Government : State Committees moving forward on proposed bills

Committees under the golden dome of the Iowa State Capitol are steaming along and doing some very good work! We are about halfway finished with this session, and the weeks are flying by. The Republicans are doing our best to make our state better each day, and the people of Iowa are the reason why this state is the best!

Review of 21st Century State Revenue Growth

As budget season approaches, discussions at the Capitol begin to focus on state revenue growth and responsible levels of state spending in the next year. With the next meeting of the Revenue Estimating Conference nearing, legislative observers often ask how today's revenue figures compare with previous years. Below is a chart showing the annual General Fund receipts for each fiscal year, starting in 2001. It also shows the percent of growth experienced in those years:

General Fund Percent

Net Receipts Change

FY 2001 4647

FY 2002 4680.8 0.70%

FY 2003 4483.8 -4.20%

FY 2004 4683.5 4.50%

FY 2005 4929 5.20%

FY 2006 5382.5 9.20%

FY 2007 5646.3 4.90%

FY 2008 6084.4 7.80%

FY 2009 5934 -2.50%

FY 2010 5633.6 -5.10%

FY 2011 5899 4.70%

FY 2012 6311.1 7.00%

FY 2013 6768.8 7.30%

FY 2014 6488.9 -4.10%

FY 2015 6819.7 5.10%

FY 2016 6921.1 1.50%

FY 2017 7095.9 2.50%

FY 2018 7383.9 4.10%

FY 2019 7858.8 6.40%

Figures are in millions

SOURCE: Legislative Services Agency

For the current fiscal year, the Revenue Estimating Conference has projected revenue will grow 2.0 percent to $8.0146 billion revenue. In Fiscal Year 2021, the REC is currently projecting revenue to rise by 2.9 percent to an annual figure of $8.249 billion. The projections will be subject to revision at the Conference's next meeting, set for Thursday, March 12 at 10 AM in the Supreme Court chamber.

As everyone knows, the tax cut approved by Republicans during the 2018 legislative session contained a two-pronged trigger for deep income tax cuts set to being in 2023. The first trigger stipulates that the 2023 income tax cuts cannot occur unless state revenue is equal to or exceeding $8,314,600,000 in FY 22. It is a near certainty that this will be met by that year. It is even a possibility that this trigger is met in FY 21. The second trigger requires that the previous fiscal year net tax receipts (FY 22 receipts for TY 23) equal or exceed 104% of net tax receipts fiscal year prior to that fiscal year - meaning FY 22 receipts need to have growth at least 4% for the trigger to be met.

As is obvious viewing the above table, reaching 4% revenue growth is a common occurrence. The table above shows that revenue growth exceeding 4% in 11 of the previous 18 years.

Removal of the 4% revenue growth trigger has generated a fair amount of discussion in the legislature this session. The data shows that reaching the 4% trigger is not an insurmountable requirement.

House Ag Panel Approves New E15 Motor-Fuel

Infrastructure Grant Measure

On Thursday, February 20, 2020, the Iowa House Agriculture Committee passed House File 2567 by a nearly unanimous 20-aye, 1-nay vote. HF 2567 creates a new E-15 Gasoline Infrastructure program that is separate; but similar in administrative process and regulation to the existing Renewable Fuels Infrastructure Program (E-85 and Biodiesel), and a new E-15 Infrastructure fund. The prospective program and fund will provide financial incentives to support new E-15 infrastructure at existing retail motor fuel locations that enable E-15 motor fuel storage and dispensing (but does not include pumps, blender pumps or tank wagons).

The measure states that the awards shall be on a cost-share basis in a form of a grant. The cost-share agreement shall be for five-years and the award may be no higher than 70% or $100,000 whichever is less for the cost of the E-15 compliant infrastructure. A person shall be awarded no more than $500,000 of E-15 infrastructure grants during any twelve-month period. The bill provides that if the equipment is used to dispense fuels other than E-15 and if a waiver is not granted to do so by the Renewable Fuels Infrastructure Board (RFIB), the grant must be immediately repaid to the E-15 fund with 25% penalty. A violation of the agreement is subject to a penalty of not more than $1,000 per day, and recaptured funds, penalties and any interest accruing on E-15 fund moneys stay with the fund. The amendment adopted by the Committee changed the original bill that was structured to add a new subaccount to the existing E-85 program by creating a separate E-15 program and account. There was some discussion during Committee consideration about some of the provisions that specified cast-share levels and the maximum amount that any one person could receive in a 12-month period in E-15 grants. HF 2567 has been referred to House Appropriations for its review and consideration.

