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Notice:
This confidential material
is for the exclusive use of ISNA members and subscribers. DO NOT
electronically distribute or photocopy this information under
penalty of federal law.
© 2005 Indiana State Nurses Association |
Executive
Director's Report from the State House
Vol. 25, No. 13
© 2005
by Ernest Klein, CAE
Executive Director and Lobbyist
2005 ISNA Legislative Wrap-up
May 17, 2005
Updated: June 11, 2005
Update: SB 533 Motor Vehicle
Matters
As we reported earlier, SB 533 went to Senate Conference committee but was
not make it through the process. This bill provided for immunity for APNs
who make a good faith report to the bureau concerning a patient's fitness to
operate a motor vehicle not more than 30 days after having examined the
patient.
The language did survive in HB 1073. Thanks to Glenna Shelby, SDS Group
(part of our Public Policy team), who read every bill that was passed that
we were able track the language.
Other Bill Updates
The General Assembly adjourned sine die with just a few minutes to
spare on Friday night, April 29, 2005. Many of the major issues, including
the budget for the next two years and daylight savings time, where not
decided until the very end. Therefore, this is the last ISNA
member-only update for the year.
Over 1,500 bills and resolutions were introduced, but only 252 headed
to the Governor's desk. Don't let that fool you though. The contents
of over 1,000 bills are in the 252. Some content had homes in three or four
different bills during the session. HB 1098 is one example. HB
1098 started out as a one-page or so bill about returning expired
medications by pharmacies. It emerged from conference committee as a 70-page
bill that: (1) adds provisions from SB 206 concerning personal
services agencies and home health services; (2) adds provisions from SB
590 concerning wholesale drug distribution; (3) allows certain state
licensure exams to apply to the psychology reciprocity requirements (HB
1599); and (4) adds provisions from HB 1599 concerning speech and
language pathologists.
One veteran observer of the General Assembly said this session was one of
the strangest that she can remember.
1. Both chambers and the Governor's office were the same political
party for the first time in years.
2. Governor Daniels had a clear legislative program and actively worked for
passage of his proposals. In spite of desire for smaller
government, Indiana now has the new Department of Agriculture, Inspector
General, Office of Management and Budget, and Child Services, and has
reestablished the Government Efficiency Commission. OK, some of them are
more of a realignment of boards and agencies rather than brand new ones.
3. Many of the freshman legislators are generally more conservative
than their predecessors.
4. The state's economy is still recovering, so finding income to match
expenses was a challenge. Also, many of the new Republican legislators were
loathe to support any type of tax increase--even sin taxes such as
cigarette, casino, and alcohol--to balance the budget.
5. House Democrats concerned about several bills that were progressing
(Inspector General with prosecutorial powers and a strict voter ID
requirement) caucused at the end of the first half of the session. Because
there was not a quorum in the House to conduct business, many House Bills
were not voted on by the deadline for action in the House of
Representatives. This set the stage for a flurry of amendments to Senate
Bills and the Senate's subsequent objection to those amendments by the
House. Most of the amended Senate bills went to conference committees, and
most of the House amendments ended up being removed from the Senate Bills.
Introduced Bills / No Action
Often times bills are filed but no action is taken on them. Bills that
ISNA was following but didn't get a committee hearing include:
HB (House Bill) 1334, LPN licensure. We
convinced the bill author,
Mary Kay Budak (R-LaPorte) and the House Public Health Committee Chair,
Vaneta Becker (R-Evansville) that military corpsman training was not
equivalent to LPN education.
HB 1415, Advisory Council on Pain and Symptom Management.
HB 1415, Immunizations by Pharmacists, was scheduled to be heard in
committee. ISNA was ready to testify about our concerns, but apparently
others also raised their concerns; so the lobbyists for the pharmacists
asked that the bill not be heard.
