Senate File 2392 - Introduced SENATE FILE 2392 BY COMMITTEE ON STATE GOVERNMENT (SUCCESSOR TO SSB 3142) A BILL FOR An Act relating to the operation of state government, including 1 the review of state boards, the regulation of professions 2 and occupations, and investigations conducted by state 3 boards, and including effective date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 5335SV (3) 88 ss/rh

S.F. 2392 DIVISION I 1 REGULATION OF PROFESSIONS 2 Section 1. NEW SECTION . 272C.12 Definitions. 3 For the purposes of this subchapter: 4 1. “Health profession board” means an entity regulating, 5 licensing, or certifying a profession regulated pursuant to 6 Title IV, subtitle 3. 7 2. “Nonhealth profession” means a profession regulated by 8 this state other than provided in Title IV, subtitle 3. 9 3. “Regulated health profession” means a profession 10 regulated pursuant to Title IV, subtitle 3. 11 4. “Unregulated health profession” means a profession 12 pursuant to Title IV, subtitle 3, that is not currently 13 regulated by any entity of this state. 14 5. “Unregulated nonhealth profession” means a profession 15 that is not currently regulated by any entity of this state 16 that is not an unregulated health profession. 17 Sec. 2. NEW SECTION . 272C.13 Regulation of unregulated 18 health professions. 19 1. An unregulated health profession shall not be subject 20 to regulation by any entity of this state for the purpose of 21 prohibiting competition but only for the exclusive purpose of 22 protecting the public interest. All proposed legislation to 23 regulate an unregulated health profession shall be reviewed by 24 the general assembly to determine that all of the following 25 conditions are met: 26 a. There is credible evidence that the unregulated 27 practice of the unregulated health profession will clearly 28 harm or endanger the public health, safety, or welfare and the 29 potential for harm is easily recognizable and not remote. 30 b. The public needs and can reasonably be expected 31 to benefit from an assurance of initial and continuing 32 professional ability. 33 c. The public cannot be effectively protected by other means 34 in a more cost-efficient manner. 35 -1- LSB 5335SV (3) 88 ss/rh 1/ 27

S.F. 2392 2. Prior to considering proposed legislation to regulate an 1 unregulated health profession for passage to the floor of the 2 senate or the house of representatives, a legislative committee 3 to which proposed legislation to regulate an unregulated 4 health profession has been referred shall consider whether the 5 conditions in subsection 1 have been met. If the committee 6 finds that the conditions in subsection 1 have been met, the 7 committee shall consider whether the legislation is the least 8 restrictive method of regulation to address the specific harm 9 or danger identified in this subsection. 10 a. If existing common law and statutory civil actions and 11 criminal prohibitions are not sufficient to eradicate existing 12 harm, the legislation shall provide for stricter civil actions 13 and criminal prohibitions. 14 b. If a service is being performed for individuals that 15 involves a hazard to the public health, safety, or welfare, the 16 legislation shall impose inspection requirements and enable an 17 appropriate state entity to respond to a violation by seeking 18 injunctive relief in court. 19 c. If the threat to the public health, safety, or welfare 20 is relatively small as a result of the operation of the 21 unregulated health profession, the legislation shall implement 22 a system of registration. 23 d. If a consumer may have a substantial basis for relying 24 on the services of a practitioner of an unregulated health 25 profession, the legislation shall implement a system of 26 certification. 27 e. If the legislative committee determines that adequate 28 regulation cannot be achieved by means other than licensing, 29 the legislation shall implement a system of licensing. 30 3. The legislative committee shall submit its findings 31 regarding whether the proposed legislation meets the conditions 32 in subsections 1 and 2 to the president of the senate and the 33 speaker of the house of representatives, who shall make the 34 findings available to each member of the general assembly. 35 -2- LSB 5335SV (3) 88 ss/rh 2/ 27

