S.F. _____ H.F. _____ Section 1. Section 125.2, subsection 11, Code 2014, is 1 amended to read as follows: 2 11. “Psychiatric advanced registered nurse practitioner” 3 means an individual currently licensed as a registered nurse 4 under chapter 152 or 152E who holds a national certification 5 in psychiatric mental health care and who is registered with 6 licensed by the board of nursing as an advanced registered 7 nurse practitioner. 8 Sec. 2. Section 135G.1, subsection 1, Code 2014, is amended 9 to read as follows: 10 1. “Advanced registered nurse practitioner” means a person 11 currently licensed as a registered nurse under chapter 152 or 12 152E who is registered with licensed by the board of nursing as 13 an advanced registered nurse practitioner. 14 Sec. 3. Section 147.74, subsection 21, Code 2014, is amended 15 to read as follows: 16 21. A registered nurse licensed under chapter 152 may use 17 the words “registered nurse” or the letters “R. N.” after the 18 person’s name. A licensed practical nurse licensed under 19 chapter 152 may use the words “licensed practical nurse” or 20 the letters “L. P. N.” after the person’s name. An advanced 21 registered nurse practitioner licensed under chapter 152 or 22 152E may use the words “advanced registered nurse practitioner” 23 or the letters “A.R.N.P.” after the person’s name. 24 Sec. 4. Section 147.107, subsection 8, Code 2014, is amended 25 to read as follows: 26 8. Notwithstanding subsection 1 , but subject to the 27 limitations contained in subsections 2 and 3 , a registered 28 nurse who is licensed and registered as an advanced registered 29 nurse practitioner and who qualifies for and is registered 30 in a recognized nursing specialty may prescribe substances 31 or devices, including controlled substances or devices, if 32 the nurse is engaged in the practice of a nursing specialty 33 regulated under rules adopted by the board of nursing in 34 consultation with the board of medicine and the board of 35 -1- LSB 5300DP (5) 85 ad/nh 1/ 17

S.F. _____ H.F. _____ pharmacy. 1 Sec. 5. Section 152.1, Code 2014, is amended by adding the 2 following new subsections: 3 NEW SUBSECTION . 0A. “Advanced registered nurse practitioner” 4 means a nurse with a current license as a registered nurse in 5 Iowa or who is licensed in another state and recognized for 6 licensure in this state pursuant to the nurse licensure compact 7 contained in chapter 152E, and is also licensed in Iowa to 8 practice in an advanced role. 9 NEW SUBSECTION . 3A. The “practice of an advanced registered 10 nurse practitioner” means the practice of a registered nurse 11 with formal advanced education who is licensed by the board to 12 do all of the following: 13 a. Use the title “advanced registered nurse practitioner” 14 and the letters “A.R.N.P.” pursuant to section 152.6. 15 b. Utilize full practice authority in a specialty area 16 approved by the board. 17 c. Prescribe, deliver, distribute, or dispense prescription 18 drugs, devices, and medical gases when the nurse is engaged in 19 the practice of a specialty area approved by the board pursuant 20 to section 147.107. 21 d. Perform a physical or an advanced assessment; order 22 and interpret diagnostic procedures; formulate a primary and 23 differential diagnosis; order therapeutic treatments; educate 24 and counsel patients and family members; delegate and assign 25 therapeutic measures to assistive personnel; maintain hospital 26 privileges; consult with other disciplines; provide referrals 27 to health care agencies, health care providers, and community 28 resources; and promote health maintenance. 29 e. Perform acts or nursing specialities that require 30 education as prescribed by the board, commensurate with the 31 advanced registered nurse practitioner’s education, continuing 32 education, demonstrated competencies, and experience. 33 f. Sign death certificates, pursuant to section 144.26 or 34 144.28. 35 -2- LSB 5300DP (5) 85 ad/nh 2/ 17

