H.F. 2676 DIVISION I 1 CONTINUING EDUCATION REQUIREMENTS —— NUTRITION AND METABOLIC 2 HEALTH 3 Section 1. Section 148.3, Code 2026, is amended by adding 4 the following new subsection: 5 NEW SUBSECTION . 5. The board shall adopt rules pursuant to 6 chapter 17A requiring a licensee practicing family medicine, 7 internal medicine, pediatrics, psychiatry, endocrinology, 8 gastroenterology, cardiology, oncology, rheumatology, 9 neurology, nephrology, dermatology, pulmonology, surgery, 10 immunology, hematology, obstetrics, or gynecology to complete a 11 minimum of one hour of continuing education on nutrition and 12 metabolic health every four years as a condition of license 13 renewal. 14 Sec. 2. Section 148C.3, subsection 1, paragraph c, Code 15 2026, is amended to read as follows: 16 c. Hours of continuing medical education necessary to become 17 or remain licensed. The board shall adopt rules pursuant to 18 chapter 17A requiring a licensee practicing family medicine, 19 internal medicine, pediatrics, psychiatry, endocrinology, 20 gastroenterology, cardiology, oncology, rheumatology, 21 neurology, nephrology, dermatology, pulmonology, surgery, 22 immunology, hematology, obstetrics, or gynecology to complete a 23 minimum of one hour of continuing education on nutrition and 24 metabolic health every four years as a condition of license 25 renewal. 26 DIVISION II 27 CERTIFICATE OF NEED 28 Sec. 3. Section 135.61, subsection 16, paragraphs e, g, i, 29 and k, Code 2026, are amended by striking the paragraphs. 30 Sec. 4. Section 135.61, subsection 16, paragraph m, 31 subparagraphs (2) and (3), Code 2026, are amended by striking 32 the subparagraphs. 33 Sec. 5. Section 135.62, subsection 2, paragraph a, Code 34 2026, is amended to read as follows: 35 -1- LSB 5336HV (2) 91 ss/ko 1/ 40

H.F. 2676 a. Private offices and private clinics of an individual 1 physician, dentist, or other practitioner or group of 2 health care providers, except as provided by section 135.61, 3 subsection 16 , paragraphs “g” , “h” , and “m” , and section 135.61, 4 subsections 2 and 18 . 5 Sec. 6. Section 135.62, subsection 2, paragraph e, 6 subparagraph (2), Code 2026, is amended to read as follows: 7 (2) Acquires major medical equipment as provided by section 8 135.61, subsection 16 , paragraphs “i” and paragraph “j” . 9 Sec. 7. Section 135.62, subsection 2, paragraph g, 10 subparagraph (1), unnumbered paragraph 1, Code 2026, is amended 11 to read as follows: 12 A reduction in bed capacity of an institutional health 13 facility, notwithstanding any provision in this subchapter to 14 the contrary, except where a provision expressly exempts such a 15 reduction, if all of the following conditions exist: 16 Sec. 8. Section 135.62, subsection 2, paragraph k, 17 subparagraph (1), unnumbered paragraph 1, Code 2026, is amended 18 to read as follows: 19 The redistribution of beds by a hospital within the acute 20 care category of bed usage, notwithstanding any provision in 21 this subchapter to the contrary, except where a provision 22 expressly exempts such a redistribution of skilled nursing 23 facility or swing beds by a hospital, if all of the following 24 conditions exist: 25 Sec. 9. Section 135.62, subsection 2, paragraph p, Code 26 2026, is amended by striking the paragraph. 27 Sec. 10. Section 135.62, subsection 2, Code 2026, is amended 28 by adding the following new paragraphs: 29 NEW PARAGRAPH . r. An outpatient facility that provides 30 behavioral health services, as defined by rule by the 31 department, to individuals on an outpatient basis, including 32 but not limited to substitution-based treatment centers for 33 opiate addiction. 34 NEW PARAGRAPH . s. Open heart surgical services. 35 -2- LSB 5336HV (2) 91 ss/ko 2/ 40

H.F. 2676 NEW PARAGRAPH . t. Organ transplantation services. 1 NEW PARAGRAPH . u. Notwithstanding any provision of this 2 subchapter to the contrary, any acquisition whether acquired 3 by purchase, lease, or donation by or on behalf of a health 4 care provider or a group of health care providers of any piece 5 of replacement equipment with a value in excess of one million 6 five hundred thousand dollars. 7 NEW PARAGRAPH . v. Notwithstanding any provision of 8 this subchapter to the contrary, any acquisition whether 9 acquired by purchase, lease, or donation by or on behalf of 10 an institutional health facility or a health maintenance 11 organization of any piece of replacement equipment with a value 12 in excess of one million five hundred thousand dollars. 13 NEW PARAGRAPH . w. Any air transportation service for 14 transportation of patients or medical personnel offered through 15 an institutional health facility. 16 NEW PARAGRAPH . x. Notwithstanding any provision of 17 this subchapter to the contrary, bed capacity changes by an 18 institutional health facility that constitute a permanent 19 change or reduction in, or a redistribution, deletion, or 20 conversion of, nursing facility beds, skilled nursing facility 21 beds, or swing beds. 22 NEW PARAGRAPH . y. Notwithstanding any provision of 23 this subchapter to the contrary, bed capacity changes 24 that constitute a permanent change or reduction in, or 25 a redistribution, deletion, or conversion of, beds in 26 intermediate care facilities for persons with mental 27 illness, or intermediate care facilities for persons with an 28 intellectual disability. 29 Sec. 11. Section 135.62, subsection 4, Code 2026, is amended 30 to read as follows: 31 4. The department shall not process applications for an 32 intermediate care facility for persons with an intellectual 33 disability, or consider a new or changed institutional health 34 service for an intermediate care facility for persons with 35 -3- LSB 5336HV (2) 91 ss/ko 3/ 40

H.F. 2676 an intellectual disability, unless both of the following 1 conditions are met: 2 a. The new or changed beds shall not result in an 3 increase in the total number of medical assistance certified 4 intermediate care facility beds for persons with an 5 intellectual disability in the state, exclusive of those beds 6 at the state resource centers or other state institutions, 7 beyond one thousand six hundred thirty-six beds. 8 b. A a letter of support for the application is provided by 9 the county board of supervisors, or the board’s designee, in 10 the county in which the beds facility is or would be located. 11 Sec. 12. Section 135.65, subsection 3, paragraph b, Code 12 2026, is amended to read as follows: 13 b. A period for the submission of written public hearing 14 comments from affected persons on the application, to be held 15 scheduled prior to completion of the evaluation required by 16 paragraph “a” . 17 Sec. 13. Section 135.65, subsection 4, Code 2026, is amended 18 by striking the subsection. 19 Sec. 14. Section 135.70, subsection 2, Code 2026, is amended 20 to read as follows: 21 2. Upon expiration of a certificate of need, and prior to 22 extension of the certificate of need, any affected person shall 23 have the right to submit to the department information which 24 may be relevant to the question of granting an extension. The 25 department may call a public hearing for this purpose. 26 DIVISION III 27 SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM —— SUMMER ELECTRONIC 28 BENEFITS TRANSFER FOR CHILDREN PROGRAM 29 Sec. 15. Section 234.1, Code 2026, is amended by adding the 30 following new subsection: 31 NEW SUBSECTION . 4A. “Summer electronic benefits transfer 32 for children program” or “summer EBT program” means the summer 33 electronic benefits transfer for children program established 34 in 42 U.S.C. §1762. 35 -4- LSB 5336HV (2) 91 ss/ko 4/ 40

H.F. 2676 Sec. 16. NEW SECTION . 234.12B Supplemental nutrition 1 assistance program —— summer electronic benefits transfer for 2 children program. 3 1. The department shall do all of the following: 4 a. Continuously maintain state participation in SNAP 5 by administering the program in accordance with guidelines 6 approved by the United States department of agriculture, 7 food and nutrition service, that specify that eligible foods 8 pursuant to 7 C.F.R. §271.2 are healthy foods as defined by the 9 director or the director’s designee. 10 b. Ensure that the provision of SNAP benefits to recipients 11 is uninterrupted. 12 2. The department may participate in the summer EBT program 13 subject to federally approved eligible foods for the summer EBT 14 program being consistent with eligible foods as described in 15 subsection 1, paragraph “a” . 16 DIVISION IV 17 IVERMECTIN —— OVER-THE-COUNTER AVAILABILITY 18 Sec. 17. NEW SECTION . 126.24 Ivermectin —— prescription 19 drug order not required. 20 1. A pharmacist or pharmacy may distribute ivermectin for 21 human consumption as an over-the-counter medicine. 22 2. A pharmacist or pharmacy shall not be subject to 23 professional discipline or civil or criminal penalties for the 24 distribution of ivermectin pursuant to this section. 25 DIVISION V 26 SCHOOL FOODS AND BEVERAGES 27 Sec. 18. Section 256E.7, subsection 2, Code 2026, is amended 28 by adding the following new paragraph: 29 NEW PARAGRAPH . 0t. Be subject to and comply with the 30 requirements of section 283A.6 relating to the preparation 31 of meals provided to students, and prohibited ingredients in 32 meals provided to students, in the same manner as a school 33 district, if the charter school provides a breakfast or lunch 34 program through the national school lunch program or the school 35 -5- LSB 5336HV (2) 91 ss/ko 5/ 40

