135DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTHIGENERAL PROVISIONS135.1Definitions.For the purposes of Title IV, subtitle 2, excluding chapter 146, unless otherwise defined:1“Director” means the director of health and human services.2“Health officer” means the physician, physician assistant, advanced registered nurse practitioner, or advanced practice registered nurse who is the health officer of the local board of health.3“Local board” means the local board of health.4“Physician” means a person licensed to practice medicine and surgery, osteopathic medicine and surgery, chiropractic, podiatry, or optometry under the laws of this state; but a person licensed as a physician and surgeon shall be designated as a “physician” or “surgeon”, a person licensed as an osteopathic physician and surgeon shall be designated as an “osteopathic physician” or “osteopathic surgeon”, a person licensed as a chiropractor shall be designated as a “chiropractor”, a person licensed as a podiatrist shall be designated as a “podiatric physician”, and a person licensed as an optometrist shall be designated as an “optometrist”. A definition or designation contained in this subsection shall not be interpreted to expand the scope of practice of such licensees.5“Rules” include regulations and orders.6“State department” or “department” means the department of health and human services.[S13, §2583-b; C24, 27, 31, 35, 39, §2181; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.1]86 Acts, ch 1245, §1101; 88 Acts, ch 1199, §1; 94 Acts, ch 1023, §10; 95 Acts, ch 108, §2; 96 Acts, ch 1036, §1; 96 Acts, ch 1212, §15; 2008 Acts, ch 1058, §14; 2008 Acts, ch 1084, §10; 2008 Acts, ch 1088, §141; 2009 Acts, ch 133, §30; 2012 Acts, ch 1113, §16; 2020 Acts, ch 1083, §1; 2023 Acts, ch 19, §125; 2024 Acts, ch 1043, §52135.2Appointment of director and acting director.Repealed by 2023 Acts, ch 19, §1357.135.3Disqualifications.Repealed by 2023 Acts, ch 19, §1357.135.4Reserved. 135.5Reserved. 135.6Assistants and employees.Repealed by 2023 Acts, ch 19, §1357.135.7Bonds.Repealed by 2023 Acts, ch 19, §1357.135.8Seal.Repealed by 2023 Acts, ch 19, §1357.135.9Expenses.Repealed by 2023 Acts, ch 19, §1357.135.10Office.Repealed by 2023 Acts, ch 19, §1357.135.11Public health duties of department.The department shall:1Exercise general supervision over the public health, promote public hygiene and sanitation, prevent substance use disorder, and, unless otherwise provided, enforce the laws relating to the same.2Conduct campaigns for the education of the people in hygiene and sanitation.3Issue health bulletins containing fundamental health principles and other health data deemed of public interest.4Make investigations and surveys in respect to the causes of disease and epidemics, and the effect of locality, employment, and living conditions upon the public health. For this purpose the department may use the services of the experts connected with the state hygienic laboratory.5Establish stations throughout the state for the distribution of antitoxins and vaccines to physicians, pharmacists, and other persons, at cost. All antitoxin and vaccine thus distributed shall be labeled “Iowa Department of Health and Human Services”.6Exercise general supervision over the administration and enforcement of the sexually transmitted diseases and infections law, chapter 139A, subchapter II.7Exercise sole jurisdiction over the disposal and transportation of the dead bodies of human beings and prescribe the methods to be used in preparing such bodies for disposal and transportation. However, the department may approve a request for an exception to the application of specific embalming and disposition rules adopted pursuant to this subsection if such rules would otherwise conflict with tenets and practices of a recognized religious denomination to which the deceased individual adhered or of which denomination the deceased individual was a member. The department shall inform the board of mortuary science of any such approved exception which may affect services provided by a funeral director licensed pursuant to chapter 156.8Establish, publish, and enforce rules which require companies, corporations, and other entities to obtain a permit from the department prior to scattering cremated human remains.9Exercise general supervision over the administration and enforcement of the vital statistics law, chapter 144.10Administer healthy aging and essential public health services by approving grants of state funds to the local boards of health for the purposes of promoting healthy aging throughout the lifespan and enhancing health promotion and disease prevention services, and by providing guidelines for the approval of the grants and allocation of the state funds. Guidelines, evaluation requirements, and formula allocation procedures for the services shall be established by the department by rule.11Administer chapters 125, 136A, 136C, 139A, 142, 144, and 147A.12Consult with the office of statewide clinical education programs at the university of Iowa college of medicine and annually submit a report to the general assembly by January 15 verifying the number of physicians in active practice in Iowa by county who are engaged in providing obstetrical care. To the extent data are readily available, the report shall include information concerning the number of deliveries per year by specialty and county, the age of physicians performing deliveries, and the number of current year graduates of the university of Iowa college of medicine and the Des Moines university osteopathic medical center entering into residency programs in obstetrics, gynecology, and family practice. The report may include additional data relating to access to obstetrical services that may be available.13Administer the statewide maternal and child health program and the program for children with disabilities by conducting mobile and regional child health specialty clinics and conducting other activities to improve the health of low-income women and children and to promote the welfare of children with actual or potential conditions which may cause disabilities and children with chronic illnesses in accordance with the requirements of Tit. V of the federal Social Security Act. The department shall provide technical assistance to encourage the coordination and collaboration of state agencies in developing outreach centers which provide publicly supported services for pregnant women, infants, and children. The department shall also, through cooperation and collaborative agreements with the mobile and regional child health specialty clinics, establish common intake proceedings for maternal and child health services. The department shall work in cooperation with the legislative services agency in monitoring the effectiveness of the maternal and child health centers, including the provision of transportation for patient appointments and the keeping of scheduled appointments.14Establish, publish, and enforce rules requiring prompt reporting of methemoglobinemia, pesticide poisoning, and the reportable poisonings and illnesses established pursuant to section 139A.21.15Collect and maintain reports of pesticide poisonings and other poisonings, illnesses, or injuries caused by selected chemical or physical agents, including methemoglobinemia and pesticide and fertilizer hypersensitivity; and compile and publish, annually, a statewide and county-by-county profile based on the reports.16Adopt rules which require personnel of a licensed hospice, of a homemaker-home health aide provider agency which receives state homemaker-home health aide funds, or of an agency which provides respite care services and receives funds to complete training concerning blood-borne pathogens, including human immunodeficiency virus and viral hepatitis, consistent with standards from the federal occupational safety and health administration.17Adopt rules which require all emergency medical services personnel, fire fighters, and law enforcement personnel to complete training concerning blood-borne pathogens, including human immunodeficiency virus and viral hepatitis, consistent with standards from the federal occupational safety and health administration.18Adopt rules which provide for the testing of a convicted or alleged offender for the human immunodeficiency virus pursuant to sections 915.40 through 915.43. The rules shall provide for the provision of counseling, health care, and support services to the victim.19Establish ad hoc and advisory committees to the director in areas where technical expertise is not otherwise readily available. Members may be compensated for their actual and necessary expenses incurred in the performance of their duties. To encourage health consumer participation, public members may also receive a per diem as specified in section 7E.6 if funds are available and the per diem is determined to be appropriate by the director. Expense moneys paid to the members shall be paid from funds appropriated to the department. A majority of the members of such a committee constitutes a quorum.20Administer annual grants to county boards of health for the purpose of conducting programs for the testing of private water supply wells, the closing of abandoned private water supply wells, and the renovation or rehabilitation of private water supply wells. Grants shall be funded through moneys transferred to the department from the agriculture management account of the groundwater protection fund pursuant to section 455E.11, subsection 2, paragraph “b”, subparagraph (2), subparagraph division (b). The department shall adopt rules relating to the awarding of the grants.21Establish and administer, if sufficient funds are available to the department, a program to assess and forecast health workforce supply and demand in the state for the purpose of identifying current and projected workforce needs. The program may collect, analyze, and report data that furthers the purpose of the program. The program shall not release information that permits identification of individual respondents of program surveys.22Develop and maintain the statewide perinatal program based on the recommendations of the American academy of pediatrics and the American college of obstetricians and gynecologists contained in the most recent edition of the guidelines for perinatal care, and adopt rules in accordance with chapter 17A to implement those recommendations. Hospitals within the state shall determine whether to participate in the statewide perinatal program, and select the hospital’s level of participation in the program. A hospital having determined to participate in the program shall comply with the guidelines appropriate to the level of participation selected by the hospital. Perinatal program surveys and reports are privileged and confidential and are not subject to discovery, subpoena, or other means of legal compulsion for their release to a person other than the affected hospital, and are not admissible in evidence in a judicial or administrative proceeding other than a proceeding involving verification of the participating hospital under this subsection.23In consultation with the department of corrections, the antibiotic resistance task force, and the American federation of state, county and municipal employees, develop educational programs to increase awareness and utilization of infection control practices in institutions listed in section 904.102.24Administer the Iowa youth survey, in collaboration with other state agencies, as appropriate, every two years to students in grades six, eight, and eleven in Iowa’s public and nonpublic schools. Survey data shall be evaluated and reported, with aggregate data available online at the Iowa youth survey internet site.25Adopt rules requiring ambulatory surgical centers to report quality data to the department of health and human services that is consistent with the data required to be reported to the centers for Medicare and Medicaid services of the United States department of health and human services as authorized by the Medicare Improvements and Extension Act of 2006 under Tit. I of the Tax Relief and Health Care Act of 2006, Pub. L. No. 109-432, and the regulations adopted under such Acts. Notwithstanding any provision of law to the contrary, nothing in this subsection shall require an ambulatory surgical center to provide health data to the department of health and human services or any other public or private entity that is in addition to, different than, or exceeds the quality data required to be reported to the centers for Medicare and Medicaid services of the United States department of health and human services.1.[C97, §2565; C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.11(1)]2, 3.[C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.11(2, 3)]4.[C97, §2565; C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.11(4)]5, 6.[C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, §135.11(8, 9); C73, 75, 77, 79, 81, §135.11(7, 8)]7.[S13, §2572-a, -b, -c; C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, §135.11(11); C73, §135.11(10); C75, 77, 79, 81, §135.11(9)]8.[C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, §135.11(12); C73, §135.11(11); C75, 77, 79, 81, §135.11(10)]9.[S13, §2575-a42; C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, §135.11(13); C73, §135.11(12); C75, 77, 79, 81, §135.11(11)]10.[C97, §2565; C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, §135.11(14); C73, §135.11(13); C75, 77, 79, 81, §135.11(12)]11, 12.[C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, §135.11(15, 16); C73, §135.11(14, 15); C75, 77, 79, 81, §135.11(13, 14)]13.[C97, §2565; C24, 27, 31, 35, 39, §2191; C46, 50, 54, 58, 62, 66, 71, §135.11(17); C73, §135.11(16); C75, 77, 79, 81, §135.11(15)]14.[C75, 77, 79, 81, §135.11(16)]15.[82 Acts, ch 1260, §55]83 Acts, ch 27, §7; 86 Acts, ch 1245, §1104; 87 Acts, ch 8, §2; 87 Acts, ch 115, §22; 87 Acts, ch 225, §202; 88 Acts, ch 1224, §12; 89 Acts, ch 304, §103; 90 Acts, ch 1259, §10; 91 Acts, ch 258, §29; 93 Acts, ch 140, §4; 94 Acts, ch 1023, §11; 94 Acts, ch 1132, §9; 96 Acts, ch 1036, §2; 96 Acts, ch 1128, §1; 96 Acts, ch 1129, §23; 97 Acts, ch 23, §13; 97 Acts, ch 197, §1; 98 Acts, ch 1053, §1; 98 Acts, ch 1087, §1; 98 Acts, ch 1090, §60, 84; 98 Acts, ch 1221, §12; 99 Acts, ch 141, §2; 2000 Acts, ch 1058, §14; 2000 Acts, ch 1066, §37; 2000 Acts, ch 1223, §18; 2001 Acts, ch 58, §3; 2001 Acts, ch 122, §1; 2001 Acts, ch 184, §6; 2001 Acts, 2nd Ex, ch 1, §25, 282002 Acts, ch 1108, §7; 2003 Acts, ch 33, §8, 11; 2003 Acts, ch 35, §45, 49; 2003 Acts, ch 44, §36; 2004 Acts, ch 1167, §1; 2005 Acts, ch 89, §2, 3; 2007 Acts, ch 10, §18; 2007 Acts, ch 159, §17; 2008 Acts, ch 1058, §1, 2, 15; 2008 Acts, ch 1084, §11; 2008 Acts, ch 1088, §83; 2008 Acts, ch 1180, §20; 2009 Acts, ch 41, §263; 2009 Acts, ch 151, §30; 2010 Acts, ch 1088, §4 – 6; 2011 Acts, ch 63, §33; 2012 Acts, ch 1113, §22; 2013 Acts, ch 129, §49; 2014 Acts, ch 1106, §1; 2017 Acts, ch 148, §2, 20; 2018 Acts, ch 1041, §127; 2019 Acts, ch 91, §1; 2023 Acts, ch 16, §31; 2023 Acts, ch 19, §126; 2024 Acts, ch 1161, §21, 137; 2024 Acts, ch 1170, §210135.11ALicensing boards expenses fees.Transferred to §10A.503; 2023 Acts, ch 19, §1711.135.11BAppointment of certain executive directors.Transferred to §10A.504; 2023 Acts, ch 19, §1711.135.12Statutory board, commission, committee, or council of committee teleconference option.Any statutorily established board, commission, committee, or council established under the purview of the department shall provide for a teleconference option for board, commission, committee, or council members to participate in official meetings.2019 Acts, ch 85, §80135.13Reserved.135.14State public health dental program.The department shall perform all of the following duties:1Plan and direct all work activities of the statewide public health dental program.2Develop comprehensive dental initiatives for prevention activities.3Evaluate the effectiveness of the statewide public health dental program and of program personnel.4Other related work as required.2007 Acts, ch 159, §13; 2021 Acts, ch 76, §28; 2023 Acts, ch 19, §127135.15Oral and health delivery systems.The department shall be responsible for all of the following:1Providing population-based oral health services, including public health training, improvement of dental support systems for families, technical assistance, awareness-building activities, and educational services, at the state and local level to assist Iowans in maintaining optimal oral health throughout all stages of life.2Performing infrastructure building and enabling services through the administration of state and federal grant programs targeting access improvement, prevention, and local oral health programs utilizing maternal and child health programs, Medicaid, and other new or existing programs.3Leveraging federal, state, and local resources for programs under the purview of the department.4Facilitating ongoing strategic planning and application of evidence-based research in oral health care policy development that improves oral health care access and the overall oral health of all Iowans.5Developing and implementing an ongoing oral health surveillance system for the evaluation and monitoring of the oral health status of children and other underserved populations.6Facilitating the provision of oral health services through dental homes. For the purposes of this section, “dental home” means a network of individualized care based on risk assessment, which includes oral health education, dental screenings, preventive services, diagnostic services, treatment services, and emergency services.2007 Acts, ch 159, §14; 2017 Acts, ch 148, §4; 2018 Acts, ch 1165, §110; 2021 Acts, ch 76, §29; 2023 Acts, ch 19, §128135.16Special supplemental nutrition program for women, infants, and children methamphetamine education.As a component of the federal funding received by the department as the administering agency for the special supplemental nutrition program for women, infants, and children, from the United States department of agriculture, food and nutrition service, the department shall incorporate a methamphetamine education program into its nutrition and health-related education services. The department shall be responsible for the development of the education program to be delivered, and for the selection of qualified contract agencies to deliver the instruction under the program.99 Acts, ch 195, §8; 2021 Acts, ch 76, §30135.16AVendors participating in federal nutrition program egg sales.1As used in this section, unless the context otherwise requires: a“Conventional eggs” means eggs other than specialty eggs.b“Eggs” means shell eggs that are graded as “AA”, “A”, or “B” pursuant to 7 C.F.R. pt. 56, subpt. A, and that are sold at retail in commercial markets.c“Federal nutrition program” means the special supplemental nutrition program for women, infants, and children as provided in 42 U.S.C. §1786 et seq.d“Grocery store” means a food establishment as defined in section 137F.1 licensed by the department of inspections, appeals, and licensing pursuant to section 137F.4, to sell food or food products to customers intended for preparation or consumption off premises.e“Specialty eggs” means eggs produced by domesticated chickens, and sold at retail in commercial markets if the chickens producing such eggs are advertised as being housed in any of the following environments:1Cage-free.2Free-range.3Enriched colony cage.2aThe department of inspections, appeals, and licensing shall assist the department in adopting rules necessary to implement and administer this section.bIf necessary to implement, administer, and enforce this section, the department, in cooperation with the department of agriculture and land stewardship, shall submit a request to the United States department of agriculture for a waiver or other exception from regulations as deemed feasible by the department. 3A grocery store that is a vendor participating in a federal nutrition program and offering specialty eggs for retail sale shall maintain an inventory of conventional eggs for retail sale sufficient to meet federal and state requirements for participation in the federal nutrition program.4This section does not require a grocery store to do any of the following:aStock or sell specialty eggs.bStock or sell eggs, if the grocery store elects not to stock or sell conventional eggs for retail sale as part of its normal business.cComply with the provisions of this section, if the grocery store’s inventory of eggs for retail sale was limited to specialty eggs prior to January 1, 2018.5A violation of subsection 3 by a grocery store shall not be construed to disqualify a grocery store from participating in a federal nutrition program unless otherwise authorized by the United States department of agriculture. 2018 Acts, ch 1025, §1; 2018 Acts, ch 1172, §19; 2021 Acts, ch 76, §31; 2023 Acts, ch 19, §129, 1880, 1881; 2024 Acts, ch 1018, §1, 13, 14135.16BRaw milk associated products.The department of health and human services may demand that a raw milk producer provide the department with all records required to be retained by the raw milk producer as provided in section 195.6, including any of the following:1The coliform count and standard plate count of dairy animals maintained at a raw milk dairy owned or operated by the raw milk producer.2The administration of antibiotic drugs to dairy animals maintained at a raw milk dairy owned or operated by the raw milk producer.2023 Acts, ch 75, §1135.16CFederal nutrition programs cultivated-protein food products.1As used in this section, unless the context otherwise requires:a“Cultivated-protein food product” means the same as defined in section 137E.1. b“Federal nutrition program” or “program” means any of the following:1The special supplemental nutrition program for women, infants, and children as provided in 42 U.S.C. §1786 et seq.2The supplemental nutrition assistance program as provided in 7 U.S.C. ch. 51.2If the United States department of agriculture approves cultivated-protein food products for purchase under a federal nutrition program, the department of health and human services shall submit a request to the United States department of agriculture for a waiver or other exception that excludes cultivated-protein food products from program eligibility in this state.2024 Acts, ch 1158, §1135.16DFederal nutrition programs fabricated-egg products.1As used in this section, unless the context otherwise requires:a“Fabricated-egg product” means the same as defined in section 137A.1.b“Federal nutrition program” or “program” means any of the following:1The special supplemental nutrition program for women, infants, and children as provided in 42 U.S.C. §1786 et seq.2The supplemental nutrition assistance program as provided in 7 U.S.C. ch. 51.2If the United States department of agriculture approves fabricated-egg products for purchase under a federal nutrition program, the department of health and human services shall submit a request to the United States department of agriculture for a waiver or other exception that excludes fabricated-egg products from program eligibility in this state.2024 Acts, ch 1158, §21135.17Dental screening of children.1aExcept as provided in paragraphs “c” and “d”, the parent or guardian of a child enrolled in elementary school shall provide evidence to the school district or accredited nonpublic elementary school in which the child is enrolled of the child having, no earlier than three years of age but no later than four months after enrollment, at a minimum, a dental screening performed by a licensed physician, a licensed nurse, a licensed physician assistant, or a licensed dental hygienist or dentist. Except as provided in paragraphs “c” and “d”, the parent or guardian of a child enrolled in high school shall provide evidence to the school district or accredited nonpublic high school in which the child is enrolled of the child having, at a minimum, a dental screening performed no earlier than one year prior to enrollment and not later than four months after enrollment by a licensed dental hygienist or dentist. A school district or accredited nonpublic school shall provide access to a process to complete the screenings described in this paragraph as appropriate.bA person authorized to perform a dental screening required by this section shall record that the screening was completed, and such additional information required by the department, on uniform forms developed by the department in cooperation with the department of education. The form shall include a space for the person to summarize any condition that may indicate a need for special services.cThe department shall specify the procedures that constitute a dental screening and authorize a waiver signed by a licensed physician, nurse, physician assistant, dental hygienist, or dentist for a person who is unduly burdened by the screening requirement.dThe dental screening requirement shall not apply to a person who submits an affidavit signed by the person or, if the person is a minor, the person’s parent or legal guardian, stating that the dental screening conflicts with a genuine and sincere religious belief.2Each public and nonpublic school shall, in collaboration with the department, do the following:aEnsure that the parent or guardian of a student enrolled in the school has complied with the requirements of subsection 1.bProvide, if a student has not had a dental screening performed in accordance with subsection 1, the parent or guardian of the student with community dental screening referral resources, including contact information for the i-smile coordinator, department, or dental society.3By May 31 annually, each local board shall furnish the department with evidence that each student enrolled in any public or nonpublic school within the local board’s jurisdiction has met the dental screening requirement in this section.4The department shall adopt rules to administer this section.2007 Acts, ch 146, §1, 2; 2008 Acts, ch 1020, §1 – 3; 2009 Acts, ch 41, §39; 2009 Acts, ch 133, §31; 2010 Acts, ch 1088, §2, 3135.18Conflicting statutes.Provisions of this chapter in conflict with the state building code, as adopted pursuant to section 103A.7, shall not apply where the state building code has been adopted or when the state building code applies throughout the state.[C73, 75, 77, 79, 81, §135.18]2004 Acts, ch 1086, §33135.19Viral hepatitis program — awareness, vaccinations, and testing.1If sufficient funds are appropriated by the general assembly, the department shall establish and administer a viral hepatitis program. The goal of the program shall be to distribute information to citizens of this state who are at an increased risk for exposure to viral hepatitis regarding the higher incidence of hepatitis C exposure and infection among these populations, the dangers presented by the disease, and contacts for additional information and referrals. The program shall also make available hepatitis A and hepatitis B vaccinations, and hepatitis C testing.2The department shall establish by rule a list of individuals by category who are at increased risk for viral hepatitis exposure. The list shall be consistent with recommendations developed by the centers for disease control and prevention of the United States department of health and human services, and shall be developed in consultation with the Iowa viral hepatitis task force and the Iowa department of veterans affairs. The department shall also establish by rule what information is to be distributed and the form and manner of distribution. The rules shall also establish a vaccination and testing program, to be coordinated by the department through local health departments and clinics and other appropriate locations.2006 Acts, ch 1045, §1; 2009 Acts, ch 182, §88; 2021 Acts, ch 76, §32135.20Hepatitis C awareness program — veterans — vaccinations.Repealed by 2009 Acts, ch 182, §89. 135.21Pay toilets.No person shall make a charge or require any special device, key or slug for the use of a toilet located in a room provided for use of the public. Violation of this section is a simple misdemeanor.