S.F. 2250 Section 1. Section 147.1, subsections 3 and 6, Code 2016, 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, genetic counselor, physician assistant, psychologist, 5 chiropractor, nurse, dentist, dental hygienist, dental 6 assistant, optometrist, speech pathologist, audiologist, 7 pharmacist, physical therapist, physical therapist assistant, 8 occupational therapist, occupational therapy assistant, 9 orthotist, prosthetist, pedorthist, respiratory care 10 practitioner, practitioner of cosmetology arts and sciences, 11 practitioner of barbering, funeral director, dietitian, marital 12 and family therapist, mental health counselor, respiratory 13 care and polysomnography practitioner, polysomnographic 14 technologist, social worker, massage therapist, athletic 15 trainer, acupuncturist, nursing home administrator, hearing 16 aid specialist, or sign language interpreter or transliterator 17 means a person licensed under this subtitle . 18 6. “Profession” means medicine and surgery, podiatry, 19 osteopathic medicine and surgery, genetic counseling, practice 20 as a physician assistant, psychology, chiropractic, nursing, 21 dentistry, dental hygiene, dental assisting, optometry, speech 22 pathology, audiology, pharmacy, physical therapy, physical 23 therapist assisting, occupational therapy, occupational therapy 24 assisting, respiratory care, cosmetology arts and sciences, 25 barbering, mortuary science, marital and family therapy, mental 26 health counseling, polysomnography, social work, dietetics, 27 massage therapy, athletic training, acupuncture, nursing 28 home administration, practice as a hearing aid specialist, 29 sign language interpreting or transliterating, orthotics, 30 prosthetics, or pedorthics. 31 Sec. 2. Section 147.2, subsection 1, Code 2016, is amended 32 to read as follows: 33 1. A person shall not engage in the practice of medicine 34 and surgery, podiatry, osteopathic medicine and surgery, 35 -1- LSB 6013SV (2) 86 tr/nh 1/ 9

S.F. 2250 genetic counseling, psychology, chiropractic, physical 1 therapy, physical therapist assisting, nursing, dentistry, 2 dental hygiene, dental assisting, optometry, speech pathology, 3 audiology, occupational therapy, occupational therapy 4 assisting, orthotics, prosthetics, pedorthics, respiratory 5 care, pharmacy, cosmetology arts and sciences, barbering, 6 social work, dietetics, marital and family therapy or mental 7 health counseling, massage therapy, mortuary science, athletic 8 training, acupuncture, nursing home administration, or sign 9 language interpreting or transliterating, or shall not practice 10 as a physician assistant or a hearing aid specialist, unless 11 the person has obtained a license for that purpose from the 12 board for the profession. 13 Sec. 3. Section 147.13, subsection 1, Code 2016, is amended 14 to read as follows: 15 1. For medicine and surgery, osteopathic medicine and 16 surgery, and acupuncture, and genetic counseling, the board of 17 medicine. 18 Sec. 4. Section 147.74, Code 2016, is amended by adding the 19 following new subsection: 20 NEW SUBSECTION . 23A. A genetic counselor licensed under 21 chapter 148H may use the words “genetic counselor”, “licensed 22 genetic counselor”, “gene counselor”, “genetic consultant”, 23 “genetic associate” or any words, letters, abbreviations, or 24 insignia indicating that the person holds a genetic counseling 25 license after the person’s name. 26 Sec. 5. NEW SECTION . 148H.1 Definitions. 27 1. “Active candidate status” means a person has met the 28 requirements established by the American board of genetic 29 counseling to take the American board of genetic counseling 30 certification examination in general genetics and genetic 31 counseling and has been granted this designation by the 32 American board of genetic counseling. 33 2. “Advisory committee” means the genetic counselor advisory 34 committee established pursuant to this chapter. 35 -2- LSB 6013SV (2) 86 tr/nh 2/ 9

S.F. 2250 3. “Board” means the board of medicine. 1 4. “Genetic counseling” means the provision of services by 2 an individual who qualifies for a license under this chapter. 3 5. “Genetic counseling intern” means a student enrolled in a 4 genetic counseling program accredited by the American board of 5 genetic counseling or the American board of medical genetics 6 and genomics. 7 6. “Genetic counselor” means an individual who is licensed 8 under this chapter to engage in the competent practice of 9 genetic counseling. 10 7. “Qualified supervisor” means any person who is a genetic 11 counselor licensed under this chapter, a physician licensed 12 under chapter 148, or a nurse practitioner licensed under 13 chapter 152. 14 8. “Supervision” means supervision by a qualified supervisor 15 who has the overall responsibility of assessing the work of 16 a provisional licensee, provided that an annual supervision 17 contract signed by the qualified supervisor and the provisional 18 licensee is on file with both parties. “Supervision” does 19 not require the qualified supervisor’s presence during the 20 performance of services. 21 Sec. 6. NEW SECTION . 148H.2 Scope of practice. 22 A person licensed under this chapter may do any of the 23 following: 24 1. Obtain and evaluate individual, family, and medical 25 histories to determine genetic risk for genetic and medical 26 conditions and diseases in a patient, the patient’s offspring, 27 and other family members. 28 2. Discuss the features, history, means of diagnosis, 29 genetic and environmental factors, and management of risk for 30 genetic and medical conditions and diseases. 31 3. Identify, order, and coordinate genetic laboratory tests 32 and other diagnostic studies as appropriate for the genetic 33 assessment of a patient. 34 4. Refer a patient to a specialty or subspecialty department 35 -3- LSB 6013SV (2) 86 tr/nh 3/ 9

