Text: SF388
Text: SF390
Complete Bill History
Senate File 389
AN ACT
RELATING TO HEALTH CARE, HEALTH CARE PROVIDERS, AND HEALTH
CARE COVERAGE, PROVIDING RETROACTIVE AND OTHER EFFECTIVE
DATES AND PROVIDING REPEALS.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
LEGISLATIVE HEALTH CARE COVERAGE COMMISSION
Section 1. LEGISLATIVE HEALTH CARE COVERAGE COMMISSION.
1. A legislative health care coverage commission is
created under the authority of the legislative council.
a. The commission shall include the following persons who
are ex officio, nonvoting members of the commission:
(1) The commissioner of insurance, or a designee.
(2) The director of human services, or a designee.
(3) The director of public health, or a designee.
(4) Four members of the general assembly, one appointed by
the speaker of the house of representatives, one appointed by
the minority leader of the house of representatives, one
appointed by the majority leader of the senate, and one
appointed by the minority leader of the senate.
b. The commission shall include the following persons who
are voting members of the commission and who are appointed by
the legislative council:
(1) A person who represents large employers.
(2) A person who represents Iowa insurers.
(3) A person who represents health underwriters.
(4) A health care provider.
(5) A person who represents labor.
(6) A consumer who represents the pre=Medicare population.
(7) A consumer who represents middle=income adults and
families.
(8) A consumer who represents low=income adults and
families.
(9) A person who represents small businesses.
(10) A person who represents nonprofit entities.
(11) A person who represents independent insurance agents.
2. The legislative council may employ or contract with a
person or persons to assist the commission in carrying out its
duties. The person or persons employed or contracted with to
assist the commission shall gather and coordinate information
for the use of the commission in its deliberations concerning
health reform initiatives and activities related to the
medical home system advisory council, the electronic health
information advisory council and executive committee, the
prevention and chronic care management advisory council, the
direct care worker task force, the health and long=term care
access technical advisory committee, the clinicians advisory
panel, the long=term living initiatives of the department of
elder affairs, medical assistance and hawk=i program
expansions and initiatives, prevention and wellness
initiatives including but not limited to those administered
through the Iowa healthy communities initiative pursuant to
section 135.27 and through the governor's council on physical
fitness and nutrition, health care transparency activities,
and other health care reform=related advisory bodies and
activities that provide direction and promote collaborative
efforts among health care providers involved in the
initiatives and activities. The legislative services agency
shall provide administrative support to the commission.
3. The legislative council shall appoint one voting member
as chairperson and one as vice chairperson. Legislative
members of the commission are eligible for per diem and
reimbursement of actual expenses as provided in section 2.10.
The consumers appointed to the commission are entitled to
receive a per diem as specified in section 7E.6 for each day
spent in performance of duties as a member, and shall be
reimbursed for all actual and necessary expenses incurred in
the performance of duties as a member of the commission.
4. The commission shall develop an Iowa health care reform
strategic plan which includes but is not limited to a review
and analysis of, and recommendations and prioritization of
recommendations for, the following:
a. Options for the coordination of a children's health
care network in the state that provides health care coverage
to all children without such coverage; utilizes, modifies, and
enhances existing public programs; maximizes the ability of
the state to obtain federal funding and reimbursement for such
programs; and provides access to private, affordable health
care coverage for children who are not otherwise eligible for
health care coverage through public programs.
b. Options for children, adults, and families to
transition seamlessly among public and private health care
coverage options.
c. 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. The
commission shall also consider options and make
recommendations for providing an array of benefits that may
include physical, mental, and dental health care coverage.
Affordable health care coverage options for purchase by adults
and families shall be developed with the goal of including
options for which the contribution requirement for all
cost=sharing expenses is no more than six and one=half percent
of family income.
d. 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.
e. 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.
f. 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.
5. As part of developing the strategic plan, the
commission shall collaborate with health care coverage experts
to do including but not limited to the following:
a. Design solutions to issues relating to guaranteed
issuance of insurance, preexisting condition exclusions,
portability, and allowable pooling and rating classifications.
b. Formulate principles that ensure fair and appropriate
practices relating to issues involving individual health care
policies such as recision and preexisting condition clauses,
and that provide for a binding third=party review process to
resolve disputes related to such issues.
c. Design affordable, portable health care coverage
options for low=income children, adults, and families.
d. Design a proposed premium schedule for health care
coverage options which includes the development of rating
factors that are consistent with market conditions.
e. Design protocols to limit the transfer from
employer=sponsored or other private health care coverage to
state=developed health care coverage plans.
6. The commission may request from any state agency or
official information and assistance as needed to perform its
duties pursuant to this section. A state agency or official
shall furnish the information or assistance requested within
the authority and resources of the state agency or official.
This subsection does not allow the examination or copying of
any public record required by law to be kept confidential.
7. The commission shall provide progress reports to the
legislative council every quarter summarizing the commission's
activities.
8. The commission shall provide a progress report to the
general assembly by January 1, 2010, summarizing the
commission's activities thus far, that includes but is not
limited to recommendations and prioritization of
recommendations for subsidized and unsubsidized health care
coverage programs which offer public and private and adequate
and affordable health care coverage for adults. The
commission shall collaborate with health care coverage experts
to ensure that health care coverage for adults that is
consistent with the commission's recommendations and
priorities is available for purchase by the public by July 1,
2010.
9. The commission shall provide a report to the general
assembly by January 1, 2011, summarizing the commission's
activities since the previous annual report provided on
January 1, 2010, including but not limited to information
about health care coverage for adults, including enrollment
information, that was available for purchase by the public by
July 1, 2010, consistent with the commission's recommendations
and priorities, and including further recommendations and
prioritization of those recommendations.
10. The commission shall conclude its deliberations by
July 1, 2011, and shall submit a final report to the general
assembly by October 1, 2011, summarizing the commission's
activities particularly pertaining to the availability of
health care coverage programs for adults, analyzing issues
studied, and setting forth options, recommendations, and
priorities for an Iowa health care reform strategic plan that
will ensure that all Iowans have access to health care
coverage which meets minimum standards of quality and
affordability. The commission may include any other
information the commission deems relevant and necessary.
11. This section is repealed on December 31, 2011.
COORDINATING AMENDMENTS
Sec. 2. Section 514E.1, subsections 15 and 22, Code 2009,
are amended by striking the subsections.
Sec. 3. Section 514E.2, subsection 3, unnumbered paragraph
1, Code 2009, is amended to read as follows:
The association shall submit to the commissioner a plan of
operation for the association and any amendments necessary or
suitable to assure the fair, reasonable, and equitable
administration of the association. The plan of operation
shall include provisions for the development of a
comprehensive health care coverage plan as provided in section
514E.5. In developing the comprehensive plan the association
shall give deference to the recommendations made by the
advisory council as provided in section 514E.6, subsection 1.
The association shall approve or disapprove but shall not
modify recommendations made by the advisory council.
Recommendations that are approved shall be included in the
plan of operation submitted to the commissioner.
Recommendations that are disapproved shall be submitted to the
commissioner with reasons for the disapproval. The plan of
operation becomes effective upon approval in writing by the
commissioner prior to the date on which the coverage under
this chapter must be made available. After notice and
hearing, the commissioner shall approve the plan of operation
if the plan is determined to be suitable to assure the fair,
reasonable, and equitable administration of the association,
and provides for the sharing of association losses, if any, on
an equitable and proportionate basis among the member
carriers. If the association fails to submit a suitable plan
of operation within one hundred eighty days after the
appointment of the board of directors, or if at any later time
the association fails to submit suitable amendments to the
plan, the commissioner shall adopt, pursuant to chapter 17A,
rules necessary to implement this section. The rules shall
continue in force until modified by the commissioner or
superseded by a plan submitted by the association and approved
by the commissioner. In addition to other requirements, the
plan of operation shall provide for all of the following:
Sec. 4. Sections 514E.5 and 514E.6, Code 2009, are
repealed.
