Senate File 274 - Enrolled
SENATE FILE
BY COMMITTEE ON HUMAN
RESOURCES
(SUCCESSOR TO SSB
1096)
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A BILL FOR
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Senate File 274
AN ACT
RELATING TO PROGRAMS AND SERVICES UNDER THE PURVIEW OF THE
DEPARTMENT OF PUBLIC HEALTH INCLUDING THE BOARD OF HEARING
AID DISPENSERS AND THE MEDICAL RESIDENCY TRAINING MATCHING
GRANTS PROGRAM AND INCLUDING EFFECTIVE DATE AND RETROACTIVE
APPLICABILITY PROVISIONS.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
HEARING AID SPECIALISTS
Section 1. Section 147.1, subsections 3 and 6, Code 2015,
are amended to read as follows:
3. "Licensed" or "certified", when applied to a physician
and surgeon, podiatric physician, osteopathic physician and
surgeon, physician assistant, psychologist, chiropractor,
nurse, dentist, dental hygienist, dental assistant,
optometrist, speech pathologist, audiologist, pharmacist,
physical therapist, physical therapist assistant, occupational
therapist, occupational therapy assistant, orthotist,
prosthetist, pedorthist, respiratory care practitioner,
practitioner of cosmetology arts and sciences, practitioner
of barbering, funeral director, dietitian, marital and family
therapist, mental health counselor, social worker, massage
therapist, athletic trainer, acupuncturist, nursing home
administrator, hearing aid dispenser specialist, or sign
language interpreter or transliterator means a person licensed
under this subtitle.
6. "Profession" means medicine and surgery, podiatry,
osteopathic medicine and surgery, practice as a physician
assistant, psychology, chiropractic, nursing, dentistry,
dental hygiene, dental assisting, optometry, speech pathology,
audiology, pharmacy, physical therapy, physical therapist
assisting, occupational therapy, occupational therapy
assisting, respiratory care, cosmetology arts and sciences,
barbering, mortuary science, marital and family therapy, mental
health counseling, social work, dietetics, massage therapy,
athletic training, acupuncture, nursing home administration,
practice as a hearing aid dispensing specialist, sign language
interpreting or transliterating, orthotics, prosthetics, or
pedorthics.
Sec. 2. Section 147.2, subsection 1, Code 2015, is amended
to read as follows:
1. A person shall not engage in the practice of medicine
and surgery, podiatry, osteopathic medicine and surgery,
psychology, chiropractic, physical therapy, physical
therapist assisting, nursing, dentistry, dental hygiene,
dental assisting, optometry, speech pathology, audiology,
occupational therapy, occupational therapy assisting,
orthotics, prosthetics, pedorthics, respiratory care,
pharmacy, cosmetology arts and sciences, barbering, social
work, dietetics, marital and family therapy or mental health
counseling, massage therapy, mortuary science, athletic
training, acupuncture, nursing home administration, hearing aid
dispensing, or sign language interpreting or transliterating,
or shall not practice as a physician assistant or a hearing aid
specialist, unless the person has obtained a license for that
purpose from the board for the profession.
Sec. 3. Section 147.13, subsection 22, Code 2015, is amended
to read as follows:
22. For hearing aid dispensing specialists, the board of
hearing aid dispensers specialists.
Sec. 4. Section 147.14, subsection 1, paragraph v, Code
2015, is amended to read as follows:
v. For hearing aid dispensers specialists, three licensed
hearing aid dispensers specialists and two members who are not
licensed hearing aid dispensers specialists who shall represent
the general public. No more than two members of the board
shall be employees of, or dispensers specialists principally
for, the same hearing aid manufacturer.
Sec. 5. Section 154A.1, subsections 1, 3, 6, 7, and 9, Code
2015, are amended to read as follows:
1. "Board" means the board of hearing aid dispensers
specialists.
