Senate File 2095 - Introduced SENATE FILE BY HATCH and BOETTGER Passed Senate, Date Passed House, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act establishing an Iowa health freedom Act. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5841XS 81 4 rn/je/5 PAG LIN 1 1 Section 1. IOWA HEALTH FREEDOM ACT == LEGISLATIVE 1 2 FINDINGS. 1 3 1. SHORT TITLE. This Act shall be known and may be cited 1 4 as the "Iowa Health Freedom Act". 1 5 2. LEGISLATIVE INTENT. The general assembly recognizes 1 6 that people find value in utilizing unlicensed and licensed 1 7 health care providers, and diverse methods, to meet a wide 1 8 variety of highly individual and personally determined needs, 1 9 including comfort, well=being, vitality, hope, prevention of 1 10 disease, treatment of chronic and acute conditions, self= 1 11 understanding, self=empowerment, and self=development. The 1 12 general assembly also recognizes that individuals are 1 13 ultimately responsible for choosing their own health care 1 14 because they are the ones that experience the effects of that 1 15 health care on their health and well=being, and that the 1 16 exercise of the constitutional right to privacy and self= 1 17 determination in regard to health care requires freedom to 1 18 access all information and all methods and providers deemed of 1 19 value by individuals so that they may have the best 1 20 opportunity to find their most suitable path to health and 1 21 well=being. The general assembly additionally recognizes that 1 22 the threat of prosecution under the chapters contained in 1 23 Title IV, subtitle 3, pertaining to licensure requirements for 1 24 health care providers, has significantly, harmfully, and 1 25 unnecessarily limited the availability of many healing arts 1 26 services in Iowa by potentially subjecting the unlicensed 1 27 providers of those services to fines, penalties, and the 1 28 restriction of their practice. 1 29 Sec. 2. NEW SECTION. 147.86A PROVISIONS NOT APPLICABLE. 1 30 The provisions of this chapter, or any chapter contained in 1 31 Title IV, subtitle 3, licensing a health care provider shall 1 32 not be construed to prohibit the practice of healing arts 1 33 diagnoses and treatments by an unlicensed person provided that 1 34 the requirements of sections 147.105 and 147.105A are met. 1 35 The provisions of this chapter, or any chapter contained in 2 1 Title IV, subtitle 3, shall not be construed to apply to, 2 2 control, or prevent the practice of healing arts diagnoses and 2 3 treatments by persons already lawfully exempt from an 2 4 applicable licensing chapter. The penalty provisions of 2 5 section 147.86, or specific penalty provisions contained 2 6 within an otherwise applicable licensing chapter, shall not 2 7 apply to the practice of healing arts diagnoses and treatment 2 8 by an unlicensed person provided that the requirements of 2 9 sections 147.105 and 147.105A are met. 2 10 Sec. 3. NEW SECTION. 147.105 PROVISION OF HEALTH CARE BY 2 11 UNLICENSED PERSONS. 2 12 Notwithstanding any other provision to the contrary, a 2 13 person who is not licensed by this state as a health care 2 14 professional, and who provides healing arts diagnoses and 2 15 treatment, does not violate Title IV, subtitle 3, pertaining 2 16 to health care provider licensure requirements, unless the 2 17 person: 2 18 1. Conducts surgery, sets fractures, or performs any other 2 19 procedure on any person that harmfully invades the skin. 2 20 2. Prescribes or administers x=ray radiation. 2 21 3. Prescribes or administers drugs, devices, or controlled 2 22 substances for which a prescription by a licensed health care 2 23 provider is required. 2 24 4. Represents, states, indicates, advertises, or implies 2 25 that the person has been issued a license to practice a health 2 26 care profession in this state. 2 27 Sec. 4. NEW SECTION. 147.105A DISCLOSURES BY UNLICENSED 2 28 PERSONS WHO PROVIDE HEALTH CARE. 2 29 1. An unlicensed person who advertises in any media that 2 30 the person is a provider of healing arts diagnoses and 2 31 treatments, or who receives financial compensation for the 2 32 provision of healing arts diagnoses and treatments, shall, 2 33 prior to the provision of such services, provide a prospective 2 34 client a plainly worded written statement disclosing the 2 35 following: 3 1 a. That the provider is not a licensed health care 3 2 provider pursuant to the licensure provisions of any of the 3 3 chapters of Title IV, subtitle 3. 3 4 b. The nature of the health care diagnoses and treatment 3 5 to be provided. 3 6 c. The education, training, experience, or other 3 7 credentials or qualifications of the unlicensed provider 3 8 regarding the diagnoses and treatment being provided, 3 9 accompanied by the following statement: 3 10 "The state of Iowa has not adopted educational and training 3 11 standards for unlicensed providers of health care services. 