Senate Amendment to House File 2676 H-8335 Amend House File 2676, as amended, passed, and reprinted by 1 the House, as follows: 2 1. By striking everything after the enacting clause and 3 inserting: 4 < DIVISION I 5 SHORT TITLE 6 Section 1. SHORT TITLE. This Act shall be known and may be 7 cited as the “Iowa Make America Healthy Again Act”. 8 DIVISION II 9 CONTINUING EDUCATION REQUIREMENTS —— NUTRITION AND METABOLIC 10 HEALTH 11 Sec. 2. Section 148.3, Code 2026, is amended by adding the 12 following new subsection: 13 NEW SUBSECTION . 5. The board shall adopt rules pursuant to 14 chapter 17A requiring a licensee practicing family medicine, 15 internal medicine, pediatrics, psychiatry, endocrinology, 16 gastroenterology, cardiology, oncology, rheumatology, 17 neurology, nephrology, dermatology, pulmonology, surgery, 18 immunology, hematology, obstetrics, or gynecology to complete a 19 minimum of one hour of continuing education on nutrition and 20 metabolic health every four years as a condition of license 21 renewal. 22 Sec. 3. Section 148C.3, subsection 1, paragraph c, Code 23 2026, is amended to read as follows: 24 c. Hours of continuing medical education necessary to become 25 or remain licensed. The board shall adopt rules pursuant to 26 chapter 17A requiring a licensee practicing family medicine, 27 internal medicine, pediatrics, psychiatry, endocrinology, 28 gastroenterology, cardiology, oncology, rheumatology, 29 neurology, nephrology, dermatology, pulmonology, surgery, 30 immunology, hematology, obstetrics, or gynecology to complete a 31 minimum of one hour of continuing education on nutrition and 32 metabolic health every four years as a condition of license 33 renewal. 34 DIVISION III 35 -1- HF 2676.3930.S (1) 91 mb 1/ 48 #1.

MEDICAL SCHOOL GRADUATION REQUIREMENT —— NUTRITION 1 Sec. 4. NEW SECTION . 148.15 Medical school graduation 2 requirement —— nutrition. 3 Beginning July 1, 2028, a medical school or college of 4 osteopathic medicine and surgery in this state shall require as 5 a condition of graduation that each student complete at least 6 forty hours of coursework on nutrition and metabolic health. 7 DIVISION IV 8 SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM —— SUMMER ELECTRONIC 9 BENEFITS TRANSFER FOR CHILDREN PROGRAM 10 Sec. 5. Section 234.1, Code 2026, is amended by adding the 11 following new subsection: 12 NEW SUBSECTION . 4A. “Summer electronic benefits transfer 13 for children program” or “summer EBT program” means the summer 14 electronic benefits transfer for children program established 15 in 42 U.S.C. §1762. 16 Sec. 6. NEW SECTION . 234.12B Supplemental nutrition 17 assistance program —— summer electronic benefits transfer for 18 children program. 19 1. The department shall do all of the following: 20 a. Implement a SNAP waiver upon receipt of approval by the 21 United States department of agriculture, food and nutrition 22 service, and continuously maintain state participation in SNAP 23 in accordance with waiver guidelines specifying that eligible 24 foods pursuant to 7 C.F.R. §271.2 are healthy foods as defined 25 by the director or the director’s designee. 26 b. Contingent upon the availability of federal funding, 27 ensure that the provision of SNAP benefits to recipients is 28 uninterrupted in accordance with federal law, regardless of 29 whether the United States department of agriculture, food and 30 nutrition service, approves state participation utilizing only 31 eligible foods as described in paragraph “a” . 32 2. The department may participate in the summer EBT program 33 subject to federally approved eligible foods for the summer EBT 34 program being consistent with eligible foods as described in 35 -2- HF 2676.3930.S (1) 91 mb 2/ 48

