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End of Session IDPH Legislative Update July 8, 2015

08 Jul 2015 10:18 AM | Lara Marsh (Administrator)

In this issue:

·         IDPH Legislative Package Summary

·         Final Action: HHS Appropriations Bill

·         A link to a list of the enacted bills from the 2015 session that relate to public health. There is also a link to all of the enacted bills at the end of this publication.

2015 End of Session Update

The first session of the 86th General Assembly came to a close on June 5. The Governor completed his actions on the 142 enrolled bills sent to him by the legislature on July 2.

 

Thank You

To my colleagues at IDPH, I greatly appreciate your dedication to session. I sincerely thank you for helping us through yet another one filled with successes.  It takes a village to navigate the session waters and it would be impossible to do without your hard work, subject matter expertise, flexibility, and patience. It’s an honor to represent our department. Thank you so much for the opportunity to do so. 

To our valued stakeholders, thank you also for your support of the department’s policy and budget package. We would not have been able to achieve the successes we had this year without your help. Our partners are too numerous to name here but please know that we value our relationships with each of you and look forward to continuing our collective work to promote and protect the health of Iowans.

Governor’s Actions

The following is an excerpt from the Legislative Services Agency’s “How a Bill Becomes a Law.” It provides a brief explanation of the Governor’s veto powers. The full document is located here:          

Bills passed by the Legislature must be reviewed by the Governor. The Governor takes final action on all bills passed by the Iowa General Assembly. The Governor has three options: sign the bill, veto the bill (or item veto an appropriations bill), or take no action. In the case of a veto, the Legislature may override the veto with two-thirds of the members of each chamber voting to reconsider and pass the bill a second time. If, during session, the Governor does not sign or veto a bill, it becomes law after three calendar days (except Sundays). Bills received by the Governor during the last three calendar days of session (except Sundays) must be signed or vetoed within 30 calendar days.

The Governor has the option to use three types of vetoes: the veto, item veto, and pocket veto. The veto indicates the Governor’s disapproval of an entire bill. The item veto may be used only for bills which appropriate funds. It strikes a specific item of an appropriations bill. A pocket veto occurs when the Governor fails to take action within 30 calendar days on a bill received within the last three calendar days of session (except Sundays). The entire bill fails to become law. When the Governor vetoes or item vetoes a bill, a veto message explaining why the veto was made is delivered to the chamber of origin with the bill and is filed with the Secretary of State. The Governor’s veto messages can be accessed on the Iowa General Assembly web site in the “Enrolled Bills” section.

 

IDPH Policy and Budget Package Recap

IDPH Policy Package:

  • 2 out of 3 bills that were introduced by IDPH were signed by the Governor. They are as follows:
    • SF 274 IDPH Omnibus Bill. Medical Residency Program and the Board of Hearing Aid Specialists. Signed Friday, April 24.
    • HF 381 Iowa Health Information Network Transition. Biggest policy priority. Also signed April 24.
    • SF 275 Local Public Health Flexibility Bill. Died…twice. Couldn’t gain enough momentum in the House.

 

IDPH Budget Priorities:

  • General Fund – Appropriated in SF 505 (FY 2016 and FY 2017 Health and Human Services Appropriations Act):
    • The reallocation request of $200,000 from the Cervical Cancer Screening Program to the Bureau of EMS and Trauma Systems (BETS) was achieved.
    • The increase of $1.0 million for the Medical Residency Program was not included in the final budget.
  • Rebuild Iowa Infrastructure Fund (RIIF) – Appropriated in HF 650 (FY 2016 Infrastructure Act):
    • $500,000 in FY 2016 for the Bureaus of Family Health and Oral Health Delivery Systems data integration project. Currently, five data management systems are operated by the bureaus, all of which function independently of each other. Not all are web-based and all lack the ability to easily share data among programs or with the public. These systems are aging and are costly to update and repair. This project will replace the five existing systems with a single web-based, integrated electronic data management system. Features of the new system will include case management, referral management, risk assessment, billing, and client and population-level reporting. The integrated system will support eight programs.
    • $500,000 to study the 98 database systems in IDPH for long and short term planning of replacement and consolidation strategies was not included in the final budget.

