Senate Study Bill 1046 - IntroducedA Bill ForAn Act 1relating to the operation of state government, including
2the review of state boards, the regulation of professions
3and occupations, and investigations conducted by state
4boards, and including effective date and applicability
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2REGULATION OF PROFESSIONS
3   Section 1.  NEW SECTION.  272C.16  Definitions.
   4For the purposes of this subchapter:
   51.  “Health profession board” means an entity regulating,
6licensing, or certifying a profession regulated pursuant to
7Title IV, subtitle 3.
   82.  “Nonhealth profession” means a profession regulated by
9this state other than provided in Title IV, subtitle 3.
   103.  “Regulated health profession” means a profession
11regulated pursuant to Title IV, subtitle 3.
   124.  “Unregulated health profession” means a profession
13pursuant to Title IV, subtitle 3, that is not currently
14regulated by any entity of this state.
   155.  “Unregulated nonhealth profession” means a profession
16that is not currently regulated by any entity of this state
17that is not an unregulated health profession.
18   Sec. 2.  NEW SECTION.  272C.17  Regulation of unregulated
19health professions.
   201.  An unregulated health profession shall not be subject
21to regulation by any entity of this state for the purpose of
22prohibiting competition but only for the exclusive purpose
23of protecting the public health or safety. All proposed
24legislation to regulate an unregulated health profession shall
25be reviewed by the general assembly to determine that all of
26the following conditions are met:
   27a.  There is credible evidence that the unregulated practice
28of the unregulated health profession will clearly harm or
29endanger the public health or safety and the potential for harm
30is easily recognizable and not remote.
   31b.  The public needs and can reasonably be expected
32to benefit from an assurance of initial and continuing
33professional ability.
   34c.  The public cannot be effectively protected by other means
35in a more cost-efficient manner.
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   12.  Prior to considering proposed legislation to regulate an
2unregulated health profession for passage to the floor of the
3senate or the house of representatives, a legislative committee
4to which proposed legislation to regulate an unregulated
5health profession has been referred shall consider whether the
6conditions in subsection 1 have been met. If the committee
7finds that the conditions in subsection 1 have been met, the
8committee shall consider whether the legislation is the least
9restrictive method of regulation to address the specific harm
10or danger identified in this subsection.
   11a.  If existing common law and statutory civil actions and
12criminal prohibitions are not sufficient to eradicate existing
13harm, the legislation shall provide for stricter civil actions
14and criminal prohibitions.
   15b.  If a service is being performed for individuals
16that involves a hazard to the public health or safety, the
17legislation shall impose inspection requirements and enable an
18appropriate state entity to respond to a violation by seeking
19injunctive relief in court.
   20c.  If the threat to the public health or safety is
21relatively small as a result of the operation of the
22unregulated health profession, the legislation shall implement
23a system of registration.
   24d.  If a consumer may have a substantial basis for relying
25on the services of a practitioner of an unregulated health
26profession, the legislation shall implement a system of
27certification.
   28e.  If the legislative committee determines that adequate
29regulation cannot be achieved by means other than licensing,
30the legislation shall implement a system of licensing.
   313.  The legislative committee shall submit its findings
32regarding whether the proposed legislation meets the conditions
33in subsections 1 and 2 to the president of the senate or the
34speaker of the house of representatives, who shall make the
35findings available to each member of the general assembly on
-2-1the internet site of the general assembly.
2   Sec. 3.  NEW SECTION.  272C.18  Proposed regulation of
3unregulated health professions — written reports.
   41.  A member of the general assembly introducing proposed
5legislation to regulate an unregulated health profession
6shall submit with the legislation a report, prepared by the
7legislative services agency, addressing the requirements
8contained in subsection 2. The report shall be submitted to
9the president of the senate or the speaker of the house of
10representatives prior to full consideration of the legislation
11by the senate or the house of representatives and made
12available on the internet site of the general assembly.
   132.  The report shall address all of the following and
14identify the source of all information contained in the report:
   15a.  Why regulation is necessary including all of the
16following:
   17(1)  The nature of the proven harm to the public if the
18unregulated health profession is not regulated and the extent
19to which there is a threat to the public health or safety.
   20(2)  The extent of autonomy a practitioner has, as indicated
21by the extent to which the profession calls for the exercise
22of independent judgment and the extent to which a practitioner
23is supervised.
   24b.  The efforts made to address the problem addressed by the
25legislation including all of the following:
   26(1)  Voluntary efforts, if any, undertaken by members of the
27profession.
   28(2)  Recourse to, and the extent of use of, applicable law
29and whether the law could be amended to control the problem.
   30c.  The alternatives considered including all of the
31following:
   32(1)  Regulation of business employers or practitioners
33rather than employee practitioners.
   34(2)  Regulation of the program or service rather than
35individual practitioners.
-3-
   1(3)  Registration of all practitioners.
   2(4)  Certification of all practitioners.
   3(5)  Other viable alternatives.
   4(6)  If licensing is sought, why licensing would serve to
5protect the public health or safety.
   6d.  The benefit to the public health or safety if regulation
7is granted including all of the following:
   8(1)  The extent to which the incidence of specific problems
9present in the unregulated health profession can reasonably be
10expected to be reduced by regulation.
   11(2)  Whether the public can identify qualified
12practitioners.
