Iowa - September 2020

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2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


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TABLE OF CONTENTS

2020 Board of Directors. ............................................................ 3

2020 Annual Meeting Agenda. ....................................................... 5

Parliamentary Procedures ............................................................ 7

2019 Annual Meeting Minutes. ...................................................... 13

2020 Strategic Plan. ............................................................... 17

2020 Legislative Priorities. .......................................................... 18

Financial Statements. .............................................................. 22

President’s Message ............................................................... 27

Executive Director’s Report .......................................................... 28

INA 2020 Membership Dashboard .................................................... 30

Legal Year in Review. .............................................................. 31

Legislative Session. ................................................................ 34

Iowa Nurses Foundation. ........................................................... 41

ANA Membership Assembly. ........................................................ 42

2020 Leadership Elections. .......................................................... 44

2020 Bylaw Amendments and Summary. ............................................... 47

Appendix

INA Bylaws. ..................................................................... 49

Published for the Iowa Nurses Foundation and the Iowa Nurses Association by:

Arthur L. Davis Publishing Agency

P.O. Box 216 | Cedar Falls, Iowa 50613

(319) 277-2414

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

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2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

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INA ANNUAL BUSINESS MEETING

AGENDA

October 13, 2020

5:00 to 7:00 pm

5:00 Call to Order-Lisa Caffery, 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

• 2019 Annual Meeting Minutes

5:10 Financial Report-Anne Cook, Treasurer

5:20 2020 INA Strategic Initiatives- Lisa Caffery, President

5:30 Membership and Operational Highlights- Tobi Lyon, Executive Director

5:40 2020 Legislative and Legal Year in Review- Lynn Boes, INA Legal Counsel

5:50 ACTION ITEM: 2020 Proposed New Bylaws-Christina Peterson, Bylaws Chair

6:00 INA Awards Presentation-Lisa Caffery, President

6:10 Iowa Nurses Foundation Scholarship Presentation-Lorinda Inman, Chair

6:20 Iowa Board of Nursing-Kathleen Weinberg, Executive Director

6:30 Membership Open Forum-Lisa Caffery, President

6:45 Recognition of Outgoing Board Members-Lisa Caffery, President

6:50 Tellers Report- Julie Schilling, Nominations Chair

7:00 Adjournment- Lisa Caffery, President

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

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PARLIAMENTARY 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 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.

Revised 2007

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.

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

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8 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


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

inserting

adding

(word(s), phrase, paragraph).”

(word(s), phrase, paragraph).”

(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.

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

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

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10 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


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

Main motion NO YES YES YES Majority

Amendment NO YES YES YES Majority

Amendment to

amendment

Vote

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.

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

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WHY DID HE CHOOSE

UNIVERSITY OF IOWA HEALTH CARE?

“Being a nurse in the pandemic is

something I never thought I would

be apart of, but it has made me

even more proud to be a nurse here.

I take pride in being part of a team

that has stepped up, cheered each

other on, and safely cared for patients

during this unprecedented time. This

unwavering teamwork and support

consistently reminds me of why I

chose University of Iowa Health Care.”

Nicholas Klein, RN

To learn more about available RN job

opportunities, find us online at:

uihc.org/nursingjobs


Iowa Nurses Association

Annual Business Meeting Minutes

October 25, 2019

Des Moines Iowa

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

Vacant, Secretary Virginia Wangerin, Resolutions Dawn Bowker, Public Policy

Christina Peterson, Staff Nurse Kate Pace, Newly Licensed Vacant, SW Region Rep

Director

Linda Opheim, NW Region Rep Brenda Helmuth, NE Region Rep Lorinda Inman, INF Chair

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 3:46 pm 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 56 members present and 18 proxy voters. A quorum was not

declared by Lynn Boes. With no quorum, no actions will occur during this annual meeting.

5. The agenda was reviewed, as written.

6. October 19, 2018, Annual Meeting minutes were presented in the annual book.

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

Moore to present the financial reports.

Operating Revenues:

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 $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

feel 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.

Net Profit:

INA ended the month of August with a net profit to date for the year at $6,539.52

8. Tobi Moore provided the executive director message. 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 in August 2018 with 1120 members. INA sees a 1.6% average monthly

growth in membership. 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 sees a 2.6% average monthly growth in membership in 2019. Whereas,

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

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14 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


in 2018, we saw an average of 1.6%. We are making significant 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 specific 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.

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.

9. No actions were taken on the proposed bylaw amendments.

10. President Ricklefs recognized outgoing Board Members. Christina Peterson, Staff Nurse at Large,

2017-2019. Kate Pace, Newly Licensed, 2017-2019

11. Sue Whitty, nominations chair, reported the teller's report.

1240 ballots were sent

180 members voted

14.5% voter turn out

Election Winners were as follows:

• President-Elect: Christina Peterson

• Staff Nurse at Large: Bettina Hoffmann

• Newly Licensed Nurse: Kate Pace

• Membership Assembly: Andrea Hughes

• 1 st Alternative for Membership Assembly: Candace Chihak

• 2 nd Alternative for Membership Assembly: Dawn Bowker

• Nominations Committee: Julie Schilling receiving the most votes to serve as chair and Kathleen

Runde and Mainda Poduska members

Iowa Nurses Foundation: Pamila Deichmann, Christine Kessel, and Linda Opheim

President Ricklefs thanked the members and the board for the past two years serving as President and

welcomed Incoming President Lisa Caffery as President.

12. Meeting ended at 4:35

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16 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


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1. Role of Nurses

• Actively oppose efforts to erode the scope of

practice rightly claimed by nurses.

• Nurses ensure human dignity is upheld by

advocating and educating in all dimensions

of health, including, but not limited to,

physical, mental, and spiritual health.

• Nurses play a critical role in care transition

and coordination (across all healthcare

settings) while supporting patient goals,

reducing hospital readmissions, decreasing

infections, and decreasing hospital-related

mortality.

• Nurses equal patient safety and positive

outcomes.

• The ongoing nurse shortage jeopardizes

patient safety and increases poor outcomes.

2. Meaningful Gun Control

• Meaningful gun control can reduce access to

a highly lethal means of suicide

• Reduce access to firearms when a family

member is at risk for suicide

• Nurses in Iowa can address meaningful

gun legislation by working collaboratively

with law enforcement, mental health

professionals, and researchers to identify

and implement evidence-based strategies to

decrease death by suicide involving firearms.

3. Vaccinations

• Protect public health by resisting efforts to

eliminate childhood immunizations.

• Vaccination is one of the most cost-effective

ways to avoid disease. It currently prevents 2

to 3 million deaths a year, and a further 1.5

million could be avoided if global coverage

of vaccinations improved.

• Immunizations have had an enormous impact

on the health of children, and the prevention

of disease by vaccination is one of the single

greatest public health achievements of the

last century.

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4. Protect School Nurses

• The physical, social, and emotional needs

of Iowa students are different than previous

generations and cannot meet their fullest

potential with unmet health needs.

• Students are the future of Iowa, and we need

to care and attend to their health needs - we

need one nurse in every building, every day,

all day.

• Teachers teach students, and nurses should

provide healthcare to students.

• School nurses are the “connectors”

between students/ families, health care, and

academics. Physical and emotional needs

impact everyone’s ability to function at their

highest level of productivity. School nurses

can and should teach youth the value of

health.

• Research shows attendance is better when

a school nurse is present to evaluate healthrelated

complaints. https://www.nasn.org/

advocacy/professional-practice- documents/

position-statements/ps-absenteeism

• Healthy students make better learners.