subsection 1, paragraph “a” . 1 DIVISION V 2 SCHOOL FOODS AND BEVERAGES 3 Sec. 7. Section 256E.7, subsection 2, Code 2026, is amended 4 by adding the following new paragraph: 5 NEW PARAGRAPH . 0t. Be subject to and comply with the 6 requirements of section 283A.6 relating to the preparation 7 of meals provided to students, and prohibited ingredients in 8 meals provided to students, in the same manner as a school 9 district, if the charter school provides a breakfast or lunch 10 program through the national school lunch program or the school 11 breakfast program administered by the food and nutrition 12 service of the United States department of agriculture. 13 Sec. 8. Section 256F.4, subsection 2, Code 2026, is amended 14 by adding the following new paragraph: 15 NEW PARAGRAPH . v. Be subject to and comply with the 16 requirements of section 283A.6 relating to the preparation of 17 meals provided to students, and prohibited ingredients in meals 18 provided to students, in the same manner as a school district, 19 if the charter school or innovation zone school provides a 20 breakfast or lunch program. 21 Sec. 9. NEW SECTION . 283A.6 School district breakfast and 22 lunch programs —— food and beverages provided to students —— 23 prohibited ingredients. 24 1. a. A school district shall not serve a meal to students 25 as part of the school district’s breakfast or lunch program 26 that contains any of the following ingredients: 27 (1) Blue dye 1. 28 (2) Blue dye 2. 29 (3) Green dye 3. 30 (4) Potassium bromate. 31 (5) Propylparaben. 32 (6) Red dye 40. 33 (7) Yellow dye 5. 34 (8) Yellow dye 6. 35 -3- HF 2676.3930.S (1) 91 mb 3/ 48

b. Paragraph “a” does not apply to food and beverages 1 received as part of a direct delivery from the foods in schools 2 program of the United States department of agriculture. 3 2. An employee or contracted vendor of a school district 4 shall not provide any food or beverages that contain an 5 ingredient described in subsection 1 to a student enrolled in 6 the school district during the school day. 7 3. A school district shall not permit the sale to students 8 of any foods or beverages that contain an ingredient described 9 in subsection 1 on the school campus, as school campus is 10 defined in 7 C.F.R. §210.11 as of January 1, 2026, unless the 11 sale takes place outside of the school day, as school day is 12 defined in 7 C.F.R. §210.11 as of January 1, 2026. 13 Sec. 10. Section 283A.10, Code 2026, is amended to read as 14 follows: 15 283A.10 School breakfast or lunch in nonpublic schools. 16 The authorities in charge of nonpublic schools may operate 17 or provide for the operation of school breakfast or lunch 18 programs in schools under their jurisdiction and may use funds 19 appropriated to them by the general assembly, gifts, funds 20 received from sale of school breakfasts or lunches under such 21 programs, and any other funds available to the nonpublic 22 school. However, school breakfast or lunch programs shall not 23 be required in nonpublic schools. The department of education 24 shall direct the disbursement of state funds to nonpublic 25 schools for school breakfast or lunch programs in the same 26 manner as state funds are disbursed to public schools. If 27 a nonpublic school receives state funds for the operation of 28 a school breakfast or lunch program, meals served under the 29 program shall be nutritionally adequate meals, as defined in 30 section 283A.1 , and shall comply with the requirements of 31 section 283A.6 . 32 Sec. 11. APPLICABILITY. This division of this Act applies 33 to school years beginning on or after July 1, 2027. 34 DIVISION VI 35 -4- HF 2676.3930.S (1) 91 mb 4/ 48

EPINEPHRINE DELIVERY SYSTEMS 1 Sec. 12. Section 135.185, Code 2026, is amended to read as 2 follows: 3 135.185 Epinephrine auto-injector delivery system supply. 4 1. For purposes of this section , unless the context 5 otherwise requires: 6 a. “Epinephrine auto-injector delivery system ” means the same 7 as provided in section 280.16 . 8 b. “Facility” means a food establishment as defined in 9 section 137F.1 , a carnival as defined in section 88A.1 , a 10 recreational camp, a youth sports facility, or a sports arena. 11 c. “Licensed health care professional” means the same as 12 provided in section 280.16 . 13 d. “Personnel authorized to administer epinephrine” means an 14 employee or agent of a facility who is trained and authorized 15 to administer an epinephrine auto-injector delivery system . 16 2. Notwithstanding any other provision of law to the 17 contrary, a licensed health care professional may prescribe 18 epinephrine auto-injectors delivery systems in the name of a 19 facility to be maintained for use as provided in this section . 20 3. A facility may obtain a prescription for epinephrine 21 auto-injectors delivery systems and maintain a supply of such 22 auto-injectors delivery systems in a secure location at each 23 location where a member of the public may be present for use 24 as provided in this section . A facility that obtains such a 25 prescription shall replace epinephrine auto-injectors delivery 26 systems in the supply upon use or expiration. Personnel 27 authorized to administer epinephrine may possess and administer 28 epinephrine auto-injectors delivery systems from the supply as 29 provided in this section . 30 4. Personnel authorized to administer epinephrine may 31 provide or administer an epinephrine auto-injector delivery 32 system from the facility’s supply to an individual present at 33 the facility if such personnel reasonably and in good faith 34 believe the individual is having an anaphylactic reaction. 35 -5- HF 2676.3930.S (1) 91 mb 5/ 48

