MortSci 2012

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Iowa Funeral Law

Iowa TITLE IV PUBLIC HEALTH

SUBTITLE 2 HEALTH-RELATED ACTIVITIES

CHAPTER 142 DEAD BODIES FOR SCIENTIFIC PURPOSES

142.1 Delivery of bodies. The body of every person dying in a public asylum, hospital, county care facility, penitentiary, or

reformatory in this state, or found dead within the state, or which is to be buried at public expense in this state, except those buried under the provisions of chapter 144C or 249, and which is suitable for scientific purposes, shall be delivered to the medical college of the state university, or some osteopathic or chiropractic college or school located in this state, which has been approved under the law regulating the practice of osteopathic medicine or chiropractic; but no such body shall be delivered to any such college or school if the deceased person expressed a desire during the person’s last illness that the person’s body should be buried or cremated, nor if such is the desire of the person’s relatives. Such bodies shall be equitably distributed among said colleges and schools according to their needs for teaching anatomy in accordance with such rules as may be adopted by the Iowa department of public health. The expense of transporting said bodies to such college or school shall be paid by the college or school receiving the same. If the deceased person has not expressed a desire during the person’s last illness that the person’s body should be buried or cremated and no person authorized to control the deceased person’s remains under section 144C.5requests the person’s body for burial or cremation, and if a friend objects to the use of the deceased person’s body for scientific purposes, said deceased person’s body shall be forthwith delivered to such friend for burial or cremation at no expense to the state or county. Unless such friend provides for burial and burial expenses within five days, the body shall be used for scientific purposes under this chapter.

142.2 Furnished to physicians. When there are more dead bodies available for use under section 142.1 than are desired by said colleges

or schools, the same may be delivered to physicians in the state for scientific study under such rules as may be adopted by the Iowa department of public health.

142.3 Notification of department. Every county medical examiner, funeral director or embalmer, and the managing officer of every public

asylum, hospital, county care facility, penitentiary, or reformatory, as soon as any dead body shall come into the person’s custody which may be used for scientific purposes as provided in sections 142.1 and 142.2, shall at once notify the nearest relative or friend of the deceased, if known, and the Iowa department of public health by telegram, and hold such body unburied for forty-eight hours. Upon receipt of such telegram the department shall telegraph instructions relative to the disposition to be made of said body. Complete jurisdiction over said bodies is vested exclusively in the Iowa department of public health. No autopsy or post mortem, except as are legally ordered by county medical examiners, shall be performed on any of said bodies prior to their delivery to the medical schools.

142.4 Surrender to relatives.

When any dead body which has been delivered underthis chapter for scientific purposes is subsequently claimed by any relative, it shall be at once surrendered to such relative for burial without public expense; and all bodies received under this chapter shall be held for a period of thirty days before being used. Unless such person claiming the body for burial pays the costs that have been incurred in the care and transportation of the body within thirty days after claiming it, all rights thereto shall cease and the body may then be used as if no claim had been made.

This section shall not apply to bodies given under authority of the revised uniform anatomical gift Act as provided in chapter 142C.

142.5 Disposition after dissection. The remains of every body received for scientific purposes under this chapter shall be decently buried

or cremated after it has been used for said purposes, and a failure to do so shall be a simple misdemeanor.

142.6 Record of receipt. Any college, school, or physician receiving the dead body of any human being for scientific purposes

shall keep a record showing: 1. The name of the person from whom, and the time and place, such body was received. 2. The description of the receptacle in which the body was received, including the shipping direction

attached to the same. 3. The description of the body, including the length, weight, and sex, apparent age at time of death,

color of hair and beard, if any, and all marks or scars which might be used to identify the same. 4. The condition of the body and whether mutilated so as to prevent identification.

142.7 Record and bodies. The record required by section 142.6 and the dead body of every human being received under this

chaptershall be subject to inspection by any peace officer, or relative of the deceased.

142.8 Purpose for which body used. The dead bodies delivered under this chapter shall be used only within the limits of this state for the

purpose of scientific, medical, and surgical study, and no person shall remove the same beyond the limits of this state or in any manner traffic therein. Any person who shall violate this section shall be guilty of a serious misdemeanor.

This section shall not apply to bodies given under authority of the revised uniform anatomical gift Act as provided in chapter 142C.

142.9 Failure to deliver dead body. Any person having the custody of the dead body of any human being which is required to be delivered

for scientific purposes by this chapter, who shall fail to notify the Iowa department of public health of the existence of such body, or fail to deliver the same in accordance with the instructions of the department, shall be guilty of a simple misdemeanor.

142.10 Use without proper record. Any physician or member of the instructional staff of any college or school who uses, or permits others

under the physician’s or member’s charge to use the dead body of a human being for the purpose of medical or surgical study without the record required in section 142.6 having been made, or who shall

refuse to allow any peace officer or relative of the deceased to inspect said record or body, shall be guilty of a serious misdemeanor.

142.11 Penalties. Any person who shall receive or deliver any dead body of a human being knowing that any of the

provisions ofthis chapter have been violated, shall be guilty of an aggravated misdemeanor.

142.12 Repealed by 69 Acts, ch 137, § 11. 142.13 Burial in private cemetery lot. In the event such deceased person, whose body has been used for scientific purposes as provided herein,

shall own or have the right of burial in a private or family cemetery lot in the state of Iowa, that such deceased person’s body shall be buried in such lot.

CHAPTER 142C REVISED UNIFORM ANATOMICAL GIFT ACT

142C.1 Short title. This chapter shall be known and may be cited as the“Revised Uniform Anatomical Gift Act”. 142C.2 Definitions. As used in this chapter, unless the context otherwise requires: 1. “Adult” means an individual who is eighteen years of age or older. 2. “Agent” means an individual who meets any of the following conditions: a. Is authorized to make health care decisions on the principal’s behalf by a durable power of attorney

for health care pursuant to chapter 144B. b. Is expressly authorized to make an anatomical gift on the principal’s behalf by any other record

signed by the principal. 3. “Anatomical gift” or “gift” means a donation of all or part of the human body effective after the

donor’s death, for the purposes of transplantation, therapy, research, or education. 4. “Decedent” means a deceased individual whose body or part is or may be the source of an

anatomical gift and includes a stillborn infant. 5. “Disinterested witness” means a witness other than the spouse, child, parent, sibling, grandchild,

grandparent, or guardian of the individual who makes, amends, revokes, or refuses to make an anatomical gift, or any other adult who exhibited special care and concern for the individual. “Disinterested witness”does not include a person who may receive an anatomical gift pursuant to section 142C.5.

6. “Document of gift” means a donor card or other record used to make an anatomical gift, including a statement or symbol on a driver’s license or identification card, or an entry in a donor registry.

7. “Donor” means an individual whose body or part is the subject of an anatomical gift. 8. “Donor registry” means a database that contains records of anatomical gifts and amendments of

anatomical gifts. 9. “Driver’s license” means a license or permit issued by the state department of transportation to

operate a vehicle, whether or not conditions are attached to the license or permit. 10. “Eye bank” means a person that is licensed, accredited, or regulated under federal or state law to

engage in the recovery, screening, testing, processing, storage, or distribution of human eyes or portions of human eyes.

11. “Forensic pathologist” means a pathologist who is further certified in the subspecialty of forensic pathology by the American board of pathology.

12. “Guardian” means a person appointed by a court to make decisions regarding the support, care, education, health, or welfare of an individual, but does not include a guardian ad litem.

13. “Hospital” means a hospital licensed underchapter 135B, or a hospital licensed, accredited, or approved under federal law or the laws of any other state, and includes a hospital operated by the federal government, a state, or a political subdivision of a state, although not required to be licensed under state laws.

14. “Identification card” means a nonoperator’s identification card issued by the state department of transportation pursuant to section 321.190.

15. “Iowa donor network” means the nonprofit organization certified by the centers for Medicare and Medicaid services of the United States department of health and human services as the single organ procurement agency serving the state and which also serves as the tissue recovery agency for the state.

16. “Iowa donor registry” means the Iowa donor registry administered by the Iowa donor network. 17. “Know” means to have actual knowledge. 18. “Medical examiner” means an individual who is appointed as a medical examiner pursuant

to section 331.801 or 691.5. 19. “Minor” means an individual who is less than eighteen years of age. 20. “Organ procurement organization” means a person designated by the United States secretary of

health and human services as an organ procurement organization. 21. “Parent” means a parent whose parental rights have not been terminated. 22. “Part” means an organ, an eye, or tissue of a human being, but does not include the whole body of

a human being. 23. “Pathologist” means a licensed physician who is certified in anatomic or clinical pathology by the

American board of pathology. 24. “Person” means person as defined in section 4.1. 25. “Physician” means an individual authorized to practice medicine and surgery or osteopathic

medicine and surgery under the laws of any state. 26. “Procurement organization” means an eye bank, organ procurement organization, or tissue bank. 27. “Prospective donor” means an individual who is dead or near death and has been determined by a

procurement organization to have a part that could be medically suitable for transplantation, therapy, research, or education, but does not include an individual who has made a refusal.

28. “Reasonably available” means able to be contacted by a procurement organization without undue effort and willing and able to act in a timely manner consistent with existing medical criteria necessary for the making of an anatomical gift.

29. “Recipient” means an individual into whose body a decedent’s part has been transplanted or is intended for transplant.

30. “Record” means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in perceivable form.

31. “Refusal” means a record created pursuant tosection 142C.3 that expressly states an individual’s intent to prohibit other persons from making an anatomical gift of the individual’s body or part.

32. “Sign” means to do any of the following with the present intent to authenticate or adopt a record: a. Execute or adopt a tangible symbol. b. Attach to or logically associate with the record an electronic symbol, sound, or process. 33. “State” means any state of the United States, the District of Columbia, Puerto Rico, the United

States Virgin Islands, or any territory or insular possession subject to the jurisdiction of the United States.

34. “Technician” means an individual determined to be qualified to remove or process parts by an appropriate organization that is licensed, accredited, or regulated under federal or state law and includes an enucleator.

35. “Tissue” means a portion of the human body other than an organ or an eye, but does not include blood unless the blood is donated for the purpose of research or education.

36. “Tissue bank” means a person that is licensed, accredited, or regulated under federal or state law to engage in the recovery, screening, testing, processing, storage, or distribution of tissue.

37. “Transplant hospital” means a hospital that furnishes organ transplants and other medical and surgical specialty services required for the care of transplant patients.

142C.3 Persons who may make — manner of making — amending or revoking — refusal to make anatomical gift before donor’s death — preclusive effect.

1. Who may make. Subject to subsection 5, an anatomical gift of a donor’s body or part may be made during the life of the donor for the purposes of transplantation, therapy, research, or education in the manner prescribed in subsection 2 by any of the following:

a. The donor if the donor is any of the following: (1) An adult. (2) A minor, if the minor is emancipated. (3) A minor, if the minor is authorized under state law to apply for a driver’s license or identification

card because the minor is at least 14 years of age, and the minor authorizes a statement or symbol indicating an anatomical gift on a driver’s license, identification card, or donor registry entry with the signed approval of a parent or guardian.

b. An agent of the donor, unless the durable power of attorney for health care or other record prohibits the agent from making the anatomical gift.

c. A parent of the donor, if the donor is an unemancipated minor. d. The guardian of the donor. 2. Manner of making. a. A donor may make an anatomical gift by any of the following means: (1) By authorizing a statement or symbol indicating that the donor has made an anatomical gift to be

imprinted on the donor’s driver’s license or identification card. (2) In a will. (3) During a terminal illness or injury of the donor, by any form of communication addressed to at least

two adults, at least one of whom is a disinterested witness. (4) As provided in paragraph “b”. b. (1) A donor or other person authorized to make an anatomical gift under subsection 1 may make a

gift by a donor card or other record signed by the donor or other person making the gift or by authorizing that a statement or symbol indicating that the donor has made an anatomical gift be included on the donor registry.

(2) If the donor or other person is physically unable to sign a record, the record may be signed by another individual at the direction of the donor or other person and shall meet all of the following requirements:

(a) Be witnessed by at least two adults, at least one of whom is a disinterested witness, who have signed at the request of the donor or other person.

(b) State that the record has been signed and witnessed as provided in subparagraph division (a). c. Revocation, suspension, expiration, or cancellation of a driver’s license or identification card upon

which an anatomical gift is indicated shall not invalidate the gift.

d. An anatomical gift made by will takes effect upon the donor’s death whether or not the will is probated. Invalidation of the will after the donor’s death does not invalidate the gift.

3. Amending or revoking gift before donor’s death. a. Subject to subsection 5, a donor or other person authorized to make an anatomical gift

under subsection 1 may amend or revoke an anatomical gift by any of the following means: (1) A record signed by any of the following: (a) The donor. (b) The other person authorized to make an anatomical gift. (c) Subject to paragraph “b”, another individual acting at the direction of the donor or the other

authorized person if the donor or other person is physically unable to sign the record. (2) A later-executed document of gift that amends or revokes a previous anatomical gift or portion of an

anatomical gift, either expressly or by inconsistency. b. A record signed pursuant to paragraph “a”, subparagraph (1), subparagraph division (c), shall

comply with all of the following: (1) Be witnessed by at least two adults, at least one of whom is a disinterested witness, who have signed

at the request of the donor or the other authorized person. (2) State that the record has been signed and witnessed as provided in subparagraph (1). c. Subject to subsection 5, a donor or other person authorized to make an anatomical gift

under subsection 1 may revoke an anatomical gift by the destruction or cancellation of the document of gift, or the portion of the document of gift used to make the gift, with the intent to revoke the gift.

d. A donor may amend or revoke an anatomical gift that was not made in a will by any form of communication during a terminal illness or injury addressed to at least two adults, at least one of whom is a disinterested witness.

e. A donor who makes an anatomical gift in a will may amend or revoke the gift in the manner provided for amendment or revocation of wills or as provided in paragraph “a”.