S.F. _____ H.F. _____ Sec. 6. Section 152.1, subsections 4 and 5, Code 2014, are 1 amended to read as follows: 2 4. The “practice of a licensed practical nurse” means the 3 practice of a natural person who is licensed by the board to do 4 all of the following: 5 a. Perform services in the provision of supportive or 6 restorative care under the supervision of a registered nurse 7 or a physician. 8 b. Perform additional acts under emergency or other 9 conditions which require education and training and which are 10 recognized by the medical and nursing professions and are 11 approved by the board, as being proper to be performed by a 12 licensed practical nurse that require education as prescribed 13 by the board, commensurate with the licensed practical nurse’s 14 education, continuing education, demonstrated competencies, and 15 experience . 16 c. Make the pronouncement of death for a patient whose death 17 is anticipated if the death occurs in a licensed hospital, a 18 licensed health care facility, a Medicare-certified home health 19 agency, a Medicare-certified hospice program or facility, or 20 an assisted living facility or residential care facility, 21 with notice of the death to a physician and in accordance 22 with any directions of a physician , advanced registered nurse 23 practitioner, or physician assistant . 24 5. The “practice of nursing” means the practice of a 25 registered nurse , or a licensed practical nurse , or an advanced 26 registered nurse practitioner . It does not mean any of the 27 following: 28 a. The practice of medicine and surgery and the practice of 29 osteopathic medicine and surgery, as defined in chapter 148 , 30 or the practice of pharmacy as defined in chapter 155A , except 31 practices which are recognized by the medical and nursing 32 professions and approved by the board as proper to be performed 33 by a registered nurse approved by the board as proper to be 34 performed by a registered nurse with appropriate education and 35 -3- LSB 5300DP (5) 85 ad/nh 3/ 17

S.F. _____ H.F. _____ demonstrated competencies . 1 b. The performance of nursing services by an unlicensed 2 student enrolled in a nursing education program if performance 3 is part of the course of study. Individuals who have been 4 licensed as registered nurses , or licensed practical or 5 vocational nurses , or advanced registered nurse practitioners 6 in any state or jurisdiction of the United States are not 7 subject to this exemption. 8 c. The performance of services by unlicensed workers 9 employed in offices, hospitals, or health care facilities, as 10 defined in section 135C.1 , under the supervision of a physician 11 or a nurse licensed under this chapter , or employed in the 12 office of a psychologist, podiatric physician, optometrist, 13 chiropractor, speech pathologist, audiologist, or physical 14 therapist licensed to practice in this state, and when acting 15 while within the scope of the employer’s license. 16 d. The practice of a nurse licensed in another state 17 and employed in this state by the federal government if the 18 practice is in discharge of official employment duties. 19 e. The care of the sick rendered in connection with the 20 practice of the religious tenets of any church or order by 21 the adherents thereof which is not performed for hire, or if 22 performed for hire by those who depend upon prayer or spiritual 23 means for healing in the practice of the religion of their 24 church or denomination, so long as they do not otherwise engage 25 in the practice of nursing as practical nurses. 26 Sec. 7. Section 152.1, subsection 6, paragraphs d and e, 27 Code 2014, are amended to read as follows: 28 d. Perform additional acts or nursing specialties which 29 that require education and training under emergency or other 30 conditions which are recognized by the medical and nursing 31 professions and are approved by the board as being proper to 32 be performed by a registered nurse as prescribed by the board, 33 commensurate with the registered nurse’s education, continuing 34 education, demonstrated competencies, and experience . 35 -4- LSB 5300DP (5) 85 ad/nh 4/ 17

S.F. _____ H.F. _____ e. Make the pronouncement of death for a patient whose death 1 is anticipated if the death occurs in a licensed hospital, a 2 licensed health care facility, a Medicare-certified home health 3 agency, a Medicare-certified hospice program or facility, an 4 assisted living facility, or a residential care facility, with 5 notice of the death to a physician and in accordance with any 6 directions of a , advanced registered nurse practitioner, or 7 physician assistant . 8 Sec. 8. Section 152.4, Code 2014, is amended to read as 9 follows: 10 152.4 Appropriations Use of funds . 11 The board may apply appropriated use any available funds to 12 and moneys retained by the board pursuant to section 147.82 for 13 any of the following : 14 1. The administration and enforcement of the applicable 15 provisions of this chapter and of chapter chapters 147 , 152E, 16 and 272C . 17 2. The elevation of the standards of the schools of nursing. 18 3. The promotion of educational and professional standards 19 of nurses in this state. 20 4. The collection, analysis, and dissemination of nursing 21 workforce data. 22 Sec. 9. Section 152.5, subsections 1 and 2, Code 2014, are 23 amended to read as follows: 24 1. All programs preparing a person to be a registered nurse , 25 or a licensed practical nurse , or an advanced registered nurse 26 practitioner shall be approved by the board. The board shall 27 not recognize a program unless it: 28 a. Is of recognized standing. 29 b. Has provisions for adequate physical and clinical 30 facilities and other resources with which to conduct a sound 31 education program. 32 c. Requires, for graduation of a registered nurse applicant, 33 the completion of at least a two academic year course of study. 34 d. Requires, for graduation of a licensed practical nurse 35 -5- LSB 5300DP (5) 85 ad/nh 5/ 17