[C24, 27, 31, 35, 39, §2839; C46, 50, 54, 58, 62, 66, 71, 73, 75, §170.34; C77, §732.25; C79, 81, §135.21]135.22Central registry for brain or spinal cord injuries.1As used in this section:a“Brain injury” means clinically evident damage to the brain resulting directly or indirectly from trauma, infection, anoxia, vascular lesions, or tumor of the brain, not primarily related to a degenerative disease or aging process, which temporarily or permanently impairs a person’s physical, cognitive, or behavioral functions, and is diagnosed by a physician. The diagnoses of clinically evident damage to the brain used for a diagnosis of brain injury shall be the same as specified by rule for eligibility for the home and community-based services waiver for persons with brain injury under the medical assistance program.b“Spinal cord injury” means the occurrence of an acute traumatic lesion of neural elements in the spinal cord including the spinal cord and cauda equina, resulting in temporary or permanent sensory deficit, motor deficit, or bladder or bowel dysfunction.2The director shall establish and maintain a central registry of persons with brain or spinal cord injuries in order to facilitate prevention strategies and the provision of appropriate rehabilitative services to the persons by the department and other state agencies. Hospitals shall report patients who are admitted with a brain or spinal cord injury and their diagnoses to the director no later than forty-five days after the close of a quarter in which the patient was discharged. The report shall contain the name, age, and residence of the person, the date, type, and cause of the brain or spinal cord injury, and additional information as the director requires, except that where available, hospitals shall report the Glasgow coma scale. The director shall consult with health care providers concerning the availability of additional relevant information. The department shall maintain the confidentiality of all information which would identify any person named in a report. However, the identifying information may be released for bona fide research purposes if the confidentiality of the identifying information is maintained by the researchers, or the identifying information may be released by the person with the brain or spinal cord injury or by the person’s guardian or, if the person is a minor, by the person’s parent or guardian.89 Acts, ch 320, §10; 92 Acts, ch 1237, §6; 94 Acts, ch 1068, §3; 99 Acts, ch 141, §3; 2012 Acts, ch 1120, §66135.22ABrain injuries policy department as lead agency.1For purposes of this section, unless the context otherwise requires:a“Brain injury” means a brain injury as defined in section 135.22.b“Council” means the council on health and human services.2The council shall do all of the following:aPromote meetings and programs for the discussion of methods to reduce the debilitating effects of brain injuries, and disseminate information in cooperation with any other department, agency, or entity on the prevention, evaluation, care, treatment, and rehabilitation of persons affected by brain injuries.bStudy and review current prevention, evaluation, care, treatment, and rehabilitation technologies and recommend appropriate preparation, training, retraining, and distribution of personnel and resources in the provision of services to persons with brain injuries through private and public residential facilities, day programs, and other specialized services.cParticipate in developing and disseminating criteria and standards which may be required for future funding or licensing of facilities, day programs, and other specialized services for persons with brain injuries in this state.dMake recommendations to the governor for developing and administering a state plan to provide services for persons with brain injuries.eMeet as necessary.3The department is designated as Iowa’s lead agency for brain injury. For the purposes of this section, the designation of lead agency authorizes the department to perform or oversee the performance of those functions specified in subsection 2, paragraphs “a” through “c”. 92 Acts, ch 1237, §7; 94 Acts, ch 1068, §4; 94 Acts, ch 1109, §2; 97 Acts, ch 203, §13; 99 Acts, ch 141, §4; 2000 Acts, ch 1058, §15; 2005 Acts, ch 89, §4; 2006 Acts, ch 1184, §77; 2013 Acts, ch 124, §2; 2023 Acts, ch 19, §130; 2024 Acts, ch 1170, §426135.22BBrain injury services program.1Definitions.For the purposes of this section, “brain injury services waiver” means the state’s medical assistance home and community-based services waiver for persons with brain injury implemented under chapter 249A.2Program created.aA brain injury services program is created and shall be administered by the department in cooperation with counties.bThe department’s duties shall include but are not limited to serving as the fiscal agent and contract administrator for the program and providing program oversight.cThe department shall consult with the council on health and human services regarding the program and shall report to the council on health and human services concerning the program at least quarterly. The council on health and human services shall make recommendations to the department concerning the program’s operation.3Purpose.The purpose of the brain injury services program is to provide services, service funding, or other support for persons with a brain injury under the cost-share program component or other components established pursuant to this section. Implementation of the cost-share component or any other component of the program is subject to the funding made available for the program.4General requirements — cost-share component.The cost-share component of the brain injury services program shall be directed to persons who have been determined to be ineligible for the brain injury services waiver or persons who are eligible for the waiver but funding was not authorized or available to provide waiver eligibility for the persons. The cost-share component is subject to general requirements which shall include but are not limited to all of the following:aServices offered are consistent with the services offered through the brain injury services waiver.bEach service consumer has a service plan developed prior to service implementation and the service plan is reviewed and updated at least quarterly.cAll other funding sources for which the service consumer is eligible are utilized to the greatest extent possible. The funding sources potentially available include but are not limited to community resources and public and private benefit programs.dThe maximum monthly cost of the services provided shall be based on the maximum monthly amount authorized for the brain injury services waiver.eAssistance under the cost-share component shall be made available to a designated number of service consumers who are eligible, as determined from the funding available for the cost-share component, on a first-come, first-served basis.fNothing in this section shall be construed or is intended as, or shall imply, a grant of entitlement to services to persons who are eligible for participation in the cost-share component based upon the eligibility provisions adopted consistent with the requirements of this section. Any obligation to provide services pursuant to this section is limited to the extent of the funds appropriated or provided for the cost-share component.5Cost-share component eligibility.An individual must meet all of the following requirements in order to be eligible for the cost-share component of the brain injury services program:aThe individual is age one month through sixty-four years.bThe individual has a diagnosis of brain injury that meets the diagnosis eligibility criteria for the brain injury services waiver.cThe individual is a resident of this state and either a United States citizen or a qualified alien as defined in 8 U.S.C. §1641.dThe individual meets the cost-share component’s financial eligibility requirements and is willing to pay a cost-share for the cost-share component.eThe individual does not receive services or funding under any type of medical assistance home and community-based services waiver.6Cost-share requirements.aThe cost-share component’s financial eligibility requirements shall be established in administrative rule. In establishing the requirements, the department shall consider the eligibility and cost-share requirements used for the Hawki program under chapter 514I.bAn individual’s cost-share responsibility for services under the cost-share component shall be determined on a sliding scale based upon the individual’s family income. An individual’s cost-share shall be assessed as a copayment, which shall not exceed thirty percent of the cost payable for the service.cThe service provider shall bill the department for the portion of the cost payable for the service that is not covered by the individual’s copayment responsibility.7Application process.aThe application materials for services under the cost-share component of the brain injury services program shall use the application form and other materials of the brain injury services waiver. In order to apply for the brain injury services program, the applicant must authorize the department to provide the applicant’s waiver application materials to the brain injury services program. The application materials provided shall include but are not limited to the waiver application and any denial letter, financial assessment, and functional assessment regarding the person.bIf a functional assessment for the waiver has not been completed due to a person’s financial ineligibility for the waiver, the brain injury services program may provide for a functional assessment to determine the person’s needs by reimbursing the department for the assessment.cThe department shall file copies of the individual’s application and needs assessment with the program resource facilitator assigned to the individual’s geographic area.dThe department shall make a final determination as to whether program funding will be authorized under the cost-share component.8Service providers and reimbursement.All of the following requirements apply to service providers and reimbursement rates payable for services under the cost-share component:aA service provider must either be certified to provide services under the brain injury services waiver or have a contract with a county to provide services and will become certified to provide services under such waiver within a reasonable period of time specified in rule.bThe reimbursement rate payable for the cost of a service provided under the cost-share component is the rate payable under the medical assistance program. However, if the service provided does not have a medical assistance program reimbursement rate, the rate shall be the amount payable under the county contract.9Resource facilitation.The program shall utilize resource facilitators to facilitate program services. The resource facilitator shall be available to provide ongoing support for individuals with brain injury in coping with the issues of living with a brain injury and in assisting such individuals in transitioning back to employment and living in the community. The resource facilitator is intended to provide a linkage to existing services and increase the capacity of the state’s providers of services to persons with brain injury by doing all of the following:aProviding brain injury-specific information, support, and resources.bEnhancing the usage of support commonly available to an individual with brain injury from the community, family, and personal contacts and linking such individuals to appropriate services and community resources.cTraining service providers to provide appropriate brain injury services.dAccessing, securing, and maximizing the private and public funding available to support an individual with a brain injury.2006 Acts, ch 1114, §1; 2007 Acts, ch 126, §35; 2008 Acts, ch 1058, §3; 2008 Acts, ch 1187, §106 – 108; 2023 Acts, ch 19, §131; 2024 Acts, ch 1170, §427; 2025 Acts, ch 30, §20135.23Reserved.135.24Volunteer health care provider program established — immunity from civil liability.1The director shall establish within the department a program to provide to eligible hospitals, clinics, free clinics, field dental clinics, specialty health care provider offices, or other health care facilities, health care referral programs, or charitable organizations, free medical, dental, chiropractic, pharmaceutical, nursing, optometric, psychological, social work, behavioral science, podiatric, physical therapy, occupational therapy, respiratory therapy, and emergency medical care services given on a voluntary basis by health care providers. A participating health care provider shall register with the department and obtain from the department a list of eligible, participating hospitals, clinics, free clinics, field dental clinics, specialty health care provider offices, or other health care facilities, health care referral programs, or charitable organizations.2The department shall adopt rules to implement the volunteer health care provider program which shall include the following:aProcedures for registration of health care providers deemed qualified by the board of medicine, the board of physician assistants, the dental board, the board of nursing, the board of chiropractic, the board of behavioral health professionals, the board of pharmacy, the board of optometry, the board of podiatry, the board of physical and occupational therapy, the board of respiratory care and polysomnography, and the department of inspections, appeals, and licensing, as applicable.bProcedures for registration of free clinics, field dental clinics, and specialty health care provider offices.cCriteria for and identification of hospitals, clinics, free clinics, field dental clinics, specialty health care provider offices, or other health care facilities, health care referral programs, or charitable organizations, eligible to participate in the provision of free medical, dental, chiropractic, pharmaceutical, nursing, optometric, psychological, social work, behavioral science, podiatric, physical therapy, occupational therapy, respiratory therapy, or emergency medical care services through the volunteer health care provider program. A free clinic, a field dental clinic, a specialty health care provider office, a health care facility, a health care referral program, a charitable organization, or a health care provider participating in the program shall not bill or charge a patient for any health care provider service provided under the volunteer health care provider program.dIdentification of the services to be provided under the program. The services provided may include but shall not be limited to obstetrical and gynecological medical services, psychiatric services provided by a physician licensed under chapter 148, dental services provided under chapter 153, or other services provided under chapter 147A, 148A, 148B, 148C, 149, 151, 152, 152B, 152E, 154, 154B, 154C, 154D, 154F, or 155A.3A health care provider providing free care under this section shall be considered an employee of the state under chapter 669, shall be afforded protection as an employee of the state under section 669.21, and shall not be subject to payment of claims arising out of the free care provided under this section through the health care provider’s own professional liability insurance coverage, provided that the health care provider has done all of the following:aRegistered with the department pursuant to subsection 1.bProvided medical, dental, chiropractic, pharmaceutical, nursing, optometric, psychological, social work, behavioral science, podiatric, physical therapy, occupational therapy, respiratory therapy, or emergency medical care services through a hospital, clinic, free clinic, field dental clinic, specialty health care provider office, or other health care facility, health care referral program, or charitable organization listed as eligible and participating by the department pursuant to subsection 1.4A free clinic providing free care under this section shall be considered a state agency solely for the purposes of this section and chapter 669 and shall be afforded protection under chapter 669 as a state agency for all claims arising from the provision of free care by a health care provider registered under subsection 3 who is providing services at the free clinic in accordance with this section or from the provision of free care by a health care provider who is covered by adequate medical malpractice insurance as determined by the department, if the free clinic has registered with the department pursuant to subsection 1.5A field dental clinic providing free care under this section shall be considered a state agency solely for the purposes of this section and chapter 669 and shall be afforded protection under chapter 669 as a state agency for all claims arising from the provision of free care by a health care provider registered under subsection 3 who is providing services at the field dental clinic in accordance with this section or from the provision of free care by a health care provider who is covered by adequate medical malpractice insurance, as determined by the department, if the field dental clinic has registered with the department pursuant to subsection 1.6A specialty health care provider office providing free care under this section shall be considered a state agency solely for the purposes of this section and chapter 669 and shall be afforded protection under chapter 669 as a state agency for all claims arising from the provision of free care by a health care provider registered under subsection 3 who is providing services at the specialty health care provider office in accordance with this section or from the provision of free care by a health care provider who is covered by adequate medical malpractice insurance, as determined by the department, if the specialty health care provider office has registered with the department pursuant to subsection 1.7For the purposes of this section:a“Charitable organization” means a charitable organization within the meaning of section 501(c)(3) of the Internal Revenue Code.b“Field dental clinic” means a dental clinic temporarily or periodically erected at a location utilizing mobile dental equipment, instruments, or supplies, as necessary, to provide dental services.c“Free clinic” means a facility, other than a hospital or health care provider’s office which is exempt from taxation under section 501(c)(3) of the Internal Revenue Code and which has as its sole purpose the provision of health care services without charge to individuals who are otherwise unable to pay for the services.d“Health care provider” means a physician licensed under chapter 148; a chiropractor licensed under chapter 151; a physical therapist licensed pursuant to chapter 148A; an occupational therapist licensed pursuant to chapter 148B; a podiatrist licensed pursuant to chapter 149; a physician assistant licensed pursuant to chapter 148C; a licensed practical nurse, a registered nurse, or an advanced registered nurse practitioner licensed pursuant to chapter 152 or 152E; a respiratory therapist licensed pursuant to chapter 152B; a dentist, dental hygienist, or dental assistant registered or licensed to practice under chapter 153; an optometrist licensed pursuant to chapter 154; a psychologist licensed pursuant to chapter 154B; a social worker licensed pursuant to chapter 154C; a mental health counselor, marital and family therapist, behavior analyst, or assistant behavior analyst licensed pursuant to chapter 154D; a speech pathologist or audiologist licensed pursuant to chapter 154F; a pharmacist licensed pursuant to chapter 155A; or an emergency medical care provider certified pursuant to chapter 147A.e“Specialty health care provider office” means the private office or clinic of an individual specialty health care provider or group of specialty health care providers, but does not include a field dental clinic, a free clinic, or a hospital.93 Acts, ch 65, §1; 95 Acts, ch 121, §1; 98 Acts, ch 1027, §1 – 6; 2001 Acts, ch 176, §31; 2002 Acts, ch 1108, §8; 2003 Acts, ch 89, §1; 2005 Acts, ch 118, §1 – 6; 2007 Acts, ch 10, §20; 2007 Acts, ch 95, §1; 2007 Acts, ch 159, §18; 2007 Acts, ch 218, §101, 193; 2008 Acts, ch 1088, §84, 85; 2009 Acts, ch 118, §43; 2009 Acts, ch 133, §32; 2015 Acts, ch 70, §1; 2018 Acts, ch 1106, §1, 14; 2019 Acts, ch 85, §66; 2023 Acts, ch 19, §132, 1581; 2023 Acts, ch 73, §1; 2024 Acts, ch 1170, §485135.24AFree clinics volunteer record check.1For purposes of this section, “free clinic” means a free clinic as defined in section 135.24 that is also a network of free clinics in this state that offers operational and collaborative opportunities to free clinics.2Persons who are potential volunteers or volunteers in a free clinic in a position having direct individual contact with patients of the free clinic shall be subject to criminal history and child and dependent adult abuse record checks in accordance with this section. The free clinic shall request that the department of public safety perform the criminal history check and the record check evaluation system of the department of health and human services perform child and dependent adult abuse record checks of the person in this state and may request these checks in other states. 3A free clinic subject to this section shall establish an evaluation process to determine whether a crime of founded child or dependent adult abuse warrants prohibition of the person’s participation as a volunteer in the free clinic. The evaluation process shall not be less stringent than the evaluation process performed by the record check evaluation system and shall be approved by the department.2018 Acts, ch 1104, §1, 5; 2023 Acts, ch 19, §133135.25Emergency medical services fund.An emergency medical services fund is created in the state treasury under the control of the department. The fund includes, but is not limited to, amounts appropriated by the general assembly, amounts transferred pursuant to section 602.8108, subsection 4, and other moneys available from federal or private sources which are to be used for purposes of this section. Funds remaining in the fund at the end of each fiscal year shall not revert to the general fund of the state but shall remain in the emergency medical services fund, notwithstanding section 8.33. The fund is established to assist counties by matching, on a dollar-for-dollar basis, moneys spent by a county for the acquisition of equipment for the provision of emergency medical services and by providing grants to counties for education and training in the delivery of emergency medical services, as provided in this section and section 422D.6. A county seeking matching funds under this section shall apply to the department. The department shall adopt rules concerning the application and awarding process for the matching funds and the criteria for the allocation of moneys in the fund if the moneys are insufficient to meet the emergency medical services needs of the counties. Moneys allocated by the department to a county for emergency medical services purposes may be used for equipment or training and education as determined by the board of supervisors pursuant to section 422D.6.93 Acts, ch 58, §1; 2000 Acts, ch 1043, §1; 2020 Acts, ch 1074, §49, 93; 2023 Acts, ch 19, §134135.26Automated external defibrillator grant program.Repealed by 2017 Acts, ch 148, §24.135.27Iowa healthy communities initiative — grant program.1Program goals.The department shall establish a grant program to energize local communities to transform the existing culture into a culture that promotes healthy lifestyles and leads collectively, community by community, to a healthier state. The grant program shall expand an existing healthy communities initiative to assist local boards of health, in collaboration with existing community resources, to build community capacity in addressing the prevention of chronic disease that results from risk factors including overweight and obesity conditions.2Distribution of grants.The department shall distribute the grants on a competitive basis and shall support the grantee communities in planning and developing wellness strategies and establishing methodologies to sustain the strategies. Grant criteria shall be consistent with the existing statewide initiative between the department and the department’s partners that promotes increased opportunities for physical activity and healthy eating for Iowans of all ages, or its successor, and the statewide comprehensive plan developed by the existing statewide initiative to increase physical activity, improve nutrition, and promote healthy behaviors. Grantees shall demonstrate an ability to maximize local, state, and federal resources effectively and efficiently.3Departmental support.The department shall provide support to grantees including capacity-building strategies, technical assistance, consultation, and ongoing evaluation.4Eligibility.Local boards of health representing a coalition of health care providers and community and private organizations are eligible to submit applications.2006 Acts, ch 1006, §1, 2; 2008 Acts, ch 1188, §60135.27AGovernor’s council on physical fitness and nutrition.Repealed by 2011 Acts, ch 129, §94, 156.135.28State substitute medical decision-making board.Repealed by 2010 Acts, ch 1031, §399.135.29Local substitute medical decision-making board.Repealed by 2017 Acts, ch 148, §24.IIMISCELLANEOUS PROVISIONS135.30Protective eyeglasses — safety provisions.Repealed by 2009 Acts, ch 56, §12. 135.30ABreast-feeding in public places.Notwithstanding any other provision of law to the contrary, a woman may breast-feed the woman’s own child in any public place where the woman’s presence is otherwise authorized.2000 Acts, ch 1140, §21135.31Location of boards of certain health care professions rulemaking.Transferred to §10A.505; 2023 Acts, ch 19, §1711.135.32Publication and distribution.Repealed by 2012 Acts, ch 1113, §19.135.33Refusal of board to enforce rules.If any local board shall fail to enforce the rules of the state department or carry out its lawful directions, the department may enforce the same within the territorial jurisdiction of such local board, and for that purpose it may exercise all of the powers given by statute to the local board, and may employ the necessary assistants to carry out its lawful directions.[C97, §2572; S13, §2569-a, 2572; C24, 27, 31, 35, 39, §2212; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.33]135.34Expenses for enforcing rules.All expenses incurred by the state department in determining whether its rules are enforced by a local board, and in enforcing the same when a local board has failed to do so, shall be paid in the same manner as the expenses of enforcing such rules when enforced by the local board.[S13, §2572; C24, 27, 31, 35, 39, §2213; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.34]135.35Duty of peace officers.All peace officers of the state when called upon by the department shall enforce its rules and execute the lawful orders of the department within their respective jurisdictions.[C97, §2572; S13, §2572; C24, 27, 31, 35, 39, §2214; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.35]135.36Interference with department officer penalties.Any person resisting or interfering with the department, its employees, or authorized agents, in the discharge of any duty imposed by law shall be guilty of a simple misdemeanor.[C24, 27, 31, 35, 39, §2215; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.36]2023 Acts, ch 19, §135135.37Tattooing permit requirement penalty.Transferred to §10A.531; 2023 Acts, ch 19, §1711.135.37ANatural hair braiding.Transferred to §10A.532; 2023 Acts, ch 19, §1711.135.38Penalty.Any person who knowingly violates any provision of this chapter, or of the rules of the department, or any lawful order, written or oral, of the department or of its officers, or authorized agents, shall be guilty of a simple misdemeanor.[C73, §419; C97, §2573; S13, §2575-a6; C24, 27, 31, 35, 39, §2217; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.38]135.39Federal aid.The department may accept financial aid from the government of the United States for the purpose of assisting in carrying on public health or substance use disorder responsibility in the state of Iowa.