Sec. 5. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION II
HEALTH CARE COVERAGE OF ADULT CHILDREN
Sec. 6. Section 422.7, Code 2009, is amended by adding the
following new subsection:
NEW SUBSECTION. 29A. If the health benefits coverage or
insurance of the taxpayer includes coverage of a nonqualified
tax dependent as determined by the federal internal revenue
service, subtract, to the extent included, the amount of the
value of such coverage attributable to the nonqualified tax
dependent.
Sec. 7. Section 509.3, subsection 8, Code 2009, is amended
to read as follows:
8. A provision that the insurer will permit continuation
of existing coverage or reenrollment in previously existing
coverage for an individual who meets the requirements of
section 513B.2, subsection 14, paragraph "a", "b", "c", "d",
or "e", and who is an unmarried child of an insured or
enrollee who so elects, at least through the policy
anniversary date on or after the date the child marries,
ceases to be a resident of this state, or attains the age of
twenty=five years old, whichever occurs first, or so long as
the unmarried child maintains full=time status as a student in
an accredited institution of postsecondary education.
In addition to the provisions required in subsections 1
through 7 8, the commissioner shall require provisions through
the adoption of rules implementing the federal Health
Insurance Portability and Accountability Act, Pub. L. No.
104=191.
Sec. 8. Section 509A.13B, Code 2009, is amended to read as
follows:
509A.13B CONTINUATION OF DEPENDENT COVERAGE OF CHILDREN ==
CONTINUATION OR REENROLLMENT.
If a governing body, a county board of supervisors, or a
city council has procured accident or health care coverage for
its employees under this chapter such coverage shall permit
continuation of existing coverage or reenrollment in
previously existing coverage for an individual who meets the
requirements of section 513B.2, subsection 14, paragraph "a",
"b", "c", "d", or "e", and who is an unmarried child of an
insured or enrollee who so elects, at least through the policy
anniversary date on or after the date the child marries,
ceases to be a resident of this state, or attains the age of
twenty=five years old, whichever occurs first, or so long as
the unmarried child maintains full=time status as a student in
an accredited institution of postsecondary education.
Sec. 9. Section 514A.3B, subsection 2, Code 2009, is
amended to read as follows:
2. An insurer issuing an individual policy or contract of
accident and health insurance which provides coverage for
children of the insured shall permit continuation of existing
coverage or reenrollment in previously existing coverage for
an individual who meets the requirements of section 513B.2,
subsection 14, paragraph "a", "b", "c", "d", or "e", and who
is an unmarried child of an insured or enrollee who so elects,
at least through the policy anniversary date on or after the
date the child marries, ceases to be a resident of this state,
or attains the age of twenty=five years old, whichever occurs
first, or so long as the unmarried child maintains full=time
status as a student in an accredited institution of
postsecondary education.
Sec. 10. NEW SECTION. 514B.9A COVERAGE OF CHILDREN ==
CONTINUATION OR REENROLLMENT.
A health maintenance organization which provides health
care coverage pursuant to an individual or group health
maintenance organization contract regulated under this chapter
for children of an enrollee shall permit continuation of
existing coverage or reenrollment in previously existing
coverage for an individual who meets the requirements of
section 513B.2, subsection 14, paragraph "a", "b", "c", "d",
or "e", and who is an unmarried child of an enrollee who so
elects, at least through the policy anniversary date on or
after the date the child marries, ceases to be a resident of
this state, or attains the age of twenty=five years old,
whichever occurs first, or so long as the unmarried child
maintains full=time status as a student in an accredited
institution of postsecondary education.
Sec. 11. APPLICABILITY. The sections of this Act amending
section 509.3, subsection 8, 509A.13B, and 514A.3B, subsection
2, and enacting section 514B.9A, apply to policies, contracts,
or plans of accident and health insurance delivered, issued
for delivery, continued, or renewed in this state on or after
July 1, 2009.
Sec. 12. RETROACTIVE APPLICABILITY DATE. The section of
this Act enacting section 422.7, subsection 29A, applies
retroactively to January 1, 2009, for tax years beginning on
or after that date.
DIVISION III
MEDICAL ASSISTANCE AND HAWK=I PROVISIONS
COVERAGE FOR ALL INCOME=ELIGIBLE CHILDREN
Sec. 13. NEW SECTION. 249A.3A MEDICAL ASSISTANCE == ALL
INCOME=ELIGIBLE CHILDREN.
The department shall provide medical assistance to
individuals under nineteen years of age who meet the income
eligibility requirements for the state medical assistance
program and for whom federal financial participation is or
becomes available for the cost of such assistance.
Sec. 14. NEW SECTION. 514I.8A HAWK=I == ALL
INCOME=ELIGIBLE CHILDREN.
The department shall provide coverage to individuals under
nineteen years of age who meet the income eligibility
requirements for the hawk=i program and for whom federal
financial participation is or becomes available for the cost
of such coverage.
REQUIRED APPLICATION FOR DEPENDENT CHILD HEALTH CARE
COVERAGE
Sec. 15. Section 422.12M, Code 2009, is amended to read as
follows:
422.12M INCOME TAX FORM == INDICATION OF DEPENDENT CHILD
HEALTH CARE COVERAGE.
1. The director shall draft the income tax form to allow
require beginning with the tax returns for tax year 2008 2010,
a person who files an individual or joint income tax return
with the department under section 422.13 to indicate the
presence or absence of health care coverage for each dependent
child for whom an exemption is claimed.
2. Beginning with the income tax return for tax year 2008
2010, a person who files an individual or joint income tax
return with the department under section 422.13, may shall
report on the income tax return, in the form required, the
presence or absence of health care coverage for each dependent
child for whom an exemption is claimed.
a. If the taxpayer indicates on the income tax return that
a dependent child does not have health care coverage, and the
income of the taxpayer's tax return does not exceed the
highest level of income eligibility standard for the medical
assistance program pursuant to chapter 249A or the hawk=i
program pursuant to chapter 514I, the department shall send a
notice to the taxpayer indicating that the dependent child may
be eligible for the medical assistance program or the hawk=i
program and providing information to the taxpayer about how to
enroll the dependent child in the programs appropriate
program. The taxpayer shall submit an application for the
appropriate program within ninety days of receipt of the
enrollment information.
b. Notwithstanding any other provision of law to the
contrary, a taxpayer shall not be subject to a penalty for not
providing the information required under this section.
c. b. The department shall consult with the department of
human services in developing the tax return form and the
information to be provided to tax filers under this section.
3. The department, in cooperation with the department of
human services, shall adopt rules pursuant to chapter 17A to
administer this section, including rules defining "health care
coverage" for the purpose of indicating its presence or
absence on the tax form.
4. The department, in cooperation with the department of
human services, shall report, annually, to the governor and
the general assembly all of the following:
a. The number of Iowa families, by income level, claiming
the state income tax exemption for dependent children.
b. The number of Iowa families, by income level, claiming
the state income tax exemption for dependent children who also
and whether they indicate the presence or absence of health
care coverage for the dependent children.
c. The effect of the reporting requirements and provision
of information requirements under this section on the number
and percentage of children in the state who are uninsured.
The number of Iowa families, by income level, claiming the
state income tax exemption for dependent children who receive
information from the department pursuant to subsection 2 and
who subsequently apply for and are enrolled in the appropriate
program.
PREGNANT WOMEN INCOME ELIGIBILITY FOR MEDICAID
Sec. 16. Section 249A.3, subsection 1, paragraph l, Code
2009, is amended to read as follows:
l. (1) Is an infant whose income is not more than two
hundred percent of the federal poverty level, as defined by
the most recently revised income guidelines published by the
United States department of health and human services.