H.F. 2676 breakfast program administered by the food and nutrition 1 service of the United States department of agriculture. 2 Sec. 19. Section 256F.4, subsection 2, Code 2026, is amended 3 by adding the following new paragraph: 4 NEW PARAGRAPH . v. Be subject to and comply with the 5 requirements of section 283A.6 relating to the preparation of 6 meals provided to students, and prohibited ingredients in meals 7 provided to students, in the same manner as a school district, 8 if the charter school or innovation zone school provides a 9 breakfast or lunch program. 10 Sec. 20. NEW SECTION . 283A.6 School district breakfast 11 and lunch programs —— food and beverages provided to students —— 12 prohibited ingredients. 13 1. a. A school district shall not serve a meal to students 14 as part of the school district’s breakfast or lunch program 15 that contains any of the following ingredients: 16 (1) Blue dye 1. 17 (2) Blue dye 2. 18 (3) Green dye 3. 19 (4) Potassium bromate. 20 (5) Propylparaben. 21 (6) Red dye 40. 22 (7) Yellow dye 5. 23 (8) Yellow dye 6. 24 b. Paragraph “a” does not apply to food and beverages 25 received as part of a direct delivery from the foods in schools 26 program of the United States department of agriculture. 27 2. An employee or contracted vendor of a school district 28 shall not provide any food or beverages that contain an 29 ingredient described in subsection 1 to a student enrolled in 30 the school district during the school day. 31 3. A school district shall not permit the sale to students 32 of any foods or beverages that contain an ingredient described 33 in subsection 1 on the school campus, as school campus is 34 defined in 7 C.F.R. §210.11 as of January 1, 2026, unless the 35 -6- LSB 5336HV (2) 91 ss/ko 6/ 40

H.F. 2676 sale takes place outside of the school day, as school day is 1 defined in 7 C.F.R. §210.11 as of January 1, 2026. 2 Sec. 21. Section 283A.10, Code 2026, is amended to read as 3 follows: 4 283A.10 School breakfast or lunch in nonpublic schools. 5 The authorities in charge of nonpublic schools may operate 6 or provide for the operation of school breakfast or lunch 7 programs in schools under their jurisdiction and may use funds 8 appropriated to them by the general assembly, gifts, funds 9 received from sale of school breakfasts or lunches under such 10 programs, and any other funds available to the nonpublic 11 school. However, school breakfast or lunch programs shall not 12 be required in nonpublic schools. The department of education 13 shall direct the disbursement of state funds to nonpublic 14 schools for school breakfast or lunch programs in the same 15 manner as state funds are disbursed to public schools. If 16 a nonpublic school receives state funds for the operation of 17 a school breakfast or lunch program, meals served under the 18 program shall be nutritionally adequate meals, as defined in 19 section 283A.1 , and shall comply with the requirements of 20 section 283A.6 . 21 Sec. 22. APPLICABILITY. This division of this Act applies 22 to school years beginning on or after July 1, 2027. 23 DIVISION VI 24 PSYCHOLOGY INTERJURISDICTIONAL COMPACT 25 Sec. 23. NEW SECTION . 147M.1 Psychology interjurisdictional 26 compact. 27 The psychology interjurisdictional compact is enacted into 28 law and entered into by this state with all states legally 29 joining in the compact in the form substantially as follows: 30 1. Article I —— Purpose. 31 a. The party states find that: 32 (1) States license psychologists, in order to protect 33 the public through verification of education, training, 34 and experience, and ensure accountability for professional 35 -7- LSB 5336HV (2) 91 ss/ko 7/ 40

H.F. 2676 practice. 1 (2) This compact is intended to regulate the day-to-day 2 practice of telepsychology, in which psychological services are 3 provided using telecommunication technologies, by psychologists 4 across state boundaries in the performance of their 5 psychological practice as assigned by an appropriate authority. 6 (3) This compact is intended to regulate the temporary 7 in-person, face-to-face practice of psychology by psychologists 8 across state boundaries for thirty days within a calendar year 9 in the performance of their psychological practice as assigned 10 by an appropriate authority. 11 (4) This compact is intended to authorize state psychology 12 regulatory authorities to afford legal recognition, in a manner 13 consistent with the terms of the compact, to psychologists 14 licensed in another state. 15 (5) This compact recognizes that states have a vested 16 interest in protecting the public’s health and safety through 17 their licensing and regulation of psychologists and that such 18 state regulation will best protect public health and safety. 19 (6) This compact does not apply when a psychologist is 20 licensed in both the home and receiving states. 21 (7) This compact does not apply to permanent in-person, 22 face-to-face practice, but it does allow for authorization of 23 temporary psychological practice. 24 b. Consistent with these principles, this compact is 25 designed to achieve the following purposes and objectives: 26 (1) Increase public access to professional psychological 27 services by allowing for telepsychological practice across 28 state lines as well as temporary in-person, face-to-face 29 services into a state in which the psychologist is not licensed 30 to practice psychology. 31 (2) Enhance the states’ ability to protect the public’s 32 health and safety, especially client-patient safety. 33 (3) Encourage the cooperation of compact states in the areas 34 of psychology licensure and regulation. 35 -8- LSB 5336HV (2) 91 ss/ko 8/ 40

H.F. 2676 (4) Facilitate the exchange of information between compact 1 states regarding psychologist licensure, adverse actions, and 2 disciplinary history. 3 (5) Promote compliance with the laws governing 4 psychological practice in each compact state. 5 (6) Invest all compact states with the authority to 6 hold licensed psychologists accountable through the mutual 7 recognition of compact state licenses. 8 2. Article II —— Definitions. 9 a. “Adverse action” means any action taken by a state 10 psychology regulatory authority which finds a violation 11 of a statute or regulation that is identified by the state 12 psychology regulatory authority as discipline and is a matter 13 of public record. 14 b. “Association of state and provincial psychology boards” 15 means the recognized membership organization composed of state 16 and provincial psychology regulatory authorities responsible 17 for the licensure and registration of psychologists throughout 18 the United States and Canada. 19 c. “Authority to practice interjurisdictional telepsychology” 20 means a licensed psychologist’s authority to practice 21 telepsychology, within the limits authorized under this 22 compact, in another compact state. 23 d. “Bylaws” means those bylaws established by the psychology 24 interjurisdictional compact commission pursuant to article 25 X for its governance, or for directing and controlling its 26 actions and conduct. 27 e. “Client-patient” means the recipient of psychological 28 services, whether psychological services are delivered in the 29 context of health care, corporate, supervision, or consulting 30 services. 31 f. “Commissioner” means the voting representative appointed 32 by each state psychology regulatory authority pursuant to 33 article X. 34 g. “Compact state” means a state, the District of Columbia, 35 -9- LSB 5336HV (2) 91 ss/ko 9/ 40