[C31, 35, §2217-c1; C39, §2217.1; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §135.39]86 Acts, ch 1245, §11082023 Acts, ch 19, §136135.39AGifts and grants fund — appropriation.The department is authorized to accept gifts, grants, or allotments of funds from any source to be used for programs authorized by this chapter or any other chapter which the department is responsible for administering. A public health gifts and grants fund is created as a separate fund in the state treasury under the control of the department. The fund shall consist of gift or grant moneys obtained from any source, including the federal government. The moneys collected under this section and deposited in the fund are appropriated to the department for the public health purposes specified in the gift or grant. Moneys in the fund shall not be subject to appropriation or expenditure for any other purpose. Notwithstanding section 8.33, moneys in the public health gifts and grants fund at the end of each fiscal year shall not revert to any other fund but shall remain in the public health gifts and grants fund for expenditure for subsequent fiscal years.2004 Acts, ch 1168, §1135.39BEarly childhood immunizations — content.1Beginning January 1, 2006, early childhood immunizations administered in this state shall not contain more than trace amounts of mercury.2For the purposes of this section:a“Early childhood immunizations” means immunizations administered to children under eight years of age, unless otherwise provided in this section.b“Trace amounts” means trace amounts as defined by the United States food and drug administration.3The prohibition under this section shall not apply to early childhood immunizations for influenza or in times of emergency or epidemic as determined by the director. If an emergency or epidemic is determined to exist by the director under this subsection, the director shall notify the council on health and human services, the governor, and the legislative council, and shall notify the public upon request.2004 Acts, ch 1159, §1; 2023 Acts, ch 19, §137135.39CElderly wellness services — payor of last resort.The department shall implement elderly wellness services in a manner that ensures that the services provided are not payable by a third-party source.2005 Acts, ch 175, §76135.39DVision screening.1The parent or guardian of a child to be enrolled in a public or accredited nonpublic elementary school shall ensure that the child is screened for vision impairment at least once before enrollment in kindergarten and again before enrollment in grade three. The parent or guardian of the child shall ensure that evidence of the vision screening is provided to the school district or accredited nonpublic school in which the child is enrolled. Evidence of the vision screening may be provided either directly from the parent or guardian or from a vision screening provider referred to in subsection 2, and may be provided in either written or electronic form.2The requirement for vision screening may be satisfied by any of the following:aA vision screening or comprehensive eye examination by a licensed ophthalmologist or licensed optometrist.bA vision screening conducted at a pediatrician’s or family practice physician’s office, a free clinic, a child care center, a local public health department, a public or accredited nonpublic school, or a community-based organization, or by an advanced registered nurse practitioner or physician assistant.cAn online vision screening, which may be conducted by a child’s parent or guardian.dA photoscreening vision screening, including a vision screening by Iowa kidsight.3All vision screening methods pursuant to subsection 2, including emerging vision screening technologies, shall be age-appropriate and shall be approved by the department in consultation with leading vision organizations in the state, licensed ophthalmologists, and licensed optometrists.4A person who performs a vision screening required pursuant to this section shall report the results of the vision screening to the department. The department may collect and maintain such reports through the statewide immunization registry or a private contractor.5Each public and accredited nonpublic elementary school shall, in collaboration with the department, do the following:aProvide the parents or guardians of students with vision screening referral resources.bArrange for evidence of vision screenings provided pursuant to subsection 1 to be forwarded to the department.6A child shall not be prohibited from attending school based upon the failure of a parent or guardian to ensure that the child has received the vision screening required by this section.7If a vision screening required pursuant to this section identifies potential vision impairment in a child, the person who performed the vision screening shall, if the person is not a licensed ophthalmologist or licensed optometrist, refer the child to a licensed ophthalmologist or licensed optometrist for a comprehensive eye examination.8The department shall establish procedures to contact parents or guardians of children identified as having potential vision impairment based on the results of a vision screening required pursuant to subsection 1 or a comprehensive eye examination required pursuant to subsection 7 in order to provide information on obtaining necessary vision correction.9The department may share information with licensed health care providers, agencies, and other persons involved with vision screenings, eye examinations, follow-up services, and intervention services as necessary to administer this section. The department shall adopt rules to protect the confidentiality of the individuals involved.10The vision screening requirement shall not apply if the vision screening conflicts with a parent’s or guardian’s genuine and sincere religious belief.11A person who acts in good faith in complying with this section shall not be civilly or criminally liable for reporting the information required to be reported by this section.12The department shall adopt rules necessary to administer this section.2013 Acts, ch 76, §1135.39EFluoridation in public water supply notice of discontinuance.1At least ninety days prior to taking any action to permanently discontinue fluoridation in its water supply, an owner or operator of a public water supply system, as defined in section 455B.171, shall provide notice to the department and the public water supply system’s customers.2In order to provide notice to its customers, the owner or operator of the public water supply system shall place a notice on each customer’s water bill or provide notice in a way that is reasonably calculated so that all customers will receive the notice.3Section 135.38 does not apply to violations of this section.2021 Acts, ch 63, §1; 2023 Acts, ch 19, §138IIIMORBIDITY AND MORTALITY STUDY135.40Collection and distribution of information.1Any person, hospital, sanatorium, nursing or rest home, or other organization may provide information, interviews, reports, statements, memoranda, or other data relating to the condition and treatment of any person to the department, the Iowa medical society or any of its allied medical societies, the Iowa osteopathic medical association, any in-hospital staff committee, or the Iowa healthcare collaborative, to be used in the course of any study for the purpose of reducing morbidity or mortality, and no liability of any kind or character for damages or other relief shall arise or be enforced against any person or organization that has acted reasonably and in good faith, by reason of having provided such information or material, or by reason of having released or published the findings and conclusions of such groups to advance medical research and medical education, or by reason of having released or published generally a summary of such studies.2For the purposes of this section, and section 135.41, the “Iowa healthcare collaborative” means an organization which is exempt from federal income taxation under section 501(c)(3) of the Internal Revenue Code and which is established to provide direction to promote quality, safety, and value improvement collaborative efforts by hospitals and physicians.[C66, 71, 73, 75, 77, 79, 81, §135.40]2006 Acts, ch 1128, §1135.41Publication.The department, the Iowa medical society or any of its allied medical societies, the Iowa osteopathic medical association, any in-hospital staff committee, or the Iowa healthcare collaborative shall use or publish said material only for the purpose of advancing medical research or medical education in the interest of reducing morbidity or mortality, except that a summary of such studies may be released by any such group for general publication. In all events the identity of any person whose condition or treatment has been studied shall be confidential and shall not be revealed under any circumstances. A violation of this section shall constitute a simple misdemeanor.[C66, 71, 73, 75, 77, 79, 81, §135.41]2006 Acts, ch 1128, §2135.42Unlawful use.All information, interviews, reports, statements, memoranda, or other data furnished in accordance with this subchapter and any findings or conclusions resulting from such studies shall not be used or offered or received in evidence in any legal proceedings of any kind or character, but nothing contained in this subchapter shall be construed as affecting the admissibility as evidence of the primary medical or hospital records pertaining to the patient or of any other writing, record or reproduction thereof not contemplated by this subchapter.[C66, 71, 73, 75, 77, 79, 81, §135.42]2019 Acts, ch 24, §104; 2020 Acts, ch 1063, §59IVSTATE MORTALITY REVIEW COMMITTEE — CHILDREN135.43State mortality review committee established duties.1A state mortality review committee is established in the department. The department shall provide staffing and administrative support to the committee.2The membership of the review committee is subject to the provisions of section 4A.12 relating to political affiliation. Review committee members who are not designated by another appointing authority shall be appointed by the director. Membership terms shall be for three years. A membership vacancy shall be filled in the same manner as the original appointment. The review committee shall elect a chairperson and other officers as deemed necessary by the review committee. The review committee shall meet upon the call of the director or as determined by the review committee. The review committee shall include the following:aThe state medical examiner or the state medical examiner’s designee.bA licensed physician knowledgeable concerning the causes of death.cA certified or licensed professional knowledgeable regarding substance use disorder.dAn attorney experienced in prosecuting domestic abuse cases.eAn expert in unexpected or unexplained infant deaths.fA clerk of a district court, to be appointed by the chief justice of the supreme court.gA judicial officer, to be appointed by the chief justice of the supreme court.hA local law enforcement official.iA social worker knowledgeable about deaths of children.jAdditional members as determined by the director.3The review committee shall perform the following duties:aCollect, review, and analyze child death certificates and child death data, including patient records or other pertinent confidential information concerning the deaths of children under age eighteen, and other information as the review committee deems appropriate for use in preparing an annual report to the governor and the general assembly concerning the causes and manner of child deaths. The report shall include analysis of factual information obtained through review and recommendations regarding prevention of child deaths.bRecommend to the governor and the general assembly interventions to prevent deaths of children based on an analysis of the cause and manner of such deaths.cRecommend to the agencies represented on the review committee changes which may prevent child deaths.dExcept as authorized by this section, maintain the confidentiality of any patient records or other confidential information reviewed.eRecommend to the department, appropriate law enforcement agencies, and any other person involved with child protection, interventions that may prevent harm to a child who is related to or is living in the same home as a child whose case is reviewed by the committee.fIf the sharing of information is necessary to assist in or initiate a child death investigation or criminal prosecution and the office or agency receiving the information does not otherwise have access to the information, share information possessed by the review committee with the office of the attorney general, a county attorney’s office, or an appropriate law enforcement agency. The office or agency receiving the information shall maintain the confidentiality of the information in accordance with this section. Unauthorized release or disclosure of the information received is subject to penalty as provided in this section.gIn order to assist the department in performing the department’s duties, if the department does not otherwise have access to the information, share information possessed by the review committee. The recipient of the information shall maintain the confidentiality of the information in accordance with this section. Unauthorized release or disclosure of the information received is subject to penalty as provided in this section.4The department shall develop protocols for the state mortality review committee to immediately review the child abuse assessments which involve the fatality of a child under age eighteen. aThe purpose of the review shall be to determine whether the department and others involved with the case of child abuse responded appropriately. The protocols shall provide for the committee to consult with any multidisciplinary team, as defined in section 235A.13, that is operating in the area in which the fatality occurred. The protocols shall also ensure that a member of the committee does not have a conflict of interest regarding the child fatality under review.bThe committee shall have access to patient records and other pertinent confidential information and, subject to the restrictions in this subsection, may redisseminate the confidential information in the committee’s report.cUpon completion of the review, the committee shall issue a report which shall include findings concerning the case and recommendations for changes to prevent child fatalities when similar circumstances exist. The report shall include but is not limited to the following information, subject to the restrictions listed in paragraph “d”:1The dates, outcomes, and results of any actions taken by the department and others in regard to each report and allegation of child abuse involving the child who died.2The results of any review of the case performed by a multidisciplinary team, or by any other public entity that reviewed the case.3Confirmation of receipt by the department of any report of child abuse involving the child, including confirmation as to whether or not any assessment involving the child was performed in accordance with section 232.71B, the results of any assessment, a description of the most recent assessment and the services offered to the family, the services rendered to the family, and the basis for the department’s decisions concerning the case.dPrior to issuing the report, the committee shall consult with the county attorney responsible for prosecution of the alleged perpetrator of the child fatality. The committee’s report shall include child abuse information associated with the case and the child, but is subject to the restrictions applicable to the department for release of information concerning a child fatality or near fatality in accordance with section 235A.15, subsection 9.eFollowing the completion of the trial of any alleged perpetrator of the child fatality and the appeal period for the granting of a new trial, the committee shall issue a supplemental report containing the information that was withheld, in accordance with paragraph “d”, so as not to jeopardize the prosecution or the rights of the alleged perpetrator to a fair trial as described in section 235A.15, subsection 9, paragraphs “e” and “f”.fThe report and any supplemental report shall be submitted to the governor and general assembly.gIf deemed appropriate by the committee, at any point in the review the committee may recommend to the department, appropriate law enforcement agencies, and any other person involved with child protection, interventions that may prevent harm to a child who is related to or is living in the same home as a child whose case is reviewed by the committee.5aThe following individuals shall designate a liaison to assist the review committee in fulfilling its responsibilities:1The director of health and human services.2The commissioner of public safety.3The attorney general.4The director of transportation.5The director of the department of education.bIn addition, the department shall designate a liaison from the public at large to assist the review committee in fulfilling its responsibilities.6The review committee may establish subcommittees to which the committee may delegate some or all of the committee’s responsibilities under subsection 3.7aThe department shall adopt rules providing for disclosure of information which is confidential under chapter 22 or any other provision of state law, to the review committee for purposes of performing its child death and child abuse review responsibilities.bA person in possession or control of medical, investigative, assessment, or other information pertaining to a child death and child abuse review shall allow the inspection and reproduction of the information by the department upon the request of the department, to be used only in the administration and for the duties of the state mortality review committee. Except as provided for a report on a child fatality by the committee under subsection 4, information and records produced under this section which are confidential under section 22.7 and chapter 235A, and information or records received from the confidential records, remain confidential under this section. A person does not incur legal liability by reason of releasing information to the department as required under and in compliance with this section.8Review committee members and their agents are immune from any liability, civil or criminal, which might otherwise be incurred or imposed as a result of any act, omission, proceeding, decision, or determination undertaken or performed, or recommendation made as a review committee member or agent provided that the review committee members or agents acted in good faith and without malice in carrying out their official duties in their official capacity. The department shall adopt rules pursuant to chapter 17A to administer this subsection. A complainant bears the burden of proof in establishing malice or lack of good faith in an action brought against review committee members involving the performance of their duties and powers under this section.9A person who releases or discloses confidential data, records, or any other type of information in violation of this section is guilty of a serious misdemeanor.95 Acts, ch 147, §2; 97 Acts, ch 159, §3, 4; 2000 Acts, ch 1051, §1; 2000 Acts, ch 1137, §1 – 3, 14; 2002 Acts, ch 1119, §129, 130; 2005 Acts, ch 6, §1 – 3; 2005 Acts, ch 179, §118; 2007 Acts, ch 159, §19, 20; 2009 Acts, ch 182, §108 – 111; 2010 Acts, ch 1069, §14; 2019 Acts, ch 85, §82; 2021 Acts, ch 76, §33, 34; 2023 Acts, ch 19, §139; 2024 Acts, ch 1004, §17; 2024 Acts, ch 1170, §211 – 218135.44Reserved.VRENAL DISEASES135.45Repealed by 2005 Acts, ch 89, §39. 135.46Repealed by 2005 Acts, ch 89, §39. 135.47Repealed by 2005 Acts, ch 89, §39. 135.48Repealed by 2005 Acts, ch 89, §39. 135.49Reserved.135.50Reserved.135.51Reserved.135.52Reserved.135.53Reserved.135.54Reserved.135.55Reserved.135.56Reserved.135.57Reserved.135.58Reserved.135.59Reserved.135.60Reserved.VIHEALTH FACILITIES135.61Definitions.As used in this subchapter, unless the context otherwise requires:1“Affected persons” means, with respect to an application for a certificate of need:aThe person submitting the application.bConsumers who would be served by the new institutional health service proposed in the application.cEach institutional health facility or health maintenance organization which is located in the geographic area which would appropriately be served by the new institutional health service proposed in the application. The appropriate geographic service area of each institutional health facility or health maintenance organization shall be determined on a uniform basis in accordance with criteria established in rules adopted by the department.dEach institutional health facility or health maintenance organization which, prior to receipt of the application by the department, has formally indicated to the department pursuant to this subchapter an intent to furnish in the future institutional health services similar to the new institutional health service proposed in the application.eAny other person designated as an affected person by rules of the department.fAny payer or third-party payer for health services.2“Ambulatory surgical center” means a distinct facility that operates primarily for the purpose of providing surgical services to patients not requiring hospitalization and in which the expected duration of services does not exceed twenty-four hours following an admission. “Ambulatory surgical center” includes a facility certified or seeking certification as an ambulatory surgical center under the federal Medicare program or under the medical assistance program established pursuant to chapter 249A. “Ambulatory surgical center” does not include the individual or group practice office of a private physician, podiatrist, or dentist who there engages in the lawful practice of surgery, or the portion of a licensed hospital designated for outpatient surgical treatment.3“Consumer” means any individual whose occupation is other than health services, who has no fiduciary obligation to an institutional health facility, health maintenance organization or other facility primarily engaged in delivery of services provided by persons in health service occupations, and who has no material financial interest in the providing of any health services.4“Department” means the department of health and human services.5“Develop”, when used in connection with health services, means to undertake those activities which on their completion will result in the offer of a new institutional health service or the incurring of a financial obligation in relation to the offering of such a service.6“Financial reporting” means reporting by which hospitals and health care facilities shall respectively record their revenues, expenses, other income, other outlays, assets and liabilities, and units of services.7“Health care facility” means health care facility as defined in section 135C.1.8“Health care provider” means a person licensed or certified under chapter 147, 148, 148A, 148C, 149, 151, 152, 153, 154, 154B, 154F, or 155A to provide in this state professional health care service to an individual during that individual’s medical care, treatment, or confinement.9“Health maintenance organization” means health maintenance organization as defined in section 514B.1, subsection 6.10“Health services” means clinically related diagnostic, curative, or rehabilitative services, and includes substance use disorder and mental health services.11“Hospital” means hospital as defined in section 135B.1, subsection 3.12“Institutional health facility” means any of the following, without regard to whether the facilities referred to are publicly or privately owned or are organized for profit or not or whether the facilities are part of or sponsored by a health maintenance organization:aA hospital.bA health care facility.cAn organized outpatient health facility.dAn ambulatory surgical center.eA community mental health facility.13“Institutional health service” means any health service furnished in or through institutional health facilities or health maintenance organizations, including mobile health services.14“Mobile health service” means equipment used to provide a health service that can be transported from one delivery site to another.15“Modernization” means the alteration, repair, remodeling, replacement or renovation of existing buildings or of the equipment previously installed therein, or both.16“New institutional health service” or “changed institutional health service” means any of the following:aThe construction, development or other establishment of a new institutional health facility regardless of ownership.bRelocation of an institutional health facility.cAny capital expenditure, lease, or donation by or on behalf of an institutional health facility in excess of one million five hundred thousand dollars within a twelve-month period.dA permanent change in the bed capacity, as determined by the department, of an institutional health facility. For purposes of this paragraph, a change is permanent if it is intended to be effective for one year or more.eAny expenditure in excess of five hundred thousand dollars by or on behalf of an institutional health facility for health services which are or will be offered in or through an institutional health facility at a specific time but which were not offered on a regular basis in or through that institutional health facility within the twelve-month period prior to that time.fThe deletion of one or more health services, previously offered on a regular basis by an institutional health facility or health maintenance organization or the relocation of one or more health services from one physical facility to another.gAny acquisition by or on behalf of a health care provider or a group of health care providers of any piece of replacement equipment with a value in excess of one million five hundred thousand dollars, whether acquired by purchase, lease, or donation.hAny acquisition by or on behalf of a health care provider or group of health care providers of any piece of equipment with a value in excess of one million five hundred thousand dollars, whether acquired by purchase, lease, or donation, which results in the offering or development of a health service not previously provided. A mobile service provided on a contract basis is not considered to have been previously provided by a health care provider or group of health care providers.iAny acquisition by or on behalf of an institutional health facility or a health maintenance organization of any piece of replacement equipment with a value in excess of one million five hundred thousand dollars, whether acquired by purchase, lease, or donation.jAny acquisition by or on behalf of an institutional health facility or health maintenance organization of any piece of equipment with a value in excess of one million five hundred thousand dollars, whether acquired by purchase, lease, or donation, which results in the offering or development of a health service not previously provided. A mobile service provided on a contract basis is not considered to have been previously provided by an institutional health facility.kAny air transportation service for transportation of patients or medical personnel offered through an institutional health facility at a specific time but which was not offered on a regular basis in or through that institutional health facility within the twelve-month period prior to the specific time.lAny mobile health service with a value in excess of one million five hundred thousand dollars.mAny of the following:1Cardiac catheterization service.2Open heart surgical service.3Organ transplantation service.4Radiation therapy service applying ionizing radiation for the treatment of malignant disease using megavoltage external beam equipment.17“Offer”, when used in connection with health services, means that an institutional health facility, health maintenance organization, health care provider, or group of health care providers holds itself out as capable of providing, or as having the means to provide, specified health services.18“Organized outpatient health facility” means a facility, not part of a hospital, organized and operated to provide health care to noninstitutionalized and nonhomebound persons on an outpatient basis; it does not include private offices or clinics of individual physicians, dentists or other practitioners, or groups of practitioners, who are health care providers.19“Technologically innovative equipment” means equipment potentially useful for diagnostic or therapeutic purposes which introduces new technology in the diagnosis or treatment of disease, the usefulness of which is not well enough established to permit a specific plan of need to be developed for the state.