Bulletin 02-12-2020

Front matter not included
ARC 4919CEnvironmental Protection Commission[567]Notice of Intended Action

Proposing rule making related to water permitting and providing an opportunity for public comment

    The Environmental Protection Commission (Commission) hereby proposes to rescind Chapter 9, “Delegation of Construction Permitting Authority,” to adopt a new Chapter 9 with the same title, and to amend Chapter 50, “Scope of Division—Definitions—Forms—Rules of Practice,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 455B.105, 455B.173, and 455B.265.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 17A.3, 455B.105, 455B.171, 455B.172, 455B.173 to 455B.176, 455B.177 to 455B.183, 455B.184 to 455B.187, 455B.261, 455B.262, 455B.264, 455B.265, 455B.266 to 455B.274, and 455B.278.Purpose and Summary    The proposed amendments conform the rules with 2019 Iowa Acts, Senate File 409, signed by Governor Reynolds on May 9, 2019. Proposed changes to Chapter 9 provide wastewater and water supply delegated construction permitting authority to rural water systems organized under Iowa Code chapter 357A or 504. The delegated authority is for the permitting of wastewater sewer extensions and water supply water main extensions. Chapter 9 has not been updated since 1985, and other rule making changes include updating forms, updating references to construction standards, and establishing criteria for rescission and revocation of delegated permitting authority.    There are two proposed amendments to Chapter 50. The first amendment changes the Iowa Department of Natural Resources’ (Department’s) annual permit fee budgeting criteria to evaluate expenses in past and succeeding years. The second proposed amendment changes the requirement for a second public notice for water use permit issuance at community public water supplies, allowing for the use of alternate methods of publishing the notice.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. A copy of the fiscal impact statement is available from the Department upon request. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found. A copy of the jobs impact statement is available from the Department upon request.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to 561—Chapter 10. Public Comment     Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 5, 2020. Comments should be directed to: Diane Moles Iowa Department of Natural Resources Wallace State Office Building 502 East 9th Street Des Moines, Iowa 50319 Fax: 515.725.8202 Email: diane.moles@dnr.iowa.govPublic Hearing     A public hearing at which persons may present their views orally or in writing will be held as follows. Upon arrival, attendees should proceed to the fourth floor to check in at the Department reception desk and be directed to the appropriate hearing location: March 4, 2020 10 to 11 a.m. DNR Conference Room 2N Wallace State Office Building Des Moines, Iowa     Persons who wish to make oral comments at the public hearing will be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.     Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Rescind 567—Chapter 9 and adopt the following new chapter in lieu thereof: CHAPTER 9DELEGATION OF CONSTRUCTION PERMITTING AUTHORITY

567—9.1(455B) Scope.  Iowa Code section 455B.183 delegates construction permitting authority over certain sewer and water main extensions to qualified local public works departments and rural water systems organized under Iowa Code chapter 357A or 504. This chapter describes the manner and criteria under which the department oversees this delegated authority.

567—9.2(455B,17A) Forms.  The following forms are to be used by the local public works department or rural water system implementing this authority:542-1001: Application for delegating permitting authority to local public works departments 542-1002: Statement of engineer’s qualifications542-1003: Review checklist for water main extensions at local public works departments 542-1004: Review checklist for sewer extensions542-1005: Quarterly report for permitting authority542-1057: Application for delegating permitting authority to rural water systems 542-1058: Review checklist for water main extensions at rural water systems

567—9.3(455B) Procedures.  A local public works department or rural water system incorporated under Iowa Code chapter 357A or 504 exercising permitting authority for sewer or water supply distribution system extensions under Iowa Code section 455B.183 shall notify the director in writing prior to the first permit issuance, using Form 542-1001 or 542-1057, as applicable, and 542-1002. Additional information may be requested by the director.

567—9.4(455B) Criteria for permitting authority at local public works departments.   The requirements for permitting authority at local public works departments are as follows:    9.4(1)   Permitting authority under this rule applies only to extensions which:    a.    Primarily serve residential consumers and will not result in an increase greater than 5 percent of the capacity of the treatment works or system, or will serve fewer than 250 dwelling units.    b.    In the case of sewer extensions, will not exceed the capacity of any treatment works which received a federal or state monetary grant after 1972.    c.    In the case of water main extensions, will not exceed the production capacity of any system constructed after 1972.    9.4(2)   The local public works department’s standard specifications must be in conformance with the Iowa Standards for Sewer Systems cited in 567—paragraph 64.2(9)“b,” or the water supply construction standards in rule 567—43.3(455B), and must be filed with and approved by the department.    9.4(3)   The reviewing engineer shall be licensed as a professional engineer in Iowa and shall be employed by the local public works department.    9.4(4)   When reviewing applications for sewer and water supply distribution system extensions under its jurisdiction, the local public works department shall use the Iowa Standards for Sewer Systems, the water supply construction standards in rule 567—43.3(455B), and the local standard specifications approved by the department.    9.4(5)   The local public works department shall use Form 542-1003 or Form 542-1004, as applicable, when reviewing plans. Upon issuance of each permit, the local public works department shall submit to the department a copy of the permit and a copy of the form used during the review.    9.4(6)   The local public works department shall submit to the department a complete quarterly report using Form 542-1005 by the fifteenth day of the month following each quarter of the calendar year.    9.4(7)   Plans for which a construction permit has been issued shall be retained on file by the local public works department for the life of the extension or until the extension has been platted.

567—9.5(455B) Criteria for permitting authority at rural water systems.   The requirements for permitting authority at rural water systems incorporated under Iowa Code chapter 357A or 504 are as follows:    9.5(1)   Permitting authority under this rule applies only to extensions which:    a.    Primarily serve residential consumers and will not result in an increase greater than 5 percent of the capacity of the treatment works or system, or will serve fewer than 250 dwelling units.    b.    In the case of sewer extensions, will not exceed the capacity of any treatment works which received a federal or state monetary grant after 1972.    c.    In the case of water main extensions, will not exceed the production capacity of any system constructed after 1972.    9.5(2)   The rural water system’s standard specifications must be in conformance with the Iowa Standards for Sewer Systems cited in 567—paragraph 64.2(9)“b,” or the water supply construction standards in 567—43.3(455B), and must be filed with and approved by the department. The system’s hydraulic modeling must comply with the water supply distribution system standards pursuant to rule 567—43.3(455B).    9.5(3)   The reviewing engineer shall be licensed as a professional engineer in Iowa and shall be employed or retained by the rural water system.    9.5(4)   When reviewing applications for sewer and water supply distribution system extensions under its jurisdiction, the rural water system shall use the Iowa Standards for Sewer Systems, the water supply construction standards in rule 567—43.3(455B), and the local standard specifications approved by the department.     9.5(5)   The rural water system shall use Form 542-1003 or Form 542-1058, as applicable, when reviewing plans. Upon issuance of each permit, the rural water system shall submit to the department a copy of the permit and a copy of the form used during the review.    9.5(6)   The rural water system shall submit to the department a complete quarterly report using Form 542-1005 by the fifteenth day of the month following each quarter of the calendar year.    9.5(7)   Plans for which a construction permit has been issued shall be retained on file by the rural water system for the life of the extension.

567—9.6(455B) No variance allowed.  No variance to the design standards is allowed under delegated permitting authority. If a variance to the design standards is needed, the local public works department or rural water system must apply to the department for an individual construction permit following the wastewater permit procedures in rule 567—60.4(455B) and rule 567—64.2(455B) and the water supply permit procedures in 567—subrule 40.4(1).

567—9.7(455B) Criteria for rescission or revocation of delegated permitting authority.      9.7(1)   The local public works department or rural water system may voluntarily request that its permitting authority be rescinded by submitting the request in writing to the director.    9.7(2)   The director may suspend or revoke delegation of review and permit authority after notice and hearing as set forth in Iowa Code chapter 17A if the director determines that a public works department or rural water system with delegated permitting authority has approved extensions which do not comply with design criteria, which exceed the capacity of waste treatment plants or the production capacity of public water supply systems, or which otherwise violate state or federal requirements.       These rules are intended to implement Iowa Code sections 17A.3, 455B.105 and 455B.171 to 455B.187.

    ITEM 2.    Amend subparagraph 50.4(2)"b" as follows:    (2)   The annual fee shall be based on the costs for administering the water use permitting program for the previous calendar yearyears and on the budgetanticipated expenses for the nextsucceeding fiscal yearyears. The department will review the annual permit fee each year and adjust the fee as necessary to cover all reasonable costs required to develop and administer the water use permitting program. Permit holders that have paid an application fee after December 1, but prior to November 30, will not be required to pay an annual fee until December 1 of the following year. If an applicant remits an annual fee for the 12-month period beginning December 1 and then later submits an application fee for a permit modification, the applicant will be refunded the lesser of the fees. The department shall request commission approval of the amount of the annual fee no later than September 30 of each year.

    ITEM 3.    Amend paragraph 50.7(3)"a" as follows:    a.    New permits and modifications of permits.(1)   Applicable to all except community public water supplies. BeforePrior to the issuance of a permit to withdraw, divert or inject water, the department shall publisha notice of recommendation to grant a permit. The notice shall summarize the application and the recommendations in the summary report. The notice shall allow 20 days to request a copy of the summary report and submit comments on the report. The department may extend the comment period upon request for good cause. The notice shallmay be published in a newspaper circulated in the locality of the proposed water source, or the department may use other methods of publishing the notice to ensure adequate notice to the affected public. The notice shall be sent to any person who has requested a copy of the notice concerning the particular water use under consideration.    (2)   Applicable only to community public water supplies. Prior to the issuance of a permit to withdraw, divert or inject water to a community public water supply, the department shall publish a notice of recommendation to grant a permit. The notice shall allow 20 days to request a copy of the summary report and submit comments on the report. The department may extend the comment period upon request for good cause. The notice shall include a brief summary of the proposed permit and shall be published in a newspaper of general circulation within the county of the proposed water source as provided in Iowa Code section 618.3. If the newspaper of general circulation is not the newspaper of the nearest locality to the proposed water source that publishes a newspaper, the notice shall also be published in the newspaper of the nearest locality to the proposed water source that publishes a newspaper, and the department may charge the applicant for the expenses associated with publishing the notice in the second newspaper. The notice shall be sent to any person who has requested a copy of the notice concerning the particular water use under consideration.
ARC 4912CHuman Services Department[441]Notice of Intended Action

Proposing rule making related to removal of third-party administrator and providing an opportunity for public comment

    The Human Services Department hereby proposes to amend Chapter 86, “Healthy and Well Kids in Iowa (HAWK-I) Program,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code chapter 514I.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapter 514I.Purpose and Summary    These proposed amendments implement 2019 Iowa Acts, House File 625, which removed the third-party administrator for HAWK-I from Iowa Code chapter 514I.  References to the third-party administrator are proposed to be deleted from Chapter 86. The proposed rule making also amends references that are not referenced correctly in the rules.Fiscal Impact    This rule making is expected to be budget-neutral. There will be savings associated with the HAWK-I third-party administrator contract that will shift to the Department to cover the cost of determining HAWK-I eligibility, payment of claims and administration of the program. Jobs Impact    This rule making may result in loss of some jobs for the individuals working for the third-party administrator. Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to 441—1.8(17A,217).Public Comment    Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 3, 2020. Comments should be directed to: Nancy Freudenberg Iowa Department of Human Services Hoover State Office Building, Fifth Floor 1305 East Walnut Street Des Moines, Iowa 50319-0114 Email: appeals@dhs.state.ia.usPublic Hearing     No public hearing is scheduled at this time. As provided in Iowa Code section 17A.4(1)“b,” an oral presentation regarding this rule making may be demanded by 25 interested persons, a governmental subdivision, the Administrative Rules Review Committee, an agency, or an association having 25 or more members. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend 441—Chapter 86, preamble, as follows:    PreambleThese rules define and structure the department of human services healthy and well kids in Iowa (HAWK-I) program and establish requirements for the third-party administrator responsible for the program administration and for the participating health and dental plans that will be delivering services to the enrollees. The purpose of this program is to provide transitional health and dental care coverage to children who are ineligible for Title XIX (Medicaid) assistance as set forth in this chapter. This chapter shall be construed to comply with all requirements for federal funding under Title XXI of the Social Security Act or under the terms of any applicable waiver of Title XXI requirements granted by the Secretary of the U.S. Department of Health and Human Services. To the extent this chapter is inconsistent with any applicable federal funding requirement under Title XXI or the terms of any applicable waiver, the requirements of Title XXI or the terms of the waiver shall prevail.

    ITEM 2.    Amend rule 441—86.1(514I), definitions of “Contract,” “Good cause,” “Health insurance coverage,” “Health Insurance Marketplace,” “Institution for mental diseases,” “Modified adjusted gross income,” “Nonmedical public institution” and “Third-party administrator,” as follows:        "Contract" shall mean the contract between the department and the person or entity selected as the third-party administrator or the contract between the department and the participating health or dental plan for the provision of medical or dental services to HAWK-I enrollees for whom the participating health or dental plans assume risk.        "Good cause" shall mean the family has demonstrated that one or more of the following conditions exist:
  1. There was a serious illness or death of the enrollee or a member of the enrollee’s family.
  2. There was a family emergency or household disaster, such as a fire, flood, or tornado.
  3. There was a reason beyond the enrollee’s control.
  4. There was a failure to receive the third-party administrator’sdepartment’s request for a reason not attributable to the enrollee. Lack of a forwarding address is attributable to the enrollee.
        "Health insurance coverage" shall mean health insurance coverage as defined in 45 CFR Section 144.103, as amended to October 1, 2008.        "Health Insurance Marketplace" "Exchange" shall mean the entity authorized under 42 U.S.C. Section 18031(d)(4)(F) as amended to April 1, 2013, to evaluate and determine eligibility of applicants for Medicaid, the Children’s Health Insurance Program (CHIP), and other health programs.        "Institution for mental diseases" shall mean a hospital, nursing facility, or other institution of more than 16 beds that is primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, including medical attention, nursing care and related services as defined at 42 CFR Section 435.1009 as amended November 10, l994435.1010.        "Modified adjusted gross income" shall mean the methodology prescribed in 42 U.S.C. Section 1396a(e)(14) and 42 CFR 435.603 as amended to April 1, 2013.        "Nonmedical publicPublic institution" shall mean an institution that is the responsibility of a governmental unit or over which a governmental unit exercises administrative control as defined in 42 CFR Section 435.1009 as amended November 10, l994435.1010.        "Third-party administrator" shall mean the person or entity with which the department contracts to provide administrative services for the HAWK-I program.

    ITEM 3.    Amend subrule 86.2(9) as follows:    86.2(9) Inmates of nonmedical public institutions.  The child shall not be an inmate of a nonmedical public institution as defined at 42 CFR Section 435.1009 as amended November 10, l994435.1010.

    ITEM 4.    Amend subrule 86.2(10) as follows:    86.2(10) Inmates of institutions for mental disease.  At the time of application or annual review of eligibility, the child shall not be an inmate of an institution for mental disease as defined at 42 CFR Section 435.1009 as amended November 10, l994435.1010.

    ITEM 5.    Amend subrule 86.3(3) as follows:    86.3(3) Place of filing.  An application for the HAWK-I program may be filed with the third-party administrator responsible for making the eligibility determinationdepartment through an Internet Web sitewebsite, by telephone, through other electronic means, or in any local or area office of the department of human services,through an exchange, disproportionate share hospital, federally qualified health center, or other facility in which outstationing activities are provided.

    ITEM 6.    Amend paragraph 86.3(7)"b" as follows:    b.    Failure to supply the information or verification or refusal to authorize the third-party administratordepartment to secure the information shall serve as a basis for rejection of the application or cancellation of coverage. If the requested information or authorization is received within 14 calendar days of the notice of decision on an application or within 14 calendar days of the effective date of cancellation for enrollees, the information or authorization shall be acted upon as though it had been provided timely. If the fourteenth calendar day falls on a weekend or state holiday, the applicant or enrollee shall have until the next business day to provide the information.

    ITEM 7.    Amend subrule 86.3(9) as follows:    86.3(9) Applicant cooperation.  An applicant must cooperate with the third-party administratordepartment in the application process, which may include providing verification or signing documents. Failure to cooperate with the application process shall serve as basis for a denial of the application.

    ITEM 8.    Amend paragraph 86.3(10)"a" as follows:    a.    The department or the third-party administrator shall mail a notice of decision to the applicant that states:    (1)   The applicant meets the eligibility requirements but that no funds are available and that the applicant will be placed on a waiting list, or    (2)   The applicant does not meet eligibility requirements, in which case the applicant shall not be put on a waiting list.

    ITEM 9.    Amend subrule 86.7(6) as follows:    86.7(6) Enrolled in other health insurance coverage.  The child shall be canceled from the program as of the first day of the month following the month in which the department or the third-party administrator is notified that the child has other health insurance coverage. If there are months during which the child is covered by both another insurance plan and the HAWK-I program, the other insurance plan shall be the primary payor and HAWK-I shall be the payor of last resort.

    ITEM 10.    Amend subrule 86.7(7) as follows:    86.7(7) Admission to a nonmedical public institution.  The child shall be canceled from the program as of the first day of the month following the month in which the child enters a nonmedical public institution unless the temporary absence provisions of paragraph 86.2(3)“d” applyif the child is in a public institution at the time of the annual review.

    ITEM 11.    Amend rule 441—86.10(514I), introductory paragraph, as follows:

441—86.10(514I) Reporting changes.  Changes that may affect eligibility shall be reported timely to the department or the third-party administrator. “Timely” shall mean no later than ten working days after the change occurred. The ten working-day period begins the first working day following the date of the change. The parent, guardian, or other adult responsible for the child shall report the change unless the child is emancipated, married, or otherwise in an independent living situation, in which case the child shall be responsible for reporting the change.

    ITEM 12.    Rescind subrule 86.10(1).

    ITEM 13.    Renumber subrules 86.10(2) to 86.10(8) as 86.10(1) to 86.10(7).

    ITEM 14.    Amend renumbered subrule 86.10(4) as follows:    86.10(4) Decrease in income.  If the family reports a decrease in income, the third-party administratordepartment shall ascertain whether the change affects the premium obligation of the family. If the change is such that the family is no longer required to pay a premium in accordance with the provisions of rule 441—86.8(514I), premiums will no longer be charged beginning with the month following the month of the report of the change.

    ITEM 15.    Rescind and reserve rule 441—86.13(514I).

    ITEM 16.    Amend paragraph 86.14(1)"o" as follows:    o.    Translation and interpreter services as specified pursuant to the federal Children’s Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-342 U.S.C. Section 1397ee(a)(1).

    ITEM 17.    Amend subrule 86.15(3) as follows:    86.15(3) Premium tax.  Premiums paid to participating health and dental plans by the third-party administratordepartment are exempt from premium tax.

    ITEM 18.    Amend subparagraph 86.15(6)"c" as follows:    (2)   All health and dental plan literature and brochures shall be available in English and any other language when enrollment in the health or dental plan by enrollees who speak the same non-English language equals or exceeds 10 percent of all enrollees in the health or dental plan and shall be made available to the third-party administrator for distribution.

    ITEM 19.    Amend subrule 86.15(9) as follows:    86.15(9) Records and reports.  The participating health and dental plans shall maintain records and reports as follows:    a.    The health or dental plan shall comply with the provisions of rule 441—79.3(249A) regarding maintenance and retention of clinical and fiscal records and shall file a letter with the commissioner of insurance as described in Iowa Code section 228.7. In addition, the health or dental plan or subcontractor of the health or dental plan, as appropriate, must maintain a medical or dental records system that:    (1)   Identifies each medical or dental record by HAWK-I enrollee identification number.    (2)   Maintains a complete medical or dental record for each enrollee.    (3)   Provides a specific medical or dental record on demand.    (4)   Meets state and federal reporting requirements applicable to the HAWK-I program.    (5)   Maintains the confidentiality of medical or dental records information and releases the information only in accordance with established policy below:
  1. All medical and dental records of the enrollee shall be confidential and shall not be released without the written consent of the enrollee or responsible party.
  2. Written consent is not required for the transmission of medical or dental records information to physicians, dentists, other practitioners, or facilities that are providing services to enrollees under a subcontract with the health or dental plan. This provision also applies to specialty providers who are retained by the health or dental plan to provide services which are infrequently used, which provide a support system service to the operation of the health or dental plan, or which are of an unusual nature. This provision is also intended to waive the need for written consent for department staff and the third-party administrator assisting in the administration of the program, reviewers from the peer review organization (PRO), monitoring authorities from the Centers for Medicare and Medicaid Services (CMS), the health or dental plan itself, and other subcontractors which require information as described under numbered paragraph “5” below.
  3. Written consent is not required for the transmission of medical or dental records information to physicians, dentists, or facilities providing emergency care pursuant to paragraph 86.15(2)“b.”
  4. Written consent is required for the transmission of the medical or dental records information of a former enrollee to any physician or dentist not connected with the health or dental plan.
  5. The extent of medical or dental records information to be released in each instance shall be based upon a test of medical or dental necessity and a “need to know” on the part of the practitioner or a facility requesting the information.
  6. Medical and dental records maintained by subcontractors shall meet the requirements of this rule.
Exception: Written consent is required for the transmission of medical records relating to substance abuse, HIV, or mental health treatment in accordance with state and federal laws.
    b.    Each health or dental plan shall provide at a minimum reports and plan information to the third-party administratordepartment as follows:    (1)   A list of providers of services under the plan.    (2)   Encounter data on a monthly basis as required by the department.    (3)   Other information as directed by the department.    c.    Each health or dental plan shall at a minimum provide reports and health or dental plan information to the department as follows:    (1)   Information regarding the plan’s appeal process.    (2)   A plan for a health improvement program.    (3)   Periodic financial, utilization and statistical reports as required by the department.    (4)   Time-specific reports which define activity for child health care, appeals and other designated activities which may, at the department’s discretion, vary among plans, depending on the services covered or other differences.    (5)   Other information as directed by the department.

    ITEM 20.    Amend subrule 86.15(10) as follows:    86.15(10) SystemsSystem.  The participating health or dental plan shall maintain data files that are compatible with the department’s and third-party administrator’s systemssystem.

    ITEM 21.    Amend subrule 86.19(1), definition of “Administrative error,” as follows:        "Administrative error" means an action of the department or the HAWK-I third-party administrator that results in incorrect payment of benefits, including premiums paid to a health or dental plan, due to one or more of the following circumstances:
  1. Misfiled or lost form or document.
  2. Error in typing or copying.
  3. Computer input error.
  4. Mathematical error.
  5. Failure to determine eligibility correctly when all essential information was available to the department or the HAWK-I third-party administrator.
  6. Failure to request essential verification necessary to make an accurate eligibility determination.
  7. Failure to make timely revision in eligibility following a change in policy requiring application of the policy change as of a specific date.
  8. Failure to issue timely notice to cancel benefits that results in benefits continuing in error.

    ITEM 22.    Amend subrule 86.20(2) as follows:    86.20(2) Eligibility.  Unless otherwise specified, eligibility for supplemental dental-only coverage shall be determined in accordance with the provisions of rules 441—86.1(514I)441—86.2(514I) through 441— 86.12(514I), 441—86.18(514I), and 441—86.19(514I).

    ITEM 23.    Amend paragraph 86.20(3)"a" as follows:    a.    No premium is charged to families who meet the provisions of subparagraph 86.8(2)“a”(1) or to families whose countable income is less than or equal to 167 percent of the federal poverty level for a family of the same size using the modified adjusted gross income methodologyor to an eligible child who is an American Indian or Alaska Native.
ARC 4911CHuman Services Department[441]Notice of Intended Action

Proposing rule making related to personal degradation and providing an opportunity for public comment

    The Human Services Department hereby proposes to amend Chapter 176, “Dependent Adult Abuse,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code section 217.6.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapter 235B.Purpose and Summary    Two pieces of legislation recently passed which resulted in these proposed rule changes.  2019 Iowa Acts, House File 569, added personal degradation as a category of dependent adult abuse.  2019 Iowa Acts, House File 323, changed the definition of exploitation within the definition of dependent adult abuse. The proposed amendments update the definition of exploitation and define personal degradation within the definition of adult abuse and set criteria for outcome determinations for dependent adult abuse evaluations conducted by the Department of Human Services to include references to personal degradation.Fiscal Impact    Both legislative changes will result in Department computer system updates, and the new category of abuse will increase case counts and result in the need for additional Department staff. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217). Public Comment    Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 3, 2020. Comments should be directed to: Nancy Freudenberg Iowa Department of Human Services Hoover State Office Building, Fifth Floor 1305 East Walnut Street Des Moines, Iowa 50319-0114 Email: appeals@dhs.state.ia.usPublic Hearing    No public hearing is scheduled at this time. As provided in Iowa Code section 17A.4(1)“b,” an oral presentation regarding this rule making may be demanded by 25 interested persons, a governmental subdivision, the Administrative Rules Review Committee, an agency, or an association having 25 or more members. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend rule 441—176.1(235B), definition of “Adult abuse,” as follows:        "Adult abuse" means either:
  1. Any of the following as a result of the willful or negligent acts or omissions of a caretaker:
  2. Physical injury to, or injury which is at variance with the history given of the injury, or unreasonable confinement, unreasonable punishment, or assault of a dependent adult.
  3. The commission of a sexual offense under Iowa Code chapter 709 or Iowa Code section 726.2 with or against a dependent adult.
  4. Exploitation of a dependent adult, which means the act or process of taking unfair advantage of a dependent adult or the adult’s physical or financial resources for one’s own personal or pecuniary profit, without the informed consent of the dependent adult, including theft, by the use of undue influence, harassment, duress, deception, false representation, or false pretenses.
  5. The deprivation of the minimum food, shelter, clothing, supervision, physical or mental health care, and other care necessary to maintain a dependent adult’s life or health.
  6. Sexual exploitation of a dependent adult by a caretaker. “Sexual exploitation” means any consensual or nonconsensual sexual contact with a dependent adult which includes but is not limited to kissing; touching of the clothed or unclothed inner thigh, breast, groin, buttock, anus, pubes, or genitals; or a sex act, as defined in Iowa Code section 702.17. “Sexual exploitation” includes the transmission, display, taking of electronic images of the unclothed breast, groin, buttock, anus, pubes, or genitals of a dependent adult by a caretaker for a purpose not related to treatment or diagnosis or as part of an ongoing assessment, evaluation or investigation. “Sexual exploitation” does not include touching which is part of a necessary examination, treatment, or care by a caretaker acting within the scope of the practice or employment of the caretaker; the exchange of a brief touch between the dependent adult and a caretaker for the purpose of reassurance, comfort, or casual friendship; or touching between spouses.
  7. Personal degradation of a dependent adult, which means a willful act or statement by a caretaker intended to shame, degrade, humiliate, or otherwise harm the personal dignity of a dependent adult, or where the caretaker knew or reasonably should have known the act or statement would cause shame, degradation, humiliation, or harm to the personal dignity of a reasonable person.
  8. The deprivation of the minimum food, shelter, clothing, supervision, physical or mental health care, and other care necessary to maintain a dependent adult’s life or health as a result of the acts or omissions of the dependent adult.

    ITEM 2.    Amend subrule 176.3(1) as follows:    176.3(1)   Dependent adult abuse reports shall be evaluated when all of the following criteria are alleged to be met:    a.    The person is a dependent adult.    b.    Dependent adult abuse exists as defined in Iowa Code section 235B.2.    c.    A caretaker exists in reports of physical injury to or unreasonable confinement or cruel punishment of a dependent adult; commission of a sexual offense; exploitation;personal degradation; and deprivation by another person of food, shelter, clothing, supervision, physical and mental health care and other care necessary to maintain life or health.

    ITEM 3.    Amend subrule 176.3(4) as follows:    176.3(4)   Confirmed, not registered. Reports of physical abuse,or denial of critical care by a caretaker, or personal degradation that would otherwise be founded reports shall be considered confirmed, not registered reports if the abuse is determined to be minor, isolated, and unlikely to reoccur. These reports shall be assessments and shall not be included on the central abuse registry. The assessment shall be maintained in the local office as directed in subrule 176.13(4).
ARC 4923CInspections and Appeals Department[481]Notice of Intended Action

Proposing rule making related to food and consumer safety and food establishment and food processing plant inspections and providing an opportunity for public comment

    The Inspections and Appeals Department hereby proposes to amend Chapter 30, “Food and Consumer Safety,” and Chapter 31, “Food Establishment and Food Processing Plant Inspections,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 10A.104 and 137F.2.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 10A.104 and 137F.2 and 2019 Iowa Acts, Senate File 265.Purpose and Summary    The proposed amendments update the reference to the adopted parts of the Code of Federal Regulations. Subrule 31.2(9) currently adopts the 2018 Code of Federal Regulations, and this rule making proposes to adopt the same sections of the 2019 Code of Federal Regulations.  No substantive changes were made to the pertinent parts of the 2019 Code of Federal Regulations.    The proposed amendments define “patrol dog” and “pet dog” and prescribe standards for permitting dogs on exterior premises of food establishments, including outdoor patio and outdoor dining areas.    Finally, the proposed amendments implement additional changes made to Iowa Code chapter 137F resulting from the enactment of 2019 Iowa Acts, Senate File 265. The legislation requires the Department to adopt rules for the sale at a farmers market of culinary mushrooms commonly referred to as a variety of wild oyster.  The Department is updating the rules it previously adopted by expressly referring to another variety of wild oyster mushroom, Pleurotus citrinopileatus.    Prior to the publication of this Notice, the Department distributed for comment a draft of these proposed amendments to industry associations, local contracting health departments and food safety educators.Fiscal Impact    This rule making has no fiscal impact to the State of Iowa.Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to 481—Chapter 6. Public Comment    Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 3, 2020. Comments should be directed to: Ashleigh Hackel Iowa Department of Inspections and Appeals Lucas State Office Building 321 East 12th Street Des Moines, Iowa 50319 Email: ashleigh.hackel@dia.iowa.govPublic Hearing     No public hearing is scheduled at this time. As provided in Iowa Code section 17A.4(1)“b,” an oral presentation regarding this rule making may be demanded by 25 interested persons, a governmental subdivision, the Administrative Rules Review Committee, an agency, or an association having 25 or more members. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Adopt the following new definitions of “Patrol dog” and “Pet dog” in rule 481—30.2(10A,137C,137D,137F):        "Patrol dog" means a dog that is accompanying a law enforcement officer or security officer.        "Pet dog" means a dog that does not meet the definition of a “patrol dog” or a “service animal” as defined in the Code of Federal Regulations, Title 28, Part 36.

    ITEM 2.    Amend subrule 31.1(4) as follows:    31.1(4) Morel mushrooms and oyster mushrooms (Pleurotus citrinopileatus,Pleurotus ostreatus, Pleurotus populinus, or Pleurotus pulmonarious).  Section 3-201.16, paragraph (A), is amended by adding the following:“A food establishment or farmers market time/temperature control for safety food licensee may serve or sell morel mushrooms or oyster mushrooms (a variety classified as Pleurotus citrinopileatus,Pleurotus ostreatus, Pleurotus populinus, or Pleurotus pulmonarious) if procured from an individual who has completed a wild-harvested mushroom identification expert course. Every morel mushroom or oyster mushroom shall be identified and found to be safe by a certified wild-harvested mushroom identification expert whose competence has been verified and approved by the department through the expert’s successful completion of a wild-harvested mushroom identification expert course provided by either an accredited college or university or a mycological society. The course may address identification of morel mushrooms, oyster mushrooms, or both. The certified wild-harvested mushroom identification expert shall personally inspect each mushroom and determine it to be a morel mushroom or an oyster mushroom. A wild-harvested mushroom identification expert course shall be at least two hours in length and include a visual identification exercise for each wild-harvested mushroom species that the individual will be certified to identify at the completion of the course. The individual’s certification of successful completion of the course must clearly indicate whether the certified wild-harvested mushroom identification expert is certified to identify morel mushrooms, oyster mushrooms, or both. “To maintain status as a wild-harvested mushroom identification expert, the individual shall have successfully completed a wild-harvested mushroom identification expert course described above within the past three years. A person who wishes to offer a wild-harvested mushroom identification expert course must submit the course curriculum to the department for review and approval. Food establishments or farmers market time/temperature control for safety food licensees offering morel mushrooms or oyster mushrooms shall maintain the following information for a period of 90 days from the date the morel mushrooms or oyster mushrooms were obtained:“1. The name, address, and telephone number of the wild-harvested mushroom identification expert;“2. A copy of the wild-harvested mushroom identification expert’s certificate of successful completion of the course, containing the date of completion; and“3. The quantity of morel mushrooms or oyster mushrooms purchased and the date(s) purchased.“Furthermore, a consumer advisory shall inform consumers by brochures, deli case or menu advisories, label statements, table tents, placards, or other effective written means that wild-harvested mushrooms should be thoroughly cooked and may cause allergic reactions or other effects.”

    ITEM 3.    Renumber subrules 31.1(15) to 31.1(18) as 31.1(16) to 31.1(19).

    ITEM 4.    Adopt the following new subrule 31.1(15):    31.1(15) Prohibiting animals.  Section 6-501.115, paragraph (B), is amended by adding the following:“(6) Pet dogs may be allowed on exterior premises of a food establishment, including outdoor patio and outdoor dining areas, provided the food establishment meets all of the following requirements:“a. A separate entrance is present so that pet dogs do not enter the food establishment to access the outdoor area;“b. No food preparation is allowed in the outdoor area, including mixing or dispensing drinks and ice;“c. Customer multi-service or reusable utensils such as plates, silverware, glasses, and bowls are not stored, displayed, or pre-set in the outdoor area;“d. Food or water provided to pet dogs shall only be in single-use disposable containers;“e. Employees are prohibited from direct contact with pet dogs while on duty;“f. The outdoor area is maintained clean;“g. In cases where excrement or bodily fluids (urine, saliva, vomit, or the like) are deposited, an employee shall immediately ensure the area is cleaned and sanitized;“h. The outdoor area shall not be fully enclosed (an enclosed area is considered part of the interior of the facility);“i. Disruptive pet dogs must be controlled or removed from the premises;“j. Rules governing pet dogs shall be posted at each entrance of the food establishment and shall, at a minimum, contain the following: “i. Pet dogs shall be leashed at all times; “ii. Pet dogs shall not enter any interior area of the food establishment at any time; “iii. Pet dogs must be controlled at all times by the dog’s owner or designee; “iv. Pet dogs are not permitted on chairs, tables, benches or seats; and “v. Pet dog owners must immediately notify the food establishment’s staff in the event that excrement or bodily fluids (urine, saliva, vomit, or the like) are deposited.”

    ITEM 5.    Amend subrule 31.2(9), introductory paragraph, as follows:    31.2(9) Adoption of Code of Federal Regulations.  The following parts of the Code of Federal Regulations (April 1, 20182019) are adopted:
ARC 4925CIowa Public Employees’ Retirement System[495]Notice of Intended Action

Proposing rule making related to five-year review of rules and providing an opportunity for public comment

    The Iowa Public Employees’ Retirement System (IPERS) hereby proposes to amend Chapter 4, “Employers,” Chapter 11, “Application for, Modification of, and Termination of Benefits,” Chapter 12, “Calculation of Monthly Retirement Benefits,” Chapter 13, “Disability for Regular and Special Service Members,” Chapter 14, “Death Benefits and Beneficiaries,” and Chapter 20, “Recognition of Agents,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 97B.4 and 97B.15.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapter 97B.Purpose and Summary    This proposed rule making is intended to conform rules with other rules and statutes or rescind rules that are outdated, redundant or inconsistent, or no longer in effect to meet the requirements of the statutory five-year review of rules for Chapters 11 to 15; to implement contribution rates for employers and regular and special service members beginning July 1, 2020; to reflect an IRS requirement verifying citizenship status; to add further clarity as to when a member’s first month of entitlement begins; to indicate that subrule 12.1(6) (renumbered as 12.1(4) herein) applies only to regular class members; to change the yearly multiplier to a quarterly multiplier as is current IPERS practice; to remove outdated language regarding average covered wages and clarify the way in which a computed year of wages is calculated; to strike obsolete language and add necessary language regarding vesting by service; to clarify that annual certifications of disability benefits are not necessary after a member meets IPERS normal retirement age; to provide for the trial work period as allowed by federal disability benefits; to acknowledge and reflect the reality that multiple medical appointments may not be able to be scheduled consecutively the same day and written notice will be the primary communication of appointment notification; to amend language to reflect current practice regarding precertification of medical eligibility for disability; to further delineate the continued requirements for qualification for special service disability benefits; to emphasize that IPERS designation of beneficiary forms may be filed online through the IPERS website; and to preserve and clearly state that the member receives the higher of two preretirement death benefit calculations. In addition, this rule making is intended to clarify that when there is no proper or valid beneficiary to whom a death benefit is to be paid, beneficiaries will be paid via the intestacy law of the State of Iowa; and to address the proper role of social security representative payees.  Fiscal Impact    IPERS’ enabling legislation requires employer and employee contribution rates for each member class be updated every fiscal year. Jobs Impact    After analysis and review of this rule making, IPERS believes the changes providing for the trial work period, as allowed by federal disability benefits, will positively impact disabled IPERS members returning to the workforce. Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition IPERS for a waiver of the discretionary provisions, if any. Public Comment    Any interested person may submit written or oral comments concerning this proposed rule making. Written or oral comments in response to this rule making must be received by IPERS no later than 4:30 p.m. on March 6, 2020. Comments should be directed to: Cheryl Vander Hart Iowa Public Employees’ Retirement System 7401 Register Drive Des Moines, Iowa 50321 Phone: 515.281.7623 Email: cheryl.vanderhart@ipers.orgPublic Hearing     A public hearing at which persons may present their views orally or in writing will be held as follows: March 5, 2020 9 to 11 a.m. IPERS 7401 Register Drive Des Moines, Iowa     Persons who wish to make oral comments at the public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.     Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact IPERS and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend subrule 4.6(1) as follows:    4.6(1)   Contribution rates for regular class members.    a.    The following contribution rates were established by the Iowa legislature for all regular class members for the indicated periods:Effective July 1, 2007Effective July 1, 2008Effective July 1, 2009Effective July 1, 2010Effective July 1, 2011Combined rate9.95%10.45%10.95%11.45%13.45%    Employer6.05%6.35%6.65%6.95%8.07%    Employee3.90%4.10%4.30%4.50%5.38%    b.    Effective July 1, 2012, and every year thereafter, the contribution rates for regular members shall be publicly declared by IPERS staff no later than the preceding December as determined by the annual valuation of the preceding fiscal year. The public declaration of contribution rates will be followed by rule making that will include a notice and comment period and that will become effective July 1 of the next fiscal year. Contribution rates for regular members are as follows.Effective July 1, 2015Effective July 1, 2016Effective July 1, 2017Effective July 1, 2018Effective July 1, 2019Effective July 1, 2020Combined rate14.88%14.88%14.88%15.73%15.73%15.73%    Employer8.93%8.93%8.93%9.44%9.44%9.44%    Employee5.95%5.95%5.95%6.29%6.29%6.29%

    ITEM 2.    Amend subrule 4.6(2) as follows:    4.6(2)   Contribution rates for sheriffs and deputy sheriffs are as follows.Effective July 1, 2015Effective July 1, 2016Effective July 1, 2017Effective July 1, 2018Effective July 1, 2019Effective July 1, 2020Combined rate19.76%19.26%18.76%19.52%19.02%18.52%    Employer9.88%9.63%9.38%9.76%9.51%9.26%    Employee9.88%9.63%9.38%9.76%9.51%9.26%

    ITEM 3.    Amend subrule 4.6(3) as follows:    4.6(3)   Contribution rates for protection occupations are as follows.Effective July 1, 2015Effective July 1, 2016Effective July 1, 2017Effective July 1, 2018 Effective July 1, 2019Effective July 1, 2020Combined rate16.40%16.40%16.40%17.02%16.52%16.02%    Employer9.84%9.84%9.84%10.21%9.91%9.61%    Employee6.56%6.56%6.56%6.81%6.61%6.41%

    ITEM 4.    Adopt the following new paragraph 11.1(1)"g":    g.    An indication whether the member is a U.S. citizen, resident alien, or non-U.S. citizen.

    ITEM 5.    Amend paragraph 11.2(4)"a" as follows:    a.    Notwithstanding the foregoing, IPERS shall commence payment of a member’s retirement benefit under Iowa Code sections 97B.49A to 97B.49I (under Option 2) no later than the “required beginning date” specified under Internal Revenue Code Section 401(a)(9), even if the member has not submitted the application for benefits. If the lump sum actuarial equivalent could have been elected by the member, payments shall be made in such a lump sum rather than as a monthly allowance. The “required beginning date” is defined as the later of: (1) April 1 of the year following the year that the member attains the age of 70½72, or (2) April 1 of the year following the year that the member actually terminates all employment with employers covered under Iowa Code chapter 97B.

    ITEM 6.    Amend subrule 11.3(1) as follows:    11.3(1) General.  A member shall submit a written application to IPERS setting forth the retirement date, provided the member has attained at least age 55 by the retirement date and the retirement date is after the member’s last day of service. A member’s first month of entitlement shall be no earlier than the first day of the first month after the member’s last day of servicedate of termination from employment or, if later, the month provided for under subrule 11.3(2). No payment shall be made for any month prior to the month the completed application for benefits is received by IPERS.If a member files a retirement application but fails to select a valid first month of entitlement, IPERS will select by default the earliest month possible. A member may appeal this default selection by sending written notice of the appeal postmarked on or before 30 days after a notice of the default selection was mailed to the member. Notice of the default selection is deemed sufficient if sent to the member at the member’s address.

    ITEM 7.    Amend subrule 11.3(2) as follows:    11.3(2) Additional FME provisions.      a.    Effective through December 31, 1992, the first month of entitlement of a member who qualifies for retirement benefits is the first month following the member’s date of termination or last day of leave, with or without pay, whichever is later.    b.    Effective January 1, 1993, the first month of entitlement of an employee who qualifies for retirement benefits shall be the first month after the employee is paid the last paycheck, if paid more than one calendar month after termination. If the final paycheck is paid within the month after termination, the first month of entitlement shall be the month following termination.c.    Effective January 1, 2001, employees of a school corporation who are permitted by the terms of their employment contracts to receive their annual salaries in monthly installments over periods ranging from 9 to 12 months may retire at the end of a school year and receive trailing wages through the end of the contract year if they have completely fulfilled their contract obligations at the time of retirement. For purposes of this paragraph, “school corporation” means body politic described in Iowa Code sections 260C.16 (community colleges), 273.2 (area education agencies) and 273.1 (K-12 public schools). For purposes of this paragraph, “trailing wages” means previously earned wage payments made to such employees of a school corporation after the first month of entitlement. This exception does not apply to hourly employees, including those who make arrangements with their employers to hold back hourly wages for payment at a later date, to employees who are placed on sick or disability leave or leave of absence, or to employees who receive lump sum leave, vacation leave, early retirement incentive pay or any other lump sum payments in installments.For all employees of all IPERS-covered employers who terminate employment in January 2003, or later, if the final paycheck is paid within the same quarter or within one quarter after termination and wages are reported under the normal pay schedule, the first month of entitlement shall be the month following termination. However, if the last paycheck is paid more than one quarter after the termination, the first month of entitlement shall be the first month after the employee is paid the last paycheck. Under no circumstances shall such trailing wages result in more than one quarter of service credit being added to retiring members’ earning records.

    ITEM 8.    Amend subrule 11.5(1) as follows:    11.5(1) Bona fide retirement—general.  To receive retirement benefits, a member under the age of 70 must officially leave employment with all IPERS-covered employers, give up all rights as an employee, and complete a period of bona fide retirement. A period of bona fide retirement means four or more consecutive calendar months for which the member qualifies for monthly retirement benefit payments. The qualification period begins with the member’s first month of entitlement for retirement benefits as approved by IPERS. A member may not return to covered employment before filing a completed application for benefits. Notwithstanding the foregoing, the continuation of group insurance coverage at employee rates for the remainder of the school year for a school employee who retires following completion of services by that individual shall not cause that person to be in violation of IPERS’ bona fide retirement requirements.A member will not be considered to have a bona fide retirement if the member is a school or university employee and returns to work with the employer after the normal summer vacation. In other positions, temporary or seasonal interruption of service which does not terminate the period of employment does not constitute a bona fide retirement. A member also will not be considered to have a bona fide retirement if the member has, prior to or during the member’s first month of entitlement, entered into verbal or written arrangements with the employermember’s former employer(s) to return to employment after the expiration of the four-month bona fide retirement period.Effective July 1, 1990, a school employee will not be considered terminated if, while performing the normal duties, the employee performs for the same employer additional duties which take the employee beyond the expected termination date for the normal duties. Only when all the employee’s compensated duties cease for that employer will that employee be considered terminated.The bona fide retirement period shall be waived for an elected official covered under Iowa Code section 97B.1A(8)“a”(1), and for a member of the general assembly covered under Iowa Code section 97B.1A(8)“a”(2), when the elected official or legislator notifies IPERS of the intent to terminate IPERS coverage for the elective office and, at the same time, terminates all other IPERS-covered employment prior to the issuance of the retirement benefit. Such an elected official or legislator may remain in the elective office and receive an IPERS retirement without violating IPERS’ bona fide retirement rules. If such elected official or legislator terminates coverage for the elective office and also terminates all other IPERS-covered employment but is then reemployed in covered employment, and has not received a retirement as of the date of hire, the retirement shall not be made. Furthermore, if such elected official or legislator is reemployed in covered employment, the election to revoke IPERS coverage for the elective position shall remain in effect, and the elected official or legislator shall not be eligible for new IPERS coverage for such elected position. The prior election to revoke IPERS coverage for the elected position shall also remain in effect if such elected official or legislator is reelected to the same position without an intervening term out of office. The bona fide retirement period will be waived if the member has been elected to public office which term begins during the normal four-month bona fide retirement period. This includes elected officials who shall be covered under this chapter as defined in Iowa Code section 97B.1A. This waiver does not apply if the member was an elected official who was reelected to the same position for another term.Effective July 1, 2000, a member does not have a bona fide retirement until all employment with covered employers, including employment which is not covered under this chapter, is terminated for at least one month, and the member does not return to covered employment for an additional three months. In order to receive retirement benefits, the member must file a completed application for benefits before returning to any employment with a covered employer.Effective July 1, 2018, a member will not have a bona fide retirement if the member enters into a verbal or written arrangement to perform duties for the member’s former employer(s) as an independent contractor prior to or during the member’s first month of entitlement or performs any duties for the member’s former employer(s) as an independent contractor prior to receiving four months of retirement benefits.

    ITEM 9.    Rescind subrule 11.5(2).

    ITEM 10.    Renumber subrules 11.5(3) to 11.5(5) as 11.5(2) to 11.5(4).

    ITEM 11.    Amend renumbered subrule 11.5(2) as follows:    11.5(2) Bona fide refund.  For a member to be eligible for a lump sum refund, the member must terminate the member’s covered employment andincur a bona fide separation from service and remain out of employment forat least 30 days with all covered employers. The 30-day bona fide refund period shall be waived for an elected official covered under Iowa Code section 97B.1A(8)“a”(1), and for a member of the general assembly covered under Iowa Code section 97B.1A(8)“a”(2), when the elected official or legislator notifies IPERS of the intent to terminate IPERS coverage for the elective office and, at the same time, terminates all other IPERS-covered employment prior to the issuance of the refund. Such an official may remain in the elective office and receive an IPERS refund without violating IPERS’ bona fide refund rules. If such elected official terminates coverage for the elective office and also terminates all other IPERS-covered employment but is then reemployed in covered employment, and has not received a refund as of the date of hire, the refund shall not be made. Furthermore, if such elected official is reemployed in covered employment, the election to revoke IPERS coverage for the elective position shall remain in effect, and the public official shall not be eligible for new IPERS coverage for such elected position.The prior election to revoke IPERS coverage for the elected position shall also remain in effect if such elected official is reelected to the same position without an intervening term out of office. The waiver granted in this subrule shall be applicable to such elected officials who were in violation of the prior bona fide refund rules on and after November 1, 2002, when such individuals have not repaid the previously invalid refund.If a member takes a refund in violation of the bona fide refund requirements of Iowa Code section 97B.53(4), the member may return the refund during the bona fide retirement period and restore the member’s account.If the repayment is not made, the member shall receive no credit for the period covered by the refund. At retirement, the member may purchase, at actuarial cost, the service credit covered by the refund.

    ITEM 12.    Amend rule 495—11.7(97B) as follows:

495—11.7(97B) Overpayment of IPERS benefits.      11.7(1) Overpayments—general.      a.    An “overpayment” means a payment of money by IPERS that results in a recipient receiving a higher payment than the recipient is entitled to under the provisions of Iowa Code chapter 97B.    b.    A “recipient” is a person or beneficiary, heir, assign, or other successor in interest who receives an overpayment from an IPERS benefit and is liable to repay the amount(s) upon receipt of a written explanation and request for the amounts to be repaid.    c.    If IPERS determines that the cost of recovering the amount of an overpayment is estimated to exceed the overpayment, the repayment may be deemed to be unrecoverable.    d.    If the overpayment is equal to or less than $50 and cannot be recovered from other IPERS payments, IPERS may limit its recovery efforts to written requests for repayment and other nonjudicial remedies.    11.7(2) Overpayment made to a retired member.  A retired member shall receive written notice of overpayment, including the reason for the overpayment, the amount of the overpayment, and a limited opportunity to repay the overpayment in full without interest. If a retired member repays an overpayment in full within 30 days after the date of the notice, there will be no interest charge. A retired member may repay an overpayment out of pocket or direct IPERS to recover the overpayment from future retirement benefit payments, or a combination of both. If the retired member cannot repay an overpayment in full, either out of pocket or from the next monthly installment of retirement benefits, or both, interest shall be charged. A retired member who cannot repay the full amount of the overpayment within 30 days after the date of the notice must enter into an agreement with IPERS to make monthly installment payments, or to have the overpayment offset against future monthly benefit payments or death benefits, if any, and authorize any unpaid balance as a first priority claim in the recipient’s estate.    11.7(3) Overpayment made to a person other than a retired member.  A recipient other than a retired member, except a recipient listed in subrule 11.7(4)11.5(2), shall receive written notice of overpayment, including the reason for the overpayment, the amount of the overpayment, and the opportunity to repay the overpayment in full without interest. If such a recipient repays an overpayment in full within 30 days after the date of the notice, there will be no interest charge. If such a recipient cannot repay an overpayment in full within 30 days after the date of the notice, interest shall be charged. If repayment in full cannot be made within 30 days, such a recipient shall make repayment arrangements subject to IPERS’ approval within 30 days of the written notice and request for repayment.If the overpayment recipient cannot be located to receive notice of the overpayment at the recipient’s last-known address, IPERS shall, after trying to locate the person, consider the recipient to have waived entitlement to the quarters covered by the refund.    11.7(4) Overpayment made to a person who violates a bona fide severance period.  If a recipient takes a refund and does not complete the required period of severance, the recipient shall receive a written notice of overpayment, including the reason for the overpayment, the amount of the overpayment, and the opportunity to repay the overpayment in full without interest. The recipient shall have 30 days after the date of notice to repay the full amount of the refund without interest. If the repayment is not made within 30 days after the date of notice, the person shall receive no credit for the period of employment covered by the refund and shall be required to buy back the refund at its actuarial cost if the member later decides that the member wants service credit for any portion of the period of employment covered by the refund.    11.(5) 11.7(4) Interest charges.      a.    Overpayment not fraudulent.If the overpayment of benefits, other than an overpayment that results from a violation described in subrule 11.7(4)11.5(2), was not the result of wrongdoing, negligence, misrepresentation, or omission of the recipient, the recipient is liable to pay interest charges at the rate of 5 percent, or the rate IPERS determines, on the outstanding balance, beginning 30 days after the date of notice of the overpayment(s) is provided by IPERS.    b.    Overpayments in violation of Iowa Code section 97B.40 or 715A.8.If the overpayment of benefits, other than an overpayment that results from a violation described in subrule 11.7(4)11.5(2), was the result of wrongdoing, negligence, misrepresentation, or omission of the recipient, the recipient is liable to pay interest charges at the rate of 7 percent on the outstanding balance, beginning on the date of the overpayment(s).    c.    Overpayments that result in a judgment.In addition to other remedies, IPERS may file a civil action to recover overpayments, and the interest rate may be set by the court.    11.(6) 11.7(5) Recovery of overpayment from a deceased recipient.  If a recipient dies prior to the full repayment of an erroneous overpayment of benefits, IPERS shall be entitled to apply to the estate of the deceased to recover the remaining balance.    11.(7) 11.7(6) Offsets against amounts payable.  IPERS may, in addition to other remedies and after notice to the recipient, request an offset against amounts owing to the recipient by the state according to the offset procedures pursuant to Iowa Code sections 8A.504 and 421.17.    11.(8) 11.7(7) Rights of appeal.  A recipient who is notified of an overpayment and required to make repayments under this rule may appeal IPERS’ determination in writing to the CEO or CEO’s designee. The written request must explain the basis of the appeal and must be received by IPERS’ office within 30 days of overpayment notice pursuant to 495—Chapter 26.    11.(9) 11.7(8) Release of overpayment.  IPERS may release a recipient from liability to repay an overpayment, in whole or in part, if IPERS determines that the receipt of overpayment is not the fault of the recipient, and that it would be contrary to equity and good conscience to collect the overpayment. No release of an individual recipient’s obligation to repay an overpayment shall stand as precedent for release of another recipient’s obligation to repay an overpayment.

    ITEM 13.    Amend subrule 12.1(2), catchwords, as follows:    12.1(2) Reduction for early retirementfor regular class members.  

    ITEM 14.    Amend subrule 12.1(3), catchwords, as follows:    12.1(3) Early retirement datefor regular class members.  

    ITEM 15.    Rescind subrules 12.1(4) and 12.1(5).

    ITEM 16.    Renumber subrules 12.1(6) and 12.1(7) as 12.1(4) and 12.1(5).

    ITEM 17.    Amend renumbered subrule 12.1(4) as follows:    12.1(4) Benefit formulas for members retiring on or after July 1, 19942012.      a.    For each active member retiring on or after July 1, 19942012, with four or more complete years ofwho is vested by service, the monthly benefit will be equal to one-twelfth of an amount equal to 60 percent of the three-yearfinal average covered wage multiplied by a fraction of years of service.    b.    For all active and inactive vested members, the monthly retirement allowance shall be determined on the basis of the formula in effect on the date of the member’s retirement. If the member takes early retirement, the benefit shall be adjusted as provided in subrule 12.1(2).    c.    Effective July 1, 1996, through June 30, 1998, inIn addition to the 60 percent multiplier identified above,regular class members who retire with years of service in excess of their “applicable years”30 years shall have the percentage multiplier increased by 1.25 percent for eachquarter of a year in excess of their “applicable years,”30, not to exceed an increase of 5 percent. For regular members, “applicable years” means 30 years; for protection occupation members, “applicable years” means 25 years; for sheriffs, deputy sheriffs, and airport firefighters, “applicable years” means 22 years.    d.    In addition to the 60 percent multiplier identified above, protection occupation members, sheriffs, and deputy sheriffs who retire with years of service in excess of 22 years shall have the percentage multiplier increased by .375 percent for each quarter of a year in excess of 22, not to exceed an increase of 12 percent.     d.    Effective July 1, 1998, sheriffs, deputy sheriffs, and airport firefighters who retire with years of service in excess of their applicable years shall have their percentage multiplier increased by 1.5 percent for each year in excess of their applicable years, not to exceed an increase of 12 percent.    e.    Effective July 1, 2000, the “applicable years” and increases in the percentage multiplier for years in excess of the applicable years for protection occupation members shall be determined under Iowa Code section 97B.49B(1), as set forth in paragraph “f” below.    f.    For special service members covered under Iowa Code section 97B.49B, the applicable percentage and applicable years for members retiring on or after July 1, 2000, shall be determined as follows:    (1)   For each member retiring on or after July 1, 2000, and before July 1, 2001, 60 percent plus, if applicable, an additional .25 percent for each additional quarter of eligible service beyond 24 years of service (the “applicable years”), not to exceed 6 additional percentage points;    (2)   For each member retiring on or after July 1, 2001, and before July 1, 2002, 60 percent plus, if applicable, .25 percent for each additional quarter of eligible service beyond 23 years of service (the “applicable years”), not to exceed a total of 7 additional percentage points;    (3)   For each member retiring on or after July 1, 2002, and before July 1, 2003, 60 percent plus, if applicable, .25 percent for each additional quarter of eligible service beyond 22 years of service (the “applicable years”), not to exceed a total of 8 additional percentage points;    (4)   For each member retiring on or after July 1, 2003, 60 percent plus, if applicable, an additional .375 percent for each additional quarter of eligible service beyond 22 years of service (the “applicable years”), not to exceed a total of 12 additional percentage points.    (5)   e.    Regular service does not count as “eligible service” in determining a special service member’s applicable percentage.

    ITEM 18.    Amend renumbered subrule 12.1(5) as follows:    12.1(5) Average covered wagesfor special service members and for wages of regular class members prior to July 2012.      a.    “Three-year average covered wage” means a member’s covered calendar year wages averaged for the highest three years of the member’s service. However, if a member’s final quarter of a year of employment does not occur at the end of a calendar year,for the member’s final year of wages, IPERS may determine the wages for the third year by computing the final quarter or quarters of wages to complete the year.The computed year will be created when the final quarter or quarters reported are combined with a computed average quarter to complete the last year. The value of this average quarter will be computed by selecting the highest covered wage year not used in the computation of the three high years and dividing the covered salary by four quarters. This value will be combined with the final quarter or quarters to complete a full calendar year. If the member’s final quarter of wages will reduce the three-year average covered wage, it can be dropped from the computation. However, if the covered wages for that quarter are dropped, the service credit for that quarter will be forfeited as well. If the final quarter is the first quarter of a calendar year, those wages must be used in order to give the member a computed year. The computed year wages shall not exceed theInternal Revenue Service maximum covered wage in effect for that calendar year. Furthermore, for members whose first month of entitlement is January of 1999 or later, the computed year shall not exceed the member’s highest actual calendar year of covered wages by more than 3 percent. Effective July 1, 2007, a member’s high three-year average wage shall be the greater of (1) the member’s high three-year average covered wage based on covered wages reported through June 30, 2007; or (2) the member’s high three-year average covered wage after application of the antispiking control as described in paragraph “c”“b” below.For members whose first month of entitlement is January 1995 or later, a full third year will be created when the final quarter or quarters reported are combined with a computed average quarter to complete the last year. The value of this average quarter will be computed by selecting the highest covered wage year not used in the computation of the three high years and dividing the covered salary by four quarters. This value will be combined with the final quarter or quarters to complete a full calendar year. If the member’s final quarter of wages will reduce the three-year average covered wage, it can be dropped from the computation. However, if the covered wages for that quarter are dropped, the service credit for that quarter will be forfeited as well. If the final quarter is the first quarter of a calendar year, those wages must be used in order to give the member a computed year. The three-year average covered wage cannot exceed the highest maximum covered wages in effect during the member’s service.If the three-year average covered wage of a member who retires on or after January 1, 1997, and before January 1, 2002, exceeds the limits set forth in paragraph “b” below, the longer period specified in paragraph “b” shall be substituted for the three-year averaging period described above. No quarters from the longer averaging period described in paragraph “b” shall be combined with the final quarter or quarters to complete the last year.    b.    For the persons retiring during the period beginning January 1, 1997, and ending December 31, 2001, the three-year average covered wage shall be computed as follows:    (1)   For a member who retires during the calendar year beginning January 1, 1997, and whose three-year average covered wage at the time of retirement exceeds $48,000, the member’s covered wages averaged for the highest four years of the member’s service or $48,000, whichever is greater.    (2)   For a member who retires during the calendar year beginning January 1, 1998, and whose three-year average covered wage at the time of retirement exceeds $52,000, the member’s covered wages averaged for the highest five years of the member’s service or $52,000, whichever is greater.    (3)   For a member who retires during the calendar year beginning January 1, 1999, and whose three-year average covered wage at the time of retirement exceeds $55,000, the member’s covered wages averaged for the highest six years of the member’s service or $55,000, whichever is greater.    (4)   For a member who retires on or after January 1, 2000, but before January 1, 2001, and whose three-year average covered wage at the time of retirement exceeds $65,000, the member’s covered wages averaged for the highest six years of the member’s service or $65,000, whichever is greater. For the calendar year beginning January 1, 2001, the six-year wage averaging trigger shall be increased to $75,000.    (5)   Effective January 1, 2002, the computation of average covered wages shall be as provided in paragraph 12.1(7)“a.”For purposes of paragraph 12.1(7)“b,” the highest years of the member’s service shall be determined using calendar years and may be determined using one computed year. The computed year shall be calculated in the manner and subject to the restrictions provided in paragraph 12.1(7)“a.”    c.    b.    Antispiking limit on the growth of a member’s high three-year average.    (1)   Selection of the control year shall give highest priority to calendar years of wages in which there are four quarters of service credit for wages on file not used in the high three-year average wage calculation. For example, if the member receives $20,000 of wages for a calendar year with four quarters of service credit for wages, and the member also has received $30,000 of wages for a calendar year with three quarters of service credit for wages, the control year selection process shall give preference to the calendar year with $20,000 of reported wages.    (2)   If there is a calendar year of covered wages outside the high three-year average wage calculation that has four quarters, but the covered wages for that year are less than the covered wages for the fourth highest calendar year of covered wages, and that fourth highest calendar year of covered wages does not have four quarters of service credit for wages, the control year will be the lowest of the high three calendar years of wages with service credits for wages in all four quarters being used in the high three-year average wage calculation.    (3)   “Service credit for wages” means service credit recorded for:
  1. Quarters in which the member receives covered wages from covered employment.
  2. Quarters in which the member is credited with covered wages due to a military leave.
  3. Quarters in which the member would have had covered wages but for the application of the IRS covered wage limitations.
  4. Quarters in which an employee of a nine-month institution receives service credit for a qualifying leave of absence under 495—subrule 7.1(2).
  5. Quarters in which a legislator, legislative employee, or elected official receives service credit for employment.
    (4)   If none of the calendar years of wages that fall outside of the high three-year average wage calculation have service credit for wages reported in all four quarters, the control year will then be the lowest of the high three calendar years of wages with service credit for wages in all four quarters being used in the high three-year average wage calculation.    (5)   If none of the wage years used in the high three-year average wage calculation have service credits for wages reported in all four quarters, the control year will then revert to the highest calendar year of wages not included in the high three-year average wage calculation, regardless of whether there are fewer than four quarters with service credits for wages on file.    (6)   For high three-year average wage calculations that utilize the computed year, the control year may be the calendar year from which the “average quarters” used in the computed year are drawn. However, the control year cannot be the computed year, as the computed year will never be a calendar year with service credit for wages in all four quarters.
    d.    c.    Effective July 1, 2012, a nonvestedregular class member’s average covered wage shall be the member’s five-year average covered wage calculated as provided in Iowa Code section 97B.1A(10A)“a.”    e.    d.    Effective July 1, 2012, forregular class members vested as of June 30, 2012, the member’s average covered wage shall be the greater of the member’s three-year average covered wage calculated as provided under paragraphs 12.1(7)“a” through “c,”12.1(5)“a” and “b,” or the member’s five-year average covered wage calculated as provided in Iowa Code section 97B.1A(10A)“a.”The “five-year average covered wage” means a member’s covered calendar year wages averaged for the highest five years of the member’s service. However, in the member’s final year of wages, IPERS may determine the wages for the fifth year by computing the final quarter or quarters of wages to complete the year. The computed year wages shall not exceed the Internal Revenue Service maximum covered wage in effect for that calendar year. Furthermore, the computed year shall not exceed the member’s highest actual calendar year of covered wages by more than 3 percent. A full fifth year will be created when the final quarter or quarters reported are combined with a computed average quarter to complete the last year. The value of this average quarter will be computed by selecting the highest covered wage year not used in the computation of the five high years and dividing the covered salary by four quarters. This value will be combined with the final quarter or quarters of wages to complete a full calendar year. If the member’s final quarter of wages will reduce the five-year average covered wage, it can be dropped from the computation. However, if the covered wages for that quarter are dropped, the service credit for that quarter will be forfeited as well. If the final quarter is the first quarter of a calendar year, those wages must be used in order to give the member a computed year. The five-year average covered wage cannot exceed the highest Internal Revenue Service maximum covered wages in effect during the member’s service. In addition, the average five-year salary is restricted to an antispiking limit of 134 percent of the highest sixth year of wages.

