General Assembly: 78 (2000 Regular GA) - Chapter 1192 - Tobacco use prevention and control


Published: 2000

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565 LAWS OF THE SEVENTY-EIGHTH G.A., 2000 SESSION

CHAPTER 1192 TOBACCO USE PREVENTION AND CONTROL

H.F.2565

CH. 1192

AN ACT relating to tobacco use prevention and control and providing an effective date.

Be It Enacted by the General Assembly of the State of Iowa:

Section 1. NEW SECTION. 142Al TOBACCO USE PREVENTION AND CONTROL PARTNERSHIP - PURPOSE AND INTENT.

1. The purpose of this chapter is to establish a comprehensive partnership among the general assembly, the executive branch, communities, and the people of Iowa in addressing the prevalence of tobacco use in the state.

2. It is the intent of the general assembly that the comprehensive tobacco use prevention and control initiative established in this chapter will specifically address reduction of to- bacco use by youth and pregnant women, promotion of compliance by minors and retailers with tobacco sales laws and ordinances, and enhancement of the capacity of youth to make healthy choices. The initiative shall allow extensive involvement of youth in attaining these results.

3. It is also the intent of the general assembly that the comprehensive tobacco use preven- tion and control initiative will foster a social and legal climate in which tobacco use be- comes undesirable and unacceptable, in which role models and those who influence youth promote healthy social norms and demonstrate behavior that counteracts the glamoriza- tion of tobacco use, and in which tobacco becomes less accessible to youth. The intent of the general assembly shall be accomplished by engaging all who are affected by the use of tobacco in the state, including smokers and nonsmokers, youth, and adults.

Sec. 2. NEW SECTION. 142A2 DEFINITIONS. As used in this chapter, unless the context otherwise requires: 1. "Administrator" means the administrator of the division of tobacco use prevention and

control. 2. "Commission" means the commission on tobacco use prevention and control estab-

lished in this chapter. 3. "Community partnership" means a public agency or nonprofit organization imple-

menting the tobacco use prevention and control initiative in a local area in accordance with this chapter.

4. "Department" means the Iowa department of public health. 5. "Director" means the director of public health. 6. "Division" means the division of tobacco use prevention and control of the Iowa depart-

ment of public health, established pursuant to this chapter. 7. "Initiative" means the comprehensive tobacco use prevention and control initiative

established in this chapter. 8. "Manufacturer" means manufacturer as defined in section 453Al. 9. "Pregnant woman" means a female of any age who is pregnant. 10. "Retailer" means retailer as defined in section 453A1. 11. "School-age youth" means a person attending school in kindergarten through grade

twelve. 12. "Tobacco" means both cigarettes and tobacco products as defined in section 453Al. 13. "Youth" means a person who is five through twenty-four years of age.

Sec. 3. NEW SECTION. 142A3 TOBACCO USE PREVENTION AND CONTROL - DNISION - COMMISSION - CREATED.

1. The department shall establish, as a separate and distinct division within the depart- ment, a division of tobacco use prevention and control. The division shall develop, imple-

CH.1192 LAWS OF THE SEVENTY-EIGHTH G.A., 2000 SESSION 566

ment, and administer the initiative established in this chapter and shall perform other duties as directed by this chapter or as assigned by the director of public health.

2. A commission on tobacco use prevention and control is established to develop policy, provide direction for the initiative, and perform all other duties as directed by this chapter or referred to the commission by the director of public health.

3. The commission shall consist of the following voting members who shall serve three-year, staggered terms:

a. Three members who are active with nonprofit health organizations that emphasize tobacco use prevention or who are active as health services providers, at the local level.

b. One member who is a retailer. c. Three members who are active with health promotion activities at the local level in

youth education, law enforcement, nonprofit services, or other activities relating to tobacco use prevention and control.

The members appointed under this subsection shall be appointed by the governor, subject to confirmation by the senate, pursuant to sections 2.32 and 69.19. At least one member appointed under this subsection shall be a member of a racial minority.

