House File 2420 - Introduced HOUSE FILE 2420 BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HSB 622) A BILL FOR An Act relating to department of public health programs and 1 activities, providing for a penalty, and including effective 2 and applicability date provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 6030HV (2) 84 ad/nh

H.F. 2420 DIVISION I 1 NURSING HOME ADMINISTRATORS 2 Section 1. Section 155.1, unnumbered paragraph 1, Code 3 2011, is amended to read as follows: 4 For the purposes of this chapter , and as used herein : 5 Sec. 2. Section 155.3, subsections 2 and 3, Code 2011, are 6 amended to read as follows: 7 2. The applicant has satisfactorily completed a course of 8 instruction and training prescribed by the board, which course 9 shall be so designed as to content and so administered as to 10 present sufficient knowledge of the needs properly to be served 11 by nursing homes; knowledge of the laws governing the operation 12 of nursing homes and the protection of the interests of 13 patients therein; and knowledge of the elements of good nursing 14 home administration; or has presented evidence satisfactory to 15 the board of sufficient education, training, or experience in 16 the foregoing fields to administer, supervise, and manage a 17 nursing home. 18 3. The applicant has passed an examination administered 19 prescribed by the board and designed to test for competence in 20 the subject matter referred to in subsection 2 of this section 21 pursuant to section 147.34 . 22 Sec. 3. Section 155.4, Code 2011, is amended to read as 23 follows: 24 155.4 Licensing function. 25 The board shall license nursing home administrators in 26 accordance with this chapter, chapter 147, and rules issued , 27 and from time to time revised, by it by the board . A nursing 28 home administrator’s license shall not be transferable and , 29 if not inactive, shall be valid until revoked pursuant to 30 section 147.55 or voluntarily surrendered for cancellation 31 or suspended or revoked for violation of this chapter or any 32 other laws or regulations relating to the proper administration 33 and management of a nursing home . Any denial of issuance or 34 renewal, suspension, or revocation under any section of this 35 -1- LSB 6030HV (2) 84 ad/nh 1/ 19

H.F. 2420 chapter shall be subject to judicial review in accordance with 1 the terms of the Iowa administrative procedure Act, chapter 2 17A . 3 Sec. 4. Section 155.5, Code 2011, is amended to read as 4 follows: 5 155.5 License fees. 6 Each person licensed as a nursing home administrator shall 7 be required to pay a license fee in an amount to be fixed by 8 the board. The license shall expire in multiyear intervals 9 determined by the board and be renewable and upon payment of 10 the license a renewal fee. A person who fails to renew a 11 license by the expiration date shall be allowed to do so within 12 thirty days following its expiration, but the board may assess 13 a reasonable penalty. 14 Sec. 5. Section 155.9, Code 2011, is amended to read as 15 follows: 16 155.9 Duties of the board. 17 The In addition to the duties and responsibilities provided 18 in chapters 147 and 272C, the board shall have the duty and 19 responsibility to: 20 1. Develop, impose, and enforce standards which must be 21 met by individuals in order to receive a license as a nursing 22 home administrator, which standards shall be designed to 23 insure that nursing home administrators will be individuals 24 who, by training or experience in the field of institutional 25 administration, are qualified to serve as nursing home 26 administrators. 27 2. Develop and apply appropriate techniques, including 28 examination and investigations, for determining whether an 29 individual meets such standards. The board may administer 30 as many examinations per year as are necessary, but shall 31 administer at least one examination per year. Any written 32 examination may be given by representatives of the board. 33 Applicants who fail the examination once shall be allowed to 34 take the examination at the next scheduled time. Thereafter, 35 -2- LSB 6030HV (2) 84 ad/nh 2/ 19

