IOWA HEALTH SYSTEM
Summary of 2009 Enacted Legislation
Table of Contents
1. Labor and Employment Issues
2. Reimbursement
3. Liability and Regulation
4. Health Care Policy
5. General Provisions
6. Pharmaceutical Related Issues
7. Interim Studies
Note: The summaries included in this document are not intended to be a substitute for a legal analysis
regarding the applicability of a particular law. Please contact the IHS legal department for in depth
questions regarding a law’s applicability to your organization or department. To view the legislation,
press control and click on the highlighted Senate or House File numbers and you will be taken to the
legislative website. The internet address for the Iowa legislative website is www.legis.state.ia.us.
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LABOR AND EMPLOYMENT ISSUES.
SENATE FILE 137 – WAGE DISCRIMINATION/ UNFAIR EMPLOYMENT PRACTICE.
This bill provides that it is an unfair or discriminatory practice for any employer to discriminate against
any employee because of the age, race, creed, color, sex, sexual orientation, gender identity, national
origin, religion, or disability of an employee by paying wages at a rate less than the rate paid to other
employees who are employed within the same establishment for equal work on jobs, the performance of
which requires equal skill, effort, and responsibility, and which are performed under similar working
conditions.
An employer can assert an affirmative defense for a claim if any of the following apply:

Payment of wages is made pursuant to a seniority system.

Payment of wages is made pursuant to a merit system.

Payment of wages is made pursuant to a system which measures earnings by quantity or
quality of production.

Pay differential is based on any other factor other than the age, race, creed, color, sex, sexual
orientation, gender identity, national origin, religion, or disability of such employee.
This bill does not apply to any employer who regularly employs less than four individuals. An employer
who is paying wages to an employee at a rate less than the rate paid to other employees is prohibited from
remedying the violation by reducing the wage rate of any employee.
Damages for an injury caused by the unfair practice include court costs, reasonable attorney fees, and
either an amount equal to two times the wage differential paid to another employee compared to the
complainant for the period of time for which the complainant has been discriminated against or in the
instances of a willful violation, an amount equal to three times the wage differential paid to another
employee as compared to the complainant for the period of time for which the complainant has been
discriminated against.
Signed by Governor April 28, 2009. Effective July 1, 2009
HOUSE FILE 618 – CHILD LABOR / WAGE PAYMENT VIOLATIONS.
This bill increases the monetary civil penalty for a violation of the wage payment collection law from
$100 to $500 for each violation and specifies that the monetary civil penalty shall be assessed per pay
period for each violation. The bill also makes several changes relating to child labor laws in chapter 92.
The penalties for a criminal child labor violation are increased from a simple misdemeanor to a serious
misdemeanor and the commissioner of labor is authorized to assess a civil penalty of up to $10,000 for
each violation.
Signed by Governor April 8, 2009. Effective July 1, 2009.
SENATE FILE 197 – UNEMPLOYMENT INSURANCE BENEFITS.
This bill relates to unemployment insurance benefits and brings Iowa into compliance with federal law in
order to receive additional federal funds. The bill establishes training extension benefits for a person who
has been separated from a declining occupation or who involuntarily lost a job due to a permanent
reduction in operations but who is in an approved job training program when the individual's regular
unemployment benefits run out. A declining occupation is defined as one in which there is a lack of
sufficient current demand in the labor market for which the individual has skills or experience. The
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training extension benefit amount is no more than 26 times the individual's weekly benefit amount and
equal to the weekly benefit amount. Employers cannot be charged for an individual's extension training
benefits.
In order to be eligible for the training extension benefits, an individual must be in training for a highdemand occupation or high-technology occupation; must file an unemployment insurance claim to which
the individual becomes entitled to under state or federal law; and must be enrolled and be making
satisfactory progress in the training. High-demand occupation or high technology occupation, includes
the fields of life sciences, advanced manufacturing, biotechnology, alternative fuels, insurance, and
environmental technology. "High-demand occupation" means an occupation in a labor market area in
which the department determines work opportunities are available and there is a lack of qualified
applicants.
The bill states that if an individual is a part-time worker for a majority of the weeks of work in the
individual's base period, then the part-time worker is not required to be available for, seek, or accept fulltime employment. An alternate method of calculating the base period, to determine the monetary
attachment-to-the-workforce eligibility of individuals for unemployment benefits, is included for cases
where the current method of calculation makes an individual ineligible for unemployment benefits. The
bill moves the base period closer, by one quarter, to the benefit claim filing date so that the base period
would consist of the first four calendar quarters immediately preceding the calendar quarter in which the
claim for unemployment benefits is filed if doing so would qualify the individual for benefits.
The bill waives employer charges for unemployment claims stemming from temporary workers who have
replaced active-duty military employees. The bill prevents the account of an employer from being
charged if benefits are paid to an individual who is laid off as the result of the return to work of a
permanent employee who is a member of the national guard of the United States armed forces reserves
for any purpose and who has completed the duty, or who is a member of the civil air patrol performing
duty to Code section 29A.3A and who has completed the duty. Signed by Governor March 25, 2009.
Effective July 1, 2009. The section of this Act amending section 96.3 applies to any week of
unemployment benefits beginning on or after July 5, 2009. The section of this Act amending section
96.4 applies to any new claim of unemployment benefits with an effective date on or after July 5, 2009.
SENATE FILE 478 – SEC. 109 – OUT-OF-STATE INJURY WORKER’S COMPENSATION.
