1999 Summary of Legislation Published by the Iowa General Assembly -- Legislative Service Bureau

HEALTH AND SAFETY

HEALTH AND SAFETY LEGISLATION

SENATE FILE 248 - Acquired Immune Deficiency Syndrome - Miscellaneous Provisions(full text of act)

BY COMMITTEE ON HUMAN RESOURCES. This Act replaces the statute pertaining to acquired immune deficiency syndrome (AIDS), which is currently divided into subchapters, with a new chapter that combines the subchapters and makes changes to the chapter. Existing Code Chapter 141 is repealed.

The Act provides a new definition of "care provider," which encompasses any person providing health care services of any kind, including emergency medical assistance or treatment. The Act expands the definition of "legal guardian" to include an "attorney in fact," deletes the definition of "ARC" or "AIDS-related complex," and adds the definition of "sample" to include any specimen obtained for the purposes of conducting a human immunodeficiency virus (HIV)-related test.

The Act designates the Iowa Department of Public Health as the lead agency in the coordination and implementation of the state's AIDS prevention and intervention plan. The Act authorizes the department to adopt rules to implement and enforce the Act and continues the authorization for the department to coordinate efforts with local health officers to investigate sources of HIV infection and to use every appropriate means to prevent the spread of the disease. The Act also continues authorization for the department to conduct epidemiological blinded and nonblinded studies. The Act assigns several duties to the department, including broad responsibilities for testing, education and disease control.

The Act continues the requirement that testing and counseling be offered for specified groups. In addition, the Act requires that all pregnant women receive information about testing and treatment opportunities to reduce the possible transmission of HIV to a fetus, requires that all pregnant women with risk factors for HIV be strongly encouraged to be tested, and requires that upon request a pregnant woman be tested regardless of the absence of risk factors.

The Act requires that the department maintain a partner notification program for persons known to have tested positive for HIV infection. Persons with positive test results must receive posttest counseling and must be encouraged to refer for counseling and testing any person who may have sustained a significant exposure from a person with a positive test result. The Act continues the provision that a physician for an infected person may initiate partner notification when the infected person will not participate and will not warn an exposed third party. The Act deletes the current requirement that when a person who tests positive for HIV infection will not participate in partner notification prior to notification of a third party, the physician proposing to cause the notification must make reasonable efforts to inform, in writing, the person who tested positive.

The Act provides for the performance of voluntary testing, eliminates anonymous testing, and continues the reporting requirements for positive test results.

The Act replaces pretest counseling with the requirement that prior to undergoing an HIV-related test, information be made available to the subject of the test concerning testing and any means of obtaining additional information regarding HIV infection and risk reduction. The Act requires that upon informing the subject of positive test results, counseling must be initiated with emphasis given to the need for precautions to prevent transmitting the virus. The Act continues the provisions granting exceptions to counseling in instances of donation of body parts, patients unable to give consent, insurance exams, and testing of deceased persons involved in a documented significant exposure incident. The provisions relating to HIV-related testing of minors are amended to eliminate the provision that if a person who personally applies for services, screening or treatment is a minor, the fact that the minor sought services or is receiving services, screening or treatment is not to be reported or disclosed except for statistical purposes. The Act retains the provision that confirmed positive HIV test results are to be reported to a minor's legal guardian.

The Act provides a notification process under which care providers who have suffered a significant exposure to an individual in the course of providing assistance may obtain information concerning that individual's HIV status. The Act adds a provision that if a care provider in the course of providing care on the premises of a hospital or health facility sustains a significant exposure, the person to whom the care provider was exposed is deemed to have consented to an HIV-related test, upon the written request of the care provider. The sample and test results are identified by a number and no report otherwise required is to be made which identifies the subject of the test. If the results are positive, the subject of the test is to be informed and provided with counseling.

The Act provides for strict confidentiality of medical information relating to a patient's HIV status and contains specific provisions relating to when that information may be released and to whom.

The Act provides immunities for persons making reports pursuant to the Act and provides that health care providers do not have a duty to warn third parties regarding contact with a person who has positive HIV test results.

The Act establishes civil and criminal remedies for violations of confidentiality and other provisions of the Act. The penalty for violation of a confidentiality requirement relating to the partner notification program is reduced from a class "D" felony (which carries a maximum sentence of confinement of not more than five years and in addition may include a fine of at least $500, but not more than $7,500) to an aggravated misdemeanor (which carries a maximum sentence of imprisonment not to exceed two years and a fine of at least $500, but not more than $5,000). The Act contains the specific civil penalty of $1,000 for a care provider who intentionally or recklessly makes an unauthorized disclosure of medical information.

