HSB 571 (LSB 5263DP (12) 83)

SENATE/HOUSE FILE _____

BY  (PROPOSED DEPARTMENT OF PUBLIC HEALTH BILL)

A BILL FOR

An Act relating to various activities regulated and programs administered by the department of public health, including the Iowa collaborative safety net provider network, fetal death certification, and optometry, cosmetology, and barbering licensure, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 135.24, subsection 7, paragraph e, Code Supplement 2009, is amended to read as follows:
   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 as referred by the Iowa collaborative safety net provider network established in section 135.153 Iowa specialty care referral network, but does not include a field dental clinic, a free clinic, or a hospital.
    Sec. 2.  Section 144.31, Code 2009, is amended to read as follows:
   144.31  Medical certification —— fetal death.
   1.  The medical certification for a fetal death shall be completed within twenty-four seventy-two hours after delivery by the physician in attendance at or after delivery except when inquiry is required by the county medical examiner.
   2.  When a fetal death occurs without medical attendance upon the mother at or after delivery or when inquiry is required by the county medical examiner, the medical examiner shall investigate the cause of fetal death and shall complete the medical certification within twenty-four seventy-two hours after taking charge of the case. The person completing the medical certification of cause of fetal death shall attest to its accuracy either by signature or as authorized by rule.
    Sec. 3.  Section 148.3, subsection 1, paragraph a, unnumbered paragraph 1, Code Supplement 2009, is amended to read as follows:
   A Evidence of a diploma issued by a medical college or college of osteopathic medicine and surgery approved by the board, or other evidence of equivalent medical education approved by the board. The board may accept, in lieu of a diploma from a medical college approved by the board, all of the following:
    Sec. 4.  Section 154.1, Code 2009, is amended to read as follows:
   154.1  Board defined—— optometry —— diagnostically certified licensed optometrists —— therapeutically certified optometrists Definitions —— optometry.
   1.  As used in this chapter, “board”:
   a.  ”Board” means the board of optometry created under chapter 147.
   b.  “Licensed optometrist” means an optometrist who is licensed to practice optometry in this state pursuant to this chapter.
   2.  For the purpose of this subtitle, the following classes of persons shall be deemed to be engaged in the practice of optometry:
   a.  Persons employing any means other than the use of drugs, medicine, or surgery for the measurement of the visual power and visual efficiency of the human eye; persons engaged in the prescribing and adapting of lenses, prisms, and contact lenses; and persons engaged in the using or employing of visual training or ocular exercise for the aid, relief, or correction of vision.
   b.  Persons who allow the public to use any mechanical device for a purpose described in paragraph “a”.
   c.  Persons who publicly profess to be optometrists and to assume the duties incident to the profession.
   3.  Diagnostically certified licensed optometrists may employ cycloplegics, mydriatics, and topical anesthetics as diagnostic agents topically applied to determine the condition of the human eye for proper optometric practice or referral for treatment to a person licensed under chapter 148. A diagnostically certified licensed optometrist is an optometrist who is licensed to practice optometry in this state and who is certified by the board to use diagnostic agents.
   4.  Therapeutically certified optometrists may employ all diagnostic and therapeutic pharmaceutical agents for the purpose of diagnosis and treatment of conditions of the human eye and adnexa pursuant to this subsection, excluding the use of injections other than to counteract an anaphylactic reaction, and notwithstanding section 147.107, may without charge supply any of the above pharmaceuticals to commence a course of therapy. Therapeutically certified optometrists may prescribe oral steroids for a period not to exceed fourteen days without consultation with a physician. Therapeutically certified optometrists shall not prescribe oral Imuran or oral Methotrexate. Therapeutically certified optometrists may be authorized, where reasonable and appropriate, by rule of the board, to employ new diagnostic and therapeutic pharmaceutical agents approved by the United States food and drug administration on or after July 1, 2002, for the diagnosis and treatment of the human eye and adnexa. The board shall not be required to adopt rules relating to topical pharmaceutical agents, oral antimicrobial agents, oral antihistamines, oral antiglaucoma agents, and oral analgesic agents. Superficial foreign bodies may be removed from the human eye and adnexa. The therapeutic efforts of a therapeutically certified optometrist are intended for the purpose of examination, diagnosis, and treatment of visual defects, abnormal conditions, and diseases of the human eye and adnexa, for proper optometric practice or referral for consultation or treatment to persons licensed under chapter 148. A therapeutically certified optometrist is an optometrist who is licensed to practice optometry in this state and who is certified by the board to use the agents and procedures authorized pursuant to this subsection.
   3.  Beginning July 1, 2012, all licensed optometrists shall meet requirements as established by the board by rule to employ diagnostic and therapeutic pharmaceutical agents for the practice of optometry. All licensees practicing optometry in this state shall have demonstrated qualifications and have obtained certification to use diagnostic and therapeutic pharmaceutical agents as a condition of license renewal.
   4.  A licensed optometrist may do any of the following:
   a.  Employ cycloplegics, mydriatics, and topical anesthetics as diagnostic agents topically applied to determine the condition of the human eye for proper optometric practice or referral for treatment to a person licensed under chapter 148.
   b.  Employ therapeutic pharmaceutical agents for the purpose of diagnosis and treatment of conditions of the human eye and adnexa pursuant to this subsection, excluding the use of injections other than to counteract an anaphylactic reaction, and notwithstanding section 147.107, may without charge supply any of the pharmaceuticals described in paragraph “a” to commence a course of therapy.
   c.  Prescribe oral steroids for a period not to exceed fourteen days without consultation with a physician. However, a licensed optometrist shall not prescribe oral Imuran or oral Methotrexate. Licensed optometrists may be authorized, where reasonable and appropriate, by rule of the board, to employ new diagnostic and therapeutic pharmaceutical agents approved by the United States food and drug administration on or after July 1, 2002, for the diagnosis and treatment of the human eye and adnexa. The board is not required to adopt rules relating to topical pharmaceutical agents, oral antimicrobial agents, oral antihistamines, oral antiglaucoma agents, or oral analgesic agents.
   d.  Remove superficial foreign bodies from the human eye and adnexa.
   5.  The therapeutic efforts of a licensed optometrist are intended for the purpose of examination, diagnosis, and treatment of visual defects, abnormal conditions, and diseases of the human eye and adnexa, for proper optometric practice or referral for consultation or treatment to persons licensed under chapter 148.
    Sec. 5.  Section 154.10, Code 2009, is amended by striking the section and inserting in lieu thereof the following:
   154.10  Standard of care.