3. "Dispense" or "sell" means a transfer of title or of
the right to use by lease, bailment, or any other means,
but excludes a wholesale transaction with a distributor or
dispenser hearing aid specialist, and excludes the temporary,
charitable loan or educational loan of a hearing aid without
remuneration.
6. "Hearing aid fitting" means the measurement of
human hearing by any means for the purpose of selections,
adaptations, and sales of hearing aids, and the instruction and
counseling pertaining thereto to the selections, adaptations,
and sales of hearing aids, and demonstration of techniques in
the use of hearing aids, and the making of earmold impressions
as part of the fitting of hearing aids.
7. "License" means a license issued by the state under this
chapter to a hearing aid dispensers specialist.
9. "Temporary permit" means a permit issued while the
applicant is in training to become a licensed hearing aid
dispenser specialist.
Sec. 6. Section 154A.1, subsection 5, Code 2015, is amended
by striking the subsection.
Sec. 7. Section 154A.1, Code 2015, is amended by adding the
following new subsection:
NEW SUBSECTION. 6A. "Hearing aid specialist" means any
person engaged in the fitting, dispensing, and sale of hearing
aids and providing hearing aid services or maintenance, by
means of procedures stipulated by this chapter or the board.
Sec. 8. Section 154A.13, Code 2015, is amended to read as
follows:
154A.13 Temporary permit.
A person who has not been licensed as a hearing aid dispenser
specialist may obtain a temporary permit from the department
upon completion of the application accompanied by the written
verification of employment from a licensed hearing aid
dispenser specialist. The department shall issue a temporary
permit for one year which shall not be renewed or reissued.
The fee for issuance of the temporary permit shall be set by
the board in accordance with the provisions for establishment
of fees in section 147.80. The temporary permit entitles an
applicant to engage in the fitting or selection and sale of
hearing aids under the supervision of a person holding a valid
license.
Sec. 9. Section 154A.19, Code 2015, is amended to read as
follows:
154A.19 Exceptions.
1. This chapter shall not prohibit a corporation,
partnership, trust, association, or other organization
maintaining an established business address from engaging in
the business of selling or offering for sale hearing aids at
retail without a license if it employs only licensed hearing
aid dispensers specialists in the direct fitting or selection
and sale of hearing aids. Such an organization shall file
annually with the board a list of all licensed hearing aid
dispensers specialists and persons holding temporary permits
directly or indirectly employed by it. Such an organization
shall also file with the board a statement on a form approved
by the board that the organization submits itself to the rules
and regulations of the board and the provisions of this chapter
which the department deems applicable.
2. This chapter shall not apply to a person who engages
in the practices covered by this chapter if this activity is
part of the academic curriculum of an accredited institution of
higher education, or part of a program conducted by a public
or charitable institution, or nonprofit organization, unless
the institution or organization also dispenses or sells hearing
aids.
3. This chapter shall not prevent any person from engaging
in practices covered by this chapter, provided the person, or
organization employing the person, does not dispense or sell
hearing aids.
Sec. 10. Section 154A.20, Code 2015, is amended to read as
follows:
154A.20 Rights of purchaser.
1. A hearing aid dispenser specialist shall deliver, to
each person supplied with a hearing aid, a receipt which
contains the licensee's signature and shows the licensee's
business address and the number of the license, together with
specifications as to the make, model, and serial number of the
hearing aid furnished, and full terms of sale clearly stated,
including the date of consummation of the sale of the hearing
aid. If a hearing aid is sold which is not new, the receipt and
the container must be clearly marked "used" or "reconditioned",
with the terms of guarantee, if any.
2. The receipt shall bear the following statement in type no
smaller than the largest used in the body copy portion of the
receipt:
The purchaser has been advised that any examination or
representation made by a licensed hearing aid dispenser
specialist in connection with the fitting or selection and
selling of this hearing aid is not an examination, diagnosis,
or prescription by a person licensed to practice medicine in
this state and therefore, must not be regarded as medical
opinion or advice.