    ITEM 19.    Rescind rule 495—12.3(97B).

    ITEM 20.    Renumber rules 495—12.4(97B) to 495—12.10(97B) as 495—12.3(97B) to 495—12.9(97B).

    ITEM 21.    Amend renumbered subrule 12.4(1) as follows:    12.4(1)   For each member who is vested prior to July 1, 2012, and is retiring prior to July 1, 2012, with less than four complete years of service,not vested by service as defined in Iowa Code section 97B.1A(25)“d,” a monthly annuity shall be determined by applying the total reservemember and employer’s accumulated contributions as of the effective retirement date (plus any retirement dividends standing to the member’s credit on December 31, 1966) to the annuity tables in use by the system according to the member’s age (or member’s and contingent annuitant’s ages, if applicable). If the member’s retirement occurs before January 1, 1995, IPERS’ revised 6.50 percent tables shall be used. If the member’s retirement occurs after December 31, 1994, IPERS’ 6.75 percent tables shall be used. If the member’s retirement occurs after December 31, 2009, IPERS’ 7.50 percent tables shall be used. If the member’s retirement occurs after December 31, 2019, IPERS’ 7.00 percent tables shall be used.

    ITEM 22.    Amend renumbered subrule 12.4(2) as follows:    12.4(2)   For each vested member for whom the present value of future benefits under Option 2 is less than the member reserve as of the effective retirement date, a monthly annuity shall be determined by applying the member reserve to the annuity tables in use by the system according to the member’s age (or member’s and contingent annuitant’s ages, if applicable). If the member’s retirement occurs before January 1, 1995, IPERS’ revised 6.50 percent tables shall be used. If the member’s retirement occurs after December 31, 1994, IPERS’ 6.75 percent tables shall be used.

    ITEM 23.    Rescind renumbered subrule 12.4(3).

    ITEM 24.    Renumber subrules 12.4(4) to 12.4(5) as 12.4(3) to 12.4(4).

    ITEM 25.    Rescind renumbered subrule 12.4(6).

    ITEM 26.    Renumber subrule 12.4(7) as 12.4(5).

    ITEM 27.    Rescind renumbered subrule 12.6(1).

    ITEM 28.    Renumber subrules 12.6(2) to 12.6(7) as 12.6(1) to 12.6(6).

    ITEM 29.    Amend renumbered subrule 12.6(5) as follows:    12.6(5) Limit on reductions.  For a member who has substantial noncovered employment, the application of theThe level payment choice factors shall not reduce the monthly amount payable to a member at age 62 to less than 50 percent of the monthly amount that would have been payable under IPERS Option 2. Accordingly, payments before age 62 to such members shall be reduced in the same manner, with the corresponding adjustments made to death benefits.

    ITEM 30.    Amend renumbered subrule 12.7(4) as follows:    12.7(4)   In recomputing a retired member’s monthly benefit, IPERS shall use the following assumptions.    a.    The member cannot change the option or beneficiary with respect to the reemployment period.    b.    If the member would only qualify for a money purchase benefit under rule 495—12.5(97B)495—12.4(97B) based solely on the period of reemployment, then the money purchase formula shall be used to compute the additional benefit amount due to the reemployment.    c.    If the member would qualify for a non-money purchase retirement allowance based solely on the period of reemployment, the benefit formula in effect as of the first month of entitlement (FME) for the reemployment period shall be used. If the FME is July 1998 or later, and the member has more than 30 years of service, including both original and reemployment service, the percentage multiplier for the reemployment period only will be at the applicable percentage (up to 65 percent) for the total years of service.    d.    If a period of reemployment would increase the monthly benefit a member is entitled to receive, the member may elect between the increase and a refund of the employee and employer contributions without regard to reemployment FME.    e.    If a member previously elected IPERS Option 1, is eligible for an increase in the Option 1 monthly benefits, and elects to receive the increase in the member’s monthly benefits, the member’s Option 1 death benefit shall also be increased if the investment is at least $1,000. The amount of the increase shall be at least the same percentage of the maximum death benefit permitted with respect to the reemployment as the percentage of the maximum death benefit elected at the member’s original retirement. In determining the increase in Option 1 death benefits, IPERS shall round up to the nearest $1,000. For example, if a member’s investment for a period of reemployment is $1,900 and the member elected at the member’s original retirement to receive 50 percent of the Option 1 maximum death benefit, the death benefit attributable to the reemployment shall be $1,000 (50 percent times $1,900, rounded up to the nearest $1,000). Notwithstanding the foregoing, if the member’s investment for the period of reemployment is less than $1,000, the benefit formula for a member who originally elected new IPERS Option 1 shall be calculated under IPERS Option 3.    f.    A retired reemployed member whose reemployment FME precedes July 1998 shall not be eligible to receive the employer contributions made available to retired reemployed members under Iowa Code section 97B.48A(4) effective July 1, 1998.    g.    f.    A retired reemployed member who requests a return of the employee and employer contributions made during a period of reemployment cannot repay the distribution and have the service credit for the period of reemployment restored.    h.    g.    If a retired reemployed member selected IPERS Option 5 at retirement, and after the period of reemployment requests an increase in the member’s monthly allowance, at death all remaining guaranteed payments with respect to both periods of employment shall be paid in a commuted lump sum.    i.    h.    If a retired reemployed member selected IPERS Option 2 (or old IPERS Option 1) at retirement, and after the period of reemployment requests an increase in the member’s monthly allowance, at death the member’s monthly payments following the increase shall be prorated between the member’s two annuities to determine the amount of the member’s remaining accumulated contributions that may be paid as a death benefit.    j.    i.    A retired reemployed member who has attained the age of 70 may take an actuarial equivalent (AE) payment. However, such a member must terminate covered employment for at least 30 days before taking an additional AE payment.

    ITEM 31.    Amend renumbered subrule 12.8(3) as follows:    12.8(3)   An AE payment under this rule shall be equal to the sum of the member’s and employer’s accumulated contributions and the retirement dividends standing to the member’s credit before December 31, 1966.

    ITEM 32.    Amend subrule 13.1(1) as follows:    13.1(1)   For IPERS regular class members retiring because of a disability:    a.    The member must be awarded federal social security benefits due to a disability which existed on or before the member’s first month of entitlement.    b.    Effective July 1, 1990, the member may also qualify for the IPERS disability provision by being awarded, and commencing to receive, disability benefits through the federal Railroad Retirement Act, 45 U.S.C. Section 231 et seq., due to a disability which existed at the time of retirement.    c.    The period for which up to 36 months of retroactive payments under Iowa Code section 97B.50(2) shall be paid is for up to 36 months preceding the month in which such completed application for IPERS disability is received by IPERS. In no event shall retroactive disability benefits payments under Iowa Code section 97B.50(2) precede the month the member actually receives the member’s first social security or railroad retirement disability payment. The member shall provide IPERS with a copy of the Social Security Administration or railroad retirement award letter showing dates of eligibility.    d.    Continued qualification monitoring.    (1)   For a member retiring due to a disability under Iowa Code section 97B.50(2), on or after July 1, 2009, the member shall provide IPERS with proof of continuing eligibility for federal social security disability benefits or railroad retirement disability benefits by June 30 of each calendar year, in order to continue qualification for IPERS disability benefits.(2)   For a member retiring due to a disability under Iowa Code section 97B.50A, the member shall provide IPERS complete copies of the member’s state and federal income tax returns, including all supporting schedules, by June 30 of each calendar year, in order to continue qualification for IPERS disability benefits.IPERS shall suspend the disability benefits of any member if the records required under these subparagraphs are not timely provided.    (2)   The annual certification of continued eligibility for federal social security disability benefits or railroad retirement disability benefits is not required as of the calendar year the member reaches normal retirement age as defined by Iowa Code section 97B.45, or for special service members aged 55, or sheriffs and deputies aged 50 with 22 years of service.

    ITEM 33.    Amend subrule 13.1(2) as follows:    13.1(2)   If a member returns to covered employment after achieving a bona fide retirement,and is no longer eligible for social security or railroad disability benefits, the benefits being provided to the member under Iowa Code section 97B.50(2)“a” or “b” shall be suspended or reduced as follows. If the member has not attained the age of 55 upon reemployment, benefit payments shall be suspended in their entirety until the member subsequently terminates employment, applies for, and is approved to receive benefits under the provisions of Iowa Code chapter 97B. If the member has attained the age of 55 or older upon reemployment, the member shall continue to receive monthly benefits adjusted as follows. Monthly benefits shall be calculated under the same benefit option that was first selected, based on the member’s age, years of service, and the applicable reductions for early retirement as of the month that the member returns to covered employment.The suspension or reduction of benefits for returning to covered employment no longer applies as of the calendar year the member reaches normal retirement age, as defined by Iowa Code section 97B.45, or for special service members aged 55, or sheriffs and deputies aged 50 with 22 years of service. The member’s benefit shall also be subject to the applicable provisions of Iowa Code section 97B.48A pertaining to reemployed retired members.

    ITEM 34.    Amend subrule 13.2(3) as follows:    13.2(3) Scheduling of appointments.  Upon receipt and forwarding of the application and sufficient medical records to the medical board, the disability retirement benefits officer shall establish an appointment for the applicant to be seen by the medical board in Iowa City. The member shall be notified by telephone and in writing of the appointment, and shall be given general instructions about where to go for the examinations. The appointment for the examinations shall be no later than 60 days after the completed application, including sufficient medical records, is provided. All examinations must be scheduled and completed on the same date. The member shall also be notified about the procedures to follow for reimbursement of travel expenses and lodging. Fees for physical examinations and medical records costs shall be paid directly by IPERS pursuant to its contractual arrangements with the medical providers required to implement Iowa Code section 97B.50A.

    ITEM 35.    Amend subrule 13.2(8) as follows:    13.2(8) General benefits provisions.  Effective July 1, 2000, if an initial disability determination is favorable, benefits shall begin as of the date of the initial disability determination or, if earlier, the member’s last day on the payroll, but no more than six months of retroactive benefits are payable, subject to Iowa Code section 97B.50A(13). “Last day on the payroll” shall include any form of authorized leave time, whether paid or unpaid. If a member receives short-term disability benefits from the employer while awaiting a disability determination hereunder, disability benefits will accrue from the date the member’s short-term disability payments are discontinued. If an initial favorable determination is appealed, the member shall continue to receive payments pending the outcome of the appeal.Any member who is awarded disability benefits under Iowa Code section 97B.50A and this rule shall be eligible to elect any of the benefit options available under Iowa Code section 97B.51. All such options shall be the actuarial equivalent of the lifetime monthly benefit provided in Iowa Code section 97B.50A(2) and (3).The disability benefits established under this subrule shall be eligible for the favorable experience dividends payable under Iowa Code section 97B.49F(2).If the award of disability benefits is overturned upon appeal, the member may be required to repay the amount already received or, upon retirement, have payments suspended or reduced until the appropriate amount is recovered.IPERS shall, at the member’s written request, precertify a member’s medical eligibility through the procedures set forth in subrules 13.2(3) and 13.2(4), provided that IPERS shall have full discretion to request additional medical information and to redetermine the member’s medical eligibility if the member chooses not to apply for disability benefits at the time of the precertification. IPERS shall not pay for the costs of more than one such precertification per 12-month period.

    ITEM 36.    Amend subrule 13.2(13) as follows:    13.2(13) Reemployment/income monitoring.  A member who retires under Iowa Code section 97B.50A and this rule shall be required to supply a copy of a complete set of the member’s state and federal income tax returns, including all supporting schedules, by June 30 of each calendar year, in order to continue qualification for IPERS special service disability benefits. IPERS may suspend the benefits of any such member if such records are not timely provided.This subrule does not apply to a member who is at least 55 years of age and would have completed 22 years of service if the member had remained in active special service employment.Only wages and self-employment income shall be counted in determining a member’s reemployment comparison amount, as adjusted for health care coverage for the member and member’s dependents.

    ITEM 37.    Amend rule 495—14.1(97B) as follows:

495—14.1(97B) Internal Revenue Code limitations.  The death benefits payable under Iowa Code sections 97B.51 and 97B.52 shall not exceed the maximum amount possible under Internal Revenue Code Section 401(a)(9).To ensure that the limit is not exceeded, a member’s combined lump sum death benefit under Iowa Code sections 97B.52(1) and 97B.52(2) shall not exceed 100 times the Option 2 amount that would have been payable to the member at the member’s earliest normal retirement age. If a beneficiary of a special service member is eligible for an in-the-line-of-duty death benefit, any reduction required under this rule shall be taken first from a death benefit payable under Iowa Code section 97B.52(1). The “100 times” limit shall apply to active and inactive members. The death benefits payable under this chapter for a period of reemployment for a retired reemployed member who dies during the period of reemployment shall also be subject to the limits described in this rule.The maximum claims period for IPERS lump sum death benefits shall not exceed the period required under Internal Revenue Code Section 401(a)(9), which may be less than five years for a member who dies after the member’s required beginning date, unless the beneficiary is a spouse. The claims period for all cases in which the member’s death occurs during the same calendar year in which a claim must be filed under this rule shall end April 1 of the year following the year of the member’s death.A member’s beneficiary or heir may file a claim for previously forfeited death benefits. Interest, if any, for periods prior to the date of the claim will only be credited through the quarter that the death benefit was required to be forfeited by law. Interest for periods following the quarter of forfeiture will accrue beginning with the quarter that the claim for reinstatement is received by IPERS. For death benefits required to be forfeited in order to satisfy Section 401(a)(9) of the federal Internal Revenue Code, in no event will the forfeiture date precede January 1, 1988. IPERS shall not be liable for any excise taxes imposed by the Internal Revenue Service on reinstated death benefits.Effective January 14, 2004, all claims for a previously forfeited death benefit shall be processed under the procedure set forth at rule 495—14.13(97B)495—14.6(97B).The system recognizes the validity of same gender marriages executed in Iowa on or after April 27, 2009, if the domestic relations order or other assignment otherwise meets the system’s minimum requirements for such orders; the system shall modify the tax treatment of distributions under such orders as required by the federal laws governing such distributions. IPERS shall adopt such rules and procedures as are deemed necessary to fully implement the provisions of this rule. The Iowa Supreme Court decision recognizing same gender marriages in Iowa specifically states that this recognition does not extend to same gender marriages of other states. The system recognizes the validity of same gender marriages based on the U.S. Supreme Court’s decision in United States v. Windsor, 133 S.Ct. 2675 (2013) and the direction of Rev. Rul. 2013-17 and IRS Notice 2014-19. IPERS shall recognize the federal tax treatment of distributions as required by the sources listed in this paragraph.

    ITEM 38.    Amend subrule 14.3(1) as follows:    14.3(1) Designation of beneficiaries.  To designate a beneficiary, the member must complete an IPERS designation of beneficiary form, which must be filed with IPERS.Members may also designate their beneficiary through the IPERS website. The designation of a beneficiary by a retiring member on the application for monthly benefits revokes all prior designation of beneficiary forms. IPERS may consider as valid a designation of beneficiary form filed with the member’s employer prior to the death of the member, even if that form was not forwarded to IPERS prior to the member’s death. If a retired member is reemployed in covered employment, the most recently filed beneficiary form shall govern the payment of all death benefits for all periods of employment. Notwithstanding the foregoing sentence, a reemployed IPERS Option 4 or 6 retired member may name someone other than the member’s contingent annuitant as beneficiary, but only for lump sum death benefits accrued during the period of reemployment and only if the contingent annuitant has died or has been divorced from the member before or during the period of reemployment unless a qualified domestic relations order (QDRO) directs otherwise. If a reemployed IPERS Option 4 or 6 retired member dies without filing a new beneficiary form, the death benefits accrued for the period of reemployment shall be paid to the member’s contingent annuitant, unless the contingent annuitant has died or been divorced from the member. If the contingent annuitant has been divorced from the member, any portion of the lump sum death benefits awarded in a QDRO shall be paid to the contingent annuitant as alternate payee, and the remainder of the lump sum death benefits shall be paid to the member’s estate or, if applicable, to the member’s heirs if no estate is probated.

    ITEM 39.    Amend subrule 14.3(3) as follows:    14.3(3) Change of beneficiary.  The beneficiary may be changed by the member by filing a new designation of beneficiary form with IPERS.Members may also change their beneficiary through the IPERS website. The latest dated designation of beneficiary form on file shall determine the identity of the beneficiary. Payment of a refund to a terminated member cancels the designation of beneficiary on file with IPERS.

    ITEM 40.    Amend rule 495—14.4(97B) as follows:

495—14.4(97B) Applications for death benefits.  Before death benefit payments can be made, application in writing must be submitted to IPERS with a copy of the member’s death certificate, or if a death certificate cannot be obtained, IPERS may rely on such resources as it has available, including but not limited to records from the Social Security Administration, bureau of health statistics, IPERS’ own internal records, or reports derived from other public records, and other departmental or governmental records to which IPERS may have access together with information establishing the claimant’s right to payment. A named beneficiary must complete an IPERS application for death benefits based on the deceased member’s account. If the claimant’s claim is based on dissolution of marriage that revoked the IPERS beneficiary designation, the claim must be processed pursuant to rule 495—14.17(97B)495—14.16(97B).

    ITEM 41.    Amend rule 495—14.6(97B) as follows:

495—14.6(97B) Payment of the death benefit when no designation of beneficiary or an invalid designation of beneficiary form is on file.  When no designation of beneficiary or an invalid designation of beneficiary form is on file with IPERS, payment shall be made in one of the following ways.    14.6(1)   Where the estate is open, payment shall be made to the administrator or executor where said executor or administrator shall be duly appointed and serving under Iowa Code chapter 633 or 635.    14.6(2)   Where no estate is probated or the estate is closed prior to the filing with IPERS of an application for death benefits, payment will be made to the surviving spouse. The following documents shall be presented as supporting evidence:in accordance with the intestacy laws of the state of Iowa. If someone, other than those identified pursuant to the intestacy laws of the state of Iowa claims entitlement to a death benefit, an estate must be opened and the death benefit shall be payable to the administrator or executor of the estate.    a.    Copy of the will, if any;    b.    Copy of any letters of appointment; and    c.    Copy of the court order closing the estate and discharging the executor or administrator.    14.6(3)   Where no estate is probated or the estate is closed prior to the filing with IPERS of an application for death benefits and there is no surviving spouse, payment will be made to the heirs-at-law as determined by the intestacy laws of the state of Iowa.    14.6(4)   Where a trustee has been named as designated beneficiary and is not willing to accept the death benefit or otherwise serve as trustee, IPERS may apply but is not required to apply to the applicable district court for an order to distribute the funds to the clerk of court on behalf of the beneficiaries of the member’s trust. Upon the issuance of an order and the giving of such notice as the court prescribes, IPERS may deposit the death benefit with the clerk of court for distribution. IPERS shall be discharged from all liability upon deposit with the clerk of court.

    ITEM 42.    Rescind rule 495—14.12(97B) and adopt the following new rule in lieu thereof:

495—14.12(97B) Preretirement death benefits.       14.12(1) Death prior to first month of entitlement.  Where an active member, or an inactive member vested by service, dies prior to the first month of entitlement, the lump sum death benefit shall be the greater of the amount provided in subrule 14.12(3) or 14.12(4). Sole beneficiaries may elect, in lieu of the lump sum amount, to receive a single life annuity that is the actuarial equivalent of such lump sum amount. Where an inactive member, not vested by service, dies prior to the first month of entitlement, the lump sum death benefit shall be as provided in subrule 14.12(7).     14.12(2) Death benefits under Iowa Code section 97B.52(1).      a.    Definitions.        "Accrued benefit" means the monthly amount that would have been payable to the deceased member under IPERS Option 2 at the member’s earliest normal retirement age, based on the member’s covered wages and service credits at the date of death. If a deceased member’s wage record consists of a combination of regular and special service credits, the monthly amount that would have been payable to the deceased member under Option 2 at the member’s earliest normal retirement age shall be determined separately for regular and special service credits, and then combined.        "Nearest age" means a member’s or beneficiary’s age expressed in whole years, after rounding for partial years of age. Ages shall be rounded down to the nearest whole year if less than six complete months have passed following the month of the member’s or beneficiary’s last birthday, and shall be rounded up if six complete months or more have passed following the month of the member’s or beneficiary’s last birthday.    b.    Process for applying.    (1)   A claim for a single life annuity under this subrule must be filed as follows:    1.   A nonspouse beneficiary must file a claim for a single life annuity within 12 months of the member’s death.    2.   A beneficiary who is a surviving spouse must file a claim for a single life annuity within 12 months of the member’s death, or by the date that the member would have attained the age of 72, whichever period is later.    (2)   Elections to receive the lump sum amount or single life annuity shall be irrevocable once the first payment is made.    (3)   No further benefits will be payable following the death of any beneficiary who qualifies and elects to receive the single life annuity provided under this subrule.    (4)   The provisions of this subrule shall not apply to members who died before January 1, 2001.    14.12(3) Accumulated contributions lump sum benefit.  An accumulated contribution lump sum death benefit is equal to the accumulated contributions of the member plus the product of an amount equal to the highest year of covered wages of the deceased member and the number of years of membership service divided by the “applicable denominator,” as provided in Iowa Code section 97B.52(1)“a.” The calculation of the highest year of covered wages shall use the highest calendar year of covered wages reported to IPERS.    14.12(4) Present value lump sum.  A lump sum death benefit equal to the present value of the member’s accrued benefit is calculated as follows:    a.    IPERS shall calculate a member’s retirement benefit at earliest normal retirement age under IPERS Option 2, based on the member’s covered wages and service credits at the date of death and the retirement benefit formula in effect in the month following the date of death.    b.    For purposes of determining the “member date of death annuity factor” under the conversion tables supplied by IPERS’ actuary, IPERS shall assume that “age” means the member’s nearest age at the member’s date of death.    c.    For purposes of determining the “member unreduced retirement annuity factor” under the conversion tables supplied by IPERS’ actuary, IPERS shall assume that “age” means the member’s nearest age at the member’s earliest normal retirement date. If a member had already attained the member’s earliest normal retirement date, IPERS shall assume that “age” means the member’s nearest age at the date of death.    14.12(5) Single life annuity benefit.  Procedures and assumptions for converting the actuarial equivalent of a lump sum death benefit to a single life annuity are as follows:    a.    For purposes of determining the “age of beneficiary annuity factor” under the conversion tables supplied by IPERS’ actuary, IPERS shall assume that “age” means the beneficiary’s nearest age as of the beneficiary’s first month of entitlement.    b.    A beneficiary’s first month of entitlement is the month after the date of the member’s death.    c.    Effective for claims filed after June 30, 2004, no retroactive payments of the single life annuity shall be made under this subrule.    d.    Effective for claims filed after June 30, 2004, the beneficiary whose single life annuity is less than $600 per year shall be able to receive only the lump sum payment under this rule.    e.    Any sole beneficiary who is eligible for and elects to receive a single life annuity under this subrule shall also qualify for the favorable experience dividend (FED) payments authorized under rule 495—15.2(97B), subject to the requirements of that rule.    14.12(6) Retired reemployed members and aged 70 members who retire without terminating employment.   Preretirement death benefits for retired reemployed members and aged 70 members who retire without terminating employment shall be calculated as follows:    a.    For beneficiaries of such members who elect IPERS Option 4 or 6 at retirement, IPERS shall recompute (for retired reemployed members) or recalculate/recompute (for aged 70 members who retired without terminating employment) the member’s monthly benefits as though the member had elected to terminate employment as of the date of death, to have the member’s benefits adjusted for postretirement wages, and then lived into the recomputation or recalculation/recomputation (as applicable) first month of entitlement.    b.    The recomputation provided under paragraph “a” shall apply only to beneficiaries of members who elected IPERS Option 4 or 6, where the member’s monthly benefit would have been increased by the period of reemployment, and is subject to the limitations of Iowa Code sections 97B.48A, 97B.49A, 97B.49B, 97B.49C, 97B.49D, and 97B.49G. The recalculation/recomputations provided under paragraph “a” shall apply only to beneficiaries of members who elected IPERS Option 4 or 6, where the member’s monthly benefit would have been increased by the period of employment after the initial retirement, and is subject to the limitations of Iowa Code sections 97B.49A, 97B.49B, 97B.49C, 97B.49D, and 97B.49G. In all other cases, including cases where members previously received a lump sum payment under Iowa Code section 97B.48(1) in lieu of a monthly retirement allowance, preretirement death benefits under this paragraph shall be the lump sum amount equal to the accumulated employee and accumulated employer contributions.    c.    Beneficiaries of members who had elected IPERS Option 4 or 6 may also elect to receive the accumulated employer and accumulated employee contributions described in paragraph 14.12(6)“b” in lieu of the increased monthly annuity amount. Notwithstanding paragraph “b” above, if the member elected IPERS Option 5 at retirement, the lump sum amount payable under this paragraph shall be the greater of the applicable commuted lump sum or the accumulated employee and accumulated employer contributions.    14.12(7) Inactive member, not vested by service death benefit.       a.    For deaths occurring after June 30, 2004, and before July 1, 2012, for inactive members who have less than 16 quarters of service credit, preretirement death benefits shall be provided solely under Iowa Code section 97B.52(1)“a,” and shall only be payable in lump sum amounts. For purposes of this paragraph, an inactive member is a member as defined under Iowa Code section 97B.1A(12).    b.    For deaths occurring after June 30, 2012, preretirement death benefits shall be provided solely under Iowa Code section 97B.52(1)“a” and shall only be payable in lump sum amounts for inactive members who are not vested by service. For purposes of this paragraph, an inactive member is a member as defined under Iowa Code section 97B.1A(12).

    ITEM 43.    Rescind rule 495—14.13(97B).

    ITEM 44.    Renumber rules 495—14.14(97B) to 495—14.17(97B) as 495—14.13(97B) to 495—14.16(97B).

    ITEM 45.    Amend rule 495—14.17(97B) as follows:

495—14.17(97B) Beneficiary revocation pursuant to Iowa Code section 598.20B, dissolution of marriage.  IPERS is not liable for the payment of death benefits to a beneficiary pursuant to a beneficiary designation that has been revoked or reinstated by a divorce, annulment, or remarriage before IPERS receives the written notice set forth in subrule 14.17(1)14.16(1). Furthermore, IPERS shall only be liable for payments made after receipt of such written notice if the written notice is received at least ten calendar days prior to the payment.    14.17(1) Form of notice.  The written notice shall include the following information:    a.    The name of the deceased member,    b.    The name of the person(s) whose entitlement to IPERS death benefits is being challenged,    c.    The name, address, and telephone number of the person(s) asserting an interest,    d.    A statement that the decedent’s divorce, annulment, or remarriage revoked the entitlement of the person(s) whose status is being challenged to the IPERS death benefits in question, and    e.    A copy of the divorce decree upon which the claim is based.In addition to the above information, if the person whose entitlement is being challenged is not the former spouse, the written notice must indicate that the person was related to the former spouse, but not the member, by blood, adoption or affinity, and state the nature of the relationship.    14.17(2) Delivery of notice.  Written notice under this rule must be addressed to IPERS General Counsel and mailed to IPERS by registered mail or served upon IPERS in the same manner as a summons in a civil action.    14.17(3) Administration.  Upon receipt of written notice that meets the requirements of subrules 14.17(1)14.16(1) and 14.17(2)14.16(2):    a.    IPERS shall review the deceased member’s account and determine if there are moneys left to be distributed from the account.    b.    IPERS shall pay the amounts owed, if any, to the probate court having jurisdiction over the decedent’s estate, if the deceased member has an open estate.    c.    IPERS shall pay the amounts owed, if any, to the probate court that had or would have had jurisdiction over the decedent’s estate, if the deceased member’s estate is closed or an estate was not opened.    d.    As IPERS makes applicable payments, a copy of the written notice received by IPERS shall be filed with the probate court.If the probate court charges a filing fee for the deposit of amounts payable hereunder, IPERS shall deduct such filing fees and other court costs from the amounts payable prior to transfer. The probate court shall hold the funds and, upon its determination, shall order disbursement or transfer in accordance with the determination. Additional filing fees and court costs, if any, shall be charged upon disbursement either to the recipient or against the funds on deposit with the probate court, in the discretion of the court.    14.17(4) Release of claims.  Payments made to a probate court under this rule shall discharge IPERS from all claims by all persons for the value of amounts paid the court.

    ITEM 46.    Amend rule 495—20.1(97B) as follows:

495—20.1(97B) Recognition of agents.      20.1(1) Recognition of agents in general.  When a member or beneficiary desires to be represented by an agent before the system, the member or beneficiary shall designate in writing, using a power of attorney form or other acceptable legal form, the name of a representative and the nature of the business the representative is authorized to transact.Other acceptable legal form can be a guardianship, conservatorship, other similar court order that appoints an agent to act upon behalf of a member or beneficiary, or social security representative payee documents for the individual so designated. An agent can be an institution or facility acting upon the member’s or beneficiary’s behalf. Such designation on the part of the member or beneficiary shall constitute for IPERS sufficient proof of the acceptability of the individual to serve as the member’s or beneficiary’s agent.     20.1(2) Payment to members or beneficiaries with a recognized agent.  When it appears that the interest of a member or beneficiary would be served, IPERS may recognize an agent to represent the member or beneficiary in the transaction of the affairs with IPERS. Recognition may be obtained through the filing with IPERS of a copy of the guardianship, trusteeship, power of attorney, conservatorship, other similar court order which appoints an agent to act upon behalf of a member or beneficiary, or social security representative payee documents by the individual so designated. Such personsagents have all the rights and obligations of the member or beneficiaryunless the document creating the agency relationship limits this authority as it pertains to the system. Notwithstanding the foregoing, none of the foregoing representativesno agent shall have the right to name the representativeagent as the member’s or beneficiary’s beneficiary unless approved to do so by a court having jurisdiction of the matter, or unless expressly authorized to do so in a power of attorney executed by the member or beneficiary.    20.1(3) Revocationor suspension of power of attorney.  Any person serving as an agent by power of attorney under this rule can have the agency relationship rescinded by the member or beneficiary by notifying IPERS verbally or in writing.A power of attorney shall be suspended and given no effect when the system receives written proof of the appointment of a guardian, conservator, or court order that appoints an agent to act upon behalf of the member or beneficiary. The power of attorney shall be reinstated when the system receives written proof that a guardianship, conservatorship, or court order appointing an agent no longer exists, has expired, or is invalid.    20.1(4) Revocation of other representative agents.  Any person, institution, or facility serving as a representativean agent under a guardianship,or conservatorship, or social security representative payee may not behave its agency relationship revoked unless by court order or notice from the social security administration in writing.    20.1(5) Social security representative payees.  The system shall accept the federal social security administration’s appointment of a person, facility, or institution to act upon a member’s or beneficiary’s behalf only with regard to the deposit of system benefits. The appointment of a person, facility, or institution by the federal social security administration shall be suspended and given no effect when the system receives written proof of the appointment of a guardian, conservator, or court order that appoints an agent to act upon behalf of the member or beneficiary. A power of attorney or court order will take precedence over the federal social security administration’s appointment of a person, facility, or institution to act upon a member’s or beneficiary’s behalf.    20.1(6) Agent standards.  A person, facility, or institution serving in the capacity of an agent shall act in the best interests of the member or beneficiary. Payments made to the agent on behalf of the member or beneficiary will be used for the direct benefit of the member or beneficiary. The failure to serve in the best interests of the member or beneficiary will cause discontinuance of the agency relationship and may serve as the basis for legal action by IPERS, the member, or the beneficiary.

    ITEM 47.    Rescind and reserve rule 495—20.2(97B).
ARC 4894CLabor Services Division[875]Notice of Intended Action

Proposing rule making related to update of rules and providing an opportunity for public comment

    The Labor Commissioner hereby proposes to amend Chapter 1, “Description of Organization and Procedures Before the Division,” Chapter 4, “Recording and Reporting Occupational Injuries and Illnesses,” Chapter 32, “Child Labor,” Chapter 38, “Employment Agency Licensing,” Chapter 61, “Administration of Iowa Code Chapter 88A,” Chapter 150, “Construction Contractor Registration,” Chapter 155, “Asbestos Removal and Encapsulation,” Chapter 156, “Bidder Preferences in Government Contracting,” and Chapter 177, “Mixed Martial Arts,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 88.5, 88A.3, 88B.3, 90A.7, 91.6, 91C.6, 92.8 and 94A.5.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapters 88, 88A, 88B, 90A, 91, 91C, 92 and 94A.Purpose and Summary    The proposed items remove obsolete references; update addresses; amend language concerning hazardous occupations for youth; allow year-round amusement operators to apply for their annual permits in November; require amusement permit applications to be submitted 30 days, rather than 14 days, in advance; align rules with statutory language; facilitate the use of hoods for asbestos abatement workers; and amend the definitions of “construction” and “mixed martial arts.”Fiscal Impact    This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Commissioner for a waiver of the discretionary provisions, if any, pursuant to 875—Chapter 1. Public Comment    Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Commissioner no later than 4:30 p.m. on March 4, 2020. Comments should be directed to: Kathleen Uehling Division of Labor Services 150 Des Moines Street Des Moines, Iowa 50309 Email: kathleen.uehling@iwd.iowa.govPublic Hearing    If requested, a public hearing at which persons may present their views orally or in writing will be held as follows: March 4, 2020 9 a.m. 150 Des Moines Street Des Moines, Iowa     Persons who wish to make oral comments at the public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.     Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Commissioner and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend subrule 1.3(2) as follows:    1.3(2)   Correspondence and payments may be mailed to Division of Labor Services, 1000 East Grand Avenue, Des Moines, Iowa 50319. The telephone number for the division is (515)242-5870. The division’s office is located at 150 Des Moines Street, Des Moines, Iowa50309. The division’s website is www.iowadivisionoflabor.gov.

    ITEM 2.    Amend rule 875—1.15(22,91) as follows:

875—1.15(22,91) Procedure by which additions, dissents, or objections may be entered into certain records.  Except as otherwise provided by law, a person may have a written statement of additions, dissents, or objections entered into a record containing personally identifiable information pertaining to that person. However, this does not authorize a person who is a subject of a record to alter the original copy or to expand the official record of any division proceeding. Written statements of additions, dissents, or objections shall be sent to the custodian or to the Labor Commissioner, 1000 E. Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309. Written statements of additions, dissents, or objections must be dated and signed and shall include the current address and telephone number of the requester or the requester’s representative.

    ITEM 3.    Amend subrule 1.41(1) as follows:    1.41(1) General.  When requested by a person, either prior to the adoption of a rule or within 30 days after its publication in the Iowa Administrative Bulletin as an adopted rule, the division will issue a concise statement of reasons for the rule. Requests for such a statement must be in writing and be delivered to the Division of Labor Services, Division Rules Coordinator, 1000 East Grand150 Des Moines Street, Des Moines, Iowa 5031950309. The request should indicate whether the statement is sought for all or only a specified part of the rule. Requests will be considered made on the date received.

    ITEM 4.    Amend subrule 1.43(4) as follows:    1.43(4) Written criticisms.  Written criticisms of a rule may be mailed to Division of Labor Services, Division Rules Coordinator, 1000 East Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309. To constitute a criticism of a rule, the criticism must be in writing, state it is a criticism of a specific rule, state the rule number, and provide reasons for criticism of the rule. All written rule criticisms received will be kept for a period of five years.

    ITEM 5.    Amend subrule 1.52(3), introductory paragraph, as follows:    1.52(3)   A petition for intervention shall be mailed to Division of Labor Services, 1000 East Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309. The petition is deemed filed when it is received by that office. The division will provide the petitioner with a file-stamped copy of the petition for intervention if the petitioner provides an extra copy for this purpose. A petition for intervention must be legible and must substantially conform to the following form:

    ITEM 6.    Amend rule 875—1.54(17A) as follows:

875—1.54(17A) Inquiries.  Inquiries concerning the status of a declaratory order proceeding may be mailed to Division of Labor Services, 1000 East Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309.

    ITEM 7.    Amend subrule 1.55(2) as follows:    1.55(2) Filing—when required.  All petitions for declaratory orders, petitions for intervention, briefs, or other papers in a proceeding for a declaratory order shall be filed with the Declaratory Orders Coordinator, Division of Labor Services, 1000 East Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309. All petitions, briefs, or other papers that are required to be served upon a party shall be filed simultaneously with the division.

    ITEM 8.    Amend subrule 1.75(4) as follows:    1.75(4)   When filing is required. After the notice of hearing, all pleadings, motions, documents or other papers in a contested case proceeding shall be mailed to the division at 1000 East Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309. All pleadings, motions, documents or other papers that are required to be served upon a party shall be filed simultaneously with the division.

    ITEM 9.    Amend subrule 1.75(6) as follows:    1.75(6)   Proof of mailing. Proof of mailing includes either: a legible United States Postal Service postmark on the envelope, a certificate of service, a notarized affidavit, or a certification in substantially the following form:    I certify under penalty of perjury and pursuant to the laws of Iowa that, on (date of mailing), I mailed copies of (describe document) addressed to the Division of Labor Services, 1000 East Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309, and to the names and addresses of the parties listed below by depositing the same in (state: a United States post office mailbox with correct postage properly affixed, state interoffice mail, courier).(Date)(Signature)

    ITEM 10.    Amend rule 875—1.102(17A,91), introductory paragraph, as follows:

875—1.102(17A,91) Petitions.  If the petition for waiver or variance relates to a pending contested case, the petition shall be filed in the contested case proceeding. Other petitions must be mailed to Labor Commissioner, Division of Labor Services, 1000 East Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309. In either case, the petition shall include the following information where applicable:

    ITEM 11.    Amend paragraph 4.3(2)"c" as follows:    c.    Visiting 1000 E. Grand Avenue150 Des Moines Street, Des Moines, Iowa.

    ITEM 12.    Amend subrule 32.8(21) as follows:    32.8(21)   Occupations deemed by the labor commissioner to be hazardous to life or limb as provided by Iowa Code section 92.8(21)Hazardous occupations prohibited by the labor commissioner include the following:    a.    Occupations involved in the operation of power cutters on corn detasseling machines.    b.    Occupations involved in the driving of power-driven detasseling machines provided thatunless the driver has a valid driver’s license or a certificate issued by the Federal Extension Service showing that the driver has completed a 4-H farm and machinery program.       This subrule is intended to implement Iowa Code section 92.8(21).

    ITEM 13.    Amend subrule 38.2(1) as follows:    38.2(1) Application.  An application for a license must be made in writing to the commissioner upon Form PEA-1(309-6164)on the form provided by the commissioner. The application formapplicant shall be accompanied by two copies ofalso complete and submit the employee-paid fee schedule Form PEA-2(309-6164)form provided by the commissioner; $75 nonrefundable fee; and all contract forms to be signed by an employee. The application shall also be accompanied by a surety company bond in the sum of $30,000, to be approved by the commissioner and conditioned to pay any damages that may accrue to any person due to a wrongful act or violation of law on the part of the applicant in the conduct of business.

    ITEM 14.    Amend subrule 38.2(3) as follows:    38.2(3) Change in officers.  A change in the name of any person required to be reported on the application under Iowa Code Supplement chapter 94A shall be forwarded to the commissioner within ten days of the change.

    ITEM 15.    Amend paragraph 38.8(2)"c" as follows:    c.    All contracts and fee schedules must clearly state that the agency is licensed by the labor commissioner and that inquiries may be made via mail to the Division of Labor Services, 1000 East Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309, or by telephone to (515)242-5870.

    ITEM 16.    Amend 875—Chapter 38, implementation sentence, as follows:       These rules are intended to implement Iowa Code Supplement chapter 94A.

    ITEM 17.    Amend subrule 61.3(1) as follows:    61.3(1) Operating permit.  No later than May 1 and at least 1430 days before operation begins each calendar year, the operator of covered equipment shall apply to the commissioner for an operating permit.Applications may be submitted in November for continuous operations. Application shall be made on a form provided by the commissioner. Each of the following shall be submitted with the completed operating permit application:    a.    The applicable fee;    b.    A certificate of insurance issued by an insurance company authorized to do business in Iowa. The certificate of insurance shall:    (1)   Certify a policy in the minimum amount of $1 million for bodily injury, death, or property damage in any one occurrence;    (2)   List the specific pieces of equipment that are covered and, if applicable, those that are not covered; and    (3)   Include “Division of Labor Services—Amusements” as a certificate holder;    c.    The operator’s itinerary identifying the covered equipment to be operated and the dates and locations where each will be operated;    d.    General design criteria, safety factors, materials utilized, and stress analysis unless the amusement ride or amusement device was granted an Iowa amusement inspection sticker during the previous calendar year;    e.    Certification of compliance with applicable training and maintenance requirements;    f.    With an application submitted after May 1, proof that the applicant could not have reasonably complied with the May 1 deadline and proof that the application was filed immediately after need for the permit was known;    g.    Separately for each bungee jump:    (1)   A site operating manual;    (2)   A report which is prepared and sealed by a professional engineer who is licensed in Iowa and which certifies that the design and construction of the equipment and structure are suitable for the intended use and conform to Iowa law, recognized engineering practices, procedures, standards and specifications;    (3)   Site plan drawings depicting the preparation area, the jump space, the landing area, the recovery area and other features to be included in the approved operating site;    (4)   Specifications of equipment and structures; and    (5)   Depictions of the location, specifications, dimensions, and type of air bag, pool or body of water where the jumper will land.

    ITEM 18.    Amend rule 875—150.2(91C), definition of “Construction,” as follows:        "Construction" means new work, additions, alterations, reconstruction, installations, repairs and demolitions. Construction activities are generally administered or managed from a relatively fixed place of business, but the actual construction work is performed at one or more different sites which may be dispersed geographically. Examples of construction activities, adopted by reference, are in 871—23.82(96) for purposes of the Iowa employment security law. For work on structures that are both located in an area that is subject to a disaster emergency proclamation pursuant to Iowa Code section 29C.6 and damaged by circumstances related to those that caused the disaster emergency proclamation, “construction” includes asbestos abatement.

    ITEM 19.    Amend subrule 155.6(1) as follows:    155.6(1) Application form.  Except as noted in this subrule, the applicant must complete and submit the entire form provided by the division with the necessary attachments. Respirator fit tests and medical examinations must have occurred within the past 12 months. Only worker and contractor/supervisor license applicants must submit the respirator fit testrespiratory protection and physician’s certification forms. Photocopies of the forms shall not be accepted.

    ITEM 20.    Amend subrule 155.6(2) as follows:    155.6(2) Training.  A certificate of appropriate training from a course provider approved for asbestos trainingas established by the U.S. Environmental Protection Agency must accompany all applications. Applicants for a license must be trained by training providers other than themselves. Applicants who completed initial training under a prior set of applicable rules will not be required to take another initial training course if they complete all annual refresher courses.

    ITEM 21.    Amend subparagraph 155.6(11)"a" as follows:    (1)   A copy of a certificate for training that was provided within the past 12 months by a course provider approvedas established by the U.S. Environmental Protection Agency and that pertains to the work being performed;

    ITEM 22.    Amend subparagraph 155.6(11)"a" as follows:    (3)   DocumentationFor a worker wearing or intending to wear a tight-fitting respirator, documentation of a respirator fit test consistent with 29 CFR 1910.134 within the past 12 months;

    ITEM 23.    Amend subparagraph 155.6(11)"b" as follows:    (1)   A copy of a certificate for training by a course provider approvedas established by the U.S. Environmental Protection Agency and that pertains to the work being performed;

    ITEM 24.    Amend subrule 156.4(1) as follows:    156.4(1) Complaints.  Any person with information regarding a violation of the Act may submit a written complaint to the commissioner. Any complaint must provide the information required pursuant to subrule 156.4(2) or as much of such information as is reasonably practicable under the circumstances. The completed written complaint form shall be mailed to the commissioner at Labor Services Division, 1000 East Grand Avenue150 Des Moines Street, Des Moines, Iowa 5031950309.

    ITEM 25.    Amend rule 875—177.1(90A), introductory paragraph, as follows:

875—177.1(90A) Definitions.  The definitions contained in Iowa Code chapter 90Aas amended by 2010 Iowa Acts, Senate File 2286, and the definitions in this rule shall apply to this chapter.

    ITEM 26.    Amend rule 875—177.1(90A), definition of “Mixed martial arts,” as follows:        "Mixed martial arts" means a style of athletic contest that includes a combination of combative skills from the sports of boxing, wrestling, kickboxing and judodifferent disciplines of the martial arts, including, without limitation, grappling, kicking and striking.
ARC 4918CNatural Resource Commission[571]Notice of Intended Action

Proposing rule making related to “no anchoring” and “no boating” zoned areas on Rathbun Lake and providing an opportunity for public comment

    The Natural Resource Commission (Commission) hereby proposes to amend Chapter 40, “Boating Speed and Distance Zoning,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 462A.26 and 462A.32.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 462A.26 and 462A.32.Purpose and Summary    The proposed amendments create new subrules allowing for the designation of “no anchoring” and “no boating” zoned areas on Rathbun Lake, which is located primarily in Appanoose County. Such zoned areas could be designated at locations where these activities would pose a risk to human safety or threaten to damage property. Current rules allow for zoned areas on Rathbun Lake that restrict the speed of watercraft and designate swimming and wading areas.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. A copy of the fiscal impact statement is available from the Department of Natural Resources (Department) upon request. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found. A copy of the jobs impact statement is available from the Department upon request.Waivers    This rule is subject to the waiver provisions of 571—Chapter 11. Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Commission for a waiver of the discretionary provisions, if any. Public Comment     Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 3, 2020. Comments should be directed to: Deborah Vitko Iowa Department of Natural Resources Wallace State Office Building 502 East Ninth Street Des Moines, Iowa 50319 Fax: 515.725.8201 Email: deborah.vitko@dnr.iowa.govPublic Hearing     A public hearing at which persons may present their views orally or in writing will be held as follows. Upon arrival, attendees should proceed to the fourth floor to check in at the Department reception desk and be directed to the appropriate hearing location: March 3, 2020 12 noon to 1 p.m. Conference Room 3 East and West Wallace State Office Building Des Moines, Iowa     Persons who wish to make oral comments at the public hearing will be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.     Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Adopt the following new subrule 40.5(3):    40.5(3)   Areas may be designated as “no anchoring” areas.

    ITEM 2.    Adopt the following new subrule 40.5(4):    40.5(4)   Areas may be designated as “no boating” areas.
ARC 4924CNatural Resource Commission[571]Notice of Intended Action

Proposing rule making related to virtual fishing tournaments and providing an opportunity for public comment

    The Natural Resource Commission (Commission) hereby proposes to amend Chapter 44, “Special Events and Fireworks Displays,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 455A.5(6), 462A.16 and 481A.39.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 455A.5(6), 462A.16 and 481A.39.Purpose and Summary    This proposed rule making would expand the existing definition of “fishing tournament” found in rule 571—44.2(321G,321I,461A,462A,481A) by adding language to include virtual fishing tournaments, also known as “catch-photo-release” tournaments. Virtual fishing tournaments are increasing in popularity; however, there is no allowance for these events within the current rules. The proposed amendments are necessary because Iowa Code section 462A.16 requires that all tournaments be authorized by the Commission.    The proposed rule making also adds definitions of “aggregated virtual fishing tournament” and “distributed virtual fishing tournament.” An aggregated virtual tournament is similar to a traditional fishing tournament in which participants gather at one location to fish, except that it does not have a weigh-in at the end of the day because all fish are immediately measured, photographed, and released. A distributed virtual tournament, usually organized as an online contest, occurs on multiple bodies of water and can last for weeks or months. This type of tournament has a minimal impact on natural resources and fish populations, and the Commission wishes to encourage the growth of these events in Iowa. The proposed rule making allows distributed virtual tournaments to occur at more than one location and last longer than the currently established nine-day period for a single special event. In addition, the proposed amendments exempt both types of virtual fishing tournaments from paying the special event permit application fee.Fiscal Impact    This rule making has no fiscal impact to the State of Iowa. A copy of the fiscal impact statement is available from the Department of Natural Resources (Department) upon request.Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found. A copy of the jobs impact statement is available from the Department upon request.Waivers    This rule is subject to the waiver provisions of 571—Chapter 11. Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Commission for a waiver of the discretionary provisions, if any. Public Comment    Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4 p.m. on March 5, 2020. Comments should be directed to: Joe Larscheid Iowa Department of Natural Resources Wallace State Office Building 502 East Ninth Street Des Moines, Iowa 50319 Fax: 515.725.8201 Email: fisheries@dnr.iowa.govPublic Hearing    Five public hearings at which persons may present their views orally or in writing will be held as follows: March 5, 2020 12 noon to 2 p.m. Wallace State Office Building Conference Room 4 East Des Moines, Iowa March 5, 2020 12 noon to 2 p.m. Spirit Lake Hatchery Conference Room 122 252nd Avenue Spirit Lake, Iowa March 5, 2020 12 noon to 2 p.m. Cold Springs District Office Conference Room 57744 Lewis Road Lewis, Iowa March 5, 2020 12 noon to 2 p.m. Lake Darling District Office Conference Room 110 Lake Darling Road Brighton, Iowa March 5, 2020 12 noon to 2 p.m. Manchester Hatchery Conference Room 22693 205th Avenue Manchester, Iowa     Persons who wish to make oral comments at a public hearing will be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.    Any persons who intend to attend a public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend rule 571—44.2(321G,321I,461A,462A,481A), definition of “Fishing tournament,” as follows:        "Fishing tournament" means any organized fishing event, except for department-sponsored fishing events held for educational purposes, involving any of the following: (1) six or more boats or 12 or more participants, except for waters of the Mississippi River, where the number of boats shall be 20 or more and the number of participants shall be 40 or more; (2) an entry fee is charged; or (3) prizes or other inducements are awarded.Additionally, a “virtual fishing tournament,” also known as a “catch-photo-release” tournament, is a fishing tournament where fish are not possessed (i.e., not placed in a live well) by the angler but instead are photographed and released upon catching. An “aggregated virtual fishing tournament” occurs when all participants are present on one body of water simultaneously. A “distributed virtual fishing tournament” occurs when participants are present on two or more bodies of water. Additionally, only five or fewer participants may be present on any one body of water simultaneously, and the tournament may occur over an extended time frame. For purposes of this chapter, “fishing tournament” is included in the definition of “special event” unless otherwise specified.

    ITEM 2.    Amend subrule 44.5(4) as follows:    44.5(4)   One application form may be submitted for all events of the same type being held at the same location within a nine-day period and will be processed as a single application.A distributed virtual fishing tournament may extend beyond the nine-day period and need not be at a single location.

    ITEM 3.    Amend rule 571—44.8(321G,321I,461A,462A,481A) as follows:

571—44.8(321G,321I,461A,462A,481A) Fees and exceptions.  The administrative fee for processing each special event application is $25. In the case of field and retriever meets and trials, the fee for processing each special event application is $2. The fees are nonrefundable.The department shall waive the administrative fee for processing special event applications for sailing schools; accredited postsecondary institutions and programs; private and public primary and secondary schools; all department-approved watercraft education courses, ATV education courses, and snowmobile education courses; fishing clinics; friends groups; and department-sponsored youth fishing days; and virtual fishing tournaments.
ARC 4920CNatural Resource Commission[571]Notice of Intended Action

Proposing rule making related to the application of chemicals to public waters and providing an opportunity for public comment

    The Natural Resource Commission (Commission) hereby proposes to amend Chapter 54, “Restrictions on Introduction and Removal of Plant Life,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code section 455A.5(6) and chapters 461A and 462A.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapters 455A, 461A and 462A.Purpose and Summary    This proposed rule making would allow cities and counties to apply chemicals to public waters, as defined by rule 571—13.3(455A,461A), for the removal of aquatic plants for navigational and recreational purposes.  This application would be subject to a permit issued by the Department of Natural Resources (Department) and a Department-approved vegetation management plan.  Currently, only Department staff may apply chemicals for plant control for navigational or recreational purposes.  An already-available alternative is for the Department to apply chemicals under an agreement with a city or county.  The city or county then reimburses the Department for the cost incurred. If the proposed rule making were implemented, the cost to the Department would be the cost of having existing staff process city and county permit applications. This cost would be much less than the cost if the Department continued to delegate staff to apply chemicals and entered into and managed written agreements with cities and counties.Fiscal Impact    This rule making has no fiscal impact to the State of Iowa. A copy of the fiscal impact statement is available from the Department upon request. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found. A copy of the jobs impact statement is available from the Department upon request.Waivers    This rule is subject to the waiver provisions of 571—Chapter 11. Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Commission for a waiver of the discretionary provisions, if any. Public Comment    Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4 p.m. on March 5, 2020. Comments should be directed to: Joe Larscheid Iowa Department of Natural Resources Wallace State Office Building 502 East Ninth Street Des Moines, Iowa 50319 Fax: 515.725.8201 Email: fisheries@dnr.iowa.govPublic Hearing    A public hearing at which persons may present their views orally or in writing will be held as follows: March 5, 2020 12 noon to 2 p.m. Wallace State Office Building Conference Room 4 East Des Moines, Iowa March 5, 2020 12 noon to 2 p.m. Cold Springs District Office Conference Room 57744 Lewis Road Lewis, Iowa March 5, 2020 12 noon to 2 p.m. Spirit Lake Hatchery Conference Room 122 252nd Avenue Spirit Lake, Iowa March 5, 2020 12 noon to 2 p.m. Manchester Hatchery Conference Room 22693 205th Avenue Manchester, Iowa March 5, 2020 12 noon to 2 p.m. Lake Darling District Office Conference Room 110 Lake Darling Road Brighton, Iowa     Persons who wish to make oral comments at a public hearing will be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.    Any persons who intend to attend a public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making action is proposed:

    ITEM 1.    Amend subrule 54.5(1) as follows:    54.5(1) Permits.      a.    The department may issue permits for the introduction and removal of aquatic plants in public waters. To be considered for a permit under this rule, applicants shall use the department’s application form for sovereign lands construction permits, as described in rule 571—13.9(455A,461A,462A), and shall complete all relevant information on that application form. Applicants shall also provide any additional information as may be necessary, as described in rule 571—13.10(455A,461A). The term of the permit shall be stated in the permit. Permits are nontransferable and shall be subject to reevaluation upon expiration. Permits may be issued for between one and five years.    b.    Cities and counties in Iowa may use chemicals, including pesticides and herbicides, to remove aquatic vegetation from water intake structures. However, such cities and counties shall be required to obtain a permit under this rule, and rules in 567—Chapter 66, as may be required, for such activities.    c.    Cities and counties in Iowa may use chemicals, including pesticides and herbicides, to remove aquatic vegetation for certain recreation and navigation purposes, including boating, fishing, and swimming. However, such cities and counties shall be required to obtain a permit under this rule, and 567—Chapter 66 as may be required, for such activities. Additionally, all such use of chemicals shall be conducted by a certified aquatic applicator and shall be subject to the terms of a vegetation management plan approved by the director. Issuance of such permits and approval of a vegetation management plan shall be at the sole discretion of the department.
ARC 4922CNatural Resource Commission[571]Notice of Intended Action

Proposing rule making related to fishing regulations and providing an opportunity for public comment

    The Natural Resource Commission (Commission) hereby proposes to amend Chapter 81, “Fishing Regulations,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code section 481A.38.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 481A.38.Purpose and Summary    This proposed rule making would standardize the methods used for establishing length limits and other fishing regulations that are specific to a site (waterbody) and would extend the Missouri River/Big Sioux River paddlefish season by three days. Currently, site-specific regulations exist as administrative rules within Chapter 81. This proposed rule making would allow the Department of Natural Resources (Department) to make changes to site-specific regulations, or implement new regulations, by posting such regulations on signage at the relevant waterbodies. The Department already uses onsite signage to alert anglers to various regulations, and this method is highly successful and well-accepted by the state’s anglers. The proposed changes are explained individually and in greater detail below.    Subrule 81.2(2) prescribes length limits and catch and release regulations for black bass. The proposed changes to this subrule would simplify how the various length limits are listed in the rule and would allow the Department greater flexibility in managing bass populations by designating site-specific restrictions via posting signage at the respective waterbodies. The alternative is to conduct rule making every time the Department determines that a length limit or other similar restriction at a specific waterbody should be changed. This is unnecessarily burdensome. The practice of posting length limits and catch and release requirements at waterbodies is already widespread, effective, and accepted by anglers.    Subrule 81.2(3) provides daily bag limits, possession limits, and length limits for walleye. Paragraph 81.2(3)“b” currently allows the Department to establish site-specific walleye regulations by posting signage at the waterbody. When paragraph 81.2(3)“b” was adopted in 2014, allowing for this method of implementing new regulations, the existing site-specific regulations for walleye in the Mississippi River were inadvertently left in the rules in paragraph 81.2(3)“c.” The proposed change to subrule 81.2(3) removes the Mississippi River-specific regulations by deleting paragraph 81.2(3)“c,” at which point the existing provision in paragraph 81.2(3)“b,” allowing for regulation adoption via signage, would apply to the Mississippi River. This change would allow the Department to more efficiently institute management regulations (length limits, etc.) for walleye on the Mississippi River and would bring statewide consistency to how walleye regulations are implemented.    Subrule 81.2(4) provides various regulations applicable to the paddlefish season on the Missouri River and Big Sioux River. This rule making proposes to amend subparagraph 81.2(4)“b”(1) by changing “February 4” to “February 1.” This change would provide three additional days for anglers to harvest paddlefish, without negatively impacting the population.    Subrule 81.2(5) currently provides various regulations applicable to trout fishing. The subrule’s single paragraph covers multiple species of trout, streams, length limits, and tackle limitations. This rule making proposes to greatly simplify this subrule by striking the paragraph and replacing it with new provisions that (1) would allow the Department to post via signage seasons, bag or possession limits, length limits, catch and release regulations, and tackle regulations specific to a waterbody at that waterbody and (2) would provide a simplified list of standard trout regulations applicable to all waterbodies that do not have posted regulations.Fiscal Impact    This rule making has no fiscal impact to the State of Iowa. A copy of the fiscal impact statement is available from the Department upon request.Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found. A copy of the jobs impact statement is available from the Department upon request.Waivers    This rule is subject to the waiver provisions of 571—Chapter 11. Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Commission for a waiver of the discretionary provisions, if any. Public Comment    Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4 p.m. on March 5, 2020. Comments should be directed to: Joe Larscheid Iowa Department of Natural Resources Wallace State Office Building 502 East Ninth Street Des Moines, Iowa 50319 Fax: 515.725.8201 Email: fisheries@dnr.iowa.govPublic Hearing    Five public hearings at which persons may present their views orally or in writing will be held as follows: March 5, 2020 12 noon to 2 p.m. Wallace State Office Building Conference Room 4E Des Moines, Iowa March 5, 2020 12 noon to 2 p.m. Spirit Lake Hatchery Conference Room 122 252nd Avenue Spirit Lake, Iowa March 5, 2020 12 noon to 2 p.m. Cold Springs District Office Conference Room 57744 Lewis Road Lewis, Iowa March 5, 2020 12 noon to 2 p.m. Manchester Hatchery Conference Room 22693 205th Avenue Manchester, Iowa March 5, 2020 12 noon to 2 p.m. Lake Darling District Office Conference Room 110 Lake Darling Road Brighton, Iowa     Persons who wish to make oral comments at a public hearing will be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.    Any persons who intend to attend a hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend subrule 81.2(2) as follows:    81.2(2)   Black bass.The department may post season, bag or possession limits, length limits, and catch and release regulations specific to a body of water at that body of water. For bodies of water without posted regulations, the following regulations apply to black bass:     a.     A 15-inch minimum length limit shall apply on black bass in all public lakes except as otherwise posted. On federal flood control reservoirs, a 15-inch minimum length limit shall apply on black bass at Coralville, Rathbun, Saylorville, and Red Rock. All black bass caught from Lake Wapello, Davis County, and Brown’s Lake, Jackson County, must be immediately released alive.    b.     A 12-inch minimum length limit shall apply on black bass in all interior streams, river impoundments, and the Missouri River including chutes and backwaters of the Missouri River where intermittent or constant flow from the river occurs.    c.     A 14-inch minimum length limit shall apply to the Mississippi River including chutes and backwaters where intermittent or constant flow from the river occurs. All black bass caught from the following stream segments must be immediately released alive:
  1. Middle Raccoon River, Guthrie County, extending downstream from below Lennon Mills Dam at Panora as posted to the dam at Redfield.
  2. Maquoketa River, Delaware County, extending downstream from below Lake Delhi Dam as posted to the first county gravel road bridge.
  3. Cedar River, Mitchell County, extending downstream from below the Otranto Dam as posted to the bridge on County Road T26 south of St. Ansgar.
  4. Upper Iowa River, Winneshiek County, extending downstream from the Fifth Street bridge in Decorah as posted to the Upper Dam.

    ITEM 2.    Amend subrule 81.2(3) as follows:    81.2(3)   Walleye.    a.    West Okoboji, East Okoboji, Spirit, Upper Gar, Minnewashta, and Lower Gar Lakes in Dickinson County, Storm Lake in Buena Vista County, Clear Lake in Cerro Gordo County, and Big Creek Lake in Polk County.The daily bag limit shall be three, with a possession limit of six.    b.    Length limits.Length limits shall apply on walleye in public waters that have length limits posted or published.    c.    Mississippi River.A 15-inch minimum length limit shall apply. All walleye from 20 inches to 27 inches in length that are caught from Mississippi River Pools 12 through 20 must be immediately released alive. No more than one walleye greater than 27 inches in length may be taken per day from Pools 12 through 20.

    ITEM 3.    Amend subparagraph 81.2(4)"b" as follows:    (1)   There shall be an open season from February 41 through April 30.