• School nurses are not just for emergencies

and chronic health concerns – School nurses

are knowledgeable, skilled, and qualified to

provide comprehensive care to students.

• Schools don’t send a teaching assistant in

to teach, and they shouldn’t send health

assistant in to provide healthcare to students.

• Per the Iowa Department of Education

School Nurse Consultant, there are 702

school nurses in Iowa and 1415 public school

buildings.

5. Tobacco Products

Iowa needs to include “vaping” in the

definition of tobacco products included in

the Iowa Smokefree Air Act.

• The US Centers for Disease Control reminds

us that “Young people who use e-cigarettes

may be more likely to smoke cigarettes in

the future.”

• E-cigarette aerosol is NOT harmless “water

vapor,” and the aerosol that users breathe

from the device and exhale can contain

harmful and potentially harmful substances.

• The aerosol that users inhale and exhale from

e-cigarettes can expose both themselves and

bystanders to harmful substances.

• The age to legally purchase all tobacco

products needs to be raised to 21.

6. Consumer Fireworks Expansion

• Consumer fireworks are dangerous. Iowa

should not expand the types of fireworks

available for sale in the state nor allow for

them to be used on days other than the

Fourth of July.

• The most recent statistics from the National

Fire Protection Safety Association show

hospital emergency rooms treated an

estimated 12,900 people forfireworks-rela

tedinjuries;54%ofthoseinjurieswere to the

extremities, and 36% were to the head.

Children younger than 15 years of age

accounted for more than one-third (36%) of

the estimated injuries.

• Proper adherence to fire safety codes,

building codes, and zoning regulations is

essential to preventing fireworks-related

injuries. These rules and regulations are

designed to protect lives and property.

7. Future of Nursing in Iowa

• Decreased Number of Nursing Graduates in

Iowa

• Aging Nursing Faculty

• Nurse Recruitment and Retention in Iowa

• To adequately support the health and

wellness of Iowans, we must address the

future of nursing in Iowa, including nursing

education, retention and recruitment, and

equitable salaries.

8. Mental Health Services and Support

• Accessing Mental Health Services and

Supports that include affordable and

accessible treatment options.

• Offering a full array of affordable, accessible

treatment options, including recoveryoriented

systems for prevention, early

intervention, and treatment.

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• Current data is alarming. In 2018,17% of

adults in Iowa had a mental health diagnosis.

Of those, over 45% did not receive treatment,

and 20% of those who received treatment

reported unmet needs.

• The statistics are more worrisome in children.

Major Depressive Disorder (MDD) diagnosis

in children increased from 9 to 14% in the

past five years. Over 50% of these children

do not receive treatment. Untreated mental

health diagnoses affect not only the child,

but the community – decreasing academic

success, productivity, and even death by

suicide. The suicide rate in Iowa is 14.55 per

100,000 people, while the national rate is

13.42. Suicide among youth is dramatically

increasing. Between 2007 to 2017, the teen

suicide rate spiked by nearly 56 percent — the

rate climbing from 6.8 deaths per 100,000

people to 10.6, according to the CDC. The

rate continued to climb in 2018, up another

1.4 percent. We need to address mental

health with the significance it deserves by

ensuring treatment options are available and

easily accessible from the beginning of the

illness.

• Increasing the number of mental health

treatment beds across the state.

• No one wants to be in the hospital. But

like with any other illnesses, hospitalization

is unavoidable at times. At this time, Iowa

remains grossly lacking in the availability of

psychiatric hospital beds to address the most

pressing needs of our residents.

• Increasing nurse providers through loan

repayment and educational funding.

Iowa has over 200 Psychiatric Mental Health

Nurse Practitioners who assess, diagnose,

and treat mental health conditions, but this

is not enough.

• Nurse Practitioners have a long history of

serving rural communities and stay where

they’re trained, meaning they are likely

to remain in Iowa after completing their

education.

• Affordability remains a barrier for many

looking to further their education, by funding

grants and loan repayment programs, we

can open access not just to education but

also to much-needed health care.

• Supporting reimbursement parity for mental

health treatment.

• Themind-bodyconnectionisundeniable;som

eone is not healthy without sound mental

health. We know that multiple disease

states are intertwined with mental health,

including cardiovascular health. We must

treat the whole body. One of the simplest

ways to ensure overall health is to require

reimbursement parity for mental health

treatment. This ensures access to care as

it decreases the cost to the patient and

ensures mental health providers can remain

financially viable. 11,000 Iowa children with

private insurance do not have mental health

coverage – if this were any other specialty,

there would be outrage. Yet, mental health

is just as serious with the rate of suicide

increasing in our state. If we intend to grow

services and ensure care is available, we will

need to ensure mental health providers are

reimbursed at the same rates as physical

health providers – the two are inseparable.

• Sources: https://afsp.org/2018mortalitydata/

https://afsp.org/about-suicide/suicide-statistics/

https://bit.ly/3c07UDX

https://bit.ly/3cdVybo

https://bit.ly/2Vkd6N4

https://bit.ly/2SVlbWG

https://bit.ly/38QTaVM

https://bit.ly/397dPF2

https://bit.ly/37TatEn

9. Monitoring the Privatization of Medicaid

• Support oversight of Medicaid contractors to

ensure quality healthcare for this vulnerable

population.

• Advocate for mutually collaborative

relationships between Medicaid contractors

and service providers that includes

responsiveness to patient needs, flexible

services, and timely, fair reimbursement

practices.

20 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


10. Midwifery

• The International Confederation of Midwives

sets the global standards for education,

practice, and regulation.

• Certified Nurse-Midwives (CNMs)

arelicensedas ARNPs in Iowa. They are

educated at the master’s level and pass a

certification exam and easily meet the global

standards. They practice in all settings.

• Certified professional midwives (CPMs)

have two pathways to be eligible for their

certification exam and practice mainly in

home birth. The most common path is the

PEP, which is a self-study/apprenticeship

pathway that does not meet global

standards. The other is by graduating from

an accredited education pathway that does

meet global standards.

• Direct entry/lay midwives are people who are

not certified and may or may not have any

apprenticeship training and practice in home

birth.

• CPMs and direct entry/lay midwives are

currently practicing illegally (practicing

medicine without a license.) and there are

lots of them.

• Mothers and families in Iowa deserve a

maternity care provider who at least meets

global education standards.

• Licensure of CPMs would require them to

meet global education standards and is

necessary to protect the mothers and families

choosing home birth in our state.

• Whether you approve of home birth or not,

mothers will continue to choose to birth

at home. Global education standards and

seamless transfer of care is the way to make

this as safe as possible.

• Licensure will allow mothers and families

to know their midwives are meeting global

education standards and is a step to improve

the relationships of home birth providers

and hospitals and physicians, improving

consultation, collaboration, and seamless

transfers.

• Currently, only CNMs practice legally in Iowa.

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

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AUGUST 2020 WRITTEN FINANCIAL SUMMARY

Operating Revenues:

Membership Dues our monthly budget for membership dues is $11,416.67, and with us eight months

into the fiscal year, we are ahead by $1,851.59.

Legislative Day was budgeted to bring in $14,500. We brought in $20,240.00. Our expenses were

$26,187.81, and that included the reception and doing the webcast. We budget to have a net loss of

$2,000, and this did not involve a legislative event. With the reception, our actual net loss was $6,147.81.

