Iowa Administrative Bulletin

Inquiries may be sent to Michael L. Fitzgerald, Treasurer of State, State Capitol, Des Moines, Iowa 50319.

This amendment is intended to eliminate the brucellosis testing requirements for cattle moving into or within Iowa through concentration points, including auction markets, from herds located in a brucellosis Class Free state. It will allow for the sale of cattle through auction markets in Iowa and into Iowa from other Class Free states without first obtaining a brucellosis test. Iowa became a Class Free state in July 1997. This amendment has been requested by the Iowa Livestock Marketing Association and the Iowa Cattlemen's Association.

Notice of Intended Action was published in the January 28, 1998, Iowa Administrative Bulletin, Volume XX, No. 16, as ARC 7783A. This amendment is identical to the Notice of Intended Action.

This amendment shall become effective on May 1, 1998.

This amendment is intended to implement Iowa Code chapter 164.

The following amendment is adopted.

Amend rule 21--66.7(163) by adding a new subrule as follows:

66.7(8) Cattle which have been located in a brucellosis Class Free state for the six months immediately prior to sale.

ARC 7888A

These rules are being revised to make the tanning rules self-contained in Chapter 46 and to facilitate 28E agreements with local health departments for the inspection of tanning facilities.

Notice of Intended Action regarding this chapter was published in the Iowa Administrative Bulletin on September 10, 1997, as ARC 7479A. A public hearing was held at 10 a.m. on September 30, 1997. There were no attendees. Written comments were received, reviewed, considered and incorporated as appropriate. Changes made from the Notice of Intended Action are as follows:

1. Inspection cost guidelines set out in 46.4(8) were revised to include details regarding the scope and frequency of inspections.

2. Effective dates were added and other revisions made to the operator training requirements set out in 46.5(10), paragraphs "b" to "d."

The State Board of Health adopted these amendments at their regular board meeting on November 12, 1997.

These amendments shall become effective April 29, 1998.

These amendments are intended to implement Iowa Code chapter 136D.

The following amendments are adopted.

ITEM 1. Rescind subrule 38.8(11).

ITEM 2. Rescind rules 641--46.1(136D) to 46.6(136D) and insert the following new rules in lieu thereof:

(There will be no changes to the appendices.)

641--46.1(136D) Purpose and scope. This chapter provides for the permitting and regulation of tanning facilities and devices used for the purpose of tanning human skin through the application of ultraviolet radiation. This includes, but is not limited to, public and private businesses,hotels, motels, apartments, condominiums, and health and country clubs.

References to CFRs in this chapter are those in effect on October 1, 1996, and any additional amendments.

These rules stipulate minimum safety requirements relating to the operation of tanning devices; procedures for obtaining a permit; qualifications for tanning facility operators; and procedures for health departments to provide for the inspection of tanning facilities and enforcement of these rules. Tanning facilities which are in compliance with these rules are not relieved from the requirements of any other federal and state regulations or local ordinances.

641--46.2(136D) Definitions.

"Board of health" means a county, city, or district board of health that has a 28E agreement with the Iowa department of public health to perform inspections under this chapter.

"Cleansing" means to remove soil, dirt, oils or other residues from the surface of the tanning unit which may come into contact with the skin.

"Cleansing agent" means a substance capable of producing the effect of "cleansing." These agents shall not adversely affect the equipment or the health of the consumer and shall be acceptable to the department or board of health.

"Consumer" means any member of the public who is provided access to a tanning facility in exchange for a fee or other compensation, or any individual who, in exchange for a fee or other compensation, is afforded use of a tanning facility as a condition or benefit of membership or access.

"Department" means the Iowa department of public health.

"Director" means the director of public health or the director's designee.

"Exposure position" means any position, distance, orientation, or location relative to the radiation surfaces of a tanning device at which the user is intended to be exposed to ultraviolet radiation from the product, as recommended by the manufacturer.

"Formal training" means a course of instruction approved by the department for operators of tanning facilities.

"Health care professional" means an individual, licensed by the state of Iowa, who has received formal medical training in the use of phototherapy.

"Inspection" means an official examination or observation including but not limited to tests, surveys, and monitoring to determine compliance with rules, orders, requirements, and conditions of these rules.

"Manufacturer's recommendations" means written guidelines established by a manufacturer and approved by the U.S. Food and Drug Administration for the installation and operation of the manufacturer's equipment.

"Operator" means an individual designated to control operation of the tanning facility and to instruct and assist the consumer in the proper operation of the tanning devices.

"Permit" or "permit to operate" means a document issued by the department which authorizes a person to operate a tanning facility in Iowa.

"Person" means any individual, corporation, partnership, firm, association, trust, estate, public or private institution, group, agency, political subdivision of this state, any other state or political subdivision or agency thereof, and any legal successor, representative, agent, or agency of the foregoing, but shall not include federal government agencies.

"Phototherapy device" means a piece of equipment that emits ultraviolet radiation and is used by a health care professional in the treatment of disease.

"Tanning device" means any equipment that emits electromagnetic radiation with wavelengths in air between 200 and 400 nanometers and that is used for tanning of human skin, such as sunlamps, tanning booths, or tanning beds. The terms also include any accompanying equipment such as protective eyewear, timers, and handrails.

"Tanning facility" means a place that provides access to tanning devices for compensation.

"Ultraviolet radiation" means electromagnetic radiation with wavelengths in air between 200 and 400 nanometers.

641--46.3(136D) Exemptions. The department may, upon application or upon its own initiative, grant exemptions from the requirements of these rules as long as it will not result in undue hazard to public health and safety. The following categories of devices are exempt from the provisions of this chapter:

46.3(1) Other purposes. Devices intended for purposes other than the deliberate exposure of human skin to ultraviolet radiation which produce or emit ultraviolet radiation incidental to their proper operation.

46.3(2) Personal use. Tanning devices which are limited exclusively to personal use by an individual and this individual's immediate family. Multiple ownership of the device by persons for personal use only does not qualify it for the "personal use only" exemption.

46.3(3) Phototherapy devices. Phototherapy devices used by a properly trained health care professional in the treatment of disease.

641--46.4(136D) Permits and fees.

46.4(1) Permit to operate. No tanning facility shall be operated in the state without having a permit to operate issued by the department.

46.4(2) Application requirements for permit. Each person acquiring or establishing a tanning facility shall:

a. Apply for a permit prior to beginning operation. The application shall be completed on forms provided by the department or board of health and shall contain all information required by the form and accompanying instructions. A nonrefundable application fee of $5 shall be remitted with the application.

b. A $15 returned check fee will be charged for each check returned for insufficient funds.

c. The permit holder shall notify the department in writing within 30 days of any changes, additions, or deletions to the initial or renewal application as appropriate. This request does not apply to changes involving replacement of components in tanning equipment.

46.4(3) Expiration of permit. Except as provided in 46.4(4)"b," each permit shall expire at the end of the specified day in the month and year stated therein.

46.4(4) Renewal of permit.

a. Permits shall be renewed annually upon acceptance of a renewal application provided by the department and upon receipt of the renewal fee of $5.

b. If application has been filed prior to the expiration date of the existing permit, the existing permit shall not expire until the application status has been finally determined by the department.

c. A $25 fee will be charged per month for failure to pay annual permit fees starting the month of expiration of the facility's permit to operate. This fee is added to the annual fee not paid.

46.4(5) Transfer or termination of permit.

a. No permit shall be transferable from one person to another or from one tanning facility to another.

b. A permit shall be returned to the department or board of health if the facility ceases business or otherwise ceases on a permanent basis or changes ownership.

46.4(6) Denial, revocation, or termination of permit.

a. The department may deny, suspend or revoke a permit applied for or issued pursuant to this chapter for any of the following reasons:

(1) Submission of false statements in the application for a permit or in any statement of fact required by provisions of this chapter;

(2) Because of conditions revealed by the application or any report, record, inspection or other means which would warrant the department to refuse to grant a permit on an original application;

(3) Operation of the tanning facility in a manner that causes or threatens to cause hazard to the public health or safety;

(4) Failure to allow authorized representatives of the department or board of health to enter the tanning facility at reasonable times for the purpose of determining compliance with the provisions of this chapter, conditions of the permit or an order of the department or board of health.

(5) Failure to pay fees or costs required in rule 46.4(136D).

(6) Violation of any of the provisions of this chapter or of Iowa Code chapter 136D.

b. Except in cases where public health and safety require otherwise, prior to the institution of proceedings for suspension or revocation of a permit, the department or board of health shall:

(1) Call to the attention of the permit holder, in writing, the facts or conduct which may warrant such actions, and

(2) Provide opportunity for the permit holder to demonstrate or achieve compliance with all lawful requirements.

c. Any person aggrieved by a decision by the department to deny a permit or to suspend or revoke a permit after issuance may request a hearing under procedures established by the department.

46.4(7) Inspections.

a. Inspections shall be conducted annually.

b. Inspection cost.

(1) An inspection cost of $33 per tanning device shall be billed to the permit holder up to a maximum of $330 per facility.

(2) Inspection costs shall be due upon receipt of payment due. When the tanning facility is located within a contracted area of a board of health, the costs billed will be paid to the contracted board of health or its designee.

(3) Inspection costs not received within 45 days of the date of billing will be assessed a $25 penalty for each month or fraction thereof that the bill is delinquent.

c. Inspections shall include the following areas: proper operation and maintenance of devices, review of requiredrecords and training documentation, operator understanding and competency, and the requirements of these rules.

641--46.5(136D) Construction and operation of tanning facilities. Unless otherwise ordered or approved by the department, each tanning facility shall be constructed, operated, and maintained to meet the following minimum requirements:

46.5(1) A tanning facility shall provide and post the following warning signs and statements that describe the hazards associated with the use of tanning devices:

a. A warning sign in a conspicuous location readily visible to persons entering the establishment. This warning sign shall use 0.5-inch (12.7-millimeter) letters for "DANGER, ULTRAVIOLET RADIATION" and 0.25-inch (6.4-millimeter) letters for all other lettering. The sign shall use red lettering against a white background, be at least 9.0 inches by 12.0 inches (22.9 centimeters _ 30.5 centimeters) and have the following wording:

ULTRAVIOLET RADIATION

-- Overexposure can cause

* Eye and skin injury

* Allergic reaction

-- Repeated exposure may cause

* Premature aging of the skin

* Skin cancer

-- Failure to wear protective eyewear may result in

* Severe burns to eyes

* Long-term injury to eyes

-- Medication or cosmetics may increase your sensitivity

c. A tanning facility shall provide each consumer with a written warning statement prior to the consumer's initial exposure which includes at least the following information:

(1) A representative list of potential photosensitizing drugs and agents. This list should at least include drugs or agents in the product classes of acne treatment, antibacterials, antibiotics, anticonvulsants, antidepressants, antidiabetics, antihypertensives, dye, estrogen and progesterones, melonogenics, perfumes and toilet articles, tranquilizers, antihistamines and antimicrobials/anti-infectious agents. A partial list of drugs and agents in these product classes is found in Appendices 1A, 1B, and 1C.

(2) Information regarding potential negative health effects related to ultraviolet exposure, including:

1. The increased risk of skin cancer later in life;

2. The increased risk of skin thickening and premature aging;

3. The possibility of burning or rashes, especially if using any of the potential photosensitizing drugs and agents. The consumer should consult a physician before using a tanning device if using medication, if there is a history of skin problems or if the consumer is especially sensitive to sunlight.