S.F. 2392 Sec. 3. NEW SECTION . 272C.14 Proposed regulation of 1 unregulated health professions —— written reports. 2 1. A member of the general assembly introducing proposed 3 legislation to regulate an unregulated health profession 4 shall submit with the legislation a report, prepared by the 5 legislative services agency, addressing the requirements 6 contained in subsection 2. The report shall be submitted to 7 the president of the senate and the speaker of the house of 8 representatives and made available on the internet site of the 9 general assembly. 10 2. The report shall address all of the following and 11 identify the source of all information contained in the report: 12 a. Why regulation is necessary including all of the 13 following: 14 (1) The nature of the potential harm to the public if the 15 unregulated health profession is not regulated and the extent 16 to which there is a threat to the public health, safety, or 17 welfare. 18 (2) The extent to which consumers need and will benefit 19 from a method of regulation, including the identification 20 of competent practitioners and typical employers in the 21 profession. 22 (3) The extent of autonomy a practitioner has, as indicated 23 by the extent to which the profession calls for the exercise 24 of independent judgment and the extent to which a practitioner 25 is supervised. 26 b. The efforts made to address the problem addressed by the 27 legislation including all of the following: 28 (1) Voluntary efforts, if any, undertaken by members of the 29 profession. 30 (2) Recourse to, and the extent of use of, applicable law 31 and whether the law could be amended to control the problem. 32 c. The alternatives considered including all of the 33 following: 34 (1) Regulation of business employers or practitioners 35 -3- LSB 5335SV (3) 88 ss/rh 3/ 27

S.F. 2392 rather than employee practitioners. 1 (2) Regulation of the program or service rather than 2 individual practitioners. 3 (3) Registration of all practitioners. 4 (4) Certification of all practitioners. 5 (5) Other viable alternatives. 6 (6) If licensing is sought, why licensing would serve to 7 protect the public interest. 8 d. The benefit to the public if regulation is granted 9 including all of the following: 10 (1) The extent to which the incidence of specific problems 11 present in the unregulated health profession can reasonably be 12 expected to be reduced by regulation. 13 (2) Whether the public can identify qualified 14 practitioners. 15 (3) The extent to which the public can be confident that 16 qualified practitioners are competent including all of the 17 following: 18 (a) The composition, powers, duties, and practices of the 19 proposed regulatory entity. 20 (b) Whether current practitioners of an unregulated health 21 profession will be allowed to continue to practice and whether 22 they will be required to meet the qualifications for the 23 regulated health profession. 24 (c) The nature of the standards proposed for registration, 25 certification, or licensure as compared with the standards in 26 other jurisdictions. 27 (d) Whether the proposed regulatory entity would be 28 authorized to enter into reciprocity agreements with other 29 jurisdictions. 30 (e) The nature and duration of any training and experience 31 required, whether applicants will be required to pass an 32 examination, and whether there will be alternative methods to 33 enter the health profession. 34 (4) Assurances from the public that practitioners have 35 -4- LSB 5335SV (3) 88 ss/rh 4/ 27

S.F. 2392 maintained their competence including all of the following: 1 (a) Whether a registration, certificate, or license will 2 include an expiration date. 3 (b) Whether the renewal of a registration, certificate, 4 or license will be based only on payment of a fee or whether 5 renewal will involve reexamination, peer review, or other 6 enforcement. 7 e. The extent to which regulation might harm the public 8 including all of the following: 9 (1) The extent to which regulation will restrict entry into 10 the profession including all of the following: 11 (a) Whether the proposed standards are more restrictive 12 than necessary to ensure a practitioner’s safe and effective 13 performance in the practice of the profession. 14 (b) Whether the proposed legislation requires registered, 15 certified, or licensed practitioners in other jurisdictions 16 who relocate to this state to qualify in the same manner as 17 other applicants if the other jurisdiction has substantially 18 equivalent requirements for registration, certification, or 19 licensure. 20 (2) Whether there are professions similar to the 21 unregulated health profession that should be included in, or 22 portions of the unregulated health profession that should be 23 excluded from, the proposed legislation. 24 f. The maintenance of professional standards including all 25 of the following: 26 (1) Whether effective quality assurance standards exist 27 in the profession such as legal requirements associated with 28 specific programs that define or enforce standards or a code 29 of ethics. 30 (2) How the proposed legislation will ensure quality, 31 including whether a code of ethics will be adopted and the 32 grounds for suspension or revocation of a registration, 33 certificate, or license. 34 g. A description of the group proposed for regulation, 35 -5- LSB 5335SV (3) 88 ss/rh 5/ 27