S.F. _____ H.F. _____ applicant, the completion of at least a one academic year 1 course of study as prescribed by the board. 2 e. Requires, for graduation of an advanced registered nurse 3 practitioner, satisfactory completion of a formal advanced 4 practice educational program of study in a nursing specialty 5 area approved by the board and appropriate clinical experience 6 as approved by the board. 7 2. All advanced postlicensure formal academic nursing 8 education programs shall also be approved by the board. 9 Sec. 10. Section 152.5, subsection 3, Code 2014, is amended 10 by striking the subsection. 11 Sec. 11. NEW SECTION . 152.5A Student record checks. 12 1. For the purposes of this section: 13 a. “Nursing program” means a nursing program that is 14 approved by the board pursuant to section 152.5. 15 b. “Student” means a person applying for, enrolled in, or 16 returning to the clinical education component of a nursing 17 program. 18 2. All nursing programs shall conduct record checks on 19 students as provided in this section. 20 3. A nursing program may access the single contact 21 repository established pursuant to section 135C.33 as necessary 22 for the nursing program to initiate record checks of students. 23 4. A nursing program shall request that the department 24 of public safety perform a criminal history check and the 25 department of human services perform child and dependent adult 26 abuse record checks in this state on the nursing program’s 27 students. 28 5. If a student has a criminal record or a record of founded 29 child or dependent adult abuse, upon request of the nursing 30 program, the department of human services shall perform an 31 evaluation to determine whether the record warrants prohibition 32 of the person’s involvement in a clinical education component 33 of a nursing program involving children or dependent adults. 34 The department of human services shall utilize the criteria 35 -6- LSB 5300DP (5) 85 ad/nh 6/ 17

S.F. _____ H.F. _____ provided in section 135C.33 in performing the evaluation and 1 shall report the results of the evaluation to the nursing 2 program. The department of human services has final authority 3 in determining whether prohibition of the person’s involvement 4 in a clinical education component is warranted. 5 Sec. 12. Section 152.6, Code 2014, is amended to read as 6 follows: 7 152.6 Licenses —— professional abbreviations. 8 The board may license a natural person to practice as a 9 registered nurse , or as a licensed practical nurse , or an 10 advanced registered nurse practitioner . However, only a person 11 currently licensed as a registered nurse in this state may 12 use that title and the abbreviation “R N” letters “R.N.” after 13 the person’s name ; and only a person currently licensed as a 14 licensed practical nurse in this state may use that title and 15 the abbreviation “L P N” letters “L.P.N.” after the person’s 16 name ; and only a person currently licensed as an advanced 17 registered nurse practitioner may use that title and the 18 letters “A.R.N.P.” after the person’s name . For purposes of 19 this section , “currently licensed” includes persons licensed 20 in another state and recognized for licensure in this state 21 pursuant to the nurse licensure compact contained in section 22 152E.1 or pursuant to the advanced practice registered nurse 23 compact contained in section 152E.3 . 24 Sec. 13. Section 152.7, Code 2014, is amended by adding the 25 following new subsection: 26 NEW SUBSECTION . 1A. An applicant to be licensed as an 27 advanced registered nurse practitioner shall have the following 28 qualifications: 29 a. Hold a current license as a registered nurse pursuant to 30 this chapter. 31 b. Complete an advanced practice educational program as set 32 out in section 152.5. 33 c. Hold an advanced level certification by an appropriate 34 national certifying body. 35 -7- LSB 5300DP (5) 85 ad/nh 7/ 17