(3) Basic information on how different skin types respond to tanning (see Appendix 2).

(4) An explanation of the need to use eyewear.

(5) The operator shall then request that the consumer sign a statement that the information has been read and understood.

46.5(2) Federal certification.

a. Only tanning devices manufactured and certified under the provisions of 21 CFR Part 1040.20, "Sunlamp products and ultraviolet lamps intended for use in sunlamp products," shall be used in tanning facilities. Compliance shall be based on the standard in effect at the time of manufacture as shown on the device identification label required by 21 CFR Parts 1010.2 and 1010.3.

b. Labeling shall meet the following requirements, be visible on each unit and be permanently affixed. Labeling shall include:

(1) A warning statement with the words "DANGER-Ultraviolet radiation. Follow instructions. Avoid overexposure. As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions. Repeated exposure may cause premature aging of the skin and skin cancer. WEAR PROTECTIVE EYEWEAR; FAILURE TO MAY RESULT IN SEVERE BURNS OR LONG-TERM INJURY TO THE EYES. Medications or cosmetics may increase your sensitivity to the ultraviolet radiation. Consult a physician before using a sunlamp if you are using medications or have a history of skin problems or believe yourself especially sensitive to sunlight. If you do not tan in the sun, you are unlikely to tan from the use of this product."

(2) Recommended exposure position(s). Any exposure position may be expressed either in terms of a distance specified both in meters and in feet (or in inches) or through the use of markings or other means to indicate clearly the recommended exposure position.

(3) Directions for achieving the recommended exposure position(s) and a warning that the use of other positions may result in overexposure.

(4) A recommended exposure schedule including duration and spacing of sequential exposures and maximum exposure time(s) in minutes.

(5) A statement of the time it may take before the expected results appear.

(6) Designation of the ultraviolet lamp type to be used in the product.

46.5(3) Tanning device timers.

a. Each tanning device shall have a timer which complies with the requirements of 21 CFR Part 1040.20. The maximum timer interval shall not exceed the manufacturer's maximum recommended exposure time by a factor greater than _ 10 percent of the indicated setting.

b. Each tanning device must have a method of remote timing located so that consumers may not control their own exposure time.

c. Tokens for token timers shall not be issued to any consumer in quantities greater than the device manufacturer's maximum recommended exposure time for the consumer.

46.5(4) Each tanning device shall incorporate a control on the product to enable the consumer to manually terminate the radiation emission from the product at any time without disconnecting the electrical source or removing the ultraviolet lamp.

46.5(5) The operator shall ensure that the facility's interior temperature does not exceed 100 degrees F or 38 degrees C.

46.5(6) Condition of tanning devices.

a. There shall be physical barriers to protect consumers from injury induced by touching or breaking the lamps.

b. The tanning devices shall be maintained in good repair and comply with all state and local electrical code requirements.

46.5(7) Additional requirements for stand-up booths.

a. There shall be physical barriers (e.g., handrails) or other means (floor markings) to indicate the proper exposure distance between ultraviolet lamps and the consumer's skin.

b. The construction of the booth shall be such that it will withstand the stress of use and the impact of a falling person.

c. Access to the booth shall be of rigid construction; doors shall open outwardly. Handrails and nonslip floors shall be provided.

46.5(8) Protective eyewear.

a. Eyewear shall not be reused by another consumer.

b. Protective eyewear shall meet the requirements of 21 CFR Part 1040.20(c)(4).

c. Protective eyewear shall not be altered in any manner that would change its use as intended by the manufacturer (e.g., removal of straps).

d. A tanning facility operator shall not allow a consumer to use a tanning device if that consumer does not use the protective eyewear required by this subrule.

46.5(9) Operation.

a. A trained operator must be present when a tanning device is operated. The operator must be within hearing distance to allow the consumer to easily summon help if necessary. If the operator is not in the immediate vicinity during use, the following conditions must be met:

(1) The consumer can summon help through use of an audible device such as an intercom or buzzer; and

(2) The operator can reach the consumer within 30 seconds after being summoned.

b. The facility permit to operate shall be displayed in an open public area of the tanning facility.

c. A record shall be kept by the facility operator of each consumer's total number of tanning visits and tanning times, exposure lengths in minutes, times and dates of the exposure, and any injuries or illness resulting from the use of a tanning device.

d. A written report of any tanning injury shall be forwarded by the permit holder to the department within five working days of its occurrence or knowledge thereof. The report shall include:

(1) The name of the affected individual;

(2) The name and location of the tanning facility involved;

(3) The nature of the injury;

(4) The name and address of the health care provider treating the affected individual, if any; and

(5) Any other information considered relevant to the situation.

e. Defective or burned-out lamps or filters shall be replaced with a type intended for use in that device as specified on the product label on the tanning device or with lamps or filters that are "equivalent" under 21 CFR Part 1040, Section 1040.20, and policies applicable at the time of lamp manufacture.

f. The permit holder shall replace ultraviolet lamps and bulbs, which are not otherwise defective or damaged, at such frequency or after such duration of use as may be recommended by the manufacturer of such lamps or bulbs.

g. Contact surfaces of tanning devices shall be cleansed by the operator with a cleansing agent between each use or the contact surfaces may be covered by a nonreusable protective material during each use.

h. Any records or documentation required by this chapter must be maintained in the tanning facility for a minimum of two years. Records maintained on computer systems shall be regularly copied, at least monthly, and updated on storage media other than the hard drive of the computer. An electronic record must be retrievable as a printed copy.

i. The operator shall limit the exposure of the consumer to the maximum exposure frequency and session duration recommended by the manufacturer.

j. When a tanning device is being used, no other person shall be allowed to remain in the tanning device area unless protective eyewear is worn.

46.5(10) Training of operators.

a. No individual shall begin functioning as an operator unless the individual has satisfactorily completed a training program. Training shall include but not be limited to:

(1) The requirements of this chapter;

(2) Procedures for correct operation of the tanning facility and tanning devices;

(3) The determination of skin type of consumers and appropriate determination of duration of exposure to tanning devices;

(4) Recognition of reaction or overexposure;

(5) Manufacturer's procedures for operation and maintenance of tanning devices;

b. Owners and managers must complete formal training approved by the department. All owners and managers trained after December 31, 1997, must satisfactorily pass a certification examination approved by the department before operating a tanning facility or training employees.

c. For operators trained after December 31, 1997. Owners and managers are responsible to train operators in the above topics and to provide review as necessary. Training programs shall be approved by the department and include final testing. Operators shall be questioned during inspections as to the level of their understanding and competencyin operating the tanning device.

d. Proof of training for both owner/managers and employees must be maintained in the tanning facility and available for inspection. For operators trained after December 31, 1997, the employee record shall be the original test which bears the signature of the employee, the date, and a statement signifying that all answers have been completed by the employee and without prior knowledge of the scoring key.

46.5(11) Promotional materials. A tanning facility shall not claim, or distribute promotional materials that claim, that using a tanning device is safe or free from risk or that the use of the device will result in medical or health benefits. The only claim that may be made is that the device is for cosmetic use only.

641--46.6(136D) Inspections, violations and injunctions.

46.6(1) The director or an authorized agent shall have access at all reasonable times to any tanning facility to inspect the facility to determine if this chapter is being violated.

46.6(2) A person who operates or uses a tanning device or tanning facility in violation of this chapter or of any rule adopted pursuant to this chapter is guilty of a simple misdemeanor.

46.6(3) If the director finds that a person has violated, or is violating or threatening to violate, this chapter and that the violation creates an immediate threat to the health and safety of the public, the director may petition the district court for a temporary restraining order to restrain the violation or threat of violation.

46.6(4) On application for injunctive relief and a finding that a person is violating or threatening to violate this chapter, the district court shall grant any injunctive relief warranted by the facts.

46.6(5) Enforcement.

a. The department shall take the following steps or use county ordinances or any other applicable ordinances, resolutions, rules or regulations when enforcement of these rules is necessary.

(1) Cite each section of the Iowa Code or rules violated.

(2) Specify the manner in which the owner or operator failed to comply.

(3) Specify the steps required for correcting the violation.

(4) Request a corrective action plan, including a time schedule for completion of the plan.

(5) Set a reasonable time limit, not to exceed 30 days from the receipt of the notice, within which the permit holder must respond.

b. The department shall review the corrective action plan and approve it or require that it be modified.

c. In cases where the permit holder fails to comply with conditions of the written notice, the department shall send a regulatory letter, via certified mail, advising the permit holder that unless action is taken within five days of receipt, the case shall be turned over to the city/county attorney for court action.

These rules are intended to implement Iowa Code chapter 136D.

ARC 7889A

The rules provide for sanitary and safety standards for funeral homes and crematoriums and clarify the process whereby the department may contract with local health departments for the inspection of funeral homes and crematoriums.

Notice of Intended Action regarding this chapter was published in the Iowa Administrative Bulletin on September 10, 1997, as ARC 7480A. A public hearing was held at 10 a.m., September 30, 1997, with one person in attendance. Written and oral comments were received from the Board of Mortuary Science Examiners and the Iowa Funeral Directors Association. The comments were reviewed, considered and incorporated as follows:

1. Definitions of "Cremated remains," "Cremation establishment," "Human remains," and "Preparation room" were rewritten.

2. Preparation room standards set out in 86.5(1) and 86.5(9) to 86.5(12) were revised.

3. In 86.6(5), the word "all" was omitted from the phrase "with all cremated remains and pulverized materials being placed in containers," and a reference to 645--100.1(156) was added.

The State Board of Health adopted this chapter at its regular board meeting on November 12, 1997.

These rules are intended to implement Iowa Code section 156.10.

These rules shall become effective on April 29, 1998.

The following rules are adopted.

Rescind 641--Chapter 86 and adopt the following new chapter in lieu thereof:

641--86.2(156) Definitions.

"Board" means the board of mortuary science examiners.

"Cremated remains" means the body of a deceased person, including any form of body prosthesis that has been permanently attached to or implanted in the body.

"Cremation" means the technical process, using heat and flame, that reduces human remains to bone fragments. The reduction takes place through heat and evaporation. Cremation shall include the processing, and may include the pulverization, of the bone fragments.

"Cremation chamber" means the enclosed space within which the cremation takes place.

"Cremation establishment" means a place of business which provides any aspect of cremation of human remains.

"Cremation room" means the room in which the cremation chamber is located.

"Department" means the Iowa department of public health.

"Funeral establishment" means a place of business, as defined by the board of mortuary science examiners, devoted to providing any aspect of mortuary science.

"Human remains" means a deceased human being for which a death certificate or fetal death certificate is required.

"Listed" means equipment or materials included in a list published by an agency that maintains periodic inspection on current production of listed equipment or materials and whose listing states either that the equipment or material complies with approved standards or has been tested and found suitable for use in a specified manner.

"Preparation room" means a room in a funeral establishment where human remains are prepared, sanitized, embalmed or held for ceremonies and final disposition.

641--86.3(156) Licensing. No person, business or corporation shall operate a funeral establishment, preparation room or cremation chamber without first licensing the establishment with the board.