 

Health and Human Services Appropriations Act

SF 505 was item-vetoed by Governor Branstad on July 2. To view the item-veto letter please click here.

The bill appropriates funding to the Departments of Public Health, Human Services, Aging, and Veterans Affairs and the Iowa Veterans Home. IDPH’s total FY 2016 General Fund budget is $57.8 million. This is a net decrease of $1.5 million compared to FY 2015. The following are new directives, new allocations, and decreases or increases in funding compared to FY 2015 in Division III, Sec. 3 of the bill:

Addictive Disorders:

  • Tobacco Use Prevention and Control (Sec. 3(1)(a)): Received status quo funding. A new directive was added for Quitline Iowa to screen patients for third-party coverage of nicotine replacement therapy. A report is required but a due date was not assigned.
  • The tobacco-related allocation paragraphs were consolidated for increased flexibility in the determination of funded activities.

Healthy Children and Families:

  • 1st Five Program (Sec. 3(2)(c)): Received an increase of $571,000 for a total allocation of $2.2 million. Initial estimates anticipate expansion into approximately 13 new counties for a total of 62.
  • Child Burial Grant Program (Sec. 3(2)(j)): This program was new in FY 2015 and received an allocation of $100,000 complete with carryforward authority. Significant funding is still available from that allocation hence, the legislature directs IDPH to continue to spend down the existing balance in FY 2016 instead of allocating additional funding to the program.
  • Office of Health Care Transformation (OHCT) (Sec. 3(3)(k)): Formerly identified as the allocation paragraph for the Medical Home Systems Advisory Council, the language in the allocation paragraph has been updated to accurately reflect the use of the funding for activities in the OHCT. The Council’s name was also updated in Iowa Code Sections 135.151 and 135.161 to be called the Patient-Centered Health Advisory Council. This change is made in Division VII, Sec. 38 of the bill.

Chronic Conditions:

  • Cervical Cancer Screening Program (Sec. 3(3)(h)): Received a decrease of $200,000 as part of a reallocation request made by IDPH. The funding has been reallocated to the Public Protection budget unit for use in the IDPH Bureau of Emergency Medical Services and Trauma Systems (BETS).

Community Capacity:

  • Iowa Collaborative Safety Net Provider Network (Sec. 3(4)(g)): The allocation paragraphs were consolidated for increased flexibility in the determination of funded activities. Received status quo funding from the legislature, however, a total of $1.6 million to be used for activities such as community care teams was vetoed by the Governor.
  • Direct Care Professional (DCP) Activities (Sec. 3(4)(h,i)): Received status quo funding. New language is included in the DCP Council’s allocation paragraph but does not appear to significantly impact the Council’s current work. A request for proposals (RFP) will be required for the funding that has been traditionally passed directly through to the Iowa CareGivers. Contract requirements are also included to use a portion of the funding to collect data to determine results based on the performance and outcomes measures included in the contract.
  • Delta Dental Loan Repayment Program (Sec. 3(4)(k)): Received an increase of $50,000 for a total of $100,000 for FY 2016.
  • Reach Out and Read Program: Funding of $50,000 was eliminated for this program.
  • University of Iowa Hospitals and Clinics (UIHC), Mental Health in Primary Care Settings (Sec. 3(4)(p)): This is a new allocation for FY 2016 of $159,619 that IDPH will pass through to the UIHC. The program will provide additional training to medical residency students about mental health and psychiatric prescriptions and on how to track data and outcomes.

Public Protection:

  • Emergency Medical Services (EMS): Increase of $200,000. Funding will support EMS activities including organizing local system/service training, data evaluation, primary system development and providing local EMS agencies assistance in capitalizing use of the system development funds; and to provide technical consultation and assistance to EMS services and providers.