5. The following persons, provided they have acted 1 reasonably and in good faith, shall not be liable for 2 any injury arising from the provision, administration, 3 or assistance in the administration of an epinephrine 4 auto-injector delivery system as provided in this section : 5 a. Any personnel authorized to administer epinephrine who 6 provide, administer, or assist in the administration of an 7 epinephrine auto-injector delivery system to an individual 8 present at the facility who such personnel believe to be having 9 an anaphylactic reaction. 10 b. The owner or operator of the facility. 11 c. The prescriber of the epinephrine auto-injector delivery 12 system . 13 6. The department, the board of medicine, the board of 14 nursing, and the board of pharmacy shall adopt rules pursuant 15 to chapter 17A to implement and administer this section , 16 including but not limited to standards and procedures for 17 the prescription, distribution, storage, replacement, and 18 administration of epinephrine auto-injectors delivery systems , 19 and for training and authorization to be required for personnel 20 authorized to administer epinephrine. 21 Sec. 13. Section 280.16, Code 2026, is amended to read as 22 follows: 23 280.16 Self-administration of respiratory distress, asthma, 24 or other airway constricting disease medication, epinephrine 25 auto-injectors delivery systems , bronchodilator canisters, or 26 bronchodilator canisters and spacers. 27 1. Definitions. For purposes of this section : 28 a. “Bronchodilator” means a bronchodilator as recommended 29 by the department of health and human services for treatment 30 of a student’s respiratory distress, asthma, or other airway 31 constricting disease. 32 b. “Bronchodilator canister” means a portable drug 33 delivery device packaged with multiple premeasured doses of a 34 bronchodilator. 35 -6- HF 2676.3930.S (1) 91 mb 6/ 48

c. “Epinephrine auto-injector delivery system ” means a 1 device for immediate self-administration or administration by 2 another trained individual of a measured dose of epinephrine 3 to a person at risk of anaphylaxis , including epinephrine 4 auto-injectors and epinephrine nasal sprays . 5 d. “ Licensed health care professional” means a person 6 licensed under chapter 148 to practice medicine and surgery or 7 osteopathic medicine and surgery, an advanced registered nurse 8 practitioner licensed under chapter 152 or 152E and registered 9 with the board of nursing, or a physician assistant licensed 10 under chapter 148C . 11 e. “Medication” means a drug that meets the definition 12 provided in section 126.2, subsection 8 , has an individual 13 prescription label, is prescribed by a licensed health care 14 professional for a student, and pertains to the student’s 15 respiratory distress, asthma, or other airway constricting 16 disease, or risk of anaphylaxis, and includes but is not 17 limited to a bronchodilator. 18 f. “Self-administration” means a student’s discretionary use 19 of medication prescribed by a licensed health care professional 20 for the student. 21 g. “Spacer” means a holding chamber that is used to optimize 22 the delivery of a bronchodilator to a person’s lungs. 23 2. The board of directors of a school district and the 24 authorities in charge of an accredited nonpublic school shall 25 permit the self-administration of medication or the use of a 26 bronchodilator canister or bronchodilator canister and spacer 27 by a student with respiratory distress, asthma, or other airway 28 constricting disease or the use of an epinephrine auto-injector 29 delivery system by a student with a risk of anaphylaxis if the 30 following conditions are met: 31 a. The student’s parent or guardian provides to the 32 school written authorization for the self-administration 33 of medication, for the use of a bronchodilator canister or 34 a bronchodilator canister and spacer, or for the use of an 35 -7- HF 2676.3930.S (1) 91 mb 7/ 48