S.F. _____ H.F. _____ Sec. 14. Section 152.10, subsection 2, paragraph d, Code 1 2014, is amended to read as follows: 2 d. (1) Having a license to practice nursing as a registered 3 nurse or licensed practical nurse revoked or suspended, or 4 having other disciplinary action taken by a licensing authority 5 of another state, territory, or country. A certified copy of 6 the record or order of suspension, revocation, or disciplinary 7 action is prima facie evidence of such fact. 8 (2) Having a license to practice nursing as a registered 9 nurse or licensed practical nurse revoked or suspended, 10 or having other disciplinary action taken, by a licensing 11 authority in another state which has adopted the nurse 12 licensure compact contained in section 152E.1 or the advanced 13 practice registered nurse compact contained in section 152E.3 14 and which has communicated information relating to such 15 action pursuant to the coordinated licensure information 16 system established by the compact. If the action taken by 17 the licensing authority occurs in a jurisdiction which does 18 not afford the procedural protections of chapter 17A , the 19 licensee may object to the communicated information and shall 20 be afforded the procedural protections of chapter 17A . 21 Sec. 15. Section 152.10, subsection 2, paragraph h, 22 subparagraph (2), Code 2014, is amended to read as follows: 23 (2) The board may, upon probable cause, request a licensee 24 to submit to an appropriate medical examination by a designated 25 physician. If requested by the licensee, the licensee may also 26 designate a physician for an independent medical examination. 27 The reasonable costs of such examinations and medical reports 28 to the board shall be paid by the board. Refusal or failure 29 of a licensee to complete such examinations shall constitute 30 an admission of any allegations relating to such condition. 31 All objections shall be waived as to the admissibility of the 32 examining physicians’ testimony or examination reports on the 33 grounds that they constitute privileged communication. The 34 medical testimony or examination reports shall not be used 35 -8- LSB 5300DP (5) 85 ad/nh 8/ 17

S.F. _____ H.F. _____ against a registered nurse or licensed practical nurse licensee 1 in another proceeding and shall be confidential. At reasonable 2 intervals, a registered nurse or licensed practical nurse 3 licensee shall be afforded an opportunity to demonstrate that 4 the registered nurse or licensed practical nurse licensee can 5 resume the competent practice of nursing with reasonable skill 6 and safety to patients. 7 Sec. 16. Section 152.11, Code 2014, is amended to read as 8 follows: 9 152.11 Investigators for nurses . 10 The board of nursing may appoint investigators, who shall 11 not be members of the board, to administer and aid in the 12 enforcement of the provisions of law related to those licensed 13 to practice nursing. The amount of compensation for the 14 investigators shall be determined pursuant to chapter 8A, 15 subchapter IV . Investigators authorized by the board of nursing 16 have the powers and status of peace officers when enforcing 17 this chapter and chapters 147 and 272C . 18 Sec. 17. Section 225C.6, subsection 4, paragraph c, 19 subparagraph (1), Code 2014, is amended to read as follows: 20 (1) A comprehensive set of wraparound services for persons 21 who have had or are at imminent risk of having acute or 22 crisis mental health symptoms that do not permit the persons 23 to remain in or threatens removal of the persons from their 24 home and community, but who have been determined by a mental 25 health professional and a licensed health care professional, 26 subject to the professional’s scope of practice, not to need 27 inpatient acute hospital services. For the purposes of this 28 subparagraph, “mental health professional” means the same as 29 defined in section 228.1 and “licensed health care professional” 30 means a person licensed under chapter 148 to practice medicine 31 and surgery or osteopathic medicine and surgery, an advanced 32 registered nurse practitioner licensed under chapter 152 or 33 152E and registered with licensed by the board of nursing, or a 34 physician assistant licensed to practice under the supervision 35 -9- LSB 5300DP (5) 85 ad/nh 9/ 17