   13(3)  The extent to which qualified practitioners are
14competent including all of the following:
   15(a)  The composition, powers, duties, and practices of the
16proposed regulatory entity.
   17(b)  Whether current practitioners of an unregulated health
18profession will be allowed to continue to practice and whether
19they will be required to meet the qualifications for the
20regulated health profession.
   21(c)  The nature of the standards proposed for registration,
22certification, or licensure as compared with the standards in
23other jurisdictions.
   24(d)  Whether the proposed regulatory entity would be
25authorized to enter into reciprocity agreements with other
26jurisdictions.
   27(e)  The nature and duration of any training and experience
28required, whether applicants will be required to pass an
29examination, and whether there will be alternative methods to
30enter the health profession.
   31(4)  Assurances to the public that practitioners have
32maintained their competence including all of the following:
   33(a)  Whether a registration, certificate, or license will
34include an expiration date.
   35(b)  Whether the renewal of a registration, certificate,
-4-1or license will be based only on payment of a fee or whether
2renewal will involve reexamination, peer review, or other
3enforcement.
   4e.  The extent to which regulation might harm the public
5including all of the following:
   6(1)  The extent to which regulation will restrict entry into
7the profession, including whether the proposed standards are
8more restrictive than necessary to ensure a practitioner’s safe
9and effective performance in the practice of the profession.
   10(2)  Whether there are professions similar to the
11unregulated health profession that should be included in, or
12portions of the unregulated health profession that should be
13excluded from, the proposed legislation.
   14f.  The maintenance of professional standards including all
15of the following:
   16(1)  Whether effective quality assurance standards exist
17in the profession such as legal requirements associated with
18specific programs that define or enforce standards or a code
19of ethics.
   20(2)  How the proposed legislation will ensure quality,
21including whether a code of ethics will be adopted and the
22grounds for suspension or revocation of a registration,
23certificate, or license.
   24g.  A description of the group proposed for regulation,
25including a list of associations, organizations, and other
26professional groups representing practitioners in this state,
27an estimate of the number of practitioners in each professional
28group, and whether the professional groups represent different
29levels of practice.
   30h.  The expected costs of regulation, including the impact of
31costs on the public and costs imposed on this state.
32   Sec. 4.  NEW SECTION.  272C.19  Proposed increased regulation
33of regulated health professions — written reports.
   341.  A member of the general assembly introducing proposed
35legislation to expand the scope of practice of a regulated
-5-1health profession shall submit with the legislation a report,
2prepared by the legislative services agency, addressing the
3requirements contained in subsection 2. The report shall be
4submitted to the president of the senate or the speaker of the
5house of representatives prior to full consideration of the
6legislation by the senate or the house of representatives and
7made available on the internet site of the general assembly.
   82.  The report shall address all of the following and
9identify the source of all information contained in the report:
   10a.  Why an expanded scope of practice for the regulated
11health profession is beneficial, including the extent to which
12health care consumers need and will benefit from safe, quality
13health care from practitioners within the expanded scope of
14practice.
   15b.  Whether expanding the scope of practice of practitioners
16in the regulated health profession will require practitioners
17to have didactic and clinical education from accredited
18professional schools or training from recognized programs that
19prepare them to perform within the proposed expanded scope of
20practice, and specific educational or training requirements for
21that proposed expanded scope of practice.
   22c.  Whether the subject matter of the proposed expanded scope
23of practice is currently tested by nationally recognized and
24accepted examinations for applicants for professional licensure
25and the details of the examination relating to the expanded
26scope of practice.
   27d.  The extent to which the proposed expanded scope
28of practice will impact the practice of practitioners
29currently licensed in this state or the entry into practice
30of practitioners who have relocated from other states with
31substantially equivalent requirements for registration,
32certification, or licensure in this state.
   33e.  The extent to which implementing the proposed expanded
34scope of practice may result in savings or a cost to this state
35and to the public.
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   1f.  The relevant regulated health profession licensure laws,
2if any, in this state and other states.
   3g.  Recommendations, if any, the applicable regulatory entity
4or entities, the department of public health, and accredited
5educational or training programs.
   63.  a.  Prior to considering proposed legislation to
7expand the scope of practice of a regulated health profession
8for passage to the floor of the senate or the house of
9representatives, a legislative committee to which proposed
10legislation has been referred shall consider all of the
11following:
   12(1)  Whether the expansion of a regulated health
13profession’s scope of practice is only for the purpose of
14protecting the public from a specific harm or danger.
   15(2)  Whether the addition of adequately trained
16practitioners providing an expanded range of health care
17services will have a beneficial effect on the public and
18increase access to safe, quality health care.
   19(3)  Whether any changes in the entity regulating the
20regulated health profession are necessary to protect the public
21health or safety.
   22b.  The legislative committee shall not consider competition
23with or from other regulated health professions or whether a
24practitioner will be able to obtain health insurance coverage
25for the proposed expanded scope of practice.
26   Sec. 5.  NEW SECTION.  272C.20  Continuing education
27requirements — evidence of efficacy.