epinephrine auto-injector delivery system . 1 b. The student’s parent or guardian provides to the school 2 a written statement from the student’s licensed health care 3 professional containing the following information: 4 (1) The name and purpose of the medication, bronchodilator 5 canister, bronchodilator canister and spacer, or epinephrine 6 auto-injector delivery system . 7 (2) The prescribed dosage. 8 (3) The times at which or the special circumstances under 9 which the medication, bronchodilator canister, bronchodilator 10 canister and spacer, or epinephrine auto-injector delivery 11 system is to be administered. 12 c. The parent or guardian and the school meet the 13 requirements of subsection 3 . 14 3. The school district or accredited nonpublic school 15 shall notify the parent or guardian of the student, in 16 writing, that the school district or accredited nonpublic 17 school and its employees are to incur no liability, except 18 for gross negligence, as a result of any injury arising from 19 self-administration of medication, use of a bronchodilator 20 canister or a bronchodilator canister and spacer, or use of 21 an epinephrine auto-injector delivery system by the student. 22 The parent or guardian of the student shall sign a statement 23 acknowledging that the school district or nonpublic school 24 is to incur no liability, except for gross negligence, as 25 a result of self-administration of medication, use of a 26 bronchodilator canister or a bronchodilator canister and 27 spacer, or use of an epinephrine auto-injector delivery system 28 by the student. A school district or accredited nonpublic 29 school and its employees acting reasonably and in good faith 30 shall incur no liability for any improper use of medication, a 31 bronchodilator canister, a bronchodilator canister and spacer, 32 or an epinephrine auto-injector delivery system as defined in 33 this section or for supervising, monitoring, or interfering 34 with a student’s self-administration of medication, use of 35 -8- HF 2676.3930.S (1) 91 mb 8/ 48

a bronchodilator canister or a bronchodilator canister and 1 spacer, or use of an epinephrine auto-injector delivery system 2 as defined in this section . 3 4. The permission for self-administration of medication, 4 for the use of a bronchodilator canister or a bronchodilator 5 canister and spacer, or for the use of an epinephrine 6 auto-injector delivery system is effective for the school year 7 for which it is granted and shall be renewed each subsequent 8 school year upon fulfillment of the requirements of this 9 section . However, the parent or guardian shall immediately 10 notify the school of any changes in the conditions listed under 11 subsection 2 . 12 5. Provided that the requirements of this section are 13 fulfilled, a student with respiratory distress, asthma, or 14 other airway constricting disease may possess and use the 15 student’s medication and a student with a written statement 16 from a licensed health care professional on file pursuant 17 to subsection 2 , paragraph “a” , may use a bronchodilator 18 canister, a bronchodilator canister and spacer, or an 19 epinephrine auto-injector delivery system while in school, at 20 school-sponsored activities, under the supervision of school 21 personnel, and before or after normal school activities, 22 such as while in before-school or after-school care on 23 school-operated property. If the student misuses this 24 privilege, the privilege may be withdrawn. A school district 25 or nonpublic school shall notify a student’s parent or guardian 26 before withdrawing the privilege to use a bronchodilator 27 canister, a bronchodilator canister and spacer, or an 28 epinephrine auto-injector delivery system . 29 6. Information provided to the school under subsection 2 30 shall be kept on file in the office of the school nurse or, in 31 the absence of a school nurse, the school’s administrator. 32 7. The Iowa school for the deaf and the institutions under 33 the control of the department of health and human services as 34 provided in section 218.1 are exempt from the provisions of 35 -9- HF 2676.3930.S (1) 91 mb 9/ 48

this section . 1 Sec. 14. Section 280.16A, Code 2026, is amended to read as 2 follows: 3 280.16A Epinephrine auto-injector delivery system , 4 bronchodilator canister, or bronchodilator canister and spacer 5 supply. 6 1. For purposes of this section , unless the context 7 otherwise requires: 8 a. “Bronchodilator” means the same as defined in section 9 280.16 . 10 b. “Bronchodilator canister” means the same as defined in 11 section 280.16 . 12 c. “Epinephrine auto-injector delivery system ” means the same 13 as provided in section 280.16 . 14 d. “Licensed health care professional” means the same as 15 provided in section 280.16 . 16 e. “Personnel authorized to administer epinephrine or a 17 bronchodilator” means a school nurse or other employee of a 18 school district or accredited nonpublic school trained and 19 authorized to administer an epinephrine auto-injector delivery 20 system , a bronchodilator canister, or a bronchodilator canister 21 and spacer. 22 f. “School nurse” means a registered nurse holding current 23 licensure recognized by the board of nursing who practices in 24 the school setting to promote and protect the health of the 25 school population by using knowledge from the nursing, social, 26 and public health sciences. 27 g. “Spacer” means the same as defined in section 280.16 . 28 2. Notwithstanding any other provision of law to the 29 contrary, a licensed health care professional may prescribe 30 epinephrine auto-injectors delivery systems , bronchodilator 31 canisters, and bronchodilator canisters and spacers in the 32 name of a school district or accredited nonpublic school to be 33 maintained for use as provided in this section . 34 3. The board of directors in charge of each school district 35 -10- HF 2676.3930.S (1) 91 mb 10/ 48

