Category: Human Resources Committee

  • Human Resources Committee – All-Bill Summary 2021

    SF 296 – Pharmacists providing vaccines; Collaborative Pharmacy Practice

    SF 296 allows pharmacists to administer an immunization or vaccination for COVID-19 to patients 18 and older. It also states that pharmacists may, in consultation with the Department of Public Health, order and administer the following to patients 6 and older:

    • Point-of-care testing and treatment for the flu, strep A and COVID-19
    • Point-of-care testing in response to a public health emergency

    Pharmacy collaborative practice agreements (CPAs) are also permitted under this bill. CPAs create formal practice relationships between pharmacists and prescribers. They allow the prescriber (e.g., a physician or nurse practitioner) to delegate certain patient-care functions to the pharmacist with the intent of increasing access to care.

    These agreements have been done in Iowa since the early 2000s, and this section of the bill would allow the Board of Pharmacy to change any administrative rules if needed. The bill also allows a health carrier to reimburse for the services provided under these agreements.
    [4/28: 48-0 (Excused: Nunn, Schultz)]

    SF 307 – State Medical Examiner child death autopsies and transportation costs

    SF 307 requires counties to pay transportation costs both to and from the State Medical Examiner’s Office. Under the bill, an autopsy is not be required for a child death when the county medical examiner’s or State Medical Examiner’s investigation determines that the deceased child’s cause and manner of death are obvious, and there are no significant legal, medical or investigative concerns. The bill also makes some technical terminology changes.
    [2/23:  48-0 (Excused: Nunn, Shipley)]

    SF 524 – Inpatient psychiatric bed tracking study

    SF 524 directs the Department of Human Services to convene a study committee during the 2021 interim to examine issues and develop policy recommendations relating to improvements in the inpatient psychiatric bed-tracking system, including expanding it to include the acuity of disabilities, behavioral disabilities, and sexually or physically aggressive behaviors; increasing reimbursement rates based on level of care; and implementing enhancements to the bed-tracking system. The bill prescribes the members of the interim committee and requires the Iowa Department of Human Services (DHS) to submit a report by December 15, 2021.
    [3/10: 48-0 (Excused: Hogg, Nunn)]

    HF 260 – Number of children in child care

    HF 260 adjusts the number of children child care providers can have. The bill makes these adjustments:

    • Child Care Homes. These homes are not registered with the state and are found in single-family residences. They currently can have five or fewer children at any time. If there are more than five children, the provider must register with the state. The bill continues to allow providers with five or fewer children to NOT register, and adds a provision that allows NO registration if the provider has six or fewer children and at least one of the children is school-aged.
    • Child Development Homes. These homes are single-family residences as well, but they are registered with the state. They currently can have six or more children at any time. The bill changes that to allow for seven or more children at any time.
      [3/29: 30-15 (Yes: Republicans, Bisignano, Kinney; Excused: Driscoll, Hogg, Kraayenbrink, Nunn, Sweeney)]

    HF 302 – Child Care Assistance graduated eligibility phase out

    HF 302 provides a graduated phase-out program for Child Care Assistance. This state-only funded program goes into effect after the Child Care Assistance Plus (CCA Plus) program benefits end, which is at 225% FPL. This new program will allow a family to remain eligible for child care assistance up to 250% FPL, or 275% for a family with a child or children needing special assistance. It sets up a sliding scale to determine the amount of child care the family will pay themselves, ranging from 33% to 60%. The program must be implemented by July 1, 2022.
    [5/17:  45-0 (Goodwin, Johnson, Nunn, Schultz, Williams excused)]

    HF 390 – Fluoridation disconnection notice

    HF 390 requires an owner or operator of a public water supply system to give at least 90 days’ notice prior to taking any action to permanently discontinue fluoridation in its water supply. The notice must be placed on each customer’s water bill or provided in a way that is reasonably noticeable. 
    [4/6: 47-0 (Excused: Hogg, Nunn, Schultz)]

    HF 835 – Iowa Achieving Better Life Experience (ABLE) Accounts

    HF 835 makes these improvements to the Iowa ABLE (Iowa Achieving a Better Life Experience) Savings Plan Trust Accounts:

    • Additional flexibility for those who have either a medical assistance special needs trust under 633C or a supplemental needs trust under 634A to transfer those funds to the Iowa ABLE Savings Plan Trust Account of the designated beneficiary.
    • Greater flexibility and reduced burden on eligible individuals by expanding the list of those eligible to enter into a participation agreement and provide signature authority under Iowa Code 12I. These changes are in accordance with the IRS final regulations for ABLE programs.
    • Even greater assurances to individuals and families with disabilities by prohibiting recovery of any account balance following the death of an individual who is a designated beneficiary of an ABLE savings account; the language would also allow flexibility for the designated beneficiary’s account to be transferred to an account for another eligible individual specified by the designated beneficiary or allow for the balance to be transferred to the estate of the designated beneficiary.

