Bills › 88th General Assembly
Establishing a veterans recovery pilot program and fund for the reimbursement of expenses related to providing hyperbaric oxygen treatment to eligible veterans
Sponsored by the Senate Veterans Affairs Committee
Where it is now
- Done: IntroducedJanuary 29, 2019
- Done: SubcommitteeJanuary 15, 2020
- Done: Senate committeeMarch 7, 2019
- Stopped: Passes the SenateDied when the General Assembly ended
- Next: House committee
- Next: Passes the House
- Next: To the Governor
- Next: Signed into law
Died when the session ended The 2020 session adjourned on June 14, 2020, the General Assembly’s last regular session. Bills that didn’t pass both chambers died. What’s a funnel?
What’s in it
This bill establishes a veterans recovery pilot program, administered by the department of human services for the reimbursement of expenses related to providing hyperbaric oxygen treatment to eligible veterans.1 establishes definitions applicable to the new Code chapter. The bill includes definitions for commission, department, health care practitioner, hyperbaric oxygen treatment, traumatic brain injury, treatment facility, and veteran. Specifically, the bill defines hyperbaric oxygen treatment as treatment, including diagnostic testing and other related medical treatments, for traumatic brain injury or post-traumatic stress disorder prescribed by a health care practitioner that utilizes a United States food and drug administration-approved hyperbaric chamber or hyperbaric oxygen device.
Read the full explanation
2 establishes the veterans recovery pilot program, subject to sufficient funds to operate the program, requires the department of human services to adopt rules to implement and administer the program, and includes a reporting requirement concerning the operation of the pilot program.3 creates a veterans recovery fund in the state treasury under the control of the department of veterans affairs. The new Code section provides that the fund shall consist of moneys contributed through or received from any devise, gift, bequest, donation, federal or other grant, reimbursement of payments made by any responsible third-party payor, repayment, judgment, transfer, or payment intended to be used for the purposes of the fund. The department of veterans affairs is directed to solicit contributions, gifts, devises, bequests, and donations for the veterans recovery fund. The department of veterans affairs is to expend moneys in the fund for expenses incurred in operating the program and for expenses authorized to be reimbursed for hyperbaric oxygen treatment and any related travel and living expenses incurred by the veteran. The new Code section provides that any moneys remaining in the fund as of June 30, 2025, shall be transferred for deposit in the veterans trust fund.4 provides for the process for a treating facility to seek reimbursement from the veterans recovery fund for providing hyperbaric oxygen treatment. The bill provides that a treating facility may submit a proposed treatment plan to the department of human services for its approval. The treatment plan shall include the prescription order for the treatment, information verifying the eligibility of the veteran and the treatment facility to provide the treatment, the estimated costs for providing the treatment and for reimbursing the veteran for any associated travel and living expenses, and any other information required by the department of human services. The new Code section provides that the treatment plan shall not be approved if sufficient moneys to reimburse the estimated costs are not available in the veterans recovery fund. The new Code section also establishes a process for submitting a modified treatment plan if the estimated costs for providing the treatment are anticipated to exceed the cost estimate in the initial treatment plan. The bill provides that the department of human services shall transmit the approval or disapproval of a proposed or modified treatment plan to the department of veterans affairs. If the proposed or modified treatment plan is approved, the department of veterans affairs shall disburse moneys from the veterans recovery fund accordingly.5 provides for requirements relative to providing hyperbaric oxygen treatment and provides for the manner in which treatment-related expenses are to be reimbursed. The Code section provides that a treatment facility shall not be reimbursed for providing treatment unless a treatment plan has been approved. If a treatment facility elects to provide hyperbaric oxygen treatment under the pilot program, the facility shall provide the treatment without charge to a veteran and shall submit regular reports to the department of human services concerning the efficacy of the treatment and on whether the treatments have been concluded. The new Code section also provides for a process for a treatment facility and a veteran to receive reimbursement for expenses incurred. The new Code section provides that the department of human services shall approve a request for reimbursement of a veteran’s travel and living expenses incurred by the veteran receiving hyperbaric oxygen treatment under the pilot program if the amount requested does not exceed the estimated cost of travel and living expenses as provided in the approved treatment plan or modified treatment plan. The department of human services shall transmit its approval or disapproval of a request for reimbursement to the department of veterans affairs. If the request is approved, the department of veterans affairs shall disburse moneys to the veteran from the veterans recovery fund accordingly. The new Code section requires the department of human services to provide written notification to the treatment facility and veteran after treatment has concluded, which notice shall indicate when any additional requests for reimbursement may be made.6 provides that the new Code chapter is repealed July 1, 2025. The bill further directs the department of human services to submit a notice of intended action to the administrative rules coordinator and the administrative code editor not later than January 1, 2020, for the adoption of rules necessary to implement and administer the new Code chapter.
Senate subcommittee
Named January 15, 2020. On January 22, 2020 it recommended amendment and passage.
