2019 Iowa Nurses Association Annual Report

October 24-25, 2019 

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TABLE OF CONTENTS 

Conference Welcome Letter. ......................................................... 3 

Listing of the Board of Directors. ...................................................... 5 

2019 Annual Meeting Agenda. ....................................................... 7 

Election Procedures and Parliamentary Information. ........................................ 8 

2018 Annual Meeting Minutes. ...................................................... 10 

2019 Strategic Plan. ............................................................... 12 

Iowa 2019 Legislative Priorities. ...................................................... 13 

Financial Statements. .............................................................. 15 

President’s Message ............................................................... 19 

Executive Director’s Report .......................................................... 21 

Membership Report ............................................................... 22 

Legal Year in Review. .............................................................. 23 

Legislative Session. ................................................................ 26 

INF Report. ...................................................................... 31 

Region Reports. .................................................................. 32 

ANA Membership Assembly. ........................................................ 33 

2019 Leadership Elections. .......................................................... 37 

2019 Bylaw Amendments. .......................................................... 38 

Appendix 

INA Bylaws. ..................................................................... 58 

Printed and published for the Iowa Nurses Foundation and the Iowa Nurses Association by: 

Arthur L. Davis Publishing Agency 

517 Washington St., P.O. Box 216 | Cedar Falls, Iowa 50613 

(319) 277-2414 

www.iowanurses.org 

Published by: 

Arthur L. Davis 

Publishing Agency, Inc. 

THE IMPACT OF CHANGE IN NURSING 

1

Welcome to the 2019 Annual Meeting 

Iowa Nurses Association/Iowa Nurses Foundation 

October 24 & 25, 2019 

On Behalf of the INA/INF Annual Meeting Planning Committee, we welcome you to our annual education 

conference and INA Business Meeting! The theme of this year’s conference is “The Impact of Change in 

Nursing.” We know that change is ever present in healthcare and that nurses must be able to continue to 

lead while adapting to the changes. The speakers at this year’s conference will provide insight into nursing 

practice of the future. We are excited to feature INA member and Public Policy Chair Dr. Dawn Bowker at 

our networking dinner on the evening of October 24. Dr. Bowker’s presentation “Is the Lack of Cultural 

Humility in Healthcare Harming our Patients?” will be informative and thought provoking. 

On Friday morning we will recognize the 2019 INA award winners and INF scholarship recipients during 

breakfast. We are thrilled to have two nationally known keynote speakers this year! Their presentations 

will help us continue to grow in our personal professional journey. Our afternoon sessions will provide 

information on medical cannabis and immunizations, both of which are current topics that are relevant 

to all nurses regardless of their practice setting. Take time to renew old friendships and create new ones 

during breaks. Be sure to visit with our vendors whose support helps to make this event possible. 

We respectfully request that you stay for the INA annual business meeting. It is critical that your voice be 

heard as we discuss proposed by-law changes that will shape the future of the organization. 

Thank you! 

INA/INF Annual Meeting Planning Committee 

Lisa Caffery, Virginia (Ginny) Wangerin, Christina Peterson and Kate Pace 


3

BOARD OF DIRECTORS 


5

6

2019 ANNUAL MEETING AGENDA 

October 25, 2019 

3:45 – 4:45 p.m. 

3:45 Call to Order – Jann Ricklefs, President 

• Roll Call of the Board of Directors 

• Roll Call of Membership by Region 

• Report of the Number of Proxies 

• Declaration of Quorum 

• Review and Approval of the Agenda 

• 2018 Annual Meeting Minutes 

3:50 INA Financial Road Map – Anne Cook, Treasurer 

3:55 President’s Update on INA Strategic Initiatives – Jann Ricklefs, President 

4:05 ACTION ITEM: 2019 Proposed New Bylaws – Lisa Caffery, Bylaws Chair 

4:25 Membership Open Forum 

4:30 Recognition of Outgoing Board Members – Jann Ricklefs, President 

4:33 Passing of the Gavel to the Incoming President 

4:35 Recognition of Outgoing President – Lisa Caffery, President 

4:40 Tellers Report – Sue Whitty, Nominations Chair 

4:45 Adjournment – Lisa Caffery President 


7

ELECTION PROCEDURES 

RULES: 

1. All members in good standing may vote 

2. No congregating or campaigning will be allowed near 

voting area while voting is in progress. 

Meeting Rules 

___________________________________________________ 

Rule 1: Registered members must wear their name 

badges during the business session. 

Rule 2: In making a motion or speaking to a question, 

a delegate shall move to the floor microphone, 

address the Chair, await recognition of the Chair, 

and give the delegate’s name and region. 

Rule 3: The correct form to use in making a motion is “I 

move that...” 

Rule 4: All motions and amendments should be written 

and signed by the maker of the motion or 

amendment and then given to the Chair. 

Rule 5: A member may not speak against her/his own 

motion, but may vote against it. 

Rule 6: No member shall speak more than once, or 

longer than three minutes, on the same question 

until all have spoken who wish to express and 

opinion. 

Rule 7: All reports and supplements to reports shall be 

written and shall not be read. 

Rule 8: A nominating speech of one minute will be 

allowed for each nomination from the floor. 

Rule 9: Only currently paid members of the Association 

are entitled to vote at the polls upon verification 

of their current dues being in good standing 

according to the most current membership 

rosters provided to the tellers. Members not in 

attendance may vote by proxy per INA Articles of 

Incorporation, Article IV. 

Rule 10: The Association staff shall report the number 

of members registered after the opening 

ceremonies. Supplementary reports may be given 

later as the Chair may direct. 

Rule 11: A member should raise her/his hand to indicate 

she/he cannot hear. 

Rule 12: The member will act only on the resolves of a 

resolution. Questions of clarification will be 

handled according to parliamentary procedure. 

Rule 13: All sessions of the Annual Business Meeting shall 

be open to the public unless the Chair declares an 

executive question. 

Rule 14: No smoking will be allowed during the sessions 

of the Annual Business Meeting. 

Rule 15: Non-ANA members, with the exception of ANA 

and INA staff, including consultants, must have 

permission of the President to speak. 

Rule 16 Items under New Business must receive a 2/3 

vote of the members present in order to be 

considered. 

Rule 17 

Revised 2007 

On the election ballot, the “write-in” names 

must also be marked with a check mark in order 

that the tellers will count it as a vote. 

Parliamentary Information 

___________________________________________________ 

Robert’s Rules of Order, Newly Revised is the parliamentary 

authority that shall govern the INA Business Meeting. The 

chair, as the presiding officer, rules on all matters relative to 

parliamentary law and procedures. The Parliamentarian 

serves only in an advisory capacity to the presiding officer and 

members. 

Member participation in the business session is governed by 

the standing rules. 

The motions that follow are defined in terms of action a 

delegate may desire to propose. Rules governing these 

motions are listed in Table 1. 

