South Dakota, Tennessee, Virginia and Wyoming.
[3/27: 49-0 (Bertrand excused)]

 

SF 471 adds new prerequisites to all abortions, including a 72-hour waiting period, mandatory ultrasound viewing and biased counseling. It bans all abortions after 20 weeks post-fertilization, except in narrow circumstances where the life of the mother is in danger. New reporting requirements are included for physicians and the Iowa Department of Public Health. The bill also includes civil penalties for doctors.
[4/18: 30-20 (party-line, D. Johnson “yes” with Republicans)]

 

SF 479 allows dental hygienists to perform certain educational functions without supervision by a dentist, including teaching the importance of dental care at schools and nursing homes.
[3/13: 49-0 (Bertrand excused)]

 

SF 484 is a Board of Pharmacy policy bill that allows creation of a pool of alternate board members; amends the definition of practitioner; makes changes to the program to aid impaired pharmacists, interns or techs; amends the pharmaceutical collection and disposal program; and repeals all provisions regarding the registration and regulation of Internet pharmacy sites because the language is outdated and not needed.
[3/16: 48-0 (Bertrand, Zumbach excused)]

 

HF 232 allows nurses and physician assistants to sign off on pronouncements of death in correctional facilities.
[4/10: 48-0 (Allen, Taylor excused)]

 

HF 233 relates to the use of step therapy protocols for prescription drugs by health insurance carriers, health benefit plans and utilization review organizations. The legislation defines “step therapy protocol” and provides that when such a protocol is in use, the participating individual or the prescribing health care professional must have a clear and readily accessible “step therapy override exception” process, which authorizes the expedited coverage of a prescription drug selected by the prescribing health care professional, based on the review of the exception request along with supporting rationale and documentation. Additionally, HF 233 updates the definition of “health carrier” to exclude the three major Managed Care Organizations (MCOs) that currently contract with the State of Iowa to provide Medicaid-related services.
[4/10: 47-0 (Allen, D. Johnson, Kapucian excused)]

 

HF 234 ends the requirement that county mental health advocates file quarterly reports. Advocates will file reports when necessary or when required by the Court.
[4/10: 48-0 (Allen, Taylor excused)]

 

HF 305 updates current law to enable biological substitution. Current state law does not provide a clear path for pharmacists to substitute biological drug products. There are two kinds of drugs: chemical and biologic. The biological products differ from traditional generics. Biosimilars are not identical; they are just similar. Biologic medicines are used to treat serious and chronic diseases, including cancer and multiple sclerosis. This bill allows the pharmacist to substitute an FDA-approved interchangeable biosimilar for a prescribed originator biologic without first seeking approval from the physician. It also requires the pharmacist to communicate to the physician that the biosimilar product was dispensed. This may provide increased access to lower-cost drugs.
[3/1: 50-0]

 

HF 306 directs the Department of Human Services to adopt rules that will allow the Department of Inspections & Appeals to certify curriculums for nurse aid training and testing programs that may be delivered online, including a definition of clock hours and how veterans can satisfy requirements through their military experience.
[4/4: 50-0]

 

HF 393 is the Iowa Department of Public Health (IDPH) policy bill. It makes a number of changes to programs and activities within the department, including:

  • Permits IDPH to use the Sunday Sales revenues transferred from the Alcoholic Beverage Division in the Department of Commerce, used for addictive disorder prevention efforts in communities, to also be spent for other best practices in substance use disorder prevention. Currently, unspent funds by communities revert to the General Fund, but this new language provides additional uses if the funding is available.
  • Makes the gambling treatment program operations report filed with the Legislature an annual, rather than semiannual, report.
  • Revises provisions relating to the Medical Home and Patient-Centered Health Advisory Council to conform to current activities and roles.
  • Updates Iowa Code language related to various workforce programs in IDPH.
  • Repeals defunct and unfunded programs and councils.
  • Makes a technical correction to facilitate the transition of the Iowa Health Information Network (IHIN) out of State government.
  • Repeals and removes references to Organized Delivery Systems.
  • Prohibits IDPH from collecting social security numbers of individuals through the inpatient/outpatient database operated by the Iowa Hospital Association.
  • Requires that the State Registrar replace certified copies of birth certificates issued between May 1993 and October 2009 that were smaller than letter size and waives the fee for certified copies for replacement.
    [4/11: 49-0 (Allen excused)]

 

HF 396 defines foster care. It does NOT include situations where parents have asked relatives to care for their children for a time.
[4/11: 49-0 (Allen excused)]

 

HF 524 creates the Medical Cannabidiol Act; expands the disease list for Iowans to have CBD oil or pills; defines cannabidiol as having no more than 3 percent THC; allows acceptance of RFPs for five dispensaries and two manufacturers; and creates a Medical Cannabidiol Advisory Board to recommend changes to the program. Changes to the level of THC must be made by the Legislature. Smoking is prohibited. It also allows Iowa to immediately reschedule epidiolex if it is rescheduled federally.

