House File 803 - Enrolled
House File 803
AN ACT
RELATING TO DUTIES PERFORMED BY PHYSICIAN ASSISTANTS.
2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 DIVISION I
2 DUTIES OF PHYSICIAN ASSISTANTS
3 Section 1. Section 90A.1, Code 2022, is amended by adding
4 the following new subsections:
5 NEW SUBSECTION. 5A. “Physician” means a person licensed as
6 a physician pursuant to chapter 148.
7 NEW SUBSECTION. 5B. “Physician assistant” means a person
8 licensed as a physician assistant pursuant to chapter 148C.
9 Sec. 2. Section 90A.8, subsection 2, Code 2022, is amended
10 to read as follows:
11 2. A contestant shall not take part in a boxing match
12 unless the contestant has presented a valid registration
13 identification card issued pursuant to section 90A.3 to the
14 commissioner prior to the weigh-in for the boxing match.
15 The contestant shall pass a rigorous physical examination
16 to determine the contestant’s fitness to engage in any such
17 match within twenty-four hours of the start of the match.
18 The examination shall be conducted by a licensed practicing
19 physician or physician assistant designated or authorized by
20 the commissioner.
21 Sec. 3. Section 96.5, subsection 1, paragraphs d and e, Code
22 2022, are amended to read as follows:
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23 d. The individual left employment because of illness,
24 injury, or pregnancy upon the advice of a licensed and
25 practicing physician or physician assistant, and upon knowledge
26 of the necessity for absence immediately notified the employer,
27 or the employer consented to the absence, and after recovering
28 from the illness, injury, or pregnancy, when recovery was
29 certified by a licensed and practicing physician or physician
30 assistant, the individual returned to the employer and offered
31 to perform services and the individual’s regular work or
32 comparable suitable work was not available, if so found by the
33 department, provided the individual is otherwise eligible.
34 e. The individual left employment upon the advice of a
35 licensed and practicing physician or physician assistant,
1 for the sole purpose of taking a member of the individual’s
2 family to a place having a different climate, during which
3 time the individual shall be deemed unavailable for work, and
4 notwithstanding during such absence the individual secures
5 temporary employment, and returned to the individual’s
6 regular employer and offered the individual’s services and the
7 individual’s regular work or comparable work was not available,
8 provided the individual is otherwise eligible.
9 Sec. 4. Section 135.109, subsection 3, paragraph b, Code
10 2022, is amended to read as follows:
11 b. A licensed physician, physician assistant, or nurse who
12 is knowledgeable concerning domestic abuse injuries and deaths,
13 including suicides.
14 Sec. 5. Section 135.146, subsection 2, Code 2022, is amended
15 to read as follows:
16 2. Participation in the vaccination program shall be
17 voluntary, except for first responders who are classified
18 as having occupational exposure to blood-borne pathogens as
19 defined by the occupational safety and health administration
20 standard contained in 29 C.F.R. §1910.1030. First responders
21 who are so classified shall be required to receive the
22 vaccinations as described in subsection 1. A first responder
23 shall be exempt from this requirement, however, when a
24 written statement from a licensed physician or physician
25 assistant is presented indicating that a vaccine is medically
26 contraindicated for that person or the first responder signs
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27 a written statement that the administration of a vaccination
28 conflicts with religious tenets.
29 Sec. 6. Section 135J.1, Code 2022, is amended by adding the
30 following new subsection:
31 NEW SUBSECTION. 01. “Attending physician” means a physician
32 licensed pursuant to chapter 148 or a physician assistant
33 licensed pursuant to chapter 148C.
34 Sec. 7. Section 135J.1, subsection 6, paragraph e, Code
35 2022, is amended to read as follows:
1 e. As deemed appropriate by the hospice, physician
2 assistants, providers of special services including but
3 not limited to a spiritual counselor, a pharmacist, or
4 professionals in the fields of mental health may be included
5 on the interdisciplinary team.
6 Sec. 8. Section 135J.3, subsections 1 and 4, Code 2022, are
7 amended to read as follows:
8 1. A planned program of hospice care, the medical components
9 of which shall be under the direction of a licensed an
10 attending physician.
11 4. Palliative care provided to a hospice patient and family
12 under the direction of a licensed an attending physician.
13 Sec. 9. Section 141A.5, subsection 2, paragraph c, Code
14 2022, is amended to read as follows:
15 c. (1) Devise a procedure, as a part of the partner
16 notification program, to provide for the notification of an
17 identifiable third party who is a sexual partner of or who
18 shares drug injecting equipment with a person who has tested
19 positive for HIV, by the department or a physician or physician
20 assistant, when all of the following situations exist:
21 (a) A physician or physician assistant for the infected
22 person is of the good faith opinion that the nature of the
23 continuing contact poses an imminent danger of HIV transmission
24 to the third party.