H.F. 2676 or United States territory that has enacted this compact 1 legislation and which has not withdrawn pursuant to article 2 XIII, or been terminated pursuant to article XII. 3 h. “Confidentiality” means the principle that data or 4 information is not made available or disclosed to unauthorized 5 persons or processes. 6 i. “Coordinated licensure information system” or “coordinated 7 database” means an integrated process for collecting, storing, 8 and sharing information on psychologists’ licensure and 9 enforcement activities related to psychology licensure laws, 10 which is administered by the recognized membership organization 11 composed of state and provincial psychology regulatory 12 authorities. 13 j. “Day” means any part of a day in which psychological work 14 is performed. 15 k. “Distant state” means the compact state where a 16 psychologist is physically present, not through the use 17 of telecommunications technologies, to provide temporary 18 in-person, face-to-face psychological services. 19 l. “E.Passport” means a certificate issued by the 20 association of state and provincial psychology boards 21 that promotes the standardization in the criteria of 22 interjurisdictional telepsychology practice and facilitates the 23 process for licensed psychologists to provide telepsychological 24 services across state lines. 25 m. “Executive board” means a group of directors elected or 26 appointed to act on behalf of, and within the powers granted to 27 them by, the commission. 28 n. “Home state” means a compact state where a psychologist 29 is licensed to practice psychology. If the psychologist is 30 licensed in more than one compact state and is practicing 31 under the authorization to practice interjurisdictional 32 telepsychology, the home state is the compact state where the 33 psychologist is physically present when the telepsychological 34 services are delivered. If the psychologist is licensed 35 -10- LSB 5336HV (2) 91 ss/ko 10/ 40

H.F. 2676 in more than one compact state and is practicing under the 1 temporary authorization to practice, the home state is any 2 compact state where the psychologist is licensed. 3 o. “Identity history summary” means a summary of information 4 retained by the federal bureau of investigation (FBI), or other 5 designee with similar authority, in connection with arrests 6 and, in some instances, federal employment, naturalization, or 7 military service. 8 p. “In-person, face-to-face” means interactions in which the 9 psychologist and the client-patient are in the same physical 10 space and which does not include interactions that may occur 11 through the use of telecommunication technologies. 12 q. “Interjurisdictional practice certificate” or “IPC” 13 means a certificate issued by the association of state and 14 provincial psychology boards that grants temporary authority 15 to practice based on notification to the state psychology 16 regulatory authority of intention to practice temporarily, and 17 verification of one’s qualifications for such practice. 18 r. “License” means authorization by a state psychology 19 regulatory authority to engage in the independent practice of 20 psychology, which would be unlawful without the authorization. 21 s. “Noncompact state” means any state which is not at the 22 time a compact state. 23 t. “Psychologist” means an individual licensed for the 24 independent practice of psychology. 25 u. “Psychology interjurisdictional compact commission” or 26 “commission” means the national administration of which all 27 compact states are members. 28 v. “Receiving state” means a compact state where the 29 client-patient is physically located when the telepsychological 30 services are delivered. 31 w. “Rule” means a written statement by the psychology 32 interjurisdictional compact commission promulgated pursuant 33 to article XI that is of general applicability, implements, 34 interprets, or prescribes a policy or provision of this 35 -11- LSB 5336HV (2) 91 ss/ko 11/ 40

H.F. 2676 compact, or an organizational, procedural, or practice 1 requirement of the commission and has the force and effect of 2 statutory law in a compact state, and includes the amendment, 3 repeal, or suspension of an existing rule. 4 x. “Significant investigatory information” means any of the 5 following: 6 (1) Investigative information that a state psychology 7 regulatory authority, after a preliminary inquiry that includes 8 notification and an opportunity to respond if required by state 9 law, has reason to believe, if proven true, would indicate more 10 than a violation of state statute or ethics code that would be 11 considered more substantial than a minor infraction. 12 (2) Investigative information that indicates that the 13 psychologist represents an immediate threat to public health 14 and safety regardless of whether the psychologist has been 15 notified or had an opportunity to respond. 16 y. “State” means a state, commonwealth, territory, or 17 possession of the United States, or the District of Columbia. 18 z. “State psychology regulatory authority” means the board, 19 office, or other agency with the legislative mandate to license 20 and regulate the practice of psychology. 21 aa. “Telepsychology” means the provision of psychological 22 services using telecommunication technologies. 23 ab. “Temporary authorization to practice” means a licensed 24 psychologist’s authority to conduct temporary in-person, 25 face-to-face practice, within the limits authorized under this 26 compact, in another compact state. 27 ac. “Temporary in-person, face-to-face practice” means where 28 a psychologist is physically present, not through the use 29 of telecommunications technologies, in the distant state to 30 provide for the practice of psychology for thirty days within a 31 calendar year and based on notification to the distant state. 32 3. Article III —— Home state licensure. 33 a. The home state shall be a compact state where a 34 psychologist is licensed to practice psychology. 35 -12- LSB 5336HV (2) 91 ss/ko 12/ 40

H.F. 2676 b. A psychologist may hold one or more compact state 1 licenses at a time. If the psychologist is licensed in more 2 than one compact state, the home state is the compact state 3 where the psychologist is physically present when the services 4 are delivered as authorized by the authority to practice 5 interjurisdictional telepsychology under the terms of this 6 compact. 7 c. Any compact state may require a psychologist not 8 previously licensed in a compact state to obtain and retain 9 a license to be authorized to practice in the compact state 10 under circumstances not authorized by the authority to practice 11 interjurisdictional telepsychology under the terms of this 12 compact. 13 d. Any compact state may require a psychologist to obtain 14 and retain a license to be authorized to practice in a 15 compact state under circumstances not authorized by temporary 16 authorization to practice under the terms of this compact. 17 e. A home state’s license authorizes a psychologist to 18 practice in a receiving state under the authority to practice 19 interjurisdictional telepsychology only if the compact state 20 meets all of the following requirements: 21 (1) Currently requires the psychologist to hold an active 22 E.Passport. 23 (2) Has a mechanism in place for receiving and investigating 24 complaints about licensed individuals. 25 (3) Notifies the commission, in compliance with the terms 26 herein, of any adverse action or significant investigatory 27 information regarding a licensed individual. 28 (4) Requires an identity history summary of all applicants 29 at initial licensure, including the use of the results of 30 fingerprints or other biometric data checks compliant with the 31 requirements of the federal bureau of investigation (FBI), or 32 other designee with similar authority, no later than ten years 33 after activation of the this compact. 34 (5) Complies with the bylaws and rules of the commission. 35 -13- LSB 5336HV (2) 91 ss/ko 13/ 40

H.F. 2676 f. A home state’s license grants temporary authorization 1 to practice to a psychologist in a distant state only if the 2 compact state meets all of the following requirements: 3 (1) Currently requires the psychologist to hold an active 4 IPC. 5 (2) Has a mechanism in place for receiving and investigating 6 complaints about licensed individuals. 7 (3) Notifies the commission, in compliance with the terms 8 herein, of any adverse action or significant investigatory 9 information regarding a licensed individual. 10 (4) Requires an identity history summary of all applicants 11 at initial licensure, including the use of the results of 12 fingerprints or other biometric data checks compliant with the 13 requirements of the federal bureau of investigation (FBI), or 14 other designee with similar authority, no later than ten years 15 after activation of this compact. 16 (5) Complies with the bylaws and rules of the commission. 17 4. Article IV —— Compact privilege to practice 18 telepsychology. 19 a. Compact states shall recognize the right of a 20 psychologist, licensed in a compact state in conformance with 21 article III, to practice telepsychology in receiving states in 22 which the psychologist is not licensed, under the authority to 23 practice interjurisdictional telepsychology as provided in this 24 compact. 25 b. To exercise the authority to practice interjurisdictional 26 telepsychology under the terms and provisions of this compact, 27 a psychologist licensed to practice in a compact state shall 28 meet all of the following requirements: 29 (1) Hold a graduate degree in psychology from an institution 30 of higher education that was either of the following, at the 31 time the degree was awarded: 32 (a) Regionally accredited by an accrediting body recognized 33 by the United States department of education to grant graduate 34 degrees, or authorized by provincial statute or royal charter 35 -14- LSB 5336HV (2) 91 ss/ko 14/ 40

H.F. 2676 to grant doctoral degrees. 1 (b) A foreign college or university deemed to be equivalent 2 to subparagraph (1), subparagraph division (a), by a foreign 3 credential evaluation service that is a member of the national 4 association of credential evaluation services or by a 5 recognized foreign credential evaluation service. 6 (2) Hold a graduate degree in psychology that meets all of 7 the following criteria: 8 (a) The program, wherever it may be administratively 9 housed, must be clearly identified and labeled as a 10 psychology program. Such a program must specify in pertinent 11 institutional catalogues and brochures its intent to educate 12 and train professional psychologists. 13 (b) The psychology program must stand as a recognizable, 14 coherent, organizational entity within the institution. 15 (c) There must be a clear authority and primary 16 responsibility for the core and specialty areas whether or not 17 the program cuts across administrative lines. 18 (d) The program must consist of an integrated, organized 19 sequence of study. 20 (e) There must be an identifiable psychology 21 faculty sufficient in size and breadth to carry out its 22 responsibilities. 23 (f) The designated director of the program must be a 24 psychologist and a member of the core faculty. 25 (g) The program must have an identifiable body of students 26 who are matriculated in that program for a degree. 27 (h) The program must include supervised practicum, 28 internship, or field training appropriate to the practice of 29 psychology. 30 (i) The curriculum shall encompass a minimum of three 31 academic years of full-time graduate study for doctoral degrees 32 and a minimum of one academic year of full-time graduate study 33 for master’s degrees. 34 (j) The program includes an acceptable residency as defined 35 -15- LSB 5336HV (2) 91 ss/ko 15/ 40

