Senate
File
2234
-
Introduced
SENATE
FILE
2234
BY
COMMITTEE
ON
STATE
GOVERNMENT
(SUCCESSOR
TO
SSB
3057)
A
BILL
FOR
An
Act
providing
for
the
licensing
of
polysomnographic
1
technologists,
making
penalties
applicable,
and
including
2
effective
date
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
TLSB
5277SV
(3)
85
jr/nh
S.F.
2234
Section
1.
Section
135.24,
subsection
2,
paragraph
a,
Code
1
2014,
is
amended
to
read
as
follows:
2
a.
Procedures
for
registration
of
health
care
providers
3
deemed
qualified
by
the
board
of
medicine,
the
board
of
4
physician
assistants,
the
dental
board,
the
board
of
nursing,
5
the
board
of
chiropractic,
the
board
of
psychology,
the
board
6
of
social
work,
the
board
of
behavioral
science,
the
board
7
of
pharmacy,
the
board
of
optometry,
the
board
of
podiatry,
8
the
board
of
physical
and
occupational
therapy,
the
board
of
9
respiratory
care
and
polysomnography
,
and
the
Iowa
department
10
of
public
health,
as
applicable.
11
Sec.
2.
Section
147.1,
subsections
3
and
6,
Code
2014,
are
12
amended
to
read
as
follows:
13
3.
“Licensed”
or
“certified”
,
when
applied
to
a
physician
14
and
surgeon,
podiatric
physician,
osteopathic
physician
and
15
surgeon,
physician
assistant,
psychologist,
chiropractor,
16
nurse,
dentist,
dental
hygienist,
dental
assistant,
17
optometrist,
speech
pathologist,
audiologist,
pharmacist,
18
physical
therapist,
physical
therapist
assistant,
occupational
19
therapist,
occupational
therapy
assistant,
orthotist,
20
prosthetist,
pedorthist,
respiratory
care
practitioner,
21
practitioner
of
cosmetology
arts
and
sciences,
practitioner
22
of
barbering,
funeral
director,
dietitian,
marital
and
23
family
therapist,
mental
health
counselor,
polysomnographic
24
technologist,
social
worker,
massage
therapist,
athletic
25
trainer,
acupuncturist,
nursing
home
administrator,
hearing
aid
26
dispenser,
or
sign
language
interpreter
or
transliterator
means
27
a
person
licensed
under
this
subtitle
.
28
6.
“Profession”
means
medicine
and
surgery,
podiatry,
29
osteopathic
medicine
and
surgery,
practice
as
a
physician
30
assistant,
psychology,
chiropractic,
nursing,
dentistry,
31
dental
hygiene,
dental
assisting,
optometry,
speech
pathology,
32
audiology,
pharmacy,
physical
therapy,
physical
therapist
33
assisting,
occupational
therapy,
occupational
therapy
34
assisting,
respiratory
care,
cosmetology
arts
and
sciences,
35
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barbering,
mortuary
science,
marital
and
family
therapy,
mental
1
health
counseling,
polysomnography,
social
work,
dietetics,
2
massage
therapy,
athletic
training,
acupuncture,
nursing
3
home
administration,
hearing
aid
dispensing,
sign
language
4
interpreting
or
transliterating,
orthotics,
prosthetics,
or
5
pedorthics.
6
Sec.
3.
Section
147.2,
subsection
1,
Code
2014,
is
amended
7
to
read
as
follows:
8
1.
A
person
shall
not
engage
in
the
practice
of
medicine
9
and
surgery,
podiatry,
osteopathic
medicine
and
surgery,
10
psychology,
chiropractic,
physical
therapy,
physical
11
therapist
assisting,
nursing,
dentistry,
dental
hygiene,
12
dental
assisting,
optometry,
speech
pathology,
audiology,
13
occupational
therapy,
occupational
therapy
assisting,
14
orthotics,
prosthetics,
pedorthics,
respiratory
care,
15
pharmacy,
cosmetology
arts
and
sciences,
barbering,
social
16
work,
dietetics,
marital
and
family
therapy
or
mental
health
17
counseling,
massage
therapy,
mortuary
science,
polysomnography,
18
athletic
training,
acupuncture,
nursing
home
administration,
19
hearing
aid
dispensing,
or
sign
language
interpreting
20
or
transliterating,
or
shall
not
practice
as
a
physician
21
assistant,
unless
the
person
has
obtained
a
license
for
that
22
purpose
from
the
board
for
the
profession.