    ITEM 4.    Amend subrule 81.2(5) as follows:    81.2(5)   Special trout regulations. A 14-inch minimum length limit shall apply on brown trout, rainbow trout, and brook trout in Spring Branch Creek, Delaware County, from the spring source to County Highway D5X as posted, and on brown trout only in portions of Bloody Run Creek, Clayton County, where posted. All trout caught from the posted portion of Waterloo Creek, Allamakee County, Hewitt and Ensign Creeks (Ensign Hollow), Clayton County, McLoud Run, Linn County, and South Pine Creek, Winneshiek County, and all brown trout caught from French Creek, Allamakee County, must be immediately released alive. Fishing in the posted area of Spring Branch Creek, Bloody Run Creek, Waterloo Creek, Hewitt and Ensign Creeks (Ensign Hollow), South Pine Creek, McLoud Run, and French Creek shall be by artificial lure only. Artificial lure means lures that do not contain or have applied to them any natural or synthetic substances designed to attract fish by the sense of taste or smell.Trout regulations. The department may post season, bag or possession limits, length limits, catch and release regulations, and tackle restrictions specific to a body of water at that body of water. On bodies of water posted as artificial lure only, “artificial lure” means lures that do not contain or have applied to them any natural or synthetic substances designed to attract fish by the sense of taste or smell. For bodies of water without posted regulations, the following regulations apply to trout:    a.    Open season is continuous.    b.    A five-fish daily bag limit and ten-fish possession limit shall apply to any combination of brown trout, brook trout, rainbow trout, and their hybrids.    c.    A trout fee is required to fish for and possess trout.
ARC 4914CNatural Resource Commission[571]Notice of Intended Action

Proposing rule making related to waterfowl hunting seasons and zones and providing an opportunity for public comment

    The Natural Resource Commission (Commission) hereby proposes to amend Chapter 91, “Waterfowl and Coot Hunting Seasons,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 455A.5(6), 481A.38, 481A.39 and 481A.48.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 481A.48.Purpose and Summary    Chapter 91 contains the regulations for hunting waterfowl and coot, and includes season dates, bag limits, possession limits, shooting hours, and areas open to hunting. The proposed amendments modify the waterfowl hunting zones and adjust the season dates to comply with what the Commission anticipates the 2021-2026 federal regulations will be after having met with the United States Fish and Wildlife Service (USFWS) in August 2019 at the Mississippi Flyway Council and reviewing the preliminary proposed regulations contained in the Federal Register (preliminary proposed in 84 Fed. Reg. 199, 55120-55129 (Oct. 15, 2019)).      More specifically, the season structure that the Department of Natural Resources (Department) is proposing uses the maximum number of days provided by the USFWS. These days are distributed across a wide range of season dates based on a waterfowl migration survey that the Department conducts each fall, an analysis of hunter participation and hunter satisfaction, and a 2019 waterfowl hunter opinion survey. Season dates differ between waterfowl hunting zones and allow for a period of rest before the regular duck seasons and the youth waterfowl hunting season.  Hunter surveys and comments show a wide range of preferences; therefore, the season structure offers a wide range of dates in an attempt to accommodate all hunting preferences.    The boundary modifications to the waterfowl hunting zones extend later season dates across southern Iowa in response to hunter interest, while maintaining early and mid-season hunting opportunities, particularly in central and northern Iowa.    The extension of the light goose conservation order is in response to hunter requests regarding the effect of particularly harsh weather during the spring of 2018, which precluded widespread hunting of light geese in northern Iowa until late April of that year.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. A copy of the fiscal impact statement is available from the Department upon request. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found. A copy of the jobs impact statement is available from the Department upon request.Waivers    This rule is subject to the waiver provisions of 571—Chapter 11. Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Commission for a waiver of the discretionary provisions, if any. Public Comment     Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 3, 2020. Comments should be directed to: Orrin Jones Department of Natural Resources 1203 North Shore Drive Clear Lake, Iowa 50428 Fax: 641.357.5523 Email: orrin.jones@dnr.iowa.govPublic Hearing     A public hearing at which persons may present their views orally or in writing will be held as follows. Upon arrival, attendees should proceed to the fourth floor to check in at the Department reception desk and be directed to the appropriate hearing location: March 3, 2020 12 noon to 1 p.m. Conference Room 5 East Wallace State Office Building 502 East Ninth Street Des Moines, Iowa     Persons who wish to make oral comments at the public hearing will be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.     Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend subrules 91.1(1) to 91.1(5) as follows:    .(1) Zone boundaries.  The following zone boundaries apply in the time frames noted:    a.    TheFor the 2020-2021 season, the north duck hunting zone is that part of Iowa north of a line beginning on the South Dakota-Iowa border at Interstate 29, southeast along Interstate 29 to State Highway 175, east to State Highway 37, southeast to State Highway 183, northeast to State Highway 141, east to U.S. Highway 30, and along U.S. Highway 30 to the Iowa-Illinois border. The Missouri River duck hunting zone is that part of Iowa west of Interstate 29 and south to the Iowa-Missouri border. The south duck hunting zone is the remainder of the state.    b.    For the fall 2021 through spring 2026 seasons, the north duck hunting zone is that part of Iowa north of a line beginning on the South Dakota-Iowa border at Interstate 29, southeast along Interstate 29 to State Highway 20 to the Iowa-Illinois border. The south duck hunting zone is that part of Iowa west of Interstate 29 and south of State Highway 92 east to the Iowa-Illinois border. The central duck hunting zone is the remainder of the state.    .(2) Season dates - north zone.      a.    For the 2020-2021 season.Special September teal season: September 1 through September 16. For all ducks: The first segment of the season will begin on the last Saturday in September and run for 7 days. The second segment of the season will open on the second Saturday in October and continue for 53 consecutive days.    b.    For the fall 2021 through spring 2026 seasons. Special September teal season: September 1 through September 16. For all ducks: The first segment of the season will begin on the Saturday nearest September 30 and run for 7 days. The second segment of the season will open on the Saturday nearest October 13 and continue for 53 consecutive days.    .(3) Season dates - southzone/central zone.      a.    For the 2020-2021 season - south zone.Special September teal season: September 1 through September 16. For all ducks: The first segment of the season will beginon the first Saturday in October and run for 7 days. The second segment of the season will open on the third Saturday in October and continue for 53 consecutive days.    b.    For the fall 2021 through spring 2026 seasons - central zone. Special September teal season: September 1 through September 16. For all ducks: The first segment of the season will begin on the Saturday nearest October 6 and run for 7 days. The second segment of the season will open on the Saturday nearest October 20 and continue for 53 consecutive days.    .(4) Season dates - Missouri Riverzone/south zone.      a.    For the 2020-2021 season - Missouri River zone.Special September teal season: September 1 through September 16. For all ducks: The first segment of the season will beginon the second Saturday in October and run for 7 days. The second segment of the season will openon the fourth Saturday in October and continue for 53 consecutive days.    b.    For the fall 2021 through spring 2026 seasons - south zone. Special September teal season: September 1 through September 16. For all ducks: The first segment of the season will begin on the Saturday nearest October 13 and run for 7 days. The second segment of the season will open on the Saturday nearest October 27 and continue for 53 consecutive days.    .(5) Bag limit.   Bag limitsfor all species other than scaup are as adopted by the U.S. Fish and Wildlife Service and published in the Federal Register.The daily bag limit for scaup will be 1 for the first 15 days of the duck hunting season and 2 for the remaining 45 days.

    ITEM 2.    Amend subrules 91.3(1) to 91.3(4) as follows:    .(1) Zone boundaries.  The following zone boundaries apply in the time frames noted:    a.    TheFor the 2020-2021 season, the north goose hunting zone is that part of Iowa north of a line beginning on the South Dakota-Iowa border at Interstate 29, southeast along Interstate 29 to State Highway 175, east to State Highway 37, southeast to State Highway 183, northeast to State Highway 141, east to U.S. Highway 30, and along U.S. Highway 30 to the Iowa-Illinois border. The Missouri River goose hunting zone is that part of Iowa west of Interstate 29 and south to the Iowa-Missouri border. The south goose hunting zone is the remainder of the state.    b.    Effective fall 2021 through spring 2026, the north goose hunting zone is that part of Iowa north of a line beginning on the South Dakota-Iowa border at Interstate 29, southeast along Interstate 29 to State Highway 20 to the Iowa-Illinois border. The south duck hunting zone is that part of Iowa west of Interstate 29 and south of State Highway 92 east to the Iowa-Illinois border. The central duck hunting zone is the remainder of the state.    .(2) Season dates - north zone.      a.    For the 2020-2021 season. For all geese: The first segment of the regular goose season will beginon the second-to-last Saturday of September and run for a 16-day period. The second segment of the goose season will openon the second Saturday in October and continue for 53 consecutive days. The goose season will then close for a 10-day period and shall then reopen on the following Saturday and remain continuously open until the total number of days used for goose hunting reaches 107.    b.    For the fall 2021 through spring 2026 seasons. For all geese: The first segment of the regular goose season will begin on the Saturday nearest September 23 and run for a 16-day period. The second segment of the goose season will open on the Saturday nearest October 13 and continue for 53 consecutive days. The goose season will reopen on the Saturday nearest December 13 and remain continuously open until the total number of days used for goose hunting reaches 107.    .(3) Season dates - southzone/central zone.      a.    For the 2020-2021 season - south zone. For all geese: The first segment of the regular goose season will beginon the last Saturday of September and run for a 16-day period. The second segment of the goose season will openon the third Saturday in October and continue for 53 consecutive days. The goose season will then close for a 10-day period and shall then reopen on the following Saturday and remain continuously open until the total number of days used for goose hunting reaches 107.    b.    For the fall 2021 through spring 2026 seasons - central zone. For all geese: The first segment of the regular goose season will begin on the Saturday nearest September 30 and run for a 16-day period. The second segment of the goose season will open on the Saturday nearest October 20 and continue for 53 consecutive days. The goose season will reopen on the Saturday nearest December 20 and remain continuously open until the total number of days used for goose hunting reaches 107.    .(4) Season dates - Missouri Riverzone/south zone.      a.    For the 2020-2021 season - Missouri River zone. For all geese: The first segment of the regular goose season will beginon the first Saturday of October and run for a 16-day period. The second segment of the goose season will openon the fourth Saturday in October and continue for 53 consecutive days. The goose season will then close for a 10-day period and shall then reopen on the following Saturday and remain continuously open until the total number of days used for goose hunting reaches 107.    b.    For the fall 2021 through spring 2026 seasons - south zone. For all geese: The first segment of the regular goose season will begin on the Saturday nearest October 6 and run for a 16-day period. The second segment of the goose season will open on the Saturday nearest October 27 and continue for 53 consecutive days. The goose season will reopen on the Saturday nearest December 27 and remain continuously open until the total number of days used for goose hunting reaches 107.

    ITEM 3.    Amend subrule 91.3(8), introductory paragraph, as follows:    91.3(8) Light goose conservation order season.  Only light geese (white and blue-phase snow geese and Ross’ geese) may be taken under a conservation order from the U.S. Fish and Wildlife Service beginning the day after the regular goose season closes and continuing until April 15May 1.
ARC 4921CNatural Resource Commission[571]Notice of Intended Action

Proposing rule making related to restitution for pollution causing injury to wild animals and providing an opportunity for public comment

    The Natural Resource Commission (Commission) hereby proposes to amend Chapter 113, “Restitution for Pollution Causing Injury to Wild Animals,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 455A.5(6) and 481A.151.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 455A.5(6) and 481A.151.Purpose and Summary    Iowa Code section 481A.151 authorizes the Commission to adopt rules incorporating the methods and values published by the American Fisheries Society (AFS) for use by the Department of Natural Resources (Department) when conducting fish kill counts and assessing restitution for damages to the state’s natural resources and wildlife. The Commission has done so in Chapter 113. The proposed amendment would update the definition of “AFS” in 571—113.2(481A) by changing “Special Publication 30” to “Special Publication 35.” Special Publication 35 is the most current version of the AFS publication regarding fish and freshwater mollusk counting methods and restitution valuation. The alternative of not adopting the newest version of the AFS publication would require the Department to use a document that is no longer considered the best available publication for these purposes.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. A copy of the fiscal impact statement is available from the Department upon request. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found. A copy of the jobs impact statement is available from the Department upon request.Waivers    This rule is subject to the waiver provisions of 571—Chapter 11. Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Commission for a waiver of the discretionary provisions, if any. Public Comment     Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Commission no later than 4:30 p.m. on March 5, 2020. Comments should be directed to: Joe Larscheid Iowa Department of Natural Resources Wallace State Office Building 502 East Ninth Street Des Moines, Iowa 50319 Fax: 515.725.8201 Email: fisheries@dnr.iowa.govPublic Hearing     Five public hearings at which persons may present their views orally or in writing will be held as follows: March 5, 2020 12 noon to 2 p.m. Wallace State Office Building Conference Room 4E Des Moines, Iowa March 5, 2020 12 noon to 2 p.m. Spirit Lake Hatchery Conference Room 122 252nd Avenue Spirit Lake, Iowa March 5, 2020 12 noon to 2 p.m. Cold Springs District Office Conference Room 57744 Lewis Road Lewis, Iowa March 5, 2020 12 noon to 2 p.m. Manchester Hatchery Conference Room 22693 205th Avenue Manchester, Iowa March 5, 2020 12 noon to 2 p.m. Lake Darling District Office Conference Room 110 Lake Darling Road Brighton, Iowa     Persons who wish to make oral comments at a public hearing will be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.     Any persons who intend to attend a hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making action is proposed:

    ITEM 1.    Amend rule 571—113.2(481A), definition of “AFS,” as follows:        "AFS" means the Special Publication 3035, “Investigation and Monetary Values of Fish and Freshwater MusselMollusk Kills,” published by the American Fisheries Society.
ARC 4917CProfessional Licensure Division[645]Notice of Intended Action

Proposing rule making related to licensure reactivation and providing an opportunity for public comment

    The Board of Physical and Occupational Therapy hereby proposes to amend Chapter 200, “Licensure of Physical Therapists and Physical Therapist Assistants,” and Chapter 206, “Licensure of Occupational Therapists and Occupational Therapy Assistants,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 147.76 and 272C.2.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapters 148A and 148B.Purpose and Summary    This proposed rule making amends the Board’s requirements for license reactivation by accepting verification from another state or jurisdiction that shows two years of active practice, consisting of a minimum of 2,080 hours, in another state or jurisdiction preceding application for reactivation in lieu of completing continuing education. Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    A waiver provision is not included in this rule making because all administrative rules of the professional licensure boards in the Professional Licensure Division are subject to the waiver provisions accorded under 645—Chapter 18.Public Comment     Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Board no later than 4:30 p.m. on March 4, 2020. Comments should be directed to: Venus A. Vendoures Walsh Professional Licensure Division Iowa Department of Public Health Lucas State Office Building 321 East 12th Street Des Moines, Iowa 50319 Email: venus.vendoures-walsh@idph.iowa.govPublic Hearing     A public hearing at which persons may present their views orally or in writing will be held as follows: March 4, 2020 9:30 to 10 a.m. Fifth Floor Conference Room 526 Lucas State Office Building Des Moines, Iowa     Persons who wish to make oral comments at the public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making. In an effort to ensure accuracy in memorializing a person’s comments, a person may provide written comments in addition to or in lieu of oral comments at the hearing.     Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Board and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend subrule 200.15(3) as follows:    200.15(3)   Provide verification of current competence to practice physical therapy by satisfying one of the following criteria:    a.    If the license has been on inactive status for five years or less, an applicant must provide the following:    (1)   Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification from a jurisdiction’s board office if the verification includes:
  1. Licensee’s name;
  2. Date of initial licensure;
  3. Current licensure status; and
  4. Any disciplinary action taken against the license; and
    (2)   Verification of completion of 20 hours of continuing education for a physical therapy assistant and 40 hours of continuing education for a physical therapist within two years of application for reactivation; or verification of active practice, consisting of a minimum of 2,080 hours, in another state or jurisdiction during the two years preceding an application for reactivation.
    b.    If the license has been on inactive status for more than five years, an applicant must provide the following:    (1)   Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification from a jurisdiction’s board office if the verification includes:
  1. Licensee’s name;
  2. Date of initial licensure;
  3. Current licensure status; and
  4. Any disciplinary action taken against the license; and
    (2)   Verification of completion of 40 hours of continuing education for a physical therapy assistant and 80 hours of continuing education for a physical therapist within two years of application for reactivation;verification of active practice, consisting of a minimum of 2,080 hours, in another state or jurisdiction during the two years preceding an application for reactivation; or evidence of successful completion of the professional examination required for initial licensure completed within one year prior to the submission of an application for reactivation.

    ITEM 2.    Amend subrule 206.11(3) as follows:    206.11(3)   Provide verification of current competence to practice occupational therapy by satisfying one of the following criteria:    a.    If the license has been on inactive status for five years or less, an applicant must provide the following:    (1)   Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification from a jurisdiction’s board office if the verification includes:
  1. Licensee’s name;
  2. Date of initial licensure;
  3. Current licensure status; and
  4. Any disciplinary action taken against the license; and
    (2)   Verification of completion of 15 hours of continuing education for an occupational therapy assistant and 30 hours of continuing education for an occupational therapist within two years of application for reactivation; or verification of active practice, consisting of a minimum of 2,080 hours, in another state or jurisdiction during the two years preceding an application for reactivation.
    b.    If the license has been on inactive status for more than five years, an applicant must provide the following:    (1)   Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification from a jurisdiction’s board office if the verification includes:
  1. Licensee’s name;
  2. Date of initial licensure;
  3. Current licensure status; and
  4. Any disciplinary action taken against the license; and
    (2)   Verification of completion of 30 hours of continuing education for an occupational therapy assistant and 60 hours of continuing education for an occupational therapist within two years of application for reactivation;verification of active practice, consisting of a minimum of 2,080 hours, in another state or jurisdiction during the two years preceding an application for reactivation; or evidence of successful completion of the professional examination required for initial licensure completed within one year prior to the submission of an application for reactivation.
ARC 4913CProfessional Licensure Division[645]Notice of Intended Action

Proposing rule making related to child abuse and dependent adult abuse identification and reporting training and providing an opportunity for public comment

    The Board of Speech Pathology and Audiology hereby proposes to amend Chapter 300, “Licensure of Speech Pathologists and Audiologists,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 272C.2, 232.69(3)“e” and 235B.16(5)“f.”State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 232.69 and 235B.16.Purpose and Summary    2019 Iowa Acts, House File 731, amended Iowa Code sections 232.69 and 235B.16, which govern mandatory training in child and dependent adult abuse identification and reporting for certain professionals. This proposed rule making amends the Board’s requirements for mandatory training in child and dependent adult abuse identification and reporting to reflect the statutory changes and requires that licensees who must report child or dependent adult abuse comply with the requirements for training every three years, as provided in the amended Iowa Code sections 232.69 and 235B.16. This proposed rule making also updates subrule 300.11(4) to correct a reference to a rescinded chapter.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    A waiver provision is not included in this rule making because all administrative rules of the professional licensure boards in the Professional Licensure Division are subject to the waiver provisions accorded under 645—Chapter 18.Public Comment     Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Board no later than 4:30 p.m. on March 3, 2020. Comments should be directed to: Venus A. Vendoures Walsh Professional Licensure Division Iowa Department of Public Health Lucas State Office Building 321 East 12th Street Des Moines, Iowa 50319 Email: venus.vendoures-walsh@idph.iowa.govPublic Hearing     A public hearing at which persons may present their views orally or in writing will be held as follows: March 4, 2020 9 to 9:30 a.m. Fifth Floor Board Conference Room 526 Lucas State Office Building Des Moines, Iowa     Persons who wish to make oral comments at the public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making. In an effort to ensure accuracy in memorializing a person’s comments, a person may provide written comments in addition to or in lieu of oral comments at the hearing.     Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Board and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making action is proposed:

    ITEM 1.    Amend subrule 300.11(4) as follows:    300.11(4)   Mandatory reporter training requirements.    a.    A licensee who, in the scope of professional practice or in the licensee’s employment responsibilities, examines, attends, counsels or treats children in Iowa shall indicate on the renewal application completion of two hours of training in child abuse identification and reportingas required by Iowa Code section 232.69(3)“b” in the previous fivethree years or condition(s) for waiver of this requirementsrequirement as identified in paragraph “f.”300.11(4)“e.”    b.    A licensee who, in the course of employment, examines, attends, counsels or treats adults in Iowa shall indicate on the renewal application completion of two hours of training in dependent adult abuse identification and reportingas required by Iowa Code section 235B.16(5)“b” in the previous fivethree years or condition(s) for waiver of this requirement as identified in paragraph “f.”300.11(4)“e.”    c.    A licensee who, in the scope of professional practice or in the course of employment, examines, attends, counsels or treats both adults and children in Iowa shall indicate on the renewal application completion of training in abuse identification and reporting for dependent adults and children in the previous five years or condition(s) for waiver of this requirement as identified in paragraph “f.”    d.    c.    Training may be completed through separate courses as identified in paragraphs “a” and “b” or in one combined two-hour course that includes curricula for identifying and reporting child abuse and dependent adult abuse. The coursecourse(s) shall be athe curriculum approvedprovided by the Iowa department of public health abuse education review panelhuman services.    e.    d.    The licensee shall maintain written documentation for fivethree years after mandatory training as identified in paragraphs “a” to “c,”300.11(4)“a” and “b,” including program date(s), content, duration, and proof of participation.    f.    e.    The requirement for mandatory training for identifying and reporting child and dependent adult abuse shall be suspended if the board determines that suspension is in the public interest or that a person at the time of license renewal:    (1)   Is engaged in active duty in the military service of this state or the United States.    (2)   Holds a current waiver by the board based on evidence of significant hardship in complying with training requirements, including an exemption of continuing education requirements or extension of time in which to fulfill requirements due to a physical or mental disability or illness as identified in 645—Chapter 303rule 645—4.14(272C).    g.    f.    The board may select licensees for audit of compliance with the requirements in paragraphs “a”300.11(4)“a” to “f.”“e.”
ARC 4915CRevenue Department[701]Notice of Intended Action

Proposing rule making related to exemption of sales and use tax for grain bins and providing an opportunity for public comment

    The Revenue Department hereby proposes to amend Chapter 226, “Agricultural Rules,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code section 421.14.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 423.3 as amended by 2019 Iowa Acts, House File 779.Purpose and Summary    During the 2019 Legislative Session, the General Assembly added a new exemption from sales and use tax: “The sales price from the sale of a grain bin, including material or replacement parts used to construct or repair a grain bin.” The exemption defines a “grain bin” as “property that is vented and covered with corrugated metal or similar material, and that is primarily used to hold loose grain for drying or storage.”     Item 2 sets forth a general explanation of what materials will be taxable or exempt under the exemption and then provides a nonexhaustive list of items commonly used to construct a grain bin or sold in conjunction with a grain bin. The proposed rule also explains how entities may claim the exemption. Item 1 amends a current rule to note that cement and concrete are exempt if used in accordance with the new rule proposed in Item 2.     The Department solicited feedback on an initial draft of these proposed amendments with a wide variety of stakeholders, including grain bin manufacturers, retailers, contractors, and others interested in the exemption. The Department made several changes, reflected in this rule making, in response to the comments received.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa beyond the impact of 2019 Iowa Acts, House File 779. The Legislative Services Agency’s fiscal note for House File 779 estimated a reduction in General Fund revenue of $5.2 million in FY 2020, increasing to $5.8 million in FY 2024. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 701—7.28(17A). Public Comment     Any interested person may submit written or oral comments concerning this proposed rule making. Written or oral comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 3, 2020. Comments should be directed to: Tim Reilly Department of Revenue Hoover State Office Building P.O. Box 10457 Des Moines, Iowa 50306 Phone: 515.725.2294 Email: tim.reilly@iowa.govPublic Hearing     A public hearing at which persons may present their views orally or in writing will be held as follows: March 3, 2020 9 to 10 a.m. Room 430, Fourth Floor Hoover State Office Building Des Moines, Iowa     Persons who wish to make oral comments at the public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.     Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend subrule 226.19(4) as follows:    226.19(4) Taxable even if used in agricultural production.  additiveslubricants and fluidsair compressorslumber * air conditioners, unless a replacement part for exempt machinery marking chalkair tanksmopsantifreezemotor oilsaxesnailsbarn cleaner, permanent office suppliesbasketsoxygenbelt dressing packing room suppliesbins, permanent ^ paint and paint sprayersbrooms pliersbuckets posthole diggers, hand toolbuilding materials * and suppliespoultry brooders, permanentburlap cleanerspoultry feeders, permanentcattle feeders, permanentpoultry nests, permanentcement # pruning toolschain sawspumps for household or lawn usecleaning brushesradios, unless a replacement part for exempt machinerycleansing agents and materialsrefrigerators for home usecomputers (including laptop), for personal userepair toolscomputer software road maintenance equipmentconstruction toolsroad scraperconcrete # roofingconveyors, permanentsanderscow ties, permanentscrapersear tagsscrewdriversfence, posts, wire, permanentshinglesfield toiletsshovelsfire prevention equipmentsilosfreonsnow fence unless portable and used directly in dairy and livestock productionfuel additivessnow plows and snow equipmentfuel tanks and pumpsspace heaters, permanentgarden hoses and rakesspecialized flooring, permanentglasssprinklers, permanentgrain bins and tanks, permanent *^ stalls, permanentgreasestaplesgrease gunsstanchions, permanenthammersstorage tankshog ringstarpshydraulic fluidstiling machinery and equipmenthypodermic syringes, disposabletractors, gardenlampswelderslanternswheel barrowslight bulbs (for household use)wrenches * The buyer of building materials is responsible for paying sales tax or use tax on those materials, including materials to construct grain bins. The buyer is the person who pays the vendor.Contractors and sponsors that purchase building materials, other than grain bin materials, are responsible for paying sales tax to the vendor or supplier or accruing and remitting use tax on those materials. ^ Does not include bins or grain tanks used to hold loose grain for drying or storage. # Does not include cement or concrete used in pads or foundations under grain bins.

    ITEM 2.    Adopt the following new rule 701—226.20(423):

701—226.20(423) Grain bins.  The Iowa Code exempts from sales and use tax the sales price from the sale of a grain bin, including material or replacement parts used to construct or repair a grain bin. “Grain bin” is defined by Iowa Code section 423.3(16A). Grain bins are real property, and grain bin materials are building materials as that term is used in rule 701—219.3(423).     226.20(1) Property considered to be a grain bin or material used to construct a grain bin.  In general, materials that are permanently attached to a grain bin and are required to hold loose grain for drying or storage are used to construct a grain bin and thus exempt from sales and use tax. This generally does not include equipment used to move loose grain into or out of a grain bin. The following lists of exempt or taxable property are not exhaustive.    a.    Exempt property:    (1)   Grain bins, including hopper bins.     (2)   Corrugated metal or other similar material for the sides or roof of a grain bin.     (3)   Bolts and other builders’ hardware.    (4)   Steps, ladders, or staircases affixed to a grain bin providing access to a grain bin.    (5)   Structural support towers for a grain bin or for steps, ladders, or staircases providing access to a grain bin.     (6)   Catwalks primarily used to allow a person to walk from one grain bin to another.     (7)   Roof vents affixed to a grain bin.     (8)   Grain bin flooring and floor supports.     (9)   Concrete pad or foundation under a grain bin.     (10)   Stirring equipment affixed in a grain bin.    (11)   Fans affixed in a grain bin.    (12)   Temperature sensors or temperature cables affixed in a grain bin.     (13)   Spreaders affixed in a grain bin.     (14)   Sweeps or augers affixed in a grain bin to move loose grain to, from, or out of a grain bin.     (15)   Controls and devices to operate the above-listed property.    (16)   Motors for the above-listed property.     (17)   Replacement parts for the above-listed property.    b.    Taxable property:    (1)   Bucket elevators.    (2)   Distributors.    (3)   Receiving stations, including drag conveyors and dump pits.     (4)   Pneumatic or air systems.     (5)   Conveyors, including chain conveyors, belt conveyors, and drag conveyors.     (6)   Anchors, bin jacks, or other construction equipment used to assemble, construct, repair, or replace a grain bin or part of a grain bin.     (7)   Samplers.    (8)   Scales or weighers.     226.20(2) Primarily used to hold loose grain for drying or storage.  Property is deemed to be “primarily used to hold loose grain for drying or storage” if it is used more than 50 percent of the time to hold loose grain for drying or storage.    226.20(3) Claiming the exemption.      a.    A sponsor of a grain bin, grain bin materials, or grain bin replacement parts shall provide an exemption certificate to the contractor of the property to purchase the property exempt from sales or use tax.     b.    A contractor may provide an exemption certificate to a supplier when purchasing a grain bin, grain bin materials, or grain bin replacement parts. The contractor would accrue consumer’s use tax on the purchase price of those grain bin materials unless the contractor obtains an exemption certificate from the sponsor. If the grain bin materials are not used in an exempt manner and if an exemption certificate is not obtained, it is the contractor’s responsibility to accrue and remit use tax. The contractor should not charge sales tax to a sponsor of grain bin materials used in a nonexempt manner because those materials remain building materials used in the performance of a construction contract.        This rule is intended to implement Iowa Code section 423.3.
ARC 4916CRevenue Department[701]Notice of Intended Action

Proposing rule making related to sales tax exemption excluding persons who are “primarily engaged” in certain activities and providing an opportunity for public comment

    The Revenue Department hereby proposes to amend Chapter 230, “Exemptions Primarily Benefiting Manufacturers and Other Persons Engaged in Processing,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code section 421.14.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 423.3 as amended by 2019 Iowa Acts, House File 779.Purpose and Summary    The 2019 Iowa Code provides a sales tax exemption for manufacturers. That exemption excludes persons who “are not commonly understood” to be manufacturers, and excludes a person who engages in any one of five listed activities.     2019 Iowa Acts, House File 779, amends that provision to exclude persons who are “primarily engaged” in one of those five activities. This proposed rule making offers guidance to taxpayers as to how a person is “primarily engaged” in one of those activities and provides several examples of how the provision will be applied.     The Department shared this provision with various interested stakeholders and made several changes prior to the publication of this proposed rule making. Fiscal Impact     This rule making has no fiscal impact to the State of Iowa beyond that of 2019 Iowa Acts, House File 779, for which there is an estimated reduction in General Fund revenues of $200,000 in FY 2020 and each year thereafter. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 701—7.28(17A). Public Comment    Any interested person may submit written or oral comments concerning this proposed rule making. Written or oral comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 3, 2020. Comments should be directed to: Tim Reilly Department of Revenue Hoover State Office Building P.O. Box 10457 Des Moines, Iowa 50306 Phone: 515.725.2294 Email: tim.reilly@iowa.govPublic Hearing     No public hearing is scheduled at this time. As provided in Iowa Code section 17A.4(1)“b,” an oral presentation regarding this rule making may be demanded by 25 interested persons, a governmental subdivision, the Administrative Rules Review Committee, an agency, or an association having 25 or more members. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making action is proposed:

    ITEM 1.    Adopt the following new paragraph 230.15(4)"c":    c.    Primarily engaged in an excluded activity.A person is not considered a manufacturer if the person is “primarily engaged” in any of the activities listed in Iowa Code section 423.3(47)“d”(4)(c). A person is “primarily engaged” in an activity if the person generates more than 50 percent of the person’s gross revenue from its operating business from, or spends more than 50 percent of the person’s time engaging in, any combination of those activities during the 12-month period after the date the person engages in one of the listed activities.
ARC 4895CTransportation Department[761]Notice of Intended Action

Proposing rule making related to updates to federal regulations and providing an opportunity for public comment

    The Department of Transportation hereby proposes to amend Chapter 520, “Regulations Applicable to Carriers,” Chapter 529, “For-Hire Interstate Motor Carrier Authority,” and Chapter 607, “Commercial Driver Licensing,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 307.12, 321.188, 321.449 and 321.450.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 307.27, 321.188, 321.449 and 321.450.Purpose and Summary    The proposed amendments are part of the regular, annual update by the Department to adopt the most recent updates to the federal regulations published by the Federal Motor Carrier Safety Administration (FMCSA) and the Pipeline and Hazardous Materials Safety Administration (PHMSA).      Iowa Code section 321.188 requires the Department to adopt rules to administer commercial driver’s licenses in compliance with certain portions of 49 Code of Federal Regulations (CFR) Part 383.    Iowa Code section 321.449 requires the Department to adopt rules consistent with the Federal Motor Carrier Safety Regulations (FMCSR) promulgated under United States Code, Title 49, and found in 49 CFR Parts 385 and 390 to 399.      Iowa Code section 321.450 requires the Department to adopt rules consistent with the Federal Hazardous Materials Regulations (HMR) promulgated under United States Code, Title 49, and found in 49 CFR Parts 107, 171 to 173, 177, 178 and 180.    Commercial vehicles transporting goods in interstate commerce are subject to the FMCSR on the effective dates specified in the Federal Register (FR). Commercial vehicles transporting hazardous materials in interstate commerce or transporting certain hazardous materials intrastate are subject to the HMR on the effective dates specified in the FR.  The adoption of the federal regulations by the Department will extend the enforcement of the regulations to commercial vehicles operated intrastate unless exempted by statute.    The proposed amendments to Chapter 520 adopt the current CFR dated October 1, 2019, for 49 CFR Parts 107, 171, 172, 173, 177, 178, 180, 385 and 390 to 399.    The proposed amendment to Chapter 529 adopts the current CFR dated October 1, 2019, for 49 CFR Parts 365 to 368 and 370 to 379.    The proposed amendment to Chapter 607 adopts the current CFR dated October 1, 2019, for certain portions of 49 CFR Part 383.    Proposed federal regulations are published in the FR to allow a period for public comment, and after adoption, the final regulations are published in the FR.    To ensure the consistency required by statute, the Department adopts the specified parts of 49 CFR as adopted by the United States Department of Transportation.    The following paragraphs provide a specific description of the amendments to the FMCSR and the HMR that have become final and effective since the 2018 edition of the CFR and that affect Chapters 520, 529 and 607:    Amendments to the FMCSR and Federal HMR    Parts 171-173, 178 and 180 (FR Vol. 83, No. 216, Pages 55792-55811, 11-7-18)    This final rule amends the HMR in response to 19 petitions for rule making submitted by the regulated community to update, clarify, streamline, or provide relief from various HMR.  By adopting these deregulatory amendments, the PHMSA is allowing more efficient and effective ways of transporting hazardous materials in commerce while maintaining an equivalent level of safety. Effective date:  December 7, 2018.    Parts 107 and 171 (FR Vol. 83, No. 228, Pages 60733-60754, 11-27-18)    This final rule amends the HMR in accordance with the Federal Civil Penalties Inflation Adjustment Act to apply the 2018 inflation adjustment to civil penalty amounts.  A civil penalty may be imposed under federal law on persons violating federal Department of Transportation regulations, including persons who knowingly violate the HMR. Effective date:  November 27, 2018.    Part 390 (FR Vol. 83, No. 233, Pages 62505-62508, 12-4-18)    This final rule extends the compliance date of the May 27, 2015, final rule titled “Lease and Interchange of Vehicles; Motor Carriers of Passengers,” from January 1, 2019, to January 1, 2021.  This extension of the compliance date was necessary to provide the FMCSA time to consider all comments raised regarding this rule making.  Effective date:  January 1, 2021.    Part 383 (FR Vol. 83, No. 245, Pages 65564-65571, 12-21-18)    This final rule amends FMCSA regulations to allow states the option of issuing a commercial learner’s permit (CLP) with an expiration date of up to one year from the date of initial issuance. This rule making simply codifies an exemption previously granted by FMCSA to state driver’s licensing agencies allowing them to issue a CLP with an expiration date of one year. Effective date:  February 19, 2019.     Part 367 (FR Vol. 83, No. 248, Pages 67124-67131, 12-28-18)    This final rule amends FMCSA regulations to reduce the annual registration fees collected from motor carriers, motor private carriers of property, brokers, freight forwarders, and leasing companies for the Unified Carrier Registration Plan and Agreement for the registration years 2019, 2020 and thereafter as set forth in the regulation. Effective date:  December 28, 2018.     Part 107 (FR Vol. 84, No. 31, Pages 3993-4001, 02-14-19)    This final rule amends the HMR to align with the federal Office of Management and Budget’s uniform administrative requirements, cost principles and audit requirements for federal grants, including the hazardous materials grants program and the hazardous materials emergency preparedness grant. Effective date:  March 18, 2019.     Part 385 (FR Vol. 84, No. 130, Pages 32323-32326, 07-08-19)    This final rule revises FMCSA regulations relating to hazardous material safety permits to incorporate by reference the April 1, 2018, edition of the Commercial Vehicle Safety Alliance’s guidance related to out-of-service criteria for commercial highway vehicles transporting transuranic (uranium) materials and highway route-controlled quantities of radioactive materials. The out-of-service criteria provide uniform enforcement tolerances for roadside inspections to enforcement personnel nationwide.  Effective date:  July 8, 2019.     Part 383 (FR Vol. 84, No. 141, Pages 35335-35339, 07-23-19)    This final rule amends FMCSA regulations to revise the list of offenses permanently disqualifying a person from operating a commercial motor vehicle to include a felony conviction for using a commercial motor vehicle while committing an offense involving a severe form of human trafficking. This regulation change will also require a change to the list of disqualifying offenses in Iowa Code section 321.208 to implement the requirement, and the Department is proposing to amend that Code section during the 2020 Iowa Legislative Session. Effective date:  September 23, 2019.  Compliance date:  September 23, 2022.     Parts 107 and 171 (FR Vol. 84, No. 147, Pages 37059-37079, 07-31-19)    This final rule amends the HMR in accordance with the Federal Civil Penalties Inflation Adjustment Act to apply the 2019 inflation adjustment to civil penalty amounts.  A civil penalty may be imposed under federal law on persons violating federal Department of Transportation regulations, including persons who knowingly violate the HMR. Effective date: July 31, 2019.     Part 390 (FR Vol. 84, No. 157, Pages 40272-40296, 08-14-19)    This final rule narrows the applicability of the May 27, 2015, final rule titled “Lease and Interchange of Vehicles; Motor Carriers of Passengers,” by excluding certain contracts and other agreements between motor carriers of passengers that have active passenger carrier operating authority registrations with FMCSA from the definition of “lease” and the associated regulatory requirements.  For passenger carriers that remain subject to the leasing and interchange requirements, FMCSA returns the bus marking requirement to its July 1, 2015, requirement, but with the slight modification to add references to leased vehicles.  FMCSA also revises the exception for the delayed writing of a lease during certain emergencies and removes the 24-hour lease notification requirement from the regulations.  Effective date:  October 15, 2019.    Part 395 (FR Vol. 84, No. 177, Pages 48077-48081, 09-12-19)    This final rule amends FMCSA regulations applicable to restart provisions for hours of service of drivers of property-carrying commercial motor vehicles.  The amendments removed provisions requiring that a 34-hour restart include two periods between 1 a.m. and 5 a.m. and limiting use of restart to once every 168 hours. In a series of federal appropriations acts, Congress suspended these provisions, pending completion of a study comparing the effects of the restart provisions both prior to and after the regulation change. The study found that there were no statistically significant benefits from the restart rule, and thus, the rules were voided by Congress.  This amendment merely removes the voided requirement from the regulations.  Effective date:  September 12, 2019.    Parts 365, 380, 382, 383, 385, 387, 389, 391, 392, 395 and 396 (FR Vol. 84, No. 189, Pages 51427-51435, 09-30-19)    This final rule amends FMCSA regulations by making technical changes to correct inadvertent errors and omissions, remove or update obsolete references, and improve the clarity and consistency of certain regulatory provisions.  Effective date:  September 30, 2019.     Fiscal Impact     The fiscal impact statement cannot be determined. The federal regulations proposed to be adopted by this rule making were subject to fiscal impact review by either the Federal Motor Carrier Safety Administration or the Pipeline and Hazardous Materials Safety Administration when the regulations were enacted and were determined not to be cost-prohibitive. Jobs Impact    The proposed amendments may have a slight impact on motor carrier operations. However, the amendments should not negatively impact jobs or employment opportunities because the amendments align the rules to federal regulations and bring uniformity and consistency to the industry, which should have a positive impact on employment. Waivers    Various portions of the federal regulations and Iowa statutes allow some exceptions when the exceptions will not adversely impact the safe transportation of commodities on the nation’s highways. Granting additional exceptions for drivers and the motor carrier industry in Iowa would adversely impact the safety of the traveling public in Iowa. Public Comment     Any interested person may submit written comments concerning this proposed rule making or may submit a written request to make an oral presentation at a public hearing. Written comments or requests to present oral comments in response to this rule making must be received by the Department no later than 4:30 p.m. on March 3, 2020. Comments should be directed to: Tracy George Department of Transportation DOT Rules Administrator, Strategic Communications and Policy Bureau 800 Lincoln Way Ames, Iowa 50010 Email: tracy.george@iowadot.usPublic Hearing    If requested, a public hearing to hear requested oral presentations will be held as follows: March 5, 2020 10 a.m. Department of Transportation Motor Vehicle Division 6310 SE Convenience Boulevard Ankeny, Iowa     Persons who wish to make oral comments at the public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.     Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact Tracy George, the Department’s rules administrator, and advise of specific needs.     The public hearing will be canceled without further notice if no oral presentation is requested. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    ITEM 1.    Amend paragraph 520.1(1)"a" as follows:    a.    Motor carrier safety regulations.The Iowa department of transportation adopts the Federal Motor Carrier Safety Regulations, 49 CFR Parts 385 and 390-399 (October 1, 20182019).

    ITEM 2.    Amend paragraph 520.1(1)"b" as follows:    b.    Hazardous materials regulations.The Iowa department of transportation adopts the Federal Hazardous Materials Regulations, 49 CFR Parts 107, 171-173, 177, 178, and 180 (October 1, 20182019).

    ITEM 3.    Amend rule 761—520.5(321) as follows:

761—520.5(321) Safety fitness.      520.5(1) New motor carrier safety audits.  Peace officers in the office of motor vehicle enforcement of the Iowa department of transportation shall perform safety audits of new motor carriers and shall have the authority to enter a motor carrier’s place of business for the purpose of performing these audits. These audits shall be performed in compliance with 49 CFR Part 385 and shall be completed within 18 months from the day the motor carrier commences business.    520.5(2) Motor carrier compliance reviews.  Peace officers in the office of motor vehicle enforcement of the Iowa department of transportation shall perform compliance reviews of motor carriers and shall have the authority to enter a motor carrier’s place of business for the purpose of performing these compliance reviews. These compliance reviews shall be performed in compliance with 49 CFR Part 385.       This rule is intended to implement Iowa Code sections 321.449 and 321.450.

    ITEM 4.    Amend rule 761—529.1(327B) as follows:

761—529.1(327B) Motor carrier regulations.  The Iowa department of transportation adopts the Code of Federal Regulations, 49 CFR Parts 365-368 and 370-379, dated October 1, 20182019, for regulating interstate for-hire carriers.Copies of this publication are available from the state law library or through the Internet at www.fmcsa.dot.gov.

    ITEM 5.    Amend paragraph 607.10(1)"c" as follows:    c.    The following portions of 49 CFR Part 383 (October 1, 20182019):    (1)   Section 383.51, Disqualification of drivers.    (2)   Subpart E—Testing and Licensing Procedures.    (3)   Subpart G—Required Knowledge and Skills.    (4)   Subpart H—Tests.
ARC 4929CAuditor of State[81]Adopted and Filed

Rule making related to amending fee schedules

    The Auditor of State hereby amends Chapter 21, “Filing Fees,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 11.6.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 11.6.Purpose and Summary    This rule making amends the fee schedules for approximately 600 Iowa municipalities with populations under 2,000 and budgeted expenditures of less than $1 million. The municipalities are subject to periodic examinations by the Auditor pursuant to Iowa Code section 11.6. Each city is assessed an annual fee based on its annual budget. The Auditor is changing the fee schedule to allocate costs more equitably. One change from the Notice has been made to strike the word “budgeted” in subrule 21.2(1) for clarification.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on December 4, 2019, as ARC 4787C. No public comments were received. Adoption of Rule Making    This rule making was adopted by the Auditor of State on January 13, 2020.Fiscal Impact    The revised fee schedule will increase the amount of fees collected by the Auditor by approximately $20,000 annually. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Office of Auditor of State for a waiver of the discretionary provisions, if any.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on April 1, 2020.    The following rule-making action is adopted:

    ITEM 1.    Amend rule 81—21.2(11) as follows:

81—21.2(11) Periodic examination fee.  A periodic examination fee, as provided for under 2012 Iowa Acts, chapter 1107, section 2Iowa Code section 11.6(11), shall be paid annually by cities that do not otherwise have an audit or fiscal year examination conducted pursuant to Iowa Code section 11.6, subsection 1 or subsection 3, during a fiscal year.    21.2(1)   The fee shall be remitted according to a fee schedule using fourfive strata based on the budgetedaverage of actual expenditures of the original certified budget of the governmental subdivision for theprevious two fiscal yearyears.    21.2(2)   The designated strata and applicable fees are as follows:    Budgeted Expendituresin Thousands of Dollars    FeeAmountUnder 50    $ 100At least 50 but less than 300    $ 475At least 300 but less than 600    $ 900600 or more    $1,200Budget Expenditures in Thousands of DollarsFee AmountUnder 100$ 200At least 100 but less than 250$ 550At least 250 but less than 500$ 800At least 500 but less than 750$1,200750 or more$1,500    21.2(3)   The fee shall be remitted to the office of auditor of state on or before March 31 each year.       This rule is intended to implement 2012 Iowa Acts, chapter 1107, section 2Iowa Code section 11.6(11).
    [Filed 1/13/20, effective 4/1/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4930CEducation Department[281]Adopted and Filed

Rule making related to extracurricular interscholastic competition

    The State Board of Education hereby amends Chapter 36, “Extracurricular Interscholastic Competition,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 256.7.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 280.13A.Purpose and Summary    Chapter 36 outlines the requirements for extracurricular interscholastic competitions. Item 1 incorporates changes to the subrule regarding scholarship rules by providing that a student may not be required to sit out in more than one school-sponsored extracurricular activity because of a failing grade. Item 2 provides the athletic associations with the discretion to set a dead period during the summer for a period up to 14 days in length in which no contact with students would be allowed.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on December 18, 2019, as ARC 4815C. A public hearing was held on January 7, 2020, at 9 a.m. in the State Board Room, Second Floor, Grimes State Office Building, Des Moines, Iowa. No one attended the public hearing. No public comments were received. No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the State Board on January 23, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the State Board for a waiver of the discretionary provisions, if any, pursuant to 281—Chapter 4.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend subrule 36.15(2) as follows:    36.15(2) Scholarship rules.      a.    All contestants must be enrolled and in good standing in a school that is a member or associate member in good standing of the organization sponsoring the event.    b.    All contestants must be under 20 years of age.    c.    All contestants shall be enrolled students of the school in good standing. They shall receive credit in at least four subjects, each of one period or “hour” or the equivalent thereof, at all times. To qualify under this rule, a “subject” must meet the requirements of 281—Chapter 12. Coursework taken from a postsecondary institution and for which a school district or accredited nonpublic school grants academic credit toward high school graduation shall be used in determining eligibility. No student shall be denied eligibility if the student’s school program deviates from the traditional two-semester school year.    (1)   Each contestant shall be passing all coursework for which credit is given and shall be making adequate progress toward graduation requirements at the end of each grading period. Grading period, graduation requirements, and any interim periods of ineligibility are determined by local policy. For purposes of this subrule, “grading period” shall mean the period of time at the end of which a student in grades 9 through 12 receives a final grade and course credit is awarded for passing grades.    (2)   If at the end of any grading period a contestant is given a failing grade in any course for which credit is awarded, the contestant is ineligible to dress for and compete in the next occurring interscholastic athletic contests and competitions in which the contestant is a contestant for 30 consecutive calendar daysunless the student has already served a period of ineligibility for 30 consecutive calendar days in another school-sponsored activity. A student shall not serve multiple periods of ineligibility because of a failing grade.    d.    A student with a disability who has an individualized education program shall not be denied eligibility on the basis of scholarship if the student is making adequate progress, as determined by school officials, towards the goals and objectives on the student’s individualized education program.    e.    A student who meets all other qualifications may be eligible to participate in interscholastic athletics for a maximum of eight consecutive semesters upon entering the ninth grade for the first time. However, a student who engages in athletics during the summer following eighth grade is also eligible to compete during the summer following twelfth grade. Extenuating circumstances, such as health, may be the basis for an appeal to the executive board which may extend the eligibility of a student when the executive board finds that the interests of the student and interscholastic athletics will be benefited.    f.    All member schools shall provide appropriate interventions and necessary academic supports for students who fail or who are at risk to fail, and shall report to the department regarding those interventions on the comprehensive school improvement plan.    g.    A student is academically eligible upon entering the ninth grade.    h.    A student is not eligible to participate in an interscholastic sport if the student has, in that same sport, participated in a contest with or against, or trained with, a National Collegiate Athletic Association (NCAA), National Junior College Athletic Association (NJCAA), National Association of Intercollegiate Athletics (NAIA), or other collegiate governing organization’s sanctioned team. A student may not participate with or against high school graduates if the graduates represent a collegiate institution or if the event is sanctioned or sponsored by a collegiate institution. Nothing in this subrule shall preclude a student from participating in a one-time tryout with or against members of a college team with permission from the member school’s administration and the respective collegiate institution’s athletic administration.    i.    No student shall be eligible to participate in any given interscholastic sport if the student has engaged in that sport professionally.    j.    The local superintendent of schools, with the approval of the local board of education, may give permission to a dropout student to participate in athletics upon return to school if the student is otherwise eligible under these rules.    k.    Remediation of a failing grade by way of summer school or other means shall not affect the student’s ineligibility. All failing grades shall be reported to any school to which the student transfers.

    ITEM 2.    Amend subrule 36.15(6) as follows:    36.15(6) Summer camps and clinics and coaching contacts out of season.      a.    School personnel, whether employed or volunteers, of a member or associate member school shall not coach that school’s student athletes during the school year in a sport for which the school personnel are currently under contract or are volunteers, outside the period from the official first day of practice through the finals of tournament play. Provided, however, school personnel may coach a senior student from the coach’s school in an all-star contest once the senior student’s interscholastic athletic season for that sport has concluded. In addition, volunteer or compensated coaching personnel shall not require students to participate in any activities outside the season of that coach’s sport as a condition of participation in the coach’s sport during its season.    b.    A summer team or individual camp or clinic held at a member or associate member school facility shall not conflict with sports in season. Coaching activities between June 1 and the first day of fall sports practices shall not conflict with sports in season.The associations in their discretion may establish a dead period up to 14 calendar days in length. During a dead period coaches will not be allowed to have contact with students.    c.    Rescinded IAB 4/20/11, effective 5/25/11.    d.    Penalty. A school whose volunteer or compensated coaching personnel violate this rule is ineligible to participate in a governing organization-sponsored event in that sport for one year with the violator(s) coaching.    [Filed 1/28/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4931CEducation Department[281]Adopted and Filed

Rule making related to repairing transportation equipment for transporting students

    The State Board of Education hereby amends Chapter 98, “Financial Management of Categorical Funding,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 256.7.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapter 298A.Purpose and Summary    Chapter 98 outlines the financial management of categorical funding. Subrule 98.64(2) addresses appropriate expenditures in the physical plant and equipment levy (PPEL) fund.    This amendment expands “repairing” of transportation equipment for transporting students to include retrofitting when such retrofitting is aligned to school bus construction standards in 281—Chapter 44. Additionally, the amendment stipulates this provision is retroactive to October 2, 2019. This date aligns to the effective date of the recently adopted amendments to 281—Chapter 44.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on December 18, 2019, as ARC 4817C. A public hearing was held on January 7, 2020, at 10 a.m. in the State Board Room, Second Floor, Grimes State Office Building, Des Moines, Iowa. No one attended the public hearing. One comment was received supporting the amendment. No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the State Board on January 23, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    An agencywide waiver provision is provided in 281—Chapter 4.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making action is adopted:

    ITEM 1.    Amend paragraph 98.64(2)"l" as follows:    l.    Purchase of transportation equipment for transporting students and for repairing such transportation equipment when the cost of the repair exceeds $2,500. “Repairing,” for purposes of this paragraph, means restoring an existing item of transportation equipment to its original condition, as near as may be, after gradual obsolescence of physical and functional use due to wear and tear, corrosion and decay, or partial destruction, and includes maintenance that meets the definition of equipment and repair and the cost of which exceeds $2,500.Effective October 2, 2019, “repairing” also means retrofitting transportation equipment when such retrofitting aligns to the school bus construction standards in 281—Chapter 44.    [Filed 1/28/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4896CHuman Services Department[441]Adopted and Filed

Rule making related to children’s behavioral health services

    The Human Services Department hereby amends Chapter 25, “Disability Services Management,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code chapter 331.State or Federal Law Implemented    This rule making implements, in whole or in part, 2019 Iowa Acts, House File 690.Purpose and Summary    These amendments to Chapter 25 provide the framework for a children’s behavioral health system requiring certain children’s behavioral health core services for children with a serious emotional disturbance. The amendments provide guidance to mental health and disability services (MHDS) regions in developing the new children’s behavioral health core services and include new definitions, provider standards, access standards, and implementation dates. The amendments also make changes in MHDS regional governance structure and reporting requirements and establish eligibility standards for children’s behavioral health services.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 20, 2019, as ARC 4762C.     The Department received 22 comments from five respondents on the proposed amendments. The comments and corresponding responses from the Department are divided into four topic areas as follows:    A. Definitions.     B. General.    C. Governing boards and advisory councils.     D. Cost-sharing and resources.         A. Definitions.    1. One respondent commented that the rules should include a definition for “medical necessity.”    Department response: No change was made in response to the comment. There is no need to define the term “medical necessity” because it is not used in Chapter 25.    2. One respondent commented that the rules should include a definition for “psychiatric medical institution for children” (PMIC).    Department response: No change was made in response to the comment. The term “psychiatric medical institution for children” is defined in Iowa Code chapter 135H and is not used in Chapter 25. A PMIC is not among the core service domains that the Legislature identified for the Department to define in rule.    3. One respondent commented that the definition for “early identification” should be changed to include “mental illness” along with “developmental delays” and “untreated conditions.”    Department response:  The Department agrees and has added “mental illness” to the conditions listed in the definition of “early identification.”    4. One respondent commented that all noncore domains and services for children should be included, along with a definition for each of them.    Department response: No change was made in response to the comment. The legislation creating the children’s behavioral health system specifically directed the Department to “define the services included in the core domains listed.” Noncore service domains were not listed; therefore, the Department does not have the authority to define them in these rules.    5. One respondent commented that “supplemental services” should be defined.    Department response: No change was made in response to the comment. The legislation creating the children’s behavioral health system specifically directed the Department to “define the services included in the core domains listed.” Supplemental services were not listed as a core domain, and the term “supplemental services” is not used in Chapter 25; therefore, the Department does not have the authority to define the term in these rules.    6. One respondent commented that the term “serious emotional disturbance” (SED) is not clearly defined and that the definition is inconsistent with other definitions of “SED” and should be changed to be the same across all funding sources in the state. The respondent suggested that if a more detailed definition of “SED” is not included in the rule that there should be a reference to the Medicaid state plan amendment that includes that detail.    Department response: No change was made in response to the comment. “Serious emotional disturbance” is defined by reference to the existing definition in Iowa Code section 225C.2, which definition is the same standard used for the children’s mental health waiver. Any further inclusionary or exclusionary criteria would be based on an individual clinical determination by a qualified mental health professional.    B. General.    7. One respondent commented that subrule 25.3(1) should be changed to add the words “for adults” after “core services.”    Department response: No change was made in response to the comment. Subrule 25.3(1) was not included in the noticed changes proposed for Chapter 25 and therefore is not open for revision at this time.    8. One respondent commented that subrule 25.3(2) should be changed to add the words “for adults” after “core services.”    Department response: No change was made in response to the comment. Subrule 25.3(2) was not included in the noticed changes proposed for Chapter 25 and therefore is not open for revision at this time.    9. One respondent commented that access centers are supposed to be for both adults and children, so language throughout the access center requirements should continue to refer to “individuals” rather than being changed to refer to “adults.”    Department response: No change was made in response to the comment. Access centers were created as a part of intensive mental health services for the purpose of serving adults and are required to provide an array of services for adults. Some of the services offered by access centers may also be accessed by individuals under the age of 18, but the centers are not designed as a children’s service. The word “individual” was used in the definition of “access center” to indicate that while regions are required to fund services for children, access centers are allowed to serve individuals under the age of 18 when appropriate and if funding is available.    10. One respondent commented that rule 441—25.7(331) only addresses the noncore services of prescreening assessment and transportation and should include all noncore service domains for adults, including a definition for each of them.    Department response: No change was made in response to the comment. 2018 Iowa Acts, House File 2456, mandated the addition of transportation and prescreening assessment standards to Chapter 25. The legislation did not direct or authorize the addition of other noncore services to these rules. Rule 441—25.7(331) was not included in the noticed changes proposed for Chapter 25 and therefore is not open for revision at this time. The legislation creating the children’s behavioral health system specifically directed the Department to “define the services included in the core domains listed.” Noncore service domains were not listed, so the Department does not have the authority to define them in these rules.    11. One respondent commented that it appears prevention, screening and early intervention services will not be paid for unless the child has a qualifying diagnosis of SED. The respondent would like clarification that prevention, screening and early intervention services are available to any child who needs them and do not require an SED diagnosis at the time of service.    Department response: No change was made in response to the comment. The definitions of and access standards for “prevention” and “education services” specify that such services are intended to increase awareness and understanding, and as described, the reasonable interpretation is that they are applicable to information and activities available to residents of the region without respect to a diagnosis. The definitions of and access standards for “early identification” and “early intervention” indicate that they involve “detecting” untreated conditions that may indicate the need for further evaluation and addressing the needs of children at the earliest stages. These definitions would be meaningless if they did not apply to children who have not yet been diagnosed.    12. One respondent commented that the access standard for early identification services is four weeks and expressed concern that services should be provided more promptly.    Department response: No change was made in response to the comment. The access standards are designed to provide achievable parameters on the reasonable time to ensure services are available. MHDS regions have to work within the capacity of qualified providers and are expected to strive to make all services available as promptly as possible.    13. One respondent commented that the rule should reference the use of telehealth services, such as telepsychiatry, and the use of advanced practice registered nurses who are certified in psychiatric and mental health care to provide services in areas with provider shortages.    Department response: No change was made in response to the comment. These suggestions are beyond the scope of these amendments as authorized by 2019 Iowa Acts, House File 690.     C. Governing boards and advisory councils.    14. One respondent commented that the voting members of the regional governing boards should include one member representing the behavioral health system in the region who is not a provider.    Department response: No change was made in response to the comment. 2019 Iowa Acts, House File 690, specified the voting membership of the regional governing boards, and the Department does not have the authority to change the requirements, which have been codified in Iowa Code section 331.390.    15. One respondent commented that subparagraph 25.14(1)“j”(7), which requires a pediatrician to sit on the regional advisory committees for children’s behavioral health services, should be broadened to include mid-level providers such as advanced registered nurse practitioners (ARNPs), doctors of nursing practice (DNPs), certified pediatric nurse practitioners (CPNPs), certified physician assistants (PA-Cs), or similar professionals because there are limited numbers of pediatricians available, particularly in rural Iowa.    Department response: No change was made in response to the comment. The requirement for a pediatrician to serve as a member of a regional advisory committee for children’s behavioral health services was established in Iowa Code by 2019 Iowa Acts, House File 690; therefore, the Department does not have the authority to make alterations.    16. One respondent commented that the subrule 25.12(1) provision requiring that a governing board member representing the education system in the region be designated as a voting member should be removed because: (1) the education system should not be viewed differently from providers of adult and children’s services which are designated as nonvoting members, and (2) since education systems receive tax dollars, there could be a conflict of interest.    Department response: No change was made in response to the comment. The requirement for a voting regional governing board member representing the education system in the region was included in 2019 Iowa Acts, House File 690, and has been codified in Iowa Code chapter 225; therefore, the Department does not have the authority to make alterations.     17. One respondent commented that the makeup of the regional advisory committees for children’s behavioral health services is too prescriptive and should have broader requirements similar to those of the adult system advisory committees. The respondent specifically suggested:    • The requirement for a pediatrician should be removed or at least broadened to allow a nurse practitioner, psychologist, or therapist.    • The requirement for a child care provider should be removed.    • The requirement for a local law enforcement representative should be allowed to be filled by one person for both the adult and child advisory committees.    Department response: No change was made in response to the comment. The requirements for a pediatrician and a child care provider to be members of the regional advisory committees for children’s behavioral health services are specified in 2019 Iowa Acts, House File 690, now codified in Iowa Code chapter 331; therefore, the Department does not have the authority to make alterations. There is nothing in these rules that prohibits one individual who meets the membership criteria for a seat on the adult advisory committee and a seat on the child advisory committee from serving in both roles.    18. One respondent commented that it would be more reasonable to require one advisory committee for both adult services and children’s services instead of two separate committees, as all the services should be seen as part of one single system.    Department response: No change was made in response to the comment. The requirement for separate advisory committees for adult services and children’s services with specific membership criteria was included in 2019 Iowa Acts, House File 690, now codified in Iowa Code chapter 331; therefore, the Department does not have the authority to make alterations.    19. One respondent commented that the composition of the regional advisory committees for children’s behavioral health services should include a school nurse in addition to the education representative.    Department response: No change was made in response to the comment. The requirements for members of the regional advisory committees for children’s behavioral health services are specified in House File 690, now codified in Iowa Code chapter 331; therefore, the Department does not have the authority to make alterations.    D. Cost-sharing and resource limits.    20. One respondent indicated support for the cost-sharing chart for children’s services and commented that there should also be a consistent cost-sharing fee scale across the state for adults.    Department response: No change was made in response to the comment. 2019 Iowa Acts, House File 690, specifically required that family income eligibility limits for children’s behavioral health services be “subject to a copayment, a single statewide sliding fee scale, or other cost-sharing requirements approved by the department.” There is no similar requirement in Iowa Code for adult services; therefore, the MHDS regions retain flexibility in how income standards are applied, and the Department does not have the authority to impose a statewide standard.    21. One respondent commented that there should be a standard resource limit for the family of a child seeking children’s behavioral health services and that having resource limits for adult services and no resource limits for children’s services does not seem reasonable or fair.    Department response: No change was made in response to the comment. Prior to this rule-making action, Chapter 25 included a resource limit for adults seeking mental health and disability services. Eligibility for new children’s behavioral health services was established by 2019 Iowa Acts, House File 690. The legislation specified an income limitation of 500 percent of the federal poverty level, subject to a copayment, a single statewide sliding fee scale, or other cost-sharing requirement approved by the Department. Since the Legislature chose not to include a resource limit for children’s services, the Department does not have the authority to establish one in rule.    22. One respondent expressed support for the sliding fee scale for children’s behavioral health services, but expressed concern about how quickly the percentage of the family cost-share amount increases, and suggested gathering data to determine if services are declined by families due to the inability to pay the cost-share amount.    Department response: No change was made in response to the comment. The cost-share percentages were established to balance keeping services affordable for families with the ability of regional funding to meet the needs of residents requesting services. MHDS regions are not required to gather data relating to the ability of families to pay the cost-share amounts, but the regions may do so if they choose.    Summary of changes: The definition of “early identification” has been changed to add the words “mental illness” in the phrase “the process of detecting developmental delays, mental illness, or untreated conditions that may indicate the need for further evaluation.” In addition, a rescinded definition in Item 27 was corrected to read “Coordinator of disability services.”Adoption of Rule Making    This rule making was adopted by the Mental Health and Disability Services Commission on January 16, 2020.Fiscal Impact    These changes are expected to increase costs for both the Medicaid program and MHDS regions. There will be additional Medicaid costs to fund increased access to Medicaid-funded services, such as crisis services. Many MHDS regions fund some services for children, such as crisis services, but they do not fund all of the core services nor does every region fund children’s services or have access to crisis services for children. Jobs Impact    These amendments are not likely to have any significant impact on private-sector jobs and employment opportunities in Iowa. To the extent there is any impact, it would be to create a demand for more mental health professionals and direct support staff. Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend 441—Chapter 25, preamble, as follows:    This chapter provides for definitions of regional core services; access standards; implementation dates; practice standards; reporting of regional expenditures; development and submission of regional management plans; data collection; applications for funding as they relate to regional service systems for individualsadults with mental illness, intellectual disabilities, developmental disabilities, or brain injury; and submission of data for Medicaid offset calculationsand children with a serious emotional disturbance.

    ITEM 2.    Adopt the following new definitions of “Behavioral health inpatient treatment,” “Behavioral health outpatient therapy,” “Child,” “Children’s behavioral health services,” “Children’s behavioral health system,” “Early identification,” “Early intervention,” “Education services,” “Mental health inpatient treatment,” “Prevention,” “Serious emotional disturbance” and “State board” in rule 441—25.1(331):        "Behavioral health inpatient treatment" "mental health inpatient treatment" means inpatient psychiatric services to treat an acute psychiatric condition provided in a licensed hospital with a psychiatric unit or a licensed freestanding psychiatric hospital.        "Behavioral health outpatient therapy" means the same as “outpatient services” described in Iowa Code section 230A.106(2)“a.”        "Child" "children" means a person or persons under 18 years of age.        "Children’s behavioral health services" means behavioral health services for children who have a diagnosis of serious emotional disturbance.        "Children’s behavioral health system" "children’s system" means the behavioral health system for children implemented pursuant to Iowa Code chapter 225C.        "Early identification" means the process of detecting developmental delays, mental illness, or untreated conditions that may indicate the need for further evaluation.        "Early intervention" means services designed to address the social, emotional, and developmental needs of children at their earliest stages to decrease long-term effects and provide support in meeting developmental milestones.        "Education services" means activities that increase awareness and understanding of the causes and nature of conditions or factors which affect an individual’s development and functioning.        "Mental health inpatient treatment" "behavioral health inpatient treatment" means inpatient psychiatric services to treat an acute psychiatric condition that are provided in a licensed hospital with a psychiatric unit or a licensed freestanding psychiatric hospital.        "Prevention" means efforts to increase awareness and understanding of the causes and nature of conditions or situations which affect an individual’s functioning in society. Prevention activities are designed to convey information about the cause of conditions, situations, or problems that interfere with an individual’s functioning or ways in which that information can be used to prevent their occurrence or reduce their effect and may include, but are not limited to, training events, webinars, presentations, and public meetings.        "Serious emotional disturbance" means the same as defined in Iowa Code section 225C.2.         "State board" means the children’s behavioral health system state board created in Iowa Code section 225C.51.

