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 2123YC (4) 87 tr/nh 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”, “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. “Board” means the board of medicine. 34 3. “Genetic counseling” means the provision of services by 35 -2- LSB 2123YC (4) 87 tr/nh 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 the American board of medical 4 genetics and genomics. 5 5. “Genetic counselor” means an individual who is licensed 6 under this chapter to engage in the practice of genetic 7 counseling. 8 6. “Qualified supervisor” means any person who is a genetic 9 counselor licensed under this chapter, a physician licensed 10 under chapter 148, or an advanced registered nurse practitioner 11 licensed under chapter 152. 12 7. “Supervision” means supervision by a qualified supervisor 13 who has the overall responsibility of assessing the work of 14 a provisional licensee, provided that an annual supervision 15 contract signed by the qualified supervisor and the provisional 16 licensee is on file with both parties. “Supervision” does 17 not require the qualified supervisor’s presence during the 18 performance of services. 19 Sec. 6. NEW SECTION . 148H.2 Scope of practice. 20 A person licensed under this chapter may do any of the 21 following: 22 1. Obtain and evaluate individual, family, and medical 23 histories to determine genetic risk for genetic and medical 24 conditions and diseases in a patient, the patient’s offspring, 25 and other family members. 26 2. Discuss the features, history, means of diagnosis, 27 genetic and environmental factors, and management of risk for 28 genetic and medical conditions and diseases. 29 3. Identify, order, and coordinate genetic laboratory tests 30 and other diagnostic studies as appropriate for the genetic 31 assessment of a patient. 32 4. Refer a patient to a specialty or subspecialty department 33 as necessary for the purpose of collaborating on diagnosis and 34 treatment involving multiple body systems and general medical 35 -3- LSB 2123YC (4) 87 tr/nh 3/ 7

H.F. _____ management. 1 5. Integrate genetic laboratory test results and other 2 diagnostic studies with personal and family medical history to 3 assess and communicate risk factors for genetic and medical 4 conditions and diseases. 5 6. Explain the clinical implications of genetic laboratory 6 tests and other diagnostic studies and their results. 7 7. Evaluate the responses of a patient or patient’s 8 family to the condition or risk of recurrence and provide 9 patient-centered counseling and anticipatory guidance. 10 8. Identify and utilize community resources that provide 11 medical, educational, financial, and psychosocial support and 12 advocacy. 13 9. Provide written documentation of medical, genetic, 14 and counseling information for families and health care 15 professionals. 16 Sec. 7. NEW SECTION . 148H.3 Qualifications for licensure —— 17 provisional licensure —— fees. 18 1. Each applicant for licensure under this chapter shall: 19 a. Submit an application form as prescribed by the board. 20 b. Pay a licensing fee as determined by the board. 21 c. Provide satisfactory evidence of certification as a 22 genetic counselor by the American board of genetic counseling 23 or the American board of medical genetics and genomics or as a 24 medical geneticist by the American board of medical genetics 25 and genomics. 26 2. A license shall be issued for a two-year period upon 27 payment of the licensing fee and shall be renewed upon the 28 filing of a renewal application and renewal fee as prescribed 29 by the board. 30 3. A licensee shall maintain active certification as a 31 genetic counselor by the American board of genetic counseling 32 or the American board of medical genetics and genomics or as a 33 medical geneticist by the American board of medical genetics 34 and genomics. 35 -4- LSB 2123YC (4) 87 tr/nh 4/ 7

