House File 193 - Introduced




                                 HOUSE FILE       
                                 BY  COMMITTEE ON HUMAN
                                     RESOURCES

                                 (SUCCESSOR TO HSB 83)

                                      A BILL FOR

  1 An Act relating to programs and services under the purview
  2    of the department of public health including the board of
  3    hearing aid dispensers and the medical residency training
  4    matching grants program and including effective date and
  5    retroactive applicability provisions.
  6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN



  1  1                           DIVISION I
  1  2                     HEARING AID SPECIALISTS
  1  3    Section 1.  Section 147.1, subsections 3 and 6, Code 2015,
  1  4 are amended to read as follows:
  1  5    3.  "Licensed" or "certified", when applied to a physician
  1  6 and surgeon, podiatric physician, osteopathic physician and
  1  7 surgeon, physician assistant, psychologist, chiropractor,
  1  8 nurse, dentist, dental hygienist, dental assistant,
  1  9 optometrist, speech pathologist, audiologist, pharmacist,
  1 10 physical therapist, physical therapist assistant, occupational
  1 11 therapist, occupational therapy assistant, orthotist,
  1 12 prosthetist, pedorthist, respiratory care practitioner,
  1 13 practitioner of cosmetology arts and sciences, practitioner
  1 14 of barbering, funeral director, dietitian, marital and family
  1 15 therapist, mental health counselor, social worker, massage
  1 16 therapist, athletic trainer, acupuncturist, nursing home
  1 17 administrator, hearing aid dispenser specialist, or sign
  1 18 language interpreter or transliterator means a person licensed
  1 19 under this subtitle.
  1 20    6.  "Profession" means medicine and surgery, podiatry,
  1 21 osteopathic medicine and surgery, practice as a physician
  1 22 assistant, psychology, chiropractic, nursing, dentistry,
  1 23 dental hygiene, dental assisting, optometry, speech pathology,
  1 24 audiology, pharmacy, physical therapy, physical therapist
  1 25 assisting, occupational therapy, occupational therapy
  1 26 assisting, respiratory care, cosmetology arts and sciences,
  1 27 barbering, mortuary science, marital and family therapy, mental
  1 28 health counseling, social work, dietetics, massage therapy,
  1 29 athletic training, acupuncture, nursing home administration,
  1 30 practice as a hearing aid dispensing specialist, sign language
  1 31 interpreting or transliterating, orthotics, prosthetics, or
  1 32 pedorthics.
  1 33    Sec. 2.  Section 147.2, subsection 1, Code 2015, is amended
  1 34 to read as follows:
  1 35    1.  A person shall not engage in the practice of medicine
  2  1 and surgery, podiatry, osteopathic medicine and surgery,
  2  2 psychology, chiropractic, physical therapy, physical
  2  3 therapist assisting, nursing, dentistry, dental hygiene,
  2  4 dental assisting, optometry, speech pathology, audiology,
  2  5 occupational therapy, occupational therapy assisting,
  2  6 orthotics, prosthetics, pedorthics, respiratory care,
  2  7 pharmacy, cosmetology arts and sciences, barbering, social
  2  8 work, dietetics, marital and family therapy or mental health
  2  9 counseling, massage therapy, mortuary science, athletic
  2 10 training, acupuncture, nursing home administration, hearing aid
  2 11 dispensing, or sign language interpreting or transliterating,
  2 12 or shall not practice as a physician assistant or a hearing aid
  2 13 specialist, unless the person has obtained a license for that
  2 14 purpose from the board for the profession.
  2 15    Sec. 3.  Section 147.13, subsection 22, Code 2015, is amended
  2 16 to read as follows:
  2 17    22.  For hearing aid dispensing specialists, the board of
  2 18 hearing aid dispensers specialists.
  2 19    Sec. 4.  Section 147.14, subsection 1, paragraph v, Code
  2 20 2015, is amended to read as follows:
  2 21    v.  For hearing aid dispensers specialists, three licensed
  2 22 hearing aid dispensers specialists and two members who are not
  2 23 licensed hearing aid dispensers specialists who shall represent
  2 24 the general public. No more than two members of the board
  2 25 shall be employees of, or dispensers specialists principally
  2 26 for, the same hearing aid manufacturer.