(2) Additionally, effective July 1, 2009, medical
assistance shall be provided to an a pregnant woman or infant
whose family income is at or below three hundred percent of
the federal poverty level, as defined by the most recently
revised poverty income guidelines published by the United
States department of health and human services, if otherwise
eligible.
Sec. 17. Section 514I.8, subsection 1, Code 2009, is
amended to read as follows:
1. Effective July 1, 1998, and notwithstanding any medical
assistance program eligibility criteria to the contrary,
medical assistance shall be provided to, or on behalf of, an
eligible child under the age of nineteen whose family income
does not exceed one hundred thirty=three percent of the
federal poverty level, as defined by the most recently revised
poverty income guidelines published by the United States
department of health and human services. Additionally,
effective July 1, 2000, and notwithstanding any medical
assistance program eligibility criteria to the contrary,
medical assistance shall be provided to, or on behalf of, an
eligible infant whose family income does not exceed two
hundred percent of the federal poverty level, as defined by
the most recently revised poverty income guidelines published
by the United States department of health and human services.
Effective July 1, 2009, and notwithstanding any medical
assistance program eligibility criteria to the contrary,
medical assistance shall be provided to, or on behalf of, a
pregnant woman or an eligible child who is an infant and whose
family income is at or below three hundred percent of the
federal poverty level, as defined by the most recently revised
poverty income guidelines published by the United States
department of health and human services.
IMPROVING ACCESS AND RETENTION
Sec. 18. Section 249A.4, Code 2009, is amended by adding
the following new subsection:
NEW SUBSECTION. 16. Implement the premium assistance
program options described under the federal Children's Health
Insurance Program Reauthorization Act of 2009, Pub. L. No.
111=3, for the medical assistance program. The department may
adopt rules as necessary to administer these options.
Sec. 19. NEW SECTION. 509.3A CREDITABLE COVERAGE.
For the purposes of any policies of group accident or
health insurance or combination of such policies issued in
this state, "creditable coverage" means health benefits or
coverage provided to an individual under any of the following:
1. A group health plan.
2. Health insurance coverage.
3. Part A or Part B Medicare pursuant to Title XVIII of
the federal Social Security Act.
4. Medicaid pursuant to Title XIX of the federal Social
Security Act, other than coverage consisting solely of
benefits under section 1928 of that Act.
5. 10 U.S.C. ch. 55.
6. A health or medical care program provided through the
Indian health service or a tribal organization.
7. A state health benefits risk pool.
8. A health plan offered under 5 U.S.C. ch. 89.
9. A public health plan as defined under federal
regulations.
10. A health benefit plan under section 5(e) of the
federal Peace Corps Act, 22 U.S.C. } 2504(e).
11. An organized delivery system licensed by the director
of public health.
12. A short=term limited duration policy.
13. The hawk=i program authorized by chapter 514I.
Sec. 20. Section 513B.2, subsection 8, Code 2009, is
amended by adding the following new paragraph:
NEW PARAGRAPH. m. The hawk=i program authorized by
chapter 514I.
Sec. 21. Section 514A.3B, subsection 1, Code 2009, is
amended to read as follows:
1. An insurer which accepts an individual for coverage
under an individual policy or contract of accident and health
insurance shall waive any time period applicable to a
preexisting condition exclusion or limitation period
requirement of the policy or contract with respect to
particular services in an individual health benefit plan for
the period of time the individual was previously covered by
qualifying previous coverage as defined in section 513C.3, by
chapter 249A or 514I, or by Medicare coverage provided
pursuant to Title XVIII of the federal Social Security Act
that provided benefits with respect to such services, provided
that the qualifying previous coverage was continuous to a date
not more than sixty=three days prior to the effective date of
the new policy or contract. Any days of coverage provided to
an individual pursuant to chapter 249A or 514I, or Medicare
coverage provided pursuant to Title XVIII of the federal
Social Security Act, do not constitute qualifying previous
coverage. Such days of chapter 249A or 514I or Medicare
coverage shall be counted as part of the maximum
sixty=three=day grace period and shall not constitute a basis
for the waiver of any preexisting condition exclusion or
limitation period.
Sec. 22. Section 514A.3B, Code 2009, is amended by adding
the following new subsection:
NEW SUBSECTION. 3. For the purposes of any policies of
accident and sickness insurance issued in this state,
"creditable coverage" means health benefits or coverage
provided to an individual under any of the following:
a. A group health plan.
b. Health insurance coverage.
c. Part A or Part B Medicare pursuant to Title XVIII of
the federal Social Security Act.
d. Medicaid pursuant to Title XIX of the federal Social
Security Act, other than coverage consisting solely of
benefits under section 1928 of that Act.
e. 10 U.S.C. ch. 55.
f. A health or medical care program provided through the
Indian health service or a tribal organization.
g. A state health benefits risk pool.
h. A health plan offered under 5 U.S.C. ch. 89.
i. A public health plan as defined under federal
regulations.
j. A health benefit plan under section 5(e) of the federal
Peace Corps Act, 22 U.S.C. } 2504(e).
k. An organized delivery system licensed by the director
of public health.
l. A short=term limited duration policy.
m. The hawk=i program authorized by chapter 514I.
Sec. 23. Section 514I.1, subsection 4, Code 2009, is
amended to read as follows:
4. It is the intent of the general assembly that the
hawk=i program be an integral part of the continuum of health
insurance coverage and that the program be developed and
implemented in such a manner as to facilitate movement of
families between health insurance providers and to facilitate
the transition of families to private sector health insurance
coverage. It is the intent of the general assembly in
developing such continuum of health insurance coverage and in
facilitating such transition, that beginning July 1, 2009, the
department implement the hawk=i expansion program.
Sec. 24. Section 514I.2, subsection 8, Code 2009, is
amended by striking the subsection.
Sec. 25. Section 514I.3, Code 2009, is amended by adding
the following new subsection:
NEW SUBSECTION. 6. Health care coverage provided under
this chapter in accordance with Title XXI of the federal
Social Security Act shall be recognized as prior creditable
coverage for the purposes of private individual and group
health insurance coverage.
Sec. 26. Section 514I.4, subsection 2, Code 2009, is
amended to read as follows:
2. a. The director, with the approval of the board, may
contract with participating insurers to provide dental=only
services.
b. The director, with the approval of the board, may
contract with participating insurers to provide the
supplemental dental=only coverage to otherwise eligible
children who have private health care coverage as specified in
the federal Children's Health Insurance Program
Reauthorization Act of 2009, Pub. L. No. 111=3.
Sec. 27. Section 514I.4, subsection 5, paragraphs a and b,
Code 2009, are amended to read as follows:
a. Develop a joint program application form not to exceed
two pages in length, which is consistent with the rules of the
board, which is easy to understand, complete, and concise, and
which, to the greatest extent possible, coordinates with the
supplemental forms, and the same application and renewal
verification process for both the hawk=i and medical
assistance program programs.
b. (1) Establish the family cost sharing amounts for
children of families with incomes of one hundred fifty percent
or more but not exceeding two hundred percent of the federal
poverty level, of not less than ten dollars per individual and
twenty dollars per family, if not otherwise prohibited by
federal law, with the approval of the board.
(2) Establish for children of families with incomes
exceeding two hundred percent but not exceeding three hundred
percent of the federal poverty level, family cost=sharing
amounts, and graduated premiums based on a rationally
developed sliding fee schedule, in accordance with federal
law, with the approval of the board.