House Agriculture Committee Approves Special Under-16

License for Farm Employees

On Thursday, February 20, 2020, the House Agriculture Committee passed House File 2548 by somewhat bipartisan 18-aye to 4-nay vote. The bill amends the definition of 'Special Minors Driver License' to include motor vehicle driving for farm/agricultural purposes between the hours of 5 a.m. to 10 p.m. that applies to children of farmers and under 16-years of age employees of farms. The privilege includes driving off-route to access a service station in order to refuel a motor vehicle. The bill was amended in Committee to modify a criterion for the school activity special minor license (321.194.3.b) to amend that Code subsection to specify that in the circumstance of the new farm employee special minor license the fact the minor lives within one mile of the school they attend does not prevent them from getting a farm employee special minor license. The House measure is somewhat similar to Senate legislation on the issue (Senate File 2094 that is in the Senate Ways & Means Committee) that creates a new separate special license for farm children and farm employees under 16 that has a $50 fee.

Transitional Policies Extended for Another Year

Iowa Insurance Commissioner Doug Ommen issued a bulletin providing guidance to Iowa consumers and insurers regarding the Center for Medicare & Medicaid Services (CMS) decision to allow transitional policies to be extended through the calendar year 2021.

"I appreciate CMS taking the action to extend transitional policies. Without this action, roughly 1.1 million individuals nationally and 72,000 Iowans would be forced off their healthcare plans and Iowans would be forced to choose between going uninsured or purchasing an ACA policy with a premium that has tripled since 2015," Ommen said. "As we've seen over the past few years, the collapsed ACA market has caused those bearing the full cost of the premiums to simply leave the market."

"Thousands of Iowans have expressed their preference for health coverage flexibility in their choice to keep their transition plan first purchased in 2013. The ACA transition plans are good plans and despite the inability for insurers to sell new policies, thousands of Iowans like their transition plans and want to keep them. With annual federal government relief and despite the ACA's actual prohibition on such flexibility, thousands of Iowans have held onto their "transition" insurance plans. Iowans should be assured that they have access to a policy that fits their needs and not be forced to go without affordable insurance coverage," Ommen said. "Ultimately only Congress can fix the structural flaws in the ACA. Until Congress acts, transitional policies need to be extended, but time is of the essence to fix the ACA."

The Iowa Insurance Division has continually called on Congress to address the structural flaws of the ACA.

"Only Congress can fix the problems created by the ACA, although states, like Iowa, have been able to increase affordable options for some through the extension of short term limited duration coverages, approval of association health plans, and the authority for a nonprofit agricultural cooperative to offer health care plans. Section 1332 or state empowerment waivers continue to offer some potential adjustments, but real opportunity for consumers to choose from affordable plans that fit their families' needs will require Congress to act. Whether the "fix" is amending the ACA, or replacing the ACA with a law by a different name with some of the same coverage guarantees, it is clear that the federal law must be changed so states can protect consumers and return affordable coverage plans to the individual insurance market," Ommen said. "Iowa can properly regulate our own market in a manner that best serves Iowans."

For further background information and charts on the ACA in Iowa, visit https://iid.iowa.gov/aca-background.

Iowa Economic Development Authority Board February Awards

Last week, the Iowa Economic Development Authority (IEDA) Board approved awards for two companies in Clinton, which will assist in the creation of 157 jobs and result in nearly $142 million in new capital investment for the state. The board also approved awards for entrepreneurial assistance and strategic infrastructure. 

Nestlè Purina PetCare-Clinton

The company, founded in 1894, produces dog and cat food, treats, and litter. Clinton has operated a Purina pet food factory since 1969. Nestlè plans to increase its existing footprint in Clinton with the expansion of its finished product warehouse. The board awarded the project tax benefits through the High Quality Jobs program (HQJ). The project is expected to generate $140 million in new capital investment for the state and create 73 jobs, all of which are incented at a qualifying wage of $16.63 per hour.

