Proposed Legislation

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Bills for Promotion by VNRC
2017-2018 General Assembly
01/26/2017

  1. BILL FOR MEDICAL MARIJUANA FOR PTSD, TBI, MST. VNRC accepts that many veterans self-medicate for the symptoms of PTSD/TBI/MST – especially for insomnia and anxiety. We need to give them prescription access for the treatment that works for them. STATUS: Main legislative advocate is leaning toward a merger with epilepsy bill.
  2. 24 HOUR HOLD FOR VETS THREATENING SUICIDE. Bill to require a 24 hour observed hold by ANY veteran requesting admission at a hospital or psychiatric facility due to suicidal tendencies. Does not require new facility construction. Only the physical presence of a nurse for 24 hours.
  3. ELEVATE VISIBILITY OF PTSD. Resolution to memorialize PTSD sufferers by providing for sculpture of Harold Hughes to be placed on the Capitol Grounds emphasizing his victory over PTSD as he rose to be Governor of Iowa and Senator from Iowa. Funds would come from donations but authorization is required by the legislature.

Suggested Plaque: “WWII Combat veteran Harold Hughes fought Post Traumatic Stress Disorder, and its companion maladies of alcoholism, depression and suicidal tendencies. He defeated his condition and rose to become Governor of Iowa and United States Senator from Iowa. He lights the hope of PTSD sufferers everywhere as a meteor lights up the skies of Iowa.”

  1. FUND LONG TERM RESIDENTIAL PSYCHIATRIC CARE FOR VETS. Fund long-term residence facilities (domiciliary) for veterans with significant PTSD/MST/TBI/Mental Health at Iowa Veterans Home for veterans of all ages, especially those age 65 and below that require health related supervision.
  2. MENTAL HEALTH PARITY FOR PTSD/TBI/MST/Mental Health in the Guard and Reserve. Krause Professional counseling services will be provided to veterans and Guard and Reserve service members with suicidal tendencies. Guard and Reserve veterans with service in Iraq and Afghanistan have a very high number of suicides, even relative to the active forces. Unfortunately, they are not provided counseling services outside of drill and battle assemblies. This is a huge gap in the effort to prevent suicides. It needs to be fixed. (2016 priority. Some work may have been done on state rules at the request of VNRC.)
  3. MST/MSA secondary jurisdiction. Allow Iowa civilian courts to hear cases regarding military rape and military sexual assault (MSA) even though the incident may have occurred while the Reservist or Guardsman was covered by federal law. There is a need for this bill, especially in the Reserve forces, because of scarce legal resources within the military. Sexual assault incidents are reported with no follow through. Iowa needs to take care of its own, and punish those that act in this reprehensible manner. (2016 Priority).

 

GETTING READY FOR THE 2017 IOWA GENERAL ASSEMBLYlobbyingwithbobandtiffany2015

The VNRC legislative program for 2017 will be posted shortly after the November election. If you have comments on what you would like the VNRC to promote, please give us a comment below.


IOWA VETERANS HOME
PROPOSED LEGISLATION
STATE OF IOWA
2015

A BILL FOR AN ACT RELATING TO
SERVICES AT THE IOWA VETERANS HOME

Be in enacted by the General Assembly of the State Of Iowa:
SECTION 1. Amend Paragraph 1 of Section 35D2 as follows:

35D.1 Purpose of home — definitions.

  • Iowa veterans home, located in Marshalltown, shall be maintained as a long-term health care facility providing nursing, psychiatric (to include but not limited to post traumatic stress disorder and traumatic brain injury), physical rehabilitation and residential levels of care for honorably discharged veterans(except as provided for in  Section 35D.2, numbered paragraph 7) and their dependent spouses, surviving spouses of honorably discharged veterans, and gold star parents. The Iowa veterans home shall also provide, directly or through contract, rehabilitative training for jobs,  based on perceived need. Except as provided elsewhere, eligibility Eligibility requirements for admission to the Iowa veterans home shall coincide with the eligibility requirements for care and treatment in a United States department of veterans affairs facility pursuant to 38 U.S.C.§ 1710, and regulations promulgated under that section, as amendedAs used in this chapter:
  1. Commandant” means the commandant of the Iowa veterans home pursuant to Section 35D.13.
  2. Commission” means the commission of veterans affairs established in 35A.2.
  3. Member means a patient or resident of the home.
  4. “Gold star parent’ means a parent of a deceased member of the United States  armed forces who died while serving on active duty during a time of military  conflict or who died as a result of such service.
  5. “Admissions panel” means a body composed of health care professionals  selected by the commandant. Such panel shall make determinations on all  admissions, denials, releases and transfers of applicants or members at the Iowa veterans home, based upon the requirements of this chapter and the needs of the veteran or spouse. Such determinations shall be final, subject to administrative review pursuant to Chapter 17A of the Code of Iowa.
  6. “Applicant” means a person applying to the admissions panel for membership at the Iowa Veterans Home.
  7. Net appropriation pool” means an appropriated amount of funds used to  maintain a cash reserve and cash float, predicated upon reimbursements to the  Iowa veterans home from several sources.