H.F. 2676 by the rules of the commission. 1 (3) Possess a current, full, and unrestricted license to 2 practice psychology in a home state which is a compact state. 3 (4) Have no history of adverse action that violates the 4 rules of the commission. 5 (5) Have no criminal record history reported on an identity 6 history summary that violates the rules of the commission. 7 (6) Possess a current, active E.Passport. 8 (7) Provide attestations in regard to areas of intended 9 practice, conformity with standards of practice, competence in 10 telepsychology technology; criminal background; and knowledge 11 and adherence to legal requirements in the home and receiving 12 states, and provide a release of information to allow for 13 primary source verification in a manner specified by the 14 commission. 15 (8) Meet other criteria as defined by the rules of the 16 commission. 17 c. The home state maintains authority over the license of 18 any psychologist practicing into a receiving state under the 19 authority to practice interjurisdictional telepsychology. 20 d. A psychologist practicing into a receiving state under 21 the authority to practice interjurisdictional telepsychology 22 shall be subject to the receiving state’s scope of practice. 23 A receiving state may, in accordance with that state’s due 24 process law, limit or revoke a psychologist’s authority to 25 practice interjurisdictional telepsychology in the receiving 26 state and may take any other necessary actions under the 27 receiving state’s applicable law to protect the health and 28 safety of the receiving state’s citizens. If a receiving state 29 takes action, the state shall promptly notify the home state 30 and the commission. 31 e. If a psychologist’s license in any home state or another 32 compact state, or any authority to practice interjurisdictional 33 telepsychology in any receiving state, is restricted, 34 suspended, or otherwise limited, the E.Passport shall be 35 -16- LSB 5336HV (2) 91 ss/ko 16/ 40

H.F. 2676 revoked and the psychologist shall not be eligible to practice 1 telepsychology in a compact state under the authority to 2 practice interjurisdictional telepsychology. 3 5. Article V —— Compact temporary authorization to practice. 4 a. Compact states shall also recognize the right of a 5 psychologist, licensed in a compact state in conformance with 6 article III, to practice temporarily in distant states in which 7 the psychologist is not licensed, as provided in this compact. 8 b. To exercise the temporary authorization to practice 9 under the terms and provisions of this compact, a psychologist 10 licensed to practice in a compact state shall meet all of the 11 following requirements: 12 (1) Hold a graduate degree in psychology from an institution 13 of higher education that was either of the following, at the 14 time the degree was awarded: 15 (a) Regionally accredited by an accrediting body recognized 16 by the United States department of education to grant graduate 17 degrees, or authorized by provincial statute or royal charter 18 to grant doctoral degrees. 19 (b) A foreign college or university deemed to be equivalent 20 to subparagraph (1), subparagraph division (a), by a foreign 21 credential evaluation service that is a member of the national 22 association of credential evaluation services or by a 23 recognized foreign credential evaluation service. 24 (2) Hold a graduate degree in psychology that meets all of 25 the following criteria: 26 (a) The program, wherever it may be administratively 27 housed, must be clearly identified and labeled as a 28 psychology program. Such a program must specify in pertinent 29 institutional catalogues and brochures its intent to educate 30 and train professional psychologists. 31 (b) The psychology program must stand as a recognizable, 32 coherent, organizational entity within the institution. 33 (c) There must be a clear authority and primary 34 responsibility for the core and specialty areas whether or not 35 -17- LSB 5336HV (2) 91 ss/ko 17/ 40

H.F. 2676 the program cuts across administrative lines. 1 (d) The program must consist of an integrated, organized 2 sequence of study. 3 (e) There must be an identifiable psychology 4 faculty sufficient in size and breadth to carry out its 5 responsibilities. 6 (f) The designated director of the program must be a 7 psychologist and a member of the core faculty. 8 (g) The program must have an identifiable body of students 9 who are matriculated in that program for a degree. 10 (h) The program must include supervised practicum, 11 internship, or field training appropriate to the practice of 12 psychology. 13 (i) The curriculum shall encompass a minimum of three 14 academic years of full-time graduate study for doctoral degrees 15 and a minimum of one academic year of full-time graduate study 16 for master’s degrees. 17 (j) The program includes an acceptable residency as defined 18 by the rules of the commission. 19 (3) Possess a current, full, and unrestricted license to 20 practice psychology in a home state which is a compact state. 21 (4) Have no history of adverse action that violates the 22 rules of the commission. 23 (5) Have no criminal record history that violates the rules 24 of the commission. 25 (6) Possess a current, active IPC. 26 (7) Provide attestations in regard to areas of intended 27 practice and work experience and provide a release of 28 information to allow for primary source verification in a 29 manner specified by the commission. 30 (8) Meet other criteria as defined by the rules of the 31 commission. 32 c. A psychologist practicing into a distant state under the 33 temporary authorization to practice shall practice within the 34 scope of practice authorized by the distant state. 35 -18- LSB 5336HV (2) 91 ss/ko 18/ 40

H.F. 2676 d. A psychologist practicing into a distant state under the 1 temporary authorization to practice shall be subject to the 2 distant state’s authority and law. A distant state may, in 3 accordance with that state’s due process law, limit or revoke 4 a psychologist’s temporary authorization to practice in the 5 distant state and may take any other necessary actions under 6 the distant state’s applicable law to protect the health and 7 safety of the distant state’s citizens. If a distant state 8 takes action, the state shall promptly notify the home state 9 and the commission. 10 e. If a psychologist’s license in any home state, another 11 compact state, or any temporary authorization to practice in 12 any distant state, is restricted, suspended, or otherwise 13 limited, the IPC shall be revoked and the psychologist shall 14 not be eligible to practice in a compact state under the 15 temporary authorization to practice. 16 6. Article VI —— Conditions of telepsychology practice in a 17 receiving state. A psychologist may practice in a receiving 18 state under the authority to practice interjurisdictional 19 telepsychology only in the performance of the scope of 20 practice for psychology as assigned by an appropriate state 21 psychology regulatory authority, as defined in the rules of the 22 commission, and under the following circumstances: 23 a. The psychologist initiates a client-patient contact 24 in a home state via telecommunications technologies with a 25 client-patient in a receiving state. 26 b. Other conditions regarding telepsychology as determined 27 by rules promulgated by the commission. 28 7. Article VII —— Adverse actions. 29 a. A home state shall have the power to impose adverse 30 action against a psychologist’s license issued by the home 31 state. A distant state shall have the power to take adverse 32 action on a psychologist’s temporary authorization to practice 33 within that distant state. 34 b. A receiving state may take adverse action on a 35 -19- LSB 5336HV (2) 91 ss/ko 19/ 40

H.F. 2676 psychologist’s authority to practice interjurisdictional 1 telepsychology within that receiving state. A home state may 2 take adverse action against a psychologist based on an adverse 3 action taken by a distant state regarding temporary in-person, 4 face-to-face practice. 5 c. If a home state takes adverse action against a 6 psychologist’s license, that psychologist’s authority to 7 practice interjurisdictional telepsychology is terminated and 8 the E.Passport is revoked. Furthermore, that psychologist’s 9 temporary authorization to practice is terminated and the IPC 10 is revoked. 11 (1) All home state disciplinary orders which impose adverse 12 action shall be reported to the commission in accordance with 13 the rules promulgated by the commission. A compact state shall 14 report adverse actions in accordance with the rules of the 15 commission. 16 (2) In the event discipline is reported on a psychologist, 17 the psychologist shall not be eligible for telepsychology or 18 temporary in-person, face-to-face practice in accordance with 19 the rules of the commission. 20 (3) Other actions may be imposed as determined by the rules 21 promulgated by the commission. 22 d. A home state’s psychology regulatory authority shall 23 investigate and take appropriate action with respect to 24 reported inappropriate conduct engaged in by a licensee which 25 occurred in a receiving state as it would if such conduct had 26 occurred by a licensee within the home state. In such cases, 27 the home state’s law shall control in determining any adverse 28 action against a psychologist’s license. 29 e. A distant state’s psychology regulatory authority 30 shall investigate and take appropriate action with respect to 31 reported inappropriate conduct engaged in by a psychologist 32 practicing under temporary authorization to practice which 33 occurred in that distant state as it would if such conduct 34 had occurred by a licensee within the home state. In such 35 -20- LSB 5336HV (2) 91 ss/ko 20/ 40