    These changes will encourage more people to use pooled trusts without fear that their money will end up in state hands upon their passing, and thereby supporting the health, independence and quality of life of more individuals and families living with disabilities.
    [4/21: 46-0 (Excused: Mathis, Nunn, Schultz, Whiting)]

  • Human Resources – All-Bill Summary 2020

    SF 2119– Controlled Substance Schedules

    SF 2119 allows the Pharmacy Board to change the schedule status of cannabis-derived products and cannabis-derived investigational products based on decisions by the Food and Drug Administration and the Federal Drug Enforcement Administration. The bill classifies nine synthetic opioids, one opioid analgesic, 10 synthetic cannabinoids and seven synthetic cathinones as Schedule I substances, meaning they have no known medical use. It classifies all products containing derivatives of barbituric acid as Schedule II. It classifies one central nervous system depressant and one central nervous system stimulant as Schedule IV, and any FDA-approved product containing cannabidiol with no more than 0.1 percent THC as Schedule V. The bill also strikes language regarding medical marijuana programs at the Board of Pharmacy.
    [2/10: 48-0 (Excused: Nunn, T. Taylor)]

    SF 2120– Prescription Monitoring Program

    SF 2120 allows veterinarians to register for and access information from the state’s Prescription Monitoring Program. Some veterinarians can prescribe controlled substances, and there have been instances of pet owners taking the animal’s medication. The bill also expands PMP reporting requirements to all Schedule III and IV controlled substances and to all Schedule V controlled substances except pseudoephedrine. Additional substances that the PMP Advisory Council and Board of Pharmacy determine could be addictive or fatal are also included in the required PMP reporting. The due date for the PMP annual reports is changed to February 1 instead of January 1.
    [2/10: 48-0 (Excused: Nunn, T. Taylor)]

    SF 2299– Health care background checks

    SF 2299 provides that in addition to background record checks being performed by the Department of Public Safety and the Department of Human Services, an entity may have a third-party vendor conduct a preliminary background check pending completion of the required record checks.
    [2/24: 50-0]

    HF 2197 – Medical Residency Grants

    HF 2197 expands specified primary care practice areas to also include obstetrics, gynecology, family medicine, internal medicine and emergency medicine, in addition to psychiatry. The medical residency training state matching grants program requires that a residency program, including federal residency positions at the University of Iowa Hospitals and Clinics, offer residents the opportunity to participate in a rural rotation to expose them to rural areas of the state.
    [6/13: 49-0 (Hogg excused)]

    HF 2220– Definition of “young adult” for PALS program

    HF 2220 relates to the definition of “young adult” for purposes of participation in the preparation for adult living program (PALS). Those turning 18 that receive court-ordered care with a relative or another person with a significant relationship will be eligible for PALS. PALS assists young adults who are leaving foster care and other court-ordered services at 18 or older in making the transition to self-sufficiency.
    [6/10: 49-0 (Excused: Bisignano)]

    HF 2221 Local Board of Health membership

    HF 2221 allows health care professionals other than physicians to be members of local boards of health.
    [6/12: 49-0 (Excused: Hogg)]

    HF 2269 – Medicaid Elder Waiver Cap removed

    HF 2269 requires the Department of Human Services to eliminate the monthly budget maximum or cap for individuals eligible for the Medicaid home and community-based services elderly waiver. The department must track the average amount expended per waiver recipient each fiscal year beginning July 1, 2020, and report the information annually to the Governor and the Legislature by October 1.
    [6/4: 49-0 (Excused: Hogg)]

    HF 2485 – Number of children allowed in child care at one time

    HF 2485 directs the Department of Human Services to adopt rules allowing registered child development homes providing care to school-aged children to exceed the child-to-staff ratio when a school-aged child’s school starts late, is dismissed early, is canceled due to inclement weather or structural damage, or during a public health emergency. The child must already be enrolled at the child development home, and the number of children present cannot exceed the child development home’s registration capacity.
    [6/13: 47-0 (Excused: Green, Hogg, Lykam)]

