Senate File 478 - Introduced



                                     SENATE FILE       
                                     BY  COMMITTEE ON HUMAN RESOURCES

                                     (SUCCESSOR TO SF 124)


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

                                      A BILL FOR

  1 An Act providing for the registration of practitioners of the
  2    healing arts, providing remedies, and making an appropriation.
  3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  4 TLSB 2121SV 82
  5 nh/je/5

PAG LIN



  1  1    Section 1.  LEGISLATIVE FINDINGS AND INTENT.  The general
  1  2 assembly recognizes the constitutional right of privacy and
  1  3 self=determination in regard to health care and that the
  1  4 effective exercise of consumer choice with regard to health
  1  5 care provided by nonlicensed practitioners requires the full
  1  6 and timely disclosure of the background and qualifications of
  1  7 such practitioners.
  1  8    Sec. 2.  NEW SECTION.  147.105  REGISTRATION OF HEALING
  1  9 ARTS PRACTITIONERS NOT REQUIRING LICENSURE.
  1 10    1.  Beginning July 1, 2008, a practitioner of the healing
  1 11 arts who is not required to be licensed under Title IV,
  1 12 subtitle 3, may apply to the department of public health for
  1 13 registration pursuant to this section.  The application shall
  1 14 contain all of the following:
  1 15    a.  A statement of the nature of the health care diagnoses
  1 16 and treatment to be provided by the practitioner.
  1 17    b.  The education, training, experience, or other
  1 18 credentials or qualifications of the practitioner regarding
  1 19 the diagnoses and treatment to be provided.
  1 20    c.  Whether the practitioner has voluntarily relinquished
  1 21 or had revoked a license to practice any health care
  1 22 profession in this state or in any other jurisdiction, has
  1 23 been disciplined by a licensing board or agency, has been
  1 24 determined civilly liable for any act or omission related to
  1 25 the provision of health care, or has been the subject of a
  1 26 criminal prosecution for any act or omission related to the
  1 27 provision of health care.
  1 28    d.  Proof of liability insurance meeting the liability
  1 29 standards required for malpractice insurance for physicians.
  1 30    2.  Prior to approval of such registration by the
  1 31 department, criminal history, child abuse, and dependent adult
  1 32 abuse record checks shall be performed in regard to the
  1 33 practitioner as provided in this subsection.
  1 34    a.  The department of public health shall request that the
  1 35 department of public safety perform a criminal history check
  2  1 and the department of human services perform child abuse and
  2  2 dependent adult abuse record checks of the practitioner in
  2  3 this state.
  2  4    b.  If the person has been convicted of a crime under a law
  2  5 of any state or has a record of founded child or dependent
  2  6 adult abuse, the department of human services shall, upon
  2  7 request of the department of public health, perform an
  2  8 evaluation to determine whether the crime or founded child or
  2  9 dependent adult abuse warrants prohibition of registration.
  2 10 The evaluation shall be performed in accordance with
  2 11 procedures adopted for this purpose by the department of human
  2 12 services.
  2 13    c.  If the department of public safety determines that a
  2 14 person has committed a crime and the practitioner still
  2 15 requests registration pursuant to this section, the department
  2 16 of public safety shall notify the practitioner that an
  2 17 evaluation, if requested by the department of public health,
  2 18 will be conducted by the department of human services to
  2 19 determine whether prohibition of registration is warranted.
  2 20 If a department of human services child or dependent adult
  2 21 abuse record check shows that the practitioner has a record of
  2 22 founded child or dependent adult abuse, the department of
  2 23 human services shall inform the practitioner that an
  2 24 evaluation, if requested by the department of public health,
  2 25 will be conducted to determine whether prohibition of
  2 26 registration is warranted.  The department of human services
  2 27 has final authority in determining whether prohibition of
  2 28 registration is warranted.
  2 29    d.  The department of public health may access the single
  2 30 contact repository established by the department pursuant to
  2 31 section 135C.33 as necessary to perform record checks of
  2 32 practitioners being considered for registration.
  2 33    Sec. 3.  NEW SECTION.  147.105A  REGISTERED PRACTITIONERS
  2 34 == PRACTICE NOT A VIOLATION == EXCEPTIONS.
  2 35    1.  Notwithstanding any other provision of law to the
  3  1 contrary, a practitioner of the healing arts who is not
  3  2 licensed by this state as a health care professional, but who
  3  3 is registered pursuant to section 147.105, does not violate
  3  4 Title IV, subtitle 3, pertaining to health care provider
  3  5 licensure requirements, unless the practitioner does any of
  3  6 the following:
  3  7    a.  Conducts surgery, sets fractures, or performs any other
  3  8 procedure on any person that invades the skin.
  3  9    b.  Prescribes or administers x=ray radiation, a
  3 10 light=emitting device including a laser, or ultrasound
  3 11 technologies.