3. Whenever any of the following conditions are found to
exist either from observations by the licensed hearing aid
dispenser specialist or person holding a temporary permit or on
the basis of information furnished by a prospective hearing aid
user, the hearing aid dispenser specialist or person holding a
temporary permit shall, prior to fitting and selling a hearing
aid to any individual, suggest to that individual in writing
that the individual's best interests would be served if the
individual would consult a licensed physician specializing
in diseases of the ear, or if no such licensed physician is
available in the community, then a duly licensed physician:
a. Visible congenital or traumatic deformity of the ear.
b. History of, or active drainage from the ear within the
previous ninety days.
c. History of sudden or rapidly progressive hearing loss
within the previous ninety days.
d. Acute or chronic dizziness.
e. Unilateral hearing loss of sudden or recent onset within
the previous ninety days.
f. Significant air=bone gap (greater greater than or equal
to 15dB ANSI 500, 1000 and 2000 Hz. average) average.
g. Obstruction of the ear canal, by structures of
undetermined origin, such as foreign bodies, impacted cerumen,
redness, swelling, or tenderness from localized infections of
the otherwise normal ear canal.
4. A copy of the written recommendation shall be retained by
the licensed hearing aid dispenser specialist for the period
of seven years. A person receiving the written recommendation
who elects to purchase a hearing aid shall sign a receipt for
the same, and the receipt shall be kept with the other papers
retained by the licensed hearing aid dispenser specialist for
the period of seven years. Nothing in this section required
to be performed by a licensed hearing aid dispenser specialist
shall mean that the hearing aid dispenser specialist is engaged
in the diagnosis of illness or the practice of medicine or any
other activity prohibited by this chapter.
5. No hearing aid shall be sold by any individual licensed
under this chapter to a person twelve years of age or younger,
unless within the preceding six months a recommendation for
a hearing aid has been made by a physician specializing in
otolaryngology. A replacement of an identical hearing aid
within one year shall be an exception to this requirement.
6. A licensed hearing aid dispenser specialist shall, upon
the consummation of a sale of a hearing aid, keep and maintain
records in the dispenser's specialist's office or place of
business at all times and each such record shall be kept
and maintained for a seven=year period. These records shall
include:
a. Results of test techniques as they pertain to fitting of
the hearing aids.
b. A copy of the written receipt and the written
recommendation.
Sec. 11. Section 154A.21, Code 2015, is amended to read as
follows:
154A.21 Notice of address.
1. A licensee or person holding a temporary permit shall
notify the department in writing of the address of the place
where the licensee or permittee engages or intends to engage in
business as a hearing aid dispenser specialist. The department
shall keep a record of the place of business of licensees and
persons holding temporary permits.
2. Any notice required to be given by the department to a
licensee shall be adequately served if sent by certified mail
to the address of the last place of business recorded.
Sec. 12. Section 154A.24, subsection 3, paragraphs e and i,
Code 2015, are amended to read as follows:
e. Representing that the service or advice of a person
licensed to practice medicine, or one who is certificated as
a clinical audiologist by the board of speech pathology and
audiology or its equivalent, will be used or made available in
the fitting or selection, adjustment, maintenance, or repair
of hearing aids when that is not true, or using the words
"doctor", "clinic", "clinical audiologist", "state approved",
or similar words, abbreviations, or symbols which tend to
connote the medical or other professions, except where the
title "certified hearing aid audiologist" has been granted
by the national hearing aid society, or that the hearing aid
dispenser specialist has been recommended by this state or the
board when such is not accurate.
i. Directly or indirectly giving or offering to give, or
permitting or causing to be given, money or anything of value
to a person who advises another in a professional capacity, as
an inducement to influence the person or cause the person to
influence others to purchase or contract to purchase products
sold or offered for sale by a hearing aid dispenser specialist,
or to influence others to refrain from dealing in the products
of competitors.