    HF 2561 – Protections for recipients of anatomical gifts

    HF 2561 prohibits a hospital, physician or other person from determining the ultimate recipient of an anatomical gift based upon a potential recipient’s disability, except to the extent that the disability has been found by a physician, following a case-by-case evaluation of potential recipients, to be medically significant to the provision of the anatomical gift.
    [6/12: 48-0 (Excused: Feenstra, Hogg)]

  • Human Resources Committee – All-Bill Summary 2019

    SF 210 – Iowa CARE Act

    SF 531 – Data registry on pediatric congenital heart surgery

    SF 563 – Pharmacy Benefit Manager’s annual report

    HF 291 – Spouse’s protected income for Medicaid eligibility

    HF 304 – Personal degradation

    HF 422 – Telehealth for CCUSO residents

    HF 423 – Medicaid for inmates

    HF 518 – Dually eligible Medicare and Medicaid members in nursing facilities

    HF 532 – Medical residencies

    HF 570 – HCBS Brain Injury cap

    HF 606 – Online continuing education for social workers, therapists and counselors

    HF 623 – Eliminating prior authorization for certain substance abuse treatment

    HF 625 – Integrating Medicaid and Hawki

    HF 642 – Sharing of information in human trafficking cases

    HF 644 – DHS to implement new federal Family First Act

    HF 690 – Children’s Mental Health

    HF 691 – MHDS regions fund balances

    HF 731 – Mandatory reporter training requirements

     

    SF 210 – Iowa CARE Act

    SF 210 allows Iowans to designate a lay caregiver who will be given instructions to care for the patient upon discharge from a hospital. The CARE Act has four main features: (1) Designate – The name of the family caregiver is recorded when a loved one is admitted into a hospital, if a patient chooses to designate one; (2) Notify – The designated family caregiver is notified when the patient is to be discharged back home; (3) Consult – The hospital discusses the caregiver’s abilities and limitations; (4) Instruct – The hospital reviews the patient’s care needs at home, and provides an explanation and live instruction of the medical tasks to be performed.
    [3/26: 49-0 (Excused: Breitbach)]

     

    SF 531 – Data registry on pediatric congenital heart surgery

    SF 531 requires a licensed hospital that provides pediatric congenital heart surgery to participate in a qualified clinical data registry and provide information on how to access the national information during educational consultations with parents.
    [3/21: 46-0 (Excused: Bisignano, Celsi, R. Taylor)]

     

    SF 563 – Pharmacy Benefit Manager’s annual report

    SF 563 requires a Pharmacy Benefit Manager to submit an annual report to the Insurance Commissioner regarding fees, drug prices and rebates received by the Pharmacy Benefit Manager in the aggregate. The reporting requirement is applicable to plans issued in 2019.
    [4/27: 49-0 (Excused: Guth)]

     

    HF 291 – Spouse’s protected income for Medicaid eligibility

    HF 291 raises the protected income that a spouse may retain when their partner is institutionalized from $24,000 to $25,284 to match federal law. Specific amounts are not spelled out in the bill, just the requirement to match federal regulations so new bills don’t have to be passed every time federal law changes.
    [4/23: 49-0 (Excused: Petersen)]

     

    HF 304 – Personal degradation

    HF 304 is a technical change that allows dependent adult abuse “personal degradation” to be classified as “confirmed, not registered” to better match the severity of the crime. It expands current law that allows “confirmed, not registered” if the action is minor, isolated and unlikely to reoccur. Other allegations of dependent adult abuse that currently have the “confirmed, not registered” option are physical injury, unreasonable confinement, unreasonable punishment, assault and neglect of a dependent adult by a caretaker.
    [4/18: 49-0 (Excused: Mathis)]

     

    HF 422 – Telehealth for CCUSO residents

    HF 422 allows the University of Iowa to provide health services for patients at the Civil Commitment Unit for Sexual Offenders (CCUSO) via telehealth when it is deemed medically necessary. This may save CCUSO some travel expenses if they don’t have to drive residents to Iowa City for treatment.
    [4/25: 49-0 (Excused: Chapman)]

     