IDPH-related items under the DHS sections of the bill:

  • Eldora Juvenile Home Substance Abuse Treatment Program (Sec. 17(1)(b)): A new directive to DHS to work with IDPH to identify substance abuse programs and resources to provide appropriate treatment for juveniles with substance-related disorders at the State Training School.
  • Child Protection Centers Grant (CPC) Program (Sec. 18(11)): The allocation paragraph was amended to specify that the grant program shall only fund CPCs located in Iowa. In addition, the funding that remains after a base amount is awarded shall be awarded by a funding formula based upon the volume of children served.

IDPH-related items in the policy sections of the bill:

  • Patient-Centered Health Advisory Council (Division VII, Secs. 38-41): Updates the name change from the Medical Homes Systems Advisory Council to the Patient-Centered Health Advisory Council that is administered by IDPH.
  • Health Policy – Oversight (Division IX, Secs. 63-66): This Division does a few things related to managed care.
    • The first is a directive to DHS to hold monthly statewide public meetings to receive input from stakeholders regarding Medicaid managed care beginning in March 2016. The Executive Committee of the Medical Assistance Advisory Council (MAAC) will review the input and make recommendations to DHS.
    • The second establishes a Legislative Health Policy Oversight Committee. This committee will consist of legislators only.
    • The third authorizes the existing Office of Long-Term Care Ombudsman to provide specified types of assistance to Medicaid enrollees that are recipients of long-term care services. This set of directives also includes a directive for a collaborative plan to develop a proposal for the establishment of a health consumer ombudsman alliance due by December 15, 2015. The Office shall work with several state agencies including IDPH.
  • Behavior Analyst and Board Certified Assistant Behavior Analyst Grants Program and Fund (Division X, Secs. 68-7): Creates a new program in IDPH to provide financial assistance to the aforementioned professionals that have been accepted for admission or are attending educational or training programs in preparation of becoming a board certified behavior analyst or assistant behavior analyst. An allocation of $250,000 is provided in Sec. 13(5)(a) of the bill from the DHS Autism Support Program.
  • Interagency Dementia Proficient Workforce Task Force (Division XII, Sec. 73). Directs the Department on Aging (IDA) to convene an interagency task force, that includes IDPH, and in collaboration with the Alzheimer’s Association to review several specified topics. A report is due by December 15, 2015
  • Children’s Mental Health and Well-Being Workgroup (Division XXII, Sec. 102): Directs DHS to facilitate a workgroup of stakeholders that includes IDPH, to study and make recommendations relating to children’s mental health and well-being in Iowa. A report is due by December 15, 2015.
  • Prevention of Disabilities Policy Council (Division XXIII, Sec. 103): Extends the Prevention of Disabilities Policy Council for one additional year until June 30, 2016 and requires the Council to work with DHS, IDPH, and other specified stakeholders to transfer duties to other existing groups.
  • Hospital and Long-Term Care Pharmacy Practice – Pneumococcal Vaccines (Division XXIV, Sec. 104): Directs the Board of Pharmacy to adopt administrative rules that permit the administration of pneumococcal conjugate vaccine to an adult pursuant to physician-approved hospital or facility policy without a written or verbal patient-specific medication administration order.
  • Physician Assistant Supervision (Division XXXI, Sec. 113): Requires the Boards of Medicine and Physician Assistants to jointly adopt rules that establish standards and definitions for supervision of physician assistants by physicians by February 1, 2016.
  • Board of Respiratory Care and Polysomnography (Division XXXIV, Sec. 116): Requires the Board of Respiratory Care and Polysomnography to repay and funds appropriated for the administration of Iowa Code Chapter 148G. IDPH received $36,000 from the Rebuild Iowa Infrastructure Fund (RIIF) in HF 650 (Infrastructure Appropriations Bill) for this purpose however it was vetoed by the Governor therefore this directive is moot.

 

For FY 2017, IDPH was appropriated 50.0% of the allocated funding for FY 2016.

 

List of 2015 Enacted Bills of Public Health Interest

  • Click here to download the publication that is a list of bills that were enacted this session that are of public health interest.
  • To view a list of all of the bills signed into law this session please click here.

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