   28A member of the general assembly introducing proposed
29legislation to impose or increase a continuing education
30requirement on a regulated health profession shall submit with
31the legislation evidence that such a requirement has proven
32effective for the health profession. The evidence shall be
33submitted to the president of the senate or the speaker of the
34house of representatives prior to full consideration of the
35legislation by the senate or the house of representatives and
-7-1made available on the internet site of the general assembly.
2   Sec. 6.  NEW SECTION.  272C.21  Regulation of unregulated
3nonhealth professions.
   41.  An unregulated nonhealth profession shall not be
5regulated except for the exclusive purpose of protecting the
6public health or safety. All proposed legislation to regulate
7an unregulated nonhealth profession shall be reviewed by the
8legislative committee to which the proposed legislation is
9referred to ensure that all of the following requirements are
10met:
   11a.  The unregulated practice of the nonhealth profession can
12clearly harm the public health or safety.
   13b.  The actual or anticipated public benefit of the
14regulation clearly exceeds the costs imposed by the regulation
15on consumers, businesses, and individuals.
   16c.  The public needs and can reasonably be expected
17to benefit from an assurance of initial and continuing
18professional ability.
   19d.  The public cannot be effectively protected by private
20certification or other alternatives.
   212.  If a legislative committee finds that the proposed
22legislation satisfies the conditions in subsection 1, the
23committee shall examine data from multiple sources and shall
24consider evidence of actual harm to the public related to
25the unregulated nonhealth profession being considered for
26regulation. The evidence may include industry association
27data; federal, state, and local government data; business
28reports; complaints to law enforcement, relevant state
29agencies, and the better business bureau; and data from
30agencies in other states with and without similar systems of
31regulation.
   323.  If, after consideration of evidence pursuant to
33subsection 2, the legislative committee finds that it is
34necessary to regulate an unregulated nonhealth profession, the
35committee shall review the proposed legislation to determine
-8-1whether it is the least restrictive regulation necessary and
2whether the regulation protects a discrete interest group from
3economic competition.
   44.  The legislative committee shall submit its findings
5regarding whether the proposed legislation meets the
6requirements of subsections 1, 2, and 3 to the president of
7the senate or the speaker of the house of representatives, who
8shall make the findings available to each member of the general
9assembly on the internet site of the general assembly.
10   Sec. 7.  NEW SECTION.  272C.22  Proposed regulation of
11unregulated nonhealth professions — written reports.
   121.  A member of the general assembly introducing legislation
13to regulate an unregulated nonhealth profession shall submit
14with the legislation a report, prepared by the legislative
15services agency, addressing the requirements contained in
16subsection 2. The report shall be submitted to the president
17of the senate or the speaker of the house of representatives
18prior to full consideration of the legislation by the senate or
19the house of representatives and made available on the internet
20site of the general assembly.
   212.  The report shall address all of the following and
22identify the source of all information contained in the report:
   23a.  Why regulation is necessary including what particular
24problem regulation would address.
   25b.  The efforts made to address the problem.
   26c.  The alternatives considered.
   27d.  The benefit to the public of regulating the profession.
   28e.  The extent to which regulation might harm the public.
   29f.  The maintenance of professional standards including all
30of the following:
   31(1)  Whether effective quality assurance standards exist
32in the profession such as legal requirements associated with
33specific programs that define or enforce standards or a code
34of ethics.
   35(2)  How the proposed legislation will assure quality
-9-1including the extent to which a code of ethics will be
2adopted and the grounds for the suspension or revocation of a
3registration, certificate, or license.
   4g.  A description of the profession proposed for regulation,
5including a list of associations, organizations, and other
6professional groups representing practitioners in this state,
7an estimate of the number of practitioners in each profession,
8and whether the professional groups represent different levels
9of practice.
   10h.  The expected costs of regulation, including the impact of
11costs on the public and costs imposed on this state.
12   Sec. 8.  REPEAL.  Section 3.20, Code 2021, is repealed.
13DIVISION II
14Board reviews
15   Sec. 9.  Section 2.69, subsection 1, Code 2021, is amended
16to read as follows:
   171.  A state government efficiency review committee is
18established which shall meet at least every two years to review
19the operations of state government
 monthly, as necessary,
20to efficiently review all boards according to the schedule
21established by the legislative services agency pursuant to
22section 4A.5
. The committee shall meet as directed by the
23legislative council.
24   Sec. 10.  Section 2.69, subsection 2, paragraph a, Code 2021,
25is amended to read as follows:
   26a.  The committee shall consist of three members of the
27senate appointed by the majority leader of the senate, two
28members of the senate appointed by the minority leader of the
29senate, three members of the house of representatives appointed
30by the speaker of the house of representatives, and two members
31of the house of representatives appointed by the minority
32leader of the house of representatives, and one ex officio,
33nonvoting member appointed by the governor
.
34   Sec. 11.  Section 2.69, subsections 4, 5, and 6, Code 2021,
35are amended by striking the subsections.
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1   Sec. 12.  NEW SECTION.  4A.1  Definitions.
   2As used in this chapter, unless the context otherwise
3requires:
   41.  “Board” means any board, council, commission, committee,
5panel, review team, or foundation of this state, except that
6“board” does not include a pension board or the Iowa ethics and
7campaign disclosure board created in section 68B.32.
   82.  “Board review criteria” means the criteria required to be
9considered under section 4A.3.
   103.  “Committee” means the state government efficiency review
11committee created pursuant to section 2.69.