The language provides that if an employee suffers a work-related injury while working outside of Iowa,
and would have been entitled to workers' compensation benefits under Iowa law if the injury had occurred
in Iowa, the employee is entitled to such benefits under Iowa law if the employer has a place of business
in this state and the employee is domiciled in this state. Signed by Governor May 26, 2009. Effective
July 1, 2009.
SENATE FILE 478 – SEC. 110 - WORKER’S COMPENSATION BENEFITS.
The language requires the Workers' Compensation Commissioner to award additional benefits if the
employee proves that a denial, delay in payment, or termination of benefits has occurred and the employer
fails to prove a reasonable excuse for the denial, delay in payment, or termination. To be considered a
reasonable or probable cause or excuse all of the following criteria must be met:
(1) The excuse was preceded by a reasonable investigation and evaluation by the employer or
Insurance carrier into whether benefits were owed to the employee.
(2) The results of the reasonable investigation and evaluation were the actual basis upon
which the employer or insurance carrier contemporaneously relied to deny, delay payment of,
or terminate benefits.
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(3) The employer or insurance carrier contemporaneously conveyed the basis for the denial,
delay in payment, or termination of benefits to the employee at the time of the denial, delay, or
termination of benefits.
Signed by Governor May 26, 2009. Effective July 1, 2009.
SENATE FILE 478 – SECs. 111 and 112 - UNEMPLOYMENT COMPENSATION FOR SHARED
WORK PLANS. Sections 111 and 112 extend the duration period for shared work benefits and
unemployment compensation benefits for an employee on a shared work plan from 26 to 52 weeks. An
individual is not entitled to receive shared work benefits and regular unemployment compensation
benefits in an aggregate amount which exceeds the maximum total amount of benefits payable to that
individual in a benefit year. Signed by Governor May 26, 2009. Effective July 1, 2009.
REIMBURSEMENT.
HOUSE FILE 811 – HEALTH AND HUMAN SERVICES APPROPRIATIONS BILL.
DIVISION XII - IOWACARE.
This language creates a nonparticipating provider reimbursement fund for reimbursement of covered
expansion population services. Beginning July 1, 2010, the Department of Human Services is required to
include in any medical assistance program waiver relating to the continuation of the IowaCare program
pursuant to chapter 249J, provisions for reimbursement of covered expansion population services
provided to an expansion population member by a nonparticipating provider. However, additional
language clarifies that the waiver request cannot go forward if the waiver would limit the federal funds
available to participating providers.
Under the proposed waiver, a nonparticipating provider would be eligible for reimbursement if the
nonparticipating provider contacts the appropriate participating provider prior to providing covered
services to verify consensus regarding one of the following courses of action:
o
o
o
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If the nonparticipating provider and the participating provider agree that the medical
status of the expansion population member indicates it is medically possible to postpone
provision of services, the nonparticipating provider shall direct the expansion population
member to the appropriate participating provider for services.
If the nonparticipating provider and the participating provider agree that the medical
status of the expansion population member indicates it is not medically possible to
postpone provision of services, the nonparticipating provider shall provide medically
necessary services.
If the nonparticipating provider and the participating provider agree that transfer of the
expansion population member is not possible due to lack of available inpatient capacity,
the nonparticipating provider shall provide medically necessary services.
If the medical status of the expansion population member indicates a medical emergency
and the nonparticipating provider is not able to contact the appropriate participating
provider prior to providing medically necessary services, the nonparticipating provider
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shall document the medical emergency and inform the appropriate participating provider
immediately after the member has been stabilized of any covered services provider.
Signed by Governor May 26, 2009. Effective July 1, 2009.
HOUSE FILE 811 - SEC. 32, subsection 1, (c), (2) MEDICAID REIMBURSEMENT.
During the 2008 legislative session, a total of $5.5 M was allocated for hospital rebasing. This was an
amount that was believed to reflect the cost of an entire year of additional Medicaid reimbursement.
However, after the session was over, it was discovered that this allocation covered only ¾ of the year and
that in order for rebasing to be annualized it would require additional funding.
The language in the bill provides that for the fiscal year beginning July 1, 2009, reimbursement rates for
inpatient hospital services shall remain at the rates in effect on June 30, 2009. This in effect funds the
rebasing for the entire year at the 2009 levels. As part of the agreement for the additional dollars, the
Iowa Hospital Association is required to submit information to the Government Oversight Committee
during the 2010 session of the General Assembly regarding actions taken to increase compensation and
other costs of employment for hospital staff who provide direct care to patients. Signed by Governor
May 26, 2009. Effective July 1, 2009.
HOUSE FILE 811 – SEC. 16, Subsection 11 - CHILD PROTECTION CENTER
The child protection center grant program was appropriated $ 1,005,166. Funding is effective for fiscal
year 2010 which starts July 1, 2009 and ends June 30, 2010. Signed by Governor May 26, 2009.
Effective July 1, 2009.
HOUSE FILE 811 - SEC. 2, SUBSECTION 8 (d) - POISON CENTER FUNDING.
Funding for the state poison center was appropriated through the Department of Public Health in the
amount of $539,457. Funding is effective for fiscal year 2010 which starts July 1, 2009 and ends June 30,
2010. Signed by Governor May 26, 2009. Effective July 1, 2009.
SENATE FILE 478 – Sec. 180 - MEDICAID ENTERPRISE STUDY.