In 2019 we had a net loss of $4,061.51, and we didn’t have a reception. In 2018 we had a net loss of

$1,290.66.

Operating Expenses:

With eight months into our fiscal year, the following items are over budget:

Marketing is over by $500 related to the nurse’s month membership mailing that was done.

Legislative Services are over by $743.93 due to our increase in months needed for our legislative bill

tracking software.

Postage is over by $373.01 related to the nurses’ month membership mailing.

Website is over by $1,259 as part of the items we itemized in the budget under the technology line-item,

which is under budget by $1,065.03. Suggest combining these two-line items in 2021 next year.

Net Loss:

We ended the month of August with a net loss of $7,871.61. The loss will be recovered throughout the

coming months. Also, the expenses for the association are more massive during the first six months of

the fiscal year, related to the lobbyist contract. Non-dues revenue has a larger volume of income that is

received during the 3rd and 4th quarters. While INA won’t be making the net profit of $5,000 from the

conference, that was budgeted. The association will be saving $8,000 in travel and meeting expenses

since ANA Leadership Summit, Membership Assembly, and there won’t be any board meetings in person

for the remainder of the year. There will be a small amount yet to pay related to staff travel to close the

office. We budgeted to have a net profit of $325.00. As long as membership dues stay ahead of schedule

and with the fourth quarter non-dues revenue coming in, we should come with a net profit of $1,000 for

the fiscal year.