The Act eliminates the provisions for accreditation of HIV testing laboratories.

The Act makes conforming changes necessitated by the enactment of new Code Chapter 141A and the repeal of Code Chapter 141.

SENATE FILE 277 - Physician Assistants and Advanced Registered Nurse Practitioners - Hospital Clinical Privileges(full text of act)

BY COMMITTEE ON STATE GOVERNMENT. This Act provides that the rules adopted for hospitals by the Department of Inspections and Appeals with the advice and approval of the Hospital Licensing Board and the State Board of Health shall not deny clinical privileges to physician assistants and advanced registered nurse practitioners solely by reason of the license held or by reason of the professional education received by the practitioner.

SENATE FILE 482 - Tobacco Product Manufacturers - Settlement Agreement(full text of act)

BY IVERSON AND GRONSTAL. This Act provides for enactment of the model statute included in the Master Settlement Agreement (MSA), entered into on November 23, 1998, by 46 states and Brown and Williamson Tobacco Corporation, Lorillard Tobacco Company, Phillip Morris Incorporated, Commonwealth Tobacco, R.J. Reynolds Tobacco Company, and Liggett and Myers, among others. One portion of the MSA is a model statute that each state is encouraged to enact as a precautionary measure in being awarded the maximum amount of payment due the state.

The model statute includes definitions and requirements of tobacco companies. Under the MSA, a tobacco company may reduce payments to the states if a participating manufacturer experiences a loss of market share. However, if a state enacts the model statute and such a market share loss occurs, that state's total settlement amount will not be reduced as would otherwise be the case; instead, a greater portion of the reduction of payments will be borne by those states that have not enacted the model statute.

Under the Act, a tobacco company either becomes a participating tobacco company or places moneys in an escrow account in the amounts and manner and for the reasons specified under the Act. The Act specifies the reasons for which moneys may be released from escrow, the penalties for not placing funds in escrow, including that the Attorney General may bring a civil action on behalf of the state against any tobacco manufacturer who fails to place the required funds in escrow, and that the court may impose a civil penalty if a tobacco manufacturer fails, in any year, to place the required funds in escrow.

The Act takes effect May 20, 1999.

HOUSE FILE 379 - Health Care Facility Care Review Committees - Name Change(full text of act)

BY COMMITTEE ON HUMAN RESOURCES. This Act changes the name of "care review committee" to "resident advocate committee" throughout the Code. Each health care facility is required to have a committee, whose members are appointed by the Director of Elder Affairs to review the needs of and care provided to residents of the facility.

HOUSE FILE 497 - Public Health - Miscellaneous Programs and Issues(full text of act)

BY COMMITTEE ON HUMAN RESOURCES. This Act provides for several changes related to the administration of programs under the purview of the Iowa Department of Public Health and health-related professional licensing and regulatory boards.

The Act eliminates the specific list of entities eligible for licensure as substance abuse treatment facilities.

The Act provides for requests for exceptions to embalming and disposition rules if the rules would conflict with the tenets and practices of a recognized religious denomination to which the deceased adhered or of which the deceased was a member.

The Act provides separate definitions for "brain injury" and "spinal cord injury," and expands the scope of the department's brain injury information registry by renaming it the Central Registry for Brain and Spinal Cord Injury and requiring hospitals to report the brain and spinal cord injuries of persons admitted as patients.

The Act changes Code references to the "Lead Abatement Program" to "Childhood Lead Poisoning Prevention Program" and eliminates the use of the term "abatement" for purposes of lead hazard surveillance. The Act eliminates a requirement that rules adopted by the State Fire Marshal for certain residential care facilities be no more restrictive than those adopted for those facilities under a demonstration waiver pilot project.

The Act modifies the membership composition of the department's technical advisory committee for operators of radiation machines, provides for the availability of emergency reserve funding to local boards of health, and defines "court of competent jurisdiction" for the purposes of inspection of an original certificate of birth, based upon an adoption.

The Act makes technical corrections and updates outdated references to the duties of the county registrar regarding fees associated with registering a certificate of birth. Fees would only be collected by the State Registrar.

The Act adds biological parent to the list of persons entitled to be informed of which court issued an adoption order and directs the department to establish a voluntary adoption registry through which adult adoptees, their siblings, and biological parents could register to reveal the identity of each other. The registry would only reveal information to those persons who have mutually consented to participate. The State Registrar is to establish a filing fee to support the costs associated with the registry.