This section requires the Department of Human Services to explore incorporating data mining, predictive
modeling, and data analytics which may include automated claims review, to address provider
overpayments, underpayments, and fraud within the Iowa Medicaid Enterprise for the fiscal period
beginning July 1, 2006, and ending June 30, 2009. The review is to assume only Iowa-specific models,
patterns, and trend data.
The department is required to issue a request for proposals to competitively procure the services no later
than August 1, 2009. If the results from the request for proposals demonstrate that such an approach will
provide a net benefit to the state, the department shall enter into a contract for such services no later than
September 30, 2009. Signed by Governor May 26, 2009. Effective May 26, 2009.
HOUSE FILE 478 – REVISIONS TO DIABETES SELF-MANAGEMENT TRAINING.
Current law requires health coverage benefits for outpatient diabetes self-management training to include
at least 10 hours of initial training within a continuous twelve-month period. This bill adds up to two
hours of follow-up training for each subsequent year for each individual diagnosed by a physician with
any type of diabetes mellitus.
The coverage requirements apply to classes of third-party payment provider contracts or policies that are
individual or group accident and sickness insurance providing coverage on an expense-incurred basis;
individual or group hospital or medical service contracts issued pursuant to Code chapter 509, 514, or
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514A; individual or group health maintenance organization contracts regulated under Code chapter 514B;
any other entity engaged in the business of insurance, risk transfer, or risk retention, which is subject to
the jurisdiction of the commissioner of insurance; plans established pursuant to Code chapter 509A for
public employees; and organized delivery systems licensed by the director of public health. Signed by
Governor May 22, 2009. Effective May 22, 2009. Applies to the classes of third-party payment
provider contracts or policies specified in Code section 514C.18 that are delivered, issued for delivery,
continued, or renewed in this state on or after July 1, 2009.
HOUSE FILE 311- MANDATED COVERAGE OF PROSTHETICS.
This bill requires that any policy, contract, or plan providing for third-party payment or prepayment of
health or medical expenses must provide coverage benefits for medically necessary prosthetic devices
when prescribed by a physician licensed under chapter 148. Coverage benefits for medically necessary
prosthetic devices must provide coverage that at a minimum, equals the coverage and payment for
medically necessary prosthetic devices provided under the most recent federal laws for health insurance
for the aged and disabled. Signed by Governor April 24, 2009. Effective July 1, 2009.
HOUSE FILE 317 – INCLUDING ASSISTED LIVING IN THE MEDICAID ELDERLY
WAIVER.
This bill directs the Department of Human Services (DHS) to request a waiver from the centers for
Medicare and Medicaid services of the United States department of health and human services to add
assisted living services to the home and community-based services waiver for the elderly under the
medical assistance program. The bill provides that until such time as the department receives approval,
the department is required to provide a progress report to the Legislative Services Agency on a quarterly
basis. The bill provides that if DHS receives approval of the waiver, DHS is to submit a plan for
implementation to the general assembly. The bill also prohibits DHS from implementing the waiver prior
to specific action being taken by the general assembly to implement the waiver. Signed by Governor
April 10, 2009. Effective July 1, 2009.
HOUSE FILE 488 – SERVICE ANIMALS .
This bill expands those who are allowed to be in control of a service animal in various locations to
include a person assisting a person with a disability. The bill requires the Department of Human Services
to submit an amendment to the centers for Medicare and Medicaid services of the United States
Department of Health and Human Services to add the maintenance of a service animal as an eligible
service reimbursable under the medical assistance home and community=based services waivers. Signed
by Governor May 26, 2009. Effective July 1, 2009.
SENATE FILE 226 – MUNICIPAL FIRE AND POLICE RETIREMENT SYSTEM PRESUMPTION OF CANCER. This bill provides that certain cancers and infectious diseases are
presumed to be a disease contracted while on active duty due to the job for purposes of establishing a
disability pension or providing a death benefit for municipal fire and police. “Cancer" means prostate
cancer, primary brain cancer, breast cancer, ovarian cancer, cervical cancer, uterine cancer, malignant
melanoma, leukemia, non=Hodgkin's lymphoma, bladder cancer, colorectal cancer, multiple myeloma,
testicular cancer, and kidney cancer and "infectious disease" means HIV or AIDS as defined in section
141A.1, all strains of hepatitis, meningococcal meningitis, and mycobacterium tuberculosis. Signed by
Governor May 8, 2009. Effective July 1, 2009.
SENATE FILE 478 - SEC. 183 ORAL CANCER TREATMENT COVERAGE.
This amendment provides that a contract, policy, or plan providing for third-party payment or prepayment
for cancer treatment shall not discriminate between coverage benefits for prescribed, orally administered
anticancer medication used to kill or slow the growth of cancerous cells and intravenously administered
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or injected cancer medications that are covered, regardless of formulation or benefit category
determination by the contract, policy, or plan. Signed by Governor May 26, 2009. Effective July 1,
2009.
SENATE FILE 478 – SEC. 182. CRITERIA FOR ADMISSION TO PSYCHIATRIC MEDICAL
INSTITUTION FOR CHILDREN.
This language relates to the criteria under the medical assistance (Medicaid) program for a child's
admission to a psychiatric medical institution for children (PMIC). It amends Code section 135H.3,
relating to the nature of care in a PMIC. If a child requires treatment for a biologically based mental
illness and meets the Medicaid program criteria for PMIC admission, the child will also meets the acuity
criteria for inpatient benefits under various types of health care coverage. The term "biologically based
mental illness" means the same as defined in Code section 514C.22, relating to health and accident
insurance coverages for such illnesses. The bill specifies that the inpatient benefits cannot be excluded or
denied under that Code section as care that is substantially custodial in nature. Signed by Governor May
26, 2009. Effective July 1, 2009.
