H.F. _____ Section 1. Section 147.1, subsections 3 and 6, Code 2017, 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 2017, 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 2670YC (2) 87 tr/rj 1/ 7

H.F. _____ 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 7 mental health counseling, massage therapy, mortuary science, 8 polysomnography, athletic training, acupuncture, nursing 9 home administration, or sign language interpreting or 10 transliterating, or shall not practice as a physician assistant 11 or a hearing aid specialist, unless the person has obtained a 12 license for that purpose from the board for the profession. 13 Sec. 3. Section 147.13, subsection 1, Code 2017, 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 2017, 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” or “licensed 22 genetic counselor” or corresponding abbreviations after the 23 person’s name. 24 Sec. 5. NEW SECTION . 148H.1 Definitions. 25 1. “Active candidate status” means a person has met the 26 requirements established by the American board of genetic 27 counseling or its equivalent or successor organization to 28 take the American board of genetic counseling certification 29 examination in general genetics and genetic counseling or its 30 equivalent or successor examination and has been granted this 31 designation by the American board of genetic counseling or its 32 equivalent or successor organization. 33 2. “Board” means the board of medicine. 34 3. “Genetic counseling” means the provision of services by 35 -2- LSB 2670YC (2) 87 tr/rj 2/ 7

H.F. _____ an individual who qualifies for a license under this chapter. 1 4. “Genetic counseling intern” means a student enrolled in 2 a genetic counseling program accredited by the accreditation 3 council for genetic counseling or its equivalent or successor 4 organization, the American board of medical genetics and 5 genomics or its equivalent or successor organization. 6 5. “Genetic counselor” means an individual who is licensed 7 under this chapter to engage in the practice of genetic 8 counseling. 9 6. “Qualified supervisor” means any person who is a genetic 10 counselor licensed under this chapter, a physician licensed 11 under chapter 148, or an advanced registered nurse practitioner 12 licensed under chapter 152. 13 7. “Supervision” means supervision by a qualified supervisor 14 who has the overall responsibility of assessing the work of 15 a provisional licensee, provided that an annual supervision 16 contract signed by the qualified supervisor and the provisional 17 licensee is on file with both parties. “Supervision” does 18 not require the qualified supervisor’s presence during the 19 performance of services. 20 Sec. 6. NEW SECTION . 148H.2 Scope of practice. 21 A person licensed under this chapter may do any of the 22 following: 23 1. Obtain and evaluate individual, family, and medical 24 histories to determine genetic risk for genetic and medical 25 conditions and diseases in a patient, the patient’s offspring, 26 and other family members. 27 2. Discuss the features, history, means of diagnosis, 28 genetic and environmental factors, and management of risk for 29 genetic and medical conditions and diseases. 30 3. Identify, order, and coordinate genetic laboratory tests 31 and other diagnostic studies as appropriate for the genetic 32 assessment of a patient. 33 4. Refer a patient to a specialty or subspecialty department 34 as necessary for the purpose of collaborating on diagnosis and 35 -3- LSB 2670YC (2) 87 tr/rj 3/ 7

H.F. _____ treatment involving multiple body systems and general medical 1 management. 2 5. Integrate genetic laboratory test results and other 3 diagnostic studies with personal and family medical history to 4 assess and communicate risk factors for genetic and medical 5 conditions and diseases. 6 6. Explain the clinical implications of genetic laboratory 7 tests and other diagnostic studies and their results. 8 7. Evaluate the responses of a patient or patient’s 9 family to the condition or risk of recurrence and provide 10 patient-centered genetic counseling and anticipatory guidance. 11 8. Identify and utilize community resources that provide 12 medical, educational, financial, and psychosocial support and 13 advocacy. 14 9. Provide written documentation of medical, genetic, 15 and counseling information for families and health care 16 professionals. 17 Sec. 7. NEW SECTION . 148H.3 Qualifications for licensure 18 —— provisional licensure. 19 1. Each applicant for licensure under this chapter shall: 20 a. Submit an application form as prescribed by the board. 21 b. Provide satisfactory evidence of certification as a 22 genetic counselor by the American board of genetic counseling 23 or its equivalent or successor organization, the American board 24 of medical genetics and genomics or its equivalent or successor 25 organization, or as a medical geneticist by the American board 26 of medical genetics and genomics or its equivalent or successor 27 organization. 28 2. A license shall be issued for a two-year period and 29 shall be renewed upon the filing of a renewal application as 30 prescribed by the board. 31 3. A licensee shall maintain active certification as a 32 genetic counselor by the American board of genetic counseling 33 or its equivalent or successor organization, the American board 34 of medical genetics and genomics or its equivalent or successor 35 -4- LSB 2670YC (2) 87 tr/rj 4/ 7