S.F. 2392 including a list of associations, organizations, and other 1 professional groups representing practitioners in this state, 2 an estimate of the number of practitioners in each professional 3 group, and whether the professional groups represent different 4 levels of practice. 5 h. The expected costs of regulation, including the impact of 6 costs on the public and costs imposed on this state. 7 Sec. 4. NEW SECTION . 272C.15 Proposed increased regulation 8 of regulated health professions —— written reports. 9 1. A member of the general assembly introducing proposed 10 legislation to expand the scope of practice of a regulated 11 health profession shall submit with the legislation a report, 12 prepared by the legislative services agency, addressing the 13 requirements contained in subsection 2. The report shall be 14 submitted to the president of the senate and the speaker of the 15 house of representatives and made available on the internet 16 site of the general assembly. 17 2. The report shall address all of the following and 18 identify the source of all information contained in the report: 19 a. Why an expanded scope of practice for the regulated 20 health profession is beneficial, including the extent to which 21 health care consumers need and will benefit from safe, quality 22 health care from practitioners within the expanded scope of 23 practice. 24 b. Whether expanding the scope of practice of practitioners 25 in the regulated health profession will require practitioners 26 to have didactic and clinical education from accredited 27 professional schools or training from recognized programs that 28 prepare them to perform within the proposed expanded scope of 29 practice, and specific educational or training requirements for 30 that proposed expanded scope of practice. 31 c. Whether the subject matter of the proposed expanded scope 32 of practice is currently tested by nationally recognized and 33 accepted examinations for applicants for professional licensure 34 and the details of the examination relating to the expanded 35 -6- LSB 5335SV (3) 88 ss/rh 6/ 27

S.F. 2392 scope of practice. 1 d. The extent to which the proposed expanded scope 2 of practice will impact the practice of practitioners 3 currently licensed in this state or the entry into practice 4 of practitioners who have relocated from other states with 5 substantially equivalent requirements for registration, 6 certification, or licensure in this state. 7 e. The extent to which implementing the proposed expanded 8 scope of practice may result in savings or a cost to this state 9 and to the public. 10 f. The relevant regulated health profession licensure laws, 11 if any, in this state and other states. 12 g. Recommendations, if any, the applicable regulatory entity 13 or entities, the department of public health, and accredited 14 educational or training programs. 15 3. a. Prior to considering proposed legislation to 16 expand the scope of practice of a regulated health profession 17 for passage to the floor of the senate or the house of 18 representatives, a legislative committee to which proposed 19 legislation has been referred shall consider all of the 20 following: 21 (1) Whether the expansion of a regulated health 22 profession’s scope of practice is only for the purpose of 23 protecting the public from a specific harm or danger. 24 (2) Whether the addition of adequately trained 25 practitioners providing an expanded range of health care 26 services will have a beneficial effect on the public and 27 increase access to safe, quality health care. 28 (3) Whether any changes in the entity regulating the 29 regulated health profession are necessary to protect the 30 public. 31 b. The legislative committee shall not consider competition 32 with or from other regulated health professions or whether a 33 practitioner will be able to obtain health insurance coverage 34 for the proposed expanded scope of practice. 35 -7- LSB 5335SV (3) 88 ss/rh 7/ 27

S.F. 2392 Sec. 5. NEW SECTION . 272C.16 Continuing education 1 requirements —— evidence of efficacy. 2 A member of the general assembly introducing proposed 3 legislation to impose or increase a continuing education 4 requirement on a regulated health profession shall submit with 5 the legislation evidence that such a requirement has proven 6 effective for the health profession. The evidence shall be 7 submitted to the president of the senate and the speaker of the 8 house of representatives and made available on the internet 9 site of the general assembly. 10 Sec. 6. NEW SECTION . 272C.17 Regulation of unregulated 11 nonhealth professions. 12 1. An unregulated nonhealth profession shall not be 13 regulated except for the exclusive purpose of protecting the 14 public interest. All proposed legislation to regulate an 15 unregulated nonhealth profession shall be reviewed by the 16 legislative committee to which the proposed legislation is 17 referred to ensure that all of the following requirements are 18 met: 19 a. The unregulated practice of the nonhealth profession can 20 clearly harm the public health, safety, or welfare. 21 b. The actual or anticipated public benefit of the 22 regulation clearly exceeds the costs imposed by the regulation 23 on consumers, businesses, and individuals. 24 c. The public needs and can reasonably be expected 25 to benefit from an assurance of initial and continuing 26 professional ability. 27 d. The public cannot be effectively protected by private 28 certification or other alternatives. 29 2. If a legislative committee finds that the proposed 30 legislation satisfies the conditions in subsection 1, the 31 committee shall examine data from multiple sources and shall 32 consider evidence of actual harm to the public related to 33 the unregulated nonhealth profession being considered for 34 regulation. The evidence may include industry association 35 -8- LSB 5335SV (3) 88 ss/rh 8/ 27