It covers these  conditions:

  1. Cancer, if the underlying condition or treatment produces one or more of these symptoms:
  1. Severe or chronic pain.
  2. Nausea or severe vomiting.

iii. Cachexia or severe wasting.

  1. Multiple sclerosis with severe and persistent muscle spasms
  2. Seizures, including those characteristic of epilepsy
  3. AIDS or HIV
  4. Crohn’s disease
  5. Amyotrophic lateral sclerosis (ALS)
  6. Parkinson’s disease
  7. Untreatable pain
  8. Any terminal illness with a probable life expectancy of under one year, if that illness or its treatment produces one or more of the following:
    1. Severe or chronic pain
    2. Nausea or severe vomiting
    3. Cachexia or severe wasting
      [4/21: 33-7 (Bolkcom, Boulton, Costello, Garrett, Hogg, McCoy, Petersen “no”; Allen, Bertrand, Bisignano, Dawson, Hart, D. Johnson, Kinney, Lykam, Mathis, Taylor excused)]

 

HF 531 requires the Department of Human Services to report by December 15 on progress toward contracting with a third-party vendor to establish an electronic asset verification system to determine eligibility for public assistance.
[3/23: 47-0 (Anderson, Bertrand, Shipley excused)]

 

HF 534 excludes child care programs administered by school districts from Department of Human Services licensing.
[4/10: 48-0 (Allen, Taylor excused)]

 

HF 543 represents the recommendations of the 2016 Drug Endangered Children Task Force. The Department of Human Services has already made the practice changes. The bill amends the definitions of “child in need of assistance” and “child abuse” to include additional adults in the home who use, possess, cultivate or distribute a dangerous substance. It adds cocaine, heroin and opioids to the list of dangerous substances.
[4/10: 48-0 (Allen, Taylor excused)]

 

HF 544 is a bill from the Department of Inspections & Appeals. The Department became aware of a gap in their definition of dependent adult abuse. This adds personal degradation to that definition. Personal degradation is an act that is humiliating to another person.
[3/21: 49-0 (Shipley excused)]

 

HF 545 relates to the Department of Human Services release of information policies and makes clarifications to fatalities and near fatalities. The bill aligns state and federal law.
[4/10: 48-0 (Allen, Taylor excused)]

 

HF 547 allows the Department of Human Services to conduct background investigations on these individuals accessing Federal Tax Information: an applicant for employment with the Department; or a contractor, vendor or employee performing work for the Department with access to FTI. This is required by the Internal Revenue Service.
[4/3: 49-0 (Bertrand excused)] HF 548 requires certified comprehensive stroke centers and nationally certified primary stroke centers in Iowa to report to the statewide stroke database consistent with nationally recognized guidelines on the treatment of individuals who have suffered a stroke. If a facility does not comply with this requirement, the Department of Public Health (IDPH) may request a review of the facility’s national certification. The IDPH must work with the University of Iowa College of Public Health to maintain and use the statewide stroke database, use the “Get With The Guidelines” stroke data platform, partner with voluntary health organizations to avoid duplicating efforts, and encourage nationally certified acute stroke-ready hospitals and emergency medical services agencies to report data consistent with formats to the statewide database.
[03/23: 47-0 (Anderson, Bertrand, Shipley excused)]

 

HF 576 requires that temporary staffing agencies conduct background checks on employees for nursing homes, assisted living centers, etc., instead of the nursing homes covering the costs of the checks.
[4/6: 49-0 (Bertrand absent)]

 

HF 577 exempts a doctor from disciplinary action by the Board of Medicine if the doctor recommendation or provision of treatment for Lyme disease or other tick-borne diseases involves a recommendation outside of the current standard of care; and criteria is met around informed consent, reasons for recommending treatment, and a review of current clinical conditions and criteria; and the treatment will not result in the direct and proximate death or serious bodily injury of the patient.
[3/21: 49-0 (Shipley excused)]

 

HF 591 makes the following changes to the Board of Medicine (BOM) and Board of Physician Assistants (PA Board):  Requires the PA Board to notify a supervising physician if the PA Board commences a contested case hearing against a PA; requires the PA Board to adopt rules for consulting and sharing information with the BOM regarding complaints that a PA may have been inadequately supervised; creates a list of rules that the PA Board cannot amend or rescind without first submitting the amendment to the BOM and receiving approval to proceed.
[4/4: 50-0]

 

HF 593 allows mental health professionals (in addition to physicians) to perform examinations, treat and prescribe treatment or medications, and submit reports to the court in accordance with certain hospitalizations and committals for patients with a substance-abuse disorder or serious mental illness. This bill is based on recommendations from a diverse group of stakeholders.
[3/29: 49-0 (Bisignano excused)]