4. Refusal to make. a. An individual may refuse to make an anatomical gift of the individual’s body or part by any of the

following means: (1) A record signed by any of the following: (a) The individual. (b) Subject to paragraph “b”, another individual acting at the direction of the individual if the

individual is physically unable to sign the record. (2) The individual’s will, whether or not the will is admitted to probate or invalidated after the

individual’s death. (3) Any form of communication made by the individual during the individual’s terminal illness or

injury addressed to at least two adults, at least one of whom is a disinterested witness. b. A record signed pursuant to paragraph “a”, subparagraph (1), subparagraph division (b), shall

comply with all of the following: (1) Be witnessed by at least two adults, at least one of whom is a disinterested witness, who have signed

at the request of the individual. (2) State that the record has been signed and witnessed as provided in subparagraph (1). c. An individual who has made a refusal may amend or revoke the refusal in accordance with any of the

following: (1) In the manner provided in paragraph “a” for making a refusal. (2) By subsequently making an anatomical gift pursuant to subsection 2 that is inconsistent with the

refusal.

(3) By destroying or canceling the record evidencing the refusal, or the portion of the record used to make the refusal, with the intent to revoke the refusal.

d. Except as otherwise provided in subsection 5, paragraph “h”, in the absence of an express, contrary indication by the individual set forth in the refusal, an individual’s unrevoked refusal to make an anatomical gift of the individual’s body or part prohibits all other persons from making an anatomical gift of the individual’s body or part.

5. Preclusive effect. a. Donor gift or amendment — subsequent actions by others prohibited. Except as otherwise provided

in paragraph “g”, and subject to paragraph“f”, in the absence of a contrary indication by the donor, a person other than the donor is prohibited from making, amending, or revoking an anatomical gift of a donor’s body or part if the donor made an anatomical gift of the donor’s body or part under subsection 2 or an amendment to an anatomical gift of the donor’s body or part under subsection 3.

b. Donor revocation not a refusal. A donor’s revocation of an anatomical gift of the donor’s body or part under subsection 3 is not a refusal and does not prohibit another person specified in subsection 1 orsection 142C.4 from making an anatomical gift of the donor’s body or part under subsection 2 or section 142C.4.

c. Gift on amendment by another — subsequent actions by others prohibited. If a person other than the donor makes an unrevoked anatomical gift of the donor’s body or part under subsection 2, or an amendment to an anatomical gift of the donor’s body or part under subsection 3, another person may not make, amend, or revoke the gift of the donor’s body or part under section 142C.4.

d. Revocation by another not prohibitive of other gift. A revocation of an anatomical gift of a donor’s body or part under subsection 3 by a person other than the donor does not prohibit another person from making an anatomical gift of the body or part undersubsection 2 or section 142C.4.

e. Gift of part not prohibitive of gift of another part. In the absence of a contrary indication by the donor or other person authorized to make an anatomical gift under subsection 1, an anatomical gift of a part is neither a refusal to donate another part nor a limitation on the making of an anatomical gift of another part at a later time by the donor or another authorized person.

f. Gift for one purpose not prohibitive of another purpose. In the absence of a contrary indication by the donor or other person authorized to make an anatomical gift under subsection 1, an anatomical gift of a part for one or more of the purposes specified insubsection 1 is not a limitation on the making of an anatomical gift of the part for any of the other purposes by the donor or any other person under subsection 2or section 142C.4.

g. Unemancipated minor gift — parent revocation. If a donor who is an unemancipated minor dies, a parent of the donor who is reasonably available may revoke or amend an anatomical gift of the donor’s body or part.

h. Unemancipated minor refusal — parent revocation or amendment. If an unemancipated minor who signed a refusal dies, a parent of the minor who is reasonably available may revoke the minor’s refusal.

142C.4 Who may make anatomical gift of decedent’s body or part — amending or revoking gift. 1. Subject to subsection 2, and unless prohibited bysection 142C.3, subsection 4 or 5, an anatomical

gift of a decedent’s body or part for purposes of transplantation, therapy, research, or education may be made by any member of the following classes of persons who is reasonably available, in the order of priority listed.

a. An agent of the decedent at the time of death who could have made an anatomical gift under section 142C.3, subsection 1, immediately before the decedent’s death.

b. The spouse of the decedent. c. Adult children of the decedent.

d. Parents of the decedent. e. Adult siblings of the decedent. f. Adult grandchildren of the decedent. g. Grandparents of the decedent. h. An adult who exhibited special care and concern for the decedent. i. Any persons who were acting as guardians of the decedent at the time of death. j. Any other person having the authority to dispose of the decedent’s body. 2. a. If there is more than one member of a class listed in subsection 1,

paragraph “a”, “c”, “d”, “e”,“f”, “g”, or “i”, entitled to make an anatomical gift, an anatomical gift may be made by one member of the class unless that member or a person to whom the gift may pass under section 142C.5 knows of an objection by another member of the class. If an objection is known, the gift shall be made only by a majority of the members of the class who are reasonably available.

b. A person shall not make an anatomical gift if, at the time of the death of the decedent, a person in a prior class under subsection 1 is reasonably available to make or to object to the making of an anatomical gift.

3. A person authorized to make an anatomical gift under subsection 1 may make an anatomical gift by a document of gift signed by the person making the gift or by the person’s oral communication that is electronically recorded or is contemporaneously reduced to a record and signed by the recipient of the oral communication.

4. Subject to subsection 5, an anatomical gift by a person authorized under subsection 1 may be amended or revoked orally or in a record by any member of the prior class who is reasonably available. If more than one member of the prior class is reasonably available, the gift made by a person authorized under subsection 1 may be:

a. Amended only if a majority of the reasonably available members agree to the amending of the gift. b. Revoked only if a majority of the reasonably available members agree to the revoking of the gift or if

they are equally divided as to whether to revoke the gift. 5. A revocation under subsection 4 is effective only if, before an incision has been made to remove a

part from the donor’s body or before invasive procedures have begun to prepare the recipient, the procurement organization, transplant hospital, or physician or technician knows of the revocation.

142C.4A Cooperation between medical examiner and organ procurement organization — facilitation of anatomical gift from decedent whose body is under jurisdiction of medical examiner.

1. A medical examiner shall cooperate with procurement organizations to maximize the opportunity to recover organs for the purpose of transplantation when the recovery of organs does not interfere with a death investigation.

2. If a medical examiner receives notice from a procurement organization that an organ might be or was made available with respect to a decedent whose body is under the jurisdiction of the medical examiner and a postmortem examination will be performed, unless the medical examiner denies recovery in accordance withthis section, the medical examiner or designee shall conduct a postmortem examination of the body or the organ in a manner and within a period compatible with its preservation for the purposes of the gift. Every reasonable effort shall be made to accomplish the mutual goals of organ donation and a thorough death investigation.

3. An organ shall not be removed from the body of a decedent under the jurisdiction of a medical examiner for transplantation unless the organ is the subject of an anatomical gift. This subsection does not preclude a medical examiner from performing a medicolegal investigation pursuant to subsection 5 upon the body or organs of a decedent under the jurisdiction of the medical examiner.

4. Upon request of an organ procurement organization, a medical examiner shall release to the organ procurement organization the name and contact information of a decedent whose body is under the jurisdiction of the medical examiner. If the decedent’s organs are medically suitable for transplantation, the pathologist or medical examiner shall release to the organ procurement organization the postmortem examination results, limited to cause and manner of death and any evidence of infection or other disease process, which might preclude safe transplantation of recovered organs. The organ procurement organization may make a subsequent disclosure of the postmortem examination results only if relevant to transplantation.

5. The medical examiner may conduct a medicolegal examination by reviewing all medical records, laboratory test results, X rays, other diagnostic results, and other information that any person possesses about a donor or prospective donor whose body is under the jurisdiction of the medical examiner, which the medical examiner determines may be relevant to the investigation.

6. A person who has any information requested by a medical examiner pursuant to subsection 5 shall provide that information as expeditiously as possible to allow the medical examiner to conduct the medicolegal investigation within a period compatible with the preservation of organs for the purpose of transplantation.

7. If an anatomical gift has been or might be made of an organ of a decedent whose body is under the jurisdiction of the medical examiner and a postmortem examination is not required, or the medical examiner determines that a postmortem examination is required but that the recovery of the organ that is the subject of an anatomical gift will not interfere with the examination, the medical examiner and organ procurement organization shall cooperate in the timely removal of the organ from the decedent for the purpose of transplantation.

8. a. If an anatomical gift of an organ from a decedent under the jurisdiction of the medical examiner has been or might be made, but the pathologist or medical examiner initially believes that the recovery of the organ could interfere with the postmortem investigation into the decedent’s cause or manner of death, the pathologist or medical examiner shall consult with the organ procurement organization or physician or technician designated by the organ procurement organization about the proposed recovery.

b. Ancillary clinical tests such as a magnetic resonance imaging (MRI), a computed tomography (CT) scan, or skeletal survey may be required by the pathologist prior to determination of suitability of organ procurement. These tests shall be performed and interpreted by the appropriate physician at the pathologist’s request, and reported in a timely fashion. All expenses for such tests shall be the responsibility of the organ procurement organization regardless of outcome.

c. After consultation pursuant to paragraph “a” and any preliminary investigation pursuant to paragraph“b”, the pathologist or medical examiner may allow recovery, depending on the nature of the case and the availability of a pathologist to view the body prior to recovery.

9. If the manner of death may be homicide or has the potential for litigation, the organ recovery shall be approved by the forensic pathologist, and the forensic pathologist may examine the body prior to organ recovery and document by diagrams and photographs all visible injuries.

10. a. If the medical examiner or designee allows recovery of an organ under subsection 7, 8, or 9, the organ procurement organization, upon request, shall cause the physician or technician who removes the organ to provide the medical examiner with a record describing the condition of the organ, a biopsy, a photograph, and any other information and observations that would assist in the postmortem examination.

b. Arrangements for the examination of bodies of such decedents shall be coordinated between the organ procurement organization and the state medical examiner.

c. If applicable, and whenever possible, the forensic pathologist who examined the decedent’s body prior to recovery of the organ shall perform the autopsy. If the forensic pathologist is unable to

accommodate examination of the body due to scheduling or staffing, the request for organ donation may be denied.

11. If a medical examiner or designee is required to be present at a removal procedure under subsection 9, upon request, the organ procurement organization requesting the recovery of the organ shall reimburse the medical examiner or designee for the additional costs incurred in complying with subsection 9.

12. A physician or technician who removes an organ at the direction of the organ procurement organization may be called to testify about findings from the surgical recovery of organs at no cost to taxpayers if the decedent is under the jurisdiction of the medical examiner.

13. a. The medical examiner or pathologist with jurisdiction over the body of a decedent has discretion to grant or deny permission for organ or tissue recovery.

b. If the recovery of organs or tissues may hinder the determination of cause or manner of death or if evidence may be destroyed by the recovery, permission may be denied.

c. The medical examiner or a pathologist performing state autopsies shall work closely with procurement organizations in an effort to balance the needs of the public and the decedent’s next of kin.

142C.5 Persons who may receive anatomical gifts and purposes for which anatomical gifts may be made.

1. An anatomical gift may be made to the following persons named in a document of gift: a. A hospital, accredited medical or osteopathic medical school, dental school, college, or university,

organ procurement organization, or other appropriate person for research or education. b. An eye bank or tissue bank. c. Subject to subsection 2, an individual designated by the person making the anatomical gift if the

individual is the recipient of the part. 2. If an anatomical gift to an individual undersubsection 1, paragraph “c”, cannot be transplanted into

the individual, the part passes in accordance withsubsection 7 in the absence of an express, contrary indication by the person making the anatomical gift.

3. If an anatomical gift of one or more specific parts or of all parts is made in a document of gift that does not name a person described in subsection 1 but identifies the purpose for which an anatomical gift may be used, the following rules apply:

a. If the part is an eye and the gift is for the purpose of transplantation or therapy, the gift passes to the appropriate eye bank.

b. If the part is tissue and the gift is for the purpose of transplantation or therapy, the gift passes to the appropriate tissue bank.

c. If the part is an organ and the gift is for the purpose of transplantation or therapy, the gift passes to the appropriate organ procurement organization as custodian of the organ.

d. If the part is an organ, an eye, or tissue and the gift is for the purpose of research or education, the gift passes to the appropriate procurement organization.

4. For the purpose of subsection 3, if there is more than one purpose of an anatomical gift set forth in the document of gift but the purposes are not set forth in any priority, the gift shall be used for transplantation or therapy, if suitable. If the gift cannot be used for transplantation or therapy, the gift may be used for research or education.

5. If an anatomical gift of one or more specific parts is made in a document of gift that does not name a person described in subsection 1 and does not identify the purpose of the gift, the gift may be used only for transplantation or therapy, and the gift passes in accordance with subsection 7.