H.F. 2420 the applicant shall be allowed to take the examination at the 1 discretion of the board. An applicant who has failed the 2 examination may request in writing information from the board 3 concerning the applicant’s examination grade and subject areas 4 or questions which the applicant failed to answer correctly, 5 except that if the board administers a uniform, standardized 6 examination, the board shall only be required to provide the 7 examination grade and such other information concerning the 8 applicant’s examination results which are available to the 9 board. 10 3. Issue licenses to individuals who, after application 11 of such techniques, are found to have met such standards; and 12 for cause and after due notice and hearing, revoke or suspend 13 licenses previously issued by such board in any case where 14 the individual holding such license is found to have failed 15 substantially to conform to the requirements of such standards. 16 The board may also accept the voluntary surrender of such 17 license without necessity of a hearing. In adopt rules for 18 granting a provisional license to an administrator appointed 19 on a temporary basis by a nursing home’s owner or owners in the 20 event of the inability of the regular administrator of a the 21 nursing home is unable to perform the administrator’s duties 22 or through death or other cause the nursing home is without 23 a licensed administrator , a provisional administrator may be 24 appointed on a temporary basis by the nursing home owner or 25 owners to perform such duties for a period not to exceed one 26 year because of death or other cause. Such provisional license 27 shall allow the provisional licensee to perform the duties of 28 a nursing home administrator. An individual shall not hold a 29 provisional license for more than twelve total combined months, 30 and the board may revoke or otherwise discipline a provisional 31 licensee for cause after due notice and a hearing on a charge 32 or complaint filed with the board . 33 4. Establish and carry out procedures designed to insure 34 that individuals licensed as nursing home administrators will, 35 -3- LSB 6030HV (2) 84 ad/nh 3/ 19

H.F. 2420 during any period that they serve as such, comply with the 1 requirements of such standards. 2 5. Receive, investigate, and take appropriate action with 3 respect to any charge or complaint filed with the board to 4 the effect that any individual licensed as a nursing home 5 administrator has failed to comply with the requirements 6 of such standards. Such appropriate action may include 7 revocation of a license, if necessary, or placing the licensee 8 on probation for a period not exceeding six months, and shall 9 be taken only for cause after due notice and a hearing on the 10 charge or complaint. 11 6. Conduct a continuing study and investigation of nursing 12 homes, and administrators of nursing homes, in this state 13 with a view to the improvement of the standards imposed for 14 the licensing of such administrators and of procedures and 15 methods for the enforcement of such standards with respect to 16 administrators of nursing homes who have been licensed as such. 17 7. Conduct, or cause to be conducted, one or more courses of 18 instruction and training sufficient to meet the requirements 19 of this chapter , and make provisions for such courses and 20 their accessibility to residents of this state unless it finds 21 that there are, and approves, a sufficient number of courses, 22 which courses are conducted by others within this state. In 23 lieu thereof the board may approve courses conducted within 24 and without this state as sufficient to meet the education and 25 training requirements of this chapter . 26 Sec. 6. Section 155.10, Code 2011, is amended by striking 27 the section and inserting in lieu thereof the following: 28 155.10 Continuing education. 29 Each person licensed as a nursing home administrator shall 30 be required to complete continuing education as a condition of 31 license renewal. Such continuing education requirements shall 32 be determined by the board. 33 Sec. 7. Section 155.14, Code 2011, is amended to read as 34 follows: 35 -4- LSB 6030HV (2) 84 ad/nh 4/ 19

H.F. 2420 155.14 Applications. 1 Applications for licensure and for license renewal shall be 2 on forms in the format prescribed and furnished by the board 3 and shall not contain a recent photograph of the applicant . An 4 applicant shall not be ineligible for licensure because of age, 5 citizenship, sex, race, religion, marital status or national 6 origin although the application may require citizenship 7 information. The board may consider the past felony record of 8 an applicant only if the felony conviction relates directly 9 to the practice of nursing home administration. Character 10 references may be required, but shall not be obtained from 11 licensed nursing home administrators. 12 Sec. 8. NEW SECTION . 155.19 Voluntary surrender. 13 The board may accept the voluntary surrender of a license if 14 accompanied by a written statement of intention. The voluntary 15 surrender, when accepted, shall have the same force and effect 16 as an order of revocation. 17 Sec. 9. REPEAL. Sections 155.2, 155.15, and 155.16, Code 18 2011, are repealed. 19 DIVISION II 20 HEARING AID DISPENSERS 21 Sec. 10. Section 154A.7, Code 2011, is amended to read as 22 follows: 23 154A.7 Meetings and expenses Board meetings . 24 The members of the board shall receive actual expenses 25 incurred in the discharge of their duties within the limits of 26 funds appropriated to the board. Each member of the board may 27 also be eligible to receive compensation as provided in section 28 7E.6 . The board shall meet at least one time per year at the 29 seat of government and may hold additional meetings as deemed 30 necessary. Additional meetings shall be held at the call of 31 the chairperson or a majority of the members of the board. 32 At any meeting of the board, a majority of the members shall 33 constitute a quorum. 34 Sec. 11. Section 154A.10, Code 2011, is amended to read as 35 -5- LSB 6030HV (2) 84 ad/nh 5/ 19

