Friday, March 9, 2001 Issue #5

Transcription

1 Friday, March 9, 2001 Issue #5 Fact of the Week: The shortest legislative session in history was 43 days, back in ! The longest was in 1978, a whopping 188 days. Sessions today normally last days. This year, the 110-day session is scheduled to end on April 27. Legislators are earning their paychecks this week. The pace at the Capitol is fast every minute of the day is full, from early in the morning to late into the evening. As legislators prepare for next week s deadline, they are meeting in subcommittees to hash out differences and put the finishing touches on their priority bills, voting in committees to keep bills alive, and holding marathon evening sessions to debate bills like the bill making English the official language, the Woman s Right to Know Act which requires women wanting abortions to be given more specific information, and finalizing the controversial budget cut package. Why the rush? Next Friday, March 16, is the first legislative deadline. The deadline is called a funnel because it functions much like a funnel lots of bills go in, but only half come out. All House Files (HF) and all House Study Bills (HSB) must be voted out of House committees by the end of the day Friday. The same goes for the Senate. All Senate Files (SF) and Senate Study Bills (SSB) must be voted out of Senate committees by the end of the day Friday. Typically, all work is concluded on Thursday, so legislators can get home for the weekend. The only committee that routinely must hold meetings on Friday is the Judiciary Committee, because of the number of bills they deal with and the complexity. Any bill that is not voted out of committee by the end of next week is dead for the session. It can no longer be discussed this year. However, tax and spending bills (bills that go through the Ways & Means and Appropriations Committees) are exempt from this funnel. So it is very important that you contact your legislators to let them know the bills that are important to you. 1

2 It is easy for bills to get lost in the shuffle as of today there are 783 bills in the House and 624 in the Senate. That is why legislators rely on their constituents to let them know about the bills important to them they simply cannot keep track of all 1,407 bills (and more will be introduced next week!). While your legislators may not be able to get your bill moving, s/he will try if you let them know your opinion. The legislative contact numbers are listed at the back of this update. Since things are moving so fast, this update will again focus on bills by issue area again. So, this update will start out with an update on the budget, talk about a few smaller issues and Capitol gossip, and get to the specific issue updates. Budget Update As you have read in the past few updates, the state s budget is in pretty bad shape. You probably are wondering why. Iowa law requires the state to spend only 99% of what it takes in each year. In that sense, it is very much like your checking account. You can only spend (or you should only spend) as much as you have in the bank. Sometimes you have to cut back on your spending because your paycheck doesn t cover your expenses. That is what is happening at the state the state is taking in less than it expected. Just how much money will come into the state in taxes this year is not known but experts say it could be $100-$200 million less than expected. That means cuts to next year s budget. The group that the state appoints to estimate how much the state will take in during the year is called the Revenue Estimating Conference (REC). They meet four times a year to look at revenues coming in to the state and anticipate growth. Last year, the REC estimated the state s revenues would grow by 4.5%. However, the revenues came in at a slower rate, so the REC revised this estimate to 3.5% at the end of Unfortunately, revenues continued to slip and by January, the state was seeing only a.2% increase over last year s revenues. This number changes daily, but has dipped into the negative numbers. Since many Iowans have not yet paid their income taxes, there is some hope that the revenues will turn around in March and April, but no one believes they can make up for the slow growth in the first six months of the year. On March 14, the REC meets again to make a final revision in its estimates. That is what has kept the House and Senate waiting. They will not decide how much each department will get until they see the numbers from the REC next week. The expectation is the Legislature will need to cut below the Governor s recommendations, but they hope to hold the line and not have to cut below the current year s budget. However, there are rumors next year s budget may be 6% below this year s. That is a big change and it will be felt in services. So, budget subcommittees have stopped meeting to wait out the budget numbers. They will pick up their work again after March 16. But do not expect budget subcommittees to meet publicly and discuss their priorities there will not be time. That means it is important for your legislators to hear from you in the coming weeks about how you want to see money spent. But do keep in mind: - There will be no new money available for new services. No matter how influential, persuasive or charming you are, there will not be money available for new services. 2

3 However, making sure there are no cuts to your priority areas is very important. - Everything is up for a cut, so make sure you let your legislators know what programs are the most important to you, whether funding for the arts or making Highway 30 a fourlane road so you can get to Des Moines faster or making sure family support services remains funded at the current level. The Legislature did cut the current year budget this week in what they call a deappropriation bill. This bill originally was to cut $40 million throughout state government. The Governor s office and state agencies said the cuts, which were mostly in administration, would have led to massive layoffs. Republican leaders say the Democrats over-reacted and the cut would really only mean a one-day furlough (unpaid day off) for employees. The Legislature and Governor have been in negotiation over these cuts for the last week and could only agree to $9 million of the cuts. However, the Legislature is sending the Governor a bill that includes those $9 million in cuts, plus another $16 million. The cuts are listed below: - $1.3 million (26.1%) cut to the Healthy And Well Kids of Iowa (HAWK-I) insurance program for low- and medium-income kids. This cut comes out of a $5 million budget. - $700,000 from state cases, leaving $12.6 million to pay for MH/MR/DD services to persons with no county of legal settlement. - $1.1 million (5.3%) cut to MH/MR/DD service reimbursements to counties. As you recall, the state appropriates funds to MH/MR/DD services. This commitment moved toward a true state-county partnership in paying for these services. Every year, a $2 million appropriation is to be made to a Risk Pool that counties experiencing big growth in populations can access to cover costs. This deappropriation takes a chunk of this appropriation back but leaves $913,459 that is carrying over from last year and $200,000 from this current year s allocation, leaving $1.8 million to cover county requests due in April. The Legislature is NOT going to cut the entire $500,000 appropriation to the New Employment Fund, as the earlier version of the bill did. This program was just getting started and provides flexible funding to assist underutilized segments of Iowa s population (particularly persons with disabilities) obtain and retain work. The funding can be used for insurance, on-the-job training, short-term basic education, assisting businesses with ADA compliance, mentoring, internships, and reducing perceived risks that cause these populations to be underutilized. The program is administered by Iowa Workforce Development, the state agency that deals with job training and workforce issues. The bill (SF 267), which also contains a 1% across-the-board cut for all state agencies, is now on its way to the Governor s desk. He is expected to line-item veto several cuts. 3