3 12 This statement of credentials is for informational purposes 3 13 only. If a client wishes to receive health care from a 3 14 licensed health care provider, the client may seek such care 3 15 at any time. Clients receiving treatment from a licensed 3 16 provider of health care should consult with that licensed 3 17 provider before modifying or discontinuing such treatment." 3 18 d. Whether the provider has voluntarily relinquished a 3 19 license to practice any health care profession in Iowa or 3 20 elsewhere under threat of discipline by a licensing board or 3 21 agency, civil liability, or criminal prosecution. 3 22 e. The revocation of a provider's license to practice any 3 23 health care profession in this or any other state for 3 24 misconduct. 3 25 f. Whether the provider has been convicted or adjudicated 3 26 not guilty of a criminal offense against a minor, or of sexual 3 27 exploitation, or of a sexually violent crime against any 3 28 person, or is under indictment for any such crimes. 3 29 g. That the parent or legal guardian of a minor seeking 3 30 treatment has a right to request and receive written 3 31 permission from the provider for access to the relevant data 3 32 in the Iowa child abuse registry. 3 33 2. An unlicensed provider of healing arts diagnoses and 3 34 treatments shall obtain written acknowledgment from a 3 35 prospective client indicating that the prospective client has 4 1 been provided with the statement of disclosures pursuant to 4 2 subsection 1, and shall supply the client with a copy of the 4 3 disclosures and acknowledgment. The acknowledgment shall be 4 4 retained by the provider for a two=year period. 4 5 3. Any advertisement by an unlicensed provider of healing 4 6 arts diagnoses and treatments shall disclose that the provider 4 7 has not been issued a license to practice a licensed health 4 8 care profession in this state. 4 9 4. Upon request, an unlicensed provider of healing arts 4 10 diagnoses and treatment shall give written permission to a 4 11 parent or legal guardian of a minor to allow the parent or 4 12 legal guardian to access the Iowa child abuse registry. 4 13 Sec. 5. NEW SECTION. 147.105B SCOPE OF CHAPTER == 4 14 REMEDIES. 4 15 1. The department may issue an immediate cease and desist 4 16 order, or seek a temporary or permanent injunction, against an 4 17 unlicensed provider of healing arts diagnoses and treatment 4 18 who fails to comply with the provisions of sections 147.105 4 19 and 147.105A. 4 20 2. State criminal and civil law not relating to the 4 21 provision of health care shall continue to apply to unlicensed 4 22 providers of healing arts diagnoses and treatments. 4 23 3. This section does not limit the right of any person to 4 24 seek relief for negligent or willful harm, or to seek any 4 25 other civil remedy against an unlicensed provider of healing 4 26 arts diagnoses and treatments. 4 27 4. This section does not restrict the state from taking 4 28 action regarding the maltreatment of minors. 4 29 EXPLANATION 4 30 This bill establishes an Iowa health freedom Act dealing 4 31 with the provision of healing arts diagnoses and treatment by 4 32 unlicensed persons. 4 33 The bill contains intent language indicating that the 4 34 general assembly recognizes that people find value in 4 35 utilizing unlicensed and licensed health care providers, and 5 1 diverse methods, to meet a wide variety of highly individual 5 2 and personally determined needs; that individuals are 5 3 ultimately responsible for choosing their own health care 5 4 because they are the ones that experience the effects of that 5 5 health care on their health and well=being; and that the 5 6 exercise of the constitutional right to privacy and self= 5 7 determination in regard to health care requires freedom to 5 8 access all information and all methods and providers deemed of 5 9 value by individuals so that they may have the best 5 10 opportunity to find their most suitable path to health and 5 11 well=being. The intent section also indicates that the 5 12 general assembly recognizes that the threat of prosecution 5 13 under the professional licensing chapters contained in Code 5 14 Title IV, subtitle 3, has significantly, harmfully, and 5 15 unnecessarily limited the availability of many healing arts 5 16 services in Iowa by potentially subjecting the unlicensed 5 17 providers of those services to fines, penalties, and the 5 18 restriction of their practice. 