House File 726 - Reprinted HOUSE FILE 726 BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HF 549) (As Amended and Passed by the House March 20, 2019 ) A BILL FOR An Act relating to certain health and human services-related 1 entities including membership, reimbursement, and the 2 elimination or combining of such entities. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 HF 726 (6) 88 pf/rh/md

H.F. 726 DIVISION I 1 IOWA COLLABORATIVE SAFETY NET PROVIDER NETWORK 2 Section 1. Section 135.24, subsection 7, paragraph e, Code 3 2019, is amended to read as follows: 4 e. “Specialty health care provider office” means the 5 private office or clinic of an individual specialty health 6 care provider or group of specialty health care providers as 7 referred by the Iowa collaborative safety net provider network 8 established in section 135.153 , but does not include a field 9 dental clinic, a free clinic, or a hospital. 10 Sec. 2. Section 135.159, subsection 1, paragraph h, Code 11 2019, is amended by striking the paragraph. 12 Sec. 3. REPEAL. Section 135.153, Code 2019, is repealed. 13 DIVISION II 14 HOSPITAL HEALTH CARE ACCESS TRUST FUND BOARD 15 Sec. 4. Section 249M.4, Code 2019, is amended to read as 16 follows: 17 249M.4 Hospital health care access trust fund —— board . 18 1. A hospital health care access trust fund is created 19 in the state treasury under the authority of the department. 20 Moneys received through the collection of the hospital health 21 care access assessment imposed under this chapter and any 22 other moneys specified for deposit in the trust fund shall be 23 deposited in the trust fund. 24 2. Moneys in the trust fund shall be used, subject to 25 their appropriation by the general assembly, by the department 26 to reimburse participating hospitals the medical assistance 27 program upper payment limit for inpatient and outpatient 28 hospital services as calculated in this section . Following 29 payment of such upper payment limit to participating hospitals, 30 any remaining funds in the trust fund on an annual basis may be 31 used for any of the following purposes: 32 a. To support medical assistance program utilization 33 shortfalls. 34 b. To maintain the state’s capacity to provide access to and 35 -1- HF 726 (6) 88 pf/rh/md 1/ 9

H.F. 726 delivery of services for vulnerable Iowans. 1 c. To fund the health care workforce support initiative 2 created pursuant to section 135.175 . 3 d. To support access to health care services for uninsured 4 Iowans. 5 e. To support Iowa hospital programs and services which 6 expand access to health care services for Iowans. 7 3. The trust fund shall be separate from the general fund 8 of the state and shall not be considered part of the general 9 fund. The moneys in the trust fund shall not be considered 10 revenue of the state, but rather shall be funds of the hospital 11 health care access assessment program. The moneys deposited 12 in the trust fund are not subject to section 8.33 and shall not 13 be transferred, used, obligated, appropriated, or otherwise 14 encumbered, except to provide for the purposes of this chapter . 15 Notwithstanding section 12C.7, subsection 2 , interest or 16 earnings on moneys deposited in the trust fund shall be 17 credited to the trust fund. 18 4. The department shall adopt rules pursuant to chapter 19 17A to administer the trust fund and reimbursements and 20 expenditures as specified in this chapter made from the trust 21 fund. 22 5. a. Beginning July 1, 2010, or the implementation date 23 of the hospital health care access assessment program as 24 determined by receipt of approval from the centers for Medicare 25 and Medicaid services of the United States department of health 26 and human services, whichever is later, the department shall 27 increase the diagnostic related groups and ambulatory patient 28 classifications base rates to provide payments to participating 29 hospitals at the Medicare upper payment limit for the fiscal 30 year beginning July 1, 2010, calculated as of July 31, 2010. 31 Each participating hospital shall receive the same percentage 32 increase, but the percentage may differ depending on whether 33 the basis for the base rate increase is the diagnostic related 34 groups or ambulatory patient classifications. 35 -2- HF 726 (6) 88 pf/rh/md 2/ 9