    HF 423 – Medicaid for inmates

    HF 423 provides that Medicaid coverage of an inmate of a public institution will be suspended, but not terminated, after the first 30 days of commitment, and that the suspension will continue during the entire period of the inmate’s commitment to the public institution. Previously, the law allowed the suspension to continue for up to the initial 12 months of an inmate’s period of commitment, at which time the inmate’s Medicaid coverage would be terminated.
    [4/17: 50-0]

     

    HF 518 – Dually eligible Medicare and Medicaid members in nursing facilities

    HF 518 requires the Iowa Department of Human Services to seek approval from Centers for Medicare & Medicaid Services (CMS) to allow the payment of nursing facility room and board expenses to be made directly to the nursing facility for a dually eligible Medicare and Medicaid member receiving the Medicare hospice benefit or a Medicaid-only member receiving hospice. Currently, the payments are made to hospice and passed along to the nursing facility. This bill is based on one of the options put forward by a 2018 interim work group.
    [4/9: 48-0 (Excused: Bisignano, Feenstra)]

     

    HF 532 – Medical residencies

    HF 532 requires the Medical Residency Training state matching grants program and the awarding of primary care (including psychiatry) residencies by the University of Iowa Hospitals and Clinics (UIHC) to give priority to eligible applicants who are residents of Iowa, attended and earned an undergraduate degree from an Iowa college or university, or attended and earned a medical degree from a medical school in Iowa. The bill also directs the UIHC to allow Des Moines University fourth-year students to take elective classes at the Carver College of Medicine if space is available. The University of Iowa’s College of Medicine must conduct a study of the state’s workforce challenges in recruiting and retaining primary and specialty care physicians.
    [4/16: 49-0 (Excused: Shipley)]

     

     

     

    HF 570 – HCBS Brain Injury cap

    HF 570 removes the monthly Medicaid cap for those on the brain injury home and community-based services (HCBS) waiver; and requires the Iowa Department of Human Services to track the average amount expended per waiver recipient each fiscal year and report the information annually to the Governor and Legislature by October 1.
    [4/16: 49-0 (Excused: Shipley)]

     

    HF 606 – Online continuing education for social workers, therapists and counselors

    HF 606 prohibits the Board of Social Work from limiting the number of continuing education credits that social workers may obtain online and the Board of Behavioral Science from limiting the number of continuing education credits that marital and family therapists and mental health counselors may obtain online. It requires programs providing the continuing education credits online to comply with standards set by the appropriate board.
    [4/16: 49-0 (Excused: Shipley)]

     

    HF 623 – Eliminating prior authorization for certain substance abuse treatment

    HF 623 removes prior authorization requirements in Medicaid fee-for-service and managed care for Medication Assisted Treatment (MAT) for substance use disorders when these medications are used: Methadone, Buprenorphine, Naloxone, Buprenorphine and Naloxone combination and Naltrexone.
    [4/11: 49-0 (Excused: Brown)]

     

    HF 625 – Integrating Medicaid and Hawki

    HF 625 integrates Medicaid and Healthy and Well Kids in Iowa (Hawki) program eligibility, payment and administrative functions by eliminating the use of an administrative contractor under the Hawki program and transferring the duties of the administrative contractor to the Iowa Department of Human Services.
    [4/22: 49-0 (Excused: Segebart)]

     

    HF 642 – Sharing of information in human trafficking cases

    HF 642 allows sharing of certain confidential information by the Iowa Department of Human Services to interdisciplinary teams. Currently, they can only share the information if the team is working on a child abuse investigation. This bill will allow information sharing in human trafficking cases when the interdisciplinary team’s sole focus is children in human trafficking cases.
    [4/25: 49-0 (Excused: Chapman)]

     

    HF 644 – DHS to implement new federal Family First Act

    HF 644 allows the Department of Human Services (DHS) to implement the new federal Families First Prevention and Services Act (Family First Act). Under the bill, DHS must be more persistent in establishing and keeping foster care kids in their medical home and amends case plan requirements accordingly. It requires DHS to send “Proof of Foster Care” letters to youth to establish eligibility for Medicaid or educational assistance, etc. Promoting frequent visits between parents and children is required unless doing so would cause eminent risk to the child’s life or health. The Family First Act promotes practices to keep a child from entering foster care by using support systems within the family of origin. Standards regarding national background checks are elevated to anyone “working in a facility where children reside.”
    [4/23: 49-0 (Excused: Petersen)]

     