22 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


FINANCIAL STATEMENTS

2:40 PM Iowa Nurses Assocation

09/03/20 Balance Sheet

Accrual Basis As of August 31, 2020

Aug 31, 20

ASSETS

Current Assets

Checking/Savings

Wells Fargo Checking 19,805.15

Wells Fargo Savings 72,607.80

Total Checking/Savings 92,412.95

Accounts Receivable

Accounts Receivable 250.00

Total Accounts Receivable 250.00

Total Current Assets 92,662.95

TOTAL ASSETS 92,662.95

LIABILITIES & EQUITY

Equity

Opening Balance Equity 87,908.43

Unrestricted Net Assets 12,626.13

Net Income -7,871.61

Total Equity 92,662.95

TOTAL LIABILITIES & EQUITY 92,662.95

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

23


2:39 PM Iowa Nurses Assocation

09/03/20 Profit & Loss

Accrual Basis August 2020

Aug 20

Income

10-000 INF Management Fee 300.00

11-000 Interest 0.62

12-000 Membership Income

12-200 ANA Dues 11,626.22

12-300 Payroll Deduction Dues 180.48

Total 12-000 Membership Income 11,806.70

13-000 Non-Dues Revenue

13-200 Career Center 185.25

Total 13-000 Non-Dues Revenue 185.25

Total Income 12,292.57

Expense

17-000 Membership Expense

17-100 ANA Payroll Deduct 91.39

Total 17-000 Membership Expense 91.39

18-000 Operations

18-100 Bank and CC Fees 50.00

18-350 Phone 160.59

18-400 Postage, Mailing Service 178.85

18-500 Rent 250.00

18-600 Technology 138.54

18-700 Website 325.00

Total 18-000 Operations 1,102.98

19-000 Professional Services

19-200 Assocation Management 6,750.00

19-300 Government & Ext Affiars 1,500.00

19-500 Legal Fees 833.33

Total 19-000 Professional Services 9,083.33

Total Expense 10,277.70

Net Income 2,014.87

Page 1

24 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


2:42 PM Iowa Nurses Assocation

09/03/20 Profit & Loss Budget vs. Actual

Accrual Basis January through August 2020

Jan - Aug 20 Budget $ Over Budget % of Budget

Income

10-000 INF Management Fee 2,100.00 3,600.00 -1,500.00 58.3%

11-000 Interest 8.04 25.00 -16.96 32.2%

12-000 Membership Income

12-1000 Affiate Membership 0.00 1,500.00 -1,500.00 0.0%

12-200 ANA Dues 93,184.95 132,000.00 -38,815.05 70.6%

12-300 Payroll Deduction Dues 1,636.90 3,500.00 -1,863.10 46.8%

Total 12-000 Membership Income 94,821.85 137,000.00 -42,178.15 69.2%

13-000 Non-Dues Revenue

13-100 Arthur Davis Publication 4,637.88 7,000.00 -2,362.12 66.3%

13-200 Career Center 694.63 1,500.00 -805.37 46.3%

13-300 NSO 500.00 500.00 0.00 100.0%

13-400 One Main Financial 0.00 0.00 0.00 0.0%

13-500 Personal Benefits Progr 210.95 100.00 110.95 211.0%

Total 13-000 Non-Dues Revenue 6,043.46 9,100.00 -3,056.54 66.4%

15-000 Program Income

15-100 Convention

15- 110 Exhibitors 0.00 3,000.00 -3,000.00 0.0%

15-120 Registration 0.00 12,000.00 -12,000.00 0.0%

15-130 Sponsorships 0.00 4,000.00 -4,000.00 0.0%

Total 15-100 Convention 0.00 19,000.00 -19,000.00 0.0%

15-200 Legislative Day

15-210 Exhibitors 2,150.00 2,500.00 -350.00 86.0%

15-220 Registration 17,890.00 12,000.00 5,890.00 149.1%

Total 15-200 Legislative Day 20,040.00 14,500.00 5,540.00 138.2%

Total 15-000 Program Income 20,040.00 33,500.00 -13,460.00 59.8%

Total Income 123,013.35 183,225.00 -60,211.65 67.1%

Expense

16-000 INF Expense 0.00 100.00 -100.00 0.0%

17-000 Membership Expense

17-100 ANA Payroll Deduct 731.12 1,500.00 -768.88 48.7%

17-200 Marketing 2,500.00 2,000.00 500.00 125.0%

Total 17-000 Membership Expense 3,231.12 3,500.00 -268.88 92.3%

18-000 Operations

18-100 Bank and CC Fees 829.06 1,250.00 -420.94 66.3%

18-150 Business Reg Fees 0.00 200.00 -200.00 0.0%

18-200 Ins. - Liability, D & O 0.00 1,200.00 -1,200.00 0.0%

18-250 Legislative Services 3,343.93 2,600.00 743.93 128.6%

18-350 Phone 1,282.29 1,200.00 82.29 106.9%

18-400 Postage, Mailing Service 773.01 400.00 373.01 193.3%

18-450 Printing and Copying 231.30 750.00 -518.70 30.8%

18-500 Rent 2,000.00 3,000.00 -1,000.00 66.7%

18-550 Supplies 0.00 500.00 -500.00 0.0%

18-600 Technology 1,434.97 2,500.00 -1,065.03 57.4%

18-650 Utilities 0.00 0.00 0.00 0.0%

18-700 Website 3,109.00 1,850.00 1,259.00 168.1%

Total 18-000 Operations 13,003.56 15,450.00 -2,446.44 84.2%

19-000 Professional Services

19-100 Accounting Fees 625.00 850.00 -225.00 73.5%

19-200 Assocation Management 54,000.00 81,000.00 -27,000.00 66.7%

19-300 Government & Ext Affiars 12,000.00 18,000.00 -6,000.00 66.7%

19-500 Legal Fees 6,666.64 10,000.00 -3,333.36 66.7%

19-600 Lobbyist 10,999.98 11,000.00 -0.02 100.0%

Total 19-000 Professional Services 84,291.62 120,850.00 -36,558.38 69.7%

20-000 Program Expense

20-100 Convention

20-110 Awards 0.00 500.00 -500.00 0.0%

20-120 Hotel and Meals 0.00 8,000.00 -8,000.00 0.0%

20-130 Presenters 0.00 4,000.00 -4,000.00 0.0%

20-140 Supplies 0.00 1,500.00 -1,500.00 0.0%

Total 20-100 Convention 0.00 14,000.00 -14,000.00 0.0%

20-200 Legislative Day

20-210 Hotel and Meals 19,528.84 14,000.00 5,528.84 139.5%

20-220 Presenter 300.00 1,000.00 -700.00 30.0%

20-230 Supplies 1,888.12 1,500.00 388.12 125.9%

20-240 Reception 2,808.76

20-250 Webcast 1,377.09

20-200 Legislative Day - Other 285.00

Total 20-200 Legislative Day 26,187.81 16,500.00 9,687.81 158.7%

Total 20-000 Program Expense 26,187.81 30,500.00 -4,312.19 85.9%

Page 1

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

25


2:42 PM Iowa Nurses Assocation

09/03/20 Profit & Loss Budget vs. Actual

Accrual Basis January through August 2020

Jan - Aug 20 Budget $ Over Budget % of Budget

21-000 Travel and Meetings

21-100 ANA Meet. & Memb. Travel 2,180.48 4,000.00 -1,819.52 54.5%

21-200 Board Meetings 368.29 2,500.00 -2,131.71 14.7%

21-300 Staff or Contract Travel 1,622.08 6,000.00 -4,377.92 27.0%

Total 21-000 Travel and Meetings 4,170.85 12,500.00 -8,329.15 33.4%

Total Expense 130,884.96 182,900.00 -52,015.04 71.6%

Net Income -7,871.61 325.00 -8,196.61 -2,422.0%

Page 2

26 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


Dear Colleagues,

INA PRESIDENT’S REPORT

Welcome to the virtual business meeting of the Iowa Nurse Association! Who would

have thought that our lives could have changed so much in one year! This is not

how I envisioned my first year as your president, but I am so proud of the things

the Association has accomplished this year while working through these challenging

times. As we were packing up after the Annual Conference last October, we had

started to make plans for the 2020 Annual Conference and celebrating the Year of

the Nurse. While the conference was canceled, we were still able to celebrate the

Year of the Nurse during Nurse Week in May in a virtual format. I hope you enjoyed

your gift and the other offerings throughout the month of May.

Lisa Caffery, MS,

BSN, RN-BC, CIC,

FAPIC

I am most proud of INA’s response to the pandemic and ensuring that nursing’s voice is heard in Iowa. The

COVID task force has worked tirelessly since March writing letters to government leaders, hosting virtual

support communities and taking calls from nurses across the state who needed someone to talk too. I am

forever grateful to all of the Task Force members for their commitment and work. THANK-YOU! As a result

of their work INA had a number of requests for interviews with media outlet across the state.

The last ANA event that I attend in person was the ANA Leadership Summit in December 2019. At that

meeting we discussed membership engagement and increasing nursing visibility in the media. This year

INA has seen an increase in membership and we now have over 1400 members and as I above I have done

multiple media interviews related to the pandemic. Tobi Lyon, Andrea Starmer, and the team at Ngage

have assisted with coordinating interviews and preparing press releases and statements. Their guidance

and support this year has been invaluable. ANA Membership Assembly and Lobby Day were held virtually

and while the virtual format worked for this year, I do hope that we can meet in person again in 2021. I

missed networking and sharing of ideas with other nursing leaders.

Throughout the pandemic ANA has offered several webinars for members and non-members. The webinars

that I have watched are excellent and I encourage you to sign-up for those that are of interest to you and

your practice area.

The future of INA is bright, and I am looking forward to working with the Board as we continue our work

to implement the strategic plan and move the organization forward. Thank-you for being a member of

INA and supporting the mission of the organization, “To connect, advocate and support for nurses and

healthcare in Iowa.”

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

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

27


EXECUTIVE DIRECTOR’S REPORT

“Don’t lose your ambition. Situation is unparalleled. Many have the instinct to hunker

down, think small. When economies shrink, there are opportunities you will never

find any other time.” -Margaret Heffernan

The quote by Margaret Heffernan is the best summary I have for 2020, as it has been

a historical anomaly in many ways with the pandemic. In response to the COVID-19

pandemic, INA strategically pivoted operations to respond to fully and support the

needs of nurses during this time of uncertainty, setting aside routine, daily operations,

and the status quo. INA’s aggressive pivot and innovative, proactive approach has

been nationally recognized, at the forefront for establishing new modern practices

and has expanded our outreach and engagement to include more front-line nurses

and potential members.

Tobi Lyon, MBA

Nursing got more attention during 2020 than we have in years. INA used this to launch new services to

better serve Iowa nurses, which resulted in a record-breaking high in INA membership. August 2020, INA

has 1385 members and is on track to break 1400 by the end of 2020. To think that in December 2017,

we had 967 members. In three years, we have grown by 44.8%!

Earlier this spring, INA launched a new COVID-19 Resources webpage for members, all nurses, and the

public, which provided evidence-based or most current information and resources available. INA, with a

generous donation, provided public messaging to thank our nurses via billboards across the state, social

media, and direct messages of support/encouragement. Messaging and a unique member gift were

provided in May to INA members in honor of the Year of the Nurse.

INA also provided multiple opportunities complimentary self-care education and virtual meetups via the

Networks of Support.

Early on in the pandemic, a group of INA members recognized the need to provide support for Iowa

nurses. This group become the INA COVID-19 task force which has worked together to provide the INA

nurse to nurse line, a 24 hour warm call line available to all Iowa nurses, letters to the Governor as well as

Letter to the Editor on what support Iowa nurses need and recommendations for public health and safety.

The COVID-19 task force also initiated a social campaign that encourage Iowans to wear masks, maintain

safe social distances, and wash hands regularly. The task force has been instrumental in providing support

to Iowa nurses during the pandemic and continues to look for ways to do so.

I also want to take the time to introduce all to your INA staff team that have made themselves available

around the clock to support not only our members but all Iowa citizens during this time of uncertainty and

who have helped contribute to our “thrival”:

Andrea Starmer, CMP, Director of Education and Membership. Andrea joined INA the summer of

2019 as an event planner and has been promoted to Director of Education and Membership. Andrea

works all the education and planning committees, to bring value programming content to the association.

Andrea is also becoming a key leader in making sure our membership gets the service they expect, but

28 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


also that we exceed their expectations. Andrea is my point person who I delegate items to, and she makes

my thoughts and visions a reality, but don’t be fooled — she has many unique ideas of her own that will

bring new services and growth to INA.

Taylor Dempsey, Director of Communications & Marketing. Taylor joined INA in the summer of 2018

as a Communications Manager and was recently promoted to Director of Communications & Marketing.

Taylor is responsible for all member communications, design, and website updates for INA and seeks to

make us stand out in the marketplace. Taylor oversees a team of Communication Specialists who help

support her in managing the day-to-day social media communication, weekly newsletters, and conference

promotion materials.

Lea Osborne, Membership Manager. Lea is the newest member of INA’s team. Lea joined in October

2019 and will be working on putting together marketing plans to help drive our membership, promote

our membership benefits to make sure that we are attracting new members and retaining all of you that

have made INA who it is today. Lea will assist Andrea and Taylor in promoting INA and bringing additional

value to members.