641--86.4(156) Public access areas. Public access areas of funeral homes and crematorium establishments shall have a public restroom with hot and cold running water.

641--86.5(156) Preparation room. The preparation room shall meet the following standards:

86.5(1) The preparation room shall be of such size and dimensions to accommodate and shall contain an embalming table, an appropriate sink, or other liquid waste receptacle with sewer and water connections, suitable cabinet or shelves, and hand-washing facilities to include hot water, soap and towels.

86.5(2) The preparation room shall be private. It shall not be used as a passageway from room to room. No toilet or commode shall be located within the preparation room. Only equipment necessary for use in preparation of bodies for burial, shipment or cremation shall be permitted in the preparation room.

86.5(3) There shall be a toilet and hand-washing facility accessible elsewhere in the building.

86.5(4) Ventilation shall be provided by an exhaust fan vented to the outside of the building.

86.5(5) Doors and windows of the preparation room shall be so installed and constructed as to obstruct view from outside and to prevent fumes and odors from entering any other part of the building.

86.5(6) There shall be adequate lighting. Light fixtures shall be easy to clean and kept clean.

86.5(7) The preparation room shall be provided with an adequate water supply with hot and cold running water.

86.5(8) The building drainage system must be discharged into the municipal sewage system where such a system is available. Where a municipal sewage system is not available, the building drainage system must be discharged into a private system of waste disposal acceptable to the Iowa department of natural resources and the Iowa department of public health.

86.5(9) Backflow prevention.

a. Funeral homes not meeting the requirements of 86.5(9)"c" shall have water-supplied aspirators equipped with a listed atmospheric vacuum breaker mounted at least six inches above the aspirator. The discharge of the aspirator shall be through an air gap.

b. Funeral homes not meeting the requirements of 86.5(9)"c" shall have hose bibbs protected by a listed nonremovable hose bibb type backflow preventer. Potable water outlets with a tube connection fitting shall be protected by a listed atmospheric vacuum breaker mounted at least six inches above the highest point of water usage.

c. In new construction, the water supply to the preparation room and to fixtures in the preparation room shall be protected against backflow in accordance with the Iowa state plumbing code (641--Chapter 25) or in accordance with the ordinance of the political subdivision in which the facility is located, provided that the requirements of the ordinance are equal to or greater than the requirements of the Iowa state plumbing code.

86.5(10) The embalming table shall have a top composed of stainless steel, porcelain or other rustproof material, and the edges shall be raised at least three-fourths inch around the entire table. There shall be a drain opening in the table.

86.5(11) Each preparation room shall have a covered, watertight receptacle for solid refuse.

86.5(12) All preparation rooms shall be maintained in a clean and sanitary condition. All embalming tables, sinks, receptacles, instruments and other appliances used in embalming dead human bodies shall be thoroughly cleaned with hot water and disinfectant. There shall be available a suitable means to sterilize instruments.

641--86.6(156) Crematorium chambers.

86.6(1) Cremation chambers shall be installed according to the manufacturer's recommendations.

86.6(2) Cremation chambers shall be vented to the outside of the building.

86.6(3) There shall be a means to bring in a fresh air supply to aid in combustion.

86.6(4) The room where the cremation chamber is located shall have adequate exhaust to prevent heat buildup.

86.6(5) The cremation chamber shall be cleaned after each use, with cremated remains and pulverized materials being placed in containers as defined in 645--100.1(156).

641--86.7(156) Inspection fees. Inspection fees shall be billed to the owner of a funeral home or crematorium upon the completion of an inspection. Inspection fees are due upon receipt of a notice of payment due. When the funeral home or crematorium is located within the contracted area of a board of health that has a 28E agreement for inspections with the department, inspection fees billed shall be paid to the contracted board of health or its designee.

86.7(1) The fee for the inspection of a funeral home or crematorium shall be $15 for each facility.

86.7(2) Penalty. Inspection fees not received by the department or contracted board of health within 45 days of the date of billing will be assessed a $25 penalty for each month or fraction thereof that the payment is delinquent.

These rules are intended to implement Iowa Code chapter 156.

ARC 7890A

The amendment will exclude certain out-of-state EMS service programs that pick up and deliver patients in Iowa on an occasional basis from applying to the Department for authorization. Out-of-state service programs must, however, be authorized to provide emergency medical care by the state in which they reside.

Notice of Intended Action was published in the Iowa Administrative Bulletin on September 10, 1997, as ARC 7482A. The Iowa Department of Public Health held a public hearing over the Iowa Communications Network (ICN) on Tuesday, September 30, 1997, from 2 to 3 p.m. The proposed amendments were presented to the EMS Advisory Council on October 8, 1997, and to the 22 EMS training programs on October 7, 1997. No comments were received prior to, during, or after the hearing. The amendment remains the same as published under Notice of Intended Action. The Iowa State Board of Health adopted this amendment on November 12, 1997.

This amendment is intended to implement Iowa Code section 147A.4.

This amendment will become effective April 29, 1998.

The following amendment is adopted.

Amend subrule 132.7(2) as follows:

132.7(2) Out-of-state service programs.

a. Service programs located in other states which wish to provide emergency medical care in Iowa must meet all requirements of Iowa Code chapter 147A and these rules and must be authorized by the department except when:

(1) Transporting patients from locations within Iowa to destinations outside of Iowa;

(2) Transporting patients from locations outside of Iowa to destinations within Iowa;

(3) Transporting patients to or from locations outside of Iowa that requires travel through Iowa; or

(4) Responding to a request for mutual aid in this state; or

(5) Making an occasional EMS response to locations within Iowa and then transporting the patients to destinations within Iowa.

b. Reserved. An out-of-state service program that meets any of the exception criteria established in 132.7(2) shall be authorized to provide emergency medical care by the state in which the program resides and shall provide the department with verification of current state authorization upon request.

ARC 7891A

Iowa Code Supplement section 147A.6(1) relates to the disposition of emergency medical provider certification fees and provides that fees paid to the Iowa Department of Public Health by emergency medical care providers are to be deposited in the emergency medical services fund established in Iowa Code section 135.25. The rules establish guidelines for the distribution of those funds.

The Iowa Department of Public Health held a public hearing over the Iowa Communications Network (ICN) on Tuesday, September 30, 1997, from 2 to 3 p.m. The proposed rules were presented to the EMS Advisory Council on October 8, 1997, and to the 22 EMS training programs on October 7, 1997. No comments were received prior to, during, or after the hearing.

The only change made from the Notice of Intended Action published as ARC 7481A on September 10, 1997, is as follows:

In rule 641--140.4(135), the words "EMS fund grant" were substituted for the word "state".

The Iowa State Board of Health adopted these rules on November 12, 1997.

These rules are intended to implement Iowa Code section 135.25, Iowa Code Supplement section 147A.6(1), and 1997 Iowa Acts, chapter 203.

These rules will become effective April 29, 1998.

The following new chapter is adopted.

Adopt 641--Chapter 140 as follows:

"Ambulance service" means any privately or publicly owned service program which utilizes ambulances in order to provide patient transportation and emergency medical care at the scene of an emergency or while en route to a hospital or during transfer from one medical care facility to another or to a private home.

"Applicant" means a county EMS association or regional EMS council that has submitted an application for an emergency medical services fund grant.

"CEHs" means continuing education hours which are based upon a minimum of 50 minutes of training per hour.

"Continuing education" means approved training which is received after becoming certified as an EMS provider to maintain skills and knowledge and to satisfy renewal of certification requirements. This includes emergency medical training for members of the general public.

"County EMS association" means a countywide group of EMS providers and various agency and organization representatives and consumers who advise the county board of supervisors or their designee on EMS needs and objectives. The county EMS association should also include representatives of services located in a neighboring county if service is provided on a regular basis to residents of the funding county.

"Department" means the Iowa department of public health.

"Designee" means a county government agency or a board, commission or committee which has entered into an agreement with the county board of supervisors pursuant to Iowa Code chapter 28E.

"Director" means the director of the Iowa department of public health.

"Emergency medical care personnel" means any individual currently certified by the department pursuant to Iowa Code section 147A.6.

"Emergency medical services" means an integrated medical care delivery system to provide emergency and nonemergency medical care at the scene or during out-of-hospital patient transportation in an ambulance.

"EMS" means emergency medical services.

"EMS course" means a course for emergency medical care personnel pursuant to Iowa Code section 147A.4, subsection 2.

"EMS provider" means emergency medical care personnel, other health care practitioners or members of the general public involved in the provision of emergency medical care.

"Fiscal year" means the 12-month period beginning July 1 and ending June 30.

"Nontransport service" means any privately or publicly owned rescue or first response service program which does not provide patient transportation (except when no ambulance is available or in a disaster situation) and utilizes only first response vehicles to provide emergency medical care at the scene of an emergency.

"Regional EMS council" means a multicounty nonprofit corporation whose purpose is to facilitate EMS development on a regional basis.

"Service program" means any 24-hour emergency medical care ambulance service, or nontransport service that has received authorization by the department.

"Training" means EMS-related courses designed and intended for EMS providers.

"Training aid" means an item used in EMS training and includes, but is not limited to: slides, films, mannequins, emergency care devices, books and other items pertinent and necessary for training purposes.

641--140.2(135) Purpose. The EMS fund grant is intended to supplement EMS funds at the county or local level.

641--140.3(135) County EMS associations. Each county shall have a county EMS association, council or board to provide the county board of supervisors or their designee with advice on EMS funding needs and objectives.

641--140.4(135) County EMS fund grants. Grants for EMS-related purposes at the regional, county, and local level are available from the department. Each EMS fund grant application requires a $1 match of regional, county, or local funds for each $1 of EMS fund grant funds. EMS fund grants may be used by an ambulance or nontransporting service located in a neighboring county if service is provided on a regular basis to residents of the funding county.

140.4(1) Application process. An application for an EMS fund grant is required. Applications may be requested from the Iowa Department of Public Health, Bureau of EMS,Lucas State Office Building, Des Moines, Iowa 50319-0075. Deadline for completed applications is June 30 of each fiscal year. The application process is as follows:

a. Each county EMS association or regional EMS council may submit an application to the department for an EMS fund grant. Consideration should be given to 1995 Iowa Acts, Senate Files 118 and 178, when establishing spending priorities.

b. The department shall review the proposal and may approve, partially approve, request clarification or request a new application.

c. Notification of grant awards shall be made by September 30 of each fiscal year.

140.4(2) Eligible costs. Costs which are eligible for EMS fund grant expenditures include, but are not limited to, the following:

a. Reimbursement of tuition, fees and materials following successful completion of an EMS course. Practical examination fees may also be included.

b. Payment of continuing education tuition, fees and materials. Emergency medical training for the general public is an allowable expense.

c. Payment for EMS training aids.

d. Defibrillators.

e. Nondisposable essential ambulance equipment, as defined by the American College of Surgeons and American College of Emergency Physicians.

f. Communications pagers, radios, and base repeaters.

g. Development and enhancement of EMS systems and emergency medical services for children.

The title to any EMS equipment purchased with these funds shall not lie with the department, but shall be determined by the county board of supervisors or their designee.

140.4(3) Ineligible costs. Costs which are not eligible for funding include, but are not limited to, the following:

a. Certification/recertification fees.

b. Written examination fees.

c. Building and construction costs.

d. Debt amortization.

e. Land.

f. Rent.

g. Utilities.

h. Vehicles including, but not limited to, ambulances, fire apparatus, boats, rescue/first response vehicles, snowmobiles and vehicle parts.