H.F. 2420 follows: 1 154A.10 Issuance of licenses. 2 After January 1, 1975, an An applicant may obtain a license, 3 if the applicant: 4 1. Successfully passes the qualifying examination 5 prescribed in section 154A.12 . 6 2. Is free of contagious or infectious disease. 7 3. Pays the necessary fees set by the board pursuant to 8 section 154A.17 . 9 Sec. 12. Section 154A.12, subsection 1, paragraph a, Code 10 2011, is amended to read as follows: 11 a. Written tests Evidence of knowledge in areas such as 12 physics of sound, anatomy and physiology of hearing, and the 13 function of hearing aids, as these areas pertain to the fitting 14 or selection and sale of hearing aids. 15 Sec. 13. Section 154A.13, Code 2011, is amended to read as 16 follows: 17 154A.13 Temporary permit. 18 A person who has not been employed licensed as a hearing 19 aid dispenser prior to January 1, 1975, may obtain a temporary 20 permit from the department upon completion of the application 21 accompanied by the written verification of employment from a 22 licensed hearing aid dispenser. The department shall issue a 23 temporary permit for one year which shall not be renewed or 24 reissued. The fee for issuance of the temporary permit shall 25 be set by the board pursuant to section 154A.17 in accordance 26 with the provisions for establishment of fees in section 27 147.80 . The temporary permit entitles an applicant to engage 28 in the fitting or selection and sale of hearing aids under the 29 supervision of a person holding a valid license. 30 Sec. 14. Section 154A.23, Code 2011, is amended to read as 31 follows: 32 154A.23 Complaints Disciplinary orders —— attorney general . 33 Any person wishing to make a complaint against a licensee 34 or holder of a temporary permit shall file a written statement 35 -6- LSB 6030HV (2) 84 ad/nh 6/ 19

H.F. 2420 with the board within twelve months from the date of the action 1 upon which the complaint is based. If the board determines 2 that the complaint alleges facts which, if proven, would be 3 cause for the suspension or revocation of the license of the 4 licensee or the permit of the holder of a temporary permit, 5 it shall make an order fixing a time and place for a hearing 6 and requiring the licensee or holder of a temporary permit 7 complained against to appear and defend. The order shall 8 contain a copy of the complaint, and the order and copy of 9 the complaint shall be served upon the licensee or holder 10 of a temporary permit at least twenty days before the date 11 set for hearing, either personally or as provided in section 12 154A.21 . Continuance or adjournment of a hearing date may be 13 made for good cause. At the hearing the licensee or holder 14 of a temporary permit may be represented by counsel. The 15 licensee or holder of a temporary permit and the board may take 16 depositions in advance of hearing and after service of the 17 complaint, and either may compel the attendance of witnesses 18 by subpoenas issued by the board. The board shall issue such 19 subpoenas at the request of a licensee or holder of a temporary 20 permit. Either party taking depositions shall give at least 21 five days’ written notice to the other party of the time and 22 place of such depositions, and the other party may attend, with 23 counsel, if desired, and cross-examine. 24 If the board determines from the evidence and proofs 25 submitted that the licensee or holder of a temporary permit is 26 guilty of violating any of the provisions of this chapter , or 27 any of the regulations promulgated by the board pursuant to 28 this chapter , the department shall, within thirty days after 29 the hearing, issue an order refusing to issue or renew, or 30 revoking or suspending, as the case may be, the hearing aid 31 dispenser’s license or temporary permit. The order shall 32 include the findings of fact and the conclusions of law made by 33 the board and counsel. A copy of the order shall be sent to the 34 licensee or holder of a temporary permit by registered mail. 35 -7- LSB 6030HV (2) 84 ad/nh 7/ 19

