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Legislative Update Week Four

IPS Legislative Update
February 3, 2017
Under the Golden Dome
We are four weeks into the legislative session that has largely been defined by divisive issues, lack of civility and general inability to come together for the good of Iowa.   It is only destined to get worse as legislators settle school funding, make changes to collective bargaining and debate educational vouchers.
The pace of work on other, less controversial, legislation, has been slow. Committees are routinely cancelled and the pace of bill introduction lags behind prior years.   Legislators did resolve the necessary reductions in the current year's budget to accommodate for a reduction in projected revenue growth.  And, the Republican leadership in the two chambers reached agreement on school funding.  This allows legislative leaders to move forward to put the FY 18 budget together.   Revenues are also projected to be tight for FY 18 with approximately $178 in new revenue available after accounting for the built-in increases in the budget.
Of note in the budget cuts: Two days ago Branstad signed a new budget bill that eliminated the state subsidy to the UI Psychiatric Hospital, in place since the 1950s. The subsidy was provided after the then chair (Paul Huston) personally lobbied the legislature. In return, we have provided large amounts of uncompensated care. Around 20 years ago, the line item to Psychiatric Hospital reverted to UIHC, and they would pass along a portion of the total to psychiatry. We all thought that was the beginning of the end. It has just taken longer than we expected. The amount has gradually been cut back each year.
RxP Update
The joint rulemaking subcommittee of the Iowa Boards of Medicine and Boards of Psychology continue to meet to implement the provisions of SF 2188 as passed by the legislature last year.  Dr. Robert Smith represents IPS on
that subcommittee.   The subcommittee has met four times and does not appear
any closer to an agreement.   This email provides the most recent comments
submitted jointly by IPS and the Iowa Medical Society as well as comments
submitted by Dr. Donald Black.   Dr. Black was asked to provide his insights
in fulfillment of the statutory requirement to consult with the University
of Iowa.   The next subcommittee meeting is likely to be held in March. See
Bills Of Interest
Complete text of bills can be accessed at the following link:
SF 75:  This bill requires a physician to notify law enforcement of a potential dangerous situation with a patient with a mental health condition.
IPS is registered as neutral on the bill and has raised concerns about what this is intended to accomplish and the potential to violate patient privacy.
The bill was referred to the Senate Human Resources Committee.
SF 115/HF 112:   These bills prohibits the Board of Medicine from taking
disciplinary action against a physician for providing an alternative treatment to Lyme disease that is not universally recognized as the treatment.  IPS is registered as opposed to both bills.  The bills were referred to the respective chambers' Human Resources Committees.
SSB 1029/HSB 38:  These bills create a process by which a pharmacist may
switch to a generic medicine for biologic prescription.   The process is
similar to that already in place for other medicines.  IPS is registered as neutral on both bills.  The bills were referred to their respective chambers' Human Resources Committees.
SSB 1032/HSB 48:  These bills would allow optometrists to perform surgical procedures and injections that are currently only allowed to be performed by ophthalmologists.  IPS is registered in opposition to these bills.  The bills were referred to their respective chambers' State Government Committees.
SSB 1043/HSB 41:  These bills expand the state employee insurance coverage for applied behavioral analysis for autism treatment.  IPS is registered in support of both bills.  The House Commerce Committee approved HSB 41.  SSB
1043 was referred to the Senate Commerce Committee.
HSB 26:  This bill outlines a protocol for insurers to utilize step therapy or "fail first" decision-making when approving physician prescriptions.
IPS is registered in support for the bill.  The House Human Resources Committee approved the bill.
Emily Piper
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Iowa Psychiatric Society
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Indianapolis, Indiana 46230