Senate Study Bill 1046 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON STATE GOVERNMENT BILL BY CHAIRPERSON SMITH) 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 and applicability 4 provisions. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 1457XC (3) 89 ss/rh

S.F. _____ DIVISION I 1 REGULATION OF PROFESSIONS 2 Section 1. NEW SECTION . 272C.16 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.17 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 22 of protecting the public health or safety. All proposed 23 legislation to regulate an unregulated health profession shall 24 be reviewed by the general assembly to determine that all of 25 the following conditions are met: 26 a. There is credible evidence that the unregulated practice 27 of the unregulated health profession will clearly harm or 28 endanger the public health or safety and the potential for harm 29 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 1457XC (3) 89 ss/rh 1/ 28

S.F. _____ 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 15 that involves a hazard to the public health or safety, 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 or safety is 20 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 or the 33 speaker of the house of representatives, who shall make the 34 findings available to each member of the general assembly on 35 -2- LSB 1457XC (3) 89 ss/rh 2/ 28

S.F. _____ the internet site of the general assembly. 1 Sec. 3. NEW SECTION . 272C.18 Proposed regulation of 2 unregulated health professions —— written reports. 3 1. A member of the general assembly introducing proposed 4 legislation to regulate an unregulated health profession 5 shall submit with the legislation a report, prepared by the 6 legislative services agency, addressing the requirements 7 contained in subsection 2. The report shall be submitted to 8 the president of the senate or the speaker of the house of 9 representatives prior to full consideration of the legislation 10 by the senate or the house of representatives and made 11 available on the internet site of the general assembly. 12 2. The report shall address all of the following and 13 identify the source of all information contained in the report: 14 a. Why regulation is necessary including all of the 15 following: 16 (1) The nature of the proven harm to the public if the 17 unregulated health profession is not regulated and the extent 18 to which there is a threat to the public health or safety. 19 (2) The extent of autonomy a practitioner has, as indicated 20 by the extent to which the profession calls for the exercise 21 of independent judgment and the extent to which a practitioner 22 is supervised. 23 b. The efforts made to address the problem addressed by the 24 legislation including all of the following: 25 (1) Voluntary efforts, if any, undertaken by members of the 26 profession. 27 (2) Recourse to, and the extent of use of, applicable law 28 and whether the law could be amended to control the problem. 29 c. The alternatives considered including all of the 30 following: 31 (1) Regulation of business employers or practitioners 32 rather than employee practitioners. 33 (2) Regulation of the program or service rather than 34 individual practitioners. 35 -3- LSB 1457XC (3) 89 ss/rh 3/ 28

S.F. _____ (3) Registration of all practitioners. 1 (4) Certification of all practitioners. 2 (5) Other viable alternatives. 3 (6) If licensing is sought, why licensing would serve to 4 protect the public health or safety. 5 d. The benefit to the public health or safety if regulation 6 is granted including all of the following: 7 (1) The extent to which the incidence of specific problems 8 present in the unregulated health profession can reasonably be 9 expected to be reduced by regulation. 10 (2) Whether the public can identify qualified 11 practitioners. 12 (3) The extent to which qualified practitioners are 13 competent including all of the following: 14 (a) The composition, powers, duties, and practices of the 15 proposed regulatory entity. 16 (b) Whether current practitioners of an unregulated health 17 profession will be allowed to continue to practice and whether 18 they will be required to meet the qualifications for the 19 regulated health profession. 20 (c) The nature of the standards proposed for registration, 21 certification, or licensure as compared with the standards in 22 other jurisdictions. 23 (d) Whether the proposed regulatory entity would be 24 authorized to enter into reciprocity agreements with other 25 jurisdictions. 26 (e) The nature and duration of any training and experience 27 required, whether applicants will be required to pass an 28 examination, and whether there will be alternative methods to 29 enter the health profession. 30 (4) Assurances to the public that practitioners have 31 maintained their competence including all of the following: 32 (a) Whether a registration, certificate, or license will 33 include an expiration date. 34 (b) Whether the renewal of a registration, certificate, 35 -4- LSB 1457XC (3) 89 ss/rh 4/ 28

