H.F. _____ Section 1. Section 147.1, subsections 3 and 6, Code 2011, 1 are amended to read as follows: 2 3. “Licensed” or “certified” , when applied to a physician 3 and surgeon, podiatric physician, osteopathic physician and 4 surgeon, physician assistant, psychologist, chiropractor, 5 nurse, dentist, dental hygienist, dental assistant, 6 optometrist, speech pathologist, audiologist, pharmacist, 7 physical therapist, physical therapist assistant, occupational 8 therapist, occupational therapy assistant, respiratory care 9 practitioner, practitioner of cosmetology arts and sciences, 10 practitioner of barbering, funeral director, dietitian, marital 11 and family therapist, mental health counselor, polysomnographic 12 technologist, social worker, massage therapist, athletic 13 trainer, acupuncturist, nursing home administrator, hearing aid 14 dispenser, or sign language interpreter or transliterator means 15 a person licensed under this subtitle. 16 6. “Profession” means medicine and surgery, podiatry, 17 osteopathic medicine and surgery, practice as a physician 18 assistant, psychology, chiropractic, nursing, dentistry, 19 dental hygiene, dental assisting, optometry, speech pathology, 20 audiology, pharmacy, physical therapy, physical therapist 21 assisting, occupational therapy, occupational therapy 22 assisting, respiratory care, cosmetology arts and sciences, 23 barbering, mortuary science, marital and family therapy, mental 24 health counseling, polysomnography, social work, dietetics, 25 massage therapy, athletic training, acupuncture, nursing home 26 administration, hearing aid dispensing, or sign language 27 interpreting or transliterating. 28 Sec. 2. Section 147.2, subsection 1, Code 2011, is amended 29 to read as follows: 30 1. A person shall not engage in the practice of medicine 31 and surgery, podiatry, osteopathic medicine and surgery, 32 psychology, chiropractic, physical therapy, physical therapist 33 assisting, nursing, dentistry, dental hygiene, dental 34 assisting, optometry, speech pathology, audiology, occupational 35 -1- LSB 5551HC (2) 84 jr/nh 1/ 12

H.F. _____ therapy, occupational therapy assisting, respiratory care, 1 pharmacy, cosmetology arts and sciences, barbering, social 2 work, dietetics, marital and family therapy or mental health 3 counseling, massage therapy, mortuary science, polysomnography, 4 athletic training, acupuncture, nursing home administration, 5 hearing aid dispensing, or sign language interpreting 6 or transliterating, or shall not practice as a physician 7 assistant, unless the person has obtained a license for that 8 purpose from the board for the profession. 9 Sec. 3. Section 147.13, subsection 3, Code 2011, is amended 10 to read as follows: 11 3. For psychology and polysomnographic technology , the 12 board of psychology. 13 Sec. 4. Section 147.14, subsection 1, paragraph g, Code 14 2011, is amended to read as follows: 15 g. For psychology, five members who are licensed to 16 practice psychology , two members who are licensed to practice 17 polysomnographic technology, and two members not licensed to 18 practice psychology and who shall represent the general public. 19 Of the five members who are licensed to practice psychology, 20 one member shall be primarily engaged in graduate teaching in 21 psychology or primarily engaged in research psychology, three 22 two members shall be persons who render services in psychology, 23 and one member shall represent areas of applied psychology and 24 may be affiliated with training institutions and shall devote 25 a major part of the member’s time to rendering service in 26 psychology. 27 Sec. 5. Section 147.74, Code 2011, is amended by adding the 28 following new subsection: 29 NEW SUBSECTION . 22A. A person who is licensed to engage 30 in the practice of polysomnography shall have the right to use 31 the title “polysomnographic technologist” or the abbreviation 32 “PSGT”. 33 Sec. 6. NEW SECTION . 148F.1 Definitions. 34 As used in this chapter, unless the context otherwise 35 -2- LSB 5551HC (2) 84 jr/nh 2/ 12