Training funds distributed to counties pursuant to 641-- Chapter 130, Iowa Administrative Code, are not eligible for the match requirement for equipment purchases.

641--140.5(135) Disbursement of funds. The department shall reimburse an approved EMS fund grant contract at a rate of 50 percent of the approved contract amount. Payment shall be made upon receipt of a paid invoice. Training, equipment, or services purchased prior to department approval are not eligible for reimbursement.

641--140.6(135) Application denial or partial denial--appeal.

140.6(1) Denial or partial denial of an application shall be effected in accordance with the requirements of Iowa Code section 17A.12. Notice to the applicant of denial or partial denial shall be served by restricted certified mail, return receipt requested, or by personal service.

140.6(2) Any request for appeal concerning denial or partial denial shall be submitted by the aggrieved party in writing to the department by certified mail, return receipt requested, within 30 days of the receipt of the department's notice. The address is: Iowa Department of Public Health, Bureau of Emergency Medical Services, Lucas State Office Building, Des Moines, Iowa 50319-0075. Prior to or at the hearing, the department may rescind the denial or partial denial. If no request for appeal is received within the 30-day time period, the department's notice of denial or partial denial shall become the department's final agency action.

140.6(3) Upon receipt of an appeal that meets contested case status, the appeal shall be forwarded within five working days to the department of inspections and appeals pursuant to the rules adopted by that agency regarding the transmission of contested cases. The information upon which the adverse action is based and any additional information which may be provided by the aggrieved party shall also be provided to the department of inspections and appeals.

140.6(4) The hearing shall be conducted according to the procedural rules of the department of inspections and appeals found in 481--Chapter 4, Iowa Administrative Code.

140.6(5) When the hearing officer makes a proposed decision and order, it shall be served by restricted certified mail, return receipt requested, or delivered by personal service. That proposed decision and order then becomes the department's final agency action without further proceedings ten days after it is received by the aggrieved party unless an appeal to the director is taken as provided in subrule 140.6(6).

140.6(6) Any appeal to the director for review of the proposed decision and order of the administrative law judge shall be filed in writing and mailed to the director by certified mail, return receipt requested, or delivered by personal service within ten days after the receipt of the administrative law judge's proposed decision and order by the aggrieved party. A copy of the appeal shall also be mailed to the administrative law judge. Any request for an appeal shall state the reason for appeal.

140.6(7) Upon receipt of an appeal request, the administrative law judge shall prepare the record of the hearing for submission to the director. The record shall include the following:

a. All pleadings, motions, and rules.

b. All evidence received or considered and all other submissions by recording or transcript.

c. A statement of all matters officially noticed.

d. All questions and offers of proof, objections and rulings on them.

e. All proposed findings and exceptions.

f. The proposed decision and order of the administrative law judge.

140.6(8) The decision and order of the director becomes the department's final agency action upon receipt by the aggrieved party and shall be delivered by restricted certified mail, return receipt requested, or by personal service.

140.6(9) It is not necessary to file an application for a rehearing to exhaust administrative remedies when appealing to the director or the district court as provided in Iowa Code section 17A.19. The aggrieved party to the final agency action of the department who has exhausted all administrative remedies may petition for judicial review of that action pursuant to Iowa Code chapter 17A.

140.6(10) Any petition for judicial review of a decision and order shall be filed in the district court within 30 days after the decision and order becomes final. A copy of the notice of appeal shall be sent to the department by certified mail, return receipt requested, or by personal service. The address is: Iowa Department of Public Health, Bureau of Emergency Medical Services, Lucas State Office Building, Des Moines, Iowa 50319-0075.

140.6(11) The party who appeals a final agency action to the district court shall pay the cost of the preparation of a transcript of the contested case hearing for the district court.

These rules are intended to implement Iowa Code section 135.25, Iowa Code Supplement section 147A.6(1), and 1997 Iowa Acts, chapter 203.

ARC 7901A

Item 1 moves existing rules from Chapter 4 to Chapter 1.

Item 2 rescinds the rules that were relocated to more appropriate chapters.

Items 3 and 4 eliminate redundant language.

Item 5 replaces the term "simulcast steward" with "commission representative".

Item 6 defines the term "Board".

Item 7 expands the type of behavior not allowed in the industry.

Item 8 corrects an inappropriate rule reference.

Item 9 moves existing rules from Chapter 4 to Chapter 13. Rule 491--13.11(99D,99F) has been changed from its format in Chapter 4 to define a restricted area.

Item 10 removes vendors and allows for the administrator's designee to request records.

Item 11 allows for wide area progressive systems.

These adopted amendments are identical to those published under Notice of Intended Action in the December 17, 1997, Iowa Administrative Bulletin as ARC 7707A.

A public hearing was held on January 6, 1998. Oral and written comments were received in favor of the wide area progressive rules.

These amendments will become effective April 29, 1998.

These amendments are intended to implement Iowa Code chapters 99D, 99F and 252J.

The following amendments are adopted.

ITEM 1. Amend 491--Chapter 1 by adding the following new rules:

491--1.6(99D,99F) Commission approval of contracts and business arrangements. No operator shall enter into any contract or business arrangement, verbal or written, with any related party, or in which the term exceeds three years or the total value of the contract exceeds $50,000, without first submitting advance written notice thereof to the commission and obtaining commission approval therefor.

1.6(1) Purpose of contract review. The commission conducts reviews of contracts to serve the public interests in order that:

a. Gaming is free from criminal and corruptive elements.

b. Gaming-related funds are directed to the lawful recipient.

c. Gaming profits are not improperly distributed.

1.6(2) Related parties. Other contract submittal requirements notwithstanding, contracts negotiated between the operator and a related party must be accompanied by an economic and qualitative justification.

1.6(3) Review criteria. The commission shall approve all contracts that, in their opinion, represent a normal business transaction. The commission may deny approval of any contract which, in their sole opinion, represents a distribution of profits that differs from commission-approved ownership and beneficial interest. This rule does not prohibit the commission from changing the approved ownership or beneficial interest.

491--1.7(99D,99F) Retention, storage and destruction of books, records and documents.

1.7(1) Except as otherwise provided, all original books, records and documents pertaining to the licensee's operations shall be:

a. Prepared and maintained in a complete and accurate form.

b. Retained at a site approved by the administrator until audited.

c. Held immediately available for inspection by the commission during business hours of operations.

d. Organized and indexed in such a manner to provide immediate accessibility to the commission.

1.7(2) For the purpose of this rule, "books, records and documents" shall be defined as any book, record or document pertaining to or prepared or generated by the licensee including, but not limited to, all forms, reports, accounting records, ledgers, subsidiary records, computer-generated data, internal audit records, correspondence, contracts, and personnel records.

1.7(3) All original books, records and documents may be copied and stored on microfilm, microfiche or other suitable media system approved by the administrator.

1.7(4) No original book, record or document, or suitable media copy, may be destroyed by a licensee, for three years, without the prior approval of the administrator.

ITEM 2. Rescind and reserve rules 491--4.30(99D,99F) through 491--4.34(99D,99F).

ITEM 3. Amend subrule 7.9(4), paragraph "a," as follows:

a. There shall be one commission steward or commission representative on the premises during simulcasting. There shall be three stewards for each racing meet, two of whom shall be appointed by the commission and one of whom shall be nominated by the association for approval by the commission. The names of the association nominees for stewards shall be submitted no later than 45 days before commencement of a racing meet and be accompanied by biographical data setting up the experience and qualifications of the nominees. The commission may consider for appointment or approval:

Further amend subrule 7.9(4), paragraph "a," by rescinding subparagraphs (1), (2) and (3).

ITEM 4. Amend subrule 10.2(6), paragraph "a," subparagraph (1), as follows:

(1) General. The board of stewards for each racing meet and simulcast steward for simulcasting meets and performances shall be responsible to the commission for the conduct of the racing meet in accordance with the laws of this state and the rules adopted by the commission. The stewards shall have authority to resolve conflicts or disputes between all other racing officials, licensees, and those persons addressed by 491--4.3(99D,99F) 4.6(99D,99F), numbered paragraph "8," where the disputes are reasonably related to the conduct of a race, or races, and to punish violators of these rules in accordance with provisions of these rules.

ITEM 5. Amend subrule 12.10(1), introductory paragraph, as follows:

12.10(1) Duties of simulcast stewards commission representative. Duties of the simulcast steward commission representative include but are not limited to the following:

ITEM 6. Amend rule 491--13.1(99D,99F) by adding the following new definition in alphabetical order.

"Board" means either the board of stewards or gaming board, as appointed by the administrator, whichever is appropriate. The administrator may serve as a board of one.

ITEM 7. Amend subrule 13.6(5) as follows:

13.6(5) Whose conduct in Iowa or elsewhere in connection with racing or gaming has been dishonest, objectionable, obnoxious, undesirable, or detrimental to or reflects negatively on the best interests of racing and gaming.

ITEM 8. Amend subrule 13.6(7) as follows:

13.6(7) Is not of good repute and moral character as defined in 491--subrule 5.7(4) or 491--subrule 20.15(3) 20.15(4).

ITEM 9. Amend 491--Chapter 13 by adding the following new rules and renumbering existing rules 491-- 13.11(99D,99F) through 491--13.22(99D) as 491-- 13.14(99D,99F) through 491--13.25(99D).

491--13.11(99D,99F) Alcohol and drug testing rule.

13.11(1) Alcohol prohibition/preliminary breath test. Licensees, including track officials, whose duties require them to be in a restricted area and employees, while on duty, of any entity associated with the conduct of racing or gaming shall not have present within their systems an amount of alcohol of .05 percent or more. A restricted area is a designated area for sample collection, or a paddock, racetrack, or other area where officials carry out the duties of their positions.

Acting with reasonable cause, an administrator's designee may direct the above licensees to submit to a preliminary breath test. A licensee shall, when so directed, submit to examination.

If the results show a reading of .05 percent alcohol content or more, the licensee shall not be permitted to continue duties for that day. For a second violation, the licensee shall not be permitted to continue duties for that day and then be subject to fine or suspension by the board or commission. For a subsequent violation the licensee may be subject to procedures following positive chemical analysis (below).

If the results show a reading of .10 percent alcohol content or more, the licensee is subject to fine or suspension by the board. For a subsequent violation the licensee may be subject to procedures following positive chemical analysis (below).

13.11(2) Drug prohibition/body fluid test. Licensees, including track officials, whose duties require them to be in a restricted area as defined in subrule 13.11(1) or employees, while on duty, of any entity associated with the conduct of racing or gaming shall not have present within their systems any controlled substance as listed in Schedules I to V of the U.S. Code Title 21 (Food and Drug Section 812), Iowa Code chapter 124 or any prescription drug unless it was obtained directly or pursuant to valid prescription or order from a duly licensed physician who is acting in the course of professional practice. Acting with reasonable cause, an administrator's designee may direct the above licensees to deliver a specimen of urine or subject themselves to the taking of a blood sample or other body fluids at a collection site approved by the commission. In these cases the administrator's designee may prohibit the licensee from participating in racing or gaming until the licensee evidences a negative test result. Sufficient sample should be collected to ensure a quantity for a split sample when possible. A licensee who refuses to provide the samples herein described shall be in violation of these rules and shall be subject to disciplinary action by the board or commission. All confirmed positive test costs and any related expenses shall be paid for by the licensee. Negative tests shall be at the expense of the commission.