S.F. _____ or license will be based only on payment of a fee or whether 1 renewal will involve reexamination, peer review, or other 2 enforcement. 3 e. The extent to which regulation might harm the public 4 including all of the following: 5 (1) The extent to which regulation will restrict entry into 6 the profession, including whether the proposed standards are 7 more restrictive than necessary to ensure a practitioner’s safe 8 and effective performance in the practice of the profession. 9 (2) Whether there are professions similar to the 10 unregulated health profession that should be included in, or 11 portions of the unregulated health profession that should be 12 excluded from, the proposed legislation. 13 f. The maintenance of professional standards including all 14 of the following: 15 (1) Whether effective quality assurance standards exist 16 in the profession such as legal requirements associated with 17 specific programs that define or enforce standards or a code 18 of ethics. 19 (2) How the proposed legislation will ensure quality, 20 including whether a code of ethics will be adopted and the 21 grounds for suspension or revocation of a registration, 22 certificate, or license. 23 g. A description of the group proposed for regulation, 24 including a list of associations, organizations, and other 25 professional groups representing practitioners in this state, 26 an estimate of the number of practitioners in each professional 27 group, and whether the professional groups represent different 28 levels of practice. 29 h. The expected costs of regulation, including the impact of 30 costs on the public and costs imposed on this state. 31 Sec. 4. NEW SECTION . 272C.19 Proposed increased regulation 32 of regulated health professions —— written reports. 33 1. A member of the general assembly introducing proposed 34 legislation to expand the scope of practice of a regulated 35 -5- LSB 1457XC (3) 89 ss/rh 5/ 28

S.F. _____ health profession shall submit with the legislation a report, 1 prepared by the legislative services agency, addressing the 2 requirements contained in subsection 2. The report shall be 3 submitted to the president of the senate or the speaker of the 4 house of representatives prior to full consideration of the 5 legislation by the senate or the house of representatives and 6 made available on the internet site of the general assembly. 7 2. The report shall address all of the following and 8 identify the source of all information contained in the report: 9 a. Why an expanded scope of practice for the regulated 10 health profession is beneficial, including the extent to which 11 health care consumers need and will benefit from safe, quality 12 health care from practitioners within the expanded scope of 13 practice. 14 b. Whether expanding the scope of practice of practitioners 15 in the regulated health profession will require practitioners 16 to have didactic and clinical education from accredited 17 professional schools or training from recognized programs that 18 prepare them to perform within the proposed expanded scope of 19 practice, and specific educational or training requirements for 20 that proposed expanded scope of practice. 21 c. Whether the subject matter of the proposed expanded scope 22 of practice is currently tested by nationally recognized and 23 accepted examinations for applicants for professional licensure 24 and the details of the examination relating to the expanded 25 scope of practice. 26 d. The extent to which the proposed expanded scope 27 of practice will impact the practice of practitioners 28 currently licensed in this state or the entry into practice 29 of practitioners who have relocated from other states with 30 substantially equivalent requirements for registration, 31 certification, or licensure in this state. 32 e. The extent to which implementing the proposed expanded 33 scope of practice may result in savings or a cost to this state 34 and to the public. 35 -6- LSB 1457XC (3) 89 ss/rh 6/ 28

S.F. _____ f. The relevant regulated health profession licensure laws, 1 if any, in this state and other states. 2 g. Recommendations, if any, the applicable regulatory entity 3 or entities, the department of public health, and accredited 4 educational or training programs. 5 3. a. Prior to considering proposed legislation to 6 expand the scope of practice of a regulated health profession 7 for passage to the floor of the senate or the house of 8 representatives, a legislative committee to which proposed 9 legislation has been referred shall consider all of the 10 following: 11 (1) Whether the expansion of a regulated health 12 profession’s scope of practice is only for the purpose of 13 protecting the public from a specific harm or danger. 14 (2) Whether the addition of adequately trained 15 practitioners providing an expanded range of health care 16 services will have a beneficial effect on the public and 17 increase access to safe, quality health care. 18 (3) Whether any changes in the entity regulating the 19 regulated health profession are necessary to protect the public 20 health or safety. 21 b. The legislative committee shall not consider competition 22 with or from other regulated health professions or whether a 23 practitioner will be able to obtain health insurance coverage 24 for the proposed expanded scope of practice. 25 Sec. 5. NEW SECTION . 272C.20 Continuing education 26 requirements —— evidence of efficacy. 27 A member of the general assembly introducing proposed 28 legislation to impose or increase a continuing education 29 requirement on a regulated health profession shall submit with 30 the legislation evidence that such a requirement has proven 31 effective for the health profession. The evidence shall be 32 submitted to the president of the senate or the speaker of the 33 house of representatives prior to full consideration of the 34 legislation by the senate or the house of representatives and 35 -7- LSB 1457XC (3) 89 ss/rh 7/ 28

