House Study Bill 571 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED DEPARTMENT OF PUBLIC HEALTH BILL) A BILL FOR An Act relating to various activities regulated and programs 1 administered by the department of public health, including 2 the Iowa collaborative safety net provider network, 3 fetal death certification, and optometry, cosmetology, 4 and barbering licensure, and including effective date 5 provisions. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 7 TLSB 5263DP (12) 83 jr/nh
S.F. _____ H.F. _____ Section 1. Section 135.24, subsection 7, paragraph e, Code 1 Supplement 2009, is amended to read as follows: 2 e. “Specialty health care provider office” means the 3 private office or clinic of an individual specialty health 4 care provider or group of specialty health care providers as 5 referred by the Iowa collaborative safety net provider network 6 established in section 135.153 Iowa specialty care referral 7 network , but does not include a field dental clinic, a free 8 clinic, or a hospital. 9 Sec. 2. Section 144.31, Code 2009, is amended to read as 10 follows: 11 144.31 Medical certification —— fetal death. 12 1. The medical certification for a fetal death shall be 13 completed within twenty-four seventy-two hours after delivery 14 by the physician in attendance at or after delivery except when 15 inquiry is required by the county medical examiner. 16 2. When a fetal death occurs without medical attendance upon 17 the mother at or after delivery or when inquiry is required 18 by the county medical examiner, the medical examiner shall 19 investigate the cause of fetal death and shall complete the 20 medical certification within twenty-four seventy-two hours 21 after taking charge of the case. The person completing the 22 medical certification of cause of fetal death shall attest to 23 its accuracy either by signature or as authorized by rule. 24 Sec. 3. Section 148.3, subsection 1, paragraph a, 25 unnumbered paragraph 1, Code Supplement 2009, is amended to 26 read as follows: 27 A Evidence of a diploma issued by a medical college or 28 college of osteopathic medicine and surgery approved by the 29 board, or other evidence of equivalent medical education 30 approved by the board. The board may accept, in lieu of a 31 diploma from a medical college approved by the board, all of 32 the following: 33 Sec. 4. Section 154.1, Code 2009, is amended to read as 34 follows: 35 -1- LSB 5263DP (12) 83 jr/nh 1/ 7
S.F. _____ H.F. _____ 154.1 Board defined —— optometry —— diagnostically 1 certified licensed optometrists —— therapeutically certified 2 optometrists Definitions —— optometry . 3 1. As used in this chapter , “board” : 4 a. ”Board” means the board of optometry created under 5 chapter 147. 6 b. “Licensed optometrist” means an optometrist who is 7 licensed to practice optometry in this state pursuant to this 8 chapter. 9 2. For the purpose of this subtitle, the following classes 10 of persons shall be deemed to be engaged in the practice of 11 optometry: 12 a. Persons employing any means other than the use of drugs, 13 medicine, or surgery for the measurement of the visual power 14 and visual efficiency of the human eye; persons engaged in 15 the prescribing and adapting of lenses, prisms, and contact 16 lenses; and persons engaged in the using or employing of visual 17 training or ocular exercise for the aid, relief, or correction 18 of vision. 19 b. Persons who allow the public to use any mechanical device 20 for a purpose described in paragraph “a” . 21 c. Persons who publicly profess to be optometrists and to 22 assume the duties incident to the profession. 23 3. Diagnostically certified licensed optometrists may 24 employ cycloplegics, mydriatics, and topical anesthetics as 25 diagnostic agents topically applied to determine the condition 26 of the human eye for proper optometric practice or referral 27 for treatment to a person licensed under chapter 148 . A 28 diagnostically certified licensed optometrist is an optometrist 29 who is licensed to practice optometry in this state and who is 30 certified by the board to use diagnostic agents. 31 4. Therapeutically certified optometrists may employ all 32 diagnostic and therapeutic pharmaceutical agents for the 33 purpose of diagnosis and treatment of conditions of the human 34 eye and adnexa pursuant to this subsection , excluding the 35 -2- LSB 5263DP (12) 83 jr/nh 2/ 7