SECTION 2  Amend 35D2 as follows:

35D.2 Right to admission.

  1. Persons described in section 35D.1 who are incapacitated by disease, physical or mental injury or declining health regardless of age, and meet the qualifications for nursing, psychiatric (including but not limited to military sexual  trauma, post traumatic stress disorder, and traumatic brain injury) or residential care, and are unable to earn a livelihood, and who are residents of the state of Iowa on the date of application and immediately preceding the date the application is accepted, may be admitted to the home as members under rules adopted by the commission. The commission shall adopt rules to emphasize the admission of and special care and rehabilitation that may be required of homeless honorably discharged veterans and disabled veterans wishing to learn to live independently.  Eligibility determinations are subject to approval by the admissions panel.
  2. There shall be no discrimination in any admittance policy for membership in the Iowa  veterans based upon age, race, marital status or sex.
  3. The Admissions panel may waive up to 40 percentage points of disability in  determining eligibility where the determination of percent disability is under appeal  the US Department of Veterans Affairs with the prospective member, and the difference in the appeal level would make the prospective member eligible without  waiver.
  4. A prospective member with a discharge other than honorable may request the admissions panel waive the requirement for an honorable discharge. The  prospective member must present proof that the less than honorable discharge was the direct or indirect result of retaliation for an act of sexual harassment or sexual  assault against the prospective member, or was because the prospective member had undiagnosed Military Sexual Trauma, Post Traumatic Stress Disorder or Traumatic Brain Injury at the time of the discharge. A discharge based on  personality disorder where there is not pre-service record of personality disorder, or other evidence may be considered as proof.
  5. In the event that there is a space limitation at the Iowa veterans home, for the  purposes of establishing eligibility and admittance quotas by gender, male and  female service members shall be treated equally. For the purpose of this numbered  paragraph, a spouse of a service member shall not be classified as either male or female in establishing the quota. However, married couples will be considered as a  category for admission purposes. This shall not be construed as denying admittance  to any spouse requiring membership as authorized by rule or statute, other than as  space constraints require. The commandant of the Iowa veterans home shall  annually transmit to the Iowa General Assembly a list of qualified applicants for membership that have been denied admittance, broken out by age, sex, race, marital status, military disability, and other breakouts considered appropriate.
  6. A person who has been diagnosed by a qualified mental health professional as mentally ill,  considered dangerous to self or others, is an acute inebriate, or is addicted to drugs, or whose documented behavior is continuously disruptive to the operation of the facility shall be eligible for appropriate services in a facility at the home designed and  operated for psychiatric and rehabilitative purposes, and will include provisions for a  determined number of secured confinement beds. The home may enter into  intergovernmental agreements with psychiatric facilities and organizations for equivalent support and treatment of such individuals where a sufficient level of professional services are unavailable at the home. Admittance for psychiatric care or rehabilitative care, or an intergovernmental agreement for professional treatment  elsewhere shall take precedence over Section 35D.15 when such action or clinical  evidence is appropriate to member or applicant actions that precipitate the review.

SECTION 3. Amend 35d.18 as follows:

35D.18 Net general fund appropriation — purpose.

