Bill Text: IA HF203 | 2015-2016 | 86th General Assembly | Enrolled

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: A bill for an act providing for the licensing of respiratory care and polysomnography practitioners and polysomnographic technologists and exceptions thereto, making penalties applicable, and including effective date provisions. Effective 7-1-15, with exception of section 3 effective 1-1-17.

Spectrum: Committee Bill

Status: (Passed) 2015-04-24 - Signed by Governor. H.J. 923. [HF203 Detail]

Download: Iowa-2015-HF203-Enrolled.html

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House File 203 - Enrolled




                              HOUSE FILE       
                              BY  COMMITTEE ON STATE
                                  GOVERNMENT

                              (SUCCESSOR TO HSB 75)
 \5
                                   A BILL FOR
 \1
                                         House File 203

                             AN ACT
 PROVIDING FOR THE LICENSING OF RESPIRATORY CARE AND
    POLYSOMNOGRAPHY PRACTITIONERS AND POLYSOMNOGRAPHIC
    TECHNOLOGISTS AND EXCEPTIONS THERETO, MAKING PENALTIES
    APPLICABLE, AND INCLUDING EFFECTIVE DATE PROVISIONS.

 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
    Section 1.  Section 135.24, subsection 2, paragraph a, Code
 2015, is amended to read as follows:
    a.  Procedures for registration of health care providers
 deemed qualified by the board of medicine, the board of
 physician assistants, the dental board, the board of nursing,
 the board of chiropractic, the board of psychology, the board
 of social work, the board of behavioral science, the board
 of pharmacy, the board of optometry, the board of podiatry,
 the board of physical and occupational therapy, the board of
 respiratory care and polysomnography, and the Iowa department
 of public health, as applicable.
    Sec. 2.  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, respiratory
 care and polysomnography practitioner, polysomnographic
 technologist, social worker, massage therapist, athletic
 trainer, acupuncturist, nursing home administrator, hearing aid
 dispenser, 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, polysomnography, social work, dietetics,
 massage therapy, athletic training, acupuncture, nursing
 home administration, hearing aid dispensing, sign language
 interpreting or transliterating, orthotics, prosthetics, or
 pedorthics.
    Sec. 3.  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, polysomnography,
  athletic training, acupuncture, nursing home administration,
 hearing aid dispensing, or sign language interpreting
 or transliterating, or shall not practice as a physician
 assistant, unless the person has obtained a license for that
 purpose from the board for the profession.
    Sec. 4.  Section 147.13, subsection 18, Code 2015, is amended
 to read as follows:
    18.  For respiratory care and polysomnography, the board of
 respiratory care and polysomnography.
    Sec. 5.  Section 147.14, subsection 1, paragraph o, Code
 2015, is amended to read as follows:
    o.  For respiratory care and polysomnography, one licensed
 physician with training in respiratory care, three two
  respiratory care practitioners who have practiced respiratory
 care for a minimum of six years immediately preceding their
 appointment to the board and who are recommended by the society
 for respiratory care, one polysomnographic technologist who
 has practiced polysomnography for a minimum of six years
 immediately preceding appointment to the board and who
 is recommended by the Iowa sleep society, and one member
 not licensed to practice medicine, osteopathic medicine,
 polysomnography, or respiratory care who shall represent the
 general public.
    Sec. 6.  Section 147.74, Code 2015, is amended by adding the
 following new subsection:
    NEW SUBSECTION.  23A.  A person who is licensed to engage in
 the practice of polysomnography shall have the right to use the
 title "polysomnographic technologist" or the letters "P.S.G.T."
 after the person's name. No other person may use that title
 or letters or any other words or letters indicating that the
 person is a polysomnographic technologist.
    Sec. 7.  NEW SECTION.  148G.1  Definitions.
    As used in this chapter, unless the context otherwise
 requires:
    1.  "Board" means the board of respiratory care and
 polysomnography established in chapter 147.
    2.  "Direct supervision" means that the respiratory care
 and polysomnography practitioner or the polysomnographic
 technologist providing supervision must be present where the
 polysomnographic procedure is being performed and immediately
 available to furnish assistance and direction throughout the
 performance of the procedure.
    3.  "General supervision" means that the polysomnographic
 procedure is provided under a physician's or qualified health
 care professional prescriber's overall direction and control,
 but the physician's or qualified health care professional
 prescriber's presence is not required during the performance
 of the procedure.
    4.  "Physician" means a person who is currently licensed in
 Iowa to practice medicine and surgery or osteopathic medicine