  2 27    Sec. 5.  Section 154A.1, subsections 1, 3, 6, 7, and 9, Code
  2 28 2015, are amended to read as follows:
  2 29    1.  "Board" means the board of hearing aid dispensers
  2 30  specialists.
  2 31    3.  "Dispense" or "sell" means a transfer of title or of
  2 32 the right to use by lease, bailment, or any other means,
  2 33 but excludes a wholesale transaction with a distributor or
  2 34 dispenser hearing aid specialist, and excludes the temporary,
  2 35 charitable loan or educational loan of a hearing aid without
  3  1 remuneration.
  3  2    6.  "Hearing aid fitting" means the measurement of
  3  3 human hearing by any means for the purpose of selections,
  3  4 adaptations, and sales of hearing aids, and the instruction and
  3  5 counseling pertaining thereto to the selections, adaptations,
  3  6 and sales of hearing aids, and demonstration of techniques in
  3  7 the use of hearing aids, and the making of earmold impressions
  3  8 as part of the fitting of hearing aids.
  3  9    7.  "License" means a license issued by the state under this
  3 10 chapter to a hearing aid dispensers specialist.
  3 11    9.  "Temporary permit" means a permit issued while the
  3 12 applicant is in training to become a licensed hearing aid
  3 13 dispenser specialist.
  3 14    Sec. 6.  Section 154A.1, subsection 5, Code 2015, is amended
  3 15 by striking the subsection.
  3 16    Sec. 7.  Section 154A.1, Code 2015, is amended by adding the
  3 17 following new subsection:
  3 18    NEW SUBSECTION.  6A.  "Hearing aid specialist" means any
  3 19 person engaged in the fitting, dispensing, and sale of hearing
  3 20 aids and providing hearing aid services or maintenance, by
  3 21 means of procedures stipulated by this chapter or the board.
  3 22    Sec. 8.  Section 154A.13, Code 2015, is amended to read as
  3 23 follows:
  3 24    154A.13  Temporary permit.
  3 25    A person who has not been licensed as a hearing aid dispenser
  3 26  specialist may obtain a temporary permit from the department
  3 27 upon completion of the application accompanied by the written
  3 28 verification of employment from a licensed hearing aid
  3 29 dispenser specialist. The department shall issue a temporary
  3 30 permit for one year which shall not be renewed or reissued.
  3 31 The fee for issuance of the temporary permit shall be set by
  3 32 the board in accordance with the provisions for establishment
  3 33 of fees in section 147.80. The temporary permit entitles an
  3 34 applicant to engage in the fitting or selection and sale of
  3 35 hearing aids under the supervision of a person holding a valid
  4  1 license.
  4  2    Sec. 9.  Section 154A.19, Code 2015, is amended to read as
  4  3 follows:
  4  4    154A.19  Exceptions.
  4  5    1.  This chapter shall not prohibit a corporation,
  4  6 partnership, trust, association, or other organization
  4  7 maintaining an established business address from engaging in
  4  8 the business of selling or offering for sale hearing aids at
  4  9 retail without a license if it employs only licensed hearing
  4 10 aid dispensers specialists in the direct fitting or selection
  4 11 and sale of hearing aids. Such an organization shall file
  4 12 annually with the board a list of all licensed hearing aid
  4 13 dispensers specialists and persons holding temporary permits
  4 14 directly or indirectly employed by it. Such an organization
  4 15 shall also file with the board a statement on a form approved
  4 16 by the board that the organization submits itself to the rules
  4 17 and regulations of the board and the provisions of this chapter
  4 18 which the department deems applicable.
  4 19    2.  This chapter shall not apply to a person who engages
  4 20 in the practices covered by this chapter if this activity is
  4 21 part of the academic curriculum of an accredited institution of
  4 22 higher education, or part of a program conducted by a public
  4 23 or charitable institution, or nonprofit organization, unless
  4 24 the institution or organization also dispenses or sells hearing
  4 25 aids.