    ITEM 3.    Amend subrule 25.2(1) as follows:    25.2(1)   The region shall ensure that core service domains are available in regions as determined in Iowa Code sectionsections331.397and 331.397A.

    ITEM 4.    Amend subrule 25.2(3) as follows:    25.2(3)   The region shall ensure that the following services are availablefor adults in the region:    a.    Access centers.    b.    Assertive community treatment.    c.    Assessment and evaluation.    d.    Case management.    e.    Crisis evaluation.    f.    Crisis stabilization community-based services.    g.    Crisis stabilization residential services.    h.    Day habilitation.    i.    Family support.    j.    Health homes.    k.    Home and vehicle modification.    l.    Home health aide.    m.    Intensive residential service homes.    n.    Job development.    o.    Medication prescribing and management.    p.    Mental health inpatient treatment.    q.    Mental health outpatient treatment.    r.    Mobile response.    s.    Peer support.    t.    Personal emergency response system.    u.    Prevocational services.    v.    Respite.    w.    Subacute mental health services.    x.    Supported employment.    y.    Supportive community living.    z.    Twenty-four-hour access to crisis response.    aa.    Twenty-three-hour crisis observation and holding.Regions may fund or provide other services in addition to the required core services consistent with requirements set forth in subrules 25.2(4) and25.2(5)and 25.2(6).

    ITEM 5.    Renumber subrules 25.2(4) and 25.2(5) as 25.2(5) and 25.2(6).

    ITEM 6.    Adopt the following new subrule 25.2(4):    25.2(4)   The region shall ensure that the following services are available for children in the region:    a.    Assessment and evaluation relating to eligibility for services.    b.    Behavioral health inpatient treatment.    c.    Behavioral health outpatient therapy.    d.    Crisis stabilization community-based services.    e.    Crisis stabilization residential services.    f.    Early identification.    g.    Early intervention.     h.    Education services.    i.    Medication prescribing and management.    j.    Mobile response.    k.    Prevention.

    ITEM 7.    Adopt the following new subrule 25.3(3):    25.3(3)   Regions shall implement the following children’s behavioral health core services on or before July 1, 2020, and meet applicable access standards on or before July 1, 2021:    a.    Assessment and evaluation relating to eligibility for services.    b.    Behavioral health outpatient therapy.    c.    Education services.    d.    Medication prescribing and management.    e.    Prevention.

    ITEM 8.    Adopt the following new subrule 25.3(4):    25.3(4)   Regions shall implement the following children’s behavioral health core services on or before July 1, 2021, and meet applicable access standards on or before July 1, 2021:    a.    Behavioral health inpatient treatment.    b.    Crisis stabilization community-based services.    c.    Crisis stabilization residential services.    d.    Early identification.     e.    Early intervention.    f.    Mobile response.

    ITEM 9.    Amend subrule 25.4(1) as follows:    25.4(1)   A sufficient provider network which shall include:    a.    A community mental health center or federally qualified health center that provides psychiatric and outpatient mental health servicesto individuals in the region.    b.    A hospital with an inpatient psychiatric unit or state mental health institute located in or within reasonably close proximity that has the capacity to provide inpatient services to the applicant.

    ITEM 10.    Amend subrule 25.4(2) as follows:    25.4(2)   Crisis services shall be available 24 hours per day, 7 days per week, 365 days per year forindividuals experiencing mental health and disability-related emergencies. A region may make arrangements with one or more other regions to meet the required access standards.    a.    Basic crisis response.    (1)   Twenty-four-hour crisis response. An individual shall have immediate access to crisis response services by means of telephone, electronic, or face-to-face communication.    (2)   Crisis evaluation. An individual shall have immediate access to a crisis screening and will have a crisis assessment by a licensed mental health professional within 24 hours of referral.    b.    Crisis stabilization community-based services.An individual who has been determined to need CSCBS shall receive face-to-face contact from the CSCBS provider within 120 minutes from the time of referral.    c.    Crisis stabilization residential services.An individual who has been determined to need CSRS shall receive CSRS within 120 minutes of referral. The service shall be located within 120 miles from the residence of the individual.    d.    Mobile response.An individual in need of mobile response services shall have face-to-face contact with mobile crisis staff within 60 minutes of dispatch.    e.    Twenty-three-hour observation and holding.An individualadult who has been determined to need 23-hour observation and holding shall receive 23-hour observation and holding within 120 minutes of referral. The service shall be located within 120 miles from the residence of the individual.

    ITEM 11.    Amend subrule 25.4(4) as follows:    25.4(4)   Subacute facility-based mental health services. An individualadult shall receive subacute facility-based mental health services within 24 hours of referral. The service shall be located within 120 miles of the residence of the individual.

    ITEM 12.    Amend subrule 25.4(5) as follows:    25.4(5)   Support for community livingfor adults. The first appointment shall occur within four weeks of the individual’s request of support for community living.

    ITEM 13.    Amend subrule 25.4(6) as follows:    25.4(6)   Support for employmentfor adults. The initial referral shall take place within 60 days of the individual’s request of support for employment.

    ITEM 14.    Amend subrule 25.4(7) as follows:    25.4(7)   Recovery servicesfor adults. An individual receiving recovery services shall not have to travel more than 30 miles if residing in an urban area or 45 miles if residing in a rural area to receive services.

    ITEM 15.    Amend subrule 25.4(8) as follows:    25.4(8)   Service coordination.    a.    An individualadult receiving service coordination shall not have to travel more than 30 miles if residing in an urban area or 45 miles if residing in a rural area to receive services.    b.    An individualadult shall receive service coordination within ten days of the initial request for such service or being discharged from an inpatient facility.

    ITEM 16.    Amend subrule 25.4(9), introductory paragraph, as follows:    25.4(9)   The region shall make the following intensive mental health services availablefor adults. A region may make arrangements with one or more other regions to meet the required access standards.

    ITEM 17.    Adopt the following new subrule 25.4(11):    25.4(11)   The region shall make the following efforts and activities related to children’s behavioral health available to the residents of the region:    a.    Prevention.Prevention activities shall be carried out at least four times a year.    b.    Education services.Education activities shall be carried out at least four times a year.

    ITEM 18.    Adopt the following new subrule 25.4(12):    25.4(12)   The region shall ensure that the following behavioral health services are available to children in the region:    a.    Early identification.A child shall receive early identification services within four weeks of the time the request for such services is made.    b.    Early intervention.A child shall receive early intervention services within four weeks of the time the request for such services is made.

    ITEM 19.    Amend rule 441—25.6(331), introductory paragraph, as follows:

441—25.6(331) Intensive mental health services.  The purpose of intensive mental health services is to provide a continuum of services and supports to individualsadults with complex mental health and multi-occurring conditions who need a high level of intensive and specialized support to attain stability in health, housing, and employment and to work toward recovery.

    ITEM 20.    Amend subrule 25.6(1) as follows:    25.6(1) Access centers.  The purpose of an access center is to serve individualsadults experiencing a mental health or substance use crisis who are not in need of an inpatient psychiatric level of care and who do not have alternative, safe, effective services immediately available.    a.    Regional coordination.Each region shall designate at least one access center provider and ensure that access center services are available to the residents of the region consistent with subrule 25.4(9).     (1)   Regions shall work collaboratively to develop a minimum of six access centers strategically located throughout the state, with the support of the medical assistance program.    (2)   Access centers may be shared by two or more regions.    (3)   Each region shall establish methods to provide for reimbursement of a region when a non-Medicaid-eligible resident of another region utilizes an access center or other non-Medicaid-covered services located in that region.     b.    Access center standards.A designated access center shall meet all of the following criteria:    (1)   An access center shall have no residential facility-based setting with more than 16 beds.    (2)   An access center provider shall be accredited to provide crisis stabilization residential services pursuant to 441—Chapter 24.    (3)   An access center provider shall be licensed to provide subacute mental health services as described in rule 441—77.56(249A).    (4)   An access center provider shall be licensed as a substance abuse treatment program pursuant to Iowa Code chapter 125 or have a cooperative agreement with and immediate access to licensed substance abuse treatment services or medical care that incorporates withdrawal management.    (5)   An access center shall provide services on a no reject, no eject basis to individuals who meet service eligibility criteria.    (6)   An access center shall accept and serve eligible individuals who are court-ordered to participate in mental health or substance use disorder treatment.    (7)   An access center shall provide all required services listed in 25.6(1)“d” in a coordinated manner. An access center may provide coordinated services in one or more locations.    c.    Eligibility for access center services.To be eligible to receive access center services, an individual shall meet all of the following criteria:    (1)   The individual isan adult in need of screening, assessment, services or treatment related to a mental health or substance use crisis.    (2)   The individual shows no obvious signs of illness or injury indicating a need for immediate medical attention.    (3)   The individual has been determined not to need an inpatient psychiatric hospital level of care.    (4)   The individual does not have immediate access to alternative, safe, and effective services.     d.    Access center services.An access center shall provide or arrange for the provision of all of the following:    (1)   Immediate intake assessment and screening that includes but is not limited to mental and physical health conditions, suicide risk, brain injury, and substance use. A crisis evaluation that includes all required screenings may serve as an intake assessment.    (2)   Comprehensive person-centered mental health assessments by appropriately licensed or credentialed professionals, as indicated by the intake assessment.    (3)   Comprehensive person-centered substance use disorder assessments by appropriately licensed or credentialed professionals, as indicated by the intake assessment.    (4)   Peer support services, as indicated by a comprehensive assessment.    (5)   Mental health treatment, as indicated by a comprehensive assessment.     (6)   Substance use treatment, as indicated by a comprehensive assessment.    (7)   Physical health care services as indicated by a health screening.    (8)   Care coordination.    (9)   Service navigation and linkage to needed services including housing, employment, shelter services, intellectual and developmental disability services, and brain injury services, with warm handoffs to other service providers.

    ITEM 21.    Amend subrule 25.6(2), introductory paragraph, as follows:    25.6(2) Assertive community treatment (ACT) services.  The purpose of assertive community treatment is to serve individualsadults with the most severe and persistent mental illness conditions and functional impairments. ACT services provide a set of comprehensive, integrated, intensive outpatient services delivered by a multidisciplinary team under the supervision of a psychiatrist, an advanced registered nurse practitioner, or a physician assistant under the supervision of a psychiatrist. An ACT program shall designate an individuala staff member to be responsible for administration of the program and with the authority to sign documents and receive payments on behalf of the program.

    ITEM 22.    Amend subrule 25.6(4) as follows:    25.6(4) 23-hour observation and holding.  The purpose of 23-hour observation and holding is to provide up to 23 hours of carefor adults in a safe and secure, medically staffed treatment environment. Twenty-three-hour observation and holding shall be provided as described in rule 441—24.37(225C).

    ITEM 23.    Amend subrule 25.6(7), introductory paragraph, as follows:    25.6(7) Subacute mental health services.  The purpose of subacute mental health services is to provide a comprehensive set of wraparound services to individualsadults who have had or are at imminent risk of having acute or crisis mental health symptoms.

    ITEM 24.    Amend subrule 25.6(8), introductory paragraph, as follows:    25.6(8) Intensive residential services.  The purpose of intensive residential services is to serve individualsadults with the most intensive severe and persistent mental illness conditions who have functional impairments and may also have multi-occurring conditions. Intensive residential services provide intensive 24-hour supervision, behavioral health services, and other supportive services in a community-based residential setting.

    ITEM 25.    Amend 441—Chapter 25, implementation sentence, Division I, as follows:       These rules are intended to implement Iowa Code chapter 331and 2018 Iowa Acts, House File 2456.

    ITEM 26.    Amend 441—Chapter 25, Division II, preamble, as follows:These rules define the standards for a regional service system. The mental health and disability services and children’s behavioral health servicesprovided by counties operating as a region shall be delivered in accordance with a regional service system management plan approved by the region’s governing board and implemented by the regional administrator (Iowa Code section 331.393). Iowa counties are encouraged to enter into a regional system when the regional approach is likely to increase the availability of services to residents of the state who need the services. It is the intent of the Iowa general assembly that the adult residents of this state should have access to needed mental health and disability servicesand that Iowa children should have access to needed behavioral health services regardless of the location of their residence.

    ITEM 27.    Rescind the definitions of “Applicant” and “Coordinator of disability services” in rule 441—25.11(331).

    ITEM 28.    Adopt the following new definitions of “Coordinator of children’s behavioral health services,” “Coordinator of mental health and disability services,” “Countable household income,” “Federal poverty level,” and “Modified adjusted gross income” in rule 441—25.11(331):        "Coordinator of children’s behavioral health services" means a member of the regional administrative entity staff who meets the requirements described in Iowa Code section 331.390(3)“b” and is responsible for coordinating behavioral health services for children.        "Coordinator of mental health and disability services" means a member of the regional administrative entity staff who meets the requirements described in Iowa Code section 331.390(3)“b” and is responsible for coordinating mental health and disability services for adults.        "Countable household income" means earned and unearned income of the family of a child according to the modified adjusted gross income methodology.        "Federal poverty level" means the most recently revised annual poverty income guidelines published in the Federal Register by the United States Department of Health and Human Services.        "Modified adjusted gross income" means the methodology prescribed in 42 U.S.C. Section 1396a(e)(14) and 42 CFR 435.603.

    ITEM 29.    Amend subrule 25.12(1) as follows:    25.12(1) Governing board.  The governing board shall comply with theprovisions of Iowa Code section 331.390, Iowa Code chapter 69 and other applicable laws relating to boards and commissions, including but not limited to the following requirements:    a.    The governing board shall comply with the membership requirements as outlined in Iowa Code section 331.390 and follow the requirements in Iowa Code chapter 69 and other applicable laws relating to boards and commissions.include the following voting members:    (1)   At least one board of supervisors member from each county comprising the region or their designees.    (2)   One adult person who utilizes mental health and disability services or is an actively involved relative of an adult who utilizes such services, designated by the regional adult mental health and disability services advisory committee.    (3)   Members designated by the regional children’s behavioral health services advisory committee as follows:    1.   One member representing the education system in the region.    2.   One member who is a parent of a child who utilizes children’s behavioral health services or is an actively involved relative of a child who utilizes such services.    b.    The governing board shall include the following nonvoting members in an ex officio capacity:    (1)   One member representing an adult service provider in the region, designated by the regional adult mental health and disability services advisory committee.    (2)   One member representing a children’s behavioral health service provider in the region, designated by the regional children’s behavioral health services advisory committee.    b.    c.    AThe governing board shall create a regionaladult mental health and disability services advisory committee shall be created and, which shall designate members to the governing board as defined in Iowa Code section 331.390(2).    d.    The governing board shall create a regional children’s behavioral health services advisory committee, which shall designate members to the governing board as defined in Iowa Code section 331.390(2).    c.    e.    The governing board shall appoint and evaluate the performance of the chief executive officer of the regional administrative entity who will serve as the single point of accountability for the region.

    ITEM 30.    Amend subrule 25.12(2) as follows:    25.12(2) Regional administrator.  The formation of the regional administrator shall be as defined in Iowa Code sections 331.388 and 331.390.    a.    The regional administrative entity is under the control of the governing board.    b.    The regional administrative entity shall enter into and manage performance-based contracts in accordance with Iowa Code section 225C.4(1)“u.”    c.    The regional administrative entity structure shall have clear lines of accountability.    d.    The regional administrative entity functions as a lead agency utilizing shared county or regional staff or other means of limiting administrative costs.    e.    The regional administrative entity staff shall include one or more coordinators ofmental health and disability services.    f.    The regional administrative entity staff shall include one or more coordinators of children’s behavioral health services.

    ITEM 31.    Amend subrule 25.13(1), introductory paragraph, as follows:    25.13(1) Funding.  Non-MedicaidFunding for non-Medicaid mental health and disability services fundingand children’s behavioral health services is under the control of the governing board and shall:

    ITEM 32.    Amend paragraph 25.14(1)"i" as follows:    i.    Provision for formation and assigned responsibilities for one or moreregional advisory committeesfor adult mental health and disability services consisting of:    (1)   Individuals who utilize services or the actively involved relatives of such individuals.    (2)   Service providersof adult mental health and disability services.    (3)   Governing board members.    (4)   Other interests identified in the agreement.

    ITEM 33.    Adopt the following new paragraph 25.14(1)"j":    j.    Provision for formation and assigned responsibilities for one or more regional advisory committees for children’s behavioral health services consisting of:    (1)   A parent of a child who utilizes services or an actively involved relative of such child.    (2)   A member of the education system.    (3)   An early childhood advocate.    (4)   A child welfare advocate.    (5)   A children’s behavioral health service provider.    (6)   A member of the juvenile court.    (7)   A pediatrician.    (8)   A child care provider.    (9)   A local law enforcement representative.    (10)   A regional governing board member.

    ITEM 34.    Amend paragraph 25.14(2)"c" as follows:    c.    A general list of the functions and responsibilities of the regional administrative entity’s chief executive officer and other staff including but not limited to coordinators ofmental health and disability servicesand coordinators of children’s behavioral health services.

    ITEM 35.    Rescind subrule 25.15(2) and adopt the following new subrule in lieu thereof:    25.15(2) Eligibility for children’s behavioral health services.  An individual must comply with all of the following requirements to be eligible for children’s behavioral health services under the regional service system:    a.    The individual is a child under 18 years of age.    b.    The child’s custodial parent is a resident of the state of Iowa, and the child is physically present in the state.    c.    The child’s family meets the financial eligibility requirements in rule 441—25.16(331).    d.    The child has been diagnosed with a serious emotional disturbance. A serious emotional disturbance diagnosis is not required to access comprehensive facility and community-based crisis services according to Iowa Code section 331.397A(4)“b.”

    ITEM 36.    Amend rule 441—25.16(331), introductory paragraph, as follows:

441—25.16(331) Financial eligibility requirements.  The regional service system management plan shall identify basic financial eligibility standards formental health and disability services as defined in Iowa Code sectionsections331.395and 331.396A.

    ITEM 37.    Rescind subrule 25.16(1) and adopt the following new subrule in lieu thereof:    25.16(1) Income requirements.      a.    Income requirements for adult mental health and disability services shall be as follows:    (1)   The person must have an income equal to or less than 150 percent of the federal poverty level.    (2)   A person who is eligible for federally funded services and other support must apply for such services and support.    b.    Income requirements for children’s behavioral health services shall be as follows:    (1)   The child’s family has countable household income equal to or less than 500 percent of the federal poverty level. Countable household income and family size shall be determined using the modified adjusted gross income methodology.    (2)   An eligible child whose family’s countable household income is at least 150 percent and not more than 500 percent of the federal poverty level shall be subject to a cost share as described in subrule 25.16(3).    (3)   Verification of income. Income shall be verified using the best information available.    1.   Pay stubs, tip records and employers’ statements are acceptable forms of verification of earned income.    2.   Self-employment income can be verified through business records from the previous year if they are representative of anticipated earnings. If business records from the previous year are not representative of anticipated earnings, an average of the business records from the previous two or three years may be used if that average is representative of anticipated earnings.    (4)   Changes in income. Financial eligibility shall be reviewed on an annual basis and may be reviewed more often in response to increases or decreases in income.    (5)   A child who is eligible for federally funded services and other support must apply for such services and support.

    ITEM 38.    Amend subrule 25.16(2), introductory paragraph, as follows:    25.16(2) Resource requirements.  There are no resource limits for the family of a child seeking children’s behavioral health services.An individualadult seeking mental health and disability services must have resources that are equal to or less than $2,000 in countable value for a single-person household or $3,000 in countable value for a multiperson household or follow the most recent federal supplemental security income guidelines.

    ITEM 39.    Rescind subrule 25.16(3) and adopt the following new subrule in lieu thereof:    25.16(3) Cost-share standards.  A regional administrative entity must comply with cost-share standards as defined in Iowa Code sections 331.395 and 331.396A.    a.    Cost sharing is allowed for adults with income above 150 percent of the federal poverty level as defined by the most recently revised poverty guidelines published by the United States Department of Health and Human Services.Cost-share amounts for regionally funded adult mental health and disability services in this rule are related to core services as defined in Iowa Code section 331.397 and must be identified in the enrollment and eligibility section of the region’s policy and procedures approved by the department.    b.    Cost-share amounts for children’s behavioral health services are applicable to core services as defined in Iowa Code section 331.397A. The family of a child receiving regional funding for behavioral health services shall be responsible for a cost-share amount based on the family’s household income as follows:Family Income as a % of FPLCost Share % Paid by Family0 to 150%0%151 to 200% 10%201 to 250% 15%251 to 300%20%301 to 350% 35%351 to 400%50%401 to 450%65%451 to 500%80%Over 500%100%

    ITEM 40.    Amend subrule 25.16(4), introductory paragraph, as follows:    25.16(4) CopaymentCost-share standards required by any federal, state, regional, or municipal program.  Any copaymentscost sharing or other client participation required by any federal, state, regional or municipal program in which the individual participates shall be required by the regional administrative entity. Such copayments includecost sharing includes, but areis not limited to:

    ITEM 41.    Amend subrule 25.18(1) as follows:    25.18(1)   The annual service and budget plan is due on April 1 prior to the July 1 implementation of the annual plan and shall be approved by the region’s governing board prior to submittal to the department. The initial plan is due on April 1, 2014.

    ITEM 42.    Amend subrule 25.18(2) as follows:    25.18(2)   The annual service and budget plan shall include but not be limited tothe following:    a.    The locations of theAccess points. A list of the local access points formental health and disability services. This shall includeand children’s behavioral health services, including the namenames of the access points includingand the physical locations and contact information.    b.    TargetedService coordination and targeted case management. TheA list of the service coordination and targeted case management agencies forutilized in the region,whether funded by the region, the medical assistance program, or third-party payers, including the physical location and contact information for those agencies, shall be included.    c.    Crisis planning. A list of accredited crisis services available in the region for crisis prevention, response and resolution, including contact information for the agencies responsible, shall be included.    d.    Intensive mental health services. Identification of theintensive mental health services designated by the region according to rule 441—25.6(331), including the provider name, contact information, and location of each of the following, shall be included:    (1)   Access center(s).    (2)   ACT services.    (3)   Intensive residential services.    (4)   Subacute mental health services.    e.    Children’s behavioral health services. Identification of children’s behavioral health services as described in subrule 25.2(4), including eligibility requirements or reference to where eligibility requirements can be found in the policies and procedures manual.    e.    f.    Scope of services. A description of the scope of services to be provided, a projection of need for the service, and the funding necessary to meet the need shall be included.    (1)   The scope shall include the regional core services as definedidentified in rule 441—25.1(331)441—25.2(331).    (2)   The scope shall also include services in addition to the required core services.    f.    g.    Budget and financing provisions for the next year. The provisions shall address how county, regional, state and other funding sources will be used to meet the service needs within the region.    g.    h.    Financial forecasting measures. The plan shall describeA description of the financial forecasting measures used in the identification of service need and funding necessary for servicesand a financial statement of actual revenues and actual expenses by chart of account codes, including levies by county.     h.    i.    The providerProvider reimbursement provisions. The plan shall describeA description of the types ofprovider reimbursement methods that will be used, including fee for service, compensating providerscompensation for a “system of care” approach, andfor use of nontraditional providers. A region also shall provideinformation on funding approaches that identify and incorporate all services and sources of funding used by the individuals receiving services, including the medical assistance program.

    ITEM 43.    Amend rule 441—25.20(331) as follows:

441—25.20(331) Annual report.  The annual report shall describe the services provided, the cost of those services, the number of individuals served, and the outcomes achieved for the previous fiscal year. The annual report is due on December 1 following a completed fiscal year of implementing the annual service and budget plan. The initial report is due on December 1, 2015. The annual report shall include but not be limited to:
  1. Services actually provided.
  2. The status of service development.
  3. 2Actual numbers of individualschildren and adults served.
  4. 3Documentation that each regionally designated access center has met the service standards in subrule 25.6(1).
  5. 4Documentation that each regionally designated ACT team has been evaluated for program fidelity, including a peer review as required by subrule 25.6(2), and documentation of each team’s most recent fidelity score.
  6. 5Documentation that each regionally designated subacute service has met the service standards in subrule 25.6(7).
  7. 6Documentation that each regionally designated intensive residential service home or intensive residential service has met the service standards in subrule 25.6(8).
  8. 7Moneys expended.Financial statement of actual revenues and actual expenditures by chart of account codes, including levies by county.
  9. 8Outcomes achieved.

    ITEM 44.    Amend subrule 25.21(1) as follows:    25.21(1) Content.  The manual shall include but not be limited to:    a.    Financing and delivery of services and supports. A description of the region’s process used to develop and ensure the ongoing financial accountability and delivery of services outlined in the region’s annual service and budget plan shall be included.    b.    Enrollment. The application and enrollment process that is readily accessible to applicantsindividuals and their families or authorized representatives shall be included. This procedure shall identify regional access points and where applicantsindividuals can apply for services and how and when the applications will reach the regional administrative entity’s designated staff for processing.    c.    Eligibility. The process utilized to determine eligibility shall be included in the manual and shall include but not be limited to:    (1)   The criteria used to authorize or deny funding for services and supports. This shall include guidelines for who is eligible to receive services and supports by eligibility group, and type of service or support.    (2)   Financial eligibility and copayment criteria, which shall meet the requirements of rule 441—25.16(331).    (3)   The time frames for conducting eligibility determination that provide for timely access to services, including necessary and immediate services not to exceed ten days.    (4)   The process for development of a written notice of decision. The time frame for sending a written notice of decision to the individual and guardian (if applicable) and the service providers identified in the notice shall be included. The notice of decision shall:
  1. Explain the action taken on the application and the reasons for that action.
  2. State what services are approved and name the service providers.
  3. Outline the applicant’sindividual’s right to appeal.
  4. Describe the appeal process.
    d.    Utilization of and access to services. The process for managing utilization of and access to services and other assistance shall be included. The process shall describe how coordination between the services included in the annual service and budget plan and the disability services administered by the state and others will be managed.    e.    Quality management and improvement process. The quality management and improvement process shall at a minimum meet the requirements of the department’s outcome and performance measures process as outlined in Iowa Code sections 225C.4(1)“j” and 225C.6A.    f.    Risk management and fiscal viability. If the region contracts with a private entity, the manual must include risk management provisions and fiscal viability of the annual services and budget plan.    g.    Targeted case management.    (1)   Designation of targeted case management providers. The process used to identify and designate targeted case management providers for the region shall be described. This process shall include the requirement for the implementation of evidence-based practice models of case management within the region. Requirements of this practice include:
  1. Providing the individual receiving the case management with a choice of providers.
  2. Allowing a service provider to be the case manager but prohibiting the provider from referring that individual only to services administered by the provider.
  3. Provisions to ensure compliance with, but not exceed, federal requirements for conflict-free case management.
    (2)   Qualifications of targeted case managers. A region’s manual shall require that any targeted case managers or other persons providing service coordination while working for the designated provider meet the qualifications of qualified case managers and supervisors as defined in rule 441—24.1(225C).    (3)   Targeted case management and service coordination services. Targeted case management and service coordination services utilized in a regional service system shall include but are not limited to the following as defined in Iowa Code section 331.393(4)“g”:
  1. Performance and outcome measures relating to the health, safety,school attendance and performance, work performance, and community residency of the individuals receiving the services.
  2. Standards for delivery of the services, including but not limited to the social history, assessment, service planning, incident reporting, crisis planning, coordination, and monitoring for individuals receiving the services.
  3. Methodologies for complying with the requirements of paragraph 25.21(1)“g.” Methodologies may include the use of electronic record keeping and remote or Internet-based training.
    h.    System of care approach plan.    i.    Decentralized service provision. Measures to provide services in a dispersed manner that meet the minimum access standards of core services and that utilize the strengths and assets of the service providers within and available to the region shall be included.    j.    Provider network formation and management. The manual shall require that providers that are subject to license, accreditation or approval meet established standards. The manual shall detail the approval process, including criteria, developed to select providers that are not currently subject to license, accreditation or approval standards. The manual shall identify the process the regional administrative entity will use to contract with providers and manage the provider network to ensure it meets the needs of the individuals in the region. The provider network will include but is not limited to the following:    (1)   A contract with a community mental health center that provides services in the individual’s region or with a federally qualified health center that provides psychiatric and outpatient mental health services in the individual’s region.    (2)   Contracts with licensed and accredited providers to provide each service in the required core service domains.    (3)   Adequate numbers of licensed and accredited providers to ensure availability of core services so that there is no waiting list for services due to lack of available providers.    (4)   A contract with an inpatient psychiatric hospital unit or state mental health institute within reasonably close proximity.    k.    Service provider payment provisions. A policy for payment of service providers which describes the method and process of paying for services and supports delivered to the region shall be included.    l.    Grievance processes. The manual shall develop and implement processes for appealing the decisions of the regional administrative entity in the following circumstances:    (1)   Nonexpedited appeal process. The appeal process shall be based on objective criteria, specify time frames, provide for notification in accessible formats of the decisions to all parties, and provide some assistance to individuals with disabilities using the process. Responsibility for the final step in the appeal process shall be a state administrative law judge in nonexpedited appeals.    (2)   Expedited appeal process. This appeal process is to be used when the decision of the regional administrative entity concerning an individual varies from the type and amount of service identified to be necessary for the individual in a clinical determination made by a mental health professional and the mental health professional believes that the failure to provide the type and amount of service identified could cause an immediate danger to an individual’s health or safety. This appeal process shall be performed by a mental health professional who is either the administrator of the division of mental health and disability services of the department of human services or the administrator’s designee.
  1. The appeal shall be filed within five days of receipt of the notice of decision by the regional administrative entity.
  2. The expedited review by the division administrator or designee shall take place within two days of receipt of the request, unless more information is needed. There is an extension of two days from the time the new information is received.
  3. The administrator shall issue an order, including a brief statement of findings of fact, conclusions of law, and policy reasons for the order, to justify the decision made concerning the expedited review. If the decision concurs with the contention that there is an immediate danger to the individual’s health or safety, the order shall identify the type and amount of service which shall be provided for the individual. The administrator or designee shall give such notice as is practicable to individuals who are required to comply with the order. The order is effective when issued.
  4. The decision of the administrator or designee shall be considered a final agency action and is subject to judicial review in accordance with Iowa Code section 17A.19.
    m.    Implementation of interagency and multisystem collaboration and care coordination. The policies and procedures manual shall describe how the region will collaborate with other funders, other regional service systems, service providers, case management, individuals and their families or authorized representatives, and advocates to ensure that authorized services and supports are responsive to individuals’ needs, consistent with system principles, and cost-efficient. The manual shall describe the process for collaboration with the court to ensure alternatives to commitment and to coordinate funding for services to individuals who are under court-ordered commitment services pursuant to Iowa Code chapter 229.    n.    Addressing multioccurring needs. The policies and procedures manual shall include criteria and measures to be used to address the needs of individuals who have two or more co-occurring mental health, intellectual or other developmental disability, brain injury, or substance-related disorders. The manual shall also include criteria and measures to be used to address the needs of individuals with specialized needs.    o.    Service management and functional assessment. The policies and procedures manual shall describe how functional assessments and service management will be incorporated in accordance with applicable requirements.    p.    Service system management. The policies and procedures manual shall identify whether the region will be directly implementing a system of service management or will contract with a private entity to manage the regional service system. If the region contracts with a private entity, the region will ensure that all requirements of Iowa Code section 331.393 and these administrative rules are fulfilled.     q.    Assistance to other than core service populations. The policies and procedures manual shall specify the services populations, other than core service populations, to whom the region will provide assistance if funding is available.    r.    Waiting list criteria. The policies and procedures manual shall specify whether the region will use waiting lists. If the policy and procedures manual specifies the use of waiting lists for funding services and supports, it shall specify criteria for the use and review of each waiting list, including the criteria to be used to determine how and when an individual will be placed on a waiting list. The criteria will include how core services and additional core services will be impacted the least by budgetary limitations. The manual shall specify how waiting list data will be used in future planning.

    ITEM 45.    Rescind 441—Chapter 25, Division IV, heading and preamble.

    ITEM 46.    Rescind rules 441—25.51(77GA,HF2545) to 441—25.55(77GA,HF2545).

    ITEM 47.    Rescind 441—Chapter 25, Division IV, implementation sentence.

    ITEM 48.    Rescind 441—Chapter 25, Division V, heading and preamble.

    ITEM 49.    Rescind rules 441—25.61(426B) to 441—25.66(426B).

    ITEM 50.    Rescind 441—Chapter 25, Division V, implementation sentence.

    ITEM 51.    Rescind 441—Chapter 25, Division VI, heading and preamble.

    ITEM 52.    Rescind rules 441—25.71(78GA,ch1221) to 441—25.77(78GA,ch1221).

    ITEM 53.    Rescind 441—Chapter 25, Division VI, implementation sentence.

    ITEM 54.    Rescind 441—Chapter 25, Division IX, heading and preamble.

    ITEM 55.    Rescind rules 441—25.95(426B) and 441—25.96(426B).

    ITEM 56.    Rescind 441—Chapter 25, Division IX, implementation sentence.

    ITEM 57.    Renumber 441—Chapter 25, Division X, heading and preamble, as 441—Chapter 25, Division IV, heading and preamble.

    ITEM 58.    Renumber rules 441—25.101(229) to 441—25.107(229) as 441—25.51(229) to 441—25.57(229).

    ITEM 59.    Amend renumbered paragraph 25.52(2)"b" as follows:    b.    A person employed as an advocate on or before July 1, 2015, who does not meet the requirements of subparagraph 25.102(2)“a”(1) or (2)25.52(2)“a”(1) or (2) shall be considered to meet those requirements so long as the person is continuously appointed as an advocate in the employing county.    [Filed 1/23/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4897CHuman Services Department[441]Adopted and Filed

Rule making related to case management services

    The Human Services Department hereby amends Chapter 73, “Managed Care,” Chapter 78, “Amount, Duration and Scope of Medical and Remedial Services,” and Chapter 83, “Medicaid Waiver Services,” rescinds Chapter 90, “Targeted Case Management,” and adopts a new Chapter 90, “Case Management Services,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 249A.4.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 249A.4.Purpose and Summary    This rule making adopts a new Chapter 90 that clarifies the case management service activities received by various populations in the Medicaid program and includes a definition of and references to a core standardized assessment (CSA) as required under the Balancing Incentive Program (BIP). BIP was created as part of the federal Patient Protection and Affordable Care Act. Participation by Iowa is required by 2012 Iowa Acts, chapter 1133, section 14, and 2013 Iowa Acts, chapter 138, section 142(20). In addition, new Chapter 90 outlines and requires billable activities for fee-for-service members, includes a requirement for provider reporting of minor incidents, and includes the person-centered service planning definition and service requirements. Also, cross-reference citations in other chapters that are affected by this rule making are updated.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 6, 2019, as ARC 4739C.     The Department received 83 written comments from eight respondents regarding the proposed changes. The following persons and organizations provided written comments: Linda Duffy, Integrated Health Home Program Manager, Child Health Specialty Clinics; Sabra Rosener, J.D., Vice President of Government and External Affairs at UnityPoint Health; Flora A. Schmidt, Executive Director, Iowa Behavioral Health Association; Jane Wollum, Administrator, Johnson County Case Management; Cynthia Pederson, J.D., State Long-Term Care Ombudsman; Melissa Ahrens, Director of Integrated Programs, Community Support Advocates; Sara Hackbart, Health Home Program Manager, Amerigroup; and Shelly Chandler, Executive Officer, Iowa Association of Community Providers.    The comments and corresponding responses from the Department are divided into ten topic areas as follows:     1. Additional clarification needed throughout Chapter 90. Twenty-nine comments were received on this topic.    • Twenty-five comments requested clarification regarding how new Chapter 90 applies to integrated health home (IHH) non-intensive care management (ICM) members.    Department response: The Department has added clarifying statements for each rule. The Department has also added statements clarifying that the requirements for this chapter apply to the IHH populations of habilitation services and the children’s mental health waiver, and not to the full IHH population.    • Three comments asked to have additional words defined.    Department response: The words “applicant” and “case management” are now defined in the chapter. The Department has taken the request to define the word “representative” under advisement, but has decided to not add the definition. “Representative” has many meanings depending upon how it is used. Leaving “representative” undefined in this chapter allows the broader meanings to all be acceptable.    • One comment requested use of the term “IHH care coordination” instead of “IHH case management.”     Department response: The term has been revised throughout the rule making as requested.    2. Location or method of contact. Seven comments were received on this topic.    • Five comments related to the change in location of the case manager quarterly face-to-face contact and to the restrictions involved in using face-to-face or telephonic contact as the methods of required monthly contact.     Department response: The Department has taken the suggestions under advisement, but has decided to not alter the chapter as suggested. The Department strongly believes that the case manager should have more direct interaction with the member and the guardian or representative to improve the case manager’s knowledge of the member’s residence in order to better assess and monitor member health, safety, and welfare. Members continue to have a choice in location and method of contact that is made outside of these three required contacts.    • One comment asked the Department to specify under what circumstances the managed care organization (MCO) contact requirements might differ from the requirements in subrule 90.4(1).    Department response: The Department has taken the comment under advisement, but has decided to not alter subrule 90.4(1) as suggested. This subrule was written without specificity to allow the Department future flexibility in MCO contract negotiation.    • One comment requested that the Department reinstate the prior rule language that allowed for broader options of methods of communication between the member and case manager for most contacts.    Department response: The Department has taken the comment under advisement, but has decided to not alter the chapter as suggested. In regard to the quarterly face-to-face contacts and the monthly face-to-face or telephonic contacts, the Department has purposely limited the method of contact in order to increase the case manager’s direct contact with the member and the guardian or representative. That increased direct contact should improve the case manager’s knowledge of the member’s residence in order to better assess and monitor member health, safety, and welfare. Members continue to have a choice in location and method of contact that is made outside of these three required contacts.    3. Core standardized assessments. Two comments were received on this topic. Commenters asked for clarification in regard to whether an MCO will perform the core standardized assessment or whether the MCO has the ability to transfer that responsibility to another entity.    Department response: The Department has revised the definition of “core standardized assessment” in rule 441—90.1(249A) to state that an MCO shall either perform core standardized assessments for MCO-enrolled members or transfer the responsibility to another entity.    4. Targeted case management and the definition of “targeted population.” Three comments were received on this topic. Commenters asked for clarification of targeted case management and the definition of “targeted population.”    Department response: Statements clarifying “targeted case management” and “targeted population” have been added to the chapter.    5. Person-centered planning. Nineteen comments were received on this topic.    • Eight comments requested changes to the wording used in subrule 90.4(1) regarding person-centered service plans and the person-centered planning process.    Department response: The Department has taken the comments under advisement, but has decided to not alter subrule 90.4(1) except as described in paragraph “6” below and except to add references to “guardian” to the subrule. The federal government has issued direction and guidance in relation to person-centered service plans and the person-centered planning process. The Department has purposefully chosen to not revise that wording other than to include a reference to “guardian” or “representative” wherever one term or the other is used.    • Five comments were received regarding the person-centered planning format or tool. Requests were made to have the formats and tools identified in rule.    Department response: The Department has taken the comments under advisement, but has decided to not make the suggested changes. The Department does not mandate or recommend any particular format or tool. If the case manager has options in either format or tool, then the member should have choice.    • One comment stated that the term “case manager” did not apply to IHH care coordination.    Department response: The definition of “case manager” in rule 441—90.1(249A) has been revised to explicitly include IHH care coordination for members participating in habilitation services and the children’s mental health waiver.    • One comment requested the addition of the word “services” after any reference to HCBS.    Department response: The Department has taken the comment under advisement, but has decided to not alter the rule as suggested. “HCBS” is an acronym for “home- and community-based services.” Adding the word “services” would be redundant.    • One comment requested that numbered paragraph 90.4(1)“b”(3)“10” be removed because the commenter thought that there was no identification of the entity responsible for carrying out the requirement stated in the paragraph.     Department response: The Department has taken the comment under advisement, but has decided to not remove or alter the paragraph. Paragraph 90.4(1)“b” already identifies the case manager as the person responsible for the person-centered service plan and processes.    • One comment asked the Department to designate the risk assessment tool to be used for all members.     Department response: The Department has taken the comment under advisement, but has decided to not alter the rules as requested. The Department has purposefully chosen to allow each case management provider to choose the risk assessment tool to be used.    • One comment asked that a redundant mention of the 365-day cycle for service plan review and revision be removed.     Department response: The Department has taken the comment under advisement, but has decided to not alter the language. The Department has purposefully used redundant language to stress the importance of the time frame.    • One comment requested that the Department reinstate prior language regarding monitoring to use the word “may” instead of the word “shall.”    Department response: The Department has taken the comment under advisement, but has decided to not alter the rule relating to monitoring. The Department purposefully revised the rule to use “shall” because the Department expects case managers to review provider service documentation to ensure the member is receiving services as authorized.    6. Assessments. Thirteen comments were received on this topic.    • Three comments asked for clarification about the use of face-to-face or telephonic reassessments.     Department response: Subrule 90.4(1) has been revised to indicate that only a Supports Intensity Scale® (SIS) assessment can be done telephonically, and then only when the situation meets the criteria outlined by the American Association on Intellectual and Developmental Disabilities (AAIDD), and to state that an interRAI reassessment cannot be done telephonically.    • Three comments asked to add the reference for the core standardized assessment used for the habilitation population.    Department response: Clarifying statements have been added to the definition of “core standardized assessment” and to subrule 90.4(1).    • One comment stated that the term “comprehensive assessment” has not been defined in the rules.     Department response: The word “comprehensive” in relation to assessments has been removed from the rules.    • Two comments requested clarification of the statement that case managers may participate during the assessment or reassessment process at the request of the member.    Department response: Subrule 90.4(1) has been clarified in response to this request. The commenters seemed to believe that the participation of the case manager in the assessment allows the case manager to become the assessor. This is not true. A trained assessor will always conduct the assessment. The case manager can participate just as a family member, representative, guardian, or provider can participate if chosen by the member.    • One commenter requested that the Department require that the case manager always be present unless contraindicated by the member.    Department response: The Department has taken the comment under advisement, but has decided to not alter the rule as suggested. While it is best practice that a case manager participates in the reassessment processes, the Department intends to allow member choice to take precedence.    • One commenter requested that the word “applicant” be used in conjunction with any mention of initial assessments, and that the word ‘“member” be used in conjunction with reassessments.    Department response: A definition of “applicant” has been added, and subrule 90.4(1) has been revised to refer to “applicant” as suggested, except in those parts of the subrule where federal guidance is used for the person-centered service plan and person-centered planning processes.    • One commenter suggested that the definition of “core standardized assessment” be moved out of the definitions rule and into the body of the rules.    Department response: The Department has taken the comment under advisement, but has decided to not alter the location of the definition.    • One commenter suggested that the Department require the assessment to be sent to the interdisciplinary team (IDT) within 14 calendar days.    Department response: The Department has taken the comment under advisement, but has decided to not alter the rule as suggested.    7. Covered services. Three comments were received on this topic.    • One comment questioned the change in subrule 90.4(1) to require monitoring activities by the case manager and stated that the words “as needed” appear to cause confusion.    Department response: The words “as needed” appeared in the proposed rules but have been removed upon revision. Monitoring is an integral part of case management and should be done as warranted by each individual situation. There are no frequency standards for this service.    • Two comments regarding case manager monitoring of provider documentation asked the Department to change the word “shall” to the word “may.”    Department response: The Department has taken the comment under advisement, but has decided to not alter the rule as suggested . The Department intends that case managers play a more active role in monitoring of provider documentation to gain better knowledge of the use of authorized services and of member welfare. At this time, the Department is not issuing guidance or mandates for this activity.    8. Billable activities. Two comments were received on this topic.    • One comment questioned the limited number of activities that are considered as billable activities for fee-for-service (FFS) case management (not applicable to MCO- or IHH-enrolled populations).    Department response: The Department has taken the comment under advisement, but has decided to not alter the rule in response to the comment. Informational Letter 1394, effective July 1, 2014, announced the then new limited billable activities list. This list was the consensus of a case management workgroup whose intention was to standardize billable activities in order to bring about standardization of provider rates. Billable activities were purposefully limited in order to stress the importance of completing case management activities efficiently.    • One comment suggested that the Department annually adjust the FFS case management fee schedule to allow for wage and benefit increases.    Department response: The Department has taken the comment under advisement, but has decided to not alter the rule as suggested. The Iowa Legislature determines when FFS provider rates are changed. If the Legislature mandates an increase, then the Department will comply.    9. 441—Chapter 24. One comment was received on this topic.    • The commenter asked if a specific subrule of 441—Chapter 24 applied to IHH-enrolled providers.     Department response: This rule making is applicable to Medicaid case management. Any questions related to 441—Chapter 24 should be addressed directly to the mental health and disability services staff.     10. Service provider requirements. Four comments were received on this topic.     • One comment questioned whether the proposed changes to who must report incidents were adding in the types of staff responsible to report.     Department response: The Department has taken the comment under advisement, but has decided to not alter the rule in response to the comment. This rule making implements a requirement that has been in practice for years and is already included in the Department’s other administrative rules.     • One comment expressed concern about the removal of references to appeal rights from the chapter.     Department response: The Department has taken the comment under advisement, but has decided to not alter the chapter in response to the comment. The Iowa Attorney General’s office advised removal of references to appeal rights because those rights are addressed under the Department’s other administrative rules. The intent is to avoid confusion due to the inclusion of these references in multiple rules. There is no effect on any member’s appeal rights by the removal of these references in this chapter.     • Two comments were received in reference to use of a risk assessment and subsequent updates to the person-centered service plan based upon review of changes to the risk assessment. The commenter asked to have the updates made to a progress note or another place in the member record instead of in the service plan.     Department response: The Department has taken the comment under advisement, but has decided to not alter the rule as requested. A progress note is not the person-centered service plan; it is merely a record of activities. The service plan drives how services are provided and is the living document used to communicate the services, or changes to services, to all providers and the others responsible for the plan.    In addition to making the changes described above, the Department added four new items to update cross-references affected by the adoption of new Chapter 90. No other changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the Council on Human Services on January 8, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend subrule 73.5(2) as follows:    73.5(2) Community-based case management service.  The managed care organization is required to provide services that meet requirements specified in the contract and in 441—subrule 90.5(1)441—Chapter 90.

    ITEM 2.    Amend paragraph 78.27(6)"a" as follows:    a.    Scope.Case management services shall be provided as set forth in rules 441—90.5(249A) and 441—90.8(249A)441—90.4(249A) through 441—90.7(249A).

    ITEM 3.    Amend paragraph 78.37(17)"a" as follows:    a.    Case management services shall be provided as set forth in rules 441—90.5(249A) and 441—90.8(249A)441—90.4(249A) through 441—90.7(249A).

    ITEM 4.    Amend paragraph 78.43(1)"a" as follows:    a.    Case management services shall be provided as set forth in rules 441—90.5(249A) and 441—90.8(249A)441—90.4(249A) through 441—90.7(249A).

    ITEM 5.    Amend subparagraph 83.2(1)"d" as follows:    (1)   The member’s designated case manager shall use the completed assessment to develop the comprehensive service plan as specified in rule 441—90.5(249A).441—paragraph 90.4(1)“b.”

    ITEM 6.    Amend rule 441—83.7(249A), introductory paragraph, as follows:

441—83.7(249A) Service plan.  A service plan shall be prepared for health and disability waiver members in accordance with 441—paragraph 90.5(1)“b.”441—paragraph 90.4(1)“b.” Service plans for both children and adults shall be completed every 12 months or when there is significant change in the person’s situation or condition.

    ITEM 7.    Amend paragraph 83.22(2)"a" as follows:    a.    Case management.Consumers under the elderly waiver shall receive case management services from a provider qualified pursuant to rule 441—77.29(249A). Case management services shall be provided as set forth in rules 441—90.5(249A) and 441—90.8(249A)441—90.4(249A) through 441—90.7(249A).

    ITEM 8.    Rescind 441—Chapter 90 and adopt the following new chapter in lieu thereof: CHAPTER 90CASE MANAGEMENT SERVICESPreamble    Case management services are designed to ensure the health, safety, and welfare of members by assisting them in gaining access to appropriate and necessary medical services and interrelated social, educational, housing, transportation, vocational, and other services. The term “case management” encompasses all categories of case management: targeted case management, case management and administrative case management provided to members enrolled in a 1915(c) waiver, community-based case management provided through managed care, and integrated health home (IHH) care coordination provided to the habilitation and children’s mental health waiver populations. If a part of these rules does not apply to all categories of case management, then the rule will clarify the affected category(ies).

441—90.1(249A) Definitions.          "Adult" means a person 18 years of age or older on the first day of the month in which service begins.        "Applicant" means a person who has applied for an HCBS waiver or habilitation program.        "Care coordination" means the case management services provided by an integrated health home to members who are also receiving home- and community-based habilitation services pursuant to rule 441—78.27(249A) or HCBS children’s mental health waiver services pursuant to rules 441—83.121(249A) through 441—83.129(249A).        "Case management" means the categories of case management: targeted case management, case management provided to members enrolled in a 1915(c) waiver, community-based case management provided through managed care, and integrated health home (IHH) care coordination provided to the habilitation and children’s mental health waiver populations.         "Case manager" means the staff person providing all categories of case management services regardless of the entity providing the service or the program in which the member is enrolled, including IHH care coordination.        "Child" means a person other than an adult.        "Chronic mental illness" means a condition present in adults who have a persistent mental or emotional disorder that seriously impairs their functioning relative to such primary aspects of daily living as personal relations, living arrangements, or employment. The definition of chronic mental illness and qualifying criteria are found at rule 441—24.1(225C). For purposes of this chapter, people with mental disorders resulting from Alzheimer’s disease or substance abuse shall not be considered chronically mentally ill.        "Community-based case manager" means the employee of a Medicaid-contracted managed care organization (MCO) who provides case management services to MCO-enrolled members.        "Core standardized assessment" "CSA" means an assessment instrument for determining the suitability of non-institutionally based long-term services and supports for an individual. The instrument shall be used in a uniform manner throughout the state to determine an applicant’s or member’s needs for training, support services, medical care, transportation, and other services and to develop an individual service plan to address such needs. The core standardized assessment shall be performed by a contractor under the direction of the department for the fee-for-service population. MCOs shall perform core standardized assessments for MCO-enrolled members or shall delegate the responsibility for completion of assessments. 441—Chapter 83 designates the assessment and reassessment tools to be used for each HCBS waiver. 441—Chapter 78 designates the assessment and reassessment tools to be used for habilitation.         "Department" means the department of human services.        "Developmental disability" means a severe, chronic disability that is determined through professionally administered screening and evaluations and that:
  1. Is attributable to a mental or physical impairment or combination of mental and physical impairments;
  2. Is manifested before the age of 22;
  3. Is likely to continue indefinitely;
  4. Results in substantial functional limitations in three or more of the following areas of major life activity: (a) self-care, (b) receptive and expressive language, (c) learning, (d) mobility, (e) self-direction, (f) capacity for independent living, and (g) economic self-sufficiency; and
  5. Reflects the person’s need for a combination and sequence of special, interdisciplinary, or generic services, individualized supports, or other forms of assistance that are of lifelong or extended duration and are individually planned and coordinated.
        "Fee-for-service member" "FFS member" means a member who is not enrolled with a managed care organization because the member is exempt from managed care organization enrollment.        "Home- and community-based services" "HCBS" means services provided pursuant to Sections 1915(c) and 1915(i) of the Social Security Act.        "Integrated health home" "IHH" means a provider of health home services that is a Medicaid-enrolled provider and that is determined through the provider enrollment process to have the qualifications, systems and infrastructure in place to provide IHH services pursuant to rule 441—77.47(249A). IHH covered services and member eligibility for IHH enrollment are also governed by rule 441—78.53(249A) and the health home state plan amendment. The IHH provides care coordination services for enrolled habilitation and children’s mental health waiver members.        "Intellectual disability" means a diagnosis of intellectual disability (intellectual developmental disorder), global developmental delay, or unspecified intellectual disability (intellectual developmental disorder). Diagnosis criteria are outlined in rule 441—83.61(249A).         "Major incident" means an occurrence that involves a member who is enrolled in an HCBS waiver, targeted case management, or habilitation services and that:
  1. Results in a physical injury to or by the member that requires a physician’s treatment or admission to a hospital;
  2. Results in the death of any person;
  3. Requires emergency mental health treatment for the member;
  4. Requires the intervention of law enforcement;
  5. Requires a report of child abuse pursuant to Iowa Code section 232.69, a report of dependent adult abuse pursuant to Iowa Code section 235B.3, or a report of elder abuse pursuant to Iowa Code chapter 235F; or
  6. Involves a member’s location being unknown by provider staff who are responsible for protective oversight.
        "Managed care organization" "MCO" means the same as defined in rule 441—73.1(249A).        "Medical institution" means an institution that is organized, staffed, and authorized to provide medical care as set forth in the most recent amendment to 42 Code of Federal Regulations Section 435.1009. A residential care facility is not a medical institution.        "Member" means a person who has been determined to be eligible for Medicaid under 441—Chapter 75.        "Minor incident" means an occurrence that involves a member who is enrolled in an HCBS waiver, targeted case management, or habilitation services and that is not a major incident but that:
  1. Results in the application of basic first aid;
  2. Results in bruising;
  3. Results in seizure activity;
  4. Results in injury to self, to others, or to property; or
  5. Constitutes a prescription medication error.
        "Person-centered service plan" "service plan" means a service plan created through the person-centered planning process, directed by the member with long-term care needs or the member’s guardian or representative, to identify the member’s strengths, capabilities, preferences, needs, and desired outcomes.        "Rights restriction" means limitations not imposed on the general public in the areas of communication, mobility, finances, medical or mental health treatment, intimacy, privacy, type of work, religion, place of residence, and people with whom a member may share a residence.        "Targeted case management" means case management services furnished to assist members who are part of a targeted population.        "Targeted population" means people who meet one of the following criteria:
  1. An adult who is identified with a primary diagnosis of intellectual disability, chronic mental illness, or developmental disability; or
  2. A child who is eligible to receive HCBS intellectual disability waiver services or HCBS children’s mental health waiver services according to 441—Chapter 83.
A member enrolled with a managed care organization or integrated health home is not part of the targeted population.

441—90.2(249A) Targeted case management.  Rule 441—90.2(249A) applies only to the case management category of targeted case management and the defined targeted population.    90.2(1) Eligibility for targeted case management.  A person who meets all of the following criteria shall be eligible for targeted case management:    a.    The person is eligible for Medicaid or is conditionally eligible under 441—subrule 75.1(35);    b.    The person is a member of a targeted population;    c.    The person resides in a community setting or qualifies for transitional case management as set forth in subrule 90.2(4);    d.    The person has applied for targeted case management in accordance with the policies of the provider;    e.    The person’s need for targeted case management has been determined in accordance with rule 441—90.2(249A); and    f.    The person is not eligible for, or enrolled in, Medicaid managed care.    90.2(2) Determination of need for targeted case management.  Assessment at least every 365 days of the need for targeted case management is required as a condition of eligibility under the medical assistance program. The targeted case management provider shall determine the member’s initial and ongoing need for service based on diagnostic reports, documentation of provision of services, and information supplied by the member and other appropriate sources. The evidence shall be documented in the member’s file and shall demonstrate that all of the following criteria are met:    a.    The member has a need for targeted case management to manage necessary medical, social, educational, housing, transportation, vocational, and other services for the benefit of the member;    b.    The member has functional limitations and lacks the ability to independently access and sustain involvement in necessary services; and    c.    The member is not receiving, under the medical assistance program or under a Medicaid managed health care plan, other paid benefits that serve the same purpose as targeted case management or integrated health home care coordination.    90.2(3) Application for targeted case management.  The provider shall process an application for targeted case management no later than 30 days after receipt of the application. The provider shall refer the applicant to the department’s service unit or mental health and disability services regions if other services outside the scope of case management are needed or requested.    a.    Application process and documentation.The application shall include the member’s name, the nature of the request for services, and a summary of any evaluation activities completed. For FFS members, the provider shall inform the applicant in writing of the applicant’s right to choose the provider of case management services and, at the applicant’s request, shall provide a list of other case management services agencies from which the applicant may choose. The provider shall maintain this documentation for at least five years.    b.    Application decision for targeted case management.The case manager shall inform the applicant, or the applicant’s guardian or representative, of any decision to approve, deny, or delay the service in accordance with the notification requirements at 441—subrule 7.7(1).    c.    Denial of applications.The case manager shall deny an application for service when:    (1)   The applicant is not currently eligible for Medicaid;    (2)   The applicant does not meet the eligibility criteria in 441—subrule 90.2(1);    (3)   The applicant, or the applicant’s guardian or representative, withdraws the application;    (4)   The applicant does not provide information required to process the application;    (5)   The applicant is receiving duplicative targeted case management or integrated health home care coordination from another Medicaid provider; or    (6)   The applicant does not have a need for targeted case management.    90.2(4) Transition to a community setting.  Managed care organizations must provide transition services to all enrolled members. Fee-for-service targeted case management services may be provided to a member transitioning to a community setting during the 60 days before the member’s discharge from a medical institution when the following requirements are met:     a.    The member is an adult who qualifies for targeted case management and is a member of a targeted population. Transitional case management is not an allowable service for other HCBS programs or populations;    b.    Case management services shall be coordinated with institutional discharge planning, but shall not duplicate institutional discharge planning;    c.    The amount, duration, and scope of case management services shall be documented in the member’s service plan, which must include case management services before and after discharge, to facilitate a successful transition to community living;    d.    Payment shall be made only for services provided by Medicaid-enrolled targeted case management providers; and    e.    Claims for reimbursement for case management services shall not be submitted until the member’s discharge from the medical institution and enrollment in community services.

441—90.3(249A) Termination of targeted case management services.  Rule 441—90.3(249A) applies only to the case management category of targeted case management and the defined targeted population.    90.3(1)   Targeted case management shall be terminated when:    a.    The member does not meet eligibility criteria under rule 441—90.2(249A);    b.    The member has achieved all goals and objectives of the service;    c.    The member has no ongoing need for targeted case management;     d.    The member is receiving targeted case management based on eligibility under an HCBS program but is no longer eligible for the program;    e.    The member or the member’s guardian or representative requests termination;    f.    The member is unwilling or unable to accept further services; or    g.    The member or the member’s guardian or representative fails to provide access to information necessary for the development of the service plan or for implementation of targeted case management.    90.3(2)   The provider shall notify the member or the member’s guardian or representative in writing of the termination of targeted case management, in accordance with 441—subrule 7.7(1).