23
Sec.
4.
Section
147.13,
subsection
18,
Code
2014,
is
amended
24
to
read
as
follows:
25
18.
For
respiratory
care
and
polysomnography
,
the
board
of
26
respiratory
care
and
polysomnography
.
27
Sec.
5.
Section
147.14,
subsection
1,
paragraph
o,
Code
28
2014,
is
amended
to
read
as
follows:
29
o.
For
respiratory
care,
one
licensed
physician
with
30
training
in
respiratory
care,
three
two
respiratory
care
31
practitioners
who
have
practiced
respiratory
care
for
a
minimum
32
of
six
years
immediately
preceding
their
appointment
to
the
33
board
and
who
are
recommended
by
the
society
for
respiratory
34
care,
one
polysomnographic
technologist
who
has
practiced
35
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2234
polysomnography
for
a
minimum
of
six
years
immediately
1
preceding
appointment
to
the
board
and
who
is
recommended
by
2
the
Iowa
sleep
society
,
and
one
member
not
licensed
to
practice
3
medicine,
osteopathic
medicine,
polysomnography,
or
respiratory
4
care
who
shall
represent
the
general
public.
5
Sec.
6.
Section
147.74,
Code
2014,
is
amended
by
adding
the
6
following
new
subsection:
7
NEW
SUBSECTION
.
22A.
A
person
who
is
licensed
to
engage
in
8
the
practice
of
polysomnography
shall
have
the
right
to
use
the
9
title
“polysomnographic
technologist”
or
the
letters
“P.S.G.T.”
10
after
the
person’s
name.
No
other
person
may
use
that
title
11
or
letters
or
any
other
words
or
letters
indicating
that
the
12
person
is
a
polysomnographic
technologist.
13
Sec.
7.
NEW
SECTION
.
148G.1
Definitions.
14
As
used
in
this
chapter,
unless
the
context
otherwise
15
requires:
16
1.
“Board”
means
the
board
of
respiratory
care
and
17
polysomnography
established
in
chapter
147.
18
2.
“Direct
supervision”
means
that
the
polysomnographic
19
technologist
providing
supervision
must
be
present
where
the
20
polysomnographic
procedure
is
being
performed
and
immediately
21
available
to
furnish
assistance
and
direction
throughout
the
22
performance
of
the
procedure.
23
3.
“General
supervision”
means
that
the
polysomnographic
24
procedure
is
provided
under
a
physician’s
or
qualified
health
25
care
professional
prescriber’s
overall
direction
and
control,
26
but
the
physician’s
or
qualified
health
care
professional
27
prescriber’s
presence
is
not
required
during
the
performance
28
of
the
procedure.
29
4.
“Physician”
means
a
person
who
is
currently
licensed
in
30
Iowa
to
practice
medicine
and
surgery
or
osteopathic
medicine
31
and
surgery
and
who
is
board
certified
in
sleep
medicine
and
32
who
is
actively
involved
in
the
sleep
medicine
center
or
33
laboratory.
34
5.
“Polysomnographic
student”
means
a
person
who
is
enrolled
35
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2234
in
a
commission
on
accreditation
of
allied
health
education
1
program
or
an
equivalent
program
accredited
by
a
nationally
2
recognized
accrediting
agency
and
who
may
provide
sleep-related
3
services
under
the
direct
supervision
of
a
polysomnographic
4
technologist
as
a
part
of
the
person’s
educational
program.
5
6.