  4 26    3.  This chapter shall not prevent any person from engaging
  4 27 in practices covered by this chapter, provided the person, or
  4 28 organization employing the person, does not dispense or sell
  4 29 hearing aids.
  4 30    Sec. 10.  Section 154A.20, Code 2015, is amended to read as
  4 31 follows:
  4 32    154A.20  Rights of purchaser.
  4 33    1.  A hearing aid dispenser specialist shall deliver, to
  4 34 each person supplied with a hearing aid, a receipt which
  4 35 contains the licensee's signature and shows the licensee's
  5  1 business address and the number of the license, together with
  5  2 specifications as to the make, model, and serial number of the
  5  3 hearing aid furnished, and full terms of sale clearly stated,
  5  4 including the date of consummation of the sale of the hearing
  5  5 aid. If a hearing aid is sold which is not new, the receipt and
  5  6 the container must be clearly marked "used" or "reconditioned",
  5  7 with the terms of guarantee, if any.
  5  8    2.  The receipt shall bear the following statement in type no
  5  9 smaller than the largest used in the body copy portion of the
  5 10 receipt:
  5 11 The purchaser has been advised that any examination or
  5 12 representation made by a licensed hearing aid dispenser
  5 13  specialist in connection with the fitting or selection and
  5 14 selling of this hearing aid is not an examination, diagnosis,
  5 15 or prescription by a person licensed to practice medicine in
  5 16 this state and therefore, must not be regarded as medical
  5 17 opinion or advice.
  5 18    3.  Whenever any of the following conditions are found to
  5 19 exist either from observations by the licensed hearing aid
  5 20 dispenser specialist or person holding a temporary permit or on
  5 21 the basis of information furnished by a prospective hearing aid
  5 22 user, the hearing aid dispenser specialist or person holding a
  5 23 temporary permit shall, prior to fitting and selling a hearing
  5 24 aid to any individual, suggest to that individual in writing
  5 25 that the individual's best interests would be served if the
  5 26 individual would consult a licensed physician specializing
  5 27 in diseases of the ear, or if no such licensed physician is
  5 28 available in the community, then a duly licensed physician:
  5 29    a.  Visible congenital or traumatic deformity of the ear.
  5 30    b.  History of, or active drainage from the ear within the
  5 31 previous ninety days.
  5 32    c.  History of sudden or rapidly progressive hearing loss
  5 33 within the previous ninety days.
  5 34    d.  Acute or chronic dizziness.
  5 35    e.  Unilateral hearing loss of sudden or recent onset within
  6  1 the previous ninety days.
  6  2    f.  Significant air=bone gap (greater greater than or equal
  6  3 to 15dB ANSI 500, 1000 and 2000 Hz. average) average.
  6  4    g.  Obstruction of the ear canal, by structures of
  6  5 undetermined origin, such as foreign bodies, impacted cerumen,
  6  6 redness, swelling, or tenderness from localized infections of
  6  7 the otherwise normal ear canal.
  6  8    4.  A copy of the written recommendation shall be retained by
  6  9 the licensed hearing aid dispenser specialist for the period
  6 10 of seven years. A person receiving the written recommendation
  6 11 who elects to purchase a hearing aid shall sign a receipt for
  6 12 the same, and the receipt shall be kept with the other papers
  6 13 retained by the licensed hearing aid dispenser specialist for
  6 14 the period of seven years. Nothing in this section required
  6 15 to be performed by a licensed hearing aid dispenser specialist
  6 16  shall mean that the hearing aid dispenser specialist is engaged
  6 17 in the diagnosis of illness or the practice of medicine or any
  6 18 other activity prohibited by this chapter.
  6 19    5.  No hearing aid shall be sold by any individual licensed
  6 20 under this chapter to a person twelve years of age or younger,
  6 21 unless within the preceding six months a recommendation for
  6 22 a hearing aid has been made by a physician specializing in
  6 23 otolaryngology. A replacement of an identical hearing aid
  6 24 within one year shall be an exception to this requirement.