H.F. 2420 The records of the department shall reflect the action taken 1 by the board on the charges, and the department shall preserve 2 a record of the proceedings in a manner similar to that used by 3 courts of record in this state. 4 The final order of the board in the proceedings may be 5 appealed to the district court of the county where the licensee 6 or holder of a temporary permit resides, or in which the 7 licensed hearing aid dispenser’s principal place of business 8 is located. 9 The department shall send a copy of the complaint and 10 a copy of the board’s final order to the attorney general 11 for purposes of information in the event the licensee or 12 holder of a temporary permit pursues a court appeal and for 13 consideration as to whether the violations are flagrant enough 14 to justify prosecution. The board shall forward a copy of 15 all final disciplinary orders, with associated complaints, 16 to the attorney general for consideration for prosecution or 17 enforcement when warranted. The attorney general and all 18 county attorneys shall assist the board and the department in 19 the enforcement of the provisions of this chapter . 20 Sec. 15. REPEAL. Sections 154A.2, 154A.3, 154A.4, 154A.5, 21 154A.6, 154A.8, 154A.9, 154A.11, 154A.14, 154A.15, 154A.17, and 22 154A.18, Code 2011, are repealed. 23 DIVISION III 24 LOCAL BOARDS OF HEALTH 25 Sec. 16. Section 135.1, subsection 6, Code 2011, is amended 26 by striking the subsection. 27 Sec. 17. Section 137.112, Code 2011, is amended by adding 28 the following new subsection: 29 NEW SUBSECTION . 4. This section does not apply to any 30 district board of health or district health department in 31 existence prior to July 1, 2010. 32 Sec. 18. Section 331.502, subsection 8, Code 2011, is 33 amended by striking the subsection. 34 Sec. 19. REPEAL. Section 135.32, Code 2011, is repealed. 35 -8- LSB 6030HV (2) 84 ad/nh 8/ 19

H.F. 2420 Sec. 20. EFFECTIVE UPON ENACTMENT. The following provision 1 or provisions of this division of this Act, being deemed of 2 immediate importance, take effect upon enactment: 3 1. The section of this Act amending section 137.112. 4 Sec. 21. RETROACTIVE APPLICABILITY. The following 5 provision or provisions of this division of this Act apply 6 retroactively to July 1, 2010: 7 1. The section of this Act amending section 137.112. 8 DIVISION IV 9 FEDERAL GRANTS REPORTING 10 Sec. 22. Section 135.11, Code Supplement 2011, is amended by 11 adding the following new subsection: 12 NEW SUBSECTION . 31. Report to the chairpersons and ranking 13 members of the joint appropriations subcommittee on health 14 and human services, the legislative services agency, the 15 legislative caucus staffs, and the department of management 16 within sixty calendar days of applying for or renewing a 17 federal grant which requires a state match or maintenance of 18 effort and has a value of over one hundred thousand dollars. 19 The report shall list the federal funding source and address 20 the potential need for the commitment of state funding in order 21 to match or continue the funding provided by the federal grant 22 in the present or future. 23 DIVISION V 24 HIV CONFIDENTIALITY 25 Sec. 23. Section 141A.9, Code Supplement 2011, is amended by 26 adding the following new subsection: 27 NEW SUBSECTION . 8. Medical information secured pursuant 28 to subsection 1 may be shared with other state or federal 29 agencies, with employees or agents of the department, or with 30 local units of government that have a need for the information 31 in the performance of their duties related to HIV prevention, 32 disease surveillance, or care of persons with HIV, only as 33 necessary to administer the program for which the information 34 is collected or to administer a program within the other 35 -9- LSB 6030HV (2) 84 ad/nh 9/ 19