Sec. 28. Section 514I.5, subsection 7, paragraph l, Code
2009, is amended to read as follows:
l. Develop options and recommendations to allow children
eligible for the hawk=i or hawk=i expansion program to
participate in qualified employer=sponsored health plans
through a premium assistance program. The options and
recommendations shall ensure reasonable alignment between the
benefits and costs of the hawk=i and hawk=i expansion programs
program and the employer=sponsored health plans consistent
with federal law. The options and recommendations shall be
completed by January 1, 2009, and submitted to the governor
and the general assembly for consideration as part of the
hawk=i and hawk=i expansion programs. In addition, the board
shall implement the premium assistance program options
described under the federal Children's Health Insurance
Program Reauthorization Act of 2009, Pub. L. No. 111=3, for
the hawk=i program.
Sec. 29. Section 514I.5, subsection 8, paragraph e, Code
2009, is amended by adding the following new subparagraph:
NEW SUBPARAGRAPH. (15) Translation and interpreter
services as specified pursuant to the federal Children's
Health Insurance Program Reauthorization Act of 2009, Pub. L.
No. 111=3.
Sec. 30. Section 514I.5, subsection 8, paragraph g, Code
2009, is amended to read as follows:
g. Presumptive eligibility criteria for the program.
Beginning January 1, 2010, presumptive eligibility shall be
provided for eligible children.
Sec. 31. Section 514I.5, subsection 9, Code 2009, is
amended to read as follows:
9. a. The hawk=i board may provide approval to the
director to contract with participating insurers to provide
dental=only services. In determining whether to provide such
approval to the director, the board shall take into
consideration the impact on the overall program of single
source contracting for dental services.
b. The hawk=i board may provide approval to the director
to contract with participating insurers to provide the
supplemental dental=only coverage to otherwise eligible
children who have private health care coverage as specified in
the federal Children's Health Insurance Program
Reauthorization Act of 2009, Pub. L. No. 111=3.
Sec. 32. Section 514I.6, subsections 2 and 3, Code 2009,
are amended to read as follows:
2. Provide or reimburse accessible, quality medical or
dental services.
3. Require that any plan provided by the participating
insurer establishes and maintains a conflict management system
that includes methods for both preventing and resolving
disputes involving the health or dental care needs of eligible
children, and a process for resolution of such disputes.
Sec. 33. Section 514I.6, subsection 4, paragraph a, Code
2009, is amended to read as follows:
a. A list of providers of medical or dental services under
the plan.
Sec. 34. Section 514I.7, subsection 2, paragraph d, Code
2009, is amended to read as follows:
d. Monitor and assess the medical and dental care provided
through or by participating insurers as well as complaints and
grievances.
Sec. 35. Section 514I.8, subsection 2, paragraph c, Code
2009, is amended to read as follows:
c. Is a member of a family whose income does not exceed
two three hundred percent of the federal poverty level, as
defined in 42 U.S.C. } 9902(2), including any revision
required by such section, and in accordance with the federal
Children's Health Insurance Program Reauthorization Act of
2009, Pub. L. No. 111=3.
Sec. 36. Section 514I.10, Code 2009, is amended by adding
the following new subsection:
NEW SUBSECTION. 2A. Cost sharing for an eligible child
whose family income exceeds two hundred percent but does not
exceed three hundred percent of the federal poverty level may
include copayments and graduated premium amounts which do not
exceed the limitations of federal law.
Sec. 37. Section 514I.11, subsections 1 and 3, Code 2009,
are amended to read as follows:
1. A hawk=i trust fund is created in the state treasury
under the authority of the department of human services, in
which all appropriations and other revenues of the program and
the hawk=i expansion program such as grants, contributions,
and participant payments shall be deposited and used for the
purposes of the program and the hawk=i expansion program. The
moneys in the fund shall not be considered revenue of the
state, but rather shall be funds of the program.
3. Moneys in the fund are appropriated to the department
and shall be used to offset any program and hawk=i expansion
program costs.
Sec. 38. MEDICAL ASSISTANCE PROGRAM == PROGRAMMATIC AND
PROCEDURAL PROVISIONS. The department of human services shall
adopt rules pursuant to chapter 17A to provide for all of the
following:
1. To allow for the submission of one pay stub per
employer by an individual as verification of earned income for
the medical assistance program when it is indicative of future
income.
2. To allow for an averaging of three years of income for
self=employed families to establish eligibility for the
medical assistance program.
3. To extend the period for annual renewal by medical
assistance members by mailing the renewal form to the member
on the first day of the month prior to the month of renewal.
4. To provide for all of the following in accordance with
the requirements for qualification for the performance bonus
payments described under the federal Children's Health
Insurance Program Reauthorization Act of 2009, Pub. L. No.
111=3:
a. Utilization of joint applications and supplemental
forms, and the same application and renewal verification
processes for the medical assistance and hawk=i programs.
b. Implementation of administrative or paperless
verification at renewal for the medical assistance program.
c. Utilization of presumptive eligibility when determining
a child's eligibility for the medical assistance program.
d. Utilization of the express lane option, including
utilization of other public program databases to reach and
enroll children in the medical assistance program.
5. To provide translation and interpretation services
under the medical assistance program as specified pursuant to
the federal Children's Health Insurance Program
Reauthorization Act of 2009, Pub. L. No. 111=3.
Sec. 39. HAWK=I PROGRAM == PROGRAMMATIC AND PROCEDURAL
PROVISIONS. The hawk=i board, in consultation with the
department of human services, shall adopt rules pursuant to
chapter 17A to provide for all of the following:
1. To allow for the submission of one pay stub per
employer by an individual as verification of earned income for
the hawk=i program when it is indicative of future income.
2. To allow for an averaging of three years of income for
self=employed families to establish eligibility for the hawk=i
program.
3. To provide for all of the following in accordance with
the requirements for qualification for the performance bonus
payments described under the federal Children's Health
Insurance Program Reauthorization Act of 2009, Pub. L. No.
111=3:
a. Utilization of joint applications and supplemental
forms, and the same application and renewal verification
processes for the hawk=i and medical assistance programs.
b. Implementation of administrative or paperless
verification at renewal for the hawk=i program.
c. Utilization of presumptive eligibility when determining
a child's eligibility for the hawk=i program.
d. Utilization of the express lane option, including
utilization of other public program databases to reach and
enroll children in the hawk=i program.
Sec. 40. DEMONSTRATION GRANTS == CHIPRA. The department
of human services in cooperation with the department of public
health and other appropriate agencies, shall apply for grants
available under the Children's Health Insurance Program
Reauthorization Act of 2009, Pub. L. No. 111=3, to promote
outreach activities and quality child health outcomes under
the medical assistance and hawk=i programs.
Sec. 41. Section 514I.12, Code 2009, is repealed.
Sec. 42. EFFECTIVE DATE. The section of this division of
this Act amending section 422.12M, takes effect July 1, 2010.
DIVISION IV
VOLUNTEER HEALTH CARE PROVIDERS
Sec. 43. Section 135.24, Code 2009, is amended to read as
follows:
135.24 VOLUNTEER HEALTH CARE PROVIDER PROGRAM ESTABLISHED
== IMMUNITY FROM CIVIL LIABILITY.
1. The director shall establish within the department a
program to provide to eligible hospitals, clinics, free
clinics, field dental clinics, specialty health care provider
offices, or other health care facilities, health care referral
programs, or charitable organizations, free medical, dental,
chiropractic, pharmaceutical, nursing, optometric,
psychological, social work, behavioral science, podiatric,
physical therapy, occupational therapy, respiratory therapy,
and emergency medical care services given on a voluntary basis
by health care providers. A participating health care
provider shall register with the department and obtain from
the department a list of eligible, participating hospitals,
clinics, free clinics, field dental clinics, specialty health
care provider offices, or other health care facilities, health
care referral programs, or charitable organizations.
