Fiscal Note
Fiscal Services Division
SF 477 – Medical License, Internationally Trained Doctors (LSB1866SV.3)
Staff Contact: Xavier Leonard (515.725.0509) xavier.leonard@legis.iowa.gov
Fiscal Note Version – Final Action
Senate File 477 relates to the licensure of internationally trained physicians and the disclosure
of electronic protected health information (EPHI) of a minor to a legal guardian and does the
following:
• Makes changes to the licensure standards for internationally trained physicians.
• Requires EPHI to be disclosed to the legal guardian of a minor, with some exceptions.
Division I — Licensure of Internationally Trained Physicians
Description
Division I directs the Iowa Board of Medicine to grant a license to practice medicine and
surgery or osteopathic medicine and surgery to an international physician who is licensed to
practice outside of the United States and meets additional requirements. Division I states that
licenses may be granted with no additional training or residency requirements, as long as the
training and residency requirements of the international physician were substantially similar.
Division I takes effect January 1, 2025.
Background
The Board is funded entirely through fees charged by its members, without a General Fund
appropriation. Additional costs for administering the Board and carrying out the duties assigned
to the Board would result in increased fees to licensees.
Assumptions
Senate File 477 requires the creation of a new type of medical practitioner license in the
licensing system used by the Board. The Board is currently procuring a new system and
anticipates that the requirements of Division I can be implemented in the new system for no
additional cost.
The Board estimates that approximately 422 individuals will apply for the license created by the
Bill. The Board estimates the fee for the new provisional license to be $340. Processing these
licenses will require an additional 1.0 full-time equivalent (FTE) position. Overseeing the
implementation of the program is expected to require approximately 25.0% of the 1.0 FTE
position currently attributed to the Board’s Licensing Director and 10.0% of the
1.0 FTE position currently assigned to the Board’s Executive Director. Because the Board is
funded entirely by fee revenue, the Board will need to add the work hours for these FTE
positions to the cost of establishing and administering the license when estimating the required
license fee.
Fiscal Impact
Ongoing FTE position costs include $50,000 for 1.0 FTE position for a Clerk Specialist to
process the additional licenses, as well as additional supervisory time from the Board’s
Licensure Director and the Board’s Executive Director. The 10.0% of the Executive Director’s
1.0 FTE position is estimated to add approximately $17,000 to the cost of administering the
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license. The 25.0% of the Licensing Director’s 1.0 FTE position is estimated to add
approximately $28,000 to the cost of administering the license. These supervisory requirements
are expected to decrease after the first two years of the license. Figure 1 shows a complete
estimate of approximate costs.
Figure 1 — Total Implementation and Administration Costs
FY 2025 FY 2026
Expense Est. Cost Est. Cost
0.25 FTE Position — Licensing Director $ 14,000 $ 28,000
0.10 FTE Position — Executive Director 9,000 17,000
1.00 FTE Position — Clerk Specialist 25,000 50,000
Other Board Costs Attributed to the New License 2,000 2,000
Total Costs $ 50,000 $ 97,000
The new license type is estimated to result in approximately $143,000 deposited into the
Licensing and Regulation Fund.
Sources
Department of Inspections, Appeals, and Licensing
Board of Medicine
Legislative Services Agency
Division II — Electronic Protected Health Information
Description and Background
Division II requires a health care provider or facility that maintains or transmits EPHI to disclose
to the legal guardian of a minor the minor’s EPHI. The EPHI must relate to health care for
which the minor is allowed to provide consent without a legal guardian. Currently legal
guardians are allowed to request paper copies of a minor’s medical records.
Assumptions and Fiscal Impact
Division II of the Bill is not estimated to have a fiscal impact to the State.
Source
Iowa Hospital Association
/s/ Jennifer Acton
April 29, 2024
Doc ID 1448838
The fiscal note for this Bill was prepared pursuant to Joint Rule 17 and the Iowa Code. Data used in developing this
fiscal note is available from the Fiscal Services Division of the Legislative Services Agency upon request.
www.legis.iowa.gov
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