As in years, past 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, and most of all, your dedication to the nursing profession. I encourage

all members to share their views as to why you are a member and to remain involved in INA.

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

29


30 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


2020 LEGAL YEAR IN REVIEW

This year, 2020, started out full of promise as the International Year of the Nurse,

and nurses demonstrated their value many times over as they met new health

care challenges with the COVID-19 pandemic. Shortages of personal protective

equipment (PPE) affected the methods for adhering to the gold standard of infection

control previously practiced by nursing and other health care staff. Staff and patients/

residents were quarantined for 14 days when potentially exposed to the virus, creating

staffing shortages. Family members (a crucial part of the health care team) were

prevented from having personal contact with their loved ones. The public at large

was encouraged to wear masks, maintain social distancing (6 feet apart from another

human being), and practice frequent and thorough handwashing for 20 seconds

minimum with anti-bacterial soap (when it could be found). Governor Reynolds

issued proclamations suspending some rules and regulations which were understood

to be more stifling than beneficial under the circumstances. The pandemic not only

J.R. “Lynn” Böes,

RN, BSN, JD,

INA Legal

Counsel

affected the health care arena but impacted the legal arena as well. The legislature was interrupted for

eleven weeks, but returned to finish with final bills and appropriations, adjourning on June 14, 2020.

Fewer rules and regulations were proposed while administrative agencies suspended such activities to deal

with the plethora of issues necessitated by COVID-19. The courts shut down at times and re-prioritized its

dockets.

Legislation. INA saw numerous successes thanks to our engaged INA members, the committed public

policy members and our lobbyists, Jim Obradovich and Robert Mulqueen. During the session the following

new laws were passed:

Senate File (hereinafter, “SF”) 2261 allowed behavioral health screening in schools, including with the

use of telehealth. The Act also prohibits private insurance providers from denying coverage of school

delivered behavioral health services. This is an issue INA and the Iowa School Nurse Organization has

supported for several years. The bill is located at the following link: https://www.legis.iowa.gov/docs/

publications/LGE/88/SF2261.pdf

SF 2268 increased the minimum age from 18 years to 21 years of age for various activities relating to

tobacco, tobacco products, alternative nicotine products, vapor products, and cigarettes. This law took

effect June 29, 2020. The bill is located at the following link: https://www.legis.iowa.gov/docs/publications/

LGE/88/SF2268.pdf

SF 2299 allowed for preliminary background checks for employees and students of certain facilities,

providers, programs and entities to be conducted by third-party vendors, and allowed provisional

employment pending the outcome of the regular background checks. Iowa’s previous law required that

background checks be conducted only by the Iowa Department of Public Safety and Iowa Department

of Human Services (“DHS”), resulting at times in back-logs and delays, impacting on the availability of

hiring otherwise-qualified nursing and other health care providers. See: https://www.legis.iowa.gov/docs/

publications/LGE/88/SF2299.pdf

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

31


House File (hereinafter, “HF”) 2221 changed the previous requirement that the five- member Board of

Health had to have a physician member. The law now allows Advanced Registered Nurse Practitioners

(ARNPs) and Physician Assistants (PAs) to serve as one of the five members instead of a physician. The bill

can be reviewed at the following link: https://www.legis.iowa.gov/docs/publications/LGE/88/HF2221.pdf

HF 2589 made numerous changes to Iowa’s Medical Cannabidiol law. ARNPs, PAs and podiatrists

now have the authority to recommend the use (note: no healthcare practitioner can “order” medical

cannabidiol) of medical cannabidiol. Several new debilitating conditions were added to the list for which

medical cannabidiol may be recommended, including chronic pain (note: untreatable pain was removed),

severe, intractable autism with self-injurious or aggressive behaviors, and post-traumatic stress disorder.

Employees need to be aware that the law allows employers to prohibit the possession and

use of any form of marijuana, including medical cannabidiol, and employers can maintain and

enforce zero-tolerance and drug testing policies. Likewise, a property owner need not allow use

or possession of marijuana on that person’s property. See: https://www.legis.iowa.gov/docs/publications/

LGE/88/HF2589.pdf

HF 2269 required DHS to eliminate the monthly budget maximum (cap) for individuals eligible for Medicaid

Home and Community-based Services Elderly Waiver. See: https://www.legis.iowa.gov/docs/publications/

LGE/88/HF2269.pdf

Certified Nurse Midwife member and long-time public policy member, Lynne Himmelreich worked with the

Certified Professional Midwifery group encouraging adoption of strong educational standards in House

Study Bill (“HSB”) 522. That bill did not adopt the recommended standards and the legislation failed.

INA successfully worked to defeat SF 2302 and SF 2174, two bills which foreseeably would have adversely

impacted childhood immunization standards.

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 (including a virtual visit in July) to the Iowa Board of Nursing to participate in various Board meetings

and to provide input on behalf of the Iowa Nurses Association.

The most significant rules appear to be a total deletion of old Chapter 6, with the introduction of a New

Chapter 6. Chapter 6 deals with nursing practice for Registered Nurses and Licensed Practical Nurses.

While the proposed rules were approved to be noticed and published in the Iowa Administrative Bulletin

during the July 15, 2020 Board Meeting, they have not been published in the IAB as of the writing of this

report.

Judicial Precedent. On February 14, 2020, the Iowa Supreme Court issued a decision impacting the ability

of licensing Boards to deprive a licensee of due process. (See Mark B. Irland v. Iowa Board of Medicine,

No.18-0353 (Iowa) 2020. While the case involved a physician and the Iowa Board of Medicine, its ruling

applies to the Iowa Board of Nursing as well. Factually, Dr. Irland was investigated when a complaint

“raised serious concerns” about his treatment of a twenty-nine year old male who died after Dr. Irland

“failed to recognize the seriousness of the patient’s condition, and ignored the concerns of other health

care professionals” also caring for the patient, and failed to transfer him for over 6 hours despite the

patient’s serious condition. (Decision (hereinafter, “Dec.”) at pg. 3). His clinical privileges were revoked by

the hospital and the Board’s investigation concluded with a confidential letter of warning which “echoed

32 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


the hospital’s concerns.” Dec. pg. 4. A confidential letter of warning is not considered discipline under

Iowa law, nor is it a public record. Dr. Irland ceased practicing medicine, thus the Board chose not to

initiate further action in his case. However, the letter required Dr. Irland to notify the Board in writing at

least sixty (60) days prior to returning to the practice of medicine. The letter stated in pertinent part,

If you choose to return to the practice of medicine, the Board will take appropriate action, including

but not limited to, issuing an order requiring you to complete a comprehensive clinical competency

evaluation, to ensure that you are able to practice medicine with reasonable skill and safety.

Id. (Emphasis in original).

Because the Board closed the case without a finding of probable cause, so no contested case proceeding

was opened, or before Dr. Irland had a chance to consent to an informal settlement, Dr. Irland filed a

petition for judicial review claiming the letter was an illegal agency action under Iowa Code 17A.19. Both

the District Court and the Court of Appeals determined that the letter was a “warning” but not a “final

agency action” entitled to relief by the courts. Dec. at pg. 5. However, the Court of Appeal recognized the

letter effectively prevented him from practicing medicine again without meeting the Board’s conditions.

Both courts found he had not been adversely affected by the letter and any future discipline is not ripe for

review by the courts.