The Act eliminates references to the Iowa Board of Medical Examiners in Code Chapter 147A (Emergency Medical Care - Trauma Care), including striking a requirement that any disciplinary actions relating to clinical issues be referred to the board. The Act also provides that investigators authorized by the department, rather than the board, have the powers of peace officers when enforcing the chapter.

The Act eliminates the prohibition on chiropractors from advertising or selling nutritional supplements, eliminates required oral exams and proficiency testing for licensing as a funeral director, provides the Board of Mortuary Science Examiners with the authority to establish practicums in mortuary science, and extends the license period for cosmetology salons and barbershops from one year to two years.

The Act provides the department and professional licensure boards with access to dependent adult and child abuse records.

The Act makes changes and updates regarding the Council on Chemically Exposed Infants and Children and changes the status of the directors of Human Services, Human Rights, Education, and Corrections from nonvoting to voting members. The Act authorizes the Department of General Services and the Director of Transportation to allow department disease investigators to use unmarked state vehicles.

The Act provides that funds transferred to the Iowa Department of Public Health from the state Department of Transportation from revenues derived from the "Love Our Kids" license plates shall not revert to the General Fund of the State.

The Act provides that county claims for autopsy expenses shall be forwarded to the State Appeal Board and paid from a standing unlimited appropriation if funds are not appropriated to the department for payment of these claims.

The Act also requires the Iowa Department of Public Health and the Department of Human Services to review and make recommendations to the General Assembly regarding implementation of an affidavit process to overcome paternity established by operation of law when the established father and mother of the child are or were married to each other at the time of conception or birth of the child, and to simultaneously establish paternity of the biological father. The departments are required to submit a report of the review to the General Assembly and to the chairpersons of the Senate and House Human Resources Committees by December 15, 1999.

HOUSE FILE 708 - Quality Care Award for Health Care Facilities(full text of act)

BY COMMITTEE ON HUMAN RESOURCES. This Act establishes a Governor's Award for Quality Care to be awarded annually to a health care facility in the state that demonstrates the provision of quality care to its residents. The Act requires the Department of Inspections and Appeals to adopt rules, in consultation with the members of the Iowa Partners for Resident Care, establishing the criteria to determine quality care.

HOUSE FILE 741 - Psychiatric Medical Institutions for Children - Authorization Requirements(full text of act)

BY COMMITTEE ON LOCAL GOVERNMENT. This Act relates to the authorization requirements for psychiatric medical institutions for children (PMICs), which are licensed by the Department of Inspections and Appeals.

The Act amends various requirements relating to inspection and conditions for issuance of PMIC licenses. Prior law required approval of a license application by the Department of Human Services based upon the department's determination of need. The number of beds that may be approved was limited to 360 general beds and 70 beds specialized in substance abuse treatment. The Act combines these two categories into a general limitation of 430 beds that are reimbursed through the Medical Assistance (Medicaid) Program. The Act authorizes the Department of Human Services to approve conversion of general PMIC beds to substance abuse specialized beds within the general limitation.

The Act clarifies that the 30 beds the Department of Human Services is authorized to establish at the Independence Mental Health Institute are in addition to the other 430 beds.

Current law permits PMICs licensed prior to January 1, 1996, to add additional licensed beds without compliance with certain requirements, if the additional beds are not reimbursed under Iowa's Medical Assistance Program. The Act changes the date to provide this authorization to PMICs licensed prior to July 1, 1999.

The Act takes effect April 22, 1999.

RELATED LEGISLATION

SENATE FILE 8 -- Health Insurance Coverage of Diabetes (Complete summary under BUSINESS, BANKING & INSURANCE.)

This Act requires that a policy or contract providing for third-party payment or prepayment of health or medical expenses provide coverage for the costs associated with certain equipment, supplies, and self-management training and education for the treatment of all types of diabetes mellitus when prescribed by certain licensed physicians.

SENATE FILE 99 -- Board of Nursing Examiners - Composition (Complete summary under STATE GOVERNMENT.)

This Act changes the composition requirements for nurses on the Iowa Board of Nursing Examiners.

SENATE FILE 106 -- Church Buildings - Accessibility Requirements (Complete summary under STATE GOVERNMENT.)

This Act provides that the provisions of the State Building Code concerning accessibility of persons with disabilities do not apply to buildings used as a place of worship. The Act takes effect on April 22, 1999.

SENATE FILE 186 -- County Enterprises (Complete summary under LOCAL GOVERNMENT.)

This Act allows counties to use revenue bonds to finance the construction and maintenance of county memorial hospitals and housing for the elderly or persons with physical disabilities.

SENATE FILE 211 -- Medicaid Eligibility - Persons With Disabilities (Complete summary under HUMAN SERVICES.)