H.F. _____ requires: 1 1. “Board” means the board of psychology established in 2 chapter 147. 3 2. “Direct supervision” means that the polysomnographic 4 technologist providing supervision must be present in the 5 area where the polysomnographic procedure is being performed 6 and immediately available to furnish assistance and direction 7 throughout the performance of the procedure. 8 3. “General supervision” means that the polysomnographic 9 procedure is provided under a physician’s overall direction and 10 control, but the physician’s presence is not required during 11 the performance of the procedure. 12 4. “Physician” means a person who is currently licensed in 13 Iowa to practice medicine and surgery or osteopathic medicine 14 and surgery. 15 5. “Polysomnographic student” means a person who is enrolled 16 in a commission on accreditation of allied health education 17 program or an equivalent program as determined by the board, 18 and who may provide sleep-related services under the direct 19 supervision of a polysomnographic technologist as a part of the 20 person’s educational program. 21 6. “Polysomnographic technician” means a person who has 22 graduated from a commission on accreditation of allied health 23 education program or an equivalent program as determined by the 24 board but has not yet passed an accepted national credentialing 25 examination given by an approved certifying agency, who has 26 obtained a temporary permit from the board, and who may provide 27 sleep-related services under the general supervision of a 28 licensed physician. 29 7. “Polysomnographic technologist” means a person who is 30 credentialed by an approved certifying agency and is licensed 31 by the board to engage in the practice of polysomnography under 32 the general supervision of a physician. 33 8. “Polysomnographic trainee” means a person who is enrolled 34 in an accredited sleep technologist educational program that is 35 -3- LSB 5551HC (2) 84 jr/nh 3/ 12

H.F. _____ accredited by the American academy of sleep medicine and who 1 may provide sleep-related services under the direct supervision 2 of a polysomnographic technologist as a part of the person’s 3 educational program. 4 9. “Practice of polysomnography” means as described in 5 section 148F.2. 6 10. “Sleep-related services” means acts performed by 7 polysomnographic technicians, polysomnographic trainees, 8 polysomnographic students, and other persons permitted to 9 perform those services under this chapter, in a setting 10 described in this chapter that would be considered the 11 practice of polysomnography if performed by a polysomnographic 12 technologist. 13 Sec. 7. NEW SECTION . 148F.2 Practice of polysomnography. 14 The practice of polysomnography consists of the following 15 tasks, under the general supervision of a licensed physician: 16 1. Monitoring, recording, and evaluating physiologic data 17 during the evaluation of sleep-related disorders, including 18 sleep-related respiratory disturbances, by applying any of the 19 following techniques, equipment, or procedures: 20 a. Noninvasive continuous, bilevel positive airway pressure, 21 or adaptive servo-ventilation titration on spontaneously 22 breathing patients using a mask or oral appliance; provided, 23 that the mask or oral appliance does not extend into the 24 trachea or attach to an artificial airway. 25 b. Supplemental low-flow oxygen therapy of less than six 26 liters per minute, utilizing a nasal cannula or incorporated 27 into a positive airway pressure device during a polysomnogram. 28 c. Capnography during a polysomnogram. 29 d. Cardiopulmonary resuscitation. 30 e. Pulse oximetry. 31 f. Gastroesophageal pH monitoring. 32 g. Esophageal pressure monitoring. 33 h. Sleep stage recording using surface 34 electroencephalography, surface electrooculography, and surface 35 -4- LSB 5551HC (2) 84 jr/nh 4/ 12