LIABILITY AND REGULATION.
SENATE FILE 438 – ACTIONS INJURIOUS TO DEPENDANT ADULTS.
The definition of sexual exploitation of a dependant adult is amended to include the transmission, display,
and taking of an inappropriate electronic image of a dependant adult. The bill also makes it a serious
misdemeanor for a caretaker who otherwise knowingly or intentionally commits dependant adult abuse.
Signed by Governor May 18, 2009. Effective July 1, 2009.
HOUSE FILE 712 – PRIVATE CAUSE OF ACTION .
This bill prohibits a person from engaging in a practice or act the person knows or reasonably should
know is an unfair practice, deception, fraud, false pretense, or false promise, or the misrepresentation,
concealment, suppression, or omission of a material fact, with the intent that others rely upon the
misrepresentation in connection with the advertisement, sale, or lease of consumer merchandise, or the
solicitation of contributions for charitable purposes. A claimant alleging an unfair practice, deception,
fraud, false pretense, false promise, or misrepresentation must prove that the prohibited practice related to
a material fact. The bill provides an exception for hospitals and health care professionals. Signed by
Governor May 26, 2009. Effective July 1, 2009.
SENATE FILE 280 – DISASTER EMERGENCY ASSISTANCE IMMUNITY.
This bill amends the Good Samaritan law by defining emergency to include a disaster as defined in
section 29C.2 or the period of time immediately following a disaster for which the governor has issued a
proclamation of a disaster emergency. Under this provision, any person, who in good faith renders
emergency care or assistance without compensation, is not liable for civil damages for acts or omissions
occurring at the place of an emergency or accident or while the person is in transit to or from the
emergency or accident or while the person is at or being moved to or from an emergency shelter unless
such acts or omissions constitute recklessness or willful and wanton misconduct. Signed by Governor
April 3, 2009. Effective July 1, 2009.
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HEALTH CARE POLICY.
SENATE FILE 101 – SHAKEN BABY SYNDROME PREVENTION PROGRAM.
The Department of Public Health (DPH) is required to establish a statewide shaken baby syndrome
prevention program directed to parents and persons responsible for the care of a child. DPH is required to
consult with various experts in developing the program plan. The program plan is required to incorporate
a multiyear, collaborative approach and address how to involve various programs, health services
providers, and agencies that work with the target population. The program plan is also required to
identify the methodology for improving the tracking of shaken baby syndrome incidents and evaluating
program results and to describe how program results will be reported. The program plan may provide
for implementation of the program through a contract with a private agency or organization experienced
in furnishing the services set forth in the program plan.
DPH’s implementation of the program plan is limited to the extent of the amount appropriated or made
available for the program for a fiscal year. This program did not receive funding this session. Signed by
Governor March 5, 2009. Effective July 1, 2009.
SENATE FILE 389 – HEALTH CARE REFORM II. The bill continues the work of the 2008
legislative session by proposing new health care reform initiatives.
Division I: LEGISLATIVE HEALTH CARE COVERAGE COMMISSION/ IOWA
HEALTHCARE REFORM STRATEGIC PLAN
Creates a Legislative Health Care Coverage Commission under the authority of the Legislative
Council. The Insurance Commissioner, the Director of the Department of Human Services, the
Department of Public Health and four members of the General Assembly are non-voting members. The
voting members include large employers, Iowa insurers, health underwriters, a health care provider, labor,
pre-Medicare population, middle-income adults and families, low-income adults and families, small
business, non-profit entities, and independent insurance agents.
The commission is required to develop an Iowa health care reform strategic plan which requires
consideration of options for the coordination of a children's health care network in the state that provides
health care coverage to all children ; options for children, adults, and families to transition seamlessly
among public and private health care coverage options; options for subsidized and unsubsidized health
care coverage programs which offer public and private, adequate and affordable health care coverage
including but not limited to options to purchase coverage with varying levels of benefits including basic
or catastrophic benefits, an intermediate level of benefits, and comprehensive benefits coverage, including
physical, mental, and dental health care coverage; options to offer a program to provide coverage under a
state health or medical group insurance plan to nonstate public employees, including employees of
counties, cities, schools, area education agencies, and community colleges, and employees of nonprofit
employers and small employers and to pool such employees with the state plan; the ramifications of
requiring each employer in the state with more than ten employees to adopt and maintain a cafeteria plan
that satisfies section 125 of the Internal Revenue Code of 1986 and options for development of a
long=term strategy to provide access to affordable health care coverage to the uninsured in Iowa,
particularly adults, and development of a structure to implement that strategy including consideration of
whether to utilize an existing government agency or a newly created entity.
The commission is required to collaborate with health care coverage experts in developing the plan. This
collaboration is to include designing solutions to issues relating to guaranteed issuance of insurance,
preexisting condition exclusions, portability, and allowable pooling and rating classifications; formulating
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principles that ensure fair and appropriate practices relating to issues involving individual health care
policies such as rescission and preexisting condition clauses, and that provide for a binding third=party
review process to resolve disputes related to such issues; designing affordable, portable health care
coverage options for low=income children, adults, and families; designing a proposed premium schedule
for health care coverage options which includes the development of rating factors that are consistent with
market conditions and designing protocols to limit the transfer from employer=sponsored or other private
health care coverage to state=developed health care coverage plans.