S.F. _____ made available on the internet site of the general assembly. 1 Sec. 6. NEW SECTION . 272C.21 Regulation of unregulated 2 nonhealth professions. 3 1. An unregulated nonhealth profession shall not be 4 regulated except for the exclusive purpose of protecting the 5 public health or safety. All proposed legislation to regulate 6 an unregulated nonhealth profession shall be reviewed by the 7 legislative committee to which the proposed legislation is 8 referred to ensure that all of the following requirements are 9 met: 10 a. The unregulated practice of the nonhealth profession can 11 clearly harm the public health or safety. 12 b. The actual or anticipated public benefit of the 13 regulation clearly exceeds the costs imposed by the regulation 14 on consumers, businesses, and individuals. 15 c. The public needs and can reasonably be expected 16 to benefit from an assurance of initial and continuing 17 professional ability. 18 d. The public cannot be effectively protected by private 19 certification or other alternatives. 20 2. If a legislative committee finds that the proposed 21 legislation satisfies the conditions in subsection 1, the 22 committee shall examine data from multiple sources and shall 23 consider evidence of actual harm to the public related to 24 the unregulated nonhealth profession being considered for 25 regulation. The evidence may include industry association 26 data; federal, state, and local government data; business 27 reports; complaints to law enforcement, relevant state 28 agencies, and the better business bureau; and data from 29 agencies in other states with and without similar systems of 30 regulation. 31 3. If, after consideration of evidence pursuant to 32 subsection 2, the legislative committee finds that it is 33 necessary to regulate an unregulated nonhealth profession, the 34 committee shall review the proposed legislation to determine 35 -8- LSB 1457XC (3) 89 ss/rh 8/ 28

S.F. _____ whether it is the least restrictive regulation necessary and 1 whether the regulation protects a discrete interest group from 2 economic competition. 3 4. The legislative committee shall submit its findings 4 regarding whether the proposed legislation meets the 5 requirements of subsections 1, 2, and 3 to the president of 6 the senate or the speaker of the house of representatives, who 7 shall make the findings available to each member of the general 8 assembly on the internet site of the general assembly. 9 Sec. 7. NEW SECTION . 272C.22 Proposed regulation of 10 unregulated nonhealth professions —— written reports. 11 1. A member of the general assembly introducing legislation 12 to regulate an unregulated nonhealth profession shall submit 13 with the legislation a report, prepared by the legislative 14 services agency, addressing the requirements contained in 15 subsection 2. The report shall be submitted to the president 16 of the senate or the speaker of the house of representatives 17 prior to full consideration of the legislation by the senate or 18 the house of representatives and made available on the internet 19 site of the general assembly. 20 2. The report shall address all of the following and 21 identify the source of all information contained in the report: 22 a. Why regulation is necessary including what particular 23 problem regulation would address. 24 b. The efforts made to address the problem. 25 c. The alternatives considered. 26 d. The benefit to the public of regulating the profession. 27 e. The extent to which regulation might harm the public. 28 f. The maintenance of professional standards including all 29 of the following: 30 (1) Whether effective quality assurance standards exist 31 in the profession such as legal requirements associated with 32 specific programs that define or enforce standards or a code 33 of ethics. 34 (2) How the proposed legislation will assure quality 35 -9- LSB 1457XC (3) 89 ss/rh 9/ 28

S.F. _____ including the extent to which a code of ethics will be 1 adopted and the grounds for the suspension or revocation of a 2 registration, certificate, or license. 3 g. A description of the profession proposed for regulation, 4 including a list of associations, organizations, and other 5 professional groups representing practitioners in this state, 6 an estimate of the number of practitioners in each profession, 7 and whether the professional groups represent different levels 8 of practice. 9 h. The expected costs of regulation, including the impact of 10 costs on the public and costs imposed on this state. 11 Sec. 8. REPEAL. Section 3.20, Code 2021, is repealed. 12 DIVISION II 13 BOARD REVIEWS 14 Sec. 9. Section 2.69, subsection 1, Code 2021, is amended 15 to read as follows: 16 1. A state government efficiency review committee is 17 established which shall meet at least every two years to review 18 the operations of state government monthly, as necessary, 19 to efficiently review all boards according to the schedule 20 established by the legislative services agency pursuant to 21 section 4A.5 . The committee shall meet as directed by the 22 legislative council. 23 Sec. 10. Section 2.69, subsection 2, paragraph a, Code 2021, 24 is amended to read as follows: 25 a. The committee shall consist of three members of the 26 senate appointed by the majority leader of the senate, two 27 members of the senate appointed by the minority leader of the 28 senate, three members of the house of representatives appointed 29 by the speaker of the house of representatives, and two members 30 of the house of representatives appointed by the minority 31 leader of the house of representatives , and one ex officio, 32 nonvoting member appointed by the governor . 33 Sec. 11. Section 2.69, subsections 4, 5, and 6, Code 2021, 34 are amended by striking the subsections. 35 -10- LSB 1457XC (3) 89 ss/rh 10/ 28