H.F. _____ submental electromyography. 1 i. Surface electromyography. 2 j. Electrocardiography. 3 k. Respiratory effort monitoring, including thoracic and 4 abdominal movement. 5 l. Plethysmography blood flow monitoring. 6 m. Snore monitoring. 7 n. Audio and video monitoring. 8 o. Body movement monitoring. 9 p. Nocturnal penile tumescence monitoring. 10 q. Nasal and oral airflow monitoring. 11 r. Body temperature monitoring. 12 2. Monitoring the effects that a mask or oral appliance 13 used to treat sleep disorders has on sleep patterns; provided, 14 however, that the mask or oral appliance shall not extend into 15 the trachea or attach to an artificial airway. 16 3. Observing and monitoring physical signs and symptoms, 17 general behavior, and general physical response to 18 polysomnographic evaluation and determining whether initiation, 19 modification, or discontinuation of a treatment regimen is 20 warranted. 21 4. Analyzing and scoring data collected during the 22 monitoring described in this section for the purpose of 23 assisting a physician in the diagnosis and treatment of sleep 24 and wake disorders that result from developmental defects, 25 the aging process, physical injury, disease, or actual or 26 anticipated somatic dysfunction. 27 5. Implementation of a written or verbal order from a 28 licensed physician to perform polysomnography. 29 6. Education of a patient regarding the treatment regimen 30 that assists the patient in improving the patient’s sleep. 31 7. Use of any oral appliance used to treat sleep-disordered 32 breathing while under the care of a licensed polysomnographic 33 technologist during the performance of a sleep study, as 34 directed by a licensed dentist. 35 -5- LSB 5551HC (2) 84 jr/nh 5/ 12

H.F. _____ Sec. 8. NEW SECTION . 148F.3 Location of services. 1 The practice of polysomnography shall take place only in a 2 hospital, a stand-alone sleep laboratory or sleep center, or 3 in the patient’s residence in accordance with a physician’s 4 order; provided, however, that the scoring of data and the 5 education of patients may take place in settings other than in 6 a hospital, sleep laboratory, sleep center, or the patient’s 7 residence. 8 Sec. 9. NEW SECTION . 148F.4 Scope of chapter. 9 Nothing in this chapter shall be construed to limit or 10 restrict a health care practitioner licensed in this state from 11 engaging in the full scope of practice of the individual’s 12 profession. 13 Sec. 10. NEW SECTION . 148F.7 Powers of the board. 14 The board may do any of the following: 15 1. Promulgate rules necessary for the implementation and 16 administration of this chapter and the applicable provisions 17 of chapter 147. 18 2. Establish fees as provided in section 147.80. 19 3. Review and approve or reject the application of each 20 person who applies for licensure as a polysomnographic 21 technologist. 22 4. Issue all temporary permits and all approved licenses and 23 renewals of licenses. 24 5. Deny, suspend, revoke, restrict, or impose conditions 25 on a license, as the board deems necessary or appropriate at 26 the time a license is issued, renewed, or reinstated, or as a 27 sanction imposed at the conclusion of a disciplinary hearing. 28 6. Issue private advisory letter rulings to any person 29 licensed under this chapter who makes a request for a ruling 30 regarding any matter within the board’s jurisdiction; provided, 31 however, that the ruling shall affect only the licensee making 32 the inquiry and shall have no precedential value for any other 33 contested case or inquiry before the board or the committee. 34 7. Develop a code of ethics for the practice of 35 -6- LSB 5551HC (2) 84 jr/nh 6/ 12

H.F. _____ polysomnography. 1 8. Develop standards of care for the practice of 2 polysomnography. 3 9. Develop standards for the educational and clinical 4 training of polysomnographic technologists, including the 5 evaluation of the accreditation status of educational programs 6 in polysomnography. 7 10. Develop criteria for the evaluation of applications for 8 licensure submitted by polysomnographic technologists who are 9 licensed in other states. 10 11. Develop continuing education requirements for licensed 11 polysomnographic technologists. 12 Sec. 11. NEW SECTION . 148F.8 Licensing requirement. 13 1. a. Commencing January 1, 2013, a person who is engaged 14 in the practice of polysomnography shall be licensed as 15 provided in this chapter and it shall be unlawful for any 16 person to engage in the practice of polysomnography without 17 such license. 18 b. (1) Prior to January 1, 2013, a person who is engaged in 19 the practice of polysomnography without being licensed under 20 this chapter shall not be deemed to be in violation of this 21 chapter. 22 (2) A person who is engaged in the practice of 23 polysomnography on January 1, 2013, shall be eligible for 24 licensure under this chapter without meeting the educational 25 requirements of this section provided that the person meets the 26 requirements of subsection 2, paragraphs “b” , “c” , and “d” . 27 2. A person seeking licensure as a polysomnographic 28 technologist shall be of good moral character, shall be at 29 least eighteen years of age, shall pay the fees established 30 by the board for licensure, and shall present proof that the 31 person meets all of the following requirements: 32 a. Meet one of the following educational requirements: 33 (1) Graduation from a polysomnographic educational program 34 that is accredited by the committee on accreditation of 35 -7- LSB 5551HC (2) 84 jr/nh 7/ 12