A main motion introduces a subject to the Business Meeting 

for consideration and is stated: “I move that....” 

FILLING OUT A MOTION FORM 

Three part motion forms are provided by the INA 

staff. They will be available at the Head Table by the 

Secretary and by the Executive Director. Please fill them 

out completely before bringing forward a motion for 

consideration at the Business meeting for discussion. 

You must sign your name and Region and get the 

signature of a person to second the motion before 

bringing it up. 

An amendment (primary) is a motion to modify the working 

of a motion. The motion to amend may be made in one of 

the following forms, determined by the action desired: “I 

move to amend by.....” 

striking (word(s), phrase, paragraph).” 

inserting (word(s), phrase, paragraph).” 

adding (word(s), phrase, or paragraph at the end 

of the motion).” 

substituting (paragraph or entire text of a resolution or 

main motion and inserting another that is 

germane). 

An amendment to an amendment is a motion to modify the 

wording of the proposed amendment and is made as follows: 

“I move to amend the amendment by....” The same forms 

for making an amendment are applicable for making a 

secondary amendment. 

8 2019 INA CONFERENCE & ANNUAL MEETING

The motion to commit or refer is generally used to send a 

pending motion (also called “the question”) to a small group 

of selected persons - a committee, board, or cabinet, for 

example - so that the question may be studied and put in 

better condition for the assembly to consider. The motion 

is stated: “I move to commit the question to..........for 

further study.” 

The motion to close a debate (previous question), if seconded 

and approved by a two-thirds vote, stops discussion on the 

pending question and is stated: “I move the previous 

question.” 

A division of the assembly may be called by any member if 

the chair’s decision on a voice vote is in question. The member 

proceeds to the microphone and states: “I call for a division 

of the house.” The chair then takes a standing or roll call 

vote. 

A division of the question may be called when a pending 

motion relates to a single subject but contains several parts, 

each capable of standing as a complete proposition. The 

parts can be separated and each considered and voted on as 

a distinct question. The motion is stated: “I move to divide 

the question........as follows....” 

The motion to reconsider enables a majority of the assembly 

to bring back for further consideration a motion that has 

already been voted. The purpose of reconsidering a vote is 

to permit correction of hasty, ill-advised, or erroneous action, 

or to take into account added information or a situation that 

has changed since the vote was taken. (Note exception on 

the Table-Rules Governing Motions) 

Parliamentary inquiry is a question directed to the presiding 

officer to obtain information on parliamentary law or the 

rules of the organization as relevant to the business at hand. 

A member addresses the chair and states: “I rise to a (point) 

of parliamentary inquiry.” 

Point of information is a request, directed to the chair or 

through the chair to another officer or member for information 

relevant to the business and hand. The request is not related 

to parliamentary procedure. The member addresses the chair 

and states: “I rise to a point of information.” 

The motion to appeal the decision of the chair is made at 

the time the chair makes a ruling. If it is made by a member 

and seconded by another member, the question is taken from 

the chair and vested in the voting body for a final decision. 

The motion is stated: “I move to appeal the decision of 

the chair.” 

Before a member can make a motion or address the assembly 

on any question, it is necessary that he or she obtain the floor 

through recognition by the presiding officer. The member 

must: 

- rise and proceed to the microphone. 

- address the chair by saying, “Madam 

Chairperson” 

- await recognition 

- give name and region 

- state immediately the reason for rising. 

Rules Governing Motions 

___________________________________________________________________________________________________________ 

Interrupt Speaker Recognized by Chair Requires a Second Debated Vote 

Main motion NO YES YES YES Majority 

Amendment NO YES YES YES Majority 

Amendment to 

amendment 

NO YES YES YES Majority 

Refer to Committee NO YES YES YES Majority 

Limit Debate NO YES YES NO Two-thirds 

Close debate (previous 

quest) 

NO YES YES NO Two-thirds 

Divide the Question NO YES YES NO Majority 

Division of Assembly YES NO NO NO 

Demand of single 

member compels division 

Reconsider NO YES YES YES Majority* 

Point of parliamentary 

inquiry 

YES NO NO NO Chair Decides 

Point of Information YES NO NO NO Chair Decides 

Appeal decision of chair 

Yes (at time of 

decision) 

NO Yes (limited ruling) YES Majority 

*Majority vote except when the motion being reconsidered required a two-thirds vote for its passage; then the motion to 

reconsider requires a two-thirds vote. 


9

Annual Business Meeting Minutes 

2018 ANNUAL BUSINESS MEETING MINUTES 

October 19, 2018 

Des Moines, Iowa 

Jann Ricklefs, President Lisa Caffery, President Elect Anne Cook, Treasurer 

Vacant, Secretary Virginia Wangerin, Resolutions Carol Chesterman, Public Policy 

Christina Peterson, Staff Nurse 

Linda Opheim, NW Region Rep 

Kate Pace, Newly Licensed 

Director 

Brenda Helmuth, NE Region Rep 

Vacant, SW Region Rep 

Lorinda Inman, INF 

Representative 

Barb Gano, Central Region Rep Becky Lewis, SE Region Rep Tobi Moore, Exec. Director 

Present: BOLD 

1. Meeting called to order by President Ricklefs at 3:34pm with the reading of the INA Mission Statement: 

To connect, advocate, and support for nurses and healthcare in Iowa. 

2. Roll Call of the Board of Directors (see bolded names above for those in attendance) 

3. Roll Call of Membership by region was held. 

4. Roll Call of Membership revealed 57 members present and 13 proxy voters. A quorum was declared by 

Lynn Boes. 

5. The agenda was reviewed and approved as written. 

6. Friday, October 20, 2017 Annual Meeting minutes were presented in the annual book. Motion to accept 

minutes was made by Virginia Wangerin and seconded by Mary Tarbox. Motion passed unanimously. 

7. Anne Cook, Treasurer couldn’t attend the annual meeting. President Ricklefs asked Executive Director 

Moore to present the financial reports. The financial committee drafted new policies and procedures 

for INA during their work in 2018. This fiscal year to date the association as made a net profit of 

$23,790.63. Motion to accept finance report was made by Lisa Caffery and seconded by Mary Tarbox. 

Motion passed unanimously. 

8. Tobi Moore provided executive director message, progress on strategic plan. On March 1, 2017 the 

association became a part of a membership pilot with ANA, called the “value pricing pilot.” Membership 

growth... 33.8% since March 1, 2017! We ended August 2018 with 1120 members. INA is seeing a 

1.6% average monthly growth in membership. 

This year we launched our CE Genius smartphone application. INA partnered with Continuing Education 

Genius to provide a smartphone application that quickly and easily records continuing education 

credits. The application, called CE Genius, will automatically update the number of acquired credits for 


each state license you have placed into the program, providing a visual summarization of your progress 

toward completing your goals. You can enter credits from all providers and maintain individual privacy. 