13.11(3) Procedures following positive chemical analysis.

a. After professional evaluation, if the licensee's condition proves nonaddictive and not detrimental to the best interest of racing or gaming, and the licensee can produce a negative test result and agrees to further testing at the discretion of the administrator's designee to ensure unimpairment, the licensee may be allowed to participate in racing or gaming.

b. After professional evaluation, should the licensee's condition prove addictive or detrimental to the best interest of racing or gaming, the licensee shall not be allowed to participate in racing or gaming until the licensee can produce a negative test result and show documented proof of successful completion of a certified alcohol/drug rehabilitation program approved by the administrator. The licensee must also agree to further testing at the discretion of the administrator or designee to ensure unimpairment.

c. For a second violation, a licensee shall be suspended and allowed to enroll in a certified alcohol/drug rehabilitation program approved by the administrator and to apply for reinstatement only at the discretion of the administrator.

491--13.12(99D,99F,252J) Failure to pay child support. Failure to pay child support shall result in license revocation, suspension, denial or nonrenewal.

13.12(1) The notice required by Iowa Code section 252J.8 shall be served upon the applicant or licensee by restricted certified mail, return receipt requested, or personal service in accordance with R.C.P. 56.1. Alternatively, the licensee or applicant may accept service personally or through authorized counsel.

13.12(2) The effective date of revocation or suspension of a license, or denial of the issuance or renewal of a license, as specified in the notice required by Iowa Code section 252J.8, shall be 60 days following service of the notice upon the licensee or applicant.

13.12(3) It is the responsibility of the administrator or commission representative to issue the notice required by Iowa Code section 252J.8.

13.12(4) Licensees and license applicants shall keep the agency informed of all court actions and all child support recovery unit actions taken under or in connection with Iowa Code chapter 252J and shall provide the agency copies, within seven days of filing or issuance, of all applications filed with the district court pursuant to Iowa Code section 252J.9, all court orders entered in such actions, and withdrawals of certificates of noncompliance by the child support recovery unit.

13.12(5) All agency fees for applications, license renewal or reinstatement must be paid by licensees or applicants before a license will be issued, renewed or reinstated after the agency has denied the issuance or renewal of a license, or has suspended or revoked a license pursuant to Iowa Code chapter 252J.

13.12(6) In the event a licensee or applicant timely files a district court action following service of an agency notice pursuant to Iowa Code sections 252J.8 and 252J.9, the agency shall continue with the intended action described in the notice upon the receipt of a court order lifting the stay, dismissing the action, or otherwise directing the agency to proceed. For purposes of determining the effective date of revocation or suspension, or denial of the issuance or renewal of a license, the agency shall count the number of days before the action was filed and the number of days after the action was disposed of by the court.

491--13.13(99D,99F) Labor organization registration required. Each labor organization, union or affiliate representing or seeking to represent employees licensed by the commission and employed by a racetrack or licensed excursion boat operator shall register with the commission annually.

13.13(1) Registration exemption. The administrator may exempt any labor organization, union or affiliate from registration requirements when it is found that such labor organization, union or affiliate:

a. Is not the certified bargaining representative of any employee licensed under this chapter or employed by a racetrack or licensed excursion boat operator; and

b. Is neither involved nor seeking to be involved actively, directly, or substantially in the control or direction of the representation of any such employee.

Such exemption shall be subject to revocation upon disclosure of information which indicates that the affiliate does not meet or no longer meets the standards for exemption.

13.13(2) Registration statement. In order to register, a labor organization, union or affiliate shall file with the commission a "Labor Organization Registration Statement." This requirement shall be completed and approved by the administrator prior to the labor organization's becoming the certified bargaining representative for employees occupationally licensed to work for a racetrack or an excursion boat gambling entity.

Said statement shall be in the form prescribed by the commission and shall include, without limitation, the following:

a. The names of all labor organizations affiliated with the registrant;

b. Information as to whether the registrant is involved or seeking to be involved actively, directly, or substantially in the control or direction of the representation of any employee licensed by the commission and employed by a racetrack or licensed excursion boat operator;

c. Information as to whether the registrant holds, directly or indirectly, any financial interest whatsoever in the racetrack or licensed excursion boat whose employees it represents;

d. The names of any pension and welfare systems maintained by the registrant and all officers and agents of such systems;

e. The names of all officers, agents, and principal employees of the registrant; and

f. All written assurances, consents, waivers, and other documentation required of a registrant by the commission.

13.13(3) Registration renewal. A labor organization registration shall be effective for one year. Any such registration may be renewed upon filing of an updated "Labor Organization Registration Statement" no later than 120 days prior to the expiration of the current registration. The commission shall act upon such application for renewal no later than 30 days prior to the date of expiration of the current registration.

13.13(4) Continuing duty to disclose. Every registered labor organization shall be under a continuing duty to promptly disclose any change in the information contained in the "Labor Organization Registration Statement" or as otherwise requested by the commission.

13.13(5) Federal reports exception. Notwithstanding the reporting requirements imposed by this chapter and the rules of the commission, no labor organization, union affiliate or person shall be required to furnish any information which is included in a report filed by any labor organization, union, affiliate or person with the Secretary of Labor, pursuant to 29 U.S.C. Section 431 et seq. (Labor-Management Reporting and Disclosure Act) or 29 U.S.C. Section 1001 et seq. (Employee Retirement Income Security Act) if a copy of such report, or if the portion thereof containing such information, is furnished to the commission pursuant to the aforesaid federal provisions.

13.13(6) Qualification of officers, agents, and principal employees. Every officer, agent, and principal employee of a labor organization, union or affiliate required to register with the commission pursuant to this chapter and the rules of the commission shall be qualified in accordance with criteria contained in 491--13.6(99D,99F) and 491--13.10(99D, 99F).

13.13(7) Qualification procedure.

a. In order to be qualified, every officer, agent and principal employee of a labor organization, union or affiliate required to register with the commission pursuant to the regulations of the commission shall file with the commission a "Labor Organization Individual Disclosure Form." This form shall be completed, signed, and filed in accordance with the requirements of this chapter, provided, however, that such a form need not be filed by an officer of a national or international labor organization where that officer exercises no authority, discretion or influence over the operation of such labor organization with regard to any employment matter relating to employees licensed under the Act and employed by a racetrack, an excursion boat or boat operator; and further provided that any such officer of a national or international labor organization may be directed by the commission to file a "Labor Organization Individual Disclosure Form" or to provide any other information in the same manner and to the same extent as may be required of any other officer of a labor organization which is required to register under this chapter.

b. Each officer, agent or principal employee required to file a "Labor Organization Individual Disclosure Form" shall do so initially at the time the pertinent labor organization, union or affiliate applies or should apply for registration or at the time the individual is elected, appointed or hired, whichever is later.

c. Following an initial finding of qualification, each qualified individual who has filed an initial "Labor Organization Individual Disclosure Form" shall annually file with the commission a properly completed, updated "Labor Organization Individual Disclosure Form."

13.13(8) Waiver of disqualification criteria. Notwithstanding the qualification requirements as to any such officer, agent or principal employee, the commission may waive any disqualification criteria upon a finding that the interests of justice so require.

13.13(9) Interest in a racetrack, an excursion gambling boat or excursion gambling boat license prohibited. Neither a labor organization, union or affiliate nor its officers, and agents not otherwise individually licensed under the Act and employed by a racetrack or an excursion gambling boat licensee may hold any financial interest whatsoever in the licensee whose employees they represent.

13.13(10) Failure to comply--consequences.

a. No labor organization, union or affiliate required to register with the commission shall receive any dues from or on behalf of or administer any pension, welfare funds from or on behalf of any licensed employee of a racetrack, an excursion boat or its agent:

(1) If the said labor organization, union, or affiliate shall fail to properly register with the commission or provide all information requested by the commission in accordance with the provisions of this chapter or the rules of the commission;

(2) If any officer, agent or principal employee of such labor organization, union or affiliate shall fail to qualify in accordance with the provisions of this chapter or the regulations of the commission; or

(3) If the said labor organization, union, affiliate or any officer or agent thereof shall hold a prohibited interest in a racetrack, an excursion gambling boat or an excursion gambling boat licensee.

b. Nothing herein shall be construed to limit the right of the commission to impose any sanctions or take any action authorized by this chapter or Iowa Code chapters 99D and 99F.

ITEM 10. Amend subrule 22.18(1), introductory paragraph, as follows:

22.18(1) Record storage required. Distributors, and manufacturers, and vendors shall maintain, in a place secure from theft, loss or destruction, adequate records of business operations which shall be made available to the administrator or administrator's designee upon request. These records shall include:

ITEM 11. Amend rule 491--26.17(99F) by adding the following new subrule:

26.17(7) Wide area progressive systems. A wide area progressive system is a method of linking progressive slot machines or electronic gaming devices across telecommunication lines as part of a network connecting participating excursion gambling boat and racetrack enclosure gaming licensees. The purpose of a wide area progressive system is to offer a common progressive jackpot (system jackpot) at all participating locations. The operation of a wide area progressive system (multilink) is permitted subject to the following conditions:

a. The method of communication over the multilink system must consist of dedicated on-line communication lines (direct connect), dial-tone lines, or wireless communication which may be subject to certain restrictions imposed by the administrator.

b. All communication between each licensee location and the central system site must be encrypted.

c. All meter reading data must be obtained in real time in an on-line, automated fashion. When requested to do so, the system must return meter readings on all slot machines or electronic gaming devices (machines) attached to the system within a reasonable time of the meter acquisition request. Manual reading of meter values may not be substituted for these requirements. There is no restriction as to the acceptable method of obtaining meter reading values, provided, however, that such methods consist of either pulses from any machine computer board or associated wiring, or the use of serial interface to the machine's random access memory (RAM) or other nonvolatile memory.

d. The multilink system must have the ability to monitor entry into the front door of the machine as well as the logic area of the machine and report such data to the central system.

e. The central system site must be located in the state of Iowa, be equipped with a noninterruptible power supply, and the central computer must be capable of on-line data redundancy should hard disk peripherals fail during operation. The office containing the central computer shall be equipped with a surveillance system which has been approved by the administrator. Any person authorized to provide a multilink system shall be required to keep and maintain an entry and exit log for the office containing the central computer. Any person authorized to provide a multilink system shall provide access to the office containing the central computer to the administrator and shall make available to the administrator all books, records and information required by the commission in fulfilling its regulatory purpose.

f. Any person authorized to provide a multilink system must suspend play on the system if a communication failure of the system cannot be corrected within 24 consecutive hours.

g. Approval by the administrator of any multilink system shall occur only after the administrator has reviewed the system software and hardware and is satisfied that the operation of the system meets accepted industry standards for multilink system products, as well as any other requirements that the administrator may impose to ensure the integrity, security and legal operation of the multilink system.

h. A meter that shows the amount of the system jackpot must be conspicuously displayed at or near the machines to which the jackpot applies. The system jackpot meter need not precisely show the actual moneys in the system jackpot award at each instant. Nothing shall prohibit the use of odometer or other paced updating progressive displays. In the case of the use of paced updating displays, the system jackpot meter must display the winning value after the jackpot broadcast is received from the central system, providing the remote site is communicating to the central computer. If a system jackpot is recognized in the middle of a systemwide poll cycle, the system jackpot display may contain a value less than the aggregated amount calculated by the central system. The coin values from the remaining portion of the poll cycle will be received by the central system but not the local site, in which case the system jackpot amount paid will always be the higher of the two reporting amounts.

i. When a system jackpot is won, a person authorized to provide the multilink system and the trust provided for in paragraph "m" (trust) shall have the opportunity to inspect the machine, EPROM, the error events received by the central system, and any other data which could reasonably be used to ascertain the validity of the jackpot.