The Commission is required to provide reports to the Legislative Council every quarter summarizing
progress made to date. The first report to the entire General Assembly is due by January 1, 2010, which is
to include recommendations for subsidized and unsubsidized health care coverage programs that could be
available for purchase by the public by July 1, 2010. The second report is due January 1, 2011. The
commission is required to conclude action by July 1, 2011, and submit a final report to the General
Assembly by October 1, 2011.
Division II: Adult Children Health Care Coverage
The Division exempts from state income tax the health benefits coverage of a non-qualified tax
dependent. The amendment is retroactive to January 1, 2009. The language allows adult children who are
under age 25 to re-enroll if they are not currently on their parent's coverage . It also strikes the current
requirement that an adult child must be continuously covered in order to be eligible under a parent's
insurance plan.
Division III: Children's Health Care.
The bill requires the Department of Human Services (DHS) to provide medical assistance or hawk-I
coverage, as appropriate, to individuals under 19 years of age who meet income eligibility requirements
and if federal funding is available. The bill directs DHS to implement provisions included in the federal
Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) for hawk-I and Medicaid;
authorizes DHS to cover legal immigrant children who have been in the United States less than 5 years
with a federal match requirement; allow for the use of one pay stub as verification of income for Medicaid
and hawk-I and makes other changes to Medicaid; allows DHS, with the approval of the hawk-I board to
contract with participating insurers to provide supplemental dental-only coverage to eligible children who
are currently covered by hawk-I; DHS, in cooperation with IDPH and other appropriate agencies, are
required to apply for grants available under CHIPRA to promote outreach and quality child health
outcomes under the Medicaid and hawk-I programs. The section takes effect July 1, 2010.
Division IV: Expansion of the Volunteer Health Care Provider Program.
The bill expands the volunteer health care provider program to include health care provider offices. A
health care provider office providing free care under the program is protected from claims arising from
the provision of free care by a health care provider registered with the program and complying with the
requirements of the program. The division defines "health care provider office" as the private office or
clinic of an individual health care provider or group of health care providers but does not include a field
dental clinic, a free clinic, or a hospital.
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Division V: Health Care Workforce Support Initiatives and Fund.
This Division addresses various health care worker initiatives and creates a Health Care Worker Fund.
The bill establishes the Medical Residency Training Grants administered by the Department of Public
Health(DPH); the Health Care Incentive Payment Program administered by the College Student Aid
Commission with assistance of Des Moines University Osteopathic Medical Center; a Nurse Educator
Incentive Payment Program, a Nursing Faculty Fellowship Program, and a Registered Nurse and Nurse
Educator Loan Forgiveness Program administered by the Student College Aid Commission with
consultation with DPH; and a Safety Net Provider Recruitment and Retention Initiative administered by
DPH in cooperation with a newly established governing group of the Iowa Collaborative Safety Net
Provider Network.
The division also establishes a physician assistant mental health fellowship program. The purpose of the
program is to determine the effect of specialized training and support for physician assistants in providing
mental health services to address the mental health professional shortage in Iowa. The bill includes a
proviso that DPH will not be required to draft rules until such time as funding is made available. It also
contains a sunset provision providing that if no funding is made available within 5 years, the provisions
will be repealed.
DPH is requested to work with the department of workforce development and health care stakeholders to
apply for federal moneys allocated in the federal American Recovery and Reinvestment Act of 2009 for
health care workforce initiatives that are available through a competitive grant process administered by
the health resources and services administration of the United States department of health and human
services or the United States department of health and human services. Any federal moneys received are
to be deposited in the health care workforce shortage fund.
Division VI: Gifts and Reporting of Sanctions.
Requires the health profession boards established in chapter 147 to report to the General Assembly by
January 15, 2010, any public information regarding sanctions levied against a health care professional for
receipt of gifts in a manner not in compliance with the requirements and limitations of the respective
health profession as established by the respective board. Chapter 147 includes medicine, surgery, and
other health care professional boards.
Division VII: Health Care Transparency.
Requires the Department of Public Health to enter into a memorandum of understanding with the Iowa
Hospital Association to collect, maintain, and disseminate hospital inpatient, outpatient, and ambulatory
information. This was initially authorized in legislation passed in 1996. Signed by Governor May 26,
2009. Effective July 1, 2009.
HOUSE FILE 811 – DIVISION XI - IOWA PUBLIC HEALTH MODERNIZATION ACT.
The intent language of this bill states that the current foundation and organizational capacity for the
governmental public health system does not allow for the equitable delivery of public health services.
Governmental public health is provided by county boards of health, city boards of health, one district
board of health, the state board of health, and the Department of Public Health (DPH). Varying degrees
of authority, administration, and organizational capacity for providing public health services exist from
community to community. This Act will allow boards of health, designated local public health agencies,
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and the department to increase system capacity, improve the equitable delivery of public health services,
address quality improvement, improve system performance, and provide a foundation to measure
outcomes through a voluntary accreditation program. This Act will assure the public of the availability of
a basic level of public health service in every community. This Act is the result of extensive
collaboration among governmental public health entities, including local boards of health, local public
health agencies, the department, and the state board of health; academia; and professional associations.