H.F. 2420 agency. Confidential information transferred to other persons 1 or entities under this subsection shall continue to maintain 2 its confidential status and shall not be rereleased by the 3 receiving person or entity. 4 DIVISION VI 5 REPEAL OF REPORTING REQUIREMENTS 6 Sec. 24. REPEAL. Section 135.165, Code 2011, is repealed. 7 DIVISION VII 8 RADIOLOGICAL HEALTH 9 Sec. 25. Section 136C.3, subsection 5, Code 2011, is amended 10 to read as follows: 11 5. Issue orders as necessary in connection with licensing 12 and registration of radiation machines and radioactive 13 materials and the operators or users thereof . 14 Sec. 26. Section 136C.8, Code 2011, is amended to read as 15 follows: 16 136C.8 Inspections. 17 The department shall may inspect all radiation machines and 18 radioactive materials located in this state, for the purpose of 19 detecting, abating, or eliminating excessive radiation exposure 20 hazards. The inspection shall include but shall not be limited 21 to an evaluation of the radiation machine or radioactive 22 material as well as the immediate environment to ensure that 23 in using the machines or materials all unnecessary hazards for 24 patients, personnel, and other persons who may be exposed to 25 radiation produced by the machine or materials are avoided. 26 The inspection shall also include an evaluation of electrical 27 hazards as well as the adequacy of mechanical supporting and 28 restraining devices. All defects and deficiencies noted by 29 the inspector shall be fully disclosed and discussed with the 30 responsible persons at the time of inspection. The department 31 shall establish rules prescribing operating procedures for 32 radiation machines and radioactive materials which ensure 33 minimum radiation exposure to patients, personnel, and other 34 persons in the immediate environment. 35 -10- LSB 6030HV (2) 84 ad/nh 10/ 19

H.F. 2420 Sec. 27. Section 136C.14, subsection 2, Code 2011, is 1 amended to read as follows: 2 2. A person, other than a licensed professional, who 3 operates a radiation machine or uses radioactive materials 4 for medical treatment or diagnostic purposes shall display 5 make available upon request the credentials which indicate 6 that person’s qualification to operate the machine or use the 7 materials in the immediate vicinity of the machine or where 8 the materials are stored . A person who owns or controls the 9 machine or materials is also responsible for the proper display 10 of credentials of those who operate the machine or use the 11 materials and shall not employ a person to operate the machine 12 or use the materials for medical treatment or diagnostic 13 purposes except as provided in this section . 14 Sec. 28. Section 136D.2, subsections 4 and 5, Code 2011, are 15 amended to read as follows: 16 4. “Tanning device” means any equipment that emits 17 electromagnetic radiation with wavelengths in the air between 18 200 and 400 nanometers and that is used for tanning of human 19 skin, such as sunlamps, tanning booths , or tanning beds. 20 The term also includes any accompanying equipment such as 21 protective eyewear, timers, and handrails. 22 5. “Tanning facility” means a place that provides access 23 to tanning devices for compensation location, place, area, 24 structure, or business, or a part thereof, which provides 25 access to a tanning device for compensation . “Tanning facility” 26 may include but is not limited to a tanning salon, health club, 27 apartment, and condominium. 28 Sec. 29. Section 136D.8, subsection 2, Code 2011, is amended 29 by striking the subsection. 30 Sec. 30. NEW SECTION . 136D.9 Penalties. 31 1. The department may impose a civil penalty not to exceed 32 one thousand dollars on a person who violates a provision 33 of this chapter, a rule adopted or order issued under this 34 chapter, or a term, condition, or limitation of a registration 35 -11- LSB 6030HV (2) 84 ad/nh 11/ 19