HB 1416, Nursing Board Membership. This bill would have added two
designated RN members to the nine-member Indiana State Board of Nursing
(ISBN): one a nurse anesthetist; the other a diploma RN. ISNA told the
authors Rep. Budak and Rep. Becker (convenient that they share an office)
that we would not support adding additional designated seats to the ISBN
after other specialty groups also wanted designated seats.
HB 1479, Nursing Home Staffing Disclosure. Would have required
wearing of name badges and the posting of the number of staff present on
each unit and the job classification.
HB 1809, Health Profession Investigation Division, proposed to move
the investigation for the licensing boards (including ISBN) from the
Consumer Protection Division, Attorney General's office, to a division of
the Health Professions Bureau.
SB (Senate Bill) 347, Do Not Resuscitate, required an identifying
symbol on the patient's wristband for DNR.
SB 406, Prescribing of Ritalin, would have limited the prescribing of
Ritalin.
SB 428, Hospital Delegation of Health Care Services. This bill would
have permitted delegation by one licensed health care provider to
another. This was supposed to fix an issue that arose after physical therapy
was ordered but it was delegated to an athletic trainer. After we and others
expressed our concerns, the Indiana Hospital and Health Association asked
the committee chair not to hear the bill.
SB 627, Hospital Staffing Levels. This would have mandated staffing
ratios similar to what has been legislated but not fully implemented in
California.
Several Bills / Similar Topics
Sometimes several legislators author bills on similar topics.
HB 1607, Licensure of Abortion
Facilities, passed out of committee but died when there was not a House
quorum to vote on it.
SB 076, Availability of Ultrasound and Fetal Heart Tone Information,
PASSED. It was signed by the Governor on 4/19/05.
SB 235, Licensure of Abortion Facilities--no action.
SB 393, Abortion Facilities (rules by Indiana State Department of
Health) - no action.
SB568, Licensure of Birthing Centers and Abortion Clinics, PASSED. It
was signed by the Governor 4/26/05.
Now You See It / Now You Don't / Now You Do
As we said before, many House Bills did not make it through the process when
the Democrats caucused at the end of the first half of the session. When
Senate Bills came to the House to be voted on, many Senate Bills were
amended with former House Bill language. Once these Senate Bills were
approved in the House, they had to go back to the Senate for concurrence to
the amendments. Many Senate Bills had dissents filed, which meant the
conference committees had to come to a consensus. The Senate has strict
rules about amendments being germane to the original bill. So, most of the
Senate bills ended up the way they started and the amended House language
was gone or had to find another home in a House
Bill.
SB 030, Rail Corridor Safety Committee,
had language from HB 1888, Reestablish the Government Efficiency
Commission, removed in conference committee. The Efficiency Commission
finally found a home in HB 1001, the budget conference committee
report.
SB 206, Licensing of Home Medical Equipment Providers. Conference
committee removed HB 1750 language for the licensing of personal
services agencies. However, that language was added back into HB 1098,
Prescription Drugs and Health Professions, in that conference committee.
SB 590, Electronic Transmission of Prescriptions. Conference
committee removed HB 1745, Wholesale Drug Licensing, but then it
shows up in HB 1098.
SB 224, Home Health and Hospice Council. Conference committee removed
HB 1444, Independent Living Services.
SB 360, Morbid Obesity Insurance Requirements. Conference committee
removed HB1343, Student Nutrition and Physical Activity, and HB
1343 is one that did not find a new home.
SB 590, Electronic Transmission of Prescriptions. Conference
committee removed HB 1745, Wholesale Drug Licensing that ended up in
HB 1098.
SB 607, Professional Licensing Agency. HB 1821, Medical
Translators, removed. This bill officially merges the Health Professions
Bureau and the Professional Licensing Agency (realtors, cosmetologists,
etc.). In actuality, the combining of staff and sharing of resources has
been going on for some time. Please let us know if you see any decrease in
the level of service from the agency and the Board of Nursing.