and the authorities in charge of each accredited nonpublic 1 school may obtain a prescription for epinephrine auto-injectors 2 delivery systems , bronchodilator canisters, and bronchodilator 3 canisters and spacers and maintain a supply of such epinephrine 4 auto-injectors delivery systems , bronchodilator canisters, 5 and bronchodilator canisters and spacers in a secure 6 location at each school for use as provided in this section . 7 The board and the authorities shall replace epinephrine 8 auto-injectors delivery systems , bronchodilator canisters, and 9 bronchodilator canisters and spacers in the supply upon use or 10 expiration. Personnel authorized to administer epinephrine 11 or a bronchodilator may possess and administer epinephrine 12 auto-injectors delivery systems , bronchodilator canisters, or 13 bronchodilator canisters and spacers, as applicable, from the 14 supply as provided in this section . 15 4. Personnel authorized to administer epinephrine or 16 a bronchodilator may provide or administer an epinephrine 17 auto-injector delivery system , a bronchodilator canister, or 18 a bronchodilator canister and spacer, as applicable, from 19 the school’s supply to a student or other individual if such 20 personnel reasonably and in good faith believe the student or 21 other individual is having an anaphylactic reaction or requires 22 treatment for respiratory distress, asthma, or other airway 23 constricting disease. 24 5. The following persons, provided they have acted 25 reasonably and in good faith, shall not be liable for 26 any injury arising from the provision, administration, 27 or assistance in the administration of an epinephrine 28 auto-injector delivery system , a bronchodilator canister, or a 29 bronchodilator canister and spacer as provided in this section : 30 a. Any personnel authorized to administer epinephrine or 31 a bronchodilator who, as applicable, provide, administer, or 32 assist in the administration of an epinephrine auto-injector 33 delivery system to a student or other individual present at the 34 school who such personnel believe to be having an anaphylactic 35 -11- HF 2676.3930.S (1) 91 mb 11/ 48

reaction or in the administration of a bronchodilator canister 1 or a bronchodilator canister and spacer to a student or other 2 individual present at the school who such personnel believe to 3 require treatment for respiratory distress, asthma, or other 4 airway constricting disease. 5 b. A school district or accredited nonpublic school 6 employing the personnel. 7 c. The board of directors in charge of the school district 8 or authorities in charge of the accredited nonpublic school. 9 d. The prescriber of the epinephrine auto-injector delivery 10 system , the bronchodilator canister, or the bronchodilator 11 canister and spacer. 12 6. The department of education, the board of medicine, 13 the board of nursing, and the board of pharmacy shall, in 14 consultation with an organization representing school nurses, 15 adopt rules pursuant to chapter 17A to implement and administer 16 this section , including but not limited to standards and 17 procedures for the prescription, distribution, storage, 18 disposal, replacement, and administration of epinephrine 19 auto-injectors delivery systems , bronchodilator canisters, 20 and bronchodilator canisters and spacers, and for training 21 and authorization to be required for personnel authorized to 22 administer epinephrine or a bronchodilator. 23 DIVISION VII 24 IVERMECTIN —— OVER-THE-COUNTER AVAILABILITY 25 Sec. 15. NEW SECTION . 126.24 Ivermectin —— prescription 26 drug order not required. 27 1. A pharmacist or pharmacy may distribute ivermectin for 28 human consumption as an over-the-counter medicine. 29 2. A pharmacist or pharmacy shall not be subject to 30 professional discipline or civil or criminal penalties for the 31 distribution of ivermectin pursuant to this section. 32 DIVISION VIII 33 STUDENT INSTRUCTIONAL TECHNOLOGY STANDARDS 34 Sec. 16. Section 256E.7, subsection 2, Code 2026, is amended 35 -12- HF 2676.3930.S (1) 91 mb 12/ 48

by adding the following new paragraph: 1 NEW PARAGRAPH . 0s. Be subject to and comply with 2 the requirements of section 279.89 relating to student 3 instructional technology standards in the same manner as a 4 school district. 5 Sec. 17. Section 256F.4, subsection 2, Code 2026, is amended 6 by adding the following new paragraph: 7 NEW PARAGRAPH . w. Be subject to and comply with 8 the requirements of section 279.89 relating to student 9 instructional technology standards in the same manner as a 10 school district. 11 Sec. 18. NEW SECTION . 279.89 Student instructional 12 technology standards. 13 1. As used in this section, unless the context otherwise 14 requires: 15 a. “Digital instruction” means lessons, assignments, 16 assessments, or instructional activities delivered through 17 instructional technology. 18 b. “Instructional technology” means a laptop, tablet, 19 computer, smart device, software platform, or other similar 20 device or platform used for student learning. 21 c. “One-to-one digital device program” means a program 22 through which a school district provides or assigns a digital 23 device to each student for instructional use. 24 2. a. For students enrolled in grades kindergarten through 25 five, digital instruction shall not exceed sixty minutes per 26 school day. 27 b. The following uses shall not count toward the daily 28 limit: 29 (1) Use required pursuant to an individualized education 30 program or a plan developed pursuant to section 504 of the 31 federal Rehabilitation Act of 1973. 32 (2) Assistive or adaptive technology used to provide a 33 student access to instruction or to accommodate differing 34 student abilities. 35 -13- HF 2676.3930.S (1) 91 mb 13/ 48