Timken Drives, LLC-Clinton

Timken Drives, LLC, a subsidiary of the Timken Company, is a leading manufacturer of power transmission roller chains, large pitch leaf chains, and engineered class chains for the industrial marketplace. To accommodate additional chain manufacturing at its Fulton, IL, location, the company plans to relocate its auger manufacturing operations to Clinton, and make significant improvements to an existing facility. The board awarded the company direct financial assistance via HQJ. The project is expected to generate $1.4 million in new capital investment, will create up to 84 jobs, 66 of which are incented at a qualifying hourly wage of $16.63.

In addition to the High Quality Jobs awards, three entrepreneurial assistance providers were awarded grants via the Entrepreneurial Investment Awards program. This program provides financial assistance to service providers that offer technical and financial assistance to entrepreneurs and startup companies seeking to create, locate, or expand a business in Iowa.

Governor Signs House Republican Education Plans

On Tuesday, February 25, 2020, Gov. Reynolds was joined by lawmakers and education advocates when she signed SF 2164, an education funding bill designed to help schools with transportation funding and per pupil student equity.

"We live in a disruptive, technologically-driven economy, and if we aren't preparing our students to succeed in the 21st century, then we are failing them," said Gov. Reynolds. "This legislation will help Iowa's many rural school districts absorb transportation costs and put more money into the classroom. Education is always a top priority, and we will continue to look for ways to provide every school, educator, and student with the tools for success."

Transportation equity was first funded in FY 19 to help absorb transportation costs associated with students traveling across rural communities. SF 2164 provides more than $7.2 million in new funding for the 204 school districts with transportation costs above the statewide average of $347.65 per pupil and provides $5.9 million for per pupil spending equity.

In her Condition of the State address, Gov. Reynolds called for over $103 million in new funding for Iowa schools, including an increase in per-pupil funding and transportation equity. With that investment, the state of Iowa will have spent $13 billion on PreK-12 since 2017. SF 2164: an act relating to public school funding by modifying provisions relating to the regular program state cost per pupil and to appropriations to the transportation equity fund and including effective date provisions.

(Info found at governor.iowa.gov)

House Environmental Protection Committee Sunsets UST Board

On Thursday, February 20, 2020, the House Environmental Protection Committee passed House File 2494 by a unanimous 20-aye vote. HF 2494 repeals both the Iowa comprehensive petroleum underground storage tank fund and eliminates the Iowa comprehensive petroleum underground storage tank fund board on July 1, 2021, and has a Senate companion bill Senate File 2371. The measure shifts the remaining UST functions to the Department of Natural Resources (DNR) and creates a DNR managed 'Iowa Tank Fund' within the state treasury under the control of DNR. Any moneys credited to the Iowa comprehensive petroleum underground storage tank fund on and after July 1, 2021, are transferred to the department for deposit in the Iowa Tanks fund, and DNR is directed to administer the fund to administrate the Iowa Tanks fund financing program to distribute financial assistance for work conducted by eligible entities.

The program allows a claimant who has previously received assistance under the Iowa comprehensive petroleum underground storage tank fund to receive reimbursement of the Iowa Tank fund-

* for all or part of the costs of corrective action for a petroleum release,

* for additional assessment and corrective action arising out of releases from sites for which a certificate of no further action has been issued, and for reimbursement of permanent closure of an underground storage tank system.

The measure was amended in Committee to provide annual allocations by the Iowa tank fund for the fiscal year 2021 and each year thereafter for five years (through FY 2026) $250,000 to be transferred to Iowa Department of Agriculture and Land Stewardship (IDALS) for sole and exclusive purpose of inspecting fuel quality at pipeline terminals and renewable fuel production facilities including salaries, support, maintenance, and miscellaneous purposes. The amendment clarified that allocated moneys from the Iowa Tank fund if not used within a fiscal year, stay with the entity into the next fiscal year and do not revert to the General Fund.

DC Circuit Court Overturns Medicaid Work Requirements

In January 2018, the Centers for Medicare & Medicaid Services (CMS) announced a new policy to allow states to pursue work and community engagement requirements for "non-elderly, non-pregnant adult Medicaid beneficiaries who are eligible for Medicaid on a basis other than disability." Since the announcement, CMS has approved 10 states and has 10 pending applications.

However, most states have not implemented work requirements due to legal challenges. Medicaid beneficiaries in Kentucky and Arkansas brought suits against Secretary of Health and Human Services Alex Azar's approval of their work requirement demonstration waivers in the United States District Court of D.C. The district court found that the Secretary acted in an arbitrary and capricious manner in granting approval.

