HOUSE FILE _____

BY  (PROPOSED COMMITTEE ON STATE GOVERNMENT BILL BY CHAIRPERSON COWNIE)

A BILL FOR

An Act relating to direct care professionals including the establishment of a board of direct care professionals, providing for implementation, making penalties applicable, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  152F.1  Definitions.
   As used in this chapter, unless the context otherwise requires:
   1.  “Board” means the board of direct care professionals created under chapter 147.
   2.  “Community living professional” means a direct care associate who has completed advanced training and is certified to provide home and community living, instrumental activities of daily living, and personal support services.
   3.  “Direct care associate” means a direct care provider who has completed core training and is certified to provide direct care services in the state.
   4.  “Direct care instructor” means an individual approved by the board to provide direct care instruction to direct care providers and direct care professionals.
   5.  “Direct care professional” means a direct care associate, a community living professional, a health support professional, a personal support professional, or a direct care associate who has received a specialty endorsement.
   6.  “Direct care provider” means an individual who provides direct care services for compensation.
   7.  “Direct care services” means services provided to individuals who are ill or individuals with disabilities, including but not limited to home and community living services, instrumental activities of daily living services, personal activities of daily living services, personal support services, and health monitoring and maintenance services. 
   8.  “Direct care trainer” means a direct care instructor who is approved by the board to train instructors.
   9.  “Health monitoring and maintenance services” means medically-oriented services that assist an individual in maintaining the individual’s health including measuring intake and output; providing catheter and ostomy care; collecting specimens; checking vital signs, including temperature, pulse, respiration, and blood pressure; measuring height and weight; performing range of motion exercises; providing assistance with urinary care; and application of thrombo embolic deterrent hose or hot and cold packs.
   10.  “Health support professional” means a direct care associate who has completed advanced training and is certified to provide personal activities of daily living and health monitoring and maintenance services.
   11.  “Home and community living services” means services to enhance or maintain independence of individuals including such activities as helping individuals develop and meet personal goals, providing direct physical and emotional support and assistance for persons with disabilities, utilizing crisis intervention and positive behavior supports, and using and following individual support plans.
   12.  “Instrumental activities of daily living services” means services provided to assist individuals with daily living tasks to allow them to function independently in a home or community setting, including but not limited to assistance with managing money, transportation, light housekeeping, and shopping and cooking.
   13.  “Personal activities of daily living services” means services to assist individuals in meeting basic needs, including but not limited to bathing, back rubs, and skin care; grooming activities; assistance with dressing and undressing; assistance with eating and feeding; assistance with toileting; and assistance with mobility, including transfers, walking, and turning in bed.
   14.  “Personal support professional” means a direct care associate who has completed advanced training and is certified to provide instrumental activities of daily living, personal activities of daily living, and personal support services.
   15.  “Personal support services” means support services provided to an individual as the individual performs personal activities of daily living including but not limited to coaching and prompting, and teaching skills and behaviors.

