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Legislation Now: Featuring Updates on State Legislation

Data bill amended, concerns remain

House File 2262, the hospital data collection bill introduced by Representative Joel Fry (R-Osceola) was heard in subcommittee and committee this week.

A subcommittee on the bill was held Wednesday and was attended by several hospital CEOs, including Robb Gardner (CEO of Henry County Health Center in Mount Pleasant), Kevin Kincaid (CEO of Knoxville Hospital & Clinics) and Fran Tramp (CEO of Burgess Health System in Onawa). During the subcommittee, IHA advocated for an amendment ensuring protection of hospitals from any fees to submit or access data, ensuring a voice for hospitals on a workgroup to consider the future of hospital data, and requesting consideration of those recommendations prior to release of a hospital data request for proposal (RFP).

Ultimately, the bill was amended to protect hospitals from fees, to include two hospitals designated as part of the workgroup and to allow the workgroup recommendations to be received prior to release of an RFP; however, the recommendations will not be impactful based on the timeline established in the legislation. Hospitals will be added to the workgroup in April or May, recommendations will be due in June and an RFP will be administered, regardless of recommendations, in July.

The bill, as amended, passed full committee yesterday and is now eligible for floor debate. IHA will continue to advocate for hospitals to have a meaningful voice in determining the future of their data.

Office of the Governor advances Invest in Iowa

The governor's office held meetings last week with individual stakeholders, including IHA, to discuss the details of the Invest in Iowa Act. The act aims to reduce overall income taxes in the state and proposes a solution for sustainable mental health funding. IHA supports the governor's proposal to fund mental health and her efforts to identify ways to increase workforce recruitment and retention.

IHA thanks the governor for outreaching to and educating stakeholders regarding the details of the act. IHA will continue to provide updates regarding the Invest in Iowa Act as it advances. 

Other bills that moved this week

Mental Health: The Health and Human Services Appropriations subcommittee heard presentations from the Department of Human Services (DHS) on the current state of mental health care in Iowa, including the core services being offered at 14 service areas statewide. DHS outlined the governors bill, House Study Bill 657, which proposes increasing state funding by an additional $80.6 million in 2021, $10 million in 2022 and $5 million in 2023. The bill would reduce the use of county tax dollars, but overall would be an increase in funding for mental health care. 

Workforce: The governor's Future Ready Iowa bill, House Study Bill 607, passed out of the full House Commerce Committee this week. This legislation includes the creation of key initiatives to support workforce and child care innovation in Iowa. IHA continues to support the Future Ready Iowa program and thanks Gov. Reynolds for her work in this area.

Emergency Medical Services: This week, a House subcommittee unanimously passed House Study Bill 631, a bill that would allow a county boards of supervisors to declare emergency medical services (EMS) an essential service. The bill would allow a county board of supervisors to declare EMS an essential service after passing two resolutions and receiving public comment. In order to impose taxes to pay for EMS, the board of supervisors would need to conduct a vote of the county’s residents. As a way to streamline the process to fund EMS, IHA worked with the Iowa Emergency Management Services Association and the Iowa State Association of Countries to propose an amendment to HSB631 that would grant a board of supervisors the authority to raise revenue by imposing taxes on county residents in order to pay for essential services without a vote of the residents. The amendment was unanimously adopted by the House subcommittee considering the bill, which will now move to a vote of the House State Government Committee next week. IHA appreciates Representative Bobby Kaufmann (R-Wilton), the author of the bill, and all members of the subcommittee for their work on this important issue.

Another bill drafted by Representative Kaufmann to bolster funding for EMS was advanced by a subcommittee this week. House File 2224 would divert tax revenue from the sports gambling to fund EMS.

In the Senate, IHA is monitoring Senate Study Bill 3139, filed by Senator Jake Chapman (R-Adel), which would allow medical care ambulance services and non-transport services to start emergency medical technician (EMT) training programs, so long as the companies obtain authorization from the Iowa Department of Public Health. Under current law, only hospitals and community colleges can run EMT training programs. SSB3139 was considered and advanced by a subcommittee on Thursday.

Tort Reform: Senator Brad Zaun (R-Urbandale) introduced Senate Study Bill 3150, which would place a “hard cap” of $250,000 on noneconomic damages in malpractice cases. Current law incorporates a “soft cap,” which means that although a $250,000 cap exists, a jury can award above and beyond the cap in exceptional circumstances. In addition to placing a “hard cap” on noneconomic damages, SSB3150 limits the evidence for damages admissible in malpractice trials. IHA is registered in support of this bill. The bill is not yet assigned to a subcommittee. 

Public Hospitals: Two House bills and one Senate bill offering alternative delivery contracts worked their way through the legislative process this week. House Study Bill 674 and Senate Study Bill 3153 were introduced by Master Builders of Iowa and allow construction manager at risk commercial construction alternative delivery methods while forbidding design build contracts for public entities. House Study Bill 586 was introduced by Design Build Institute of America allows for both options. All three passed out of committee.

A bill introduced by the Iowa Public Information Board (IPIB), House Study Bill 622, extends the filing deadline for a complaint with IPIB from 60 to 90 days. This bill was reviewed and advanced through a full committee.

Ambulatory Surgical Centers: House File 2026, House File 2066 and House File 2122 were all introduced by Representative Holly Brink (R-Oskaloosa) and all passed through the House Human Resources Committee this week. These three bills address concerns regarding physician referrals to ambulatory surgical centers (ASC), having policies in place, making sure physicians have admitting privileges at nearby hospitals and providing appropriate information and education to patients who are choosing between having a procedure done at a hospital or an ASC.

Boards and Commissions: Several bills relating to boards and commissions advanced this week. Senate Study Bill 3122 relates to the regulation of professional licenses in Iowa, including the recognition of out-of-state licenses and disqualification for criminal convictions. Senate Study Bill 3111 eliminates the hospital licensing board and allows the Iowa Department of Public Health (IDPH), along with the state board of health, to adopt rules setting the standards for different types of hospital licensure. Senate Study Bill 3142 provides for the review and sunset of state boards and agencies. Finally, House File 2283 replaces the division of tobacco use prevention and control of IDPH with the bureau of tobacco use prevention and control as well as eliminates the commission on tobacco use and prevention and control. All three Senate bills were approved by a subcommittee and the House bill is being held for now to allow for time to gather more information.

Public Health: Senators Zaun and Annette Sweeney (R-Alden) introduced similar bills that would require insurers to cover diagnostic breast exams and medications for stage IV cancer without needing to first follow step therapy protocols. IHA’s advocacy team is monitoring the bills, which are Senate File 2216, Senate Study Bill 3161 and Senate Study Bill 3162.

Regulations: House Study Bill 660 advanced through subcommittee this week and would require hospitals to advise patients on fetal death certificates and disposition of bodily remains beginning at 12 weeks. IHA has requested an amendment to ensure that mandated conversations regarding these issues be between clinical staff and the patient. As the bill currently reads, hospital CEOs would be required to have the mandated conversations with patients. IHA has also requested clarification regarding provisions within the bill that require communication with the parents of a minor. Additionally, House Study Bill 672 advanced through subcommittee this week and would require hospitals to post signs in conspicuous areas of admitting rooms notifying patients of medication abortions and possible reversal of medication abortions. The bill also requires physicians to notify patients of the possible reversal of medication abortions.