  3 12    c.  Prescribes or administers drugs, devices, or controlled
  3 13 substances for which a prescription by a licensed health care
  3 14 provider is required.
  3 15    d.  Represents, states, indicates, advertises, or implies
  3 16 that the person has been issued a license to practice a health
  3 17 care profession in this state.
  3 18    2.  This section shall not be construed to authorize the
  3 19 practice of lay midwifery, ayurvedic medicine, or naturopathic
  3 20 medicine.
  3 21    Sec. 4.  NEW SECTION.  147.105B  DISCLOSURES BY REGISTERED
  3 22 PRACTITIONERS.
  3 23    1.  A practitioner of the healing arts who is registered
  3 24 pursuant to section 147.105, who advertises in any media that
  3 25 the person is a practitioner of healing arts diagnoses and
  3 26 treatments, or who receives financial compensation for the
  3 27 provision of healing arts diagnoses and treatments, shall,
  3 28 prior to the provision of such services, provide a prospective
  3 29 client a plainly worded written statement disclosing the
  3 30 following:
  3 31    a.  That the practitioner is not a licensed health care
  3 32 provider pursuant to the licensure provisions of any of the
  3 33 chapters of Title IV, subtitle 3.
  3 34    b.  The nature of the health care diagnoses and treatment
  3 35 to be provided.
  4  1    c.  The education, training, experience, or other
  4  2 credentials or qualifications of the unlicensed practitioner
  4  3 regarding the diagnoses and treatment being provided,
  4  4 accompanied by the following statement:
  4  5    "The state of Iowa has not adopted educational and training
  4  6 standards for unlicensed providers of health care services.
  4  7 This statement of credentials is for informational purposes
  4  8 only.  If a client wishes to receive health care from a
  4  9 licensed health care provider, the client may seek such care
  4 10 at any time.  Clients receiving treatment from a licensed
  4 11 provider of health care should consult with that licensed
  4 12 provider before modifying or discontinuing such treatment."
  4 13    d.  That the practitioner is registered with the department
  4 14 of public health and that the registration is posted at the
  4 15 location where services are provided.
  4 16    e.  That the parent or legal guardian of a minor seeking
  4 17 treatment has a right to request and receive written
  4 18 permission from the practitioner for access to the relevant
  4 19 data in regard to the practitioner in the Iowa child abuse
  4 20 registry.
  4 21    2.  A practitioner registered pursuant to section 147.105
  4 22 shall obtain written acknowledgment from a prospective client
  4 23 indicating that the prospective client has been provided with
  4 24 the statement of disclosures pursuant to subsection 1, and
  4 25 shall supply the client with a copy of the disclosures and
  4 26 acknowledgment.  The acknowledgment shall be retained by the
  4 27 practitioner for a two=year period.
  4 28    3.  Any advertisement by a practitioner registered pursuant
  4 29 to section 147.105 shall disclose that the provider has not
  4 30 been issued a license to practice a licensed health care
  4 31 profession in this state but is registered with the state of
  4 32 Iowa.  Any such advertisement in print or electronic media
  4 33 shall include the following statement in twelve point type or
  4 34 larger:
  4 35    "The state of Iowa has not adopted educational or training
  5  1 standards for unlicensed providers of health care and has made
  5  2 no determination whatsoever as to the scientific validity or
  5  3 safety or effectiveness of such care."
  5  4    4.  Upon request, a practitioner registered pursuant to
  5  5 section 147.105, shall give written permission to a parent or
  5  6 legal guardian of a minor to allow the parent or legal
  5  7 guardian to access data in regard to the practitioner in the
  5  8 central registry for founded child abuse pursuant to section
  5  9 235A.15, subsection 2, paragraph "f".
  5 10    Sec. 5.  NEW SECTION.  147.105C  SCOPE OF CHAPTER ==
  5 11 REMEDIES.
  5 12    1.  The department may issue an immediate cease and desist
  5 13 order, or seek a temporary or permanent injunction, against a
  5 14 practitioner registered pursuant to section 147.105, who fails
  5 15 to comply with the provisions of sections 147.105A and
  5 16 147.105B.
  5 17    2.  State criminal and civil law not relating to the
  5 18 provision of health care shall continue to apply to
  5 19 practitioners registered pursuant to section 147.105.
  5 20    3.  This section does not limit the right of any person to
  5 21 seek relief for negligent or willful harm, or to seek any
  5 22 other civil remedy against a practitioner registered pursuant
  5 23 to section 147.105.
  5 24    4.  This section does not restrict the state from taking
  5 25 action regarding the maltreatment of minors.
  5 26    Sec. 6.  APPROPRIATION.  There is appropriated from the
  5 27 general fund of the state to the department of public health
  5 28 for the fiscal year beginning July 1, 2007, and ending June
  5 29 30, 2008, the following amount, or so much thereof as is
  5 30 necessary, to be used for the purposes designated:
  5 31    For implementation of registration procedures for
  5 32 practitioners of the healing arts as provided in this Act,
  5 33 including salaries, support, maintenance, miscellaneous
  5 34 purposes, and for not more than the following full=time
  5 35 equivalent positions:
  6  1 .................................................. $    500,000
  6  2 ............................................... FTEs       5.00
  6  3                           EXPLANATION
  6  4    This bill provides for the registration of practitioners of
  6  5 the healing arts and makes an appropriation.
  6  6    The bill contains intent language indicating that the
  6  7 general assembly recognizes the constitutional right to
  6  8 privacy and self=determination in regard to health care and
  6  9 that the effective exercise of consumer choice in regard to
  6 10 care provided by nonlicensed practitioners requires the full
  6 11 and timely disclosure of such practitioners' background and
  6 12 qualifications.
  6 13    The bill provides for the voluntary registration of
  6 14 practitioners of the healing arts who are not required to be
  6 15 licensed as health care professionals.  The bill requires an
  6 16 application for such registration to contain information
  6 17 regarding the nature of the health care diagnoses and
  6 18 treatment provided; the education, training, experience, or
  6 19 other qualifications of the practitioner; any health
  6 20 care=related sanction, discipline, civil liability, or
  6 21 criminal violation; and proof of liability insurance.
  6 22 Applicants for registration are subject to criminal history,
  6 23 child abuse, and dependent adult abuse record checks.
  6 24    The bill provides that a registrant's provision of healing
  6 25 arts diagnoses and treatment does not violate Code Title IV,
  6 26 subtitle 3, pertaining to health care provider licensure
  6 27 requirements, unless the provider of such services conducts
  6 28 surgery, sets fractures, or performs any other procedure on
  6 29 any person that invades the skin; prescribes or administers
  6 30 x=ray radiation; prescribes or administers drugs, devices, or
  6 31 controlled substances for which a prescription by a licensed
  6 32 health care provider is required; or represents, states,
  6 33 indicates, advertises, or implies that the person has been
  6 34 issued a license to practice a health care profession in this
  6 35 state.
  7  1    The bill requires a registrant who advertises in any media
  7  2 that they are a provider of healing arts diagnoses and
  7  3 treatment, or who receives financial compensation for the
  7  4 provision of healing arts diagnoses and treatment, to supply a
  7  5 prospective client prior to the provision of such services
  7  6 with a plainly worded written statement making several
  7  7 disclosures.  It must be disclosed that the provider is not a
  7  8 licensed heath care provider; the nature of the health care
  7  9 diagnoses and treatment to be provided; and the education,
  7 10 training, experience, or other credentials or qualifications
  7 11 of the unlicensed provider regarding the diagnoses and
  7 12 treatment being provided, accompanied by a statement that Iowa
  7 13 has not adopted educational and training standards for
  7 14 unlicensed providers of health care services; that the
  7 15 statement of credentials is for informational purposes only;
  7 16 and that if a client wishes to receive health care from a
  7 17 licensed health care provider, the client may seek such care
  7 18 at any time and should consult with a licensed provider before
  7 19 modifying or discontinuing such existing treatment.  A
  7 20 registrant must also disclose that the practitioner is
  7 21 registered with the department and that the registration is
  7 22 posted where services are provided and that the parent or
  7 23 legal guardian of a minor seeking treatment has a right to
  7 24 request and receive written permission from the practitioner
  7 25 for access to relevant data in the Iowa child abuse registry
  7 26 regarding the practitioner.  The bill provides that written
  7 27 acknowledgment from a prospective client that the client was
  7 28 provided a statement of disclosures must be obtained, and
  7 29 retained for a two=year period, and that the prospective
  7 30 client shall receive a copy of the disclosures and
  7 31 acknowledgment.
  7 32    The bill additionally provides that an advertisement by a
  7 33 registrant shall disclose that the provider has not been
  7 34 issued a license to practice a licensed health care profession
  7 35 but is registered with the state, and that upon request, a
  8  1 registrant shall give written permission to a parent or legal
  8  2 guardian of a minor to allow the parent or legal guardian to
  8  3 access the Iowa child abuse registry.
  8  4    The bill also provides for the scope of the bill's
  8  5 provisions and penalties.  The bill provides that the
  8  6 department of public health may issue an immediate cease and
  8  7 desist order, or seek a temporary or permanent injunction,
  8  8 against a registrant who fails to comply with the bill's
  8  9 provisions, and that state criminal and civil law not relating
  8 10 to the provision of health care shall continue to be
  8 11 applicable.  The bill provides that its provisions shall not
  8 12 limit the right of any person to seek relief for negligent or
  8 13 willful harm, or to seek any other civil remedy, and does not
  8 14 restrict the state from taking action regarding the
  8 15 maltreatment of minors.
  8 16    The bill appropriates $500,000 for fiscal year 2007=2008
  8 17 for implementation of the bill.
  8 18 LSB 2121SV 82
  8 19 nh:rj/je/5