H.F. 2676 cases, the distant state’s law shall control in determining any 1 adverse action against a psychologist’s temporary authorization 2 to practice. 3 f. Nothing in this compact shall override a compact state’s 4 decision that a psychologist’s participation in an alternative 5 program may be used in lieu of adverse action and that such 6 participation shall remain nonpublic if required by the compact 7 state’s law. Compact states shall require psychologists who 8 enter any alternative programs to not provide telepsychology 9 services under the authority to practice interjurisdictional 10 telepsychology or provide temporary psychological services 11 under the temporary authorization to practice in any other 12 compact state during the term of the alternative program. 13 g. No other judicial or administrative remedies shall 14 be available to a psychologist in the event a compact state 15 imposes an adverse action pursuant to paragraph “c” . 16 8. Article VIII —— Additional authorities invested in a 17 compact state’s psychology regulatory authority. In addition 18 to any other powers granted under state law, a compact state’s 19 psychology regulatory authority shall have the authority under 20 this compact to do all of the following: 21 a. Issue subpoenas, for both hearings and investigations, 22 which require the attendance and testimony of witnesses and 23 the production of evidence. Subpoenas issued by a compact 24 state’s psychology regulatory authority for the attendance 25 and testimony of witnesses or the production of evidence from 26 another compact state shall be enforced in the latter state by 27 any court of competent jurisdiction, according to that court’s 28 practice and procedure in considering subpoenas issued in its 29 own proceedings. The issuing state psychology regulatory 30 authority shall pay any witness fees, travel expenses, mileage, 31 and other fees required by the service statutes of the state 32 where the witnesses or evidence are located. 33 b. Issue cease and desist or injunctive relief 34 orders to revoke a psychologist’s authority to practice 35 -21- LSB 5336HV (2) 91 ss/ko 21/ 40

H.F. 2676 interjurisdictional telepsychology or temporary authorization 1 to practice. 2 c. During the course of any investigation, a psychologist 3 may not change the psychologist’s home state licensure. A 4 home state psychology regulatory authority is authorized to 5 complete any pending investigations of a psychologist and 6 to take any actions appropriate under its law. The home 7 state psychology regulatory authority shall promptly report 8 the conclusions of such investigations to the commission. 9 Once an investigation has been completed, and pending the 10 outcome of said investigation, the psychologist may change the 11 psychologist’s home state licensure. The commission shall 12 promptly notify the new home state of any such decisions as 13 provided in the rules of the commission. All information 14 provided to the commission or distributed by compact states 15 pursuant to the psychologist shall be confidential, filed under 16 seal, and used for investigatory or disciplinary matters. 17 The commission may create additional rules for mandated or 18 discretionary sharing of information by compact states. 19 9. Article IX —— Coordinated licensure information system. 20 a. The commission shall provide for the development and 21 maintenance of a coordinated licensure information system and 22 reporting system containing licensure and disciplinary action 23 information on all psychologists individuals to whom this 24 compact is applicable in all compact states as defined by the 25 rules of the commission. 26 b. Notwithstanding any other provision of state law to the 27 contrary, a compact state shall submit a uniform data set to 28 the coordinated database on all licensees as required by the 29 rules of the commission, including all of the following: 30 (1) Identifying information. 31 (2) Licensure data. 32 (3) Significant investigatory information. 33 (4) Adverse actions against a psychologist’s license. 34 (5) An indicator that a psychologist’s authority to 35 -22- LSB 5336HV (2) 91 ss/ko 22/ 40

H.F. 2676 practice interjurisdictional telepsychology or temporary 1 authorization to practice is revoked. 2 (6) Nonconfidential information related to alternative 3 program participation information. 4 (7) Any denial of application for licensure, and the reasons 5 for such denial. 6 (8) Other information which may facilitate the 7 administration of this compact, as determined by the rules of 8 the commission. 9 c. The coordinated database administrator shall promptly 10 notify all compact states of any adverse action taken against, 11 or significant investigative information on, any licensee in a 12 compact state. 13 d. Compact states reporting information to the coordinated 14 database may designate information that may not be shared with 15 the public without the express permission of the compact state 16 reporting the information. 17 e. Any information submitted to the coordinated database 18 that is subsequently required to be expunged by the law of the 19 compact state reporting the information shall be removed from 20 the coordinated database. 21 10. Article X —— Establishment of the psychology 22 interjurisdictional compact commission. 23 a. The compact states hereby create and establish a joint 24 public agency known as the psychology interjurisdictional 25 compact commission. 26 (1) The commission is a body politic and an instrumentality 27 of the compact states. 28 (2) Venue is proper and judicial proceedings by or against 29 the commission shall be brought solely and exclusively in a 30 court of competent jurisdiction where the principal office of 31 the commission is located. The commission may waive venue and 32 jurisdictional defenses to the extent it adopts or consents to 33 participate in alternative dispute resolution proceedings. 34 (3) Nothing in this compact shall be construed to be a 35 -23- LSB 5336HV (2) 91 ss/ko 23/ 40

H.F. 2676 waiver of sovereign immunity. 1 b. Membership, voting, and meetings. 2 (1) The commission shall consist of one voting 3 representative appointed by each compact state who shall serve 4 as that state’s commissioner. The state psychology regulatory 5 authority shall appoint its delegate. This delegate shall be 6 empowered to act on behalf of the compact state. This delegate 7 shall be limited to one of the following: 8 (a) The executive director, executive secretary, or similar 9 executive. 10 (b) A current member of the state psychology regulatory 11 authority of a compact state. 12 (c) A designee empowered with the appropriate delegate 13 authority to act on behalf of the compact state. 14 (2) Any commissioner may be removed or suspended from office 15 as provided by the law of the state from which the commissioner 16 is appointed. Any vacancy occurring in the commission shall 17 be filled in accordance with the laws of the compact state in 18 which the vacancy exists. 19 (3) Each commissioner shall be entitled to one vote with 20 regard to the promulgation of rules and creation of bylaws 21 and shall otherwise have an opportunity to participate in 22 the business and affairs of the commission. A commissioner 23 shall vote in person or by such other means as provided 24 in the bylaws. The bylaws may provide for commissioners’ 25 participation in meetings by telephone or other means of 26 communication. 27 (4) The commission shall meet at least once during each 28 calendar year. Additional meetings shall be held as set forth 29 in the bylaws. 30 (5) All meetings shall be open to the public, and public 31 notice of meetings shall be given in the same manner as 32 required under the rulemaking provisions in article XI. 33 (6) The commission may convene in a closed, nonpublic 34 meeting if the commission must discuss any of the following: 35 -24- LSB 5336HV (2) 91 ss/ko 24/ 40

H.F. 2676 (a) Noncompliance of a compact state with its obligations 1 under this compact. 2 (b) The employment, compensation, discipline, or other 3 personnel matters, practices, or procedures related to specific 4 employees or other matters related to the commission’s internal 5 personnel practices and procedures. 6 (c) Current, threatened, or reasonably anticipated 7 litigation against the commission. 8 (d) Negotiation of contracts for the purchase or sale of 9 goods, services, or real estate. 10 (e) Accusation against any person of a crime or formal 11 censure of any person. 12 (f) Disclosure of trade secrets or commercial or financial 13 information which is privileged or confidential. 14 (g) Disclosure of information of a personal nature where 15 disclosure would constitute a clearly unwarranted invasion of 16 personal privacy. 17 (h) Disclosure of investigatory records compiled for law 18 enforcement purposes. 19 (i) Disclosure of information related to any investigatory 20 reports prepared by or on behalf of or for use of the 21 commission or other committee charged with responsibility for 22 investigation or determination of compliance issues pursuant 23 to the compact. 24 (j) Matters specifically exempted from disclosure by 25 federal and state statute. 26 (7) If a meeting, or portion of a meeting, is closed 27 pursuant to subparagraph (6), the commission’s legal counsel or 28 designee shall certify that the meeting may be closed and shall 29 reference each relevant exempting provision. The commission 30 shall keep minutes which fully and clearly describe all matters 31 discussed in a meeting and shall provide a full and accurate 32 summary of actions taken, of any person participating in the 33 meeting, and the reasons therefore, including a description of 34 the views expressed. All documents considered in connection 35 -25- LSB 5336HV (2) 91 ss/ko 25/ 40