CE Genius has a built-in reminder for continuing education, license requirements and other events. 

INA partnered with NSO to bring professional liability insurance to Iowa Nurses. For over 40 years, 

Nurses Service Organization (NSO) has been helping defend RNs, nurse practitioners, LPN/LVNs, CNSs, 

nursing aides and student nurses from medical malpractice lawsuits. Over 550,000 nursing professionals 

safeguard their careers with professional liability insurance through NSO. 

9. Lisa Caffery, Bylaws Chair reviewed the following bylaw amendments: 

a. Amendment #1. Providing for the Iowa Nurses Foundation President to have a vote on the Iowa 

Nurses Association Board of Directors. President Ricklefs called for motion. Vote was held, and 

motion passed unanimously 

b. Amendment #2 was a follow up amendment related to creating the President Elect position during 

the 2019 membership meeting. President Ricklefs called for motion. Vote was held, and motion 

passed unanimously. 

10. There were no motions from the membership. 

11. President Ricklefs recognized outgoing Board Members. Carol Chesterman, Public Policy Director 

2016-2018. 

12. Julie Shilling, nominations chair recognized incoming Board Members. 

• Secretary, Kim Bergen Jackson 

• Treasurer, Anne Cook 

• Public Poly Director, Dawn Boettcher 

• Resolutions Director, Virginia Wangerin 

• Nominations Committee: Mary Tarbox and Candace Chihak 

• Iowa Nurses Foundation: Christina Peterson, Lorinda Inman and Kim Bergen Jackson 

13. Motion made by Linda Opehim, seconded by Candace Chihak to adjourn the meeting. Meeting was 

adjourned by President Ricklefs at 4:22. 

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IOWA 2019 LEGISLATIVE PRIORITIES 


13

Operating Revenues: 

WRITTEN FINANCIAL SUMMARY 

Membership Dues: Our monthly budget for membership dues is $10,416.67, with us eight (8) months 

into our fiscal year, we are ahead of budget in our membership dues revenue by $6,039.19. 

Miscellaneous Revenue: We received $2,080 from ANA to produce our membership promotional video. 

Legislative Day: We had a net loss of $4,061.51 for the 2019 event. Registration was down and we 

fell short of our planned revenue which resulted in this net loss. The 2018 lobby day had a net loss of 

$1,290.66. 

Operating Expenses: 

Currently all the expenses are within budget. 

August 2019 

Net Profit: 

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FINANCIAL STATEMENTS 


15



17


PRESIDENT’S MESSAGE 

Dear Colleagues, 

As I conclude my final year as your INA President, I reflect on the importance and 

relevance that INA has to support quality patient care and nursing practice in Iowa 

and beyond its borders. In the past I would have simply said Iowa, but in today’s 

nursing practice, many nurses are working in other states through direct care and 

telehealth under the Nurse Compact Act. The number of states participating in this 

formal professional agreement continues to grow and now stands at 33. 

The American Nurses Association provides valuable evidence-based tools to guide 

all nursing practice. One such tool that is especially important in today’s social and 

Jann Ricklefs, 

PhD, RN, CNE 

political environment is the Code of Ethics for Nurses (The Code). This document is published and regularly 

updated by the ANA Center for Ethics and Human Rights to reflect current health care structures, provision 

of health care, and fiscal responsibilities. The Code “supports nurses in providing consistently respectful, 

humane, and dignified care. These values are often second nature to nurses’ caregiving but are frequently 

challenged by the failings in U.S. health care and by negative social determinants of health.” The Code of 

Ethics is relevant to all actions of nurses, including the mission, vision, and activities of your Iowa Nurses 

Association. 

Since the 2018 conference, I have continued to lead INA and its Board through various activities. Our Board 

meetings include oversight of general business of the organization and continuing to search out new 

ideas to ensure our organization is up-to-date and relevant. Growing and maintaining our membership 

is vital; many discussions and brain-storming sessions have brought about new and innovative ideas. This 

is reflected in our strategic planning, recently developed Vision Statement, and proposed Bylaw changes. 

This spring and summer I again represented INA by participating on the selection committee for the 100 

Great Iowa Nurses recognition and awards. Every nomination I read identified how nurses in our state 

provide exceptional quality care in a diversity of healthcare settings. These nurses demonstrate outstanding 

courage, commitment, and caring. I was especially proud to have some of the students I taught recognized. 

Last December Tobi Lyon Moore, Lisa Caffery, and I attended the ANA Leadership Summit in Alexandria, 

Virginia. This annual event brings together nursing leaders from all the state’s member organizations. 

Attendees have opportunities to deliberate, strategize, and advise on professional topics and organizational 

functions. It was an interesting and motivating two days of meetings. 

In February I participated in the INA Lobby Day in Des Moines. Despite the weather challenges, nurses and 

nursing students were able to learn about the political advocacy process and spend time advocating for 

patients and nurses with state legislators. 

In June, Lisa Caffery, Carol Chesterman, Tobi Lyon Moore, and I attended ANA Hill Day and Membership 

Assembly in Washington D.C. We were able to meet with legislators and their representatives and discuss 

Title VIII legislation that provides federal support to fund nursing legislation. Soon after we were there, 

this legislation was passed. Other topics we discussed with the legislators were workplace violence, home 


19

healthcare planning, and safe staffing. To emphasize and personalize the issues, we were able to share 

stories that we or our colleagues back home in Iowa have experienced. This was especially appreciated by 

our legislative leaders. 

I am honored and privileged to have served as your President the past 3½ years and am assured that Lisa 

Caffery, President-Elect, will be an outstanding leader for this organization. The staff lead by Tobi Lyon 

Moore, Executive Director, have been wonderful to work with and will continue to help our organization 

continue its mission, “To connect, advocate, and support for nurses and healthcare in Iowa.” 


EXECUTIVE DIRECTOR’S REPORT 

Tobi Lyon Moore, MBA, CAE, CFRE 

“Never doubt that a small group of thoughtful, committed citizens can change the 

world. Indeed, it is the only thing that ever has.” – Margaret Mead 

2019 was a year that brought a few changes and new additions to INA. 

The INA Board approved a new vision statement that better articulates our future: 

“Together, we promote the growth of the profession, guide nursing practice, and 

monitor current issues in nursing. Our strength is to stay engaged, by advocating for 

and connecting with Iowa nurses in the diverse, dynamic health care environment.” 

Tobi Lyon Moore, 

MBA, CAE, CFRE 

On March 1, 2017, the association launched a new membership structure with ANA. 

Membership growth... is at 47.7%. Yes, 47.7% growth in just two years! We ended September 2019 with 

1298 members. INA is seeing a 2.6% average monthly growth in membership in 2019. Whereas, in 2018, 

we saw an average of 1.6%. We are making great progress. 