The bill creates a multimember governmental public health advisory council, appointed by the director of
DPH to advise the department and make policy recommendations concerning administration,
implementation, and coordination of the Public Health Modernization Act. The bill also creates a
governmental public health evaluation committee, also appointed by the director, to develop, implement,
and conduct evaluation of the governmental public health system and a voluntary accreditation program
for public health entities.
The governmental public health system shall function to prevent epidemics and spread of disease, protect
against environmental hazards, prevent injuries, promote healthy behavior, and deal with public
emergencies. DPH is directed to establish an accreditation data collection system to monitor the
implementation and effectiveness of the governmental public health system based on the Iowa public
health standards. Local boards of health are required to provide all data and information necessary to
determine the local board's capacity to comply with the Iowa public health standards. DPH may share
data or information with the advisory council or the evaluation committee as necessary to perform the
duties of the council and committee; however, data and information which is confidential shall not be
released by the department, the council, or the committee. The bill establishes a governmental public
health system fund. DPH is only required to implement the Act, if funding is available. A portion of the
necessary funding was appropriated for this purpose. Signed by Governor May 26, 2009. This section of
House File 811 is effective May 26, 2009.
GENERAL PROVISIONS.
HOUSE FILE 708 – ABSENTEE BALLOTS.
This bill makes changes relating to delivery of absentee ballots to applicants who are patients or residents
of hospitals or health care facilities. Under current law, an absentee ballot applied for by a patient or
resident of a hospital or health care facility is to be personally delivered sometime during the 10 days
preceding the election, or on election day in some circumstances. The bill changes that time period to 14
days preceding the election and provides that, in addition to that delivery, absentee ballots applied for by
patients or residents of a hospital or health care facility may also be personally delivered within 10 days
after the ballots have been printed. The bill prohibits observers from being present when ballots are
delivered to a hospital or health care facility. Signed by Governor May 22, 2009. Effective July 1, 2009.
SENATE FILE 204 – RENAMING DEPARTMENT OF ELDER AFFAIRS.
The bill renames the Department of Elder Affairs as the Department on Aging. Also includes some policy
changes for implementation of the Substitute Decision Maker program. Signed by Governor March 25,
2009. Effective July 1, 2009.
HOUSE FILE 314 – DEPARTMENT OF PUBLIC HEALTH SUBSTANTIVE PROVISIONS.
The bill addresses the licensing and notification for the removal of lead paint in renovation projects and
addresses issues to allow the Department to more adequately address the next natural disaster. In
addition, the bill requires a birthing hospital or other facility to report the results of a hearing screening to
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the primary care provider of the newborn or infant upon discharge from the birthing hospital or other
facility. Signed by Governor April 2, 2009. Effective July 1, 2009.
HOUSE FILE 380 – DEPARTMENT OF PUBLIC HEALTH NONSUBSTANTIVE PROVISIONS.
The bill contains several nonsubstantive corrective provisions. This bill defines "Emergency medical
services medical director" to be a physician licensed under chapter 148, who is responsible for overall
medical direction of an emergency medical services program and who has completed a medical director
workshop, sponsored by the department, within one year of assuming duties. An emergency medical
services medical director who receives no compensation for the performance of the director's volunteer
duties under this chapter shall be considered a state volunteer as provided in section 669.24 while
performing volunteer duties as an emergency medical services medical director. Signed by Governor
April 10, 2009. Effective July 1, 2009.
HOUSE FILE 260 – PUBLIC HOSPITAL CLEAN-UP.
This Iowa Hospital Association bill reorganizes and updates three Iowa Code chapters relating to Iowa’s
public hospitals. Signed by Governor May 18, 2009. Effective July 1, 2009.
SENATE FILE 224 – PLUMBING CLEAN-UP BILL
The bill makes clean-up changes to the plumber’s licensure bill. It amends a section that exempted
hospitals when performing plumbing related work on the health care facility to exempt only work that
would be valued at $100,000 or less. Signed by Governor May 26, 2009. Effective July 1, 2009.
SENATE FILE 478 – STANDINGS BILL - DIVISION XXIII - CITY FRANCHISE FEES
This section authorizes a city to impose a franchise fee of up to 5% based upon a percentage of gross
revenues generated from sales of franchised electricity of gas within the city not to exceed five percent.
The amendment limits the use of the moneys collected to certain specified purposes. Signed by
Governor May 26, 2009. Division XXIII Effective May 26, 2009.
PHARMACY RELATED LEGISLATION.
SENATE FILE 467 – PHARMACEUTICAL COLLECTION AND DISPOSAL PILOT
PROGRAM.
Senate File 467, the FY 2010 Appropriations bill for agriculture, natural resources and environmental
protection directs the Department of Natural Resources to award up to $165,000 to the Board of
Pharmacy to implement and administer a Pharmaceutical Collection and Disposal pilot program to
provide for the management and disposal of unused, excess, and expired pharmaceuticals. Signed by
Governor May 26, 2009. Effective July 1, 2009.
SENATE FILE 377 – PRESECRIPTION DRUG DONATION REPOSITORY PROGRAM.
This bill provides that in addition to pharmacies and medical facilities that participate in the prescription
drug donation repository (Code chapter 135M), the department of public health may also receive
prescription drugs or supplies directly from the prescription drug donation repository contractor and may
distribute the prescription drugs and supplies to eligible individuals. The department may receive and
distribute such prescription drugs and supplies during or in preparation for a proclaimed state of disaster
emergency or a public health disaster. The bill also provides immunity from civil and criminal liability
for the department, or the department's employees, agents or volunteers acting reasonably and in good
faith under the program. Signed by Governor May 22, 2009. Effective July 1, 2009.