Sec. 13. Section 154A.25, subsection 2, Code 2015, is
amended to read as follows:
2. Purchase or procure by barter a license or temporary
permit with intent to use it as evidence of the holder's
qualifications to engage in business as a hearing aid dispenser
specialist.
Sec. 14. Section 154F.2, subsection 1, paragraph b, Code
2015, is amended to read as follows:
b. Hearing aid fitting, the dispensing or sale of hearing
aids, and the providing of hearing aid service and maintenance
by a hearing aid dispenser specialist or holder of a temporary
permit as defined and licensed under chapter 154A.
Sec. 15. Section 154F.2, subsection 2, Code 2015, is amended
to read as follows:
2. A person exempted from the provisions of this chapter by
this section shall not use the title "speech pathologist" or
"audiologist" or any title or device indicating or representing
in any manner that the person is a speech pathologist or is
an audiologist; provided, a hearing aid dispenser specialist
licensed under chapter 154A may use the title "certified
hearing aid audiologist" when granted by the national hearing
aid society; and provided, persons who meet the requirements
of section 154F.3, subsection 1, who are certified by the
department of education as speech clinicians may use the title
"speech pathologist" and persons who meet the requirements
of section 154F.3, subsection 2, who are certified by the
department of education as hearing clinicians may use the
title "audiologist", while acting within the scope of their
employment.
Sec. 16. Section 216E.7, Code 2015, is amended to read as
follows:
216E.7 Exemptions.
This chapter does not apply to a hearing aid sold, leased,
or transferred to a consumer by an audiologist licensed under
chapter 154F, or a hearing aid dispenser specialist licensed
under chapter 154A, if the audiologist or dispenser specialist
provides either an express warranty for the hearing aid or
provides for service and replacement of the hearing aid.
Sec. 17. Section 272C.1, subsection 6, paragraph v, Code
2015, is amended to read as follows:
v. The board of hearing aid dispensers specialists, created
pursuant to chapter 154A.
DIVISION II
MEDICAL RESIDENCY TRAINING STATE MATCHING GRANTS PROGRAM ==
REENACTMENT
Sec. 18. NEW SECTION. 135.176 Medical residency training
state matching grants program.
1. The department shall establish a medical residency
training state matching grants program to provide matching
state funding to sponsors of accredited graduate medical
education residency programs in this state to establish,
expand, or support medical residency training programs.
Funding for the program may be provided through the health
care workforce shortage fund or the medical residency training
account created in section 135.175. For the purposes of this
section, unless the context otherwise requires, "accredited"
means a graduate medical education program approved by the
accreditation council for graduate medical education or the
American osteopathic association. The grant funds may be
used to support medical residency programs through any of the
following:
a. The establishment of new or alternative campus accredited
medical residency training programs. For the purposes of
this paragraph, "new or alternative campus accredited medical
residency training program" means a program that is accredited
by a recognized entity approved for such purpose by the
accreditation council for graduate medical education or the
American osteopathic association with the exception that
a new medical residency training program that, by reason
of an insufficient period of operation is not eligible for
accreditation on or before the date of submission of an
application for a grant, may be deemed accredited if the
accreditation council for graduate medical education or the
American osteopathic association finds, after consultation with
the appropriate accreditation entity, that there is reasonable
assurance that the program will meet the accreditation
standards of the entity prior to the date of graduation of the
initial class in the program.
b. The provision of new residency positions within existing
accredited medical residency or fellowship training programs.
c. The funding of residency positions which are in excess of
the federal residency cap. For the purposes of this paragraph,
"in excess of the federal residency cap" means a residency
position for which no federal Medicare funding is available
because the residency position is a position beyond the cap for
residency positions established by the federal Balanced Budget
Act of 1997, Pub. L. No. 105=33.