Both Kentucky and Arkansas appealed the case to the DC Circuit Court of Appeals, however, Kentucky later terminated its demonstration project leaving Arkansas as the sole state continuing to try to uphold its work requirements waiver.

Recently, the DC Circuit Court upheld the district court decision. The ruling found that "healthier outcomes for beneficiaries or more engagement in their health care are secondary benefits outside the primary objective of the Medicaid program as deemed by Congress." The Court found that without Congress specifically stating that Medicaid benefits are conditioned on fulfilling work requirements, HHS would have to have justified its "decision based on a belief that the project will help Medicaid-eligible persons to gain sufficient financial resources to be able to purchase private insurance." The Court found that HHS did not consider whether the project would result in coverage loss, and therefore was "arbitrary and capricious."

More Opportunities for Iowa Students Under

Republican Dental/Medical School Bill

The House Human Resources Committee advanced many bipartisan initiatives aimed to increase access to high quality and affordable health care. The following bills highlight some of that work:

HF 2115 / HF 2383 - University of Iowa Dental and Medical School Admissions - This bill requires at least 75% of the students accepted to the University of Iowa college of medicine and the college of dentistry to be residents of Iowa or currently attending undergraduate school in Iowa. The bill also requires additional reporting of the University of Iowa and hospital to track its dental and medical school graduates and medical residents following the completion of their training to see whether they are staying in Iowa following their state-funded training. The report will include additional information about the graduates prior to being admitted to school or residency.

HF 2052 / HF 2197 - Rural Residency Rotation - This bill specifies the specialties of the residency programs required to have a rural rotation to psychiatry, obstetrics, gynecology, family medicine, internal medicine, and emergency medicine under the Medical Residency Training State Matching Grants Program and the University of Iowa Hospitals and Clinics.

HSB 501 / HF 2138 - Insulin Out-of-Pocket Expenses - This bill limits the amount charged to a patient receiving insulin to $100 per 30-day supply of the insulin drug covered by their health insurance plan.

HF 2001 / HF 2192 - Telehealth Payment Parity - This bill requires health insurers to reimburse for services provided through telehealth at the same rate as services provided in person. Iowa Medicaid has provided telehealth payment parity since 2015, and health insurers have been required to cover telehealth services since 2019. At least 10 other states have telehealth payment parity laws in place.

HSB 582 / HF 2499 - Prescription Limitations - This bill prohibits a pharmacy or health insurance company from charging an additional dispensing fee or copayment when a partial quantity of a 30-day supply of a prescription drug is dispensed. This bill is in reaction to pharmacies and insurers self-imposing opioid prescription limitations and potentially charging the patient twice for the entire prescription as prescribed by their provider.

HSB 685 / HF 2533 - Pharmacy Benefit Managers

This bill regulates Pharmacy Benefit Managers (PBMs) which are intermediaries between health insurers and drug manufacturers. This bill:

* Protects rural pharmacies by preventing a PBM from limiting access to drugs through national or regional wholesalers

* Prevents a PBM from reimbursing a pharmacy for a prescription in an amount less than the amount that the PBM reimburses a PBM affiliate for providing the same prescription drug.

* Requires PBMs to have an appeal procedure for pharmacies

* Prohibits a PBM from conducting spread pricing. Spread pricing is a model of prescription drug pricing in which a PBM charges a health insurer a contracted price for a prescription drug, and the contracted price for the prescription drug differs from the amount the PBM directly or indirectly pays a pharmacy for the drug.

* Prevents a PBM from retroactively reducing payment on a claim to a pharmacy after the date of payment for a clean claim.

* Allows the Insurance Division to review compensations programs of a PBM for a health insurer to ensure that the reimbursement for services provided by a contracted pharmacy is fair, reasonable, and appropriate to provide an adequate network.

HF 2215 - Medicaid Reimbursement of Breast Pumps - This bill requires Medicaid to reimburse for breast pump supplies prescribed by the member's health care provider.

HF 2051 / HF 2269 - Elderly Waiver Monthly Budget Maximum - This bill eliminates the monthly budget maximum for individuals in the Medicaid Home and Community-Based Services Elderly Waiver.

HF 2089 / HF 2423 - Nonmedical Switching and Coverage Exemptions - This bill prohibits health insurers from switching a covered person's prescription drugs to a less costly alternative or increasing the cost of the drug on the covered person when the individual is stable on the drug and their health care provider continues to prescribe the same drug. This bill also requires health insurers to follow certain coverage exemption processes and requirements.

