Bill Text: IA HF2053 | 2023-2024 | 90th General Assembly | Introduced

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Bill Title: A bill for an act relating to the cardiac health of children, and providing for licensee discipline and civil penalties.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2024-01-16 - Introduced, referred to State Government. H.J. 92. [HF2053 Detail]

Download: Iowa-2023-HF2053-Introduced.html

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House File 2053 - Introduced
HOUSE FILE 2053
BY JACOBY
A BILL FOR
An Act relating to the cardiac health of children, and
providing for licensee discipline and civil penalties.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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Section 1. NEW SECTION . 147.165 Definitions.
As used in sections 147.166 through 147.168:
1. “Health care provider” means an individual licensed under
chapter 148 to practice medicine and surgery or osteopathic
medicine and surgery, a physician assistant licensed under
chapter 148C, a chiropractor licensed under chapter 151, an
advanced registered nurse practitioner licensed under chapter
152, or an advanced practice registered nurse under chapter
152E.
2. “Nonpublic school” means any school, other than a public
school, which is accredited pursuant to section 256.11.
3. “Public school” means any school directly supported in
whole or in part by taxation.
Sec. 2. NEW SECTION . 147.166 Child cardiac health ——
development of child cardiac health evaluation form, childhood
cardiac screening professional development training module, and
child cardiac health education pamphlet.
1. No later than October 1, 2024, the department of health
and human services in collaboration with the department of
education shall do all of the following:
a. Develop a child cardiac health evaluation form that
incorporates all of the following:
(1) The questions that evaluate a child’s family
history related to cardiac conditions contained in the Iowa
preparticipation physical evaluation form that is based on
the most recent edition of the preparticipation physical
evaluation developed jointly by the American academy of family
physicians, American academy of pediatrics, American college of
sports medicine, American medical society for sports medicine,
American orthopedic society for sports medicine, and American
osteopathic academy of sports medicine.
(2) The questions included in the American heart
association’s fourteen point screening for heart disease in the
young.
(3) Questions regarding the biologic heart health history
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H.F. 2053
of the child including the history of any biological parent.
(4) The four questions recommended by the American academy
of pediatrics to identify children who may be at risk for
sudden cardiac arrest or sudden cardiac death as published in
the July 2021 issue of “Pediatrics”.
b. Develop a childhood cardiac screening professional
development training module for health care providers.
(1) The module shall be developed by the department of
health and human services and the department of education in
consultation with representatives of the Iowa chapter of the
American academy of pediatrics, the Iowa academy of family
physicians, the American heart association, and the Iowa
chapter of the American college of cardiology.
(2) The module shall include but is not limited to all of
the following:
(a) How to complete and review a detailed medical history
with an emphasis on cardiovascular family history and personal
reports of symptoms.
(b) Identifying symptoms of sudden cardiac arrest that may
require follow up with a cardiologist.
(c) Recognizing normal structural changes of the athletic
heart.
(d) Recognizing prodromal symptoms that precede sudden
cardiac arrest.
(e) Performing the cardiovascular physical examination.
(f) Reviewing the major etiologies of sudden unexplained
cardiac death with an emphasis on structural abnormalities and
acquired conditions.
(g) When to refer a child to a cardiologist for further
assessment.
(3) The module shall require a health care provider to read
the child cardiac health education pamphlet developed under
paragraph “c” every four years, or more frequently following
revision of the pamphlet as prescribed by rule.
c. Develop a child cardiac health education pamphlet for
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health care providers, students, parents, and guardians.
(1) The department of health and human services and
the department of education shall develop the pamphlet in
consultation with the American heart association and the Iowa
chapter of the American academy of pediatrics.
(2) The pamphlet shall provide information about the
causes of sudden cardiac arrest in children, and shall include
an explanation of sudden cardiac arrest, its incidence, a
description of early warning signs, and an overview of the
options that are available to screen for cardiac conditions
that may lead to sudden cardiac arrest, including a statement
about the limitations of these options.
(3) The department of health and human services and
the department of education shall update the pamphlet as
necessary to include the most current best practices, and shall
distribute the pamphlet at no charge to all public schools
and nonpublic schools throughout the state for subsequent
distribution to students and parents or guardians.
Sec. 3. NEW SECTION . 147.167 Child cardiac health ——
annual well-child visit examinations and child cardiac health
evaluation form —— required professional development —— license
requirements.