4. In addition to the members described in subsection 3, the membership of the commis- sion shall include three voting members who are selected by the participants in the annual statewide youth summit of the initiative's youth program. The youth membership appoint- ments are not subject to section 69.16 or 69.16A. However, the selection process shall provide for diversity among the members and at least one of the youth members shall be a female. These members shall also serve three-year staggered terms.

5. The commission shall also include the following ex officio, nonvoting members: a. Four members of the general assembly, with not more than one member from each

chamber being from the same political party. The majority leader of the senate and the minority leader of the senate shall each appoint one of the senate members. The majority leader of the house and the minority leader of the house of representatives shall each ap- point one of the house members.

b. The presiding officer of the statewide youth executive body, selected by the delegates to the statewide youth summit.

6. In addition to the members of the council, the following agencies, organizations, and persons shall each assign a single liaison to the commission to provide assistance to the commission in the discharge of the commission's duties:

a. The department of education. b. The drug policy coordinator. c. The department of justice, office of the attorney general. d. The department of human services. e. The alcoholic beverages division of the department of commerce. 7. Citizen members shall be reimbursed for actual and necessary expenses incurred in

performance of their duties. Citizen members shall be paid a per diem as specified in section 7E.6. Legislative members are eligible for per diem and expenses as provided in section 2.10.

8. A member of the commission who is convicted of a crime relating to tobacco, alcohol, or controlled substances is subject to removal from the commission.

9. The commission may designate an advisory council. The commission shall determine the membership and representation of the advisory council and members of the council shall serve at the pleasure of the commission. The advisory council may include represen- tatives of health care provider groups, parent groups, antitobacco advocacy programs and organizations, tobacco retailers, research and evaluation experts, and youth organizers.

10. A vacancy on the commission other than for the youth members shall be filled in the same manner as the original appointment for the balance of the unexpired term. A youth member vacancy shall be filled by the presiding officer of the statewide executive body as selected by the delegates to the statewide youth summit. The commission shall elect a chairperson from among its voting members and may select other officers from among its

567 LAWS OF THE SEVENTY-EIGHTH G.A., 2000 SESSION CH.1192

voting members, as determined necessary by the commission. The commission shall meet regularly as determined by the commission, upon the call of the chairperson, or upon the call of a majority of the voting members.

Sec. 4. NEW SECTION. 142A.4 COMMISSION DUTIES. The commission shall do all of the following: 1. Develop and implement the comprehensive tobacco use prevention and control initia-

tive as provided in this chapter. 2. Provide a forum for the discussion, development, and recommendation of public policy

alternatives in the field of tobacco use prevention and control. 3. Develop an educational component of the initiative. Educational efforts provided through

the school system shall be developed in conjunction with the department of education. 4. Develop a plan for implementation of the initiative in accordance with the purpose and

intent specified in section 142A.l. 5. Provide for technical assistance, training, and other support under the initiative. 6. Take actions to develop and implement a statewide system for the initiative programs

that are delivered through community partnerships. 7. Manage and coordinate the provision of funding and other moneys available to the

initiative by combining all or portions of appropriations or other revenues as authorized by law. 8. Assist with the linkage of the initiative with child welfare and juvenile justice

decategorization projects, education programming, community empowerment areas, and other programs and services directed to youth at the state and community level.

9. Coordinate and respond to any requests from a community partnership relating to any of the following:

a. Removal of barriers to community partnership efforts. b. Pooling and redirecting of existing federal, state, or other public or private funds avail-

able for purposes that are consistent with the initiative. c. Seeking of federal waivers to assist community partnership efforts. In coordinating and responding to the requests, the commission shall work with state

agencies, the governor, and the general assembly as necessary to address requests deemed appropriate by the commission.