HSB 581 / HF 2492 - Iowa Health and Wellness Plan Member Reenrollment - This bill as amended requires DHS to seek federal approval to require Iowa Health and Wellness Plan members who have reenrolled after failing to pay their monthly contributions to repay the state those funds before being reenrolled after their second termination. This will incentivize members to complete their preventive health care screenings. Under this bill, the requirement of paying unpaid premiums before re-enrollment will never exceed $40.

What's Next for House Judiciary Bills

The legislative process can be confusing for those not directly involved with the day to day activities in the Capitol. Knowing where a bill is in the process and what comes next is essential if you want to truly understand the Iowa Legislature. After seven weeks of the session, many Iowans are wondering what comes next for the policy they care about.

Representatives' focus is beginning to shift to floor debate as committee work is completed. Floor debate is a chance for all 100 members to express their opinion on a bill, offer amendments, and vote. Just because a bill advanced out of committee, does not mean it is guaranteed a vote on the floor. Majority Leader Matt Windschitl meets with committee chairs and carefully evaluates each bill before advancing it for debate. Once a bill has been called to the floor, it is the responsibility of the subcommittee chair to advocate for the bill, answer questions, address any amendments and move the bill for a final vote.

While most bills pass out of the house with bipartisan support, some become partisan. The more partisan a bill, the longer debate may take. Debate on a bill can last for two minutes or two days. Representatives are given ample time to comment on bills and make recommendations for change.

Once a bill passes on the House floor it is sent to the Senate and begins the committee process all over again. The second funnel is the week of March 16th- 19th. All bills that started in the House must be out of the Senate committee by that time. The same goes for Senate bills moving through House committees.

After a bill has passed both the House and Senate in identical forms, it is sent to the Governor for her approval. Last year the Governor signed over 160 bills into law.

Even though the first major deadline has passed, there is still a lot for time for bills to advance through the process. The legislature is expected to adjourn for the session, sometime in late April. April 21st is the last day legislators receive a per diem, but it is not uncommon to end a few days before or after the 100-day deadline.

Labor Committee Bills

Five bills survived funnel week in Labor Committee and are eligible for floor debate. These range from including landscapers at the same level of construction workers, language clean-up, updating obsolete programs, and others. A brief summary of those bills is below.

* HF 2362-This bill provides that an appeal by a nonprofit organization of a redetermination by the department of workforce development of the amount due for reimbursement of the cost of unemployment benefits, for nonprofit organizations that have elected to pay such costs by reimbursement, shall be referred to an administrative law judge for a hearing. Currently, appeals are filed in district court.

* HF 2363-This bill provides that a landscaping contributory employer which is newly subject to unemployment insurance shall pay contributions at the rate specified until the end of the calendar year in which the employer's account has been chargeable with benefits for 12 consecutive calendar quarters.

* HF 2364-This bill provides that an employer or employing unit subject to unemployment insurance that refuses or fails to make and file required records is subject to a possible injunction by the department of workforce development for the violation. Previously code section just said reports. Modifies reference to plans for liquidation of deficiencies relating to unemployment insurance by an employer or employing unit to specify that plan is for the liquidation of a business to pay for such deficiencies.

* HF 2365-This bill strikes language providing that notification of interested parties that a claim for unemployment benefits has been made be sent by ordinary mail. The bill instead provides that such notifications shall be in a format as specified by the IWD selected by the parties.

* HSB 602 Strikes language requiring the director of the department of workforce development to recompute wage credits to calculate an individual's maximum total amount of unemployment benefits payable during the benefit year. Language refers to layoffs due to factory or establishment going out of business. Strikes language providing an additional 13 weeks of benefits.

Hunting Bills Lead Natural Resources Committee Bills List

The following 9 bills passed the House Natural Resources Committee with bipartisan votes before the first funnel deadline:

HF 156 / HF 326 - Eagle Taking Penalties - This bill increases the penalty for unlawfully selling, taking, catching, killing, injuring, destroying, or having in their possession an eagle of $50 to $2,500. These penalties go to the Fish & Wildlife Trust Fund. An individual who violates this section also violates Iowa Code 481A.32 and is guilty of a simple misdemeanor.