S.F. 2392 data; federal, state, and local government data; business 1 reports; complaints to law enforcement, relevant state 2 agencies, and the better business bureau; and data from 3 agencies in other states with and without similar systems of 4 regulation. 5 3. If, after consideration of evidence pursuant to 6 subsection 2, the legislative committee finds that it is 7 necessary to regulate an unregulated nonhealth profession, the 8 committee shall review the proposed legislation to determine 9 whether it is the least restrictive regulation necessary and 10 whether the regulation protects a discrete interest group from 11 economic competition. 12 4. The legislative committee shall submit its findings 13 regarding whether the proposed legislation meets the 14 requirements of subsections 1, 2, and 3 to the president of the 15 senate and the speaker of the house of representatives, who 16 shall make the findings available to each member of the general 17 assembly. 18 Sec. 7. NEW SECTION . 272C.18 Proposed regulation of 19 unregulated nonhealth professions —— written reports. 20 1. A member of the general assembly introducing legislation 21 to regulate an unregulated nonhealth profession shall submit 22 with the legislation a report, prepared by the legislative 23 services agency, addressing the requirements contained in 24 subsection 2. The report shall be submitted to the president 25 of the senate and the speaker of the house of representatives 26 and made available on the internet site of the general 27 assembly. 28 2. The report shall address all of the following and 29 identify the source of all information contained in the report: 30 a. Why regulation is necessary including what particular 31 problem regulation would address. 32 b. The efforts made to address the problem. 33 c. The alternatives considered. 34 d. The benefit to the public of regulating the profession. 35 -9- LSB 5335SV (3) 88 ss/rh 9/ 27

S.F. 2392 e. The extent to which regulation might harm the public. 1 f. The maintenance of professional standards including all 2 of the following: 3 (1) Whether effective quality assurance standards exist 4 in the profession such as legal requirements associated with 5 specific programs that define or enforce standards or a code 6 of ethics. 7 (2) How the proposed legislation will assure quality 8 including the extent to which a code of ethics will be 9 adopted and the grounds for the suspension or revocation of a 10 registration, certificate, or license. 11 g. A description of the profession proposed for regulation, 12 including a list of associations, organizations, and other 13 professional groups representing practitioners in this state, 14 an estimate of the number of practitioners in each profession, 15 and whether the professional groups represent different levels 16 of practice. 17 h. The expected costs of regulation, including the impact of 18 costs on the public and costs imposed on this state. 19 DIVISION II 20 BOARD REVIEWS 21 Sec. 8. Section 2.69, subsections 4, 5, and 6, Code 2020, 22 are amended by striking the subsections. 23 Sec. 9. NEW SECTION . 4A.2 Definitions. 24 As used in this chapter, unless the context otherwise 25 requires: 26 1. “Board” means any board, council, commission, committee, 27 panel, review team, or foundation of this state, except that 28 “board” does not include a pension board or the Iowa ethics and 29 campaign disclosure board created in section 68B.32. 30 2. “Board review criteria” means the criteria required to be 31 considered under section 4A.5. 32 3. “Committee” means the state government efficiency review 33 committee created pursuant to section 2.69. 34 Sec. 10. NEW SECTION . 4A.3 Committee —— review of boards. 35 -10- LSB 5335SV (3) 88 ss/rh 10/ 27

S.F. 2392 1. The committee shall carry out the functions provided in 1 this chapter. 2 2. Administrative assistance shall be provided by the 3 legislative services agency and by staff of each caucus of the 4 general assembly. 5 Sec. 11. NEW SECTION . 4A.5 Board reviews. 6 1. The committee shall review the usefulness, performance, 7 and efficacy of each board as provided in subsection 2. The 8 committee shall hold hearings to receive the testimony of the 9 public and of the chief executive officer of the board. After 10 completing a review, the committee shall prepare and publish 11 a report of its findings and recommendations as provided in 12 section 4A.6. 13 2. The legislative services agency shall establish a 14 schedule for the committee to review each board such that 15 the committee reviews approximately one-fifth of all boards 16 each calendar year and each board has been reviewed once 17 between the calendar years 2021 and 2026. The committee may 18 modify the schedule as necessary to facilitate the efficient 19 administration of the committee. 20 3. A board that is scheduled for review shall submit a 21 report to the committee prior to the date that it is scheduled 22 for review that includes all of the following information: 23 a. The board’s primary purpose and its goals and objectives. 24 b. The board’s past and anticipated workload, the number of 25 staff required to complete that workload, and the board’s total 26 number of staff. 27 c. The board’s past and anticipated budgets and its sources 28 of funding. 29 d. The number of members that compose the governing board or 30 other governing entity of the board and member compensation, 31 if any. 32 4. A board subject to review shall bear the burden of 33 demonstrating to the committee a public need for its continued 34 existence. In determining whether a board has met that 35 -11- LSB 5335SV (3) 88 ss/rh 11/ 27