New services in 2019 include launching an online Legislative Action Center. The Legislative Action Center 

is a platform to allow our public policy committee and membership to track legislation and keep our 

membership updated on INA positions with certain legislation. The other benefit is that we can track 

when a member has clicked on an email, visited our page, or taken any action. As we advance our level 

of advocacy within the Association, this service will be able very beneficial. 

In addition, INA partnered with NSO to bring professional liability insurance to Iowa Nurses. For over 40 

years, Nurses Service Organization (NSO) has been helping defend RNs, nurse practitioners, LPN/LVNs, CNSs, 

nursing aids and student nurses from medical malpractice lawsuits. Over 550,000 nursing professionals 

safeguard their careers with professional liability insurance through NSO. 

INA continues to look for ways to grow membership and retain the members we have. Thank you to 

all the INA members for knowing the importance of your membership, and the hard work that you put 

into this organization. Most of all, thank you for your dedication to the profession. With every member 

being engaged and active, INA will be able to maximize our progress and work together for success in 

the profession. I encourage all members to share their views as to why you are a member and to remain 

involved in INA. 


21

MEMBERSHIP REPORT 


2019 LEGAL YEAR IN REVIEW 

J.R. Lynn Böes, R.N., B.S.N., J.D. 

As is typical in matters dealing with the legislation and regulations, there were some 

twists and turns in Legislature and the regulatory arena in 2019. Additionally, in the 

area of judicial precedent, the Iowa Court of Appeals rendered a decision involving a 

nurse, which reaffirmed the authority of the Board of Nursing to impose discipline and 

reaffirming the standard that the courts use when reviewing such discipline. 

Legislation. The Legislative session opened on January 14, 2019 and ended on April 

27, 2019. During the session the following new laws were passed: 

• House File 731 transferred the obligation to create the dependent adult 

abuse and child abuse curriculum from the Iowa Department of Public Health 

(IDPH) to the Iowa Department of Human Services (DHS). This law increases 

the frequency of such training, now required every three (3) years, from the 

J.R. “Lynn” Böes, 

RN, BSN, JD, 

INA Legal 

Counsel 

previous five (5) year requirement. This law also removed the ability of a licensee to have combined 

dependent adult abuse and child abuse program. Instead, a nurse caring for both children and 

adults will have to take two separate courses that are two (2) hours in length, and the course 

content must be provided by DHS. Employers can provide additional training if they choose, but 

it cannot take the place of the required DHS curriculum. The bill is located at the following link: 

https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=hf731 

• Senate File 210 established an Iowa Caregiver Law, which will be located at Iowa Code 144F (at the 

time of preparation of this report, it was not posted on the Iowa Legislative Web Site). Numerous 

attempts by the AARP over the years to get this bill passed had been unsuccessful. However, in 

working with the Iowa Nurses Association this year, there was much more acceptable language. 

The bill requires hospitals to provide an opportunity for an individual to designate a lay caregiver 

who may be involved in the care of the patient if they return home to their own residence (not to 

an assisted living program or group home or other nursing facility). If the patient declines to have 

a lay caregiver designated, the declination needs to be noted in the record. If the patient elects to 

have a person designated as a lay caregiver, that person will be given discharge information on how 

to care for the individual upon their discharge from the hospital. See https://www.legis.iowa.gov/ 

legislation/BillBook?ga=88&ba=sf210 

• In a rare show of bipartisan support this session, House File 758 was passed and signed by the 

Governor on May 13, 2019. This bill added $50,000 for health care loan repayment for RNs, 

ARNPs, PAs, nurse educators and health professionals that meet specific criteria. See https://www. 

legis.iowa.gov/legislation/BillBook?ga=88&ba=hf758 

• House File 690 was passed and signed by the Governor on May 1, 2019. This bill established a child’s 

behavioral health system and established certain core children’s behavioral health services that must 

be provided. It mandates a single statewide 24-hour mental health crisis hotline. The Governor’s 

approved bill may be found at: https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=hf690 


23

• Senate File 304, which amended Iowa Code 17A.3 and § 272C4 was passed this session. That 

law eliminated the ability of the healthcare licensing boards to suspend or revoke a license issued 

by that Board to a licensee who is in default or delinquent on repayment or a services obligation 

for certain student loans solely on the basis of their default or delinquency. This includes Federal 

or State Post-Secondary Educational loans, or public or private services-conditional post-secondary 

tuition assistance. See https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=SF304 

• House File 288 also amended § 17A.3 and § 272C.4 requiring the Board to expedite the licensing 

of an individual who is licensed as a nurse in another state and who is the spouse of an active 

duty member of the military forces. The link for that bill is found at: https://www.legis.iowa.gov/ 

legislation/BillBook?ga=88&ba=HF288 

Two other surprising twists and turns in the legislature occurred. INA spoke up on several occasions 

attempting to prevent the Iowa Board of Nursing (IBON) Executive Director (along with the Executive 

Directors from the Boards of Pharmacy, Medicine and Dentistry) from being moved to the oversight of the 

IDPH. It appeared that provision of the bill was dead, as it did not even make it out of subcommittee. But 

the proposal was amended to another bill, which passed at the end of the session. Section XV of House 

File 766 (pgs. 73-74) was signed by the Governor on May 3, 2019. For the first time in my 23 years as legal 

counsel for INA, we took the extraordinary step of asking the Governor to line item veto this section, but 

that was unsuccessful. See https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=hf766 

House File 766 also eliminated a number of committees, one of which was the Patient Centered Advisory 

Committee on which INA had been privileged to serve. It also significantly curtailed the size of the voting 

members of the Medical Assistance Advisory Council (MAAC), allowing only five organizations to be 

voting members of the official council. 

Additionally, House File 732, which recognized ARNPs and PAs as healthcare practitioners who would have 

the authority to certify to the existence of a qualifying diagnosis for a patient to obtain cannabidiol (CBD) 

was vetoed by the Governor. Her concern over the bill was the marked increase in the amount of THC 

that a patient could have and accordingly, she vetoed the entire bill. Yet, she has voiced her willingness to 

work with an evidenced-based protocol for the CBD. She understands, and has received information from 

numerous individuals, about the effectiveness of CBD on treating their conditions. Look for that in the next 

Legislative Session. See https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=hf732 

Regulations. The Iowa Administrative Bulletin (IAB) publishes all agencies’ proposed rules and adopted 

rules every two weeks. These were reviewed throughout the year. Additionally, this necessitated several 

visits to the Iowa Board of Nursing to participate in various Board meetings and to provide input on behalf 

of the Iowa Nurses Association. 

DHS proposed to recognize ARNPs as primary care providers for the purposes of managed care organizations 

(MCOs). On behalf of INA, comments were submitted supporting this. This would allow payment for their 

services as they provide primary care services to enrollees in Iowa’s MCOs. More than a decade ago, the 

Iowa Board of Nursing recognized ARNPs as providers of primary care. 