H.F. 2676 with an action shall be identified in such minutes. All 1 minutes and documents of a closed meeting shall remain under 2 seal, subject to release only by a majority vote of the 3 commission or order of a court of competent jurisdiction. 4 c. The commission shall, by a majority vote of the 5 commissioners, prescribe bylaws or rules to govern its conduct 6 as may be necessary or appropriate to carry out the purposes 7 and exercise the powers of this compact, including but not 8 limited to or providing for all of the following: 9 (1) Establishing the fiscal year of the commission. 10 (2) Providing reasonable standards and procedures for all 11 of the following: 12 (a) The establishment and meetings of other committees. 13 (b) Governing any general or specific delegation of any 14 authority or function of the commission. 15 (3) Providing reasonable procedures for calling and 16 conducting meetings of the commission, ensuring reasonable 17 advance notice of all meetings and providing an opportunity 18 for attendance of such meetings by interested parties, 19 with enumerated exceptions designed to protect the public’s 20 interest, the privacy of individuals of such proceedings, 21 and proprietary information, including trade secrets. The 22 commission may meet in closed session only after a majority 23 of the commissioners vote to close a meeting to the public in 24 whole or in part. As soon as practicable, the commission shall 25 make public a copy of the vote to close the meeting revealing 26 the vote of each commissioner with no proxy votes allowed. 27 (4) Establishing the titles, duties, and authority and 28 reasonable procedures for the election of the officers of the 29 commission. 30 (5) Providing reasonable standards and procedures for the 31 establishment of the personnel policies and programs of the 32 commission. Notwithstanding any civil service or other similar 33 law of any compact state, the bylaws shall exclusively govern 34 the personnel policies and programs of the commission. 35 -26- LSB 5336HV (2) 91 ss/ko 26/ 40

H.F. 2676 (6) Promulgating a code of ethics to address permissible and 1 prohibited activities of commission members and employees. 2 (7) Providing a mechanism for concluding the operations of 3 the commission and the equitable disposition of any surplus 4 funds that may exist after the termination of the compact after 5 the payment or reserving of all of its debts and obligations. 6 (8) The commission shall publish its bylaws in a convenient 7 form and file a copy thereof and a copy of any amendment 8 thereto, with the appropriate agency or officer in each of the 9 compact states. 10 (9) The commission shall maintain its financial records in 11 accordance with the bylaws. 12 (10) The commission shall meet and take such actions as are 13 consistent with the provisions of this compact and the bylaws. 14 d. The commission shall have all of the following powers: 15 (1) The authority to promulgate uniform rules to facilitate 16 and coordinate implementation and administration of this 17 compact. The rules shall have the force and effect of law and 18 shall be binding in all compact states. 19 (2) To bring and prosecute legal proceedings or actions in 20 the name of the commission, provided that the standing of any 21 state psychology regulatory authority or other regulatory body 22 responsible for psychology licensure to sue or be sued under 23 applicable law shall not be affected. 24 (3) To purchase and maintain insurance and bonds. 25 (4) To borrow, accept, or contract for services of 26 personnel, including but not limited to employees of a compact 27 state. 28 (5) To hire employees, elect or appoint officers, fix 29 compensation, define duties, grant such individuals appropriate 30 authority to carry out the purposes of the compact, and to 31 establish the commission’s personnel policies and programs 32 relating to conflicts of interest, qualifications of personnel, 33 and other related personnel matters. 34 (6) To accept any and all appropriate donations and grants 35 -27- LSB 5336HV (2) 91 ss/ko 27/ 40

H.F. 2676 of money, equipment, supplies, materials and services, and to 1 receive, utilize, and dispose of the same; provided that at all 2 times the commission shall strive to avoid any appearance of 3 impropriety or conflict of interest. 4 (7) To lease, purchase, accept appropriate gifts or 5 donations of, or otherwise to own, hold, improve, or use, 6 any property, real, personal, or mixed; provided that at all 7 times the commission shall strive to avoid any appearance of 8 impropriety. 9 (8) To sell, convey, mortgage, pledge, lease, exchange, 10 abandon, or otherwise dispose of any property real, personal, 11 or mixed. 12 (9) To establish a budget and make expenditures. 13 (10) To borrow money. 14 (11) To appoint committees, including advisory committees 15 comprised of members, state regulators, state legislators or 16 their representatives, and consumer representatives, and such 17 other interested persons as may be designated in this compact 18 and the bylaws. 19 (12) To provide and receive information from, and to 20 cooperate with, law enforcement agencies. 21 (13) To adopt and use an official seal. 22 (14) To perform such other functions as may be necessary or 23 appropriate to achieve the purposes of this compact consistent 24 with the state regulation of psychology licensure, temporary 25 in-person, face-to-face practice, and telepsychology practice. 26 e. The executive board. 27 (1) The elected officers shall serve as the executive board, 28 which shall have the power to act on behalf of the commission 29 according to the terms of this compact. 30 (2) The executive board shall be comprised of the following 31 six members: 32 (a) Five voting members who are elected from the current 33 membership of the commission by the commission. 34 (b) One ex officio, nonvoting member from the recognized 35 -28- LSB 5336HV (2) 91 ss/ko 28/ 40

H.F. 2676 membership organization composed of state and provincial 1 psychology regulatory authorities. 2 (3) The ex officio member must have served as staff or 3 member on a state psychology regulatory authority and shall be 4 selected by its respective organization. 5 (4) The commission may remove any member of the executive 6 board as provided in the bylaws. 7 (5) The executive board shall meet at least annually. 8 (6) The executive board shall have all of the following 9 duties and responsibilities: 10 (a) Recommend to the entire commission changes to the rules 11 or bylaws, changes to this compact legislation, fees paid by 12 compact states such as annual dues, and any other applicable 13 fees. 14 (b) Ensure compact administration services are 15 appropriately provided, contractual or otherwise. 16 (c) Prepare and recommend the budget. 17 (d) Maintain financial records on behalf of the commission. 18 (e) Monitor compact compliance of member states and provide 19 compliance reports to the commission. 20 (f) Establish additional committees as necessary. 21 (g) Other duties as provided in the rules or bylaws. 22 f. Financing of the commission. 23 (1) The commission shall pay, or provide for the payment of, 24 the reasonable expenses of its establishment, organization, and 25 ongoing activities. 26 (2) The commission may accept any and all appropriate 27 revenue sources, donations and grants of money, equipment, 28 supplies, materials, and services. 29 (3) The commission may levy on and collect an annual 30 assessment from each compact state or impose fees on other 31 parties to cover the cost of the operations and activities of 32 the commission and its staff which must be in a total amount 33 sufficient to cover its annual budget as approved each year 34 for which revenue is not provided by other sources. The 35 -29- LSB 5336HV (2) 91 ss/ko 29/ 40

H.F. 2676 aggregate annual assessment amount shall be allocated based 1 upon a formula to be determined by the commission which shall 2 promulgate a rule binding upon all compact states. 3 (4) The commission shall not incur obligations of any kind 4 prior to securing the funds adequate to meet the same; nor 5 shall the commission pledge the credit of any of the compact 6 states, except by and with the authority of the compact state. 7 (5) The commission shall keep accurate accounts of all 8 receipts and disbursements. The receipts and disbursements of 9 the commission shall be subject to the audit and accounting 10 procedures established under its bylaws. However, all receipts 11 and disbursements of funds handled by the commission shall be 12 audited yearly by a certified or licensed public accountant and 13 the report of the audit shall be included in and become part of 14 the annual report of the commission. 15 g. Qualified immunity, defense, and indemnification. 16 (1) The members, officers, executive director, employees, 17 and representatives of the commission shall be immune from suit 18 and liability, either personally or in their official capacity, 19 for any claim for damage to or loss of property or personal 20 injury or other civil liability caused by or arising out of any 21 actual or alleged act, error, or omission that occurred, or 22 that the person against whom the claim is made had a reasonable 23 basis for believing occurred within the scope of commission 24 employment, duties, or responsibilities; provided that nothing 25 in this subparagraph shall be construed to protect any such 26 person from suit or liability for any damage, loss, injury, 27 or liability caused by the intentional or willful or wanton 28 misconduct of that person. 29 (2) The commission shall defend any member, officer, 30 executive director, employee, or representative of the 31 commission in any civil action seeking to impose liability 32 arising out of any actual or alleged act, error, or omission 33 that occurred within the scope of commission employment, 34 duties, or responsibilities, or that the person against 35 -30- LSB 5336HV (2) 91 ss/ko 30/ 40