  6 25    6.  A licensed hearing aid dispenser specialist shall, upon
  6 26 the consummation of a sale of a hearing aid, keep and maintain
  6 27 records in the dispenser's specialist's office or place of
  6 28 business at all times and each such record shall be kept
  6 29 and maintained for a seven=year period. These records shall
  6 30 include:
  6 31    a.  Results of test techniques as they pertain to fitting of
  6 32 the hearing aids.
  6 33    b.  A copy of the written receipt and the written
  6 34 recommendation.
  6 35    Sec. 11.  Section 154A.21, Code 2015, is amended to read as
  7  1 follows:
  7  2    154A.21  Notice of address.
  7  3    1.  A licensee or person holding a temporary permit shall
  7  4 notify the department in writing of the address of the place
  7  5 where the licensee or permittee engages or intends to engage in
  7  6 business as a hearing aid dispenser specialist. The department
  7  7 shall keep a record of the place of business of licensees and
  7  8 persons holding temporary permits.
  7  9    2.  Any notice required to be given by the department to a
  7 10 licensee shall be adequately served if sent by certified mail
  7 11 to the address of the last place of business recorded.
  7 12    Sec. 12.  Section 154A.24, subsection 3, paragraphs e and i,
  7 13 Code 2015, are amended to read as follows:
  7 14    e.  Representing that the service or advice of a person
  7 15 licensed to practice medicine, or one who is certificated as
  7 16 a clinical audiologist by the board of speech pathology and
  7 17 audiology or its equivalent, will be used or made available in
  7 18 the fitting or selection, adjustment, maintenance, or repair
  7 19 of hearing aids when that is not true, or using the words
  7 20 "doctor", "clinic", "clinical audiologist", "state approved",
  7 21 or similar words, abbreviations, or symbols which tend to
  7 22 connote the medical or other professions, except where the
  7 23 title "certified hearing aid audiologist" has been granted
  7 24 by the national hearing aid society, or that the hearing aid
  7 25 dispenser specialist has been recommended by this state or the
  7 26 board when such is not accurate.
  7 27    i.  Directly or indirectly giving or offering to give, or
  7 28 permitting or causing to be given, money or anything of value
  7 29 to a person who advises another in a professional capacity, as
  7 30 an inducement to influence the person or cause the person to
  7 31 influence others to purchase or contract to purchase products
  7 32 sold or offered for sale by a hearing aid dispenser specialist,
  7 33 or to influence others to refrain from dealing in the products
  7 34 of competitors.
  7 35    Sec. 13.  Section 154A.25, subsection 2, Code 2015, is
  8  1 amended to read as follows:
  8  2    2.  Purchase or procure by barter a license or temporary
  8  3 permit with intent to use it as evidence of the holder's
  8  4 qualifications to engage in business as a hearing aid dispenser
  8  5  specialist.
  8  6    Sec. 14.  Section 154F.2, subsection 1, paragraph b, Code
  8  7 2015, is amended to read as follows:
  8  8    b.  Hearing aid fitting, the dispensing or sale of hearing
  8  9 aids, and the providing of hearing aid service and maintenance
  8 10 by a hearing aid dispenser specialist or holder of a temporary
  8 11 permit as defined and licensed under chapter 154A.
  8 12    Sec. 15.  Section 154F.2, subsection 2, Code 2015, is amended
  8 13 to read as follows:
  8 14    2.  A person exempted from the provisions of this chapter by
  8 15 this section shall not use the title "speech pathologist" or
  8 16 "audiologist" or any title or device indicating or representing
  8 17 in any manner that the person is a speech pathologist or is
  8 18 an audiologist; provided, a hearing aid dispenser specialist
  8 19  licensed under chapter 154A may use the title "certified
  8 20 hearing aid audiologist" when granted by the national hearing
  8 21 aid society; and provided, persons who meet the requirements
  8 22 of section 154F.3, subsection 1, who are certified by the
  8 23 department of education as speech clinicians may use the title
  8 24 "speech pathologist" and persons who meet the requirements
  8 25 of section 154F.3, subsection 2, who are certified by the
  8 26 department of education as hearing clinicians may use the
  8 27 title "audiologist", while acting within the scope of their
  8 28 employment.