“Polysomnographic
technician”
means
a
person
who
6
has
graduated
from
a
commission
on
accreditation
of
allied
7
health
education
program
or
equivalent
program
accredited
8
by
a
nationally
recognized
accrediting
agency,
but
has
not
9
yet
received
an
accepted
national
credential
awarded
from
10
an
examination
program
that
is
accredited
by
a
nationally
11
recognized
examination
accrediting
organization
but
who
may
12
provide
sleep-related
services
under
the
direct
supervision
of
13
a
licensed
polysomnographic
technologist
for
a
period
of
up
to
14
thirty
days
following
graduation
while
awaiting
credentialing
15
examination
scheduling
and
results.
16
7.
“Polysomnographic
technologist”
means
a
person
licensed
17
by
the
board
to
engage
in
the
practice
of
polysomnography
under
18
the
general
supervision
of
a
physician
or
a
qualified
health
19
care
professional
prescriber.
20
8.
“Practice
of
polysomnography”
means
as
described
in
21
section
148G.2.
22
9.
“Qualified
health
care
practitioner”
means
an
individual
23
who
is
licensed
under
section
147.2,
and
who
holds
a
24
credential
listed
on
the
board
of
registered
polysomnographic
25
technologists
list
of
accepted
allied
health
credentials.
26
10.
“Qualified
health
care
professional
prescriber”
means
a
27
physician
assistant
operating
under
the
prescribing
authority
28
granted
in
section
147.107
or
an
advanced
registered
nurse
29
practitioner
operating
under
the
prescribing
authority
granted
30
in
section
147.107.
31
11.
“Sleep-related
services”
means
acts
performed
by
32
polysomnographic
technicians,
polysomnographic
students,
and
33
other
persons
permitted
to
perform
those
services
under
this
34
chapter,
in
a
setting
described
in
this
chapter
that
would
be
35
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2234
considered
the
practice
of
polysomnography
if
performed
by
a
1
polysomnographic
technologist.
2
Sec.
8.
NEW
SECTION
.
148G.2
Practice
of
polysomnography.
3
The
practice
of
polysomnography
consists
of
but
is
not
4
limited
to
the
following
tasks
as
performed
for
the
purpose
of
5
polysomnography,
under
the
general
supervision
of
a
licensed
6
physician
or
qualified
health
care
professional
prescriber:
7
1.
Monitoring,
recording,
and
evaluating
physiologic
8
data
during
polysomnographic
testing
and
review
during
the
9
evaluation
of
sleep-related
disorders,
including
sleep-related
10
respiratory
disturbances,
by
applying
any
of
the
following
11
techniques,
equipment,
or
procedures:
12
a.
Noninvasive
continuous,
bilevel
positive
airway
pressure,
13
or
adaptive
servo-ventilation
titration
on
spontaneously
14
breathing
patients
using
a
mask
or
oral
appliance;
provided,
15
that
the
mask
or
oral
appliance
does
not
extend
into
the
16
trachea
or
attach
to
an
artificial
airway.
17
b.
Supplemental
low-flow
oxygen
therapy
of
less
than
six
18
liters
per
minute,
utilizing
a
nasal
cannula
or
incorporated
19
into
a
positive
airway
pressure
device
during
a
polysomnogram.
20
c.
Capnography
during
a
polysomnogram.
21
d.
Cardiopulmonary
resuscitation.
22
e.
Pulse
oximetry.
23
f.
Gastroesophageal
pH
monitoring.
24
g.
Esophageal
pressure
monitoring.
25
h.
Sleep
stage
recording
using
surface
26
electroencephalography,
surface
electrooculography,
and
surface
27
submental
electromyography.
28
i.
Surface
electromyography.
29
j.
Electrocardiography.
30
k.
Respiratory
effort
monitoring,
including
thoracic
and
31
abdominal
movement.
32
l.
Plethysmography
blood
flow
monitoring.
33
m.
Snore
monitoring.
34
n.
Audio
and
video
monitoring.
35
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o.
Body
movement
monitoring.
1
p.
Nocturnal
penile
tumescence
monitoring.
2
q.
Nasal
and
oral
airflow
monitoring.