4 Focus on the Issues Medicaid Buy-In Rep. Betty Grundberg (R-Des Moines) asked her fellow House Human Resources Committee members to take a stand against age discrimination by voting HF 45 out of committee on Thursday, March 8. The federal government (Health Care Finance Administration) has told Iowa its new Medicaid for Employed Disabled Persons, also called the Medicaid Buy-In, is illegal because it excludes persons who are age 65 and older. This is age discrimination, and it is illegal under Medicaid. The Department of Human Services, which is appealing this decision, must do something to save the program this year. Rep. Grundberg said Iowa should not discriminate and should simply lift the age limit. Many contend the number of older Iowans applying will be small, far smaller than the original $10 million fiscal impact which predicted 85% of those eligible would apply and still smaller than the current $1.6 million impact which predicts 35% will enroll. The Department of Human Services has not introduced a counter-proposal, but has indicated the Legislature could move the program under the recent federal Ticket to Work Act, which allows the age discrimination. There are cost estimates floating around (but unconfirmed) that this approach could cost the state more money than the first approach. Rep. Grundberg rejected this idea, saying it is unfair to discriminate. The House Human Resources Committee passed the bill without hesitation or dissent. It has survived the funnel. Property Tax Bill As mentioned in the last update, this bill could have devastating impact on cities and counties because it limits their ability to spend. The bills, HF 4 and SF 226, cap the amount of money a city or county can spend each year and limit their budget growth to 4%. That means everything from public transportation and para-transit to libraries and parks and recreation could be cut or experience no-growth years. Both bills have survived the funnel and are now in the House and Senate Ways & Means Committees for further discussion. Personal Needs Allowance Another bill (HF 181) sponsored by Rep. Betty Grundberg raises the personal needs allowance for nursing home residents on Medicaid from $30 to $50 per month. This is a much-needed increase, and is on the House Calendar. Some advocates would like to see the personal needs allowance for persons in other placements also increase, but that would take an appropriation and an amendment to make that happen. You can ask your legislator to do that if you would like to see other personal needs allowances raised. It has survived the funnel. Affirmative Action In the last update, we talked about a bill that gets rid of all affirmative action programs at the state level. Affirmative action means that women, minorities, and persons with disabilities are given special consideration in employment, education and contracting decisions. Supporters say it is time for the state to have a new policy this one was borne of the 1960 s civil rights movement. Opponents say there is continued discrimination and affirmative action is critical to battling it. The bill gets rid of the Targeted Small Business program, which benefits persons with disabilities, but retains the Entrepreneurs with Disabilities program. The bill also gets rid of so-called comparable worth rules, which say women and men with the same capabilities, in the same jobs, will be paid 4

5 the same. Instead, the bill makes the statement that the state of Iowa is an equal opportunity employer. This bill has not yet survived the funnel (which is bad if you want to get rid of affirmative action and good if you want to keep affirmative action). Mental Health Court Again, Rep. Betty Grundberg has introduced yet another mental health bill that is intended to help make the court process for persons with mental illness more streamlined and effective. The bill, HF 563, directs the Judicial Branch to study the possibility of creating a Mental Health Court. This is an excellent way to get judges that are more understanding of mental health issues, because they hear only mental health issues in mental health court. They are familiar with the laws governing commitments and other mental health issues, and are more educated in how to deal with the issues. They also tend to understand the diagnoses better, leading to a better understanding of placements and treatment. This has been very successful in other states, including Florida. Iowa has experienced success with a similar court for drug cases, in a pilot drug court project. The Judicial Branch is to report back to the Legislature by October 1, This bill is in the House Judiciary Committee and has not yet survived the funnel. Mental Health Parity Progress on mental health parity is slow this year, and there are rumors that the issue is dead. Some say it is because advocates are being too insistent on broad parity and substance abuse, others say it is because the insurance industry, while not actively opposed to all parity bills, does not really want to do it. There have been 12 bills introduced on parity so far this year. Some include substance abuse and the definitions of mental health are vastly different. Some advocates are declaring an all or nothing strategy they want broad parity, an all-inclusive definition of mental health, strong coverage options, and substance abuse coverage. Others are asking for it all, but hoping to get to a compromise that includes at least a study on the costs associated with substance abuse and an expanded mental health definition. Mental health parity means insurance plans are required to cover mental health services in the same way they cover physical health services. It seems straight-forward, almost common sense. However, the insurance industry has traditionally been opposed to any kind of mandates on coverage. They feel it sets a bad precedent. That said, insurance companies are not the big opponents to parity this year. They are amenable to a limited parity bill. It is the Association of Business and Industry, the group that represents employers, that is causing the real opposition. They feel parity will cause an increase in health insurance premiums, and most businesses have already endured big hikes in insurance premiums over the last two years. On the other side, there is a large and growing informal coalition of organizations that support parity. Some of these organizations will settle for a compromise bill to get their foot in the door, others are more adamant about full parity. However, they stay together to send the message that parity is an important issue that should be addressed this year. Over 40 legislators attended a luncheon meeting at the Capitol on Thursday, March 1, to hear a national expert on mental health insurance parity. Ronald Bachman, a Georgia consultant with Price Waterhouse, came to Iowa at the request of the legislature and the National Association of State Legislatures. Bachman has been speaking around the country about parity and consulting with state legislators on parity policies. 5