This Act provides that under the optional categories to be covered under the Medical Assistance (Medicaid) Program, the highest priority is provision of coverage to persons with disabilities who are less than 65 years of age, with family net incomes of less than 250 percent of the federal poverty level, and who have earned income, but are eligible for medical assistance if such earnings are disregarded.

SENATE FILE 231 -- Sales and Use Tax Exemption for Hospices (Complete summary under TAXATION.)

This Act exempts sales and services provided to a freestanding nonprofit hospice facility that operates a hospice program if the sales and services are to be used in the program.

SENATE FILE 254 -- Emergency Management Services (Complete summary under STATE GOVERNMENT.)

This Act authorizes the Emergency Management Division of the Department of Public Defense to repair, calibrate or maintain radiological detection equipment for a fee, in competition with private business; requires local governments to file an approved comprehensive operations plan with the state effective July 1, 2000, to be eligible for state financial assistance for disaster-related expenses, serious needs or hazard mitigation; and requires the administrator of the division to report to the General Assembly by January 15, 2000, regarding state government preparedness to respond to nuclear, chemical or biological materials incidents and identify unmet needs for preparedness and response efforts.

SENATE FILE 275 -- Children's Centers - Certification or Licensing Standards (Complete summary under CHILDREN & YOUTH.)

This Act requires the Department of Human Services to adopt licensing or certification standards for a new facility category called "children's centers." Children's centers are privately funded facilities that provide various types of services to children who are not under the custody or authority of the Department of Human Services, juvenile court, or other governmental agency.

SENATE FILE 283 -- Federal Block Grant Appropriations (Complete summary under APPROPRIATIONS.)

This Act appropriates federal block grant and other nonstate moneys to various state agencies for the federal fiscal year beginning October 1, 1999, and ending September 30, 2000, and for the state fiscal year beginning July 1, 1999, and ending June 30, 2000. The Act includes appropriations for maternal and child health, preventive health and health services, substance abuse, and other health-related programs.

SENATE FILE 287 -- Foster Care Placements and Plans - Child Abuse Information - Decategorization Plans (Complete summary under CHILDREN & YOUTH.)

This Act relates to child welfare provisions and affects voluntary court-ordered foster care placements of children with mental retardation or other developmental disability in facilities.

SENATE FILE 323 -- Audiologists and Speech Pathologists - Professional Designations (Complete summary under STATE GOVERNMENT.)

This Act prescribes the professional prefix or suffix that may be utilized by a speech pathologist or audiologist with an earned doctoral degree obtained beyond a bachelor's degree from an accredited school, college or university.

SENATE FILE 361 -- Appropriations - Substance Abuse and Sexual Abuse (Complete summary under APPROPRIATIONS.)

This Act provides funding and establishes programs for enforcement, prevention, education, and treatment for substance abuse, especially methamphetamine abuse, and sexual abuse, and for programs for at-risk youth. The Act appropriates moneys to the Iowa Department of Public Health to establish a Model Substance Abuse Prevention Program. The Act also requires the Iowa Department of Public Health to incorporate methamphetamine education into various programs administered by the department.

SENATE FILE 439 -- Iowa Community Empowerment - Miscellaneous Provisions (Complete summary under CHILDREN & YOUTH.)

This Act relates to the Iowa Community Empowerment Act, the Iowa Empowerment Board, and related provisions.

HOUSE FILE 224 -- Public Hospital and Health Care Facility Operations (Complete summary under LOCAL GOVERNMENT.)

This Act authorizes a city or county having a memorial or other public hospital to change the number of commissioners or trustees who supervise the administration of the hospital and, in some cases, the qualifications of the commissioners. The Act strikes a requirement that at least one trustee visit and examine the county hospital each month; and provides that a county hospital may deliver any health care service, assisted or independent living service, or other ancillary service to the public.

HOUSE FILE 242 -- Substantive Code Corrections (Complete summary under STATE GOVERNMENT.)