10. Adopt rules pursuant to chapter 17A as necessary for the designation, governance, and oversight of the initiative and the implementation of this chapter. The commission shall provide for community partnership and youth program input in the rules adoption process. The rules shall include but are not limited to all of the following:

a. Performance indicators for initiative programs, community partnerships, and the ser- vices provided under the auspices of community partnerships. The performance indicators shall be developed with input from communities.

b. Minimum standards to further the provision of equal access to services. 11. Monitor and evaluate the effectiveness of performance measures utilized under the

initiative. 12. Submit a report to the governor and the general assembly on a periodic basis, during

the initial year of operation, and on an annual basis thereafter, regarding the initiative, including demonstrated progress based on performance indicators. The commission shall report more frequently if requested by the joint appropriations subcommittee that makes recommendations concerning the commission's budget. Beginning July 1, 2005, the com- mission shall also perform a comprehensive review of the initiative and shall submit a report of its findings to the governor and the general assembly on or before December 15, 2005.

13. Approve contracts entered into with the alcoholic beverages division of the depart- ment of commerce, to provide for enforcement of tobacco laws and regulations.

14. Advise the director in evaluating potential candidates for the position of administra- tor, consult with the director in the hiring of the administrator, and review and advise the director on the performance of the administrator in the discharge of the administrator's duties.

CH.1192 IA WS OF THE SEVENTY-EIGHTH GA, 2000 SESSION 568

15. Prioritize funding needs and the allocation of moneys appropriated and other re- sources available for the programs and activities of the initiative.

16. Ensure that sufficient resources are available to promote and ensure retailer compli- ance with tobacco laws and ordinances relating to minors and ensure that compliance with 42 U.S.C. § 300X-26 is prioritized when allocating funds under this chapter.

17. Review fiscal needs of the initiative and make recommendations to the director in the development of budget requests.

18. Solicit and accept any gift of money or property, including any grant of money, ser- vices, or property from the federal government, the state, a political subdivision, or a private source that is consistent with the goals of the initiative. The commission shall adopt rules prohibiting the acceptance of gifts from a manufacturer of tobacco products.

19. Advise and make recommendations to the governor, the general assembly, the direc- tor, and the administrator, relative to tobacco use, treatment, intervention, prevention, con- trol, and education programs in the state.

20. Evaluate the work of the division and the department relating to the initiative. For this purpose, the commission shall have access to any relevant department records and docu- ments, and other information reasonably obtainable by the department.

21. Develop the structure for the statewide youth summit to be held annually.

Sec. 5. NEW SECTION. 142A.5 DIRECTOR AND ADMINISTRATOR DUTIES. 1. The director shall do all of the following: a. Establish and maintain the division of tobacco use prevention and control. b. Employ a division administrator who shall be responsible for the administration and

oversight of the division. The division administrator shall report to and shall serve at the pleasure of the director. The administrator shall be exempt from the merit system provisions of chapter 19A.

c. Coordinate all tobacco use prevention and control programs and activities under the purview of the department.

d. Receive and review budget recommendations from the commission. The director shall consider these recommendations in developing the budget request for the department.

e. Enter into contracts with the alcoholic beverages division of the department of com- merce, to provide enforcement of tobacco laws and regulations. Such contracts shall require that enforcement efforts include training of local authorities who issue retailer permits and education of retailers.

2. The administrator shall do all of the following: a. Implement the initiative, coordinate the activities of the commission and the initiative,

and coordinate other tobacco use prevention and control activities as assigned by the director. b. Monitor and evaluate the effectiveness of performance measures. c. Provide staff and administrative support to the commission. d. Administer contracts entered into under this chapter. e. Coordinate and cooperate with other tobacco use prevention and control programs

within and outside of the state. f. Coordinate the efforts of the division with tobacco law enforcement programs funded

through the commission.

Sec. 6. NEW SECTION. 142A.6 COMPREHENSNE TOBACCO USE PREVENTION AND CONTROL INITIATIVE ESTABLISHED - PURPOSE - RESULTS.

