After weeks of behind-the-scenes work, our tort reform efforts take center stage next week as Physician Week on the Hill kicks off a week of coordinated advocacy in support of a hard cap on noneconomic damages. If you haven’t already, register to join our live advocacy briefing and legislative address on Tuesday over the noon hour. This week saw action on several issues of interest:
IMS efforts to address physician workforce saw further progress this week as the House Human Resources unanimously passed SF 129 on Tuesday. This bill – a joint priority of IMS and the Iowa Psychiatric Society – will expand the Rural Physician Loan Repayment program to include OB/GYNs, to establish true geographic standards for qualifying rural communities, and to allow psychiatrists who practice in federally-designated mental health shortage areas to also qualify for loan repayment. The bill also allows new physicians to enter into part-time practice arrangements in exchange for a longer service commitment and still qualify for the maximum $200,000 in loan repayment under the program.
This same bill unanimously passed the Senate and a House subcommittee last year, before the 11 week COVID-19 shutdown of session halted its progress. This year’s bill is now eligible for consideration by the full House where it is expected to easily pass and make its way to the Governor’s desk for signature in the next few weeks.
This week saw further movement on efforts to advance anti-vaccine legislation at the capitol. On Tuesday, the Senate Human Resources Committee took up and passed on a party-line vote SF 125 to require the listing of infant vaccination records on medical examiner forms. This legislation creates a pathway for anti-vaccine advocates to obtain death records that will allow them to identify families who lost a young child. In other states where this measure has been enacted, the advocates then target these grieving families to spread misinformation about a purported link between immunizations and SIDS, and try to recruit families to publicly use their child’s death as an example of the dangers of vaccines.
IMS is working with AAP-IA and the Iowa Immunizes Coalition to oppose this legislation, which is now eligible for consideration by the full chamber. In the coming weeks, IMS and AAP-IA will be coordinating to present a webinar to educate legislators on the child death review process and how this legislation has been utilized to undermine vaccine confidence around the country.
Scope of Practice
On Thursday, the House Human Resources Committee discussed multiple bills to expand scope of practice for non-physician providers.
Among these was HSB 71, which would allow dentists to administer the COVID-19 and flu vaccines to patients of any age. As we told you a few weeks ago, this legislation is being brought forward by the Iowa Dental Board who argue that it will expand the number of eligible COVID-19 vaccine administrators and as a result speed the rollout of the vaccine. This is despite the Department of Public Health reporting that Iowa has a sufficient number of approved administrators and it is a lack of vaccine supply, not providers, that is the cause for the slow rollout.
IMS has had a number of conversations with legislators in recent weeks to educate them about the vaccine rollout process. We have also explained how critical is it to ensure that any provider of the COVID-19 vaccine be well-versed in utilizing the IRIS system to ensure that every dose of Iowa’s limited supply is accurately tracked and reported so as to not negatively impact our weekly statewide allocation from the federal government. Despite these concerns, the overriding belief that we will eventually get to the point where Iowa does not have a sufficient supply of providers to administer the COVID-19 vaccine in a timely manner, has motivated legislators to support the bill. HSB 71 passed out of committee nearly unanimously and now moves to the full chamber for consideration. A companion bill in the Senate has not been introduced.
The House Human Resources Committee on Thursday was also scheduled to consider a pair of bills to expand pharmacist scope of practice. HSB 91 would expand the pharmacist statewide protocols to allow pharmacists to administer pediatric immunizations and tobacco cessation products; oversee point-of-care testing and treatment for influenza, strep, and COVID-19; and to enter into a collaborative practice agreement with any practitioner with prescriptive authority, rather than just physicians. HSB 73 would build upon these expansions by allowing pharmacists to delegate any services permissible under the statewide protocols to be administered by pharmacy support staff.
Emergency authority under the federal Public Health Emergency declaration has allows for pharmacist-administered pediatric immunizations since last spring and for delegation to pharmacy support staff since last fall. This temporary authority has given some legislators a new level of comfort with keeping these authorities permanently after the PHE declarations expire, however, several additional questions and concerns were raised when the committee caucused before the start of the meeting. Given these concerns, the committee opted to not take up HSB 91
at this time. They did vote to advance HSB 73
to the full House for consideration.