 and surgery and who is board certified and who is actively
 involved in the sleep medicine center or laboratory.
    5.  "Polysomnographic student" means a person who is
 enrolled in a program approved by the board and who may
 provide sleep=related services under the direct supervision
 of a respiratory care and polysomnography practitioner or
 a polysomnographic technologist as a part of the person's
 educational program.
    6.  "Polysomnographic technician" means a person who has
 graduated from a program approved by the board, but has not
 yet received an accepted national credential awarded from an
 examination program approved by the board and who may provide
 sleep=related services under the direct supervision of a
 licensed respiratory care and polysomnography practitioner or a
 licensed polysomnographic technologist for a period of up to
 thirty days following graduation while awaiting credentialing
 examination scheduling and results.
    7.  "Polysomnographic technologist" means a person licensed
 by the board to engage in the practice of polysomnography under
 the general supervision of a physician or a qualified health
 care professional prescriber.
    8.  "Practice of polysomnography" means as described in
 section 148G.2.
    9.  "Qualified health care practitioner" means an individual
 who is licensed under section 147.2, and who holds a
 credential listed on the board of registered polysomnographic
 technologists list of accepted allied health credentials.
    10.  "Qualified health care professional prescriber" means a
 physician assistant operating under the prescribing authority
 granted in section 147.107 or an advanced registered nurse
 practitioner operating under the prescribing authority granted
 in section 147.107.
    11.  "Sleep=related services" means acts performed by
 polysomnographic technicians, polysomnographic students, and
 other persons permitted to perform those services under this
 chapter, in a setting described in this chapter that would
 be considered the practice of polysomnography if performed
 by a respiratory care and polysomnography practitioner or a
 polysomnographic technologist.
    Sec. 8.  NEW SECTION.  148G.2  Practice of polysomnography.
    The practice of polysomnography consists of but is not
 limited to the following tasks as performed for the purpose of
 polysomnography, under the general supervision of a licensed
 physician or qualified health care professional prescriber:
    1.  Monitoring, recording, and evaluating physiologic
 data during polysomnographic testing and review during the
 evaluation of sleep=related disorders, including sleep=related
 respiratory disturbances, by applying any of the following
 techniques, equipment, or procedures:
    a.  Noninvasive continuous, bilevel positive airway pressure,
 or adaptive servo=ventilation titration on spontaneously
 breathing patients using a mask or oral appliance; provided,
 that the mask or oral appliance does not extend into the
 trachea or attach to an artificial airway.
    b.  Supplemental low=flow oxygen therapy of less than six
 liters per minute, utilizing a nasal cannula or incorporated
 into a positive airway pressure device during a polysomnogram.
    c.  Capnography during a polysomnogram.
    d.  Cardiopulmonary resuscitation.
    e.  Pulse oximetry.
    f.  Gastroesophageal pH monitoring.
    g.  Esophageal pressure monitoring.
    h.  Sleep stage recording using surface
 electroencephalography, surface electrooculography, and surface
 submental electromyography.
    i.  Surface electromyography.
    j.  Electrocardiography.
    k.  Respiratory effort monitoring, including thoracic and
 abdominal movement.
    l.  Plethysmography blood flow monitoring.
    m.  Snore monitoring.
    n.  Audio and video monitoring.
    o.  Body movement monitoring.
    p.  Nocturnal penile tumescence monitoring.
    q.  Nasal and oral airflow monitoring.
    r.  Body temperature monitoring.
    2.  Monitoring the effects that a mask or oral appliance
 used to treat sleep disorders has on sleep patterns; provided,
 however, that the mask or oral appliance shall not extend into
 the trachea or attach to an artificial airway.
    3.  Observing and monitoring physical signs and symptoms,
 general behavior, and general physical response to
 polysomnographic evaluation and determining whether initiation,
 modification, or discontinuation of a treatment regimen is
 warranted.
    4.  Analyzing and scoring data collected during the
 monitoring described in this section for the purpose of
 assisting a physician in the diagnosis and treatment of sleep
 and wake disorders that result from developmental defects,
 the aging process, physical injury, disease, or actual or
 anticipated somatic dysfunction.
    5.  Implementation of a written or verbal order from a
 physician or qualified health care professional prescriber to
 perform polysomnography.
    6.  Education of a patient regarding the treatment regimen
 that assists the patient in improving the patient's sleep.
    7.  Use of any oral appliance used to treat sleep=disordered
 breathing while under the care of a licensed polysomnographic
 technologist during the performance of a sleep study, as