H.F. 726 b. The percentage increase shall be calculated by dividing 1 the amount calculated under subparagraph (1) by the amount 2 calculated under subparagraph (2) as follows: 3 (1) The amount under the Medicare upper payment limit for 4 the fiscal year beginning July 1, 2010, for participating 5 hospitals. 6 (2) The projected expenditures for participating hospitals 7 for the fiscal year beginning July 1, 2010, as determined by 8 the fiscal management division of the department, plus the 9 amount calculated under subparagraph (1). 10 6. For the fiscal year beginning July 1, 2011, and for 11 each fiscal year beginning July 1, thereafter, the payments to 12 participating hospitals shall continue to be calculated based 13 on the upper payment limit as calculated for the fiscal year 14 beginning July 1, 2010. 15 7. Reimbursement of participating hospitals shall 16 incorporate the rebasing process for inpatient and outpatient 17 services for state fiscal year 2012. However, the total amount 18 of increased funding available for reimbursement attributable 19 to rebasing shall not exceed four million five hundred thousand 20 dollars for state fiscal year 2012 and six million dollars for 21 state fiscal year 2013. 22 8. Any payments to participating hospitals under this 23 section shall result in budget neutrality to the general fund 24 of the state. 25 9. a. A hospital health care access trust fund board is 26 established consisting of the following members: 27 (1) The co-chairpersons and the ranking members of the joint 28 appropriations subcommittee on health and human services. 29 (2) The Iowa medical assistance program director. 30 (3) Two hospital executives representing the two largest 31 private health care systems in the state. 32 (4) The president of the Iowa hospital association. 33 (5) A representative of a consumer advocacy group, involved 34 in both state and national initiatives, that provides data on 35 -3- HF 726 (6) 88 pf/rh/md 3/ 9

H.F. 726 key indicators of well-being for children and families in order 1 to inform policymakers to help children and families succeed. 2 b. The board shall do all of the following: 3 (1) Provide oversight of the trust fund. 4 (2) Make recommendations regarding the hospital health care 5 access assessment program, including recommendations regarding 6 the assessment calculation, assessment amounts, payments to 7 participating hospitals, and use of the moneys in the trust 8 fund. 9 (3) Submit an annual report to the governor and the general 10 assembly regarding the use and expenditure of moneys deposited 11 in the trust fund. 12 c. The department shall provide administrative assistance 13 to the board. 14 DIVISION III 15 ADVISORY COMMITTEE TO THE CENTER FOR RURAL HEALTH AND PRIMARY 16 CARE 17 Sec. 5. Section 135.107, subsection 5, Code 2019, is amended 18 by striking the subsection. 19 Sec. 6. Section 262.78, subsection 3, Code 2019, is amended 20 to read as follows: 21 3. The president of the university of Iowa, in consultation 22 with the president of Iowa state university of science and 23 technology, shall employ a full-time director of the center. 24 The center may employ staff to carry out the center’s purpose. 25 The director shall coordinate the agricultural health and 26 safety programs of the center. The director shall regularly 27 meet and consult with the advisory committee to the center for 28 rural health and primary care. The director shall provide 29 the board of regents with relevant information regarding the 30 center. 31 DIVISION IV 32 GOVERNMENTAL PUBLIC HEALTH ADVISORY COUNCIL 33 Sec. 7. Section 135A.2, subsection 2, Code 2019, is amended 34 by striking the subsection. 35 -4- HF 726 (6) 88 pf/rh/md 4/ 9