S.F. _____ Sec. 12. NEW SECTION . 4A.1 Definitions. 1 As used in this chapter, unless the context otherwise 2 requires: 3 1. “Board” means any board, council, commission, committee, 4 panel, review team, or foundation of this state, except that 5 “board” does not include a pension board or the Iowa ethics and 6 campaign disclosure board created in section 68B.32. 7 2. “Board review criteria” means the criteria required to be 8 considered under section 4A.3. 9 3. “Committee” means the state government efficiency review 10 committee created pursuant to section 2.69. 11 Sec. 13. NEW SECTION . 4A.2 Committee —— review of boards. 12 1. The committee shall carry out the functions provided in 13 this chapter. 14 2. Administrative assistance shall be provided by the 15 legislative services agency and by staff of each caucus of the 16 general assembly. 17 Sec. 14. NEW SECTION . 4A.3 Board reviews. 18 1. The committee shall review the usefulness, performance, 19 and efficacy of each board as provided in subsection 2. The 20 committee shall hold hearings to receive the testimony of the 21 public and of the chief executive officer of the board. After 22 completing a review, the committee shall prepare and publish 23 a report of its findings and recommendations as provided in 24 section 4A.4. 25 2. The legislative services agency shall establish a 26 schedule for the committee to review each board such that 27 the committee reviews approximately one-fifth of all boards 28 each calendar year and each board has been reviewed once 29 between the calendar years 2022 and 2027. The committee may 30 modify the schedule as necessary to facilitate the efficient 31 administration of the committee. 32 3. A board that is scheduled for review shall submit a 33 report to the committee thirty days prior to the date that it 34 is scheduled for review that includes all of the following 35 -11- LSB 1457XC (3) 89 ss/rh 11/ 28

S.F. _____ information: 1 a. The board’s primary purpose and its goals and objectives. 2 b. The board’s past and anticipated workload, the number of 3 staff required to complete that workload, and the board’s total 4 number of staff. 5 c. The board’s past and anticipated budgets and its sources 6 of funding. 7 d. The number of members that compose the governing board or 8 other governing entity of the board and member compensation, 9 if any. 10 4. A board subject to review shall bear the burden of 11 demonstrating to the committee a public need for its continued 12 existence. In determining whether a board has met that 13 burden, the committee shall consider all of the following, as 14 applicable: 15 a. Whether continuation of the board is necessary to protect 16 the health or safety of the public, and if so, whether the 17 board’s authority is narrowly tailored to protect against 18 present, recognizable, and significant harms to the health or 19 safety of the public. 20 b. Whether the public could be protected or served in an 21 alternate or less restrictive manner. 22 c. Whether the board serves a specific private interest. 23 d. Whether rules adopted by the board are consistent with 24 the legislative mandate of the board as expressed in the 25 statutes that created and empowered the board. 26 e. The extent to which the board’s jurisdiction and programs 27 overlap or duplicate those of other boards, the extent to which 28 the board coordinates with those other boards, and the extent 29 to which the board’s programs could be consolidated with the 30 programs of other state departments or boards. 31 f. The number of other states that regulate the occupation, 32 whether a license is required to engage in the occupation in 33 other states, whether the initial licensing and license renewal 34 requirements for the occupation are substantially equivalent 35 -12- LSB 1457XC (3) 89 ss/rh 12/ 28