The IBON amended its rules in Chapter 3 related to the practice of nursing. It will no longer be issuing 

wallet cards, so, it removed references to that in its rules. It mandated a nurse refresher course for licensees 


who have not held an active license in any jurisdiction for the previous five years within 12 months prior 

to the reactivation of their license. Since the old nurse licensure compact is no longer valid, it’s struck 

references to Chapter 16 since Iowa is now a participant in the new Enhanced Nurse Licensure Compact. 

The IBON also amended Chapter 7 pertaining to ARNPs, including new definitions, streamlining the 

requirements and process for licensure as an ARNP and clarifying the role and expectation of an ARNP 

per the consensus model and current standards of practice. The Board revised the rules to allow ARNPs 

to exercise their professional judgment when performing pertinent health histories and revised the 

disciplinary provision related to that. The Board clarified DEA and Controlled Substance Act registrations 

are required by the Board only when it’s required by the DEA and the Iowa Board of Pharmacy. The original 

definition of “collaboration” remained in the rules consistent with the Board’s fluoroscopy rules that 

require collaboration as needed. The definitions for the Nursing Board removed “collaborative practice 

agreement” from its rules and added a definition of “dispense” to clarify the term of art. Dispense does 

not include administration. The Board rules clearly and unequivocally stated that an ARNP shall have 

the authority to practice to the full extent of the ARNP’s license, education and experience in the ARNPs 

respective population foci. (See 655 IAC § 7.4(4)) 

Due to Legislative action in 2018, Iowa law requires electronic transmission of prescriptions effective 

January 1, 2020. The Pharmacy Board proposed rules to implement this law along with exemptions allowed 

in the law. 

Judicial President. On August 7th, the Iowa Court of Appeals rendered a decision providing further 

clarity to Iowa Nursing law. (See Dawn Marie Leach vs. Iowa Board of Nursing, Iowa Court of Appeals 

filed August 7, 2019). The Court reaffirmed the authority of the IBON to discipline a nurse who remotely 

accessed patient census data to see if it was likely she would be off from working in the Intensive Care 

Unit due to a low census day. Even though the testimony at the hearing indicated that she did not look 

at patient information, which was on the census list, the Board determined that she should be disciplined 

with a citation and warning, the lowest level of formal discipline the Board can give. 

When the court reviews the IBON’s actions, the Court will only overturn the Board’s decision if it was 

irrational, illogical or wholly unjustifiable. The Board determined that this was unethical conduct or a 

practice that was detrimental to the public and was a violation of privacy. This case serves as a reminder 

for all to take seriously, not only the authority of the Board, but HIPAA requirements as well. Even though 

it might be seemingly innocent to access information that doesn’t pertain directly to patients you’re caring 

for at the time of access, that should not be done, as it is a violation of HIPAA. Protected Health Information 

is allowed only on a need to know basis. Even though she was not looking at the names, the presence 

of the names on the accessed list, according to Iowa Nursing Law, was a violation of their privacy rights. 


25

LEGISLATIVE SESSION 

Jim Obradovich, President 

The Capitol Group 

After a four day stretch of nearly 12-hour long days, the 2019 edition of the Iowa Legislature finally 

concluded its work during the afternoon of Saturday, April 27. 

The battle over how much to spend on health care programs and what, if any tax credits, would be 

approved were the focus of much of the consternation and deliberations that punctuated the ending days 

and hours. 

Governor Reynolds has until the end of May to either veto or sign into law the bills that were passed by 

both chambers. 

We will keep you updated on any action taken by the Governor on bills of interest. 

Education Appropriations Bill Increases Healthcare Loan Repayment Program Funds 

The bipartisan team of Rep. Dave Kerr of Morning Sun and Rep, Lindsey James of Dubuque worked 

together to increase the amount of funds available for an important nurse educational program. 

Included in the Education Appropriations bill, House File 758, is an additional $50,000 for the Healthcare 

Loan Repayment Program. This increase will allow for 5 more program participants. 

The program repays the qualified student loans of registered nurses, advanced registered nurse practitioners, 

mental health professionals, physician assistants, and nurse educators who practice full-time in a service 

commitment area or teach in this state. 

To qualify for the program, applicants must complete and return to the student aid commission an affidavit 

of practice verifying that the applicant is or will be practicing full-time in a service commitment area in this 

state. A service commitment area is a city in Iowa with a population of less than 26,000 that is located 

more than 20 miles from a city with a population of 50,000 or more. 

The annual amount of loan repayment to a program applicant is $6,000 or 20 percent of the recipient’s 

total qualified student loan, whichever amount is less. 

House Human Services Budget Leader Insists on Change to BON Policy 

Representative Joe Fry successfully rebuffed the requests of his Senate counterpart to drop a major policy 

initiative included in the Health and Human Services Appropriations bill. 

Included on pages 80 to 82 of the massive 113-page House File 766, are provisions to give the power to 

hire and supervise the executive directors of the boards of nursing, pharmacy, dentistry and medicine to 

the Director of the Department of Public Health. 


The INA opposed this proposed policy when it was a stand alone bill and continued to oppose it as part 

of a large spending bill. 

Please know the INA has already sent a letter to Governor Reynolds urging her to exercise her line item 

veto power to not approve this portion of the spending bill. 

ARNP and PA Psychiatric Training Funds Approved 

New funding will soon be available to increase the access to mental health care services through the 

training of additional physician assistants and nurse practitioners. 

The Health and Human Services budget included a new appropriation of $150,000 for ARNP and PA 

psychiatric training at the University of Iowa Hospitals and Clinics. 

New Student Mental Health Program Funding Approved 

The education spending plan, House File 758, agreed to by the House and Senate contains $2.1 million 

dollars for a new school mental health awareness program. 

During budget negotiations, Representative Dave Kerr of Morning Sun was able to fend off Senate efforts 

to not fund the program. 

Of the $2.1 million dollars appropriated, $1,200,000 will be allocated to the area education agencies to 

provide mental health awareness training for educators and schools. 

$750,000 will be allocated to the area education agencies to be used to identify a range of approaches to 

best meet the mental health needs of students and to strengthen community support for students. 

Finally $150,000 be used by the area education agencies to create a clearinghouse of mental health 

resources for use by schools and community providers. 

Thanks to all the INA members who contacted lawmakers to make sure that school mental health 

programing and community mental health programs are as integrated as possible. Without your efforts, 

this would not have taken place! 

Whistleblower Protections Bill Sent To The Governor 

Senate File 502, a bill to add protections for school district and state employees who report suspected 

illegal activities, is awaiting the signature of Governor Reynolds. 