2. The department shall adopt rules pursuant to chapter 17A
to provide for all of the following:
a. Eligibility requirements for and qualifications
of a sponsor of an accredited graduate medical education
residency program to receive a grant. The requirements and
qualifications shall include but are not limited to all of the
following:
(1) Only a sponsor that establishes a dedicated fund to
support a residency program that meets the specifications of
this section shall be eligible to receive a matching grant. A
sponsor funding residency positions in excess of the federal
residency cap, as defined in subsection 1, paragraph "c",
exclusive of funds provided under the medical residency
training state matching grants program established in this
section, is deemed to have satisfied this requirement and
shall be eligible for a matching grant equal to the amount of
funds expended for such residency positions, subject to the
limitation on the maximum award of grant funds specified in
paragraph "e".
(2) A sponsor shall demonstrate, through documented
financial information as prescribed by rule of the department,
that funds have been reserved and will be expended by the
sponsor in the amount required to provide matching funds for
each residency proposed in the request for state matching
funds.
(3) A sponsor shall demonstrate, through objective evidence
as prescribed by rule of the department, a need for such
residency program in the state.
b. The application process for the grant.
c. Criteria for preference in awarding of the grants,
including preference in the residency specialty.
d. Determination of the amount of a grant. The total amount
of a grant awarded to a sponsor shall be limited to no more
than twenty=five percent of the amount that the sponsor has
demonstrated through documented financial information has been
reserved and will be expended by the sponsor for each residency
sponsored for the purpose of the residency program.
e. The maximum award of grant funds to a particular
individual sponsor per year. An individual sponsor shall not
receive more than twenty=five percent of the state matching
funds available each year to support the program. However,
if less than ninety=five percent of the available funds has
been awarded in a given year, a sponsor may receive more than
twenty=five percent of the state matching funds available
if total funds awarded do not exceed ninety=five percent of
the available funds. If more than one sponsor meets the
requirements of this section and has established, expanded,
or supported a graduate medical residency training program,
as specified in subsection 1, in excess of the sponsor's
twenty=five percent maximum share of state matching funds, the
state matching funds shall be divided proportionately among
such sponsors.
f. Use of the funds awarded. Funds may be used to pay the
costs of establishing, expanding, or supporting an accredited
graduate medical education program as specified in this
section, including but not limited to the costs associated with
residency stipends and physician faculty stipends.
Sec. 19. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
Sec. 20. APPLICABILITY. This division of this Act applies
retroactively to June 30, 2014.
DIVISION III
MEDICAL RESIDENCY TRAINING STATE MATCHING GRANTS PROGRAM ==
AMENDMENTS
Sec. 21. Section 135.176, as enacted in this Act, is amended
to read as follows:
135.176 Medical residency training state matching grants
program.
1. The department shall establish a medical residency
training state matching grants program to provide matching
state funding to sponsors of accredited graduate medical
education residency programs in this state to establish,
expand, or support medical residency training programs.
Funding for the program may be provided through the health
care workforce shortage fund or the medical residency training
account created in section 135.175. For the purposes of this
section, unless the context otherwise requires, "accredited"
means a graduate medical education program approved by the
accreditation council for graduate medical education or the
American osteopathic association. The grant funds may be
used to support medical residency programs through any of the
following:
a. The establishment of new or alternative campus accredited
medical residency training programs. For the purposes of
this paragraph, "new or alternative campus accredited medical
residency training program" means a program that is accredited
by a recognized entity approved for such purpose by the
accreditation council for graduate medical education or the
American osteopathic association with the exception that
a new medical residency training program that, by reason
of an insufficient period of operation is not eligible for
accreditation on or before the date of submission of an
application for a grant, may be deemed accredited if the
accreditation council for graduate medical education or the
American osteopathic association finds, after consultation with
the appropriate accreditation entity, that there is reasonable
assurance that the program will meet the accreditation
standards of the entity prior to the date of graduation of the
initial class in the program.
b. The provision of new residency positions within existing
accredited medical residency or fellowship training programs.
c. The funding of residency positions which are in excess of
the federal residency cap. For the purposes of this paragraph,
"in excess of the federal residency cap" means a residency
position for which no federal Medicare funding is available
because the residency position is a position beyond the cap for
residency positions established by the federal Balanced Budget
Act of 1997, Pub. L. No. 105=33.