1. A comprehensive tobacco use prevention and control initiative is established. The division shall implement the initiative as provided in this chapter.

2. The purpose of the initiative is to attain the following results: a. Reduction of tobacco use by youth. b. Strong, active youth involvement in activities to prevent youth tobacco use and to pro-

mote cessation of youth tobacco use.

569 LAWS OF THE SEVENTY-EIGHTH G.A., 2000 SESSION CH.1192

c. Enhanced capacity of youth to make healthy choices. d. Reduction of tobacco use by pregnant women. e. Increased compliance by minors and retailers with tobacco sales laws and ordinances. 3. Success in achieving the initiative's desired results may be demonstrated by a mini-

mum of the following: a. Data demonstrating consistent progress in reducing the prevalence of tobacco use

among youth and adults. b. Survey results indicating widespread support among youth for the initiative's tobacco

use prevention and control activities; for programs that enhance the ability of youth to make healthy choices including those related to use of tobacco, alcohol, and other substances; and for the media, marketing, and communications efforts supporting the initiative's de- sired results. Any survey conducted may also include an assessment of the effectiveness of tobacco use prevention and control activities in affecting other unhealthy youth behaviors including sexual activity and violent behavior.

c. Data demonstrating increased compliance by minors and retailers with tobacco sales laws and ordinances.

4. The division shall implement the initiative in a manner that ensures that youth are extensively involved in the decision making for the programs implemented under the initia- tive. The initiative shall also involve parents, schools, and community members in activities to achieve the results desired for the initiative. The division shall encourage collaboration at the state and local levels to maximize available resources and to provide flexibility to sup- port community efforts.

5. Procurement of goods and services necessary to implement the initiative is subject to approval of the commission. Notwithstanding chapter 18 or any other provision of law to the contrary, such procurement may be accomplished by the commission under its own competitive bidding process which shall provide for consideration of such factors as price, bidder competence, and expediency in procurement.

6. In order to promote the tobacco use prevention and control partnership established in section 142A.l, the following persons shall comply with the following, as applicable:

a. A manufacturer, distributor, wholesaler, retailer, or distributing agent or agent thereof shall not give away cigarettes or tobacco products.

b. A manufacturer, distributor, wholesaler, retailer, or distributing agent or agent thereof shall not provide free articles, products, commodities, gifts, or concessions in any exchange for the purchase of cigarettes or tobacco products.

c. The prohibitions in this section do not apply to transactions between manufacturers, distributors, wholesalers, or retailers.

d. For the purpose of this subsection, manufacturer, distributor, wholesaler, retailer, and distributing agent mean as defined in section 453A.l.

Sec. 7. NEW SECTION. 142A.7 INITIATIVE COMPONENTS. 1. The initiative shall include but is not limited to all of the following: a. Youth programs, designed to achieve the initiative's desired results, that are directed by

youth participants for youth. b. A media, marketing, and communications program to achieve the initiative's desired

results. Advertising shall not include the name, voice, or likeness of any elected or ap- pointed public official or of any candidate for elective office.

c. Independent evaluation of each component of the statewide initiative. d. Ongoing statewide assessment of data, review of indicators used in assessing the effec-

tiveness of the initiative, and evaluation of the initiative, its programs, and its marketing strategy. The initial baseline used to measure the effectiveness of the initiative shall be developed using existing, available indicators. Following development of the initial baseline, indicators of the effectiveness of the initiative shall be reviewed on at least an annual basis to ensure that the indicators used most accurately provide for measurement of such effective-

CH. 1192 LAWS OF THE SEVENTY-EIGHTH G.A., 2000 SESSION 570

ness. Primary emphasis in data assessment shall be on data relating to tobacco usage and may include data demonstrating the prevalence of tobacco use among youth and pregnant women, and the prevalence of the use of alcohol and other substances among youth. Sources of data considered shall include but are not limited to the centers for disease control and prevention of the United States department of health and human services and the Iowa youth tobacco survey, and may include the Iowa youth risk survey conducted by the depart- ment or the youth risk behavior survey.

e. A tobacco use prevention and control education program. f. An enforcement program. 2. Administrative costs associated with each program of the initiative and program pro-

vider shall be established at a reasonable level consistent with effective management prac- tices.