The bill prohibits adverse employment actions (i.e. firing or demotion) for disclosures of information by 

an employee of the state or a political subdivision of the state. The bill specifically authorizes disclosure 

of information by an employee to a person providing human resource management for the political 

subdivision of the state. 


27

The bill provides that an aggrieved employee may recover civil damages in an amount up to three times 

the employee’s annual wages and benefits at the time of the inappropriate adverse employment action. 

The bill also requires each political subdivision of the state to provide information to new employees of 

the authority of the office of ombudsman to investigate complaints and to provide information to all 

employees of the political subdivision, including the toll-free telephone number of the ombudsman. 

Other Bills Sent To The Governor 

HF 732 (formerly HSB 244) - Medical Cannabidoil (F) - The bill adds ARNP’s to the persons allowed to 

certify a person to receive a medical cannabis card. 

Passed the House 96-3. Approved by the Senate 40-7. Awaiting Governor’s action. 

HF 731 - Mandatory Reporter Training (M) - Moves the responsibility for child abuse and dependent adult 

abuse curriculum from the Department of Human Services to the Department of Public Health. The bill 

also changes the frequency when the curriculum must be completed from the current 5 years to 3 years. 

Passed the House 96-0. Approved by the Senate 49-0. Awaiting Governor's action. 

HF 690 (formerly HSB 206) - Children’s Mental Health (F) - The bill establishes a children’s behavioral health 

system and a children’s behavioral health system state board, and requires certain children’s behavioral 

health core services be provided. The bill also includes the establishment of a single statewide 24-hour 

mental health crisis telephone hotline. 

Passed the House 83-14. Passed by the Senate 46-2. Awaiting Governor’s action. 

SF 609 (formerly SSB 1251) - Ag and DNR Appropriations (F) - Included in the spending bill is a new 

appropriation of $130,000 for Iowa’s Center for Agricultural Safety and Health (I-CASH.) The center 

focuses on rural health issues such as mental health, suicide prevention and painkiller abuse. INA was 

singled out for its support of the appropriation. 

Approved by the Senate 32-18. Amended and approved by the House 54-45. Amended and approved by 

the Senate 33-16. Amendment approved by the House 55-44. Awaiting Governor's action. 

Bill of interest 

These bills remain eligible for continued consideration during the 2020 session of the Iowa Legislature. 

SF 564 (formerly SF 60) - Newborn Screen Panel (M) - This bill authorizes the congenital and inherited 

disorders advisory committee Iowa newborn screening panel subcommittee to evaluate and make 

recommendations, annually, regarding additions to the Iowa newborn screening panel. 

Passed the Senate 48-0. Referred to House Human Resources Committee 

SF 535 (formerly SSB 1035) - Fireworks Expansion, etc (A) - This bill modifies provisions relating to the 

regulation and sale of certain fireworks. 

The bill provides that a city or county shall not adopt or enforce any zoning regulation under Code chapter 

335 or 414 to regulate, restrict, or prohibit the location of permanent buildings or temporary structures 

used for the sale of consumer fireworks pursuant to Code section 100.19, in any location zoned for 

commercial or industrial purposes regardless of NFPA or building code requirements. 


Also the bill provides that the state fire marshal shall adopt rules to prohibit the sale of consumer fireworks 

in any residential zone or district. The bill provides that the state fire marshal shall have the sole authority 

to require or authorize inspections relating to consumer fireworks seller licensure. A city or county shall not 

have the authority to require or authorize any such inspection. 

On Senate debate calendar 

SF 500 (formerly SF 125) Needle Exchange Pilot Program (F) - The bill creates a needle exchange pilot 

program to be administered by DPH in cooperation with the department of public safety, the governor’s 

office of drug control policy, cities, counties, and nongovernmental organizations. 

On Senate debate calendar 

SF 438 (formerly SSB 1190) - Student Health, School Omnibus (M) - This omnibus bill strikes current law 

that requires a parent or guardian of a child enrolled in public and accredited nonpublic elementary schools 

or high schools to provide evidence to the school that the child has had a dental screening, a child’s vision 

screening and blood lead test. Instead the bill requires the person who performs the child’s screenings and 

tests to submit the information regarding completion to the department of public health. 

Passed the Senate 32-17. Amended and and Approved by House subcommittee 

SF 376 (formerly SF 270) - Health Education Requirements (F) - This bill adds mental health awareness, 

coping skills, and suicide prevention to the subject matter that must be included in the unit of health 

education which school districts and accredited nonpublic schools must offer and teach in grades 7-12. 

SF 342 - Alcohol Overdose Reporting Protection (F) - The bill provides that a person under the age of 21 

shall not be charged or prosecuted for public intoxication, possession of alcohol under the legal age, use 

of a driver’s license by an underage person to obtain alcohol, or possession of an open container in a 

motor vehicle, if the person in good faith sought emergency assistance for the person or another person 

due to an alcohol overdose or because the person or other person is a victim of assault, sexual abuse, or 

human trafficking. 

On Senate Debate Calendar 

HF 700 (formerly HF 447) - Emergency Insulin Access (F) - Allows a pharmacist to execute professional 

judgement to refill an insulin prescription without prescriber authority. 

Passed the House 97-0. Amended and passed by the Senate 49-0. 

HF 684 (formerly HSB 175) - Alcohol Overdose Reporting Protection (F) - The bill provides that a person 

under the age of 21 shall not be charged or prosecuted for public intoxication, possession of alcohol under 

the legal age, use of a driver’s license by an underage person to obtain alcohol, or possession of an open 

container in a motor vehicle, if the person in good faith sought emergency assistance for the person or 

another person due to an alcohol overdose or because the person or other person is a victim of assault, 

sexual abuse, or human trafficking. 

On House debate calendar 


29

HF 504 - Health Education Requirements (F) - This bill adds mental health awareness, coping skills, and 

suicide prevention to the subject matter that must be included in the unit of health education which 

school districts and accredited nonpublic schools must offer and teach in grades 7-12. 

Subcommittee: Approved by subcommittee 

HF 419 (formerly HSB 60) - Music Therapist Certification (M) - This bill requires any person claiming to be 

a music therapist to hold a music therapist board-certified credential granted by the certification board 

for music therapists or a professional designation in good standing listed on the national music therapy 

registry. 

Approved by the House 96-3. 

HF 274 - School PE Stats (M) - The bill requires the department of education, beginning with the school 

year starting July 1, 2019, to annually compile reports on statistics and data relating to physical education 

classes and instruction offered by each school district as a whole and by attendance center in a format 

determined by the department. 

Approved by subcommittee 

HF 98 - Center For Suicide Prevention (M) - This bill establishes the Iowa center for suicide prevention in 

the department of education to provide, in a coordinated and comprehensive way, ongoing support to 

Iowa’s schools relating to suicide prevention and postvention and the identification of adverse childhood 

experiences and strategies to mitigate toxic stress response, in the form of information, resources, and 

evidence-based training content. 