6. If a document of gift specifies only a general intent to make an anatomical gift by words such as “donor”, “organ donor”, or “body donor”, or by a symbol or statement of similar import, the gift may be used only for transplantation or therapy, and the gift passes in accordance with subsection 7.

7. For the purposes of subsections 2, 5, and 6, the following rules shall apply: a. If the part is an eye, the gift passes to the appropriate eye bank. b. If the part is tissue, the gift passes to the appropriate tissue bank. c. If the part is an organ, the gift passes to the appropriate organ procurement organization as custodian

of the organ. 8. An anatomical gift of an organ for transplantation or therapy, other than an anatomical gift

undersubsection 1, paragraph “c”, passes to the organ procurement organization as custodian of the organ.

9. If an anatomical gift does not pass pursuant tosubsections 1 through 8, or the decedent’s body or part is not used for transplantation, therapy, research, or education, custody of the body or part passes to the person under obligation to dispose of the body or part.

10. A person shall not accept an anatomical gift if the person knows that the gift was not effectively made under section 142C.3, subsection 2, or section 142C.4, or if the person knows that the decedent made a refusal under section 142C.3, subsection 4, that was not revoked. For purposes of this subsection, if a person knows that an anatomical gift was made on a document of gift, the person is deemed to know of any amendment or revocation of the gift or any refusal to make an anatomical gift on the same document of gift.

11. Except as otherwise provided in subsection 1, paragraph “c”, nothing in this chapter shall affect the allocation of organs for transplantation or therapy.

142C.5A Search and notification. 1. The following persons shall make a reasonable search of an individual who the person reasonably

believes is dead or near death for a document of gift or other information identifying the individual as a donor or as an individual who made a refusal:

a. A law enforcement officer, fire fighter, paramedic, or other emergency rescuer finding the individual. b. If no other source of the information is immediately available, a hospital, as soon as practical after

the individual’s arrival at the hospital. 2. If a document of gift or a refusal to make an anatomical gift is located by the search required

bysubsection 1, paragraph “a”, and the individual or deceased individual to whom it relates is taken to a hospital, the person responsible for conducting the search shall deliver the document of gift or refusal to the hospital.

3. A person is not subject to criminal or civil liability for failing to discharge the duties imposed by this section but may be subject to administrative sanctions.

142C.6 Delivery of document of gift not required — right to examine. 1. A document of gift does not require delivery during the donor’s lifetime to be effective. 2. Upon or after an individual’s death, a person in possession of the document of gift or a refusal to

make an anatomical gift with respect to the individual shall allow examination and copying of the document of gift or the refusal by a person authorized to make or object to the making of an anatomical gift with respect to the individual or by a person to whom the gift could pass under section 142C.5.

142C.7 Confidential information. A hospital, licensed or certified health care professional pursuant to chapter 148, 148C, or 152, or

medical examiner may release patient information to a procurement organization as part of a referral or retrospective review of the patient as a potential donor. Any information regarding a patient, including the patient’s identity, however, constitutes confidential medical information and under any other circumstances is prohibited from disclosure without the written consent of the patient or the patient’s legal representative.

142C.8 Rights and duties of procurement organizations and donors. 1. When a hospital refers an individual at or near death to a procurement organization, the procurement

organization shall make a reasonable search of the records of the state department of transportation and any donor registry that the hospital knows exists for the geographical area in which the individual resides to ascertain whether the individual has made an anatomical gift.

2. A procurement organization shall be allowed reasonable access to information in the records of the state department of transportation to ascertain whether an individual at or near death is a donor.

3. When a hospital refers an individual at or near death to a procurement organization, the procurement organization may conduct any reasonable examination necessary to ensure the medical suitability of a part that is or could be the subject of an anatomical gift for transplantation, therapy, research, or education from a donor or a prospective donor. During the examination period, measures necessary to ensure the medical suitability of the part shall not be withdrawn unless the hospital or procurement organization knows that the individual expressed a contrary intent.

4. Unless prohibited by law other than this chapter, at any time after a donor’s death, the person to whom a part passes under section 142C.5 may conduct any reasonable examination necessary to ensure the medical suitability of the body or part for its intended purpose.

5. Unless prohibited by law other than this chapter, an examination under subsection 3 or 4 may include an examination of all medical and dental records of the donor or prospective donor.

6. Upon the death of a minor who was a donor or had signed a refusal, unless a procurement organization knows the minor is emancipated, the procurement organization shall conduct a reasonable search for the parents of the minor and provide the parents with an opportunity to revoke or amend the anatomical gift or revoke the refusal.

7. Upon referral by a hospital under subsection 1, a procurement organization shall make a reasonable search for any person listed in section 142C.4 having priority to make an anatomical gift on behalf of a prospective donor. If a procurement organization receives information that an anatomical gift to any other person was made, amended, or revoked, the procurement organization shall promptly advise the other person of all relevant information.

8. Subject to section 142C.5, subsection 9, the rights of a person to whom a part passes under section 142C.5 are superior to the rights of all other persons with respect to the part.

9. The person may accept or reject an anatomical gift in whole or in part. Subject to the terms of the document of gift and this chapter, a person who accepts an anatomical gift of an entire body may allow embalming, burial or cremation, and use of the remains in a funeral service. If the gift is of a part, the person to whom the part passes under section 142C.5, upon the death of the donor and prior to embalming, burial, or cremation, shall cause the part to be removed without unnecessary mutilation.

10. The physician who attends the decedent at death and the physician who determines the time of death shall not participate in the procedures for removing or transplanting a part from the decedent.

11. A physician or technician may remove a donated part from the body of a donor that the physician or technician is qualified to remove.

142C.9 Coordination of procurement and use. Each hospital in the state shall enter into agreements or affiliations with procurement organizations for

coordination of procurement and use of anatomical gifts.

142C.10 Sale or purchase of parts prohibited — penalty.

1. A person shall not knowingly, for valuable consideration, purchase or sell a part for transplantation or therapy if removal of the part is intended to occur after the death of the decedent.

2. Valuable consideration does not include reasonable payment for the removal, processing, preservation, quality control, storage, transportation, implantation, or disposal of a part.

3. A person who violates this section commits a class “C” felony.

142C.10A Other prohibited acts — penalty. A person who, in order to obtain a financial gain, intentionally falsifies, forges, conceals, defaces, or

obliterates a document of gift, an amendment or revocation of a document of gift, or a refusal, commits a class “C” felony.

142C.11 Immunity. 1. A person who complies with this chapter in good faith or with the applicable anatomical gift law of

another state, or who attempts in good faith to comply, is immune from liability in any civil action, criminal prosecution, or administrative proceeding.

2. An individual who makes an anatomical gift pursuant to this chapter and the individual’s estate are not liable for any injury or damages that may result from the making or the use of the anatomical gift, if the gift is made in good faith.

3. In determining whether an anatomical gift has been made, amended, or revoked under this chapter, a person may rely upon representations of an individual listed insection 142C.4, subsection 1, paragraph “b”, “c”,“d”, “e”, “f”, “g”, or “h”, relating to the individual’s relationship to the donor or prospective donor unless the person knows that the representation is untrue.

142C.12 Service but not a sale. The procurement, removal, preservation, processing, storage, distribution, or use of parts for the purpose

of injecting, transfusing, or transplanting any of the parts into the human body is, for all purposes, the rendition of a service by every person participating in the act, and whether or not any remuneration is paid, is not a sale of the part for any purposes. However, any person that renders such service warrants only under this section that due care has been exercised and that acceptable professional standards of care in providing such service according to the state of the medical arts have been followed. Strict liability, in tort, shall not be applicable to the rendition of such services.

142C.12A Law governing validity, choice of law, presumption of validity. 1. A document of gift is valid if executed in accordance with any of the following: a. This chapter. b. The laws of the state or country where the document of gift was executed. c. The laws of the state or country where the person making the anatomical gift was domiciled, has a

place of residence, or was a national at the time the document of gift was executed. 2. If a document of gift is valid under this section, the law of this state governs the interpretation of the

document of gift. 3. A person may presume that a document of gift or amendment of an anatomical gift is valid unless

that person knows that it was not validly executed or was revoked.

142C.12B Effect of anatomical gift on advance health care directive. 1. As used in this section:

a. “Advance health care directive” means a durable power of attorney for health care pursuant tochapter 144B or a record signed or authorized by a prospective donor containing the prospective donor’s direction concerning a health care decision for the prospective donor.

b. “Declaration” means a record signed by a prospective donor specifying the circumstances under which a life support system may be withheld or withdrawn from the prospective donor.

c. “Health care decision” means any decision regarding the health care of the prospective donor. 2. a. If a prospective donor has a declaration or advance health care directive and the terms of the

declaration or directive and the express or implied terms of a potential anatomical gift are in conflict with regard to the administration of measures necessary to ensure the medical suitability of a part for transplantation or therapy, the prospective donor’s attending physician and prospective donor shall confer to resolve the conflict.

b. If the prospective donor is incapable of resolving the conflict, an agent acting under the prospective donor’s declaration or directive or, if no agent exists or the agent is not reasonably available, another person, authorized by law other than this chapter to make health care decisions on behalf of the prospective donor, shall act for the donor to resolve the conflict. The agent or other person shall resolve the conflict consistent with the desires of the donor as expressed in a declaration executed in accordance with chapter 144A, or a durable power of attorney for health care executed in accordance with chapter 144B, or as otherwise known, or if not known, consistent with the donor’s best interest.

c. The conflict shall be resolved as expeditiously as possible. d. Information relevant to the resolution of the conflict may be obtained from the appropriate

procurement organization and any other person authorized to make an anatomical gift for the prospective donor under section 142C.4. Prior to resolution of the conflict, measures necessary to ensure the medical suitability of the part shall not be withheld or withdrawn from the prospective donor if withholding or withdrawing the measures is not contraindicated by appropriate end-of-life care.

142C.13 Transitional provisions. This chapter applies to an anatomical gift, or amendment to, revocation of, or refusal to make an

anatomical gift, whenever made.

142C.14 Uniformity of application and construction. This chapter shall be applied and construed with consideration given to the need to promote uniformity

of the law with respect to anatomical gifts among states which enact this law.

142C.14A Electronic signatures. This chapter modifies, limits, and supersedes the federal Electronic Signatures in Global and National

Commerce Act, 15 U.S.C. § 7001 et seq., but does not modify, limit, or authorize electronic delivery of any of the notices described in § 103(b) of that Act, 15 U.S.C. § 7003(b).

142C.15 Anatomical gift public awareness and transplantation fund — established — uses of fund.

1. An anatomical gift public awareness and transplantation fund is created as a separate fund in the state treasury under the control of the Iowa department of public health. The fund shall consist of moneys remitted by the county treasurer of a county or by the department of transportation which were collected through the payment of a contribution made by an applicant for registration of a motor vehicle pursuant tosection 321.44A and any other contributions to the fund.

2. The moneys collected under this section and deposited in the fund are appropriated to the Iowa department of public health for the purposes specified in this section. Moneys in the fund shall not be subject to appropriation or expenditure for any other purpose.

3. The treasurer of state shall act as custodian of the fund and shall disburse amounts contained in the fund as directed by the department. The treasurer of state may invest the moneys deposited in the fund. The income from any investment shall be credited to and deposited in the fund. Notwithstanding section 8.33, moneys in the fund are not subject to reversion to the general fund of the state. The fund shall be administered by the department which shall make expenditures from the fund consistent with the purposes of this section.

4. The Iowa department of public health may use not more than five percent of the moneys in the fund for administrative costs. The remaining moneys in the fund may be expended through grants to any of the following persons, subject to the following conditions:

a. Not more than twenty percent of the moneys in the fund annually may be expended in the form of grants to state agencies or to nonprofit legal entities with an interest in anatomical gift public awareness and transplantation to conduct public awareness projects. Moneys remaining that were not requested and awarded for public awareness projects may be used to support the Iowa donor registry. Grants shall be made based upon the submission of a grant application.

b. Not more than thirty percent of the moneys in the fund annually may be expended in the form of grants to hospitals for reimbursement for costs directly related to the development of in-hospital anatomical gift public awareness projects, anatomical gift referral protocols, and associated administrative expenses. As a condition of receiving a grant, a hospital shall demonstrate, through documentation, that the hospital, during the previous calendar year, properly complied with in-hospital anatomical gift request protocols for all deaths occurring in the hospital at a percentage rate which places the hospital in the upper fifty percent of all protocol compliance rates for hospitals submitting documentation for cost reimbursement under this section.

c. Not more than fifty percent of the moneys in the fund annually may be expended in the form of grants to transplant recipients, transplant candidates, living organ donors, or to legal representatives on behalf of transplant recipients, transplant candidates, or living organ donors. Transplant recipients, transplant candidates, living organ donors, or the legal representatives of transplant recipients, transplant candidates, or living organ donors shall submit grant applications with supporting documentation provided by a hospital that performs transplants, verifying that the person by or for whom the application is submitted requires a transplant or is a living organ donor and specifying the amount of the costs associated with the following, if funds are not available from any other third-party payor:

(1) The costs of the organ transplantation procedure. (2) The costs of post-transplantation drug or other therapy. (3) Other transplantation costs including but not limited to food, lodging, and transportation.

142C.16 Anatomical gift public awareness advisory committee — established — duties. Repealed by 2010 Acts, ch 1031, § 399.