3. Requests for information or for proposals shall emphasize that performance measures are required for any contract or allocation of funding under the initiative.

Sec. 8. NEW SECTION. 142A.8 COMMUNITY PARTNERSHIPS. 1. A community partnership is a public agency or nonprofit organization operating in a

local area under contract with the department to implement the initiative in that local area utilizing broad community involvement. The community partnership or its designee shall act as the fiscal agent for moneys administered by the community partnership.

2. A community partnership area shall encompass a county or multicounty area, school district or multischool district area, economic development enterprise zone that meets the requirements of an urban or rural enterprise community under Title XIII of the federal Om- nibus Budget Reconciliation Act of 1993, or community empowerment area, in accordance with criteria adopted by the commission for appropriate population levels and size of geo- graphic areas.

3. The commission shall adopt rules pursuant to chapter 17 A providing procedures for the initial designation of community partnership areas and for subsequent changes to the ini- tially designated areas.

4. The requirements for contracts entered into by a community partnership and the de- partment shall include but are not limited to all of the following:

a. Administrative functions. b. Fiscal provisions. c. Community and youth involvement in program and administrative decisions. d. Law enforcement involvement. e. Evaluation of the program.

Sec. 9. NEW SECTION. 142A.9 YOUTH PROGRAM. 1. A youth program component shall be implemented in each community partnership

area to achieve the purposes of the initiative. 2. The youth program shall include but is not limited to all of the following: a. A structure for program participants to interact with other participating youth within

the community partnership area and in other areas of the state. b. A structure for formal youth involvement in youth program governance at the commu-

nity partnership area level and in a statewide youth summit or summits consisting of par- ticipation by representatives of the community partnership area level.

c. A structure for participation in a statewide executive body consisting of participants selected by the delegates to the statewide youth summit of the youth program.

d. Youth activities that are character-based and focused on rewarding appropriate values, behavior, and healthy choices by participants.

3. To the greatest extent possible, the youth program shall be directed by youth for youth participants. State and local administrators associated with the initiative shall consult with and utilize the youth program participants in the media, marketing, and communica- tions program; education efforts; and other aspects of the initiative including evaluation, collaboration, and enforcement.

571 LAWS OF THE SEVENTY-EIGHTH G.A., 2000 SESSION CH. 1192

Sec. 10. NEW SECTION. 142A.10 FUNDING OF PROGRAMS DELIVERED THROUGH COMMUNITY PARTNERSHIPS.

1. The commission shall develop and implement a statewide system for the initiative programs that are delivered through community partnerships.

2. The system shall provide for equitable allocation of funding for initiative programs among the state's community partnership areas, based upon school-age population and other criteria established by the commission.

3. The specific programs, distribution provisions, and other provisions approved by the commission for expenditure of the maximum allocation amount established for a commu- nity partnership area shall be outlined in the written contract with the community partner- ship.

4. Any allocation received by a community partnership shall be matched with local fund- ing, in-kind services, office support, or other tangible support or offset of costs.

Sec. 11. NEW SECTION. 142A.11 REPEAL. This chapter is repealed June 30, 2010.

Sec. 12. Section 453A.39, Code 1999, is repealed.

Sec. 13. INITIAL APPOINTMENTS. 1. The initial appointments to the commission on tobacco use prevention and control of

the members who are not youth members selected at the youth summit or who are not commission nonvoting members, as established by this Act, are as follows:

a. Two members to a one-year term. b. Two members to a two-year term. c. Three members to a three-year term. 2. The initial youth appointments shall be as follows: a. One member to a one-year term. b. One member to a two-year term. c. One member to a three-year term. 3. The initial appointments to the commission on tobacco use prevention and control

who are not youth members selected at the annual youth summit or who are not commission nonvoting members shall be made by the governor. The legislative council may compile a list of individuals based on recommendations received from members of the general assem- bly, following public input, and submit the list to the governor to assist efforts in identifying qualified and capable candidates for initial appointments.