3
r.
Body
temperature
monitoring.
4
2.
Monitoring
the
effects
that
a
mask
or
oral
appliance
5
used
to
treat
sleep
disorders
has
on
sleep
patterns;
provided,
6
however,
that
the
mask
or
oral
appliance
shall
not
extend
into
7
the
trachea
or
attach
to
an
artificial
airway.
8
3.
Observing
and
monitoring
physical
signs
and
symptoms,
9
general
behavior,
and
general
physical
response
to
10
polysomnographic
evaluation
and
determining
whether
initiation,
11
modification,
or
discontinuation
of
a
treatment
regimen
is
12
warranted.
13
4.
Analyzing
and
scoring
data
collected
during
the
14
monitoring
described
in
this
section
for
the
purpose
of
15
assisting
a
physician
in
the
diagnosis
and
treatment
of
sleep
16
and
wake
disorders
that
result
from
developmental
defects,
17
the
aging
process,
physical
injury,
disease,
or
actual
or
18
anticipated
somatic
dysfunction.
19
5.
Implementation
of
a
written
or
verbal
order
from
a
20
physician
or
qualified
health
care
professional
prescriber
to
21
perform
polysomnography.
22
6.
Education
of
a
patient
regarding
the
treatment
regimen
23
that
assists
the
patient
in
improving
the
patient’s
sleep.
24
7.
Use
of
any
oral
appliance
used
to
treat
sleep-disordered
25
breathing
while
under
the
care
of
a
licensed
polysomnographic
26
technologist
during
the
performance
of
a
sleep
study,
as
27
directed
by
a
licensed
dentist.
28
Sec.
9.
NEW
SECTION
.
148G.3
Location
of
services.
29
The
practice
of
polysomnography
shall
take
place
only
in
a
30
facility
that
is
accredited
by
a
nationally
recognized
sleep
31
medicine
laboratory
or
center
accrediting
agency,
in
a
hospital
32
licensed
under
chapter
135B,
or
in
a
patient’s
home
pursuant
to
33
rules
adopted
by
the
board;
provided,
however,
that
the
scoring
34
of
data
and
the
education
of
patients
may
take
place
in
another
35
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setting.
1
Sec.
10.
NEW
SECTION
.
148G.4
Scope
of
chapter.
2
Nothing
in
this
chapter
shall
be
construed
to
limit
or
3
restrict
a
health
care
practitioner
licensed
in
this
state
from
4
engaging
in
the
full
scope
of
practice
of
the
individual’s
5
profession.
6
Sec.
11.
NEW
SECTION
.
148G.5
Rulemaking.
7
The
board
shall
adopt
rules
necessary
for
the
implementation
8
and
administration
of
this
chapter
and
the
applicable
9
provisions
of
chapters
147
and
272C.
10
Sec.
12.
NEW
SECTION
.
148G.6
Licensing
requirements.
11
1.
Beginning
January
1,
2016,
a
qualified
health
care
12
practitioner,
as
determined
by
the
board
by
rule,
may
apply
to
13
the
board
for
a
license
to
perform
polysomnography.
The
board
14
shall
issue
a
license
to
the
health
care
practitioner,
without
15
examination,
provided
the
application
contains
verification
16
that
the
health
care
practitioner
has
completed
five
hundred
17
hours
of
paid
clinical
or
nonclinical
polysomnographic
work
18
experience
within
the
three
years
prior
to
submission
of
the
19
application.
The
application
shall
also
contain
verification
20
from
the
health
care
practitioner’s
supervisor
that
the
health
21
care
practitioner
is
competent
to
perform
polysomnography.
22
2.
Beginning
January
1,
2016,
a
person
seeking
licensure
23
as
a
polysomnographic
technologist
shall
be
of
good
moral
24
character,
be
at
least
eighteen
years
of
age,
pay
the
fees
25
established
by
the
board
for
licensure,
and
present
proof
that
26
the
person
has
satisfied
one
of
the
following
educational
27
requirements:
28
a.