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HOUSE FILE 122 – PRECURSOR SUBSTANCE REGULATION.
This bill relates to requiring reports for certain precursor substances and extending an information
program for drug prescribing and dispensing. It adds iodine and N=phenethyl=4=piperidone to the list of
precursor substances which require a manufacturer, retailer, or other person who transfers such a
substance, to report the transfer to the board of pharmacy as provided in Code chapter 124B. "Precursor
substance" is defined in Code chapter 124B to mean a substance which may be used as a precursor in the
illegal production of a controlled substance and is specified under Code section 124B.2. The bill also
extends the authorization of the board of pharmacy to establish and administer a prescription drug
database program containing a record of the dispensing of prescriptions for identified controlled
substances. The purpose of the program extended by the bill is to collect information regarding the
dispensing of controlled substance prescriptions by pharmacies in order to improve patient health care by
facilitating the early identification of patients who may be at risk for addiction, or who may be using,
abusing, or diverting drugs for unlawful or otherwise unauthorized purposes. The bill extends the
program from June 30, 2009, to June 30, 2011. Signed by Governor April 2, 2009. Effective July 1,
2009, except for program extension which is effective on April 2, 2009.
HOUSE FILE 381 – PHARMACY ISSUES.
This bill establishes a registration program for pharmacy support persons who may perform only routine
clerical and support functions. A pharmacy support person shall not perform any professional duties or
any technical or dispensing duties. The bill also establishes new requirements for the internet sale of
prescription drugs by pharmacies. The bill prohibits a pharmacist from filling a prescription drug order
from a provider if the order is based solely on an internet questionnaire, an internet consultation, or a
telephonic consultation and a valid patient-practitioner relationship does not exist. The bill requires
internet pharmacies to display certain information on their internet sites and requires them to obtain
certification as a verified internet pharmacy practice site from the national association of boards of
pharmacy. The bill requires internet pharmacies to obtain an internet site registration from the board and
prevents internet pharmacies from disclaiming, limiting, or waiving liability to which they otherwise
would be subject under the law. The bill allows a prescriber or the prescriber's agent to authorize the
refill of a prescription by any means of communication, including word of mouth. The bill exempts
family planning clinics that dispense birth control pills and devices from pharmacy regulation under Code
chapter 155A. The bill also amends Code chapter 4, adding a general definition of the term "internet
site". Signed by Governor April 17, 2009. Effective July 1, 2009.
SENATE FILE 237 - SALE OF PSEUDOEPHEDRINE BY A PHARMACY OR RETAILER.
This bill provides that a person shall not purchase more than 3,600 milligrams of pseudoephedrine, either
collectively or separately, within a 24=hour period from a pharmacy unless the person has a prescription.
A person who violates this provision of the bill commits a serious misdemeanor. Under current law and
the bill, a person commits a serious misdemeanor if the person purchases more than 7,500 milligrams of
pseudoephedrine within a 30=day period from a pharmacy or retailer.
The bill requires a purchaser of a pseudoephedrine product from a pharmacy to sign an electronic
logbook. If an electronic logbook is unavailable, the pharmacy is required to keep an alternative record
that complies with rules adopted by both the governor's office of drug control policy and the state board
of pharmacy. The bill requires a pharmacy, an employee of a pharmacy, or a licensed pharmacist, to enter
a purchaser's name, address, date of purchase, time of purchase, name of pseudoephedrine product, and
quantity sold into the electronic logbook. If the electronic logbook is unavailable for use, the bill requires
the pharmacy to keep written records of the transaction including a signature. The bill requires a
pharmacy to keep electronic logbook records for a period of 24 months from the date of the last entry.
Current law requires the pharmacy to keep the logbook 12 months from the date of the last entry. The
bill provides that the office of governor's drug control policy shall implement and maintain a statewide
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real=time central repository to track pseudoephedrine product sales at pharmacies. The bill requires a
pharmacy dispensing pseudoephedrine products to report all such sales electronically to the central
repository under the control of the office of governor's drug control policy. If the pharmacy has written
records, the records are also to be reported for entry into the repository. If the electronic logbook is
unavailable for use, the bill requires the pharmacy to keep written records of the transaction including a
signature.
The bill makes confidential the information collected in the central repository unless otherwise ordered by
a court, or the records are released by the custodian of the records pursuant to state or federal law. The
bill provides that a pharmacy, an employee of a pharmacy, or a licensed pharmacist shall not be liable to
any person for any claim which may arise when reporting in good faith pseudoephedrine sales to the
central repository. The bill also requires a pharmacy to comply with training requirements pursuant to
federal law. Under the bill, a pharmacy, an employee of a pharmacy, or a licensed pharmacist shall not be
provided access to the stored information in the electronic central repository, except for the limited
purpose of determining what sales have been made by the pharmacy. A person who discloses
information stored in the central repository in violation of the bill commits a simple misdemeanor.
The bill requires a retailer or an employee of a retailer to print the name of the pseudoephedrine product
purchased and the quantity sold next to the name of each purchaser in the logbook. The bill requires the
retailer to keep the logbook 24 months from the date of the last entry. Current law requires the retailer to
keep the logbook 12 months from the date of the last entry. The bill does not require a retailer to keep an
electronic logbook of pseudoephedrine purchases. The bill also requires a retailer to comply with
training requirements pursuant to federal law.