6 Bachman has been involved in a number of actuarial studies on the impact of parity. The Rand/UCLA study found that concerns about parity costs have stifled many health system reform proposals. However, policy decisions were often based on inaccurate assumptions and outdated data that led to dramatic overestimates. Bachman said many of the costs cited by opponents of parity legislation were based in the 1980 s, before managed care really permeated the health care industry. In fact, health care in total has changed dramatically over this same course in time. Bachman pointed to medication management as an example. Many mental health treatments are now outpatient and can be treated with medications, as opposed to the 1980 s when inpatient services were more common. Bachman s studies have found that to date in Minnesota there has been no recognized cost concerns or exodus of insured plans to avoid the Minnesota parity mandate. Bachman also outlined several other state experiences with parity and increases (or lack thereof) in premium rates: State Premium Rate Increase Maine less than.5% New Hampshire Minimal Vermont 0-3% Maryland less than 1% Rhode Island less than.33% Minnesota less than 1% While the impact on premiums seems to be minor, the actual savings occurring in the state health plans is major. In fact, Bachman said that states have seen no increase in the number of uninsureds after parity was enacted. Typically, the insurance industry finds 200,000 people drop insurance for every 1% increase in costs. But this has not occurred in parity states. Bachman said that several states were seeing significant first year and ongoing declines in their health plan costs: State Health Plan Costs North Carolina -37% Ohio -34% Alaska -65% Texas -48% According to Bachman and a Price Waterhouse study, the benefits offered really don t have an impact on cost. It is how the insurance plan is managed that impacts costs. - An unmanaged health care plan would go from $4.55/day to $9.88/day after full parity is passed. This is a 3% overall increase. - A preferred provider network (PPO) would go from $3.01/day to $6.84/day, a 2.6% increase. - An HMO would move from $2.00/day to $3.30/day. This is less than the starting costs for an unmanaged health plan. 6

7 Bachman said states should pass broad parity and let the insurance companies manage their costs as they do with other plans and benefits. When asked how other states convinced their business communities to sign on to the parity legislation, Bachman said Maine and Vermont required employees to have a choice in mental health parity. This was a popular provision among employers, but not mental health advocates. In addition, many states allow insurance companies to require treatment be received within their managed care network only. However, the states enacted a broader definition of mental health than considered in Iowa. The chart that follows on this page demonstrates the characteristics of parity legislation in other states. We apologize for the size of print it wouldn t fit on the page otherwise. If you need a larger print version, please contact the Governor s DD Council at 515/ Characteristics of Legislation Conditions Covered Definition of mental illness Does not define mental illness (i.e. covers mental illness broadly) Defines mental illness Covers only serious mental illness or biologically based mental illness Designates particular diagnoses Covers substance abuse Specificity of Parity Provides specific language about how MH/SA benefits may not differ from those with physical health benefits Minimum Benefits Specifies minimum benefit requirements Approved Providers Specifies providers who may offer services under the mandate Managed Care Mentions managed care AR CO CT IN ME MD MN NH NC RI TX VT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 7

8 Characteristics of Legislation Contains medical necessity clauses Exemptions & Population Covered Only applies to government employees Exempts small businesses AR CO CT IN ME MD MN NH NC RI TX VT!!!!!!!!!!!! Bachman acknowledged that the issue of substance abuse and dual diagnosis is difficult, saying there is certainly a need for dual treatment but society still looks at substance abuse as a choice behavior. On the following pages, we have made charts that show you the difference between the parity bills introduced so far this session. You can compare them with the chart above to see how we rank with other states. This has been updated with two new bills since the last time you saw it. The bills are listed from the broadest (and most inclusive) to the most limited. 8

9 Bill # (companion) By Committee Diagnosis Population Co- Pays Limits Substance Abuse Managed Care Exclusions SF 119 (HF 72) HF 72 (SF 119) Sen. Connolly Rep. Jochum Senate Commerce Committee: Sens. J. Johnson, Deluhery, Schuerer House Commerce & Regulation Committee: Reps. D. Johnson, Osterhaus, Schrader, Shey, Van Fossen All mental conditions All third party and substance abuse payment provider contracts All mental conditions All third party and substance abuse payment provider contracts Same as medical Same as medical Lifetime limits the same as medical Lifetime limits the same as medical Substance Abuse Covered Substance Abuse Covered None Managed Care clause None Can exclude marital, family, educational, developmental or training services; custodial care; experimental treatments 9