The Iowa Supreme Court disagreed, finding the letter currently restricted his ability to return to practicing his

profession. The Board failed to follow its own rules for processing complaints and conducting investigations,

though it is required to follow them. The Court found that the Board’s condition for resuming practice was

discipline taken without formal action or a finding of probable cause. Thus, the letter issued by the Board

“allowed discipline to be imposed without the procedural safeguards of a contested case proceeding and

without the reporting obligations that safeguard the public by disclosing disciplinary actions.” Dec. pg.

10. “Cloaking discipline within confidential warning letters undermines the public’s right to know when a

physician’s competence has been called into question by a licensing board.” Dec. pg. 14. The Court noted

without the record of discipline, Dr. Irland could move to another state and practice medicine.

Furthermore, while the Board has the authority to impose the sanction of a clinical competency evaluation,

“it may do so over the physician’s objection only after a contested case proceeding. Dec. pg. 12. The Court

determined this was “final agency action” subject to judicial review because the Board had “concluded”

its investigation of the case, and he had no avenue to seek relief from the Board. The Court required the

Board to remove the offending language in the confidential letter of warning, and specifically noted that

the Court’s decision did not prevent the Board from re-opening its investigation and following proper

procedures to determine if discipline is warranted. Dec. at pg. 16.

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

33


LEGISLATIVE SESSION

Jim Obradovich, President

The Capitol Group

2020 Iowa Legislative Session Comes to An End

The nearly three month long “pandemic pause” will certainly be what is remembered most about the

2020 Session of the Iowa Legislature.

Monday, March 16 was the day lawmakers hit the “pause button” on activity at the Statehouse. They

returned on Wednesday, June 3 and initiated a schedule that compressed the missed time into 11 days of

work.

With state revenues down due to the forced closure of most businesses, budget decisions were even more

difficult. Most proposed changes to tax policy were also not acted upon.

Thanks to the dedication of both the leaders and members of the Association, the INA continues to be the

leading healthcare organization at the Iowa Statehouse.

Telehealth for Schools Approved by Lawmakers

A major move forward for providing mental health services in schools is on its way to the desk of the

Governor.

Senate File 2261 allows behavioural health services to be offered in schools, either in person or by

telehealth. Further, the bill prohibits private insurance providers from denying coverage of school delivered

behavioural health services.

More Bills of Interest That Await the Governor’s Signature

• HF 2627 - Included in this omnibus bill dealing with licenses, are provisions to extend the deadline for

continuing education requirements (for current licensees that are set to expire in 2020) until June 20,

2021.

• HF 2627 - Also allows continuing education to be fulfilled electronically through June 30, 2021.

• HF 2589 - Included in this omnibus bill is a provision that makes ARNPs and APRNs approved healthcare

providers to recommend a patient receive a medical cannabis card. The INA has worked for the last

three years to get this provision passed into law.

• HF 2561 - This INA backed bill seeks to make illegal an incident that took place in Iowa, where a donor

put a stop to the donation because they did not want the organ to be given to a person with Downs

Syndrome.

• HF 2221 - This INA backed bill reverses a long-standing policy that one member of a county board

of public health must be a doctor. This bill provides that instead of requiring one of five members

34 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


of a county board of health to be a physician, one of five members be either a physician, physician

assistant, advanced registered nurse practitioner or advanced practice registered nurse.

• SF 2268 - The INA pushed bill. increases the minimum age to purchase tobacco, tobacco products,

alternative nicotine products, vapor products and cigarettes from 18 to 21. It conforms Iowa’s laws to

federal rules, so local police can enforce the age restrictions.

Healthcare Loan Repayment Program Keeps Funding Increase

Included in the Omnibus Appropriations bill, House File 2643, is $250,000 for the Healthcare Loan

Repayment Program. After receiving $200,000 annually for many years, this is the second year in a row

that the program has seen an increase of $50,000.

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.

Bills of Interest:

This is the final disposition of bills of concern/interest.

(SF = Senate File, SSB = Senate Study Bill, HF = House File, HSB = House Study Bill)

Awaiting action by the Governor:

SF 2360 (formerly SF 2190 and SSB 3080) - Disruptive Students (M) - The bill does all of the following:

a) Provides for the development and distribution of guidelines for schools to use in response to student

behavior that presents an imminent threat of bodily injury to a student or faculty; b) Establishes a

Therapeutic Classroom Incentive grant program and appropriates money for student transportation to

therapeutic classrooms; and c) and protects school employees from charges of “corporal punishment” if

they are attacked or defending themselves.

Passed the Senate 50-0. Amended and approved by the House 95-3. Approved by the Senate 48-1.

SF 2268 (formerly SSB 3016) - Smoking Age Increase (F) - The bill increases the minimum age to purchase

tobacco, tobacco products, alternative nicotine products, vapor products and cigarettes from 18 to 21.

The bill also conforms Iowa’s laws to federal rules, so local police can enforce the age restrictions.

Approved by the Senate 43-6. Approved by the House 84-13

SF 2261 (formerly SF 2100) - School Mental Health via Telehealth (F) - The bill would allow behavioral

health services to be offered to students via telehealth at schools.

Approved by the Senate 49-0. Amended and Approved by the House 92-4. Passed by the Senate 50-0.

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35


HF 2627 - Licensing Omnibus Bill (M) - The final version of the bill will now have little to no effect of nurses.

The bill does not affect the nursing compacts that the state is party to. If signed into law, the family and

spouse of active duty service members stationed in Iowa will have an expedited licensure process. Also,

the bill would allow people with criminal records to petition a licensing board for a determination if they

would be eligible for licensure in that occupation.

The bill made changes to continuing education rules for the upcoming year.

Approved by the House 62-35. Approved by the Senate 32-17

HF 2589 - Medical Cannabis Update (F) - Included in this omnibus bill is a provision that makes ARNPs and

APRNs approved to recommend a patient receive a medical cannabis card.

Approved by the House 52-48. Approved by the Senate 32-17.

HF 2561 - Anatomical Gift Discrimination (F) - This bill seeks to make illegal an incident that took place

in Iowa, where a donor put a stop to the donation because they did not want the organ to be given to a

person with Downs Syndrome.

Passed the House 99-0. Passed the Senate 48-0.

HF 2221 (formerly HF 2031) - County Board of Heath Membership (F) - The bill provides that instead of

requiring one of five members of a county board of health be a physician, one of five members be either

a physician, physician assistant, advanced registered nurse practitioner or advanced practice registered

nurse.

Approved by the House 96-0. Approved by the Senate 49-0.

HF 684 - Alcohol Overdose Immunity (F) - The bill provides immunity from prosecution for any person who

reports an alcohol overdose emergency, especially those who are under the legal drinking age.).

Passed the House 95-3. Amended and approved by the Senate 47-2. Approved by the House 96-1.

Not approved by both chambers of the Legislature:

SF 2329 (formerly SF 2066) - Adding Physical Therapists as School Athletic Healthcare Providers (M) - This

bill seeks to change the current law that identifies the licensed healthcare providers qualified to exercise

concussion and brain injury at interscholastic athletic events. Current law identifies physicians, physician

assistants, advanced registered nurse practitioners, nurses, and physical therapists.

Passed the Senate 49-0. On House debate calendar

SF 2319 (formerly SF 2128) - Medicaid Coverage for Breast Pumps (F) - The bill required Medicaid to cover

breast pumps and associated supplies.

On Senate debate calendar

SF 2317 (formerly SF 2230) - State Plan to Promote Breastfeeding (F) - The bill requires the Iowa Department

of Public Health to convene a stakeholder’s group to develop an actionable breastfeeding action plan.