- Sen. Carrie Koelker REmail
- Sen. Jeff Edler R
- Sen. R. Taylor
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
Fiscal note
Cost: up to $760,000 Compare with other bills
AI summary This bill creates a pilot program to reimburse eligible veterans for hyperbaric oxygen treatment and related travel or living expenses for PTSD or traumatic brain injury. The estimated annual cost to the state is between $348,000 and $1.0 million. This total includes the cost of treating veterans and the salary and benefits for an executive-level position at the Department of Human Services and the Department of Veterans Affairs.2
Read the fiscal note
Description
Senate File 529 creates a veterans recovery pilot program, administered by the Department of Human Services (DHS), for the reimbursement of expenses related to providing hyperbaric oxygen treatment for eligible veterans who have been diagnosed with post-traumatic stress disorder (PTSD) or a traumatic brain injury (TBI).
The Bill creates a Veterans Recovery Fund under the control of the Department of Veterans Affairs (DVA). The General Assembly is prohibited from appropriating any public money to the Fund. The DVA and the DHS can use money in the Fund for expenses incurred in administering the pilot program. The DVA is required to solicit contributions to the Fund. The pilot program pays for the treatment and any necessary travel and living expenses of a veteran required to travel to obtain treatment. The pilot program is repealed after five years (FY 2025), and any remaining funds are transferred to the Iowa Veterans Trust Fund.
Background
Hyperbaric oxygen treatment involves breathing pure oxygen in a pressurized room or tube. Hyperbaric oxygen treatment is a well-established treatment for decompression sickness, a hazard of scuba diving. Other conditions treated with hyperbaric oxygen treatment include serious infections, bubbles of air in blood vessels, and wounds that will not heal because of diabetes or radiation injury.
In a hyperbaric oxygen therapy chamber, the air pressure is increased to three times higher than normal air pressure. Under these conditions, the lungs can gather more oxygen than would be possible breathing pure oxygen at normal air pressure. Blood carries this oxygen throughout the body. This helps fight bacteria and stimulates the release of substances called growth factors and stem cells, which promote healing.
Indiana has a similar pilot program in place that was appropriated $500,000 in FY 2018 and FY 2019.
Assumptions
- There is a sufficient pool of eligible veterans who may seek treatment.
- The University of Iowa Hospital and Clinics (UIHC) charges $926 per half hour of hyperbaric treatment. Rates charged by other hospitals in Iowa with chambers are currently unknown. However, a hospital “charge” is not the same as “expected payment.” “Charge” is the amount billed for a service. Typically, hospitals are paid less than the billed amount. The Medicaid floor reimbursement rate for one half hour of hyperbaric oxygen treatment is $40.35 and there is $125.59 per treatment session for physician supervision of the treatment. This creates a range of $206 to $1,852 per “dive.”
- A course of treatment can consist of anywhere between 40 and 80 dives. A protocol utilized by researchers at Louisiana State University for treatment involved 60 minutes of dive time, twice a day, five days a week, until reaching 40 dives over the course of four weeks.
- The Bill allows for “living expenses” of the veteran to be reimbursed while getting treatment. This is assumed to include mileage for traveling, hotels, and food. In-state travel reimbursement rates that the State uses were utilized in this analysis. Mileage could fluctuate depending on the location of the hospital, but an average of 80 miles round trip was used for this analysis. Each veteran served is estimated to incur $1,600 in “living expenses” over the course of four weeks.
- The DHS and DVA will require staff to implement the pilot program.
Fiscal Impact
The costs of treating one veteran through the program are estimated to range from $10,000 to $76,000. Therefore, treating 10 veterans could cost $100,000 to $760,000. The actual amount will be dependent upon the rates that DHS and DVA approve in the treatment plans proposed by the hospitals and the living expenses required by the veterans.
Additionally, salary and benefits for a public service executive-level position in the DHS and the DVA is estimated to cost $124,000 annually. There would be additional one-time and ongoing costs for a computer, phone, and office equipment. This brings the total program budget estimated need to between $348,000 and $1.0 million annually.
Sources
- Department of Veterans Affairs
- Department of Human Services
- Department of Administrative Services
- Board of Regents, University of Iowa Hospitals and Clinics
- The Mayo Clinic
- Indiana Legislative Services Agency
- Louisiana State University, Health Science Center
- LSA analysis and calculations
- Veterans Recovery Pilot Program · March 18, 2019 · $760,000
Iowa Code it changes
Lobbying
1 for · 3 against · 8 undecided · Who →
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Earlier and later bills are matched by wording or an identical title.
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- HF 479 Establishing a veterans recovery pilot program and fund for the reimbursement of expenses …90th General Assembly · Renumbered as HF 574Nearly identical
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- HSB 561 HSB 56188th General Assembly · Subcommittee recommends passageNearly identical
- HF 2481 Establishing a veterans recovery program and fund for the reimbursement of expenses relate…91st General Assembly · Renumbered as HF 2662Similar
Matched by wording or an identical title.