25 (b) When the physician or physician assistant believes
26 in good faith that the infected person, despite strong
27 encouragement, has not and will not warn the third party and
28 will not participate in the voluntary partner notification
29 program.
30 (2) Notwithstanding subsection 3, the department or a
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31 physician or physician assistant may reveal the identity of a
32 person who has tested positive for HIV infection pursuant to
33 this subsection only to the extent necessary to protect a third
34 party from the direct threat of transmission. This subsection
35 shall not be interpreted to create a duty to warn third parties
1 of the danger of exposure to HIV through contact with a person
2 who tests positive for HIV infection.
3 (3) The department shall adopt rules pursuant to chapter
4 17A to implement this paragraph “c”. The rules shall provide a
5 detailed procedure by which the department or a physician or
6 physician assistant may directly notify an endangered third
7 party.
8 Sec. 10. Section 141A.6, subsections 3 and 4, Code 2022, are
9 amended to read as follows:
10 3. Within seven days of diagnosing a person as having AIDS
11 or an AIDS-related condition, the diagnosing physician or
12 physician assistant shall make a report to the department on a
13 form provided by the department.
14 4. Within seven days of the death of a person with HIV
15 infection, the attending physician or attending physician
16 assistant shall make a report to the department on a form
17 provided by the department.
18 Sec. 11. Section 141A.7, subsection 3, Code 2022, is amended
19 to read as follows:
20 3. A person may apply for voluntary treatment,
21 contraceptive services, or screening or treatment for HIV
22 infection and other sexually transmitted diseases directly to a
23 licensed physician and surgeon, an osteopathic physician and
24 surgeon, a physician assistant, or a family planning clinic.
25 Notwithstanding any other provision of law, however, a minor
26 shall be informed prior to testing that, upon confirmation
27 according to prevailing medical technology of a positive
28 HIV-related test result, the minor’s legal guardian is required
29 to be informed by the testing facility. Testing facilities
30 where minors are tested shall have available a program to
31 assist minors and legal guardians with the notification process
32 which emphasizes the need for family support and assists in
33 making available the resources necessary to accomplish that
34 goal. However, a testing facility which is precluded by
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35 federal statute, regulation, or centers for disease control
1 and prevention guidelines from informing the legal guardian
2 is exempt from the notification requirement. The minor shall
3 give written consent to these procedures and to receive the
4 services, screening, or treatment. Such consent is not subject
5 to later disaffirmance by reason of minority.
6 Sec. 12. Section 144A.2, Code 2022, is amended by adding the
7 following new subsections:
8 NEW SUBSECTION. 2A. “Attending physician assistant” means
9 the physician assistant selected by, or assigned to, the
10 patient who has primary responsibility for the treatment and
11 care of the patient.
12 NEW SUBSECTION. 10A. “Physician assistant” means a person
13 licensed to practice as a physician assistant in this state.
14 Sec. 13. Section 144A.4, Code 2022, is amended to read as
15 follows:
16 144A.4 Revocation of declaration.
17 1. A declaration may be revoked at any time and in any
18 manner by which the declarant is able to communicate the
19 declarant’s intent to revoke, without regard to mental or
20 physical condition. A revocation is only effective as to
21 the attending physician or attending physician assistant
22 upon communication to such physician or physician assistant
23 by the declarant or by another to whom the revocation was
24 communicated.
25 2. The attending physician or attending physician assistant
26 shall make the revocation a part of the declarant’s medical
27 record.
28 Sec. 14. Section 144A.7A, subsection 1, Code 2022, is
29 amended to read as follows:
30 1. If an attending physician or attending physician
31 assistant issues an out-of-hospital do-not-resuscitate order
32 for an adult patient under this section, the physician shall
33 use the form prescribed pursuant to subsection 2, include a
34 copy of the order in the patient’s medical record, and provide
35 a copy to the patient or an individual authorized to act on the
1 patient’s behalf.
2 Sec. 15. Section 144A.7A, subsection 3, paragraph e, Code
3 2022, is amended to read as follows:
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4 e. The physician’s or physician assistant’s signature.
5 Sec. 16. Section 144B.1, subsection 3, Code 2022, is amended
6 to read as follows:
7 3. “Durable power of attorney for health care” means a
8 document authorizing an attorney in fact to make health care
9 decisions for the principal if the principal is unable, in the
10 judgment of the attending physician or attending physician
11 assistant, to make health care decisions.
12 Sec. 17. Section 144B.5, subsection 1, Code 2022, is amended
13 to read as follows:
14 1. A durable power of attorney for health care executed
15 pursuant to this chapter may, but need not, be in the following
16 form:
17 I hereby designate ........ as my attorney in fact (my
18 agent) and give to my agent the power to make health care
19 decisions for me. This power exists only when I am unable, in
20 the judgment of my attending physician or attending physician
21 assistant, to make those health care decisions. The attorney
22 in fact must act consistently with my desires as stated in this
23 document or otherwise made known.