   Licensed optometrists employing diagnostic and therapeutic pharmaceutical agents as authorized by section 154.1 shall be held to the same standard of care in the use of such agents and in diagnosis and treatment as is common to persons licensed under chapter 148.
    Sec. 6.  Section 157.1, subsection 5, paragraph c, Code 2009, is amended to read as follows:
   c.  Removing superfluous hair from the face or body of a person with the use of depilatories, wax, sugars, threading, or tweezing.
    Sec. 7.  Section 157.1, subsection 12, paragraph c, Code 2009, is amended to read as follows:
   c.  Removing superfluous hair from the body of a person by the use of depilatories, waxing, sugaring, tweezers, threading, or use of any certified laser products or intense pulsed light devices. This excludes the practice of electrology, whereby hair is removed with an electric needle.
    Sec. 8.  Section 157.8, subsection 2, Code 2009, is amended to read as follows:
   2.  The number of instructors for each school shall be based upon total enrollment, with a minimum of two licensed instructors employed on a full-time basis for up to thirty students and an additional licensed instructor for each fifteen additional students.  A student instructor shall not be used to meet licensed instructor-to-student ratios. However, a A school operated by an area community college prior to September 1, 1982, with only one instructor per fifteen students is not subject to this paragraph and may continue to operate with the ratio of one licensed instructor to fifteen students.  A student instructor may not be used to meet this requirement.
   a.  A person employed as an instructor in the cosmetology arts and sciences by a licensed school shall be licensed in the practice and shall possess a separate instructor’s license which shall be renewed biennially. An instructor shall file an application with the department on forms prescribed by the board. Prior to licensure, an applicant for an instructor’s license shall have been actively engaged in the practice for a period of two years and complete a course of study required by the board or an instructor’s course at a school for cosmetology arts and sciences, and meet any other requirement established by the board.  Requirements for licensure as an instructor shall be determined by the board by rule.
   b.  The application for an instructor’s license shall be accompanied by the biennial fee determined pursuant to section 147.80.
    Sec. 9.  Section 158.4, subsection 2, Code 2009, is amended to read as follows:
   2.  The department may issue a temporary permit for the purpose of demonstrating barbering upon recommendation of the board which allows the applicant to practice barbering for purposes determined by rule. The board shall determine and state its recommendations and the length of time the temporary permit issued under this subsection is valid.
    Sec. 10.  REPEAL.  Section 152B.13, Code Supplement 2009, is repealed.
    Sec. 11.  EFFECTIVE DATE.  The sections of this Act amending sections 154.1 and 154.10 take effect July 1, 2012.
EXPLANATION
   This bill contains revisions to a variety of programs and licensing provisions administered by the department of public health. 
   The bill amends Code section 144.31 to extend the deadline for fetal death certification from 24 hours to 72 hours, making this requirement consistent with the time frames for other death certifications.
   The bill amends Code section 148.3 to allow the submission of medical education documentation previously submitted to another state’s licensing authority rather than having to provide the actual diploma.
   The bill repeals Code section 152B.13, establishing the board of respiratory care. Similar language exists in Code chapter 147, which regulates health professions generally.
   The bill amends Code sections 154.1 and 154.10, relating to the practice of optometry, effective July 1, 2012. On that July 1, 2012 date, the amendment requires optometrists to meet board requirements to employ diagnostic and therapeutic pharmaceutical agents. The bill eliminates the option of preparation and certification at the diagnostic level only, and requires every optometrist to demonstrate qualification and certification to use both diagnostic and therapeutic agents as a condition of license renewal.
   The bill amends Code section 157.1 by adding the practice of threading to the scope of practice of cosmetology and esthetics. The bill also amends Code section 157.8, by providing that a student instructor does not count toward meeting the instructor-student ratio detailed in that Code section. In addition, the bill strikes specific licensure requirements and provides that licensure requirements for instructors will be determined by rule. 
   Code section 158.4 allows the department to issue a temporary barbering permit for persons who are demonstrating barbering techniques. The bill empowers the department to determine by rule the reasons for which a temporary permit may be issued.