10 Bill # (companion) By Committee Diagnosis Population Co- Pays Limits Substance Abuse Managed Care Exclusions SF 177 Sens. (HF 423 & Hammond, HF 491) Harper, Dvorsky, Fink, Shearer, Connolly, Deluhery, Kibbie, Horn, Hansen, McCoy, Gronstal, Fraise, Black, Bolkcom, Dearden, Soukup, Holveck, Fiegen, Flynn Senate Appropriations Committee: Sens. Veenstra, Hammond, King Schizophrenia; schizo-affective disorder; bipolar disorder; major depressive disorder; obsessivecompulsive disorder; autism; pervasive developmental disorders; anxiety disorders; paranoia and other psychotic disorders; eating disorders, including but not limited to bulimia nervosa and anorexia nervosa; substance abuse All third party payment provider contracts renewed on or after January, 2002; Act is repealed July 1, 2004 Same as medical A minimum of 30 inpatient and 60 outpatient days annually; increase life time limit to $100,000 Substance Abuse Covered Managed Care clause A group policy can be exempt from this section upon submitting to the commissioner evidence demonstrating a premium increase for the policy term in excess of 3% as a result of the requirements of this section. Can exclude marital, family, educational, developmental, or training services; custodial care; experimental treatments 10

11 Bill # (companion) By Committee Diagnosis Population Co- Pays Limits Substance Abuse Managed Care Exclusions HF 423 (SF 177 & HF 491) Reps. Smith, Osterhaus, T.Taylor, Hatch, Larkin, Bell, Cohoon, Mascher, Reynolds, Lensing, Scherrman, Bukta, Petersen, Ford, Winckler, Stevens, Dotzler, Kuhn, Frevert, Seng, Connors, O Brien, Mertz, May, Falck, Chiodo, Atteberry, & Foege House Appropriations Committee: Reps. Heaton, Barry, T. Taylor Schizophrenia; schizo-affective disorder; bipolar disorder; major depressive disorder; obsessivecompulsive disorder; autism; pervasive developmental disorders; anxiety disorders; paranoia and other psychotic disorders; eating disorders, including but not limited to bulimia nervosa and anorexia nervosa; substance abuse All third party payment provider contracts renewed on or after January, 2002; Act is repealed July 1, 2004 Same as medical A minimum of 30 inpatient and 60 outpatient days annually; increase life time limit to $100,000 Substance Abuse Covered Managed Care clause A group policy can be exempt from this section upon submitting to the commissioner evidence demonstrating a premium increase for the policy term in excess of 3% as a result of the requirements of this section. Can exclude marital, family, educational, developmental, or training services; custodial care; experimental treatments 11

12 Bill # (companion) By Committee Diagnosis Population Co- Pays Limits Substance Abuse Managed Care Exclusions HF 491 Reps. (SF 177 & Atteberry, Witt, HF 423) Ford, Dotzler, Murphy, Hatch, Warnstadt, Greimann, Foege, Cohoon, Mascher, Lensing & Osterhaus SF 137 (HF 107) Sens. Tinsman & Maddox House Commerce & Regulation Committee: Not yet assigned. Senate Commerce Committee: Sens. J. Johnson, S. Hansen, Maddox Schizophrenia; schizo-affective disorder; bipolar disorder; major depressive disorder; obsessivecompulsive disorder; autism; pervasive developmental disorders; anxiety disorders; paranoia and other psychotic disorders; eating disorders, including but not limited to bulimia nervosa and anorexia nervosa; substance abuse Neurobiological: Schizophrenia and other psychotic disorders; mood disorders; anxiety disorders; pervasive developmental disorders; attention deficit disorder All third party payment provider contracts renewed on or after January, 2002; Act is repealed July 1, 2004 Over 50 full time employees; if smaller and provides mental health coverage; public employees Same as medical Same as medical A minimum of 30 inpatient and 60 outpatient days annually; increase life time limit to $100,000 Substance Abuse Covered Same as Study by medical Insurance limits for Division on lifetime impact of benefits; providing minimum 30 coverage inpatient for and 52 Substance outpatient Abuse days Managed Care clause Managed Care clause A group policy can be exempt from this section upon submitting to the commissioner evidence demonstrating a premium increase for the policy term in excess of 3% as a result of the requirements of this section. Can exclude marital, family, educational, developmental, or training services; custodial care; experimental treatments Can exclude marital, family, educational, developmental or training services; custodial care; experimental treatments 12