S.F. 2250 as necessary for the purpose of collaborating on diagnosis and 1 treatment involving multiple body systems and general medical 2 management. 3 5. Integrate genetic laboratory test results and other 4 diagnostic studies with personal and family medical history to 5 assess and communicate risk factors for genetic and medical 6 conditions and diseases. 7 6. Explain the clinical implications of genetic laboratory 8 tests and other diagnostic studies and their results. 9 7. Evaluate the responses of a patient or patient’s 10 family to the condition or risk of recurrence and provide 11 patient-centered counseling and anticipatory guidance. 12 8. Identify and utilize community resources that provide 13 medical, educational, financial, and psychosocial support and 14 advocacy. 15 9. Provide written documentation of medical, genetic, 16 and counseling information for families and health care 17 professionals. 18 Sec. 7. NEW SECTION . 148H.3 Qualifications for licensure —— 19 reciprocity —— provisional licensure. 20 1. Each applicant for licensure under this chapter shall: 21 a. Submit an application form as prescribed by the board. 22 b. Pay a licensing fee as determined by the board. 23 c. Provide satisfactory evidence of certification as a 24 genetic counselor by the American board of genetic counseling 25 or the American board of medical genetics and genomics or as a 26 medical geneticist by the American board of medical genetics. 27 2. A license shall be issued for a two-year period upon 28 payment of the licensing fee and shall be renewed upon the 29 filing of a renewal application and renewal fee as prescribed 30 by the board. 31 3. An applicant who is licensed or registered under the 32 laws of another state or a territory or jurisdiction of the 33 United States, which in the opinion of the board imposes 34 substantially the same licensing requirements as this chapter, 35 -4- LSB 6013SV (2) 86 tr/nh 4/ 9

S.F. 2250 may be licensed pursuant to this chapter. 1 4. a. The board may issue a provisional license to an 2 applicant who meets all of the requirements for licensure 3 except for the certification component and who has been granted 4 active candidate status. 5 b. The applicant shall pay a fee as determined by the board 6 upon filing of an application prescribed by the board for 7 provisional licensure. 8 c. A provisional license shall expire upon the earlier of 9 issuance of a full license by the board or the loss of active 10 candidate status from the American board of genetic counseling 11 by the holder of the provisional license. 12 Sec. 8. NEW SECTION . 148H.4 Scope of chapter. 13 This chapter shall not be construed to apply to any of the 14 following: 15 1. A physician or surgeon or an osteopathic physician or 16 surgeon licensed under chapter 148, a registered nurse or an 17 advanced registered nurse practitioner licensed under chapter 18 152, or a physician assistant licensed under chapter 148C when 19 acting within the scope of the person’s profession and doing 20 work of a nature consistent with the person’s training. 21 2. A person employed as a genetic counselor by the federal 22 government or an agency thereof if such person provides genetic 23 counseling services solely under the direction and control of 24 the organization by which the person is employed. 25 3. A genetic counseling intern. 26 4. A genetic counselor visiting from outside the state 27 performing activities or services for less than thirty days 28 each year. A visiting genetic counselor shall be licensed 29 by the genetic counselor’s home state if such licensure is 30 available in the home state. 31 Sec. 9. NEW SECTION . 148H.5 Continuing education. 32 1. An applicant for renewal of a license under this 33 chapter shall submit satisfactory evidence to the board that 34 in the period since the license was issued or last renewed, 35 -5- LSB 6013SV (2) 86 tr/nh 5/ 9