142C.17 Annual donation and compliance report. The Iowa department of public health, in conjunction with any statewide organ procurement

organization in Iowa, shall prepare and submit a report to the general assembly on or before January 1 each year regarding organ donation rates and voluntary compliance efforts with hospital organ and tissue donation protocols by physicians, hospitals, and other health systems organizations. The report shall contain the following:

1. An evaluation of organ procurement efforts in the state, including statistics regarding organ and tissue donation activity as of September 30 of the preceding year.

2. Efforts by any statewide organ procurement organization in Iowa, and related parties, to increase organ and tissue donation and consent rates.

3. Voluntary compliance efforts with hospital organ and tissue donation protocols by physicians, hospitals, and health systems organizations and the results of those efforts.

4. Annual contribution levels to the anatomical gift public awareness and transplantation fund created insection 142C.15, and any distributions made from the fund.

5. Efforts and ideas for increasing public awareness of the option of organ and tissue donation. 6. Additional information deemed relevant by the department in assessing the status and progress of

organ and tissue donation efforts in the state.

142C.18 Iowa donor registry. 1. The director of public health shall contract with and recognize the Iowa donor registry for the

purpose of indicating on the donor registry all relevant information regarding a donor’s making or amending of an anatomical gift.

2. The state department of transportation shall cooperate with a person that administers the Iowa donor registry for the purpose of transferring to the donor registry all relevant information regarding a donor’s making of an anatomical gift.

3. The Iowa donor registry shall do all of the following: a. Allow a donor or other person authorized undersection 142C.3 to include on the donor registry a

statement or symbol that the donor has made or amended an anatomical gift. b. Be accessible to a procurement organization to allow the procurement organization to obtain relevant

information on the donor registry to determine, at or near the death of the donor or a prospective donor, whether the donor or prospective donor has made, amended, or revoked an anatomical gift.

c. Be accessible for purposes of paragraphs “a”and “b” seven days a week on a twenty-four-hour per day basis.

d. Provide a centralized, automated system to compile donation information received by the state department of transportation, county treasurers, and the Iowa donor network.

e. Provide educational materials regarding the making, amending, or revoking of an anatomical gift or a refusal to make an anatomical gift.

4. Personally identifiable information on the donor registry about a donor or prospective donor shall not be used or disclosed without the express consent of the donor, prospective donor, or person that made the anatomical gift for any purpose other than to determine, at or near the death of the donor or prospective donor, whether the donor or prospective donor has made, amended, or revoked an anatomical gift.

CHAPTER 144 VITAL STATISTICS

144.1 Definitions. As used in this chapter, unless the context otherwise requires: 1. “Board” means the state board of health. 2. “Book”, “list”, “record”, or “schedule” kept by a county auditor, assessor, treasurer, recorder,

sheriff, or other county officer means the county system as defined in section 445.1.

3. “Court of competent jurisdiction” when used to refer to inspection of an original certificate of birth based upon an adoption means the court where the adoption was ordered.

4. “Dead body” means a lifeless human body or parts or bones of a body, if, from the state of the body, parts, or bones, it may reasonably be concluded that death recently occurred.

5. “Department” means the Iowa department of public health. 6. “Division” means a division, within the department, for records and statistics. 7. “Fetal death” means death prior to the complete expulsion or extraction from its mother of a product

of human conception, irrespective of the duration of pregnancy. Death is indicated by the fact that after expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. In determining a fetal death, heartbeats shall be distinguished from transient cardiac contractions, and respirations shall be distinguished from fleeting respiratory efforts or gasps.

8. “Filing” means the presentation of a certificate, report, or other record, provided for in this chapter, of a birth, death, fetal death, adoption, marriage, dissolution, or annulment for registration by the division.

9. “Final disposition” means the burial, interment, cremation, removal from the state, or other disposition of a dead body or fetus.

10. “Institution” means any establishment, public or private, which provides inpatient medical, surgical, or diagnostic care or treatment, or nursing, custodial, or domiciliary care to two or more unrelated individuals, or to which persons are committed by law.

11. “Live birth” means the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy, which, after such expulsion or extraction, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached. In determining a live birth, heartbeats shall be distinguished from transient cardiac contractions, and respirations shall be distinguished from fleeting respiratory efforts or gasps.

12. “Registration” means the process by which vital statistic records are completed, filed, and incorporated by the division in the division’s official records.

13. “State registrar” means the state registrar of vital statistics. 14. “System of vital statistics” includes the registration, collection, preservation, amendment, and

certification of vital statistics records, and activities and records related thereto including the data processing, analysis, and publication of statistical data derived from such records.

15. “Vital statistics” means records of births, deaths, fetal deaths, adoptions, marriages, dissolutions, annulments, and data related thereto.

144.2 Division of records and statistics. There is established in the department a division for records and statistics which shall install, maintain,

and operate the system of vital statistics throughout the state. No system for the registration of births, deaths, fetal deaths, adoptions, marriages, dissolutions, and annulments, shall be maintained in the state or any of its political subdivisions other than the one provided for inthis chapter. Suitable quarters shall be provided for the division by the executive council at the seat of government. The quarters shall be properly equipped for the permanent and safe preservation of all official records made and returned under this chapter.

144.9 County recorder as registrar. The county recorder is the county registrar and with respect to the county shall: 1. Administer and enforce this chapter and the rules issued by the department.

2. Record and transmit the certificates, reports, or other returns filed with the county registrar to the state registrar at least semimonthly, or more frequently when directed by the state registrar.

144.9 County recorder as registrar. The county recorder is the county registrar and with respect to the county shall: 1. Administer and enforce this chapter and the rules issued by the department. 2. Record and transmit the certificates, reports, or other returns filed with the county registrar to the

state registrar at least semimonthly, or more frequently when directed by the state registrar.

144.11 Public access to records. The county registrar shall allow public access to public records under the custody of the county registrar

during normal business hours for county offices in the county.

144.12 Forms uniform. In order to promote and maintain uniformity in the system of vital statistics, the forms of certificates,

reports, and other returns shall include as a minimum the items recommended by the federal agency responsible for national vital statistics, subject to approval and modification by the department. Forms shall be furnished by the department. The forms or other recording methods used to register records required under this chapter shall be prescribed by the department.

144.16 Delayed registration of death or marriage. When a death or marriage occurring in this state has not been registered, a certificate may be filed in

accordance with regulations. Such certificate shall be registered subject to evidentiary requirements prescribed to substantiate the alleged facts of death or marriage. Certificates of death and marriage registered one year or more after the date of occurrence shall be marked “delayed” and shall show on their face the date of the delayed registration.

144.26 Death certificate. 1. A death certificate for each death which occurs in this state shall be filed as directed by the state

registrar within three days after the death and prior to final disposition, and shall be registered by the county registrar if it has been completed and filed in accordance with this chapter. A death certificate shall include the social security number, if provided, of the deceased person. All information including the certifying physician’s name shall be typewritten.

2. All information included on a death certificate may be provided as mutually agreed upon by the division and the child support recovery unit, including by automated exchange.

3. The county in which a dead body is found is the county of death. If death occurs in a moving conveyance, the county in which the dead body is first removed from the conveyance is the county of death.

4. a. The department shall establish by rule procedures for making a finding of presumption of death when no body can be found. The department shall also provide by rule the responsibility for completing and signing the medical certification of cause of death in such circumstances. The presumptive death certificate shall be in a form prescribed by the state registrar and filed in the county where the death was presumed to occur.

b. The division shall provide for the correction, substitution, or removal of a presumptive death certificate when the body of the person is later found, additional facts are discovered, or the person is discovered to be alive.

144.27 Funeral director’s duty. The funeral director who first assumes custody of a dead body shall file the death certificate, obtain the

personal data from the next of kin or the best qualified person or source available and obtain the medical certification of cause of death from the person responsible for completing the certification. When a person other than a funeral director assumes custody of a dead body, the person shall be responsible for carrying out the provisions of this section.

144.28 Medical certification. 1. a. For the purposes of this section,“nonnatural cause of death” means the death is a direct or

indirect result of physical, chemical, thermal, or electrical trauma, or drug or alcohol intoxication or other poisoning.

b. Unless there is a nonnatural cause of death, the medical certification shall be completed and signed by the physician in charge of the patient’s care for the illness or condition which resulted in death within seventy-two hours after receipt of the death certificate from the funeral director or individual who initially assumes custody of the body.

c. If there is a nonnatural cause of death, the county or state medical examiner shall be notified and shall conduct an inquiry.

d. If the decedent was an infant or child and the cause of death is not known, a medical examiner’s inquiry shall be conducted and an autopsy performed as necessary to exclude a nonnatural cause of death.

e. If upon inquiry into a death, the county or state medical examiner determines that a preexisting natural disease or condition was the likely cause of death and that the death does not affect the public interest as described in section 331.802, subsection 3, the medical examiner may elect to defer to the physician in charge of the patient’s preexisting condition the certification of the cause of death.

f. When an inquiry is required by the county or state medical examiner, the medical examiner shall investigate the cause and manner of death and shall complete and sign the medical certification within seventy-two hours after determination of the cause and manner of death.

2. The person completing the medical certification of cause of death shall attest to its accuracy either by signature or by an electronic process approved by rule.

144.29 Fetal deaths. A fetal death certificate for each fetal death which occurs in this state after a gestation period of twenty

completed weeks or greater, or for a fetus with a weight of three hundred fifty grams or more shall be filed as directed by the state registrar within three days after delivery and prior to final disposition of the fetus. The certificate shall be registered if it has been completed and filed in accordance with this chapter.

The county in which a dead fetus is found is the county of death. The certificate shall be filed within three days after the fetus is found. If a fetal death occurs in a moving conveyance, the county in which the fetus is first removed from the conveyance is the county of death.

144.29A Termination of pregnancy reporting. 1. A health care provider who initially identifies and diagnoses a spontaneous termination of pregnancy

or who induces a termination of pregnancy shall file with the department a report for each termination within thirty days of the occurrence. The health care provider shall make a good faith effort to obtain all of the following information that is available with respect to each termination:

a. The confidential health care provider code as assigned by the department. b. The report tracking number.

c. The maternal health services region of the Iowa department of public health, as designated as of July 1, 1997, in which the patient resides.

d. The race of the patient. e. The age of the patient. f. The marital status of the patient. g. The educational level of the patient. h. The number of previous pregnancies, live births, and spontaneous or induced terminations of

pregnancies. i. The month and year in which the termination occurred. j. The number of weeks since the patient’s last menstrual period and a clinical estimate of gestation. k. The method used for an induced termination, including whether mifepristone was used. 2. It is the intent of the general assembly that the information shall be collected, reproduced, released,

and disclosed in a manner specified by rule of the department, adopted pursuant to chapter 17A, which ensures the anonymity of the patient who experiences a termination of pregnancy, the health care provider who identifies and diagnoses or induces a termination of pregnancy, and the hospital, clinic, or other health facility in which a termination of pregnancy is identified and diagnosed or induced. The department may share information with federal public health officials for the purposes of securing federal funding or conducting public health research. However, in sharing the information, the department shall not relinquish control of the information, and any agreement entered into by the department with federal public health officials to share information shall prohibit the use, reproduction, release, or disclosure of the information by federal public health officials in a manner which violates this section. The department shall publish, annually, a demographic summary of the information obtained pursuant to this section, except that the department shall not reproduce, release, or disclose any information obtained pursuant to this section which reveals the identity of any patient, health care provider, hospital, clinic, or other health facility, and shall ensure anonymity in the following ways:

a. The department may use information concerning the report tracking number or concerning the identity of a reporting health care provider, hospital, clinic, or other health facility only for purposes of information collection. The department shall not reproduce, release, or disclose this information for any purpose other than for use in annually publishing the demographic summary under this section.

b. The department shall enter the information, from any report of termination submitted, within thirty days of receipt of the report, and shall immediately destroy the report following entry of the information. However, entry of the information from a report shall not include any health care provider, hospital, clinic, or other health facility identification information including, but not limited to, the confidential health care provider code, as assigned by the department.

c. To protect confidentiality, the department shall limit release of information to release in an aggregate form which prevents identification of any individual patient, health care provider, hospital, clinic, or other health facility. For the purposes of this paragraph,“aggregate form” means a compilation of the information received by the department on termination of pregnancies for each information item listed, with the exceptions of the report tracking number, the health care provider code, and any set of information for which the amount is so small that the confidentiality of any person to whom the information relates may be compromised. The department shall establish a methodology to provide a statistically verifiable basis for any determination of the correct amount at which information may be released so that the confidentiality of any person is not compromised.

3. Except as specified in subsection 2, reports, information, and records submitted and maintained pursuant to this section are strictly confidential and shall not be released or made public upon subpoena, search warrant, discovery proceedings, or by any other means.

4. The department shall assign a code to any health care provider who may be required to report a termination under this section. An application procedure shall not be required for assignment of a code to a health care provider.

5. A health care provider shall assign a report tracking number which enables the health care provider to access the patient’s medical information without identifying the patient.

6. To ensure proper performance of the reporting requirements under this section, it is preferred that a health care provider who practices within a hospital, clinic, or other health facility authorize one staff person to fulfill the reporting requirements.

7. For the purposes of this section, “health care provider” means an individual licensed under chapter 148, 148C, 148D, or 152, or any individual who provides medical services under the authorization of the licensee.

8. For the purposes of this section, “inducing a termination of pregnancy” means the use of any means to terminate the pregnancy of a woman known to be pregnant with the intent other than to produce a live birth or to remove a dead fetus.