S.F. _____ H.F. _____ of a physician as authorized in chapters 147 and 148C . 1 Sec. 18. Section 228.1, subsection 6, paragraph b, Code 2 2014, is amended to read as follows: 3 b. The individual holds a current Iowa license if 4 practicing in a field covered by an Iowa licensure law and 5 is a psychiatrist, an advanced registered nurse practitioner 6 who holds a national certification in psychiatric mental 7 health care registered by the board of nursing and who is 8 licensed by the board of nursing as an advanced registered 9 nurse practitioner , a physician assistant practicing under the 10 supervision of a psychiatrist, or an individual who holds a 11 doctorate degree in psychology and is licensed by the board of 12 psychology. 13 Sec. 19. Section 229.1, subsection 13, Code 2014, is amended 14 to read as follows: 15 13. “Psychiatric advanced registered nurse practitioner” 16 means an individual currently licensed as a registered nurse 17 under chapter 152 or 152E who holds a national certification 18 in psychiatric mental health care and who is registered with 19 licensed by the board of nursing as an advanced registered 20 nurse practitioner. 21 Sec. 20. Section 231B.21, subsection 2, paragraph a, Code 22 2014, is amended to read as follows: 23 a. If administration of medications is delegated to 24 the elder group home by the tenant or tenant’s legal 25 representative, the medications shall be administered by 26 a registered nurse, licensed practical nurse, or advanced 27 registered nurse practitioner licensed or registered in Iowa 28 or by the individual to whom such licensed or registered 29 individuals may properly delegate administration of 30 medications. 31 Sec. 21. Section 231C.16A, subsection 2, paragraph a, Code 32 2014, is amended to read as follows: 33 a. If administration of medications is delegated to the 34 program by the tenant or tenant’s legal representative, 35 -10- LSB 5300DP (5) 85 ad/nh 10/ 17

S.F. _____ H.F. _____ the medications shall be administered by a registered 1 nurse, licensed practical nurse, or advanced registered 2 nurse practitioner licensed or registered in Iowa or by the 3 individual to whom such licensed or registered individuals may 4 properly delegate administration of medications. 5 Sec. 22. Section 231D.13A, subsection 2, paragraph a, Code 6 2014, is amended to read as follows: 7 a. If administration of medications is delegated to 8 the program by the participant or the participant’s legal 9 representative, the medications shall be administered by 10 a registered nurse, licensed practical nurse, or advanced 11 registered nurse practitioner licensed or registered in Iowa 12 or by the individual to whom such licensed or registered 13 individuals may properly delegate administration of 14 medications. 15 Sec. 23. Section 321.34, subsection 14, Code 2014, is 16 amended to read as follows: 17 14. Persons with disabilities special plates. An owner 18 referred to in subsection 12 or an owner of a trailer used 19 to transport a wheelchair who is a person with a disability, 20 or who is the parent or guardian of a child who resides 21 with the parent or guardian owner and who is a person with a 22 disability, as defined in section 321L.1 , may, upon written 23 application to the department, order special registration 24 plates with a persons with disabilities processed emblem 25 designed by the department bearing the international symbol 26 of accessibility. The special registration plates with a 27 persons with disabilities processed emblem shall only be 28 issued if the application is accompanied with a statement from 29 a physician licensed under chapter 148 or 149 , a physician 30 assistant licensed under chapter 148C , an advanced registered 31 nurse practitioner licensed under chapter 152 or 152E , or 32 a chiropractor licensed under chapter 151 , written on the 33 physician’s, physician assistant’s, nurse practitioner’s, 34 or chiropractor’s stationery, stating the nature of the 35 -11- LSB 5300DP (5) 85 ad/nh 11/ 17

S.F. _____ H.F. _____ applicant’s or the applicant’s child’s disability and such 1 additional information as required by rules adopted by the 2 department, including proof of residency of a child who is 3 a person with a disability. If the application is approved 4 by the department, the special registration plates with a 5 persons with disabilities processed emblem shall be issued 6 to the applicant. There shall be no fee in addition to the 7 regular annual registration fee for the special registration 8 plates with a persons with disabilities processed emblem. The 9 authorization for special registration plates with a persons 10 with disabilities processed emblem shall not be renewed 11 without the applicant furnishing evidence to the department 12 that the owner of the vehicle or the owner’s child is still 13 a person with a disability as defined in section 321L.1 . An 14 owner who has a child who is a person with a disability shall 15 provide satisfactory evidence to the department that the 16 child with a disability continues to reside with the owner. 17 The registration plates with a persons with disabilities 18 processed emblem shall be surrendered in exchange for regular 19 registration plates as provided in subsection 12 when the owner 20 of the vehicle or the owner’s child no longer qualifies as a 21 person with a disability as defined in section 321L.1 or when 22 the owner’s child who is a person with a disability no longer 23 resides with the owner. 24 Sec. 24. Section 321.186, subsection 4, Code 2014, is 25 amended to read as follows: 26 4. A physician licensed under chapter 148 , an advanced 27 registered nurse practitioner licensed under chapter 152 and 28 registered with the board of nursing or 152E , a physician 29 assistant licensed under chapter 148C , or an optometrist 30 licensed under chapter 154 may report to the department 31 the identity of a person who has been diagnosed as having a 32 physical or mental condition which would render the person 33 physically or mentally incompetent to operate a motor vehicle 34 in a safe manner. The physician, advanced registered nurse 35 -12- LSB 5300DP (5) 85 ad/nh 12/ 17