(1) The central system shall produce reports that will clearly demonstrate the method of arriving at the payoff amount. This shall include the coins contributed beginning with the polling cycle immediately following the previous jackpot and will include all coins contributed up to, and including, the polling cycle, which includes the jackpot signal. Coins contributed to and registered by the system before the jackpot message is received will be deemed to have been contributed to the progressive amount prior to the current jackpot. Coins contributed to the system subsequent to the jackpot message being received as well as coins contributed to the system before the jackpot message is received by the system, but registered after the jackpot message is received at the system, will be deemed to have been contributed to the progressive amount of the next jackpot.

(2) The system jackpot may be disbursed in periodic payments as long as each machine clearly displays the fact that the jackpot will be paid in such periodic payments. In addition, the number of periodic payments and time between payments must be clearly displayed on the face of the slot machine in a nonmisleading manner.

(3) Two system jackpots which occur in the same polling cycle before the progressive amount can reset will be deemed to have occurred simultaneously; therefore, each winner shall receive the full amount shown on the system jackpot meter.

j. Any person authorized to provide a multilink system must supply, as requested, reports to the commission office and the trust which support and verify the economic activity of the system.

(1) Any person authorized to provide a multilink system must supply, as requested, reports and information to the commission office and the trust indicating the amount of, and basis for, the current system jackpot amount. Such reports may include an aggregate report and a detail report. The aggregate report may show only the balancing of the system with regard to systemwide totals. The detail report shall be in such form as to indicate for each machine, summarized by location, the coin-in totals as such terms are commonly understood in the industry.

(2) In addition, upon the invoicing of any licensee participating in a multilink system, each such licensee must be given a printout of each machine operated by that licensee, the coins contributed by each machine to the system jackpot for the period for which an invoice is remitted, and any other information required by the commission to confirm the validity of the licensee's contributions to the system jackpot amount.

k. In calculating adjusted gross receipts, a licensee may deduct its pro-rata share of the present value of any system jackpots awarded during the month. Such deduction amount shall be listed on the detailed accounting records provided by the person authorized to provide the multilink system. A licensee's pro-rata share is based on the number of coins-in from that licensee's machines on the multilink system, compared to the total amount of coins-in on the whole system for the time period(s) between jackpot(s) awarded.

l. In the event an excursion gambling boat or racetrack enclosure licensee ceases operations and a progressive jackpot is awarded subsequent to the last day of the final month of operation, the excursion gambling boat or racetrack enclosure licensee may not file an amended wagering tax submission or make a claim for a wagering tax refund based on its contributions to that particular progressive prize pool.

m. An excursion gambling boat or racetrack enclosure licensee, or an entity that is licensed as a manufacturer or distributor, shall provide the multilink system in accordance with a written agreement which shall be reviewed and approved by the commission prior to offering the jackpots, provided, however, a trust comprised of the participating excursion gambling boat and racetrack enclosure licensees shall be established to control the system jackpot fund (trust fund) provided for in paragraph "n," subparagraph "3."

n. The payment of any system jackpot offered on a multilink system shall be administered by a trust, in accordance with a written trust agreement which shall be reviewed and approved by the commission prior to the offering of the jackpot. The trust may contract with a licensed manufacturer or distributor to administer the trust fund. The trust agreement shall require the following:

(1) Any excursion gambling boat or racetrack enclosure licensee participating in offering the multilink system jackpot shall serve as trustee for the trust fund.

(2) Any excursion gambling boat or racetrack enclosure licensee shall be jointly and severally liable for the payment of system jackpots won on a multilink system in which the licensee is or was a participant at the time the jackpot was won.

(3) The moneys in the trust fund shall consist of the sum of funds invoiced to and received by the trust from the excursion gambling boat or racetrack enclosure licensees with respect to each particular system, which invoices shall be based on a designated percentage of the handle generated by all machines linked to the particular system; any income earned by the trust; and sums borrowed by the trust and any other property received by the trust. Prior to the payment of any other expenses, the trust funds shall be used to purchase Iowa state issued debt instruments or United States Treasury debt instruments in sufficient amounts to ensure that the trust will have adequate moneys available in each year to make all multilink system jackpot payments which are required under the terms of the multilink system jackpots which are won.

(4) A reserve shall be established and maintained within the trust fund sufficient to purchase any United States Treasury or Iowa state debt instruments required as multilink system jackpots are won (systems reserves). For purposes of this rule, the multilink system reserves shall mean an amount equal to the sum of the present value of the aggregate remaining balances owed on all jackpots previously won by patrons on the multilink systems; the present value of the amount currently reflected on the system jackpot meters of the multilink systems; and the present value of one additional reset (start amount) on such systems.

(5) The trust shall continue to be maintained until all payments owed to winners of the multilink system jackpots have been made.

(6) Any United States Treasury or Iowa state debt instrument shall have a surrender value at maturity, excluding any interest paid before the maturity date, equal to or greater than the value of the corresponding periodic jackpot payment, and shall have a maturity date prior to the date the periodic jackpot payment is required to be made. Any United States Treasury or Iowa state debt instruments shall be purchased within 30 days following notice of the win of the multilink system jackpot, and a copy of such debt instruments will be provided to the commission office within 30 days of their purchase.

(7) The trust shall not be permitted to sell, trade, or otherwise dispose of any United States Treasury or Iowa state debt instruments prior to maturity unless approval to do so is first obtained from the commission.

(8) Upon becoming aware of an event of noncompliance with the terms of the approved trust agreement or reserve requirement mandated by paragraph "n," subparagraph (4) above, the trust must immediately notify the commission of such event. An event of noncompliance includes a nonpayment of a jackpot periodic payment or a circumstance which may cause the trust to be unable to fulfill, or otherwise impair, its ability to satisfy its jackpot payment obligations.

(9) With the exception of the transfer to the estate or heir(s) of a deceased system jackpot winner or to the estate or heir(s) of such transferee upon death or the granting of a first priority lien to the trust to secure repayment of a tax loan to the winner should a tax liability on the full amount of the jackpot be assessed by the Internal Revenue Service against the winner, no interest in income or principal shall be alienated, encumbered or otherwise transferred or disposed of in any way by any person while in the possession and control of the trust.

(10) On a quarterly basis, the trust must deliver to the commission office a calculation of system reserves required under paragraph "n," subparagraph (4), above.

(11) The trust must be audited, in accordance with generally accepted auditing standards, on the fiscal year of the trust by an independent certified public accountant. Two copies of the report must be submitted to the commission office within 90 days after the conclusion of the trust's fiscal year.

ARC 7903A

New rule 3.25(125) establishes specific standards for the licensing of screening, intake, assessment and evaluation programs. This new rule reflects the current needs of assessment and evaluation programs and patients in general areas including application for licensure; procedures for denial,revocation, suspension, and refusal to renew a license; placement screening, admission and assessment clinical services; administration; programming and facilities; and management of care.

Notice of Intended Action was published in the Iowa Administrative Bulletin on November 19, 1997, as ARC 7662A.

Based on public comment and to address the needs of sole practitioners and individuals in private practice, numerous and extensive changes were made following the Notice of Intended Action. Changes include the deletion of proposed requirements that do not appear to be necessary for the benefit of the patient/client or for licensing and regulation of providers. Other changes include clarifications of definitions and moving proposed subrules to more appropriate locations in the rule.

In subrule 3.25(1), definitions of "Admission," "Admission criteria," and "Substance abuser" were revised. "Treatment supervisor" was changed to "Clinical oversight" and a definition for "Sole practitioner" was added.

Subrule 3.25(2) was revised to exempt individuals in private practice as sole practitioners. Noticed subparagraphs 3.25(2)"b"(1), (4) and (5) and 3.25(2)"c"(5) were not adopted.

Subrule 3.25(3) was rewritten to delete redundancies, and noticed 3.25(3)"a"(1) to (6) and 3.25(3)"b"(1) to (4) were deleted as unnecessary.

Subrule 3.25(4) was revised to clarify oversight provisions.

Subrule 3.25(5) was revised for clarity and to provide that individuals operating as sole practitioners and organized as professional corporations could meet orientation requirements through continuing education requirements for professional licensure or substance abuse certification.

Subrule 3.25(6) was revised to clarify that programs receiving Medicaid or state funding and those conducting OWI evaluations are to submit client data to the Department.

Subrule 3.25(7) was revised as follows: Noticed paragraphs "b," "g," "h," "i," "l," "m," and "n" were deleted and remaining paragraphs were relettered as "a" to "h." Relettered paragraph "b" was amended to exempt a sole practitioner; relettered "c" added the word "emergency" to address patients' needs; relettered "d" replaced the word "training" with the word "development"; and relettered paragraphs "e," "g" and "h" were clarified.

Subrule 3.25(8), paragraph "a," of the Notice was not adopted. Relettered paragraph "a" deleted the requirement of an independent fiscal audit, and paragraph "b" now requires providers to make public the OWI fee schedule and inform patients/clients of the fee schedule at the time of scheduling an evaluation.

Subrule 3.25(9) was revised to exempt sole practitioners, subparagraph 3.25(9)"a"(2) was deleted, and remaining subparagraphs were renumbered. Noticed paragraphs "c," "d," and "e" were combined in a new "c" and remaining paragraphs were relettered and revised for clarity. Noticed paragraph "h," subparagraphs (1) to (4), was moved to 3.25(11)"b" to address child abuse/criminal records check. Also, noticed paragraph "j" was moved to 3.25(10) and paragraphs "k" and "l" were moved to 3.25(19).

Subrule 3.25(10) concerning professional qualifications includes language from noticed 3.25(9).

Noticed subrule 3.25(10) was revised and renumbered as 3.25(11).

Noticed subrule 3.25(11) was revised and renumbered as 3.25(12).

Noticed subrule 3.25(12) was renumbered as 3.25(13), and noticed paragraph "a," subparagraph (1), paragraph "c," and subparagraphs (1), (2), and (3) of paragraph "d" were deleted.

Noticed subrule 3.25(13) was revised and renumbered as 3.25(14).

Noticed subrule 3.25(14) was deleted as not necessary for programs providing screening and evaluation services only.

Subrule 3.25(15) was revised to delete "on a 24-hour basis" and insert policy and procedure language to ensure that service is available. In addition, noticed paragraphs "a" and "b" were deleted as unnecessary for providers of screening and assessment services.

Subrule 3.25(17) was revised to delete noticed paragraphs "a," "b," and "c" and to include language from noticed subrule 3.25(19) and subrule 3.25(20), paragraph "a."