441—90.4(249A) Case management services.  Rule 441—90.4(249A) applies to all categories of case management and all populations covered by case management.    90.4(1) Covered services.  The following shall be included in case management services provided to members, whether FFS members or MCO-enrolled members:    a.    Assessment.Initial assessments and regular reassessments must be done for each applicant and member to determine the need for any medical, social, educational, housing, transportation, vocational, or other services. The assessments and reassessments shall address all of the applicant’s and member’s areas of need, strengths, preferences, and risk factors, considering the person’s physical and social environment. Applicants and members will receive individualized prior notification of the assessment tool to be used and of who will conduct the assessment. The assessment and reassessment will be done using the core standardized assessment or another tool as designated in 441—Chapter 83 for each waiver population and 441—Chapter 78 for the habilitation population. Initial assessments must be face to face. Reassessments using the interRAI must be done face to face. Only the Supports Intensity Scale® assessment can be done telephonically, and then only when the situation meets the criteria outlined by the American Association on Intellectual and Developmental Disabilities (AAIDD). The off-year assessment (OYA) for the intellectual disability waiver can be done telephonically. A reassessment must be conducted at a minimum every 365 days and more frequently if material changes occur in the member’s condition or circumstances. Case managers may participate during the assessment or reassessment process at the request of the applicant or member; the case manager does not assume the role of the assessor.    b.    Person-centered service plan.At least every 365 days, the case manager shall develop and revise a comprehensive, person-centered service plan in collaboration with the member, the member’s service providers, and other people identified as necessary by the member, as practicable. The person-centered service plan will be developed based on the assessment and shall include a crisis intervention plan based on the risk factors identified in a risk assessment. The case manager shall document the member’s history, including current and past information and social history, and shall update the history annually. The case manager shall gather information from other sources such as family members, medical providers, social workers, guardians, representatives, and others as necessary to form a thorough social history and comprehensive person-centered service plan with the member. The person-centered service plan may also be referred to as a person-centered treatment plan.    (1)   The person-centered service plan shall address all service plan components outlined in this chapter and in 441—Chapter 83 for the waiver in which the member is enrolled or 441—Chapter 78 for members enrolled in habilitation.    (2)   Person-centered planning shall be implemented in a manner that supports the member, makes the member central to the process, and recognizes the member as the expert on goals and needs. In order for this to occur, there are certain process elements that must be included in the process. These include:     1.   The member, guardian or representative must have control over who is included in the planning process, as well as have the authority to request meetings and revise the person-centered service plan (and any related budget) whenever reasonably necessary.    2.   The process is timely and occurs at times and locations of convenience to the member, the member’s guardian or representative and family members, and others, as practicable.    3.   Necessary information and support are provided to ensure that the member or the member’s guardian or representative is central to the process and understands the information. This includes the provision of auxiliary aids and services when needed for effective communication.    4.   A strengths-based approach to identifying the positive attributes of the member shall be used, including an assessment of the member’s strengths and needs. The member should be able to choose the specific planning format or tool used for the planning process.    5.   The member’s personal preferences shall be considered to develop goals and to meet the member’s HCBS needs.    6.   The member’s cultural preferences must be acknowledged in the planning process, and policies/practices should be consistent with the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards) of the Office of Minority Health, U.S. Department of Health and Human Services.    7.   The planning process must provide meaningful access to members and their guardians or representatives with limited English proficiency (LEP), including low literacy materials and interpreters.    8.   Members who are under guardianship or other legal assignment of individual rights, or who are being considered as candidates for these arrangements, must have the opportunity in the planning process to address any concerns.    9.   There shall be mechanisms for solving conflict or disagreement within the process, including clear conflict of interest guidelines.    10.   Members shall be offered information on the full range of HCBS available to support achievement of personally identified goals.    11.   The member or the member’s guardian or representative shall be central in determining what available HCBS are appropriate and will be used.    12.   The member shall be able to choose between providers or provider entities, including the option of self-directed services when available.    13.   The person-centered service plan shall be reviewed at least every 365 days or sooner if the member’s functional needs change, circumstances change, or quality of life goals change, or at the member’s request. There shall be a clear process for members to request reviews. The case management entity must respond to such requests in a timely manner that does not jeopardize the member’s health or safety.     14.   The planning process should not be constrained by any case manager’s or guardian’s or representative’s preconceived limits on the member’s ability to make choices.    15.   Employment and housing in integrated settings shall be explored, and planning should be consistent with the member’s goals and preferences, including where the member resides and with whom the member lives.    (3)   Elements of the person-centered service plan. The person-centered service plan shall identify the services and supports that are necessary to meet the member’s identified needs, preferences, and quality of life goals. The person-centered service plan shall:    1.   Reflect that the setting where the member resides is chosen by the member. The chosen setting must be integrated in, and support full access to, the greater community, including opportunities to seek employment and work in competitive integrated settings, engage in community life, control personal resources, and receive services in the community to the same degree of access as individuals not receiving HCBS.     2.   Be prepared in person-first singular language and be understandable by the member or the member’s guardian or representative.    3.   Note the strengths-based positive attributes of the member at the beginning of the plan.    4.   Identify risks, while considering the member’s right to assume some degree of personal risk, and include measures available to reduce risks or identify alternate ways to achieve personal goals.     5.   Document goals in the words of the member or the member’s guardian or representative, with clarity regarding the amount, duration, and scope of HCBS services that will be provided to assist the member. Goals shall consider the quality of life concepts important to the member.    6.   Describe the services and supports that will be necessary and specify what HCBS services are to be provided through various resources, including natural supports, to meet the goals in the person-centered service plan.     7.   Document the specific person or persons, provider agency and other entities providing services and supports.    8.   Ensure the health and safety of the member by addressing the member’s assessed needs and identified risks.    9.   Document non-paid supports and items needed to achieve the goals.    10.   Include the signatures of everyone with responsibility for the plan’s implementation, including the member or the member’s guardians or representatives, the case manager, the support broker/agent (when applicable), and providers, and include a timeline for review of the plan. The plan must be discussed with family, friends, and caregivers designated by the member so that they fully understand it and their roles.    11.   Identify each person and entity responsible for monitoring the plan’s implementation.    12.   Identify needed services based upon the assessed needs of the member and prevent unnecessary or inappropriate services and supports not identified in the assessed needs of the member.    13.   Document an emergency back-up plan that encompasses a range of circumstances (e.g., weather, housing, and staff).    14.   Address elements of self-direction through the consumer choices option (e.g., financial management service, support broker/agent, alternative services) whenever the consumer choices option is chosen.    15.   Be distributed directly to all parties involved in the planning process.    c.    Referral and related activities.The case manager shall assist, as needed, the member in obtaining needed services, such as by scheduling appointments for the member and by connecting the member with medical, social, educational, housing, transportation, vocational or other service providers or programs that are capable of providing needed services to address identified needs and risk factors and to achieve goals specified in the person-centered service plan.    d.    Monitoring and follow-up.The case manager shall perform monitoring activities and make contacts that are necessary to ensure the health, safety, and welfare of the member and to ensure that the person-centered service plan is effectively implemented and adequately addresses the needs of the member. At a minimum, monitoring shall include assessing the member, the places of service (including the member’s home, when applicable), and all services regardless of the service funding stream. Monitoring shall also include review of service provider documentation. Monitoring of the following aspects of the person-centered service plan shall lead to revisions of the plan if deficiencies are noted:    (1)   Services are being furnished in accordance with the member’s person-centered service plan, including the amount of service provided and the member’s attendance and participation in the service;    (2)   The member has declined services in the service plan;    (3)   Communication among providers is occurring, as practicable, to ensure coordination of services;    (4)   Services in the person-centered service plan are adequate, including the member’s progress toward achieving the goals and actions determined in the person-centered service plan; and    (5)   There are changes in the needs or circumstances of the member. Follow-up activities shall include making necessary adjustments in the person-centered service plan and service arrangements with providers.    e.    Contacts.Case managers shall make contacts with the member, the member’s guardians or representatives, or service providers as frequently as necessary and no less frequently than necessary to meet the following requirements:    (1)   The case manager shall have at least one face-to-face contact with the member in the member’s residence at least quarterly;    (2)   The case manager shall have at least one contact per month with the member or the member’s guardians or representatives. This contact may be face to face or by telephone;    (3)   Community-based case management contacts will be made in accordance with the Medicaid contract MED-16-019, or subsequent Medicaid managed care contracts with the department, in those instances where the contract specifies contacts different from this rule.    90.4(2) Exclusions.  Payment shall not be made for activities otherwise within the definition of case management services when any of the following conditions exist:    a.    The activities are an integral component of another covered Medicaid service.    b.    The activities constitute the direct delivery of underlying medical, social, educational, housing, transportation, vocational or other services to which a member has been referred. Such services include, but are not limited to:    (1)   Services under parole and probation programs;    (2)   Public guardianship programs;    (3)   Special education programs;    (4)   Child welfare and child protective services; or    (5)   Foster care programs.    c.    The activities are components of the administration of foster care programs, including but not limited to the following:    (1)   Research gathering and completion of documentation required by the foster care program;    (2)   Assessing adoption placements;    (3)   Recruiting or interviewing potential foster care parents;    (4)   Serving legal papers;    (5)   Conducting home investigations;    (6)   Providing transportation related to the administration of foster care;    (7)   Administering foster care subsidies; or    (8)   Making placement arrangements.    d.    The activities for which a member may be eligible are a component of the administration of another nonmedical program, such as a guardianship, child welfare or child protective services, parole, probation, or special education program, except for case management that is included in an individualized education program or individualized family service plan consistent with Section 1903(c) of the Social Security Act.    e.    The activities duplicate institutional discharge planning.

441—90.5(249A) Rights restrictions.  Rule 441—90.5(249A) applies to all categories of case management and all populations covered by case management. Any effort to restrict the rights of a member to realize the member’s preferences or goals must be justified by a specific individualized assessed safety need and documented in the person-centered service plan. The following requirements must be documented in the plan when a safety need has been identified that warrants a rights restriction:    1.   The specific and individualized assessed safety need;    2.   The positive interventions and supports used prior to any modifications or additions to the person-centered service plan regarding safety needs;    3.   The less intrusive methods of meeting the safety needs that have been tried but were not successful;     4.   A clear description of the rights restriction that is directly proportionate to the specific assessed safety need;    5.   The regular collection and review of data to measure the ongoing effectiveness of the rights restriction;    6.   The established time limits for periodic reviews to determine whether the rights restriction is still necessary or can be terminated;    7.   The informed consent of the member to the proposed rights restriction; and    8.   An assurance that the rights restriction itself will not cause undue harm to the member.

441—90.6(249A) Documentation and billing.      90.6(1) Documentation of contacts.  Subrule 90.6(1) applies to all categories of case management and all populations covered by case management.    a.    Documentation of case management services contacts shall include:    (1)   The name of the individual case manager;    (2)   The need for, and occurrences of, coordination with other case managers within the same agency or referral or transition to another case management agency; and    (3)   Other requirements as outlined in rule 441—79.3(249A) to support payment of services.    b.    Targeted case management providers serving FFS members must also adhere to 441—subrule 24.4(4).    90.6(2) Rounding units of service for case management services.  Subrule 90.6(2) applies only to targeted case management provided to FFS members or case management provided to brain injury or elderly waiver FFS members. For all fee-for-service case management units of service, the following rounding process shall be used:    a.    Add together the minutes spent on all billable activities during a calendar day for a daily total;    b.    For each day, divide the total minutes spent on billable activities by 15 to determine the number of full 15-minute units for that day;    c.    Round the remainder using these guidelines: Round 1 to 7 minutes down to zero units; round 8 to 14 minutes up to one unit; and    d.    Add together the number of full units and the number of rounded units to determine the total number of units to bill for that day.    90.6(3) Collateral contacts.  Subrule 90.6(3) applies only to targeted case management provided to FFS members or case management provided to brain injury or elderly waiver FFS members. For all fee-for-service case management units of service, the case manager may bill for documented contacts with other entities and individuals if the contacts are directly related to the member’s needs and care, such as helping the member access services, identifying needs and supports to assist the member in obtaining services, providing other case managers with useful feedback, and alerting other case managers to changes in the member’s needs.    90.6(4) Billable activities for case management services.  Subrule 90.6(4) applies only to targeted case management provided to FFS members or case management provided to brain injury or elderly waiver FFS members. Billable activities for case management services are limited to the following activities, and any activity included in this list must be billed if the activity has occurred.    a.    Face-to-face meeting with the member:    (1)   Contact time; and    (2)   Documentation completed during meeting.    b.    Telephone conversation with the member:    (1)   Contact time; and    (2)   Documentation completed during meeting.    c.    Collateral contacts on behalf of the member, including face-to-face, telephone, and email contacts:    (1)   Contact time; and    (2)   Documentation completed during meeting.    d.    Individual care plans and person-centered service plans:    (1)   Creation; and    (2)   Revision.    e.    Social histories:    (1)   Creation; and    (2)   Revision.    f.    Assessments and reassessments:    (1)   Participation during the assessment if requested by the member; and    (2)   Utilization of the assessment for creation of the person-centered service plan.

441—90.7(249A) Case management services provider requirements.  Rule 441—90.7(249A) applies to all categories of case management and all populations covered by case management.    90.7(1) Reporting procedures for major incidents.      a.    When a major incident occurs or a staff member becomes aware of a major incident:    (1)   The staff member shall notify the following persons of the incident by midnight of the next calendar day after the incident:    1.   The staff member’s supervisor;    2.   The member or member’s legal guardians; and    3.   The member’s case manager. The case manager shall create an incident report if a provider has not submitted a report.    (2)   By midnight of the next business day after the incident, the staff member who observed or first became aware of the incident shall also report as much information as is known by the staff member about the incident to the member’s managed care organization in the format required by the managed care organization. If the member is not enrolled with a managed care organization, or is receiving money follows the person funding, the staff member shall report the information by direct data entry into the Iowa Medicaid portal access (IMPA) system. The case manager is responsible for reporting the incident if the provider of service has not already reported the incident.    (3)   The following information shall be reported:    1.   The name of the member involved;    2.   The date, time, and location where the incident occurred;    3.   A description of the incident;    4.   The names of all provider staff and others who were present at the time of the incident or who responded after becoming aware of the incident. The confidentiality of other Medicaid-eligible members or non-Medicaid-eligible persons who were present must be maintained by the use of initials or other means;    5.   The action taken to manage or respond to the incident;    6.   The resolution of or follow-up to the incident; and    7.   The date the report is made and the handwritten or electronic signature of the person making the report.    (4)   When complete information about the incident is not available at the time of the initial report, the case management services provider must submit follow-up reports until the case manager is satisfied with the incident resolution and follow-up.    (5)   The case management services provider shall maintain the completed report in a centralized file with a notation in the member’s file.    (6)   The case management services provider shall track incident data and analyze trends to assess the health and safety of members served and to determine whether changes need to be made for service implementation or whether staff training is needed to reduce the number or severity of incidents.    b.    When an incident report for a major incident is received from any provider, the case manager shall monitor the situation to ensure that the member’s needs continue to be met.    c.    When any major incident occurs, the case manager shall reevaluate the risk factors identified in the risk assessment portion of the service plan in order to ensure the continued health, safety, and welfare of the member. Documentation must be made in the person-centered service plan of this review and follow-up activities.     90.7(2) Reporting procedures for minor incidents.  Minor incidents may be reported in any format designated by the case management services provider. When a minor incident occurs, or a staff member becomes aware of a minor incident, the staff member involved shall submit the completed incident report to the staff member’s supervisor within 72 hours of the incident. The completed report shall be maintained in a centralized file with a notation in the member’s file.    90.7(3) Quality assurance.  Case management services providers shall cooperate with quality assurance activities conducted by the Iowa Medicaid enterprise or a Medicaid managed care organization, as well as any other state or federal entity with oversight authority to ensure the health, safety, and welfare of Medicaid members. These activities may include, but are not limited to:    a.    Postpayment review of case management services;    b.    Review of incident reports;    c.    Review of reports of abuse or neglect; and    d.    Technical assistance in determining the need for service.       These rules are intended to implement Iowa Code section 249A.4.
    [Filed 1/14/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4898CHuman Services Department[441]Adopted and Filed

Rule making related to the monthly standard deduction for personal care services at a residential care facility

    The Human Services Department hereby amends Chapter 75, “Conditions of Eligibility,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 249A.4.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 249.12.Purpose and Summary    This rule making will continue to allow an annual change in the statewide monthly standard deduction for personal care services provided in a licensed residential care facility (RCF) based on the Consumer Price Index (CPI) for All Urban Consumers. This annual change continues to benefit medically needy members who reside in licensed RCFs because it continues to allow personal care needs to be applied to the spenddown obligation.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 6, 2019, as ARC 4738C. No public comments were received. No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the Council on Human Services on January 8, 2020.Fiscal Impact     There is minimal fiscal impact expected as a result of this rule making. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making action is adopted:

    ITEM 1.    Amend subparagraph 75.1(35)"g" as follows:    (2)   Order of deduction. Spenddown shall be adjusted when a bill for a Medicaid-covered service incurred during the certification period has been applied to meet spenddown if a bill for a covered service incurred prior to the certification period is subsequently received. Spenddown shall also be adjusted when a bill for a noncovered Medicaid service is subsequently received with a service date prior to the Medicaid-covered service. Spenddown shall be adjusted when an unpaid bill for a Medicaid-covered service incurred during the certification period has been applied to meet spenddown if a paid bill for a covered service incurred in the certification period is subsequently received with a service date prior to the date of the notice of spenddown status.If spenddown has been met and a bill is received with a service date after spenddown has been met, the bill shall not be deducted to meet spenddown.Incurred medical expenses, including those reimbursed by a state or political subdivision program other than Medicaid, but excluding those otherwise subject to payment by a third party, shall be deducted in the following order:
  1. Medicare and other health insurance premiums, deductibles, or coinsurance charges.
Exception: When some of the household members are eligible for full Medicaid benefits under the Health Insurance Premium Payment Program (HIPP), as provided in rule 441—75.21(249A), the health insurance premium shall not be allowed as a deduction to meet the spenddown obligation of those persons in the household in the medically needy coverage group.
  1. An average statewide monthly standard deduction for the cost of medically necessary personal care services provided in a licensed residential care facility shall be allowed as a deduction for spenddown. These personal care services include assistance with activities of daily living such as preparation of a special diet, personal hygiene and bathing, dressing, ambulation, toilet use, transferring, eating, and managing medication.The average statewide monthly standard deduction for personal care services shall be based on the average per day rate of health care costs associated with residential care facilities participating in the state supplementary assistance program for a 30.4-day month as computed in the Compilation of Various Costs and Statistical Data (Category: All; Type of Care: Residential Care Facility; Location: All; Type of Control: All)by multiplying the previous year’s average per day rate by the inflation factor increase during the preceding calendar year ending December 31 of the Consumer Price Index for All Urban Consumers as published by the Bureau of Labor Statistics. The average statewide standard deduction for personal care services used in the medically needy program shall be updated and effective the first day of the first month beginning two full months after the release of the Compilation of Various Costs and Statistical Data for the previous fiscal year.
  2. Medical expenses for necessary medical and remedial services that are recognized under state law but not covered by Medicaid, chronologically by date of submission.
  3. Medical expenses for acupuncture, chronologically by date of submission.
  4. Medical expenses for necessary medical and remedial services that are covered by Medicaid, chronologically by date of submission.
    [Filed 1/9/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4899CHuman Services Department[441]Adopted and Filed

Rule making related to medical and remedial services

    The Human Services Department hereby amends Chapter 78, “Amount, Duration and Scope of Medical and Remedial Services,” and Chapter 79, “Other Policies Relating to Providers of Medical and Remedial Care,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 249A.4.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 249A.4.Purpose and Summary    This rule making updates and clarifies language to reflect existing prescribed outpatient drug policies for qualified prescribers, reasons for nonpayments of drugs, covered nonprescription drugs, quantity prescribed, drug reimbursement methodology (including dispensing fee limitation) and credits for returned unit dose drugs not consumed. This rule making also adds language regarding initiation of refill requirements with the prohibition of automatic refills without the member’s consent and includes legislatively required prior authorization (PA) limitations on medication-assisted treatment (MAT), including opioid overdose treatment, under the pharmacy and medical benefits.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 20, 2019, as ARC 4763C.     The Department received seven comments from two respondents regarding the proposed changes: Flora A. Schmidt, Executive Director, Iowa Behavioral Health Association; and Casey Ficek, J.D., Director, Public Affairs, Iowa Pharmacy Association. The comments and corresponding responses from the Department are divided into five topic areas as follows:    1. Nonpayment of drugs. Two comments were received on this topic.    • One respondent commented that the rules, in not allowing payment for drug products administered in a practitioner’s office, outpatient clinic or infusion center, may limit access to MAT drugs at opioid treatment programs, MAT unit sites and mental health centers and substance abuse treatment facilities. The respondent requested deletion of the provision or its amendment, with exceptions for behavioral health facilities.    • One respondent commented that not allowing payment for drug products administered in a practitioner’s office, outpatient clinic or infusion center, while current policy under Medicaid, has resulted in some access issues for certain therapies provided in an infusion center controlled setting for Medicaid patients and requested reconsideration.    Department response: The Department will further research the access concerns identified in the comments before formalizing the policy in rule. The proposed statement has been removed from this adopted rule making.    2. Prior authorization for medication-assisted treatment drugs. Two comments were received on this topic.    • One respondent recommended a formatting change for the rule language and requested deletion of added language, indicating that it was not in the legislative language for this requirement.    Department response: The Department inserted a line break return after the last drug in the list in subrule 78.28(2). The language “opioid overdose agent” clarifies that naltrexone is approved by the Food and Drug Administration (FDA) for the treatment of opioid overdose. The Department revised the language to clarify concerns.    • One respondent expressed support for the removal of the prior authorization requirements to increase access to treatment for opioid use disorder.    Department response: The Department agrees with the comment. Increased access to treatment was the reason the Department initiated removal of the prior authorization requirement in the administrative rules.    3. Qualified prescriber. One comment was received on this topic.    • One respondent expressed support for the change to eliminate the list of specific qualified prescribers to ensure that the list will not have to be continually updated to reflect future changes in state law.    Department response: The Department agrees with the comment, and this was the reason the Department initiated removal of the prescriber list in the administrative rules.    4. Professional dispensing fee. One comment was received on this topic.    • One respondent expressed concerns about how one dispensing per month may affect patients seeking to utilize medication synchronization services, patients residing in nursing home and long-term care facilities, and prepacked drugs in less than a 30-day supply (for example, oral contraceptives).    Department response: Medication synchronization services are not a currently covered policy under Medicaid, and this rule language will not change that. If a pharmacy makes a business model decision to service nursing homes and long-term care facilities, that pharmacy has the ability to continue billing according to its existing process (for example, less than a month’s supply). However, a dispensing fee will only be reimbursed once a month for maintenance drugs. Additionally, the pharmacy may choose to accumulate the billing to once a month as is the current process these pharmacies utilize for controlled substances. Lastly, the dispensing fee programming takes into account the monthly package size in allowing reimbursement of a dispensing fee in accordance with the refill tolerance of 90 percent consumption. Reimbursement of a dispensing fee would be allowed on a 28-day oral contraceptive when the refill is allowed on the 25th day. The Department updated the dispensing fee language in this rule making to account for the refill tolerance.    5. Unit dose packaging credits. One comment was received on this topic.    • A respondent commented that returns of unit dose packaging by a pharmacy must be consistent with Iowa Board of Pharmacy’s rules and that the Department’s rule language would result in pharmacies losing the cost of the medication returned and credited.    Department response: The Department agrees that a pharmacy must follow the Iowa Board of Pharmacy’s rules on drug returns and has added that wording to these rules to clarify. This language is consistent with guidance in Informational Letter No. 497 released on April 21, 2006, and in the Prescribed Drugs Provider Manual.    Following review of the comments related to the proposed rule making, the Department has made the following changes from the Notice:        1. Removed proposed subparagraph 78.2(4)“b”(13), which would have prohibited payment for drug products administered in a practitioner’s office, outpatient clinic or infusion center.        2. Revised new subrule 78.28(2) in Item 17 to include the clarifications described above. The subrule now reads as follows:    “78.28(2) Notwithstanding the provisions of 78.28(1)“a,” under both Medicaid fee-for-service and managed care administration, at least one form of each of the following drugs for medication-assisted treatment as approved by the United States Food and Drug Administration for treatment of substance use disorder or overdose treatment will be available without prior authorization:    “a. Buprenorphine,    “b. Buprenorphine and naloxone combination,    “c. Methadone,    “d. Naltrexone, and    “e. Naloxone.    “For the purpose of this subrule, “medication-assisted treatment” means the medically monitored use of certain substance use disorder medications in combination with treatment services.”        3. Added clarifying language to subparagraph 79.1(8)“c”(2) and paragraph 79.1(8)“d” in Item 19. Specifically, the phrase “accounting for the refill tolerance of 90 percent consumption” was added to subparagraph 79.1(8)“c”(2), and the phrase “consistent with the Iowa board of pharmacy’s rules on return of drugs” was added to paragraph 79.1(8)“d.”Adoption of Rule Making    This rule making was adopted by the Council on Human Services on January 8, 2020.Fiscal Impact    Removal of clinical PA for MAT drugs is projected to have the following impacts:     For the pharmacy benefit: It is estimated removing the PA requirement will result in additional expenditures for this category of drugs. There will be increased prescribing/utilization.     Pharmacy benefit increased expenditures are estimated at the following: Total dollars before rebates $80,000 ($24,000 state share); $35,000 net of rebates ($10,500 state share). The state share is based on a blend between the traditional Medicaid and Iowa Health and Wellness Plan populations. This fiscal impact is a combined total for both fee-for-service (FFS) and managed care programs.     There are no associated programming costs with this change.     For the medical benefit: There is no fiscal impact as none of these drugs require a PA under the medical benefit.     Medical contracts: No impact is projected to the medical contracts general fund appropriation.     Enforcement of the dispensing fee allowance on maintenance drugs is projected to have the following impacts:      Clarifying the quantity prescribed and dispensing fee allowance could result in savings to the Medicaid program in cases where a pharmacy has been reimbursed greater than one dispensing fee per drug per member per month for maintenance drugs.     The annualized savings are projected to be as follows per program based on the current dispensing fee of $10.07 and current utilization:     ○ FFS $31,418 total (state and federal) dollars (based on April 2019 data and annualized).     ○ Amerigroup $336,000 (based on April 2019 data and annualized).     ○ UnitedHealthcare $660,965 (based on March 2019 data and annualized).    For both changes, PA removal and limit of one dispensing fee, the managed care organization (MCO) cost impact is part of the capitation rate setting.Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend subrule 78.1(18) as follows:    78.1(18)   Payment and procedure for obtaining eyeglasses, contact lenses, and visual aids, shall be the same as described in 441—78.6(249A). (Cross reference 78.28(3)78.28(4))

    ITEM 2.    Adopt the following new subrule 78.1(25):    78.1(25)   Prior authorization for medication-assisted treatment shall be governed pursuant to subrule 78.28(2).

    ITEM 3.    Amend subrules 78.2(1) to 78.2(6) as follows:    .(1) Qualified prescriber.  All drugs are covered only if prescribed by a legally qualified practitioner (physician, dentist, podiatrist, optometrist, physician assistant, or advanced registered nurse practitioner). Pursuant to Public Law 111-148, Section 6401, any practitioner prescribing drugs must be enrolled with the Iowa Medicaid enterprise in order for such prescribed drugs to be eligible for payment.    .(2) Prescription required.  As a condition of payment for all drugs, including “nonprescription” or “over-the-counter” drugs that may otherwise be dispensed without a prescription, a prescription shall be transmitted as specified in Iowa Code sections 124.308 and 155A.27, subject to the provisions of Iowa Code section 155A.29 regarding refills. All prescriptions shall be available for audit by the department.    .(3) Qualified source.  All drugs are covered only if marketed by manufacturers that have signed a Medicaid rebate agreement with the Secretary of Health and Human Services in accordance with Public Law 101-508 (Omnibus Budget Reconciliation Act of 1990).    .(4) Prescription drugs.  Drugs that may be dispensed only upon a prescription are covered subject to the following limitations.    a.    Prior authorization is required as specified in the preferred drug list published by the department pursuant to Iowa Code section 249A.20Aas amended by 2010 Iowa Acts, Senate File 2088, section 347.    (1)   For any drug requiring prior authorization, reimbursement will be made for a 72-hour or three-day supply dispensed in an emergency when a prior authorization request cannot be submitted.    (2)   Unless the manufacturer or labeler of a mental health prescription drug that has a significant variation in therapeutic or side effect profile from other drugs in the same therapeutic class enters into a contract to provide the state with a supplemental rebate, the drug may be placed on the preferred drug list as nonpreferred, with prior authorization required. However, prior authorization shall not be required for such a drug for a member whose regimen on the drug was established before January 1, 2011, as verified by documented pharmacy claims.    (3)   For mental health prescription drugs requiring prior authorization that have a significant variation in therapeutic or side effect profile from other drugs in the same therapeutic class, reimbursement will be made for up to a seven-day supply pending prior authorization. A request for prior authorization shall be deemed approved if the prescriber:
  1. Has on file with the department current contact information, including a current fax number, and a signed Form 470-4914, Fax Confidentiality Certificate, and
  2. Does not receive a notice of approval or disapproval within 48 hours of a request for prior authorization.
    (4)   Prior authorization for medication-assisted treatment shall be governed pursuant to subrule 78.28(2).
    b.    Payment is not made for:    (1)   Drugs whose prescribed use is not for a medically accepted indication as defined by Section 1927(k)(6) of the Social Security Act.    (2)   Drugs used for anorexia, weight gain, or weight loss.    (3)   Drugs used for cosmetic purposes or hair growth.    (4)   Rescinded IAB 2/8/12, effective 3/14/12.    (5)   Otherwise covered outpatient drugs if the manufacturer seeks to require as a condition of sale that associated tests or monitoring services be purchased exclusively from the manufacturer or the manufacturer’s designee.    (6)   Drugs described in Section 107(c)(3) of the Drug Amendments of 1962 and identical, similar, or related drugs (within the meaning of Section 310.6(b)(1) of Title 21 of the Code of Federal Regulations (drugs identified through the Drug Efficacy Study Implementation (DESI) review)).    (7)   “Covered Part D drugs” as defined by 42 U.S.C. Section 1395w-102(e)(1)-(2) for any “Part D eligible individual” as defined by 42 U.S.C. Section 1395w-101(a)(3)(A), including a member who is not enrolled in a Medicare Part D plan.    (8)   Drugs prescribed for fertility purposes, except when prescribed for a medically accepted indication other than infertility, as defined in subparagraph (1).    (9)   Drugs used for the treatment of sexual or erectile dysfunction, except when used to treat a condition other than sexual or erectile dysfunction for which the drug has been approved by the U.S. Food and Drug Administration.    (10)   Prescription drugs for which the prescription was executed in written (and nonelectronic) form unless the prescription was executed on a tamper-resistant pad, as required by Section 1903(i)(23) of the Social Security Act (42 U.S.C. Section 1396b(i)(23)).    (11)   Drugs used for symptomatic relief of cough and colds, except for nonprescription drugs listed at subrule 78.2(5).    (12)   Investigational drugs, including drugs that are the subject of an investigational new drug (IND) application allowed to proceed by the U.S. Food and Drug Administration (FDA) but that do not meet the definition of a covered outpatient drug in 42 U.S.C. 1396r-8(k)(2)-(4).
    .(5) Nonprescription drugs.      a.    The following drugs that may otherwise be dispensed without a prescription are covered subject to the prior authorization requirements stated below and as specified in the preferred drug list published by the department pursuant to Iowa Code section 249A.20A:Acetaminophen tablets 325 mg, 500 mgAcetaminophen elixir 160 mg/5 mlAcetaminophen solution 100 mg/mlAcetaminophen suppositories 120 mgArtificial tears ophthalmic solutionArtificial tears ophthalmic ointmentAspirin tablets 81 mg, chewableAspirin tablets81 mg, 325 mg,and 650 mg, 81 mg (chewable)oralAspirin tablets, enteric coated 325 mg, 650 mg, 81 mgAspirin tablets, buffered 325 mgBacitracin ointment 500 units/gmBenzoyl peroxide 5%, gel, lotionBenzoyl peroxide 10%, gel, lotionCalcium carbonate chewable tablets 500 mg, 750 mg, 1000 mg, 1250 mgCalcium carbonate suspension 1250 mg/5 mlCalcium carbonate tablets 600 mgCalcium carbonate-vitamin D tablets 500 mg-200 unitsCalcium carbonate-vitamin D tablets 600 mg-200 unitsCalcium citrate tablets 950 mg (200 mg elemental calcium)Calcium gluconate tablets 650 mgCalcium lactate tablets 650 mgCetirizine hydrochloride liquid 1 mg/mlCetirizine hydrochloride tablets 5 mgCetirizine hydrochloride tablets 10 mgChlorpheniramine maleate tablets 4 mgClotrimazole vaginal cream 1%Diphenhydramine hydrochloride capsules 25 mgDiphenhydramine hydrochloride elixir, liquid, and syrup 12.5 mg/5 mlEpinephrine racemic solution 2.25%Ferrous sulfate solution 75 mg/0.6 ml (15 mg/0.6 ml elemental iron)Ferrous sulfate tablets 325 mgFerrous sulfate elixir 220 mg/5 mlFerrous sulfate drops 75 mg/0.6 mlFerrous gluconate tablets 325 mgFerrous fumarate tablets 325 mgGuaifenesin 100 mg/5 ml with dextromethorphan 10 mg/5 ml liquidIbuprofen suspension 100 mg/5 mlIbuprofen tablets 200 mgInsulinLactic acid (ammonium lactate) lotion 12%Levonorgestrel 1.5 mgLoperamide hydrochloride liquid 1 mg/5 mlLoperamide hydrochloride liquid 1 mg/7.5 mlLoperamide hydrochloride tablets 2 mgLoratadine syrup 5 mg/5 mlLoratadine tablets 10 mgMagnesium hydroxide suspension 400 mg/5 mlMagnesium oxide capsule 140 mg (85 mg elemental magnesium)Magnesium oxide tablets 400 mgMeclizine hydrochloride tablets 12.5 mg, 25 mg oral and chewableMiconazole nitrate cream 2% topical and vaginalMiconazole nitrate vaginal suppositories, 100 mgMultiple vitamin and mineralMineral products with prior authorizationNeomycin-bacitracin-polymyxin ointmentNiacin (nicotinic acid) tablets 50 mg, 100 mg, 250 mg, 500 mgNicotine gum 2 mg, 4 mgNicotine lozenge 2 mg, 4 mgNicotine patch 7 mg/day, 14 mg/day and 21 mg/dayPediatric oral electrolyte solutionsPermethrin lotion 1%Polyethylene glycol 3350 powderPseudoephedrine hydrochloride tablets 30 mg, 60 mgPseudoephedrine hydrochloride liquid 30 mg/5 mlPyrethrins-piperonyl butoxide liquid 0.33-4%Pyrethrins-piperonyl butoxide shampoo 0.3-3%Pyrethrins-piperonyl butoxide shampoo 0.33-4%Salicylic acid liquid 17%Senna tablets 187 mgSennosides-docusate sodium tablets 8.6 mg-50 mgSennosides syrup 8.8 mg/5 mlSennosides tablets 8.6 mgSodium bicarbonate tablets 325 mgSodium bicarbonate tablets 650 mgSodium chloride hypertonic ophthalmic ointment 5%Sodium chloride hypertonic ophthalmic solution 5%Tolnaftate 1% cream, solution, powderVitamins, single and multiple with prior authorizationOther nonprescription drugs listed as preferred in the preferred drug list published by the department pursuant to Iowa Code section 249A.20A.    b.    Nonprescription drugs for use in a nursing facility, PMIC, or ICF/ID shall be included in the per diem rate paid to the nursing facility, PMIC, or ICF/ID.    .(6) Quantity prescribed and dispensed.      a.    Quantity prescribed.When it is not therapeutically contraindicated, the legally qualified practitioner shall prescribe a quantitynot less than a one-month supply ofcovered prescriptionand nonprescription medication sufficient for up to a 31-day supply. Oral contraceptivesContraceptives may be prescribed in 90-daythree-month quantities.    b.    Oral solid forms of covered nonprescription items shall be prescribed and dispensed in a minimum quantity of 100 units per prescription or the currently available consumer package size except when dispensed via a unit-dose system.    b.    Prescription refills.    (1)   Prescription refills shall be performed and recorded in a manner consistent with existent state and federal laws, rules and regulations.    (2)   Automatic refills.    1.   Automatic refills are not allowed. A request specific to each medication is required.    2.   All prescription refills shall be initiated by a request at the time of each fill by the prescriber, Medicaid member or person acting as an agent of the member, based on continued medical necessity.

    ITEM 4.    Amend rule 441—78.3(249A), introductory paragraph, as follows:

441—78.3(249A) Inpatient hospital services.  Payment for inpatient hospital admission is approved when it meets the criteria for inpatient hospital care as determined by the Iowa Medicaid enterprise. All cases are subject to random retrospective review and may be subject to a more intensive retrospective review if abuse is suspected. In addition, transfers, outliers, and readmissions within 31 days are subject to random review. Selected admissions and procedures are subject to a 100 percent review before the services are rendered. Medicaid payment for inpatient hospital admissions and continued stays are approved when the admissions and continued stays are determined to meet the criteria for inpatient hospital care. (Cross reference 78.28(5)78.28(6)) The criteria are available from the IME Medical Services Unit, 100 Army Post Road, Des Moines, Iowa 50315, or in local hospital utilization review offices. No payment will be made for waiver days.

    ITEM 5.    Amend subrule 78.3(18) as follows:    78.3(18)   Preprocedure review by the IME medical services unit is required if hospitals are to be reimbursed for certain frequently performed surgical procedures as set forth under subrule 78.1(19). Preprocedure review is also required for other types of major surgical procedures, such as organ transplants. Criteria are available from the IME medical services unit. (Cross reference 78.28(5)78.28(6))

    ITEM 6.    Amend subrule 78.4(4) as follows:    78.4(4) Periodontal services.  Payment may be made for the following periodontal services:    a.    Full-mouth debridement to enable comprehensive periodontal evaluation and diagnosis is payable once every 24 months. This procedure is not payable on the same date of service when other prophylaxis or periodontal services are performed.    b.    Periodontal scaling and root planing is payable once every 24 months when prior approval has been received. Prior approval shall be granted per quadrant when radiographs demonstrate subgingival calculus or loss of crestal bone and when the periodontal probe chart shows evidence of pocket depths of 4 mm or greater. (Cross reference 78.28(2)“a”(1)78.28(3)“a”(1))    c.    Periodontal surgical procedures which include gingivoplasty, osseous surgery, and osseous allograft are payable services when prior approval has been received. Payment for these surgical procedures will be approved after periodontal scaling and root planing has been provided, a reevaluation examination has been completed, and the member has demonstrated reasonable oral hygiene. Payment is also allowed for members who are unable to demonstrate reasonable oral hygiene due to a physical or mental condition, or who exhibit evidence of gingival hyperplasia, or who have a deep carious lesion that cannot be otherwise accessed for restoration.    d.    Tissue grafts. Pedicle soft tissue graft, free soft tissue graft, and subepithelial connective tissue graft are payable services with prior approval. Authorization shall be granted when the amount of tissue loss is causing problems such as continued bone loss, chronic root sensitivity, complete loss of attached tissue, or difficulty maintaining adequate oral hygiene. (Cross reference 78.28(2)“a”(2)78.28(3)“a”(2))    e.    Periodontal maintenance therapy requires prior authorization. Approval shall be granted for members who have completed periodontal scaling and root planing at least three months prior to the initial periodontal maintenance therapy and the periodontal probe chart shows evidence of pocket depths of 4 mm or greater. (Cross reference 78.28(2)“a”(3)78.28(3)“a”(3))    f.    Tissue regeneration procedures require prior authorization. Approval shall be granted when radiographs show evidence of recession in relation to the muco-gingival junction and the bone level indicates the tooth has a fair to good long-term prognosis.    g.    Localized delivery of antimicrobial agents requires prior authorization. Approval shall be granted when at least one year has elapsed since periodontal scaling and root planing was completed, the member has maintained regular periodontal maintenance, and pocket depths remain at a moderate to severe depth with bleeding on probing. Authorization is limited to once per site every 12 months.

    ITEM 7.    Amend subparagraph 78.4(5)"c" as follows:    (2)   Correction of problems resulting from conventional treatment including gross underfilling, perforations, and canal blockages with restorative materials. (Cross reference 78.28(2)“c”78.28(3)“c”)

    ITEM 8.    Amend subrule 78.4(7) as follows:    78.4(7) Prosthetic services.  Payment may be made for the following prosthetic services:    a.    An immediate denture or a first-time complete denture. Six months’ postdelivery care is included in the reimbursement for the denture.    b.    A removable partial denture replacing anterior teeth when prior approval has been received. Approval shall be granted when radiographs demonstrate adequate space for replacement of a missing anterior tooth. Six months’ postdelivery care is included in the reimbursement for the denture.    c.    A removable partial denture replacing posterior teeth including six months’ postdelivery care when prior approval has been received. Approval shall be granted when the member has fewer than eight posterior teeth in occlusion, excluding third molars, or the member has a full denture in one arch and a partial denture replacing posterior teeth is required in the opposing arch to balance occlusion. When one removable partial denture brings eight posterior teeth in occlusion, no additional removable partial denture will be approved. Six months’ postdelivery care is included in the reimbursement for the denture. (Cross reference 78.28(2)“b”(1)78.28(3)“b”(1))    d.    A fixed partial denture (including an acid etch fixed partial denture) replacing anterior teeth when prior approval has been received. Approval shall be granted for members who:    (1)   Have a physical or mental condition that precludes the use of a removable partial denture, or    (2)   Have an existing bridge that needs replacement due to breakage or extensive, recurrent decay.High noble or noble metals shall be approved only when the member is allergic to all other restorative materials. (Cross reference 78.28(2)“b”(2)78.28(3)“b”(2))    e.    A fixed partial denture replacing posterior teeth when prior approval has been received. Approval shall be granted for members who meet the criteria for a removable partial denture and:    (1)   Have a physical or mental condition that precludes the use of a removable partial denture, or    (2)   Have a full denture in one arch and a partial fixed denture replacing posterior teeth is required in the opposing arch to balance occlusion.High noble or noble metals will be approved only when the member is allergic to all other restorative materials.    f.    Obturator for surgically excised palatal tissue or deficient velopharyngeal function of cleft palate patients.    g.    Chairside relines and laboratory-processed relines are payable only once per prosthesis every 12 months, beginning 6 months after placement of the denture.    h.    Tissue conditioning is a payable service twice per prosthesis in a 12-month period.    i.    Two repairs per prosthesis in a 12-month period are payable.    j.    Adjustments to a complete or removable partial denture are payable when medically necessary after six months’ postdelivery care. An adjustment consists of removal of acrylic material or adjustment of teeth to eliminate a sore area or to make the denture fit better. Warming dentures and massaging them for better fit or placing them in a sonic device does not constitute an adjustment.    k.    Dental implants and related services when prior authorization has been received. Prior authorization shall be granted when the member is missing significant oral structures due to cancer, traumatic injuries, or developmental defects such as cleft palate and cannot use a conventional denture.    l.    Replacement of complete or partial dentures in less than a five-year period requires prior authorization. Approval shall be granted once per denture replacement per arch in a five-year period when the denture has been lost, stolen or broken beyond repair or cannot be adjusted for an adequate fit. Approval shall also be granted for more than one denture replacement per arch within five years for members who have a medical condition that necessitates thorough mastication. Approval will not be granted in less than a five-year period when the reason for replacement is resorption.    m.    A complete or partial denture rebase requires prior approval. Approval shall be granted when the acrylic of the denture is cracked or has had numerous repairs and the teeth are in good condition.    n.    An oral appliance for obstructive sleep apnea requires prior approval and must be custom-fabricated. Approval shall be granted in accordance with Medicare criteria.

    ITEM 9.    Amend paragraph 78.4(8)"a" as follows:    a.    Minor treatment to control harmful habits when prior approval has been received. Approval shall be granted when it is cost-effective to lessen the severity of a malformation such that extensive treatment is not required. (Cross reference 78.28(2)“c”78.28(3)“c”)

    ITEM 10.    Amend subrule 78.6(4) as follows:    78.6(4) Prior authorization.  Prior authorization is required for the following:    a.    A second lens correction within a 24-month period for members eight years of age and older. Approval shall be given when the member’s vision has at least a five-tenths diopter of change in sphere or cylinder or ten-degree change in axis in either eye.    b.    Visual therapy may be authorized when warranted by case history or diagnosis for a period of time not greater than 90 days. Should continued therapy be warranted, the prior approval process shall be reaccomplished, accompanied by a report showing satisfactory progress. Approved diagnoses are convergence insufficiency and amblyopia. Visual therapy is not covered when provided by opticians.    c.    Subnormal visual aids where near visual acuity is at or better than 20/100 at 16 inches, 2M print. Prior authorization is not required if near visual acuity as described above is less than 20/100. Subnormal visual aids include, but are not limited to, hand magnifiers, loupes, telescopic spectacles, or reverse Galilean telescope systems. Payment shall be actual laboratory cost as evidenced by an attached invoice.    d.    Approval for photochromatic tint shall be given when the member has a documented medical condition that causes photosensitivity and less costly alternatives are inadequate.    e.    Approval for press-on prisms shall be granted for members whose vision cannot be adequately corrected with other covered prisms.(Cross reference 78.28(3)78.28(4))

    ITEM 11.    Amend rule 441—78.7(249A), introductory paragraph, as follows:

441—78.7(249A) Opticians.  Payment will be approved only for certain services and supplies provided by opticians when prescribed by a physician (MD or DO) or an optometrist. Payment and procedure for obtaining services and supplies shall be the same as described in rule 441—78.6(249A). (Cross reference 78.28(3)78.28(4))

    ITEM 12.    Amend subrule 78.9(10) as follows:    78.9(10) Private duty nursing or personal care services for persons aged 20 and under.  Payment for private duty nursing or personal care services for persons aged 20 and under shall be approved if determined to be medically necessary. Payment shall be made on an hourly unit of service.    a.    Definitions.    (1)   Private duty nursing services are those services which are provided by a registered nurse or a licensed practical nurse under the direction of the member’s physician to a member in the member’s place of residence or outside the member’s residence, when normal life activities take the member outside the place of residence. Place of residence does not include nursing facilities, intermediate care facilities for the mentally retarded, or hospitals.Services shall be provided according to a written plan of care authorized by a licensed physician. The home health agency is encouraged to collaborate with the member, or in the case of a child with the child’s caregiver, in the development and implementation of the plan of treatment. These services shall exceed intermittent guidelines as defined in subrule 78.9(3). Private duty nursing and personal care services shall be inclusive of all home health agency services personally provided to the member. Enhanced payment under the interim fee schedule shall be made available for services to children who are technology dependent, i.e., ventilator dependent or whose medical condition is so unstable as to otherwise require intensive care in a hospital.Private duty nursing or personal care services do not include:
  1. Respite care, which is a temporary intermission or period of rest for the caregiver.
  2. Nurse supervision services including chart review, case discussion or scheduling by a registered nurse.
  3. Services provided to other persons in the member’s household.
  4. Services requiring prior authorization that are provided without regard to the prior authorization process.
  5. Transportation services.
  6. Homework assistance.
    (2)   Personal care services are those services provided by a home health aide or certified nurse’s aide and which are delegated and supervised by a registered nurse under the direction of the member’s physician to a member in the member’s place of residence or outside the member’s residence, when normal life activities take the member outside the place of residence. Place of residence does not include nursing facilities, intermediate care facilities for the mentally retarded, or hospitals. Payment for personal care services for persons aged 20 and under that exceed intermittent guidelines may be approved if determined to be medically necessary as defined in subrule 78.9(7). These services shall be in accordance with the member’s plan of care and authorized by a physician. The home health agency is encouraged to collaborate with the member, or in the case of a child with the child’s caregiver, in the development and implementation of the plan of treatment.Medical necessity means the service is reasonably calculated to prevent, diagnose, correct, cure, alleviate or prevent the worsening of conditions that endanger life, cause pain, result in illness or infirmity, threaten to cause or aggravate a disability or chronic illness, and no other equally effective course of treatment is available or suitable for the member requesting a service.
    b.    Requirements.    (1)   Private duty nursing or personal care services shall be ordered in writing by a physician as evidenced by the physician’s signature on the plan of care.    (2)   Private duty nursing or personal care services shall be authorized by the department or the department’s designated review agent prior to payment.    (3)   Prior authorization shall be requested at the time of initial submission of the plan of care or at any time the plan of care is substantially amended and shall be renewed with the department or the department’s designated review agent. Initial request for and request for renewal of prior authorization shall be submitted to the department’s designated review agent. The provider of the service is responsible for requesting prior authorization and for obtaining renewal of prior authorization.The request for prior authorization shall include a nursing assessment, the plan of care, and supporting documentation. The request for prior authorization shall include all items previously identified as required treatment plan information and shall further include: any planned surgical interventions and projected time frame; information regarding caregiver’s desire to become involved in the member’s care, to adhere to program objectives, to work toward treatment plan goals, and to work toward maximum independence; and identify the types and service delivery levels of all other services to the member whether or not the services are reimbursable by Medicaid. Providers shall indicate the expected number of private duty nursing RN hours, private duty nursing LPN hours, or home health aide hours per day, the number of days per week, and the number of weeks or months of service per discipline. If the member is currently hospitalized, the projected date of discharge shall be included.Prior authorization approvals shall not be granted for treatment plans that exceed 16 hours of home health agency services per day. (Cross reference 78.28(9)78.28(10))

    ITEM 13.    Amend subparagraph 78.10(3)"b" as follows:    (10)   Vibrotactile aids. Vibrotactile aids are payable only once in a four-year period unless the original aid is broken beyond repair or lost. (Cross reference 78.28(4)78.28(5))

    ITEM 14.    Amend subparagraphs 78.14(7)"d" and 78.14(7)"d" as follows:    (1)   Payment for the replacement of a hearing aid less than four years old shall require prior approval except when the member is under 21 years of age. The department shall approve payment when the original hearing aid is lost or broken beyond repair or there is a significant change in the member’s hearing that would require a different hearing aid. (Cross reference 78.28(4)“a”78.28(5)“a”)    (2)   Payment for a hearing aid costing more than $650 shall require prior approval. The department shall approve payment for either of the following purposes (Cross reference 78.28(4)“b”78.28(5)“b”):
  1. Educational purposes when the member is participating in primary or secondary education or in a postsecondary academic program leading to a degree and an in-office comparison of an analog aid and a digital aid matched (+/- 5dB) for gain and output shows a significant improvement in either speech recognition in quiet or speech recognition in noise or an in-office comparison of two aids, one of which is single channel, shows significantly improved audibility.
  2. Vocational purposes when documentation submitted indicates the necessity, such as varying amounts of background noise in the work environment and a need to converse in order to do the job, and an in-office comparison of an analog aid and a digital aid matched (+/- 5dB) for gain and output shows a significant improvement in either speech recognition in quiet or speech recognition in noise or an in-office comparison of two aids, one of which is single channel, shows significantly improved audibility.

    ITEM 15.    Amend paragraph 78.26(4)"c" as follows:    c.    Preprocedure review by the IME medical services unit is required if ambulatory surgical centers are to be reimbursed for certain frequently performed surgical procedures as set forth under subrule 78.1(19). Criteria are available from the IME medical services unit. (Cross reference 78.28(6)78.28(7))

    ITEM 16.    Renumber subrules 78.28(2) to 78.28(11) as 78.28(3) to 78.28(12).

    ITEM 17.    Adopt the following new subrule 78.28(2):    78.28(2)   Notwithstanding the provisions of 78.28(1)“a,” under both Medicaid fee-for-service and managed care administration, at least one form of each of the following drugs for medication-assisted treatment as approved by the United States Food and Drug Administration for treatment of substance use disorder or overdose treatment will be available without prior authorization:    a.    Buprenorphine,    b.    Buprenorphine and naloxone combination,    c.    Methadone,    d.    Naltrexone, and    e.    Naloxone.For the purpose of this subrule, “medication-assisted treatment” means the medically monitored use of certain substance use disorder medications in combination with treatment services.

    ITEM 18.    Amend renumbered paragraphs 78.28(12)"a" and 78.28(12)"b" as follows:    a.     Except as provided in paragraph 78.28(11)“b,”78.28(12)“b,” the following radiology procedures require prior approval:    (1)   Magnetic resonance imaging (MRIs);    (2)   Computed tomography (CTs), including combined abdomen and pelvis CT scans;    (3)   Computed tomographic angiographs (CTAs);    (4)   Positron emission tomography (PETs); and     (5)   Magnetic resonance angiography (MRAs).    b.    Notwithstanding paragraph 78.28(11)“a,”78.28(12)“a,” prior authorization is not required when any of the following applies:    (1)   Radiology procedures are billed on a CMS 1500 claim for places of service “hospital inpatient” (POS 21) or “hospital emergency room” (POS 23), or on a UB04 claim with revenue code 45X;    (2)   The member has Medicare coverage;     (3)   The member received notice of retroactive Medicaid eligibility after receiving a radiology procedure at a time prior to the member’s receipt of such notice (see paragraph 78.28(11)“e”78.28(12)“e”); or    (4)   A radiology procedure is ordered or requested by the department of human services, a state district court, law enforcement, or other similar entity for the purposes of a child abuse/neglect investigation, as documented by the provider.

    ITEM 19.    Amend paragraphs 79.1(8)"a" to 79.1(8)"g" as follows:    a.    Except as provided below in paragraphs 79.1(8)“d” through “i,” all providers are reimbursed for covered drugs as follows:    (1)   Reimbursement for covered generic prescription drugs and for covered nonprescription drugs shall be the lowest of the following, as of the date of dispensing:
  1. The average state actual acquisition cost (AAC), determined pursuant to paragraph 79.1(8)“b,” plus the professional dispensing fee determined pursuant to paragraph 79.1(8)“c.”79.1(8)“c”;
  2. The federal upper limit (FUL), defined as the upper limit for a multiple source drug established in accordance with the methodology of the Centers for Medicare and Medicaid Services as described in 42 CFR 447.514(a)-(c), plus the professional dispensing fee determined pursuant to paragraph 79.1(8)“c.”79.1(8)“c”;
  3. The total submitted charge., represented by the lower of the gross amount due (GAD) as defined by the National Council for Prescription Drug Programs (NCPDP) standards definition, or the ingredient cost submitted plus the state defined professional dispensing fee, determined pursuant to paragraph 79.1(8)“c”; or
  4. Providers’ usual and customary charge to the general public.
    (2)   Reimbursement for covered brand-name prescription drugs shall be the lowest of the following, as of the date of dispensing:
  1. The average state AAC, determined pursuant to paragraph 79.1(8)“b,” plus the professional dispensing fee determined pursuant to paragraph 79.1(8)“c.”79.1(8)“c”;
  2. The total submitted charge., represented by the lower of the GAD as defined by the NCPDP standards definition, or the ingredient cost submitted plus the state defined professional dispensing fee; or
  3. Providers’ usual and customary charge to the general public.
    b.    For purposes of this subrule, average state AAC is defined as retail pharmacies’ average prices paid to acquire drug products. Average state AAC shall be determined by the department based on a survey of invoice prices paid by Iowa Medicaid retail pharmacies. Surveys shall be conducted at least once every six months, or more often at the department’s discretion. The average state AAC shall be calculated as a statistical mean based on one reported cost per drug per pharmacy. The average state AAC determined by the department shall be published on the Iowa Medicaid enterprise website. If no current average state AAC has been determined for a drug, the wholesale acquisition cost (WAC) published by Medi-Span shall be used as the average state AAC.    c.    Professional dispensing fee.    (1)   For purposes of this subrule, the professional dispensing fee shall be a fee schedule amount determined by the department based on a survey of Iowa Medicaid participating pharmacy providers’ costs of dispensing drugs to Medicaid beneficiaries. The survey shall be conducted every two years beginning in state fiscal year 2014-2015.    (2)   There is a one-time professional dispensing fee reimbursed per one-month or three-month period, accounting for the refill tolerance of 90 percent consumption, per member, per drug, per strength, billed per provider for maintenance drugs as identified by MediSpan and maintenance nonprescription drugs.    d.    For an oral solid dispensed to a patient in a nursing home in unit dose packaging prepared by the pharmacist, an additional one cent per dose shall be added to reimbursement based on acquisition cost or FUL. Payment may be made only for unit-dose-packaged drugs that are consumed by the patient. Any previous charges for unused unit-dose packages returned to the pharmacy must be credited to the Medicaid program, consistent with the Iowa board of pharmacy’s rules on return of drugs.    e.    340B-purchased drugs.    (1)   Notwithstanding paragraph 79.1(8)“a” above, reimbursement to a covered entity as defined in 42 U.S.C. 256b(a)(4) for covered outpatient drugs acquired by the entity through the 340B drug pricing program will be the lowest of:
  1. The submitted 340B covered entity actual acquisition cost (not to exceed the 340B ceiling price), submitted in the ingredient cost field, plus the professional dispensing fee pursuant to paragraph 79.1(8)“c”;
  2. The average state AAC determined pursuant to paragraph 79.1(8)“b” plus the professional dispensing fee pursuant to paragraph 79.1(8)“c”;
  3. For generic prescription drugs and nonprescription drugs only, the FUL pursuant to 79.1(8)“a”(1)“2” plus the professional dispensing fee pursuant to paragraph 79.1(8)“c”;
  4. The total submitted charge, represented by the GAD as defined by the NCPDP standards definition; or
  5. Providers’ usual and customary charge to the general public.
    (2)   Reimbursement for covered outpatient drugs to a 340B contract pharmacy, under contract with a covered entity described in 42 U.S.C. 256b(a)(4), will be according to paragraph 79.1(8)“a” because covered outpatient drugs purchased through the 340B drug pricing program cannot be billed to Medicaid by a 340B contract pharmacy.
    f.    Federal supply schedule (FSS) drugs. Notwithstanding paragraph 79.1(8)“a” above, reimbursement for drugs acquired by a provider through the FSS program managed by the federal General Services Administration will be the lowest of:    (1)   The provider’s actual acquisition cost,(not to exceed the FSS price), submitted in the ingredient cost field, plus the professional dispensing fee pursuant to paragraph 79.1(8)“c”;    (2)   The average state AAC determined pursuant to paragraph 79.1(8)“b” plus the professional dispensing fee pursuant to paragraph 79.1(8)“c”;    (3)   For generic prescription drugs and nonprescription drugs only, the FUL pursuant to 79.1(8)“a”(1)“2” plus the professional dispensing fee pursuant to paragraph 79.1(8)“c”;    (4)   The total submitted charge, represented by the GAD as defined by the NCPDP standards definition; or    (5)   Providers’ usual and customary charge to the general public.    g.    Nominal-price drugs. Notwithstanding paragraph 79.1(8)“a” above, reimbursement for drugs acquired by providers at nominal prices and excluded from the calculation of the drug’s “best price” pursuant to 42 CFR 447.508 will be the lowest of:    (1)   The provider’s actual acquisition cost (not to exceed the nominal price paid), submitted in the ingredient cost field, plus the professional dispensing fee pursuant to paragraph 79.1(8)“c”;    (2)   The average state AAC determined pursuant to paragraph 79.1(8)“b” plus the professional dispensing fee pursuant to paragraph 79.1(8)“c”;    (3)   For generic prescription drugs and nonprescription drugs only, the FUL pursuant to 79.1(8)“a”(1)“2” plus the professional dispensing fee pursuant to paragraph 79.1(8)“c”;    (4)   The total submitted charge, represented by the GAD as defined by the NCPDP standards definition; or    (5)   Providers’ usual and customary charge to the general public.
    [Filed 1/14/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4900CHuman Services Department[441]Adopted and Filed

Rule making related to Medicaid payments to nursing facilities

    The Human Services Department hereby amends Chapter 81, “Nursing Facilities,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 249A.4.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 249A.4.Purpose and Summary    The Department adopts these amendments in order to provide clarification on the treatment of depreciation when a change of nursing facility ownership occurs. The amendments clarify leasing arrangements, update the Iowa Medicaid Enterprise (IME) mailing address, and make changes to reflect current operations of IME.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 6, 2019, as ARC 4740C. The Department received 34 comments from four respondents on the proposed amendments. A summary of the comments and the corresponding responses from the Department are as follows:    1. Four respondents asked about the intent of IME in changing the lease rule.    Department response: The Provider Cost Audit and Rate Setting Unit of the Department worked with IME policy staff and the Attorney General’s office on the intent of the nursing facility leasing rule.  It was determined that the rule should be updated to more clearly present the intent of the rule and clearly identify allowable lessor costs.    2. Two respondents asked whether IME can clearly identify acceptable sources for reporting landlord costs.      Department response: The amendments identify allowable landlord costs.  Acceptable sources for these costs would be documentation that can be provided to support the amounts being reported.    3.  Two respondents commented that there are specific examples where the landlord may not maintain information on a specific property when it is part of a larger group of properties. The respondents asked that additional information be provided on this topic in the provider manual.      Department response: The Department will make updates to the provider manual based on the rule change.    4.  Three respondents asked whether the Department can provide an initial schedule or form for each of the respondents’ clients impacted by this rule change and use historical data to populate the form.     Department response: The Department will not provide such a form because the Department does not have access to all historical data for providers.     5.  Three respondents asked whether providers will be informed of amounts IME has determined to be allowable, and if so, on what date that information will be given to providers.      Department response: Providers are responsible for supporting cost information included on the financial and statistical report.  If adjustments are made by IME to reimbursable costs, those adjustments will be sent to the provider for review, as is the current practice.      6.  Two respondents commented that the historical basis only references depreciable fixed assets.  The respondents asked if the value of the land or other assets can be used in the calculation.      Department response: The question seems to be related to the calculation of a Reasonable Rate of Return.  Paragraph 81.6(11)“m” states “historical cost of the facility.” This can include land at its historical cost but would not include other assets.      7.  Two respondents commented that in the past, some landlord companies have preferred to not provide their cost information directly to the tenant.  The respondents asked if there has been consideration of a separate reporting procedure for the nonrelated party lessors to transmit their cost information to IME.     Department response: If a lessor does not provide the required information or does not support what is provided, the terms of cost should not be included as a reimbursable cost or can be removed from reimbursable cost by IME.     8.  Three respondents commented about the verbiage used referring to “tax cost” and asked what the definition of “tax cost” is, what the impact of using tax cost would be, and whether there would be additional record-keeping requirements related to tax cost.    Department response: The use of the words “tax cost” in subrule 81.6(11) was not changed in this rule making, and there is no change to current usage.  Tax cost is the historical cost of an asset, and depreciation is to be calculated based on the straight-line basis.  Therefore, there is no impact on providers, and there are no additional schedules that need to be created.    9.  One respondent asked whether, if there is no existing determination of the financial impact to providers, the Department will consider delaying the effective date until that calculation can be determined.     Department response: There have been no discussions on delaying the rule change.    10.  One respondent commented on the area of reporting and that the providers potentially impacted have limited access to historical information that may be necessary to comply with the changes.      Department response: The analysis of the underlying information can be very complex and labor-intensive.  The respondent asked whether the rule changes can be delayed until the specific providers are identified and the potential impact determined. There have been no discussions on delaying the rule making.  If a provider has been through a change of ownership or leases the facility where services are provided, the provider may be impacted.    11. One respondent asked the Department to clarify how the treatment of depreciation will change following a change of ownership.     Department response: The treatment of depreciation following a change of ownership should not change.  The asset cost basis and depreciation for assets purchased by the previous owner are carried forward to the new owner.  The new owner has been limited to the previous owner’s cost basis in the asset (historical cost).    12.  One respondent asked the Department to estimate how many providers could be impacted by the proposed rule changes.      Department response: If a provider has been through a change of ownership or leases the facility where services are provided, the provider may be impacted.  Based on the FY 2018 financial and statistical reports, there were 146 providers that had some amount of lease expenses reported on Schedule C, line 87 (facility lease), column 1 (expenses per the general ledger). Some of these providers may be leasing space other than the facility where services are provided.    13.  One respondent asked if the rule changes impact both related party leases and nonrelated party leases.      Department response: Both related party and nonrelated party leasing arrangements would be impacted.    14.  One respondent asked what changes to the annual cost report would need to be implemented.      Department response: It is not anticipated that any changes to the financial and statistical report are necessary based solely on the amendments in this rule making.    15.  One respondent asked what changes to the provider manual for cost reporting would be necessary.    Department response: The provider manual will be updated as a result of this rule making.    16.  One respondent asked to have IME provide instructions detailing the information that would be required from the prior owner and the new owner based on these  rule changes.     Department response: Providers are responsible for being able to support all cost information that is included on the financial and statistical report.    17.  One respondent asked if the provisions in the rule making will apply to all providers, including those in other cost-based programs, and not just to leased facilities in the nursing facility program.     Department response: This rule making is only for the nursing facility program.    18.  One respondent stated that the respondent’s clients are concerned that the use of historical basis as a source of the calculation will not represent the full capital investment of the current property owners, especially those whose properties have undergone physical renovation.    Department response: Any depreciation on improvements or capital assets purchased by the lessor can be allowed depreciation. The cost basis of the items purchased through a change of ownership must be reported, and depreciation must be based on the historical cost of the program in the hands of the original owner when the facility entered the Medicaid program.  This does not change with this rule making; however, providers should ensure that depreciation of capital assets that have changed hands through a change in ownership is reported this way.    19.  One respondent asked if IME intends to send information or instructional letters limited to those providers that may be impacted by the rule change.    Department response: IME does not intend to send information or instructional letters to only those providers that are impacted. If a provider has been through a change of ownership or leases the facility where services are provided, the provider may be impacted.  IME does intend to send a general informational letter about the rule change.    20.  One respondent asked if IME is proposing a method or some type of forum for the affected landlords and facility operators to work together to develop a timeline of information-reporting for the calculation of provider payment rates.      Department response: A forum for affected landlords and providers has not been discussed.    No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the Council on Human Resources on January 8, 2020.Fiscal Impact    Without having all of the lessors’ financial data relating to ownership of the facilities in leasing arrangements and comparing to lease expenses being paid by the facilities, it would be impossible to determine what the impact of these rules would be on the facilities. However, given the scope of the change coupled with the fact that providers do not receive reimbursement at full cost through their per diem, the rule is expected to have a relatively minimal impact.Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend subrule 81.6(6) as follows:    81.6(6) Census of public assistance recipientsMedicaid members.  Census figures of public assistance recipientsMedicaid members shall be obtained on the last day of the month ending the reporting period.

    ITEM 2.    Rescind paragraph 81.6(11)"j" and adopt the following new paragraph in lieu thereof:    j.    For financial and statistical reports received after March 18, 2020, the depreciation, as limited in this rule, may be included as an allowable patient cost.     (1)   Limitation on calculation. Depreciation shall be calculated based on the tax cost using only the straight-line method of computation and recognizing the estimated useful life of the asset as defined in the most recent edition of the American Hospital Association Useful Life Guide.     (2)   Limitation—full depreciation. Once an asset is fully depreciated, no further depreciation shall be claimed on that asset.     (3)   Change of ownership. Depreciation is further limited by the limitations in subrule 81.6(12).

    ITEM 3.    Rescind paragraph 81.6(11)"m" and adopt the following new paragraph in lieu thereof:    m.    For financial and statistical reports received after March 18, 2020, the following definitions, calculations, and limitations shall be used to determine allowable rent expense on a cost report.    (1)   Landlord’s other expenses. Landlord’s other expenses are limited to amortization, mortgage interest, property taxes unless claimed as a lessee expense, utilities paid by the landlord unless claimed as a lessee expense, property insurance, and building maintenance and repairs.    (2)   Reasonable rate of return. Reasonable rate of return means the historical cost of the facility in the hands of the owner when the facility first entered the Medicaid program multiplied by the 30-year Treasury bond rate as reported by the Federal Reserve Board at the date of lease inception.    (3)   Nonrelated party leases. When the operator of a participating facility rents from a party that is not a related party, as defined in paragraph 81.6(11)“l,” the allowable cost report rental expense shall be the lesser of:    1.   Lessor’s annual depreciation as identified in paragraph 81.6(11)“j” plus the landlord’s other expenses, plus a reasonable rate of return; or    2.   Actual rent payments.    (4)   Related party leases. When the operator of a participating facility rents from a related party, as defined in paragraph 81.6(11)“l,” the allowable cost report rental expense shall be the lesser of:    1.   Lessor’s annual depreciation as identified in paragraph 81.6(11)“j” plus the landlord’s other expenses; or    2.   Actual rent payments.