13 Bill # (companion) By Committee Diagnosis Population Co- Pays Limits Substance Abuse Managed Care Exclusions HF 107 (SF 137) SF 131 (HF 113) HF 113 (SF 131) Rep. Grundberg Sen. Tinsman Rep. Grundberg House Commerce & Regulation Committee: Reps. B. Hansen, Seng, Shey Senate Commerce Committee: Sens. J. Johnson, S. Hansen, Maddox House Commerce & Regulation Committee: Reps. B. Hansen, Schrader, Shey Neurobiological: Schizophrenia and other psychotic disorders; mood disorders; anxiety disorders; pervasive developmental disorders; attention deficit disorder Neurobiological: Schizophrenia and other psychotic disorders; mood disorders; anxiety disorders; pervasive developmental disorders; attention deficit disorder Neurobiological: Schizophrenia and other psychotic disorders; mood disorders; anxiety disorders; pervasive developmental disorders; attention deficit disorder Over 50 full time employees; if smaller and provides mental health coverage; public employees Public employees Public employees Same as medical Same as medical Same as medical Same as Study by medical Insurance limits for Division on lifetime impact of benefits; providing minimum 30 coverage inpatient for and 52 Substance outpatient Abuse days Same as medical limits for lifetime benefits; minimum 30 inpatient and 52 outpatient days Same as medical limits for lifetime benefits; minimum 30 inpatient and 52 outpatient days Substance Abuse Covered Substance Abuse Covered Managed Care clause Managed Care clause Managed Care clause Can exclude marital, family, educational, developmental or training services; custodial care; experimental treatments Can exclude marital, family, educational, developmental or training services; custodial care; experimental treatments Can exclude marital, family, educational, developmental or training services; custodial care; experimental treatments 13

14 Bill # (companion) By Committee Diagnosis Population Co- Pays Limits Substance Abuse Managed Care Exclusions SF 132 (HF 153) HF 153 (SF 132) SF 136* Sen. Tinsman Rep. Grundberg Sens. Tinsman & Maddox Senate Commerce Committee: Sens. J. Johnson, S. Hansen, Maddox House Commerce & Regulation Committee: Reps. B. Hansen, Osterhaus, Shey Senate Commerce Committee: Sens. J. Johnson, S. Hansen, Maddox Neurobiological: Schizophrenia and other psychotic disorders; mood disorders; anxiety disorders; pervasive developmental disorders; attention deficit disorder Neurobiological: Schizophrenia and other psychotic disorders; mood disorders; anxiety disorders; pervasive developmental disorders; attention deficit disorder Biologically Based: Schizophrenia; biopolar disorders; major depressive disorders; obsessivecompulsive disorders; pervasive developmental disorders; autistic disorders Children under age 19 for companies over 50 full time employees or smaller if already providing mental health coverage Children under age 19 for companies over 50 full time employees or smaller if already providing mental health coverage Over 50 full time employees; if smaller and provides mental health coverage; public employees Same as medical Same as medical Same as medical Same as Substance medical Abuse limits for Covered lifetime benefits; minimum 30 inpatient and 52 outpatient days Same as Substance medical Abuse limits for Covered lifetime benefits; minimum 30 inpatient and 52 outpatient days Same as None medical limits for lifetime benefits; minimum 30 inpatient and 52 outpatient days Managed Care clause Managed Care clause Managed Care clause Can exclude marital, family, educational, developmental or training services; custodial care; experimental treatments Can exclude marital, family, educational, developmental or training services; custodial care; experimental treatments Can exclude marital, family, educational, developmental or training services; custodial care; experimental treatments *Same as HF 2080 from 2000 legislative session 14

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16 ( Bills Introduced This Week HF 388 HF 403 HF 405 HF 423 HF 450 Nursing Home Insurance Tax Credit Same as SF 4, except it refers to the tax credit as a Nursing Home Tax Credit instead of a Long Term Care Insurance Tax Credit. Also similar to SF 182 and SF 255. Sponsor: Rep. Hoffman et al; Status: House Ways & Means Committee Election Law Revisions Clarifies that a person who holds the power of attorney for another does not have authority to sign a voter registration form unless the person registering to vote is disabled and requests the help. This bill requires a person to sign all voting documents his/herself. If a person is unable to write, s/he can use a rubber stamp of their signature or they may request another person to sign the document for him/her. However, if someone else signs the voter s name or affixes the voter s signature, the voter must be present when this occurs. The bill also requires voters to show identification at the polling place to prove their identities. Successor to HSB 18. Sponsor: House State Government Committee; Status: Passed House, 96-1; Senate State Government Committee State Contracts Requires the Department of General Services to approve all noncompetitive contracts for equipment, supplies, and services exceeding $20,000. However, the Department of Transportation, the Department for the Blind, and Regents institutions are exempt from this bill. Sponsor: Rep. Bradley; Status: House State Government Committee Governor s Abuse & Parity Bill See companion bill, SF 177. Similar to SF 119, SF 131, SF 132, SF 136, SF 137, HF 72, HF 107, HF 113, HF 153, and HF 491. Sponsor: Rep. Smith et al; Status: House Appropriations Committee Nursing Homes Accounting Procedures Gives nursing homes and care facilities notice of violation before receiving citation for the problem. Under this legislation, the State Fire Marshal would give notice first, instead of immediately issuing a citation for the violation. The notice is to describe the nature of the deficiency, identify the rule violated, provide corrective options, and specify the time allowed for the correction (at the end of which time the Fire Marshal is to perform a follow-up inspection). The bill requires the State Fire Marshal and the Department of Inspections and Appeals consult with the Fire Marshal to make sure rules for health care facilities are consistent. Similar to HF 190. Successor to HF 256. Sponsor: Committee on Human Resources; Status: House Calendar 16