2. The department, in consultation with the department of
human services, shall adopt rules to implement the volunteer
health care provider program which shall include the
following:
a. Procedures for registration of health care providers
deemed qualified by the board of medicine, the board of
physician assistants, the dental board, the board of nursing,
the board of chiropractic, the board of psychology, the board
of social work, the board of behavioral science, the board of
pharmacy, the board of optometry, the board of podiatry, the
board of physical and occupational therapy, the board of
respiratory care, and the Iowa department of public health, as
applicable.
b. Procedures for registration of free clinics, and field
dental clinics, and specialty health care provider offices.
c. Criteria for and identification of hospitals, clinics,
free clinics, field dental clinics, specialty health care
provider offices, or other health care facilities, health care
referral programs, or charitable organizations, eligible to
participate in the provision of free medical, dental,
chiropractic, pharmaceutical, nursing, optometric,
psychological, social work, behavioral science, podiatric,
physical therapy, occupational therapy, respiratory therapy,
or emergency medical care services through the volunteer
health care provider program. A free clinic, a field dental
clinic, a specialty health care provider office, a health care
facility, a health care referral program, a charitable
organization, or a health care provider participating in the
program shall not bill or charge a patient for any health care
provider service provided under the volunteer health care
provider program.
d. Identification of the services to be provided under the
program. The services provided may include, but shall not be
limited to, obstetrical and gynecological medical services,
psychiatric services provided by a physician licensed under
chapter 148, dental services provided under chapter 153, or
other services provided under chapter 147A, 148A, 148B, 148C,
149, 151, 152, 152B, 152E, 154, 154B, 154C, 154D, 154F, or
155A.
3. A health care provider providing free care under this
section shall be considered an employee of the state under
chapter 669, shall be afforded protection as an employee of
the state under section 669.21, and shall not be subject to
payment of claims arising out of the free care provided under
this section through the health care provider's own
professional liability insurance coverage, provided that the
health care provider has done all of the following:
a. Registered with the department pursuant to subsection
1.
b. Provided medical, dental, chiropractic, pharmaceutical,
nursing, optometric, psychological, social work, behavioral
science, podiatric, physical therapy, occupational therapy,
respiratory therapy, or emergency medical care services
through a hospital, clinic, free clinic, field dental clinic,
specialty health care provider office, or other health care
facility, health care referral program, or charitable
organization listed as eligible and participating by the
department pursuant to subsection 1.
4. A free clinic providing free care under this section
shall be considered a state agency solely for the purposes of
this section and chapter 669 and shall be afforded protection
under chapter 669 as a state agency for all claims arising
from the provision of free care by a health care provider
registered under subsection 3 who is providing services at the
free clinic in accordance with this section or from the
provision of free care by a health care provider who is
covered by adequate medical malpractice insurance as
determined by the department, if the free clinic has
registered with the department pursuant to subsection 1.
5. A field dental clinic providing free care under this
section shall be considered a state agency solely for the
purposes of this section and chapter 669 and shall be afforded
protection under chapter 669 as a state agency for all claims
arising from the provision of free care by a health care
provider registered under subsection 3 who is providing
services at the field dental clinic in accordance with this
section or from the provision of free care by a health care
provider who is covered by adequate medical malpractice
insurance, as determined by the department, if the field
dental clinic has registered with the department pursuant to
subsection 1.
5A. A specialty health care provider office providing free
care under this section shall be considered a state agency
solely for the purposes of this section and chapter 669 and
shall be afforded protection under chapter 669 as a state
agency for all claims arising from the provision of free care
by a health care provider registered under subsection 3 who is
providing services at the specialty health care provider
office in accordance with this section or from the provision
of free care by a health care provider who is covered by
adequate medical malpractice insurance, as determined by the
department, if the specialty health care provider office has
registered with the department pursuant to subsection 1.
6. For the purposes of this section:
a. "Charitable organization" means a charitable
organization within the meaning of section 501(c)(3) of the
Internal Revenue Code.
b. "Field dental clinic" means a dental clinic temporarily
or periodically erected at a location utilizing mobile dental
equipment, instruments, or supplies, as necessary, to provide
dental services.
c. "Free clinic" means a facility, other than a hospital
or health care provider's office which is exempt from taxation
under section 501(c)(3) of the Internal Revenue Code and which
has as its sole purpose the provision of health care services
without charge to individuals who are otherwise unable to pay
for the services.
d. "Health care provider" means a physician licensed under
chapter 148, a chiropractor licensed under chapter 151, a
physical therapist licensed pursuant to chapter 148A, an
occupational therapist licensed pursuant to chapter 148B, a
podiatrist licensed pursuant to chapter 149, a physician
assistant licensed and practicing under a supervising
physician pursuant to chapter 148C, a licensed practical
nurse, a registered nurse, or an advanced registered nurse
practitioner licensed pursuant to chapter 152 or 152E, a
respiratory therapist licensed pursuant to chapter 152B, a
dentist, dental hygienist, or dental assistant registered or
licensed to practice under chapter 153, an optometrist
licensed pursuant to chapter 154, a psychologist licensed
pursuant to chapter 154B, a social worker licensed pursuant to
chapter 154C, a mental health counselor or a marital and
family therapist licensed pursuant to chapter 154D, a
pharmacist licensed pursuant to chapter 155A, or an emergency
medical care provider certified pursuant to chapter 147A.
e. "Specialty health care provider office" means the
private office or clinic of an individual specialty health
care provider or group of specialty health care providers as
referred by the Iowa collaborative safety net provider network
established in section 135.153, but does not include a field
dental clinic, a free clinic, or a hospital.
DIVISION V
HEALTH CARE WORKFORCE SUPPORT INITIATIVE
Sec. 44. NEW SECTION. 135.153A SAFETY NET PROVIDER
RECRUITMENT AND RETENTION INITIATIVES PROGRAM REPEAL.
The department, in accordance with efforts pursuant to
sections 135.163 and 135.164 and in cooperation with the Iowa
collaborative safety net provider network governing group as
described in section 135.153, shall establish and administer a
safety net provider recruitment and retention initiatives
program to address the health care workforce shortage relative
to safety net providers. Funding for the program may be
provided through the health care workforce shortage fund or
the safety net provider network workforce shortage account
created in section 135.175. The department, in cooperation
with the governing group, shall adopt rules pursuant to
chapter 17A to implement and administer such program. This
section is repealed June 30, 2014.
Sec. 45. NEW SECTION. 135.175 HEALTH CARE WORKFORCE
SUPPORT INITIATIVE == WORKFORCE SHORTAGE FUND == ACCOUNTS ==
REPEAL.
1. a. A health care workforce support initiative is
established to provide for the coordination and support of
various efforts to address the health care workforce shortage
in this state. This initiative shall include the medical
residency training state matching grants program created in
section 135.176, the health care professional and nursing
workforce shortage initiative created in sections 261.128 and
261.129, the safety net provider recruitment and retention
initiatives program credited in section 135.153A, health care
workforce shortage national initiatives, and the physician
assistant mental health fellowship program created in section
135.177.
b. A health care workforce shortage fund is created in the
state treasury as a separate fund under the control of the
department, in cooperation with the entities identified in
this section as having control over the accounts within the
fund. The fund and the accounts within the fund shall be
controlled and managed in a manner consistent with the
principles specified and the strategic plan developed pursuant
to sections 135.163 and 135.164.
2. The fund and the accounts within the fund shall consist
of moneys appropriated from the general fund of the state for
the purposes of the fund or the accounts within the fund;
moneys received from the federal government for the purposes
of addressing the health care workforce shortage;
contributions, grants, and other moneys from communities and
health care employers; and moneys from any other public or
private source available.