S.F. _____ in every state, and the amount of regulation exercised by the 1 board compared to the regulation, if any, in other states. 2 g. Whether the board recognizes national uniform licensure 3 requirements for the occupation. 4 h. Whether private contractors could be used, in an 5 effective and efficient manner, either to assist the board in 6 the performance of its duties or to perform the board’s duties 7 in place of the board. 8 i. Whether the operation of the board has inhibited economic 9 growth, reduced efficiency, or increased government costs. 10 j. An assessment of the authority of the board regarding 11 fees, inspections, enforcement, and penalties. 12 k. The extent to which the board has permitted qualified 13 applicants to serve the public. 14 l. The extent to which the board has allowed individuals to 15 practice elements of the occupation without a license. 16 m. The cost-effectiveness of the board in terms of the 17 number of employees, services rendered, and administrative 18 costs incurred, both past and present. 19 n. Whether the board’s operation has been impeded or 20 enhanced by existing statutes and procedures and by budgetary, 21 resource, and personnel practices. 22 o. Whether the board has recommended statutory changes to 23 the general assembly that would benefit the public rather than 24 the individuals regulated by the board, if any, and whether the 25 board’s recommendations and other policies have been adopted 26 and implemented. 27 p. Whether the board has required any individuals subject to 28 the board’s regulations to report to the board the impact of 29 board rules and decisions on the public as they affect service 30 costs and service delivery. 31 q. Whether individuals regulated by the board, if any, have 32 been required to assess problems in their business operations 33 that affect the public. 34 r. Whether the board has encouraged public participation in 35 -13- LSB 1457XC (3) 89 ss/rh 13/ 28

S.F. _____ its rulemaking and decision making. 1 s. The efficiency with which formal public complaints filed 2 with the board have been processed to completion. 3 t. Whether the purpose for which the board was created has 4 been fulfilled, has changed, or no longer exists. 5 u. Whether federal law requires that the board be renewed 6 in some form. 7 v. An assessment of the administrative hearing process of 8 the board if the board has an administrative hearing process, 9 and whether the hearing process is consistent with due process 10 rights. 11 w. Whether the requirement for an occupational license 12 is consistent with the principles expressed in section 4B.2, 13 serves the public health or safety, and provides the least 14 restrictive form of regulation that adequately protects the 15 public health or safety. 16 x. The extent to which licensing ensures that practitioners 17 have occupational skill sets or competencies that are 18 substantially related to protecting consumers from present, 19 significant, and substantiated harms that threaten the public 20 health or safety, and the impact that those criteria have on 21 applicants for a license, particularly those with moderate or 22 low incomes, seeking to enter the occupation or profession. 23 y. The extent to which the requirement for the occupational 24 license stimulates or restricts competition, affects consumer 25 choice, and affects the cost of services. 26 z. An assessment of whether changes are needed in the 27 enabling laws of the board in order for the board to comply 28 with the criteria listed in this subsection. 29 Sec. 15. NEW SECTION . 4A.4 Reports of the committee. 30 1. After completing a review of a board pursuant to section 31 4A.3, the committee shall prepare and submit a report of its 32 findings and recommendations by December 21 of each year 33 beginning in 2022 and ending in 2027. A report may include 34 findings and recommendations for more than one board. Copies 35 -14- LSB 1457XC (3) 89 ss/rh 14/ 28

S.F. _____ of the report shall be submitted to the president of the 1 senate, the speaker of the house of representatives, the 2 governor, and each affected board, and shall be made publicly 3 available on the internet site of the general assembly. The 4 committee shall present its recommendations to the general 5 assembly in the form of a bill. 6 2. Recommendations of the committee shall indicate how or 7 whether implementation of the recommendations would do each of 8 the following: 9 a. Improve efficiency in the management of state government. 10 b. Improve services rendered to citizens of the state. 11 c. Simplify and improve preparation of the state budget. 12 d. Conserve the natural resources of the state. 13 e. Promote the orderly growth of the state and its 14 government. 15 f. Promote occupational regulations to increase economic 16 opportunities, encourage competition, and encourage innovation. 17 g. Provide for the least restrictive regulations by 18 repealing current regulations and replacing them with less 19 restrictive regulations that are consistent with the principles 20 expressed in section 4B.2. 21 h. Improve the effectiveness of the services performed by 22 the boards of the state. 23 i. Avoid duplication of effort by state agencies or boards. 24 j. Improve the organization and coordination of the state 25 government. 26 Sec. 16. NEW SECTION . 4A.5 Activities of the general 27 assembly not restricted. 28 This chapter shall not be construed to restrict the general 29 assembly from considering any legislation concerning a board 30 subject to this chapter. 31 Sec. 17. NEW SECTION . 4B.1 Definitions. 32 For the purposes of this chapter: 33 1. “Certification” means a voluntary program in which 34 a private organization or the state grants nontransferable 35 -15- LSB 1457XC (3) 89 ss/rh 15/ 28