S.F. 2392 burden, the committee shall consider all of the following, as 1 applicable: 2 a. Whether continuation of the board is necessary to protect 3 the health, safety, or welfare of the public, and if so, 4 whether the board’s authority is narrowly tailored to protect 5 against present, recognizable, and significant harms to the 6 health, safety, or welfare of the public. 7 b. Whether the public could be protected or served in an 8 alternate or less restrictive manner. 9 c. Whether the board serves a specific private interest. 10 d. Whether rules adopted by the board are consistent with 11 the legislative mandate of the board as expressed in the 12 statutes that created and empowered the board. 13 e. The extent to which the board’s jurisdiction and programs 14 overlap or duplicate those of other boards, the extent to which 15 the board coordinates with those other boards, and the extent 16 to which the board’s programs could be consolidated with the 17 programs of other state departments or boards. 18 f. The number of other states that regulate the occupation, 19 whether a license is required to engage in the occupation in 20 other states, whether the initial licensing and license renewal 21 requirements for the occupation are substantially equivalent 22 in every state, and the amount of regulation exercised by the 23 board compared to the regulation, if any, in other states. 24 g. The extent to which significant changes in the board’s 25 rules could prevent an individual licensed in this state from 26 practicing, or allow an individual licensed in this state to 27 practice, the same occupation in another jurisdiction without 28 obtaining an occupational license for that occupation in that 29 other jurisdiction. 30 h. Whether the board recognizes national uniform licensure 31 requirements for the occupation. 32 i. Whether private contractors could be used, in an 33 effective and efficient manner, either to assist the board in 34 the performance of its duties or to perform the board’s duties 35 -12- LSB 5335SV (3) 88 ss/rh 12/ 27

S.F. 2392 in place of the board. 1 j. Whether the operation of the board has inhibited economic 2 growth, reduced efficiency, or increased government costs. 3 k. An assessment of the authority of the board regarding 4 fees, inspections, enforcement, and penalties. 5 l. The extent to which the board has permitted qualified 6 applicants to serve the public. 7 m. The extent to which the board has allowed individuals to 8 practice elements of the occupation without a license. 9 n. The cost-effectiveness of the board in terms of the 10 number of employees, services rendered, and administrative 11 costs incurred, both past and present. 12 o. Whether the board’s operation has been impeded or 13 enhanced by existing statutes and procedures and by budgetary, 14 resource, and personnel practices. 15 p. Whether the board has recommended statutory changes to 16 the general assembly that would benefit the public rather than 17 the individuals regulated by the board, if any, and whether the 18 board’s recommendations and other policies have been adopted 19 and implemented. 20 q. Whether the board has required any individuals subject to 21 the board’s regulations to report to the board the impact of 22 board rules and decisions on the public as they affect service 23 costs and service delivery. 24 r. Whether individuals regulated by the board, if any, have 25 been required to assess problems in their business operations 26 that affect the public. 27 s. Whether the board has encouraged public participation in 28 its rulemaking and decision making. 29 t. The efficiency with which formal public complaints filed 30 with the board have been processed to completion. 31 u. Whether the purpose for which the board was created has 32 been fulfilled, has changed, or no longer exists. 33 v. Whether federal law requires that the board be renewed 34 in some form. 35 -13- LSB 5335SV (3) 88 ss/rh 13/ 27