H.F. 726 Sec. 8. Section 135A.9, subsection 1, Code 2019, is amended 1 by striking the subsection. 2 Sec. 9. REPEAL. Section 135A.4, Code 2019, is repealed. 3 DIVISION V 4 PATIENT-CENTERED HEALTH ADVISORY COUNCIL 5 Sec. 10. REPEAL. Section 135.159, Code 2019, is repealed. 6 DIVISION VI 7 COMBINING STATE MEDICAL EXAMINER ADVISORY COUNCIL WITH THE 8 INTERAGENCY COORDINATING COUNCIL 9 Sec. 11. Section 691.6B, Code 2019, is amended to read as 10 follows: 11 691.6B Interagency coordinating council. 12 1. An interagency coordinating council is created to advise 13 do all of the following: 14 a. Advise and consult with the state medical examiner on a 15 range of issues affecting the organization and functions of the 16 office of the state medical examiner and the effectiveness of 17 the medical examiner system in the state. 18 b. Advise the state medical examiner concerning the 19 assurance of effective coordination of the functions and 20 operations of the office of the state medical examiner with the 21 needs and interests of the departments of public safety and 22 public health. 23 2. Members of the interagency coordinating council shall 24 include the all of the following: 25 a. The state medical examiner, or when the state medical 26 examiner is not available, the deputy state medical examiner ; 27 the . 28 b. The commissioner of public safety or the commissioner’s 29 designee ; the . 30 c. The director of public health or the director’s designee ; 31 and the . 32 d. The governor or the governor’s designee. 33 e. Representatives from the office of the attorney general, 34 the Iowa county attorneys association, the Iowa medical 35 -5- HF 726 (6) 88 pf/rh/md 5/ 9

H.F. 726 society, the Iowa association of pathologists, the Iowa 1 association of medical examiners, the statewide emergency 2 medical system, and the Iowa funeral directors association. 3 3. The interagency coordinating council shall meet on 4 a regular basis , and shall be organized and function as 5 established by the state medical examiner by rule . 6 Sec. 12. REPEAL. Section 691.6C, Code 2019, is repealed. 7 DIVISION VII 8 TOBACCO USE PREVENTION AND CONTROL COMMISSION —— MEMBERSHIP —— 9 MEETINGS —— EXPENSES 10 Sec. 13. Section 142A.3, subsection 6, Code 2019, is amended 11 to read as follows: 12 6. Citizen members shall be reimbursed for actual and 13 necessary expenses incurred in performance of their duties. 14 Citizen members shall be paid a per diem as specified in 15 section 7E.6 . Legislative members are eligible for per diem 16 and expenses as provided in section 2.10 . 17 Sec. 14. Section 142A.3, subsection 9, Code 2019, is amended 18 to read as follows: 19 9. The commission shall elect a chairperson from among its 20 voting members and may select other officers from among its 21 voting members, as determined necessary by the commission. 22 The commission shall meet regularly no more than quarterly as 23 determined by the commission, upon the call of the chairperson, 24 or upon the call of a majority of the voting members. 25 Sec. 15. TOBACCO USE PREVENTION AND CONTROL COMMISSION —— 26 MEMBERSHIP REDUCTION. The tobacco use prevention and control 27 commission shall evaluate the membership of the commission 28 and shall submit to the department of public health the 29 commission’s recommendation, to be submitted by the director 30 of public health as proposed legislation in compliance with 31 section 2.16 for consideration by the general assembly during 32 the 2020 legislative session, to reduce the number of voting 33 members from nine to seven members. 34 DIVISION VIII 35 -6- HF 726 (6) 88 pf/rh/md 6/ 9

H.F. 726 TRAUMA SYSTEM ADVISORY COUNCIL 1 Sec. 16. Section 147A.24, subsection 2, Code 2019, is 2 amended to read as follows: 3 2. The council shall consist of seven members to be 4 appointed by the director from the recommendations of 5 the organizations in subsection 1 for terms of two years. 6 Vacancies on the council shall be filled for the remainder of 7 the term of the original appointment. Members whose terms 8 expire may be reappointed. 9 Sec. 17. TRANSITION PROVISIONS. Notwithstanding any 10 provision of section 147A.24, subsection 2, to the contrary, a 11 member of the trauma system advisory council on July 1, 2019, 12 shall continue serving until the expiration of that member’s 13 term or until a vacancy occurs prior to the expiration of the 14 applicable term, and such vacancy shall only be filled to the 15 extent consistent with and necessary to maintain the total 16 number of members of the council specified in section 147A.24, 17 subsection 2, as amended in this Act. 18 DIVISION IX 19 TELECONFERENCE OPTION FOR STATE ENTITIES 20 Sec. 18. NEW SECTION . 135.11B Statutory board, commission, 21 committee, or council of committee —— teleconference option. 22 Any statutorily established board, commission, committee, or 23 council established under the purview of the department shall 24 provide for a teleconference option for board, commission, 25 committee, or council members to participate in official 26 meetings. 27 DIVISION X 28 ELIMINATION OF PAYMENT OF EXPENSES FOR PUBLIC MEMBERS OF 29 CERTAIN STATE ENTITIES 30 Sec. 19. Section 105.3, subsection 6, Code 2019, is amended 31 by striking the subsection. 32 Sec. 20. Section 135.43, subsection 2, unnumbered paragraph 33 1, Code 2019, is amended to read as follows: 34 The membership of the review team is subject to the 35 -7- HF 726 (6) 88 pf/rh/md 7/ 9