S.F. _____ recognition to an individual who meets personal qualifications 1 established by the private organization or state law. 2 2. “Lawful occupation” means a course of conduct, pursuit, 3 or profession that includes the sale of goods or services that 4 are not themselves illegal to sell irrespective of whether 5 the individual selling the goods or services is subject to an 6 occupational regulation. 7 3. “Least restrictive regulation” means the public policy of 8 relying on one of the following, listed from the least to the 9 most restrictive, as a means of consumer protection: 10 a. Market competition. 11 b. Third-party or consumer-created ratings and reviews. 12 c. Private certifications. 13 d. Actions under section 714H.5. 14 e. Actions under section 714.16. 15 f. Regulation of the process of providing the specific goods 16 or services to consumers. 17 g. Inspections. 18 h. Bonding or insurance. 19 i. Registrations. 20 j. Government certifications. 21 k. Occupational licenses, including specialty occupational 22 licenses for medical reimbursement. 23 4. “Occupational license” means a government permission slip 24 to work that is a nontransferable authorization in law that an 25 individual must possess in order to perform a lawful occupation 26 for compensation based on meeting personal qualifications 27 established by statute or by a rule authorized by statute. 28 “Occupational license” does not include a commercial or other 29 driver’s license. 30 5. “Occupational licensing board” means any board, 31 commission, committee, or council, or any other similar state 32 public body, and any agency, division, or office of state 33 government, that issues an occupational license. 34 6. “Occupational regulation” means a statute, policy, rule, 35 -16- LSB 1457XC (3) 89 ss/rh 16/ 28

S.F. _____ practice, or other state law requiring an individual to possess 1 certain personal qualifications to use an occupational title or 2 work in a lawful occupation. “Occupational regulation” includes 3 a registration, certification, and occupational license. 4 “Occupational regulation” excludes a business license, facility 5 license, building permit, or zoning and land use regulation, 6 except to the extent those laws regulate an individual’s 7 personal qualifications to perform a lawful occupation, and 8 excludes a commercial or other driver’s license. 9 7. “Personal qualifications” means criteria related to an 10 individual’s personal background and characteristics including 11 completion of an approved educational program, satisfactory 12 performance on an examination, work experience, other evidence 13 of attainment of requisite skills or knowledge, moral standing, 14 criminal history, and completion of continuing education. 15 8. “Registration” means a requirement to give notice to the 16 government that may include the individual’s name and address, 17 the individual’s agent for service of process, the location of 18 the activity to be performed, and a description of the service 19 the individual provides. “Registration” does not include 20 personal qualifications but may require a bond or insurance. 21 9. “Specialty occupational license for medical reimbursement” 22 is a nontransferable authorization in law for an individual 23 to qualify for payment or reimbursement from a government 24 agency for providing identified medical services based on 25 meeting personal qualifications established in law which may be 26 recognized by a private company. 27 Sec. 18. NEW SECTION . 4B.2 Occupational regulation 28 principles. 29 With respect to the occupational regulation of individuals, 30 all of the following shall be policies of this state: 31 1. Occupational regulations shall be construed and applied 32 to increase economic opportunities, promote competition, and 33 encourage innovation. 34 2. If the state finds it is necessary to displace 35 -17- LSB 1457XC (3) 89 ss/rh 17/ 28