17 HF 457 HF 462 HF 473 HF 487 HF 491 Community Empowerment Boards Fiscal Agent Authorizes Area Education Agencies to serve as fiscal agents for Community Empowerment Boards. Effective upon enactment. Successor to HF 295. Sponsor: Committee on Local Government; Status: House Local Government Committee IDEA Administrative Costs Allows AEAs to use more than 25% of the funds received under the federal Infants and Toddlers with Disabilities Program of the Individuals with Disabilities Education Act for administration. There is currently a 25% cap on administrative costs. Successor to HF 362. Sponsor: Committee on Education; Status: House Calendar Bicycle Helmet List Requires a person under age 12, except for those who have completed the 5th grade, to wear a bicycle helmet while operating a bike or while sitting in a bike seat or bike trailer. Under this legislation, parents and legal guardians can be fined $15 for failure to comply. The bill also requires those renting bicycles to offer helmets at a reasonable price, and requires the Department of Public Health to compile a list of approved helmets and establish a bicycle safety fund. This fund would pay for educational programs and assist in buying helmets for low-income families. Similar to SF 321. Sponsor: Rep. Ford; Status: House Human Resources Committee Health Insurance Rate Increases See companion bill, SF 373. Sponsor: Rep. Petersen; Status: House Commerce & Regulation Committee Mental Health Parity Contains the Governor s mental health and substance abuse parity recommendation, which is exactly the same as language in SF 177 and HF 423. However, unlike those bills, it does not contain the Governor s other recommendations dealing with abuse. Mental Health Parity: Requires all group health insurance policies to cover the costs of treatment for mental health disorders, including schizophrenia, schizo-affective disorders, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, autism, pervasive developmental disorders, anxiety disorders, paranoia and other psychotic disorders, eating disorders (including but not limited to bulimia nervosa and anorexia nervosa) and substance abuse. The bill allows insurers to manage benefits through common practices, but prohibits plans from imposing aggregate annual or lifetime limits on this coverage unless they are also imposed on all medical and surgical coverage benefits. The bill also raises the lifetime limit from $50,000 to $100,000 and requires plans to cover at least 30 inpatient days and 60 outpatient visits annually. Policies can include deductibles, coinsurance or co-payments, as long as they are the same as those established for medical and surgical coverage. Under this legislation, the policies may exclude marital, family, educational, developmental, or training services; care that is substantially custodial in nature; services and supplies that are not medically necessary or clinically appropriate; and experimental treatments. An employer may petition the Insurance 17

18 Commissioner if there is evidence demonstrating a premium increase of 3% or more as a result of the requirements of this bill. Applicable to plans issued or renewed after January 1, The bill is repealed July 1, Similar to SF 119, SF 131, SF 132, SF 136, HF 72, HF 107, HF 113, HF 153. Sponsor: Rep. Atteberry et al; Status: House Commerce & Regulation Committee HF 494 HF 501 HF 510 HF 523 HF 537 Access to Medical Treatment Act Permits a doctor to use investigational, experimental, new or unconventional medical treatment as long as the physician has examined the individual and there is no reason to conclude the treatment poses a risk to them. Sponsor: Rep. Mertz; Status: House Human Resources Committee Magistrate Duties Permits magistrates who are not licensed to practice law in Iowa to review commitment applications for involuntary hospitalization. Sponsor: Rep. Horbach; Status: House Judiciary Committee Peer Review Committee Requires each nursing home facility to have a quality assessment and assurance committee to identify issues that may adversely impact the quality of care and services provided to residents and develop corrective actions. The bill clarifies peer review activities to include monitoring, evaluating and recommendation actions to improve and ensure the delivery of quality services. The bill also adds nursing facility administrators and nursing facilities to the list of those that can be sued to recover damages for personal injury. Sponsor: Rep. Hoffman; Status: House Human Resources Committee MH/DD Fund Bill Every year, the Legislature appropriates funds for its share of the costs for mental health services. The counties make up the remainder of these costs. The Legislature actually appropriates mental health funds, but requires counties to pass this off to their citizens as property tax relief. The theory is the county does not have to tax its citizens more for mental health services, so the replacement dollars both fund mental health services and reduce property taxes at the same time. This bill makes changes in that appropriation to counties. The bill changes how these funds are distributed, how counties can access various pools of funding under the mental health relief umbrella, eliminates the little-used incentive and efficiency pool of funding which was originally intended to help counties become more efficient (but the funding was never enough to really do this), and creates disincentives for carrying over large sums of money at the end of the year (thereby giving counties the incentives to spend all or most of their MH/DD funds on services each year). Sponsor: Rep. Carroll; Status: House Local Government Committee Property Tax Limitation & State Mandates Removes the city and county property tax rate limitations and replaces them with limitations on the amount of property tax dollars certified. This new limitation will begin with a maximum property tax dollar base, calculated by multiplying the three-year average of tax asking by a growth factor (a price index, adjusted for each 18