S.F. _____ H.F. _____ practitioner, physician assistant, or optometrist shall make 1 reasonable efforts to notify the person who is the subject of 2 the report, in writing. The written notification shall state 3 the nature of the disclosure and the reason for the disclosure. 4 A physician, advanced registered nurse practitioner, physician 5 assistant, or optometrist making a report under this section 6 shall be immune from any liability, civil or criminal, which 7 might otherwise be incurred or imposed as a result of the 8 report. A physician, advanced registered nurse practitioner, 9 physician assistant, or optometrist has no duty to make a 10 report or to warn third parties with regard to any knowledge 11 concerning a person’s mental or physical competency to operate 12 a motor vehicle in a safe manner. Any report received by 13 the department from a physician, advanced registered nurse 14 practitioner, physician assistant, or optometrist under this 15 section shall be kept confidential. Information regulated by 16 chapter 141A shall be subject to the confidentiality provisions 17 and remedies of that chapter. 18 Sec. 25. Section 321L.2, subsection 1, unnumbered paragraph 19 1, Code 2014, is amended to read as follows: 20 A resident of the state with a disability desiring a persons 21 with disabilities parking permit shall apply to the department 22 upon an application form furnished by the department providing 23 the applicant’s full legal name, address, date of birth, and 24 social security number or Iowa driver’s license number or 25 Iowa nonoperator’s identification card number, and shall also 26 provide a statement from a physician licensed under chapter 27 148 or 149 , a physician assistant licensed under chapter 148C , 28 an advanced registered nurse practitioner licensed under 29 chapter 152 or 152E , or a chiropractor licensed under chapter 30 151 , or a physician, physician assistant, nurse practitioner, 31 or chiropractor licensed to practice in a contiguous state, 32 written on the physician’s, physician assistant’s, nurse 33 practitioner’s, or chiropractor’s stationery, stating the 34 nature of the applicant’s disability and such additional 35 -13- LSB 5300DP (5) 85 ad/nh 13/ 17

S.F. _____ H.F. _____ information as required by rules adopted by the department 1 under section 321L.8 . If the person is applying for a 2 temporary persons with disabilities parking permit, the 3 physician’s, physician assistant’s, nurse practitioner’s, or 4 chiropractor’s statement shall state the period of time during 5 which the person is expected to be disabled and the period 6 of time for which the permit should be issued, not to exceed 7 six months. The department may waive the requirement that 8 the applicant furnish the applicant’s social security number, 9 Iowa driver’s license number, or nonoperator’s identification 10 card number when the application for a temporary persons with 11 disabilities parking permit is made on behalf of a person who 12 is less than one year old. 13 Sec. 26. Section 514C.11, Code 2014, is amended to read as 14 follows: 15 514C.11 Services provided by licensed physician assistants 16 and licensed advanced registered nurse practitioners. 17 Notwithstanding section 514C.6 , a policy or contract 18 providing for third-party payment or prepayment of health or 19 medical expenses shall include a provision for the payment 20 of necessary medical or surgical care and treatment provided 21 by a physician assistant licensed pursuant to chapter 148C , 22 or provided by an advanced registered nurse practitioner 23 licensed pursuant to chapter 152 or 152E and performed within 24 the scope of the license of the licensed physician assistant 25 or the licensed advanced registered nurse practitioner if the 26 policy or contract would pay for the care and treatment if 27 the care and treatment were provided by a person engaged in 28 the practice of medicine and surgery or osteopathic medicine 29 and surgery under chapter 148 . The policy or contract shall 30 provide that policyholders and subscribers under the policy 31 or contract may reject the coverage for services which may 32 be provided by a licensed physician assistant or licensed 33 advanced registered nurse practitioner if the coverage is 34 rejected for all providers of similar services. A policy or 35 -14- LSB 5300DP (5) 85 ad/nh 14/ 17