  8 29    Sec. 16.  Section 216E.7, Code 2015, is amended to read as
  8 30 follows:
  8 31    216E.7  Exemptions.
  8 32 This chapter does not apply to a hearing aid sold, leased,
  8 33 or transferred to a consumer by an audiologist licensed under
  8 34 chapter 154F, or a hearing aid dispenser specialist licensed
  8 35 under chapter 154A, if the audiologist or dispenser specialist
  9  1  provides either an express warranty for the hearing aid or
  9  2 provides for service and replacement of the hearing aid.
  9  3    Sec. 17.  Section 272C.1, subsection 6, paragraph v, Code
  9  4 2015, is amended to read as follows:
  9  5    v.  The board of hearing aid dispensers specialists, created
  9  6 pursuant to chapter 154A.
  9  7                           DIVISION II
  9  8  MEDICAL RESIDENCY TRAINING STATE MATCHING GRANTS PROGRAM ==
  9  9                           REENACTMENT
  9 10    Sec. 18.  NEW SECTION.  135.176  Medical residency training
  9 11 state matching grants program.
  9 12    1.  The department shall establish a medical residency
  9 13 training state matching grants program to provide matching
  9 14 state funding to sponsors of accredited graduate medical
  9 15 education residency programs in this state to establish,
  9 16 expand, or support medical residency training programs.
  9 17 Funding for the program may be provided through the health
  9 18 care workforce shortage fund or the medical residency training
  9 19 account created in section 135.175.  For the purposes of this
  9 20 section, unless the context otherwise requires, "accredited"
  9 21 means a graduate medical education program approved by the
  9 22 accreditation council for graduate medical education or the
  9 23 American osteopathic association.  The grant funds may be
  9 24 used to support medical residency programs through any of the
  9 25 following:
  9 26    a.  The establishment of new or alternative campus accredited
  9 27 medical residency training programs.  For the purposes of
  9 28 this paragraph, "new or alternative campus accredited medical
  9 29 residency training program" means a program that is accredited
  9 30 by a recognized entity approved for such purpose by the
  9 31 accreditation council for graduate medical education or the
  9 32 American osteopathic association with the exception that
  9 33 a new medical residency training program that, by reason
  9 34 of an insufficient period of operation is not eligible for
  9 35 accreditation on or before the date of submission of an
 10  1 application for a grant, may be deemed accredited if the
 10  2 accreditation council for graduate medical education or the
 10  3 American osteopathic association finds, after consultation with
 10  4 the appropriate accreditation entity, that there is reasonable
 10  5 assurance that the program will meet the accreditation
 10  6 standards of the entity prior to the date of graduation of the
 10  7 initial class in the program.
 10  8    b.  The provision of new residency positions within existing
 10  9 accredited medical residency or fellowship training programs.
 10 10    c.  The funding of residency positions which are in excess of
 10 11 the federal residency cap.  For the purposes of this paragraph,
 10 12 "in excess of the federal residency cap" means a residency
 10 13 position for which no federal Medicare funding is available
 10 14 because the residency position is a position beyond the cap for
 10 15 residency positions established by the federal Balanced Budget
 10 16 Act of 1997, Pub. L. No. 105=33.
 10 17    2.  The department shall adopt rules pursuant to chapter 17A
 10 18 to provide for all of the following:
 10 19    a.  Eligibility requirements for and qualifications
 10 20 of a sponsor of an accredited graduate medical education
 10 21 residency program to receive a grant.  The requirements and
 10 22 qualifications shall include but are not limited to all of the
 10 23 following:
 10 24    (1)  Only a sponsor that establishes a dedicated fund to
 10 25 support a residency program that meets the specifications of
 10 26 this section shall be eligible to receive a matching grant.  A
 10 27 sponsor funding residency positions in excess of the federal
 10 28 residency cap, as defined in subsection 1, paragraph "c",
 10 29 exclusive of funds provided under the medical residency
 10 30 training state matching grants program established in this
 10 31 section, is deemed to have satisfied this requirement and
 10 32 shall be eligible for a matching grant equal to the amount of
 10 33 funds expended for such residency positions, subject to the
 10 34 limitation on the maximum award of grant funds specified in
 10 35 paragraph "e".