S.F. _____ H.F. _____ use of injections other than to counteract an anaphylactic 1 reaction, and notwithstanding section 147.107 , may without 2 charge supply any of the above pharmaceuticals to commence a 3 course of therapy. Therapeutically certified optometrists may 4 prescribe oral steroids for a period not to exceed fourteen 5 days without consultation with a physician. Therapeutically 6 certified optometrists shall not prescribe oral Imuran or 7 oral Methotrexate. Therapeutically certified optometrists 8 may be authorized, where reasonable and appropriate, by 9 rule of the board, to employ new diagnostic and therapeutic 10 pharmaceutical agents approved by the United States food 11 and drug administration on or after July 1, 2002, for the 12 diagnosis and treatment of the human eye and adnexa. The 13 board shall not be required to adopt rules relating to 14 topical pharmaceutical agents, oral antimicrobial agents, 15 oral antihistamines, oral antiglaucoma agents, and oral 16 analgesic agents. Superficial foreign bodies may be removed 17 from the human eye and adnexa. The therapeutic efforts of 18 a therapeutically certified optometrist are intended for the 19 purpose of examination, diagnosis, and treatment of visual 20 defects, abnormal conditions, and diseases of the human eye 21 and adnexa, for proper optometric practice or referral for 22 consultation or treatment to persons licensed under chapter 23 148 . A therapeutically certified optometrist is an optometrist 24 who is licensed to practice optometry in this state and who 25 is certified by the board to use the agents and procedures 26 authorized pursuant to this subsection . 27 3. Beginning July 1, 2012, all licensed optometrists shall 28 meet requirements as established by the board by rule to 29 employ diagnostic and therapeutic pharmaceutical agents for 30 the practice of optometry. All licensees practicing optometry 31 in this state shall have demonstrated qualifications and have 32 obtained certification to use diagnostic and therapeutic 33 pharmaceutical agents as a condition of license renewal. 34 4. A licensed optometrist may do any of the following: 35 -3- LSB 5263DP (12) 83 jr/nh 3/ 7
S.F. _____ H.F. _____ a. Employ cycloplegics, mydriatics, and topical anesthetics 1 as diagnostic agents topically applied to determine the 2 condition of the human eye for proper optometric practice or 3 referral for treatment to a person licensed under chapter 148. 4 b. Employ therapeutic pharmaceutical agents for the purpose 5 of diagnosis and treatment of conditions of the human eye 6 and adnexa pursuant to this subsection, excluding the use of 7 injections other than to counteract an anaphylactic reaction, 8 and notwithstanding section 147.107, may without charge supply 9 any of the pharmaceuticals described in paragraph “a” to 10 commence a course of therapy. 11 c. Prescribe oral steroids for a period not to exceed 12 fourteen days without consultation with a physician. However, 13 a licensed optometrist shall not prescribe oral Imuran or oral 14 Methotrexate. Licensed optometrists may be authorized, where 15 reasonable and appropriate, by rule of the board, to employ new 16 diagnostic and therapeutic pharmaceutical agents approved by 17 the United States food and drug administration on or after July 18 1, 2002, for the diagnosis and treatment of the human eye and 19 adnexa. The board is not required to adopt rules relating to 20 topical pharmaceutical agents, oral antimicrobial agents, oral 21 antihistamines, oral antiglaucoma agents, or oral analgesic 22 agents. 23 d. Remove superficial foreign bodies from the human eye and 24 adnexa. 25 5. The therapeutic efforts of a licensed optometrist 26 are intended for the purpose of examination, diagnosis, and 27 treatment of visual defects, abnormal conditions, and diseases 28 of the human eye and adnexa, for proper optometric practice 29 or referral for consultation or treatment to persons licensed 30 under chapter 148. 31 Sec. 5. Section 154.10, Code 2009, is amended by striking 32 the section and inserting in lieu thereof the following: 33 154.10 Standard of care. 34 Licensed optometrists employing diagnostic and therapeutic 35 -4- LSB 5263DP (12) 83 jr/nh 4/ 7