19 of the three years). Adjustments are made for ending fund balance differentials, property tax replacements received, and local options sales taxes collected. This base year becomes the maximum property tax base for FY Cities and counties that do not levy at their maximum rate may carry forward their unused taxing authority from year to year, as long as it makes up no more than 25% of their budget. The bill allows cities, counties and the secondary road fund levy to exceed limitations for up to two years at a time if approved by voters in a special election. The bill also prohibits ending fund balances in excess of 25% in the city general and the county general and rural services funds with a 10% flexibility for designated or reserved funds. The county supplemental levy and sections which currently allow cities and counties to exceed their levy rate limitations are repealed but counties are given the authority to establish a cemetery fund and trust and agency funds. The bill also requires the state to fully fund any new mandates imposed after July 1, 2001, and exempts local governments from new unfunded or underfunded mandates. Creates a thirteen member Commission on State and Local Taxation that will conduct a review of revenue resources available to local and state governments including taxes, fees, and federal money received. The commission report is to be submitted to the legislature no later than March 15, Effective beginning fiscal year Similar to SF 226. Sponsor: Committee on Local Government; Status: House Ways & Means Committee HF 548 HF 563 HSB 208 Increased Community Spouse Allowance Increases the minimum Medicaid community spouse resource allowance retained for an institutionalized individual s community spouse under from $24,000 to $48,000. Successor to HF 183. Sponsor: Committee on Human Resources; Status: House Appropriations Committee Mental Health Court Study Directs the Judicial Branch to study the possibility of creating a Mental Health Court, similiar to drug courts. This is an excellent way to get judges that are more understanding of mental health issues, because they hear only mental health issues in mental health court. This has been very successful in other states, including Florida. Iowa has experienced success with a similar court for drug cases, in a pilot drug court project. The Judicial Branch is to report back to the Legislature by October 1, Sponsor: Rep. Grundberg; Status: House Judiciary Committee Legislative Expenses Appropriates $5,545,300 for session expenses, including annual compensation for legislators and staff members, $419,000 for interim expenses, $2,375,000 for fixed expenses, $125,000 for renovation, restoration and equipment improvements in the House chamber and $100,000 for technology improvements. Sponsor: Committee on Rules & Administration; Status: House Rules & Administration Committee 19

20 SF 93 SF 200 SF 280 SF 283 SF 284 SF 298 Affirmative Action Repeal Reiterates the state policy to ensure equal opportunity in state employment, contracts, and services, regardless of race, color, religion, national origin, age, or physical or mental disability (and strikes references to creed ). The bill deletes all Iowa Code references to affirmative action programs; repeals Department of Management authority to enforce state agency compliance with affirmative action policies; eliminates the definition of targeted small business (which included women, minorities and persons with disabilities); repeals the focused small business linked investments program for small businesses owned or operated by women and minorities; repeals the contract set-aside for disadvantaged small businesses for contracts with the Department of Transportation; and replaces comparable worth directives (which require wages paid to male and female workers for the same work be at the same rate) with non-discrimination in pay language. Sponsor: Sen. Miller; Status: Senate State Government Committee ATS Community Assistance Fund Creates an Advanced Telecommunications Services (ATS) Community Assistance Fund to implement and administer an ATS Community Assistance Program designed to assist Iowa communities in acquiring access to high-speed, reliable, competitively priced ATS. Funds may be used to conduct technology assessments, develop community technology plans, and, if necessary, aid in the implementation of ATS deployment. Communities must have completed a comprehensive information technology plan that includes components for ATS deployment, training in the use of ATS, and integration of ATAs into other community development plans. Companion to HF 333 and HSB 145. Sponsor: Sen. Harper et al; Status: Senate Small Business, Economic Development & Tourism Committee State Employment Opportunities Program Establishes within the Iowa Department of Personnel a Disabled Employment Opportunities Program and appropriates $500,000 to the program. State agencies are awarded grants of up to $5,000 per employee with disabilities to accommodate new employees with disabilities and existing employees who become disabled and provide continuing accommodations so that those persons with disabilities can continue to be employed. Sponsor: Sen. Lamberti; Status: Senate Appropriations Committee Absentee Ballot Envelopes Reduces the number of envelopes used in absentee voting from two to one. Sponsor: Sen. Bolkcom; Status: Senate State Government Committee Requests For Absentee Ballot Combines a voter registration form with an absentee ballot request. Sponsor: Sen. Bolkcom; Status: Senate State Government Committee TSB Guarantee Fee Tax Credit Permits a woman, minority, or disabled small business owner to take a tax credit equal to the fee paid to the U.S. Small Business Administration for a guaranteed 20

21 loan. The credit is applicable to the tax year the fee was paid. Excess credits are nonrefundable, but may be carried forward for up to four years. Retroactive to January 1, Sponsor: Sen. Lamberti; Status: Senate Ways & Means Committee SF 308 SF 321 SF 373 SSB 1175 Accountable Government Act Requires a review of state government agency performance and operations, and establishes a system for planning, performance measurement, investment, and oversight. Budgeting: Requires budgets to include an explanation that correlates each expenditure item to the state s enterprise strategic plan and identify any goals that require legislation. This legislation requires all budgets to explain how appropriations will help the agency achieve enterprise goals and what results can be expected and measured. Strategic Planning: Makes the Department of Management (DOM) responsible for developing a state enterprise strategic plan, and makes each agency responsible for developing its own agency strategic plans. These agency plans are to be based on the enterprise strategic plan. The bill requires broad public participation in formulating these plans. DOM is to oversee and review agency planning. The bill states that agencies are expected to carry out their plans and achieve the goals outlined using performance targets and measures. Agencies are required to prepare reports outlining their progress in achieving goals. Investment Decisions: Requires agencies to incorporate methodologies in decisions to make major investments, which may be based on return on investment and cost-benefit analysis. Contracts for Services: Requires the Department of General Services (in cooperation with the Attorney General, DOM, Department of Personnel, Department of Revenue & Finance, and other state agencies) to set uniform terms and conditions for state contracts. Contracts must now be performance-based and outline a way to measure a contractor s compliance (including itemized invoices of work performed) and performance. Companion to SSB Sponsor: Sen. Shearer et al; Status: Senate State Government Committee Bike Helmets Allows local governments to pass laws requiring a child under the age of 14 to wear a bicycle helmet while riding on a bicycle or in a restraining seat connected to a bicycle. Persons who rent bicycles to the public must also provide helmets and may charge a reasonable fee for use of the helmet. The bill requires the Department of Public Health to work with the Iowa Safe Kids Coalition to provide bicycle safety information to the public. Similar to HF 473. Sponsor: Committee on Judiciary; Status: Senate Calendar Health Insurance Rate Increases Requires insurance companies to provide a 90-day notice prior to a rate increase. Companion to HF 487. Sponsor: Sen. Holveck; Status: Senate Commerce Committee Affirmative Action Repeal See companion bill, SF 93. Sponsor: Committee on State Government; Status: Senate State Government Committee 21