On Senate debate calendar

SF 2303 (formerly SF 443) - Occupational Therapist Access to MH Records (A) - The bill would classify

occupational therapists as mental health professionals to allow for the disclosure of mental health records.

On Senate debate calendar

36 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


SF 2302 (formerly SF 2172) - Infant Death Form Immunization Reporting (A) - This unique bill requires

the certificate of death for an infant to include a request for information regarding the infant’s last

immunizations.

On Senate debate calendar

SF 2173 - Foster Home Immunizations Discrimination (A) - The bill would prohibit the Department of

Human Services from denying licensure to a foster home on the basis of the immunization status of the

foster parents or their children.

In Senate Human Resources

SF 2153 (formerly SSB 3067) - School Health Screenings (A) - The bill prohibits a school from administering

any student health screenings that are not required by state of federal laws without the written consent

of the student’s parent or guardian. The bill defines screenings to mean intentionally planned, periodic

processes to identify if a student may be at risk for a health concern. The bill also states that the prohibition

does not include health screenings in emergent care situations.

Approved by the Senate 49-0. Approved by subcommittee

SF 2120 (formerly SSB 3051) - Allowing Vets to Use the PMP (M) - The bill allows veterinarians to access

information on the state’s prescription monitoring program (PMP.)

Approved by the Senate 48-0. Passed the House 98-0. Signed into law.

SF 2081 (formerly SSB 3020) - Student ID’s Suicide Prevention Number (F) - The bill requires schools to

include the national suicide prevention hotline telephone number on student ID cards.

On Senate debate calendar

SF 2174 - School Vaccination Programs (A) - The bill provides that schools shall not permit the administration

of vaccines to students through a school sponsored vaccination effort unless the school receives prior

written permission from a student’s parent or guardian.

Approved by subcommittee

SF 2067 - Excused Absences for Mental Health Treatment (F) - The bill requires schools to adopt policies

permitting a student to take excused absences from school for mental health treatment.

Subcommittee: Sinclair, Behn and Celsi

SF 2056 - Required School Seizure Plans (M) - This bill requires school districts and accredited nonpublic

schools that have a student enrolled who has known an epilepsy diagnosis or seizure disorder or has a

seizure rescue medication to have an individual health plan, including a seizure action plan. The bill also

requires schools to provide employees seizure related training.

Subcommittee: Cournoyer, Wahls and Edler

SF 2027 - Student ID’s Suicide Prevention Number (F) - The bill requires schools to include the national

suicide prevention hotline telephone number on student ID cards.

Subcommittee; Cournoyer, Edler and Wahls

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37


SF 2017 - CCO CDAC Database (M) - the bill directs the state Medicaid Office to create and maintain a

searchable database of community choice option (CCO) and consumer-directed attendant care (CDAC)

providers for the use of Medicaid members.

Referred to Human Resources

SF 535 - Fireworks (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 regulations 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.

Subcommittee: Chapman, Mathis, and R. Smith

SF 501 - Medical Cannabidiol (F) - Included in the bill is a provision to recognize advanced registered nurse

practitioners and physician assistants as those who can certify a patient to receive a medical cannabis card.

Subcommittee: Zaun, Sinclair and R. Taylor

SF 376 - Mental Health Education Requirements (F) - The bill adds mental health awareness, coping skills

and suicide prevention to the subject matter that must be included in a unit of health education.

Subcommittee: Sinclair, Behn and J. Smith

SF 342 - Immunity for Reporting Alcohol Injuries (F) - The bill provides immunity from certain alcohol related

criminal offenses and prohibits certain disciplinary actions for persons who seek or require emergency

assistance for alcohol overdoses.

Subcommittee: Zaun, Nunn and R. Taylor

SSB 3052 - Smoke Free Air Act Expansion (F) - The bill adds vaping to the definition of smoking in the Act.

Approved by subcommittee

HF 2590 (formerly HF 2036) - EMS Personnel to Carry Weapons (M) - The bill would allow emergency

medical care providers to carry a weapon provided that the emergency medical care provider accompanies

police tactical teams into potentially high casualty situations.

On House debate calendar

HF 2521 (formerly HF 2120) - School Suicide Prevention Program Reporting (F) - The bill would require

school districts to report to the Department of Education what types of suicide prevention training they

are providing employees

On House debate calendar

HF 2507 (formerly HSB 533) - Pharmacists Omnibus including Collaborative Practice (M) - Induced in the

bill is the authorization of collaborative pharmacy practice between pharmacists and physicians, advanced

registered nurse practitioners, advanced practice registered nurses and dentists.

On House debate calendar

38 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


HF 2500 (formerly HF 2215) - Medicaid Coverage for Breast Pumps (F) - The bill required Medicaid to cover

breast pumps and associated supplies.

In House Appropriations

HF 2457 (formerly HF 2169) - Bleeding Control Education (M) - The bill adds bleeding control as a required

topic of instruction in health education

On House debate calendar

HF 2192 (formerly HF 2001) - Telehealth Payments (F) - The bill requires a health carrier to reimburse a

healthcare professional for services at the same rate no matter if the service is provided in person or via

telehealth. The bill would take effect beginning January 1, 2021.

Approved by the House 99-0. Senate subcommittee: Edlar, Mathis and Segebart

HF 2141 - Immunization Required Information (A) - The bill would require that each person who receives

a vaccine would also be provided a copy of the Federal Registry’s sections on immunizations.

Not approved by subcommittee

HF 2139 - School Immunization Exemptions (A) - The bill would mandate that any communication from a

school or school district regarding vaccinations must also include information on religion exemptions from

the required vaccinations.

Approved by subcommittee.

HF 2094 - Psych Interjurisdictional Compact (M) - The bill creates an interstate compact to allow psychologists

to practice telepsychology with patients in Iowa; practice face to face psychology for a temporary basis;

and allow Iowa psychologists to practice telepsychology with patients located outside of the state.

Subcommittee: Bergan, Bacon and James

HF 2090 - Seizure Disorder School Protocols (M) - The bill requires schools that have a student with a

known epilepsy diagnosis (or seizure disorder or has seizure rescue medication or medication to prevent

seizures) to have an individual health plan including a seizure action plan.

Approved by subcommittee

HF 2085 - Newborn Screening for Tongue Tie (M) - the bill requires screening for all newborns tongue tie

and lip tie prior to discharge from the hospital or birthing center.

Approved by subcommittee

HF 298 - Nurse Staffing Agency Restrictions (A) - The bill seeks to regulate nurse staffing agencies and the

nurses who choose to use a staffing agency. Specifically, the bill would prohibit a staffing agency to require

the payment of liquidated damages, employment fees or other compensation if the temporary employee

is subsequently hired as a full-time employee of the health facility.

Subcommittee: Meyer, Ehlert and Fry

HSB 627 - Smoke Free Air Act Expansion (F) - The bill adds vaping to the definition of smoking in the Act.

Subcommittee: Bacon, T Moore, and James

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39


HSB 522 - Midwife Licensure (A) - The bill requires a person practicing midwifery in Iowa to obtain a license

no later than July 1, 2021.

The bill establishes minimum requirements for a license as a midwife and creates a midwifery board. The

bill fails to prohibit midwives from conducting breech births, multiples, and vaginal births after a C-section,

which is of great concern.

