H.F. 2178 Section 1. Section 147.13, subsection 1, Code 2026, is 1 amended to read as follows: 2 1. For medicine and surgery, osteopathic medicine and 3 surgery, acupuncture, reflexology, and genetic counseling, the 4 board of medicine. 5 Sec. 2. Section 147.74, Code 2026, is amended by adding the 6 following new subsection: 7 NEW SUBSECTION . 29. A reflexologist certified pursuant to 8 chapter 148K may use the words “certified reflexologist” after 9 the person’s name. 10 Sec. 3. NEW SECTION . 148K.1 Definitions. 11 As used in this chapter, unless the context otherwise 12 requires: 13 1. “Board” means the board of medicine established in 14 chapter 147. 15 2. “Reflexologist” means a person who is engaged in the 16 practice of reflexology. 17 3. “Reflexology” means a protocol of manual techniques, 18 including thumb-walking and finger-walking, hook and backup, 19 and rotating-on-a-point, that are applied to specific reflex 20 areas predominantly on the feet and hands of an individual who 21 is fully clothed except for footwear, to activate the complex 22 neural pathways linking body systems and support the body’s 23 efforts to function optimally. “Reflexology” does not include 24 the diagnosis of or treatment for specific diseases, or joint 25 manipulations. 26 Sec. 4. NEW SECTION . 148K.2 Reflexology —— certification. 27 1. An applicant for a reflexologist certification shall 28 submit an application on a form prescribed by the board that 29 includes all of the following: 30 a. Evidence of an active certification from the American 31 reflexology certification board, or its successor organization. 32 b. Evidence of successful completion of a reflexology 33 education program as described in section 148K.3 and approved 34 by the board by rule. 35 -1- LSB 5744YH (4) 91 ss/ko 1/ 5

H.F. 2178 c. Evidence of successful completion of a psychometrically 1 valid reflexology exam approved by the board by rule. 2 d. Any other information required by the board by rule. 3 e. An application fee as provided by the board by rule. 4 2. An applicant for a reflexologist certification must meet 5 all of the following requirements: 6 a. Be at least eighteen years of age. 7 b. Have no history of adverse actions on a professional or 8 occupational license during the two years immediately preceding 9 the submission of the application. 10 c. Submit to a criminal history check. 11 3. Notwithstanding subsections 1 and 2, the board shall 12 issue a reflexologist certification to an applicant who 13 completes an application as provided by the board by rule, 14 submits evidence of having completed an education program that 15 is substantially similar to the education program described in 16 section 148K.3, and submits evidence of a current and active 17 reflexologist certification in another state or territory of 18 the United States. 19 Sec. 5. NEW SECTION . 148K.3 Reflexology —— educational 20 requirements. 21 1. A reflexology education program shall consist of 22 a minimum of two hundred credit hours and shall include 23 instruction on all of the following: 24 a. Anatomy and physiology of the body systems. 25 b. Anatomy and biomechanics as they relate to the study of 26 the lower legs, feet, hands, forearms, and outer ears. 27 c. Reflexology maps, reflexology techniques, and reflexes as 28 anatomically reflected on the feet, hands, and outer ears. 29 d. Critical thinking as applied to assessment, pathologies, 30 contraindications, medical consideration, the interrelatedness 31 of body systems, organ function, and health. 32 e. Reflexology theory, history, and research. 33 f. Business practices, including ethics, business standards, 34 record keeping, security, and local and state laws. 35 -2- LSB 5744YH (4) 91 ss/ko 2/ 5