Graduation
from
a
polysomnographic
educational
program
29
that
is
accredited
by
the
committee
on
accreditation
for
30
polysomnographic
technologist
education
or
an
equivalent
31
program
as
determined
by
the
board.
32
b.
Graduation
from
a
respiratory
care
educational
program
33
that
is
accredited
by
the
commission
on
accreditation
34
for
respiratory
care
or
by
a
committee
on
accreditation
35
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for
the
commission
on
accreditation
of
allied
health
1
education
programs,
and
completion
of
the
curriculum
for
a
2
polysomnographic
certificate
established
and
accredited
by
the
3
commission
on
accreditation
of
allied
health
education
programs
4
as
an
extension
of
the
respiratory
care
program.
5
c.
Graduation
from
an
electroneurodiagnostic
technologist
6
educational
program
that
is
accredited
by
the
committee
7
on
accreditation
for
education
in
electroneurodiagnostic
8
technology
or
by
a
committee
on
accreditation
for
the
9
commission
on
accreditation
of
allied
health
education
10
programs,
and
completion
of
the
curriculum
for
a
11
polysomnographic
certificate
established
and
accredited
by
the
12
commission
on
accreditation
of
allied
health
education
programs
13
as
an
extension
of
the
electroneurodiagnostic
educational
14
program.
15
d.
An
individual
who
is
licensed
under
section
147.2
16
who
holds
an
active
license
in
good
standing
may
practice
17
polysomnography
without
holding
a
polysomnographic
license
upon
18
approval
of
the
board.
Individuals
shall
submit
verification
19
to
the
board
of
either
of
the
following:
20
(1)
Successful
completion
of
an
educational
program
in
21
polysomnography
approved
by
the
board.
22
(2)
Successful
completion
of
an
examination
in
23
polysomnography
approved
by
the
board.
24
Sec.
13.
NEW
SECTION
.
148G.7
Persons
exempt
from
licensing
25
requirement.
26
1.
The
following
persons
may
provide
sleep-related
services
27
without
being
licensed
as
a
polysomnographic
technologist
under
28
this
chapter:
29
a.
A
qualified
health
care
practitioner
may
provide
30
sleep-related
services
under
the
direct
supervision
of
a
31
licensed
polysomnographic
technologist
for
a
period
of
up
to
32
six
months
while
gaining
the
clinical
experience
necessary
33
to
meet
the
admission
requirements
for
a
polysomnographic
34
credentialing
examination.
The
board
may
grant
a
one-time
35
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extension
of
up
to
six
months.
1
b.
A
polysomnographic
student
may
provide
sleep-related
2
services
under
the
direct
supervision
of
a
polysomnographic
3
technologist
as
a
part
of
the
student’s
educational
program
4
while
actively
enrolled
in
a
polysomnographic
educational
5
program
that
is
accredited
by
the
commission
on
accreditation
6
of
allied
health
education
programs
or
an
equivalent
program
as
7
determined
by
the
board.
8
2.
Before
providing
any
sleep-related
services,
a
9
polysomnographic
technician
or
polysomnographic
student
who
is
10
obtaining
clinical
experience
shall
give
notice
to
the
board
11
that
the
person
is
working
under
the
direct
supervision
of
a
12
polysomnographic
technologist
in
order
to
gain
the
experience
13
to
be
eligible
to
sit
for
a
national
certification
examination.
14
The
person
shall
wear
a
badge
that
appropriately
identifies
the
15
person
while
providing
such
services.
16
Sec.
14.
NEW
SECTION
.
148G.8
Licensing
sanctions.
17
The
board
may
impose
sanctions
for
violations
of
this
18
chapter
as
provided
in
chapters
147
and
272C.
19
Sec.
15.
Section
152B.1,
subsection
1,
Code
2014,
is
amended
20
to
read
as
follows:
21
1.
“Board”
means
the
board
of
respiratory
care
and
22
polysomnography
created
under
chapter
147
.
23
Sec.
16.
Section
272C.1,
subsection
6,
paragraph
z,
Code
24
2014,
is
amended
to
read
as
follows:
25
z.
