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[Dome]Interim Calendar and Briefing

September 25, 1996

Contents:
Calendar of Scheduled Meetings
Agenda Information Regarding Scheduled Meetings
BRIEFINGS - Information Regarding Recent Meetings

Calendar of Scheduled Meetings

Friday, October 4, 1996
Fiscal Committee of the Legislative Council
10:00 a.m., Room 116
Tuesday, October 8, 1996
Administrative Rules Review Committee -
10:00 a.m., Room 22
Wednesday, October 9, 1996
Administrative Rules Review Committee -
9:00 a.m., Room 22

Agenda Information Regarding Scheduled Meetings

Fiscal Committee of the Legislative Council

Co-chairperson: Senator Larry Murphy
Co-chairperson: Representative David Millage

Administrative Rules Review Committee

Co-chairperson: Senator Berl E. Priebe
Co-chairperson: Representative Janet Metcalf

BRIEFINGS - Information Regarding Recent Meetings

ANIMAL AGRICULTURE CONSULTING ORGANIZATION

September 17, 1996

Overview.
The Animal Agriculture Consulting Organization was established in 1995 pursuant to H.F. 519 to provide recommendations to the Department of Natural Resources regarding the regulation of animal feeding operations. The Organization invited persons to provide comments. The organization heard comments regarding the need for more stringent regulations concerning animal feeding operations. The Organization then considered a number of issues, including the following:
The sale of manure, and specifically poultry and turkey manure under chapter 200. Concerns were expressed that producers could avoid manure management plan requirements by registering and selling the manure as fertilizer or soil conditioners under chapter 200.
Standards relating to the construction of anaerobic lagoons which are dug into the earth near groundwater. The Organization was presented with information by the Department of Natural Resources Geographical Survey Bureau concerned with the vulnerability of certain regions of the state where groundwater sources are close to the earth's surface.
The improper construction of a number of anaerobic lagoons by a producer. The Organization saw a number of photographs showing the inadequate installation of clay liners and the use of rip rap.
The adoption of standards for the concrete construction of manure storage structures.
Distance requirements between land where manure is applied and agricultural drainage wells.
The determination of when two or more operations are considered adjacent for purposes of regulation.
Action.
Several subcommittees were established and the Organization agreed to consider these issue at a future date.

LEGISLATIVE FISCAL COMMITTEE OF THE LEGISLATIVE COUNCIL

September 18, 1996

Meeting Place.
Veterinary Medicine College, Iowa State University, Ames, Iowa.
Revenue Update.
Mr. Dennis Prouty, Director of the Legislative Fiscal Bureau (LFB) reported that daily revenue receipts, as of September 17, are 7.3 percent greater than they were last year at this time. The Revenue Estimating Conference will meet on November 21 at 10:00 a.m. in Room 22 of the State Capitol Building to develop the estimate used in calculating the expenditure limitation for the General Fund for Fiscal Year 1997-1998.
Lottery Administrative Expenses.
The Des Moines Register ran a story in August claiming that the Iowa lottery's administrative costs, based upon U.S. Census Bureau figures, are double that of the national average. The story prompted the following testimony:
Mr. Jeff Robinson, LFB, reported that the U.S. Census Bureau's information is insufficient for the purpose of comparing the administrative costs of state lotteries. As an example, he noted that the Census Bureau did not include the sales tax collected or compensation for ticket retailers in either the revenues or expenditures of the Iowa Lottery. He calculates that Administrative expenses for FY 1996, including advertising, retail compensation, tickets, vendor compensation, personnel, communications, rentals, and other administration, totaled 17.8 percent of total revenues.
Dr. Ed Stanek, Iowa Lottery Commissioner, refuted the Register's conclusions, citing errors in the Register's use of Census Bureau data and in the chart on which the Register based its conclusions. He noted that some states appropriate sums for law enforcement and legal services, for example, from their general funds, while in Iowa such expenses are paid from the Iowa Lottery's appropriation. He reported that Iowa's administrative costs will be higher than states which, for example, benefit from economies of scale, location, a history of gaming, more lottery options, fewer gambling opportunities, lower telephone costs, and lower legal gambling ages. He pointed out that each year, administration costs have decreased (except in 1993 due to a decision in a collective bargaining court case), and the number of full-time positions at the Iowa Lottery has fallen each year since 1992 (109 in FY 1996 compared to 132 in FY 1991).
Mr. Duane Burke, Chairman and CEO of the Public Gaming Research Institute, Inc., Seattle, WA, reported that the Iowa Lottery recently earned an A+ for efficiency and performance from his organization.
Tours of ISU Departments and Buildings.
Members and staff toured the Veterinary Medicine facility, Kildee Hall, the Intensive Livestock Research Site, and learned about plans for the Engineering Department's facilities, the university's meat irradiation facility, and the many research projects being conducted under the Healthy Livestock Initiative.
Next Meeting.
Friday, October 4 at 10:00 a.m. in Room 116 at the State Capitol Building.