2. The department shall adopt rules pursuant to chapter 17A
to provide for all of the following:
a. Eligibility requirements for and qualifications
of a sponsor of an accredited graduate medical education
residency program to receive a grant. The requirements and
qualifications shall include but are not limited to all of the
following:
(1) Only a sponsor that establishes a dedicated fund to
support a residency program that meets the specifications of
this section shall be eligible to receive a matching grant. A
sponsor funding residency positions in excess of the federal
residency cap, as defined in subsection 1, paragraph "c",
exclusive of funds provided under the medical residency
training state matching grants program established in this
section, is deemed to have satisfied this requirement and
shall be eligible for a matching grant equal to the amount of
funds expended for such residency positions, subject to the
limitation on the maximum award of grant funds specified in
paragraph "e".
(2) A sponsor shall demonstrate, through documented
financial information as prescribed by rule of the department,
that funds have been reserved budgeted and will be expended by
the sponsor in the amount required to provide matching funds
for each residency proposed in the request for state matching
funds.
(3) (2) A sponsor shall demonstrate, through objective
evidence as prescribed by rule of the department, a need for
such residency program in the state.
b. The application process for the grant.
c. Criteria for preference in awarding of the grants,
including preference in the residency specialty.
d. Determination of the amount of a grant. The total amount
of a grant awarded to a sponsor proposing the establishment
of a new or alternative campus accredited medical residency
training program as defined in subsection 1, paragraph "a",
shall be limited to no more than twenty=five one hundred
percent of the amount the sponsor has budgeted as demonstrated
under paragraph "a". The total amount of a grant awarded to
a sponsor proposing the provision of a new residency position
within an existing accredited medical residency or fellowship
training program as specified in subsection 1, paragraph "b"
or the funding of residency positions which are in excess of
the federal residency cap as defined in subsection 1, paragraph
"c", shall be limited to no more than twenty=five percent of
the amount that the sponsor has demonstrated through documented
financial information has been reserved and will be expended by
the sponsor budgeted for each residency position sponsored for
the purpose of the residency program.
e. The maximum award of grant funds to a particular
individual sponsor per year. An individual sponsor that
establishes a new or alternative campus accredited medical
residency training program as defined in subsection 1,
paragraph "a" shall not receive more than twenty=five fifty
percent of the state matching funds available each year to
support the program. However, if less than ninety=five percent
of the available funds has been awarded in a given year, a
sponsor may receive more than twenty=five percent of the
state matching funds available if total funds awarded do not
exceed ninety=five percent of the available funds. If more
than one sponsor meets the requirements of this section and
has established, expanded, or supported a graduate medical
residency training program, as specified in subsection 1, in
excess of the sponsor's twenty=five percent maximum share of
state matching funds, the state matching funds shall be divided
proportionately among such sponsors. An individual sponsor
proposing the provision of a new residency position within an
existing accredited medical residency or fellowship training
program as specified in subsection 1, paragraph "b" or the
funding of residency positions which are in excess of the
federal residency cap as defined in subsection 1, paragraph "c",
shall not receive more than twenty=five percent of the state
matching funds available each year to support the program.
f. Use of the funds awarded. Funds may be used to pay the
costs of establishing, expanding, or supporting an accredited
graduate medical education program as specified in this
section, including but not limited to the costs associated with
residency stipends and physician faculty stipends.
PAM JOCHUM
President of the Senate
KRAIG PAULSEN
Speaker of the House
I hereby certify that this bill originated in the Senate and
is known as Senate File 274, Eighty=sixth General Assembly.
MICHAEL E. MARSHALL
Secretary of the Senate
Approved , 2015
TERRY E. BRANSTAD
Governor
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