S.F. _____ H.F. _____ contract subject to this section shall not impose a practice 1 or supervision restriction which is inconsistent with or more 2 restrictive than the restriction already imposed by law. This 3 section applies to services provided under a policy or contract 4 delivered, issued for delivery, continued, or renewed in this 5 state on or after July 1, 1996, and to an existing policy or 6 contract, on the policy’s or contract’s anniversary or renewal 7 date, or upon the expiration of the applicable collective 8 bargaining contract, if any, whichever is later. This section 9 does not apply to policyholders or subscribers eligible for 10 coverage under Tit. XVIII of the federal Social Security Act 11 or any similar coverage under a state or federal government 12 plan. For the purposes of this section , third-party payment 13 or prepayment includes an individual or group policy of 14 accident or health insurance or individual or group hospital 15 or health care service contract issued pursuant to chapter 16 509 , 514 , or 514A , an individual or group health maintenance 17 organization contract issued and regulated under chapter 514B , 18 an organized delivery system contract regulated under rules 19 adopted by the director of public health, or a preferred 20 provider organization contract regulated pursuant to chapter 21 514F . Nothing in this section shall be interpreted to require 22 an individual or group health maintenance organization, an 23 organized delivery system, or a preferred provider organization 24 or arrangement to provide payment or prepayment for services 25 provided by a licensed physician assistant or licensed advanced 26 registered nurse practitioner unless the physician assistant’s 27 supervising physician, the physician-physician assistant team, 28 the advanced registered nurse practitioner, or the advanced 29 registered nurse practitioner’s collaborating physician has 30 entered into a contract or other agreement to provide services 31 with the individual or group health maintenance organization, 32 the organized delivery system, or the preferred provider 33 organization or arrangement. 34 Sec. 27. Section 514C.13, subsection 1, paragraph c, Code 35 -15- LSB 5300DP (5) 85 ad/nh 15/ 17

S.F. _____ H.F. _____ 2014, is amended to read as follows: 1 c. “Health care provider” means a hospital licensed 2 pursuant to chapter 135B , a person licensed under chapter 148 , 3 148C , 149 , 151 , or 154 , or a person licensed as an advanced 4 registered nurse practitioner under chapter 152 or 152E . 5 Sec. 28. Section 514F.6, subsection 2, paragraph a, Code 6 2014, is amended to read as follows: 7 a. “Advanced registered nurse practitioner” means a licensed 8 an advanced registered nurse who is also registered to practice 9 in an advanced role practitioner licensed under chapter 152 or 10 152E . 11 Sec. 29. TRANSITION PROVISIONS —— CONTINUING VALIDITY OF 12 REGISTRATIONS. A registration as an advanced registered nurse 13 practitioner issued prior to July 1, 2014, remains valid until 14 its expiration. A renewal shall be by license as provided in 15 this Act. 16 EXPLANATION 17 The inclusion of this explanation does not constitute agreement with 18 the explanation’s substance by the members of the general assembly. 19 This bill contains various revisions to Code provisions 20 relating to the practice of nursing. The bill requires 21 advanced registered nurse practitioners to be licensed by the 22 board of nursing rather than registered, and authorizes the 23 professional abbreviation “A.R.N.P.” 24 Current Code language authorizes licensed practical nurses 25 and registered nurses to perform acts or nursing specialties 26 which are recognized by the medical and nursing professions 27 and are approved by the board. The bill eliminates this 28 provision and provides that the regulation of nursing is the 29 authority and responsibility of the board to determine which 30 acts or specialties may be performed by a nurse, commensurate 31 with the nurse’s education, continuing education, demonstrated 32 competencies and experience. 33 The bill specifies the purposes for which licensing fees 34 which are treated as return receipts may be used by the board. 35 -16- LSB 5300DP (5) 85 ad/nh 16/ 17