(3) Teacher-directed demonstrations using a projector, 1 smartboard, or similar display device when students are not 2 individually operating a digital device. 3 (4) State assessments, screening, progress monitoring, 4 and local diagnostic assessments that require the use of a 5 one-to-one digital device. 6 (5) Dedicated computer science and technology curriculum. 7 3. a. The board of directors of each school district shall 8 adopt a written technology use policy applicable to grades 9 kindergarten through five. 10 b. The policy shall include all of the following: 11 (1) The district’s daily digital instruction limits. 12 (2) Notice of a parent’s or guardian’s right to request 13 additional reductions in the parent’s or guardian’s child’s 14 digital instruction. 15 (3) A statement that instructional technology shall 16 support, and not supplant, foundational learning. 17 (4) A prohibition on the use of digital devices during 18 recess. 19 c. The policy shall be published on each elementary school’s 20 internet site. 21 4. a. Prior to adopting or renewing a one-to-one digital 22 device program for any grade level, the board of directors of a 23 school district shall complete a technology adoption checklist 24 that documents consideration of all of the following: 25 (1) The instructional purpose of the device. 26 (2) Age appropriateness of the device and associated 27 software. 28 (3) Content-filtering limitations and the district’s 29 capacity to mitigate those limitations. 30 (4) Whether student data is collected, stored, or shared, 31 and the nature of such data practices. 32 b. The checklist shall be retained by the board and made 33 available to the department of education upon request for audit 34 or compliance purposes. 35 -14- HF 2676.3930.S (1) 91 mb 14/ 48

5. This section shall not apply to students enrolled in an 1 online learning program operating pursuant to section 256.43. 2 6. This section does not limit the authority of a school 3 district or accredited nonpublic school under section 279.10, 4 subsection 1, regarding provision of instruction over the 5 internet to meet the minimum school calendar requirements. 6 Sec. 19. DEPARTMENT OF EDUCATION —— WORKING GROUP —— IMPACT 7 OF TECHNOLOGY ON COGNITIVE LEARNING. 8 1. The department of education, in collaboration with the 9 department of health and human services, shall convene and 10 provide administrative support to a working group that shall 11 examine research related to the impact of school-provided 12 technology on the cognitive function and academic performance 13 of students in grades six through twelve. For purposes of 14 this section, “school-provided technology” includes laptop 15 computers, online learning management systems, and classroom 16 slide show presentations. 17 2. The membership of the working group shall include but 18 not be limited to educators, mental health professionals, and 19 parents of school-age children. 20 3. Any expenses incurred by a member of the working group 21 shall be the responsibility of the individual member or the 22 respective entity represented by the member. 23 4. The working group shall submit its findings and 24 recommendations in a report to the general assembly by December 25 31, 2026. The report shall include recommendations on best 26 practices related to the use of school-provided technology in 27 educational contexts with a focus on ways to mitigate possible 28 negative impacts on the social and behavioral development, 29 attention span, mental concentration, and learning ability of 30 students in grades six through twelve. 31 DIVISION IX 32 PRESIDENTIAL PHYSICAL FITNESS TEST 33 Sec. 20. Section 256.11, subsection 3, paragraph a, 34 subparagraph (6), Code 2026, is amended to read as follows: 35 -15- HF 2676.3930.S (1) 91 mb 15/ 48