H.F. 2178 g. Supervised practicum or clinical work that provides 1 hands-on palpation of landmarks and reflex points with sensory 2 identification of palpated areas. 3 2. A reflexology education program may include additional 4 coursework on documenting client reflexology sessions, 5 instructor or classroom discussions of client sessions, and 6 other coursework that provides for practical experience. 7 3. Instruction on reflexology maps, reflexology techniques, 8 and reflexes as anatomically reflected on the feet, hands, and 9 outer ears shall be performed by an instructor certified by 10 the American reflexology certification board, or its successor 11 organization. 12 Sec. 6. NEW SECTION . 148K.4 Examination —— waiver. 13 1. An applicant who fails to pass a reflexology exam as 14 approved by the board by rule may retake the examination up to 15 two additional times. The board may require an applicant who 16 has failed three examinations to complete further educational 17 coursework prior to retaking the examination. 18 2. a. The board may waive the examination required in 19 section 148K.2, subsection 1, paragraph “c” , for an applicant 20 who does all of the following: 21 (1) Submits a completed application form as provided by the 22 board by rule. 23 (2) Provides evidence of completion of an approved 24 reflexology education program described in section 148K.3. 25 (3) Provides evidence that the applicant has practiced 26 reflexology as part of the applicant’s occupation for the five 27 years immediately preceding the effective date of this Act. 28 (4) Submits an application fee as provided by the board by 29 rule. 30 b. This subsection is repealed effective July 1, 2028. 31 Sec. 7. NEW SECTION . 148K.5 Certification —— renewal —— 32 fees. 33 1. A certification issued pursuant to section 148K.2 is 34 valid for a period of two years and expires on the date of birth 35 -3- LSB 5744YH (4) 91 ss/ko 3/ 5

H.F. 2178 of the reflexologist. 1 2. The board shall impose the following fees for the 2 issuance and renewal of a reflexology certification: 3 a. For issuance of an initial certification, fifty dollars. 4 b. For renewal of a certification, forty dollars. 5 c. For renewal of a certification within three months after 6 expiration, sixty-five dollars. 7 d. For reissuance of an expired certification, sixty-five 8 dollars. 9 e. For issuance of an official certification to a third 10 party, ten dollars. 11 f. For issuance of a duplicate certification to a 12 certificate holder, ten dollars. 13 Sec. 8. NEW SECTION . 148K.6 Rules. 14 The board shall adopt rules pursuant to chapter 17A for the 15 administration of this chapter. 16 EXPLANATION 17 The inclusion of this explanation does not constitute agreement with 18 the explanation’s substance by the members of the general assembly. 19 This bill relates to the practice of reflexology, defined 20 in the bill as a protocol of manual techniques applied to 21 specific reflex areas predominantly on the feet and hands of 22 an individual. 23 The bill requires the board of medicine (board) to issue 24 a reflexologist certification to an applicant who submits 25 proof of an active certification from the American reflexology 26 certification board, or its successor organization, proof of 27 completion of a reflexology education program approved by the 28 board and described in the bill, proof of completion of an exam 29 approved by the board, any other information required by the 30 board, and an application fee. An applicant must be at least 31 18 years of age, submit to a criminal history check, and not 32 have been subject to any form of professional or occupational 33 discipline within the two years immediately preceding the 34 submission of the application. The board shall also issue 35 -4- LSB 5744YH (4) 91 ss/ko 4/ 5

H.F. 2178 a certification to a person who has completed an education 1 program that is substantially similar to an education program 2 approved by the board and is certified as a reflexologist in 3 another state or territory of the United States. 4 The bill allows a person who has failed a reflexology exam 5 to retake the exam two additional times. The bill also allows 6 the board to require a person who failed the reflexology exam 7 three times to complete further educational coursework prior 8 to taking the exam again. If an applicant has completed 9 an approved reflexology education program and practiced 10 reflexology as part of the applicant’s profession for the last 11 five years, the bill allows the board to waive the reflexology 12 examination requirement. This provision of the bill is 13 repealed effective July 1, 2028. 14 The bill establishes fees for the issuance and renewal of 15 a reflexology certification. The bill requires the board to 16 adopt rules for the administration of the bill. 17 -5- LSB 5744YH (4) 91 ss/ko 5/ 5