IMS Advocate: 2021 Session - Week Nine

Saturday, March 13, 2021 7:30 AM | Sydney Maras (Administrator)

With the first funnel deadline now passed, the legislature spent significant time this week on floor debate as the work to move bills to the opposing chamber so they can begin to move through the process once more. We have just three weeks until the second funnel deadline on Friday, April 2 – the deadline for the majority of policy bills to clear a full chamber and a committee in the opposing chamber to remain eligible for consideration. These funnel deadlines help to shorten the list of policy measures under consideration, allowing the legislature to turn its attention to development of the annual budget and any tax policy, which will impact state revenues.

Tort Reform

With last week’s Senate Judiciary Committee passage of SF 557, our tort reform efforts are now funnel-proof through the end of the legislative session given that the House companion bill HF 592 has previously cleared a committee in that chamber as well. This critical designation gives us additional time to work with leadership and our champions in the two chambers to educate and push our remaining holdout votes on the need for a hard cap on noneconomic damages.

IMS continues to coordinate with our coalition of provider, business, and insurance organizations to strategically approach each of the individual holdouts in a manner that seems most likely to be impactful based upon our extensive group conversations with each this session. At the same time, grassroots efforts continue outside the building. To date, Iowa physicians, residents, and medical students have sent more than 800 emails to their individual legislators via the Iowa Action Alert system. Andy Conlin, our Grassroots Coordinator, is directly reaching out physicians in targeted House districts to make sure local physicians are connecting with legislators at the moment our lobbying team identifies someone in need of additional local reinforcement of the need for this critical reform. This week, IMS President Brian Privett, MD, also personally called several of our most persistent undecided votes to have a more in-depth discussion about the implications of the current liability climate in Iowa.

No more than ever, it is critical that legislators – especially House Republicans – hear from their local physicians on the need for a hard cap on noneconomic damages. If you haven’t reached out yet, please take a minute to send a note via the IMS Action Center. If you’ve already reached out, please follow up with your legislators to ask about the progress of this issue. These sustained conversations throughout the next few weeks will be an important reminder to legislators that this issue matters to their local physicians and that their constituents are continue to track the progress of these efforts.

Scope of Practice

Dentists

On Wednesday, a Senate subcommittee took up consideration of HF 528, a bill to allow dentists to administer the flu and COVID-19 vaccines. As we have reported previously, IMS has had numerous conversations over the summer and fall on this issue. Following the guidance of the Committee on Legislation, we have told the dental community that IMS would not object to authorizing dentists to administer the flu vaccine to adult patients so long as these vaccinations were reported into IRIS. We would, however, oppose efforts to authorize dental administration of the COVID-19 vaccine at a time when doses remain scare and Iowa has a sufficient number of authorized administrators, or to administer either vaccine to pediatric patients or seniors.

This week, IMS and the Iowa Dental Association agreed upon amendment language to narrow HF 528 to authorize only the administration of the flu vaccine to established patients over the age of 18. The Iowa Dental Board and representatives of the Dental Services Organizations objected to the compromise language, arguing that administration of the COVID-19 vaccine was their primary motivation for pursuing the legislation in the first place. The subcommittee opted to move the bill to the full State Government Committee without amendment, asking the interested parties to work to work toward agreement on amendment language.

Podiatrists

On Monday evening, the House took up and overwhelmingly passed HF 686, which would allow podiatrists to order and administer and CDC-recommended vaccines, as well as epinephrine. Unlike the current pharmacist immunization statute and the proposal for dental immunizations, the bill does not impose any limitations on podiatric immunization of pediatric or high-risk populations, require additional vaccine-specific education prior to offering this service, and require reporting of podiatric-administered immunizations into the IRIS system. The bill now moves to the Senate where it’s future remains uncertain.

Anti-Vaccine Efforts

As we have previously reported, there are a record number of anti-vaccine bills moving through the legislature this session. Last week’s first legislative funnel eliminated many of these proposals, whoever, three anti-vaccine bills were able to clear committee and remain eligible for consideration yet this session:

Infant Medical Examiner Forms

SF 125 would require the listing of children’s vaccination history on the medical examiner’s form for any death under the age of three. The bill ignores the fact that the Child Death Review Team through the Iowa Department of Public Health already completes a more comprehensive review of all pediatric deaths and would create a pathway for anti-vaccine advocates to more easily identify grieving families so they can share misinformation about the widely-discredited purported link between vaccines and SIDS.

Restricting Vaccine Mandates

SF 555 originally started as an omnibus bill that included a number anti-vaccine, however, it was amended as it passed committee last week to only retain the section, which prohibits employers from mandating that employees the COVID-19 vaccine and the section, which prohibits the linking of vaccination status and any state-issued ID. While this dramatic scaling back of the bill represents a significant improvement to the original bill, it still poses a number of problems for healthcare facilities who may want to put in place limitations such as ensuring that unvaccinated staff are not in patient-facing roles.

IRIS & VAERS Reporting

HF 769 requires vaccine providers to report into VAERS any adverse events a patient experiences within eight weeks of receiving a vaccine and requires all vaccine administrators to report into IRIS. As written, the bill would significantly penalize providers who fail to report an adverse event, even if it were something like a broken arm that is clearly unrelated to the patient’s vaccinations or if it were a minor event that does not meet the federal reporting criteria. Earlier this session, a standalone bill mandating IRIS use was derailed when a group of anti-vaccine legislators tried to add an amendment requiring explicit informed consent for reporting a patient’s vaccinations into IRIS and the option to opt-out of having records included in the system. It is unclear if a similar amendment will be proposed to this bill now that is it eligible for consideration by the full House.

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SF 125 and SF 555 are now eligible for consideration by the full Senate and HF 769 is now eligible for consideration by the full House. IMS is working with the Iowa Immunizes Coalition to oppose further action on all three bills. If they fail to clear their full chambers and a committee in the opposing chamber by the second funnel on Friday, April 3, they will become ineligible for further consideration this session.

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