Subcommittee: T. Moore, Bloomingdale and Konfrst

HSB 510 - Surgical Smoke Protection (F) - The bill requires all hospitals and freestanding ambulatory

surgery centers to adopt policies no later than July 1, 2021 to ensure the elimination of surgical smoke

through the use of smoke evacuation systems.

Approved by subcommittee

40 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


INF ANNUAL REPORT 2020

INF Members: Lorinda Inman, Chair, Kim Bergen-Jackson, Secretary (resigned),

Pamela Deichmann, Treasurer, Christine Kessel, Christina Peterson (resigned), Linda

Opheim, and Diane Anderson (appointed).

The Iowa Nurses Foundation held four meetings commencing October 2019, and

subcommittee meting for investment review, marketing and scholarship review.

Goals for the year continued as the previous year. The goals were to promote

attendance at the annual convention, explore fundraising at the annual convention,

explore fundraising ideas and develop goals and strategies for the marketing and the

fundraising functions of the Foundation. Annual Convention 2020 will not be held. 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 INA Board discontinued the IBON Continuing Education Provider, approved by the Iowa Board of

Nursing.

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

organizations in the 16th annual 100 Great Nurses Celebration. The Celebration provides opportunity for

recognition of Iowa Great Nurses. A Lifetime Achievement Award Winner was recognized this year. Due

to the Covid 19 pandemic, an in-person celebration was not possible. The program was unable to offer

scholarships in 2020. Fundraising efforts continue with a plan to offer scholarships in 2021. Nominations

for 2021 may be submitted through the 100 Great Nurses website. GreatNurses.org.

INF continues to explore new ways to fund scholarships.

Current activities include memorials, donations and interest-bearing investment 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.

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41


ANA’S MEMBERSHIP ASSEMBLY

ANA’s Membership Assembly was held virtually this year on Friday, June 19th. INA’s representatives

were Lisa Caffery, President, Christina Peterson, President Elect, Andrea Hughes, Membership Assembly

Representative, and Tobi Lyon, Executive Director.

Tobi Lyon, Iowa Nurses Association Executive Director, presented during the Membership Assembly on the

Future Impact of COVID-19 Pandemic. Tobi touched on the main points of the impact on the future of

nursing including changes to nursing education programs and the need for innovation in teaching nursing

outside of the traditional classroom setting, increased focus on community health and primary care, more

focus on disaster preparedness, and the correct use of and access to PPE for nurses in all areas of practice.

She also spoke on the impact of COVID-19 on the future of our organization, which included rethinking

how to interact with members and allowing for meaningful engagement and what long term affects the

pandemic will have on our nurses and how we can support them as well how we are establishing ourselves

as a voice of expertise in these times.

During the Membership Assembly, Ernest J. Grant, PhD, RN, FAAN, condemned the brutal death of

George Floyd and the many other Black, Indigenous, and People of Color who have been unjustly killed by

individuals within law enforcement. Such cruelty and abject racism must not go unchallenged. Racism is a

public health crisis that impacts the mental, spiritual, and physical health of all people. The Code of Ethics

for Nurses with Interpretive Statements obligates nurses to be allies and to advocate and speak up against

racism, discrimination, and injustice. Consistent with this obligation, ANA has taken positions against

racism, discrimination, and health care disparities and advocating for human rights.

ANA, along with nurses everywhere, are again called to action. Collectively, we must emerge from silence

and speak with one strong voice as leaders and role models of compassion and empathy for our patients,

families, communities and most importantly, towards one another. Our voice is our commitment to making

a difference in all that we do for those we serve.

ANA, along with the Constituent/State Nurses Associations and the ANA Individual Member Division,

pledges to:

• Oppose and address all forms of racism and discrimination.

• Condemn brutality by law enforcement and all acts of violence.

• Champion the Code of Ethics for Nurses which calls on us to recognize human dignity regardless of

race, culture, creed, sexual orientation, ethnicity, gender, age, experience, or any aspect of identity.

• In partnership with nurses everywhere educate, advocate, and collaborate to end systemic racism,

particularly within nursing.

• Advance institutional and legislative policies that promote diversity, equity, inclusion, and social

justice for all.

• Advocate for the ending of health inequities within communities and health care systems that stem

from systemic racism.

• Promote deliberate and respectful dialogue, effective listening, and commitment to change as a

means to improve the health of all individuals and the communities where they live and work.

42 2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE


Ernest J. Grant, PhD, RN, FAAN, has been re-elected to a second term as the American Nurses Association’s

(ANA) national President. The voting representatives of ANA’s Membership Assembly also elected four

members to the 9-member board of directors. Terms of service will begin January 1, 2021.

“It is with great pride, duty and purpose that I serve nurses, represent nurses, and advocate on behalf of

nurses nationwide,” said Dr. Grant. “Throughout history, nurses have responded to every public health

crisis, marched for civil rights and provided patients and communities optimal care. As our nation grapples

with the COVID-19 pandemic, racism and health inequities, nurses are once again demonstrating the

resolve, compassion and undisputed skill that defines our distinguished profession. Undoubtedly, the

“Year of the Nurse” looks much different than we had expected. We have experienced tremendous loss,

but we are resilient, and we will emerge even stronger. I am forever proud to be a nurse and to serve our

profession in the company of other great leaders.”

These ANA members were elected to serve on the board of directors: Director-At-Large Brienne Sandow,

MSN, RN, NEA-BC, of the Idaho Nurses Association; Director-At-Large, Staff Nurse Amanda Buechel, BSN,

RN, CCRN, of ANA-Illinois.

The following ANA board members were re-elected: Secretary Stephanie Pierce, PhD, MN, RN, CNE, of the

Louisiana State Nurses Association; Director-At-Large Jennifer Gil, BSN, RN, of the New Jersey State Nurses

Association.

Those continuing their terms on the ANA board in 2021 are: Vice President Susan Y. Swart, EdD, MS, RN,

CAE of ANA-Illinois; Treasurer Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN of the Oregon

Nurses Association; Director-at-Large Jeff Watson, DNP, RN, NEA-BC, of the Texas Nurses Association;

Director-at-Large, Recent Graduate Marcus Henderson, MSN, BSN, RN of the of the Pennsylvania State

Nurses Association.

Elected to serve on the Nominations and Elections Committee are: Amanda Foster, BSN, RN, of the Arizona

Nurses Association; Tonisha Melvin, DNP, CRRN, NP-C, of the Georgia Nurses Association; Marylee Pakieser,

MSN, RN, FNP-BC, of ANA-Michigan.

Dues Policy Escalator

The motion on the dues policy escalator passed with the following results:

FOR: 354.20 votes (158 voters)

AGAINST: 24.70 votes (13 voters)

2020 ANNUAL BOOK OF REPORTS | YEAR OF THE NURSE

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2020 Proposed Bylaw Amendments

On behalf of the INA Bylaws Committee, we are submitting to the membership two (2) proposed bylaw

amendments. These amendments update the INA membership categories.

Membership will vote on this proposed amendment at the upcoming virtual INA Annual Membership

Meeting which will be held on Tuesday, October 13, 2020 at 5:00 pm by Zoom.

Proposed amendments to the bylaws are presented in the order of suggested consideration:

• Amendment #1 - The proposed changes reflect a simpler categorization of membership to promote

membership of both INA and ANA.

• Amendment #2 - In order to reflect the changes in membership classification set forth in AMENDMENT

#1, each reference in these Bylaws to “INA Only member” shall be replaced with “INA/ANA Premier

member,” and each reference to “INA/ANA member” shall be replaced with “INA/ANA Standard

member.”

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