   16.  “Specialty endorsement” means an advanced level of certification based on requirements developed by experts in a particular discipline or professional area and approved by the board.
    Sec. 2.  NEW SECTION.  152F.2  Certification required —— exceptions —— use of title.
   1.  Unless otherwise exempt under section 152F.4, beginning January 1, 2014, a direct care provider shall not provide direct care services in this state without being certified as a direct care associate. 
   2.  A direct care provider who is not certified pursuant to this chapter shall not use words or titles which imply or represent that the person is certified as a direct care professional under this chapter.
   3.  A direct care associate shall not act as or represent that the person is a direct care professional with advanced training certification or a specialty endorsement, unless the direct care associate is first certified at the appropriate level of certification under this chapter.
   4.  Notwithstanding any provision to the contrary, a person who completes advanced training or meets the requirements for a specialty endorsement is not required to be certified at that level if the person does not act as or represent that the person is certified at that level. Section 147.83 does not apply to a direct care associate who is not certified as a direct care professional with advanced training certification or a specialty endorsement if the direct care associate does not act as or represent that the person is certified at that level.
    Sec. 3.  NEW SECTION.  152F.3  Requirements to obtain certification —— renewal —— continuing education —— reciprocity.
   1.  An applicant for certification as a direct care associate shall present evidence satisfactory to the board that the applicant meets all of the following requirements:
   a.  The applicant has successfully completed the required education for the certification from a board-approved direct care instructor or direct care trainer.
   b.  The applicant has paid all fees required by the board.
   c.  The applicant certifies that the applicant will conduct all professional activities in accordance with standards for professional conduct established by the board.
   2.  An applicant for certification as a direct care professional with advanced training or a specialty endorsement shall present evidence satisfactory to the board that the applicant meets all of the following requirements:
   a.  The applicant has successfully completed the required education for the certification from a board-approved direct care instructor or direct care trainer.
   b.  The applicant has paid all fees required by the board.
   c.  The applicant has passed a state examination approved by the board.
   d.  The applicant certifies that the applicant will conduct all professional activities in accordance with standards for professional conduct established by the board.
   3.  A person shall renew the person’s certification biennially. Prior to such renewal, the person shall present evidence that the person has satisfied continuing education requirements and shall pay a renewal fee as determined by the board.
   4.  The board shall issue the appropriate certification to an applicant who demonstrates experience in direct care services in another state and meets the requirements established by the board for the specific certification.
    Sec. 4.  NEW SECTION.  152F.4  Scope of chapter.
   The provisions of this chapter do not apply to any of the following:
   1.  A person who is providing direct care services to a family member with or without compensation or through the medical assistance consumer choice option program.
   2.  A person otherwise licensed who is operating within the scope of that license and does not represent to the public that the person is a direct care professional.
    Sec. 5.  NEW SECTION.  152F.5  Duties of the board.
   The board shall do all of the following:
   1.  Adopt rules consistent with this chapter, chapter 147, and chapter 272C which are necessary for the performance of its duties.
   2.  Adopt rules to provide a transition process that allows direct care providers providing direct care services on or before July 1, 2014, to continue providing direct care services while completing certification under this chapter. A direct care provider subject to the transition process shall complete the requirements for direct care associate certification no later than June 30, 2015.
   3.  Establish standards and guidelines for certification reciprocity.
   4.  Establish standards and guidelines for direct care associates, including minimum curriculum requirements.
   5.  Prepare and conduct, or prescribe, an examination for applicants for certification.
   6.  Establish standards and guidelines for direct care instructors and direct care trainers, including minimum curriculum requirements and continuing education requirements.
   7.  Define educational activities which fulfill continuing education requirements for renewal of certification.
   8.  Establish guidelines for inactive certification status and inactive certification reentry.
    Sec. 6.  NEW SECTION.  152F.6  Certification suspension and revocation.
   A certification issued by the board under this chapter may be suspended or revoked, or renewal of certification may be denied by the board, for violation of any provision of this chapter, section 147.55 or 272C.10, or rules adopted by the board.
    Sec. 7.  Section 147.1, subsections 3 and 6, Code 2011, are amended to read as follows:
   3.  “Licensed” or “certified”, when applied to a physician and surgeon, podiatric physician, osteopathic physician and surgeon, physician assistant, psychologist, chiropractor, nurse, dentist, dental hygienist, dental assistant, optometrist, speech pathologist, audiologist, pharmacist, physical therapist, physical therapist assistant, occupational therapist, occupational therapy assistant, respiratory care practitioner, practitioner of cosmetology arts and sciences, practitioner of barbering, funeral director, dietitian, marital and family therapist, mental health counselor, social worker, massage therapist, athletic trainer, acupuncturist, nursing home administrator, hearing aid dispenser, or sign language interpreter or transliterator, or direct care professional means a person licensed under this subtitle.
   6.  “Profession” means medicine and surgery, podiatry, osteopathic medicine and surgery, practice as a physician assistant, psychology, chiropractic, nursing, dentistry, dental hygiene, dental assisting, optometry, speech pathology, audiology, pharmacy, physical therapy, physical therapist assisting, occupational therapy, occupational therapy assisting, respiratory care, cosmetology arts and sciences, barbering, mortuary science, marital and family therapy, mental health counseling, social work, dietetics, massage therapy, athletic training, acupuncture, nursing home administration, hearing aid dispensing, or sign language interpreting or transliterating, or practice as a direct care professional.
    Sec. 8.  Section 147.2, subsection 1, Code 2011, is amended to read as follows:
   1.  A person shall not engage in the practice of medicine and surgery, podiatry, osteopathic medicine and surgery, psychology, chiropractic, physical therapy, physical therapist assisting, nursing, dentistry, dental hygiene, dental assisting, optometry, speech pathology, audiology, occupational therapy, occupational therapy assisting, respiratory care, pharmacy, cosmetology arts and sciences, barbering, social work, dietetics, marital and family therapy or mental health counseling, massage therapy, mortuary science, athletic training, acupuncture, nursing home administration, hearing aid dispensing, or sign language interpreting or transliterating, or shall not practice as a physician assistant
 