S.F. 2392 w. An assessment of the administrative hearing process of 1 the board if the board has an administrative hearing process, 2 and whether the hearing process is consistent with due process 3 rights. 4 x. Whether the requirement for an occupational license 5 is consistent with the principles expressed in section 4C.2, 6 serves a meaningful, defined public interest, and provides the 7 least restrictive form of regulation that adequately protects 8 the public interest. 9 y. The extent to which licensing ensures that practitioners 10 have occupational skill sets or competencies that are 11 substantially related to protecting consumers from present, 12 significant, and substantiated harms that threaten the public 13 health, safety, or welfare, and the impact that those criteria 14 have on applicants for a license, particularly those with 15 moderate or low incomes, seeking to enter the occupation or 16 profession. 17 z. The extent to which the requirement for the occupational 18 license stimulates or restricts competition, affects consumer 19 choice, and affects the cost of services. 20 aa. An assessment of whether changes are needed in the 21 enabling laws of the board in order for the board to comply 22 with the criteria listed in this subsection. 23 Sec. 12. NEW SECTION . 4A.6 Reports of the committee. 24 1. After completing a review of a board pursuant to section 25 4A.5, the committee shall prepare and submit a report of its 26 findings and recommendations by December 21. A report may 27 include findings and recommendations for more than one board. 28 Copies of the report shall be submitted to the president of 29 the senate, the speaker of the house of representatives, the 30 governor, and each affected board, and shall be made publicly 31 available on the internet site of the general assembly. The 32 committee shall present its recommendations to the general 33 assembly in the form of a bill. 34 2. Recommendations of the committee shall indicate how or 35 -14- LSB 5335SV (3) 88 ss/rh 14/ 27

S.F. 2392 whether implementation of the recommendations would do each of 1 the following: 2 a. Improve efficiency in the management of state government. 3 b. Improve services rendered to citizens of the state. 4 c. Simplify and improve preparation of the state budget. 5 d. Conserve the natural resources of the state. 6 e. Promote the orderly growth of the state and its 7 government. 8 f. Promote occupational regulations to increase economic 9 opportunities, encourage competition, and encourage innovation. 10 g. Provide for the least restrictive regulations by 11 repealing current regulations and replacing them with less 12 restrictive regulations that are consistent with the principles 13 expressed in section 4C.2. 14 h. Improve the effectiveness of the services performed by 15 the boards of the state. 16 i. Avoid duplication of effort by state agencies or boards. 17 j. Improve the organization and coordination of the state 18 government. 19 Sec. 13. NEW SECTION . 4A.7 Activities of the general 20 assembly not restricted. 21 This chapter shall not be construed to restrict the general 22 assembly from considering any legislation concerning a board 23 subject to this chapter. 24 Sec. 14. NEW SECTION . 4C.1 Definitions. 25 For the purposes of this chapter: 26 1. “Certification” means a voluntary program in which 27 a private organization or the state grants nontransferable 28 recognition to an individual who meets personal qualifications 29 established by the private organization or state law. 30 2. “Lawful occupation” means a course of conduct, pursuit, 31 or profession that includes the sale of goods or services that 32 are not themselves illegal to sell irrespective of whether 33 the individual selling the goods or services is subject to an 34 occupational regulation. 35 -15- LSB 5335SV (3) 88 ss/rh 15/ 27

S.F. 2392 3. “Least restrictive regulation” means the public policy of 1 relying on one of the following, listed from the least to the 2 most restrictive, as a means of consumer protection: 3 a. Market competition. 4 b. Third-party or consumer-created ratings and reviews. 5 c. Private certifications. 6 d. Actions under section 714H.5. 7 e. Actions under section 714.16. 8 f. Regulation of the process of providing the specific goods 9 or services to consumers. 10 g. Inspections. 11 h. Bonding or insurance. 12 i. Registrations. 13 j. Government certifications. 14 k. Occupational licenses, including specialty occupational 15 licenses for medical reimbursement. 16 4. “Occupational license” means a government permission slip 17 to work that is a nontransferable authorization in law that an 18 individual must possess in order to perform a lawful occupation 19 for compensation based on meeting personal qualifications 20 established by statute or by a rule authorized by statute. 21 “Occupational license” does not include a commercial or other 22 driver’s license. 23 5. “Occupational licensing board” means any board, 24 commission, committee, or council, or any other similar state 25 public body, and any agency, division, or office of state 26 government, that issues an occupational license. 27 6. “Occupational regulation” means a statute, policy, rule, 28 practice, or other state law requiring an individual to possess 29 certain personal qualifications to use an occupational title or 30 work in a lawful occupation. “Occupational regulation” includes 31 a registration, certification, and occupational license. 32 “Occupational regulation” excludes a business license, facility 33 license, building permit, or zoning and land use regulation, 34 except to the extent those laws regulate an individual’s 35 -16- LSB 5335SV (3) 88 ss/rh 16/ 27