 11  1    (2)  A sponsor shall demonstrate, through documented
 11  2 financial information as prescribed by rule of the department,
 11  3 that funds have been reserved and will be expended by the
 11  4 sponsor in the amount required to provide matching funds for
 11  5 each residency proposed in the request for state matching
 11  6 funds.
 11  7    (3)  A sponsor shall demonstrate, through objective evidence
 11  8 as prescribed by rule of the department, a need for such
 11  9 residency program in the state.
 11 10    b.  The application process for the grant.
 11 11    c.  Criteria for preference in awarding of the grants,
 11 12 including preference in the residency specialty.
 11 13    d.  Determination of the amount of a grant.  The total amount
 11 14 of a grant awarded to a sponsor shall be limited to no more
 11 15 than twenty=five percent of the amount that the sponsor has
 11 16 demonstrated through documented financial information has been
 11 17 reserved and will be expended by the sponsor for each residency
 11 18 sponsored for the purpose of the residency program.
 11 19    e.  The maximum award of grant funds to a particular
 11 20 individual sponsor per year.  An individual sponsor shall not
 11 21 receive more than twenty=five percent of the state matching
 11 22 funds available each year to support the program.  However,
 11 23 if less than ninety=five percent of the available funds has
 11 24 been awarded in a given year, a sponsor may receive more than
 11 25 twenty=five percent of the state matching funds available
 11 26 if total funds awarded do not exceed ninety=five percent of
 11 27 the available funds.  If more than one sponsor meets the
 11 28 requirements of this section and has established, expanded,
 11 29 or supported a graduate medical residency training program,
 11 30 as specified in subsection 1, in excess of the sponsor's
 11 31 twenty=five percent maximum share of state matching funds, the
 11 32 state matching funds shall be divided proportionately among
 11 33 such sponsors.
 11 34    f.  Use of the funds awarded.  Funds may be used to pay the
 11 35 costs of establishing, expanding, or supporting an accredited
 12  1 graduate medical education program as specified in this
 12  2 section, including but not limited to the costs associated with
 12  3 residency stipends and physician faculty stipends.
 12  4    Sec. 19.  EFFECTIVE DATE.  This division of this Act, being
 12  5 deemed of immediate importance, takes effect upon enactment.
 12  6    Sec. 20.  APPLICABILITY.  This division of this Act applies
 12  7 retroactively to June 30, 2014.
 12  8                          DIVISION III
 12  9  MEDICAL RESIDENCY TRAINING STATE MATCHING GRANTS PROGRAM ==
 12 10                           AMENDMENTS
 12 11    Sec. 21.  Section 135.176, as enacted in this Act, is amended
 12 12 to read as follows:
 12 13    135.176  Medical residency training state matching grants
 12 14 program.
 12 15    1.  The department shall establish a medical residency
 12 16 training state matching grants program to provide matching
 12 17 state funding to sponsors of accredited graduate medical
 12 18 education residency programs in this state to establish,
 12 19 expand, or support medical residency training programs.
 12 20 Funding for the program may be provided through the health
 12 21 care workforce shortage fund or the medical residency training
 12 22 account created in section 135.175.  For the purposes of this
 12 23 section, unless the context otherwise requires, "accredited"
 12 24 means a graduate medical education program approved by the
 12 25 accreditation council for graduate medical education or the
 12 26 American osteopathic association.  The grant funds may be
 12 27 used to support medical residency programs through any of the
 12 28 following:
 12 29    a.  The establishment of new or alternative campus accredited
 12 30 medical residency training programs.  For the purposes of
 12 31 this paragraph, "new or alternative campus accredited medical
 12 32 residency training program" means a program that is accredited
 12 33 by a recognized entity approved for such purpose by the
 12 34 accreditation council for graduate medical education or the
 12 35 American osteopathic association with the exception that
 13  1 a new medical residency training program that, by reason
 13  2 of an insufficient period of operation is not eligible for
 13  3 accreditation on or before the date of submission of an
 13  4 application for a grant, may be deemed accredited if the
 13  5 accreditation council for graduate medical education or the
 13  6 American osteopathic association finds, after consultation with
 13  7 the appropriate accreditation entity, that there is reasonable
 13  8 assurance that the program will meet the accreditation
 13  9 standards of the entity prior to the date of graduation of the
 13 10 initial class in the program.
