Nurse Leaders of Idaho
2014 Idaho Legislature
Final Report
Dear NLI Members,
The 2014 Session of the Idaho legislature concluded, as predicted, the third week of March. Only 74 days long, it was one of the shortest sessions on record. Here at NLI, I struggled to keep up as a result of staffing changes and pressing projects and once I got behind I stayed behind. I am committed however, to preserve our presence in the legislative process and to be more on top of things next year! One of our barriers was an accurate Voter Voice email contact list. Susie Casebolt, RN our new Director of Operations has worked hard to update our list and download it with Voter Voice. Please communicate with us if you did not receive an alert this session and we will correct our information.
Margaret Wainwright Henbest, MSN, APRN, RN
NLI Executive Director
SESSION HIGHLIGHTS
The three largest budgets for state government are : Education, Health and Welfare and Corrections in that order. Here are the highlights in those areas.
EDUCATION:
Probably the single biggest topic area for the legislature this session was K-12 education policy and funding. Several of the recommendations from the Governors Task Force for Improving Education were funded including discretionary funds, leadership wards, professional development and technology. The acceptance of Common Core standards was debated intensely. The public schools budget saw a 5% increase including a 1% raise for teachers. The Higher Education budget was also increased by 6%. However, both budgets still lag the pre-recession funding levels of 2009.
HEALTH:
The Legislature passed bills that focused on time sensitive emergencies, battery against healthcare workers, behavioral health, medical malpractice, access to controlled substances, healthcare data collection and telehealth (see legislation detail at the end of the report).
The Legislature rejected bills that would have repealed the Health Insurance Exchange legislation of 2013, would have shifted money from the catastrophic health care fund (CAT) to provide additional funding for community health centers, and would have limited eligibility to the CAT fund for only those with incomes less than 100% of poverty (about $11,000 for an individual). The final appropriation for the CAT fund had a .4% increase, and legislation passed that established a reimbursement rate for the program of 95% of Medicaid rate.
Medicaid was not expanded leaving over 75,000 Idahoans who make less than 100% of the poverty level with no affordable options for the purchase of private insurance through the exchange, or coverage through Medicaid. Unfortunately for those stuck in this “gap”, it will be another year before a solution can be considered.Director Armstrong presented an option that the Department of Health and Welfare is considering, should the legislature decide to expand Medicaid to include all persons up to 100% of poverty in the future. For these persons, one solution might be to create a “private option” for Medicaid. This would include a federally funded expansion of Medicaid that would purchase private insurance for these Idahoans. The private option would require a waiver, which have been approved by the federal government for other states already.
There was great news about enrollment of Idahoans in the Health Insurance Exchange. Over 44,000 have now been successfully enrolled, making Idaho the second highest state per capita to enroll persons in insurance through an exchange!
The Senate and House held joint listening sessions and heard lengthy testimony about Optum Idaho, which is the contractor for Medicaid reimbursed behavior health services. The citizen criticism centered around the pre-authorization process and long wait times on customer service calls. Optum vowed to improve these processes as a result.
The legislation creating three regionally located behavioral health crisis centers passed successfully through the legislature and has been signed into law. However, at the end of the day money was appropriated in an amount that was 1/3 of the request, essentially funding a pilot strategy only. Legislation that reflected over a decade of work focused on the re-design of mental health and substance abuse services in Idaho did pass both Houses, and was signed into law, the first step in creating a comprehensive behavioral health care system in Idaho.
CORRECTIONS:
Probably the most significant accomplishment of the session related to Corrections was the acceptance and initial implementation of recommendations of the justice reinvestment project. The Council of State Governments and the Pew Trusts have worked since last June to analyze the state’s high incarceration and recidivism rate, which contrasts its low crime rate. Improvements to treatment, supervision, parole and probation procedures, restitution and data systems are recommended in the report.Legislation passed which is designed to continue to address the issues identified in the report.
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The session was not without controversy. A bill to allow guns on public college and university campuses passed both houses and was signed by the Governor into law, despite opposition from law enforcement leadership and the college and university presidents. Protesters appeared at the Capital on a number of occasions to rally for the inclusion of words related to sexual orientation in the Idaho Human Rights Act. In contrast to these protests, two bills were introduced and subsequently pulled by the sponsor that would have allowed services to be denied if doing so violated a person’s religious beliefs. And the Department of Administration, the Department of Education, the Department of Corrections and the Treasurer’s Office have been scrutinized for contracts and processes that have allegedly wasted taxpayer dollars.
LEGISLATION:
H0351:Medicaid Managed Care for Dual Eligibles: Replaces current language to allow for the creation of a Medicaid managed care plan with a focus on people who dually qualify for both Medicaid and Medicare.Held in House Health and Welfare
H0348:Prescription Drug Monitoring Program: Allows individuals to access information about themselves in the Board of Pharmacy controlled substance database, and to designate access to others, such as peer assistance entities. LAW
H394: General Surgery:The purpose of this legislation is to increase the primary care physician workforce in designated shortage areas of rural and frontier Idaho by adding general surgery to the definition of primary care medicine. LAW
H395: Medicaid Adult Dental:
Amends existing law to provide dental services for adult participants with disabilities or special health needs. LAWH418: Health Insurance Exchange Repeal: Repeals existing law relating to the Idaho Health Insurance Exchange Act. Held in House Ways and Means
H426: Religious Freedom: This bill prohibits government from denying, revoking or suspending any professional or occupational license or registration based upon actions including the denial of services based on their religious beliefs. Held in House State Affairs
H427: Religious Freedom: Provides that a person whose exercise of religion is burdened in violation of specified law may obtain appropriate relief against any person relying upon the government action. Held in House State Affairs
H438: Board of Midwifery: This legislation clarifies and changes the Midwifery Act including specific scope of practice wording and referral. LAW
H458: Children Treatment by Prayer: Provides that an exemption for treatment by prayer shall not apply when a child's medical condition has caused death or disability. Held in House Judiciary and Rules
H475: Health Insurance Exchange, Shopping: Provides that shoppers on the exchange may comparison shop and only provide certain information upon submission of an application and to provide for a warning regarding a submission of estimated income. To GOV
H497: Hospital Pricing Transparency Provides for the creation of a website where Idaho citizens shop and compare prices on the 50 most common inpatient and outpatient non-surgical procedures, as well as the 25 most common inpatient and outpatient surgical procedures from all hospitals and surgical centers in Idaho. Held in House Health and Welfare
H519: Patient Restraints: Provide for the use of restraints against the medical advice of a licensed physician. LAW
H535: Indigent Sick: Amends existing law to provide that medical indigency means those at or below 100% of the federal poverty level making only those individuals below 100% eligible for support through the CAT fund. Passed House, Held in Senate Health and Welfare
H561: Hospitals: This bill makes the assessments of $50M on hospitals to help the State fund Trustee and Benefits in the Medicaid Program that were underfunded because of the downturn in the economy continue in perpetuity. To GOV
S1224: Behavioral Health System: The intent of this legislation is to make changes to the Behavioral Health System of Care (BHSC). First is the integration of the substance abuse and mental health systems. Second is to allow local communities to have more influence over the BHSC. Third is to clearly articulate the roles of system partners, public agencies, and Branches of Government. Fourth is to create a BHSC that is recovery oriented and consumer driven. LAW
S1254: Guns on Campus: Removes the authority of public colleges and universities to regulate firearms on their campuses and amends existing law to provide penalties for carrying concealed weapons under the influence of alcohol or drugs on a college campus. LAW
S1261: Nurses, Criminal Background Check: Amends existing law to revise provisions relating to criminal history checks in alignment with a recent audit recommendation. LAW
S1262: Nurse, Discipline: Amends existing law to authorize the imposition of a monetary penalty as an alternative to formal discipline against nurses who violate nursing statutes or rules. Failed Senate
S1263:Advanced Practice Registered Nurse Title: Amends existing law to revise a definition and to clarify the role of an advanced practice registered nurse. LAW
S1288a: Nurses, Grounds for Discipline: Amends existing law to revise a provision relating to discipline and to provide that certain conduct with a patient may be grounds for discipline. LAW
S1327: Epinephrine Pens at Schools: Amends and adds to existing law to authorize schools to voluntarily maintain a supply of epinephrine auto-injectors; to provide for the use of epinephrine auto-injectors; to authorize schools to enter into arrangements with manufacturers of epinephrine auto-injectors; to provide guidelines for participation; and to provide for protection from liability for good Samaritans. LAW
S1329: Time Sensitive Emergencies: Adds to and amends existing law to create a Time Sensitive Emergency (TSE) System within the Department of Health and Welfare; and to redesignate the Trauma Registry as the TSE Registry. LAW
S1347: Elimination of the CAT Fund: Amends, repeals and adds to existing law to remove references to the Catastrophic Health Care Cost Program; and to establish a program and funding to aid community health centers. Held in Senate Health and Welfare
S1351: Battery Against Healthcare Workers: Adds to existing law to authorize punishment for battery against certain health care workers. To GOV
S1352: Behavioral Health Crisis Centers: Adds to existing law to establish Behavioral Health Community Crisis Centers and to provide for governance, evaluation and funding for crisis centers. LAW
S1355: Standard of Medical Care: Provide that metrics established by the federal government under the Affordable Care Act and by insurers do not establish the standard of medical care in Idaho. To GOV
S1393: Special Committee on Criminal Justice Oversight: Provides for the Special Committee on Criminal Justice Reinvestment Oversight and related provisions. To GOV