or as a direct care professional, unless the person has obtained a license for that purpose from the board for the profession.
    Sec. 9.  Section 147.13, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  24.  For direct care professionals, the board of direct care professionals.
    Sec. 10.  Section 147.14, subsection 1, Code 2011, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  x.  For the board of direct care professionals, a total of nine members, five of whom are direct care professionals who represent diverse settings and populations served, two members of the public, one registered nurse who serves as a direct care instructor, and one human services professional who serves as a direct care instructor.
    Sec. 11.  Section 147.74, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  24.  A direct care professional certified under chapter 152F and this chapter may use the following:
   a.  A direct care professional certified as a direct care associate may use the title “direct care associate” or D.C.A. after the person’s name.
   b.  A direct care professional certified as a community living professional may use the title “community living professional” or the letters C.L.P. after the person’s name.
   c.  A direct care professional certified as a personal support professional may use the title “personal support professional” or the letters P.S.P. after the person’s name.
   d.  A direct care professional certified as a health support professional may use the title “health support professional” or the letters H.S.P. after the person’s name.

   e.  A direct care professional certified with a specialty endorsement may use the title or letters determined by the specialty endorsement entity and approved by the board of direct care professionals.
    Sec. 12.  Section 272C.1, subsection 6, Code 2011, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  ag.  The board of direct care professionals, created pursuant to chapter 147.
    Sec. 13.  TRANSITION PROVISIONS.
   1.  A direct care provider providing direct care services on or before January 1, 2014, may continue providing direct care services while completing certification as required under this Act. The board of direct care professionals shall adopt rules to provide a transition process that allows such direct care providers to complete the requirements for direct care associate certification no later than June 30, 2015.
   2.  Notwithstanding sections 147.14 and 147.16, for the initial board of direct care professionals, the governor may appoint, subject to confirmation by the senate, in lieu of the five members required to be direct care associates and the two members required to be direct care instructors, members with experience and expertise that is substantially equivalent to the professional requirements for a direct care associate or direct care instructor, as applicable.
    Sec. 14.  IMPLEMENTATION.  The provisions of this Act shall be implemented as follows:
   1.  The sections of this Act relating to the board of direct care professionals including sections 152F.1 and 152F.5, as enacted in this Act; sections 147.13, 147.14, and 272C.1, as amended in this Act, and as specified in the transition provisions; and the section of this Act providing transition provisions relating to the board shall be implemented so that a board of direct care professionals is appointed no later than December 15, 2012.
   2.  The sections of this Act relating to requirements for certification of direct care professionals including sections 152F.2, 152F.3, 152F.4, and 152F.6, as enacted in this Act; and sections 147.1, 147.2, and 147.74, as amended in this Act, shall be implemented so that the requirements are applicable beginning no later than January 1, 2014.
    Sec. 15.  EFFECTIVE UPON ENACTMENT.  This Act, being deemed of immediate importance, takes effect upon enactment.
EXPLANATION
   This bill provides for the certification of direct care professionals under new Code chapter 152F. The bill provides definitions relating to levels of certification and services provided, and defines the “board” as the board of direct care professionals.
   The bill requires individuals who provide direct care services for compensation (direct care providers) to be certified as direct care associates.
   The bill also provides for advanced training and specialty endorsements as the bases for higher levels of certification.
   The bill provides requirements for certification, renewal of certification, continuing education, and reciprocity of certification. The bill provides for exemptions from certification and for suspension or revocation of certification. The bill specifies the duties of the board of direct care professionals.
   The bill makes conforming changes in the Code under Code chapter 147 (general provisions for health-related professions), and Code chapter 272C (regulation of licensed professions and occupations).
   The bill provides transition provisions for the initial appointment of the board and for application of requirements to direct care providers providing direct care services prior to implementation of direct care professional requirements on January 1, 2014. The bill takes effect upon enactment, but provides for phased-in implementation.
   The provisions of Code chapters 147 and 272C, including a provision in Code section 147.86 that a violation of Code chapter 147 or 152F is a serious misdemeanor, are applicable to new Code chapter 152F.