    ITEM 4.    Amend subparagraph 81.6(16)"h" as follows:    (5)   Submission of request. A facility shall submit a written request for the capital cost per diem instant relief add-on, the enhanced non-direct care rate component limit, or a preliminary evaluation of whether a project may qualify for additional reimbursement to the Iowa Medicaid Enterprise, Provider Cost Audit and Rate Setting Unit, 100 Army Post RoadP.O. Box 36450, Des Moines, Iowa 50315. A qualifying facility may request one or both types of additional reimbursement.
  1. A request for the capital cost per diem instant relief add-on may be submitted no earlier than 30 days before the complete replacement, new construction, or major renovations are placed in service.
  2. A request for the enhanced non-direct care rate component limit may be submitted with a request for a capital cost per diem instant relief add-on or within 60 days after the release of a rate determination letter reflecting a change in the non-direct care rate component limit.
  3. A request for a preliminary evaluation may be submitted when a facility is preparing a feasibility projection for a construction or renovation project. A preliminary evaluation does not guarantee approval of the capital cost per diem instant relief add-on or enhanced non-direct care rate component limit upon submission of a formal request.

    ITEM 5.    Rescind paragraph 81.10(4)"h" and adopt the following new paragraph in lieu thereof:    h.    Ventilator patients.    (1)   Definition. For purposes of this paragraph only, “ventilator patients” means Medicaid-eligible patients who, as determined by the quality improvement organization, require a ventilator at least six hours every day, are inappropriate for home care, and have medical needs that require skilled care.     (2)   Reimbursement. In-state nursing facilities shall receive reimbursement for care of ventilator patients equal to the sum of the Medicare-certified hospital-based nursing facility rate plus the Medicare-certified hospital-based nursing facility non-direct care rate component as defined in subparagraph 81.6(16)“f”(3). Facilities may continue to receive this reimbursement at this rate for 30 days after a ventilator patient is weaned from a ventilator if, during the 30 days, the patient continues to reside in the facility and continues to meet skilled care criteria.

    ITEM 6.    Amend paragraph 81.10(5)"a" as follows:    a.    Supplies or services that the facility shall provide:    (1)   Nursing services, social work services, activity programs, individual and group therapy, rehabilitation or habilitation programs provided by facility staff in order to carry out the plan of care for the resident.    (2)   Services related to the nutrition, comfort, cleanliness and grooming of a resident as required under state licensure and Medicaid survey regulations.    (3)   Medical equipment and supplies including wheelchairs except for customized wheelchairs for which separate payment may be made pursuant to 441—subparagraph 78.10(2)“a”(4),441—paragraph 78.10(2)“d,” medical supplies except for those listed in 441—paragraph 78.10(4)“b,” oxygen except under circumstances specified in 441—paragraph 78.10(2)“a,” and other items required in the facility-developed plan of care.    (4)   Nonprescription drugs ordered by the physician.except for those specified in 441—paragraph 78.1(2)“f.”    (5)   Fees charged by medical professionals for services requested by the facility that do not meet criteria for direct Medicaid payment.

    ITEM 7.    Amend paragraph 81.13(5)"e" as follows:    e.    Privacy and confidentiality.The resident has the right to personal privacy and confidentiality of personal and clinical records.    (1)   Personal privacy includes accommodations, medical treatment, written and telephone communications, personal care, visits, and meetings of family and resident groups, but this does not require the facility to provide a private roomfor each resident.    (2)   The facility must respect the resident’s right to personal privacy, including the right to privacy in the resident’s oral (that is, spoken or sign language), written, and electronic communications.    (2)   (3)   Except as provided in subparagraph (3)(4) below, the resident may approve or refuse the release of personal and clinical records to any person outside the facility.    (3)   (4)   The resident’s right to refuse release of personal and clinical records does not apply when the resident is transferred to another health care institution or record release is required by law.to the following:
  1. The release of personal and clinical records to a health care institution to which the resident is transferred; or
  2. A record release that is required by law.

    ITEM 8.    Rescind paragraph 81.13(5)"i" and adopt the following new paragraph in lieu thereof:    i.    Mail.The resident has the right to send and receive mail, and to receive letters, packages and other materials delivered to the facility for the resident, whether delivered by a postal service or by other means, including the right to:    (1)   Privacy of such communications consistent with this section; and     (2)   Access to stationary, postage, and writing implements at the resident’s own expense.

    ITEM 9.    Adopt the following new paragraph 81.13(5)"q":    q.    Electronic communication.The resident has the right to have reasonable access to and privacy in the resident’s use of electronic communications, including, but not limited to, email and video communications, and for Internet research:    (1)   If accessible to the facility;    (2)   At the resident’s expense, if any additional expense is incurred by the facility to provide such access to the resident; and     (3)   To the extent that such use may comply with state and federal law.

    ITEM 10.    Amend subparagraph 81.13(9)"b" as follows:    (7)   Automated data processing requirement.
  1. Entering data. Within seven days after a facility completes a resident’s assessment, a facility shall enter the following information for the resident into a computerized format that meets the specifications defined in numbered paragraphs “2” and “4” below.
  2. Admission assessment.
  3. Annual assessment updates.
  4. Significant change in status assessments.
  5. Quarterly review assessments.
  6. A subset of items upon a resident’s transfer, reentry, discharge, and death.
  7. Background (face sheet) information, if there is no admission assessment.
  8. Transmitting data. Within seven days after a facility completes a resident’s assessment, a facility shall be capable of transmitting to the state each resident’s assessment information contained in the MDS in a format that conforms to standard record layouts and data dictionaries and that passes edits that ensure accurate and consistent coding of the MDS data as defined by the Centers for Medicare and Medicaid Services (CMS) and the department of human services or the department of inspections and appeals.
  9. Monthly transmittal requirements. On at least a monthly basis, a facility shall input and electronically transmit accurate and complete MDS data for all assessments conducted during the previous month, including the following:
  10. Admission assessment.
  11. Annual assessment.
  12. Significant correction of prior full assessment.
  13. Significant correction of prior quarterly assessment.
  14. Quarterly review.
  15. A subset of items upon a resident’s transfer, reentry, discharge, and death.
  16. Background (face sheet) information, for an initial transmission of MDS data on a resident who does not have an admission assessment.
  17. The facility must transmit MDS data in the ASCII format specified by CMS.
    [Filed 1/9/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4901CHuman Services Department[441]Adopted and Filed

Rule making related to eliminating the application fee for child support recovery

    The Human Services Department hereby amends Chapter 95, “Collections,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 217.6.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 252B.4.Purpose and Summary    This rule making aligns the Department’s rules about child support recovery with recent legislative changes. 2019 Iowa Acts, Senate File 605, amended Iowa Code chapter 252B to eliminate the customer-paid application fee.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 20, 2019, as ARC 4764C. No public comments were received. No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the Council on Human Services on January 8, 2020.Fiscal Impact    2019 Iowa Acts, Senate File 605, also amended Iowa Code chapter 252B to increase the annual fee for nonassistance child support cases. Because the legislation coupled the loss of the application fee with the increase in the annual fee, there is no fiscal impact in these changes.Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend subrule 95.2(4) as follows:    95.2(4) Application for services.  a.    A person who is not on public assistance requesting services under this chapter, except for those persons eligible to receive support services under paragraphs 95.2(2)“a,” “b,” and “c,” shall complete and return Form 470-0188, Application for Nonassistance Support Services, for each parent from whom the person is seeking support.    (1)   a.    The application shall be returned to the child support recovery unit serving the county where the person resides. If the person does not live in the state, the application form shall be returned to the county in which the support order is entered or in which the other parent or putative father resides.    (2)   b.    The person requesting services has the option to seek support from one or both of the child’s parents.    b.    An individual who is required to complete Form 470-0188, Application for Nonassistance Support Services, shall be charged an application fee in the amount set by statute. The unit shall charge one application fee for each parent from whom support is sought. The unit shall charge the fee at the time of initial application and any subsequent application for services. The individual shall pay the application fee to the local child support recovery unit before services are provided.

    ITEM 2.    Amend subrule 95.18(3) as follows:    95.18(3) Reapplication for services.  A person whose services were denied or terminated may reapply for services under this chapter by completing the application process and paying the application fee described in subrule 95.2(4).    [Filed 1/9/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4910CInsurance Division[191]Adopted and Filed

Rule making related to insurance producers

    The Insurance Division hereby amends Chapter 10, “Insurance Producer Licenses and Limited Licenses,” Chapter 11, “Continuing Education for Insurance Producers,” Chapter 13, “Consent for Prohibited Persons to Engage in the Business of Insurance,” and Chapter 48, “Viatical and Life Settlements,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code sections 505.8, 508E.19, 522A.7, 522B.18 and 522E.14.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapters 252J, 261, 505, 508E, 522A, 522B and 522E.Purpose and Summary    The amendments to these chapters are a result of the Division’s five-year review of rules. The amendments generally update the chapters by removing unnecessary language, removing duplicative definitions, and reflecting current practices. The most significant changes to Chapter 48 are due to aligning the requirements for viatical settlement brokers to those for producers in Chapters 10 and 11 to establish a uniform process and changing the license and continuing education term to align with the statutes. A reissuance fee is added to Chapters 10 and 48 to correspond to the reinstatement fee. The Division processes only a few of these reissuances each year. Finally, the rule making updates the reinstatement procedures to prohibit reinstatement prior to the end of a suspension period regardless of the timing of the licensure term since this requirement is not expressly stated in the rules and has caused confusion among producers.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on December 18, 2019, as ARC 4821C. A public hearing was held on January 7, 2020, at 10 a.m. at the Division’s offices, Fourth Floor, Two Ruan Center, 601 Locust Street, Des Moines, Iowa. No one attended the public hearing. No public comments were received.    The Division made a slight change to subrule 10.12(4) to clarify the amount of time a producer has to change the producer’s address after a resident license termination. Also, cross-references in subrule 10.10(1) were corrected to reflect the consolidation of rules 191—10.21(261) and 191—10.23(82GA,SF2428). Finally, a cross-reference in subrule 48.3(8) was corrected due to the addition of new paragraphs in subrule 10.10(2).Adoption of Rule Making    This rule making was adopted by Douglas Ommen, Iowa Insurance Commissioner, on January 22, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. While these rules do add a reissuance fee, the Division has only processed five such reissuances since 2017. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    These rules do not include a provision for the waiver of a rule because the Division’s general waiver rules of 191—Chapter 4 apply. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend subrule 10.1(2) as follows:    10.1(2)   These rules are authorized by Iowa Code section 505.8 and are intended to implement Iowa Code chapters 252J, 261272D and 522B.

    ITEM 2.    Amend rule 191—10.2(522B) as follows:

191—10.2(522B) Definitions.  In addition to the definitions in 191—1.1(502,505), the following definitions apply:        "Appointment" means a notification filed with the division or its designated vendor that an insurer has established an agency relationship with a producer. A company filing such a request must verify that the producer is licensed for the appropriate line(s) of authority.        "Birth month" means the month in which a producer was born.        "Business entity" means a corporation, association, partnership, limited liability company, limited liability partnership or other legal entity.        "Commissioner" means the Iowa insurance commissioner.        "CSAC" means college student aid commission.        "CSRU" means child support recovery unit.        "Division" means the Iowa insurance division.        "Home state" means the District of Columbia andor any state or territory of the United States in which a producer maintains the producer’s principal place of residence or principal place of business and is licensed to act as a producer.        "Individual" means a private or natural person, as distinguished from a partnership, corporation or association.        "Insurance" means any of the lines of insurance listed in subrule 10.7(1)rule 191—10.7(522B).        "License" means the division’s authorization for a person to act as a producer for the authorized lines of insurance.        "License number" means the National Insurance Producer Registry (NIPR) national producer number (NPN) issued to all licensees whose license records exist in the state producer licensing database (SPLD). For purposes of this definition, “state producer licensing database (SPLD)” means the national database of producers maintained by the National Association of Insurance Commissioners (NAIC), its affiliates or subsidiaries.        "National Insurance Producer Registry" "NIPR" means the nonprofit affiliate of the National Association of Insurance Commissioners (NAIC). The NIPR’s Web sitewebsite is www.NIPR.com.        "Negotiate" means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance concerning any of the substantive benefits, terms or conditions of the contract provided that the person engaged in that act either sells insurance or obtains insurance for purchasers.        "NIPR Gateway" means the communication network developed and operated by NIPR that links state insurance regulators with the entities they regulate to facilitate the electronic exchange of producer information regarding license applications, license renewals, appointments and terminations.        "Nonresident" means a person whose home state is not Iowa.        "Notification" means a written or electronic communication from a producer to the division.        "Person" means an individual or a business entity.        "Producer" "insurance producer" means a person required to be licensed in this state to sell, solicit or negotiate insurance.        "Producer renewal notice" means an electronic communication issued by the division to inform a producer about license renewal.        "Resident" means a person whose home state is Iowa.        "Sell" means to exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurer.        "Solicit" "solicitation" means attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company.        "Termination" means that an insurer has ended its agency relationship with a producer.        "Termination for cause" means that an insurer has ended its agency relationship with a producer for one of the reasons set forth in Iowa Code section 522B.11.        "Uniform application" means the National Association of Insurance Commissioners’ uniform application for resident and nonresident insurance producer licensing, as it appears on the NAIC Web sitewebsite.

    ITEM 3.    Amend subrule 10.3(3) as follows:    10.3(3)   A person shall not advise an Iowa resident to cancel, not renew, or otherwise change an existing insurance policy unless that person holds an Iowa producer license regarding the line of insurance for which the advice is given. This subrule shalldoes not apply to a licensed attorney or certified public accountant who does not sell or solicit insurance.

    ITEM 4.    Amend subrule 10.4(2) as follows:    10.4(2)   Examinations are conducted by the outside testing service on contract with the division. Applications and fees for examinations and for initial producer licensing will be submitted either to the outside testing service on contract with the division or as directed by the division. Instructions are available aton the division’s Web site: www.iid.state.ia.uswebsite.

    ITEM 5.    Amend subrule 10.4(5) as follows:    10.4(5)   Amendments to producer licenses shall be done either by an outside vendor or by the division, as directed by the division. Any licensed producer desiring to become licensed in an additional line of authority shallmust:    a.    Submit a completed uniform application form through the NIPR Gateway or as directed by the division, specifying the line(s) of authority requested to be added. Instructions are available aton the division’s Web site: www.iid.state.ia.uswebsite; and    b.    For each line of authority requested to be added, pass any required examination.

    ITEM 6.    Amend subrule 10.4(7) as follows:    10.4(7)   To receive a license for excess and surplus lines, the applicant must have successfully completed the excess and surplus lines examination and also have successfully completed either: (1) the examinations for property and casualty lines of authority; or (2) the examinationexaminations for personal lines of authority and the commercial insurance subject examination.

    ITEM 7.    Amend rule 191—10.6(522B) as follows:

191—10.6(522B) Issuance of license.      10.6(1)   AIn order to be issued a producer license, a person who meetsmust meet the requirements of Iowa Code sections 522B.4 and 522B.5, or section 522B.7, and ofand rule 191—10.5(522B), unless otherwise denied licensure pursuant to Iowa Code section 522B.11 or rule 191—10.20(522B), shall be issued a producer license. AThe initial term of a producer license shall remain in effect for an initial term ofis three yearsand ends after the last day of the applicant’s birth month of the year the license was issued, unless revoked or suspended. A license may be continually renewed pursuant to rule 191—10.8(522B) as long as the proper fees are paid and home state continuing education requirements are met. A renewal term is three years. If not renewed, a producer license automatically terminates on the last day of the month of the initial or renewal term.    10.6(2)   An individual producer whose license has expired may seek reinstatement as set forth in rule 191—10.9(522B).    10.6(3)   The license shall contain the producer’s name, address, license number, date of issuance, date of expiration, the line(s) of authority held, and any other information the division deems necessary. The license number shall be the same as the producer’s National Insurance Producer Registry (NIPR) national producer number (NPN).    10.6(4)   If the division issues or renews a producer license and subsequently determines that payment for the license or renewal was returned to the division by a bank without payment, or that the credit card company does not approve,or cancels, or refuses amounts charged to the credit card, the license shallmust be immediately suspended until the payments are made and any fees or penalties charged by the division are paid, at which time the license may be reinstated. The individual may request a hearing within 30 days of receipt ofthe division’s notice by the division that the license was suspended.

    ITEM 8.    Amend rule 191—10.7(522B) as follows:

191—10.7(522B) License lines of authority.  In addition to the lines of authority listed in Iowa Code subsection 522B.6(2), the following lines of authority also are available for issuance in Iowa: crop;, surety;, and reciprocal (any other line of insurance issued in another state and for which Iowa grants authority to sell, solicit or negotiate in this state).

    ITEM 9.    Amend rule 191—10.8(522B) as follows:

191—10.8(522B) License renewal.      10.8(1)   Upon request by alicensed producer, the division shallmust electronically transmit a producer renewal notice to a licensed producer at the producer’s last-known electronic mail address as it appears in division records. If the division has received notification that the electronic address of record is no longer valid, no renewal notice will be transmitted.    10.8(2)   A producer must apply for license renewal within 60during the 90 days prior to the expiration date of the license. Failure to apply to renew a license and pay appropriate fees prior to the expiration date of the license will result in expiration of the license.    10.8(3)   A producer may submit an electronic mail address to the division as directed by the division.    10.8(4)   Resident producer licenses may be renewed electronically through the NIPR Gateway at www.NIPR.com.    10.8(5)   Nonresident producer licenses mayonly be renewed only through the NIPR Gateway, or as otherwise directed by the division.

    ITEM 10.    Amend rule 191—10.9(522B) as follows:

191—10.9(522B) License reinstatement.      10.9(1)   A resident producer may reinstate an expired license up to 12 months after the license expiration date by proving that during the CEapplicable continuing education (CE) term the producer met the CE requirements found in 191—Chapter 11, and by paying a reinstatement fee anda license renewal feesfee. A resident producer who fails to apply for license reinstatement within 12 months of the license expiration date must apply for a new license.    10.9(2)   A nonresident producer may reinstate an expired license up to 12 months after the expiration date by submitting a request through the NIPR Gateway and by paying a reinstatement fee anda license renewal fee. After the 12-month period, aA nonresident producer must apply for a new licensewho fails to apply for a license reinstatement within 12 months of the license expiration date must apply for license reissuance.    10.9(3)   A producer who has surrendered a license for a nondisciplinary reason and stated an intent to exit the insurance business may file a request to reactivate the license. The request must be received at the division within 90 days of the date the license was placed on inactive status. The request will be granted if the former producer is otherwise eligible to receive the license. If the request is not received within 90 days, the producer must apply for a new license.

    ITEM 11.    Amend rule 191—10.10(522B) as follows:

191—10.10(522B) Reinstatement or reissuance of a license after suspension, revocation or forfeiture in connection with disciplinary matters; and forfeiture in lieu of compliance.      10.10(1) Terminology.  The term “reinstatement” as used in this rule means the reinstatement of a suspended license. The term “reissuance” as used in this rule means the issuance of a new license following either the revocation of a license, the suspension and subsequent termination of a license, or the forfeiture of a license in connection with a disciplinary matter, including but not limited to proceedings pursuant to rulesrule191—10.21(252J,272D), 191—10.22(261) and 191—10.23(82GA,SF2428). This rule does not apply to the reinstatement of an expired licenseor the issuance of a new license that is not in connection with a disciplinary matter.    10.10(2) Application required.  Any producer whose license has been revoked or suspended by order, or who forfeited a license in connection with a disciplinary matter, maymust apply to the commissioner for reinstatement or reissuance in accordance with the terms of the order of revocation or suspension or the order accepting the forfeiture.    a.    All proceedings for reinstatement or reissuance shallmust be initiated by the applicant, who shall file with the commissioner an application for reinstatement or reissuance of a licenseIowa Insurance Producer Application for Reinstatement or an Iowa Insurance Producer Application for Reissuance.An applicant is not eligible for reinstatement or reissuance until the applicant has satisfied the other prescribed requirements of rule 191—10.4(522B), including the timing requirements of subrule 10.4(4).    b.    An application for reinstatement or reissuance shallmust allege facts which, if established, will be sufficient to enable the commissioner to determine that the basis of revocation, suspension, or forfeiture of the applicant’s license no longer exists and that it will be in the public interest for the application to be grantedmust disclose whether the producer has engaged in any conduct that is listed as a cause for licensing action under Iowa Code section 507B.4 or 522B.11(1) that was not included in the order for suspension, revocation, or forfeiture.     c.    An application for reinstatement or reissuance must allege sufficient facts to enable the commissioner to determine that it will be in the public interest for the application to be granted. The commissioner may determine it is not in the public interest if the producer has engaged in any conduct that is listed as a cause for licensing action under Iowa Code section 507B.4 or 522B.11(1) that was not included in the order for suspension, revocation, or forfeiture.    d.    The burden of proof to establish such facts shall be on the applicant.    c.    e.    A producer may request reinstatement of a suspended license prior to the end of the suspension term; however, reinstatement will not be effected until the suspension period has ended.    d.    f.    Unless otherwise provided by law, if the order of revocation,or suspension, or acceptance of forfeiture did not establish terms upon which reinstatement or reissuance may occur, or if the license was forfeited, an initial application for reinstatement or reissuance may not be made until at least one year has elapsed from the date of the order of the suspension (notwithstanding paragraph 10.10(2)“c”10.10(2)“e”), revocation, or acceptance of the forfeiture of a license.    10.10(3) Proceedings.  All proceedings upon the application for reinstatement or reissuance, including matters preliminary and ancillary thereto, shall be held in accordance with Iowa Code chapter 17A. Such application shall be docketed in the original case in which the original license was suspended, revoked, or forfeited, if a case exists.    10.10(4) Order.  An order of reinstatement or reissuance shallmust be based upon a written decision whichthat incorporates findings of fact and conclusions of law. An order granting an application for reinstatement or reissuance may impose such terms and conditions as the commissioner or the commissioner’s designee deems desirableappropriate, which may include one or more of the types of disciplinary sanctions provided by Iowa Code section 522B.11. The order shall beis a public record, available to the public, and may be disseminated in accordance with Iowa Code chapter 22.    10.10(5) Voluntary forfeiture.  A request forsubmission of voluntary forfeiture of a license shallmust be made in writing toas prescribed by the commissioner. Forfeiture of a license is effective uponthe submission of the request unless a contested case proceeding is pending at the time the request is submittedof the submission. If a contested case proceeding is pending at the time of the request, the forfeiture becomes effective when and upon such conditions as required by order of the commissioner. A forfeiture made during the pendency of a contested case proceeding is considereda disciplinary action and shallmust be published in the same manner as is applicable to any other form of disciplinary order.    10.10(6) Suspension in relation to expiration date.  When a producer’s license has been suspended for a period of time whichthat extends beyond the producer’s license expiration date, the license will terminateterminates at the license expiration date, and the producer must request reinstatementreissuance pursuant to subrule 10.10(2).However, reissuance will not be effected until the suspension period has ended. If suspension for a period of time ends prior to the producer’s license expiration dateand the producer has met all applicable requirements, the division shallcommissioner must reinstate the license atas soon as practicable but no earlier than the end of the suspension period. TheHowever, the commissioner is not prohibited fromdenying an application for reinstatement or reissuance or bringing an additional immediate action if the producer has engaged in misconduct during the period of suspensionany additional violation of Iowa Code section 507B.4 or 522B.11(1) or otherwise failed to meet all of the applicable requirements.

    ITEM 12.    Amend rules 191—10.11(522B) to 191—10.13(522B) as follows:

191—10.11(522B) Temporary licenses.  An Iowa resident may apply for a temporary license pursuant to Iowa Code section 522B.10. The applicant shouldmust submit a written request to the division whichthat includes the reason for the request and the length of time for which the temporary license is requested. Temporary licenses will be issued for 90 days, with extensions allowed, but in no event for longer than 180 days, pursuant to Iowa Code section 522B.10.

191—10.12(522B) Change in name, address or state of residence.      10.12(1)   If a producer’s name is changed, the producer must file notification with the divisionthrough the NIPR Gateway at www.NIPR.com, unless the division instructs otherwise, within 30 days of the name change. The notification must include the producer’s:    a.    Prior name;    b.    License number; and    c.    New name.Notification shall be filed through the NIPR Gateway at www.NIPR.com, unless the division instructs the producer otherwise.    10.12(2)   Address change. If a resident or nonresident producer’s address is changed, the producer must file notification with the divisionthrough the NIPR Gateway at www.NIPR.com, unless the division instructs otherwise, within 30 days of the address change. The notification must include the producer’s:    a.    Name;    b.    License number;    c.    Previous address; and    d.    New address. A producer may designate a business address instead of a resident address at the option of the producer.Notification shall be filed through the NIPR Gateway at www.NIPR.com, unless the division instructs the producer otherwise.    10.12(3)   A nonresident producer who moves from one state to another state or an Iowa resident producer who moves to another state and wishes to retain an Iowa producer license must file a change of address with the division and provide a certification from the new resident state within 30 days of the change of legal residence. No fee or license application is required. If the new resident state is actively participating in the producer database, a letter of certification is not required. A nonresident licensed producer who moves to Iowa and wishes to retain the nonresident’s producer license must file a change of address with the division within 90 days of the change of legal residence.    10.12(4)   Issuance of an Iowa nonresident producer license is contingent on proper licensure in the nonresident producer’s home state. Termination of the producer’s resident license will be deemed termination of the Iowa nonresident producer license unless the producer timely files a change of address pursuant to this rulewithin 30 days of the termination of the resident license.    10.12(5)   If a producer has provided an E-mailemail address to the division, the division has the option tomay send information to the producer through the E-mailemail address rather than through the mail.

191—10.13(522B) Reporting of actions.      10.13(1)   A producer shallmust report to the division any actions required to be reported by Iowa Code section 522B.16.    10.13(2)   A producer shallmust report to the division all CSAC or CSRUor centralized collection unit of the department of revenue actions taken under or in connection with Iowa Code chapter 261 or252Jor 272D and all court orders entered in such actions.    10.13(3)   Failure to file reports required by this rule is a violation of this chapter and will subject producers to penalty pursuant to rule 191—10.20(522B).

    ITEM 13.    Amend subrule 10.15(2) as follows:    10.15(2)   Insurers shallmust file and pay for initial appointments using the NIPR Gateway, except that insurers authorized under Iowa Code chapter 518 or 518Ashallmust file appointments directly with the division by arrangement with the division.

    ITEM 14.    Amend subrule 10.15(7) as follows:    10.15(7)   Insurance companies are required tomust file the name, address, and electronic address of a contact person for the company, to whom the billing statements will be sent. Insurance companies are required tomust notify the division if a there is a change of the person appointed as the contact person or if a change of the address of such contact occurs. If aan insurance company fails to notify the division of such a change, the division shall charge the insurance companymust pay a $100 fee.

    ITEM 15.    Amend rules 191—10.16(522B) to 191—10.21(252J) as follows:

191—10.16(522B) Appointment renewal.      10.16(1)   On or about December 1 of each year, the division or its designee will deliver reminders to insurance companies that appointment renewals are imminent. Appointments shallmust be renewed electronically via the NIPR Gateway at www.NIPR.com.    10.16(2)   On or about January 2 of each year, a list of the producers currently appointed with each insurance company and a billing statement will be provided to each insurance company via the NIPR Gateway. The billing statement maymust not be altered, amended or used for appointing or terminating producers.    10.16(3)   Payment is due on or before March 1.    10.16(4)   Failure to pay renewal appointment fees by March 15 will result in termination of a company’s appointments. Appointments that are terminated due to nonpayment of renewal fees may be reinstated upon payment of the renewal fee plus a reinstatement fee of $500.    10.16(5)   Insurance companies are required tomust file the name, address, and electronic address of a contact person for the company, to whom the appointment renewals will be sent. Insurance companies are required tomust notify the division if a change of the address of such contact occurs. If aan insurance company fails to notify the division of such a change of address, the division shall charge the insurance companymust pay a $100 fee.

191—10.17(522B) Appointment terminations.      10.17(1)   When an insurance company terminates its relationship with a producer, the company shallmust notify the division using the NIPR Gateway. The termination must be filed within 30 days of the date the insurer terminated its agency relationship with the producer. The company shallmust also notify the producer that the producer’s appointment has been canceledterminated.    10.17(2)   There is no fee for the filing of an appointment termination.    10.17(3)   The division may adopt special procedures for the filing of termination requests for a group of affiliated insurance companies that comprise a holding company.    10.17(4)   When an insurer terminates an appointment for cause pursuant to Iowa Code section 522B.14, the notification of termination may be filed according to subrule 10.17(1). The supporting documents required by Iowa Code section 522B.14shallmust be submitted to the division within ten days of the filing of the notification. The documents shallmust include a certification by an officer or authorized representative of the insurer.

191—10.18(522B) Licensing of a business entity.      10.18(1) Application.  A business entity may apply for an Iowa insurance license. For purposes of this rule, upon approval of an application by the division, the business entity shallwill be classified as a producer and shall beis subject to all standards of conduct and reporting requirements applicable to producers.    10.18(2) Requirements.      a.    To qualify for such a license, the business entity must:    (1)   File a completed NAIC uniform business entity application through the NIPR Gateway or as directed by the division. For purposes of this subrule, “uniform business entity application” means the National Association of Insurance Commissioners’ uniform business entity application for resident and nonresident business entities, as the application appears on the NAIC Web sitewebsite;    (2)   Designate one officer, owner, partner, or member of the business entity, which person also is a producer licensed by the division, as the person who will have full responsibility for the conduct of all business transactions of the business entity or of producers affiliated with the business entity;    (3)   For a nonresident business entity, submit an appropriate request through the NIPR Gateway; and    (4)   Pay the license fee.    b.    The designated responsible producer shallmust maintain an active Iowa producer license. If the license of the designated responsible producer terminates or lapses for any reason, the business entity must supply the division with a substitute designated responsible producer within ten days. If the business entity does not provide a substitute, the division shallmust immediately terminate the license, and the entity shallmust submit a new applicationand pay the appropriate license fee.    10.18(3) License term.  A business entity license issued under this rule shall beis effective for three years and one month, including the year of application, beginning on the first day of the month of the business entity’s formation date and ending with the last day of the month of the business entity’s formation date. By arrangement with the division, a business entity may choose a different month for its license term.    10.18(4) License renewal.  Upon request by a business entity, the division shallmust electronically transmit a renewal notice to the electronic mail address of the business entity on file with the division on or before the first day of the month preceding the renewal month. The renewal fee must be received by the division or its designated vendor on or before the license expiration date. All business entities must renew their licenses through the NIPR Gateway or as otherwise directed by the division.    10.18(5) Business address.  Business entities licensed under this rule must maintain a current business address with the division. If a business entity’s address is changed, notification from the designated responsible producer must be submitted to the division within 30 days of the address change, stating:    a.    Name of the business entity;    b.    License number;    c.    Previous address; and    d.    New address.The notification may be sent by electronic mail through the NIPR Gateway at www.NIPR.com, unless the division instructs the producer otherwise.    10.18(6) Business name.  A business entity licensed under this rule must keep the division informed of its business name. If a business entity changes the name under which it is operating, notification from the designated responsible producer must be submitted to the division within 30 days of the name change. The notification may be sent through the NIPR Gateway, if available, or as instructed on the division’s website.

191—10.19(522B) Use of senior-specific certifications and professional designations in the sale of life insurance and annuities.      10.19(1) Purpose.  The purpose of this rule is to set forth standards to protect consumers from misleading and fraudulent marketing practices with respect to the use of senior-specific certifications and professional designations in the solicitation, sale or purchase of, or advice made in connection with, a life insurance or annuity product.    10.19(2) Scope.  This rule shall applyapplies to any solicitation, sale or purchase of, or advice made in connection with, a life insurance or annuity product by a producer.    10.19(3) Authority.      a.    This rule is promulgated under the authority of Iowa Code chapters 507B and 522B.    b.    Nothing in this rule shall limitlimits the division's authority to enforce existing provisions of law.    10.19(4) Prohibited uses of senior-specific certifications and professional designations.      a.    It is an unfair and deceptive act or practice in the business of insurance within the meaning of Iowa Code chapter 507B for a producer to use a senior-specific certification or professional designation that indicates or implies in such a way as to mislead a purchaser or prospective purchaser that the producer has special certification or training in advising or servicing seniors in connection with the solicitation, sale or purchase of a life insurance or annuity product or in the provision of advice as to the value of or the advisability of purchasing or selling a life insurance or annuity product, either directly or indirectly through publications or writings, or by issuing or promulgating analyses or reports related to a life insurance or annuity product.    b.    The prohibited use of senior-specific certifications or professional designations includes, but is not limited to, the following:    (1)   Use of a certification or professional designation by an insurance producer who has not actually earned or is otherwise ineligible to use such certification or designation;    (2)   Use of a nonexistent or self-conferred certification or professional designation;    (3)   Use of a certification or professional designation that indicates or implies a level of occupational qualifications obtained through education, training or experience that the producer using the certification or designation does not have; and    (4)   Use of a certification or professional designation that was obtained from a certifying or designating organization that:
  1. Is primarily engaged in the business of instruction in sales or marketing;
  2. Does not have reasonable standards or procedures for assuring the competency of its certificants or designees;
  3. Does not have reasonable standards or procedures for monitoring and disciplining its certificants or designees for improper or unethical conduct; or
  4. Does not have reasonable continuing education requirements for its certificants or designees in order to maintain the certificate or designation.
    c.    There is a rebuttable presumption that a certifying or designating organization is not disqualified solely for purposes of subparagraph 10.19(4)“b”(4) when the certification or designation issued from the organization does not primarily apply to sales or marketing and when the organization or the certification or designation in question has been accredited by:    (1)   The American National Standards Institute (ANSI);    (2)   The National Commission for Certifying Agencies; or    (3)   Any organization that is on the U.S. Department of Education’s list entitled “Accrediting Agencies Recognized for Title IV Purposes.”    d.    In determining whether a combination of words or an acronym standing for a combination of words constitutes a certification or professional designation indicating or implying that a person has special certification or training in advising or servicing seniors, factors to be considered shall include:    (1)   Use of one or more words such as “senior,” “retirement,” “elder,” or like words combined with one or more words such as “certified,” “registered,” “chartered,” “adviser,” “specialist,” “consultant,” “planner,” or like words, in the name of the certification or professional designation; and    (2)   The manner in which those words are combined.    e.    Financial services regulatory agency.    (1)   For purposes of this rule, a job title within an organization that is licensed or registered by a state or federal financial services regulatory agency is not a certification or professional designation, unless it is used in a manner that would confuse or mislead a reasonable consumer, when the job title:
  1. Indicates seniority or standing within the organization; or
  2. Specifies an individual’s area of specialization within the organization.
    (2)   For purposes of paragraph 10.19(4)“e,” “financial services regulatory agency” includes, but is not limited to, an agency that regulates insurers, insurance producers, broker-dealers, investment advisers, or investment companies as defined under the Investment Company Act of 1940.
    f.    Effective date. This rule shall become effective January 1, 2009.

191—10.20(522B) Violations and penalties.      10.20(1)   A producer who sells, solicits or negotiates insurance, directly or indirectly, in violation of this chapter shall beis deemed to be in violation of Iowa Code section 522B.2 andis subject to the penalties provided in Iowa Code section 522B.17.    10.20(2)   A person who sells, solicits or negotiates insurance, directly or indirectly, who is not properly licensed as a producer is subject to the penalties provided in Iowa Code chapter 507A and Iowa Code section 522B.17.    10.20(3)   Any company or company representative who aids and abets a producer in the above-described violation shall beis deemed to be in violation of Iowa Code section 522B.2 andis subject to the penalties provided in Iowa Code section 522B.17.    10.20(4)   The commissioner may place on probation, suspend, revoke, or refuse to issue or renew a producer’s license or may levy a civil penalty, in accordance with Iowa Code section 522B.17 or any combination of actions, for any action listed in Iowa Code section 522B.11 and any one or more of the following causes:    a.    Submitting to the division or to the outside testing service on contract with the division a check which is returned to the division by a bank without payment, or submitting a payment to the division by credit card which the credit card company does not approve, or canceling or refusing amounts charged to a credit card by the outside testing service on contract with the division where services were received by the producer;    b.    Failing to report any administrative action or criminal prosecution taken against the producer or failure to report the termination of a resident producer license;    c.    Acting as a producer through persons not licensed as producers; or    d.    Taking any action to circumvent the spirit of these rules and the Iowa insurance statutes or any other action that shows noncompliance with the requirements of Iowa Code chapter 522B or these rules.    10.20(5)   If a producer fails to provide to the division any notification required either by Iowa Code chapter 522B or by this chapter, including but not limited to notification of a change of address, notification of change of name, or notification of administrative criminal action as required by rules 191—10.12(522B) and 191—10.13(522B), within the required time, the producer shallmust pay a late fee of $100for each notification unless otherwise ordered pursuant to Iowa Code section 522B.6(7) or 522B.17. A business entity that fails to make a notification to the division as required by rule 191—10.18(522B) within the required time shallmust pay a late fee of $100for each notification unless otherwise ordered pursuant to Iowa Code section 522B.6(7) or 522B.17.    10.20(6)   In the event that the division denies a request to renew a producer license or denies an application for a producer license, the commissioner shallmust provide written notification to the producer or applicant of the denial or failure to renew, including the reason therefor. The producer or applicant may request a hearing within 30 days of receipt of the notice to determine the reasonableness of the division’s action. The hearing shallmust be held within 30 days of the date of the receipt of the written demand by the applicant, unless otherwise agreed to by the producer, and shall be held pursuant to 191—Chapter 3.    10.20(7)   The commissioner may suspend, revoke, or refuse to issue the license of a business entity if the commissioner finds, after hearing, that an individual licensee’s violation was known or should have been known by one or more of the partners, officers or managers acting on behalf of the entity and the violation was neither reported to the insurance division nor was corrective action taken.

191—10.21(252J,272D) Suspension for failure to pay child supportor state debt.      10.21(1)   The commissioner must deny the producer’s application for license issuance, renewal, reinstatement, or reissuance; suspend a current license; or revoke a currently suspended license upon receipt of a certificate of noncompliance from the CSRU according to the procedures in Iowa Code chapter 252J or upon receipt of a certificate of noncompliance from the centralized collection unit of the department of revenue according to the procedures in Iowa Code chapter 272D. In addition to the procedures set forth in Iowa Code chapters 252J and 272D, this rule applies.    10.(1) 10.21(2)   Upon receipt of a certificate of noncompliance from the child support recovery unit (CSRU), the commissioner shallmust issue a notice to the producer that the producer's pending application for licensure, pending request for renewal, or current license will be suspendedthe division will, unless the certificate of noncompliance is withdrawn, deny the producer’s application for license issuance, renewal, reinstatement, or reissuance; suspend a current license; or revoke a currently suspended license 30 days after the datemailing of the notice. Notice shallmust be sent to the producer's last-known address by regular mailrestricted certified mail, return receipt requested, or in accordance with the division’s rules for service.    10.(2) 10.21(3)   The notice shallmust contain the following items:    a.    A statement that the commissioner intends to suspend the producer's application, request for renewal or current insurance licensedeny the producer’s application for license issuance, renewal, reinstatement, or reissuance; suspend a current license; or revoke a currently suspended license in 30 daysunless the certificate of noncompliance is withdrawn.    b.    A statement that the producer must contact the CSRUagency that issued the certificate of noncompliance (“the issuing agency”) to request a withdrawal of the certificate of noncompliance;    c.    A statement that the producer's application, request for renewal or current license will be suspended if the certificate of noncompliance is not withdrawn;    d.    c.    A statement that the producer does not have a right to a hearing before the division, but that the producer may file an application for a hearing in district court pursuant to Iowa Code section 252J.9or 272D.9, as applicable;    e.    d.    A statement that the filing of an application with the district court will stay the proceedings of the division;and    f.    e.    A copy of the certificate of noncompliance.    10.21(4)   Producers must keep the commissioner informed of all actions taken by the district court or the issuing agency in connection with the certificate of noncompliance. Producers must provide to the commissioner, within seven days of filing or issuance, copies of all applications filed with the district court pursuant to an application of hearing, of all court orders entered in such actions, and of all withdrawals of certificates of noncompliance.    10.(3) 10.21(5)   The filing of an application for hearing with the district court will stay allIn the event an applicant or licensed producer timely files an application for hearing in district court and the division is notified of such a filing, the commissioner’s denial, suspension, or revocation proceedingswill be stayed until the division is notified by the district court, the issuing agency, the licensee, or the applicant of the resolution of the application.Upon receipt of a court order lifting the stay or otherwise directing the commissioner to proceed, the commissioner shall continue with the intended action described in the notice.     10.(4) 10.21(6)   If the divisioncommissioner does not receive a withdrawal of the certificate of noncompliance from the CSRUissuing agency or a notice from a clerk of court, the issuing agency, the licensee, or the applicant that an application for hearing has been filed, the division shall suspend the producer's application, request for renewal or current licensecommissioner must deny the producer’s application for license issuance, renewal, reinstatement, or reissuance; suspend a current license; or revoke a currently suspended license 30 days after the notice is issued.    10.(5) 10.21(7)   Upon receipt of a withdrawal of the certificate of noncompliance from the CSRUissuing agency, suspensionor revocation proceedings shallmust halt and the named producer shallmust be notified that the proceedings have been halted. If the producer's license has already been suspended, theproducer must apply for reinstatement and the license shallmust be reinstated if the producer is otherwise in compliance with division rules.If the producer’s application for licensure was stayed, application processing must resume. All fees required for license renewal,or license reinstatement, or reissuance must be paid by producers and all continuing education requirements must be met before a producer license will be renewed or reinstated after a license suspension or revocation pursuant to this subrulechapter.    10.21(8)   The commissioner must notify the producer in writing through regular first-class mail, or such other means as the commissioner deems appropriate in the circumstances, within ten days of the effective date of the suspension or revocation of a producer license, and must similarly notify the producer when the producer license is reinstated following the commissioner’s receipt of a withdrawal of the certificate of noncompliance.    10.21(9)   Notwithstanding any statutory confidentiality provision, the division may share information with the CSRU or the centralized collection unit of the department of revenue for the sole purpose of identifying producers subject to enforcement under Iowa Code chapter 252J or 272D.

    ITEM 16.    Rescind and reserve rule 191—10.22(261).

    ITEM 17.    Rescind and reserve rule 191—10.23(82GA,SF2428).

    ITEM 18.    Amend rules 191—10.24(522B) to 191—10.26(522B) as follows:

191—10.24(522B) Administration of examinations.      10.24(1)   The division willmay enter into a contractual relationship with an outside testing service, in compliance with Iowa law, to provide the licensing examinations for all lines of authority which require an examination.    10.24(2)   TheIf contracted, the outside testing service willmust administer all examinations for license applicants.    10.24(3)   Any contract to implement subrule 10.24(1)shallmust require the outside testing service to:    a.    Update, on a continual basis, the licensing examinations;    b.    Ensure that the examinations are job-related;    c.    Adequately inform the applicants of the procedures and requirements for taking the licensing examinations;    d.    Prepare and administer examinations for all lines listed in Iowa Code subsection 522B.6(2) and rule 191—10.7(522B), except variable contracts; and    e.    Conform to division guidelines and Iowa law, and report to the division on at least a quarterly basis.

191—10.25(522B) Forms.  An original of each form necessary for the producer’s licensure, appointment and termination may be downloaded from the NAIC Web sitewebsite, and the division’s Web site (www.iid.state.ia.us)website will provide a link to that site. Exact, readable, high-quality copies may be made therefrom. A self-addressed, stamped envelope must be submitted with each request.

191—10.26(522B) Fees.      10.26(1)   Fees may be paid by check, money order, or credit card.    10.26(2)   The fee for an examination shallmay be set by the outside testing service under contract with the division andmust be approved by the division.    10.26(3)   The fee for issuance or renewal of a producer license is $50 for three years.    10.26(4)   The fee for issuance or renewal of a business entity license is $50 for three years.    10.26(5)   The fee for reinstatementor reissuance of a producer license is a total of the renewal fee plus $100.In addition, applicable issuance or renewal fees will be assessed.    10.26(6)   The fee for an appointment or the renewal of an appointment is $5 for each producer appointed to a domestic company. The fee for appointment or renewal of each producer appointed to a foreign company is the fee charged by the state of domicile.    10.26(7)   The division may charge a reasonable fee for the compilation and production of producer licensing records.

    ITEM 19.    Rescind 191—Chapter 10, implementation sentence, following rule 191—10.26(522B).

    ITEM 20.    Amend rule 191—10.51(522A,86GA,SF487) as follows:

191—10.51(522A,86GA,SF487522E) Limited licenses.      10.51(1) Limited licenses for vehicle rental companies and counter employees.      a.    Purpose.The purpose of this subrule is to govern the qualifications of and procedures for the licensing of vehicle rental companies and counter employees and to set out the requirements, procedures and fees relating to the qualification and licensure of vehicle rental companies and counter employees.    b.    Definitions.For purposes of this subrule,in addition to the definitions in rule 191—1.1(502,505), the definitions of Iowa Code chapter 522Aand the following definitions shall apply:.        "Division" means the commissioner of insurance and the Iowa insurance division.        "Division Web site" means the Web site for the division, www.iid.iowa.gov.        "File" means to submit information to the division. A submission is considered filed when it is received by the division.        "Vehicle rental counter employee limited license" means a license issued to an individual employed by a rental company authorized as a limited licensee as defined by Iowa Code section 522A.2.        "Vehicle rental counter employee limited license application" means the form used by an individual to apply for a counter employee license, pursuant to Iowa Code section 522A.3.        "Vehicle rental limited license" means a license issued to a rental company authorized as a limited licensee as defined by Iowa Code section 522A.2.        "Vehicle rental limited license application" means the form used by a vehicle rental company to apply for a limited license, pursuant to Iowa Code section 522A.3.    c.    Requirement to hold a license.    (1)   A rental company that desires to offer or sell insurance set forth in Iowa Code section 522A.3 in connection with the rental of a vehicle shallmust file a vehicle rental limited license application with the division and, at the discretion of the division, receive a vehicle rental limited license.    (2)   A counter employee who desires to offer or sell insurance products shallmust file a vehicle rental counter employee limited license application with the division and, at the discretion of the division, receive a vehicle rental counter employee limited license.    d.    Limited license application process for vehicle rental company.    (1)   To obtain a limited license, a vehicle rental company shallmust file a completed vehicle rental limited license application with the division and pay a fee of $50 for a license. The vehicle rental limited license application form is available on the division Web sitedivision’s website.     (2)   If the vehicle rental limited license application is approved, the division shallmust issue a vehicle rental limited license. The vehicle rental limited license term shall beis from the date of approval through the third December 31 after the vehicle rental limited license is issued.     e.    Limited license application process for counter employees.    (1)   An individual may not obtain a vehicle rental counter employee limited license unless that individual is employed by a vehicle rental limited licensee.    (2)   To obtain a vehicle rental counter employee limited license, an individual shallmust successfully complete an examination and submit to the division a completed vehicle rental counter employee limited license application, pursuant to Iowa Code section 522A.3. The vehicle rental counter employee limited license application form is available on the division Web sitedivision’s website.    (3)   If the application is approved, the division shallmust issue a vehicle rental counter employee limited license. Vehicle rental counter employee limited license applications shallwill be deemed approved if not disapproved by the division within 30 days of receipt by the division. The vehicle rental counter employee limited license term shall beis from the date of approval through the third December 31 after the license is issued.    (4)   The vehicle rental counter employee limited license shallwill automatically terminate:
  1. When the counter employee ceases employment with a vehicle rental limited licensee; or
  2. At the end of the term of the vehicle rental counter employee limited license term if the license is not renewed pursuant to this subrule.
    f.    Duties of vehicle rental limited licensees.    (1)   Pursuant to Iowa Code section 522A.3, a vehicle rental limited licensee is responsible for the training, examination and payment of license fees for all individuals it employs for whom the licensee desires to obtain vehicle rental counter employee limited licenses.    (2)   A vehicle rental limited licensee shallmust obtain and administer an examination for all vehicle rental counter employee limited license candidates. The content of the examination and the manner of its administration must be approved by the division.    (3)   The vehicle rental limited licensee must develop a system for the security of examination content.    (4)   The vehicle rental limited licensee must administer the vehicle rental counter employee limited license examination under controlled conditions, approved by the division, which ensure that each candidate completes the examination without outside assistance or interference.    (5)   The vehicle rental limited licensee must notify the division of the termination of employment of any of its vehicle rental counter employee limited licensees. The vehicle rental limited licensee shallmust file reports of terminations semiannually on January 1 and July 1.    g.    License renewal.    (1)   All vehicle rental limited licenses and vehicle rental counter employee limited licenses shallmust be issued with an expiration date of the December 31 at the end of the license terms and must be renewed before the end of the license terms.    (2)   Each year, the division shallmust mail to the vehicle rental limited licensee’s latest electronic mail or mailing address appearing in the division’s records a renewal form for use in renewing the vehicle rental limited license and all of the vehicle rental counter employee limited licenses that will expire that year.    (3)   The vehicle rental limited licensee shallmust complete the renewal form for its license if applicable and for all of the vehicle rental counter employee limited licenses that will expire that year and shallmust return the completed renewal form and applicable fee to the division on or before December 31 of the renewal year or all licenses listed on the renewal form shallwill expire.    (4)   The fee for renewal of a vehicle rental limited license is $50, and the fee to renew each vehicle rental counter employee limited license is $50.    h.    Limitation on fees.A vehicle rental limited licensee shallis not be required to pay license and renewal fees of more than $1,000 in aggregate in any calendar year.    i.    Change in name or address.    (1)   Vehicle rental limited licensees shallmust file written notification with the division of a change in name or address within 30 days of the change. This requirement applies to any change in any locations at which the vehicle rental limited licensee is doing business.    (2)   Vehicle rental limited licensees shallmust file written notification with the division of changes in names or addresses of vehicle rental counter employee limited licensees. If the change of name is by a court order, a copy of the order shall be included with the notification. The limited licensee shallmust file reports of name and address changes semiannually on January 1 and July 1.    j.    Violations and penalties.    (1)   A rental company or counter employee who sells insurance in violation of this rule shall be deemed to beis in violation of Iowa Code chapter 522A andis subject to the penalties provided in Iowa Code section 522A.3.    (2)   A vehicle rental limited licensee or vehicle rental counter employee limited licensee who commits an unfair or deceptive trade practice in violation of Iowa Code chapter 507B, or in violation of administrative rules which implement that chapter, is subject to the penalties provided for in Iowa Code chapter 507B.
    10.51(2) Limited licenses for persons who sell portable electronics insurance.      a.    Purpose.The purpose of this subrule is to govern the qualifications of and procedures for the licensing of persons offering or selling any form of portable electronics insurance in this state, pursuant to 2015 Iowa Acts, Senate File 487Iowa Code chapter 522E.    b.    Definitions.For purposes of this subrule, in addition to the definitions in rule 191—1.1(502,505), the definitions of 2015 Iowa Acts, Senate File 487, and the following definitions shallIowa Code chapter 522E apply:.        "Division" means the commissioner of insurance and the Iowa insurance division.        "Division Web site" means the Web site for the division, www.iid.iowa.gov.        "File" means to submit information to the division. A submission is considered filed when it is received by the division.        "Portable electronics insurance limited license" means a portable electronics insurance license as defined by 2015 Iowa Acts, Senate File 487, section 1.        "Portable electronics insurance limited license application" means the form used by a portable electronics vendor to apply for a portable electronics insurance limited license.    c.    Requirement to hold a portable electronics insurance limited license.A person that desires to offer or sell any form of portable electronics insurance in this state shallmust:    (1)   Be licensed as an insurance producer pursuant to Iowa Code chapter 522B;    (2)   Submit an application to the division and, at the discretion of the division, receive a portable electronics insurance limited license pursuant to 2015 Iowa Acts, Senate File 487, sections 2, 3 and 4,Iowa Code sections 522E.2, 522E.3, and 522E.4 and this subrule; or    (3)   Be an endorsee in compliance with 2015 Iowa Acts, Senate File 487, sections 6 and 7,Iowa Code sections 522E.6 and 522E.7 and this subrule.    d.    Application process for portable electronics insurance limited license.    (1)   To obtain a portable electronics insurance limited license, a portable electronics vendor shallmust submit to the division a completed portable electronics insurance limited license application and the appropriate fee, as required by 2015 Iowa Acts, Senate File 487, section 3Iowa Code section 522E.3.    (2)   If the application is approved, the division shallmust issue a portable electronics insurance limited license. The portable electronics insurance limited license term shall beis from the date of approval through the third December 31 after the portable electronics insurance limited license was issued.    e.    Portable electronics insurance limited license renewal.    (1)   All portable electronics insurance limited licenses shallmust be issued for a license period as defined in 2015 Iowa Acts, Senate File 487, section 1,Iowa Code section 522E.1 and must be renewed triennially.    (2)   Not less than 60 days before the end of the license period, the division shallmust mail a renewal form to the portable electronics insurance limited licensee at the last-known electronic mail or mailing address appearing in the division’s records.     (3)   The portable electronics insurance limited licensee shallmust complete and return to the division the completed renewal form and the applicable fee, as required by 2015 Iowa Acts, Senate File 487, section 5Iowa Code section 522E.5, on or before the expiration date of the portable electronics insurance limited license, or the licensee’s portable electronics insurance limited license shallwill expire and the authority of all endorsees to sell under the portable electronics insurance limited license also shallwill expire.     f.    Change in name or address.A portable electronics insurance limited licensee shallmust file written notification with the division of a change in name or address within 30 days of the change. This requirement applies to any change in any location at which the portable electronics insurance limited licensee is doing business.    g.    Violations and penalties.A portable electronics vendor or endorsee that sells insurance in violation of this rule shall be deemed to beis in violation of 2015 Iowa Acts, Senate File 487,Iowa Code chapter 522E andis subject to the penalties in 2015 Iowa Acts, Senate File 487, section 8Iowa Code chapter 522E.       This rule isThese rules are intended to implement Iowa Code chapterchapters 252J, 272D,522A, 522B, and 2015 Iowa Acts, Senate File 487522E.

    ITEM 21.    Amend rules 191—11.1(505,522B) to 191—11.5(505,522B) as follows:

191—11.1(505,522B) Statutory authority—purpose—applicability.      11.1(1)   These rules are adopted pursuant to the general rule-making authority of the insurance commissioner in Iowa Code chapters 505 and 522B to establish continuing education requirements for resident and nonresident insurance producers.    11.1(2)   The purpose of these rules is to establish requirements by prescribing:    a.    The minimum number of continuing education credits that an insurance producer must complete;    b.    The procedure and standards that the division will utilize in the approval of continuing education providers and courses;    c.    The procedure for establishing that the required continuing education has been completed; and    d.    Enforcement criteria and guidelines.    11.1(3)   These rules do not apply to:    a.    A nonresident producer who resides in a state or district having a continuing education (CE) requirement for insurance producers.    b.    A resident producer who holds qualification in one of the followingthe surety or credit lines of authority: surety; or credit life, accident and health insurance.    c.    Licensed attorneys who are also producers who submit proof of completion of continuing legal education for the appropriate calendar years during the CE term, pay the continuing education fee set forth in subrule 11.14(1) and otherwise comply with the producer license renewal procedures set forth in 191—Chapter 10.    d.    A producer who serves full-time in the armed forces of the United States of America on active duty during a substantial part of the CE term and who submits evidence of such service.    e.    A resident producer who holds qualification only for a crop insurance line of authority and who complies with subrule 11.3(8).

191—11.2(505,522B) Definitions.  In addition to the definitions in rules 191—1.1(502,505) and 191—10.2(522B), the following definitions apply:        "Approved subject" "approved course" means any educational presentation which has been approved by the division.        "Attendance record" means a record on which a CE provider requires attendees of a CE course to sign in at the time of entrance to the course.        "CE" means continuing education as definedreferenced in Iowa Code chapter 522B.        "CE provider" means any individual or entity that is approved to offer continuing education courses in Iowa.        "CE term" means the period of time that begins either on the date when a new producer's insurance license is issued or on the date after the expiration date of an existing producer’s license and that ends on the following license expiration date.        "Credit" means continuing education credit. One credit is 50 minutes of instruction or reading material in an acceptable topic.        "License" means the division’s authorization for a person to act as an insurance producer for the authorized lines of insurance.        "National Insurance Producer Registry" "NIPR" means the nonprofit affiliate of the National Association of Insurance Commissioners (NAIC). Its Web site is www.licenseregistry.com.        "NIPR Gateway" means the communication network developed and operated by NIPR that links state insurance regulators with the entities they regulate to facilitate the electronic exchange of producer information regarding license applications, license renewals, appointments and terminations.        "Proctored" "independently proctored" means the supervision by a CE provider or disinterested third party over the conduct of a producer while that producer is completing an examination that is part of a self-study CE course.        "Producer" "insurance producer" means a person required to be licensed in this state to sell, solicit or negotiate insurance.        "Resident" means a person residing permanently in Iowa.        "Roster" means a listing of all licensed attendees at an approved course and includes the Iowa course number, the National Insurance Producer Registry (NIPR) National Producer Number (NPN), the date the course was completed, and the actual number of credits earned by each producer.        "Self-study course" means an educational program that consists of a self-study manual and comprehensive examination. A self-study course may be an on-lineonline course.

191—11.3(505,522B) Continuing education requirements for producers.      11.3(1)   Every licensed resident producer must complete a minimum of 36 credits for each CE term in courses approved by the division. Three of these credits must be in the subject of ethics. By the end of the last business day of the producer’s CE term, the division must receive from the producer proof of completion ofthe CE courses and payment of the CE fee.    11.3(2)   An instructor of an approved subject is entitled to the same credit as a student completing that subject and may receive such credit once during a CE term.    11.3(3)   A producer cannot carry over CE credits earned in excess of the producer’s CE term requirements from one CE term to the next.    11.3(4)   A producer may receive CE credit for self-study courses. A self-study course is considered completed when the examination is received by the CE provider.    a.    A producer may receive CE credit for self-study courses that are part of a recognized national designation program as described in subrule 11.5(5).    b.    A producer may receive up to 18 CE credits for self-study courses during a CE term that do not meet the definition of paragraph “a” if the producer:    (1)   Submits an affidavit to the CE provider stating that the examination was independently proctored and was completed without any outside assistance, and    (2)   Correctly answers at least 70 percent of the questions presented.    11.3(5)   A producer may not receive CE credit for courses taken prior to the issuance of an initial license.    11.3(6)   A producer cannot receive CE credit for the same course twice in one CE term. A producer cannot receive CE credit both for the classroom portion and for the examination portion of a national designation program as defined in subrule 11.5(5).    11.3(7)   A producer may elect to comply with the CE requirements by taking and passing the appropriate licensing examination for each qualification held by the producer.    a.    A producer who holds property and casualty lines of authority must successfully complete the commercial insurance subject examination.    b.    A producer who holds an excess and surplus line of authority must successfully complete the examination for the excess and surplus line of authority and the commercial insurance subject examination.    11.3(8)   For aA resident producer whoonly holds qualification only for a crop insurance line of authority and who is requesting renewal of a producer license on or after January 1, 2010, the producer must be able toneeds only to demonstrate the following each time renewal of a license is requestedto renew:    a.    The producer has completed all training and continuing education requirements imposed by the federal Risk Management Association, if any; and     b.    The producer has completed 18 credits of continuing education, 3 of which must be in the area of ethics, except that a producer who is requesting renewal of a producer license during 2010 must demonstrate that the producer has completed 9 credits of continuing education, 3 of which must be in the area of ethics.

191—11.4(505,522B) Proof of completion of continuing education requirements.      11.4(1) Producer duties.      a.    Producers are required tomust demonstrate compliance with the CE requirements at the time of license renewal. Procedures for completing the license renewal process are outlined in 191—Chapter 10.    b.    Producers are required tomust maintain a record of all CE courses completed by keeping the original certificates of completion for four years after the end of the year of attendance.    11.4(2) Insurer duties regarding federal flood insurance.  An insurer authorized to do business in Iowa shallmust demonstrate to the division, upon the division’s request, that producers appointed by the insurer have complied with all continuing education guidelines as established by the National Flood Insurance Program (NFIP).

191—11.5(505,522B) Course approval.      11.5(1)   To qualify for approval a course must be designed to expand technical insurance skills and knowledge obtained prior to initial licensure or to develop new and relevant skills and knowledge.    11.5(2)   Any approved active CE provider shallmust submit a request for approval of any course, program of study, or subject for continuing education credit to the division on an NAIC uniform form. If an outside vendor is retained by the division for course reviews, requests for approval shallmust be filed directly with the vendor.    11.5(3)   Requests for course approval whichthat do not include all required information will be returned as incomplete.    11.5(4)   Except as provided in subrule 11.5(5), requests for approval shallmust be submitted at least 30 days prior to the beginning of the course. A request for renewal of a previously approved course shallmust be submitted at least 30 days prior to the end of the 24-month approval period. Requests received later may be disapproved.    11.5(5)   A request for approval of any self-study course that is part of a recognized national designation program may be filed within 60 days after the course is completed. This course will be reviewed and may be approved for up to the number of credits awarded for passage of the national examination in topics that are otherwise approvable under these rules. This subrule applies only to national designation programs such as AAI, ARM, CIC, CEBS, ChFC, CFP, CLU, CPCU, FLMI, LUTCF, RHU and similar courses as determined by the division.    11.5(6)   An insurance producer who attends a classroom course offered by a college, university or governmental agency that has not been approved by the division may make application for approval of theprovider and course for CE credit. The application must be filed within 60 days of attendance at the course and must contain sufficient materials to allow for a thorough evaluation of theprovider, course content, and instructor qualifications. To be eligible for CE credit, the course must meet all division guidelines for course approval. All course review fees must be paid by the producer.    11.5(7)   A CE course must be offered for a minimum of one credit. Fractional credits will not be awarded. The total credit whichthat may be awarded for a CE course is limited to 36 credits, except that credit for a self-study course as defined inparagraph11.3(4)“b”shall beis limited to 18 CE credits.    11.5(8)   Notification will be sent to the CE provider indicating approval or disapproval. Approved courses will be assigned a course number.    11.5(9)   The division may deem the approval of a CE course by another state’s insurance division as adequate evidence that a course is eligible for approval in Iowa and may award the same number of credits for the course awarded by the other state. The CE provider must submit the NAIC uniform form demonstrating the other state’s approval of the CE course.    11.5(10)   Within 30 days of course approval, CE providers shallmust inform the division or its vendor, as directed by the division, of the dates and locations that the course will be offered. Failure to timely file the dates and locations will subjectsubjects the CE provider to penalty and suspension or rescission of course approval.    11.5(11)   CE courses approved by the division may be offered for a 24-month period following the date of approval.

    ITEM 22.    Strike “shall” wherever it appears in rules 191—11.10(505,522B) and 191—11.11(505,522B) and insert “must” in lieu thereof.

    ITEM 23.    Amend rule 191—11.12(505,522B) as follows:

191—11.12(505,522B) Outside vendor.  The division may enter into a contractual arrangement with a qualified outside vendor to assist the division with any or all continuing education services. Fees charged by the outside vendor will be subject to division approval and will be paid by the CE provider. Course approval fees are nonrefundable.

    ITEM 24.    Amend subrule 11.14(1) as follows:    11.14(1)   The fees for approval and renewal of CE providers, CE courses and registration of instructors shall be set by the outside vendor retained by the division and are subject to approval by the division.Course approval fees are nonrefundable.