Subcommittee: Mommsen, Hanusa and Mascher 


INF REPORT 

Members: Lorinda Inman, Chair; Kim Bergen-Jackson, Secretary; Pamela Deichmann, 

Treasurer; Christine Kessel, Christina Peterson; and Dawn Bowker. The Iowa Nurses 

Foundation held three meetings commencing October, 2018, and subcommittee 

meetings for investment review, marketing, scholarship review and convention 

planning. 

Goals for the year continued as the previous year. The goals were to focus on quality 

continuing education at convention and legislative day, promote attendance at the 

annual convention, explore fundraising ideas and develop goals and strategies for the 

marketing and the fundraising functions of the Foundation. It continues to be critical 

that INA members give to the INF on an annual basis to fund nursing scholarships. 

Lorinda Inman, 

RN, MSN, FRE 

The Foundation is an IBON Continuing Education Provider, approved by the Iowa Board of Nursing. CEU’s 

were awarded for the Iowa Nurses Association Legislative Day held on February 13, 2019. Christina 

Peterson - INF, participated in convention planning, The Impact of Change in Nursing. CE programs were 

developed to provide quality CEU’s at Convention and Legislative Day. 

INF and INA participated with the University of Iowa, College of Nursing and several other nursing 

organizations in the 15th annual 100 Great Nurses event held on May 5, 2019. This event provides 

opportunity for recognition of Iowa Great nurses. Scholarships were given to DNP candidates Laura Budde 

and Megan Hart-Fernandez. Nominations for 2020 may be submitted through the 100 Great Nurses 

website. 

INF awarded six scholarships in 2019. The recipients of the Anderson Scholarships are Macy Ludwig, Alli 

Brown, and Jennifer Thomason. INF scholarship recipients are Anita Leveke, Megan Hart-Fernandez, and 

Jennifer Sue Lopez. 

INF continues to explore new ways to fund scholarships. Current activities include convention, memorials, 

donations, CEU fees and interest-bearing accounts. INF is working to raise funds for nursing scholarships. 

INF is the charitable and philanthropic arm of the INA with a mission to promote and support the professional 

and educational development of the registered nurses in Iowa. 


31

REGION REPORTS 

Central Region 

Pam Deichmann 

TOPIC 

Meeting Schedule 

Member Highlights 

Other Business 

DATA 

• The Central Region met in early in Feb to network and develop a 2019 action 

plan. The plan included a decision to host a networking event for Nurses week; 

participate in the INA strategic planning session this summer and support BSN 

students (from central Iowa nursing schools) to attend the fall annual meeting. 

• INA Central Region hosted a wine and cheese networking reception for 

members and nursing friends Monday May 6 from 6-7:30pm at the Courtyard 

by Marriot in Ankeny. 

• INA Central Region has been unsuccessful in recruiting new secretary position 

and plans to discuss and recruit at the annual meeting in the fall. 


2019 ANA Membership Assembly 

ANA’s Membership Assembly was held Friday, June 20th and Saturday June 21st in Washington, DC. 

Approximately 360 nurses, observers and other leaders attended the annual two-day governance 

meeting. Included in those attendees were four from Iowa: Jann Ricklefs (INA President), Lisa Caffery 

(INA President-Elect), Carol Chesterman (INA Membership Assembly Representative) and Tobi Moore 

(INA Executive Director). 

Assembly members participated in four dialogue forums where they gained in-depth information on 

the issues, as well as shared their experiences, knowledge and perspectives. 

Annual reports were presented from association officers and executives with opportunity to provide 

feedback by representatives. Updates on activities of ANA’s subsidiaries, American Academy of 

Nursing (AAN), American Nurses Credentialing Center (ANCC), and American Nurses Foundation 

(ANF), were received. Of note to Iowa nurses is ANCC’s plans to introduce outcome-based education 

for CEs. 

A candidate forum was held for ANA officers and Board members whose terms were up for election, 

and representatives were offered opportunities to meet the candidates throughout the Assembly. On 

Saturday morning voting was conducted and newly elected officials were introduced. 

Ultimately, Assembly representatives took the following actions: 

Increasing Access to Vaccination Compliance: ANA believes that to protect the health of the 

public, all individuals should be immunized against vaccine-preventable diseases, according to the best 

and most current evidence. Given the recent surge of measles cases and potentially uncontrollable 

outbreaks of other vaccine-preventable illnesses, the Assembly voted to strengthen ANA’s position 

statement on vaccination compliance, removing the religious exemption and requiring annual 

recertification for medical exemptions. They expressed strong support for this vital policy, which is 

crucial to protecting at-risk children and others who can’t be vaccinated. Representatives also called 

for advocacy for increased funding for social marketing education campaigns, which in part, can help 

combat vaccine hesitancy and misinformation. 

DACA Recipients Eligibility to take the NCLEX: Representatives approved a recommendation 

aimed at allowing nursing students who are Deferred Action for Childhood Arrivals (DACA) recipients 

– often called DREAMers – to take the NCLEX in all states without facing barriers. (The DACA program 

provides deportation relief for eligible immigrant individuals who came to the U.S. when they were 

young children.) Only eight states allow DACA students to sit for this licensing exam. This action 

would also help increase diversity in the workforce and ease nursing shortages. 

Human Trafficking: To help solve the public health crisis of human trafficking, they called for ANA 

and its member organizations to educate nurses on the use of effective screening tools when an 

individual comes into a health care facility. Two other recommendations focused on promoting 

trauma-informed care using a collaborative approach when dealing with a human trafficking victim/ 

survivor, as well as requesting ANA to convene a national task force on this issue. 


33

Visibility of Nurses in the Media: To increase the visibility of nurses in the media, Assembly 

representatives approved recommendations focused on improving nurses’ and the media’s 

understanding of each other, as well as positioning nurses as influencers. A hackathon was held 

and Assembly participants generated strategic ideas, which included creating an Institute of Media 

Ambassadors that provides intensive media training and developing a database of nurse content 

experts who could quickly respond to media requests. 

Representatives acted on two additional timely and compelling topics: 

Medical Aid in Dying: They approved the revised ANA position statement, The Nurse’s Role When a 

Patient Requests Aid in Dying. According to the revised statement, ANA supports recommendations 

that nurses remain objective when discussing end-of-life options with patients who are exploring 

medical aid in dying; have an ethical duty to be knowledgeable about this evolving issue; and have 

the right to conscientiously object to being involved in the aid-in-dying process, among others. 

ANA Presidential Election Engagement Policy: Rather than continuing to endorse a presidential 

candidate, a new policy was adopted that includes reaching out to each declared candidate with 

information on ANA; educating ANA members and the public on presidential candidates’ positions 

on ANA’s policy agenda and priorities; and aggressive promotion of voter registration and voting 

among RNs. In addition, resources will be applied at the grassroots level to engage members in 

political activities. 