S.F. _____ competition, the state shall use the least restrictive 1 regulation to protect consumers from present, significant, and 2 substantiated harms that threaten public health or safety. The 3 policy of employing the least restrictive regulation shall 4 presume that market competition and private remedies are 5 sufficient to protect consumers. If necessary, regulations 6 shall be tailored to meet the predominate identified need to 7 protect consumers as follows: 8 a. If a regulation is intended to protect consumers against 9 fraud, the appropriate state action shall be to strengthen 10 powers under deceptive trade practices acts. 11 b. If a regulation is intended to protect consumers against 12 unsanitary facilities and general health or safety concerns, 13 the appropriate state action shall be to require periodic 14 inspections. 15 c. If a regulation is intended to protect a consumer against 16 potential damages to a third party who is not a party to a 17 contract between the seller and buyer, and other types of 18 externalities, the appropriate state action shall be to require 19 bonding or insurance. 20 d. If a regulation is intended to protect a consumer against 21 potential damages by transient providers, the appropriate state 22 action shall be to require registration with the secretary of 23 state. 24 e. If a regulation is intended to protect a consumer 25 against asymmetrical information between the seller and buyer, 26 the appropriate state action shall be to offer voluntary 27 certification, unless appropriate, privately offered voluntary 28 certification for the relevant occupation is available. 29 f. If a regulation is intended to facilitate governmental 30 reimbursement for providing medical services for an emerging 31 medical specialty, the appropriate state action shall be 32 to require a specialty occupational license for medical 33 reimbursement. A person shall not be required to hold a 34 specialty occupational license for medical reimbursement in 35 -18- LSB 1457XC (3) 89 ss/rh 18/ 28

S.F. _____ order to lawfully provide a medical service for an emerging 1 medical specialty; however, a person providing a medical 2 service for an emerging medical specialty without a specialty 3 occupational license for medical reimbursement shall not 4 receive governmental reimbursement for providing that service. 5 A specialty occupational license for medical reimbursement 6 shall not restrict governmental reimbursement for services 7 similar to the regulated service that may be provided by other 8 regulated persons. 9 g. If a regulation is required to perform services 10 regulated by both federal laws and the laws of this state, 11 the appropriate state action shall be to require the state 12 to recognize an individual’s occupational license from 13 another state or territory of the United States to allow that 14 individual to practice in this state. 15 3. An occupational regulation may be enforced against an 16 individual only to the extent the individual sells goods and 17 services that are included explicitly in the statute that 18 defines the occupation’s scope of practice. 19 4. This chapter shall not restrict an occupational 20 licensing board from requiring, as a condition of licensure 21 or renewal of licensure, that an individual’s personal 22 qualifications include obtaining or maintaining certification 23 from a private organization that credentials individuals in the 24 relevant occupation. 25 Sec. 19. NEW SECTION . 4B.3 Local licensing —— preemption. 26 This chapter preempts any ordinance or other local law or 27 regulation which conflicts with or is inconsistent with any 28 policy of the state expressed in this chapter by any political 29 subdivision that regulates an occupation that is not regulated 30 by the state. 31 DIVISION III 32 ACCOUNTABLE GOVERNMENT ACT REPORTS 33 Sec. 20. Section 8E.210, Code 2021, is amended by adding the 34 following new subsection: 35 -19- LSB 1457XC (3) 89 ss/rh 19/ 28

S.F. _____ NEW SUBSECTION . 1A. In addition to the requirements 1 of subsection 1, an agency’s annual performance report 2 shall include a description of how the agency improved 3 efficiency, modernized processes, eliminated duplication and 4 outdated processes, reduced costs, increased accountability, 5 expanded the use of technology, and incorporated productivity 6 improvement measures. The section of the annual performance 7 report addressing the factors listed in this subsection shall 8 be submitted to the state government committee of each chamber 9 of the general assembly and made publicly available on the 10 internet site of the general assembly. 11 DIVISION IV 12 PROFESSIONAL LICENSING BOARD INVESTIGATIONS 13 Sec. 21. Section 272C.3, subsection 1, paragraph d, Code 14 2021, is amended to read as follows: 15 d. Determine in any case whether an investigation, or 16 further investigation, or a disciplinary proceeding is 17 warranted. Notwithstanding the provisions of chapter 17A , 18 a determination by a licensing board that an investigation 19 is not warranted or that an investigation should be closed 20 without initiating a disciplinary proceeding is not subject to 21 judicial review pursuant to section 17A.19 . Notwithstanding 22 any other provision of law, if a board determines that there 23 is no probable cause to believe that an asserted violation has 24 occurred, the complaint shall be returned to the complainant 25 with a statement specifying the reasons for rejection 26 sufficient to enable the complainant to review the agency’s 27 determination. 28 DIVISION V 29 ADMINISTRATIVE RULES REVIEW COMMITTEE REVIEW OF ENTRY 30 REGULATIONS 31 Sec. 22. NEW SECTION . 17A.35 Review of occupational entry 32 regulations. 33 1. For purposes of this section, unless the context 34 otherwise requires: 35 -20- LSB 1457XC (3) 89 ss/rh 20/ 28