(6) Physical education. The physical education curriculum 1 shall include an assessment of the physical fitness of students 2 who are physically able using the presidential physical fitness 3 test. 4 Sec. 21. Section 256.11, subsection 4, paragraph a, 5 subparagraph (8), Code 2026, is amended to read as follows: 6 (8) Physical education. The physical education curriculum 7 shall include an assessment of the physical fitness of students 8 who are physically able using the presidential physical fitness 9 test. 10 Sec. 22. Section 256.11, subsection 5, paragraph g, Code 11 2026, is amended to read as follows: 12 g. (1) All students physically able shall be required 13 to participate in a minimum of one-eighth unit of physical 14 education activities during each semester they are enrolled in 15 school except as otherwise provided in this paragraph. The 16 physical education activities must satisfy all of the following 17 requirements: 18 (a) Emphasize leisure time activities which will benefit 19 the student outside the school environment and after graduation 20 from high school. 21 (b) Include an assessment of the physical fitness of 22 students who are physically able using the presidential 23 physical fitness test. 24 (2) (a) A student who meets the requirements of this 25 paragraph subparagraph shall be excused from the physical 26 education activities requirement under subparagraph (1) by the 27 principal of the school in which the student is enrolled if 28 the parent or guardian of the student requests in writing that 29 the student be excused from the physical education activities 30 requirement. A student who wishes to be excused from the 31 physical education activities requirement must be seeking to be 32 excused in order to enroll in academic courses not otherwise 33 available to the student, or be enrolled or participating in 34 any of the following: 35 -16- HF 2676.3930.S (1) 91 mb 16/ 48

(a) (i) A work-based learning program or other educational 1 program authorized by the school which requires the student to 2 leave the school premises for specified periods of time during 3 the school day. 4 (b) (ii) An activity that is sponsored by the school in 5 which the student is enrolled which requires at least as much 6 physical activity per week as one-eighth unit of physical 7 education activities . 8 (2) (b) The principal of the school shall inform the 9 superintendent of the school district or nonpublic school that 10 the student has been excused. Physical education activities 11 shall emphasize leisure time activities which will benefit the 12 student outside the school environment and after graduation 13 from high school. 14 (3) A student who is enrolled in a junior reserve officers’ 15 training corps shall not be required to participate in physical 16 education activities under subparagraph (1) or to meet the 17 physical activity requirements of subsection 6 , paragraph 18 “b” , subparagraph (2), but shall receive one-eighth unit of 19 physical education activities credit for each semester, or the 20 equivalent, of junior reserve officers’ training corps the 21 student completes. 22 Sec. 23. CONTINGENT EFFECTIVE DATE. This division of 23 this Act takes effect upon the issuance of final guidance for 24 administration of the presidential physical fitness test by the 25 federal government. The department of education shall inform 26 the Iowa Code editor upon the issuance of final guidance for 27 administration of the presidential physical fitness test by the 28 federal government. 29 DIVISION X 30 PSYCHOLOGY INTERJURISDICTIONAL COMPACT 31 Sec. 24. NEW SECTION . 147M.1 Psychology interjurisdictional 32 compact. 33 The psychology interjurisdictional compact is enacted into 34 law and entered into by this state with all states legally 35 -17- HF 2676.3930.S (1) 91 mb 17/ 48

joining in the compact in the form substantially as follows: 1 1. Article I —— Purpose. 2 a. The party states find that: 3 (1) States license psychologists, in order to protect 4 the public through verification of education, training, 5 and experience, and ensure accountability for professional 6 practice. 7 (2) This compact is intended to regulate the day-to-day 8 practice of telepsychology, in which psychological services are 9 provided using telecommunication technologies, by psychologists 10 across state boundaries in the performance of their 11 psychological practice as assigned by an appropriate authority. 12 (3) This compact is intended to regulate the temporary 13 in-person, face-to-face practice of psychology by psychologists 14 across state boundaries for thirty days within a calendar year 15 in the performance of their psychological practice as assigned 16 by an appropriate authority. 17 (4) This compact is intended to authorize state psychology 18 regulatory authorities to afford legal recognition, in a manner 19 consistent with the terms of the compact, to psychologists 20 licensed in another state. 21 (5) This compact recognizes that states have a vested 22 interest in protecting the public’s health and safety through 23 their licensing and regulation of psychologists and that such 24 state regulation will best protect public health and safety. 25 (6) This compact does not apply when a psychologist is 26 licensed in both the home and receiving states. 27 (7) This compact does not apply to permanent in-person, 28 face-to-face practice, but it does allow for authorization of 29 temporary psychological practice. 30 b. Consistent with these principles, this compact is 31 designed to achieve the following purposes and objectives: 32 (1) Increase public access to professional psychological 33 services by allowing for telepsychological practice across 34 state lines as well as temporary in-person, face-to-face 35 -18- HF 2676.3930.S (1) 91 mb 18/ 48