12   Sec. 13.  NEW SECTION.  4A.2  Committee — review of boards.
   131.  The committee shall carry out the functions provided in
14this chapter.
   152.  Administrative assistance shall be provided by the
16legislative services agency and by staff of each caucus of the
17general assembly.
18   Sec. 14.  NEW SECTION.  4A.3  Board reviews.
   191.  The committee shall review the usefulness, performance,
20and efficacy of each board as provided in subsection 2. The
21committee shall hold hearings to receive the testimony of the
22public and of the chief executive officer of the board. After
23completing a review, the committee shall prepare and publish
24a report of its findings and recommendations as provided in
25section 4A.4.
   262.  The legislative services agency shall establish a
27schedule for the committee to review each board such that
28the committee reviews approximately one-fifth of all boards
29each calendar year and each board has been reviewed once
30between the calendar years 2022 and 2027. The committee may
31modify the schedule as necessary to facilitate the efficient
32administration of the committee.
   333.  A board that is scheduled for review shall submit a
34report to the committee thirty days prior to the date that it
35is scheduled for review that includes all of the following
-11-1information:
   2a.  The board’s primary purpose and its goals and objectives.
   3b.  The board’s past and anticipated workload, the number of
4staff required to complete that workload, and the board’s total
5number of staff.
   6c.  The board’s past and anticipated budgets and its sources
7of funding.
   8d.  The number of members that compose the governing board or
9other governing entity of the board and member compensation,
10if any.
   114.  A board subject to review shall bear the burden of
12demonstrating to the committee a public need for its continued
13existence. In determining whether a board has met that
14burden, the committee shall consider all of the following, as
15applicable:
   16a.  Whether continuation of the board is necessary to protect
17the health or safety of the public, and if so, whether the
18board’s authority is narrowly tailored to protect against
19present, recognizable, and significant harms to the health or
20safety of the public.
   21b.  Whether the public could be protected or served in an
22alternate or less restrictive manner.
   23c.  Whether the board serves a specific private interest.
   24d.  Whether rules adopted by the board are consistent with
25the legislative mandate of the board as expressed in the
26statutes that created and empowered the board.
   27e.  The extent to which the board’s jurisdiction and programs
28overlap or duplicate those of other boards, the extent to which
29the board coordinates with those other boards, and the extent
30to which the board’s programs could be consolidated with the
31programs of other state departments or boards.
   32f.  The number of other states that regulate the occupation,
33whether a license is required to engage in the occupation in
34other states, whether the initial licensing and license renewal
35requirements for the occupation are substantially equivalent
-12-1in every state, and the amount of regulation exercised by the
2board compared to the regulation, if any, in other states.
   3g.  Whether the board recognizes national uniform licensure
4requirements for the occupation.
   5h.  Whether private contractors could be used, in an
6effective and efficient manner, either to assist the board in
7the performance of its duties or to perform the board’s duties
8in place of the board.
   9i.  Whether the operation of the board has inhibited economic
10growth, reduced efficiency, or increased government costs.
   11j.  An assessment of the authority of the board regarding
12fees, inspections, enforcement, and penalties.
   13k.  The extent to which the board has permitted qualified
14applicants to serve the public.
   15l.  The extent to which the board has allowed individuals to
16practice elements of the occupation without a license.
   17m.  The cost-effectiveness of the board in terms of the
18number of employees, services rendered, and administrative
19costs incurred, both past and present.
   20n.  Whether the board’s operation has been impeded or
21enhanced by existing statutes and procedures and by budgetary,
22resource, and personnel practices.
   23o.  Whether the board has recommended statutory changes to
24the general assembly that would benefit the public rather than
25the individuals regulated by the board, if any, and whether the
26board’s recommendations and other policies have been adopted
27and implemented.
   28p.  Whether the board has required any individuals subject to
29the board’s regulations to report to the board the impact of
30board rules and decisions on the public as they affect service
31costs and service delivery.
   32q.  Whether individuals regulated by the board, if any, have
33been required to assess problems in their business operations
34that affect the public.
   35r.  Whether the board has encouraged public participation in
-13-1its rulemaking and decision making.
   2s.  The efficiency with which formal public complaints filed
3with the board have been processed to completion.
   4t.  Whether the purpose for which the board was created has
5been fulfilled, has changed, or no longer exists.
   6u.  Whether federal law requires that the board be renewed
7in some form.
   8v.  An assessment of the administrative hearing process of
9the board if the board has an administrative hearing process,
10and whether the hearing process is consistent with due process
11rights.
   12w.  Whether the requirement for an occupational license
13is consistent with the principles expressed in section 4B.2,
14serves the public health or safety, and provides the least
15restrictive form of regulation that adequately protects the
16public health or safety.
   17x.  The extent to which licensing ensures that practitioners
18have occupational skill sets or competencies that are
19substantially related to protecting consumers from present,
20significant, and substantiated harms that threaten the public
21health or safety, and the impact that those criteria have on
22applicants for a license, particularly those with moderate or
23low incomes, seeking to enter the occupation or profession.
   24y.  The extent to which the requirement for the occupational
25license stimulates or restricts competition, affects consumer
26choice, and affects the cost of services.