1. Beginning January 1, 2025, all of the following shall
apply:
a. A health care provider who performs annual well-child
visit examinations of children nineteen years of age or younger
shall include as part of the examination completion of the
child cardiac health evaluation form developed pursuant to
section 147.166.
b. A health care provider who performs annual well-child
visit examinations or Iowa preparticipation physical
evaluations of children nineteen years of age or younger
shall complete the childhood cardiac screening professional
development training module developed pursuant to section
147.166.
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c. A health care provider who is under contract with a
public school or nonpublic school to provide medical care
to children nineteen years of age or younger shall complete
and sign a certificate as part of the contract attesting to
completion of the childhood cardiac screening professional
development training module.
d. A health care provider who completes the childhood
cardiac screening professional development training module as
required under this section shall retain the original signed
certificate of completion and shall make a copy of the signed
certificate of completion available to the department upon
request.
2. Beginning July 1, 2025, the license of a health care
provider who performs annual well-child visit examinations or
Iowa preparticipation physical evaluations of children nineteen
years of age or younger, shall not be issued or renewed unless
the health care provider completes and attests to completion
of the childhood cardiac screening professional development
training module.
Sec. 4. NEW SECTION . 147.168 Database —— report.
1. A health care provider who performs annual well-child
examinations for children nineteen years of age or younger,
including the required completion of the child cardiac health
evaluation form, shall report annually to the department
the number of such examinations performed and the number of
children referred to a cardiologist as the result of such
examinations. The department shall maintain the data for ten
years following each annual report.
2. The department shall report annually to the governor and
the general assembly on the outcomes of the requirements of
sections 147.166 and 147.167, and shall post the annual report
on the department’s internet site.
Sec. 5. NEW SECTION . 147.169 Childhood cardiac health
requirements for health care providers —— civil penalties ——
licensee discipline —— Medicaid reimbursement.
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1. A health care provider required to complete the childhood
cardiac screening professional development training module
under section 147.166 who fails to produce a certificate of
completion of the module upon request by the department is
subject to a civil penalty established by the department by
rule.
2. A health care provider required to complete the
childhood cardiac screening professional development training
module under section 147.166 who fails to do so is subject to
professional discipline.
3. A health care provider shall not be eligible as an
enrolled Medicaid provider and entitled to reimbursement
for completion of a well-child visit examination or an Iowa
preparticipation physical evaluation for a child nineteen years
of age or younger unless the health care provider has completed
the childhood cardiac screening professional development
training module as required under section 147.166.
Sec. 6. NEW SECTION . 147.170 Administrative rules.
The department, in consultation with the departments of
health and human services and education, shall adopt rules
pursuant to chapter 17A to administer sections 147.165 through
147.169.
Sec. 7. NEW SECTION . 280.13D Child cardiac health policies.
1. The department of education in consultation with the
department of health and human services shall ensure that
the Iowa preparticipation physical evaluation form utilized
beginning with the 2025-2026 school year be expanded to include
all of the following information and be made available to all
public and nonpublic schools:
a. All of the information included in the Iowa
preparticipation physical evaluation form as updated for the
2022-2023 school year.
b. The questions included in the American heart
association’s fourteen point screening for heart disease in the
young.
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c. Questions regarding the biologic heart health history of
the child including the history of any biological parent.
d. The four questions recommended by the American academy of
pediatrics to identify children who may be at risk for sudden
cardiac arrest or sudden cardiac death as published in the July
2021 issue of “Pediatrics”.
e. A certificate form to be completed by the health care
provider attesting that the health care provider has completed
the childhood cardiac screening professional development
training module as required pursuant to section 147.167.
2. Beginning with the 2025-2026 school year, and in each
subsequent school year, all of the following shall apply:
a. Prior to participating, all students enrolled in
kindergarten through grade twelve who participate in an
interscholastic activity or intramural activity shall complete
and present to the superintendent of the public school
district or the authorities in charge of the nonpublic school a
completed Iowa preparticipation physical evaluation form.
b. Each public school and nonpublic school shall distribute
the child cardiac health education pamphlet developed pursuant
to section 147.166 to each student who completes the Iowa
preparticipation physical evaluation form and to each student’s
parent or guardian.
c. A health care provider who performs an Iowa
preparticipation physical evaluation shall sign the certificate
included in the Iowa preparticipation physical evaluation form
attesting to completion of the childhood cardiac screening
professional development training module, and shall provide
a copy of the signed certificate to the student’s school
district or accredited nonpublic school. The school district
or accredited nonpublic school shall retain the copy of the
signed certificate and the health care provider shall retain
the original signed certificate in the health care provider’s
records.