 13 11    b.  The provision of new residency positions within existing
 13 12 accredited medical residency or fellowship training programs.
 13 13    c.  The funding of residency positions which are in excess of
 13 14 the federal residency cap.  For the purposes of this paragraph,
 13 15 "in excess of the federal residency cap" means a residency
 13 16 position for which no federal Medicare funding is available
 13 17 because the residency position is a position beyond the cap for
 13 18 residency positions established by the federal Balanced Budget
 13 19 Act of 1997, Pub. L. No. 105=33.
 13 20    2.  The department shall adopt rules pursuant to chapter 17A
 13 21 to provide for all of the following:
 13 22    a.  Eligibility requirements for and qualifications
 13 23 of a sponsor of an accredited graduate medical education
 13 24 residency program to receive a grant.  The requirements and
 13 25 qualifications shall include but are not limited to all of the
 13 26 following:
 13 27    (1)  Only a sponsor that establishes a dedicated fund to
 13 28 support a residency program that meets the specifications of
 13 29 this section shall be eligible to receive a matching grant.  A
 13 30 sponsor funding residency positions in excess of the federal
 13 31 residency cap, as defined in subsection 1, paragraph "c",
 13 32 exclusive of funds provided under the medical residency
 13 33 training state matching grants program established in this
 13 34 section, is deemed to have satisfied this requirement and
 13 35 shall be eligible for a matching grant equal to the amount of
 14  1 funds expended for such residency positions, subject to the
 14  2 limitation on the maximum award of grant funds specified in
 14  3 paragraph "e".
 14  4    (2)  A sponsor shall demonstrate, through documented
 14  5 financial information as prescribed by rule of the department,
 14  6  that funds have been reserved budgeted and will be expended by
 14  7 the sponsor in the amount required to provide matching funds
 14  8 for each residency proposed in the request for state matching
 14  9 funds.
 14 10    (3)  (2)  A sponsor shall demonstrate, through objective
 14 11 evidence as prescribed by rule of the department, a need for
 14 12 such residency program in the state.
 14 13    b.  The application process for the grant.
 14 14    c.  Criteria for preference in awarding of the grants,
 14 15 including preference in the residency specialty.
 14 16    d.  Determination of the amount of a grant.  The total amount
 14 17 of a grant awarded to a sponsor proposing the establishment
 14 18 of a new or alternative campus accredited medical residency
 14 19 training program as defined in subsection 1, paragraph "a",
 14 20  shall be limited to no more than twenty=five one hundred
 14 21 percent of the amount the sponsor has budgeted as demonstrated
 14 22 under paragraph "a".  The total amount of a grant awarded to
 14 23 a sponsor proposing the provision of a new residency position
 14 24 within an existing accredited medical residency or fellowship
 14 25 training program as specified in subsection 1, paragraph "b"
 14 26  or the funding of residency positions which are in excess of
 14 27 the federal residency cap as defined in subsection 1, paragraph
 14 28 "c", shall be limited to no more than twenty=five percent of
 14 29 the amount that the sponsor has demonstrated through documented
 14 30 financial information has been reserved and will be expended by
 14 31 the sponsor budgeted for each residency position sponsored for
 14 32 the purpose of the residency program.