[C79, 81, §135.61; 82 Acts, ch 1194, §1, 2]87 Acts, ch 215, §39; 91 Acts, ch 225, §1; 97 Acts, ch 93, §1, 2; 2002 Acts, ch 1162, §77; 2008 Acts, ch 1088, §86; 2019 Acts, ch 24, §104; 2023 Acts, ch 16, §32 – 34; 2023 Acts, ch 19, §140, 1443, 1584 – 1587C2024, §10A.7112024 Acts, ch 1012, §1; 2025 Acts, ch 43, §1, 2; 2025 Acts, ch 120, §27, 40, 42, 43C2026, §135.61135.62Certificate of need required — exclusions.1A new institutional health service or changed institutional health service shall not be offered or developed in this state without prior application to the department for and receipt of a certificate of need, pursuant to this subchapter. The application shall be made upon forms furnished or prescribed by the department and shall contain such information as the department may require under this subchapter. The application shall be accompanied by a fee equivalent to three-tenths of one percent of the anticipated cost of the project with a minimum fee of six hundred dollars and a maximum fee of twenty-one thousand dollars. The fee shall be remitted by the department to the treasurer of state, who shall place it in the general fund of the state. If an application is voluntarily withdrawn within thirty calendar days after submission, seventy-five percent of the application fee shall be refunded; if the application is voluntarily withdrawn more than thirty but within sixty days after submission, fifty percent of the application fee shall be refunded; if the application is withdrawn voluntarily more than sixty days after submission, twenty-five percent of the application fee shall be refunded. Notwithstanding the required payment of an application fee under this subsection, an applicant for a new institutional health service or a changed institutional health service offered or developed by an intermediate care facility for persons with an intellectual disability or an intermediate care facility for persons with mental illness as defined pursuant to section 135C.1 is exempt from payment of the application fee.2This subchapter shall not be construed to augment, limit, contravene, or repeal in any manner any other statute of this state which may authorize or relate to licensure, regulation, supervision, or control of, nor to be applicable to:aPrivate offices and private clinics of an individual physician, dentist, or other practitioner or group of health care providers, except as provided by section 135.61, subsection 16, paragraphs “g”, “h”, and “m”, and section 135.61, subsections 2 and 18.bDispensaries and first aid stations, located within schools, businesses, or industrial establishments, which are maintained solely for the use of students or employees of those establishments and which do not contain inpatient or resident beds that are customarily occupied by the same individual for more than twenty-four consecutive hours.cEstablishments such as motels, hotels, and boarding houses which provide medical, nursing personnel, and other health related services as an incident to their primary business or function.dThe remedial care or treatment of residents or patients in any home or institution conducted only for those who rely solely upon treatment by prayer or spiritual means in accordance with the creed or tenets of any recognized church or religious denomination.eA health maintenance organization or combination of health maintenance organizations or an institutional health facility controlled directly or indirectly by a health maintenance organization or combination of health maintenance organizations, except when the health maintenance organization or combination of health maintenance organizations does any of the following:1Constructs, develops, renovates, relocates, or otherwise establishes an institutional health facility.2Acquires major medical equipment as provided by section 135.61, subsection 16, paragraphs “i” and “j”.fA residential care facility, as defined in section 135C.1, including a residential care facility for persons with an intellectual disability, notwithstanding any provision in this subchapter to the contrary.g1A reduction in bed capacity of an institutional health facility, notwithstanding any provision in this subchapter to the contrary, if all of the following conditions exist:aThe institutional health facility reports to the department the number and type of beds reduced on a form prescribed by the department at least thirty days before the reduction. In the case of a health care facility, the new bed total must be consistent with the number of licensed beds at the facility. In the case of a hospital, the number of beds must be consistent with bed totals reported to the department of inspections, appeals, and licensing for purposes of licensure and certification.bThe institutional health facility reports the new bed total on its next annual report to the department.2If these conditions are not met, the institutional health facility is subject to review as a “new institutional health service” or “changed institutional health service” under section 135.61, subsection 16, paragraph “d”, and is subject to sanctions under section 135.72. If the institutional health facility reestablishes the deleted beds at a later time, review as a “new institutional health service” or “changed institutional health service” is required pursuant to section 135.61, subsection 16, paragraph “d”.h1The deletion of one or more health services, previously offered on a regular basis by an institutional health facility or health maintenance organization, notwithstanding any provision of this subchapter to the contrary, if all of the following conditions exist:aThe institutional health facility or health maintenance organization reports to the department the deletion of the service or services at least thirty days before the deletion on a form prescribed by the department.bThe institutional health facility or health maintenance organization reports the deletion of the service or services on its next annual report to the department.2If these conditions are not met, the institutional health facility or health maintenance organization is subject to review as a “new institutional health service” or “changed institutional health service” under section 135.61, subsection 16, paragraph “f”, and is subject to sanctions under section 135.72.3If the institutional health facility or health maintenance organization reestablishes the deleted service or services at a later time, review as a “new institutional health service” or “changed institutional health service” may be required pursuant to section 135.61, subsection 16.iA residential program exempt from licensing as a health care facility under chapter 135C in accordance with section 135C.6, subsection 8.jThe construction, modification, or replacement of nonpatient care services, including parking facilities, heating, ventilation and air conditioning systems, computers, telephone systems, medical office buildings, and other projects of a similar nature, notwithstanding any provision in this subchapter to the contrary.k1The redistribution of beds by a hospital within the acute care category of bed usage, notwithstanding any provision in this subchapter to the contrary, if all of the following conditions exist:aThe hospital reports to the department the number and type of beds to be redistributed on a form prescribed by the department at least thirty days before the redistribution.bThe hospital reports the new distribution of beds on its next annual report to the department.2If these conditions are not met, the redistribution of beds by the hospital is subject to review as a new institutional health service or changed institutional health service pursuant to section 135.61, subsection 16, paragraph “d”, and is subject to sanctions under section 135.72.lThe replacement or modernization of any institutional health facility if the replacement or modernization does not add new health services or additional bed capacity for existing health services, notwithstanding any provision in this subchapter to the contrary. With respect to a nursing facility, “replacement” means establishing a new facility within the same county as the prior facility to be closed. With reference to a hospital, “replacement” means establishing a new hospital that demonstrates compliance with all of the following criteria through evidence submitted to the department:1Is designated as a critical access hospital pursuant to 42 U.S.C. §1395i-4.2Serves at least seventy-five percent of the same service area that was served by the prior hospital to be closed and replaced by the new hospital.3Provides at least seventy-five percent of the same services that were provided by the prior hospital to be closed and replaced by the new hospital.4Is staffed by at least seventy-five percent of the same staff, including medical staff, contracted staff, and employees, as constituted the staff of the prior hospital to be closed and replaced by the new hospital.mHemodialysis services provided by a hospital or freestanding facility, notwithstanding any provision in this subchapter to the contrary.nHospice services provided by a hospital, notwithstanding any provision in this subchapter to the contrary.oThe change in ownership, licensure, organizational structure, or designation of the type of institutional health facility if the health services offered by the successor institutional health facility are unchanged. This exclusion is applicable only if the institutional health facility consents to the change in ownership, licensure, organizational structure, or designation of the type of institutional health facility and ceases offering the health services simultaneously with the initiation of the offering of health services by the successor institutional health facility.pThe conversion of an existing number of beds by an intermediate care facility for persons with an intellectual disability to a smaller facility environment, including but not limited to a community-based environment which does not result in an increased number of beds, notwithstanding any provision in this subchapter to the contrary, including subsection 4, if all of the following conditions exist:1The intermediate care facility for persons with an intellectual disability reports the number and type of beds to be converted on a form prescribed by the department at least thirty days before the conversion.2The intermediate care facility for persons with an intellectual disability reports the conversion of beds on its next annual report to the department.qCosmetic, reconstructive, or plastic surgery services provided in an ambulatory surgical center licensed under chapter 135R.3This subchapter shall not be construed to be applicable to a health care facility operated by and for the exclusive use of members of a religious order, which does not admit more than two individuals to the facility from the general public, and which was in operation prior to July 1, 1986. However, this subchapter is applicable to such a facility if the facility is involved in the offering or developing of a new or changed institutional health service on or after July 1, 1986.4 The department shall not process applications for an intermediate care facility for persons with an intellectual disability, or consider a new or changed institutional health service for an intermediate care facility for persons with an intellectual disability, unless both of the following conditions are met:aThe new or changed beds shall not result in an increase in the total number of medical assistance certified intermediate care facility beds for persons with an intellectual disability in the state, exclusive of those beds at the state resource centers or other state institutions, beyond one thousand six hundred thirty-six beds.bA letter of support for the application is provided by the county board of supervisors, or the board’s designee, in the county in which the beds would be located.[C79, 81, §135.63; 82 Acts, ch 1194, §3]86 Acts, ch 1150, §1; 86 Acts, ch 1245, §1110; 91 Acts, ch 225, §4; 92 Acts, ch 1043, §1; 92 Acts, ch 1206, §1; 95 Acts, ch 120, §1; 96 Acts, ch 1129, §113; 97 Acts, ch 93, §4 – 8; 2002 Acts, ch 1120, §10; 2006 Acts, ch 1184, §78; 2008 Acts, ch 1191, §47; 2009 Acts, ch 184, §38; 2012 Acts, ch 1019, §7 – 10; 2019 Acts, ch 24, §104; 2023 Acts, ch 19, §1443, 1590 – 1601, 1882C2024, §10A.7132024 Acts, ch 1012, §2; 2024 Acts, ch 1043, §9, 10; 2025 Acts, ch 120, §28, 40, 44 – 52C2026, §135.62135.63Criteria for evaluation of applications.1In determining whether a certificate of need shall be issued, the department shall consider the following:aThe contribution of the proposed institutional health service in meeting the needs of the medically underserved, including persons in rural areas, low-income persons, racial and ethnic minorities, persons with disabilities, and the elderly, as well as the extent to which medically underserved residents in the applicant’s service area are likely to have access to the proposed institutional health service.bThe relationship of the proposed institutional health services to the long-range development plan, if any, of the person providing or proposing the services.cThe need of the population served or to be served by the proposed institutional health services for those services.dThe distance, convenience, cost of transportation, and accessibility to health services for persons who live outside metropolitan areas.eThe availability of alternative, less costly, or more effective methods of providing the proposed institutional health services.fThe immediate and long-term financial feasibility of the proposal presented in the application, as well as the probable impact of the proposal on the costs of and charges for providing health services by the person proposing the new institutional health service.gThe relationship of the proposed institutional health services to the existing health care system of the area in which those services are proposed to be provided.hThe appropriate and efficient use or prospective use of the proposed institutional health service, and of any existing similar services, including but not limited to a consideration of the capacity of the sponsor’s facility to provide the proposed service, and possible sharing or cooperative arrangements among existing facilities and providers.iThe availability of resources, including, but not limited to, health care providers, management personnel, and funds for capital and operating needs, to provide the proposed institutional health services and the possible alternative uses of those resources to provide other health services.jThe appropriate and nondiscriminatory utilization of existing and available health care providers. Where both allopathic and osteopathic institutional health services exist, each application shall be considered in light of the availability and utilization of both allopathic and osteopathic facilities and services in order to protect the freedom of choice of consumers and health care providers.kThe relationship, including the organizational relationship, of the proposed institutional health services to ancillary or support services.lSpecial needs and circumstances of those entities which provide a substantial portion of their services or resources, or both, to individuals not residing in the immediate geographic area in which the entities are located, which entities may include but are not limited to medical and other health professional schools, multidisciplinary clinics, and specialty centers.mThe special needs and circumstances of health maintenance organizations.nThe special needs and circumstances of biomedical and behavioral research projects designed to meet a national need and for which local conditions offer special advantages.oThe impact of relocation of an institutional health facility or health maintenance organization on other institutional health facilities or health maintenance organizations and on the needs of the population to be served, or which was previously served, or both.pIn the case of a construction project, the costs and methods of the proposed construction and the probable impact of the proposed construction project on total health care costs.qIn the case of a proposal for the addition of beds to a health care facility, the consistency of the proposed addition with the plans of other agencies of this state responsible for provision and financing of long-term care services, including home health services.rThe recommendations of staff personnel of the department assigned to the area of certificate of need, concerning the application.2In addition to the findings required with respect to any of the criteria listed in subsection 1 of this section, the department shall grant a certificate of need for a new institutional health service or changed institutional health service only if the department finds in writing, on the basis of data submitted, that:aLess costly, more efficient, or more appropriate alternatives to the proposed institutional health service are not available and the development of such alternatives is not practicable;bAny existing facilities providing institutional health services similar to those proposed are being used in an appropriate and efficient manner;cIn the case of new construction, alternatives including but not limited to modernization or sharing arrangements have been considered and have been implemented to the maximum extent practicable;dPatients will experience serious problems in obtaining care of the type which will be furnished by the proposed new institutional health service or changed institutional health service, in the absence of that proposed new service.3In the evaluation of applications for certificates of need submitted by the university of Iowa hospitals and clinics, the unique features of that institution relating to statewide tertiary health care, health science education, and clinical research shall be given due consideration. Further, in administering this subchapter, the unique capacity of university hospitals for the evaluation of technologically innovative equipment and other new health services shall be utilized.[C79, 81, §135.64]91 Acts, ch 225, §5; 92 Acts, ch 1043, §2; 96 Acts, ch 1129, §113; 2002 Acts, ch 1120, §11; 2014 Acts, ch 1026, §29; 2019 Acts, ch 24, §104; 2023 Acts, ch 19, §1443, 1602C2024, §10A.7142025 Acts, ch 120, §29 – 31, 40, 53C2026, §135.63135.64Letter of intent to precede application — review and comment.1Before applying for a certificate of need, the sponsor of a proposed new institutional health service or changed institutional health service shall submit to the department a letter of intent to offer or develop a service requiring a certificate of need. The letter shall be submitted as soon as possible after initiation of the applicant’s planning process, and in any case not less than thirty days before applying for a certificate of need and before substantial expenditures to offer or develop the service are made. The letter shall include a brief description of the proposed new or changed service, its location, and its estimated cost.2Upon request of the sponsor of the proposed new or changed service, the department shall make a preliminary review of the letter for the purpose of informing the sponsor of the project of any factors which may appear likely to result in denial of a certificate of need, based on the criteria for evaluation of applications in section 135.63. A comment by the department under this section shall not constitute a final decision.[C79, 81, §135.65]91 Acts, ch 225, §6; 97 Acts, ch 93, §92023 Acts, ch 19, §1443C2024, §10A.7152025 Acts, ch 120, §40, 54C2026, §135.64135.65Procedure upon receipt of application — public notification.1Within fifteen business days after receipt of an application for a certificate of need, the department shall examine the application for form and completeness and accept or reject it. An application shall be rejected only if it fails to provide all information required by the department pursuant to section 135.62, subsection 1. The department shall promptly return to the applicant any rejected application, with an explanation of the reasons for its rejection.2Upon acceptance of an application for a certificate of need, the department shall promptly undertake to notify all affected persons in writing that formal review of the application has been initiated. Notification to those affected persons who are consumers or third-party payers or other payers for health services may be provided by distribution of the pertinent information to the news media.3Each application accepted by the department shall be formally reviewed to enable the department to determine whether or not to grant the certificate of need. A formal review shall consist, at a minimum, of the following steps:aEvaluation of the application against the criteria specified in section 135.63.bA public hearing on the application, to be held prior to completion of the evaluation required by paragraph “a”.4When a hearing is to be held pursuant to subsection 3, paragraph “b”, the department shall give at least ten days’ notice of the time and place of the hearing. At the hearing, any affected person or that person’s designated representative shall have the opportunity to present testimony.[C79, 81, §135.66]91 Acts, ch 225, §72023 Acts, ch 19, §1443C2024, §10A.7162025 Acts, ch 120, §32, 40, 55C2026, §135.65135.66Summary review procedure.1The department may waive the letter of intent procedures prescribed by section 135.64 and substitute a summary review procedure, which shall be established by rules of the department, when it accepts an application for a certificate of need for a project which meets any of the criteria in paragraphs “a” through “e”:aA project which is limited to repair or replacement of a facility or equipment damaged or destroyed by a disaster, and which will not expand the facility nor increase the services provided beyond the level existing prior to the disaster.bA project necessary to enable the facility or service to achieve or maintain compliance with federal, state, or other appropriate licensing, certification, or safety requirements.cA project which will not change the existing bed capacity of the applicant’s facility or service, as determined by the department, by more than ten percent or ten beds, whichever is less, over a two-year period.dA project the total cost of which will not exceed one hundred fifty thousand dollars.eAny other project for which the applicant proposes and the department agrees to summary review.2The department’s decision to disallow a summary review shall be binding upon the applicant.[C79, 81, §135.67]91 Acts, ch 225, §8 – 10; 2009 Acts, ch 41, §1912023 Acts, ch 19, §1443C2024, §10A.7172025 Acts, ch 120, §40, 56C2026, §135.66135.67Status reports on review in progress.While formal review of an application for a certificate of need is in progress, the department shall upon request inform any affected person of the status of the review, any findings which have been made in the course of the review, and any other appropriate information concerning the review.[C79, 81, §135.68]2023 Acts, ch 19, §1443C2024, §10A.7182025 Acts, ch 120, §40C2026, §135.67135.68Department to make final decision.1The department shall complete its formal review of the application within ninety days after acceptance of the application, except as otherwise provided by section 135.71, subsection 4. Upon completion of the formal review, the department shall approve or deny the application. The department shall issue written findings stating the basis for its decision on the application and shall send copies of the decision and the written findings supporting the decision to the applicant and to any other person who so requests.2Failure by the department to issue a written decision on an application for a certificate of need within the time required by this section shall constitute denial of and final administrative action on the application.[C79, 81, §135.69]91 Acts, ch 225, §11; 2018 Acts, ch 1041, §127; 2023 Acts, ch 19, §1443C2024, §10A.7192025 Acts, ch 120, §33, 40C2026, §135.68135.69Appeal of certificate of need decisions.The department’s decision on an application for certificate of need, when announced pursuant to section 135.68, shall be a final decision. Any dissatisfied party who is an affected person with respect to the application, and who participated or sought unsuccessfully to participate in the formal review procedure prescribed by section 135.65, may request a rehearing in accordance with chapter 17A and rules of the department. If a rehearing is not requested or an affected party remains dissatisfied after the request for rehearing, an appeal may be taken in the manner provided by chapter 17A. Notwithstanding the Iowa administrative procedure Act, chapter 17A, a request for rehearing is not required prior to appeal under section 17A.19.[C79, 81, §135.70]91 Acts, ch 225, §122023 Acts, ch 19, §1443C2024, §10A.7202025 Acts, ch 120, §34, 40C2026, §135.69135.70Period for which certificate is valid extension or revocation.1A certificate of need shall be valid for a maximum of one year from the date of issuance. Upon the expiration of the certificate, or at any earlier time while the certificate is valid, the holder of the certificate shall provide the department information on the development of the project covered by the certificate as the department may request. The department shall determine at the end of the certification period whether sufficient progress is being made on the development of the project. The certificate of need may be extended by the department for additional periods of time as are reasonably necessary to expeditiously complete the project, but may be revoked by the department at the end of the first or any subsequent certification period for insufficient progress in developing the project.2Upon expiration of a certificate of need, and prior to extension of the certificate of need, any affected person shall have the right to submit to the department information which may be relevant to the question of granting an extension. The department may call a public hearing for this purpose.[C79, 81, §135.71]97 Acts, ch 93, §10; 2018 Acts, ch 1041, §127; 2023 Acts, ch 19, §1443C2024, §10A.7212025 Acts, ch 120, §35, 40C2026, §135.70135.71Authority to adopt rules.The department shall adopt such administrative rules as are necessary to enable it to implement this subchapter. These rules shall include:1Additional procedures and criteria for review of applications for certificates of need.2Uniform procedures for variations in application of criteria specified by section 135.63 for use in formal review of applications for certificates of need, when such variations are appropriate to the purpose of a particular review or to the type of institutional health service proposed in the application being reviewed.3Uniform procedures for summary reviews conducted under section 135.66.4Criteria for determining when it is not feasible to complete formal review of an application for a certificate of need within the time limits specified in section 135.68. The rules adopted under this subsection shall include criteria for determining whether an application proposes introduction of technologically innovative equipment, and if so, procedures to be followed in reviewing the application. However, a rule adopted under this subsection shall not permit a deferral of more than sixty days beyond the time when a decision is required under section 135.68, unless both the applicant and the department agree to a longer deferment.[C79, 81, §135.72]91 Acts, ch 225, §13; 2019 Acts, ch 24, §104; 2023 Acts, ch 19, §1443, 1603C2024, §10A.7222025 Acts, ch 120, §36, 40, 57C2026, §135.71135.72Sanctions.1Any party constructing a new institutional health facility or an addition to or renovation of an existing institutional health facility without first obtaining a certificate of need or, in the case of a mobile health service, ascertaining that the mobile health service has received certificate of need approval, as required by this subchapter, shall be denied licensure or change of licensure by the appropriate responsible licensing agency of this state.2A party violating this subchapter shall be subject to penalties in accordance with this section. The department shall adopt rules setting forth the violations by classification, the criteria for the classification of any violation not listed, and procedures for implementing this subsection.aA class I violation is one in which a party offers a new institutional health service or changed institutional health service modernization or acquisition without review and approval by the department. A party in violation is subject to a penalty of three hundred dollars for each day of a class I violation. The department may seek injunctive relief which shall include restraining the commission or continuance of an act which would violate the provisions of this paragraph. Notice and opportunity to be heard shall be provided to a party pursuant to rule of civil procedure 1.1507 and contested case procedures in accordance with chapter 17A. The department may reduce, alter, or waive a penalty upon the party showing good faith compliance with the department’s request to immediately cease and desist from conduct in violation of this section.bA class II violation is one in which a party violates the terms or provisions of an approved application. The department may seek injunctive relief which shall include restraining the commission or continuance of or abating or eliminating an act which would violate the provisions of this subsection. Notice and opportunity to be heard shall be provided to a party pursuant to rule of civil procedure 1.1507 and contested case procedures in accordance with chapter 17A. The department may reduce, alter, or waive a penalty upon the party showing good faith compliance with the department’s request to immediately cease and desist from conduct in violation of this section. A class II violation shall be abated or eliminated within a stated period of time determined by the department and specified by the department in writing. The period of time may be modified by the department for good cause shown. A party in violation may be subject to a penalty of five hundred dollars for each day of a class II violation.3Notwithstanding any other sanction imposed pursuant to this section, a party offering or developing any new institutional health service or changed institutional health service without first obtaining a certificate of need as required by this subchapter, may be temporarily or permanently restrained from doing so by any court of competent jurisdiction in any action brought by the state, any of its political subdivisions, or any other interested person.4The sanctions provided by this section are in addition to, and not in lieu of, any penalty prescribed by law for the acts against which these sanctions are invoked.[C79, 81, §135.73]91 Acts, ch 225, §14; 2019 Acts, ch 24, §104; 2023 Acts, ch 19, §1443, 1604 – 1606C2024, §10A.7232025 Acts, ch 120, §37, 40, 58, 59C2026, §135.72135.73Uniform financial reporting.1The department, after study and in consultation with any advisory committees which may be established pursuant to law, shall promulgate by rule pursuant to chapter 17A uniform methods of financial reporting, including such allocation methods as may be prescribed, by which hospitals and health care facilities shall respectively record their revenues, expenses, other income, other outlays, assets and liabilities, and units of service, according to functional activity center. These uniform methods of financial reporting shall not preclude a hospital or health care facility from using any accounting methods for its own purposes provided these accounting methods can be reconciled to the uniform methods of financial reporting prescribed by the department and can be audited for validity and completeness. Each hospital and each health care facility shall adopt the appropriate system for its fiscal year, effective upon such date as the department shall direct.2In establishing uniform methods of financial reporting, the department shall consider all of the following:aThe existing systems of accounting and reporting currently utilized by hospitals and health care facilities.bDifferences among hospitals and health care facilities, respectively, according to size, financial structure, methods of payment for services, and scope, type and method of providing services.cOther pertinent distinguishing factors.3The department shall, where appropriate, provide for modification, consistent with the purposes of this subchapter, of reporting requirements to correctly reflect the differences among hospitals and among health care facilities referred to in subsection 2, and to avoid otherwise unduly burdensome costs in meeting the requirements of uniform methods of financial reporting.4The uniform financial reporting methods, where appropriate, shall be structured so as to establish and differentiate costs incurred for patient-related services rendered by hospitals and health care facilities, as distinguished from those incurred in the course of educational, research and other nonpatient-related activities including but not limited to charitable activities of these hospitals and health care facilities.[C79, 81, §135.74]2013 Acts, ch 30, §27; 2019 Acts, ch 24, §104; 2020 Acts, ch 1063, §60; 2023 Acts, ch 19, §1443, 1607C2024, §10A.7242025 Acts, ch 120, §40, 60C2026, §135.73135.74Annual reports by hospitals, health care facilities.1Each hospital and each health care facility shall annually, after the close of its fiscal year, file all of the following with the department:aA balance sheet detailing the assets, liabilities and net worth of the hospital or health care facility.bA statement of its income and expenses.cSuch other reports of the costs incurred in rendering services as the department may prescribe.2Where more than one licensed hospital or health care facility is operated by the reporting organization, the information required by this section shall be reported separately for each licensed hospital or health care facility. The department shall require preparation of specified financial reports by a certified public accountant, and may require attestation of responsible officials of the reporting hospital or health care facility that the reports submitted are to the best of their knowledge and belief prepared in accordance with the prescribed methods of reporting. The department shall have the right to inspect the books, audits and records of any hospital or health care facility as reasonably necessary to verify reports submitted pursuant to this subchapter.3In obtaining the reports required by this section, the department and other state agencies shall coordinate their reporting requirements.4All reports filed under this section, except privileged medical information, shall be open to public inspection.[C79, 81, §135.75]2013 Acts, ch 30, §28; 2019 Acts, ch 24, §104; 2023 Acts, ch 19, §1443, 1608C2024, §10A.7252025 Acts, ch 120, §40, 61C2026, §135.74135.75Analyses and studies by department.1The department shall from time to time undertake analyses and studies relating to hospital and health care facility costs and to the financial status of hospitals or health care facilities, or both, which are subject to the provisions of this subchapter. It shall further require the filing of information concerning the total financial needs of each individual hospital or health care facility and the resources currently or prospectively available to meet these needs, including the effect of proposals made by health systems agencies. The department shall also prepare and file such summaries and compilations or other supplementary reports based on the information filed with it as will, in its judgment, advance the purposes of this subchapter.2The analyses and studies required by this section shall be conducted with the objective of providing a basis for determining whether or not regulation of hospital and health care facility rates and charges by the state of Iowa is necessary to protect the health or welfare of the people of the state.3In conducting its analyses and studies, the department should determine whether:aThe rates charged and costs incurred by hospitals and health care facilities are reasonably related to the services offered by those respective groups of institutions.bAggregate rates of hospitals and of health care facilities are reasonably related to the aggregate costs incurred by those respective groups of institutions.cRates are set equitably among all purchasers or classes of purchasers of hospital and of health care facility services.dThe rates for particular services, supplies or materials established by hospitals and by health care facilities are reasonable. Determination of reasonableness of rates shall include consideration of a fair rate of return to proprietary hospitals and health care facilities.4All data gathered and compiled and all reports prepared under this section, except privileged medical information, shall be open to public inspection.[C79, 81, §135.76]2019 Acts, ch 24, §104; 2023 Acts, ch 19, §1443, 1609C2024, §10A.7262025 Acts, ch 120, §40, 62C2026, §135.75135.76Data to be compiled.The department shall compile all relevant financial and utilization data in order to have available the statistical information necessary to properly monitor hospital and health care facility charges and costs. Such data shall include necessary operating expenses, appropriate expenses incurred for rendering services to patients who cannot or do not pay, all properly incurred interest charges, and reasonable depreciation expenses based on the expected useful life of the property and equipment involved. The department shall also obtain from each hospital and health care facility a current rate schedule as well as any subsequent amendments or modifications of that schedule as it may require. In collection of the data required by this section and sections 135.73 through 135.75, the department and other state agencies shall coordinate their reporting requirements.[C79, 81, §135.78]2002 Acts, ch 1119, §14; 2003 Acts, ch 108, §342023 Acts, ch 19, §1443C2024, §10A.7272025 Acts, ch 120, §40, 63C2026, §135.76135.77Civil penalty.Any hospital or health care facility which fails to file with the department the financial reports required by sections 135.73 through 135.76 is subject to a civil penalty of not to exceed five hundred dollars for each offense.[C79, 81, §135.79]2021 Acts, ch 80, §67; 2023 Acts, ch 19, §1443C2024, §10A.7282025 Acts, ch 120, §40, 64C2026, §135.77135.78Contracts for assistance with analyses, studies, and data.In furtherance of the department’s responsibilities under sections 135.75 and 135.76, the director may contract with the Iowa hospital association and third-party payers, the Iowa health care facilities association and third-party payers, or leading age Iowa and third-party payers for the establishment of pilot programs dealing with prospective rate review in hospitals or health care facilities, or both. Such contract shall be subject to the approval of the executive council and shall provide for an equitable representation of health care providers, third-party payers, and health care consumers in the determination of criteria for rate review. No third-party payer shall be excluded from positive financial incentives based upon volume of gross patient revenues. No state or federal funds appropriated or available to the department shall be used for any such pilot program.[C79, 81, §135.83]98 Acts, ch 1100, §13; 2001 Acts, ch 74, §2; 2002 Acts, ch 1050, §16; 2013 Acts, ch 30, §29; 2023 Acts, ch 19, §1443C2024, §10A.7292025 Acts, ch 120, §40, 65C2026, §135.78135.79Civil penalty.Transferred to §10A.728; 2023 Acts, ch 19, §1443.135.80Reserved.135.81Reserved.135.82Reserved.135.83Contracts for assistance with analyses, studies, and data.Transferred to §10A.729; 2023 Acts, ch 19, §1443.135.84Reserved.135.85Reserved.135.86Reserved.135.87Reserved.135.88Reserved.135.89Reserved.VIIRESERVED135.90Reserved.135.91Reserved.135.92Reserved.135.93Reserved.135.94Reserved.135.95Reserved.135.96Reserved.135.97Reserved.135.98Reserved.135.99Reserved.VIIILEAD POISONING PREVENTION PROGRAM — BLOOD LEAD TESTING135.100Definitions.For the purposes of this subchapter, unless the context otherwise requires:1“Department” means the department of health and human services.2“Local board” means the local board of health.87 Acts, ch 55, §1; 2019 Acts, ch 24, §104; 2023 Acts, ch 19, §141135.101Childhood lead poisoning prevention program.There is established a childhood lead poisoning prevention program within the department. The department shall implement and review programs necessary to eliminate potentially dangerous toxic lead levels in children in Iowa in a year for which funds are appropriated to the department for this purpose.87 Acts, ch 55, §2; 99 Acts, ch 141, §52023 Acts, ch 19, §142135.102Rules.The department shall adopt rules, pursuant to chapter 17A, regarding the:1Implementation of the grant program pursuant to section 135.103.2Maintenance of laboratory facilities for the childhood lead poisoning prevention program.3Maximum blood lead levels in children living in targeted rental dwelling units.4Standards and program requirements of the grant program pursuant to section 135.103.5Prioritization of proposed childhood lead poisoning prevention programs, based on the geographic areas known with children identified with elevated blood lead level resulting from surveys completed by the department.6Model regulations for lead hazard remediation to be used in instances in which a child is confirmed as lead poisoned. The department shall make the model regulations available to local boards of health and shall promote the adoption of the regulations at the local level, in cities and counties implementing lead hazard remediation programs. Nothing in this subsection shall be construed as requiring the adoption of the model regulations.7Implementation of a requirement that children receive a blood lead test prior to the age of six and before enrolling in any elementary school in Iowa in accordance with section 135.105D.87 Acts, ch 55, §3; 99 Acts, ch 141, §6; 2001 Acts, ch 182, §9; 2007 Acts, ch 79, §1135.103Grant program.The department shall implement a childhood lead poisoning prevention grant program which provides federal, state, or other funds to local boards of health or cities for the program after standards and requirements for the local program are developed. The department may also use federal, state, or other funds provided for the childhood lead poisoning prevention grant program to purchase environmental and blood testing services from a public health laboratory.87 Acts, ch 55, §4; 91 Acts, ch 268, §307; 99 Acts, ch 141, §7; 2004 Acts, ch 1168, §2135.104Requirements.The program by a local board of health or city receiving funding for an approved childhood lead poisoning prevention grant program shall include:1A public education program about lead poisoning and dangers of lead poisoning to children.2An effective outreach effort to ensure availability of services in the predicted geographic area.3A screening program for children, with emphasis on children less than six years of age.4Access to laboratory services for lead analysis.5A program of referral of identified children for assessment and treatment.6An environmental assessment of suspect dwelling units.7Surveillance to ensure correction of the identified hazardous settings.8A plan of intent to continue the program on a maintenance basis after the grant is discontinued.87 Acts, ch 55, §5; 99 Acts, ch 141, §8, 9; 2002 Acts, ch 1108, §9; 2004 Acts, ch 1168, §3135.105Department duties.The department shall:1Coordinate the childhood lead poisoning prevention program with the department of natural resources, the university of Iowa poison control program, the mobile and regional child health specialty clinics, and any agency or program known for a direct interest in lead levels in the environment.2Survey geographic areas not included in the grant program pursuant to section 135.103 periodically to determine prioritization of such areas for future grant programs.87 Acts, ch 55, §6; 99 Acts, ch 141, §10; 2012 Acts, ch 1023, §24135.105ALead inspector, lead abater, and lead-safe renovator training and certification program established — civil penalty.Transferred to §10A.902; 2023 Acts, ch 19, §1711.135.105BVoluntary guidelines — health and environmental measures — confirmed cases of lead poisoning.1The department may develop voluntary guidelines which may be used to develop and administer local programs to address the health and environmental needs of children who are confirmed as lead poisoned.2The voluntary guidelines may be based upon existing local ordinances that address the medical case management of children’s health needs and the mitigation of the environmental factors which contributed to the lead poisoning.3Following development of the voluntary guidelines, cities or counties may elect to utilize the guidelines in developing and administering local programs through city or county health departments on a city, county, or multicounty basis or may request that the state develop and administer the local program. However, cities and counties are not required to develop and administer local programs based upon the guidelines.96 Acts, ch 1161, §2, 4135.105CRenovation, remodeling, and repainting — lead hazard notification process established.Transferred to §10A.903; 2023 Acts, ch 19, §1711.135.105DBlood lead testing — provider education — payor of last resort.1For purposes of this section:a“Blood lead testing” means taking a capillary or venous sample of blood and sending it to a laboratory to determine the level of lead in the blood.b“Capillary” means a blood sample taken from the finger or heel for lead analysis.c“Health care provider” means a physician who is licensed under chapter 148, or a person who is licensed as a physician assistant under chapter 148C or as an advanced registered nurse practitioner.d“Venous” means a blood sample taken from a vein in the arm for lead analysis.2aA parent or guardian of a child under the age of two is strongly encouraged to have the child tested for elevated blood lead levels by the age of two. Except as provided in paragraph “b” and subsection 4, a parent or guardian shall provide evidence to the school district elementary attendance center or the accredited nonpublic elementary school in which the parent’s or guardian’s child is enrolled that the child was tested for elevated blood lead levels by the age of six according to recommendations provided by the department.bThe board of directors of each school district and the authorities in charge of each nonpublic school shall, in collaboration with the department, do the following:1Ensure that the parent or guardian of a student enrolled in the school has complied with the requirements of paragraph “a”.2Provide, if the parent or guardian cannot provide evidence that the child received a blood lead test in accordance with paragraph “a”, the parent or guardian with community blood lead testing program information, including contact information for the department.cNotwithstanding any other provision to the contrary, nothing in this section shall subject a parent, guardian, or legal custodian of a child of compulsory attendance age to any penalties under chapter 299.3The board of directors of each school district and the authorities in charge of each nonpublic school shall furnish the department, in the format specified by the department, within sixty days after the start of the school calendar, a list of the children enrolled in kindergarten. The department shall notify the school districts and nonpublic schools of the children who have not met the blood lead testing requirements set forth in this section and shall work with the school districts, nonpublic schools, and the local childhood lead poisoning prevention programs to assure that these children are tested as required by this section.4The department may waive the requirements of subsection 2 if the department determines that a child is of very low risk for elevated blood lead levels, or if the child’s parent or legal guardian submits an affidavit, signed by the parent or legal guardian, stating that the blood lead testing conflicts with a genuine and sincere religious belief.5The department shall provide rules adopted pursuant to section 135.102, subsection 7, to local school boards and the authorities in charge of nonpublic schools.6The department shall work with health care provider associations to educate health care providers regarding requirements for testing children who are enrolled in certain federally funded programs and regarding department recommendations for testing other children for lead poisoning.7The department shall implement blood lead testing for children under six years of age who are not eligible for the testing services to be paid by a third-party source. The department shall contract with one or more public health laboratories to provide blood lead analysis for such children. The department shall establish by rule the procedures for health care providers to submit samples to the contracted public health laboratories for analysis. The department shall also establish by rule a method to reimburse health care providers for drawing blood samples from such children and the dollar amount that the department will reimburse health care providers for the service. The department shall also establish by rule a method to reimburse health care providers for analyzing blood lead samples using a portable blood lead testing instrument and the dollar amount that the department will reimburse health care providers for the service. Payment for blood lead analysis and drawing blood samples shall be limited to the amount appropriated for the program in a fiscal year.2006 Acts, ch 1184, §79; 2007 Acts, ch 79, §2, 3; 2007 Acts, ch 215, §88; 2008 Acts, ch 1020, §4 – 6; 2008 Acts, ch 1088, §87IXHEALTHY FAMILIES PROGRAM135.106Healthy families programs — HOPES-HFI program.1The department shall establish a healthy opportunities for parents to experience success (HOPES) healthy families Iowa (HFI) program to provide services to families and children during the prenatal through preschool years. The program shall be designed to do all of the following:aPromote optimal child health and development.bImprove family coping skills and functioning.cPromote positive parenting skills and intrafamilial interaction.dPrevent child abuse and neglect and infant mortality and morbidity.2The HOPES-HFI program shall be developed by the department, and may be implemented, in whole or in part, by contracting with a nonprofit child abuse prevention organization, local nonprofit certified home health program or other local nonprofit organizations, and shall include, but is not limited to, all of the following components:aIdentification of barriers to positive birth outcomes, encouragement of collaboration and cooperation among providers of health care, social and human services, and other services to pregnant women and infants, and encouragement of pregnant women and women of childbearing age to seek health care and other services which promote positive birth outcomes.bProvision of community-based home-visiting family support to pregnant women and new parents who are identified through a standardized screening process to be at high risk for problems with successfully parenting their child.cProvision by family support workers of individual guidance, information, and access to health care and other services through care coordination and community outreach, including transportation.dProvision of systematic screening, prenatally or upon the birth of a child, to identify high-risk families.eInterviewing by a HOPES-HFI program worker or hospital social worker of families identified as high risk and encouragement of acceptance of family support services.fProvision of services including, but not limited to, home visits, support services, and instruction in child care and development.gIndividualization of the intensity and scope of services based upon the family’s needs, goals, and level of risk.hAssistance by a family support worker to participating families in creating a link to a “medical home” in order to promote preventive health care.iEvaluation and reporting on the program, including an evaluation of the program’s success in reducing participants’ risk factors and provision of services and recommendations for changes in or expansion of the program.jProvision of continuous follow-up contact with a family served by the program until identified children reach age three or age four in cases of continued high need or until the family attains its individualized goals for health, functioning, and self-sufficiency.kProvision or employment of family support workers who have experience as a parent, knowledge of health care services, social and human services, or related community services and have participated in a structured training program.lProvision of a training program that meets established standards for the education of family support workers. The structured training program shall include at a minimum the fundamentals of child health and development, dynamics of child abuse and neglect, and principles of effective parenting and parenting education.mProvision of crisis child care through utilization of existing child care services to participants in the program.nProgram criteria shall include a required match of one dollar provided by the organization contracting to deliver services for each two dollars provided by the state grant. This requirement shall not restrict the department from providing unmatched grant funds to communities to plan new or expanded programs for HOPES-HFI. The department shall establish a limit on the amount of administrative costs that can be supported with state funds.oInvolvement with the community assessment and planning process in the community served by HOPES-HFI programs to enhance collaboration and integration of family support programs.pCollaboration, to the greatest extent possible, with other family support programs funded or operated by the state.qUtilization of private party, third party, and medical assistance for reimbursement to defray the costs of services provided by the program to the extent possible.3It is the intent of the general assembly to provide communities with the discretion and authority to redesign existing local programs and services targeted at and assisting families expecting babies and families with children who are newborn through five years of age. The department, department of education, and other state agencies and programs, as appropriate, shall provide technical assistance and support to communities desiring to redesign their local programs and shall facilitate the consolidation of existing state funding appropriated and made available to the community for family support services. Funds which are consolidated in accordance with this subsection shall be used to support the redesigned service delivery system. In redesigning services, communities are encouraged to implement a single uniform family risk assessment mechanism and shall demonstrate the potential for improved outcomes for children and families. Requests by local communities for the redesigning of services shall be submitted to the department and the department of education, and are subject to the approval of the early childhood Iowa state board in consultation with the departments, based on the practices utilized with early childhood Iowa areas under chapter 256I.4It is the intent of the general assembly that priority for family support funding be given to approaches using evidence-based or promising models for family support.92 Acts, 2nd Ex, ch 1001, §41997 Acts, ch 138, §1; 98 Acts, ch 1206, §10; 2004 Acts, ch 1086, §35; 2006 Acts, ch 1157, §15; 2010 Acts, ch 1031, §290; 2011 Acts, ch 129, §84, 156; 2016 Acts, ch 1113, §1; 2023 Acts, ch 19, §143 – 145XRURAL HEALTH AND PRIMARY CARE135.107Rural health and primary care duties.The department shall do all of the following:1Provide technical planning assistance to rural communities and counties exploring innovative means of delivering rural health services through community health services assessment, planning, and implementation, including but not limited to hospital conversions, cooperative agreements among hospitals, physician and health practitioner support, recruitment and retention of primary health care providers, public health services, emergency medical services, medical assistance facilities, rural health care clinics, and alternative means which may be included in the long-term community health services assessment and developmental plan. The department shall encourage collaborative efforts of the local boards of health, hospital governing boards, and other public and private entities located in rural communities to adopt a long-term community health services assessment and developmental plan pursuant to rules adopted by the department and perform the duties required of the department in section 135B.33.2Provide technical assistance to assist rural communities in improving Medicare reimbursements through the establishment of rural health clinics, defined pursuant to 42 U.S.C. §1395x, and distinct part skilled nursing facility beds.3Coordinate services to provide research for the following items:aExamination of the prevalence of rural occupational health injuries in the state.bAssessment of training and continuing education available through local hospitals and others relating to diagnosis and treatment of diseases associated with rural occupational health hazards.cDetermination of continuing education support necessary for rural health practitioners to diagnose and treat illnesses caused by exposure to rural occupational health hazards.dDetermination of the types of actions that can help prevent agricultural accidents.eSurveillance and reporting of disabilities suffered by persons engaged in agriculture resulting from diseases or injuries, including identifying the amount and severity of agricultural-related injuries and diseases in the state, identifying causal factors associated with agricultural-related injuries and diseases, and indicating the effectiveness of intervention programs designed to reduce injuries and diseases.4Cooperate with the center for agricultural safety and health established under section 262.78, the center for health effects of environmental contamination established under section 263.17, and the department of agriculture and land stewardship. The agencies shall coordinate programs to the extent practicable.5Administer grants for farm safety education efforts directed to rural families for the purpose of preventing farm-related injuries to children.6Coordinate with the college student aid commission to administer the health professional incentive program created in section 256.222.89 Acts, ch 304, §702; 90 Acts, ch 1207, §1, 2; 90 Acts, ch 1223, §18C93, §135.1394 Acts, ch 1168, §2C95, §135.10795 Acts, ch 67, §10; 96 Acts, ch 1128, §2, 3; 97 Acts, ch 23, §14; 97 Acts, ch 203, §14; 98 Acts, ch 1100, §15; 2000 Acts, ch 1058, §16, 17; 2000 Acts, ch 1140, §23 – 25; 2000 Acts, ch 1223, §20, 21; 2005 Acts, ch 89, §5; 2009 Acts, ch 41, §41; 2010 Acts, ch 1031, §396; 2010 Acts, ch 1061, §26; 2017 Acts, ch 148, §13 – 15; 2019 Acts, ch 85, §70; 2022 Acts, ch 1032, §35; 2023 Acts, ch 19, §146; 2025 Acts, ch 120, §3, 4XISTATE MORTALITY REVIEW COMMITTEE — DOMESTIC ABUSE135.108Definitions.As used in this subchapter, unless the context otherwise requires:1“Committee” or “review committee” means the state mortality review committee established in section 135.43.2“Department” means the department of health and human services.3“Director” means the director of health and human services.4“Domestic abuse death” means a homicide or suicide that involves or is a result of an assault as defined in section 708.1 and to which any of the following circumstances apply to the parties involved:aThe alleged or convicted perpetrator is related to the decedent as spouse, separated spouse, or former spouse.bThe alleged or convicted perpetrator resided with the decedent at the time of the assault that resulted in the homicide or suicide.cThe alleged or convicted perpetrator and the decedent resided together in the past but did not reside together at the time of the assault that resulted in the homicide or suicide.dThe alleged or convicted perpetrator and decedent are parents of the same minor child, whether they were married or lived together at any time.eThe alleged or convicted perpetrator was in an ongoing personal relationship with the decedent.fThe alleged or convicted perpetrator was arrested for or convicted of stalking or harassing the decedent, or an order or court-approved agreement was entered against the perpetrator under chapter 232, 236, 598, or 915 to restrict contact by the perpetrator with the decedent.gThe decedent was related by blood or affinity to an individual who lived in the same household with or was in the workplace or proximity of the decedent, and that individual was threatened with assault by the perpetrator.2000 Acts, ch 1136, §1; 2019 Acts, ch 24, §104; 2023 Acts, ch 19, §147; 2024 Acts, ch 1170, §219, 220135.109Iowa domestic abuse death review team membership.Repealed by 2024 Acts, ch 1170, §368.135.110Committee powers and duties.1The review committee shall perform the following duties:aPrepare a biennial report for the governor, supreme court, attorney general, and the general assembly concerning the following subjects:1The causes and manner of domestic abuse deaths, including an analysis of factual information obtained through review of domestic abuse death certificates and domestic abuse death data, including patient records and other pertinent confidential and public information concerning domestic abuse deaths.2The contributing factors of domestic abuse deaths.3Recommendations regarding the prevention of future domestic abuse deaths, including actions to be taken by communities, based on an analysis of these contributing factors.bAdvise and consult state agencies regarding program and regulatory changes that may prevent domestic abuse deaths.cDevelop protocols for domestic abuse death investigations and committee review.2In performing duties pursuant to subsection 1, the review committee shall review the relationship between the decedent victim and the alleged or convicted perpetrator from the point where the abuse allegedly began, until the domestic abuse death occurred, and shall review all relevant documents pertaining to the relationship between the parties, including but not limited to protective orders and dissolution, custody, and support agreements and related court records, in order to ascertain whether a correlation exists between certain events in the relationship and any escalation of abuse, and whether patterns can be established regarding such events in relation to domestic abuse deaths in general. The review committee shall consider such conclusions in making recommendations pursuant to subsection 1.3The committee shall meet upon the call of the chairperson, upon the request of a state agency, or as determined by a majority of the committee.4The committee shall annually elect a chairperson and other officers as deemed necessary by the committee.5The committee may establish subcommittees or panels to whom the committee may assign some or all of the committee’s responsibilities.6Members of the committee who are currently practicing attorneys or current employees of the judicial branch of state government shall not participate in the following:aAn investigation by the committee that involves a case in which the committee member is presently involved in the member’s professional capacity.bDevelopment of protocols by the committee for domestic abuse death investigations and committee review.cDevelopment of regulatory changes related to domestic abuse deaths.2000 Acts, ch 1136, §3; 2000 Acts, ch 1232, §48; 2002 Acts, ch 1119, §131; 2006 Acts, ch 1184, §82; 2024 Acts, ch 1170, §221 – 223135.111Confidentiality of domestic abuse death records.1A person in possession or control of medical, investigative, or other information pertaining to a domestic abuse death and related incidents and events preceding the domestic abuse death, shall allow for the inspection and review of written or photographic information related to the death, whether the information is confidential or public in nature, by the department upon the request of the department and the committee, to be used only in the administration and for the official duties of the committee. Information and records produced under this section that are confidential under the law of this state or under federal law, or because of any legally recognized privilege, and information or records received from the confidential records, remain confidential under this section.2A person does not incur legal liability by reason of releasing information to the department as required under and in compliance with this section.3A person who releases or discloses confidential data, records, or any other type of information in violation of this section is guilty of a serious misdemeanor.2000 Acts, ch 1136, §4; 2024 Acts, ch 1170, §224135.112Rulemaking.The department shall adopt rules pursuant to chapter 17A relating to the administration of the committee and sections 135.108 through 135.111.2000 Acts, ch 1136, §5; 2024 Acts, ch 1170, §225135.113Reserved.135.114Reserved.135.115Reserved.135.116Reserved.135.117Reserved.XIICHILD PROTECTION —CHILD PROTECTION CENTER GRANTS— SHAKEN BABY SYNDROME PREVENTION135.118Child protection center grant program.1A child protection center grant program is established in the department in accordance with this section. The department shall establish requirements for the grant program and shall award grants. A grant may be used for establishment of a new center or for support of an existing center.2The eligibility requirements for a child protection center grant shall include but are not limited to all of the following:aA grantee must meet or be in the process of meeting the standards established by the national children’s alliance for children’s advocacy centers.bA grantee must have in place an interagency memorandum of understanding regarding participation in the operation of the center and for coordinating the activities of the government entities that respond to cases of child abuse in order to facilitate the appropriate disposition of child abuse cases through the juvenile and criminal justice systems. Agencies participating under the memorandum must include the following that are operating in the area served by the grantee:1Department of human services county offices assigned to child protection.2County and municipal law enforcement agencies.3Office of the county attorney.4Other government agencies involved with child abuse assessments or service provision.cThe interagency memorandum must provide for a cooperative team approach to responding to child abuse, reducing the number of interviews required of a victim of child abuse, and establishing an approach that emphasizes the best interest of the child and that provides investigation, assessment, and rehabilitative services.dAs necessary to address serious cases of child abuse such as those involving sexual abuse, serious physical abuse, and substance use disorder, a grantee must be able to involve or consult with persons from various professional disciplines who have training and expertise in addressing special types of child abuse. These persons may include but are not limited to physicians and other health care professionals, mental health professionals, social workers, child protection workers, attorneys, juvenile court officers, public health workers, child development experts, child educators, and child advocates.3The director shall create a committee to consider grant proposals and to make grant recommendations to the director. The committee membership may include but is not limited to representatives of the following:departments of health and human services and justice, Iowa medical society, Iowa hospital association, Iowa nurses association, and an association representing social workers.4Implementation of the grant program is subject to the availability of funding for the grant program.5The department shall adopt rules pursuant to chapter 17A to administer this section.2001 Acts, ch 166, §1; 2023 Acts, ch 19, §149 – 151; 2025 Acts, ch 135, §38135.119Shaken baby syndrome prevention program.1For the purposes of this section:a“Child care provider” means the same as a child care facility, as defined in section 237A.1, that is providing child care to a child who is newborn through age three.b“Family support program” means a program offering instruction and support for families in which home visitation is the primary service delivery mechanism.c“Parent” means the same as “custodian”, “guardian”, or “parent”, as defined in section 232.2, of a child who is newborn through age three.d“Person responsible for the care of a child” means the same as defined in section 232.68, except that it is limited to persons responsible for the care of a child who is newborn through age three.e“Shaken baby syndrome” means the collection of signs and symptoms resulting from the vigorous shaking of a child who is three years of age or younger. Shaken baby syndrome may result in bleeding inside the child’s head and may cause one or more of the following conditions:irreversible brain damage; blindness, retinal hemorrhage, or eye damage; cerebral palsy; hearing loss; spinal cord injury, including paralysis; seizures; learning disability; central nervous system injury; closed head injury; rib fracture; subdural hematoma; or death. Shaken baby syndrome also includes the symptoms included in the diagnosis code for shaken infant syndrome utilized by Iowa hospitals.2aThe department shall establish a statewide shaken baby syndrome prevention program to educate parents and persons responsible for the care of a child about the dangers to children three years of age or younger caused by shaken baby syndrome and to discuss ways to reduce the syndrome’s risks. The program plan shall allow for voluntary participation by parents and persons responsible for the care of a child.bThe program plan shall describe strategies for preventing shaken baby syndrome by providing education and support to parents and persons responsible for the care of a child and shall identify multimedia resources, written materials, and other resources that can assist in providing the education and support.cThe department shall consult with experts with experience in child abuse prevention, child health, and parent education in developing the program plan.dThe program plan shall incorporate a multiyear, collaborative approach for implementation of the plan. The plan shall address how to involve those who regularly work with parents and persons responsible for the care of a child, including but not limited to child abuse prevention programs, child care resource and referral programs, child care providers, family support programs, programs receiving funding through the early childhood Iowa initiative, public and private schools, health care providers, local health departments, birth centers, and birthing hospitals.eThe program plan shall identify the methodology to be used for improving the tracking of shaken baby syndrome incidents and for evaluating the effectiveness of the plan’s education and support efforts.fThe program plan shall describe how program results will be reported.gThe program plan may provide for implementation of the program through a contract with a private agency or organization experienced in furnishing the services set forth in the program plan.3The department shall implement the program plan to the extent of the amount appropriated or made available for the program for a fiscal year.2009 Acts, ch 7, §1; 2010 Acts, ch 1031, §291; 2025 Acts, ch 43, §3XIIITAXATION OF ORGANIZED DELIVERY SYSTEMS135.120Taxation of organized delivery systems.Repealed by 2017 Acts, ch 148, §101.135.121Reserved.135.122Reserved.135.123Reserved.135.124Reserved.135.125Reserved.135.126Reserved.135.127Reserved.135.128Reserved.135.129Reserved.XIVSUBSTANCE USE DISORDER TREATMENT FACILITYFOR PERSONS ON PROBATION135.130Substance abuse treatment facility for persons on probation.Repealed by 2017 Acts, ch 148, §24.XVNEWBORN AND INFANTHEARING SCREENING135.131Universal newborn and infant hearing screening.1For the purposes of this section, unless the context otherwise requires:a“Birth center” means a facility or institution, which is not an ambulatory surgical center or a hospital or in a hospital, in which births are planned to occur following a normal, uncomplicated, low-risk pregnancy.b“Birthing hospital” means a private or public hospital licensed pursuant to chapter 135B that has a licensed obstetric unit or is licensed to provide obstetric services.2All newborns and infants born in this state shall be screened for hearing loss in accordance with this section. The person required to perform the screening shall use at least one of the following procedures:aAutomated or diagnostic auditory brainstem response.bOtoacoustic emissions.cAny other technology approved by the department.3aA birthing hospital shall screen every newborn delivered in the hospital for hearing loss prior to discharge of the newborn from the birthing hospital. A birthing hospital that transfers a newborn for acute care prior to completion of the hearing screening shall notify the receiving facility of the status of the hearing screening. The receiving facility shall be responsible for completion of the newborn hearing screening.bThe birthing hospital or other facility completing the hearing screening under this subsection shall report the results of the screening to the parent or guardian of the newborn and to the department in a manner prescribed by rule of the department. The birthing hospital or other facility shall also report the results of the hearing screening to the primary care provider of the newborn or infant upon discharge from the birthing hospital or other facility. If the newborn or infant was not tested prior to discharge, the birthing hospital or other facility shall report the status of the hearing screening to the primary care provider of the newborn or infant.4A birth center shall refer the newborn to a licensed audiologist, physician, or hospital for screening for hearing loss prior to discharge of the newborn from the birth center. The hearing screening shall be completed within thirty days following discharge of the newborn. The person completing the hearing screening shall report the results of the screening to the parent or guardian of the newborn and to the department in a manner prescribed by rule of the department. Such person shall also report the results of the screening to the primary care provider of the newborn.5If a newborn is delivered in a location other than a birthing hospital or a birth center, the physician or other health care professional who undertakes the pediatric care of the newborn or infant shall ensure that the hearing screening is performed within three months of the date of the newborn’s or infant’s birth. The physician or other health care professional shall report the results of the hearing screening to the parent or guardian of the newborn or infant, to the primary care provider of the newborn or infant, and to the department in a manner prescribed by rule of the department.6A birthing hospital, birth center, physician, or other health care professional required to report information under subsection 3, 4, or 5 shall report all of the following information to the department relating to a newborn’s or infant’s hearing screening, as applicable:aThe name, address, and telephone number, if available, of the mother of the newborn or infant.bThe primary care provider at the time of the newborn’s or infant’s discharge from the birthing hospital or birth center.cThe results of the hearing screening.dAny rescreenings and the diagnostic audiological assessment procedures used.eAny known risk indicators for hearing loss of the newborn or infant.fOther information specified in rules adopted by the department.7The department may share information with agencies and persons involved with newborn and infant hearing screenings, follow-up, and intervention services, including the local birth-to-three coordinator or similar agency, the local area education agency, and local health care providers. The department shall adopt rules to protect the confidentiality of the individuals involved.8An audiologist who provides services addressed by this section shall conduct diagnostic audiological assessments of newborns and infants in accordance with standards specified in rules adopted by the department. The audiologist shall report all of the following information to the department relating to a newborn’s or infant’s hearing, follow-up, diagnostic audiological assessment, and intervention services, as applicable:aThe name, address, and telephone number, if available, of the mother of the newborn or infant.bThe results of the hearing screening and any rescreenings, including the diagnostic audiological assessment procedures used.cThe nature of any follow-up or other intervention services provided to the newborn or infant.dAny known risk indicators for hearing loss of the newborn or infant.eOther information specified in rules adopted by the department.9aIf the results of the newborn hearing screening performed under this section demonstrate that the newborn has hearing loss, the birthing hospital, birth center, physician, or other health care professional required to ensure that the hearing screening is performed on the newborn under this section, shall do all of the following:1Test the newborn or ensure that the newborn is tested for congenital cytomegalovirus before the newborn is twenty-one days of age.2Provide information to the parent of the newborn including information regarding the birth defects caused by congenital cytomegalovirus and early intervention and treatment resources and services available for children diagnosed with congenital cytomegalovirus.bThis subsection shall not apply if the parent objects to the testing. If a parent objects to the testing, the birthing hospital, birth center, physician, or other health care professional required to test or to ensure that the newborn is tested for congenital cytomegalovirus under this subsection shall obtain a written refusal from the parent, shall document the refusal in the newborn’s or infant’s medical record, and shall report the refusal to the department in the manner prescribed by rule of the department.10This section shall not apply if the parent objects to the screening. If a parent objects to the screening, the birthing hospital, birth center, physician, or other health care professional required to report information under subsection 3, 4, or 5 to the department shall obtain a written refusal from the parent, shall document the refusal in the newborn’s or infant’s medical record, and shall report the refusal to the department in the manner prescribed by rule of the department.11A person who acts in good faith in complying with this section shall not be civilly or criminally liable for reporting the information required to be reported by this section.2003 Acts, ch 102, §1; 2009 Acts, ch 37, §3; 2017 Acts, ch 77, §2; 2025 Acts, ch 43, §4; 2025 Acts, ch 120, §66XVIINTERAGENCY PHARMACEUTICALSBULK PURCHASING COUNCIL135.132Interagency pharmaceuticals bulk purchasing council.Repealed by 2017 Acts, ch 148, §26.135.133Reserved.135.134Reserved.135.135Reserved.135.136Reserved.135.137Reserved.135.138Reserved.135.139Reserved.XVIIDISASTER PREPAREDNESS135.140Definitions.As used in this subchapter, unless the context otherwise requires:1“Bioterrorism” means the intentional use of any microorganism, virus, infectious substance, or biological product that may be engineered as a result of biotechnology, or any naturally occurring or bioengineered component of any such microorganism, virus, infectious substance, or biological product, to cause death, disease, or other biological malfunction in a human, an animal, a plant, or another living organism.2“Department” means the department of health and human services.3“Director” means the director of health and human services or the director’s designee.4“Disaster” means disaster as defined in section 29C.2.5“Public health disaster” means a state of disaster emergency proclaimed by the governor in consultation with the department pursuant to section 29C.6 for a disaster which specifically involves an imminent threat of an illness or health condition that meets any of the following conditions of paragraphs “a” and “b”:aIs reasonably believed to be caused by any of the following:1Bioterrorism or other act of terrorism.2The appearance of a novel or previously controlled or eradicated infectious agent or biological toxin.3A chemical attack or accidental release.4An intentional or accidental release of radioactive material.5A nuclear or radiological attack or accident.6A natural occurrence or incident, including but not limited to fire, flood, storm, drought, earthquake, tornado, or windstorm.7A man-made occurrence or incident, including but not limited to an attack, spill, or explosion.bPoses a high probability of any of the following:1A large number of deaths in the affected population.2A large number of serious or long-term disabilities in the affected population.3Widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of the affected population.4Short-term or long-term physical or behavioral health consequences to a large number of the affected population.6“Public health response team” means a team of professionals, including licensed health care providers, nonmedical professionals skilled and trained in disaster or emergency response, and public health practitioners, which is sponsored by a hospital or other entity and approved by the department to provide disaster assistance in the event of a disaster or threatened disaster.2003 Acts, ch 33, §1, 11; 2003 Acts, ch 179, §64; 2005 Acts, ch 89, §6, 7; 2006 Acts, ch 1184, §83; 2009 Acts, ch 37, §4, 5; 2019 Acts, ch 24, §104; 2023 Acts, ch 19, §152135.141Department duties related to acute disease prevention and emergency response.1The department shall coordinate the administration of this subchapter with federal, state, and local agencies and officials.2The department shall do all of the following:aCoordinate with the department of homeland security and emergency management the administration of emergency planning matters which involve the public health, including development, administration, and execution of the public health components of the comprehensive emergency plan and emergency management program pursuant to section 29C.8.bCoordinate with federal, state, and local agencies and officials, and private agencies, organizations, companies, and persons, the administration of emergency planning, response, and recovery matters that involve the public health.cIf a public health disaster exists, or if there is reasonable cause to believe that a public health disaster is imminent, conduct a risk assessment of any present or potential danger to the public health from chemical, radiological, or other potentially dangerous agents.dFor the purpose of paragraph “c”, an employee or agent of the department may enter into and examine any premises containing potentially dangerous agents with the consent of the owner or person in charge of the premises or, if the owner or person in charge of the premises refuses admittance, with an administrative search warrant obtained under section 808.14. Based on findings of the risk assessment and examination of the premises, the director may order reasonable safeguards or take any other action reasonably necessary to protect the public health pursuant to rules adopted to administer this subsection.eCoordinate the location, procurement, storage, transportation, maintenance, and distribution of medical supplies, drugs, antidotes, and vaccines to prepare for or in response to a public health disaster, including receiving, distributing, and administering items from the strategic national stockpile program of the centers for disease control and prevention of the United States department of health and human services.fConduct or coordinate public information activities regarding emergency and disaster planning, response, and recovery matters that involve the public health.gApply for and accept grants, gifts, or other funds to be used for programs authorized by this subchapter.hEstablish and coordinate other programs or activities as necessary for the prevention, detection, management, and containment of public health disasters, and for the recovery from such disasters.iAdopt rules pursuant to chapter 17A for the administration of this subchapter including rules adopted in cooperation with the Iowa pharmacy association and the Iowa hospital association for the development of a surveillance system to monitor supplies of drugs, antidotes, and vaccines to assist in detecting a potential public health disaster. Prior to adoption, the rules shall be approved by the director of the department of homeland security and emergency management.2003 Acts, ch 33, §2, 11; 2003 Acts, ch 179, §157; 2005 Acts, ch 89, §8; 2009 Acts, ch 37, §6; 2009 Acts, ch 41, §42; 2012 Acts, ch 1021, §45; 2013 Acts, ch 29, §45; 2017 Acts, ch 148, §21, 22; 2019 Acts, ch 24, §99, 100; 2023 Acts, ch 19, §153; 2024 Acts, ch 1170, §387135.142Health care supplies.1The department may purchase and distribute antitoxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies as deemed advisable in the interest of preparing for or controlling a public health disaster.2If a public health disaster exists or there is reasonable cause to believe that a public health disaster is imminent and if the public health disaster or belief that a public health disaster is imminent results in a statewide or regional shortage or threatened shortage of any product described under subsection 1, whether or not such product has been purchased by the department, the department may control, restrict, and regulate by rationing and using quotas, prohibitions on shipments, allocation, or other means, the use, sale, dispensing, distribution, or transportation of the relevant product necessary to protect the public health, safety, and welfare of the people of this state. The department shall collaborate with persons who have control of the products when reasonably possible.3In making rationing or other supply and distribution decisions, the department shall give preference to health care providers, disaster response personnel, and mortuary staff.4During a public health disaster, the department may procure, store, or distribute any antitoxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies located within the state as may be reasonable and necessary to respond to the public health disaster, and may take immediate possession of these pharmaceutical agents and supplies. If a public health disaster affects more than one state, this section shall not be construed to allow the department to obtain antitoxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies for the primary purpose of hoarding such items or preventing the fair and equitable distribution of these pharmaceutical and medical supplies among affected states. The department shall collaborate with affected states and persons when reasonably possible.5The state shall pay just compensation to the owner of any product lawfully taken or appropriated by the department for the department’s temporary or permanent use in accordance with this section. The amount of compensation shall be limited to the costs incurred by the owner to procure the item.2003 Acts, ch 33, §3, 11; 2004 Acts, ch 1086, §34135.143Public health response teams.1The department shall approve public health response teams to supplement and support disrupted or overburdened local medical and public health personnel, hospitals, and resources. Assistance shall be rendered under the following circumstances:aAt or near the site of a disaster or threatened disaster by providing direct medical care to victims or providing other support services.bIf local medical or public health personnel or hospitals request the assistance of a public health response team to provide direct medical care to victims or to provide other support services in relation to any of the following incidents:1During an incident resulting from a novel or previously controlled or eradicated infectious agent, disease, or biological toxin.2After a chemical attack or accidental chemical release.3After an intentional or accidental release of radioactive material.4In response to a nuclear or radiological attack or accident.5Where an incident poses a high probability of a large number of deaths or long-term disabilities in the affected population.6During or after a natural occurrence or incident, including but not limited to fire, flood, storm, drought, earthquake, tornado, or windstorm.7During or after a man-made occurrence or incident, including but not limited to an attack, spill, or explosion.2The department shall provide by rule a process for registration and approval of public health response team members and sponsor entities and shall authorize specific public health response teams, which may include but are not limited to disaster assistance teams and environmental health response teams. The department may expedite the registration and approval process during a disaster, threatened disaster, or other incident described in subsection 1.3A member of a public health response team acting pursuant to this subchapter shall be considered an employee of the state under section 29C.21 and chapter 669, shall be afforded protection as an employee of the state under section 669.21, and shall be considered an employee of the state for purposes of workers’ compensation, disability, and death benefits, provided that the member has done all of the following:aRegistered with and received approval to serve on a public health response team from the department.bProvided direct medical care or other support services during a disaster, threatened disaster, or other incident described in subsection 1; or participated in a training exercise to prepare for a disaster or other incident described in subsection 1.4The department shall provide the department of administrative services with a list of individuals who have registered with and received approval from the department to serve on a public health response team. The department shall update the list on a quarterly basis, or as necessary for the department of administrative services to determine eligibility for coverage.5Upon notification of a compensable loss, the department of administrative services shall seek authorization from the executive council to pay as an expense from the appropriations addressed in section 7D.29 those costs associated with covered workers’ compensation benefits.2003 Acts, ch 33, §4, 11; 2003 Acts, ch 145, §286; 2005 Acts, ch 89, §9; 2009 Acts, ch 37, §7, 8; 2011 Acts, ch 131, §25, 158; 2019 Acts, ch 24, §101135.144Additional duties of the department related to a public health disaster.If a public health disaster exists, the department, in conjunction with the governor, may do any of the following:1Decontaminate or cause to be decontaminated, to the extent reasonable and necessary to address the public health disaster, any facility or material if there is cause to believe the contaminated facility or material may endanger the public health.2Adopt and enforce measures to provide for the identification and safe disposal of human remains, including performance of postmortem examinations, transportation, embalming, burial, cremation, interment, disinterment, and other disposal of human remains. To the extent possible, religious, cultural, family, and individual beliefs of the deceased person or the deceased person’s family shall be considered when disposing of any human remains.3Take reasonable measures as necessary to prevent the transmission of infectious disease and to ensure that all cases of communicable disease are properly identified, controlled, and treated.4Take reasonable measures as necessary to ensure that all cases of chemical, biological, and radiological contamination are properly identified, controlled, and treated.5Order physical examinations and tests and collect specimens as necessary for the diagnosis or treatment of individuals, to be performed by any qualified person authorized to do so by the department. An examination or test shall not be performed or ordered if the examination or test is reasonably likely to lead to serious harm to the affected individual. The department may isolate or quarantine, pursuant to chapter 139A and the rules implementing chapter 139A and this subchapter, any individual whose refusal of medical examination or testing results in uncertainty regarding whether the individual has been exposed to or is infected with a communicable or potentially communicable disease or otherwise poses a danger to public health.6Vaccinate or order that individuals be vaccinated against an infectious disease and to prevent the spread of communicable or potentially communicable disease. Vaccinations shall be administered by any qualified person authorized to do so by the department. The vaccination shall not be provided or ordered if it is reasonably likely to lead to serious harm to the affected individual. To prevent the spread of communicable or potentially communicable disease, the department may isolate or quarantine, pursuant to chapter 139A and the rules implementing chapter 139A and this subchapter, any person who is unable or unwilling to undergo vaccination pursuant to this subsection.7Treat or order that individuals exposed to or infected with disease receive treatment or prophylaxis. Treatment or prophylaxis shall be administered by any qualified person authorized to do so by the department. Treatment or prophylaxis shall not be provided or ordered if the treatment or prophylaxis is reasonably likely to lead to serious harm to the affected individual. To prevent the spread of communicable or potentially communicable disease, the department may isolate or quarantine, pursuant to chapter 139A and the rules implementing chapter 139A and this subchapter, any individual who is unable or unwilling to undergo treatment or prophylaxis pursuant to this section.8Isolate or quarantine individuals or groups of individuals pursuant to chapter 139A and the rules implementing chapter 139A and this subchapter.9Inform the public when a public health disaster has been declared or terminated, about protective measures to take during the disaster, and about actions being taken to control the disaster.10Accept grants and loans from the federal government pursuant to section 29C.6 or available provisions of federal law.11If a public health disaster or other public health emergency situation exists which poses an imminent threat to the public health, safety, and welfare, the department, in conjunction with the governor, may provide financial assistance, from funds appropriated to the department that are not otherwise encumbered, to political subdivisions as needed to alleviate the disaster or the emergency. If the department does not have sufficient unencumbered funds, the governor may request the executive council to authorize the payment of up to one million dollars as an expense from the appropriations addressed in section 7D.29 to alleviate the disaster or the emergency. If additional financial assistance is required in excess of one million dollars, approval by the legislative council is also required.12Temporarily reassign department employees for purposes of response and recovery efforts, to the extent such employees consent to the reassignments.13Order, in conjunction with the department of education, temporary closure of any public school or nonpublic school, as defined in section 280.2, to prevent or control the transmission of a communicable disease as defined in section 139A.2.2003 Acts, ch 33, §5, 11; 2003 Acts, ch 179, §65; 2004 Acts, ch 1097, §1; 2005 Acts, ch 19, §32; 2009 Acts, ch 37, §9; 2010 Acts, ch 1088, §1; 2011 Acts, ch 131, §26, 158; 2019 Acts, ch 24, §102135.145Information sharing.1When the department of public safety or other federal, state, or local law enforcement agency learns of a case of a disease or health condition, unusual cluster, or a suspicious event that may be the cause of a public health disaster, the department or agency shall immediately notify the department, the director of the department of homeland security and emergency management, the department of agriculture and land stewardship, and the department of natural resources as appropriate.2When the department learns of a case of a disease or health condition, an unusual cluster, or a suspicious event that may be the cause of a public health disaster, the department shall immediately notify the department of public safety, the department of homeland security and emergency management, and other appropriate federal, state, and local agencies and officials.3Sharing of information on diseases, health conditions, unusual clusters, or suspicious events between the department and public safety authorities and other governmental agencies shall be restricted to sharing of only the information necessary for the prevention, control, and investigation of a public health disaster.4Release of information pursuant to this section shall be consistent with the federal Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.2003 Acts, ch 33, §6, 11; 2003 Acts, ch 179, §157; 2006 Acts, ch 1079, §1; 2013 Acts, ch 29, §46135.146First responder vaccination program.1In the event that federal funding is received for administering vaccinations for first responders, the department shall offer a vaccination program for first responders who may be exposed to infectious diseases when deployed to disaster locations. For purposes of this section, “first responder” means state and local law enforcement personnel, fire department personnel, and emergency medical personnel who will be deployed to sites of bioterrorism attacks, terrorist attacks, catastrophic or natural disasters, and other disasters. The vaccinations shall include, but not be limited to, vaccinations for hepatitis B, diphtheria, tetanus, influenza, and other vaccinations when recommended by the United States public health service and in accordance with federal emergency management agency policy. Immune globulin will be made available when necessary.2Participation in the vaccination program shall be voluntary, except for first responders who are classified as having occupational exposure to blood-borne pathogens as defined by the occupational safety and health administration standard contained in 29 C.F.R. §1910.1030. First responders who are so classified shall be required to receive the vaccinations as described in subsection 1. A first responder shall be exempt from this requirement, however, when a written statement from a licensed physician or physician assistant is presented indicating that a vaccine is medically contraindicated for that person or the first responder signs a written statement that the administration of a vaccination conflicts with religious tenets.3The department shall establish first responder notification procedures regarding the existence of the program by rule, and shall develop, and distribute to first responders, educational materials on methods of preventing exposure to infectious diseases. In administering the program, the department may contract with county and local health departments, not-for-profit home health care agencies, hospitals, physicians, and military unit clinics.2004 Acts, ch 1012, §1, 2; 2005 Acts, ch 3, §31; 2022 Acts, ch 1066, §5135.147Immunity for emergency aid — exceptions.1A person, corporation, or other legal entity, or an employee or agent of such person, corporation, or entity, who, during a public health disaster, in good faith and at the request of or under the direction of the department or the department of public defense renders emergency care or assistance to a victim of the public health disaster shall not be liable for civil damages for causing the death of or injury to a person, or for damage to property, unless such acts or omissions constitute recklessness.2The immunities provided in this section shall not apply to any person, corporation, or other legal entity, or an employee or agent of such person, corporation, or entity, whose act or omission caused in whole or in part the public health disaster and who would otherwise be liable therefor.2007 Acts, ch 159, §21135.148Reserved.135.149Reserved.XVIIIGAMBLING TREATMENT PROGRAM135.150Gambling treatment program — standards and licensing.1aThe department shall operate a gambling treatment program to provide programs which may include but are not limited to outpatient and follow-up treatment for persons affected by problem gambling, rehabilitation and residential treatment programs, information and referral services, crisis call access, education and preventive services, and financial management and credit counseling services.bA person shall not maintain or conduct a gambling treatment program funded through the department unless the person has obtained a license for the program from the department. The department shall adopt rules to establish standards for the licensing and operation of gambling treatment programs under this section. The rules shall specify, but are not limited to specifying, the qualifications for persons providing gambling treatment services, standards for the organization and administration of gambling treatment programs, and a mechanism to monitor compliance with this section and the rules adopted under this section.2The department shall report annually to the general assembly’s standing committees on government oversight regarding the operation of the gambling treatment program. The report shall include but is not limited to information on the moneys expended and grants awarded for operation of the gambling treatment program.2004 Acts, ch 1136, §55; 2005 Acts, ch 175, §77; 2009 Acts, ch 182, §106; 2010 Acts, ch 1069, §15; 2017 Acts, ch 148, §3135.151Reserved.XIXOBSTETRICAL AND NEWBORNINDIGENT PATIENTCARE PROGRAM135.152Statewide obstetrical and newborn indigent patient care program.Repealed by 2017 Acts, ch 148, §24.XXCOLLABORATIVE SAFETY NETPROVIDER NETWORK135.153Iowa collaborative safety net provider network established.Repealed by 2019 Acts, ch 85, §68.135.153ASafety net provider recruitment and retention initiatives program repeal.Repealed by its own terms; 2015 Acts, ch 30, §211.XXIIOWA HEALTH INFORMATION NETWORK135.154Repealed by 2015 Acts, ch 73, §8, 9. See chapter 135D.135.155Repealed by 2015 Acts, ch 73, §8, 9. See chapter 135D.135.155ARepealed by 2015 Acts, ch 73, §8, 9. See chapter 135D.135.156Repealed by 2015 Acts, ch 73, §8, 9. See chapter 135D.135.156ARepealed by 2015 Acts, ch 73, §8, 9. See chapter 135D.135.156BRepealed by 2015 Acts, ch 73, §8, 9. See chapter 135D.135.156CRepealed by 2015 Acts, ch 73, §8, 9. See chapter 135D.135.156DRepealed by 2015 Acts, ch 73, §8, 9.See chapter 135D.135.156ERepealed by 2015 Acts, ch 73, §8, 9. See chapter 135D.135.156FRepealed by 2015 Acts, ch 73, §8, 9. See chapter 135D.XXIIPATIENT-CENTERED HEALTH135.157Definitions.Repealed by 2017 Acts, ch 148, §11.135.158Medical home purposes — characteristics.Repealed by 2017 Acts, ch 148, §11.135.159Patient-centered health advisory council.Repealed by 2019 Acts, ch 85, §75.XXIIIPREVENTION AND CHRONICCARE MANAGEMENT135.160Definitions.Repealed by 2012 Acts, ch 1021, §120.135.161Prevention and chronic care management initiative — advisory council.Repealed by 2011 Acts, ch 129, §81, 82.135.162Clinicians advisory panel.Repealed by 2011 Acts, ch 63, §35.XXIVHEALTH CARE ACCESS135.163Health care access.The department shall coordinate public and private efforts to develop and maintain an appropriate health care delivery infrastructure and a stable, well-qualified, diverse, and sustainable health care workforce in this state. The health care delivery infrastructure and the health care workforce shall address the broad spectrum of health care needs of Iowans throughout their lifespan. The department shall, at a minimum, do all of the following:1Develop a strategic plan for health care delivery infrastructure and health care workforce resources in this state.2Provide for the continuous collection of data to provide a basis for health care strategic planning and health care policymaking.3Make recommendations regarding the health care delivery infrastructure and the health care workforce that assist in monitoring current needs, predicting future trends, and informing policymaking.2008 Acts, ch 1188, §57; 2017 Acts, ch 148, §16135.164Strategic plan.Repealed by 2017 Acts, ch 148, §19.XXVHEALTH DATA135.165Health care transparency — reporting requirements — hospitals and nursing facilities.Repealed by 2012 Acts, ch 1113, §24.135.166Health data collection and use collection from hospitals.1aThe department shall enter into a memorandum of understanding with the contractor selected through a request for proposals process to act as the department’s intermediary in collecting, maintaining, and disseminating hospital inpatient, outpatient, and ambulatory data, as initially authorized in 1996 Iowa Acts, ch. 1212, §5, subsection 1, paragraph “a”, subparagraph (4), and 641 IAC 177.3.bThe memorandum of understanding shall include but is not limited to provisions that address the duties of the department and the contractor regarding the collection, reporting, disclosure, storage, and confidentiality of the data.2Unless otherwise authorized or required by state or federal law, data collected under this section shall not include the social security number or name of the individual subject of the data.2009 Acts, ch 118, §57; 2014 Acts, ch 1026, §143; 2017 Acts, ch 148, §104; 2019 Acts, ch 85, §96; 2022 Acts, ch 1131, §61; 2023 Acts, ch 19, §154135.167Reserved.135.168Reserved.135.169Reserved.135.170Reserved.XXVIALZHEIMER’S DISEASESERVICE NEEDS135.171Alzheimer’s disease service needs.1The department shall regularly analyze Iowa’s population by county and age to determine the existing service utilization and future service needs of persons with Alzheimer’s disease and similar forms of irreversible dementia. The analysis shall also address the availability of existing caregiver services for such needs and the appropriate service level for the future.2The department shall modify its community needs assessment activities to include questions to identify and quantify the numbers of persons with Alzheimer’s disease and similar forms of irreversible dementia at the community level.3The department shall collect data on the numbers of persons demonstrating combative behavior related to Alzheimer’s disease and similar forms of irreversible dementia. The department shall also collect data on the number of physicians and geropsychiatric units available in the state to provide treatment and services to such persons. Health care facilities that serve such persons shall provide information to the department for the purposes of the data collection required by this subsection.4The department’s implementation of the requirements of this section shall be limited to the extent of the funding appropriated or otherwise made available for the requirements.2008 Acts, ch 1140, §1135.172Reserved.XXVIISTATE CHILD CARE ADVISORY COMMITTEE135.173Early childhood Iowa council.Repealed by 2010 Acts, ch 1031, §308.135.173AChild care advisory committee.Repealed by 2024 Acts, ch 1170, §368.135.174Lead agency and other state agencies.Repealed by 2010 Acts, ch 1031, §308.XXVIIIHEALTH CARE WORKFORCE SUPPORTINITIATIVE AND FUND135.175Health care workforce support initiative workforce shortage fund accounts.1aA health care workforce support initiative is established to provide for the coordination and support of various efforts to address the health care workforce shortage in this state. This initiative shall include the medical residency training state matching grants program created in section 135.176, the nurse residency state matching grants program created in section 135.178, and the fulfilling Iowa’s need for dentists matching grant program created in section 135.179.bA health care workforce shortage fund is created in the state treasury as a separate fund under the control of the department, in cooperation with the entities identified in this section as having control over the accounts within the fund. The fund and the accounts within the fund shall be controlled and managed in a manner consistent with the principles specified and the strategic plan developed pursuant to section 135.163.2The fund and the accounts within the fund shall consist of moneys appropriated from the general fund of the state for the purposes of the fund or the accounts within the fund; moneys received from the federal government for the purposes of addressing the health care workforce shortage; contributions, grants, and other moneys from communities and health care employers; and moneys from any other public or private source available.3The department and any entity identified in this section as having control over any of the accounts within the fund, may receive contributions, grants, and in-kind contributions to support the purposes of the fund and the accounts within the fund. Not more than five percent of the moneys allocated to any account within the fund may be used for administrative costs.4The fund and the accounts within the fund shall be separate from the general fund of the state and shall not be considered part of the general fund of the state. The moneys in the fund and the accounts within the fund shall not be considered revenue of the state, but rather shall be moneys of the fund or the accounts. The moneys in the fund and the accounts within the fund are not subject to section 8.33 and shall not be transferred, used, obligated, appropriated, or otherwise encumbered, except to provide for the purposes of this section. Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys deposited in the fund shall be credited to the fund and the accounts within the fund.5The fund shall consist of the following accounts:aThe medical residency training account. The medical residency training account shall be under the control of the department and the moneys in the account shall be used for the purposes of the medical residency training state matching grants program as specified in section 135.176. Moneys in the account shall consist of moneys appropriated or allocated for deposit in or received by the fund or the account and specifically dedicated to the medical residency training state matching grants program or account for the purposes of such account.bThe nurse residency state matching grants program account. The nurse residency state matching grants program account shall be under the control of the department and the moneys in the account shall be used for the purposes of the nurse residency state matching grants program as specified in section 135.178. Moneys in the account shall consist of moneys appropriated or allocated for deposit in or received by the fund or the account and specifically dedicated to the nurse residency state matching grants program account for the purposes of such account.cThe health care workforce shortage national initiatives account. The health care workforce shortage national initiatives account shall be under the control of the state entity identified for receipt of the federal funds by the federal government entity through which the federal funding is available for a specified health care workforce shortage initiative. Moneys in the account shall consist of moneys appropriated or allocated for deposit in or received by the fund or the account and specifically dedicated to health care workforce shortage national initiatives or the account and for a specified health care workforce shortage initiative.dThe fulfilling Iowa’s need for dentists matching grant program account. The fulfilling Iowa’s need for dentists matching grant program account shall be under the control of the department and the moneys in the account shall be used for the purposes of the fulfilling Iowa’s need for dentists matching grant program as specified in section 135.179. Moneys in the account shall consist of moneys appropriated or allocated for deposit in the account or received by the fund or the account and specifically dedicated to the fulfilling Iowa’s need for dentists matching grant program account for the purposes of such account.6aMoneys in the fund and the accounts in the fund shall only be appropriated in a manner consistent with the principles specified and the strategic plan developed pursuant to section 135.163 to support the medical residency training state matching grants program, the nurse residency state matching grants program, the fulfilling Iowa’s need for dentists matching grant program, and to provide funding for state health care workforce shortage programs as provided in this section.bState programs that may receive funding from the fund and the accounts in the fund, if specifically designated for the purpose of drawing down federal funding, are the primary care recruitment and retention endeavor (PRIMECARRE), the Iowa affiliate of the national rural recruitment and retention network, the dental program of the department, the primary care office and shortage designation program, and the state office of rural health of the department; any entity identified by the federal government entity through which federal funding for a specified health care workforce shortage initiative is received; and a program developed in accordance with the strategic plan developed by the department in accordance with section 135.163.cAny federal funding received for the purposes of addressing state health care workforce shortages shall be deposited in the health care workforce shortage national initiatives account, unless otherwise specified by the source of the funds, and shall be used as required by the source of the funds. If use of the federal funding is not designated, the funds shall be used in accordance with the strategic plan developed by the department in accordance with section 135.163, or to address workforce shortages as otherwise designated by the department. Other sources of funding shall be deposited in the fund or account and used as specified by the source of the funding.7No more than five percent of the moneys in any of the accounts within the fund shall be used for administrative purposes, unless otherwise provided by the appropriation, allocation, or source of the funds.8The department, in cooperation with the entities identified in this section as having control over any of the accounts within the fund, shall submit an annual report to the governor and the general assembly regarding the status of the health care workforce support initiative, including the balance remaining in and appropriations from the health care workforce shortage fund and the accounts within the fund.2015 Acts, ch 30, §212, 218, 219; 2016 Acts, ch 1073, §55, 56, 187, 189; 2017 Acts, ch 148, §17, 18; 2018 Acts, ch 1165, §111 – 113; 2023 Acts, ch 19, §156XXIXHEALTH CARE WORKFORCE SUPPORT135.176Medical residency training state matching grants program.1The department shall establish a medical residency training state matching grants program to provide matching state funding to sponsors of accredited graduate medical education residency programs in this state to establish, expand, or support medical residency training programs. Funding for the program may be provided through the health care workforce shortage fund or the medical residency training account created in section 135.175. For the purposes of this section, unless the context otherwise requires, “accredited” means a graduate medical education program approved by the accreditation council for graduate medical education or the American osteopathic association. The grant funds may be used to support medical residency programs through any of the following:aThe establishment of new or alternative campus accredited medical residency training programs. For the purposes of this paragraph, “new or alternative campus accredited medical residency training program” means a program that is accredited by a recognized entity approved for such purpose by the accreditation council for graduate medical education or the American osteopathic association with the exception that a new medical residency training program that, by reason of an insufficient period of operation is not eligible for accreditation on or before the date of submission of an application for a grant, may be deemed accredited if the accreditation council for graduate medical education or the American osteopathic association finds, after consultation with the appropriate accreditation entity, that there is reasonable assurance that the program will meet the accreditation standards of the entity prior to the date of graduation of the initial class in the program.bThe provision of new residency positions within existing accredited medical residency or fellowship training programs.cThe funding of residency positions which are in excess of the federal residency cap. For the purposes of this paragraph, “in excess of the federal residency cap” means a residency position for which no federal Medicare funding is available because the residency position is a position beyond the cap for residency positions established by the federal Balanced Budget Act of 1997, Pub. L. No. 105-33.dFor the period beginning July 1, 2021, and ending June 30, 2026, the payment by the sponsor of medical residency program liability costs subject to provision by the sponsor of dollar-for-dollar matching funds used for payment of such costs. This paragraph shall not apply to medical residency programs to which chapter 669 applies.2The department shall adopt rules pursuant to chapter 17A to provide for all of the following:aEligibility requirements for and qualifications of a sponsor of an accredited graduate medical education residency program to receive a grant. The requirements and qualifications shall include but are not limited to all of the following:1A sponsor shall demonstrate that funds have been budgeted and will be expended by the sponsor in the amount required to provide matching funds for each residency position proposed in the request for state matching funds.2A sponsor shall demonstrate, through objective evidence as prescribed by rule of the department, a need for such residency program in the state.bThe application process for the grant.cCriteria for preference in awarding of the grants, including preference in the residency specialty and preference for candidates who are residents of Iowa, attended and earned an undergraduate degree from an Iowa college or university, or attended and earned a medical degree from a medical school in Iowa.dDetermination of the amount of a grant. The total amount of a grant awarded to a sponsor proposing the establishment of a new or alternative campus accredited medical residency training program as defined in subsection 1, paragraph “a”, shall be limited to no more than one hundred percent of the amount the sponsor has budgeted as demonstrated under paragraph “a”. The total amount of a grant awarded to a sponsor proposing the provision of a new residency position within an existing accredited medical residency or fellowship training program as specified in subsection 1, paragraph “b”, or the funding of residency positions which are in excess of the federal residency cap as defined in subsection 1, paragraph “c”, shall be limited to no more than twenty-five percent of the amount that the sponsor has budgeted for each residency position sponsored for the purpose of the residency program.eThe maximum award of grant funds to a particular individual sponsor per year. An individual sponsor that establishes a new or alternative campus accredited medical residency training program as defined in subsection 1, paragraph “a”, shall not receive more than fifty percent of the state matching funds available each year to support the program. An individual sponsor proposing the provision of a new residency position within an existing accredited medical residency or fellowship training program as specified in subsection 1, paragraph “b”, the funding of residency positions which are in excess of the federal residency cap as defined in subsection 1, paragraph “c”, or the funding of the payment by the sponsor of medical residency program liability costs subject to provision by the sponsor of dollar-for-dollar matching funds used for payment of such costs as specified in subsection 1, paragraph “d”, shall not receive more than twenty-five percent of the state matching funds available each year to support the program.fUse of the funds awarded. Funds may be used to pay the costs of establishing, expanding, or supporting an accredited graduate medical education program as specified in this section, including but not limited to the costs associated with residency stipends and physician faculty stipends. For the period beginning July 1, 2021, and ending June 30, 2026, use of the funds awarded may include payment by the sponsor of medical residency program liability costs in accordance with subsection 1, paragraph “d”, and subject to provision by the sponsor of dollar-for-dollar matching funds used for payment of such costs.gA requirement that the residency program offer persons to whom a primary care residency position is awarded, the opportunity to participate in a rural rotation to expose the resident to the rural areas of the state. For the purposes of this paragraph, “primary care” shall include psychiatry, obstetrics, gynecology, family medicine, internal medicine, and emergency medicine.2015 Acts, ch 30, §213, 218, 219; 2015 Acts, ch 57, §18 – 21; 2016 Acts, ch 1073, §57; 2019 Acts, ch 55, §1, 2; 2020 Acts, ch 1082, §1; 2021 Acts, ch 182, §63, 64135.177Physician assistant mental health fellowship program repeal.Repealed by its own terms; 2015 Acts, ch 30, §214.135.178Nurse residency state matching grants program.The department shall establish a nurse residency state matching grants program to provide matching state funding to sponsors of nurse residency programs in this state to establish, expand, or support nurse residency programs that meet standards adopted by rule of the department. Funding for the program may be provided through the health care workforce shortage fund or the nurse residency state matching grants program account created in section 135.175. The department, in cooperation with the Iowa board of nursing, the department of education, Iowa institutions of higher education with board of nursing-approved programs to educate nurses, and the Iowa nurses association, shall adopt rules pursuant to chapter 17A to establish minimum standards for nurse residency programs to be eligible for a matching grant that address all of the following:1Eligibility requirements for and qualifications of a sponsor of a nurse residency program to receive a grant, including that the program includes both rural and urban components.2The application process for the grant.3Criteria for preference in awarding of the grants.4Determination of the amount of a grant.5Use of the funds