3. The department and any entity identified in this
section as having control over any of the accounts within the
fund, may receive contributions, grants, and in=kind
contributions to support the purposes of the fund and the
accounts within the fund.
4. The fund and the accounts within the fund shall be
separate from the general fund of the state and shall not be
considered part of the general fund of the state. The moneys
in the fund and the accounts within the fund shall not be
considered revenue of the state, but rather shall be moneys of
the fund or the accounts. The moneys in the fund and the
accounts within the fund are not subject to section 8.33 and
shall not be transferred, used, obligated, appropriated, or
otherwise encumbered, except to provide for the purposes of
this section. Notwithstanding section 12C.7, subsection 2,
interest or earnings on moneys deposited in the fund shall be
credited to the fund and the accounts within the fund.
5. The fund shall consist of the following accounts:
a. The medical residency training account. The medical
residency training account shall be under the control of the
department and the moneys in the account shall be used for the
purposes of the medical residency training state matching
grants program as specified in section 135.176. Moneys in the
account shall consist of moneys appropriated or allocated for
deposit in or received by the fund or the account and
specifically dedicated to the medical residency training state
matching grants program or account for the purposes of such
account.
b. The health care professional and nurse workforce
shortage initiative account. The health care professional and
nurse workforce shortage initiative account shall be under the
control of the college student aid commission created in
section 261.1 and the moneys in the account shall be used for
the purposes of the health care professional incentive payment
program and the nurse workforce shortage initiative as
specified in sections 261.128 and 261.129. Moneys in the
account shall consist of moneys appropriated or allocated for
deposit in or received by the fund or the account and
specifically dedicated to the health care professional and
nurse workforce shortage initiative or the account for the
purposes of the account.
c. The safety net provider network workforce shortage
account. The safety net provider network workforce shortage
account shall be under the control of the governing group of
the Iowa collaborative safety net provider network created in
section 135.153 and the moneys in the account shall be used
for the purposes of the safety net provider recruitment and
retention initiatives program as specified in section
135.153A. Moneys in the account shall consist of moneys
appropriated or allocated for deposit in or received by the
fund or the account and specifically dedicated to the safety
net provider recruitment and retention initiatives program or
the account for the purposes of the account.
d. The health care workforce shortage national initiatives
account. The health care workforce shortage national
initiatives account shall be under the control of the state
entity identified for receipt of the federal funds by the
federal government entity through which the federal funding is
available for a specified health care workforce shortage
initiative. Moneys in the account shall consist of moneys
appropriated or allocated for deposit in or received by the
fund or the account and specifically dedicated to health care
workforce shortage national initiatives or the account and for
a specified health care workforce shortage initiative.
e. The physician assistant mental health fellowship
program account. The physician assistant mental health
fellowship program account shall be under the control of the
department and the moneys in the account shall be used for the
purposes of the physician assistant mental health fellowship
program as specified in section 135.177. Moneys in the
account shall consist of moneys appropriated or allocated for
deposit in or received by the fund or the account and
specifically dedicated to the physician assistant mental
health fellowship program or the account for the purposes of
the account.
6. a. Moneys in the fund and the accounts in the fund
shall only be appropriated in a manner consistent with the
principles specified and the strategic plan developed pursuant
to sections 135.163 and 135.164 to support the medical
residency training state matching grants program, the health
care professional incentive payment program, the nurse
educator incentive payment and nursing faculty fellowship
programs, the safety net recruitment and retention initiatives
program, for national health care workforce shortage
initiatives, for the physician assistant mental health
fellowship program, and to provide funding for state health
care workforce shortage programs as provided in this section.
b. State programs that may receive funding from the fund
and the accounts in the fund, if specifically designated for
the purpose of drawing down federal funding, are the primary
care recruitment and retention endeavor (PRIMECARRE), the Iowa
affiliate of the national rural recruitment and retention
network, the primary care office shortage designation program,
the state office of rural health, and the Iowa health
workforce center, administered through the bureau of health
care access of the department of public health; the area
health education centers programs at Des Moines university ==
osteopathic medical center and the university of Iowa; the
Iowa collaborative safety net provider network established
pursuant to section 135.153; any entity identified by the
federal government entity through which federal funding for a
specified health care workforce shortage initiative is
received; and a program developed in accordance with the
strategic plan developed by the department of public health in
accordance with sections 135.163 and 135.164.
c. State appropriations to the fund shall be allocated in
equal amounts to each of the accounts within the fund, unless
otherwise specified in the appropriation or allocation. Any
federal funding received for the purposes of addressing state
health care workforce shortages shall be deposited in the
health care workforce shortage national initiatives account,
unless otherwise specified by the source of the funds, and
shall be used as required by the source of the funds. If use
of the federal funding is not designated, twenty=five percent
of such funding shall be deposited in the safety net provider
network workforce shortage account to be used for the purposes
of the account and the remainder of the funds shall be used in
accordance with the strategic plan developed by the department
of public health in accordance with sections 135.163 and
135.164, or to address workforce shortages as otherwise
designated by the department of public health. Other sources
of funding shall be deposited in the fund or account and used
as specified by the source of the funding.
7. No more than five percent of the moneys in any of the
accounts within the fund, not to exceed one hundred thousand
dollars in each account, shall be used for administrative
purposes, unless otherwise provided by the appropriation,
allocation, or source of the funds.
8. The department, in cooperation with the entities
identified in this section as having control over any of the
accounts within the fund, shall submit an annual report to the
governor and the general assembly regarding the status of the
health care workforce support initiative, including the
balance remaining in and appropriations from the health care
workforce shortage fund and the accounts within the fund.
9. This section is repealed June 30, 2014.
Sec. 46. NEW SECTION. 135.176 MEDICAL RESIDENCY TRAINING
STATE MATCHING GRANTS PROGRAM == REPEAL.
1. The department shall establish a medical residency
training state matching grants program to provide matching
state funding to sponsors of accredited graduate medical
education residency programs in this state to establish,
expand, or support medical residency training programs.
Funding for the program may be provided through the health
care workforce shortage fund or the medical residency training
account created in section 135.175. For the purposes of this
section, unless the context otherwise requires, "accredited"
means a graduate medical education program approved by the
accreditation council for graduate medical education or the
American osteopathic association. The grant funds may be used
to support medical residency programs through any of the
following:
a. The establishment of new or alternative campus
accredited medical residency training programs. For the
purposes of this paragraph, "new or alternative campus
accredited medical residency training program" means a program
that is accredited by a recognized entity approved for such
purpose by the accreditation council for graduate medical
education or the American osteopathic association with the
exception that a new medical residency training program that,
by reason of an insufficient period of operation is not
eligible for accreditation on or before the date of submission
of an application for a grant, may be deemed accredited if the
accreditation council for graduate medical education or the
American osteopathic association finds, after consultation
with the appropriate accreditation entity, that there is
reasonable assurance that the program will meet the
accreditation standards of the entity prior to the date of
graduation of the initial class in the program.
b. The provision of new residency positions within
existing accredited medical residency or fellowship training
programs.
c. The funding of residency positions which are in excess
of the federal residency cap. For the purposes of this
paragraph, "in excess of the federal residency cap" means a
residency position for which no federal Medicare funding is
available because the residency position is a position beyond
the cap for residency positions established by the federal
Balanced Budget Act of 1997, Pub. L. No. 105=33.
2. The department shall adopt rules pursuant to chapter
17A to provide for all of the following:
a. Eligibility requirements for and qualifications of a
sponsor of an accredited graduate medical education residency
program to receive a grant. The requirements and
qualifications shall include but are not limited to all of the
following:
(1) Only a sponsor that establishes a dedicated fund to
support a residency program that meets the specifications of
this section shall be eligible to receive a matching grant. A
sponsor funding residency positions in excess of the federal
residency cap, as defined in subsection 1, paragraph "c",
exclusive of funds provided under the medical residency
training state matching grants program established in this
section, is deemed to have satisfied this requirement and
shall be eligible for a matching grant equal to the amount of
funds expended for such residency positions, subject to the
limitation on the maximum award of grant funds specified in
paragraph "e".