One of the Senate Bills we were following did keep the amendments. SB 326,
Information Concerning Meningococcal Meningitis, kept the language from
HB 1386, providing for the return of medications possessed by schools at
the end of the school year.
Other Bills of Note
SB 591, Psychologists, finally emerged from conference committee as
"Requires members of the state psychology board and the social worker,
marriage and family therapist, and mental health counselor board to meet
before July 1, 2005, to establish, for recommendation to the legislative
council:
(1) definitions of assessment, diagnosis, psychological testing, and
appraisal instrument; and
(2) criteria individuals should be required to meet to be authorized to
perform or use assessment, diagnosis, psychological testing, and appraisal
instruments. Requires the board members to submit a report to the
legislative council not later than October 1, 2005. Provides that the state
psychology board may not adopt new rules to establish, maintain, and update
a list of restricted psychology tests and instruments until after December
31, 2005." The provision that ISNA worked on several years ago to exempt
other licensed or certified health care professionals practicing within the
scope of practice
remains in law. ISNA will continue to monitor the situation.
SB 533, Bureau of Motor Vehicles, passed the Senate with an ISNA
requested amendment to include advanced practice nurses with physicians in
being granted immunity for reporting examinations to the BMV. It was amended
and passed in the House. The Senate dissented and the bill was sent to
conference committee. There the trail gets fuzzy. Looks like it did not
emerge from conference committee; so the bill is gone for this year.
HB 1001, Budget (actually an expenditure bill), makes for very
interesting reading. Since this is a biennial budget, amounts were
appropriated for the fiscal year July 1, 2005 to June 30, 2006 and July 1,
2006 to June 30, 2007. Some of the appropriated amounts follow:
The State would be in very dire straights if it weren't for the Tobacco
Settlement Funds:
* Attorney General's Office - $250,000/year
* Indiana Prescription Drug Program - $8,000,000/year
* Children's Health Insurance Program - $29,935,718 first
year/$33,835,718 second year
* Division of Disability, Aging, and Rehabilitative Services -
$3,012,462/year
* Residential Services - Case Management - $2,050,626/year
* Residential Services for Developmentally Disabled Person -
$22,300,000/year
* Independent Living Transitional Services $1,000,000/year
* Public Health - more than $51,223,800 first year and a very small
increase the second year. This includes personal services and operating
expenses for Indiana State Department of Health and operating expenses for
Cancer Registry, Minority Health Initiative, AIDS Education, HIV/AIDS
Services, Test for Drug Afflicted Babies, Breast Cancer Diagnosis/Education,
Local Health Departments, Community Health Centers and Minority Health
Coalitions projects on Sickle Cell and Tuberculosis, to name a few.
* Oh yes, the Tobacco Use Prevention and Cessation Program gets
$10,848,441 in year one and a bit more in year two.
Other Appropriations of Note
Medical/Nursing Grant Fund - $137,201/year. This is the program
administered by the ISDH to encourage primary care providers to work in
underserved areas.
IUPUI Health Divisions operating expenses - $88,039,600/$87,844,755
IU School of Medicine regional campuses (IUPU Ft Wayne, IUNW, Purdue, Ball
State, Notre Dame, ISU, USI) - $11,260,700 with a slight decrease in year
two.
Purdue North Central - Valpo Nursing Partnership - $98,662/year. This allows
AA graduates of North Central to complete BSN program at Valparaiso
University at Purdue tuition rates.
State Student Assistance Commission, Nursing Scholarship Program -
$402,142/year.
And so now that the General Assembly has adjourned for this year, the ISNA
Public Policy program will still have a busy year. The General Assembly
still has numerous study committees and commissions that will swing into
high gear in late summer and autumn. Many pieces of legislation originate
from these study committees.
ISNA will also be busy monitoring the agencies such as Family and Social
Services Administration, Indiana State Department of Health, and the
Professional Licensing Agency (no more Health Professions Bureau after July
1) as Governor Daniels and his administration moves forward with the goals
of increased government efficiency.
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