 directed by a licensed dentist.
    Sec. 9.  NEW SECTION.  148G.3  Location of services.
    The practice of polysomnography shall take place only in a
 facility that is accredited by a nationally recognized sleep
 medicine laboratory or center accrediting agency, in a facility
 operated by a hospital or a hospital licensed under chapter
 135B, or in a patient's home pursuant to rules adopted by the
 board; provided, however, that the scoring of data and the
 education of patients may take place in another setting.
    Sec. 10.  NEW SECTION.  148G.4  Scope of chapter.
    Nothing in this chapter shall be construed to limit or
 restrict a health care practitioner licensed in this state from
 engaging in the full scope of practice of the individual's
 profession.
    Sec. 11.  NEW SECTION.  148G.5  Rulemaking.
    The board shall adopt rules necessary for the implementation
 and administration of this chapter and the applicable
 provisions of chapters 147 and 272C.
    Sec. 12.  NEW SECTION.  148G.6  Licensing requirements.
    1.  Beginning January 1, 2017, a person seeking licensure
 as a respiratory care and polysomnography practitioner or
 as a polysomnographic technologist shall apply to the board
 and pay the fees established by the board for the type of
 license for which the applicant is applying. Beginning with
 the March 31, 2016, license renewal period, a person licensed
 as a respiratory care practitioner who seeks a respiratory
 care and polysomnography practitioner license shall make such
 application with the application for license renewal and pay
 the fees established by the board. The fees established by the
 board for a respiratory care and polysomnography practitioner
 license shall not exceed one hundred twenty percent of the cost
 of a respiratory care practitioner license issued pursuant to
 chapter 152B or a polysomnographic technologist license issued
 pursuant to this section. The application for a respiratory
 care and polysomnography practitioner license must meet the
 requirements of this section. Upon receipt of an application,
 the board shall conduct a background check of the applicant.
 An application for either type of licensure shall show that the
 applicant is of good moral character and is at least eighteen
 years of age, and shall include proof that the person has
 satisfied one of the following educational requirements:
    a.  Graduation from a polysomnographic educational program
 that is accredited by the committee on accreditation for
 polysomnographic technologist education or an equivalent
 program as determined by the board.
    b.  Graduation from a respiratory care educational program
 that is accredited by the commission on accreditation for
 respiratory care or by a committee on accreditation for
 the commission on accreditation of allied health education
 programs, and any of the following:
    (1)  Completion of the curriculum for a polysomnographic
 certificate established and accredited by the commission
 on accreditation of allied health education programs as an
 extension of the respiratory care program.
    (2)  Obtaining the sleep disorder specialist credential from
 the national board for respiratory care.
    (3)  Obtaining the registered polysomnographic technologist
 credential from the board of registered polysomnographic
 technologists.
    (4)  Completing or obtaining any other certificate or
 credential program as recognized by the board.
    c.  Graduation from an electroneurodiagnostic technologist
 educational program that is accredited by the committee
 on accreditation for education in electroneurodiagnostic
 technology or by a committee on accreditation for the
 commission on accreditation of allied health education
 programs, and completion of the curriculum for a
 polysomnographic certificate established and accredited by the
 commission on accreditation of allied health education programs
 as an extension of the electroneurodiagnostic educational
 program or an equivalent program as determined by the board.
    2.  Notwithstanding subsection 1, beginning January 1, 2017,
 the board shall issue a license to perform polysomnography to
 an individual who holds an active license under section 147.2
 in a profession other than polysomnography and who is in good
 standing with the board for that profession upon application to
 the board demonstrating any of the following:
    a.  Successful completion of an educational program in
 polysomnography approved by the board.
    b.  Successful completion of an examination in
 polysomnography approved by the board.
    c.  Verification from the medical director of the
 individual's current employer or the medical director's
 designee that the individual has completed on=the=job
 training in the field of polysomnography, along with written
 verification from the medical director of the individual's
 current employer or the medical director's designee that the
 individual is competent to perform polysomnography.
    3.  Notwithstanding subsection 1, beginning January 1,
 2017, a person who is working in the field of sleep medicine
 on January 1, 2017, may apply to the board for a license to
 perform polysomnography. The board shall issue a license to