H.F. _____ polysomnographic technologist education or by a committee 1 on accreditation for the commission on accreditation of 2 allied health education programs, or an equivalent program as 3 determined by the board. 4 (2) Graduation from a respiratory care educational 5 program that is accredited by the committee on accreditation 6 for respiratory care or by a committee on accreditation 7 for the commission on accreditation of allied health 8 education programs, and completion of the curriculum for a 9 polysomnographic certificate established and accredited by the 10 commission on accreditation of allied health education programs 11 as an extension of the respiratory care program. 12 (3) Graduation from an electroneurodiagnostic technologist 13 educational program that is accredited by the committee 14 on accreditation for education in electroneurodiagnostic 15 technology or by a committee on accreditation for the 16 commission on accreditation of allied health education 17 programs, and completion of the curriculum for a 18 polysomnography certificate established and accredited by the 19 commission on accreditation of allied health education programs 20 as an extension of the electroneurodiagnostic education 21 program. 22 (4) Successful completion of an accredited sleep 23 technologist educational program that is accredited by the 24 American academy of sleep medicine. 25 b. Pass the national certifying examination given by 26 the board of registered polysomnographic technologists or a 27 nationally recognized accredited certifying agency. 28 c. Be credentialed by the board of registered 29 polysomnographic technologists or a nationally recognized 30 accredited certifying agency. 31 d. Meet any additional educational or clinical requirements 32 established by the board, as recommended by the committee. 33 3. To be eligible for renewal of a license to engage in the 34 practice of polysomnography, a polysomnographic technologist 35 -8- LSB 5551HC (2) 84 jr/nh 8/ 12

H.F. _____ shall maintain that person’s credential in compliance with 1 rules set forth by a national accredited certifying agency, as 2 adopted by the board in rule. 3 Sec. 12. NEW SECTION . 148F.9 Persons exempt from licensing 4 requirement —— temporary permit. 5 1. The following persons may provide sleep-related services 6 without being licensed as a polysomnographic technologist under 7 this chapter: 8 a. A polysomnographic technician may provide sleep-related 9 services under the general supervision of a physician for 10 a period of up to six months from the date of the person’s 11 graduation from one of the accredited programs described in 12 section 148F.8. The board may in its sole discretion grant a 13 one-time extension of up to three months beyond this one-year 14 period. 15 b. A polysomnographic trainee may provide sleep-related 16 services under the direct supervision of a polysomnographic 17 technologist as a part of the person’s educational program 18 while actively enrolled in an accredited sleep technologist 19 educational program. 20 c. A polysomnographic student may provide sleep-related 21 services under the direct supervision of a polysomnographic 22 technologist as a part of the person’s educational program 23 while actively enrolled in a polysomnographic educational 24 program that is accredited by the commission on accreditation 25 of allied health education programs or an equivalent program as 26 determined by the board. 27 d. A person, other than a respiratory care practitioner 28 licensed under this chapter, credentialed in one of the 29 health-related fields accepted by the board of registered 30 polysomnographic technologists or another nationally recognized 31 certifying agency, may provide sleep-related services under 32 the direct supervision of a polysomnographic technologist 33 for a period of up to one year while obtaining the clinical 34 experience necessary to be eligible to take the examination. 35 -9- LSB 5551HC (2) 84 jr/nh 9/ 12