This Act contains statutory corrections that adjust language to reflect current practices, insert earlier omissions, delete redundancies and inaccuracies, delete temporary language, resolve inconsistencies and conflicts, update ongoing provisions, or remove ambiguities. The Act amends child abuse record check provisions to specify that if the Department of Human Services determines that an applicant for employment with a health care facility has a record of founded child abuse, the department is also to notify the licensee that an evaluation will be conducted to determine whether the person's employment is warranted; changes, in provisions relating to reporting of certain wounds that appear to have been received as the result of a criminal offense, the term "serious bodily injury" to the defined term "serious injury," which is referenced in the provisions; strikes an obsolete requirement relating to providing information regarding on-site review of waste management in product bidding and contract procedures for institutions under the Commission for the Blind and the State Board of Regents; corrects an internal reference in provisions relating to computation of tax deductions for medical expenses; deletes references to the former Community Health Management Information System; corrects references that pertain to the availability of suspended or deferred sentences in the domestic abuse assault provisions; conforms, in provisions relating to the powers and duties of the Director of the Department of Corrections, language relating to the provision of "habilitative services and treatment" to the term as defined within Code Section 904.108; conforms, in the Victim Rights chapter, provisions relating to the performance of medical examination and treatment to existing practice; amends HIV-related testing provisions to conform to prior Code changes; and conforms language relating to transportation of domestic abuse victims to medical care to the provisions cited.

HOUSE FILE 402 -- Proposed Licensure of Midwives - Review (Complete summary under STATE GOVERNMENT.)

This Act provides for the establishment of a Scope of Practice Review Committee regarding the proposed licensure of certified professional midwives.

HOUSE FILE 489 -- Infectious Waste Regulation (Complete summary under ENVIRONMENTAL PROTECTION.)

This Act eliminates certain requirements relating to the regulation of infectious waste. The Act eliminates the requirement that the Department of Natural Resources institute an infectious waste management program in cooperation with the Iowa Department of Public Health.

HOUSE FILE 664 -- Mental Health, Mental Retardation, and Developmental Disabilities Services (Complete summary under HUMAN SERVICES.)

This Act addresses a number of provisions involving mental health, mental retardation and developmental disabilities (MH/MR/DD) services, including facility regulatory provisions.

HOUSE FILE 760 -- Appropriations - Human Services (Complete summary under APPROPRIATIONS.)

This Act provides appropriations to the Department of Human Services (DHS) for FY 1999-2000, and includes provisions related to human services and health care. The Act directs DHS, in consultation with the Iowa Department of Public Health and the Department of Education, to continue the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program; provides that if allowed under federal law and regulation, $65,000 of the penalties collected for violations by health care facilities which receive MA reimbursements shall not be deposited in the General Fund but shall be used to continue to fund the recruitment and retention strategies to provide additional training and support for certified nurse aides, employed by nursing facilities, as a means of reducing staff turnover; and directs DHS to implement a study, with an advisory committee, of disease-specific pharmaceutical case management; directs DHS to expand the drug prior authorization requirement for prescription drugs under the Medical Assistance program; directs DHS to ensure that meetings of the Drug Utilization Commission are conducted in compliance with the open meetings law and that physician and pharmacist membership terms are limited; and appropriates funding for the state Children's Health Insurance Program.

HOUSE FILE 761 -- Child Care - Miscellaneous Provisions (Complete summary under CHILDREN & YOUTH.)

This Act makes numerous changes to child care Code provisions and directs the departments of Education, Human Services and Public Health to jointly establish a leadership council to develop a proposal for implementation of a statewide child care provider training and development system. The council is directed to submit an initial proposal to the three departments in December 1999. This part of the Act takes effect upon enactment, May 27, 1999.

HOUSE FILE 782 -- Miscellaneous Supplemental and Other Appropriations and Provisions (Complete summary under APPROPRIATIONS.)

Division III of this Act transfers the position of State Medical Examiner, for administrative purposes, to the Iowa Department of Public Health. The Division also creates the position of deputy state medical examiner, an Interagency Coordinating Council to advise the State Medical Examiner regarding the needs and interests of the departments of Public Safety and Public Health, and a State Medical Examiner Advisory Council. The Division also provides for acceptance of federal or private grants for the office by the Director of Public Health. Division VI of the Act amends Code Chapter 137F, relating to exemptions from inspection requirements under the definition of a "food establishment," and exempts certain food items from inspections pursuant to the state Food Code; repeals the exemption from the regulation of home food establishments for those establishments having gross annual sales of prepared food of $1,000 or less if the preparer of the food identifies, by name and address, the person preparing the food; and provides that under the Healthy and Well Kids in Iowa (HAWK-I) Program the HAWK-I Board does not have to, but may, include in its outreach efforts a comprehensive statewide media campaign, solicitation of cooperation from programs, agencies, and other persons likely to have contact with eligible children, and the development of community plans for outreach and marketing. In addition, the Division repeals the requirement that the administrative contractor for the HAWK-I Program perform outreach activities based upon the outreach plan approved by the HAWK-I Board.

© 1998 Cornell College and League of Women Voters of Iowa

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Last update: SAT July 10 1999
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