4. The initial appointments to the commission shall be made within sixty days of the effective date of this Act.

Sec. 14. REVIEW OF ENFORCEMENT EFFORTS. The tobacco use prevention and control commission created under chapter 142A, in cooperation with the office of the attor- ney general, the Iowa department of public health, and the alcoholic beverages division of the department of commerce, shall review current state and local tobacco enforcement regu- lations and activities, including those related to retailers, clerks and minors, and shall submit recommendations to the governor and the general assembly, on or before December 1,2000, to provide for balanced and uniform enforcement statewide.

Sec. 15. ADMINISTRATOR - INITIAL HIRING. The provisions of section 142A.4 re- lating to the commission providing advice and consultation with regard to the hiring of the administrator do not apply to the initial hiring of an administrator if the commission is not operational at the time that a potential candidate for the position of administrator is for- mally offered the administrator position. However, under such circumstances, the director shall consult with the ex officio members of the commission, if appointed at the time such a formal offer is extended.

CH.1192 LAWS OFTHE SEVENTY-EIGHTH G.A., 2000 SESSION 572

Sec. 16. EMERGENCY RULES. The department of public health may adopt emergency rules under section 17A.4, subsection 2, and section 17A.5, subsection 2, paragraph "b", to implement this Act, and the rules shall become effective immediately upon filing, unless the effective date is delayed by the administrative rules review committee, notwithstanding section 17A.4, subsection 5, and section 17A.8, subsection 9, or a later effective date is specified in the rules. Any rules adopted in accordance with this section shall not take effect before the rules are reviewed by the administrative rules review committee. Any rules adopted in accordance with the provisions of this section shall also be published as notice of in- tended action as provided in section 17 A.4.

Sec. 17. EFFECTNE DATE. This Act, being deemed of immediate importance, takes effect upon enactment.

Approved May 15,2000

CHAPTER 1193 INSURANCE COVERAGE OF ANESTHESIA AND

HOSPITAL CHARGES FOR DENTAL CARE

H.F. 754

AN ACT relating to individual and group accident and sickness insurance, nonprofit health service plans, and health maintenance organizations, by mandating coverage for anesthesia and certain hospital charges associated with the provision of dental care services.

Be It Enacted by the General Assembly of the State of Iowa:

Section 1. NEW SECTION. 514C.19 MANDATED COVERAGE FOR DENTAL CARE - ANESTHESIA AND CERTAIN HOSPITAL CHARGES.

1. Notwithstanding section 514C.6, and subject to the terms and conditions of the policy or contract, a policy or contract providing for third-party payment or prepayment of health or medical expenses shall provide coverage for the administration of general anesthesia and hospital or ambulatory surgical center charges related to the provision of dental care services provided to any of the following covered individuals:

a. A child under five years of age upon a determination by a licensed dentist and the child's treating physician licensed pursuant to chapter 148, 150, or 150A, that such child requires necessary dental treatment in a hospital or ambulatory surgical center due to a dental condition or a developmental disability for which patient management in the dental office has proved to be ineffective.

b. Any individual upon a determination by a licensed dentist and the individual's treating physician licensed pursuant to chapter 148, 150, or 150A, that such individual has one or more medical conditions that would create significant or undue medical risk for the indi- vidual in the course of delivery of any necessary dental treatment or surgery if not rendered in a hospital or ambulatory surgical center.

2. Prior authorization of hospitalization or ambulatory surgical center for dental care procedures may be required in the same manner that prior authorization is required for hospitalization for other coverages under the contract or policy.