S.F. 2392 personal qualifications to perform a lawful occupation, and 1 excludes a commercial or other driver’s license. 2 7. “Personal qualifications” means criteria related to an 3 individual’s personal background and characteristics including 4 completion of an approved educational program, satisfactory 5 performance on an examination, work experience, other evidence 6 of attainment of requisite skills or knowledge, moral standing, 7 criminal history, and completion of continuing education. 8 8. “Registration” means a requirement to give notice to the 9 government that may include the individual’s name and address, 10 the individual’s agent for service of process, the location of 11 the activity to be performed, and a description of the service 12 the individual provides. “Registration” does not include 13 personal qualifications but may require a bond or insurance. 14 9. “Specialty occupational license for medical reimbursement” 15 is a nontransferable authorization in law for an individual 16 to qualify for payment or reimbursement from a government 17 agency for providing identified medical services based on 18 meeting personal qualifications established in law which may be 19 recognized by a private company. 20 Sec. 15. NEW SECTION . 4C.2 Occupational regulation 21 principles. 22 With respect to the occupational regulation of individuals, 23 all of the following shall be policies of this state: 24 1. Occupational regulations shall be construed and applied 25 to increase economic opportunities, promote competition, and 26 encourage innovation. 27 2. If the state finds it is necessary to displace 28 competition, the state shall use the least restrictive 29 regulation to protect consumers from present, significant, 30 and substantiated harms that threaten public health, safety, 31 or welfare. The policy of employing the least restrictive 32 regulation shall presume that market competition and private 33 remedies are sufficient to protect consumers. If necessary, 34 regulations shall be tailored to meet the predominate 35 -17- LSB 5335SV (3) 88 ss/rh 17/ 27

S.F. 2392 identified need to protect consumers as follows: 1 a. If a regulation is intended to protect consumers against 2 fraud, the appropriate state action shall be to strengthen 3 powers under deceptive trade practices acts. 4 b. If a regulation is intended to protect consumers against 5 unsanitary facilities and general health, safety, or welfare 6 concerns, the appropriate state action shall be to require 7 periodic inspections. 8 c. If a regulation is intended to protect a consumer against 9 potential damages to a third party who is not a party to a 10 contract between the seller and buyer, and other types of 11 externalities, the appropriate state action shall be to require 12 bonding or insurance. 13 d. If a regulation is intended to protect a consumer against 14 potential damages by transient providers, the appropriate state 15 action shall be to require registration with the secretary of 16 state. 17 e. If a regulation is intended to protect a consumer 18 against asymmetrical information between the seller and buyer, 19 the appropriate state action shall be to offer voluntary 20 certification, unless appropriate, privately offered voluntary 21 certification for the relevant occupation is available. 22 f. If a regulation is intended to facilitate governmental 23 reimbursement for providing medical services for an emerging 24 medical specialty, the appropriate state action shall be 25 to require a specialty occupational license for medical 26 reimbursement. A person shall not be required to hold a 27 specialty occupational license for medical reimbursement in 28 order to lawfully provide a medical service for an emerging 29 medical specialty; however, a person providing a medical 30 service for an emerging medical specialty without a specialty 31 occupational license for medical reimbursement shall not 32 receive governmental reimbursement for providing that service. 33 A specialty occupational license for medical reimbursement 34 shall not restrict governmental reimbursement for services 35 -18- LSB 5335SV (3) 88 ss/rh 18/ 27

S.F. 2392 similar to the regulated service that may be provided by other 1 regulated persons. 2 g. If a regulation is required to perform services 3 regulated by both federal laws and the laws of this state, 4 the appropriate state action shall be to require the state 5 to recognize an individual’s occupational license from 6 another state or territory of the United States to allow that 7 individual to practice in this state. 8 3. An occupational regulation may be enforced against an 9 individual only to the extent the individual sells goods and 10 services that are included explicitly in the statute that 11 defines the occupation’s scope of practice. 12 4. This chapter shall not restrict an occupational 13 licensing board from requiring, as a condition of licensure 14 or renewal of licensure, that an individual’s personal 15 qualifications include obtaining or maintaining certification 16 from a private organization that credentials individuals in the 17 relevant occupation. 18 Sec. 16. NEW SECTION . 4C.3 Local licensing —— preemption. 19 This chapter preempts any ordinance or other local law or 20 regulation which conflicts with or is inconsistent with any 21 policy of the state expressed in this chapter by any political 22 subdivision that regulates an occupation that is not regulated 23 by the state. 24 DIVISION III 25 ACCOUNTABLE GOVERNMENT ACT REPORTS 26 Sec. 17. Section 8E.210, Code 2020, is amended by adding the 27 following new subsection: 28 NEW SUBSECTION . 1A. In addition to the requirements 29 of subsection 1, an agency’s annual performance report 30 shall include a description of how the agency improved 31 efficiency, modernized processes, eliminated duplication and 32 outdated processes, reduced costs, increased accountability, 33 expanded the use of technology, and incorporated productivity 34 improvement measures. The section of the annual performance 35 -19- LSB 5335SV (3) 88 ss/rh 19/ 27

