National Health Law and Policy Resource Center - More Information

The University of Iowa College of Law's Josephine Gittler, JD, and the University of Iowa College of Medicine's John C. MacQueen, MD, founded the NHLPR Center. Professor Gittler, who is the Wiley B. Rutledge Professor of Law, serves as director of the center, and Dr. MacQueen, who is professor emeritus of Pediatrics, serves as co-director of the center. Under their leadership the center has become a nationally recognized "think tank" and has compiled a highly impressive record of achievements.

The center was originally known as the National Maternal and Child Health Resource Center, and its original focus was the expansion and improvement of health and health-related services for mothers and children, including children with disabilities and chronic illnesses. Over the years, however, the center's focus broadened. Today the center maintains the following programs: the Maternal and Child Health Program, the Program on Health Care for the Aging, the Rural Health Care Program and the Health Care Conflict Management Program.

A core activity of the center is conducting research and demonstration projects involving health law and policy. Other core activities are the provision of education and training and the provision of technical assistance and consultation to public policy makers, third-party payers of health services, health-care administrators, providers of health services and related services, health-care consumers and health-law practitioners. The center's Health Care Conflict Management Program also provides facilitation and mediation services for prevention and resolution of health care disputes. Another center activity is the operation of an Information Clearinghouse for a variety of health law and policy topics. These activities are externally funded through grants and contracts.

Since its creation, the center has issued 31 publications widely distributed nationwide, and center staff members and consultants have authored, coauthored or edited 34 publications issued by other entities; center personnel have made nearly 400 presentations at national, regional and statewide conferences and workshops; and they have participated in more than 170 congressional hearings, forums and briefings and state legislative hearings, forums and briefings.

The center has had a major impact on public policy and law. A great deal of this impact is attributable to the center's success in translating the results of research and demonstration projects into the enactment of legislation and the implementation of legislation.

A specific illustration is the center's intensive and long-term efforts to reform the financing, organization and delivery of health services and other needed services for children with special health-care needs and their families. These efforts began in the mid-1980s and extended through the 1990s.

The center initially conducted a project, with funding from the Federal Maternal and Child Health (MCH) Bureau, delineating future directions of services for children with special health-care needs. This project led to a national initiative, on the part of the U.S. Surgeon General, The University of Iowa College of Law, 35 Attorney General's Offices and the Federal MCH Bureau, calling for the development of community-based systems of services that are comprehensive, coordinated and family-centered for these children and families. The center acted as the coordinator of a national U.S. Surgeon's General Conference, with more than 75 cosponsors, which launched this initiative.

In connection with this initiative, Professor Gittler then drafted legislation amending the Title V Maternal and Child Health Services Block Grant so as to mandate that states receiving federal funding under the block grant to develop such systems of services, and she was instrumental in securing congressional enactment of this legislation. After the enactment of the legislation, Dr. MacQueen and Professor Gittler assisted the Federal MCH Bureau in planning and carrying out a series of activities to guide the states in implementation of the new systems development mandate, and the center subsequently administered a project for the Federal MCH Bureau that furnished states with extensive education and training and technical assistance and consultation to enable them to implement this mandate.

During the past two decades, the center also conducted a number of other externally funded projects. Some of the subjects with which past projects have dealt are: legal and public policy issues related to HIV infection among pregnant women, adolescents and children; legal and public policy issues related to pregnant women with substance abuse problems and infants exposed to drugs in utero; adolescent health care decision-making and parental consent and notification requirements; various aspects of implementation of the Individuals with Disabilities Education Act; legal and public policy issues related to the provision of health services to children in public school settings; models for comprehensive conflict management systems in managed (health-) care settings; alternative dispute resolution in managed (health-) care settings; and judicial review of medical malpractice awards.

The center is currently collaborating with the Urban Institute on a project examining the effectiveness of state medical licensure boards in disciplining physicians for lack of competency. The Office of the Assistant Secretary for Evaluation and Planning of the U.S. Department of Health and Human Services is funding this project, which is part of a large exploration of ways to deter medical errors and to assure better quality of medical care.

Another current center project is directed at encouraging the pro bono representation of individuals with health problems in need of legal advocacy. This project was undertaken for the Health Law Section of the American Bar Association.

Still another current center project is examining privacy and confidentiality issues posed by the mandatory reporting of cancer cases to state registries and the use of data in these registries for public health surveillance and research. This project involves collaboration with the University of Iowa College of Public Health and is funded by the Federal Centers for Disease Control.

A hallmark of the center is its interdisciplinary approach to projects. The center's staff and consultants have been drawn not only from the discipline of law but also from the disciplines of medicine, nursing, public health, special education and early childhood education, social work, psychology and business administration. The Center's key staff members all have distinguished reputations in their respective fields.

In addition to Professor Gittler and Dr. MacQueen, key staff members include Kathleen C. Buckwalter, RN, PhD, who is a center co-director; Claibourne I. Dungy, MD, MPH, who is a center senior associate director; and Rachel Anderson, PhD, who is a center associate director. Buckwalter is a professor of nursing at the University of Iowa College of Nursing, where she directs the Hartford Center for Geriatric Nursing Excellence, and she served as University of Iowa Associate Provost for the Health Sciences for the seven-year period from 1997 to 2004. Dungy is a professor of pediatrics and director of the Division of General Pediatrics and Adolescent Medicine at the University of Iowa College of Medicine and UIHC. Anderson is an assistant professor of health management and policy at the University of Iowa College of Public Health.

In order to more effectively fulfill its mission, the center regularly collaborates with a wide and diverse array of national, regional and state agencies, institutions and organizations at other sites. Equally important, the center is a resource for and has collaborative relationships with the University of Iowa health sciences colleges.

The center's affiliation with the College of Law has made a significant contribution to enrichment of the law school curriculum. Among the law school courses which are a direct outgrowth of center activities are the Health Law and Policy Practicum and Federal Regulation of the Health Care Industry: Health Care Fraud and Abuse. Another product of center activities is a new Child and Family Advocacy Clinic, which will give law students, under law faculty supervision, experience in representing children and families seen in UIHC pediatric clinics. Over the past 20 years Dr. MacQueen, as well as other center personnel, co-teach and participate in law school courses taught by Professor Gittler. Center projects likewise have generated many opportunities for law faculty and law students to engage in health law and policy research.