Subrule 3.25(18) was noticed as subrule 3.25(21).

Noticed subrule 3.25(22), paragraph "a," was moved to 3.25(18), paragraph "e," and paragraph "d" was moved to 3.25(18)"g" and revised to allow programs to restrict smoking in designated areas.

Noticed subrule 3.25(23) was renumbered as 3.25(19), and paragraph "a" was revised to clarify that it applied to evaluation programs only.

Noticed subrule 3.25(24) was renumbered as 3.25(20).

This rule was adopted in final form on February 18, 1998.

This rule will become effective April 29, 1998.

This rule is intended to implement Iowa Code section 125.13.

The following rule is adopted.

Adopt new rule 643--3.25(125) as follows:

643--3.25(125) Specific standards for assessment and evaluation programs.

3.25(1) Definitions.

"Acute intoxication or withdrawal potential" is a category to be considered in the ASAM-PPC-2 placement, continued stay, and discharge criteria. This category evaluates client/patient's current status of intoxication and potential for withdrawal complications as it impacts on level of care decision making. Historical information about client/patient's withdrawal patterns may also be considered.

"Admission" means the point in an individual's relationship with the program at which the evaluation, placement screening and assessment process has been completed and the individual is entitled to receive treatment services.

"Admission criteria" means specific ASAM-PPC-2 criteria to be considered in determining appropriate client/patient placement and resultant referral to a level of care. Criteria vary in intensity and are organized into six categories: acute intoxication or withdrawal potential, biomedical conditions or complications, emotional/behavioral conditions or complications, treatment resistance/acceptance, relapse potential, and recovery environment.

"ASAM-PPC-2" means the American Society of Addiction Medicine, Patient Placement Criteria for the Treatment of Substance-Related Disorders, Second Edition.

"Assessment" means the ongoing process of identifying a diagnosis, ruling out other diagnoses, and determining the level of care needed by the client.

"Biomedical condition or complication" means one category to be considered in ASAM-PPC-2 placement, continued stay, and discharge criteria. This category evaluatesclient/patient's current physical condition as it impacts on level of care decision making. Historical information onclient/patient's medical/physical functioning may also be considered.

"Case management" means the process of using predefined criteria to evaluate the necessity and appropriateness of client care.

"Chemical dependency" means alcohol or drug dependence or psychoactive substance use disorder as defined by current Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV) criteria or by other standardized and widely accepted criteria.

"Client/patient" means an individual who has a substance abuse problem or is chemically dependent, has been assessed as appropriate for services, and for whom screening procedures have been completed.

"Clinically managed high-intensity residential services" (Level III.5) offers high-intensity residential services designed to address significant problems with living skills. The prime example of Level III.5 care is the therapeutic community, which provides a highly structured recovery environment in combination with moderate- to high-intensity professional clinical services to support and promote recovery. (Reference ASAM-PPC-2)

"Clinically managed low-intensity residential services" (Level III.1) offers low-intensity professional addiction treatment services at least five hours a week. Treatment is directed toward applying recovery skills, preventing relapse, promoting personal responsibility and reintegrating the resident into the worlds of work, education, and family life. The services provided may include individual, group and family therapy. Mutual/self-help meetings usually are available on site. (Reference ASAM-PPC-2)

"Clinically managed medium-intensity residential services" (Level III.3) is frequently referred to as extended or long-term care. Level III.3 programs provide a structured recovery environment in combination with medium-intensity professional clinical services to support and promote recovery. (Reference ASAM-PPC-2)

"Clinical oversight" means oversight provided by an individual who, by virtue of education, training or experience, is capable of assessing the psychosocial history of a substance abuser to determine the treatment plan most appropriate for the client. The person providing oversight shall be designated by the applicant.

"Continued stay criteria" means specific ASAM-PPC-2 criteria to be considered in determining appropriate client/patient placement for continued stay at a level of care or referral to a more appropriate level of care. Criteria vary inintensity and are organized into six categories: acute intoxication or withdrawal potential; biomedical conditions or complications; emotional/behavioral conditions or complications; treatment resistance/acceptance; relapse potential; and recovery environment.

"Continuing care" means Level I service of ASAM-PPC-2 placement criteria, which provides a specific period of structured therapeutic involvement designed to enhance, facilitate and promote transition from primary care to ongoing recovery. (Reference ASAM-PPC-2)

"Detoxification" means the process of eliminating the toxic effects of drugs and alcohol from the body. Supervised detoxification methods include social detoxification and medical monitoring or management and are intended to avoid withdrawal complications. (Reference ASAM-PPC-2 for detoxification level of care)

"Emotional/behavioral conditions or complications" is a category to be considered in ASAM-PPC-2 placementcriteria. This category evaluates client/patient's current emotional/behavioral status as it impacts on level of care decision making. Emotional/behavioral status may include, but is not limited to, anxiety, depression, impulsivity, and guilt and the behavior that accompanies or follows theseemotional states. Historical information on client/patient's emotional/behavioral functioning may also be considered.

"Evaluation" means the process to evaluate the client/patient's strengths, weaknesses, problems, and needs for the purpose of defining a course of treatment. This includes use of the standardized placement screening and any additional client/patient profile information and recommendation to an appropriate level of care.

"Intake" means gathering additional assessment information at the time of admission to services.

"Intensive outpatient treatment" (Level II.1) programs generally provide nine or more hours of structured programming per week, consisting primarily of counseling and education concerning alcohol and other drug problems. Intensive outpatient treatment differs from partial hospitalization (Level II.5) in the intensity of clinical services that are directly available; specifically, intensive outpatient treatment has less capacity to effectively treat individuals who have substantial medical and psychiatric problems.

"Levels of care" is a general term that encompasses the different options for treatment that vary according to the intensity of the services offered. Each treatment option in the client/patient placement criteria is a level of care.

"Recovery environment" means one category to be considered in the ASAM-PPC-2 placement, continued stay and discharge criteria. This category evaluates client/patient's current recovery environment as it impacts on level of care decision making. Recovery environment may include, but is not limited to, current relationships and degree of support for recovery, current housing, employment situation, and availability of alternatives. Historical information on client/patient's recovery environment may also be considered.

"Relapse" means progressive irresponsible, inappropriate and dysfunctional behavior patterns that could lead to resumption of alcohol or drug use. "Relapse" also refers to the resumption of alcohol or drug use.

"Relapse potential" means a category to be considered in ASAM-PPC-2 placement, continued stay, and discharge criteria. This category evaluates client/patient's current relapse potential as it impacts on level of care decision making. Relapse potential may include, but is not limited to, current statements by client/patient about relapse potential, reports from others on client/patient's potential for relapse, and assessment by clinical staff. Historical information on client/patient's relapse potential may also be considered.

"Screening" means the process by which a client/patient is determined appropriate and eligible for admission to a particular program or level of care. The focus is on the minimum criteria necessary for appropriateness/eligibility.

"Sole practitioner" means an individual incorporated under the laws of the state of Iowa.

"Substance abuser" means a person who lacks self-control as to the use of chemical substances or uses chemical substances to the extent that the person's health is substantially impaired or endangered or that the person's social or economic function is substantially disrupted.

"Treatment acceptance/resistance" is a category to be considered in ASAM-PPC-2 placement, continued stay, and discharge criteria. This category evaluates client/patient's current treatment acceptance/resistance as it impacts on level of care decision making. Treatment acceptance/resistance may include, but is not limited to, current statements byclient/patient about treatment acceptance/resistance, reports from others on client/patient treatment acceptance/resistance, and assessment by clinical staff on client/patient motivation. Historical information on client/patient may also be considered.

3.25(2) Governing body. Each program shall have a formally designated governing body that is representative of the community being served, complies with the Iowa Code and is the ultimate authority for the overall program operations. Persons in private practice as sole practitioners shall be exempt from this subrule.

a. The governing body shall develop and adopt written bylaws and policies that define the powers and duties of the governing body, its committees, advisory groups, and the executive director. These bylaws shall be reviewed and revised by the governing body as necessary.

b. The bylaws shall minimally specify the following:

(1) The type of membership;

(2) The term of appointment;

(3) The frequency of meetings;

(4) The attendance requirements; and

(5) The quorum necessary to transact business.

c. Minutes of all meetings shall be kept and be available for review by the department and shall include, but not necessarily be limited to:

(1) Date of the meeting;

(2) Names of members attending;

(3) Topics discussed; and

(4) Decisions reached and actions taken.

d. The duties of the governing body shall include, but not necessarily be limited to, the following:

(1) Appointment of a qualified executive director who shall have the responsibility and authority for the management of the program in accordance with the governing body's established policies;

(2) Establish an effective control which will ensure that quality services are delivered;

(3) Review and approve the program's annual budget; and

(4) Approve all contracts.

e. The governing body shall develop and approve policies for the effective operation of the program.

f. The governing body shall be responsible for all funds, equipment, supplies and the facility in which the program operates. The governing body shall be responsible for the appropriateness and adequacy of services provided by the program.

g. The governing body shall at least annually prepare a report which will include, but not necessarily be limited to, the following items:

(1) The name, address, occupation, and place of employment of each governing body member;

(2) Any family relationship which a member of the governing body may have to a program staff member; and

(3) Where applicable, the names and addresses of all owners or controlling parties whether they are individuals, partnerships, corporation body, or subdivision of other bodies, such as a public agency, or religious group, fraternity, or other philanthropic organization.

h. The governing body shall assume responsibility in seeing that the program has malpractice and liability insurance and a fidelity bond.

3.25(3) Executive director. This individual shall have primary responsibility for the overall program operations. The duties of the executive director shall be clearly defined by the governing authority, when applicable.

3.25(4) Clinical oversight. The program shall have appropriate clinical oversight to ensure quality of clinical services provided to client/patients. This may be provided in house or through a consultation agreement.

3.25(5) Staff development and training. There shall be written policies and procedures that establish staff development. Staff development shall include orientation for staff and opportunities for continuing job-related education. For corporations organized under Iowa Code chapter 496C and sole practitioners, documentation of continuing education to maintain professional license or substance abuse certification will meet the requirement of this subrule.

a. Evidence of professional education, substance abuse certification or licensing, or orientation which includes the following: psychosocial, medical, pharmacological, confidentiality, tuberculosis, community resources; screening, evaluation, HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome) information/education; and the attitudes, values and lifestyles of racially diverse cultures, other cultures and special populations.

b. Staff development shall ensure that staff members are kept informed of new developments in the field of substance abuse screening, evaluation and placement.

3.25(6) Management information system. Programs receiving Medicaid or state funding and programs performing OWI evaluation in accordance with 643 IAC Chapter 8 shall submit client data to the Iowa Department of Public Health, Division of Substance Abuse and Health Promotion, Lucas State Office Building, Des Moines, Iowa 50319-0075, in accordance with substance abuse reporting system procedures.

3.25(7) Procedures manual. All programs shall develop and maintain a procedures manual. This manual shall define the program's policies and procedures to reflect the program's activities. Revisions shall be entered with the date, name and title of the individual making the entries. This manual shall contain all of the required written policies, procedures, definitions, and all other documentation required by these standards in the following areas:

a. Legal authority and organization;

b. Personnel policies, except for sole practitioner;

c. Emergency medical services;

d. Staff development;

e. Maintenance of client case records;

f. Confidentiality of client records;

g. Clinical services, such as placement screening, evaluation and assessment; and

h. Relationship with other providers.