   27z.  An assessment of whether changes are needed in the
28enabling laws of the board in order for the board to comply
29with the criteria listed in this subsection.
30   Sec. 15.  NEW SECTION.  4A.4  Reports of the committee.
   311.  After completing a review of a board pursuant to section
324A.3, the committee shall prepare and submit a report of its
33findings and recommendations by December 21 of each year
34beginning in 2022 and ending in 2027. A report may include
35findings and recommendations for more than one board. Copies
-14-1of the report shall be submitted to the president of the
2senate, the speaker of the house of representatives, the
3governor, and each affected board, and shall be made publicly
4available on the internet site of the general assembly. The
5committee shall present its recommendations to the general
6assembly in the form of a bill.
   72.  Recommendations of the committee shall indicate how or
8whether implementation of the recommendations would do each of
9the following:
   10a.  Improve efficiency in the management of state government.
   11b.  Improve services rendered to citizens of the state.
   12c.  Simplify and improve preparation of the state budget.
   13d.  Conserve the natural resources of the state.
   14e.  Promote the orderly growth of the state and its
15government.
   16f.  Promote occupational regulations to increase economic
17opportunities, encourage competition, and encourage innovation.
   18g.  Provide for the least restrictive regulations by
19repealing current regulations and replacing them with less
20restrictive regulations that are consistent with the principles
21expressed in section 4B.2.
   22h.  Improve the effectiveness of the services performed by
23the boards of the state.
   24i.  Avoid duplication of effort by state agencies or boards.
   25j.  Improve the organization and coordination of the state
26government.
27   Sec. 16.  NEW SECTION.  4A.5  Activities of the general
28assembly not restricted.
   29This chapter shall not be construed to restrict the general
30assembly from considering any legislation concerning a board
31subject to this chapter.
32   Sec. 17.  NEW SECTION.  4B.1  Definitions.
   33For the purposes of this chapter:
   341.  “Certification” means a voluntary program in which
35a private organization or the state grants nontransferable
-15-1recognition to an individual who meets personal qualifications
2established by the private organization or state law.
   32.  “Lawful occupation” means a course of conduct, pursuit,
4or profession that includes the sale of goods or services that
5are not themselves illegal to sell irrespective of whether
6the individual selling the goods or services is subject to an
7occupational regulation.
   83.  “Least restrictive regulation” means the public policy of
9relying on one of the following, listed from the least to the
10most restrictive, as a means of consumer protection:
   11a.  Market competition.
   12b.  Third-party or consumer-created ratings and reviews.
   13c.  Private certifications.
   14d.  Actions under section 714H.5.
   15e.  Actions under section 714.16.
   16f.  Regulation of the process of providing the specific goods
17or services to consumers.
   18g.  Inspections.
   19h.  Bonding or insurance.
   20i.  Registrations.
   21j.  Government certifications.
   22k.  Occupational licenses, including specialty occupational
23licenses for medical reimbursement.
   244.  “Occupational license” means a government permission slip
25to work that is a nontransferable authorization in law that an
26individual must possess in order to perform a lawful occupation
27for compensation based on meeting personal qualifications
28established by statute or by a rule authorized by statute.
29“Occupational license” does not include a commercial or other
30driver’s license.
   315.  “Occupational licensing board” means any board,
32commission, committee, or council, or any other similar state
33public body, and any agency, division, or office of state
34government, that issues an occupational license.
   356.  “Occupational regulation” means a statute, policy, rule,
-16-1practice, or other state law requiring an individual to possess
2certain personal qualifications to use an occupational title or
3work in a lawful occupation. “Occupational regulation” includes
4a registration, certification, and occupational license.
5“Occupational regulation” excludes a business license, facility
6license, building permit, or zoning and land use regulation,
7except to the extent those laws regulate an individual’s
8personal qualifications to perform a lawful occupation, and
9excludes a commercial or other driver’s license.
   107.  “Personal qualifications” means criteria related to an
11individual’s personal background and characteristics including
12completion of an approved educational program, satisfactory
13performance on an examination, work experience, other evidence
14of attainment of requisite skills or knowledge, moral standing,
15criminal history, and completion of continuing education.
   168.  “Registration” means a requirement to give notice to the
17government that may include the individual’s name and address,
18the individual’s agent for service of process, the location of
19the activity to be performed, and a description of the service
20the individual provides. “Registration” does not include
21personal qualifications but may require a bond or insurance.
   229.  “Specialty occupational license for medical reimbursement”
23is a nontransferable authorization in law for an individual
24to qualify for payment or reimbursement from a government
25agency for providing identified medical services based on
26meeting personal qualifications established in law which may be
27recognized by a private company.
28   Sec. 18.  NEW SECTION.  4B.2  Occupational regulation
29principles.
   30With respect to the occupational regulation of individuals,
31all of the following shall be policies of this state:
   321.  Occupational regulations shall be construed and applied
33to increase economic opportunities, promote competition, and
34encourage innovation.
   352.  If the state finds it is necessary to displace
-17-1competition, the state shall use the least restrictive
2regulation to protect consumers from present, significant, and
3substantiated harms that threaten public health or safety. The
4policy of employing the least restrictive regulation shall
5presume that market competition and private remedies are
6sufficient to protect consumers. If necessary, regulations
7shall be tailored to meet the predominate identified need to
8protect consumers as follows:
   9a.  If a regulation is intended to protect consumers against
10fraud, the appropriate state action shall be to strengthen
11powers under deceptive trade practices acts.