 the person, without examination, provided the application
 contains verification that the person has completed five
 hundred hours of paid clinical or nonclinical polysomnographic
 work experience within the three years prior to submission
 of the application. The application shall also contain
 verification from the medical director of the person's current
 employer or the medical director's designee that the person is
 competent to perform polysomnography.
    4.  A person who is working in the field of sleep medicine
 on January 1, 2017, who is not otherwise eligible to obtain
 a license pursuant to this section shall have until January
 1, 2018, to achieve a passing score on an examination as
 designated by the board. The board shall allow the person
 to attempt the examination and be awarded a license as a
 polysomnographic technologist by meeting or exceeding the
 passing point established by the board. After January 1, 2018,
 only persons licensed as respiratory care and polysomnography
 practitioners or as polysomnographic technologists pursuant to
 this chapter, or excepted from the requirements of this chapter
 may perform sleep=related services.
    5.  The fees assessed by the board shall be sufficient to
 cover all costs associated with the administration of this
 chapter.
    Sec. 13.  NEW SECTION.  148G.7  Persons exempt from licensing
 requirement.
    1.  The following persons may provide sleep=related
 services without being licensed as a respiratory care
 and polysomnography practitioner or as a polysomnographic
 technologist under this chapter:
    a.  A qualified health care practitioner may provide
 sleep=related services under the direct supervision of a
 licensed respiratory care and polysomnography practitioner or
 a licensed polysomnographic technologist for a period of up
 to six months while gaining the clinical experience necessary
 to meet the admission requirements for a polysomnographic
 credentialing examination. The board may grant a one=time
 extension of up to six months.
    b.  A polysomnographic student may provide sleep=related
 services under the direct supervision of a respiratory care and
 polysomnography practitioner or a polysomnographic technologist
 as a part of the student's educational program while actively
 enrolled in a polysomnographic educational program that is
 accredited by the commission on accreditation of allied health
 education programs or an equivalent program as determined by
 the board.
    2.  Before providing any sleep=related services, a
 polysomnographic technician or polysomnographic student who
 is obtaining clinical experience shall give notice to the
 board that the person is working under the direct supervision
 of a respiratory care and polysomnography practitioner or a
 polysomnographic technologist in order to gain the experience
 to be eligible to sit for a national certification examination.
 The person shall wear a badge that appropriately identifies the
 person while providing such services.
    Sec. 14.  NEW SECTION.  148G.8  Licensing sanctions.
    The board may impose sanctions for violations of this
 chapter as provided in chapters 147 and 272C.
    Sec. 15.  Section 152B.1, subsection 1, Code 2015, is amended
 to read as follows:
    1.  "Board" means the board of respiratory care and
 polysomnography created under chapter 147.
    Sec. 16.  Section 272C.1, subsection 6, paragraph z, Code
 2015, is amended to read as follows:
    z.  The board of respiratory care and polysomnography in
 licensing respiratory care practitioners pursuant to chapter
 152B, respiratory care and polysomnography practitioners
 pursuant to chapter 152B, and polysomnographic technologists
 pursuant to chapter 148G.
    Sec. 17.  INITIAL APPOINTMENT OF POLYSOMNOGRAPHIC
 TECHNOLOGIST TO BOARD.  For the initial appointment of the
 polysomnographic member to the board of respiratory care and
 polysomnography pursuant to section 147.14, as amended in this
 Act, such appointee must be eligible for licensure pursuant to
 this Act. The appointment shall be effective upon the first
 expiration of the term of an existing respiratory care board
 member which occurs after the effective date of this section
 of this Act.
    Sec. 18.  EFFECTIVE DATE.  The following provision or
 provisions of this Act take effect January 1, 2017:
    1.  The section of this Act amending section 147.2,
 subsection 1.


                                                             
                               KRAIG PAULSEN
                               Speaker of the House


                                                             
                               PAM JOCHUM
                               President of the Senate
    I hereby certify that this bill originated in the House and
 is known as House File 203, Eighty=sixth General Assembly.


                                                             
                               CARMINE BOAL
                               Chief Clerk of the House
 Approved                , 2015


                                                             
                               TERRY E. BRANSTAD
                               Governor

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