  1. Appropriation for Cash Reserve Float. The Iowa Veterans Home shall operate on the basis of a net appropriation pool from the general fund of the state. The appropriation amount shall be the net amount of state monies projected to be needed for the Iowa veterans home for the fiscal year of the appropriation. The purpose of utilizing net appropriations is to encourage the Iowa veterans home to operate with increased self-sufficiency, to improve quality and efficiency, and to support collaborative efforts among all providers of funding for the services available from the Iowa veterans home.
  2. Appropriations for programs and services and facilities. However, because some requirements  of members are unique to veterans and may not be funded through non-veteran programs,  funding for certain programs not covered by reimbursement shall not be included within the net appropriation pool as described in paragraph 1. At a minimum, these programs, operations,  services and purposes shall include on-site and off-site recreation, on-site orthopedic and  mobility device repair, library and computer lab services, certain on-site and off-site psychiatric (including but not limited to military sexual trauma, post-traumatic stress disorder and  traumatic brain inky) and medical services not covered by reimbursement, educational classes  including staff training, job training and lob placement, therapy classes and activities such as  woodworking, arts and crafts, and medical equipment not covered by reimbursement. These shall be treated as regular appropriated expenditures in addition to any reimbursements  received from other programs.
  3. The net appropriation made to the Iowa veterans home may be used throughout the year in the manner necessary for cash flow management. The Iowa veterans home may temporarily draw more than the amount appropriated, provided the amount appropriated is not exceeded at the end of the fiscal year.
  4. Revenues received that are attributed to the Iowa veterans home during a fiscal year shall be credited to the Iowa veterans home account and shall be considered repayment receipts as defined in section 8.2, including but not limited to all of the following:
  1. United States department of veterans affairs payments.
  2. Medical assistance program revenue received under chapter 249A.
  3. Federal Medicare program payments.
  4. Other revenues generated from current, new or expanded services that the Iowa Veterans Home is authorized to provide, including out-patient and out-member services which may be in any category where in-patient or in-member services are authorized.
  1. 5. For the purposes of allocating moneys to the Iowa veterans home from a salary adjusted fund created by section 8.43, the Iowa veterans home shall be considered to be funded entirely with state moneys.
  2. 6. Notwithstanding section 8.33, any balance in the Iowa veterans home annual appropriation or revenues that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for programs, operations, services or other purposes up to a cap of $13 million dollars.

EXPLANATION

SECTION 1 redefines the purpose of the Iowa Veterans Home so that it can be a full service facility that meets the needs of the newer veteran, as well as the older veteran. Over the past several years IVH has shifted from a facility specializing in the service connected needs of veterans, to a specialized nursing home facility. Psychiatric services at IVH have essentially ended in spite of the needs of post-911 veterans.

It also adds a new definition for “Admissions panel.” An admissions panel is created later in the bill. It takes the place of the Commandant of IVH as the arbiter of admission/denial/transfer/release decisions.

The “Gold Star Parent” definition is moved from paragraph one of the section to paragraph two.

Definitions are created for “applicant” and for “Net appropriations pool.” “Net appropriations pool” is a budgeting technique described in current law.

SECTION 2 of the bill revises the admissions requirements for IVH. Several issues are addressed:

  1. Admissions eligibility is broadened under the bill. Psychiatric problems are included as admission eligible, to include conditions relating to military sexual trauma, post-traumatic stress disorder, and traumatic brain injury. Age discrimination is prohibited, so that younger veterans are not discriminated against for membership if their condition requires it.
  2. Persons requiring rehabilitation and independent living training are included in the pool of those eligible for membership.
  3. Discrimination based on age, race, marital status and sex is prohibited.
  4. Additional admissions points are awarded to be used at the discretion of the admissions panel where the US Department of Veterans Affairs has granted at least a 10% disability to a veteran. Because of the wartime backlog, the VA often awarded low level disabilities to veterans to get them off of the backlog and into the VA appeals process. Because this process can take several years, veterans applying to IVH may not technically be eligible for membership, although the Admissions panel may perceive a need.
  5. Persons with less-than honorable discharges may appeal to the Admissions panel for admittance under certain circumstances. Early in the war, many individuals with PTSD, TBI and war-driven personality disorders were given less-than-honorable discharges to get them out of the service. Personality disorder as a pre-enlistment condition is a less than honorable discharge. A less-than-honorable discharge prevents those veterans from receiving such the treatment that they require.
  6. Space issues at the 1VH are dealt with for admission purposes by creating separate quotas for male, female and married couples. Currently the non-veteran spouse of a member is counted against either male or female capacity. Effectively, it has occasionally prevented woman veterans from being admitted because the female quota was completely filled by female spouses.
  7. The expulsion of member/denial of admission provision is re-written. As the statute is currently written, it targets persons with PTSD, TBI and psychiatric disorders for expulsion back into the general population without treatment. Besides not allowing treatment, it drives these people into the homeless population.