The bill requires the office of drug control policy to establish a pseudoephedrine advisory committee to
provide input and advise the office regarding the implementation and maintenance of the statewide
real=time central repository. The advisory committee shall consist of four licensed pharmacists including
a pharmacist from an independent pharmacy, a regional chain pharmacy, and a national chain pharmacy.
The bill requires the office of drug control policy to solicit recommendations for membership on the
council from the Iowa pharmacy association and Iowa retail federation. The bill also provides that the
council shall also consist of four members of the general assembly serving as ex officio, nonvoting
members.
New Code sections 124.212A and 124.212B created in the bill do not become applicable until sufficient
funding is received and the central repository under the control of the office of drug control policy is
established on a statewide basis. Signed by Governor March 25, 2009. Effective July 1, 2009.
Electronic logbook requirement for pharmacies effective March 25, 2009.
INTERIM STUDIES.
HOUSE FILE 811 – SEC. 40 - INAPPROPRIATE MEDICATION USE IN HEALTH CARE
SYSTEM. This provision requests a legislative study committee for the 2009 interim to identify
strategies and solutions to address problems arising from inappropriate medication use in the health care
system. The study committee shall consist of members of the general assembly, and representatives of the
department of public health, the Iowa pharmacy association, the Iowa medical society, the Iowa nurses
association, the federation of Iowa insurers, the university of Iowa college of public health, the Iowa retail
federation, the prevention and chronic care management advisory council established in section 135.161,
the medical home system advisory council established in section 135.159, the Iowa healthcare
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collaborative, as defined in section 135.40, the health policy corporation of Iowa, and the Iowa foundation
for medical care.
The study committee shall document the extent and causes of medication use problems and examine
potential solutions including medication therapy management programs, evidence=based prescriber
education programs, clinical pharmacy services in the primary medical home, collaborative practice
models of care, and quality and performance=based payment systems. The study committee shall submit
a report of its findings and recommendations to the general assembly for consideration during the 2010
legislative session.
SENATE FILE 372 - STATEWIDE BROADBAND POLICY DEVELOPMENT. The legislative
council is requested to establish an interim study committee to evaluate the need for statewide broadband
access, the extent to which such access exists, and the necessity for and content of a statewide broadband
policy. In conducting the study, the committee shall review exclusively the provisions of the federal
communications code and other federal laws affecting the implementation of broadband. The committee
shall be composed of ten members, representing both political parties and both houses of the general
assembly. Five members shall be members of the senate, three of whom shall be appointed by the
majority leader of the senate, and two of whom shall be appointed by the minority leader of the senate.
Five members shall be members of the house of representatives, three of whom shall be appointed by the
speaker of the house of representatives, and two of whom shall be appointed by the minority leader of the
house of representatives. If the committee decides to issue a report on its review of federal law to the
general assembly, the report shall be issued by January 15, 2010.
HOUSE FILE 811 – SEC. 135 - EXCHANGE OF ELECTRONIC INDIVIDUALLY
IDENTIFIABLE HEALTH INFORMATION. The executive committee of the electronic health
information advisory council created in section 135.156, with the technical assistance of the advisory
council and the support of the department of public health, shall review the electronic exchange of
individually identifiable health information by health care providers for the purpose of treatment with the
goal of facilitating informed treatment decisions and providing higher quality and safer care, while
protecting the privacy of patients and the security and confidentiality of patient information. Following
the review, the executive committee shall report the results of its review and recommendations, including
any proposed changes in state law and rules relating to such information exchange, to the governor and
the general assembly no later than December 15, 2009.
HOUSE FILE 811 – SEC. 56 ADULT MENTAL HEALTH AND DEVELOPMENTAL
DISABILITIES SERVICES SYSTEM TASK FORCE. The co-chairpersons of the joint
appropriations subcommittee on health and human services, in consultation with the ranking members of
the subcommittee, shall appoint a task force of stakeholders for the 2009 legislative interim to address the
service system administered by counties for adult mental health and developmental disabilities services.
The task force shall address both funding and service issues and may utilize a facilitator to assist the
process. The task force shall submit a final report with recommendations to the governor and general
assembly for action during the 2010 legislative session.
HOUSE FILE 811 – SEC. 57 MENTAL HEALTH, MENTAL RETARDATION,
DEVELOPMENTAL DISABILITIES, AND BRAIN INJURY COMMISSION AND MENTAL
HEALTH PLANNING COUNCIL.
During the fiscal year beginning July 1, 2009, the mental health, mental retardation, developmental
disabilities, and brain injury commission and the Iowa mental health planning council established by the
department of human services pursuant to federal requirements for the community mental health services
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block grant, or the officers of such bodies, shall meet at least quarterly to coordinate the efforts of the
bodies.
SENATE FILE 478 - SEC. 188. JOB TRAINING INTERIM STUDY COMMITTEE. The
Legislative Council shall establish a job training interim study committee to examine job training issues
during the 2009 legislative interim period. The study committee shall examine and make
recommendations concerning job training needs in Iowa. The study committee shall focus on job training
mechanisms that provide services to underserved populations in Iowa. Underserved populations include
people making less than twenty thousand dollars per year, minorities, women, persons with disabilities,
the elderly, and people convicted of felonies trying to re-enter society after release from prison. The
Legislative Council shall consider providing funding for the hiring of a private consultant to identify
duplicative programs that contribute to the fragmentation of job training efforts. The study committee
shall make recommendations for the removal of any such duplicative programs. The committee shall
submit a report to the general assembly.
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