3.25(8) Fiscal management. The program shall ensure proper fiscal management.

a. The fiscal management system shall be maintained in accordance with generally accepted accounting principles, including internal controls to reasonably protect the agency assets.

b. The OWI evaluation fee schedule shall be made public, and the client/patient shall be informed of the fee schedule at the time of scheduling the evaluation.

c. There shall be an insurance program that provides for the protection of the physical and financial resources of the program which provides coverage for all people, buildings, and equipment. The insurance program shall be reviewed annually by the governing body.

3.25(9) Personnel. Written personnel policies and procedures shall be developed, except for the sole practitioner.

a. These policies and procedures shall address the following areas:

(1) Recruitment, selection, and certification of staff members;

(2) Wage and salary administration;

(3) Promotions;

(4) Employee benefits;

(5) Working hours;

(6) Vacation and sick leave;

(7) Lines of authority;

(8) Rules of conduct;

(9) Disciplinary actions and termination of employees;

(10) Methods for handling cases of inappropriate client care;

(11) Work performance appraisal;

(12) Employee accidents and safety;

(13) Employee grievances; and

(14) Policy on staff persons suspected of using or abusing substances.

b. The written personnel policies and practices shall include an equal employment opportunity policy and an affirmative action plan for hiring members of protected classes.

c. There shall be written job descriptions that reflect the actual job situation.

d. The written personnel policies and practices shall include a mechanism for a written evaluation of personnel performance on at least an annual basis. There shall be evidence that this evaluation is reviewed with the employee and that the employee is given the opportunity to respond to this evaluation.

e. There shall be a personnel record kept on each staff member. These records shall contain as applicable:

(1) Verification of training, experience, and all professional credentials relevant to the position;

(2) Job performance evaluations;

(3) Incident reports;

(4) Disciplinary actions taken; and

(5) Documentation of review and adherence to confidentiality laws and regulations. This review and agreement shall occur prior to assumption of duties.

f. There shall be written policies and procedures designed to ensure confidentiality of personnel records and a delineation of authorized personnel who have access to various types of personnel information.

3.25(10) Professional qualifications.

a. Personnel conducting screenings, placements, and assessments shall be certified through the Iowa board of substance abuse certification, or certified by an international certification and reciprocity consortium member board in the states of Illinois, Minnesota, Nebraska, Missouri, South Dakota, and Wisconsin; or be eligible for certification or have education, training, or experience in the substance abuse field.

b. The sole practitioner shall subscribe to a code of conduct such as that found in professional certification or licensure.

3.25(11) Child abuse/criminal records check.

a. Written policies and procedures shall prohibit mistreatment, neglect, or abuse of children and specify reporting and enforcement procedures for the program. Alleged violations shall be reported immediately to the director of the facility and appropriate department of human services personnel. Written policies and procedures on reporting alleged violations shall be in compliance with the department of human services, 42 CFR, Part 2, regulations on confidentiality of alcohol and drug abuse client records. Any employee found to be in violation of Iowa Code chapter 232, division III, part 2, as substantiated by the department of human services' investigation shall be subject to the agency's policies concerning dismissal.

b. For each employee working within a juvenile service area, the following shall be documented:

(1) Documentation of a criminal records check with the Iowa division of criminal investigation on all new applicants for employment asking whether the applicant has been convicted of a crime.

(2) A written, signed, and dated statement furnished by a new applicant for employment which discloses any substantiated reports of child abuse, neglect, or sexual abuse that may exist on the applicant.

(3) Documentation of a check after hiring on probationary or temporary status, but prior to permanently employing the individual with the Iowa central child abuse registry for any substantiated reports of child abuse, neglect, or sexual abuse.

(4) A person who has a record of a criminal conviction or founded child abuse report shall not be employed, unless an evaluation of the crime or founded child abuse has been made by the department of human services which concludes that the crime or founded child abuse does not merit prohibition of employment. If a record of criminal conviction or founded child abuse exists, the person shall be offered the opportunity to complete and submit Form 470-2310, Record Check Evaluation. In its evaluation, the department of human services shall consider the nature and seriousness of the crime or founded abuse in relation to the position sought, the time elapsed since the commission of the crime or founded abuse, the circumstances under which the crime or founded abuse was committed, the degree of rehabilitation, and the number of crimes or founded abuses committed by the person involved.

c. Each treatment staff member shall complete two hours of training relating to the identification and reporting of child abuse and dependent adult abuse within six months of initial employment, and at least two hours of additional training every five years thereafter.

3.25(12) Client case record maintenance. There shall be written policies and procedures governing the compilation, storage and dissemination of individual client case records.

a. These policies and procedures shall ensure that:

(1) The program exercises its responsibility for safeguarding and protecting the client case record against loss, tampering, or unauthorized disclosure of information;

(2) Content and format of client records are kept uniform; and

(3) Entries in the client case record are signed and dated.

b. The program shall provide adequate physical facilities for the storage, processing, and handling of client case records. These facilities shall include suitably locked, secured rooms or file cabinets.

c. Appropriate records shall be readily accessible to those staff members providing services directly to the client and other individuals specifically authorized by program policy.

d. There shall be a written policy governing the disposal and maintenance of client case records. Client case records shall be maintained for not less than five years from the date they are officially closed.

e. Each file cabinet or storage area containing client/patient case records shall be locked.

f. Policies shall be established that specify the conditions under which information on applicants or clients may be released and the procedures to be followed for releasing such information. All such policies and procedures shall be in accordance with the federal confidentiality regulations, "Confidentiality of Alcohol and Drug Abuse Patient Rec-ords," 42 CFR, Part 2, effective June 9, 1987, which implement federal statutory provisions, 42 U.S.C. 290dd-3 applicable to alcohol abuse patient records, and 42 U.S.C. 290ee-3 applicable to drug abuse patient records, and state confidentiality laws and regulations.

g. Confidentiality of alcohol and drug abuse patient rec-ords. The confidentiality of alcohol and drug abuse patient records maintained by a program is protected by the "Confidentiality of Alcohol and Drug Abuse Patient Records" regulations, 42 CFR, Part 2, effective June 9, 1987, which implement federal statutory provisions, 42 U.S.C. 290dd-3 applicable to alcohol abuse patient records, and 42 U.S.C. 290ee-3 applicable to drug abuse patient records.

3.25(13) Placement screening, evaluation and assessment. There shall be clearly stated written criteria for determining the eligibility of individuals for placement screening evaluation and assessment.

a. The program shall have written policies and procedures governing a uniform process that defines:

(1) Procedures to be followed when accepting referrals from outside agencies or organizations;

(2) The types of records to be kept on all individuals applying for services.

b. The program shall conduct a screening, which shall include evaluation of the ASAM-PPC-2 for determining the recommendation of individuals for placement into a level of care.

c. At the time of screening, documentation shall be made that the individual has been informed of:

(1) Evaluation costs to be borne by the client, if any;

(2) Client's rights and responsibilities; and

(3) Confidentiality laws, rules and regulations.

d. Sufficient information shall be collected during the screening and evaluation process so that a recommendation can be made for placement into a level of care.

e. The results of the screening and evaluation process shall be clearly explained to the client and to the client's family when appropriate. This shall be documented in the client record.

f. Programs conducting screenings and evaluations on persons convicted of operating a motor vehicle while intoxicated (OWI), Iowa Code section 321J.2, and persons whose driver's license or nonresident operating privileges are revoked under chapter 321J, shall do so in accord with and adhere to 643 IAC Chapter 8.

3.25(14) Client case record contents. There shall be a case record for each client that contains:

a. Results of all examinations, tests, and screening and admissions information;

b. Reports from referring sources when applicable;

c. Reports from outside resources shall be dated and include the name of the resource;

d. Multidisciplinary case conference and consultation notes, including the date of the conference or consultation, recommendations made, actions taken, and individuals involved when applicable;

e. Correspondence related to the client, including all letters and dated notations of telephone conversations relevant to the client's treatment;

f. Information release forms;

g. Records of services provided; and

h. Management information system or other appropriate data forms.

3.25(15) Emergency medical services. The program shall ensure that emergency medical services are available through an affiliation agreement or contract or policy and procedure.

3.25(16) Management of care. The program shall ensure appropriate level of care utilization by implementing and maintaining the written placement screening.

3.25(17) Building construction and safety. All buildings in which clients receive treatment shall be designed, constructed, equipped, and maintained in a manner that is designed to provide for the physical safety of clients, personnel, and visitors.

a. All programs shall have written policies and procedures to provide a safe environment for clients, personnel and visitors. The program shall have written policies and procedures for the maintenance, supervision, and safe use of all its grounds and equipment.

b. Safety education shall include orientation of new employees to general facilitywide safety practices.

3.25(18) Outpatient facility. The outpatient facility shall be safe, clean, well ventilated, properly heated and in good repair.

a. The facility shall be appropriate for providing services available from the program and for protecting client confidentiality.

b. Furniture shall be clean and in good repair.

c. Written reports of annual inspections by state or local fire safety officials and records of corrective action taken by the program on recommendations articulated in such reports shall be maintained.

d. There shall be a written plan outlining procedures to be followed in the event of fire and tornado. This plan shall be conspicuously displayed at the facility.

e. All services shall be accessible to people with disabilities, or the program shall have written policies and procedures that describe how people with disabilities can gain access to the facility for necessary services.

f. The program shall ensure confidentiality of clients receiving services.

g. Smoking shall be prohibited except in designated areas.

3.25(19) Client rights. The program shall maintain written policies and procedures that ensure that the legal and human rights of clients participating in the program shall be observed and protected.

a. There shall be procedures to inform all clients of their legal and human rights at the time of evaluation.

b. There shall be documentation of the implementation of these procedures.

c. There shall be written policies and procedures for:

(1) Clients' communications, e.g., opinions, recommendations;

(2) Client grievances, with a mechanism for redress;

(3) Prohibition of sexual harassment; and

(4) Implementation of the Americans with Disabilities Act.

d. There shall be procedures designed to protect the clients' rights and privacy.

3.25(20) Administrative and procedural standards. The program shall comply with the following rules:

a. 643--3.2(125) Licensing.

b. 643--3.3(125) Type of licenses.

c. 643--3.4(125) Nonassignability.

d. 643--3.5(125) Application procedures.

e. 643--3.6(125) Application review.

f. 643--3.7(125) Inspection of licensees.

g. 643--3.8(125) Licenses--renewal.

h. 643--3.9(125) Corrective action plan.

i. 643--3.10(125) Grounds for denial of initial license.

j. 643--3.11(125) Suspension, revocation, or refusal to renew a license.

k. 643--3.12(125) Contested case hearing.

l. 643--3.13(125) Rehearing application.

m. 643--3.14(125) Judicial review.

n. 643--3.15(125) Reissuance or reinstatement.

o. 643--3.16(125) Complaints.

p. 643--3.17(125) Variances.

q. 643--3.18(125) Reserved.

r. 643--3.19(125) Funding.

s. 643--3.20(125) Inspection.

This rule is intended to implement Iowa Code section 125.13.

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Last update: Wed Mar 25 0:01:07 CST 1998
URL: /Rules/1998/Bulletin/acb980325.html
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