9. For the purposes of this section, “spontaneous termination of pregnancy” means the occurrence of an unintended termination of pregnancy at any time during the period from conception to twenty weeks gestation and which is not a spontaneous termination of pregnancy at any time during the period from twenty weeks or greater which is reported to the department as a fetal death under this chapter.

144.30 Funeral director’s duty — fetal death certificate. The funeral director who first assumes custody of a fetus shall file the fetal death certificate. In the

absence of such a person, the physician or other person in attendance at or after the delivery shall file the certificate of fetal death. The person filing the certificate shall obtain the personal data from the next of kin or the best qualified person or source available and shall obtain the medical certification of cause of death from the person responsible for completing the certification. When a person other than a funeral director assumes custody of a fetus, the person shall be responsible for carrying out the provisions of this section.

144.31 Medical certification — fetal death. 1. The medical certification for a fetal death shall be completed within seventy-two hours after delivery

by the physician in attendance at or after delivery except when inquiry is required by the county medical examiner.

2. When a fetal death occurs without medical attendance upon the mother at or after delivery or when inquiry is required by the county medical examiner, the medical examiner shall investigate the cause of fetal death and shall complete the medical certification within seventy-two hours after taking charge of the case. The person completing the medical certification of cause of fetal death shall attest to its accuracy either by signature or as authorized by rule.

144.32 Burial transit permit. If a person other than a funeral director, medical examiner, or emergency medical service assumes

custody of a dead body or fetus, the person shall secure a burial transit permit. To be valid, the burial transit permit must be issued by the county medical examiner, a funeral director, or the county registrar of the county where the certificate of death or fetal death was filed. The permit shall be obtained prior to the removal of the body or fetus from the place of death and the permit shall accompany the body or fetus to the place of final disposition.

To transfer a dead body or fetus outside of this state, the funeral director who first assumes custody of the dead body or fetus shall obtain a burial transit permit prior to the transfer. The permit shall accompany the dead body or fetus to the place of final disposition.

A dead body or fetus brought into this state for final disposition shall be accompanied by a burial transit permit under the law of the state in which the death occurred.

A burial transit permit shall not be issued to a person other than a funeral director when the cause of death is or is suspected to be a communicable disease as defined by rule of the department.

144.33 Bodies brought into state. A burial transit permit issued under the law of another state which accompanies a dead body or fetus

brought into this state shall be authority for final disposition of the body or fetus in this state.

144.34 Disinterment — permit. Disinterment of a dead body or fetus shall be allowed for the purpose of autopsy or reburial only, and

then only if accomplished by a funeral director. A permit for such disinterment and, thereafter, reinterment shall be issued by the state registrar according to rules adopted pursuant to chapter 17A or when ordered by the district court of the county in which such body is buried. The state registrar, without a court order, shall not issue a permit without the consent of the person authorized to control the decedent’s remains undersection 144C.5. Disinterment for the purpose of reburial may be allowed by court order only upon a showing of substantial benefit to the public. Disinterment for the purpose of autopsy or reburial by court order shall be allowed only when reasonable cause is shown that someone is criminally or civilly responsible for such death, after hearing, upon reasonable notice prescribed by the court to the person authorized to control the decedent’s remains undersection 144C.5. Due consideration shall be given to the public health, the dead, and the feelings of relatives.

144.35 Extensions of time by rules. The department may, by regulation and upon such conditions as it may prescribe to assure compliance

with the purposes of this chapter, provide for extension of the periods prescribed in sections 144.26, 144.28, 144.29, and 144.31, for filing of death certificates, fetal death certificates, and medical certifications of cause of death in cases in which compliance with the applicable prescribed period would result in undue hardship.

144.38 Amendment of official record. To protect the integrity and accuracy of vital statistics records, a certificate or record registered

under this chapter may be amended only in accordance with this chapter and regulations adopted hereunder. A certificate that is amended under this section shall be marked “amended” except as provided in section 144.40. The date of amendment and a summary description of the evidence submitted in support of the amendment shall be endorsed on or made a part of the record. The department shall prescribe by regulation the conditions under which additions or minor corrections shall be made to birth certificates within one year after the date of birth without the certificate being marked “amended”.

144.43 Vital records closed to inspection — exceptions. 1. To protect the integrity of vital statistics records, to ensure their proper use, and to ensure the

efficient and proper administration of the vital statistics system kept by the state registrar, access to vital statistics records kept by the state registrar shall be limited to the state registrar and the state registrar’s employees, and then only for administrative purposes.

2. a. It shall be unlawful for the state registrar to permit inspection of, or to disclose information contained in vital statistics records, or to copy or permit to be copied all or part of any such record except as authorized by regulation.

b. However, the following vital statistics records may be inspected and copied as of right under chapter 22when they are in the custody of a county registrar or when they are in the custody of the state archivist and are at least seventy-five years old:

(1) A record of birth. (2) A record of marriage. (3) A record of divorce, dissolution of marriage, or annulment of marriage. (4) A record of death if that death was not a fetal death. 3. A public record shall not be withheld from the public because it is combined with data processing

software. The state registrar shall not implement any electronic data processing system for the storage, manipulation, or retrieval of vital records that would impair a county registrar’s ability to permit the examination of a public record and the copying of a public record, as established by rule. If it is necessary to separate a public record from data processing software in order to permit the examination of the public record, the county registrar shall periodically generate a written log available for public inspection which contains the public record.

144.44 Permits for research. The department may permit access to vital statistics by professional genealogists and historians, and

may authorize the disclosure of data contained in vital statistics records when deemed essential for bona fide research purposes which are not for private gain. The department shall adopt rules which establish the parameters for access to and authorized disclosure of vital statistics and data contained in vital statistics records relating to birth and adoption records under this section.

144.45 Certified copies. The state registrar and the county registrar shall, upon written request from any applicant entitled to a

record, issue a certified copy of any certificate or record in the registrar’s custody or of a part of a certificate or record. Each copy issued shall show the date of registration; and copies issued from records marked “delayed”, “amended”, or “court order” shall be similarly marked and show the effective date.

A certified copy of a certificate, or any part thereof, shall be considered for all purposes the same as the original and shall be prima facie evidence of the facts therein stated, provided that the evidentiary value of a certificate or record filed more than one year after the event, or a record which has been amended, shall be determined by the judicial or administrative body or official before whom the certificate is offered as evidence.

The national division of vital statistics may be furnished copies or data which it requires for national statistics, provided that the state be reimbursed for the cost of furnishing data, and provided further that data shall not be used for other than statistical purposes by the national division of vital statistics unless so authorized by the state registrar.

Federal, state, local, and other public or private agencies may, upon written request, be furnished copies or data for statistical purposes upon terms or conditions prescribed by the department.

No person shall prepare or issue any certificate which purports to be an original, certified copy, or copy of a certificate of birth, death, fetal death, or marriage except as authorized in this chapter.

144.48 Institutions — dead persons.

When a dead human body is released or disposed of by an institution, the person in charge of the institution shall keep a record showing the name of the deceased, date of death, name and address of the person to whom the body is released, date of removal from the institution, or if finally disposed of by the institution, the date, place, and manner of disposition shall be recorded.

144.49 Additional record by funeral director. A funeral director or other person who removes from the place of death or transports or finally disposes

of a dead body or fetus, in addition to filing any certificate or other form required by this chapter, shall keep a record which shall identify the body, and information pertaining to the funeral director’s or other person’s receipt, removal, and delivery of the body as prescribed by the department.

144.50 Length of time records to be kept. Records maintained under sections 144.47 to 144.49shall be retained for a period of not less than ten

years and shall be made available for inspection by the state registrar or the state registrar’s representative upon demand.

144.51 Information by others furnished on demand. Any person having knowledge of the facts shall furnish information the person possesses regarding any

birth, death, fetal death, adoption, marriage, dissolution, or annulment, upon demand of the state registrar or the state registrar’s representative.

144.52 Unlawful acts — punishment. Any person committing any of the following acts is guilty of a serious misdemeanor: 1. Willfully and knowingly makes any false statement in a report, record, or certificate required to be

filed under this chapter, or in an application for an amendment thereof, or willfully and knowingly supplies false information intending that such information be used in the preparation of any such report, record, or certificate, or amendment thereof.

2. Without lawful authority and with the intent to deceive, makes, alters, amends, or mutilates any report, record, or certificate required to be filed under this chapter or a certified copy of such report, record, or certificate.

3. Willfully and knowingly uses or attempts to use or furnish to another for use for any purpose of deception, any certificate, record, report, or certified copy thereof so made, altered, amended, or mutilated.

4. Willfully, with the intent to deceive, uses or attempts to use any certificate of birth or certified copy of a record of birth knowing that such certificate or certified copy was issued upon a record which is false in whole or in part or which relates to the birth of another person.

5. Willfully and knowingly furnishes a certificate of birth or certified copy of a record of birth with the intention that it be used by a person other than the person whose birth the record relates.

6. Disinterring a body in violation of section 144.34. 7. Knowingly violates a provision of section 144.29A.

144.53 Other acts — simple misdemeanors. Any person committing any of the following acts is guilty of a simple misdemeanor: 1. Knowingly transports or accepts for transportation, interment, or other disposition a dead body

without an accompanying permit as provided in this chapter. 2. Refuses to provide information required by this chapter.

3. Willfully violates any of the provisions of this chapter or refuses to perform any of the duties imposed upon the person by this chapter.

144.54 Report to county attorney. The department shall report cases of alleged violations to the proper county attorney, with a statement of

the facts and circumstances, for such action as is appropriate.

144.55 Attorney general to assist in enforcement. Upon request of the department, the attorney general shall assist in the enforcement of the provisions

of this chapter.

144.56 Autopsy. 1. An autopsy or postmortem examination may be performed upon the body of a deceased person by a

physician whenever the written consent to the examination or autopsy has been obtained from the person authorized to control the deceased person’s remains under section 144C.5.

2. This section does not apply to any death investigated under the authority of sections 331.802 to331.804.

144.57 Public safety officer death — required notice — autopsy. A person who is authorized to pronounce individuals dead is required to inform one of the persons

authorized to request an autopsy, as provided in section 144.56, that an autopsy will be required if the individual who died was a public safety officer* who may have died in the line of duty and an eligible beneficiary of the deceased seeks to claim a federal public safety officer death benefit.*

CHAPTER 144C FINAL DISPOSITION ACT

144C.1 Short title. This chapter may be cited as the “Final Disposition Act”. 144C.2 Definitions. As used in this chapter, unless the context otherwise requires: 1. “Adult” means a person who is married or who is eighteen years of age or older. 2. “Adult day services program” means adult day services program as defined in section 231D.1. 3. “Assisted living program” means an assisted living program under chapter 231C. 4. “Ceremony” means a formal act or set of formal acts established by custom or authority to

commemorate a decedent. 5. “Child” means a son or daughter of a person, whether by birth or adoption. 6. “Decedent” means a deceased adult. 7. “Declarant” means a competent adult who executes a declaration pursuant to this chapter. 8. “Declaration” means a written instrument, contained in or attached to a durable power of attorney

for health care under chapter 144B, that is executed by a declarant in accordance with the requirements ofthis chapter, and that names a designee who shall have the sole responsibility and discretion for making decisions concerning the final disposition of the declarant’s remains and the ceremonies planned after the declarant’s death.

9. “Designee” means a competent adult designated under a declaration who shall have the sole responsibility and discretion for making decisions concerning the final disposition of the declarant’s remains and the ceremonies planned after the declarant’s death.

10. “Elder group home” means elder group home as defined in section 231B.1. 11. “Final disposition” means the burial, interment, cremation, removal from the state, or other

disposition of remains. 12. “Health care facility” means health care facility as defined in section 135C.1. 13. “Health care provider” means health care provider as defined in section 144A.2. 14. “Hospital” means hospital as defined in section 135B.1. 15. “Interested person” means a decedent’s spouse, parent, grandparent, adult child, adult sibling, adult

grandchild, or a designee. 16. “Licensed hospice program” means a licensed hospice program as defined in section 135J.1. 17. “Reasonable under the circumstances” means consideration of what is appropriate in relation to the

declarant’s finances, cultural or family customs, and religious or spiritual beliefs. “Reasonable under the circumstances” may include but is not limited to consideration of the declarant’s preneed funeral, burial, or cremation plan, and known or reasonably ascertainable creditors of the declarant.

18. “Remains” means the body or cremated remains of a decedent. 19. a. “Third party” means a person who is requested to dispose of remains by an adult with the right

to dispose of a decedent’s remains under section 144C.5 or assist with arrangements for ceremonies planned after the declarant’s death.

b. “Third party” includes but is not limited to a funeral director, funeral establishment, cremation establishment, cemetery, the state medical examiner, or a county medical examiner.

144C.3 Declaration — designee. 1. A declaration shall name a designee who shall have the sole responsibility and discretion for making

decisions concerning the final disposition of the declarant’s remains and the ceremonies planned after the declarant’s death. A declaration may name one or more alternate designees and may include contact information for the designees and alternate designees.

2. A declaration shall not include directives for final disposition of the declarant’s remains and shall not include arrangements for ceremonies planned after the declarant’s death.

3. A designee, an alternate designee, and a third party shall act in good faith and in a manner that is reasonable under the circumstances.

4. A funeral director, an attorney, or any agent, owner, or employee of a funeral establishment, cremation establishment, cemetery, elder group home, assisted living program, adult day services program, or licensed hospice program shall not serve as a designee unless related to the declarant within the third degree of consanguinity.