 14 33    e.  The maximum award of grant funds to a particular
 14 34 individual sponsor per year.  An individual sponsor that
 14 35 establishes a new or alternative campus accredited medical
 15  1 residency training program as defined in subsection 1,
 15  2 paragraph "a" shall not receive more than twenty=five fifty
 15  3  percent of the state matching funds available each year to
 15  4 support the program.  However, if less than ninety=five percent
 15  5 of the available funds has been awarded in a given year, a
 15  6 sponsor may receive more than twenty=five percent of the
 15  7 state matching funds available if total funds awarded do not
 15  8 exceed ninety=five percent of the available funds.  If more
 15  9 than one sponsor meets the requirements of this section and
 15 10 has established, expanded, or supported a graduate medical
 15 11 residency training program, as specified in subsection 1, in
 15 12 excess of the sponsor's twenty=five percent maximum share of
 15 13 state matching funds, the state matching funds shall be divided
 15 14 proportionately among such sponsors.  An individual sponsor
 15 15 proposing the provision of a new residency position within an
 15 16 existing accredited medical residency or fellowship training
 15 17 program as specified in subsection 1, paragraph "b" or the
 15 18 funding of residency positions which are in excess of the
 15 19 federal residency cap as defined in subsection 1, paragraph "c",
 15 20 shall not receive more than twenty=five percent of the state
 15 21 matching funds available each year to support the program.
 15 22    f.  Use of the funds awarded.  Funds may be used to pay the
 15 23 costs of establishing, expanding, or supporting an accredited
 15 24 graduate medical education program as specified in this
 15 25 section, including but not limited to the costs associated with
 15 26 residency stipends and physician faculty stipends.
 15 27                           EXPLANATION
 15 28 The inclusion of this explanation does not constitute agreement with
 15 29 the explanation's substance by the members of the general assembly.
 15 30    This bill relates to programs and services under the purview
 15 31 of the department of public health.
 15 32    Division I of the bill changes references to and relating
 15 33 to "hearing aid dispensers" to "hearing aid specialists".
 15 34 The bill changes the references to the "board of hearing aid
 15 35 dispensers" to the "board of hearing aid specialists" and makes
 16  1 other conforming changes throughout the Code.
 16  2    Division II of the bill relates to the medical residency
 16  3 training state matching grants program.  The medical residency
 16  4 training state matching grants program (Code section 135.176,
 16  5 Code 2013), that was repealed on June 30, 2014, is reenacted
 16  6 as amended by 2014 Iowa Acts, chapter 1190, section 7. The
 16  7 division takes effect upon enactment and is retroactively
 16  8 applicable to June 30, 2014.
 16  9    Division III of the bill amends the newly reenacted Code
 16 10 section 135.176, to provide that instead of a requirement that
 16 11 a sponsor establish a dedicated fund to support a residency
 16 12 program, a sponsor shall demonstrate that funds have been
 16 13 budgeted in the amount required in the request for matching
 16 14 funds.  Additionally, the bill provides that the limit on the
 16 15 total amount of a grant made to a sponsor is based upon the
 16 16 type of residency position to be funded.  Under the bill, the
 16 17 limit is no more than 100 percent of the amount the sponsor
 16 18 budgeted if the sponsor is proposing the establishment of
 16 19 a new or alternative campus accredited medical residency
 16 20 training program, and the limit is not more than 25 percent
 16 21 of the amount the sponsor has budgeted if the sponsor is
 16 22 proposing provision of a new residency position within an
 16 23 existing accredited medical residency or  fellowship training
 16 24 program or the funding of residency positions which are in
 16 25 excess of the federal residency cap.  Under the bill, the
 16 26 maximum award of grant funds to a particular sponsor that
 16 27 establishes a new or alternative campus accredited medical
 16 28 residency training program shall be not more than 50 percent
 16 29 of the state matching funds available each year; and the
 16 30 maximum award to a particular sponsor that is proposing
 16 31 provision of a new residency position within an existing
 16 32 accredited medical residency or  fellowship training program
 16 33 or the funding of residency positions which are in excess of
 16 34 the federal residency cap shall not be more than 25 percent of
 16 35 the state matching funds available each year. Under the bill,
 17  1 unlike under the prior program, there is not a formula for the
 17  2 awarding of funds if less than 95 percent of the available
 17  3 funds were awarded.
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