5 19 The bill provides that Code Title IV, subtitle 3, providing 5 20 for the licensing of health care providers shall not be 5 21 construed to prohibit the practice of healing arts diagnoses 5 22 and treatment by an unlicensed person provided that the 5 23 requirements of new Code sections 147.105 and 147.105A 5 24 relating to prohibited practices and disclosure, are met, nor 5 25 shall they be construed to apply to, control, or prevent the 5 26 practice of healing arts diagnoses and treatment by persons 5 27 already lawfully exempt from an applicable licensing Code 5 28 chapter. The bill removes the practice of healing arts 5 29 diagnoses and treatment from the penalty provisions of Code 5 30 section 147.86, or specific penalty provisions contained 5 31 within an otherwise applicable licensing Code chapter. 5 32 The bill provides that the provision of healing arts 5 33 diagnoses and treatment does not violate Code Title IV, 5 34 subtitle 3, pertaining to health care provider licensure 5 35 requirements, unless the provider of such services conducts 6 1 surgery, sets fractures, or performs any other procedure on 6 2 any person that harmfully invades the skin; prescribes or 6 3 administers x=ray radiation; prescribes or administers drugs, 6 4 devices, or controlled substances for which a prescription by 6 5 a licensed health care provider is required; or represents, 6 6 states, indicates, advertises, or implies that the person has 6 7 been issued a license to practice a health care profession in 6 8 this state. 6 9 The bill requires an unlicensed person who advertises in 6 10 any media that they are a provider of healing arts diagnoses 6 11 and treatment, or who receives financial compensation for the 6 12 provision of healing arts diagnoses and treatment, to supply a 6 13 prospective client prior to the provision of such services 6 14 with a plainly worded written statement making several 6 15 disclosures. It must be disclosed that the provider is not a 6 16 licensed heath care provider; the nature of the health care 6 17 diagnoses and treatment to be provided; and the education, 6 18 training, experience, or other credentials or qualifications 6 19 of the unlicensed provider regarding the diagnoses and 6 20 treatment being provided, accompanied by a statement that Iowa 6 21 has not adopted educational and training standards for 6 22 unlicensed providers of health care services; that the 6 23 statement of credentials is for informational purposes only; 6 24 and that if a client wishes to receive health care from a 6 25 licensed health care provider, the client may seek such care 6 26 at any time and should consult with a licensed provider before 6 27 modifying or discontinuing such existing treatment. An 6 28 unlicensed provider of healing arts diagnoses and treatment 6 29 must also disclose whether the provider has voluntarily 6 30 relinquished a license to practice; had a license revoked; 6 31 been convicted or adjudicated of a criminal offense against a 6 32 minor, or of sexual exploitation, or of a sexually violent 6 33 crime against any person, or is under indictment for any such 6 34 crimes; and that the parent or legal guardian of a minor 6 35 seeking treatment has a right to request and receive written 7 1 permission from the provider for access to the relevant data 7 2 in the Iowa child abuse registry. The bill provides that 7 3 written acknowledgment from a prospective client that the 7 4 client was provided a statement of disclosures must be 7 5 obtained, and retained for a two=year period, and that the 7 6 prospective client shall receive a copy of the disclosures and 7 7 acknowledgment. 7 8 The bill additionally provides that an advertisement by an 7 9 unlicensed provider of healing arts diagnoses and treatments 7 10 shall disclose that the provider has not been issued a license 7 11 to practice a licensed health care profession, and that upon 7 12 request, an unlicensed provider of health care services shall 7 13 give written permission to a parent or legal guardian of a 7 14 minor to allow the parent or legal guardian to access the Iowa 7 15 child abuse registry. 7 16 The bill also provides for the scope of the bill's 7 17 provisions and penalties. The bill provides that the Iowa 7 18 department of public health may issue an immediate cease and 7 19 desist order, or seek a temporary or permanent injunction, 7 20 against an unlicensed provider of healing arts diagnoses and 7 21 treatment who fails to comply with the bill's provisions, and 7 22 that state criminal and civil law not relating to the 7 23 provision of health care shall continue to be applicable. The 7 24 bill provides that its provisions shall not limit the right of 7 25 any person to seek relief for negligent or willful harm, or to 7 26 seek any other civil remedy, and does not restrict the state 7 27 from taking action regarding the maltreatment of minors. 7 28 LSB 5841XS 81 7 29 rn:nh/je/5