   12b.  If a regulation is intended to protect consumers against
13unsanitary facilities and general health or safety concerns,
14the appropriate state action shall be to require periodic
15inspections.
   16c.  If a regulation is intended to protect a consumer against
17potential damages to a third party who is not a party to a
18contract between the seller and buyer, and other types of
19externalities, the appropriate state action shall be to require
20bonding or insurance.
   21d.  If a regulation is intended to protect a consumer against
22potential damages by transient providers, the appropriate state
23action shall be to require registration with the secretary of
24state.
   25e.  If a regulation is intended to protect a consumer
26against asymmetrical information between the seller and buyer,
27the appropriate state action shall be to offer voluntary
28certification, unless appropriate, privately offered voluntary
29certification for the relevant occupation is available.
   30f.  If a regulation is intended to facilitate governmental
31reimbursement for providing medical services for an emerging
32medical specialty, the appropriate state action shall be
33to require a specialty occupational license for medical
34reimbursement. A person shall not be required to hold a
35specialty occupational license for medical reimbursement in
-18-1order to lawfully provide a medical service for an emerging
2medical specialty; however, a person providing a medical
3service for an emerging medical specialty without a specialty
4occupational license for medical reimbursement shall not
5receive governmental reimbursement for providing that service.
6A specialty occupational license for medical reimbursement
7shall not restrict governmental reimbursement for services
8similar to the regulated service that may be provided by other
9regulated persons.
   10g.  If a regulation is required to perform services
11regulated by both federal laws and the laws of this state,
12the appropriate state action shall be to require the state
13to recognize an individual’s occupational license from
14another state or territory of the United States to allow that
15individual to practice in this state.
   163.  An occupational regulation may be enforced against an
17individual only to the extent the individual sells goods and
18services that are included explicitly in the statute that
19defines the occupation’s scope of practice.
   204.  This chapter shall not restrict an occupational
21licensing board from requiring, as a condition of licensure
22or renewal of licensure, that an individual’s personal
23qualifications include obtaining or maintaining certification
24from a private organization that credentials individuals in the
25relevant occupation.
26   Sec. 19.  NEW SECTION.  4B.3  Local licensing — preemption.
   27This chapter preempts any ordinance or other local law or
28regulation which conflicts with or is inconsistent with any
29policy of the state expressed in this chapter by any political
30subdivision that regulates an occupation that is not regulated
31by the state.
32DIVISION III
33ACCOUNTABLE GOVERNMENT ACT REPORTS
34   Sec. 20.  Section 8E.210, Code 2021, is amended by adding the
35following new subsection:
-19-1   NEW SUBSECTION.  1A.  In addition to the requirements
2of subsection 1, an agency’s annual performance report
3shall include a description of how the agency improved
4efficiency, modernized processes, eliminated duplication and
5outdated processes, reduced costs, increased accountability,
6expanded the use of technology, and incorporated productivity
7improvement measures. The section of the annual performance
8report addressing the factors listed in this subsection shall
9be submitted to the state government committee of each chamber
10of the general assembly and made publicly available on the
11internet site of the general assembly.
12DIVISION IV
13PROFESSIONAL LICENSING BOARD INVESTIGATIONS
14   Sec. 21.  Section 272C.3, subsection 1, paragraph d, Code
152021, is amended to read as follows:
   16d.  Determine in any case whether an investigation, or
17further investigation, or a disciplinary proceeding is
18warranted. Notwithstanding the provisions of chapter 17A,
19a determination by a licensing board that an investigation
20is not warranted or that an investigation should be closed
21without initiating a disciplinary proceeding is not subject to
22judicial review pursuant to section 17A.19. Notwithstanding
23any other provision of law, if a board determines that there
24is no probable cause to believe that an asserted violation has
25occurred, the complaint shall be returned to the complainant
26with a statement specifying the reasons for rejection
27sufficient to enable the complainant to review the agency’s
28determination.

29DIVISION V
30ADMINISTRATIVE RULES REVIEW COMMITTEE REVIEW OF ENTRY
31REGULATIONS
32   Sec. 22.  NEW SECTION.  17A.35  Review of occupational entry
33regulations.
   341.  For purposes of this section, unless the context
35otherwise requires:
-20-
   1a.  “Entry regulation” means any rule adopted pursuant to
2chapter 17A by a licensing board for the purpose of regulating
3an occupational or professional group, including but not
4limited to any rule prescribing qualifications or requirements
5for a person’s entry into, or continued participation in, any
6business, trade, profession, or occupation in this state.
   7b.  “Licensing board” or “board” means the same as defined
8in section 272C.1.
   92.  A licensing board shall designate any entry regulation
10filed with the administrative rules coordinator and
11administrative code editor pursuant to section 17A.4 or 17A.5
12as an entry regulation in the preamble.
   133.  The administrative rules review committee, when
14reviewing a rule pursuant to section 17A.8, subsection 6, that
15is designated as an entry regulation by a licensing board,
16shall consider the following factors when reviewing the rule:
   17a.  Whether the entry regulation is required by state or
18federal law.
   19b.  Whether the entry regulation is necessary to protect the
20public health or safety.