24 Except as otherwise specified in this document, this document
25 gives my agent the power, where otherwise consistent with the
26 law of this state, to consent to my physician or physician
27 assistant not giving health care or stopping health care which
28 is necessary to keep me alive.
29 This document gives my agent power to make health care
30 decisions on my behalf, including to consent, to refuse to
31 consent, or to withdraw consent to the provision of any care,
32 treatment, service, or procedure to maintain, diagnose, or
33 treat a physical or mental condition. This power is subject
34 to any statement of my desires and any limitations included in
35 this document.
1 My agent has the right to examine my medical records and to
2 consent to disclosure of such records.
3 Sec. 18. Section 144B.6, subsection 1, Code 2022, is amended
4 to read as follows:
5 1. Unless the district court sitting in equity specifically
6 finds that the attorney in fact is acting in a manner contrary
7 to the wishes of the principal or the durable power of attorney
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8 for health care provides otherwise, an attorney in fact who
9 is known to the health care provider to be available and
10 willing to make health care decisions has priority over any
11 other person, including a guardian appointed pursuant to
12 chapter 633, to act for the principal in all matters of health
13 care decisions. The attorney in fact has authority to make
14 a particular health care decision only if the principal is
15 unable, in the judgment of the attending physician or attending
16 physician assistant, to make the health care decision. If the
17 principal objects to a decision to withhold or withdraw health
18 care, the principal shall be presumed to be able to make a
19 decision.
20 Sec. 19. Section 144D.4, subsection 3, Code 2022, is amended
21 to read as follows:
22 3. If the individual’s physician or physician assistant has
23 issued an out-of-hospital do-not-resuscitate order pursuant
24 to section 144A.7A, the POST form shall not supersede the
25 out-of-hospital do-not-resuscitate order.
26 Sec. 20. Section 144F.2, subsection 1, paragraph b, Code
27 2022, is amended to read as follows:
28 b. A legal representative who is an agent under a durable
29 power of attorney for health care pursuant to chapter 144B
30 shall be given the opportunity to designate a lay caregiver
31 in lieu of the patient’s designation of a lay caregiver only
32 if, consistent with chapter 144B, in the judgment of the
33 attending physician or attending physician assistant, the
34 patient is unable to make the health care decision. A legal
35 representative who is a guardian shall be given the opportunity
1 to designate a lay caregiver in lieu of the patient’s
2 designation of a lay caregiver to the extent consistent with
3 the powers and duties granted the guardian pursuant to sections
4 232D.401 and 232D.402 or section 633.635.
5 Sec. 21. Section 189A.6, Code 2022, is amended to read as
6 follows:
7 189A.6 Health examination of employees.
8 The operator of any establishment shall require all
9 employees of such establishment to have a health examination
10 by a physician or physician assistant and a certified health
11 certificate for each employee shall be kept on file by the
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12 operator. The secretary may at any time require an employee
13 of an establishment to submit to a health examination by a
14 physician or physician assistant. No person suffering from
15 any communicable disease, including any communicable skin
16 disease, and no person with infected wounds, and no person who
17 is a “carrier” of a communicable disease shall be employed in
18 any capacity in an establishment. No person shall work or
19 be employed in or about any establishment during the time in
20 which a communicable disease exists in the home in which such
21 person resides unless such person has obtained a certificate
22 from a physician or physician assistant to the effect that
23 no danger of public contagion or infection will result from
24 the employment of such person in such establishment. Every
25 person employed by an establishment and engaged in direct
26 physical contact with meat or poultry products during its
27 preparation, processing, or storage, shall be clean in person,
28 wear clean washable outer garments and a suitable cap or other
29 head covering used exclusively in such work. Only persons
30 specifically designated by the operator of an establishment
31 shall be permitted to touch meat or poultry products with their
32 hands, and the persons so designated shall keep their hands
33 scrupulously clean.
34 Sec. 22. Section 225.9, Code 2022, is amended to read as
35 follows:
1 225.9 Voluntary private patients.
2 Voluntary private patients may be admitted in accordance
3 with the regulations to be established by the state board of
4 regents, and their care, nursing, observation, treatment,
5 medicine, and maintenance shall be without expense to
6 the state. However, the charge for such care, nursing,
7 observation, treatment, medicine, and maintenance shall not
8 exceed the cost of the same to the state. The physicians or
9 physician assistants who meet the qualifications set forth
10 in the definition of a mental health professional in section
11 228.1 on the hospital staff may charge such patients for
12 their medical services under such rules, regulations and plan
13 therefor as approved by the state board of regents.
14 Sec. 23. Section 225.10, unnumbered paragraph 1, Code 2022,
15 is amended to read as follows: