House Study Bill 626

                                       SENATE/HOUSE FILE       
                                       BY  (PROPOSED DEPARTMENT OF
                                            PUBLIC HEALTH BILL)


    Passed Senate, Date               Passed House,  Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act providing for specified changes regarding programs under
  2    the purview of the department of public health, providing a
  3    penalty, and making an appropriation.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  5 TLSB 5217DP 80
  6 rn/cf/24

PAG LIN

  1  1    Section 1.  NEW SECTION.  135.39A  GIFTS AND GRANTS FUND ==
  1  2 APPROPRIATION.
  1  3    The department is authorized to accept gifts, grants, or
  1  4 allotments of funds from any source to be used for programs
  1  5 authorized by this chapter or any other chapter which the
  1  6 department is responsible for administering.  A public health
  1  7 gifts and grants fund is created as a separate fund in the
  1  8 state treasury under the control of the department.  The fund
  1  9 shall consist of gift or grant moneys obtained from any
  1 10 source, including the federal government.  The moneys
  1 11 collected under this section and deposited in the fund are
  1 12 appropriated to the department for the public health purposes
  1 13 specified in the gift or grant.  Moneys in the fund shall not
  1 14 be subject to appropriation or expenditure for any other
  1 15 purpose.  Notwithstanding section 8.33, moneys in the public
  1 16 health gifts and grants fund at the end of each fiscal year
  1 17 shall not revert to any other fund but shall remain in the
  1 18 public health gifts and grants fund for expenditure for
  1 19 subsequent fiscal years.
  1 20    Sec. 2.  Section 135.103, Code 2003, is amended to read as
  1 21 follows:
  1 22    135.103  GRANT PROGRAM.
  1 23    The department shall implement a childhood lead poisoning
  1 24 prevention grant program which provides matching funds to
  1 25 local boards of health or cities for the program after
  1 26 standards and requirements for the local program are
  1 27 developed.  The state shall provide funds to approved programs
  1 28 on the basis of three dollars for each one dollar designated
  1 29 by the local board of health or city for the program for the
  1 30 first two years of a program, and funds on the basis of one
  1 31 dollar for each one dollar designated by the local board of
  1 32 health or city for the program for the third and subsequent
  1 33 years of the program if such funding is determined necessary
  1 34 by the department for such subsequent years.  This requirement
  1 35 shall apply to all federal, state, and other funds received by
  2  1 the department for the childhood lead poisoning prevention
  2  2 grant program.  The department may also use federal, state, or
  2  3 other funds provided for the childhood lead poisoning
  2  4 prevention program to purchase environmental and blood testing
  2  5 from a public health laboratory.  A public health laboratory
  2  6 shall not be required to designate matching funds.
  2  7    Sec. 3.  Section 136B.1, subsection 2, Code 2003, is
  2  8 amended to read as follows:
  2  9    2.  The department shall establish programs and adopt rules
  2 10 for the certification of persons who test for the presence of
  2 11 radon gas and radon progeny in buildings and for buildings,
  2 12 the credentialing of persons abating the level of radon in
  2 13 buildings, and construction standards for radon abatement
  2 14 systems.
  2 15    Sec. 4.  Section 136B.3, Code 2003, is amended to read as
  2 16 follows:
  2 17    136B.3  TESTING AND REPORTING OF RADON LEVEL.
  2 18    The department or its duly authorized agents shall from
  2 19 time to time perform inspections and testing of the premises
  2 20 of a property to determine the level at which it is
  2 21 contaminated with radon gas or radon progeny as a spot=check
  2 22 of the validity of measurements or the adequacy of abatement
  2 23 measures performed by persons certified or credentialed under
  2 24 section 136B.1.  Following testing the department shall
  2 25 provide the owner of the property with a written report of its
  2 26 results including the concentration of radon gas or radon
  2 27 progeny contamination present, an interpretation of the
  2 28 results, and recommendation of appropriate action.  A person
  2 29 certified or credentialed under section 136B.1 shall also be
  2 30 advised of the department's results, discrepancies revealed by
  2 31 the spot=check, actions required of the person, and actions
  2 32 the department intends to take with respect to the person's
  2 33 continued certification or credentialing.
  2 34    Sec. 5.  Section 139A.2, subsection 20, Code Supplement
  2 35 2003, is amended to read as follows:
  3  1    20.  "Quarantine" means the limitation of freedom of
  3  2 movement of persons or animals that have been exposed to a
  3  3 communicable quarantinable disease within specified limits
  3  4 marked by placards for a period of time equal to the longest
  3  5 usual incubation period of the disease in such manner as to
  3  6 prevent the spread of a communicable quarantinable disease
  3  7 which affects people.
  3  8    Sec. 6.  NEW SECTION.  139A.13A  ISOLATION OR QUARANTINE ==
  3  9 EMPLOYMENT PROTECTION.
  3 10    1.  An employer shall not discharge an employee, or take or
  3 11 fail to take action regarding an employee's promotion or
  3 12 proposed promotion, or take action to reduce an employee's
  3 13 wages or benefits for actual time worked, due to the
  3 14 compliance of an employee with a quarantine or isolation order
  3 15 issued by the department or a local board.
  3 16    2.  An employer who violates this section commits a simple
  3 17 misdemeanor.
  3 18    3.  An employee whose employer violates this section shall
  3 19 also be entitled to recover damages from the employer
  3 20 including, but not limited to, actual damages, court costs,
  3 21 and reasonable attorney fees.  The employee may also petition
  3 22 the court for imposition of a cease and desist order against
  3 23 the person's employer and for reinstatement to the person's
  3 24 previous position of employment.
  3 25    Sec. 7.  Section 147.107, subsection 7, Code Supplement
  3 26 2003, is amended by striking the subsection.
  3 27    Sec. 8.  Section 148.3, subsection 3, Code 2003, is amended
  3 28 to read as follows:
  3 29    3.  Present to the medical examiners satisfactory evidence
  3 30 that the applicant has successfully completed one year of
  3 31 postgraduate internship or resident training in a hospital
  3 32 approved for such training by the medical examiners.
  3 33 Beginning July 1, 2006, an applicant who holds a valid
  3 34 certificate issued by the educational commission for foreign
  3 35 medical graduates shall submit satisfactory evidence of
  4  1 successful completion of two years of such training.
  4  2    Sec. 9.  Section 148C.1, subsection 4, Code Supplement
  4  3 2003, is amended to read as follows:
  4  4    4.  "Licensed physician assistant" means a person who is
  4  5 licensed by the board to practice as a physician assistant
  4  6 under the supervision of one or more physicians specified in
  4  7 the license.  "Supervision" does not require the personal
  4  8 presence of the supervising physician at the place where
  4  9 medical services are rendered except insofar as the personal
  4 10 presence is expressly required by this chapter or required by
  4 11 rules of the board adopted pursuant to this chapter.
  4 12    Sec. 10.  Section 152.1, subsection 6, paragraph b, Code
  4 13 Supplement 2003, is amended to read as follows:
  4 14    b.  Execute regimen prescribed by a physician, a nurse
  4 15 practitioner, or a physician assistant.
  4 16    Sec. 11.  Section 154A.18, Code 2003, is amended to read as
  4 17 follows:
  4 18    154A.18  DISPLAY OF LICENSE.
  4 19    A person shall not engage in business as a hearing aid
  4 20 dispenser, or display a sign, or in any other way advertise or
  4 21 claim to be a hearing aid dispenser after January 1, 1975,
  4 22 unless the person holds a valid license issued by the
  4 23 department as provided in this chapter.  The license shall be
  4 24 conspicuously posted in the person's office or place of
  4 25 business primary location of practice.  The department shall
  4 26 issue duplicate licenses to valid license holders operating
  4 27 more than one office.  A license confers upon the holder the
  4 28 right to operate a business practice as a hearing aid
  4 29 dispenser.
  4 30    Sec. 12.  Section 155.9, subsection 3, unnumbered paragraph
  4 31 2, Code 2003, is amended to read as follows:
  4 32    The board may also accept the voluntary surrender of such
  4 33 license without necessity of a hearing.  In the event of the
  4 34 inability of the regular administrator of a nursing home to
  4 35 perform the administrator's duties or through death or other
  5  1 cause the nursing home is without a licensed administrator, a
  5  2 provisional administrator may be appointed on a temporary
  5  3 basis by the nursing home owner or owners, to perform such
  5  4 duties for a period not to exceed six months one year.
  5  5    Sec. 13.  NEW SECTION.  156.16  UNLICENSED PRACTICE ==
  5  6 INJUNCTIONS, CIVIL PENALTIES, CONSENT AGREEMENTS.
  5  7    1.  If the board has reasonable grounds to believe that a
  5  8 person or establishment which is not licensed under this
  5  9 chapter has engaged, or is about to engage, in an act or
  5 10 practice which requires licensure under this chapter, or
  5 11 otherwise violates a provision of this chapter, the board may
  5 12 issue an order to require the unlicensed person or
  5 13 establishment to comply with the provisions of this chapter,
  5 14 and may impose a civil penalty not to exceed one thousand
  5 15 dollars for each violation of this chapter by an unlicensed
  5 16 person or establishment.  Each day of a continued violation
  5 17 constitutes a separate offense.
  5 18    2.  The board may conduct an investigation as needed to
  5 19 determine whether probable cause exists to initiate the
  5 20 proceedings described in this section.  To aid in such an
  5 21 investigation or in connection with any other proceeding under
  5 22 this section, the board may issue subpoenas to compel
  5 23 witnesses to testify or persons to produce evidence consistent
  5 24 with the provisions of section 272C.6, subsection 3.
  5 25    3.  The board, in determining the amount of a civil penalty
  5 26 to be imposed, may consider any of the following:
  5 27    a.  Whether the amount imposed will be a substantial
  5 28 economic deterrent to the violation.
  5 29    b.  The circumstances leading to the violation.
  5 30    c.  The severity of the violation and the risk of harm to
  5 31 the public.
  5 32    d.  The economic benefits gained by the violator as a
  5 33 result of noncompliance.
  5 34    e.  The interest of the public.
  5 35    4.  The board, before issuing an order under this section,
  6  1 shall provide the person or establishment written notice and
  6  2 the opportunity to request a hearing.  The hearing must be
  6  3 requested within thirty days after receipt of the notice and
  6  4 shall be conducted in the same manner as provided for
  6  5 disciplinary proceedings involving a licensee under this
  6  6 chapter.
  6  7    5.  The board may request the attorney general to bring an
  6  8 action to enforce the subpoena.
  6  9    6.  A person or establishment aggrieved by the issuance of
  6 10 an order or the imposition of a civil penalty under this
  6 11 section may seek judicial review pursuant to section 17A.19.
  6 12    7.  If a person or establishment fails to pay a civil
  6 13 penalty within thirty days after entry of an order imposing
  6 14 the civil penalty, or, if the order is stayed pending an
  6 15 appeal, within ten days after the court enters a final
  6 16 judgment in favor of the board, the board shall notify the
  6 17 attorney general.  The attorney general may commence an action
  6 18 to recover the amount of the penalty, including reasonable
  6 19 attorney fees and costs.
  6 20    8.  An action to enforce an order under this section may be
  6 21 joined with an action for an injunction pursuant to section
  6 22 147.83.
  6 23    9.  The board, in its discretion and in lieu of issuing or
  6 24 enforcing an order or imposing a civil penalty for an initial
  6 25 violation under this section, may enter into a consent
  6 26 agreement with a violator, or with a person who aided or
  6 27 abetted a violator, which acknowledges the violation and the
  6 28 violator's agreement to refrain from any further violation.
  6 29                           EXPLANATION
  6 30    This bill provides for a number of technical and
  6 31 substantive changes regarding programs under the purview of
  6 32 the department of public health.
  6 33    The bill provides for the establishment of a gifts and
  6 34 grants fund, and provides that the department is authorized to
  6 35 accept gifts, grants, or allotments of funds from any source
  7  1 to be used for programs the department is authorized to
  7  2 administer.  The bill provides that the fund shall consist of
  7  3 gift or grant moneys obtained from any source, including the
  7  4 federal government, and that the moneys are appropriated to
  7  5 the department for the public health purposes specified in the
  7  6 gift or grant.  The bill provides that moneys in the fund
  7  7 shall not be subject to appropriation or expenditure for any
  7  8 other purpose, and shall not revert to the general fund.
  7  9    The bill provides for changes in funding provisions
  7 10 concerning the childhood lead poisoning prevention grant
  7 11 program.  The bill provides for the deletion of language
  7 12 currently providing for funding of $3 by the state for every
  7 13 $1 provided locally for the first two years of a program,
  7 14 changing to a dollar=for=dollar basis thereafter if determined
  7 15 necessary.  Instead, the bill provides that the $3 to $1 match
  7 16 shall apply to all federal, state, and other funds received by
  7 17 the department for the childhood lead poisoning prevention
  7 18 grant program; that the department may also use federal,
  7 19 state, or other funds provided for the childhood lead
  7 20 poisoning prevention program to purchase environmental and
  7 21 blood testing from a public health laboratory; and that a
  7 22 public health laboratory shall not be required to designate
  7 23 matching funds.
  7 24    The bill provides, with reference to the radon testing and
  7 25 abatement program contained in Code chapter 136B, that the
  7 26 department shall establish programs and adopt rules relating
  7 27 to construction standards for radon abatement systems.  The
  7 28 bill also provides that inspections and testing of premises as
  7 29 a spot=check of radon contamination, currently conducted by
  7 30 the Iowa department of public health, may be performed either
  7 31 by the department or its duly authorized agents.
  7 32    The bill provides employment protection provisions relating
  7 33 to individuals complying with a quarantine or isolation order
  7 34 issued by the department.  The bill provides that an employer
  7 35 shall not discharge an employee, or take or fail to take
  8  1 action regarding an employee's promotion or proposed
  8  2 promotion, or take action to reduce an employee's wages or
  8  3 benefits for actual time worked, due to such compliance, and
  8  4 that an employer who violates these provisions commits a
  8  5 simple misdemeanor.  The bill also provides that employees
  8  6 shall be entitled to recover damages from an employer
  8  7 including, and may petition the court for, imposition of a
  8  8 cease and desist order against an employer and for
  8  9 reinstatement to their previous position of employment.
  8 10    The bill provides for changes relating to the definition of
  8 11 "quarantine", deletion of outdated language relating to a
  8 12 physician assistant rules review group, deletion of a
  8 13 provision regarding specification of a supervising physician
  8 14 in a physician assistant license, clarifying that the practice
  8 15 of nursing includes execution of a regimen prescribed by a
  8 16 nurse practitioner or physician assistant, and expansion of
  8 17 the amount of postgraduate training for international medical
  8 18 graduates from one year to two years beginning July 1, 2006.
  8 19 The bill additionally provides for terminology changes
  8 20 regarding engaging in business as a hearing aid dispenser,
  8 21 providing that a license shall be displayed in the person's
  8 22 primary location of practice as opposed to the current
  8 23 requirement of posting in their office or place of business,
  8 24 and characterizing the business as the "practice" of hearing
  8 25 aid dispensing.  The bill provides for an extension of time
  8 26 from six months to one year regarding the duration during
  8 27 which it is permissible for a provisional nursing home
  8 28 administrator to perform such duties prior to obtaining
  8 29 licensure.
  8 30    The bill authorizes the board of mortuary science examiners
  8 31 to impose civil penalties upon a finding of unlicensed
  8 32 practice.  The bill provides that the board may impose a civil
  8 33 penalty upon an unlicensed person or establishment not to
  8 34 exceed $1,000 for each violation of Code chapter 156, and that
  8 35 each day of a continued violation constitutes a separate
  9  1 offense.  The bill provides for board authority to conduct
  9  2 investigations consistent with the provisions of Code section
  9  3 272C.6, imposes notice and hearing requirements, specifies
  9  4 factors to consider regarding determination by the board of
  9  5 the amount of a civil penalty to be imposed, and includes
  9  6 other provisions related to board authority to act in
  9  7 unlicensed practice situations.
  9  8 LSB 5217DP 80
  9  9 rn/cf/24.1