H.F. 2676 whom the claim is made had a reasonable basis for believing 1 occurred within the scope of commission employment, duties, or 2 responsibilities; provided that nothing in this subparagraph 3 shall be construed to prohibit that person from retaining the 4 person’s own counsel; and provided further, that the actual 5 or alleged act, error, or omission did not result from that 6 person’s intentional or willful or wanton misconduct. 7 (3) The commission shall indemnify and hold harmless 8 any member, officer, executive director, employee, or 9 representative of the commission for the amount of any 10 settlement or judgment obtained against that person arising 11 out of any actual or alleged act, error, or omission that 12 occurred within the scope of commission employment, duties, 13 or responsibilities, or that such person had a reasonable 14 basis for believing occurred within the scope of commission 15 employment, duties, or responsibilities, provided that the 16 actual or alleged act, error, or omission did not result from 17 the intentional or willful or wanton misconduct of that person. 18 11. Article XI —— Rulemaking. 19 a. The commission shall exercise its rulemaking powers 20 pursuant to the criteria set forth in this article XI and the 21 rules adopted under this article XI. Rules and amendments 22 shall become binding as of the date specified in each rule or 23 amendment. 24 b. If a majority of the legislatures of the compact states 25 rejects a rule, by enactment of a statute or resolution in the 26 same manner used to adopt this compact, then such rule shall 27 have no further force and effect in any compact state. 28 c. Rules or amendments to the rules shall be adopted at a 29 regular or special meeting of the commission. 30 d. Prior to promulgation and adoption of a final rule or 31 rules by the commission, and at least sixty days in advance 32 of the meeting at which the rule will be considered and voted 33 upon, the commission shall file a notice of proposed rulemaking 34 on both of the following: 35 -31- LSB 5336HV (2) 91 ss/ko 31/ 40

H.F. 2676 (1) On the internet site of the commission. 1 (2) On the internet site of each compact state’s psychology 2 regulatory authority or the publication in which each state 3 would otherwise publish proposed rules. 4 e. The notice of proposed rulemaking shall include all of 5 the following: 6 (1) The proposed time, date, and location of the meeting in 7 which the rule will be considered and voted upon. 8 (2) The text of the proposed rule or amendment and the 9 reason for the proposed rule. 10 (3) A request for comments on the proposed rule from any 11 interested person. 12 (4) The manner in which interested persons may submit notice 13 to the commission of their intention to attend the public 14 hearing and any written comments. 15 f. Prior to adoption of a proposed rule, the commission 16 shall allow persons to submit written data, facts, opinions, 17 and arguments, which shall be made available to the public. 18 g. The commission shall grant an opportunity for a public 19 hearing before it adopts a rule or amendment if a hearing is 20 requested by any of the following: 21 (1) At least twenty-five persons who submit comments 22 independently of each other. 23 (2) A governmental subdivision or agency. 24 (3) A duly appointed person in an association that has at 25 least twenty-five members. 26 h. If a hearing is held on the proposed rule or amendment, 27 the commission shall publish the place, time, and date of the 28 scheduled public hearing. 29 (1) All persons wishing to be heard at the hearing shall 30 notify the executive director of the commission or other 31 designated member in writing of their desire to appear and 32 testify at the hearing not less than five business days before 33 the scheduled date of the hearing. 34 (2) Hearings shall be conducted in a manner providing each 35 -32- LSB 5336HV (2) 91 ss/ko 32/ 40

H.F. 2676 person who wishes to comment a fair and reasonable opportunity 1 to comment orally or in writing. 2 (3) No transcript of the hearing is required, unless 3 a written request for a transcript is made, in which case 4 the person requesting the transcript shall bear the cost of 5 producing the transcript. A recording may be made in lieu of a 6 transcript under the same terms and conditions as a transcript. 7 This subparagraph shall not preclude the commission from making 8 a transcript or recording of the hearing if it so chooses. 9 (4) Nothing in this article shall be construed as requiring 10 a separate hearing on each rule. Rules may be grouped for the 11 convenience of the commission at hearings required by this 12 article. 13 i. Following the scheduled hearing date, or by the close 14 of business on the scheduled hearing date if the hearing was 15 not held, the commission shall consider all written and oral 16 comments received. 17 j. The commission shall, by majority vote of all members, 18 take final action on the proposed rule and shall determine the 19 effective date of the rule, if any, based on the rulemaking 20 record and the full text of the rule. 21 k. If no written notice of intent to attend the public 22 hearing by interested parties is received, the commission may 23 proceed with promulgation of the proposed rule without a public 24 hearing. 25 l. Upon determination that an emergency exists, the 26 commission may consider and adopt an emergency rule without 27 prior notice, opportunity for comment, or hearing, provided 28 that the usual rulemaking procedures provided in this compact 29 and in this article shall be retroactively applied to the rule 30 as soon as reasonably possible, in no event later than ninety 31 days after the effective date of the rule. For the purposes of 32 this paragraph, an emergency rule is one that must be adopted 33 immediately in order to address any of the following: 34 (1) Meet an imminent threat to public health, safety, or 35 -33- LSB 5336HV (2) 91 ss/ko 33/ 40

H.F. 2676 welfare. 1 (2) Prevent a loss of commission or compact state funds. 2 (3) Meet a deadline for the promulgation of an 3 administrative rule that is established by federal law or rule. 4 (4) Protect public health and safety. 5 m. The commission or an authorized committee of the 6 commission may direct revisions to a previously adopted rule 7 or amendment for purposes of correcting typographical errors, 8 errors in format, errors in consistency, or grammatical errors. 9 Public notice of any revisions shall be posted on the website 10 of the commission. The revision shall be subject to challenge 11 by any person for a period of thirty days after posting. The 12 revision may be challenged only on grounds that the revision 13 results in a material change to a rule. A challenge shall be 14 made in writing, and delivered to the chair of the commission 15 prior to the end of the notice period. If no challenge is 16 made, the revision will take effect without further action. If 17 the revision is challenged, the revision shall not take effect 18 without the approval of the commission. 19 12. Article XII —— Oversight, dispute resolution, and 20 enforcement. 21 a. Oversight. 22 (1) The executive, legislative, and judicial branches 23 of state government in each compact state shall enforce this 24 compact and take all actions necessary and appropriate to 25 effectuate this compact’s purposes and intent. The provisions 26 of this compact and the rules promulgated under this compact 27 shall have standing as statutory law. 28 (2) All courts shall take judicial notice of this compact 29 and the rules in any judicial or administrative proceeding in a 30 compact state pertaining to the subject matter of this compact 31 which may affect the powers, responsibilities, or actions of 32 the commission. 33 (3) The commission shall be entitled to receive service 34 of process in any such proceeding, and shall have standing to 35 -34- LSB 5336HV (2) 91 ss/ko 34/ 40

H.F. 2676 intervene in such a proceeding for all purposes. Failure to 1 provide service of process to the commission shall render a 2 judgment or order void as to the commission, this compact, or 3 promulgated rules. 4 b. Default, technical assistance, and termination. 5 (1) If the commission determines that a compact state 6 has defaulted in the performance of its obligations or 7 responsibilities under this compact or the promulgated rules, 8 the commission shall do all of the following: 9 (a) Provide written notice to the defaulting state and other 10 compact states of the nature of the default, the proposed means 11 of remedying the default, or any other action to be taken by 12 the commission. 13 (b) Provide remedial training and specific technical 14 assistance regarding the default. 15 (2) If a state in default fails to remedy the default, the 16 defaulting state may be terminated from this compact upon an 17 affirmative vote of a majority of the compact states, and all 18 rights, privileges, and benefits conferred by this compact 19 shall be terminated on the effective date of termination. A 20 remedy of the default does not relieve the offending state 21 of obligations or liabilities incurred during the period of 22 default. 23 (3) Termination of membership in this compact shall be 24 imposed only after all other means of securing compliance have 25 been exhausted. Notice of intent to suspend or terminate shall 26 be submitted by the commission to the governor, the majority 27 and minority leaders of the defaulting state’s legislature, and 28 each of the compact states. 29 (4) A compact state which has been terminated is 30 responsible for all assessments, obligations, and liabilities 31 incurred through the effective date of termination, including 32 obligations which extend beyond the effective date of 33 termination. 34 (5) The commission shall not bear any costs incurred by 35 -35- LSB 5336HV (2) 91 ss/ko 35/ 40