(2) A sponsor shall demonstrate through documented
financial information as prescribed by rule of the department,
that funds have been reserved and will be expended by the
sponsor in the amount required to provide matching funds for
each residency proposed in the request for state matching
funds.
(3) A sponsor shall demonstrate through objective evidence
as prescribed by rule of the department, a need for such
residency program in the state.
b. The application process for the grant.
c. Criteria for preference in awarding of the grants,
including preference in the residency specialty.
d. Determination of the amount of a grant. The total
amount of a grant awarded to a sponsor shall be limited to no
more than twenty=five percent of the amount that the sponsor
has demonstrated through documented financial information has
been reserved and will be expended by the sponsor for each
residency sponsored for the purpose of the residency program.
e. The maximum award of grant funds to a particular
individual sponsor per year. An individual sponsor shall not
receive more than twenty=five percent of the state matching
funds available each year to support the program. However, if
less than ninety=five percent of the available funds has been
awarded in a given year, a sponsor may receive more than
twenty=five percent of the state matching funds available if
total funds awarded do not exceed ninety=five percent of the
available funds. If more than one sponsor meets the
requirements of this section and has established, expanded, or
supported a graduate medical residency training program, as
specified in subsection 1, in excess of the sponsor's
twenty=five percent maximum share of state matching funds, the
state matching funds shall be divided proportionately among
such sponsors.
f. Use of the funds awarded. Funds may be used to pay the
costs of establishing, expanding, or supporting an accredited
graduate medical education program as specified in this
section, including but not limited to the costs associated
with residency stipends and physician faculty stipends.
3. This section is repealed June 30, 2014.
Sec. 47. NEW SECTION. 135.177 PHYSICIAN ASSISTANT MENTAL
HEALTH FELLOWSHIP PROGRAM == REPEAL.
1. The department, in cooperation with the college student
aid commission, shall establish a physician assistant mental
health fellowship program in accordance with this section.
Funding for the program may be provided through the health
care workforce shortage fund or the physician assistant mental
health fellowship program account created in section 135.175.
The purpose of the program is to determine the effect of
specialized training and support for physician assistants in
providing mental health services on addressing Iowa's shortage
of mental health professionals.
2. The program shall provide for all of the following:
a. Collaboration with a hospital serving a thirteen=county
area in central Iowa that provides a clinic at the Iowa
veterans home, a private nonprofit agency headquartered in a
city with a population of more than one hundred ninety
thousand that operates a freestanding psychiatric medical
institution for children, a private university with a medical
school educating osteopathic physicians located in a city with
a population of more than one hundred ninety thousand, the
Iowa veterans home, and any other clinical partner designated
for the program. Population figures used in this paragraph
refer to the most recent certified federal census. The
clinical partners shall provide supervision, clinical
experience, training, and other support for the program and
physician assistant students participating in the program.
b. Elderly, youth, and general population clinical
experiences.
c. A fellowship of twelve months for three physician
assistant students, annually.
d. Supervision of students participating in the program
provided by the university and the other clinical partners
participating in the program.
e. A student participating in the program shall be
eligible for a stipend of not more than fifty thousand dollars
for the twelve months of the fellowship plus related fringe
benefits. In addition, a student who completes the program
and practices in Iowa in a mental health professional shortage
area, as defined in section 135.80, shall be eligible for up
to twenty thousand dollars in loan forgiveness. The stipend
and loan forgiveness provisions shall be determined by the
department and the college student aid commission, in
consultation with the clinical partners.
f. The state and private entity clinical partners shall
regularly evaluate and document their experiences with the
approaches utilized and outcomes achieved by the program to
identify an optimal model for operating the program. The
evaluation process shall include but is not limited to
identifying ways the program's clinical and training
components could be modified to facilitate other student and
practicing physician assistants specializing as mental health
professionals.
3. This section is repealed June 30, 2014.
Sec. 48. Section 261.2, Code 2009, is amended by adding
the following new subsection:
NEW SUBSECTION. 10. Administer the health care
professional incentive payment program established in section
261.128 and the nursing workforce shortage initiative created
in section 261.129. This subsection is repealed June 30,
2014.
Sec. 49. Section 261.23, subsection 1, Code 2009, is
amended to read as follows:
1. A registered nurse and nurse educator loan forgiveness
program is established to be administered by the commission.
The program shall consist of loan forgiveness for eligible
federally guaranteed loans for registered nurses and nurse
educators who practice or teach in this state. For purposes
of this section, unless the context otherwise requires, "nurse
educator" means a registered nurse who holds a master's degree
or doctorate degree and is employed as a faculty member who
teaches nursing as provided in 655 IAC 2.6(152) at a community
college, an accredited private institution, or an institution
of higher education governed by the state board of regents.
Sec. 50. Section 261.23, subsection 2, paragraph c, Code
2009, is amended to read as follows:
c. Complete and return, on a form approved by the
commission, an affidavit of practice verifying that the
applicant is a registered nurse practicing in this state or a
nurse educator teaching at a community college, an accredited
private institution, or an institution of higher learning
governed by the state board of regents.
Sec. 51. NEW SECTION. 261.128 HEALTH CARE PROFESSIONAL
INCENTIVE PAYMENT PROGRAM == REPEAL.
1. The commission shall establish a health care
professional incentive payment program to recruit and retain
health care professionals in this state. Funding for the
program may be provided through the health care workforce
shortage fund or the health care professional and nurse
workforce shortage account created in section 135.175.
2. The commission shall administer the incentive payment
program with the assistance of Des Moines university ==
osteopathic medical center.
3. The commission, with the assistance of Des Moines
university == osteopathic medical center, shall adopt rules
pursuant to chapter 17A, relating to the establishment and
administration of the health care professional incentive
payment program. The rules adopted shall address all of the
following:
a. Eligibility and qualification requirements for a health
care professional, a community, and a health care employer to
participate in the incentive payment program. Any community
in the state and all health care specialties shall be
considered for participation. However, health care employers
located in and communities that are designated as medically
underserved areas or populations or that are designated as
health professional shortage areas by the health resources and
services administration of the United States department of
health and human services shall have first priority in the
awarding of incentive payments.
(1) To be eligible, a health care professional at a
minimum must not have any unserved obligations to a federal,
state, or local government or other entity that would prevent
compliance with obligations under the agreement for the
incentive payment; must have a current and unrestricted
license to practice the professional's respective profession;
and must be able to begin full=time clinical practice upon
signing an agreement for an incentive payment.
(2) To be eligible, a community must provide a clinical
setting for full=time practice of a health care professional
and must provide a fifty thousand dollar matching contribution
for a physician and a fifteen thousand dollar matching
contribution for any other health care professional to receive
an equal amount of state matching funds.
(3) To be eligible, a health care employer must provide a
clinical setting for a full=time practice of a health care
professional and must provide a fifty thousand dollar matching
contribution for a physician and a fifteen thousand dollar
matching contribution for any other health care professional
to receive an equal amount of state matching funds.
b. The process for awarding incentive payments. The
commission shall receive recommendations from the department
of public health regarding selection of incentive payment
recipients. The process shall require each recipient to enter
into an agreement with the commission that specifies the
obligations of the recipient and the commission prior to
receiving the incentive payment.
c. Public awareness regarding the program including
notification of potential health care professionals,
communities, and health care employers about the program and
dissemination of applications to appropriate entities.
d. Measures regarding all of the following:
(1) The amount of the incentive payment and the specifics
of obligated service for an incentive payment recipient. An
incentive payment recipient shall agree to provide service in
full=time clinical practice for a minimum of four consecutive
years. If an incentive payment recipient is sponsored by a
community or health care employer, the obligated service shall
be provided in the sponsoring community or health care
employer location. An incentive payment recipient sponsored
by a health care employer shall agree to provide health care
services as specified in an employment agreement with the
sponsoring health care employer.