22 SSB 1178 SSB 1196 Accountable Government Act See companion bill, SF 308. Sponsor: Committee on State Government; Status: Senate State Government Committee Voter Registration and Elections Current law allows people to register to vote by mail, or in person at designated sites. Regardless of where a person registers, current law allows them to vote by absentee (mail-in) ballot. This bill requires persons who mailed in their voter registration forms to vote in person at their polling places during the first election in which they vote. However, this new requirement would not apply to persons that registered to vote at a driver s license station, at a voter registration agency or if the voter meets certain other criteria. This language is also contained in HF 304. Sponsor: Committee on State Government; Status: Senate State Government Committee Sent to the Governor HF 192 Background Checks for DIA Applicants Allows the Department of Inspections and Appeals to conduct background checks on applicants by accessing criminal history records and child and domestic abuse registries. Companion to SF 127. Sponsor: Committee on State Government; Status: Passed Senate, 44-0; Sent to Governor House Resolutions HR 7 HR 16 Nancy Coover Andreasen Recognition Recognizes award-winning, internationally acknowledged psychiatrist, educator, researcher and author Nancy Coover Andreasen, currently the Andrew Woods Chair of Psychiatry at the University of Iowa College of Medicine and editor of the American Journal of Psychiatry, for her genuine compassion and understanding for persons with mental illnesses and their families. Companion to SR 5 & SR 7. Sponsor: Rep. Grundberg et al; Status: Adopted by House Theresa Uchytil Recognition See companion bill, SR 12. Sponsor: Reps. Metcalf & Raecker; Status: House Calendar Senate Resolutions SR 5 Nancy Coover Andreasen Recognition See companion bill, HR 7. Same as SR 7. Sponsor: Sens. Dvorsky & Bolkcom; Status: Senate Rules & Administration Committee 22

23 SR 7 SR 12 Nancy Coover Andreasen Recognition See companion bill, HR 7. Same as SR 5. Sponsor: Sen. Dvorsky et al; Status: Adopted by Senate Theresa Uchytil Recognition Recognizes talents and achievements of Theresa Uchytil, Miss Iowa 2000 and the first Miss Iowa with a disability. The resolution applauds Ms. Uchytil for her refusal to be defined by her disability, her efforts to encourage people, regardless of their challenge, to overcome the obstacles in their lives, and using her pageant platform Facing the Challenge and her position as a national ADA advocate to educate the public about Americans with disabilities. Companion to HR 16. Sponsor: Sen. Maddox; Status: Adopted by Senate House Files HF 2 HF 4 HF 11 HF 26 HF 31 Social Security Benefits Tax Phase-Out Phases out the individual income tax on social security income beginning tax year 2001, with the full elimination in tax year Under current law, Iowa receives $47 million in income tax revenues due to the tax on Social Security benefits and income tax receipts raised by the taxes are expected to increase by 7.5% each year. The actual cost is $11.8 million (FY02); $25.3 million (FY03); $40.7 million (FY04); and $58.4 million (FY05 & beyond). Companion to SF 59. Similar to HF 11 & SF 40. Sponsor: Rep. Rants et al; Status: House Calendar Property Tax Limitation & State Mandates This bill is now, HF 537. Sponsor: Reps. Rants & Houser; Status: House Ways & Means Committee Social Security Benefits Tax Elimination Eliminates the individual income tax on social security income beginning tax year Similar to HF 2, SF 40, and SF 59. Sponsor: Rep. Tyrrell; Status: House Ways & Means Committee Personal Needs Allowance Directs DHS to raise the personal needs allowance nursing home residents participating in Medicaid receive from $30 to $50 per month, unless a greater amount is allowed under state or federal law. The bill appropriates $1.5 million is made to DHS to implement this directive. Similar to HF 181, SF 201, and SF 243. Sponsor: Rep. Wise; Status: House Appropriations Committee Social Security Numbers Use & Disclosure Directs government bodies to refrain from disclosing a person s social security number unless required in the performance of duty or authorized by law. The bill further instructs government bodies to delete social security numbers from requested public records without delaying the release of the records. Effective January 1, Sponsor: Reps. Jacobs, Gipp, & Tymeson; Status: House State Government Committee 23