H.F. _____ 2. Before providing any sleep-related services, a 1 polysomnographic technician shall obtain a temporary permit 2 from the board. While providing sleep-related services, the 3 technician shall wear a badge that appropriately identifies the 4 person as a polysomnographic technician. 5 3. Before providing any sleep-related services, a 6 polysomnographic trainee shall give notice to the board that 7 the trainee is enrolled in an approved educational program. 8 Trainees shall wear a badge that appropriately identifies the 9 trainee as a polysomnographic trainee while providing such 10 services. 11 4. Before providing any sleep-related services, a person 12 who is obtaining clinical experience shall give notice to the 13 board that the person is working under the direct supervision 14 of a polysomnographic technologist in order to gain the 15 experience to be eligible to sit for a national certification 16 examination. The person shall wear a badge that appropriately 17 identifies the person while providing such services. 18 5. Polysomnographic students shall not receive compensation 19 for the sleep-related services they provide and shall wear 20 badges that appropriately identify them as students. 21 Sec. 13. NEW SECTION . 148F.10 Issuance, retirement, and 22 renewal of licenses. 23 1. The board shall issue and renew licenses under this 24 chapter as provided by the board in rule. 25 2. A person who has been issued a license to practice under 26 this chapter who wishes to retire that license shall file with 27 the board an affidavit on a form to be furnished by the board 28 stating the date on which the person retired from practice 29 and other facts that verify the retirement as the board deems 30 necessary. Any such person who thereafter wishes to reenter 31 practice shall request reinstatement of licensure. 32 3. A license issued by the board under this chapter 33 shall contain the name and address of the person to whom it 34 is issued, the date and number of the license, and other 35 -10- LSB 5551HC (2) 84 jr/nh 10/ 12

H.F. _____ information that the board deems necessary. 1 a. The address contained on the license shall be the address 2 where all correspondence and renewal forms from the board shall 3 be sent. 4 b. Any person whose address changes shall, within thirty 5 days after the change in address, notify the board of the 6 address change. The most recent address contained in the 7 board’s records for each license holder shall be the address 8 deemed sufficient for purposes of service of process. 9 4. A license shall either be prominently displayed in the 10 office or place in which the person practices or be stored in a 11 place from which it can be immediately produced upon request of 12 a patient or representative of the board. 13 5. A person whose license has been lost may make application 14 to the board for a replacement. The application shall be 15 accompanied by an affidavit setting out the facts concerning 16 the loss of the original license. 17 Sec. 14. NEW SECTION . 148F.11 Licensing sanctions. 18 The board may impose sanctions for violations of this 19 chapter as provided in chapters 147 and 272C. 20 Sec. 15. INITIAL APPOINTMENTS. 21 1. Initial appointments of polysomnographic technologists 22 to the board of psychology pursuant to this Act shall be made 23 as follows: one member shall be appointed to a term of four 24 years and one member shall be appointed to a term of three 25 years. Each regular appointment thereafter shall be for a term 26 of four years. 27 2. The Iowa sleep society may submit a list of three 28 names to the governor for each position to be filled by a 29 polysomnographic technologist. 30 EXPLANATION 31 This bill requires the licensing of polysomnographic 32 technologists and makes the provisions of Code chapters 147 33 and 272C, including penalty and other regulatory provisions, 34 applicable to other health professions applicable to the 35 -11- LSB 5551HC (2) 84 jr/nh 11/ 12

H.F. _____ practice of polysomnography. Code section 147.86 provides 1 that it is a serious misdemeanor to violate a provision of the 2 licensing laws. The licensing program is administered and 3 regulated by the board of psychology. The membership of the 4 board of psychology is modified. The board currently has five 5 licensed psychologist members and two public members. The 6 bill provides for five psychologists, two polysomnographic 7 technologists, and two public members, for a total of nine 8 members. 9 A licensed polysomnographic technologist practices under 10 the general supervision of a licensed physician, providing 11 specifically enumerated services related to sleep disorders. 12 A polysomnographic student or trainee enrolled in an approved 13 educational program provides services under the direct 14 supervision of a polysomnographic technologist. 15 The bill sets out educational standards and testing 16 requirements, and provides for disciplinary actions. 17 -12- LSB 5551HC (2) 84 jr/nh 12/ 12