5. This section shall not be construed to permit a person who is not licensed pursuant to chapter 156 to make funeral arrangements.

144C.4 Reliance — immunities. 1. A designee or third party who relies in good faith on a declaration is not subject to civil liability or to

criminal prosecution or professional disciplinary action to any greater extent than if the designee or third party dealt directly with the declarant as a fully competent and living person.

2. A designee or third party who relies in good faith on a declaration may presume, in the absence of actual knowledge to the contrary, all of the following:

a. That the declaration was validly executed.

b. That the declarant was competent at the time the declaration was executed. 3. A third party who relies in good faith on a declaration is not subject to civil or criminal liability for

the proper application of property delivered or surrendered in compliance with decisions made by the designee including but not limited to trust funds held pursuant to chapter 523A.

4. A third party who has reasonable cause to question the authenticity or validity of a declaration may promptly and reasonably seek additional information from the person proffering the declaration or from other persons to verify the declaration.

5. The state medical examiner or a county medical examiner shall not be subject to civil liability or to criminal prosecution or professional disciplinary action for releasing a decedent’s remains to a person who is not a designee or alternate designee.

6. This section shall not be construed to impair any contractual obligations of a designee or third party incurred in fulfillment of a declaration.

144C.5 Final disposition of remains — right to control. 1. The right to control final disposition of a decedent’s remains or to make arrangements for the

ceremony after a decedent’s death vests in and devolves upon the following persons who are competent adults at the time of the decedent’s death, in the following order:

a. A designee, or alternate designee, acting pursuant to the decedent’s declaration. b. The surviving spouse of the decedent, if not legally separated from the decedent, whose whereabouts

is reasonably ascertainable. c. A surviving child of the decedent, or, if there is more than one, a majority of the surviving children

whose whereabouts are reasonably ascertainable. d. The surviving parents of the decedent whose whereabouts are reasonably ascertainable. e. A surviving grandchild of the decedent, or, if there is more than one, a majority of the surviving

grandchildren whose whereabouts are reasonably ascertainable. f. A surviving sibling of the decedent, or, if there is more than one, a majority of the surviving siblings

whose whereabouts are reasonably ascertainable. g. A surviving grandparent of the decedent, or, if there is more than one, a majority of the surviving

grandparents whose whereabouts are reasonably ascertainable. h. A person in the next degree of kinship to the decedent in the order named by law to inherit the estate

of the decedent under the rules of inheritance for intestate succession or, if there is more than one, a majority of such surviving persons whose whereabouts are reasonably ascertainable.

i. A person who represents that the person knows the identity of the decedent and who signs an affidavit warranting the identity of the decedent and assuming the right to control final disposition of the decedent’s remains and the responsibility to pay any expense attendant to such final disposition. A person who warrants the identity of the decedent pursuant to this paragraph is liable for all damages that result, directly or indirectly, from that warrant.

j. The county medical examiner, if responsible for the decedent’s remains. 2. A third party may rely upon the directives of a person who represents that the person is a member of

a class of persons described in subsection 1, paragraph“c”, “e”, “f”, “g”, or “h”, and who signs an affidavit stating that all other members of the class, whose whereabouts are reasonably ascertainable, have been notified of the decedent’s death and the person has received the assent of a majority of those members of that class of persons to control final disposition of the decedent’s remains and to make arrangements for the performance of a ceremony for the decedent.

3. A third party may await a court order before proceeding with final disposition of a decedent’s remains or arrangements for the performance of a ceremony for a decedent if the third party is aware of a

dispute among persons who are members of the same class of persons described in subsection 1, or of a dispute between persons who are authorized undersubsection 1 and the executor named in a decedent’s will or a personal representative appointed by the court.

144C.6 Declaration of designee — form — requirements. 1. A declaration executed pursuant to this chaptermay but need not be in the following form:

I hereby designate .......... as my designee. My designee shall have the sole responsibility for making decisions concerning the final disposition of my remains and the ceremonies to be performed after my death. This declaration hereby revokes all prior declarations. This designation becomes effective upon my death. My designee shall act in a manner that is reasonable under the circumstances. I may revoke or amend this declaration at any time. I agree that a third party (such as a funeral or cremation establishment, funeral director, or cemetery) who receives a copy of this declaration may act in reliance on it. Revocation of this declaration is not effective as to a third party until the third party receives notice of the revocation. My estate shall indemnify my designee and any third party for costs incurred by them or claims arising against them as a result of their good faith reliance on this declaration. I execute this declaration as my free and voluntary act.

2. A declaration executed pursuant to this chaptershall be in a written form that substantially complies with the form in subsection 1, is properly completed, is contained in or attached to a durable power of attorney for health care under chapter 144B, and is dated and signed by the declarant or another person acting on the declarant’s behalf at the direction of and in the presence of the declarant. In addition, a declaration shall be either of the following:

a. Signed by at least two individuals who are not named therein and who, in the presence of each other and the declarant, witnessed the signing of the declaration by the declarant, or another person acting on the declarant’s behalf at the direction of and in the presence of the declarant, and witnessed the signing of the declaration by each other.

b. Acknowledged before a notarial officer. 3. A declaration may include the location of an agreement for prearranged funeral services or funeral

merchandise as defined in and executed under chapter 523A, cemetery lots owned by or reserved for the declarant, and special instructions regarding organ donation consistent with chapter 142C.

4. A declaration for disposition of remains made by a service member, as defined in section 29A.90, on forms provided and authorized by the department of defense for service members for this purpose shall constitute a valid declaration of designee for purposes of this chapter.

144C.7 Revocation of declaration. 1. A declaration is revocable by a declarant in a writing signed and dated by the declarant. 2. Unless otherwise expressly provided in a declaration: a. A dissolution of marriage, annulment of marriage, or legal separation between the declarant and the

declarant’s spouse that occurs subsequent to the execution of the declaration constitutes an automatic revocation of the spouse as a designee.

b. A designation of a person as a designee pursuant to a declaration is ineffective if the designation is revoked by the declarant in writing subsequent to the execution of the declaration or if the designee is unable or unwilling to serve as the designee.

144C.8 Forfeiture of designee’s authority. A designee shall forfeit all rights and authority under a declaration and all rights and authority under the

declaration shall vest in and devolve upon an alternate designee, or if there is none, vest in and devolve pursuant to section 144C.5, under either of the following circumstances:

1. The designee is charged with murder in the first or second degree or voluntary manslaughter in connection with the declarant’s death and those charges are known to a third party.

2. The designee does not exercise the designee’s authority under the declaration within twenty-four hours of receiving notification of the death of the declarant or within forty hours of the declarant’s death, whichever is earlier.

144C.9 Interstate effect of declaration. Unless otherwise expressly provided in a declaration: 1. It is presumed that the declarant intended to have a declaration executed pursuant to this

chapter have the full force and effect of law in any state of the United States, the District of Columbia, and any other territorial possessions of the United States.

2. A declaration or similar instrument executed in another state that complies with the requirements of this chapter may be relied upon, in good faith, by the designee, an alternate designee, and a third party in this state so long as the declaration is not invalid, illegal, or unconstitutional in this state.

SUBTITLE 3 HEALTH-RELATED PROFESSIONS

CHAPTER 156 FUNERAL DIRECTING, MORTUARY SCIENCE, AND CREMATION

156.1 Definitions. As used in this chapter unless the context otherwise requires: 1. “Board” means the board of mortuary science. 2. “Cremation” means the technical process, using heat and flame, that reduces human remains to bone

fragments. The reduction takes place through heat and evaporation. Cremation shall include the processing, and may include the pulverization, of the bone fragments.

3. “Cremation establishment” means a place of business as defined by the board which provides any aspect of cremation services.

4. “Funeral director” means a person licensed by the board to practice mortuary science. 5. “Funeral establishment” means a place of business as defined by the board devoted to providing any

aspect of mortuary science. 6. “Intern” means a person registered by the board to practice mortuary science under the direct

supervision of a preceptor certified by the board. 7. “Mortuary science” means the engaging in any of the following: a. Preparing, for burial or disposal, or directing and supervising burial or disposal of dead human bodies

except supervising cremations.

b. Making funeral arrangements or furnishing any funeral services in connection with disposition of dead human bodies or sale of any casket, vault, urn, or other burial receptacle.

c. Using the words “funeral director”, “mortician”, or any other title implying that the person is engaged as a funeral director as defined in this section.

d. Embalming dead human bodies, entire or in part, by the use of chemical substances, fluids, or gases in the body, or by the introduction of the same into the body by vascular injections, hypodermic injections, or by surface application into the organs or cavities for the purpose of preservation or disinfection.

156.1A Provision of services. Nothing contained in this chapter shall be construed as prohibiting the operation of any funeral home,

funeral establishment, or cremation establishment by any person, heir, fiduciary, firm, cooperative burial association, or corporation. However, each such person, firm, cooperative burial association, or corporation shall ensure that all mortuary science services are provided by a funeral director, and shall keep the Iowa department of public health advised of the name of the funeral director.

156.2 Persons excluded. Section 156.1 shall not be construed to include the following classes of persons: 1. Manufacturers, wholesalers, distributors, and retailers of caskets, vaults, urns, or other burial

receptacles not engaged in the other functions of furnishing of funeral services or embalming as above defined.

2. Those who use bodies for scientific purposes as defined in sections 142.1, 142.2, and 142.5; or those who make scientific examinations of dead bodies; or those who perform autopsies.

3. Physicians or institutions who preserve parts of human bodies either for scientific purposes or for use as evidence in prospective legal cases.

4. Persons who, without compensation, bury their own dead under a burial transit permit secured pursuant to section 144.32.

156.3 Eligibility requirements. To be eligible to take the examination for a funeral director’s license, a person must have completed two

academic years of instruction in a recognized college or university in a course of study approved by the board or have equivalent education as defined by the board and have satisfactorily completed a course of instruction in mortuary science in an accredited school approved by the board.

156.4 Funeral directors. 1. The practice of a funeral director must be conducted from a funeral establishment licensed by the

board. The board may specify criteria for exceptions to the requirement of this subsection in rules. 2. A person shall not engage in the practice of mortuary science unless licensed. 3. Applications for the examination for a funeral director’s license shall be verified on a form furnished

by the board. 4. Applicants shall pass an examination prescribed by the board, which shall include the subjects of

funeral directing, burial or other disposition of dead human bodies, sanitary science, embalming, restorative art, anatomy, public health, transportation, business ethics, and such other subjects as the board may designate.

5. After the applicant has completed satisfactorily the course of instruction in mortuary science in an accredited school approved by the board, the applicant must pass the examination prescribed by the board

as provided in section 147.34. The applicant may then receive an internship certificate and shall then complete a minimum one-year internship as determined by the board. 156.5 to 156.7 Repealed by 78 Acts, ch 1075, § 19

156.8 Internships. The board shall, by rule, provide for internships in mortuary science, and shall regulate the registration,

training, and fee for internships.

156.8A Student practicum. The board, by rule, shall provide for practicums in mortuary science for students available through any

school accredited by the American board of funeral service education.

156.9 Revocation of license to practice mortuary science. 1. Notwithstanding section 147.87, the board may restrict, suspend, or revoke a license to practice

mortuary science or place a licensee on probation. The board shall adopt rules of procedure pursuant tochapter 17A by which to restrict, suspend, or revoke a license. The board may also adopt rules pursuant tochapter 17A relating to conditions of license reinstatement.

2. In addition to the grounds stated in sections 147.55 and 272C.10, the board may revoke or suspend the license of, or otherwise discipline, a funeral director for any one of the following acts:

a. Knowingly misrepresenting any material matter to a prospective purchaser of funeral merchandise, furnishings, or services.

b. A violation of chapter 144 related to the practice of mortuary science. c. Knowingly aiding, assisting, procuring, advising, or allowing a person to unlawfully practice

mortuary science. d. Willful or repeated violations of this chapter, or the rules adopted pursuant to this chapter. e. Conviction of any crime related to the practice of mortuary science or implicating the licensee’s

competence to safely perform mortuary science services, including but not limited to a crime involving moral character, dishonesty, fraud, theft, embezzlement, extortion, or controlled substances, in a court of competent jurisdiction in this state, or in another state, territory, or district of the United States, or in a foreign jurisdiction. For purposes of this paragraph,“conviction” includes a guilty plea, deferred judgment, or other finding of guilt. A certified copy of the judgment is prima facie evidence of the conviction.

156.10 Inspection. 1. The director of public health shall inspect all places where dead human bodies are prepared or held

for burial, entombment, or cremation, and shall adopt and enforce such rules and regulations in connection with the inspection as shall be necessary for the preservation of the public health.

2. The Iowa department of public health shall assess an inspection fee for an inspection of a place where dead human bodies are prepared for burial or cremation. The fee shall be determined by the department by rule.

156.11 Repealed by 78 Acts, ch 1075, § 19. 156.12 Funeral directors — solicitation of business — exceptions — penalty.

Every funeral director, or person acting on behalf of a funeral director, who pays or causes to be paid any money or other thing of value as a commission or gratuity for the securing of business for the funeral director, and every person who accepts or offers to accept any money or other thing of value as a commission or gratuity from a funeral director in order to secure business for the funeral director commits a simple misdemeanor. This sectiondoes not prohibit any person, firm, cooperative burial association, or corporation, subject to the provisions ofthis chapter, from using legitimate and honest advertising. This section does not apply to sales made in accordance with chapter 523A.