S.F. 2392 report addressing the factors listed in this subsection shall 1 be submitted to the state government committee of each chamber 2 of the general assembly and made publicly available on the 3 internet site of the general assembly. 4 DIVISION IV 5 PROFESSIONAL LICENSING BOARD INVESTIGATIONS 6 Sec. 18. Section 272C.3, subsection 1, paragraph d, Code 7 2020, is amended to read as follows: 8 d. Determine in any case whether an investigation, or 9 further investigation, or a disciplinary proceeding is 10 warranted. Notwithstanding the provisions of chapter 17A , 11 a determination by a licensing board that an investigation 12 is not warranted or that an investigation should be closed 13 without initiating a disciplinary proceeding is not subject to 14 judicial review pursuant to section 17A.19 . Notwithstanding 15 any other provision of law, if a board determines that there 16 is no probable cause to believe that an asserted violation has 17 occurred, the complaint shall be returned to the complainant 18 with a statement specifying the reasons for rejection 19 sufficient to enable the complainant to review the agency’s 20 determination. 21 DIVISION V 22 ADMINISTRATIVE RULES REVIEW COMMITTEE REVIEW OF ENTRY 23 REGULATIONS 24 Sec. 19. NEW SECTION . 17A.35 Review of occupational entry 25 regulations. 26 1. For purposes of this section, unless the context 27 otherwise requires: 28 a. “Entry regulation” means any rule adopted pursuant to 29 chapter 17A by a licensing board for the purpose of regulating 30 an occupational or professional group, including but not 31 limited to any rule prescribing qualifications or requirements 32 for a person’s entry into, or continued participation in, any 33 business, trade, profession, or occupation in this state. 34 b. “Licensing board” or “board” means the same as defined 35 -20- LSB 5335SV (3) 88 ss/rh 20/ 27

S.F. 2392 in section 272C.1. 1 2. A licensing board shall designate any entry regulation 2 filed with the administrative rules coordinator and 3 administrative code editor pursuant to section 17A.4 or 17A.5 4 as an entry regulation in the preamble. 5 3. The administrative rules review committee, when 6 reviewing a rule pursuant to section 17A.8, subsection 6, that 7 is designated as an entry regulation by a licensing board, 8 shall consider the following factors when reviewing the rule: 9 a. Whether the entry regulation is required by state or 10 federal law. 11 b. Whether the entry regulation is necessary to protect the 12 public health, safety, or welfare. 13 c. Whether the purpose or effect of the entry regulation is 14 to unnecessarily inhibit competition or arbitrarily deny entry 15 into a business, trade, profession, or occupation. 16 d. Whether the intended purpose of the entry regulation 17 could be accomplished by less restrictive or burdensome means. 18 e. Whether the entry regulation is outside of the scope of 19 the licensing board’s statutory authority to adopt rules. 20 4. The administrative rules review committee, when 21 considering the factors provided in subsection 3, shall not 22 give deference to a statement or interpretation made by a 23 licensing board regarding an entry regulation, statute, or 24 other legal authority. 25 5. If the administrative rules review committee disapproves 26 of an entry regulation after consideration of the factors 27 provided in subsection 3, the committee may take any action on 28 the rule otherwise permitted to the committee. 29 6. a. No later than December 31, 2020, each licensing board 30 shall submit to the administrative rules review committee a 31 list of all entry regulations adopted by the board that are in 32 effect as of the date of submission. 33 b. The administrative rules review committee shall review 34 all entry regulations submitted to the committee pursuant 35 -21- LSB 5335SV (3) 88 ss/rh 21/ 27