Pictured from left to right: Tobi Moore 

(INA Executive Director), Lisa Caffery (INA 

President-Elect), Jann Ricklefs (INA President), 

and Carol Chesterman (INA Membership 

Assembly Representative). 

Pictured from left to right: Jann Ricklefs (INA 

President), Lisa Caffery (INA President-Elect), 

and Carol Chesterman (INA Membership 

Assembly Representative). 


The Power of Nursing Makes 

Itself Known on Capitol Hill 

ANA Hill Day, Thursday, June 20, 2019 

As part of ANA’s annual Hill Day, nurses, 

students and other leaders “stormed” 

the Hill and met with members of 

Congress and their staff to build support 

for federal legislation addressing 

workplace violence, funding for nurse 

workforce development programs, and 

APRNs’ ability to order home health care 

services. Over 400 participants from 

48 states shared their perspectives 

and expertise with their senators and 

representatives. Participating from Iowa 

were Jann Ricklefs (INA President), Lisa 

Caffery (INA President-Elect), Carol 

Chesterman (Membership Assembly 

Representative, and Tobi Lyon Moore 

(INA Executive Director). 

To kick off the day’s activities, participants 

attended a breakfast briefing, where 

they learned more about ANA-supported legislation and were welcomed by ANA President Ernest Grant, 

PhD, RN, FAAN. “The broader public needs you to be advocating just as much as an individual patient 

needs their nurses advocating for them at the bedside,” said Grant. He further stated, “Rest assured, the 

people with whom you’re meeting are relying on nursing’s perspective, so they can better serve you and 

your patients.” 

Grant held ANA’s Hill Day version of a “fireside chat” with the newest nurse to join the 116th Congress, 

U.S. Rep. Lauren Underwood (D-IL). “Health care was the No. 1 issue in our elections, and health care is 

a human right,” stated Underwood, MSN, MPH, RN, who worked on implementing the Affordable Care 

Act while serving in the Obama administration. It was her concerns about several legislative attempts to 

repeal the ACA and take away protections for people with preexisting conditions that led her to run for 

Congress. She continues to push for efforts to protect and ensure people’s access to affordable care. 

Underwood addressed the biggest challenge she sees as the Senate’s refusal to take up bills sent from the 

House for consideration. She encouraged nurses to compel Senators, both Republican and Democrat, to 

support the Title VIII Nursing Workforce Reauthorization Act. Underwood recommended for all nurses to 

“make it your business to find out who your Congress member is and meet with them. Talk about what 

is important to you. Talk with confidence. You are the experts.” She added that the most powerful thing 

nurses have is their patient stories, and all the factors that affect someone’s health. 


35

The three key bills that Hill Day attendees addressed were: 

• The Workplace Violence Prevention for Health Care and Social Service Workers Act (R. 1309/S. 851) 

• The Home Health Care Planning Improvement Act (R. 2150/ S. 296) 

• The Title VIII Nursing Workforce Reauthorization Act of 2019 (R. 728/S. 1399) 

Additionally, participants addressed the importance of nurse staffing as ANA continues to work with 

federal policymakers on this critical nurse and patient safety issue. 

The Iowa nursing delegation was fortunate to be able to meet with Senator Charles Grassley, and 

Representatives Steve King and Representative Dave Loebsack. Although not able to visit with Senator 

Joni Ernst and Representative Amy Finkenauer, they were able to visit with staff members. 

Nursing is so much more than advocating for the patient at the bedside. Advocating for the patient and 

the health of the country through legislation is a duty and an honor. Those interested in becoming more 

involved with ANA/INA are encouraged to one day join us on “the Hill.” It is an experience of a lifetime! 

INA Meeting 

Pictured from left to right: Jann Ricklefs 

(INA President), Lisa Caffery (INA President-Elect), 

Carol Chesterman (INA Membership Assembly 

Representative), Senator Chuck Grassley, and 

Tobi Moore (INA Executive Director). 

Pictured from left to right: Jann Ricklefs 

(INA President), Lisa Caffery (INA President-Elect), 

and Carol Chesterman (INA Membership Assembly 

Representative). 

Pictured from left to right: Lisa Caffery (INA President- 

Elect), Carol Chesterman (INA Membership Assembly 

Representative), and Congressman Dave Loebsack. 


2019 LEADERSHIP ELECTIONS 

INA Members received their official electronic ballot, by email, Thursday, October 3, 2019. The email 

contained instructions on how to cast your vote. Voting remained open until Thursday, October 17th. 

Election results will be announced at the annual meeting on Friday, October 25th in Des Moines. 


37

BY-LAWS COMMITTEE REPORT 

The work of the By-laws Committee this year focused on the Board’s request to revise the By-laws to reflect 

current practices within INA and best practices of other ANA-Constituent-State Nurses Associations. 

The proposed changes listed below were sent to members via the weekly e-newsletter on August 22, 

2019. 

• On June 22, 2019, the Value Pricing Model was institutionalized by ANA. INA wishes to continue to 

offer the new “standard” membership previously referred to as value pricing. These new proposed bylaw 

changes will adopt these membership categories as our only membership options going forward. 

• The INA Board of Directors is recommending that the Board of Directors be restructured. This will 

improve the size and efficiency of the Board. Directors elected from the entire membership will enhance 

the ability for all members to become involved. 

• The INA Board of Directors is recommending restructuring of committees to allow for more membership 

engagement and participation. All committee members will be appointed by the INA Board of Directors 

annually, except for the nominations committee, which will be elected. 

• The INA Board of Directors is recommending that Regions be eliminated. This will remove barriers to 

participations by all members. Currently more than 30% of members are not represented by a Region. 

Two of the regions are not active and the remaining regions have varying degrees of participation. 

Programming and attendance vary widely as does the financial support for activities. Not all regions have 

full representation on the state-level board and committees. The Board, committees, and work groups 

will be drawn from the membership. The streamlined governance process will allow for programming 

to be established at the state level and be based on the needs and interests of members. 

Two By-laws hearings will be held prior to the October 25th Annual Conference and Meeting. The meeting 

will be held Tuesday, September 10, at 7:00 p.m. and Wednesday, October 16th at 7:00 p.m. via Zoom. 

This new process will allow for time to address minor corrections such as grammar and spelling changes as 

well as obtain feedback from members who are not able to attend the Annual Conference and Meeting. 

The proposed By-laws will be presented to the Membership for voting on October 25, 2019. 

A special thank-you to Ginny Wangerwin and Linda Opheim for their assistance and expertise with the 

writing of the proposed By-laws. 

Respectfully submitted, 

Lisa Caffery, MS, BSN, RN-BC, CIC, FAPIC 



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Advancing Nursing in Siouxland 

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2019 Iowa Nurses Association Annual Report

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