awarded. Funds may be used to pay the costs of establishing, expanding, or supporting a nurse residency program as specified in this section, including but not limited to the costs associated with residency stipends and nursing faculty stipends.2015 Acts, ch 30, §215, 218, 219; 2016 Acts, ch 1139, §76, 78, 79135.179Fulfilling Iowa’s need for dentists.1The department, in cooperation with a dental nonprofit health service corporation, shall create the fulfilling Iowa’s need for dentists matching grant program.2Funding for the program may be provided through the health care workforce shortage fund or the fulfilling Iowa’s need for dentists matching grant program account created in section 135.175. The purpose of the program is to establish, expand, or support the placement of dentists in dental or rural shortage areas across the state by providing education loan repayments.3The department shall contract with a dental nonprofit health service corporation to implement and administer the program. The dental nonprofit health service corporation shall provide loan repayments to dentists who practice in a dental or rural shortage area as defined by the department.2014 Acts, ch 1106, §10XXXSTATE-FUNDED PSYCHIATRY RESIDENCY AND FELLOWSHIP POSITIONS135.180State-funded psychiatry residency and fellowship positions fund appropriations.1aThe university of Iowa hospitals and clinics shall administer state-funded psychiatry residency and fellowship positions for up to seven residents and up to two fellows, annually. In addition, a county medical center, and a medical center operating for more than one hundred forty years, that are members of separate health systems, administer psychiatry residency programs, and are located in a county with a population over five hundred thousand shall each administer state-funded psychiatry residency positions for one resident, annually. The university of Iowa hospitals and clinics and the specified medical centers shall expand their psychiatry residency programs to provide additional residency positions by providing financial support for residency positions which are in excess of the federal residency cap established by the federal Balanced Budget Act of 1997, Pub. L. No. 105-33. bThe university of Iowa hospitals and clinics and the specified medical centers shall cooperate with the state mental health institutes at Independence and Cherokee, the state resource center at Woodward, the state training school at Eldora, and the Iowa medical and classification center at Oakdale in administering the positions. Participating residents and fellows shall complete a portion of their psychiatry training at one of the state mental health institutes, the state resource center, the state training school, or the Iowa medical and classification center at Oakdale. For accreditation-required clinical experiences not available at the state mental health institutes, the state resource center, the state training school, or the Iowa medical and classification center at Oakdale, the residents awarded the residency positions administered by the university of Iowa hospitals and clinics may utilize clinical rotations at the university of Iowa hospitals and clinics and its affiliates across the state and the residents awarded the residency positions administered by the specified medical centers may utilize clinical rotations at affiliates of such medical centers across the state.2The university of Iowa hospitals and clinics shall apply to the accreditation council for graduate medical education for approval of seven additional residency positions for each class of residents and shall award the total number of residency positions approved for each class of residents. The university of Iowa hospitals and clinics shall approve and award up to two fellowship positions annually. The specified medical centers shall apply to the accreditation council for graduate medical education for approval of one additional residency position each for each class of residents and shall award the total number of residency positions approved for each class of residents. Preference in the awarding of residency and fellowship positions shall be given to candidates who are residents of Iowa, attended and earned an undergraduate degree from an Iowa college or university, or attended and earned a medical degree from a medical school in Iowa.3A psychiatry residency and fellowship positions fund is created in the state treasury consisting of the moneys appropriated or credited to the fund by law. Notwithstanding section 8.33, moneys in the fund at the end of each fiscal year shall not revert to any other fund but shall remain in the psychiatry residency and fellowship positions fund for use in subsequent fiscal years. Moneys in the fund are appropriated to the university of Iowa hospitals and clinics to be used for the purposes of this section. For the fiscal years beginning on or after July 1, 2023, there is appropriated from the general fund of the state to the psychiatry residency and fellowship positions fund one hundred thousand dollars for each residency position approved and awarded and one hundred fifty thousand dollars for each fellowship position approved and awarded under this section. Of the amount appropriated annually from the fund to the university of Iowa hospitals and clinics, the university of Iowa hospitals and clinics shall distribute one hundred thousand dollars to each of the specified medical centers for each residency position approved and awarded.2022 Acts, ch 1131, §82; 2023 Acts, ch 37, §1; 2024 Acts, ch 1157, §72XXXIBEHAVIOR ANALYST AND ASSISTANT BEHAVIOR ANALYST GRANTS PROGRAM135.181Board-certified behavior analyst and board-certified assistant behavior analyst grants program fund.1The department shall establish a board-certified behavior analyst and board-certified assistant behavior analyst grants program to provide grants to Iowa resident and nonresident applicants who have been accepted for admission or are attending a university, community college, or an accredited private institution, within or outside the state of Iowa, are enrolled in a program that is accredited and meets coursework requirements to prepare the applicant to be eligible for board certification as a behavior analyst or assistant behavior analyst, and demonstrate financial need. 2The department, in cooperation with the department of education, shall adopt rules pursuant to chapter 17A to establish minimum standards for applicants to be eligible for a grant that address all of the following: aEligibility requirements for and qualifications of an applicant to receive a grant. The applicant shall agree to practice in the state of Iowa for a period of time, not to exceed four years, as specified in the contract entered into between the applicant and the department at the time the grant is awarded. In addition, the applicant shall agree, as specified in the contract, that during the contract period, the applicant will assist in supervising an individual working toward board certification as a behavior analyst or assistant behavior analyst or to consult with schools and service providers that provide services and supports to individuals with autism.bThe application process for the grant.cCriteria for preference in awarding of the grants. Priority in the awarding of a grant shall be given to applicants who are residents of Iowa.dDetermination of the amount of a grant. The amount of funding awarded to each applicant shall be based on the applicant’s enrollment status, the number of applicants, and the total amount of available funds. The total amount of funds awarded to an individual applicant shall not exceed fifty percent of the total costs attributable to program tuition and fees, annually.eUse of the funds awarded. Funds awarded may be used to offset the costs attributable to tuition and fees for the accredited behavior analyst or assistant behavior analyst program.3aA board-certified behavior analyst and board-certified assistant behavior analyst grants program fund is created in the state treasury as a separate fund under the control of the department. The fund shall consist of moneys appropriated from the general fund of the state for the purposes of the fund and moneys from any other public or private source available.bThe department may receive contributions, grants, and in-kind contributions to support the purposes of the fund. Not more than five percent of the moneys in the fund may be used annually for administrative costs.cThe fund shall be separate from the general fund of the state and shall not be considered part of the general fund of the state. The moneys in the fund shall not be considered revenue of the state, but rather shall be moneys of the fund. Moneys within the fund are not subject to section 8.33 and shall not be transferred, used, obligated, appropriated, or otherwise encumbered, except to provide for the purposes of this section. Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys deposited in the fund shall be credited to the fund. dThe moneys in the fund are appropriated to the department and shall be used to provide grants to individuals who meet the criteria established under this section.2015 Acts, ch 137, §68, 162, 163; 2016 Acts, ch 1139, §57, 58; 2024 Acts, ch 1018, §2, 13, 14135.182Reserved.135.183Reserved.Reserved.135.184Reserved.Reserved.XXXIIEPINEPHRINE AUTO-INJECTOR SUPPLY135.185Epinephrine auto-injector supply.1For purposes of this section, unless the context otherwise requires:a“Epinephrine auto-injector” means the same as provided in section 280.16.b“Facility” means a food establishment as defined in section 137F.1, a carnival as defined in section 88A.1, a recreational camp, a youth sports facility, or a sports arena.c“Licensed health care professional” means the same as provided in section 280.16.d“Personnel authorized to administer epinephrine” means an employee or agent of a facility who is trained and authorized to administer an epinephrine auto-injector.2Notwithstanding any other provision of law to the contrary, a licensed health care professional may prescribe epinephrine auto-injectors in the name of a facility to be maintained for use as provided in this section.3A facility may obtain a prescription for epinephrine auto-injectors and maintain a supply of such auto-injectors in a secure location at each location where a member of the public may be present for use as provided in this section. A facility that obtains such a prescription shall replace epinephrine auto-injectors in the supply upon use or expiration. Personnel authorized to administer epinephrine may possess and administer epinephrine auto-injectors from the supply as provided in this section.4Personnel authorized to administer epinephrine may provide or administer an epinephrine auto-injector from the facility’s supply to an individual present at the facility if such personnel reasonably and in good faith believe the individual is having an anaphylactic reaction.5The following persons, provided they have acted reasonably and in good faith, shall not be liable for any injury arising from the provision, administration, or assistance in the administration of an epinephrine auto-injector as provided in this section:aAny personnel authorized to administer epinephrine who provide, administer, or assist in the administration of an epinephrine auto-injector to an individual present at the facility who such personnel believe to be having an anaphylactic reaction.bThe owner or operator of the facility.cThe prescriber of the epinephrine auto-injector.6The department, the board of medicine, the board of nursing, and the board of pharmacy shall adopt rules pursuant to chapter 17A to implement and administer this section, including but not limited to standards and procedures for the prescription, distribution, storage, replacement, and administration of epinephrine auto-injectors, and for training and authorization to be required for personnel authorized to administer epinephrine.2015 Acts, ch 68, §1; 2016 Acts, ch 1073, §58; 2023 Acts, ch 19, §157135.186Reserved.Reserved.135.187Reserved.Reserved.135.188Reserved.Reserved.135.189Reserved.Reserved.XXXIIIOPIOID ANTAGONISTS QUALIFIED IMMUNITY MEDICATION FUND135.190Possession and administration of opioid antagonists immunity.1For purposes of this section, unless the context otherwise requires:a“Community-based organization” means a public or private organization that provides health or human services to meet the needs of a community including but not limited to a nonprofit organization, a social service provider, or an organization providing substance use disorder prevention, treatment, recovery, or harm reduction services.b“Licensed health care professional” means the same as defined in section 280.16.c“Opioid antagonist” means the same as defined in section 147A.1.d“Opioid-related overdose” means the same as defined in section 147A.1.e“Person in a position to assist” means a family member, friend, caregiver, community-based organization, health care provider, employee of a substance use disorder treatment facility, school employee, first responder as defined in section 147A.1, or other person who may be in a place to render aid to a person at risk of experiencing an opioid-related overdose.f“Secondary distributor” means a law enforcement agency, emergency medical services program, fire department, school district, health care provider, licensed behavioral health provider, county health department, or the department of health and human services.2aNotwithstanding any other provision of law to the contrary, a licensed health care professional may prescribe an opioid antagonist to a person in a position to assist or to a secondary distributor.b1Notwithstanding any other provision of law to the contrary, a pharmacist licensed under chapter 155A may, by standing order or through collaborative agreement, dispense, furnish, or otherwise provide an opioid antagonist to a person in a position to assist or to a secondary distributor.2A pharmacist or secondary distributor who dispenses, furnishes, or otherwise provides an opioid antagonist pursuant to a valid prescription, standing order, or collaborative agreement shall provide written instruction, which shall include emergency, crisis, and substance use referral contact information, to the recipient in accordance with any protocols and instructions developed by the department under this section.3A person in a position to assist may possess and provide or administer an opioid antagonist to an individual if the person in a position to assist reasonably and in good faith believes that such individual is experiencing an opioid-related overdose.4Notwithstanding any other provision of law to the contrary, the chief medical officer of the department may issue a standing order that does not identify individual patients at the time it is issued for the purpose of dispensing opioid antagonists to a person in a position to assist.5A person in a position to assist may distribute an opioid antagonist to any individual pursuant to this section.6A person in a position to assist, a secondary distributor, or a prescriber of an opioid antagonist who has acted reasonably and in good faith shall not be liable for any injury arising from the provision, administration, or assistance in the administration of an opioid antagonist as provided in this section.7A school district may obtain a valid prescription for an opioid antagonist and maintain a supply of opioid antagonists in a secure location at each location where a student may be present for use as provided in this section.8The department may adopt rules pursuant to chapter 17A to implement and administer this section.2016 Acts, ch 1061, §1; 2016 Acts, ch 1139, §68 – 70, 72 – 75; 2022 Acts, ch 1121, §2, 3; 2023 Acts, ch 19, §158; 2023 Acts, ch 86, §15 – 18; 2024 Acts, ch 1043, §53135.190AOpioid antagonist medication fund.1An opioid antagonist medication fund for first responders is created within the state treasury under the control of the department. The fund shall consist of moneys appropriated to or deposited into the fund. 2Moneys in the fund are appropriated to the department for the purchase, maintenance, and replacement of opioid antagonist medication administered by first responders to persons experiencing an opioid-related overdose. The department is authorized to designate moneys in the fund for the purchase, maintenance, and replacement of opioid antagonist medication used by the department or other entities under this section. 3First responders may contact the department for the procurement of opioid antagonist medication. The department shall keep a record of the distribution of moneys from the fund.4The fund may consist of available federal or state moneys available, as well as any available opioid lawsuit settlement moneys. Funds may be transferred between other state agencies and the fund as appropriate.5Notwithstanding section 8.33, moneys in the fund that remain unencumbered or unobligated at the close of a fiscal year shall not revert but shall remain available for expenditure for the purposes designated unless federal regulations otherwise require. Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys in the fund shall be credited to the fund.6The department shall submit a report to the general assembly on or before December 31 of each year which shall contain a list of deposits and expenditures from the fund for the prior fiscal year and the amount of carryover funds, if any, to be distributed in the next fiscal year.7For purposes of this section:a“First responder” means an emergency medical care provider, a registered nurse staffing an authorized service program under section 147A.12, a physician assistant staffing an authorized service program under section 147A.13, a physician staffing an authorized service program under section 147A.13A, a fire fighter, or a peace officer as defined in section 801.4 who is trained and authorized to administer an opioid antagonist.b“Opioid antagonist” means the same as defined in section 147A.1.c“Opioid-related overdose” means the same as defined in section 147A.1.2022 Acts, ch 1121, §4; 2023 Acts, ch 19, §159; 2024 Acts, ch 1044, §1XXXIVSTROKE CARE — REPORTING AND DATABASE135.191Stroke care continuous quality improvement.1A nationally certified comprehensive stroke center or a nationally certified primary stroke center operating in the state shall report to the statewide stroke database data consistent with nationally recognized guidelines on the treatment of individuals with confirmed cases of stroke within the state. If a nationally certified comprehensive stroke center or nationally certified primary stroke center does not comply with this subsection by reporting data consistent with nationally recognized guidelines, the department may request a review of the certification of the comprehensive stroke center or the primary stroke center by the certifying entity.2The department, in partnership with the university of Iowa college of public health, department of epidemiology, shall do all of the following:aMaintain or utilize a statewide stroke database that compiles information and statistics on stroke care which aligns with nationally recognized stroke consensus metrics.bUtilize the get with the guidelines-stroke data set platform or a data tool with equivalent data measures and with confidentiality standards consistent with federal and state law and other health information and data collection, storage, and sharing requirements of the department.cPartner with national voluntary health organizations and stroke advocacy organizations that plan for achieving stroke care quality improvement to avoid duplication and redundancy.dEncourage nationally certified acute stroke-ready hospitals and emergency medical services agencies to report data consistent with nationally recognized guidelines on the treatment of individuals with confirmed cases of stroke within the state.2017 Acts, ch 26, §1XXXVRECIPIENTS OF ANATOMICAL GIFTS — PROTECTIONS135.192Protections of certain prospective recipients of anatomical gifts.1A hospital, physician, or other person shall not determine the ultimate recipient of an anatomical gift based upon a potential recipient’s disability, except to the extent that the disability has been found by a physician, following a case-by-case evaluation of the potential recipient, to be medically significant to the provision of the anatomical gift.2Subsection 1 shall apply to each part of the anatomical gift process including all of the following:aThe referral from a primary care provider to a specialist.bThe referral from a specialist to a transplant center.cThe evaluation of the patient for the transplant by the transplant hospital.dThe consideration of the patient for placement on the list of potential transplant recipients pursuant to 42 C.F.R. §121.7.3A person with a disability shall not be required to demonstrate postoperative independent living abilities in order to be placed on the list of potential transplant recipients pursuant to 42 C.F.R. §121.7 if there is evidence that the person will have sufficient, compensatory support and assistance.4A court shall accord priority on its calendar and handle expeditiously any action brought to seek any remedy authorized by law for purposes of enforcing compliance with this section.5This section shall not be deemed to require referrals or recommendations for, or the performance of, a medically inappropriate transplant of a part.6As used in this section:a“Anatomical gift” means the same as defined in section 142C.2.b“Disability” means the same as defined in the federal Americans with Disabilities Act of 1990, 42 U.S.C. §12101 et seq.2020 Acts, ch 1101, §1XXXVIFAMILY MEDICINE OBSTETRICS FELLOWSHIP PROGRAM135.193State-funded family medicine obstetrics fellowship program fund.1The department shall establish a state-funded family medicine obstetrics fellowship program to increase access to family medicine obstetrics practitioners in rural and underserved areas of the state. A person who has completed an accreditation council for graduate medical education residency program in family medicine is eligible for participation in the fellowship program. Participating fellows shall enter into a program agreement with a participating teaching hospital which, at a minimum, requires the fellow to complete a one-year fellowship and to engage in full-time family medicine obstetrics practice in a rural or underserved area of the state for a period of at least five years within nine months following completion of the fellowship and receipt of a license to practice medicine in the state.2Each fellow participating in the program shall be eligible for a salary and benefits including a stipend as determined by the participating teaching hospital which shall be funded through the family medicine obstetrics fellowship program fund.3The department shall adopt rules pursuant to chapter 17A to administer the program, including defining rural and underserved areas for the purpose of the required full-time practice of a person following completion of the fellowship.4aA family medicine obstetrics fellowship program fund is created in the state treasury consisting of the moneys appropriated or credited to the fund by law. Notwithstanding section 8.33, moneys in the fund at the end of each fiscal year shall not revert to any other fund but shall remain in the fund for use in subsequent fiscal years. Moneys in the fund are appropriated to the department to be used to fund fellowship positions as provided in this section.bFor the fiscal year beginning July 1, 2023, and each fiscal year beginning July 1 thereafter, there is appropriated from the general fund of the state for deposit in the family medicine obstetrics fellowship program fund an amount sufficient to support the creation of four fellowship positions as provided in this section.5The department and the participating teaching hospitals shall regularly evaluate and document their experiences including identifying ways the program may be modified or expanded to facilitate increased access to family medicine obstetrics practitioners in rural and underserved areas of the state. The department shall submit an annual report to the general assembly by January 1. The report shall include the number of fellowships funded to date and any other information identified by the department and the participating teaching hospitals as indicators of outcomes and the effectiveness of the program.6For the purposes of this section, “teaching hospital” means a hospital or medical center that provides medical education to prospective and current health professionals.2023 Acts, ch 112, §67XXXVIIMINOR ELECTRONIC PROTECTED HEALTH INFORMATION DISCLOSURE TO LEGAL GUARDIAN135.194Electronic protected health information of minor disclosure to legal guardian option to provide printed copy.1A health care provider or facility that maintains or transmits electronic protected health information shall disclose to the legal guardian of a minor the minor’s electronic protected health information, with the following exceptions:aElectronic protected health information that relates to health care for which the minor is legally authorized to consent without the consent of a legal guardian.bIf disclosure of the electronic protected health information to a legal guardian is otherwise prohibited by state law or federal law, including federal statute, regulation, or centers for disease control and prevention guidelines.2In lieu of disclosing the minor’s electronic protected health information to the legal guardian of a minor as required pursuant to subsection 1, a health care provider or facility may comply with this section by providing a printed copy of the minor’s electronic protected health information, subject to the exceptions prescribed pursuant to subsection 1, and at no charge to the legal guardian of the minor.3For the purposes of this section:a“Disclosure” means the release, transfer, provision of access to, or divulging in any manner of electronic protected health information outside the entity holding the electronic protected health information.b“Electronic media” means electronic storage material on which data is or may be recorded electronically and transmission media used to exchange information already in electronic storage media.c“Electronic protected health information” means protected health information that is transmitted or maintained by or in electronic media.d“Facility” means a health care delivery system location that provides a range of primary, secondary, and tertiary inpatient, outpatient, and physician services; an institution providing health care services; and any other health care setting including but not limited to a hospital or other licensed inpatient center, ambulatory surgical center or treatment center, skilled nursing center, residential treatment center, diagnostic, laboratory or imaging centers, rehabilitation or other therapeutic health setting, or the private office or clinic of an individual health care provider or group of health care providers.e“Health care” means care, services, or supplies related to the health of a person and includes but is not limited to:1Preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, and any counseling, service, assessment, or procedure with respect to the physical or mental condition, or functional status of a person, or that affects the structure or function of the body.2The sale or dispensing of a drug, device, equipment, or other item in accordance with a prescription.f“Health care provider” means a physician or osteopathic physician licensed under chapter 148, a physician assistant licensed under chapter 148C, a podiatrist licensed under chapter 149, a chiropractor licensed under chapter 151, a licensed practical nurse, a registered nurse, or an advanced registered nurse practitioner licensed under chapter 152 or 152E, a dentist licensed under chapter 153, an optometrist licensed under chapter 154, a pharmacist licensed under chapter 155A, or any other person who is licensed, certified, or otherwise authorized or permitted by the law of this state to administer health care in the ordinary course of business or in the practice of a profession.g“Health information” means health information as defined in 45 C.F.R. §160.103 that is maintained or transmitted by a health care provider or facility.h“Legal guardian” means a person appointed by a court as the guardian of a minor pursuant to chapter 232D, or the parent or other person responsible for the care of the minor.i“Protected health information” means protected health information as defined in 45 C.F.R. §160.103 that is maintained or transmitted by a health care provider or facility.2024 Acts, ch 1130, §4; 2024 Acts, ch 1154, §12XXXVIIICENTERS OF EXCELLENCE GRANT PROGRAM135.195Centers of excellence grant program.1The department shall administer a centers of excellence grant program to encourage innovation and collaboration among regional health care providers in rural areas, based upon the results of a regional community needs assessment, in order to transform health care delivery that provides quality, sustainable care in meeting the needs of the local community. 2There is appropriated from the general fund of the state to the department, beginning July 1, 2024, and for each subsequent fiscal year, the sum of four hundred twenty-five thousand dollars to award two program grants.3An applicant for a grant shall specify how the grant will be expended to accomplish the goals of the program and shall provide a detailed five-year sustainability plan prior to being awarded the grant. 4Following receipt of a grant, a recipient shall submit periodic reports as specified by the department to the governor and the general assembly regarding the recipient’s expenditure of the grant and progress in accomplishing the program’s goals. 2024 Acts, ch 1157, §59