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.