H.F. 2420 certificate issued pursuant to this chapter, or who commits 1 a violation for which a registration certificate may be 2 revoked under rules issued pursuant to this chapter. Each 3 day of continuing violation constitutes a separate offense 4 in computing the civil penalty. However, the maximum civil 5 penalty for a continuing violation shall not exceed five 6 thousand dollars. 7 2. The department shall notify a person of the intent to 8 impose a civil penalty against the person. The department 9 shall establish the notification process to include an 10 opportunity for the person to respond in writing, within a 11 reasonable time as the department shall establish by rule, 12 regarding reasons why the civil penalty should not be imposed. 13 3. The department may compromise, mitigate, or refund a 14 civil penalty imposed under this section. A person upon whom 15 a civil penalty is imposed may appeal the action pursuant to 16 chapter 17A. The department shall remit moneys collected from 17 civil penalties to the treasurer of the state who shall deposit 18 the moneys in the general fund of the state. 19 EXPLANATION 20 This bill relates to programs and activities under the 21 purview of the department of public health. 22 Division I relates to nursing home administrators. The bill 23 eliminates certain provisions in the Code chapter that are 24 duplicative or inconsistent with the provisions in Code chapter 25 147, relating to health-related professions generally. The 26 bill eliminates the requirement that an applicant for a nursing 27 home administrator license satisfactorily complete a course of 28 instruction and training that was designed and administered 29 to present sufficient knowledge of the needs properly to be 30 served by nursing homes, knowledge of the laws governing the 31 operation of nursing homes and the protection of the interests 32 of patients, and knowledge of the elements of good nursing home 33 administration. The bill amends Code section 155.3 to state 34 that the board of nursing home administrators prescribes the 35 -12- LSB 6030HV (2) 84 ad/nh 12/ 19

H.F. 2420 examination pursuant to Code section 147.34, which governs 1 the examinations required for licensure for health care 2 professions, rather than administering the exam that tests 3 for competence in the needs properly to be served by nursing 4 homes, laws governing the operation of nursing homes and the 5 protection of the interests of patients, and the elements of 6 good nursing home administration. 7 The bill adds that the board shall license nursing home 8 administrators in accordance with the rules as well as Code 9 chapters 147 and 155. The bill makes technical changes 10 regarding the terminology of a licensee’s voluntary or 11 involuntary loss of license and refers to Code section 147.55 12 for revocation of a nursing home administrator’s license while 13 eliminating language in Code section 155.4 subjecting any 14 denial of issuance or renewal, suspension, or revocation under 15 Code chapter 155 to the judicial review procedure under Code 16 chapter 17A. 17 The bill makes technical changes to the licensing fees 18 provision. The bill allows the board to determine the 19 multiyear interval in which a license shall expire and allows 20 for the license to be renewed upon payment of a renewal fee 21 rather than a license fee. 22 The bill provides that the board has the general duties 23 and responsibilities for health-related boards listed in Code 24 chapters 147 and 272C and strikes the board’s specific duties 25 relating to standards to be met by individuals in order to 26 receive licenses as nursing home administrators; techniques for 27 determining whether an individual meets the required standards; 28 the issuance of and disciplinary actions relating to licenses; 29 and complaints against nursing home administrators. The bill 30 removes language allowing the board to conduct a continuing 31 study and investigation of nursing homes and administrators in 32 the state to improve the standards. The bill strikes language 33 allowing the board to conduct or cause to be conducted courses 34 of instruction and training sufficient to meet the requirements 35 -13- LSB 6030HV (2) 84 ad/nh 13/ 19