(2) Determination of the conditions of the incentive
payment applicable to an incentive payment recipient. At the
time of approval for participation in the program, an
incentive payment recipient shall be required to submit proof
of indebtedness incurred as the result of obtaining loans to
pay for educational costs resulting in a degree in health
sciences. For the purposes of this subparagraph,
"indebtedness" means debt incurred from obtaining a government
or commercial loan for actual costs paid for tuition,
reasonable education expenses, and reasonable living expenses
related to the graduate, undergraduate, or associate education
of a health care professional.
(3) Enforcement of the state's rights under an incentive
payment agreement, including the commencement of any court
action. A recipient who fails to fulfill the requirements of
the incentive payment agreement is subject to repayment of the
incentive payment in an amount equal to the amount of the
incentive payment. A recipient who fails to meet the
requirements of the incentive payment agreement may also be
subject to repayment of moneys advanced by a community or
health care employer as provided in any agreement with the
community or employer.
(4) A process for monitoring compliance with eligibility
requirements, obligated service provisions, and use of funds
by recipients to verify eligibility of recipients and to
ensure that state, federal, and other matching funds are used
in accordance with program requirements.
(5) The use of the funds received. Any portion of the
incentive payment that is attributable to federal funds shall
be used as required by the federal entity providing the funds.
Any portion of the incentive payment that is attributable to
state funds shall first be used toward payment of any
outstanding loan indebtedness of the recipient. The remaining
portion of the incentive payment shall be used as specified in
the incentive payment agreement.
4. A recipient is responsible for reporting on federal
income tax forms any amount received through the program, to
the extent required by federal law. Incentive payments
received through the program by a recipient in compliance with
the requirements of the incentive payment program are exempt
from state income taxation.
5. This section is repealed June 30, 2014.
Sec. 52. NEW SECTION. 261.129 NURSING WORKFORCE SHORTAGE
INITIATIVE == REPEAL.
1. NURSE EDUCATOR INCENTIVE PAYMENT PROGRAM.
a. The commission shall establish a nurse educator
incentive payment program. Funding for the program may be
provided through the health care workforce shortage fund or
the health care professional and nurse workforce shortage
initiative account created in section 135.175. For the
purposes of this subsection, "nurse educator" means a
registered nurse who holds a master's degree or doctorate
degree and is employed as a faculty member who teaches nursing
in a nursing education program as provided in 655 IAC 2.6 at a
community college, an accredited private institution, or an
institution of higher education governed by the state board of
regents.
b. The program shall consist of incentive payments to
recruit and retain nurse educators. The program shall provide
for incentive payments of up to twenty thousand dollars for a
nurse educator who remains teaching in a qualifying teaching
position for a period of not less than four consecutive
academic years.
c. The nurse educator and the commission shall enter into
an agreement specifying the obligations of the nurse educator
and the commission. If the nurse educator leaves the
qualifying teaching position prior to teaching for four
consecutive academic years, the nurse educator shall be liable
to repay the incentive payment amount to the state, plus
interest as specified by rule. However, if the nurse educator
leaves the qualifying teaching position involuntarily, the
nurse educator shall be liable to repay only a pro rata amount
of the incentive payment based on incompleted years of
service.
d. The commission, in consultation with the department of
public health, shall adopt rules pursuant to chapter 17A
relating to the establishment and administration of the nurse
educator incentive payment program. The rules shall include
provisions specifying what constitutes a qualifying teaching
position.
2. NURSING FACULTY FELLOWSHIP PROGRAM.
a. The commission shall establish a nursing faculty
fellowship program to provide funds to nursing schools in the
state, including but not limited to nursing schools located at
community colleges, for fellowships for individuals employed
in qualifying positions on the nursing faculty. Funding for
the program may be provided through the health care workforce
shortage fund or the health care professional and nurse
workforce shortage initiative account created in section
135.175. The program shall be designed to assist nursing
schools in filling vacancies in qualifying positions
throughout the state.
b. The commission, in consultation with the department of
public health and in cooperation with nursing schools
throughout the state, shall develop a distribution formula
which shall provide that no more than thirty percent of the
available moneys are awarded to a single nursing school.
Additionally, the program shall limit funding for a qualifying
position in a nursing school to no more than ten thousand
dollars per year for up to three years.
c. The commission, in consultation with the department of
public health, shall adopt rules pursuant to chapter 17A to
administer the program. The rules shall include provisions
specifying what constitutes a qualifying position at a nursing
school.
d. In determining eligibility for a fellowship, the
commission shall consider all of the following:
(1) The length of time a qualifying position has gone
unfilled at a nursing school.
(2) Documented recruiting efforts by a nursing school.
(3) The geographic location of a nursing school.
(4) The type of nursing program offered at the nursing
school, including associate, bachelor's, master's, or doctoral
degrees in nursing, and the need for the specific nursing
program in the state.
3. REPEAL. This section is repealed June 30, 2014.
Sec. 53. HEALTH CARE WORKFORCE INITIATIVES == FEDERAL
FUNDING. The department of public health shall 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 shall
be deposited in the health care workforce shortage fund
created in section 135.175 as enacted by this division of this
Act and shall be used for the purposes specified for the fund
and for the purposes specified in the federal American
Recovery and Reinvestment Act of 2009.
Sec. 54. IMPLEMENTATION. This division of this Act shall
be implemented only to the extent funding is available.
Sec. 55. CODE EDITOR DIRECTIVES. The Code editor shall do
all of the following:
1. Create a new division in chapter 135 codifying section
135.175, as enacted in this division of this Act, as the
health care workforce support initiative and fund.
2. Create a new division in chapter 135 codifying sections
135.176 and 135.177, as enacted in this division of this Act,
as health care workforce support.
3. Create a new division in chapter 261 codifying section
261.128, as enacted in this division of this Act, as the
health care professional incentive payment program.
4. Create a new division in chapter 261 codifying section
261.129, as enacted in this division of this Act, as the
nursing workforce shortage initiative.
DIVISION VI
GIFTS == REPORTING OF SANCTIONS
Sec. 56. REPORTING OF SANCTIONS FOR GIFTS. The health
profession boards established in chapter 147 shall 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.
DIVISION VII
HEALTH CARE TRANSPARENCY
Sec. 57. NEW SECTION. 135.166 HEALTH CARE DATA ==
COLLECTION FROM HOSPITALS.
1. The department of public health shall enter into a
memorandum of understanding to utilize the Iowa hospital
association to act as the department's intermediary in
collecting, maintaining, and disseminating hospital inpatient,
outpatient, and ambulatory information, as initially
authorized in 1996 Iowa Acts, chapter 1212, section 5,
subsection 1, paragraph "a", subparagraph (4) and 641 IAC
177.3.
2. The memorandum of understanding shall include but is
not limited to provisions that address the duties of the
department and the Iowa hospital association regarding the
collection, reporting, disclosure, storage, and
confidentiality of the data.
JOHN P. KIBBIE
President of the Senate
PATRICK J. MURPHY
Speaker of the House
I hereby certify that this bill originated in the Senate and
is known as Senate File 389, Eighty=third General Assembly.
MICHAEL E. MARSHALL
Secretary of the Senate
Approved , 2009
CHESTER J. CULVER
Governor
-1-
Text: SF388
Text: SF390
Complete Bill History