H.F. 726 provisions of sections 69.16 and 69.16A , relating to political 1 affiliation and gender balance. Review team members who 2 are not designated by another appointing authority shall be 3 appointed by the state medical examiner. Membership terms 4 shall be for three years. A membership vacancy shall be filled 5 in the same manner as the original appointment. The review 6 team shall elect a chairperson and other officers as deemed 7 necessary by the review team. The review team shall meet upon 8 the call of the state medical examiner or as determined by 9 the review team. The members of the team are eligible for 10 reimbursement of actual and necessary expenses incurred in the 11 performance of their official duties. The review team shall 12 include the following: 13 Sec. 21. Section 135.62, subsection 2, paragraph e, Code 14 2019, is amended by striking the paragraph. 15 Sec. 22. Section 147A.3, Code 2019, is amended to read as 16 follows: 17 147A.3 Meetings of the council —— quorum —— expenses . 18 Membership, terms of office, and quorum , and expenses shall 19 be determined by the director pursuant to chapter 135 . 20 Sec. 23. Section 256I.3, subsection 3, Code 2019, is amended 21 by striking the subsection. 22 DIVISION XI 23 ELIMINATION OF CHILD WELFARE ADVISORY COMMITTEE, CHILD 24 SUPPORT ADVISORY COMMITTEE, CHILDREN’S MENTAL HEALTH WAIVER 25 IMPLEMENTATION COMMITTEE, AND PROPERTY TAX RELIEF FUND RISK 26 POOL. 27 Sec. 24. Section 217.3A, subsection 1, Code 2019, is amended 28 to read as follows: 29 1. General. The council on human services shall establish 30 and utilize the advisory committees committee identified in 31 this section and may establish and utilize other advisory 32 committees. The council shall establish appointment 33 provisions, membership terms, operating guidelines, and other 34 operational requirements for committees established pursuant to 35 -8- HF 726 (6) 88 pf/rh/md 8/ 9

H.F. 726 this section . 1 Sec. 25. Section 217.3A, subsections 3 and 4, Code 2019, are 2 amended by striking the subsections. 3 Sec. 26. Section 426B.5, subsection 1, Code 2019, is amended 4 by striking the subsection. 5 Sec. 27. 2005 Iowa Acts, chapter 117, section 4, subsection 6 3, is amended by striking the subsection. 7 DIVISION XII 8 MEDICAL ASSISTANCE ADVISORY COUNCIL 9 Sec. 28. MEDICAL ASSISTANCE ADVISORY COUNCIL —— VOTING 10 MEMBER SUSPENSION. Notwithstanding any provision of law to the 11 contrary, if a representative of a professional or business 12 entity, a public member, or a member of the hawk-i board who 13 is a voting member of the medical assistance advisory council 14 pursuant to section 249A.4B, subsection 2, is absent for 15 two consecutive meetings of the medical assistance advisory 16 council, the member shall be suspended from participation in 17 the deliberations of the advisory council for a period of 18 twelve months from the date of the member’s second absence. 19 During the member’s suspension period, the voting rights of the 20 professional or business entity, consumer group or consumer 21 organization, or the hawk-i board shall not be exercised, but 22 the vacancy in voting membership shall not prohibit the medical 23 assistance advisory council from achieving a quorum. 24 -9- HF 726 (6) 88 pf/rh/md 9/ 9