H.F. _____ organization, or as a medical geneticist by the American 1 board of medical genetics and genomics, or its equivalent or 2 successor organization. 3 4. a. The board may issue a provisional license to an 4 applicant who meets all of the requirements for licensure 5 except for the certification component and who has been granted 6 active candidate status by the American board of genetic 7 counseling or its equivalent or successor organization. 8 b. The applicant shall submit a provisional license 9 application form prescribed by the board as determined by the 10 board. 11 c. A provisional license shall expire upon the earlier of 12 issuance of a full license by the board or the loss of active 13 candidate status from the American board of genetic counseling 14 or its equivalent or successor organization by the holder of 15 the provisional license. 16 d. A person with a provisional license shall only practice 17 genetic counseling under the supervision of a qualified 18 supervisor. 19 Sec. 8. NEW SECTION . 148H.4 Scope of chapter. 20 This chapter shall not be construed to apply to any of the 21 following: 22 1. A physician or surgeon or an osteopathic physician or 23 surgeon licensed under chapter 148, a registered nurse or an 24 advanced registered nurse practitioner licensed under chapter 25 152, a physician assistant licensed under chapter 148C, or 26 other persons licensed under chapter 147 when acting within the 27 scope of the person’s profession and doing work of a nature 28 consistent with the person’s education and training. 29 2. A person who is certified by the American board of 30 medical genetics and genomics or its equivalent or successor 31 organization as a doctor of philosophy and is not a genetic 32 counselor licensed pursuant to this chapter. 33 3. A person employed as a genetic counselor by the federal 34 government or an agency thereof if the person provides genetic 35 -5- LSB 2670YC (2) 87 tr/rj 5/ 7

H.F. _____ counseling services solely under the direction and control of 1 the entity by which the person is employed. 2 4. A genetic counseling intern. 3 Sec. 9. NEW SECTION . 148H.5 Continuing education. 4 An applicant for renewal of a license under this chapter 5 shall submit satisfactory evidence to the board that in the 6 period since the license was issued or last renewed, the 7 applicant has completed thirty hours of national society of 8 genetic counselors or its equivalent or successor organization 9 or American board of medical genetics and genomics or its 10 equivalent or successor organization continuing education units 11 as approved by the board. 12 Sec. 10. NEW SECTION . 148H.6 Rules —— authority of board. 13 The board shall adopt rules consistent with this chapter and 14 chapters 147 and 148 which are necessary for the performance 15 of its duties under this chapter. The board may consult with 16 genetic counselors during an investigative or disciplinary 17 proceeding as it deems necessary. 18 Sec. 11. NEW SECTION . 148H.7 Licensee discipline. 19 1. In addition to the grounds for revocation or suspension 20 referred to in section 147.55 and in accordance with the 21 disciplinary process established for the board by section 22 148.6, the board may discipline a person licensed under this 23 chapter who is guilty of any of the following acts or offenses: 24 a. Conviction of a felony under state or federal law or 25 commission of any other offense involving moral turpitude. 26 b. Having been adjudged mentally ill or incompetent by a 27 court of competent jurisdiction. 28 c. Engaging in unethical or unprofessional conduct including 29 but not limited to negligence or incompetence in the course of 30 professional practice. 31 d. Violating any lawful order, rule, or regulation rendered 32 or adopted by the board. 33 e. Having been refused issuance of or disciplined in 34 connection with a license issued by any other jurisdiction. 35 -6- LSB 2670YC (2) 87 tr/rj 6/ 7

H.F. _____ 2. A genetic counselor whose license is suspended or revoked 1 or whose surrender of license with or without prejudice has 2 been accepted by the board shall promptly deliver the original 3 license to the board. 4 3. A provisional licensee who loses active candidate status 5 with the American board of genetic counseling or its equivalent 6 or successor organization shall surrender the provisional 7 license to the board immediately. 8 Sec. 12. EFFECTIVE DATE AND IMPLEMENTATION. This Act shall 9 take effect January 1, 2018, except that the board of medicine 10 may begin implementation prior to that date, to the extent 11 necessary to fully implement the provisions providing for the 12 licensure of genetic counselors by January 1, 2018. 13 EXPLANATION 14 The inclusion of this explanation does not constitute agreement with 15 the explanation’s substance by the members of the general assembly. 16 This bill provides for the licensure of genetic counselors. 17 Under the bill, the board of medicine would be responsible 18 for the licensure, discipline, and rulemaking relating to the 19 practice of genetic counseling. The bill establishes a scope 20 of practice for genetic counselors, provides requirements for 21 licensure and continuing education, and includes licensee 22 discipline provisions. The bill provides that persons not 23 licensed under the bill, but who refer to themselves as genetic 24 counselors or use other similar terms or abbreviations shall 25 be guilty of a simple misdemeanor. A simple misdemeanor is 26 punishable by confinement for no more than 30 days or a fine of 27 at least $65 but not more than $625 or by both. 28 The bill takes effect January 1, 2018, except that the board 29 of medicine may begin implementation before that date. 30 -7- LSB 2670YC (2) 87 tr/rj 7/ 7