H.F. 2676 the state which is found to be in default or which has been 1 terminated from this compact, unless agreed upon in writing 2 between the commission and the defaulting state. 3 (6) The defaulting state may appeal the action of the 4 commission by petitioning the United States district court for 5 the state of Georgia or the federal district where the compact 6 has its principal offices. The prevailing member shall be 7 awarded all costs of such litigation, including reasonable 8 attorney fees. 9 c. Dispute resolution. 10 (1) Upon request by a compact state, the commission shall 11 attempt to resolve disputes related to this compact which arise 12 among compact states and between compact and noncompact states. 13 (2) The commission shall promulgate a rule providing for 14 both mediation and binding dispute resolution for disputes that 15 arise before the commission. 16 d. Enforcement. 17 (1) The commission, in the reasonable exercise of its 18 discretion, shall enforce the provisions and rules of this 19 compact. 20 (2) By majority vote, the commission may initiate legal 21 action in the United States district court for the state 22 of Georgia or the federal district where the compact has 23 its principal offices against a compact state in default to 24 enforce compliance with the provisions of the compact and its 25 promulgated rules and bylaws. The relief sought may include 26 both injunctive relief and damages. In the event judicial 27 enforcement is necessary, the prevailing member shall be 28 awarded all costs of such litigation, including reasonable 29 attorney’s fees. 30 (3) The remedies in this article shall not be the exclusive 31 remedies of the commission. The commission may pursue any 32 other remedies available under federal or state law. 33 13. Article XIII —— Date of implementation of the psychology 34 interjurisdictional compact commission and associated rules, 35 -36- LSB 5336HV (2) 91 ss/ko 36/ 40

H.F. 2676 withdrawal, and amendments. 1 a. This compact shall come into effect on the date on which 2 the compact is enacted into law in the seventh compact state. 3 The provisions which become effective at that time shall be 4 limited to the powers granted to the commission relating to 5 assembly and the promulgation of rules. Thereafter, the 6 commission shall meet and exercise rulemaking powers necessary 7 to the implementation and administration of this compact. 8 b. Any state which joins the compact subsequent to the 9 commission’s initial adoption of the rules shall be subject 10 to the rules as they exist on the date on which the compact 11 becomes law in that state. Any rule which has been previously 12 adopted by the commission shall have the full force and effect 13 of law on the day the compact becomes law in that state. 14 c. Any compact state may withdraw from this compact by 15 enacting a statute repealing the compact. 16 (1) A compact state’s withdrawal shall not take effect until 17 six months after enactment of the repealing statute. 18 (2) Withdrawal shall not affect the continuing requirement 19 of the withdrawing state’s psychology regulatory authority to 20 comply with the investigative and adverse action reporting 21 requirements of this compact prior to the effective date of 22 withdrawal. 23 d. Nothing contained in this compact shall be construed to 24 invalidate or prevent any psychology licensure agreement or 25 other cooperative arrangement between a compact state and a 26 noncompact state which does not conflict with the provisions of 27 this compact. 28 e. This compact may be amended by the compact states. No 29 amendment to this compact shall become effective and binding 30 upon any compact state until it is enacted into the law of all 31 compact states. 32 14. Article XIV —— Construction and severability. This 33 compact shall be liberally construed so as to effectuate the 34 purposes thereof. If this compact shall be held contrary to 35 -37- LSB 5336HV (2) 91 ss/ko 37/ 40

H.F. 2676 the constitution of any compact state, the compact shall remain 1 in full force and effect as to the remaining compact states. 2 EXPLANATION 3 The inclusion of this explanation does not constitute agreement with 4 the explanation’s substance by the members of the general assembly. 5 This bill relates to the regulation of health-related 6 matters, including health-related professions, health 7 facilities, nutrition, and taxation. The bill is organized in 8 divisions. 9 DIVISION I —— CONTINUING EDUCATION REQUIREMENTS —— NUTRITION 10 AND METABOLIC HEALTH. The bill requires the board of medicine 11 and the board of physician assistants to adopt rules requiring 12 certain licensees to receive continuing education credits 13 regarding nutritional and metabolic health as a condition of 14 license renewal. 15 DIVISION II —— CERTIFICATE OF NEED. The bill changes the 16 definition of “new institutional health service” or “changed 17 institutional health service”. The bill alters the list of 18 items that are excluded from the provisions of Code chapter 19 135 (department of health and human services —— public 20 health), subchapter VI (health facilities). The bill strikes 21 a provision restricting the department of health and human 22 services (HHS) from processing applications for an intermediate 23 care facility for persons with an intellectual disability, or 24 considering a new or changed institutional health service for 25 an intermediate care facility for persons with an intellectual 26 disability, unless the new or changed beds shall not result 27 in an increase in the total number of medical assistance 28 certified intermediate care facility beds for persons with an 29 intellectual disability in the state, exclusive of those beds 30 at the state resource centers or other state institutions, 31 beyond 1,636 beds. 32 The bill replaces a requirement that HHS hold a public 33 hearing on an application for a certificate of need with a 34 requirement that the department provide a period for the 35 -38- LSB 5336HV (2) 91 ss/ko 38/ 40

H.F. 2676 submission of written comments from affected persons. The bill 1 strikes an authorization for the department to call a public 2 hearing on the question of whether to grant an extension for an 3 expiring certificate of need. 4 DIVISION III —— SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM —— 5 SUMMER ELECTRONIC BENEFITS TRANSFER FOR CHILDREN PROGRAM. The 6 bill requires HHS to continuously maintain state participation 7 in the federal supplemental nutrition assistance program (SNAP) 8 by administering the program in accordance with guidelines 9 approved by the United States department of agriculture, food 10 and nutrition service, to define “eligible foods” as “healthy 11 foods”, as that term is defined by the department, and to seek 12 any federal approval necessary to ensure that provision of 13 benefits is continuous. The bill requires HHS to ensure that 14 the provision of SNAP benefits to recipients is uninterrupted. 15 The bill also allows HHS to participate in the summer 16 electronic benefits transfer for children program, subject to 17 federal approval of guidelines for eligible foods under the 18 program that are similar to the guidelines for eligible foods 19 under SNAP. 20 DIVISION IV —— IVERMECTIN —— OVER-THE-COUNTER AVAILABILITY. 21 The bill allows a pharmacist or pharmacy to distribute 22 ivermectin for human consumption as an over-the-counter 23 medicine. A pharmacist or pharmacy who distributes ivermectin 24 pursuant to the bill shall not be subject to professional 25 discipline or civil or criminal penalties. 26 DIVISION V —— SCHOOL FOODS AND BEVERAGES. The bill prohibits 27 school districts, certain charter schools, and innovation zone 28 schools from serving meals to students as part of the school’s 29 breakfast or lunch program that contain blue dye 1, blue dye 30 2, green dye 3, potassium bromate, propylparaben, red dye 40, 31 yellow dye 5, or yellow dye 6, unless the foods or beverages in 32 the meal were received as part of a direct delivery from the 33 foods in schools program of the United States department of 34 agriculture. The bill also prohibits schools from permitting 35 -39- LSB 5336HV (2) 91 ss/ko 39/ 40

H.F. 2676 the sale to students of any foods or beverages that contain 1 such ingredients on school campus unless the sale takes place 2 after the end of the school day. The bill requires nonpublic 3 schools that use moneys appropriated by the general assembly 4 to provide breakfast or lunch to students to ensure that the 5 meals comply with the same prohibition on ingredients as school 6 districts. 7 This division of the bill applies to school years beginning 8 on or after July 1, 2027. 9 DIVISION VI —— PSYCHOLOGY INTERJURISDICTIONAL COMPACT. The 10 bill creates an interstate compact to allow psychologists from 11 other states to practice telepsychology with patients living 12 in Iowa, to practice “face-to-face” psychology on a temporary 13 basis in Iowa, and to allow Iowa psychologists to practice 14 telepsychology with patients in other states. The compact 15 is intended to authorize regulatory authorities to afford 16 legal recognition, in a manner consistent with the terms of 17 the compact, to psychologists licensed in another state. The 18 compact does not apply when a psychologist is licensed in both 19 the “home” and “receiving” states. A commission is created to 20 oversee the compact, which is effective upon the enactment into 21 law by the seventh compact state. 22 -40- LSB 5336HV (2) 91 ss/ko 40/ 40