services into a state in which the psychologist is not licensed 1 to practice psychology. 2 (2) Enhance the states’ ability to protect the public’s 3 health and safety, especially client-patient safety. 4 (3) Encourage the cooperation of compact states in the areas 5 of psychology licensure and regulation. 6 (4) Facilitate the exchange of information between compact 7 states regarding psychologist licensure, adverse actions, and 8 disciplinary history. 9 (5) Promote compliance with the laws governing 10 psychological practice in each compact state. 11 (6) Invest all compact states with the authority to 12 hold licensed psychologists accountable through the mutual 13 recognition of compact state licenses. 14 2. Article II —— Definitions. 15 a. “Adverse action” means any action taken by a state 16 psychology regulatory authority which finds a violation 17 of a statute or regulation that is identified by the state 18 psychology regulatory authority as discipline and is a matter 19 of public record. 20 b. “Association of state and provincial psychology boards” 21 means the recognized membership organization composed of state 22 and provincial psychology regulatory authorities responsible 23 for the licensure and registration of psychologists throughout 24 the United States and Canada. 25 c. “Authority to practice interjurisdictional telepsychology” 26 means a licensed psychologist’s authority to practice 27 telepsychology, within the limits authorized under this 28 compact, in another compact state. 29 d. “Bylaws” means those bylaws established by the psychology 30 interjurisdictional compact commission pursuant to article 31 X for its governance, or for directing and controlling its 32 actions and conduct. 33 e. “Client-patient” means the recipient of psychological 34 services, whether psychological services are delivered in the 35 -19- HF 2676.3930.S (1) 91 mb 19/ 48

context of health care, corporate, supervision, or consulting 1 services. 2 f. “Commissioner” means the voting representative appointed 3 by each state psychology regulatory authority pursuant to 4 article X. 5 g. “Compact state” means a state, the District of Columbia, 6 or United States territory that has enacted this compact 7 legislation and which has not withdrawn pursuant to article 8 XIII, or been terminated pursuant to article XII. 9 h. “Confidentiality” means the principle that data or 10 information is not made available or disclosed to unauthorized 11 persons or processes. 12 i. “Coordinated licensure information system” or “coordinated 13 database” means an integrated process for collecting, storing, 14 and sharing information on psychologists’ licensure and 15 enforcement activities related to psychology licensure laws, 16 which is administered by the recognized membership organization 17 composed of state and provincial psychology regulatory 18 authorities. 19 j. “Day” means any part of a day in which psychological work 20 is performed. 21 k. “Distant state” means the compact state where a 22 psychologist is physically present, not through the use 23 of telecommunications technologies, to provide temporary 24 in-person, face-to-face psychological services. 25 l. “E.Passport” means a certificate issued by the 26 association of state and provincial psychology boards 27 that promotes the standardization in the criteria of 28 interjurisdictional telepsychology practice and facilitates the 29 process for licensed psychologists to provide telepsychological 30 services across state lines. 31 m. “Executive board” means a group of directors elected or 32 appointed to act on behalf of, and within the powers granted to 33 them by, the commission. 34 n. “Home state” means a compact state where a psychologist 35 -20- HF 2676.3930.S (1) 91 mb 20/ 48

is licensed to practice psychology. If the psychologist is 1 licensed in more than one compact state and is practicing 2 under the authorization to practice interjurisdictional 3 telepsychology, the home state is the compact state where the 4 psychologist is physically present when the telepsychological 5 services are delivered. If the psychologist is licensed 6 in more than one compact state and is practicing under the 7 temporary authorization to practice, the home state is any 8 compact state where the psychologist is licensed. 9 o. “Identity history summary” means a summary of information 10 retained by the federal bureau of investigation (FBI), or other 11 designee with similar authority, in connection with arrests 12 and, in some instances, federal employment, naturalization, or 13 military service. 14 p. “In-person, face-to-face” means interactions in which the 15 psychologist and the client-patient are in the same physical 16 space and which does not include interactions that may occur 17 through the use of telecommunication technologies. 18 q. “Interjurisdictional practice certificate” or “IPC” 19 means a certificate issued by the association of state and 20 provincial psychology boards that grants temporary authority 21 to practice based on notification to the state psychology 22 regulatory authority of intention to practice temporarily, and 23 verification of one’s qualifications for such practice. 24 r. “License” means authorization by a state psychology 25 regulatory authority to engage in the independent practice of 26 psychology, which would be unlawful without the authorization. 27 s. “Noncompact state” means any state which is not at the 28 time a compact state. 29 t. “Psychologist” means an individual licensed for the 30 independent practice of psychology. 31 u. “Psychology interjurisdictional compact commission” or 32 “commission” means the national administration of which all 33 compact states are members. 34 v. “Receiving state” means a compact state where the 35 -21- HF 2676.3930.S (1) 91 mb 21/ 48