SECTION 3  of the bill re-writes the method by which state appropriations to the 1VH are handled. Currently the state appropriation to IVH is treated as a net appropriation pool to smooth out cash-flow from when services are given the veteran until federal reimbursement money is received. This allows the IVH to better capture federal money. However, it also creates an incentive to maximize the net appropriations pool by reducing the appropriation that may have been intended for services that are not reimbursable from other sources. The bill establishes two pools of money. One is the net appropriations pool which is to be used for smoothing cash flow, and the other is for appropriated services.

HF ____ SF _____ HSB_____ SSB _____

1. A bill for an Act relating to
SERVICES AT THE IOWA VETERANS HOME

PURPOSE

The purpose of this bill is to better align the Iowa Veterans Home with its federally designated mission. By federal law, state veterans homes are charged with the responsibility of providing long term care for veterans. While this is often elderly veterans, it also includes veterans that have been disabled physically and mentally by the effects of war. The current law actually allows and encourages PTSD/TBI afflicted veterans to be denied entry, and if they do become members, to be kicked out of the Iowa Veterans Home if they exhibit symptoms.

EXPLANATION

SECTION 1 redefines the purpose of the Iowa Veterans Home so that it can be a full service facility that meets the needs of the newer veteran, as well as the older veteran. Over the past several years IVH has shifted from a facility specializing in the service connected needs of veterans, to a specialized nursing home facility. Psychiatric services at IVH have essentially ended in spite of the needs of post-911 veterans.

It also adds a new definition for “Admissions panel.” An admissions panel is created later in the bill. It takes the place of the Commandant of IVH as the arbiter of admission/denial/transfer/release decisions.

The “Gold Star Parent” definition is moved from paragraph one of the section to paragraph two.

Definitions are created for “applicant” and for “Net appropriations pool.” “Net appropriations pool” is a budgeting technique described in current law.

SECTION 2 of the bill revises the admissions requirements for IVH. Several issues are addressed:

1. Admissions eligibility is broadened under the bill. Psychiatric problems are included as admission eligible, to include conditions relating to military sexual trauma, post-traumatic stress disorder, and traumatic brain injury. Age discrimination is prohibited, so that younger veterans are not discriminated against for membership if their condition requires it.

2. Persons requiring rehabilitation and independent living training are included in the pool of those eligible for membership.

3. Discrimination based on age, race, marital status and sex is prohibited.

4. Additional admissions points are awarded to be used at the discretion of the admissions panel where the US Department of Veterans Affairs has granted at least a 10% disability to a veteran. Because of the wartime backlog, the VA often awarded low level disabilities to veterans to get them off of the backlog and into the VA appeals process. Because this process can take several years, veterans applying to IVH may not technically be eligible for membership, although the Admissions panel may perceive a need.

5. Persons with less-than honorable discharges may appeal to the Admissions panel for admittance under certain circumstances. Early in the war, many individuals with PTSD, TBI and war-driven personality disorders were given less-than-honorable discharges to get them out of the service. Personality disorder as a pre-enlistment condition is a less than honorable discharge. A less-than-honorable discharge prevents those veterans from receiving such the treatment that they require.

6. Space issues at the IVH are dealt with for admission purposes by creating separate quotas for male, female and married couples. Currently the non-veteran spouse of a member is counted against either male or female capacity. Effectively, it has occasionally prevented woman veterans from being admitted because the female quota was completely filled by female spouses.

7. The expulsion of member/denial of admission provision is re-written. As the statute is currently written, it targets persons with PTSD, TBI and psychiatric disorders for expulsion back into the general population without treatment. Besides not allowing treatment, it drives these people into the homeless population.