The
board
of
respiratory
care
and
polysomnography
in
26
licensing
respiratory
care
practitioners
pursuant
to
chapter
27
152B
and
polysomnographic
technologists
pursuant
to
chapter
28
148G
.
29
Sec.
17.
INITIAL
APPOINTMENT
OF
POLYSOMNOGRAPHIC
30
TECHNOLOGIST
TO
BOARD.
For
the
initial
appointment
of
the
31
polysomnographic
member
to
the
board
of
respiratory
care
and
32
polysomnography
pursuant
to
section
147.14,
as
amended
in
this
33
Act,
such
appointee
must
be
eligible
for
licensure
pursuant
to
34
this
Act.
The
appointment
shall
be
effective
upon
the
first
35
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expiration
of
the
term
of
an
existing
respiratory
care
board
1
member.
2
Sec.
18.
EFFECTIVE
DATE.
The
following
provision
or
3
provisions
of
this
Act
take
effect
January
1,
2015:
4
1.
The
section
of
this
Act
amending
section
147.2,
5
subsection
1.
6
Sec.
19.
IMPLEMENTATION
PERIOD.
A
person
who
is
working
7
in
the
field
of
sleep
medicine
on
January
1,
2016,
who
is
not
8
eligible
to
obtain
the
registered
polysomnographic
credential
9
shall
have
until
January
1,
2017,
to
achieve
a
passing
score
on
10
the
registered
polysomnographic
technologist
examination
for
11
licensure
only.
The
individual
shall
be
allowed
to
attempt
12
the
examination
and
be
awarded
a
license
as
a
polysomnographic
13
technologist
by
meeting
or
exceeding
the
passing
point
14
established
by
the
board.
After
January
1,
2017,
only
persons
15
licensed
as
polysomnographic
technologists
or
excepted
from
16
this
chapter
may
perform
sleep-related
services.
17
EXPLANATION
18
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
19
the
explanation’s
substance
by
the
members
of
the
general
assembly.
20
This
bill
requires
the
licensing
of
polysomnographic
21
technologists
beginning
January
1,
2016,
and
makes
the
22
provisions
of
Code
chapters
147
and
272C,
including
penalty
23
and
other
regulatory
provisions,
applicable
to
other
health
24
professions
applicable
to
the
practice
of
polysomnography.
25
Code
section
147.86
provides
that
it
is
a
serious
misdemeanor
26
to
violate
a
provision
of
the
licensing
laws.
A
serious
27
misdemeanor
is
punishable
by
confinement
for
no
more
than
one
28
year
and
a
fine
of
at
least
$315
but
not
more
than
$1,875.
The
29
licensing
program
is
administered
and
regulated
by
the
board
of
30
respiratory
care
and
polysomnography,
with
one
respiratory
care
31
practitioner
replaced
by
a
polysomnographic
technologist.
32
The
board
may
license
other
licensed
health
care
33
professionals,
without
examination,
to
perform
polysomnography.
34
The
applicant
must
provide
evidence
that
the
applicant
35
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11
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2234
has
completed
500
hours
of
paid
clinical
or
nonclinical
1
polysomnographic
work
experience
within
the
three
years
prior
2
to
submission
of
the
application.
The
application
shall
also
3
contain
verification
from
the
applicant’s
supervisor
that
the
4
applicant
is
competent
to
perform
polysomnography.
5
A
licensed
polysomnographic
technologist
practices
under
6
the
general
supervision
of
a
physician,
a
physician
assistant,
7
or
an
advanced
registered
nurse
practitioner,
providing
8
specifically
enumerated
services
related
to
sleep
disorders.
A
9
polysomnographic
student
enrolled
in
an
approved
educational
10
program
provides
services
under
the
direct
supervision
of
a
11
polysomnographic
technologist.
12
The
bill
sets
out
educational
standards
and
testing
13
requirements,
and
provides
for
disciplinary
actions.
14
-11-
LSB
5277SV
(3)
85
jr/nh
11/
11