S.F. _____ H.F. _____ pharmaceutical agents as authorized by section 154.1 shall be 1 held to the same standard of care in the use of such agents and 2 in diagnosis and treatment as is common to persons licensed 3 under chapter 148. 4 Sec. 6. Section 157.1, subsection 5, paragraph c, Code 2009, 5 is amended to read as follows: 6 c. Removing superfluous hair from the face or body of a 7 person with the use of depilatories, wax, sugars, threading, or 8 tweezing. 9 Sec. 7. Section 157.1, subsection 12, paragraph c, Code 10 2009, is amended to read as follows: 11 c. Removing superfluous hair from the body of a person 12 by the use of depilatories, waxing, sugaring, tweezers, 13 threading, or use of any certified laser products or 14 intense pulsed light devices. This excludes the practice of 15 electrology, whereby hair is removed with an electric needle. 16 Sec. 8. Section 157.8, subsection 2, Code 2009, is amended 17 to read as follows: 18 2. The number of instructors for each school shall 19 be based upon total enrollment, with a minimum of two 20 licensed instructors employed on a full-time basis for up to 21 thirty students and an additional licensed instructor for each 22 fifteen additional students. A student instructor shall not be 23 used to meet licensed instructor-to-student ratios. However, 24 a A school operated by an area community college prior to 25 September 1, 1982, with only one instructor per fifteen 26 students is not subject to this paragraph and may continue to 27 operate with the ratio of one licensed instructor to fifteen 28 students. A student instructor may not be used to meet this 29 requirement. 30 a. A person employed as an instructor in the cosmetology 31 arts and sciences by a licensed school shall be licensed in 32 the practice and shall possess a separate instructor’s license 33 which shall be renewed biennially. An instructor shall file 34 an application with the department on forms prescribed by the 35 -5- LSB 5263DP (12) 83 jr/nh 5/ 7
S.F. _____ H.F. _____ board. Prior to licensure, an applicant for an instructor’s 1 license shall have been actively engaged in the practice for a 2 period of two years and complete a course of study required by 3 the board or an instructor’s course at a school for cosmetology 4 arts and sciences, and meet any other requirement established 5 by the board. Requirements for licensure as an instructor 6 shall be determined by the board by rule. 7 b. The application for an instructor’s license shall be 8 accompanied by the biennial fee determined pursuant to section 9 147.80. 10 Sec. 9. Section 158.4, subsection 2, Code 2009, is amended 11 to read as follows: 12 2. The department may issue a temporary permit for the 13 purpose of demonstrating barbering upon recommendation of the 14 board which allows the applicant to practice barbering for 15 purposes determined by rule . The board shall determine and 16 state its recommendations and the length of time the temporary 17 permit issued under this subsection is valid. 18 Sec. 10. REPEAL. Section 152B.13, Code Supplement 2009, is 19 repealed. 20 Sec. 11. EFFECTIVE DATE. The sections of this Act amending 21 sections 154.1 and 154.10 take effect July 1, 2012. 22 EXPLANATION 23 This bill contains revisions to a variety of programs and 24 licensing provisions administered by the department of public 25 health. 26 The bill amends Code section 144.31 to extend the deadline 27 for fetal death certification from 24 hours to 72 hours, making 28 this requirement consistent with the time frames for other 29 death certifications. 30 The bill amends Code section 148.3 to allow the submission of 31 medical education documentation previously submitted to another 32 state’s licensing authority rather than having to provide the 33 actual diploma. 34 The bill repeals Code section 152B.13, establishing the 35 -6- LSB 5263DP (12) 83 jr/nh 6/ 7
S.F. _____ H.F. _____ board of respiratory care. Similar language exists in Code 1 chapter 147, which regulates health professions generally. 2 The bill amends Code sections 154.1 and 154.10, relating to 3 the practice of optometry, effective July 1, 2012. On that 4 July 1, 2012 date, the amendment requires optometrists to 5 meet board requirements to employ diagnostic and therapeutic 6 pharmaceutical agents. The bill eliminates the option of 7 preparation and certification at the diagnostic level only, and 8 requires every optometrist to demonstrate qualification and 9 certification to use both diagnostic and therapeutic agents as 10 a condition of license renewal. 11 The bill amends Code section 157.1 by adding the practice 12 of threading to the scope of practice of cosmetology and 13 esthetics. The bill also amends Code section 157.8, by 14 providing that a student instructor does not count toward 15 meeting the instructor-student ratio detailed in that Code 16 section. In addition, the bill strikes specific licensure 17 requirements and provides that licensure requirements for 18 instructors will be determined by rule. 19 Code section 158.4 allows the department to issue a 20 temporary barbering permit for persons who are demonstrating 21 barbering techniques. The bill empowers the department to 22 determine by rule the reasons for which a temporary permit may 23 be issued. 24 -7- LSB 5263DP (12) 83 jr/nh 7/ 7