    ITEM 25.    Amend rule 191—13.1(505,522B) as follows:

191—13.1(505,522B) Purpose and authority.  The purpose of these rules is to implement the provisions of 18 U.S.C. Section 1033 and Iowa Code section 522B.16B. The Iowa insurance commissioner has jurisdiction under 18 U.S.C. Section 1033 to grant requests for consent to engage in the business of insurance. Insurance companies, producers, and individuals shall comply with these rules beginning January 1, 2010.

    ITEM 26.    Amend rule 191—13.2(505,522B), introductory paragraph, as follows:

191—13.2(505,522B) Definitions.  For the purpose of this chapter,the definitions in rule 191—1.1(502,505) and the following definitions shall apply:

    ITEM 27.    Rescind the definitions of “Commissioner” and “Division” in rule 191—13.2(505,522B).

    ITEM 28.    Amend rule 191—13.4(505,522B) as follows:

191—13.4(505,522B) Applications for consent.  The prohibited person must file with the division an application for consent as set forth in this rule.    13.4(1)   Except as provided in subrule 13.4(2), a prohibited person who is, or seeks to be, employed in any capacity in the business of insurance in Iowa shallmust complete and file an application for consent using the “Short Form Application for Written Consent to Engage in the Business of Insurance Pursuant to 18 U.S.C. § 1033 and 1034.” The form is, in a format prescribed by the division, available on the division’s Web site at www.iid.state.ia.uswebsite or is available by request from the division.    13.4(2)   The commissioner may at any time request additional information from an applicant to support a pending application for consent. Failure to provide such information is grounds for denial of the application.    13.4(3)   An application must include:    a.    Two 2″ × 2″ recent passport-typeidentical photographs attached to the upper right-hand corner of the first page ofas indicated on the application for consent.    b.    A certified copy of the applicant’s criminal history record both from the applicant’s state of residence and from the state in which the felony was committed if different from the state of residence. A Record Check Request form may be obtained from the Iowa division of criminal investigation at: www.state.ia.us/government/dps/dci/crimhist.htmwww.dps.state.ia.us.    c.    A certified copy ofall court documents that demonstrate completion and performance of all conditions imposed by the court.    d.    An affidavit from the immediate supervisor or potential immediate supervisor for the entity that employs the applicant or that seeks to employ the applicant stating in detail the duties and responsibilities which the applicant will perform and for which the applicant seeks consent.    e.    Any other relevant documents or information that the prohibited person would like to have considered.    13.4(4)   Upon the occurrence of any event that would change any answer on the application, an amendment must be promptly filed. Failure to file an amendment may result in denial of the request for consent or the immediate suspension or revocation of a previously granted consent.

    ITEM 29.    Amend rule 191—13.6(505,522B) as follows:

191—13.6(505,522B) Review of application by the division.      13.6(1)   A completed application shall be reviewed by the commissioner, and the following shall be consideredThe commissioner must consider the following when reviewing a completed application:    a.    The information submitted by the applicant;    b.    The factors set forth in subrule 13.5(2); and    c.    Any mitigating or aggravating circumstances.    13.6(2)   At the commissioner’s discretion, the commissioner may convene a hearing to receive evidence and testimony about the application.    13.6(3)   If the commissioner determines that the applicant does not seem to constitute a significant threat to the public, the commissioner shall issue the consent and specify its scope.    13.6(4)   If the commissioner determines that the applicant does seem to constitute a significant threat to the public, the commissioner shall deny the application. Notice of the denial shallmust be sent to the applicant via certified mail to the address on record with the division, return receipt requested. The prohibited person shall havemay request a hearing with the commissioner within30 days to request a hearing with the commissionerfrom the date of mailing of the division’s notice.    13.6(5)   The application and materials supplied with the application or, provided at the request of the division and any information, or obtained by the division during the course of its review, including materials and testimony received at a hearing regarding an application, shall be considered information submitted to the insurance division or obtained by the insurance division in the course of an investigation for purposes of Iowa Code section 505.8(8), and the commissioner shall keep such information confidential. A consent issued by the commissioner shall be deemedis a public record for purposes of Iowa Code chapter 22; however, Iowa Code section 505.8(9) also shall apply.

    ITEM 30.    Amend rule 191—13.8(505,522B) as follows:

191—13.8(505,522B) Change in circumstances.      13.8(1) Failure to disclose.  In the event that the division determines that the prohibited person receiving the consent made materially false or misleading statements, or failed to disclose material information in the application for consent, the consent shall be suspended or revoked. The prohibited person shall havemay request a hearing with the commissioner within 30 days to request a hearing with the commissionerfrom the date of mailing of the division’s notice.    13.8(2) New felony.      a.    A prohibited person who previously received consent from the commissioner to participate in the business of insurance shallmust immediately notify the division if that person is subsequently convicted of an offense under the Act, or of any felony offense involving dishonesty or breach of trust.    b.    The entry of a new conviction shall automatically terminateterminates the prior consent.    c.    When the division becomes aware of the new conviction, it willmust inform the prohibited person in writing, via certified mail to the address on record with the division, return receipt requested, that the consent previously issued has been revoked.    d.    The prohibited person may seek a new consent from the commissioner pursuant to the Act and to this chapter after reporting the new conviction.    13.8(3) Violation of terms of consent.  If the commissioner determines that a prohibited person has violated the terms of a consent, the commissioner shall immediately terminate the consent.The division must inform the prohibited person in writing, via certified mail to the address on record with the division, return receipt requested, that the consent previously issued has been terminated. The prohibited person shall havemay request a hearing with the commissioner within 30 days to request a hearing with the commissionerfrom the date of mailing of the division’s notice.    13.8(4) Suspension of insurance producer license.  The commissioner may summarily suspend the insurance producer license of a prohibited person for any of the actions described in subrule 13.8(1), 13.8(2) or 13.8(3) if the person has been issued a license by the division. A hearing shall be scheduled in accordance with Iowa Code chapter 17A to determine whether the person’s license should be revoked.

    ITEM 31.    Amend rule 191—13.10(505,522B) as follows:

191—13.10(505,522B) Violations and penalties.  A prohibited person who engages in the business of insurance without the consent of the commissioner or otherwise in violation of this chapter shall be deemed to be in violation of Iowa Code section 522B.2 and shall beis subject to the penalties provided in Iowa Code section 522B.17.

    ITEM 32.    Amend rules 191—48.2(508E) and 191—48.3(508E) as follows:

191—48.2(508E) Definitions.  For purposes of this chapter, the definitions in Iowa Code chapter 508E are incorporated by reference. In additionto those definitions and the definitions in rule 191—1.1(502,505), the following definitions shall apply:        "Commissioner’s Web site" means the Web site of the commissioner and of the Iowa insurance division, www.iid.state.ia.us.        "Life settlement" means a viatical settlement in which the viator has not been diagnosed as terminally or chronically ill. For purposes of these rules, unless otherwise distinguished, the term “life settlement” shall be synonymous with viatical settlement.        "Renewal year" means the last year of the viatical settlement license three-year term.

191—48.3(508E) License requirements.      48.3(1) Viatical settlement provider.      a.    To be considered for licensure as a viatical settlement provider pursuant to Iowa Code section 508E.3, a person must complete the viatical settlement provider application form found at the commissioner’s Web site, file with the commissioner thea completedviatical settlement provider application in the format prescribed by the commissioner, and include the payment ofpay an application fee in the amount of $100. An application shall not be deemed filed until all information necessary to process the application has been received by the commissioner. In addition to complying with Iowa Code section 508E.3, the applicant also shall, and provide the following:    (1)   Copies of the provider’s audited financial statements for the current year and each of the previous five years. At the commissioner’s discretion, the applicant also shall provide a copy of the current year’s consolidated annual audited financial statement with a financial guarantee from the provider’s ultimate controlling person, and copies of the provider’s unaudited financial statements for the current year and each of the previous five years;    (2)   Evidence that the applicant maintains books and records in compliance with generally accepted accounting principles;    (3)   If a legal entity intending to have any partners, officers, members, and designated employees act as viatical settlement providers or viatical settlement brokers under the legal entity’s license pursuant to Iowa Code section 508E.3, all completed forms, fees, and information required to be filed under subrule 48.3(2) for each such person named in the application and any supplements to the application;    (4)   Biographical affidavits, in a form prescribed by the commissioner, for the following: officers and directors (as listed on the most recent financial statement), key managerial personnel (including any vice presidents or other individuals who will control the operations of the applicant), and individuals with a 10 percent or more beneficial ownership in the applicant who will exercise control over the applicant;    (5)   An independent business character report on the individuals listed in subparagraph (4). The business character report shall be filed directly with the commissioner by the independent third party that certified the report. The business character report shall be in a format prescribed by the commissioner and shall not be older than one year prior to the date the application is filed. For purposes of subparagraph (5), “business character report” means a statement certified by an independent third party which has conducted a comprehensive review of the applicant’s background and has indicated that the biographical information provided in the report, as completed by the applicant, has no inaccurate or conflicting information. An independent third party is one that has no affiliation with the applicant and is in the business of providing background checks or investigations. Business character reports must be current and shall not be older than one year prior to the date the application is filed. The business character report shall be in the format prescribed by the commissioner;    (6)   Initial viatical settlement contracts, disclosure statements, and advertising material that have been or are being submitted for approval and that have been approved or that are approved during the course of the application process pursuant to Iowa Code section 508E.5;    (7)   A copy of the provider trust, pursuant to 48.3(1)“c”; and    (8)   A report of any civil, criminal or administrative actions taken or pending against the viatical settlement provider in any state or federal court or agency, regardless of outcome.    b.    A form for the antifraud plan that is required to be submitted with an application pursuant to Iowa Code section 508E.3, to meet the requirements of Iowa Code section 508E.15, can be found on the commissioner’s Web sitedivision’s website.    c.    The provider trust that is required to be submitted with an application, pursuant to subparagraph 48.3(1)“a”(7), shall be in a format acceptable to the commissioner and shall include the following provisions:    (1)   The provider trust cannot be terminated without the prior written consent of the commissioner.    (2)   The provider trust is subject to the prior approval of the commissioner.    (3)   The provider trust funds shall not be intermingled.    (4)   The provider trust funds held shall be identified based on individual policyholders.    (5)   The provider trust trustee is obligated to indemnify the provider or the policyholder or both for any lost funds.    (6)   The agreement can only be amended or terminated with the prior written consent of the commissioner.    (7)   The provider trust trustee shall be a bank or trust company, having its principal place of business in the United States.    (8)   The provider trust trustee shall be audited annually by independent public accountants and complete the audit report, related financial statements, and opinion on internal controls. All reports shall be available for review by the commissioner.    d.    In addition to the information required in this subrule, the commissioner may ask for other information necessary to determine whether the applicant for a license as a viatical settlement provider complies with the requirements of this subrule and Iowa Code subsection 508E.3(7).    48.3(2)   Viatical settlement broker.    a.    To be considered for licensure as a viatical settlement broker pursuant to Iowa Code section 508E.3, a person must complete the viatical settlement broker application form found at the commissioner’s Web site, file thea completedviatical settlement broker application in the format prescribed by the commissioner, and include the payment ofpay an application fee in the amount of $100. In addition to finding compliance with Iowa Code section 508E.3, the commissioner also shall find that the applicant:    (1)   Has provided proof of one of the following:
  1. The applicant is a licensed insurance producer with a life line of authority for at least the 12 months preceding the date of application; or
  2. The applicant has taken and passed an examination on viatical and life settlement contracts required by another state insurance department and currently holds a license as a viatical settlement broker from that state; or
  3. The applicant has passed the viatical settlement examination required by the commissioner. Examination results are valid for 90 days after the date of the examination. If the applicant fails to apply for licensure within 90 days after passing the examination, the examination results shall be void;
    (2)   Has provided a report of any civil, criminal or administrative actions taken or pending against the viatical settlement broker in any state or federal court or agency, regardless of outcome, excluding misdemeanor traffic citations and juvenile offenses; and    (3)   Has provided proof that the applicant is covered by an errors and omissions policy for an amount of not less than $100,000 liability per occurrence and not less than $100,000 total annual aggregate for all claims during the policy period.
    b.    A form for the antifraud plan that is required to be submitted with an application pursuant to Iowa Code section 508E.3, to meet the requirements of Iowa Code section 508E.15, can be found on the commissioner’s Web sitedivision’s website.    c.    In addition to the information required in this subrule, the commissioner may ask for other information necessary to determine whether the applicant for a license as a viatical settlement broker complies with the requirements of this subrule and has made a filing pursuant to Iowa Code subsection 508E.3(7).
    48.3(3) Governing law where viators are residents of different states.  For purposes of this subrule, if there is more than one viator on a single policy and the viators are residents of different states, the viatical settlement contract shall be governed by the law of the state in which the viator having the largest percentage ownership resides or, if the viators hold equal ownership, the state of residence of one viator agreed upon in writing by all viators. If another state does not have a statute or rule substantially similar to Iowa Code chapter 508E and this rule, the actions related to the viatical settlement contract shall be governed by the law of this state.    48.3(4) License term.      a.    A viatical settlement provider or viatical settlement broker who meets the requirements of this rule, unless otherwise denied licensure pursuant to rule 48.10(508E), shall be issued a license.    b.    A viatical settlement provider license is valid for one yearthree years and automatically terminates on the last day of the month of the anniversary of the issue date unless renewed pursuant to subrule 48.3(6).    c.    A viatical settlement broker license is valid for an initial term of one yearthree years from the last day of the applicant’s anniversary month following the issuance of the license, and automatically terminates on the last day of the month of the initial term unless renewed pursuant to subrule 48.3(6).    d.    A viatical settlement provider license or a viatical settlement broker license may remain in effect for the term of the license plus any renewals, unless the license is revoked or suspended, as long as all required fees are paid in the time prescribed by the commissioner.    e.    The license issued to a viatical settlement provider or viatical settlement broker shall be a limited license that allows the licensee to operate only within the scope of its license.    48.3(5) Continuing education for viatical settlement broker.      a.    An individual licensed as a viatical settlement broker shallmust complete 1536 credits of approved continuing education during every two license termsterm. A license term is as set forth in paragraph 48.3(4)“c,” and, for purposes of this rule, the two-term continuing education requirement shall be called the “CE reporting term.”48.3(4)“c.”    b.    The required continuing education credits shall include a minimum of:    (1)   ThirteenThirty-three credits related tolife insurance, viatical settlements and viatical settlement transactions; and    (2)   TwoThree credits in ethics.    c.    The viatical settlement broker may submit the same completed credits to the commissioner both to meet the continuing education requirements for the viatical settlement broker license and to meet the continuing education requirements for an applicable insurance producer license.    d.    The license of a viatical settlement broker who fails to comply with this continuing education requirement shallwill terminate.    e.    An instructor of an approved continuing education course shall be granted the same credit as a student who completes the continuing education course, and the instructor may receive such credit once during a license term.    f.    A viatical settlement broker cannot carry overexcess continuing education credits from one CE reportinglicense term to the next continuing education credits earned in excess of the viatical settlement broker’s CE reporting term requirements.    g.    A viatical settlement broker may receive continuing education credit for self-study courses. A self-study course is considered completed when the continuing education provider receives the completed examination from the viatical settlement broker.    (1)   A viatical settlement broker may receive continuing education credit for self-study courses that are part of a recognized national designation program as described in 191—subrule 11.5(5).    (2)   A viatical settlement broker may receive continuing education credits for self-study courses that do not meet the requirement of subparagraph (1) if the viatical settlement broker:
  1. Submits an affidavit to the continuing education provider that the examination was independently proctored and was completed without any outside assistance, and
  2. Correctly answers at least 70 percent of the questions presented.
    h.    A viatical settlement broker shall not receive continuing education credit for courses taken prior to the issuance of an initial license.    i.    A viatical settlement broker cannot receive continuing education credit for the same course twice in one CE reportinglicense term. A viatical settlement broker cannot receive continuing education credit both for the classroom portion and for the examination portion of a national designation program as defined in 191—subrule 11.5(5).    j.    A viatical settlement broker may elect to comply with the continuing education requirements by taking and passing the viatical settlement broker licensing examination within 90 days prior to the date on which the renewal application is submitted.    k.    A viatical settlement broker shall demonstrate compliance with the continuing education requirements at the time of license renewal. A viatical settlement broker shall maintain a record of all continuing education courses completed by keeping the original certificates of completion for four years after the end of the year of course completion.    l.    For purposes of rule 191—48.3(508E), “credit” means continuing education credit. One credit is 50 minutes of instruction or reading material in an acceptable topic.    m.    Viatical settlement broker continuing education courses will be approved in the same manner that insurance continuing education courses are approved pursuant to 191—Chapter 11. The approval of continuing education providers, the responsibilities of continuing education providers, the prohibited conduct for continuing education providers, and the fees for approval and renewal of continuing education providers and courses shall be the same as those for insurance continuing education courses, continuing education providers, and insurance producers set forth in rules 191—11.9(505,522B) to 191—11.11(505,522B) and 191—11.14(505,522B). The commissioner may enter into a contractual arrangement with a qualified outside vendor to assist the commissioner with any or all continuing education services in the same manner as the commissioner may for insurance continuing education services pursuant to rule 191—11.12(505,522B). The commissioner may audit any continuing education course in the same manner as the commissioner may for insurance continuing education courses pursuant to rule 191—11.13(505,522B).
    48.3(6) License renewal.  A viatical settlement provider license or a viatical settlement broker license may be renewed as follows:    a.    A viatical settlement provider license may be renewed by payment of $100 within 6090 days prior to the expiration date of the license and by demonstration that the viatical settlement provider continues to meet the requirements of Iowa Code section 508E.3 and subrule 48.3(1), has provided biographical affidavits not older than one year prior to the renewal date on all persons listed in subparagraph 48.3(1)“a”(4), has provided business character reports for any new persons listed in subparagraph 48.3(1)“a”(4), and has provided the reports required by rule 48.7(508E)191—48.7(508E).    (1)   If renewal is approved, the license will be renewed effective the last day of the month of the anniversary of the issue date in the renewal year, will be valid for one yearthree years, and will automatically terminate on the last day of the month of the anniversary of the issue date in the following renewal year unless renewed pursuant tothis subrule 48.3(6).    (2)   Viatical settlement providers that had licenses prior to January 1, 2009, shall have a renewal date of January 1.    b.    A viatical settlement broker license may be renewed by demonstration of completion of continuing education as required in subrule 48.3(5) and payment of $100 within 6090 days prior to the expiration date of the license. If renewal is approved, the license will be renewed effective the last day of the month of the anniversary of the issue date in the renewal year, will be valid for one yearthree years, and will automatically terminate on the last day of the month of the anniversary of the issue date in the following renewal year unless renewed pursuant tothis subrule 48.3(6).    c.    If a legal entity has any partners, officers, members, or designated employees acting as viatical settlement providers or viatical settlement brokers under the legal entity’s license pursuant to Iowa Code section 508E.3, the legal entity must provide all completed forms, fees, and information required to be filed under paragraphs 48.3(6)“a” and “b” for each such person named in the application, or in any supplements to the application, and must provide any deletions to the list of names that was provided with the original application. If there are any new partners, officers, members, and designated employees that the legal entity intends will act as viatical settlement providers or viatical settlement brokers under the legal entity’s license, the legal entity shall provide for each such person the forms, information and fees required by subrule 48.3(2).    d.    If a viatical settlement provider or viatical settlement broker fails to comply with the renewal procedures within the time prescribed, or a viatical settlement provider fails either to meet the requirements of Iowa Code section 508E.3 and subrule 48.3(1) or to submit the reports required in rule 48.7(508E), such nonpayment or failure shall result in lapse of the license.    e.    A licensed viatical settlement broker who is unable to comply with license renewal procedures due to military service or some other extenuating circumstance may request from the commissioner a waiver of renewal procedures. Such viatical settlement broker may also request a waiver of any examination requirement or any other penalty or sanction imposed for failure to comply with renewal procedures.    48.3(7) License reinstatement.      a.    A viatical settlement broker may reinstate an expired license up to 12 months after the license expiration date by proving that during the CE reportinglicense term the viatical settlement broker met the CE requirements found in subrule 48.3(5), and by paying to the commissioner a reinstatement fee and license renewal fee. A viatical settlement broker who fails to apply for license reinstatement within 12 months of the license expiration date must apply for a new license.    b.    A viatical settlement broker who has surrendered a license for a nondisciplinary reason and stated an intent to exit the viatical settlement business may file a request to reactivate the license. The request must be received by the commissioner within 90 days of the date the license was placed on inactive status. The request will be granted if the former viatical settlement broker is otherwise eligible to receive the license. If the request is not received within 90 days, the viatical settlement broker must apply for a new license.    48.3(8) Reinstatement or reissuance of a license after suspension, revocation or forfeiture in connection with disciplinary matters; and forfeiture in lieu of compliance.      a.    The term “reinstatement” as used in this subrule means the reinstatement of a suspended license. The term “reissuance” as used in this subrule means the issuance of a new license following either the revocation of a license, the suspension and subsequent termination of a license, or the forfeiture of a license in connection with a disciplinary matter. This subrule does not apply to the reinstatement of an expired licenseor the issuance of a new license after the reinstatement period has passed that is not in connection with a disciplinary matter.    b.    Any viatical settlement broker whose license has been revoked or suspended by order, or who forfeited a license in connection with a disciplinary matter, maymust apply to the commissioner for reinstatement or reissuance in accordance with the terms of the order of revocation or suspension or the order accepting the forfeiture.    (1)   All proceedings for reinstatement or reissuance shall be initiated by the applicant who shall file with the commissioner an application for reinstatement or reissuance of a license.    (2)   An application for reinstatement or reissuance shall allege facts which, if established, will be sufficient to enable the commissioner to determine that the basis of revocation, suspension or forfeiture of the applicant’s license no longer exists and that it will be in the public interest for the application to be granted. The burden of proof to establish such facts shall be on the applicant.    (3)   A viatical settlement broker may request reinstatement of a suspended license prior to the end of the suspension term; however, reinstatement will not be effected until the suspension period has ended.    (4)   Unless otherwise provided by law, if the order of revocation or suspension did not establish terms upon which reinstatement or reissuance may occur, or if the license was forfeited, an initial application for reinstatement or reissuance may not be made until at least one year has elapsed from the date of the order of the suspension (notwithstanding 191—paragraph 10.10(2)“c”191—paragraph 10.10(2)“e”), revocation, or acceptance of the forfeiture of a license.    c.    All proceedings upon the application for reinstatement or reissuance, including matters preliminary and ancillary thereto, shall be held in accordance with Iowa Code chapter 17A. Such application shall be docketed in the original case in which the original license was suspended, revoked, or forfeited, if a case exists.    d.    An order of reinstatement or reissuance shallmust be based upon a written decision whichthat incorporates findings of fact and conclusions of law. An order granting an application for reinstatement or reissuance may impose such terms and conditions as the commissioner or the commissioner’s designee deems desirableappropriate, which may include one or more of the types of disciplinary sanctions provided by this chapter or by Iowa Code chapter 508E. The order shall beis a public record, available to the public, and may be disseminated in accordance with Iowa Code chapter 22.    e.    A request forsubmission of voluntary forfeiture of a license shallmust be made in writing toin the format prescribed by the commissioner. Forfeiture of a license is effective uponthe submission of the request unless a contested case proceeding is pending at the time the request is submittedof the submission. If a contested case proceeding is pending at the time of the request, the forfeiture becomes effective when and upon such conditions as required by order of the commissioner. A forfeiture made during the pendency of a contested case proceeding is considereda disciplinary action and shallmust be published in the same manner as is applicable to any other form of disciplinary order.    f.    A license may be voluntarily forfeited in lieu of compliance with an order of the commissioner or the commissioner’s designee with the written consent of the commissioner. The forfeiture becomes effective when and upon such conditions as required by order of the commissioner, which may include one or more of the types of disciplinary sanctions provided by this chapter or by Iowa Code chapter 508E.    g.    When a viatical settlement broker’s license has been suspended for a period of time whichthat extends beyond the viatical settlement broker’s license expiration date, the license will terminateterminates at the license expiration date, and the viatical settlement broker must request reinstatementreissuance pursuant tothis subrule 48.3(7).However, reissuance will not be effected until the suspension period has ended. If suspension for a period of time ends prior to the viatical settlement broker’s license expiration date,and the viatical settlement broker has met all applicable requirements, the commissioner shallmust reinstate the license atas soon as practicable but no earlier than the end of the suspension period pursuant to paragraph 48.3(8)“b.” The commissioner is not prohibited fromdenying an application for reinstatement or reissuance or bringing an additional immediate action if the viatical settlement broker has engaged in misconduct during the period of suspension.    48.3(9) Duty to notify commissioner of cessation of business in the state.  If a viatical settlement provider intends to cease business in Iowa, it must notify the commissioner of those intentions and of its plan of operation for such cessation at least 180 days before the cessation shall occur. This requirement is not meant to imply that a company must continue to accept new viatical or life settlement business during the 180-day period.    48.3(10) Duty to notify commissioner of changes.      a.    A viatical settlement provider shall provide to the commissioner any new or revised information about officers, stockholders holding 10 percent or more of the stock of the company, partners, directors, members or designated employees within 30 days of the date the addition or revision occurred.    b.    A viatical settlement provider or viatical settlement broker shall inform the commissioner in writing of any change of name or address within 30 days of the date of such change. In addition, a viatical settlement provider shall provide the commissioner with 30 days’ notice of the cancellation or nonrenewal of a fidelity bond required for licensure under subrule 48.3(1) and the name of the carrier that will be providing coverage subsequent to such cancellation or nonrenewal.    c.    A viatical settlement provider or viatical settlement broker shall report to the commissioner any administrative action taken against the viatical settlement provider or viatical settlement broker in another state or federal jurisdiction or by another governmental agency in this state within 30 days of the final disposition of the matter. This report shall include a copy of the order, consent to the order, or other relevant legal documents. Within 30 days of the initial pretrial hearing date, a viatical settlement provider or viatical settlement broker shall report to the commissioner any criminal prosecution of the viatical settlement provider or viatical settlement broker taken in any jurisdiction. The report shall include a copy of the initial complaint filed, the order resulting from the hearing, and any other relevant legal documents.    48.3(11) Commissioner may use outside assistance.  In order to assist with the commissioner’s duties, the commissioner may contract with a nongovernmental entity, including, but not limited to, the National Association of Insurance Commissioners (NAIC) or any affiliate or subsidiary the NAIC oversees, to perform any ministerial functions related to licensing of viatical settlement providers or viatical settlement brokers that the commissioner deems appropriate including, but not limited to, the collection of fees.    48.3(12) Fees.      a.    Fees shall be paid by check, money order, or credit card.    b.    The fee for an examination shallmay be set by the outside testing service under contract with the division andmust be approved by the division.    c.    The annual fee for issuance or renewal of a viatical broker, legal entity or provider license is $100.    d.    The fee for reinstatementor reissuance of a viatical broker, legal entity or provider license is the sum of the renewal fee plus $100.In addition, applicable issuance or renewal fees will be assessed.    e.    The division may charge a reasonable fee for the compilation and production of viatical broker, legal entity or provider licensing records.

    ITEM 33.    Rescind rule 191—48.11(252J) and adopt the following new rule in lieu thereof:

191—48.11(252J,272D) Suspension for failure to pay child support or state debt.  The division must follow the procedures in rule 191—10.21(252J,272D) relating to producer suspension for failure to pay child support or state debt for viatical settlement brokers, replacing “producer” with “viatical settlement broker.”

    ITEM 34.    Rescind and reserve rule 191—48.12(261).

    ITEM 35.    Rescind and reserve rule 191—48.13(272D).

    ITEM 36.    Amend 191—Chapter 48, implementation sentence, as follows:       These rules are intended to implement Iowa Code chapters 508E, 252J, 261 and 272D.    [Filed 1/23/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4902CIowa Finance Authority[265]Adopted and Filed

Rule making related to beginning farmer program changes

    The Iowa Finance Authority hereby amends Chapter 44, “Iowa Agricultural Development Division,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 16.5.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapter 16, subchapter VIII, part 5, as amended by 2019 Iowa Acts, House File 768, section 7.Purpose and Summary    2019 Iowa Acts, House File 768, creates a Beginning Farmer Tax Credit Program. Pursuant to 2019 Iowa Acts, House File 768, section 7, the Authority is directed to adopt rules that are necessary for the administration of the program. This rule making sets forth the eligibility criteria for eligible taxpayers and qualified beginning farmers, the requirements of an agricultural lease agreement upon which the tax credit is based, the process to be followed when a lease is amended, the application process and the required content of the tax credit application, and the procedure for calculating tax credit awards.    The rule making also updates outdated statutory references and amends the Beginning Farmer Loan Program’s eligibility criteria and related definitions to clarify the differences between the loan program and the tax credit program.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on October 23, 2019, as ARC 4729C.     The Authority received a comment from a stakeholder about paragraph 44.6(2)“b.” The stakeholder expressed concern that the meaning of “term,” as used in that paragraph, was unclear. The Authority revised the paragraph to clarify the beginning of the “term” of a tax credit and thus clarify the overall meaning of “term.” The stakeholder approved the revised paragraph 44.6(2)“b.”    Specifically, the Authority revised paragraph 44.6(2)“b” to indicate when the tax credit “term” begins to clarify how long the tax credit “term” will last. The Authority also incorporated a sentence from Iowa Code section 16.82(7) that indicates the tax credit shall not be carried back to a tax year prior.     Also, the Authority added a new paragraph 44.6(3)“e” to allow any applicant wishing to appeal a decision of the Iowa Agricultural Development (IAD) Board to appeal directly to the IAD Board.     Finally, the Authority made one technical change that was not a result of public comment.Adoption of Rule Making    This rule making was adopted by the Authority on January 8, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, the impact on jobs is expected to be positive. The Beginning Farmer Tax Credit program is likely to create additional opportunities for individuals who wish to begin farming in Iowa. Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Authority for a waiver of the discretionary provisions, if any, pursuant to 265—Chapter 18. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend rule 265—44.1(16) as follows:

265—44.1(16) General.      44.1(1) Description of Iowa agricultural development division (IADD)(IAD) board.  The IADDIAD board consists of five members appointed by the governor. The executive director of the Iowa finance authority or the executive director’s designee shall serve as an ex officio nonvoting member. Members are appointed for staggered six-year terms. The appointed members shall elect a chairperson and vice chairperson annually, and other officers as the appointed members determine.     44.1(2) Division organization and personnel.  The executive director of the authority may organize the division and employ necessary qualified personnel.    44.(2) 44.1(3) General course and method of operations.  The IADDIAD board generally meets on a monthly basis or at the call of the chairperson or whenever two appointed members so request. The purpose of the meetings shall be to review progress in implementation and administration of programs, to consider and act upon proposals for assistance, and take other actions as necessary and appropriate.    44.(3) 44.1(4) Location where public may submit requests for assistance or obtain information.  Requests for assistance or information should be directed to the Iowa finance authority at the address set forth in rule 265—1.3(16); telephone (515)725-4900. Requests may be made personally, by telephone, U.S. mail or any other medium available, between the hours of 8 a.m. and 4:30 p.m., Monday through Friday. Special arrangements for accessibility to the authority at other times will be provided as needed.

    ITEM 2.    Amend rule 265—44.2(16) as follows:

265—44.2(16) Definitions.          "Act" means Iowa Code chapter 16.        "Agricultural asset" means agricultural land,located in this state, including any agricultural improvements,machinery, equipment, and other depreciable agricultural property, crops or livestock used for farming purposes.        "Agricultural development board" "IAD board" means the agricultural development board created in Iowa Code section 16.2C and described in rule 265—44.1(16).        "Agricultural asset transfer agreement" means any commonly accepted written agreement which specifies the terms of the transfer of operation of the agricultural asset. The agreement may be made on a cash basis or a commodity share basis.        "Agricultural improvements" means any improvements, buildings, structures or fixtures suitable for use in farming which are located on agricultural land. “Agricultural improvements” includes a single-family dwelling located on agricultural land which is or will be occupied by the beginning farmer and structures attached to or incidental to the use of the dwelling.        "Agricultural land" means land located in Iowasuitable for use in farming and which is or will be operated as a farm.        "Agricultural lease agreement" "agreement" means an agreement for the transfer of agricultural assets, that must at least include a lease of agricultural land, from an eligible taxpayer to a qualified beginning farmer as provided in 2019 Iowa Acts, House File 768, section 9.        "Application" means a completed instrument on a form approved by IADD.        "Authority" means the Iowa finance authority created in Iowa Code section 16.1A.        "Beginning farmer" means an individual, partnership, family farm corporation, or family farm limited liability company, with a low or moderate net worth that engages in farming or wishes to engage in farming.        "BFCF" means beginning farmer custom farming tax credit program.        "BFCF eligible applicant" means an individual, partnership, family farm corporation or family farm limited liability company that has a net worth of not more than the maximum allowable net worth. The applicant must also satisfy all of the criteria contained in Iowa Code sections 16.79 and 16.81 and the provisions of these rules relating to recipient eligibility.        "BFLP" means beginning farmer loan program.        "BFLP eligible applicantbeginning farmer" means an individual who has a net worth of not more than the maximum allowable net worth. The applicant must also be a beginning farmer, as defined in Iowa Code section 16.75, who satisfies all of the criteria contained in the Act and provisions of these rules relating to recipient eligibilitya beginning farmer who also meets the requirements of a first-time farmer as defined in Section 147(c) of the Internal Revenue Code.        "BFTC" means beginning farmer tax credit program.        "BFTC eligible applicant" means an individual, partnership, family farm corporation or family farm limited liability company that has a net worth of not more than the maximum allowable net worth. The applicant must also satisfy all of the criteria contained in Iowa Code sections 16.79 and 16.80 and the provisions of these rules relating to recipient eligibility.        "Bond purchaser" means any lender or any person, as defined in Iowa Code section 4.1(20), who purchases an authority bond under the individual agricultural development bond program.        "Cash basisrent agreement" means an agreement whereby operation of the agricultural asset is transferred via a fixed cash payment per annum.        "Commodity share basisagreement" means an agreement whereby operation of the agricultural asset is transferred via a risk-sharing mechanism, whereby the agricultural asset owner receives a portion of the production as payment for use of the agricultural asset.        "Custom farming contract" means any commonly accepted written contract which specifies the terms of the work to be performed by the beginning farmer for an Iowa landowner or tenant or livestock owner. The contract must provide for the production of crops or livestock located on agricultural land. The taxpayer will pay the BFCF eligible applicant on a cash basis, and the total amount paid for each tax year that the tax credit is claimed must equal at least $1,000. The contract must be in writing for a term of not more than 24 months. A contract is not allowed if the taxpayer and BFCF eligible applicant are: persons who hold a legal or equitable interest in the same agricultural land or livestock; related family members, such as spouse, child, stepchild, brother, or sister; or partners in the same partnership which holds a legal or equitable interest.        "Eligible taxpayer" means a taxpayer who is eligible to participate in the beginning farmer tax credit program, including by meeting all the criteria provided in paragraph 44.6(1)“a.”        "Farm" means a farming enterprise which is generally recognized as a farm rather than a rural residence.        "Farming" means the cultivation of land for the production of agricultural crops, the raising of poultry, the production of eggs, the production of milk, the production of fruit or other horticultural crops, grazing, the production of livestock, aquaculture, hydroponics, the production of forest products, or other activities designated by the authority.        "Flex lease agreement" means an agreement whereby operation of the agricultural asset is transferred via a combination of fixed cash payments and, at times, additional payment based on the production or other variables.        "IADD" means the Iowa agricultural development division of the Iowa finance authority.        "Lender" means any regulated bank, trust company, bank holding company, mortgage company, national banking association, savings and loan association, life insurance company, state or federal governmental agency or instrumentality, or other financial institution or entity authorized and able to make mortgage loans or secured loans in this state.        "Low-income farmer" means a farmer who cannot obtain financing to purchase agricultural property without the assistance of an LPP loan with the authority.        "Low or moderate net worth" means a net worth that does not exceed the maximum allowable net worth defined in this rule.        "LPP" means loan participation program.        "LPP eligible applicant" means an individual who has a net worth of not more than the maximum allowable net worth. The applicant must be a low-income farmer who cannot obtain financing to purchase agricultural property without the assistance of an LPP loan and who satisfies all of the criteria contained in the Act and the provisions of these rules relating to recipient eligibility.        "LPP loan" means the “last-in/last-out” loan participation requested by the lender from the authority.        "Maximum allowable net worth" for calendar year 2013 is $691,172. Themeans themaximum allowable net worth for each calendar year, which shall be increased or decreased as of January 1 of such calendar yearfrom the previous year by an amount equal to the percentage increase or decrease (September to September) in the United States Department of Agriculture “Index of Prices Paid for Commodities and Services, Interest, Taxes, and Farm Wage Rates” reported as of October 1 of the immediately preceding calendar year.The maximum allowable net worth will be rounded to the nearest thousand dollars. The authority will post the maximum allowable net worth for each calendar year on its website at www.iowafinanceauthority.gov.        "Net worth" means total assets minus total liabilities as determined in accordance with generally accepted accounting principles with appropriate exceptions and exemptions reasonably related to an equitable determination of the net worth of the individual, partnership, limited liability company or corporation. Assets shall be valued at fair market value.        "Participated loan" means a loanor loans, any portion of which is participated to the authority by the lender.        "Qualified beginning farmer" means a beginning farmer who is eligible to participate in the beginning farmer tax credit program by meeting the criteria set forth in paragraph 44.6(1)“b.”        "Total assets" means all assets including but not limited to cash, crops or feed on hand, livestock held for sale, breeding stock, marketable bonds and securities, securities not readily marketable, accounts receivable, notes receivable, cash invested in growing crops, net cash value of life insurance, machinery, equipment, cars, trucks, farm and other real estate including life estates and personal residence, value of beneficial interest in a trust, government payments or grants, and any other assets.“Total assets” shall not include items used for personal, family or household purposes by the applicant; but in no event shall any property be excluded, to the extent a deduction for depreciation is allowable for federal income tax purposes. All assets shall be valued at fair market value by the lender. The value shall be what a willing buyer would pay a willing seller in the locality. A deduction of 10 percent may be made from fair market value of farm and other real estate.        "Total liabilities" means all liabilities including but not limited to accounts payable, notes or other indebtedness owed, taxes, rent, amount owed on any real estate contract or real estate mortgage, judgments, accrued interest payable, and any other liabilities. Liabilities shall be determined on the basis of generally accepted accounting principles.In only those cases where the liabilities include an amount for deferred tax liability that causes the applicant’s net worth to change from exceeding the maximum allowable net worth to an amount no greater than the maximum allowable net worth, the applicant is required to have a certified public accountant prepare the financial statement and provide supporting calculations and documentation acceptable to the board.        "USDA" means the United States Department of Agriculture.        "USDA-NASS" means the United States Department of Agriculture’s National Agricultural Statistics Service.        "Veteran" means the same as defined in Iowa Code section 35.1.

    ITEM 3.    Rescind rule 265—44.3(16) and adopt the following new rule in lieu thereof:

265—44.3(16) Beginning farmer loan program eligibility.  A loan to or on behalf of a beginning farmer shall be provided only if the following criteria are satisfied:    1.   The beginning farmer is an individual and a resident of Iowa.    2.   The agricultural land and agricultural improvements or depreciable agricultural property the beginning farmer proposes to purchase will be located in the state.    3.   The beginning farmer has sufficient education, training, or experience in the type of farming for which the beginning farmer requests the loan and must demonstrate that education, training, or experience to the satisfaction of the authority.    4.   If the loan is for the acquisition of agricultural land, the beginning farmer has or will have access to adequate working capital, farm equipment, machinery, or livestock. If the loan is for the acquisition of depreciable agricultural property, the beginning farmer has or will have access to adequate working capital or agricultural land. In the loan application, the beginning farmer must demonstrate to the satisfaction of the authority that the beginning farmer has or will have access to adequate working capital, farm equipment, machinery, or livestock.    5.   The beginning farmer shall materially and substantially participate in farming.    6.   The agricultural land and agricultural improvements shall only be used for farming by the beginning farmer, the beginning farmer’s spouse, or the beginning farmer’s minor children.

    ITEM 4.    Strike “eligible applicant” and “eligible applicants” wherever they appear in rule 265—44.4(16) and insert “beginning farmer” and “beginning farmers,” respectively, in lieu thereof.

    ITEM 5.    Amend subrule 44.5(1) as follows:    44.5(1) Program summary.  The loan participation program is intended to assist lenders and LPP eligible applicants (hereinafter referred to as “borrower(s)”)beginning farmers by purchasing a portion of a loan made by a lender to a borrowerbeginning farmer for the purchase of agricultural property.    a.    Supplement to borrower’sbeginning farmer’s down payment.The LPP loan can be used to supplement the borrower’sbeginning farmer’s down payment so that the borrowerbeginning farmer can more readily secure a loan (the “participated loan”) from a lender.    b.    Last-in/last-out collateral position.The program enables lenders to request a “last-in/last-out” LPP loan from the authority. The lender, on behalf of the borrowerbeginning farmer, shall apply for the LPP loan on application forms provided by the authority.    c.    Lender’s certification.The lender and the borrowerbeginning farmer shall certify that the information included in the application and any other documents submitted for consideration is true and correct to the best of their knowledge.    d.    LPP loan in conjunction with BFLP loan.The loan participation program may be used in conjunction with the authority’s beginning farmer loan program, provided the borrowerbeginning farmer meets the criteria for both programs.

    ITEM 6.    Amend paragraph 44.5(3)"e" as follows:    e.    Machinery and equipment.The participated loan can be used for the purchase of agricultural machinery and equipment for which an income tax deduction for depreciation is allowed in computing state and federal income taxes. This machinery and equipment must be used in the borrower’sbeginning farmer’s farming operation.

    ITEM 7.    Amend subrule 44.5(5) as follows:    44.5(5) Program parameters.      a.    Purchase price impact.Maximum LPP loan amount and loan terms will be determined by the IADDIAD board.    b.    LPP interest rate.The IADDIAD board will set the interest rate on the LPP loan.    c.    LPP loans outstanding.Loans under the program may be issued more than once, provided that the outstanding LPP loan totals do not exceed the maximum amount set by the IADDIAD board.

    ITEM 8.    Amend subrule 44.5(6) as follows:    44.5(6) LPP loan application procedures.      a.    Financial statement.Lenders may use their own form of financial statement. The authority may require other forms deemed necessary and appropriate to document the eligibility of the borrowerbeginning farmer and the borrower’sbeginning farmer’s ability to make principal and interest payments.If the borrowerbeginning farmer or the borrower’sbeginning farmer’s spouse is involved in a business, partnership, limited liability company, or corporation, either related or unrelated to the borrower’sbeginning farmer’s farming operation, a financial statement from this entity must also be submitted with the application.    b.    Income statement.A copy of the borrower’sbeginning farmer’s prior three years’ federal income tax returns (if available) shall be submitted.    c.    Background letter.The application will also include a background letter on the borrowerbeginning farmer, documenting to the satisfaction of the authority sufficient training, experience and access to capital.    d.    Credit evaluation.The lender will submit a credit evaluation of the project for which an LPP loan is sought. The lender will evaluate the borrower’sbeginning farmer’s net worth and ability to pay principal and interest and certify the sufficiency of security for the participated loan. The authority will review the application and make its own credit evaluation prior to issuance of an LPP loan.    e.    Processing LPP loan applications.Applications for the program will be taken and processed by the authority on a first-come, first-served basis. The authority reserves the right to change the program or terminate the approval of LPP loans under the program at any time. Grounds for termination/suspension of the program would include, but not be limited to, reaching the maximum allowable limit for total outstanding LPP loans as established by the authority or changing the program by order of the Iowa general assembly or by rules promulgated by the authority.    f.    Security for participated loans and use of security documents.The lender shall take any security, cosignatures, guarantees or sureties that are deemed necessary for any participated loan. Any guarantee of repayment or pledge of additional collateral required by the lender to secure the participated loan shall secure the entire participated loan.    g.    Recording documents and fees.Any recording or filing fees or transfer taxes associated with the participated loan will be paid by the borrowerbeginning farmer or lender and not the authority. Also, the authority will have no responsibility with respect to the preparation, execution, or filing of any declaration of value or groundwater hazard statements.

    ITEM 9.    Amend subrule 44.5(7) as follows:    44.5(7) Loan administration procedures.      a.    Lender’s responsibilities.The lender is responsible for servicing the participated loan following accepted standards of loan servicing and for transferring LPP loan payments to the authority.    (1)   At the request of IADDthe authority, the lender shall:
  1. On an annual basis, provide the authority with copies of a current financial statement or a current tax return, or both.
  2. Provide copies of insurance to the authority with the lender named as loss payee. The lender will apply payments to the participated loanaccording to the IADD-approved amortization schedule(s) or on a pro-rata basis.
    (2)   The lender shall not, without prior consent of the authority:
  1. Make or consent to any substantial alterations in the terms of any participated loan instrument;
  2. Make or consent to releases of security or collateral unless replaced with collateral of equal value on the participated loan;
  3. Use the collateral purchased with funds from the participated loan as security for any other loan without prior written consent of the authority;
  1. 4Accelerate the maturity of the participated loan;
  2. 5Sue upon any participated loan instrument;
  3. 6Waive any claim against any borrowerbeginning farmer, cosignor, guarantor, obligor, or standby creditor arising out of any instruments.
    b.    Payment due dates.Payment due dates for the LPP loan will be the same as for the lender’s share of the loan.    c.    Prepayment penalty.There is no penalty for early repayment of principal or interest.    d.    Repayment proceeds and collateral.Without limitation, the repayment of proceeds and collateral shall include rights of setoff and counterclaim, which the lender or the authority jointly or severally may at any time recover on any participated loan.    e.    Subsequent loans.Any loan or advance made by a lender to a borrowerbeginning farmer subsequent to the beginning farmer’sobtaining an LPP loan under the program and secured by collateral or security pledged for the participated loan will be subordinate to the participated loan.    f.    Events of loan default.    (1)   Default will occur when the participated loan payment is 30 days past due. Notice to cure will be sent by the lenderto the borrowerbeginning farmer with a copy sent to the authority; and the lender will take appropriate steps to cure the default through mediation, liquidation, or foreclosure if needed.    (2)   After a participated loan is in default for a period of 30 days, the lender shall file with the authority monthly reports regarding the status of the participated loan.    (3)   The authority may, anytime a participated loan is in default, purchase the unpaid portion of the participated loan from the lender including the note, security agreements, additional guarantees, and other documents. The authority would become the servicer of the participated loan in such case.    g.    Applying principal and interest payments.Lenders shall receive all payments of principal and interest. All payments made prior to liquidation or foreclosure shall be made according to the IADD-approved amortization schedule(s) oron a pro-rata basis. All accrued interest must be paid to zero at least annually on the anniversary date of the note.    h.    Application of proceeds of loan liquidation.Application of proceeds of loan liquidation will be determined after a written liquidation plan is approved by the authority or the authority’s loan committee. All amounts recovered upon liquidation or foreclosure will be applied first to the unpaid balance of the lender’s portion and then to the unpaid portion of the LPP loan’s portion. All funds received from liquidation or foreclosure procedures shall be applied in the following order of priority:First Priority: To the payment of the outstanding principal of and accrued interest on the lender’s portion of the participated loan;Second Priority: To the payment of the outstanding principal of and accrued interest on the authority’s LPP loan;Third Priority: To the payment on a pro-rata basis of all reasonable and necessary expenses incurred by the lender or the authority in connection with such liquidation or foreclosure procedures.

    ITEM 10.    Amend subrule 44.5(8) as follows:    44.5(8) Right to audit.  The authority shall have, at any time, the right to audit records of the lender and the borrowerbeginning farmer relating to any participated loan made under the program.

    ITEM 11.    Amend rule 265—44.6(16) as follows:

265—44.6(16) Beginning farmer tax credit program.      44.6(1) Eligibility.      a.    Eligible taxpayer.A taxpayer is eligible to participate in the beginning farmer tax credit program if the taxpayer meets all of the following requirements:    (1)   The taxpayer is a person who may acquire or otherwise obtain or lease agricultural land in this state pursuant to Iowa Code chapter 9H or 9I. However, the taxpayer must not be a person who may acquire or otherwise obtain or lease agricultural land exclusively because of an exception provided in one of those chapters or in a provision of another chapter of the Iowa Code, including but not limited to Iowa Code chapter 10, 10D, or 501 or section 15E.207.    (2)   The taxpayer has entered into an agricultural lease agreement with a qualified beginning farmer to lease agricultural land as provided in 2019 Iowa Acts, House File 768, section 9.    (3)   The taxpayer has not been at fault for terminating a prior agreement under the program or another agreement in which the taxpayer was allowed to claim a tax credit under Iowa Code section 175.37 as it existed prior to January 1, 2015, or Iowa Code section 16.80 as it existed prior to January 1, 2018.    (4)   If the agreement includes the lease of a confinement feeding operation structure as defined in Iowa Code section 459.102, the taxpayer is not a party to a pending administrative or judicial action, including a contested case proceeding under Iowa Code chapter 17A, relating to an alleged violation involving an animal feeding operation as regulated by the department of natural resources, regardless of whether the pending action is brought by the department or the attorney general.    (5)   The taxpayer is not a partner of a partnership, shareholder of a family farm corporation, or member of a family farm limited liability company that is the lessee of an agricultural asset that is part of an agricultural lease agreement.    b.    Qualified beginning farmer.A beginning farmer must meet all of the following criteria to be eligible for participation in the beginning farmer tax credit program:    (1)   Is a resident of the state. If the beginning farmer is a partnership, all partners must be residents of the state. If the beginning farmer is a family farm corporation, all shareholders must be residents of the state. If the beginning farmer is a family farm limited liability company, all members must be residents of the state.    (2)   Has sufficient education, training, or experience in farming. If the beginning farmer is a partnership, at least one partner who is not a minor must have sufficient education, training, or experience in farming. If the beginning farmer is a family farm corporation, at least one shareholder who is not a minor must have sufficient education, training, or experience in farming. If the beginning farmer is a family farm limited liability company, at least one member who is not a minor must have sufficient education, training, or experience in farming.    (3)   Has access to adequate working capital and production items.    (4)   Will materially and substantially participate in farming. If the beginning farmer is a partnership, family farm corporation, or family farm limited liability company, at least one of the partners, shareholders, or members who is not a minor must materially and substantially participate in farming.    (5)   Does not own more than 10 percent ownership interest in an agricultural asset included in the agreement.    (6)   Is of majority age pursuant to Iowa Code section 599.1 and is legally able to enter into a contract.    44.(1) 44.6(2) General provisions.      a.    A beginning farmer tax credit is allowed only for agricultural assets that are subject to an agricultural lease agreement entered into by an eligible taxpayer and a qualifying beginning farmer participating in the beginning farmer tax credit program established pursuant to 2019 Iowa Acts, House File 768, section 7.    a.    b.    Term.The term of the credit shall be equal to the term of the agricultural assets transfer agreement, except that any unused credit may be carried forward for a period of ten yearsA tax credit in excess of the eligible taxpayer’s tax liability for the tax year is not refundable but may be credited to the tax liability for a period set forth in Iowa Code section 16.82, if unused in the tax year the credits are earned. Credits may not be carried back to past tax years.A tax credit shall not be carried back to a tax year prior to the tax year in which the eligible taxpayer redeems the tax credit. The term of the credit shall begin in the crop year in which the IAD board approves the award. The maximum term of the credit shall not exceed the term of the agricultural lease agreement.    b.    Fees.The authority may charge reasonable and necessary fees to defray the costs of this program.    c.    Expiration of lease.The BFTC eligible applicant will continue to be eligible for the term of the lease. Upon expiration of the lease, both the taxpayer and BFTC eligible applicant must reapply to continue the tax credit.    44.(2) 44.6(3) Application procedures.      a.    The authority shall prepare and make available appropriate forms to be used in making application for the tax credit, including forms for both the taxpayer and the BFTC eligible applicantqualified beginning farmer.    b.    Each application shall include, but not be limited to, the following:    (1)   Taxpayer information: name, and address, email address if available,andsocial security number, length of the lease, type of lease, and location of the agricultural asset to be leasedor tax identification number. In addition, the application shall have attached to it a copy of the lease agreement between the parties.The taxpayer shall also indicate the length of the lease, the type of lease, and the location of the agricultural asset to be leased.    (2)   BFTC eligible applicantQualified beginning farmer information: name and address, email address if available, and location of the asset to be leased. In addition, the application shall have attached to it a copy of the BFTC eligible applicant’s most recentqualified beginning farmer’s current financial statement (generally prepared one month preceding application submission). The application will also include a background letter on the BFTC eligible applicantqualified beginning farmer documenting to the satisfaction of the authoritythat the beginning farmer has sufficienteducation, training,or experience in farmingandhas access toadequate working capitaland production items. This letter may be submitted by one or more of the following: the BFTC eligible applicantqualified beginning farmer, the taxpayer or another third party.    (3)   A copy of the agricultural lease agreement that conforms to the requirements set forth in subrule 44.6(4).    c.    Complete applications shall be processed in the order they are received by the authority.    d.    Authority staff will review applications for completeness and eligibility and make recommendations to the IAD board. The IAD board will review applications and recommendations from authority staff and make recommendations to the authority. Upon review of the recommendations of the IAD board, the authority will approve, defer, or deny each application.    e.    Any applicant wishing to appeal a decision of the IAD board can appeal directly to the IAD board.    44.6(3) Execution of an agricultural assets transfer agreement.  In addition to the requirements of rule 265—44.6(16), both the taxpayer and the BFTC eligible applicant shall execute an agricultural assets transfer agreement. The form used shall be a commonly accepted form and signed by all parties.    44.6(4) Procedures following tax credit approval.  Either the BFTC eligible applicant or the taxpayer shall immediately notify the authority of any material changes in the agricultural assets transfer agreement. Written approval from the authority is required if the change impacts the amount of the tax credit awarded. The authority shall act upon these changes pursuant to Iowa Code section 16.80.     44.6(4) Requirements of an agricultural lease agreement.      a.    The agricultural lease agreement must meet the following requirements:    (1)   The agreement must include the lease of agricultural land located in this state, including any improvements, and may provide for the rental of agricultural equipment as defined in Iowa Code section 322F.1.    (2)   The agreement must include provisions which describe the consideration paid for the agreement in a manner that allows the authority to calculate the value of the lease in order to determine the tax credit amount as provided in 2019 Iowa Acts, House File 768, section 11.    (3)   The agreement must be in writing and signed by all parties.    (4)   The agreement must be for at least two years, but not more than five years. The agreement may be renewed by the eligible taxpayer and qualified beginning farmer for a term of at least two years, but not more than five years.    (5)   The agreement shall not include a lease or rental of equipment intended as a security.    b.    The agreement cannot be assigned, and the agricultural land subject to the agreement shall not be subleased.    c.    The agricultural assets shall not be leased or rented at a rate that is substantially higher than the market rate for similar agricultural assets leased or rented within the same community. As used in this paragraph, when referring to an agricultural asset that is cropland, “substantially higher” means not more than 30 percent above the average cash rent paid for cropland rented in the same county according to the most recent cash rent survey for cropland published by a unit of Iowa State University of Science and Technology recognized by the authority.    44.6(5) Changes to an agricultural lease agreement.      a.    The underlying lease for agricultural land may only be amended without submitting a new application if any of the following apply:    (1)   The terms of the amended lease are more favorable to the qualified beginning farmer, including but not limited to the rent payment being reduced.    (2)   A party has changed their name.    (3)   The owner of an agricultural asset is changed to the owner’s estate or trust upon the eligible taxpayer’s death.    b.    If the eligible taxpayer and the qualified beginning farmer are amending an agricultural lease agreement but none of the conditions of paragraph 44.6(5)“a” apply, then the eligible taxpayer must submit a new application for a tax credit.    c.    If an amendment to an agreement changes the total amount that will be paid to the eligible taxpayer under the agreement, the eligible taxpayer shall notify the authority in a manner and form prescribed by the authority within 30 days of the date the amendment is executed by the parties.    (1)   If the amendment will reduce the total amount paid to the eligible taxpayer under the agreement, the authority shall recalculate and reduce the eligible taxpayer’s tax credit award under 2019 Iowa Acts, House File 768, section 12.    (2)   If the amendment will increase the total amount paid to the eligible taxpayer under the agreement, the tax credit award shall not be increased unless the eligible taxpayer submits an amended application to the authority on the relevant form available on the authority’s website and that meets the requirements of 2019 Iowa Acts, House File 768, section 10. If the amended application is approved under 2019 Iowa Acts, House File 768, section 10, the authority may increase the amount of the tax credit award. The increased amount of the tax credit award shall be subject to the aggregate award limitation in 2019 Iowa Acts, House File 768, section 12, for the calendar year in which the increased award is made.    d.    Paragraph 44.6(5)“c” does not apply to an amendment to an agreement that requires a new application under paragraph 44.6(5)“b” in order to be valid.    e.    An eligible taxpayer or qualified beginning farmer may terminate an agreement as provided in the agreement or by law. The eligible taxpayer must notify the authority of the termination within 30 days of the date of termination in the manner and form prescribed by the authority.    f.    Expiration of lease. Prior to the expiration of the lease, the qualified beginning farmer will continue to be eligible for the term of the lease. Upon expiration of the lease, both the taxpayer and qualified beginning farmer must reapply to continue the tax credit.    44.6(6) Procedure for calculating tax credit awards.      a.    The amount of the tax credit for a cash rent agreement equals 5 percent of the amount of rent received for each year.    b.    For a commodity share agreement, the amount of the tax credit shall equal 15 percent of the gross amount that the eligible taxpayer would receive as a rent payment from the sale of the eligible taxpayer’s share of the crop in each harvest year.    c.    To calculate the credit for a commodity share agreement, the authority will use the following assumptions:    (1)   Fifty percent of the leased land is allocated to corn and 50 percent of the leased land is allocated to soybeans, unless the lease specifies a different allocation of corn and soybeans. If the lease specifies a different allocation of corn and soybeans, then the leased land will be allocated proportionally, in accordance with the terms of the lease.    (2)   For all years of the lease, the prices used for corn and soybeans will be the average prices for the last five years excluding the highest and lowest prices based on the USDA-NASS statewide data calculated at the time the application is approved.    (3)   For all years of the lease, the commodity yields used for corn and soybeans will be the past ten-year average per-bushel yields for the same county where the leased land is located excluding the years of highest and lowest per-bushel yields based on the USDA-NASS data calculated at the time the application is approved.    (4)   If the lease specifies a crop other than corn and soybeans, the relevant price and yield data from USDA-NASS for that crop will be used.    d.    To calculate the credit for a commodity share agreement, the authority will use the following formula: (1/2 acres leased multiplied by corn yield multiplied by corn price multiplied by percentage of owner’s share multiplied by .15) plus (1/2 acres leased multiplied by soybean yield multiplied by soybean price multiplied by owner’s share multiplied by .15) = the amount of the tax credit. If the lease specifies a different allocation of corn and soybeans, then the leased acres will be in accordance with the terms of the lease.    e.    The amount of the tax credit for a flex lease agreement equals the sum of the following amounts:    (1)   The portion of the lease that is based on rent will be calculated as a cash rent agreement.    (2)   The portion of the lease that is based on crop yield will be calculated as a commodity share agreement.    (3)   If the flexible or bonus portion of the lease is based on crop production, the annual yield used to calculate the bonus will be the yield defined in subparagraph 44.6(6)“c”(3). If the annual yield is above the yield needed to trigger the bonus, the taxpayer will be awarded additional tax credits. The formula for calculating the tax credit will be yield above lease bonus trigger multiplied by price multiplied by percentage of owner’s share multiplied by 0.15.    (4)   For other factors used in a flex lease agreement, the relevant data used will be the past ten-year average per-bushel yield for the same county where the leased land is located excluding the highest and lowest years based on the USDA-NASS data.    f.    The amount of the tax credit shall be reduced by the percent ownership interest of the qualifying beginning farmer in the agricultural asset.

    ITEM 12.    Rescind and reserve rule 265—44.7(16).    [Filed 1/21/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4926CNursing Board[655]Adopted and Filed

Rule making related to child abuse and dependent adult abuse mandatory reporter training

    The Board of Nursing hereby amends Chapter 3, “Licensure to Practice—Registered Nurse/Licensed Practical Nurse,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code sections 147.10, 232.69(3)“e,” 235B.16(5)“f” and 272C.2.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 232.69 and 235B.16.Purpose and Summary    2019 Iowa Acts, House File 731, amends Iowa Code sections 232.69(3) and 235B.16(5), which govern mandatory child abuse and dependent adult abuse reporter training requirements for certain professionals.  This rule making amends Chapter 3 to conform to those changes and requires that nurses who must make reports for child abuse or dependent adult abuse, or both, comply with the training requirements provided in the amended Iowa Code sections 232.69 and 235B.16 every three years.    This rule making also amends Chapter 3 to remove references to wallet cards because the Board no longer issues physical wallet cards to licensees.    This rule making also amends Chapter 3 to clarify that a passing score on the Internet-based Test of English as a Foreign Language (TOEFL®) test is an 84 with a speaking score of at least 26.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 6, 2019, as ARC 4743C. A public hearing was held on December 6, 2019, at 9 a.m. at the Board’s office, Suite B, 400 S.W. Eighth Street, Des Moines, Iowa. No one attended the public hearing. No public comments were received. No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the Board on January 15, 2020.Fiscal Impact    This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Board for a waiver of the discretionary provisions, if any, pursuant to 655—Chapter 15.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend rule 655—3.1(17A,147,152,272C), definition of “Fees,” as follows:        "Fees" means those fees collected which are based upon the cost of sustaining the board’s mission to protect the public health, safety and welfare. The nonrefundable fees set by the board are as follows:
  1. Application for original license based on the registered nurse examination, $93 (plus the fee for evaluation of the fingerprint cards and the criminal history background checks by the Iowa division of criminal investigation (DCI) and the Federal Bureau of Investigation (FBI)).
  2. Application for original license based on the practical nurse examination, $93 (plus the fee for evaluation of the fingerprint cards and the criminal history background checks by the DCI and the FBI).
  3. Application for registered nurse/licensed practical nurse license by endorsement, $119 (plus the fee for evaluation of the fingerprint cards and the criminal history background checks by the DCI and the FBI).
  4. Application for original license or renewal as an advanced registered nurse practitioner, $81 for any period of licensure up to three years.
  5. For a certified statement that a registered nurse/licensed practical nurse is licensed in this state or registered as an advanced registered nurse practitioner, $25.
  6. For written verification of licensure status, not requiring certified statements, $3 per license.
  7. For reactivation of a license to practice as a registered nurse/licensed practical nurse, $175 for a license lasting more than 24 months up to 36 months (plus the fee for evaluation of the fingerprint cards and the criminal history background checks by the DCI and the FBI).
  8. For reactivation of a license to practice as an advanced registered nurse practitioner, $81 for any period of licensure up to three years.
  9. For the renewal of a license to practice as a registered nurse/licensed practical nurse, $99 for a three-year period.
  10. For a duplicate or reissued wallet card or original certificate to practicerecognizing Iowa licensure as a registered nurse, licensed practical nurse, or advanced registered nurse practitioner, $20.
  11. For late renewal of a registered nurse/licensed practical nurse license, $50, plus the renewal fee as specified in paragraph “9” of this definition.
  12. For a check returned for any reason, $15. If licensure/registration has been issued by the board office based on a check for the payment of fees and the check is later returned by the bank, the board shall request payment by certified check or money order.
  13. For a certified copy of an original document, $20.
  1. For the evaluation of the fingerprint cards and the DCI and FBI criminal history background checks, $50.