   21c.  Whether the purpose or effect of the entry regulation is
22to unnecessarily inhibit competition or arbitrarily deny entry
23into a business, trade, profession, or occupation.
   24d.  Whether the intended purpose of the entry regulation
25could be accomplished by less restrictive or burdensome means.
   26e.  Whether the entry regulation is outside of the scope of
27the licensing board’s statutory authority to adopt rules.
   284.  The administrative rules review committee, when
29considering the factors provided in subsection 3, shall not
30give deference to a statement or interpretation made by a
31licensing board regarding an entry regulation, statute, or
32other legal authority.
   335.  If the administrative rules review committee disapproves
34of an entry regulation after consideration of the factors
35provided in subsection 3, the committee may take any action on
-21-1the rule otherwise permitted to the committee.
   26.  a.  No later than December 31, 2021, each licensing board
3shall submit to the administrative rules review committee a
4list of all entry regulations adopted by the board that are in
5effect as of the date of submission.
   6b.  The administrative rules review committee shall review
7all entry regulations submitted to the committee pursuant
8to paragraph “a” by December 31, 2025. The committee shall
9prescribe a schedule for such review and shall update the
10schedule as necessary. The schedule shall be posted by the
11legislative services agency on the general assembly’s internet
12site.
13   Sec. 23.  APPLICABILITY.  Section 17A.35, subsection
142, as enacted by this Act, applies to rules filed with the
15administrative rules coordinator and administrative code editor
16pursuant to section 17A.4 or 17A.5 for publication in an Iowa
17administrative bulletin published on or after May 1, 2021.
18DIVISION VI
19EFFECTIVE DATE
20   Sec. 24.  EFFECTIVE DATE.  This Act, being deemed of
21immediate importance, takes effect upon enactment.
22EXPLANATION
23The inclusion of this explanation does not constitute agreement with
24the explanation’s substance by the members of the general assembly.
   25This bill relates to the operation of state government,
26including the review and sunset of state boards and agencies
27and the regulation of professions. The bill is organized into
28divisions.
   29DIVISION I — REGULATION OF PROFESSIONS. The division
30relates to the regulation of professions. The bill requires
31a legislative committee reviewing legislation to impose
32regulations on a health profession that is not currently
33subject to regulation by the state to verify that: the
34unregulated practice of the profession will clearly harm or
35endanger the public, the public will benefit from assurances
-22-1of professional ability, and the public cannot be effectively
2protected in a more cost-efficient manner. The legislative
3committee must then verify that the legislation is the least
4restrictive method of regulation to protect the public. After
5completing its review, the bill requires the committee to
6submit its findings to the president of the senate and speaker
7of the house of representatives, who shall make the findings
8available to each member of the general assembly on the
9internet site of the general assembly.
   10The bill requires a member of the general assembly
11introducing legislation to regulate an unregulated health
12profession to submit a report, prepared by the legislative
13services agency, with the legislation addressing why the
14regulation is necessary, the efforts that have been made to
15address the problem, the alternatives considered, the benefits
16and harms to the public from regulation, the maintenance of
17professional standards, and shall include a description of the
18profession proposed for regulation and the expected costs of
19regulation. The report shall be submitted to the president
20of the senate and the speaker of the house of representatives
21prior to full consideration of the legislation, and shall be
22made publicly available on the internet site of the general
23assembly.
   24The bill requires a member of the general assembly
25introducing legislation to expand the scope of practice of a
26regulated health profession to submit a report, prepared by the
27legislative services agency, addressing why the expanded scope
28of practice is beneficial, whether practitioners currently
29have or will be required to obtain training because of the
30expanded scope of practice, whether the new practice is
31currently tested by a nationally recognized examination, the
32extent to which the expanded scope of practice will impact
33the practice of professionals currently in the state or who
34relocate to the state, the costs or savings from the expanded
35scope of practice, relevant laws in other states, and any
-23-1recommendations from regulatory entities. The report shall be
2submitted to the president of the senate and the speaker of
3the house of representatives prior to full consideration of
4the legislation, and shall be made publicly available on the
5internet site of the general assembly. A legislative committee
6reviewing such legislation shall consider whether the scope
7of practice is being expanded only to protect the public,
8whether the expansion of services will benefit the public, and
9whether any changes to the entity regulating the profession
10are necessary. The committee shall not consider competitive
11implications of expanding the scope of practice.
   12The bill requires a member of the general assembly
13introducing legislation to impose or increase a continuing
14education requirement on a health profession to submit evidence
15of the efficacy of the requirement to the president of the
16senate and the speaker of the house of representatives. The
17evidence shall also be made publicly available on the internet
18site of the general assembly.
   19The bill requires a legislative committee reviewing
20legislation to impose a regulation on an unregulated nonhealth
21profession to consider whether the unregulated practice of the
22profession can clearly harm the public, whether the benefits
23of regulation clearly exceeds the costs imposed on consumers,
24and whether the public needs assurances of professional
25ability. If the committee finds in the affirmative with
26respect to the preceding factors, the committee shall examine
27data to find evidence of actual harm to the public related
28to the unregulated nonhealth profession being considered
29for regulation. If the committee finds that regulation is
30necessary, the committee shall review the legislation to
31determine whether it is the least restrictive regulation
32necessary to protect the public and that it is not being
33imposed to protect a profession from economic competition. The
34committee shall submit its findings to the president of the
35senate and the speaker of the house of representatives, who
-24-1shall make the findings available to each member of the general
2assembly.
   3The bill requires a member of the general assembly
4introducing legislation to regulate an unregulated nonhealth
5profession to submit a report prior to full consideration of
6the legislation, prepared by the legislative services agency,
7addressing why regulation is necessary, the efforts made to
8address the problem, the alternatives considered, the benefits
9and harm to the public, the maintenance of professional
10standards, the professional groups proposed for regulation, and
11the expected costs of regulation.
   12The bill repeals a Code provision creating principles to
13guide the general assembly for the state licensure of an
14occupation or profession.
   15DIVISION II — STATE BOARD REVIEWS. This division relates
16to the review of state boards.
   17The bill requires the state government efficiency review
18committee to meet monthly, as necessary, to review the
19usefulness, performance, and efficacy of the board. The
20legislative services agency shall create a schedule, which the
21committee may revise, for review of approximately one-fifth of
22all boards each calendar year between the year 2022 and the
23year 2027. The bill removes duties of the state government
24efficiency review committee not related to the review of
25boards. The bill adds one ex officio, nonvoting member
26appointed by the governor to the committee.
   27A board that is subject to review shall submit a report to
28the committee prior to the date the board is scheduled for
29a sunset review that includes certain information specified
30in the bill, and shall bear the burden of demonstrating a
31continued public need for its existence. The bill provides
32several factors for the committee to consider.
   33After completing a review, the committee shall prepare a
34report of its findings and recommendations by December 21 of
35each year beginning in 2022 and ending in 2027, which report
-25-1may include findings and recommendations for more than one
2board. The committee shall present its findings to the general
3assembly in the form of a bill. The committee shall include
4with its recommendations an explanation of the benefits of
5implementing the recommendations.
   6The division does not restrict the general assembly from
7taking any other action with respect to regulating boards.
   8The division creates principles for the imposition of
9professional regulations. The principles created by the
10bill include a policy of enacting the least restrictive
11regulation necessary to protect the public, encouraging
12economic opportunities and competition, providing guidance
13for determining what style of regulation is appropriate, and
14enforcing an occupational regulation against an individual only
15to the extent that it is explicitly provided for by a statute.
16The bill does not prohibit a licensing board from requiring
17licensees to obtain credentials from private organizations.
18The bill enacts a rule of construction that any law of a
19political subdivision regulating a profession that is not
20regulated by the state shall be preempted if it is inconsistent
21with the principles expressed in the bill.
   22DIVISION III — ACCOUNTABLE GOVERNMENT ACT REPORTS. The
23division relates to accountable government Act reports
24submitted by agencies. The bill requires such reports
25to include descriptions of how the agency has improved
26efficiency, modernized processes, eliminated duplication and
27outdated processes, reduced costs, increased accountability,
28expanded the use of technology, and incorporated productivity
29improvement measures. This portion of the report shall be
30submitted to the state government committee of both chambers of
31the general assembly and posted publicly on the internet site
32of the general assembly.
   33DIVISION IV — PROFESSIONAL LICENSING BOARD INVESTIGATIONS.
34This division relates to investigations by professional
35licensing boards. The bill strikes the provision that a
-26-1determination by a licensing board that an investigation is not
2warranted or should be closed without a disciplinary hearing
3is not subject to judicial review. However, the bill requires
4a board that determines that no probable cause exists for
5an asserted violation to return the complaint asserting the
6violation to the complainant with a statement specifying the
7reasons for rejection of the complaint.
   8DIVISION V — ADMINISTRATIVE RULES REVIEW COMMITTEE
9REVIEW OF ENTRY REGULATIONS. This division requires the
10administrative rules review committee (ARRC), when reviewing an
11entry regulation, to consider certain factors specified in the
12bill.
   13The bill defines “entry regulation” as any rule adopted
14pursuant to Code chapter 17A by a licensing board for the
15purpose of regulating an occupational or professional
16group, including but not limited to any rule prescribing
17qualifications or requirements for a person’s entry into, or
18continued participation in, any business, trade, profession, or
19occupation in this state.
   20The bill provides that the ARRC shall not give deference to a
21statement or interpretation made by a licensing board regarding
22an entry regulation, statute, or other legal authority when
23considering the factors. If the ARRC disapproves of an entry
24regulation after consideration of the factors provided in
25the bill, the ARRC may take any action on the rule otherwise
26permitted to the ARRC.
   27The bill requires each licensing board to submit to the
28ARRC no later than December 31, 2021, a list of all entry
29regulations adopted by the board that are in effect as of the
30date of submission.
   31The bill requires the ARRC to review all submitted entry
32regulations by December 31, 2024, and to establish and update a
33schedule for such review. The schedule shall be posted on the
34general assembly’s internet site by the legislative services
35agency.
-27-
   1The bill includes an applicability provision requiring that
2an entry regulation be designated as such in the preamble to
3the entry regulation, beginning with the May 1, 2021, Iowa
4administrative bulletin.
   5DIVISION VI — EFFECTIVE DATE. The bill takes effect upon
6enactment.
-28-
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