HF 657 / HF 2455 - Leashed Dog Tracking - The bill allows a hunter to use a dog to track and retrieve wounded deer as long as the dog is leashed with a maximum of a 50-foot lead during certain times on public land. A hunter can do this on private land at any time with the landowner's permission. The dog and hunter must be trained in blood tracking.

HF 2240 / HF 2458 - Wild Animal Disease Management - This bill adds chronic wasting disease to the list of infectious or contagious diseases and allows the DNR to establish wild animal disease management zones as set out in the bill.

HF 2014 / HF 2517 - Nonresident Hunters - This bill as amended and increases the potential nonresident antlered or any sex deer hunting licenses of the current 6,000 to between 6,000 and 8,000 annually depending on Natural Resources Commission approval.

HF 2133 / HF 2341 - Black Bear Hunting - The bill establishes a hunting season for black bears and imposes a $2,500 fine for violating this bill.

SF 537 - Infrared Coyote Hunting - This bill allows the use of an infrared light source to hunt coyotes, except for during the muzzleloader or shotgun deer hunting seasons. The infrared light source must be either mounted to the method of takr or the scope on the method of take.

HF 217 / HF 2369 - Senior Trout Fishing - This bill requires the DNR to issue a lifetime trout fishing license to a person who is at least 65 years old for a fee determined by the DNR.

HSB 564 / HF 2404 - Public Land Hunting Apparel - The bill prohibits a person passing through public land or water while approaching or leaving a tree stand on public land during a muzzleloading season unless the person is wearing solid blaze orange.

HSB 565 / HF 2410 - Senior Crossbow - This bill changes the age of 70 to 65 to purchase a senior crossbow deer hunting license.

Cyber Crime Bill Part of Public Safety Efforts

After a very busy funnel, the Public Safety Committee has advanced a significant number of bills to the floor. Below are some of the bills eligible for floor debate in the upcoming weeks:

HF 2502- Firearms Accessories and Firing Ranges

HF 2502 prevents political subdivisions of enacting arbitrary standards on firing ranges that are stronger than state law. Additionally, the bill prevents a patchwork of regulations on firearms accessories by assuring the state is solely responsible for regulating these accessories. Finally, if a political subdivision bans firearms off their property they must provide appropriate security.

STATUS-House Floor

HSB 616- Cyber Crime Investigation Unit

This bill establishes a cybercrime investigation unit under the department of public safety. The unit will investigate crimes with a nexus to the internet or computers.

STATUS-House Floor

HSB 653- Medical Cannabidiol

HSB 653 adopts recommendations for the Iowa Medical Cannabidiol Board. Recommendations include capping THC levels to 4.5 grams per 90 days, expanding the list of care providers who can recommend a patient for medical cannabidiol, providing a way for a patient to receive more than the 4.5 grams with appropriate recommendation, and ensuring patients cannot doctor shop for more medical cannabidiol.

STATUS-House Floor

HF 2413- Controlled Substance Updates

HF 2413 the board of pharmacy and updates the list of controlled substances. The bill also allows the board of pharmacy to make scheduled changes to certain marijuana-based medicine based on USDA and FDA changes. This does not allow the board to change the schedule of marijuana without legislative action.

STATUS-House Floor

HF 2334-Reunification of an Unaccompanied Child or Dependent Adult

HF 2334 establishes a taskforce relating to the unification of an unaccompanied child or dependent adult with their parent or guardian following a natural disaster.

STATUS-House Floor

House GOP Keeps Promises on EMS

There has been a growing concern through Iowa, especially in rural counties and communities, about the access to emergency medical services. A common misconception is that emergency medical services are considered an essential service under the Iowa Code. They are not. However, it is currently an option for counties to choose to make it an essential service. Under current law, county supervisors may offer for voter approval a local option income surtax or an ad valorem property tax. Additionally, if it is considered an essential service, it has to be re-approved every five years.

House Study Bill 631/HF 2434 makes significant changes to the emergency medical services chapter (IA Code 422D). The first change that it makes allows the county board of supervisors to declare EMS an essential service without calling for an election to approve this decision. EMS advocates believe that this will greatly reduce the burden and cost of declaring EMS an essential service.

This bill also gets rid of the five-year sunset that required the voters to re-approve emergency medical services. This gives the voters the option to end EMS as an essential service only under a reverse referendum. EMS advocates have complained that they are uncomfortable purchasing equipment if after only five years the service could not be renewed.