    ITEM 2.    Amend paragraph 3.6(2)"c" as follows:    c.    The ability to read, write, speak, and understand the English language as determined by passing the TOEFL® or IELTS™ test. AFor the TOEFL® test, a passing score is as follows: 560 for the TOEFL® paper-based test;or 220 for the TOEFL® computer-based test;or 84 for the TOEFL® Internet-based test; andwith a speaking score of at least 26. For the IELTS™ test, a passing score is as follows: an overall score of 6.5 and a speaking score of 7.0 for the IELTS™ test. An applicant shall be exempt from taking either the TOEFL® or IELTS™ test when all of the followingrequirements are met: (1) the nursing education was completed in a college, university, or professional school located in Australia, Barbados, Canada (except Quebec), Ireland, Jamaica, New Zealand, South Africa, Trinidad and Tobago, or the United Kingdom; (2) the language of instruction in the nursing program was English; and (3) the language of the textbooks in the nursing program was English.

    ITEM 3.    Amend paragraph 3.7(3)"b" as follows:    b.    Mandatory reporter training.    (1)   The coursecourse(s) shall be athe curriculum approvedprovided by the Iowa department of public healthhuman services.    (2)   A licensee who regularly examines, attends, counsels or treats children in Iowa shall indicate on the renewal application completion of two hours of training in child abuse identification and reportingas required by Iowa Code section 232.69(3)“b” in the previous fivethree years or condition(s) for rule suspension as identified in subparagraph 3.7(3)“b”(6)3.7(3)“b”(5).    (3)   A licensee who regularly examines, attends, counsels or treats adults in Iowa shall indicate on the renewal application completion of two hours of training in dependent adult abuse identification and reportingas required by Iowa Code section 235B.16(5)“b” in the previous fivethree years or condition(s) for rule suspension as identified in subparagraph 3.7(3)“b”(6)3.7(3)“b”(5).    (4)   A licensee who regularly examines, attends, counsels or treats both adults and children in Iowa shall indicate on the renewal application completion of training on abuse identification and reporting in dependent adults and children or condition(s) for rule suspension as identified in subparagraph 3.7(3)“b”(6). Training may be completed through separate courses as identified in subparagraphs 3.7(3)“b”(2) and (3) or in one combined two-hour course that includes curricula for identifying and reporting child abuse and dependent adult abuse.    (5)   (4)   The licensee shall maintain written documentation for fivethree years after mandatory training as identified in subparagraphs 3.7(3)“b”(2) to (4)and (3), including program date(s), content, duration, and proof of participation.    (6)   (5)   The requirement for mandatory training for identifying and reporting child and dependent adult abuse shall be suspended if the board determines that suspension is in the public interest or that a person at the time of license renewal:
  1. Is engaged in active duty in the military service of this state or the United States.
  2. Holds a current exemption based on evidence of significant hardship in complying with training requirements, including an exemption of continuing education requirements or extension of time in which to fulfill requirements due to a physical or mental disability or illness as identified in 655—Chapter 5 .
    (7)   (6)   The board may select licensees for audit of compliance with the requirements in subparagraphs 3.7(3)“b”(1) to (6)(5).

    ITEM 4.    Rescind subrule 3.7(6).

    ITEM 5.    Renumber subrule 3.7(7) as 3.7(6).

    ITEM 6.    Amend renumbered subrule 3.7(6) as follows:    3.7(6) Reissue of aan original certificate or wallet card.  The board shall reissue aan original certificate or current wallet cardrecognizing Iowa licensure upon receipt of a written request from the licensee, return of the original document and payment of the fee as specified in rule 655—3.1(17A,147,152,272C). No fee shall be required if an error was made by the board on the original document.    [Filed 1/23/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4927CNursing Board[655]Adopted and Filed

Rule making related to continuing education and child and dependent adult abuse mandatory reporter training

    The Board of Nursing hereby amends Chapter 5, “Continuing Education,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code sections 147.76 and 272C.2(1).State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 272C.2.Purpose and Summary    2019 Iowa Acts, House File 731, amends Iowa Code sections 232.69(3) and 235B.16(5), which govern mandatory child abuse and dependent adult abuse identification and reporting training requirements for certain professionals. This rule making amends Chapter 5 to conform to the new statutory language and clarifies that the proof of completion issued by the Department of Human Services shall satisfy the Board’s documentation requirements.     This rule making also clarifies that the subject matter of the licensee’s continuing education should be applicable to the licensee’s practice area.     This rule making also expands the list of entities that may approve a continuing education offering.  Due to the expansion of the list of approving entities, licensees will have access to a broader range of courses and will more easily be able to find courses that are applicable to their practice areas.  Additionally, this rule making removes the requirement for Board staff to approve coursework under the special approval process for the added approving entities.    This rule making also eliminates the 90-day response deadline to submit documentation for continuing education make-up credit to reflect internal procedural changes to the process of reviewing incomplete continuing education submissions.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 6, 2019, as ARC 4744C. A public hearing was held on December 6, 2019, at 9 a.m. at the Board’s office, Suite B, 400 S.W. Eighth Street, Des Moines, Iowa. No one attended the public hearing. No public comments were received. No changes from the Notice have been made.    Adoption of Rule Making    This rule making was adopted by the Board on January 15, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Board for a waiver of the discretionary provisions, if any, pursuant to 655—Chapter 15.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend paragraph 5.2(4)"a" as follows:    a.    Appropriate subject matter for continuing education credits reflects the educational needs of the nurse learner and the health needs of the consumer. Appropriate subject matter is limited to offerings that are scientifically founded, applicable to the licensee’s practice area, and predominantly for professional growth. The following areas are deemed appropriate subject matter for continuing education credit:    (1)   Nursing practice related to health care of patients/clients/families in any setting.    (2)   Professional growth and development related to nursing practice roles with a health care focus.    (3)   Sciences upon which nursing practice, nursing education, or nursing research is based, e.g., nursing theories and biological, physical, behavioral, computer, social, or basic sciences.    (4)   Social, economic, ethical and legal aspects of health care.    (5)   Management of or administration of health care, health care personnel, or health care facilities.    (6)   Education of patients or patients’ significant others, students, or personnel in the health care field.

    ITEM 2.    Amend paragraph 5.2(5)"a" as follows:    a.    Informal offeringsapproved by the following entities:     (1)   Board-approved providersIowa board of nursing.    (2)   Other approved providers from state boards of nursing that have mandatory continuing education requirements.    (3)   American Nurses Credentialing Center (ANCC) Commission on Accreditation.    (4)   National League for Nursing (NLN).    (5)   National Federation of Licensed Practical Nurses Continuing Education (NFLPN) and the NFLPN Education Foundation.    (6)   National Association for Practical Nurse Education and Service, Inc. (NAPNES).    (7)   American Association of Nurse Practitioners (AANP).    (8)   National Association of Pediatric Nurse Practitioners (NAPNAP).    (9)   Accreditation Council for Continuing Medical Education (ACCME).    (10)   American Medical Association (AMA) Continuing Medical Education.    (11)   International Association for Continuing Education and Training (IACET).    (12)   American Psychological Association (APA).    (13)   National Commission for Health Education Credentialing.    (14)   National Board of Public Health Examiners.    (15)   National Commission for Certifying Agencies (NCCA).    (16)   Commission for Case Manager Certification (CCMC).    (17)   National Council for Behavioral Health.

    ITEM 3.    Amend paragraph 5.2(10)"b" as follows:    b.    The licensee must submit verification of completion of the mandatory reporter training course approvedcourse(s) provided by the Iowa department of public healthhuman services in the previous fivethree years as specified in 655—subrule 3.7(3).The proof of completion issued by the Iowa department of human services shall satisfy the documentation requirements of subrule 5.2(6).

    ITEM 4.    Amend paragraph 5.2(10)"d" as follows:    d.    If submitted materials are incomplete or unsatisfactory, the licensee shall be notified. The licensee shall be given the opportunity to submit make-up credit to cover the deficit found through the audit. The deadline for receipt of the documentation for this make-up credit is within 90 days of the board office notification. The licensee may be reaudited during the next renewal period when make-up credit has been accepted. The make-up credit shall not be reused for the current renewal period.     [Filed 1/23/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4903CPharmacy Board[657]Adopted and Filed

Rule making related to expedited partner therapy

    The Board of Pharmacy hereby amends Chapter 6, “General Pharmacy Practice,” Chapter 7, “Hospital Pharmacy Practice,” Chapter 8, “Universal Practice Standards,” and Chapter 18, “Centralized Prescription Filling and Processing,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 147.76.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 139A.41.Purpose and Summary    The amendments allow a pharmacist to fill a non-patient-specific prescription when the prescription is issued pursuant to Iowa Code section 139A.41 for the purpose of expedited partner therapy to treat a sexually transmitted chlamydia or gonorrhea infection in an unnamed partner or partners.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on October 9, 2019, as ARC 4693C. The Board received two comments from the public, both in support of the amendments with no suggested changes. No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the Board on January 8, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Board for a waiver of the discretionary provisions, if any, pursuant to 657—Chapter 34.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making actions are adopted:

    ITEM 1.    Amend subrule 6.10(1) as follows:    6.10(1) Required information.  The label affixed to or on the dispensing container of any prescription drug or device dispensed by a pharmacy pursuant to a prescription drug order shall bear the following:    a.    Serial number (a unique identification number of the prescription);    b.    The name, telephone number, and address of the pharmacy;    c.    ExceptThe name of the patient or, if such drug is prescribed for an animal, the species of the animal and the name of its owner, except as provided in 657—subrule 8.19(7) for epinephrine auto-injectors,or 657—subrule 8.19(8) for opioid antagonists, the name of the patient or, if such drug is prescribed for an animal, the species of the animal and the name of its owner;or 657—subrule 8.19(9) for expedited partner therapy.    d.    The name of the prescribing practitioner;    e.    The date the prescription is dispensed;    f.    The directions or instructions for use, including precautions to be observed;    g.    Unless otherwise directed by the prescriber, the label shall bear the name, strength, and quantity of the drug dispensed.    (1)   If a pharmacist selects an equivalent drug product for a brand name drug product prescribed by a practitioner, the prescription container label shall identify the generic drug and may identify the brand name drug for which the selection is made, such as “(generic name) Generic for (brand name product)”;    (2)   If a pharmacist selects a brand name drug product for a generic drug product prescribed by a practitioner, the prescription container label shall identify the brand name drug product dispensed and may identify the generic drug product ordered by the prescriber, such as “(brand name product) for (generic name)”;    (3)   If a pharmacist selects an interchangeable biological product for the biological product prescribed by a practitioner, the prescription container label shall identify the interchangeable biological product dispensed and may identify the biological product prescribed by the practitioner, such as “(interchangeable biological product) for (biological product)”;    h.    The initials or other unique identification of the dispensing pharmacist, unless the identification of the pharmacist involved in each step of the prescription filling process is electronically documented and retrievable.

    ITEM 2.    Adopt the following new subrule 6.13(4):    6.13(4) Expedited partner therapy.  When a pharmacy dispenses a prescription drug pursuant to Iowa Code section 139A.41 and 657—subrule 8.19(9) for expedited partner therapy, a pharmacy is only required to maintain the information about the patient who is known to the pharmacy.

    ITEM 3.    Amend rule 657—7.12(124,126,155A) as follows:

657—7.12(124,126,155A) Drugs in the emergency department.  Drugs maintained in the emergency department are kept for use by or at the direction of prescribers in the emergency department. Drugs shall be administered or dispensed only to emergency department patients. For the purposes of this rule, “emergency department patient” means a patient who is examined and evaluated in the emergency departmentand includes the partner or partners of a patient treated pursuant to Iowa Code section 139A.41.    7.12(1) Accountability.  Established policies and procedures shall include a system of drug control and accountability in the emergency department. The system shall identify drugs of the nature and type to meet the emergency needs of patients. Drugs shall be administered or dispensed only in accordance with the system.    7.12(2) Controlled substances.  Controlled substances maintained in the emergency department are kept for use by or at the direction of prescribers in the emergency department.    a.    In order to receive a controlled substance, a patient shall be examined in the emergency department by a prescriber who shall determine the need for the drug. It is not permissible under state and federal regulations for a prescriber to see a patient outside the emergency department setting, or talk to the patient on the telephone, and then proceed to call the emergency department and order the administration of a stocked controlled substance upon the patient’s arrival at the emergency department except as provided in paragraph 7.12(2)“c” or “d.”    b.    A prescriber may authorize, without again examining the patient, the administration of additional doses of a previously authorized drug to a patient presenting to the emergency department within 24 hours of the patient’s examination and treatment in the emergency department.    c.    In an emergency situation when a health care practitioner authorized to prescribe controlled substances is not available on site, and regardless of the provisions of paragraph 7.12(2)“a,” the emergency department nurse may examine the patient in the emergency department and contact the on-call prescriber. The on-call prescriber may then authorize the nurse to administer a controlled substance to the patient pending the arrival of the prescriber at the emergency department. As soon as possible, the prescriber shall examine the patient in the emergency department and determine the patient’s further treatment needs.    d.    In an emergency situation when a health care practitioner authorized to prescribe controlled substances examines a patient in the prescriber’s office and determines a need for the administration of a controlled substance, and regardless of the provisions of paragraph 7.12(2)“a,” the prescriber may direct the patient to present to the emergency department for the administration of a controlled substance for which the prescriber has issued a prescription in compliance with federal regulation and board rules. As soon as possible, the prescriber shall examine the patient in the emergency department and determine the patient’s further treatment needs.    7.12(3) Drug dispensing.  Only a pharmacist or prescriber may dispense any drugs to an emergency department patient pursuant to the provisions of this rule.    a.    Responsibility.Pursuant to rule 657—8.3(155A), policies and procedures shall be established to ensure the accuracy and labeling of prepackaged drugs and accurate records of dispensing of drugs from the emergency department shall be maintained.    (1)   Except as provided in subrule 7.12(4), drugs dispensed to an emergency department patient may be dispensed in quantities not to exceed a 72-hour supply or the minimum quantity in suitable containers, except that an authorized supply of a drug provided through the department of public health may be dispensed for the treatment of a victim of sexual assault. Prepackaged drugs shall be prepared pursuant to the requirements of rule 657—22.3(126).    (2)   Drugs dispensed pursuant to this paragraph shall be appropriately labeled as required in paragraph 7.12(3)“b,” including necessary auxiliary labels.    b.    Prescriber responsibility.Except as provided in subrule 7.12(4), a prescriber who authorizes the dispensing of a prescription drug to an emergency department patient is responsible for the accuracy of the dispensed drug and for the accurate completion of label information pursuant to this paragraph, including when any portion of the dispensing process is delegated to a licensed nurse under the supervision of the prescriber.    (1)   Except as provided in subrule 7.12(4), at the time of delivery of the drug the prescriber shall be responsible for ensuring that the dispensing container bears a label with at least the following information:
  1. Name and address of the hospital;
  2. Date dispensed;
  3. Name of prescriber;
  4. Name of patient, except when the drug is dispensed for one or more unnamed partners receiving expedited partner therapy pursuant to Iowa Code section 139A.41;
  5. Directions for use;and
  6. Name, quantity, and strength of drug.
    (2)   Except as provided in subrule 7.12(4), the prescriber, or a licensed nurse under the supervision of the prescriber, shall give the appropriately labeled, packaged drug to the patient or patient’s caregiver. The prescriber, or a licensed nurse under the supervision of the prescriber, shall explain the correct use of the drug and shall explain to the patient that the dispensing is for an emergency or starter supply of the drug. If additional quantities of the drug are required to complete the needed course of treatment, the prescriber shall issue a prescription for the additional quantities to be filled at a pharmacy of the patient’s choice.
    7.12(4) Use of an outpatient point-of-care automated dispensing system (OPCADS).  A hospital located in an area of the state where 24-hour outpatient pharmacy services are not available within 15 miles of the hospital may utilize an outpatient point-of-care automated dispensing system (OPCADS) in the emergency department only as provided by this subrule. For the purpose of this rule, an OPCADS is a secure dispensing system which contains prepackaged medications verified by authorized pharmacy personnel for dispensing to a patient upon issuance of a valid prescription by a prescriber. The OPCADS shall be owned by the facility, shall be operated under the facility’s hospital pharmacy license, shall not be issued a separate general or limited use pharmacy license, and shall not provide any financial incentive for use to any prescriber employed or under contract with the emergency department.    a.    Persons with access to the OPCADS for the purposes of stocking, inventory, and monitoring shall be limited to pharmacists, pharmacy technicians, and pharmacist-interns.    b.    The OPCADS shall be used only in the emergency department for the benefit of patients examined or treated in the emergency department when the benefit to the patient outweighs the burden on the patient to obtain the medication elsewhere.    c.    The OPCADS shall be located in a secure and professionally appropriate environment.    d.    The stock of drugs maintained and dispensed utilizing the OPCADS shall be limited to acute care drugs provided in appropriate quantities for a 72-hour supply or the minimum commercially available package size, except that antimicrobials may be dispensed in a quantity to provide the full course of therapy.    e.    Drugs dispensed utilizing the OPCADS shall be appropriately labeled as provided in 657—paragraphs 6.10(1)“a” through “g.”    f.    Prior to authorizing the dispensing of a drug utilizing the OPCADS, the prescriber shall offer to issue the patient a prescription that may be filled at a pharmacy of the patient’s choice.    g.    During consultation with the patient or the patient’s caregiver, the prescriber or licensed nurse under the supervision of the prescriber shall clearly explain the appropriate use of the drug supplied. If additional quantities of the drug are required to complete the needed course of treatment, the prescriber shall issue a prescription for the additional quantity to be filled at a pharmacy of the patient’s choice.    h.    The pharmacy shall, in conjunction with the emergency department, implement policies and procedures to ensure that a patient utilizing the OPCADS has been positively identified.

    ITEM 4.    Amend paragraph 8.19(1)"a" as follows:    a.    Written, electronic, or facsimile prescription.In addition to the electronic prescription application and pharmacy prescription application requirements of this rule, a written, electronic, or facsimile prescription shall include:    (1)   The date issued.    (2)   The name and address of the patient except as provided in subrule 8.19(7) for epinephrine auto-injectors,and in subrule 8.19(8) for opioid antagonists, or subrule 8.19(9) for expedited partner therapy.    (3)   The name, strength, and quantity of the drug or device prescribed.    (4)   The name and address of the prescriber and, if the prescription is for a controlled substance, the prescriber’s DEA registration number.    (5)   The written or electronic signature of the prescriber.

    ITEM 5.    Adopt the following new subrule 8.19(9):    8.19(9) Expedited partner therapy.  Pursuant to Iowa Code section 139A.41, a physician, physician assistant, or advanced registered nurse practitioner may issue a prescription to one or more sexual partners of an infected patient for an oral antibiotic intended to treat a sexually transmitted chlamydia or gonorrhea infection. The prescription shall comply with all requirements of subrule 8.19(1) as applicable to the form of the prescription except that the prescription shall not be required to contain the patient name and address. The prescription shall indicate the antibiotic is being issued for the purpose of expedited partner therapy. Provisions requiring a preexisting patient-prescriber relationship shall not apply to a prescription issued pursuant to this subrule.

    ITEM 6.    Amend rule 657—8.21(155A) as follows:

657—8.21(155A) Prospective drug use review.      8.21(1)   For purposes of promoting therapeutic appropriateness and ensuring rational drug therapy, a pharmacist shall review the patient record, information obtained from the patient, and each prescription drug or medication order to identify:    1a.    Overutilization or underutilization;    2b.    Therapeutic duplication;    3c.    Drug-disease contraindications;    4d.    Drug-drug interactions;    5e.    Incorrect drug dosage or duration of drug treatment;    6f.    Drug-allergy interactions;    7g.    Clinical abuse/misuse;    8h.    Drug-prescriber contraindications.Upon recognizing any of the above, the pharmacist shall take appropriate steps to avoid or resolve the problem and shall, if necessary, include consultation with the prescriber. The review and assessment of patient records shall not be delegated to pharmacy technicians or pharmacy support persons but may be delegated to registered pharmacist-interns under the direct supervision of the pharmacist.    8.21(2)   A pharmacist shall be exempt from the requirements of subrule 8.21(1) when dispensing a prescription issued to an unnamed patient for an oral antibiotic pursuant to Iowa Code section 139A.41.

    ITEM 7.    Amend subrule 18.3(4) as follows:    18.3(4) Central fill label requirements.  The label affixed to the prescription container filled by a central fill pharmacy on behalf of an originating pharmacy shall include the following:    a.    A unique identifier indicating that the prescription was filled at the central fill pharmacy;    b.    Serial number (a unique identification number of the prescription) as assigned by the originating pharmacy;    c.    The name, address, and telephone number of the originating pharmacy;    d.    ExceptThe name of the patient or, if such drug is prescribed for an animal, the species of the animal and the name of its owner, except as provided in 657—subrule 8.19(7) for epinephrine auto-injectors,or 657—subrule 8.19(8) for opioid antagonists, the name of the patient or, if such drug is prescribed for an animal, the species of the animal and the name of its owner;or 657—subrule 8.19(9) for expedited partner therapy.    e.    The name of the prescribing practitioner;    f.    The date the prescription is filled by the central fill pharmacy;    g.    The directions or instructions for use, including precautions to be observed;    h.    Unless otherwise directed by the prescriber, the name, strength, and quantity of the drug dispensed.    (1)   If a pharmacist selects an equivalent drug product for a brand name drug product prescribed by a practitioner, the prescription container label shall identify the generic drug and may identify the brand name drug for which the selection is made, such as “(generic name) Generic for (brand name product)”;    (2)   If a pharmacist selects a brand name drug product for a generic drug product prescribed by a practitioner, the prescription container label shall identify the brand name drug product dispensed and may identify the generic drug product ordered by the prescriber, such as “(brand name product) for (generic name)”;    (3)   If a pharmacist selects an interchangeable biological product for the biological product prescribed by a practitioner, the prescription container label shall identify the interchangeable biological product dispensed and may identify the biological product prescribed by the practitioner, such as “(interchangeable biological product) for (biological product)”;    i.    The initials or other unique identification of the pharmacist who performed drug use review, unless the identification of the pharmacist involved in each step of the prescription filling process is electronically documented and retrievable.    [Filed 1/13/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4904CPharmacy Board[657]Adopted and Filed

Rule making related to synthetic cathinones

    The Board of Pharmacy hereby amends Chapter 10, “Controlled Substances,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code sections 124.201 and 124.301.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 124.201.Purpose and Summary    This rule making temporarily places into Schedule I of the Iowa Uniform Controlled Substances Act six synthetic cathinones in response to scheduling action of the same nature by the U.S. Drug Enforcement Administration.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on October 9, 2019, as ARC 4692C. No public comments were received. No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the Board on January 8, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Board for a waiver of the discretionary provisions, if any, pursuant to 657—Chapter 34.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making action is adopted:

    ITEM 1.    Amend subrule 10.39(5) as follows:    10.39(5)   Amend Iowa Code section 124.204(6)“i” by adding the following new subparagraphsubparagraphs:    (27)   1-(1,3-benzodioxol-5-yl)-2-(ethylamino)-pentan-1-one. Other names: N-ethylpentylone or ephylone.    (28)   N-Ethylhexedrone, its optical, positional, and geometric isomers, salts and salts of isomers. Other name: 2-(ethylamino)-1-phenylhexan-1-one.    (29)   alpha-pyrrolidinohexanophenone, its optical, positional, and geometric isomers, salts and salts of isomers. Other names: α-PHP; alpha-pyrrolidinohexiophenone; 1-phenyl-2-(pyrrolidin-1-yl)hexan-1-one.    (30)   4-Methyl-alpha-ethylaminopentiophenone, its optical, positional, and geometric isomers, salts and salts of isomers. Other names: 4—MEAP; 2-(ethylamino)-1-(4-methylphenyl)pentan-1-one.    (31)   4’-Methyl-alpha-pyrrolidinohexiophenone, its optical, positional, and geometric isomers, salts and salts of isomers. Other names: MPHP; 4’-methyl-alpha-pyrrolidinohexanophenone; 1-(4-methylphenyl)-2-(pyrrolidin-1-yl)hexan-1-one.    (32)   alpha-Pyrrolidinoheptaphenone, its optical, positional, and geometric isomers, salts and salts of isomers. Other names: PV8; 1-phenyl-2-(pyrrolidin-1-yl)heptan-1-one.    (33)   4’-Chloro-alpha-pyrrolidinovalerophenone, its optical, positional, and geometric isomers, salts and salts of isomers. Other names: 4-chloro-α-PVP; 4’-chloro-alpha-pyrrolidinopentiophenone; 1-(4-chlorophenyl)-2-(pyrrolidin-1-yl)pentan-1-one.    [Filed 1/13/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4905CPublic Health Department[641]Adopted and Filed

Rule making related to Iowa care for yourself program

    The Public Health Department hereby amends Chapter 8, “Iowa Care for Yourself (IA CFY) Program,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 135.11(1).State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 135.11(1).Purpose and Summary    These amendments update Chapter 8 to reflect the current practices of the IA CFY Program.    Recognizing the value of screening and early detection of breast and cervical cancer, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990 and in 1993 authorized additional preventative health services to participants in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The Breast and Cervical Cancer Early Detection Program (BCCEDP) provides screening for breast and cervical cancer.    In addition, the Well-Integrated Screening and Evaluation for Women Across the Nation Program (WISEWOMAN) provides preventative screening for cardiovascular disease risk factors. Cardiovascular-related lifestyle interventions, tailored to each individual’s cardiovascular screening results and the individual’s readiness to make lifestyle behavior changes, are also offered to participants. These two programs are funded through cooperative agreements with the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). Iowa first received CDC funding in 1993 for the BCCEDP and began providing early detection services in 1995. Iowa received funding for WISEWOMAN as a research study in 2001 and started providing limited services in 2003. The current framework of services as a standard program was implemented in 2018.    The rules in Chapter 8 allow the services offered through the BCCEDP and WISEWOMAN to be offered in Iowa under one program, the IA CFY Program. The purposes of the IA CFY Program are to provide breast and cervical cancer screening and diagnostic services and cardiovascular risk factor screening and intervention services to low-income, uninsured, underinsured and underserved individuals, to provide public and professional development, and to support community partnerships enhancing statewide breast and cervical cancer and cardiovascular disease control activities. Chapter 8 covers agencies designated by contracting county boards of health to provide community-based IA CFY Program services and to receive funds from the Department for that purpose. The designated agencies facilitate the essential screening and diagnostic services consistent with CDC and IA CFY Program guidelines.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 20, 2019, as ARC 4766C. No public comments were received. No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the State Board of Health on January 8, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to the Department’s waiver and variance provisions contained in 641—Chapter 178.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).Effective Date    This rule making will become effective on March 18, 2020.    The following rule-making action is adopted:

    ITEM 1.    Amend 641—Chapter 8 as follows: CHAPTER 8IOWA CARE FOR YOURSELF (IA CFY) PROGRAM[Prior to 4/4/12, see 641—Chapter 37]

641—8.1(135) Definitions.  For purposes of this chapter, the following definitions apply:        "Abnormal screen" means a suspicion of breast or cervical cancer or laboratory values of total cholesterol or blood glucose and average blood pressure reading in the range defined by the CDC according to National Heart, Lung and Blood Institute guidelines.
  1. A suspicion of breast cancer includes clinical breast examination findings of: palpable breast mass, breast dimpling, nipple retraction, bloody nipple discharge, palpable lymph nodes around clavicle or axilla, nipple erythema and scaliness, a mammography result of breast imaging reporting and data systems (BI-RADS) category 4 (suspicious abnormality suggesting need for biopsy) or category 5 (highly suggestive of malignancy) (ICD-9 793.810 R92.0, R92.1, R92.2, R92.8), breast biopsy result of ductal cancer in situ(ICD-10 D05.10, D05.11, D05.12), lobular cancer in situ (ICD-9 233.010 D05.00, D05.01, D05.02), or breast or lymph node (or other) biopsy result of breast cancer.
  2. Suspicion of cervical cancer is a Pap test result of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H) (ICD-9 795.0210 R87.611 or R87.622), atypical glandular cells (AGC) (ICD-9 795.0010 R87.619 or R87.629), low-grade squamous intraepithelial lesions (LSIL) (ICD-9 622.11 or 795.0310 R87.612 or R87.622), or high-grade squamous intraepithelial lesions (HSIL) (ICD-9 622.12 or 795.0410 R87.613 or R87.623), leukoplakia of the cervix (ICD-9 622.210 N88.0), or cervical biopsy result of cervical intraepithelial neoplasia II(ICD-10 N.87.1) or III (ICD-9 622.10, 622.11, 622.12, 795.03, or 795.0410 D06.0, D06.1, D06.7 or D06.9), or cancer in situ (ICD-9 233.110 D06.0, D06.1, D06.7 or D06.9).
  3. Abnormal value means laboratory values of total cholesterol or blood glucose (HbA1c if diagnosed diabetic) and average blood pressure reading in the range defined by the CDC according to National Heart, Lung and Blood Institute guidelines.
        "ACR" "American College of Radiology" means one of the Food and Drug Administration-recognized accreditation bodies for minimum quality standards for personnel, equipment, and record keeping in facilities that provide mammographybreast imaging.        "Advanced registered nurse practitioner" means an individual licensed to practice under 655—Chapter 7.        "Alert value" means laboratory values of total cholesterol,or blood glucose andor average blood pressure reading in the range defined by the CDC according to National Heart, Lung and Blood Institute guidelines.        "BCCPTA" "Breast and Cervical Cancer Prevention and Treatment Act of 2000" means a federal law that provides each state with the option of extending Medicaid eligibility to womenindividuals who were diagnosed with breast or cervical cancer through the National Breast and Cervical Cancer Early Detection Program.        "BCCT option of Medicaid" "breast and cervical cancer treatment option of Medicaid" means the optional program of medical aid designed for womenindividuals who are unable to afford regular medical service and are diagnosed with breast or cervicalprecancer or cancer through the National Breast and Cervical Cancer Early Detection Program or through funds from Susan G. Komen for the Curefamily planning centers, community health centers, or nonprofit organizations. The individuals who receive screening or services meet eligibility requirements established by the Iowa care for yourself program. The BCCT option of Medicaid is financed by federal and state payment sources and is authorized by Title XIX of the Social Security Act.        "Benign" means a noncancerous condition that does not spread to other parts of the body.        "Biopsy" means the removal of a sample or an entire abnormality for microscopic examination to diagnose a problem. Examples of a sampling would be a core biopsy or incisional biopsy; an example of entire removal would be an excisional biopsy.        "BI-RADS" "breast imaging reporting and data systems" means a standardized reporting system for mammography, breast ultrasound and breast magnetic resonance imaging (MRI) reports.        "Blood glucose" means a simple sugar found in the blood that is an important energy source in living organisms and is a component of many carbohydrates.        "Blood pressure" means the pressure or tensionforce of the blood withinagainst the systemic arteries, maintained by the contraction of the left ventricle, the resistance of the arterioles and capillaries, the elasticity of the arterial walls, as well as the viscosity and volume of the blood; expressed as relative to the ambient atmospheric pressurecirculatory system. The systolic blood pressure is the force caused when the heart contracts and pushes out the blood. The diastolic blood pressure is when the heart relaxes and fills with blood.        "BMI" "body-mass index" means a number calculated from a person’s weight and heightan index for relating weight to height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.        "Breast ultrasound" means the use ofan imaging technique commonly used to screen for tumors and other breast abnormalities. The breast ultrasound uses high-energy sound waves that are bounced off internal tissues and make echoes to produce a pictorial representation of the internal structuredetailed image of the inside of the breast.        "Cancer" means a malignant tumor of potentially unlimited growth of new cells that expand locally by invasion and systemically by metastasisgroup of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.        "Carcinoma in situ" means cell changes in which malignant cells are localized and may press against adjoining tissue but have not penetrated or spread beyond their site of origina group of abnormal cells found only in the place where they first formed in the body.        "Cardiologist" means a physicianlicensed to practice under Iowa Code chapter 148 who specializes in the study of the heart and its action and diseases.        "Cardiovascular disease" means a broad term used to describe a range of diseases that affect the heart and, in some cases, blood vessels.        "Cardiovascular disease risk factors" means identifiable factors that make some people more susceptible than others to cardiovascular disease. Cardiovascular disease risk factors include:
  1. Obesity.
  2. Physical inactivity.
  3. High blood pressure.
  4. High blood cholesterol.
  5. Diabetes.
  6. Tobacco use.
Risk factors that cannot be changed are age, gender and family history. The more cardiovascular disease risk factors a person has increases the person’s chance of developing cardiovascular disease.
        "Case management" means the IA CFY program component that involves establishing, brokering, and sustaining a system of available clinical and essential support services for all womenindividuals enrolled in the program.        "CBE" "clinical breast examination" means complete examination of a woman’san individual’s breast and axilla with palpation by a health care provider, including examination of the breast in both the upright and supine positionstrained to recognize many different types of abnormalities and warning signs.        "CDC" means the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services, a federal agency that conducts and supports health promotion, prevention and preparedness activities in the U.S., with the goal of improving overall public health.        "Cholesterol" means a waxy, fat-like substance made in the liver and other cells and found in certain foods, such as foods from animals, for example, dairy products, eggs and meat. Types of cholesterol are as follows:
  1. Low density lipoprotein or LDL, also called “bad” cholesterol. LDL can cause buildup of plaque on the walls of arteries. The more LDL there is in the blood, the greater the risk of heartcardiovascular disease.
  2. High density lipoprotein or HDL, also called “good” cholesterol. HDL helps the body get rid of bad cholesterol in the blood. If levels of HDL are low, risk of heartcardiovascular disease increases.
  3. Very low density lipoprotein or VLDL. VLDL is similar to LDL cholesterol in that it contains mostly fat and not much protein.
  4. Total cholesterol means the sum of the very low, low and high density lipoproteins.
        "CLIA" "Clinical Laboratory Improvement ActActs of 1988" means the law which establishedfederal regulatory standards that apply to all clinical laboratory testing performed on humans in the U.S. These standards establish minimum quality standards for personnel and quality assurance methods that monitor patient test management and assess quality control, proficiency testing, and personnel handling of laboratory and pathology specimens.        "CLIA-waived tests" means simple laboratory examinations and procedures that are cleared by the federal government for home use;, that employ methodologies that are so simple and accurate that erroneous results would be negligible;, or that pose no reasonable risk of harm to the patient if the test is performed incorrectly.        "CMS" "Centers for Medicare and Medicaid Services" is a federal agency within the United States Department of Health and Human Services that administers health care programs, including Medicare, Medicaid, the children’s health insurance program (CHIP) and health insurance exchanges, in partnership with state governments.        "Colposcopy" means amedical procedure that allows close examination of the surface of the cervix with a high-powered microscope.        "Community referral" means the act, action or instance of directing a participant to a community resourceto direct individuals elsewhere to obtain needed information, mutual support or community resources through help lines or other methods.        "Community resource" means a source of information, service or expertise that is available within the community, including respite care services, health and mental health services and other social services.        "Cooperative agreement" means a signed contract between the department and another party, for example, a health care provider. This contractfacility, which allows the department to pay the health care providerfacility for providing services to IA CFY program participants.        "CPT" "current procedural terminology" is a listing of descriptive terms and identifying codes for uniform language to report medical services and procedures performed by qualified health care professionals and allows clinicians, statisticians, politicians, health insurance programs, health planners and others to speak a common language.        "Creditable coverage" means any insurance that pays for medical bills incurred for the screening, diagnosis, or treatment of breast and cervical cancer. Creditable coverage as described by the Health Insurance Portability and Accountability Act of 1996 includes, but is not limited to, group health plans or health insurance coverage consisting of medical care under any hospital or medical service policy, health maintenance organization, Medicare Part A or B, Medicaid, armed forces insurance, or state health risk pool. A womanAn individual who has creditable coverage shall not be eligible for coverage under the breast and cervical cancer treatment option of Medicaid.        "Creditable coverage circumstances" means those instances in which a womanan individual has creditable coverage but is not actually covered for treatment of breast or cervical cancer.
  1. When there is a preexisting-condition exclusion or when the annual or lifetime limit on benefits has been exhausted, a womanan individual is not considered to have creditable coverage for this treatment.
  2. If the womanan individual has limited coverage, such as a high deductible, limited drug coverage, or a limited number of outpatient visits, shethe individual is still considered to have creditable coverage and is not eligible for coverage under the breast and cervical cancer treatment option of Medicaid.
  3. If the womanan individual has a policy with a limited scope of coverage, such as only dental, vision, or long-term care, or has a policy that covers only a specific disease or illness, shethe individual is not considered to have creditable coverage unless the policy provides coverage for breast and cervical cancer treatment.
  4. For the purposes of this program, eligibility for Indian Health Services or tribal health care is not considered creditable coverage (according to P.L. 107-121, the Native American Breast and Cervical Cancer Treatment Technical Amendment Act of 2001).
        "Cytology" means the scientific study of cellsbranch of biology that studies the structure and function of a cell.        "Cytopathology" means the scientific study of cells in diseasebranch of pathology that studies and diagnoses disease on the cellular level.        "Cytotechnologist" means a medical technician trained in the identification of cells and cellulara laboratory professional who studies cells and cellular abnormalities.        "Department" means the Iowa department of public health.        "DHS" "department of human services" means the Iowa department of human services, a state agency that provides a wide range of services, including health care coverage for low-income uninsured individuals diagnosed with breast or cervical cancer or precancer and requiring treatment.        "Diagnostic mammography" means a radiological examination performed for appropriate clinical indications, such as breast mass(es), other breast signs or symptoms (spontaneous nipple discharge, skin changes), or special cases, such as a history of breast cancer with breast conservation or augmented breasts.        "Family planning clinic" means a Title X family planning program site dedicated to the provision of family planning and related preventive health services to low-income and underserved populations.        "FDA" "Food and Drug Administration" means the federal governmental body which certifies that a mammographybreast imaging facility meets minimum quality standards for personnel, equipment, and record keeping.        "Follow-up" means the IA CFY program component that involves a system for seeking information about or reviewing an abnormal condition, rescreening, or recall for annual visits.        "Glucose" means a simple sugar that is an important carbohydrate in biology. Cells use glucose as a source of energy and a metabolic intermediate.        "Gynecologist" means a physicianlicensed to practice under Iowa Code chapter 148 who specializes in diseases of the reproductive organs in women.         "HbA1c" "glycosylated hemoglobin" means a clinical laboratory test for the purposes of monitoring blood glucose control of a participant diagnosed with diabetesdiagnosing diabetes or determining control of diabetes over the past two to three months.        "Health care provider" means any physician,pharmacist, advanced registered nurse practitioner, or physician assistant who is licensedauthorized to practice by the state of Iowa; who is performing within the scope of the practice as defined by state law; andwho provides care to IA CFY program-enrolled womenindividuals.        "Heart disease" means a broad term used to describe a range of diseases that affect the heart and, in some cases, blood vessels. The term is often used interchangeably with “cardiovascular disease,” which generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke.        "Heart disease risk factors" means identifiable factors that make some people more susceptible than others to heart disease. Heart disease risk factors include:
  1. Being overweight.
  2. Lack of physical activity.
  3. High blood pressure.
  4. High blood cholesterol.
  5. Diabetes.
  6. Cigarette smoking.
Risk factors that cannot be changed are age and family history. The more heart disease risk factors a person has increases the person’s chance of developing heart disease.
        "IA BCCEDP" "Iowa breast and cervical cancer early detection program" means a comprehensive breast and cervical cancer screening program established and funded under Title XV of the federal Public Health Service Act and administered by the Iowa department of public health, with the delegated responsibility of implementation and evaluation from the CDC, Division of Cancer Prevention and Control.        "IA CFY program" "Iowa care for yourself program" means an integrated comprehensive breast and cervical cancer screening program and cardiovascular risk factor screening and intervention program administered by the Iowa department of public health.        "IA WISEWOMAN" "Iowa well-integrated screening and evaluation for women across the nation" means a cardiovascular-related risk factor screening and intervention program to provide standard preventive screening services, including blood pressure measurements, cholesterol testing,blood glucose testing, and lifestyle interventions that target poor nutrition, physical inactivity, and tobacco use. The program is authorized by the federal government and administered by the CDC to help reduce deaths and disability from heartcardiovascular disease and stroke.        "ICD-9ICD-10" "International Classification of Disease, 9th10th edition" means a standardized classification of diseases, injuries, and reasons of death, by cause and anatomic localization, which is systematically put into a number of up to sixseven digits and which allows clinicians, statisticians, politicians, health planners and others to speak a common language, both in the United States and internationally.        "Infrastructure" means the basic framework of sufficient staff and adequate support systems to plan, implement, and evaluate the components of the IA CFY program.        "In need of treatment" means that a medical or surgical intervention is required because of an abnormal finding of breast or cervical cancer or precancer that was determined as a result of a screening or diagnostic procedure for breast or cervical cancer/precancer under the NBCCEDP.        "Intervention" means services that promote a heart-healthycardiovascular-healthy diet and physical activity and that are based on screening results, which include blood pressure, cholesterol,blood glucose, weight, height, personal medical history, family medical history, and health behavior and readiness-to-change assessments.         "MATFMAB" "medical advisory task forceboard" means an advisory boarda body that may be utilized by the IA CFY program to offer knowledge and experience as related to the fields of expertise of the members of the task forceboard. Duties of the MATFMAB may include, but are not limited to, the following:
  1. Reviewing and making recommendations for clinical service expansion.
  2. Reviewing program-developed clinical protocols.
  3. Providing recommendations related to other clinical and participant-related issues.
  4. Providing input related to quality assurance issues.
  5. Reviewing program screening and diagnostic data.
        "MDEs" "minimum data elements" means a set of standardized data elements used to collect demographic and clinical information on women whose screening or diagnosis was paid for with IA CFY program funds. MDEs were developed by the CDC, Division of Cancer Prevention and Control, to ensure that consistent and complete information is collected on women whose screening or diagnosis was paid for with IA CFY program fundingpatient-level screening records on individuals served through the NBCCEDP in order to evaluate whether programs are meeting clinical standards and programmatic priorities.        "Medicaid" meansa health care program that assists low-income families or individuals in paying for doctor visits, hospital stays, long-term medical care, custodial care costs and more; the program of medical aid designed for those unable to afford regular medical service,is financed by federal and state payment sources, and authorized by Title XIX of the Social Security Actand administered by the Iowa department of human services.        "Medicare" means the program of federal payment source for health benefits, especially for the aged, which is authorized by Title XVIII of the Social Security Act.        "NBCCEDP" "National Breast and Cervical Cancer Early Detection Program" means a program established with the passage of the Breast and Cervical Cancer Mortality Prevention Act of 1990 (Public Law 101-354). The law authorizes the CDC to establish a program of grants to states, tribes, and territories for the purpose of increasing the early detection of breast and cervical cancer, particularly among low-income, uninsured, and underserved womenindividuals.        "Nonprofit organization" means a group organized for purposes other than generating profit and in which no part of the organization’s income is distributed to its members, directors, or officers, except under limited circumstances.        "Oncologist" means a physicianlicensed to practice under Iowa Code chapter 148 who is a specialist in treating or studying the physical, chemical, and biologic properties and features of neoplasms, including causation, pathogenesis, and treatment.        "Outreach" means the IA CFY program component that involves recruiting targeted populations or womenindividuals who never or rarely utilize preventive health services.        "Pap test" means the Papanicolaou screening test that collects cells from the cervix for examination under a microscope. The Pap test can detect abnormal cells or precancerous cells before cancer develops.        "Pathologist" means a physicianlicensed to practice under Iowa Code chapter 148 who is a specialist in identifying diseases by studying cells and tissues under a microscope.        "Patient navigation" means an IA CFY program component that assists individuals in overcoming health care system barriers and facilitates timely access to quality screening and diagnostics as well as initiation of breast or cervical cancer treatment services.         "Pharmacist" means an individual licensed to practice under Iowa Code chapter 155A.        "Physician" means an individual licensed to practice under Iowa Code chapter 148.        "Physician assistant" means an individual licensed to practice under Iowa Code chapter 148C.        "Precancerous" means a condition that may become, or is likely to become,or lesion involving abnormal cells that are associated with an increased risk of developing into cancer.        "Program and fiscal management" means the IA CFY program component that includes planning, organizing, directing, coordinating, managing, budgeting for, and evaluating program activities.        "Quitline Iowa" means a toll-free, statewide smoking cessation telephone counseling hotline through which trained counselors provide caller assistance in making an individualized tobacco use quit plan and provide ongoing support through optional follow-up calls.        "Radiologist" means a physicianlicensed to practice under Iowa Code chapter 148 who specializes in creating and interpreting pictures of areas inside the body. The pictures are produced withthe branch of medicine that diagnoses injuries and diseases using medical imaging procedures such as X-rays, sound waves, or other types of energy.        "Rarely or never been screened" means, as defined for the NBCCEDP, that a womanan individual has not had cervical cancer screening within the last five years or has never been screened for cervical cancer.        "Recruitment" means the IA CFY program component that involves enrolling targeted populations or womenindividuals for preventive health services.        "Referral" means the IA CFY program component that involves directing womenindividuals with abnormalabnormal/alert screening results to appropriate resources for follow-up action.        "Screening mammography" means the use of X-ray of the breasts of asymptomatic womenindividuals in an attempt to detect abnormal lesions of the breast when they are small, nonpalpable, and confined to the breast.        "Service delivery" means providing, either directly or through contractual arrangements, comprehensive breast and cervical cancer screening and heartcardiovascular disease and stroke risk factor screening, diagnosis, and treatment services through tracking of screening intervals, timeliness of diagnosis, and timeliness of treatment of womenindividuals.        "Surgeon" means a physicianlicensed to practice under Iowa Code chapter 148 who treats disease, injury, or deformity by physical operation or manipulation.         "Surveillance" means the IA CFY program component that involves the systematic collection, analysis, and interpretation of health data.        "Susan G. Komen for the Cure" means an international organization with a network of volunteers working through local affiliates and Komen Race for the Cure® events to eradicate breast cancer as a life-threatening disease by advancing research, education, screening, and treatment.        "TBS" "the Bethesda system" means a system that was developed to provide uniform diagnostic terminology for reporting cervical or vaginal cytologic findings to facilitate communication between the laboratory and the cliniciandiagnoses, used for reporting Pap test results.        "Triglycerides" means a type of fat that is carried in the blood by very low density lipoproteins. Excess calories, alcohol, or sugar in the body are converted into triglycerides and stored in fat cells throughout the body.        "WISEWOMAN" "Well-Integrated Screening and Evaluation for Women Across the Nation" means a national program that offers blood pressure, diabetes, and cholesterol risk factor screening, lifestyle intervention, and referral services in an effort to prevent cardiovascular disease.

641—8.2(135) Components of the Iowa care for yourself (IA CFY) program.  The IA CFY program shall include the following key components:    8.2(1)   Program and fiscal management shall be conducted by ensuring strategic planning, implementation, coordination, integration, and evaluation of all programmatic activities and administrative systems, as well as the development of key communication channels and oversight mechanisms to aid in these processes. Program management shall ensure that infrastructure adequately supports service delivery.    8.2(2)   Service delivery of specific and appropriate clinical procedures to detect breast and cervical abnormalities and heartcardiovascular disease or stroke risk factors for womenindividuals enrolled in the IA CFY program shall be directly provided or provided through contractual arrangements.    a.    The IA CFY program shall cover breast and cervical cancer screening and diagnostic services including, but not limited to, the following when those services are provided by a participating health care provider who has a cooperative agreement with the IA CFY programIowa department of public health. Payment shall be based on Medicare Part B participating-provider rates as released annually at the beginning of each calendar year.    (1)   Physical examinations that include two recorded blood pressurespressure measurements in addition to one or more of the following screening services: CBE, pelvic examination, or Pap test;    (2)   Height and weight measurements, when provided in conjunction with one or more of the screening services listed in subparagraph 8.2(2)“a”(1) above;    (3)   Mammography (screening and diagnostic);    (4)   Breast ultrasound, when used as an adjunct to mammography;    (5)   Fine-needle aspiration of breast cysts;    (6)   Breast biopsies, excisional and nonexcisional (physician charges only; hospital charges are not covered);    (7)   Colposcopy of the cervix, with or without biopsy;    (8)   Surgical consultations for diagnosis of breast and cervical cancer;    (9)   Pathology charges for breast and cervical biopsies;    (10)   Anesthesia for breast biopsiesprogram-approved CPT and ICD-10 codes (health care provider charges only; hospital charges and supplies are not covered).    b.    Breast and cervical cancer-related services not covered by the IA CFY program include, but are not limited to, the following:    (1)   Services not related to breast or cervical cancer screening or diagnosis;    (2)   Treatment procedures and services;    (3)   Services provided by nonparticipating providers;    (4)   Hospital charges for breast biopsies and anesthesia;    (5)   Inpatient services.    c.    The IA CFY program shall cover cardiovascular disease-related services for thoseselect participants enrolled in the IA CFY programfor WISEWOMAN services for whom at least onebreast or cervical cancer screening service was paid for using federal funds. Cardiovascular disease-related services shall include, but not be limited to, the following when those services are provided by a participating health care provider whothat has a cooperative agreement with the IA CFY programdepartment provides those services. Payment shall be based on Medicare Part B participating-provider rates as released annually at the beginning of each calendar year.    (1)   Physical examinations that include two recorded blood pressurespressure measurements;    (2)   Height and weight measurements;    (3)   Fasting lipid panel that includes total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides; and     (4)   Diabetes screening:1. For a nondiagnosed diabetican individual who has not been diagnosed with diabetes, fasting blood glucose; and 2. For a diagnosed diabetican individual who has been diagnosed with diabetes, glycosylated hemoglobin (HbA1c).    d.    Cardiovascular disease-related services not covered by the IA CFY program include, but are not limited to, the following:    (1)   A follow-up diagnostic visit to a health care provider if one or more screening values are in the CDC-defined abnormal value range;    (2)   Repeat laboratory testing;    (3)   Any additional testing;    (4)   Medication; and     (5)   Treatment.    e.    IA CFY programcardiovascular intervention shall be conducted as a component of the program for all womenindividuals who are eligible and enrolled to receive IA CFY programWISEWOMAN services.    f.    A health care provider whothat has a cooperative agreement with the IA CFY program shall be subject to the following:    (1)   The health care provider agrees that reimbursement of procedures and services provided shall not exceed the amount that would be paid under Medicare Part B participating-provider rates as released annually at the beginning of each calendar year.    (2)   A mammography health care provider shall ensure that the provider’s facility has current FDA certification and ACR or state of Iowa accreditation and is a Medicare and Medicaid-approved facility utilizing BI-RADS and following ACR guidelines for mammography report content.    (3)   A board-certified radiologist must be immediately available to determine selection of views and readings when a diagnostic mammogram is performed.    (4)   The health care provider shall submit obtained cytology and pathology specimens to a CLIA-certified laboratory for processing. The laboratory shall provide cytological reading and analysis of cervical and vaginal Pap tests by certified/registered cytotechnologists. Cytology (Pap) teststest results shall be reported using current TBS terminology. The laboratory shall provide board-certified pathologists or experienced certified cytotechnologists to rescreen all analyses and readings of cervical and breast biopsies.    (5)   The health care provider shall practice according to the current standards of medical care for breast and cervical cancer early detection, diagnosis, and treatment.    (6)   Service delivery may be provided in a variety of settings. Service delivery, however, must, however, include:1. Providing screening services for specific geographic areas;2. Providing a point of contact for scheduling appointments;3. Providing age and income eligibility screening;4. Providing breast and cervical cancer screening and heartcardiovascular disease and stroke screening to eligible womenindividuals;5. Providing referral and follow-up for womenindividuals who have alert-valuecardiovascular disease screening results;6. Providing the required reporting system for screening and follow-up activities;7. Providing population-based education, outreach, and recruitment activities;8. Providing IA CFY program cardiovascular intervention as a component of the program for all womenindividuals eligible for and enrolled to receive IA CFYWISEWOMAN program services; and 9. Submitting data within 60 days of service date to establish screening documentation.    (7)   The health care provider shall ensure compliance with this chapter and other terms and conditions included in the cooperative agreement.    8.2(3)   Referral, tracking, and follow-up utilizing a data system to monitor each enrolled woman’sindividual’s receipt of screening/rescreening, diagnostic, and treatment procedures shall be conducted by the IA CFY program and contracted county board of health designated agency staff.    a.    The enrolled womanindividual shall be notified by contracted county board of health designated agency staff of the results of the service, whether the results are normal, benign, or abnormal.    b.    The data system shall provide tracking of appropriate and timely clinical services following an abnormal test result or diagnosis of cancer.    c.    If the enrolled womanindividual has an abnormal Pap test or breast screening or an alert-value heartcardiovascular disease risk factor, the health care provider shall provide to the womanindividual with a comprehensive referral directing her to appropriate additional diagnostic or treatment services.    d.    The comprehensive referral shall be written. Follow-up shall be conducted to determine whether services were timely, completed, or met.    8.2(4)   The IA CFY program and contracted county board of health designated agency staff shall provide case management and shall assist participants whose canceror precancerous breast or cervical condition was diagnosed through the program in obtaining needed treatment services.    8.2(5)   IA CFY program staff shall use quality assurance and improvement techniques including use of established standards, systems, policies and procedures to monitor, assess and identify practical methods for improvement of the program and its components.    a.    Quality assurance tools shall include utilizing FDA and ACR minimum standards for mammography facilities and CLIA minimum standards for cytopathology and pathology laboratories.    b.    Quality assurance measures shall contribute to the identification of corrective actions to be taken to remedy problems found as a result of investigating quality of care.    8.2(6)   Professional development shall be provided by the IA CFY program and contracted county board of health designated agency staff through a variety of channels and activities that enable professionals to perform their jobs competently, identify needs and resources, and contribute to ensuring that health care delivery systems provide positive clinical outcomes.    8.2(7)   Using a variety of methods and strategies to reach priority populations, the IA CFY program and contracted county board of health designated agency staff shall provide population-based public education and recruitment that involve the systematic design and delivery of clear and consistent messages about breast and cervical cancer and the benefits of early detection. Outreach activities should focus on womenindividuals who have never or rarely been screened and should work toward the removal of barriers to care (i.e., the need for child care, respite care, interpreter services and transportation) through collaborative activities with other community organizations.    8.2(8)   The IA CFY program may develop coalitions and partnerships to bring together groups and individuals that establish a reciprocal agreement for sharing resources and responsibilities to achieve the common goal of reducing breast and cervical cancer mortality and heartcardiovascular disease and stroke mortality.    8.2(9)   The IA CFY program shall conduct surveillance utilizing continuous, proactive, timely and systematic collection, analysis, interpretation and dissemination of breast and cervical cancer screening and heartcardiovascular disease and stroke risk factor behaviors and incidence, prevalence, survival, and mortality rates. Epidemiological studies shall be conducted utilizing MDEs and other data sources to establish trends of disease, diagnosis, treatment, and research needs. Program planning, implementation, and evaluation shall be based on the epidemiological evidence.    8.2(10)   Evaluation of the program shall be conducted through systematic documentation of the operations and outcomes of the program, compared to a set of explicit or implicit standards or objectives.

641—8.3(135) Participant eligibility criteria.  An applicant for the IA CFY program must satisfy the criteria outlined in this rule. If an applicant does not meet these criteria, the applicant shall be provided information by contracted county board of health designated agency staff regarding IowaCareIowa health and wellness, health insurance marketplace, free care, or sliding-fee clinics available in the area in which the applicant lives.    8.3(1) Age.  An applicant for the IA CFY program must satisfy only one of these criteriato participate in the IA CFY program.    a.    WomenIf the applicant is 50 through 64 years of age, the program’s priority population, shallthe applicant may receive annual breast and cervical (if appropriate) cancer screening.    b.    WomenIf the applicant is 40 through 64 years of age shall, the applicant may receive cardiovascular risk factor screening in addition to breast and cervical cancer screening services.    c.    WomenIf the applicant is 40 through 49 years of age shall, the applicant may receive annual breast and cervical (if appropriate) cancer screening.    d.    WomenIf the applicant is under 40 years of age, ifand symptomatic for breast cancer, shallthe applicant may receive breast and cervical cancer screening services based upon funding availability.Exception: This categorized group is not eligible for cardiovascular services under this program.    e.    WomenIf the applicant is 65 years of age and older shalland the applicant does not have Medicare Part B coverage, the applicant may be eligible to receive annual breast and cervical (if appropriate) cancer screening if they do not have Medicare Part B coverage.Exception: This categorized group is not eligible for cardiovascular services under this program.    8.3(2) Income.      a.    IA CFY program income guidelines are based upon 250 percent of the federal poverty level, which is set annually by CMS. New IA CFY program income guidelines will be adjusted following any change in CMS guidelines.    b.    Self-declaration of income may be accepted.    c.    Eligibility shall be based on net income for the household.    d.    Assets shall not affect income status and shall not be counted when eligibility under the IA CFY program is determined.    8.3(3) Insurance.      a.    The IA CFY program shall determine a womanan individual to be uninsured if the womanindividual does not have health insurance coverage.    b.    The IA CFY program shall determine a womanan individual to be underinsured if the womanindividual has health insurance with unreasonably high copayments, deductibles, or coinsurance or the insurance does not cover IA CFY program-covered services.    c.    WomenIndividuals who havecreditable coverage, Medicaid, or Medicare Part B are not eligibleif declaring a barrier to services. Exceptions: IowaCare, Medicaid with spenddown, Iowa family planning network.    8.3(4) Residency.      a.    A womanAn individual must be a resident of Iowa or of a state that shall enroll a womanan individual in the BCCT option of Medicaid if the womanindividual is screened or diagnosed by the IA CFY program.    b.    A womanAn individual who is a resident of a state that does not accept womenindividuals into the BCCT option of Medicaid and who chooses to continue to receive services in the IA CFY program must be informed that shethe individual may not be able to have herthe individual’s treatment paid for by the BCCT option of Medicaid if shethe individual does not receive services in herthe individual’s state of residence.    c.    Proof and length of residency in Iowa are not required.Exception: An individual is not eligible for cardiovascular services if the individual is not a resident of Iowa.    8.3(5) Ineligible.  The IA CFY program does not provide coverage for:    a.    Men.    b.    Women with Medicare Part B coverage.    c.    b.    WomenIndividuals 39 years of age and younger unless they have symptoms of breast cancer.

641—8.4(135) Participant application procedures for IA CFY program services.      8.4(1) Enrollment.  After a womanan individual is determined eligible for services:    a.    The womanindividual must complete, sign, and return a consent and release form to the IA CFY program. The date on the signed form shall be the participant’s enrollment date.    b.    Upon enrollment, the participant must select an IA CFY program health care provider andfacility.    c.    The individual is eligible for services for 12 months from the enrollment date, subject to restrictions in program coverage as provided in rule 641—8.5(135).    c.    d.    If a participant is unable to access a particular health care provider due to unavailability of appointments or if a participant requests to change to another health care provider, designated agency staff shall assist the participant in choosing another IA CFY program health care provider who is available in the participant’s area.    8.4(2) Reenrollment.      a.    A participant’s continued eligibility for program coverage shall be determined annually.    b.    No more than 45 days prior to the end of the 12-month coverage period, the IA CFY program shall contact the participant to see if shethe participant wishes to reenroll in the program.    c.    If a participant wishes to reenroll, shethe participant must complete, sign and return a consent and release form before receiving any further services.    8.4(3) Termination of enrollment.  The IA CFY program shall terminate a participant’s enrollment if the participant:    a.    Requests termination from the program;    b.    No longer meets the criteria set forth in rule 641—8.3(135);    c.    Does not return a signed IA CFY program consent and release form; or    d.    Refuses to receive screening and diagnostic services through an IA CFY program health care provider.

641—8.5(135) Priority for program expenditures.      8.5(1)   In the event the IA CFY program director determines that there are inadequate funds to meet participants’program needs, either attributable to a reduction in federal funding from the CDC or to a projected enrollment of womenindividuals in excess of anticipated enrollment, the program director may restrict new applicants’ participation in the IA CFY program as follows:    a.    First priority shall be given to womenindividuals 50 through 64 years of age.    b.    Second priority shall be given to women 40 through 49individuals under 50 years of age who are symptomatic.    c.    Third priority shall be given to womenindividuals 40 through 49 years of age who are asymptomatic.    d.    Fourth priority shall be given to womenindividuals 65 years of age and older who do not have Medicare Part B coverage.    8.5(2)   In the event that the financial demand abates, the program director shall withdraw the financial shortfall determination, at which time womenindividuals shall be eligible for program services in accordance with rule 641—8.3(135).

641—8.6(135) Right to appeal.  If an individual disagrees with or is dissatisfied with program eligibility, the covered-service determination, or the decision of the program, the individual has the right to appeal the decision or action.    8.6(1)   The appeal shall be in writing and shall be submitted, within ten working days of the decision or action, to the designated agency personnel with whom the individual has been working.    8.6(2)   The designated agency staff shall contact a state IA CFY program staff person and shall provide the information regarding the appeal to the staff person.    8.6(3)   State IA CFY program staff shall confer with the bureau chief supervising the IA CFY program and provide a decision to the designated agency staff within five business days. A decision made by state IA CFY program staff shall be delivered by telephone, if possible, to the individual making the appeal and shall be followed by a written notification of the decision. The decision of state IA CFY program staff shall be considered a final agency decision in accordance with Iowa Code chapter 17A.

641—8.7(135) Verification for the breast or cervical cancer treatment (BCCT) option of Medicaid.  The Iowa department of public health and theIowa department of human services have coordinated to develop procedures for womenindividuals to access Medicaid coverage for treatment of breast or cervical canceror precancerous conditions.    8.7(1)   Before referring a womanan individual to herthe individual’s county of residence’s local office of the department of human services, a contracted county board of health designated agency staff member shall document the following regarding the womanindividual:    a.    The woman is currentlyindividual was enrolled in the IA CFY program. To be considered enrolled in the program, the woman must meet program age guidelines, havewhen diagnosed; has had at least one of the basic screening services (Pap test, screening mammogram, or CBEor MRI) or diagnostic procedures paid for by the IA CFY program or with Susan G. Komen for the Cure funds,from family planning centers, community health centers, or nonprofit organizations; andmust be in need of treatment for breast or cervical cancer or precancerous conditions; or    b.    The womanindividual was enrolled in NBCCEDP and has moved to Iowa. To be considered enrolled in NBCCEDP, the womanindividual must meet the Iowa program age guidelines,; havehad at least one of the basic screening services (Pap test, screening mammogram, or CBEor MRI) or a diagnostic procedure paid for by the NBCCEDP or with Susan G. Komen for the Cure funds,from family planning centers, community health centers, or nonprofit organizations; and be in need of treatment for breast or cervical cancer or precancerous conditions; and    c.    The womanindividual has creditable coverage circumstances or has no creditable coverage for breast or cervical cancer treatment.    8.7(2)   The BCCT option of Medicaid is administered by the Iowa department of human services under 441 Iowa Administrative Code Chapter 75441—Chapter 75, “Conditions of Eligibility.”       These rules are intended to implement Iowa Code sections 135.11(1) and 135.39 and 42 U.S.C. Section 300k, as amended.
    [Filed 1/13/20, effective 3/18/20][Published 2/12/20]Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/12/20.
ARC 4906CPublic Health Department[641]Adopted and Filed

Rule making related to lead-based paint

    The Public Health Department hereby amends Chapter 70, “Lead-Based Paint Activities,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 135.105A.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 135.105A.Purpose and Summary    These amendments consist of several changes grouped into the following categories: dust-lead hazard adjustment, deletion of and addition to definitions, deletion of rules that the program no longer deems necessary, and clarification of training requirements.    The United States Environmental Protection Agency (EPA) recently adjusted the dust-lead hazard threshold for floors and window sills. The changes in this area were driven by recent evidence and science in the field, and were made effective in January 2020. Iowa is an authorized state for lead-based paint activities and must be in compliance with EPA regulations.    The other changes are related to definitions, training provider requirements/course, and outdated program rules and language. These changes are needed to reflect current practices and requirements.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 20, 2019, as ARC 4773C. No public comments were received. No changes from the Notice have been made.Adoption of Rule Making    This rule making was adopted by the State Board of Health on January 8, 2020.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to the Department’s waiver and variance provisions contained in 641—Chapter 1