SECTION 3 of the bill re-writes the method by which state appropriations to the IVH are handled. Currently the state appropriation to IVH is treated as a net appropriation pool to smooth out cash-flow from when services are given the veteran until federal reimbursement money is received. This allows the IVH to better capture federal money. However, it also creates an incentive to maximize the net appropriations pool by reducing the appropriation that may have been intended for services that are not reimbursable from other sources. The bill establishes two pools of money. One is the net appropriations pool which is to be used for smoothing cash flow, and the other is for appropriated services.

HF ____ SF _____ HSB_____ SSB _____

2. A bill for an Act relating to
CONCURRENT JURISDICTION OVER RAPE AND SEXUAL ASSAULT IN THE ARMED FORCES

PURPOSE

The purpose of this bill is to create a voluntary mechanism for federal Reserve forces that are not part of the National Guard, to hand-off military sexual assault cases to civilian prosecutors under a concurrent jurisdiction arrangement. In peacetime, assault and harassment matters in the Reserve are sometimes not dealt with because of distance and because there are insufficient military lawyer assets.

EXPLANATION

This Concurrent jurisdiction bill for Rape and Sexual Assault was brought about because Judge Advocate General (JAG) assets are relatively scarce in the Reserve forces. JAG officers available to a commander begin at brigade and sometimes at battalion level. In the Reserve, this may include units spread all across the United States in some instances. Distances like these make cases expensive and difficult to prosecute. Thus, some violations of the UCMJ can fall through the cracks.   The bill is intended to support reserve forces, and can only be implemented with agreement of the military.

The proposed law is only in effect in Iowa. It includes the verbatim Article 120 UCMJ as a base (with the inclusion of civilian courts). It is designed to cover both Guard and Reserve while on Title 10, Title 32 and/or state duty. There is an opt-out provision for the National Guard to go back under last year’s law in case the Adjutant General doesn’t want it.

The big concept change is that UCMJ Rape and Sexual Assault covers a wider range off offenses than does Iowa law. It can be argued that this is a practical way to deal with service members by agreeing to a uniform definition of the crime. The new coverage is mostly in the area that is sexual harassment in the Code of Iowa. Under Iowa law, sexual harassment is considered only as a grounds for civil action.

The proposed bill is not yet linked with Iowa’s criminal penalty system. That is something that the legislature can determine.

HF ____ SF _____ HSB_____ SSB _____

3. A bill for an Act relating to INSURANCE COVERAGE FOR CERTAIN COUNSELING SERVICES & SUICIDE PREVENTION COUNSELING FOR MILITARY PERSONNEL & VETERANS

Purpose

The purpose of this bill is to insure that Guard and Reserve forces get adequate mental health counseling for military sexual trauma and also for suicide prevention. Because suicidal tendencies are incipient and not an actual condition, drilling Guard and Reserve forces often do not have insurance coverage for suicide counseling. Until very recently Tri-Care refused counseling coverage for MST victims. VA just recently allowed it, but limits counseling to 8 sessions. Physiologically, MST is nearly identical to PTSD, and this is just not enough.

EXPLANATION

This bill ads new categories of required coverage for accident and health insurance policies sold in the state of Iowa. This covers counseling services for rape, sexual assault and suicide prevention.

Counseling services for Suicidal Tendencies, is important because suicidal tendencies may pop up in a service member or veteran either while in active service or not in active service. For instance, if a reservist or Guardsman with undiagnosed PTSD exhibits suicidal tendencies between drills, the service member is not eligible for paid counseling services.

Very recent changes in VA coverage for rape and sexual assault in the military now include VA coverage for counseling services. As recently as December 2014, VA counseling services were not available to rape and sexual assault victims, and Tricare (military insurance) was refusing coverage to people covered. However, counseling services are limited by the new policy to twelve visits, which may be insufficient. However, there are circumstances where VA coverage may not be immediately available, or the victim may be in a situation where his or her personal insurance will be required for coverage. This insures that the service member or veteran is able to afford adequate counseling services.

HF ____ SF _____ HSB_____ SSB _____

4. A bill for an Act relating to PROTECTION OF WHISTLE BLOWERS UNDER THE IOWA CODE OF MILITARY JUSTICE

EXPLANATION

This bill can be considered a corrective bill to changes made in the Iowa Code of Military Justice. Language changes created in SF 2321 created a broad offense for “conduct of a nature to bring discredit upon the state military forces.” There is no caveat to this language that might protect a covered service member whose intent is to reveal wrong-doing.

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