H.F. 2420 of Code chapter 155. 1 The bill retains language in Code section 155.9 that allows 2 the board to establish rules to grant a provisional license to 3 an administrator, but makes technical changes. The bill allows 4 the board to grant a provisional license to an administrator 5 appointed on a temporary basis by a nursing home’s owner 6 if the regular administrator is unable to perform the 7 administrator’s duties or the nursing home is otherwise without 8 an administrator for some other reason. The bill strikes a 9 provision which states that an administrator appointed on a 10 temporary basis could not perform the duties for a period which 11 exceeds one year. The bill provides that a provisional license 12 can be held for no more than 12 combined months and the board 13 may revoke or otherwise discipline a person with a provisional 14 license for cause after due notice and a hearing. 15 The bill strikes the language in Code section 155.10 16 regarding renewal of licenses. Under the bill, Code chapter 17 272C would control the renewal of licenses. The bill provides 18 that a licensed nursing home administrator must complete 19 continuing education as a condition precedent for a license 20 renewal. The bill states the board will determine the 21 continuing education requirements. 22 The bill provides that applications for license renewal 23 shall be prescribed by the board. Under the amended language 24 of Code section 155.14, the bill states the board is not 25 required to furnish forms for licensure or license renewal. 26 The bill strikes the language regarding the characteristics the 27 board may consider when receiving an applicant’s application. 28 Under the bill the characteristics to consider for eligibility 29 would be controlled by Code section 147.3. 30 The bill also adds a section to Code chapter 155 regarding a 31 licensee’s voluntary surrender of a license. The bill states 32 the board may accept a voluntary surrender if it is accompanied 33 by a written statement of intention. The voluntary surrender 34 will have the same force and effect as revocation after the 35 -14- LSB 6030HV (2) 84 ad/nh 14/ 19

H.F. 2420 surrender is accepted. 1 The bill repeals the language regarding the composition 2 of the board of nursing home administrators. The board’s 3 composition is governed by Code sections 147.12 through 147.20 4 and 147.82. The bill repeals the language in section 155.15 5 regarding the fees for examination, licensure, and renewal of 6 licensure. The language in Code section 147.80 would control. 7 The bill also repeals language in Code section 155.16 regarding 8 the public members of the board, making the language in Code 9 section 147.21 applicable. 10 Division II relates to hearing aid dispensers. The bill 11 eliminates certain provisions within Code chapter 154A as Code 12 chapter 147 regarding health-related professions now governs 13 the board of hearing aid dispensers in its provisions. 14 The bill eliminates language in Code section 154A.7 15 regarding board members’ expenses for discharging duties and 16 members’ eligibility to receive compensation provided in Code 17 section 7E.6. The bill also eliminates language in Code 18 section 154A.7 regarding a quorum. The language on board 19 members’ expenses and compensation is provided in Code section 20 147.24 and the language on a board quorum is provided by Code 21 section 147.14(2). 22 The bill eliminates language regarding the date on which an 23 applicant may obtain a license and deletes the reference to the 24 fee provision in Code section 154A.17. 25 The bill amends Code section 154A.12 regarding the scope of 26 examination to require evidence, rather than a written test, of 27 the applicant’s knowledge in areas such as physics of sound, 28 anatomy and physiology of hearing, and function of hearing 29 aids. 30 The bill amends Code section 154A.13 regarding temporary 31 permits and states that only an individual who has not been 32 licensed as a hearing aid dispenser, rather than a person who 33 has not been employed as a hearing aid dispenser, may obtain 34 a temporary permit. The bill also states that a fee for a 35 -15- LSB 6030HV (2) 84 ad/nh 15/ 19

H.F. 2420 temporary permit will be set by the board pursuant to Code 1 section 147.80 rather than Code section 154A.17, which is 2 repealed under the bill. 3 The bill removes language from Code chapter 154A regarding 4 the process for filing a complaint against a licensee or holder 5 of a temporary permit, the hearing process, the required 6 elements of a board’s order, the notice of the order, and the 7 right to appeal the board’s final order. Under the bill, 8 complaints would be governed by Code chapters 17A, 147, and 9 272C. The bill amends Code section 154A.23 to allow the board 10 to forward a copy of final disciplinary orders along with 11 the complaint to the attorney general for consideration for 12 prosecution or enforcement when warranted. 13 The bill repeals Code section 154A.2 regarding the 14 establishment of the board; Code section 154A.3 regarding 15 terms of board members; Code section 154A.4 regarding duties 16 of the board; Code section 154A.5 regarding public members 17 of the board; Code section 154A.6, regarding disclosure of 18 confidential information (the governing provision in Code 19 section 147.21(2) does not contain a provision which prohibits 20 the disclosure of an applicant’s criminal history); Code 21 section 154A.8 regarding duties of the board; Code section 22 154A.9 regarding applications for licensure; Code section 23 154A.11 regarding examinations (however, the governing 24 provision in Code section 147.34 does not require examinations 25 to occur at least once a year and does not require the identity 26 of the applicant to be concealed until after the grading 27 of the exam); Code section 154A.14 concerning reciprocity; 28 Code section 154A.15 concerning license renewal (however, 29 Code section 147.10 does not require the department to mail 30 notice of the expiration date of a license at least a month 31 in advance); and Code section 154A.17 regarding fees. Code 32 section 154A.18, regarding the display of the license is 33 also repealed, however, Code sections 147.6 and 147.7 do not 34 prohibit a person from engaging in business as a hearing aid 35 -16- LSB 6030HV (2) 84 ad/nh 16/ 19