    HF 690 – Children’s Mental Health

    HF 690 codifies that the Children’s State Board will provide oversight to the Children’s Mental Health System. It sets up the regional governance structure for the children’s system by adding members and advisory councils to the current Mental Health and Disability Services (MHDS) Regional governing boards. The MHDS regional boards must hire a children’s coordinator. Eligibility for services is defined, as well as core services. No new funding mechanism is established.
    [4/16: 46-2 (No: Guth, Hogg; Excused: Dawson, Shipley)]

     

    HF 691 – MHDS regions fund balances

    HF 691 modifies the amount of excess funds counties can retain for cash flow for the adult Mental Health and Disability Services (MH/DS) system. Beginning in FY24, counties are limited to a fund balance reserved for cash flow of 40 percent of gross expenditures. Counties must reduce their levies by any dollar amount in excess of 40 percent beginning in FY24. If the bill takes effect on or after March 15, 2019, a county may recertify its budget as necessary to implement the provisions of the bill. In addition, MH/DS regions may amend a regional service system management plan or annual service and budget plan for FY19 and FY20. The bill strikes the current requirements of 20 or 25 percent cap on fund balances.
    [4/17: 50-0]

     

    HF 731 – Mandatory reporter training requirements

    HF 731 is based on an interim workgroup’s recommendations regarding mandatory reporter training requirements. The training is for child abuse and dependent adult abuse. The frequency of the required refresher training is changed from every five years to every three years. The training is two hours unless retraining occurs before the third year and then it is one hour. The training is to be developed and provided by the Iowa Department of Human Services (previously many curriculums were developed by numerous groups and approved by the Iowa Department of Public Health). An employer may provide supplemental training specific to the person’s professional practice.
    [4/17: 49-0 (Excused: Guth)]

  • Human Resources Committee – All-Bill Summary 2018

    All bills passed by the Legislature and sent to the Governor for her signature during the 2018 session. 

    SF 359 – Fetal tissue and six-week abortion ban
    SF 360 – Newborn Safe Haven Act
    SF 2203 – Limited nurses authorization
    SF 2228 – Licensure of genetic counselors
    SF 2298 – Pharmacy regulation and wholesaling
    HF 2285 – Ground Emergency Medical Transportation (GEMT)
    HF 2309 – Dual enrolled Medicare/Medicaid hospice benefit
    HF 2356 – Direct primary care agreements
    HF 2377 – Opioids
    HF 2414 – Child support and public coverage
    HF 2427 – Free Clinics access to SING
    HF 2444 – Child care mandatory reporting
    HF 2445 – Mental health billing process for county of residence
    HF 2449 – Department of Aging substitute decision maker
    HF 2451 – Department of Aging policy bill
    HF 2456 – Complex mental health needs 

     

    SF 359 indicates all cells and tissues external to the fetal body (cord blood) are exceptions to “fetal body parts”; bans abortions after the first six weeks of pregnancy; updates “medical emergency” to preserving the life of a mother whose life is endangered by a physical disorder, illness or injury (this does not include the psychological or emotional condition of the mother, family circumstances, woman’s age or serious risk to the future health of the mother); adds a definition of “medically necessary” that includes a pregnancy resulting from rape (IF reported to law enforcement or a family physician within 45 days of the incident), a pregnancy resulting from incest (IF reported to law enforcement or a family physician within 140 days of the incident), a miscarriage or a fetal abnormality (IF the physician determines that the fetus would not live).

    Abortion is prohibited if there is a detectable heartbeat except in cases of a medical emergency or medical necessity. This law will not apply if the fetus is 20 weeks or more post fertilization. In those cases, the 20-week abortion law passed in 2017 will apply.

     

    SF 360 expands the Newborn Safe Haven Act to allow a parent to relinquish physical custody of a newborn up to 30 days old without fear of prosecution for abandonment, and adds a procedure for a confidential call to 911 to dispatch a first responder to pick up the infant and deliver the infant to a medical facility.

     

    SF 2203 allows the Board of Nursing to issue a limited nursing authorization to complete a clinical nurse refresher course. This is for nurses who have not held a valid license within the last five years. Limited authorization allows the nurse to be in a clinical environment for training required for licensing. Currently, 18 other states allow this. This provision is not expected to be widely used because most nurses don’t let their licenses expire.