H.F. _____ 4. a. The board may issue a provisional license to an 1 applicant who meets all of the requirements for licensure 2 except for the certification component and who has been granted 3 active candidate status by the American board of genetic 4 counseling. 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 d. A person with a provisional license shall only practice 13 genetic counseling under the supervision of a qualified 14 supervisor. 15 5. The fees established and collected by the board 16 pursuant to this section shall be sufficient to administer the 17 provisions of this chapter. 18 Sec. 8. NEW SECTION . 148H.4 Scope of chapter. 19 This chapter shall not be construed to apply to any of the 20 following: 21 1. A physician or surgeon or an osteopathic physician or 22 surgeon licensed under chapter 148, a registered nurse or an 23 advanced registered nurse practitioner licensed under chapter 24 152, a physician assistant licensed under chapter 148C, or 25 other persons licensed under chapter 147 when acting within the 26 scope of the person’s profession and doing work of a nature 27 consistent with the person’s training. 28 2. A person who is certified by the American board of 29 medical genetics and genomics as a doctoral medical geneticist 30 and is not a genetic counselor. 31 3. A person employed as a genetic counselor by the federal 32 government or an agency thereof if the person provides genetic 33 counseling services solely under the direction and control of 34 the entity by which the person is employed. 35 -5- LSB 2123YC (4) 87 tr/nh 5/ 7

H.F. _____ 4. A genetic counseling intern. 1 Sec. 9. NEW SECTION . 148H.5 Continuing education. 2 An applicant for renewal of a license under this chapter 3 shall submit satisfactory evidence to the board that in the 4 period since the license was issued or last renewed, the 5 applicant has completed thirty hours of national society of 6 genetic counselors or American board of medical genetics 7 and genomics continuing education units or other continuing 8 education approved by the board. 9 Sec. 10. NEW SECTION . 148H.6 Rules —— authority of board. 10 The board shall adopt rules consistent with this chapter and 11 chapters 147 and 148 which are necessary for the performance 12 of its duties under this chapter. The board may consult with 13 genetic counselors during an investigative or disciplinary 14 proceeding as it deems necessary. 15 Sec. 11. NEW SECTION . 148H.7 Licensee discipline. 16 1. In addition to the grounds for revocation or suspension 17 referred to in section 147.55 and in accordance with the 18 disciplinary process established for the board by section 19 148.6, the board may discipline a person licensed under this 20 chapter who is guilty of any of the following acts or offenses: 21 a. Conviction of a felony under state or federal law or 22 commission of any other offense involving moral turpitude. 23 b. Having been adjudged mentally ill or incompetent by a 24 court of competent jurisdiction. 25 c. Engaging in unethical or unprofessional conduct including 26 but not limited to negligence or incompetence in the course of 27 professional practice. 28 d. Violating any lawful order, rule, or regulation rendered 29 or adopted by the board. 30 e. Having been refused issuance of or disciplined in 31 connection with a license issued by any other jurisdiction. 32 2. A genetic counselor whose license is suspended or revoked 33 or whose surrender of license with or without prejudice has 34 been accepted by the board shall promptly deliver the original 35 -6- LSB 2123YC (4) 87 tr/nh 6/ 7

H.F. _____ license to the board. 1 3. A provisional licensee who loses active candidate status 2 with the American board of genetic counseling shall surrender 3 the provisional license to the board immediately. 4 Sec. 12. EFFECTIVE DATE AND IMPLEMENTATION. This Act shall 5 take effect January 1, 2018, except that the board of medicine 6 may begin implementation prior to that date, to the extent 7 necessary to fully implement the provisions providing for the 8 licensure of genetic counselors by January 1, 2018. 9 EXPLANATION 10 The inclusion of this explanation does not constitute agreement with 11 the explanation’s substance by the members of the general assembly. 12 This bill provides for the licensure of genetic counselors. 13 Under the bill, the board of medicine would be responsible 14 for the licensure, discipline, and rulemaking relating to the 15 practice of genetic counseling. The bill establishes a scope 16 of practice for genetic counselors, provides requirements for 17 licensure and continuing education, and includes licensee 18 discipline provisions. The bill provides that persons not 19 licensed under the bill, but who refer to themselves as genetic 20 counselors or use other similar terms or abbreviations shall 21 be guilty of a simple misdemeanor. A simple misdemeanor is 22 punishable by confinement for no more than 30 days or a fine of 23 at least $65 but not more than $625 or by both. 24 The bill takes effect January 1, 2018, except that the board 25 of medicine may begin implementation before that date. 26 -7- LSB 2123YC (4) 87 tr/nh 7/ 7