Week 4 Legislative Update

We’ve wrapped another busy week at the capitol, with a number of issues of interest to the House of Medicine seeing action this week. Several bills of interest saw subcommittee hearings or committee consideration. Health policy leaders heard presentations on recommendations for the children’s mental health system, the numerous initiatives of the Iowa Department of Public Health, and the joint legislative initiative of IMS and the Iowa Association of School Boards to create a regulatory framework to allow for the administration of behavioral health services via telehealth in a school-based setting.

School-Based Telehealth

On Thursday, the Health and Human Services (HHS) Appropriations Subcommittee invited the Iowa Medical Society and the Iowa Association of School Boards to brief the committee on the school-based telehealth legislation our two organizations are pursuing this session. Under the proposal put forward, our bill would allow individual schools or Area Education Associations to enter into a contractual arrangement with an Iowa-licensed mental health provider to provide behavioral health services via telehealth to students. The bill outlines requirements for parental notification and consent, ensures a feedback loop with the student’s primary care provider, and creates safeguards to protect patient privacy and ensure students receiving on-going behavioral health care via the system have an established relationship with that mental health provider. A full summary of the proposed legislation is available here.

IDPH Legislative Report

On Wednesday, the Senate Human Resources Committee heard a report from Gerd Clabaugh, Director of the Iowa Department of Public Health. Director Clabaugh reported on a number of public health initiatives underway at the department, including the success to-date of the 5-2-1-0 initiative and the need for continued funding for this program. He thanked IMS for its involvement on the issue and reiterated the importance of the work, citing Iowa’s ranking as the 4th most obese state in the nation. The discussion also focused on the ongoing concerns regarding the increase in individuals choosing to not vaccinate their children. Director Clabaugh reported that 97% of Iowa children are current on their recommended immunizations, however, the department is seeing an increase in religious exceptions to vaccinations.

Board of Medicine Administration

This week, legislation was introduced to alter the administrative structure of the Boards of Medicine, Pharmacy, Nursing, and Dentistry. HF 212 was drafted in response to the confusion that arose last year when the Executive Director of the Board of Medicine was suspended, reinstated, and ultimately allowed to retire rather than be terminated. The incident led some to question by these four boards are treated differently than the other health licensure boards that are administratively housed under the Iowa Department of Public Health’s Bureau of Professional Licensure. Under the proposed legislation, these four boards would be moved into the same bureau as the other professions, the requirement for a dedicated Executive Director for each bill would be eliminated, and the dedicated investigators for the individual boards would be eliminated.

During a packed hearing, the subcommittee members heard from numerous representatives of the four affected professions, as well as representatives of the four boards. IMS recommended, should the bill move forward, that the bill be amended to ensure each of the big four boards continue to have a dedicated Executive Director, rather than a shared director like the other professions have, and to ensure that professional licensure fees stay with the board that collects them rather than subsidizing the numerous boards currently within the Bureau of Professional Licensure that currently fail to collect sufficient fees to offset their ongoing expenses. Representative Fry, the bill sponsor and subcommittee chair, indicated that he is working on an amendment to address these two issues and was open to additional changes, including protection of designated investigators to ensure those conducting an investigation of a licensee are knowledgeable about that profession’s appropriate practice. The bill did not advance from subcommittee. Representative Fry indicated that he would like to sit down with the Executive Directors of the big four licensure boards and to finalize his amendment before calling another subcommittee to discuss the bill’s future.

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