     

    SF 2228 establishes licensing for genetic counselors under the Board of Medicine, including scope of practice, requirements for licensure, continuing education and discipline. Genetic counselors are health care professionals who help people with genetic conditions or health concerns. They work in a variety of settings, including hospital clinics, diagnostic and research laboratories, advocacy organizations, government and industry. There is no fiscal impact.

     

    SF 2298 adds a certified pharmacy technician to the Board of Pharmacy; updates wholesale transactions to be in compliance with the federal Drug Supply Chain Security Act; creates a new category of “third-party logistics” provider; and amends the section on “limited drug and device distributor” for those that don’t meet the definition of wholesaler (e.g., medical gas distributors, medical device distributors, veterinary drug distributors, manufacturer/repackager, dialysis solution distribution). This separation of licensure categories ensures compliance with federal law and protects entities from being subject to federal minimum standards for wholesalers when they do not meet the definition of a wholesaler.

     

    HF 2285 allows Medicaid providers to track actual costs of Ground Emergency Medical Transportation and use the unreimbursed portion as the state match to draw down federal funds without additional state appropriations. The extra funds would provide supplemental payments to service providers.

     

    HF 2309 deals with reimbursements for dually eligible hospice patients. Payment will go directly to the nursing facility without passing through the hospice agency.

     

    HF 2356 addresses Direct Primary Care Agreements. Also known as concierge medicine, individuals can contract with health care providers to get a certain set of primary care services for a monthly fee.

     

    HF 2377 addresses Iowa’s opioid crisis. Under the bill, prescribing practitioners must register for the Prescription Monitoring Program (PMP); information in the PMP must be submitted within one business day; a surcharge can be added to registration fees to administer the PMP; electronic prescribing will be required for all opioids by January 1, 2020; an annual report will be sent to prescribers detailing their history of prescribing controlled substances; the Pharmacy Board may establish penalties for those who prescribe too much of a controlled substance; more substances are added to Schedule I and II; and Good Samaritan language allows a person to seek help for themselves or another individual using drugs.

     

    HF 2414 requires the Child Support Recovery Unit to consider public health coverage, such as hawk-i or Medicaid, when determining a medical support obligation. Currently, it only considers private health coverage. The bill also aligns Child Support Recovery code sections with federal law updates from January 2017; defines cash medical support, health care coverage and public coverage. This should cause less disruption for children and families.

     

    HF 2427 allows the Free Clinics of Iowa to electronically access the SING (background check) system. Currently, they can access the data but part of the background check process is on paper, which may stretch it out one to two months, sometimes causing volunteer health care providers to lose volunteers.

     

    HF 2444 deals with mandatory reporting for child care workers. It expands mandatory reporting requirements to those that work in a children’s residential facility and expands the list of offenses that ban people from working in child care to those on the sex offender registry and those with an arson conviction; aligns Iowa Code to federal law; and adds to mandatory child abuse providers an employee, operator, owner or other person at a children’s residential facility (chapter 237C). A person who refuses a background check cannot be involved with child care.

     

    HF 2445 allows services provided at a state hospital to be billed directly to the Mental Health and Disability Services region instead of the county auditor. This will make the billing process more efficient. The bill eliminates the outdated term “homemaker-home health aide.” It also makes updates to “county of residence.” County of residence is the county where a person lives when they apply for or receive services. The person should have established an ongoing presence with the declared, good-faith intention of living in the county permanently or indefinitely. The county of residence of a person who is homeless is the county where they usually sleep.

     

    HF 2449, a Department of Aging code clean-up bill, changes the name of the Office of Substitute Decision Maker to the Office of Public Guardian, and clarifies that local offices may use their own attorney if they wish.

     

    HF 2451 clarifies programs within the Department of Aging, adds flexibility to distribution of state funds to Area Agencies on Aging by changing “formula” to “method,” and adds language conforming to federal laws.

     

    HF 2456 addresses mental health reform based on the Complex Needs Workgroup recommendations. The bill allows disclosure of mental illness from mental health professionals to law enforcement; updates the commitment laws and process; allows for commitment hearings via video conferencing; allows contracting with a transportation agency for secure transportation of patients; changes Core Plus services to Core Services that are required; requires regions to provide start-up costs; directs regions to develop 22 Assertive Community Treatment teams, six Access Centers, Intensive Residential Service Homes and a 24-hour crisis hotline; requires a review of the commitment processes; requires a report on the role of tertiary care psychiatric hospitals; and requires a fiscal viability committee in 2018.

  • 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)]