3. For the purposes of this section:
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a. “Health care provider” means the same as defined in
section 147.165.
b. “Interscholastic activity” means any dance or
cheerleading activity, contest, or practice that is a contact
or limited contact activity as identified by the American
academy of pediatrics that involves students of different
public schools or nonpublic schools.
c. “Intramural activity” means any dance or cheerleading
activity, contest, or practice that is a contact or limited
contact activity as identified by the American academy of
pediatrics that involves the students of the same public school
or nonpublic school.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
This bill incorporates provisions of the healthy cardiac
monitoring Act proposed by the hypertrophic cardiomyopathy
association to ensure the cardiovascular health needs of all
children, including student athletes, are met and that health
care providers are trained to meet those needs.
The bill defines “health care provider” (provider) to mean a
person licensed to practice medicine and surgery or osteopathic
medicine and surgery, a licensed physician assistant, a
licensed chiropractor, a licensed advanced registered nurse
practitioner, or an advanced practice registered nurse.
“Nonpublic school” and “public school” are also defined in the
bill.
The bill requires that by October 1, 2024, the department
of health and human services (HHS) in collaboration with the
department of education (DE) take certain actions relating to
child cardiac health. The departments are required to develop
a child cardiac health evaluation form that incorporates the
questions that evaluate a child’s family history related to
cardiac conditions contained in the Iowa preparticipation
physical evaluation form; the questions included in the
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American heart association’s 14 point screening for heart
disease in the young; questions regarding the biologic heart
health history of the child including the history of any
biological parent; and the four questions recommended by the
American academy of pediatrics to identify children who may be
at risk for sudden cardiac arrest or sudden cardiac death. The
departments are also required to develop a childhood cardiac
screening professional development training module (module) for
providers and a child cardiac health education pamphlet to be
included in the module. The pamphlet must also be distributed
to public and nonpublic schools for further distribution to
students and parents or guardians of students.
The bill requires that beginning January 1, 2025, a provider
who performs an annual well-child visit examination of a
child 19 years of age or younger to include as part of that
examination completion of the child cardiac health evaluation
form; requires a provider who performs an annual well-child
visit examination or an Iowa preparticipation physical
evaluation (athlete physical) of a child 19 years of age or
younger to complete the module; requires a provider who is
under contract with a public school or nonpublic school to
provide medical care to children 19 years of age or younger
to complete and to provide a signed certificate attesting to
completion of the module as part of the contract; and requires
a provider who completes the required module to retain the
signed original of the certificate of completion and to make
a copy of the certificate available to the department of
inspections, appeals, and licensing (DIAL) upon request. The
bill also provides that beginning July 1, 2025, the license of
a provider who performs annual well-child visit examinations
or athlete physicals of children 19 years of age or younger
shall not be issued or renewed unless the provider completes
and attests to completion of the module.
The bill requires a provider who performs annual well-child
visit examinations for children 19 years of age or younger,
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including the required completion of the child cardiac health
evaluation form, to annually report to DIAL the number of
examinations performed and the number of children referred to
a cardiologist. DIAL is required to maintain the data for
10 years following each annual report, to report annually to
the governor and the general assembly on the outcomes of the
requirements of the bill, and to post the annual report on the
department’s internet site.
The bill provides that a provider required to complete the
module who fails to produce a certificate of completion upon
request by DIAL is subject to a civil penalty established by
DIAL by rule. A provider required to complete the module who
fails to do so is also subject to professional discipline.
Additionally, a provider shall not be eligible as an enrolled
Medicaid provider and entitled to reimbursement for completion
of a well-child visit examination or an athlete physical unless
the provider has completed the required module.
The bill also includes child cardiac health policies in
Code chapter 280 (uniform school requirements). The bill
requires DE, in consultation with HHS, to ensure that the
Iowa preparticipation physical evaluation form be expanded to
include certain child cardiac health information and be made
available to all public and nonpublic schools. The additional
required information is detailed in the bill.
The bill requires that beginning with the 2025-2026
school year, and in each subsequent school year, prior to
participating, all students enrolled in kindergarten through
grade 12 who participate in interscholastic activities or
intramural activities, as defined in the bill, shall complete
and present to the superintendent of the public school district
or the authorities in charge of the nonpublic school the
completed Iowa preparticipation physical evaluation form; that
each public school and nonpublic school distribute the child
cardiac health education pamphlet to each student and to each
student’s parent or guardian who completes the evaluation form;
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and that a provider who performs an athlete physical complete
the certificate included in the evaluation form attesting to
completion of the module and provide a copy of the signed
certificate to the student’s school district or accredited
nonpublic school. The school district or the accredited
nonpublic school must retain the copy of the signed certificate
and the provider must retain the original.
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