H.F. 2420 dispenser or displaying a sign or advertising to be a hearing 1 aid dispenser without a valid license nor do the Code sections 2 require the license to be conspicuously posted in the person’s 3 primary location of practice. The Code sections instead state 4 that a license is presumptive evidence of the right to practice 5 and a board may require every person licensed by the board to 6 publicly display the license and evidence of current renewal. 7 Division III relates to local boards of health. The bill 8 strikes the definition of “sanitation officer”. The bill 9 states that the district public health fund budget provisions 10 do not apply to a district board of health or district health 11 department in existence prior to July 1, 2010. The bill 12 repeals the department’s duty to publish and distribute 13 its rules to the counties. The bill provides an immediate 14 effective date and retroactive date for the application of 15 the provisions of the health fund budget only to the district 16 boards of health or district health departments in existence 17 prior to July 1, 2010. 18 Division IV relates to reporting on federal grants. The 19 bill requires the department of public health to report to 20 chairpersons and ranking members of the joint appropriations 21 subcommittee on health and human services, the legislative 22 services agency, the legislative caucus staffs, and the 23 department of management within 60 days of applying for or 24 renewing a federal grant valued at over $100,000, if the grant 25 requires a state match or maintenance of effort. The report 26 must list the federal funding source and address the need 27 for the commitment of state funding to match or continue the 28 funding provided by the federal grant. 29 Division V relates to HIV confidentiality. The bill adds a 30 new provision allowing medical information secured pursuant to 31 Code section 141A.9 to be shared with other state or federal 32 agencies, employees or agents of the department, or with local 33 units of government. The information may be shared when 34 the persons or entities have a need for the information in 35 -17- LSB 6030HV (2) 84 ad/nh 17/ 19

H.F. 2420 the performance of their duties related to HIV prevention, 1 disease surveillance, or care of persons with HIV and only as 2 necessary to administer the program for which the information 3 is collected or to administer a program within the other 4 agency. The confidential information transferred maintains its 5 confidential status and the receiving entity may not rerelease 6 the information. 7 Division VI relates to reporting requirements for hospitals 8 and nursing facilities. The bill repeals Code section 9 135.165, which requires hospitals and nursing facilities that 10 are recognized by the Internal Revenue Code as a nonprofit 11 organization or entity to annually submit a copy of the 12 internal revenue service form 990 to the department of public 13 health and the legislative services agency. 14 Division VII relates to radiological health. 15 The bill allows the department to regulate the operators of 16 radiation machines and users of radioactive material. The bill 17 makes the department’s inspection of all radiation machines 18 and radioactive materials in the state permissive rather than 19 mandatory. The bill provides the department is no longer 20 required to evaluate the radiation machine or radioactive 21 material, the electrical hazards, or the adequacy of mechanical 22 supporting and restraining devices. 23 The bill amends Code section 136C.14 to state that a person 24 other than a licensed professional who operates a radiation 25 machine or uses radioactive materials for medical treatment 26 or diagnostic purposes does not need to display his or her 27 credentials, but the person must provide credentials upon 28 request. The bill also provides that a person who owns or 29 controls the machine is no longer responsible for the proper 30 display of such credentials. 31 The bill amends the definitions for “tanning device” and 32 “tanning facility”. The bill eliminates language stating that 33 “tanning device” includes accompanying equipment. The bill 34 eliminates the current definition for a tanning facility and 35 -18- LSB 6030HV (2) 84 ad/nh 18/ 19