HEALTH REGULATION TASK FORCE

September 18, 1996

Background.
The Iowa Health Regulation Task Force was established by the Iowa Department of Public Health to review health regulation in Iowa and to make recommendations to the Governor by December 1996 for appropriate changes to improve health care access, cost, and delivery. The Task Force grew out of a health care regulation conference sponsored by state government and private sector organizations held in August 1995. The Task Force membership includes legislators, and representatives of business, labor, health care industry, interest groups, and health care regulators. Three committees are focusing on particular aspects of health regulation.
Committee Progress Reports.
Summaries of progress made by the three Task Force committees during the first meeting of the Task Force were provided:
Health Facilities/Long Term Care.
The committee heard from several interested groups regarding the certificate of need program, and voted to retain it in a modified form. The committee will be focusing on necessary changes and modifications to the program, and also on specific objectives with regard to regulatory system change.
Health Systems and Plans.
The committee dealt with the regulation of organized delivery systems, and was interested in additional information regarding private sector promotion of managed care systems. A matrix of identified regulatory issues, their current approach, and recommendations for changes will be developed.
Health Professions.
The committee will be addressing three primary issues -- scope of practice, focusing on informing the political process; the organization of boards, focusing on the functions of licensing boards; and continuing education and competency.
Presentations To The Full Task Force:
Mr. David Montgomery, Administrator for the Nebraska Health Department and Chairman of the Council On Licensure Enforcement And Regulation of the Council of State Governments, addressed national perspectives on the issue of health regulation. Mr. Montgomery discussed the fundamental goals of health professional licensing, state responses to those goals, and the major tensions and issues regarding state struggles to accomplish them. Four primary goals of professional regulation were identified -- efficiency, fairness, practicability, and accountability.
Mr. Paul Pietzsch, President of the Health Policy Corporation of Iowa, discussed the challenge of effective regulation in the public interest in a market-based system. Mr. Pietzsch indicated that the current environment has managed cost, not care, and that in the future the health care market will be driven by quality concerns in addition to cost.
Health Professions Committee:
Scope of Practice. Mr. Montgomery defined a scope of practice as that which a profession is authorized to do, and indicated that it is constantly changing and evolving. Criteria for identifying scope of practice issues were set forth, and procedures in Nebraska and Ontario for scope of practice changes were outlined. The committee determined that a survey should be developed and distributed to legislators, board members, and staffs, identifying what is currently working, what isn't, and what additional research and education process would be beneficial. Results of the survey will be distributed and discussed at the next meeting.
Organizational Structure of Health Licensing Boards. A list of basic board functions was discussed. Identified functions include issuing an initial license, license review, defining practice standards, enforcement of laws and regulations, ensuring continuing professional and board member competency, evaluation and definition of board operating capacity and expertise, administrative function, and effective communication and education of members of the public, licensees, and policy-makers. It was determined that feedback from the 22 boards relating to organization and function issues is needed.
Continuing Education and Competency. Mr. Montgomery summarized approaches taken to continuing education requirements in several states, and indicated that while there is consensus that the continued competency of health service providers must be provided for, there is a lack of consensus regarding methodology. There is also a lack of evidence that continuing education equals continuing competency for any given professional. The committee determined that a role for continuing education still exists. Additional information will be obtained on approaches in Ontario and New York, as well as a self-assessment tool utilized by the Wisconsin Pharmacy Board.
Next Meeting.
The next meeting of the Task Force is scheduled for October 16th.

ICN AUTHORIZED USER & USE TASK FORCE

September 20, 1996, First of Two Meetings

Background.
The ICN (Iowa Communications Network) Authorized User & Use Task Force was created by the Iowa Telecommunications and Technology Commission (ITTC) for the purpose of recommending to the ITTC a set of guidelines relating to access to the network. The Task Force is comprised of representatives from each authorized user group and the telecommunications industry. The Task Force is to complete its work and submit a report to the ITTC by no later than November 15, 1996. The Task Force is scheduled to conduct two meetings which are being facilitated by State Public Policy Group.
Project Overview.
The Task Force reviewed its task and identified its mission as recommending "to the ITTC a set of guidelines that assure compliance with current state laws governing access to ICN facilities." The Task Force will use current statutory authority and identify those entities which are authorized to connect to the ICN and those entities which are authorized to access and utilize ICN facilities for authorized purposes. The Task Force also hopes to identify those entities which are not authorized to access and utilize ICN facilities and those instances where there appears to be a question as to whether the entity may access and utilize such facilities.
Task Force Action.
The Task Force received information and discussed legal issues associated with the study and the network. The Task Force also began development of an ICN authorized user profile information sheet which will be used to identify those entities where there is agreement that access is not authorized, agreement that access is authorized, agreement that access is authorized under certain circumstances, and where agreement cannot be reached regarding access.
Next Meeting.
The second and final meeting of the Task Force is scheduled for Friday, October 25, 1996.

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