IEMSA had a solid and active 2018 legislative session, with key
victories and continued support voiced from our friends in Capitol.
- GEMT - IEMSA led a coalition of groups that worked extensively
on ground emergency medical transport (GEMT) funding. HF 2285
requires the Iowa Department of Human Services to submit a state
plan amendment to the federal Centers for Medicare and Medicaid
Services to allow for qualified EMS programs to access GEMT
funding. Our language was drafted to allow for both public and
private EMS programs to be eligible, subject to CMS approval. Gov.
Reynolds signed the bill on March 29, with immediate effect. IEMSA
is also leading the way on helping DHS draft its state plan
amendment. We will continue to update you on its progress through
this state and federal bureaucratic maze.
- EMS as an Essential Service - IEMSA also made significant
progress in its push to create a dedicated funding stream for
rural EMS. HF 2479 passed the House 96-0, but stalled in the
Senate Ways and Means committee after rural firefighters raised
questions about how this would impact townships that are already
at their maximum property tax levy. IEMSA had offered an amendment
to address this perceived problem, but the shot clock ran out and
the Legislature adjourned before they could bring it up. All
throughout this process, legislators acknowledged the needs of
rural EMS in Iowa, and lauded IEMSA for coming to them with new
ideas to study. IEMSA will continue its push for permanent and
sustainable funding for all levels of EMS in Iowa.
- Concussion Protocols - The Legislature took another crack at
addressing the concussion problem in high school sports with the
passage of HF 2442. Many rural legislators voiced concerns that
some sports contests would have to be cancelled if specific types
of medical providers were not available, so they narrowly allowed
circumstances in which EMRs, EMTs, AEMTs and paramedics could
remove a player from competition if they observe “signs, symptoms,
or behaviors consistent with a concussion or brain injury”.
However, these same emergency medical care providers are NOT
allowed to clear the student to return to practice or play. IEMSA
was glad to work with legislators to address their concerns within
the context of our training, insurance and certifications.
- Narcan ... again - IEMSA also worked with legislators late in
the session on the vexing issue of who can administer narcan and
by which method. As you know, our scope of practice is narrow and
does not allow several levels of emergency care providers to
inject medicines; however, several legislators were hearing from
some of their constituents (some of whom are paramedics) that they
should expand our scope of practice to allow for injectable
delivery of opioid antagonists. IEMSA opposes this, and spent a
significant bulk of one afternoon explaining to lawmakers why they
should leave our scope as is. In the end, IEMSA’s views prevailed
and our scope of practice remained intact.
- This will be my last article as Legislative Counsel for IEMSA.
Due to another client’s merger with a large, national health
insurer, there is a distinct possibility that I would be in
conflict on an insurance issue if I were to work with both groups.
As a result, I feel it is only fair to all for me to choose now
rather than in the middle of the 2019 session. This will also give
you time to prepare your new lobbyists to help you strategize and
advocate for your issues.
- IEMSA has accomplished so much in the past few years, and I am
glad to have been a part of your successes. The GEMT bill is a
perfect example of this. It passed and was signed before the end
of March, when some people thought it would be a 2 or 3 year
process to get it signed. The language that ended up passing
existed in FIVE different bills in various forms, which shows that
a) lawmakers were hearing our concerns and wanted to help and; b)
we knew how to work the process to position ourselves for success.
Kudos to all of us for such great work!
- I must say that I was proud to represent you every day I
walked into the Capitol. You are strong and passionate advocates
and sacrifice so much to make your communities safer. Legislators
are hearing your voice, and I would urge you to continue your push
for permanent and sustainable funding for all levels of EMS.
During the 2015 86th Iowa General Assembly, IEMSA was able
accomplish and make progress on a NUMBER OF IMPORTANT items on our
- We were able to hold off the fireworks legislation. By working
with a coalition of healthcare and public safety entities, along
with our members engaging their legislators on this important
item, we kept this piece of legislation from becoming law. The end
of the session only means the start of our work for the 2016 87th
Iowa General Assembly. The hurdles this bill passed this session,
assures that it WILL be introduced next year. Our lobbyist, Lynzey
Kenworthy, has already met with the coalition to strategize on how
to best prevent this from becoming law next session. It will be
imperative we remain engaged in the fight to keep Iowans safe from
- We secured a seat on the Statewide Interoperable
Communications System Board. Now, Iowa’s EMS providers will have a
voice and representation in communications issues going forward.
- Work continues on drafting a Comprehensive EMS Reform Bill.
IEMSA is continuing to solicit concerns through our membership
surveys to identify issues that need to be addressed in Iowa.
Rather than rush through legislation that would need reworking
later, drafting a well thought out piece of legislation that
addresses these issues is our goal. Findings from the National
Highway Traffic Safety Administration EMS Assessment will be
critical in making a strong case for change.
- Building a strong foundation for Mobile Integrated Healthcare
and Community Paramedicine in Iowa continues to be a priority for
IEMSA. This is a great opportunity to move EMS forward and provide
the best and most appropriate care for our patients.
- Medicaid reimbursement is still a challenge. With two years of
10% increases in the Iowa Medicaid reimbursement rate, Iowa still
ranks the lowest in the Midwest. With anticipated changes, IEMSA
will continue to pursue to bring Iowa’s Medicaid reimbursement in
line with other states and ultimately, at a parity with Medicare
HF 2459 increased the individual state income tax credit for
qualifying volunteer firefighters and emergency medical services
personnel from the existing maximum of $50 to $100, with changes
retroactive to tax year 2014. The bill also created a tax credit for
reserve peace officers equal to $100, first eligible for tax year
2014. This is a great achievement for volunteer and reserve public
safety personnel in the state of Iowa!
More than 100 public safety professionals attended the bill
signing ceremony in West Des Moines, during which Governor Branstad
paid tribute to First Responders, saying, “I personally have
benefitted from those services as I know literally hundreds of
thousands of other Iowans have,” recalling the care he received from
Lake Mills Emergency Medical Services 34 years ago after being
involved in a motor vehicle crash. Governor Branstad also signed a
proclamation declaring the week of May 18, 2014 as Emergency Medical
Services Week in Iowa.
Positive news regarding other IEMSA supported initiatives
- HF 2463 - HHS Appropriations Bill.
Contains language that increases the Medicaid reimbursement for
ambulance service another 10 percent, signed by Governor Branstad.
- SF 2349 - Infrastructure Funding.
Contains language that appropriates $150,000 to the Bureau of EMS
for software development and data tracking, signed by Governor
Thanks to the hard work of our IEMSA Lobbyists, Mike Triplett and
Lynzey Kenworthy, as well as our President, Jerry Ewers, the Board
of Directors, and our Office Manager, Lisa Arndt for their hard work
and persistence, which contributed to the legislative success
achieved this year.
IEMSA will continue to work to make Emergency Medical Services an
essential service in the state of Iowa, and to accomplish this, we
need your help! Please take a moment to take our survey which will
assist in determining our legislative priorities for the upcoming
session. If you aren’t a member of IEMSA, please consider joining to
help the greatest EMS Association in our county make a difference
for our patients, communities, and our people; it’s time to make a
THANK you for your dedication to the improvement of emergency
medical services in the state of Iowa!
House File 648 creates a Public Safety Training Task Force and
includes a representative from IEMSA. The bill also appropriates
$50,000 to run the task force through its period to make
Senate File 446 included language to create an EMS Task Force of 23
members, who are charged with holding six meetings. The Task Force
is also required to issue a report that will be due to the
Legislature and others by December 2013. The bill also appropriates
$28,664 to run this task force.
The House and Senate finally agreed, in Senate File 446, to expand
Medicaid for certain populations currently covered by Iowa Care.
This means we will be reimbursed at the Medicaid rate for ambulance
service for these patients, effective January 1, 2014. Iowa Care
will officially go out of existence on December 31, 2013.
SF 446 also includes a 10 percent increase in funding for EMS
reimbursement in Medicaid. Effective July 1, 2013.
Governor Branstad has until June 22
to sign both of these bills. Since they are both appropriations
bill, he has the constitutional item veto authority to approve bills
but disapprove of specific provisions within. IEMSA has written a
letter to Governor Branstad, urging him to approve of all four
In 2012, IEMSA worked with several other groups to pass the IPOST
bill, HF 2165. This bill expanded a pilot project that created a
transportable medical order, called a “Physicians Orders for Scope
of Treatment”, for the elderly, the frail and infirm or people
with terminal diseases. This document would travel with the patient
to all settings and would give health care providers guidance on the
patient’s end-of-life wishes in certain circumstances. Under Iowa
Code 144D, EMS personnel are given the flexibility to comply with or
disregard the directives in a POST form, and will not be subject to
criminal, civil or regulatory liability for acting in compliance
with or failure to comply with a POST form. The new law was
effective July 1, 2012.
Also in 2012, IEMSA and the Iowa Fire Fighters Association worked
on a bill that created a $50 income tax credit for volunteer EMS and
fire personnel. This has been an IEMSA priority issue for many
years, and Governor Branstad signed SF 2322 into law on April 27,
2012, for tax years beginning on or after January 1, 2013. This has
been a long-standing priority issue for IEMSA.
Also in 2012, IEMSA supported a bill that changed the E911 system
in Iowa. The bill changed the funding allocation for the wireless
surcharge, moving more money toward the local PSAPs to help them
build their infrastructure. SF 2332 also created a Task Force to
review local and state governance issues facing the E911 system. The
new law has a variety of effective dates.
In 2011, IEMSA worked with the American Heart Association and the
Red Cross to defeat a bill, HF 109, that would have eliminated the
requirement that CPR be taught in all Iowa high schools.
In 2010, IEMSA worked with the Iowa Department of Public Health’s
EMS Bureau and a group of legislators to make technical changes to
the existing statutes governing EMS. These changes were necessary
with the advent of the new national scope of practice model. The
changes took effect on July 1, 2010. In 2010, IEMSA worked with a
coalition of groups on clarifying the obligations of EMS personnel
to communicate with law enforcement when treating gunshot wounds,
stab wounds or other serious injuries in certain circumstances. The
changes are incorporated in Iowa Code 147.111. This law took effect
on July 1, 2010.
Also in 2010, IEMSA worked with a coalition of other groups to
pass HF 2402. This law establishes a stroke triage system and
registry, and was effective July 1, 2010.
In 2009, IEMSA helped pass legislation HF 380, which granted
volunteer EMS medical directors immunity from civil liability for
acts within the scope of their practice. Now, the definition of an
“emergency medical services medical director” under Iowa Code 147A.
1(6) contains language that an EMS medical director “who receives no
compensation for the performance of the director’s volunteer duties
….. shall be considered a state volunteer”. Under Iowa Code 669.24,
state volunteers are granted limited immunity from liability in
certain circumstances. This became effective on July 1, 2009. This
was one of IEMSA’s major priority issues for 2009.
Also that year, IEMSA worked to amend and pass legislation (HF
671) that granted volunteer EMS personnel protection from job
termination for responding to EMS-related situations. Known as the
“Volunteer Emergency Services Providers Job Protection Act, Iowa
Code 100B.14 offers limited protection for volunteer EMS personnel
against job termination and discrimination in hiring. This law also
took effect on July 1, 2009.