S.F. 2250 the applicant has completed thirty hours of national society 1 of genetic counselors or American board of medical genetics 2 continuing education units or other continuing education 3 approved by the board. 4 2. The board shall adopt rules to allow exceptions to the 5 requirements in subsection 1. 6 Sec. 10. NEW SECTION . 148H.6 Duties of board. 7 The board shall adopt rules consistent with this chapter and 8 chapters 147 and 148 which are necessary for the performance of 9 its duties under this chapter. 10 Sec. 11. NEW SECTION . 148H.7 Advisory committee. 11 1. a. Under the supervision of the board, there shall be 12 established a genetic counselor advisory committee consisting 13 of five persons licensed in accordance with this chapter. 14 b. Advisory committee members shall be appointed by the 15 board, serve terms of no greater than four consecutive years, 16 and be residents of this state. An advisory committee member 17 shall not be appointed to more than two consecutive full terms. 18 Advisory committee members appointed for less than a full term 19 may serve two full terms in addition to such part of a full 20 term. A former member shall be eligible for appointment after 21 a lapse of one year. 22 c. The advisory committee shall, at its first meeting and 23 annually thereafter, organize by electing from its membership 24 a chairman, a vice chairman, and a secretary. Those officers 25 shall serve until their successors are elected and qualified. 26 d. The advisory committee shall meet at least twice annually 27 and shall hold additional meetings at the call of the chair or 28 at such times as may be determined by the advisory committee. 29 2. The duties and responsibilities of the advisory 30 committee shall include the following: 31 a. Draft rules as are necessary to enforce this chapter for 32 review and adoption by the board. 33 b. Receive, review, and recommend to the board the approval 34 or disapproval of applications for licensure, renewal, and 35 -6- LSB 6013SV (2) 86 tr/nh 6/ 9

S.F. 2250 reinstatement. 1 c. Perform such other functions and duties as may be 2 required to carry out this chapter. 3 3. Advisory committee members shall serve without 4 compensation but shall be reimbursed for actual and reasonable 5 expenses incurred in the performance of their duties. 6 Sec. 12. NEW SECTION . 148H.8 Licensee discipline —— license 7 revocation or suspension. 8 1. In addition to the grounds for revocation or suspension 9 referred to in section 147.55 and in accordance with the 10 disciplinary process established for the board by section 11 148.6, a license issued under this chapter shall be revoked or 12 suspended when the genetic counselor is guilty of any of the 13 following acts or offenses: 14 a. Conviction of a felony under state or federal law or 15 commission of any other offense involving moral turpitude. 16 b. Having been adjudged mentally ill or incompetent by a 17 court of competent jurisdiction. 18 c. Engaging in unethical or unprofessional conduct including 19 but not limited to negligence or incompetence in the course of 20 professional practice. 21 d. Violating any lawful order, rule, or regulation rendered 22 or adopted by the board. 23 e. Having been refused issuance of or disciplined in 24 connection with a license issued by any other jurisdiction. 25 2. A genetic counselor whose license is suspended or revoked 26 or whose surrender of license with or without prejudice has 27 been accepted by the board shall promptly deliver the original 28 license to the board. 29 Sec. 13. TRANSITION PROVISIONS. 30 1. Notwithstanding section 147.16, the board of medicine 31 may appoint, as the initial members of the genetic counselor 32 advisory committee created in section 148H.7, individuals who 33 have been certified as genetic counselors by the American board 34 of genetic counseling or the American board of medical genetics 35 -7- LSB 6013SV (2) 86 tr/nh 7/ 9

S.F. 2250 and genomics or as medical geneticists by the American board of 1 medical genetics. The initial members shall have been engaged 2 in the practice of genetic counseling for not less than five 3 years before being appointed by the board of medicine. 4 2. Notwithstanding section 148H.3, subsection 1, as enacted 5 in this Act, during the period of one year from the effective 6 date of rules implementing this Act, the board of medicine 7 may grant a license to practice genetic counseling for an 8 applicant who provides documentation satisfactory to the board 9 that the applicant is certified as a genetic counselor by the 10 American board of genetic counseling or the American board of 11 medical genetics and genomics or as a medical geneticist by the 12 American board of medical genetics and has been engaged in the 13 practice of genetic counseling for not less than five years at 14 the time of the effective date of rules adopted by the board to 15 implement this Act. 16 Sec. 14. EFFECTIVE DATE AND IMPLEMENTATION. This Act shall 17 take effect January 1, 2017, except that the board of medicine 18 may begin implementation prior to that date, to the extent 19 necessary to fully implement the provisions providing for the 20 licensure of genetic counselors by January 1, 2017. 21 EXPLANATION 22 The inclusion of this explanation does not constitute agreement with 23 the explanation’s substance by the members of the general assembly. 24 This bill provides for the licensure of genetic counselors. 25 Under the bill, the board of medicine would be responsible 26 for the licensure, discipline, and rulemaking relating to the 27 practice of genetic counseling. The bill establishes a scope 28 of practice for genetic counselors, provides requirements for 29 licensure and continuing education, and includes licensee 30 discipline provisions. The bill creates a genetic counselor 31 advisory committee to propose rules and make recommendations 32 on licensure to the board. The bill provides that persons not 33 licensed under the bill, but who refer to themselves as genetic 34 counselors or use other similar terms or abbreviations shall 35 -8- LSB 6013SV (2) 86 tr/nh 8/ 9