156.13 Certificate of national board in lieu of examination. Repealed by 2007 Acts, ch 159, § 12. 156.14 Funeral establishment and cremation establishment license. 1. A person shall not establish, conduct, or maintain a funeral establishment or a cremation

establishment in this state without a license. The license shall be identified as an establishment license. a. An establishment license issued by the board under this chapter shall be issued for a site and in the

name of the individual in charge and is not transferable or assignable. b. A license is required for each place of practice. c. The license of the establishment shall be displayed. 2. The board shall specify by rule the licensing procedures to be followed, including specifications of

forms for use in applying for an establishment license and fees for filing an application. The board shall specify by rule minimum standards for professional responsibility in the conduct of a funeral establishment or a cremation establishment.

3. To qualify for a funeral establishment or a cremation establishment license, the applicant shall submit to the board a license fee as determined by the board and a completed application on a form prescribed by the board that shall include the following information and be given under oath:

a. Ownership of the establishment. b. Location of the establishment. c. The license number of each funeral director employed by the establishment at the time of the

application. d. The trade or corporate name of the establishment. e. The name of the individual in charge, who has the authority and responsibility for the establishment’s

compliance with laws and rules pertaining to the operation of the establishment. 4. A person who falsely makes the affidavit prescribed in subsection 3 is subject to all penalties

prescribed for making a false affidavit. 96 Acts, ch 1148, §9 156.15 Funeral establishments and cremation establishments — license required — discipline,

violations, and penalties. 1. A funeral establishment or cremation establishment shall not be operated until a license or renewal

certificate has been issued to the establishment by the board. 2. The board shall refuse to issue an establishment license when an applicant fails to meet the

requirements of section 156.14. The board may refuse to issue or renew a license or may impose a penalty, not to exceed ten thousand dollars, issue a reprimand, or revoke, restrict, cancel, or suspend a license, and may place a licensee on probation, if the board finds that the applicant or licensee has done any of the following:

a. Been convicted of a felony or any crime related to the practice of mortuary science or implicating the establishment’s ability to safely perform mortuary science services, or if the applicant is an association,

joint stock company, partnership, or corporation, that a managing officer or owner has been convicted of such a crime, under the laws of this state, another state, or the United States.

b. Violated this chapter or any rule adopted underthis chapter or that any owner or employee of the establishment has violated this chapter or any rule adopted under this chapter.

c. Knowingly aided, assisted, procured, advised, or allowed a person to unlawfully practice mortuary science.

d. Failed to engage in or ceased to engage in the business described in the application for a license. 3. Failed to keep and maintain records as required by this chapter or rules adopted under this chapter. 96 Acts, ch 1148, §10; 2007 Acts, ch 159, §11 156.16 Unlicensed practice — injunctions, civil penalties, consent agreements. 1. If the board has reasonable grounds to believe that a person or establishment which is not licensed

under this chapter has engaged, or is about to engage, in an act or practice which requires licensure under this chapter, or otherwise violates a provision of this chapter, the board may issue an order to require the unlicensed person or establishment to comply with the provisions of this chapter, and may impose a civil penalty not to exceed one thousand dollars for each violation of this chapter by an unlicensed person or establishment. Each day of a continued violation constitutes a separate offense.

2. The board may conduct an investigation as needed to determine whether probable cause exists to initiate the proceedings described in this section. To aid in such an investigation or in connection with any other proceeding under this section, the board may issue subpoenas to compel witnesses to testify or persons to produce evidence consistent with the provisions of section 272C.6, subsection 3.

3. The board, in determining the amount of a civil penalty to be imposed, may consider any of the following:

a. Whether the amount imposed will be a substantial economic deterrent to the violation. b. The circumstances leading to the violation. c. The severity of the violation and the risk of harm to the public. d. The economic benefits gained by the violator as a result of noncompliance. e. The interest of the public. 4. The board, before issuing an order under this section, shall provide the person or establishment

written notice and the opportunity to request a hearing. The hearing must be requested within thirty days after receipt of the notice and shall be conducted in the same manner as provided for disciplinary proceedings involving a licensee under this chapter.

5. The board may request the attorney general to bring an action to enforce the subpoena. 6. A person or establishment aggrieved by the issuance of an order or the imposition of a civil penalty

under this section may seek judicial review pursuant tosection 17A.19. 7. If a person or establishment fails to pay a civil penalty within thirty days after entry of an order

imposing the civil penalty, or, if the order is stayed pending an appeal, within ten days after the court enters a final judgment in favor of the board, the board shall notify the attorney general. The attorney general may commence an action to recover the amount of the penalty, including reasonable attorney fees and costs.

8. An action to enforce an order under this sectionmay be joined with an action for an injunction pursuant to section 147.83.

9. The board, in its discretion and in lieu of issuing or enforcing an order or imposing a civil penalty for an initial violation under this section, may enter into a consent agreement with a violator, or with a person who aided or abetted a violator, which acknowledges the violation and the violator’s agreement to refrain from any further violation.

2004 Acts, ch 1168, §11

LICENSURE OF FUNERAL DIRECTORS, FUNERAL ESTABLISHMENTS, AND

CREMATION ESTABLISHMENTS 645—101.1 (156) Definitions. For purposes of these rules, the following definitions shall apply: “Active license” means a license that is current and has not expired. “Board” means the board of mortuary science. “Grace period” means the 30-day period following expiration of a license when the license is still considered to be active. In order to renew a license during the grace period, a licensee is required to pay a late fee. “Inactive license” means a license that has expired because it was not renewed by the end of the grace period. The category of “inactive license” may include licenses formerly known as lapsed, inactive, delinquent, closed, or retired. “Licensee” means any person licensed to practice as a funeral director in the state of Iowa. “License expiration date” means the fifteenth day of the birth month every two years following initial licensure. “Licensure by endorsement” means the issuance of an Iowa license to practice mortuary science to an applicant who is or has been licensed in another state. “Reactivate” or “reactivation” means the process as outlined in rule 101.18(17A,147,272C) by which an inactive license is restored to active status. “Reciprocal license” means the issuance of an Iowa license to practice mortuary science to an applicant who is currently licensed in another state which has a mutual agreement with the Iowa board of mortuary science to license persons who have the same or similar qualifications to those required in Iowa. “Reinstatement” means the process as outlined in 645—1 1.31(272C) by which a licensee who has had a license suspended or revoked or who voluntarily surrendered a license may apply to have the license reinstated, with or without conditions. Once the license is reinstated, the licensee may apply for active status. 645—101.2 (156) Requirements for licensure. The following criteria shall apply to licensure: 101.2(1) The applicant shall complete a board-approved application packet. Application forms may be obtained from the board’ s W eb site ( http://www .idph.state.ia.us/licensure ) or directly from the board office. All applications shall be sent to Board of Mortuary Science, Professional Licensure Division, Fifth Floor , Lucas State Of fice Building, Des Moines, Iowa 50319-0075. 101.2(2) The applicant shall complete the application form according to the instructions contained in the application. If the application is not completed according to the instructions, the application will not be reviewed by the board.

101.2(3) Each application shall be accompanied by the appropriate fees payable to the Board of Mortuary Science. The fees are nonrefundable. 101.2(4) No application will be considered by the board until official copies of academic transcripts showing the completion of training in a college of mortuary science approved by the Iowa board of mortuary science have been sent directly from the school to the board. 101.2(5) Licensees who were issued their initial licenses within six months prior to the renewal shall not be required to renew their licenses until the renewal month two years later . 101.2(6) Incomplete applications that have been on file in the board of fice for more than two years shall be: a. Considered invalid and shall be destroyed; or b. Maintained upon written request of the candidate. The candidate is responsible for requesting that the file be maintained.Ch 101, p. 2 Professional Licensure[645] IAC 1 1/17/10 645—101.3 (156) Educational qualifications. 101.3(1) The applicant shall be issued a license to practice mortuary science by the board when the applicant has successfully completed: a. A minimum of 60 hours as indicated on the transcript from a regionally accredited college or university with a minimum of a 2.0 or “C” grade point average. The 60 semester hours shall not include any technical mortuary science courses; and b. A program in mortuary science from a school accredited by the American Board of Funeral Service Education. c. A college course of at least one semester hour or equivalent in current Iowa law and rules covering mortuary science content areas including but not limited to Iowa law and rules governing the practice of mortuary science, cremation, vital statistics, cemeteries and preneed. 101.3(2) Foreign-trained funeral directors shall: a. Provide an equivalency evaluation of their educational credentials by International Educational Research Foundations, Inc., Credentials Evaluation Service, P .O. Box 3665, Culver City , CA 90231-3665, telephone (310)258-9451, W eb site www .ierf.or g , or E-mail at info@ierf.or g . The professional curriculum must be equivalent to that stated in these rules. A candidate shall bear the expense of the curriculum evaluation. b. Provide a notarized copy of the certificate or diploma awarded to the applicant from a mortuary science program in the country in which the applicant was educated. c. Receive a final determination from the board regarding the application for licensure. d. Successfully complete a college course of at least one semester hour or equivalent in current Iowa law and rules covering mortuary science content areas including but not limited to Iowa law and rules governing the practice of mortuary science, cremation, vital statistics, cemeteries and preneed. [ ARC 9239B , IAB 1 1/17/10, ef fective 12/22/10] 645—101.4 (156) Examination r equir ements. 101.4(1) The board shall accept a certificate of examination issued by the International Conference

of Funeral Service Examining Boards, Inc., indicating a passing score on both the arts and sciences portions of the examination. 101.4(2) Prior to being registered as an intern in Iowa, an applicant shall successfully complete a college course of at least one semester hour or equivalent in current Iowa law and rules covering mortuary science content areas including but not limited to Iowa law and rules governing the practice of mortuary science, cremation, vital statistics, cemeteries and preneed. [ ARC 9239B , IAB 1 1/17/10, ef fective 12/22/10] 645—101.5 (147,156) Internship and pr eceptorship. 101.5(1) Internship. a. The intern must serve a minimum of one year of internship under the direct supervision of an Iowa board-certified preceptor . The beginning and ending dates of the internship shall be indicated on the internship certificate. The intern shall engage in the practice of mortuary science only during the time indicated on the internship certificate. b. The intern shall, during the internship, be a full-time employee with the funeral establishment at the site of internship except as provided in paragraph 101.5(2) “j.” c. No licensed funeral director shall permit any person in the funeral director ’ s employ or under the funeral director ’ s supervision or control to serve an internship in funeral directing unless that person has a certificate of registration as a registered intern from the department of public health. The registration shall be posted in a conspicuous place in the intern’ s primary place of practice. d. No licensed funeral director or licensed funeral establishment shall have more than one intern funeral director for the first 100 human remains embalmed or funerals conducted per year , and with a maximum of two interns per funeral establishment. e. Registered interns shall not advertise or hold themselves out as funeral directors or use the degree F .D. or any other title or abbreviation indicating that the intern is a funeral director .IAC 1 1/17/10 Professional Licensure[645] Ch 101, p. 3 f. The intern shall, during the internship, embalm not fewer than 25 human remains and direct or assist in the direction of not fewer than 25 funerals under the direct supervision of the certified preceptor and shall submit reports on forms furnished by the department of public health. W ork on the first 5 embalming cases and funeral cases must be completed in the physical presence of the preceptor . The first 12 embalming cases and the first 12 funeral case reports must be completed and submitted by the completion of the sixth month of the internship. g. Before being eligible for licensure, the intern must have filed the 25 completed embalming and funeral directing case reports and a 6-month and a 12-month evaluation form with the department of public health. h. When, for any valid reason, the board determines that the education a registered intern is receiving under the supervision of the present preceptor might be detrimental to the intern or the profession at lar ge, the intern may be required to serve the remainder of the internship under the supervision of a licensed funeral director who is approved by the board. i. The length of an internship may be extended if the board determines that the intern requires additional time or supervision in order to meet the minimum proficiency in the practice of mortuary science. j. The board views a one-year internship completed in a consecutive 12-month period as the best training option. If an internship is interrupted, the internship must be completed within 24 months of

the date it started in order to be readily accepted by the board. Internships that are not completed within 24 months shall be preapproved by the board on such terms as the board deems reasonable under the circumstances. The board may require any or all of the following:

(1) Completion of a college course or continuing education course covering mortuary science laws and rules;

(2) Additional case reports; (3) Extension of an internship up to an additional 12 months depending on such factors as the

number of months completed during the internship, length of time that has lapsed since the intern was actively involved in the internship program, and the experience attained by the intern. k. Application for change of preceptor or any other alteration must be made in writing and approval granted by the board before the status of the intern is altered. l. The intern shall complete on a form provided by the board a confidential evaluation of the preceptorship program at the end of the internship. This form shall be submitted before the funeral director ’ s license is issued to the intern. m. The intern must be approved and licensed following a successful internship before the intern may practice mortuary science. 101.5(2) Pr eceptorship. a. A preceptor must have completed a training course within five years prior to accepting an intern. This training course shall cover Iowa law and rule content areas, including but not limited to Iowa law and rules governing licensure and the practice of mortuary science and human resource issues. The training course may be counted toward the continuing education hours required for the licensure biennium in which the training course was completed. b. Any duly Iowa-licensed funeral director who has been practicing for a minimum of five years and who has not had any formal disciplinary action within the past five years with the board of mortuary science and has completed a preceptor training course detailed in paragraph 101.5(2) “a” will be eligible to be a preceptor . c. The preceptor shall be af filiated with a funeral establishment that has not had any formal disciplinary action within the past five years. d. The preceptor is required to file a progress report of the intern that has been signed by both the preceptor and the intern on a board-prescribed form. The 6-month progress report form shall be submitted to the board by the end of the sixth month. The 12-month progress report form shall be submitted to the board by the end of the twelfth month. e. The preceptor shall certify that the intern engages in the practice of mortuary science only during the time frame designated on the of ficial intern certificate.Ch 101, p. 4 Professional Licensure[645] IAC 1 1/17/10 f. A preceptor ’ s duties shall include the following:

(1) Be physically present and supervise the first five embalmings and first five funeral cases; (2) Familiarize the intern in the areas specified by the preceptor training outline; (3) Read and sign each of the 25 embalming reports and the 25 funeral directing reports completed

by the intern; (4) Complete a written six-month report of the intern on a form provided by the board. This report

is to be reviewed with and signed by the intern and submitted to the board before the end of the seventh month; and

(5) At the end of the internship, complete a confidential evaluation of the intern on a form provided

by the board. This evaluation shall be submitted within two weeks of the end of the internship. g. Failure of a preceptor to fulfill the requirements set forth by the board, including failure to remit the required six-month progress report, as well as the final evaluation, shall result in an investigation of the preceptor by the board. h. If a preceptor does not serve the entire year , the board will evaluate the situation; and if a certified preceptor is not available, a licensed funeral director may serve with the approval of the board. i. No licensed funeral director or licensed funeral establishment shall have more than one intern funeral director for the first 100 human remains embalmed or funerals conducted per year , and with a maximum of two interns per funeral establishment. j. W ith prior board approval, an intern may serve under the supervision of more than one preceptor under the following terms and conditions:

(1) A single preceptor must act in the role of the primary preceptor. (2) The primary preceptor is responsible for coordinating all intern training and activities. (3) The intern shall be a full-time employee of the funeral establishment of the primary preceptor;

however, compensation may be shared between preceptors. (4) The primary preceptor may make arrangements with a maximum of two additional preceptors

to share preceptor responsibilities for such purposes as providing an intern with a higher volume practice or a broader range of intern experiences.

(5) Each preceptor shall be individually responsible for directly supervising the intern’ s activities performed under the preceptor ’ s guidance, but the primary preceptor remains responsible for coordinating the intern’ s activities and submitting all forms to the board. [ ARC 9239B , IAB 1 1/17/10, ef fective 12/22/10] 645—101.6 (156) Student practicum. 101.6(1) A student may participate in a student practicum in a licensed funeral establishment in Iowa if the student’ s school is accredited by and in good standing with the American Board of Funeral Service Education (ABFSE). The student practicum must meet the requirements of the ABFSE. 101.6(2) Students serving a practicum in Iowa shall be under the direct physical supervision of a funeral director who meets the following requirements: a. Has completed the Iowa preceptor training course within the immediately preceding five years. b. Has not had any formal disciplinary action within the past five years. c. Is af filiated with a funeral establishment that has not had formal disciplinary action within the past five years. 645—101.7 (156) Funeral establishment license or cr emation establishment license or both establishment licenses. 101.7(1) A place of business devoted to providing any aspect of mortuary science or cremation services shall hold an establishment license issued by the board. An establishment license shall not be issued more than 30 days prior to the opening of a new establishment. a. A funeral establishment, a cremation establishment, or a combined funeral and cremation establishment shall not be operated until it has obtained a license from the board. Such an establishment shall timely renew the license in order to continue operations.IAC 1 1/17/10 Professional Licensure[645] Ch 101, p. 5

b. A funeral or cremation establishment shall surrender its license to the board if it fails to engage in or ceases to engage in the business for which the license was issued, pursuant to Iowa Code section 156.15(2) “d.” c. A funeral or cremation establishment license is not transferable or assignable. d. A change in ownership shall require the issuance of a new license. A change in ownership shall be reported to the board prior to the date ownership will change or , in the case of change of ownership by death or other unexpected event, within 30 days following change of ownership. The board may request legal proof of the ownership transfer . A change in ownership shall be defined as any change of controlling interest in any corporation or other business entity . e. An establishment license shall be issued for a specific physical location. A change in location or site of an establishment shall require the submission of an application for a new license and payment of the fee required by 645—subrule 105.1(9). A new establishment license must be issued prior to the commencement of business in a new location. f. A change in the name of an establishment shall be reported to the board within 30 days. The establishment owner shall pay the fee for reissuing the certificate. g. A change in address or of the funeral director in responsible char ge shall be reported to the board within 30 days. h. An establishment shall have an employment or other relationship with one or more licensed funeral directors who shall perform all mortuary science services for which licensure as a funeral director is required by Iowa Code chapter 156. A cremation establishment is not, however , required to employ or contract with a funeral director on an ongoing basis because a cremation establishment shall not of fer services directly to the general public. When a funeral establishment has an employment or other relationship with multiple funeral directors, the funeral establishment shall designate the funeral director who shall be in responsible char ge of all mortuary science services performed at the funeral establishment. The funeral establishment shall report to the board any change of the funeral director in responsible char ge within 30 days of the change. i. Rescinded IAB 10/8/08, ef fective 1 1/12/08. j. The board shall not routinely issue more than one establishment license for a single location, but the board may do so if the multiple applicants provide proof, satisfactory to the board, that the establishments are wholly separate except for the sharing of facilities. If the board issues more than one establishment license for a single location, the licensees shall ensure that the public will not be confused or deceived as to the establishment with which the public is interacting. A facility may have a funeral establishment license and a separate cremation establishment license at a single location. k. The establishment license shall be displayed in a conspicuous place at the location of the establishment. l. Failure to comply with any of these rules shall constitute grounds for discipline pursuant to 645—Chapter 103 or civil penalties for unlicensed practice pursuant to 645—Chapter 104. 101.7(2) A funeral establishment, cremation establishment, or both establishments shall be subject to applicable local, state and federal health and environmental requirements and shall obtain all necessary licenses and permits from the agencies with jurisdiction. 101.7(3) License application. An application for a funeral establishment license, cremation establishment license, or both establishment licenses shall be in writing on forms furnished by the board and shall be accompanied by the funeral or cremation establishment fee. The application shall contain

all of the following: a. The name, mailing address and telephone number of the applicant. b. The physical location of the establishment. c. The mailing address, telephone number , fax and E-mail address of the establishment. d. The name, home address and telephone number of the individual in char ge who has the authority and responsibility for the establishment’ s compliance with laws and rules pertaining to the operation of the establishment. e. The name and address of all owners and managers of the establishment (e.g., sole proprietor , partner , director , of ficer , managing partner , member , or shareholder with 10 percent or more of the stock).Ch 101, p. 6 Professional Licensure[645] IAC 1 1/17/10 f. The legal name of the establishment and all trade names, assumed names, or other names used by the establishment. g. The signature of the responsible authority at the site of the establishment and an acknowledgment of the funeral director in responsible char ge of mortuary science services at the funeral establishment that the funeral director is aware of and consents to the designation. h. The names and license numbers of all funeral directors employed by or associated with the establishment through contract or otherwise who provide mortuary science services at or for the establishment. When a funeral establishment has an employment or other relationship with multiple funeral directors, the funeral establishment shall designate the funeral director who shall be in responsible char ge of all mortuary science services performed at the funeral establishment. No funeral establishment shall be issued a license if it fails to designate the funeral director in responsible char ge of the mortuary science services to be performed at the establishment. i. All felony or misdemeanor convictions of the applicant and all owners and managing of ficers of the applicant (except minor traf fic of fenses with fines of less than $500). j. All disciplinary actions against any professional or occupational license of the applicant by any jurisdiction including, but not limited to, disciplinary action by the Iowa insurance division under Iowa Code chapter 523A or 523I, or action by the Federal T rade Commission. k. Further information that the board may reasonably require, such as whether the establishment includes a preparation room. 645—101.8 (156) Licensur e by endorsement. An applicant who has been a licensed funeral director under the laws of another jurisdiction shall file an application for licensure by endorsement with the board of fice. Applicants licensed before 1980 are exempt from showing a passing grade on the national board examination. The board may receive by endorsement any applicant from the District of Columbia or another state, territory , province or foreign country who: 101.8(1) Submits to the board a completed application; 101.8(2) Pays the licensure fee; 101.8(3) Shows evidence of licensure requirements that are similar to those required in Iowa; 101.8(4) Provides of ficial copies of the academic transcripts showing the completion of a mortuary science program accredited by the American Board of Funeral Service Education; 101.8(5) Provides of ficial transcript of grades showing 60 semester hours from a regionally

accredited college or university with a minimum of a 2.0 or “C” grade point average; 101.8(6) Completes a college course of at least one semester hour or equivalent in current Iowa law and rules covering mortuary science content areas including but not limited to Iowa law and rules governing the practice of mortuary science, cremation, vital statistics, cemeteries and preneed; 101.8(7) Furnishes certified evidence of two or more years of actual practice as a licensed funeral director in the state from which the applicant desires to endorse; 101.8(8) W as issued the initial license by endorsement within six months of the birth month and will not be required to renew the license until the fifteenth day of the birth month two years later . The new licensee is exempt from meeting the continuing education requirement for the continuing education biennium in which the license was originally issued; 101.8(9) Provides verification of license(s) from every jurisdiction in which the applicant has been licensed, sent directly from the jurisdiction(s) to the board of fice. W eb-based verification may be substituted for verification direct from the jurisdiction’ s board of fice if the verification provides: a. Licensee’ s name; b. Date of initial licensure; c. Current licensure status; and d. Any disciplinary action taken against the license. [ ARC 9239B , IAB 1 1/17/10, ef fective 12/22/10] 645—101.9 (156) Licensur e by r ecipr ocal agr eement. Rescinded IAB 10/8/08, ef fective 1 1/12/08.IAC 1 1/17/10 Professional Licensure[645] Ch 101, p. 7 645—101.10 (156) License r enewal. 101.10(1) The biennial license renewal period for a license to practice as a funeral director shall begin on the sixteenth day of the licensee’ s birth month and end on the fifteenth day of the licensee’ s birth month two years later . The board shall send a renewal notice by regular mail to each licensee at the address on record at least 60 days prior to expiration of the license. The licensee is responsible for renewing the license prior to its expiration. Failure of the licensee to receive the notice does not relieve the licensee of the responsibility for renewing the license. All licensees shall renew on a biennial basis. 101.10(2) An individual who was issued a license within six months of the license renewal date will not be required to renew the license until the subsequent renewal date two years later . Continuing education hours acquired anytime from the initial licensing until the second license renewal may be used. The licensee will be required to complete a minimum of 24 hours of continuing education per biennium for each subsequent license renewal, with 2 of the 24 hours covering current Iowa law and rules as identified in 645—paragraph 102.3(2) “f.” 101.10(3) A licensee seeking renewal shall: a. Meet the continuing education requirements of rule 645—102.2(272C). A licensee whose license was reactivated during the current renewal compliance period may use continuing education credit earned during the compliance period for the first renewal following reactivation; and

b. Submit the completed renewal application and renewal fee before the license expiration date. c. Persons licensed to practice funeral directing shall keep their renewal licenses displayed in a conspicuous public place at the primary site of practice. 101.10(4) Upon receiving the information required by this rule and the required fee, board staf f shall administratively issue a two-year license and shall send the licensee a wallet card by regular mail. In the event the board receives adverse information on the renewal application, the board shall issue the renewal license but may refer the adverse information for further consideration or disciplinary investigation. 101.10(5) A person licensed to practice as a funeral director shall keep the license certificate displayed in a conspicuous public place at the primary site of practice. 101.10(6) Late renewal. The license shall become late when the license has not been renewed by the expiration date on the wallet card. The licensee shall be assessed a late fee as specified in 645—subrule 105.1(3). T o renew a late license, the licensee shall complete the renewal requirements and submit the late fee within the grace period. 101.10(7) Inactive license. A licensee who fails to renew the license by the end of the grace period has an inactive license. A licensee whose license is inactive continues to hold the privilege of licensure in Iowa, but may not practice as a funeral director in Iowa until the license is reactivated. A licensee who practices as a funeral director in the state of Iowa with an inactive license may be subject to disciplinary action by the board, injunctive action pursuant to Iowa Code section 147.83, criminal sanctions pursuant to Iowa Code section 147.86, and other available legal remedies. [ ARC 9239B , IAB 1 1/17/10, ef fective 12/22/10] 645—101.1 1 (147) Duplicate certificate or wallet card. Rescinded IAB 10/8/08, ef fective 1 1/12/08. 645—101.12 (147) Reissued certificate or wallet card. Rescinded IAB 10/8/08, ef fective 1 1/12/08. 645—101.13 (272C) Renewal of a funeral establishment license or cr emation establishment license or both establishment licenses. 101.13(1) The renewal cycle shall be triennial beginning July 1 and ending on June 30 of the third year . The renewal shall be: a. Submitted on a form provided by the board; and b. Accompanied by the renewal fee. 101.13(2) A renewal of license application shall be mailed at least 60 days prior to the expiration of the license. Failure to receive the notice shall not relieve the license holder of the obligation to pay triennial renewal fees on or before the renewal date.Ch 101, p. 8 Professional Licensure[645] IAC 1 1/17/10 101.13(3) Funeral and cremation establishments shall keep their renewal licenses displayed in a conspicuous public place at the primary site of practice.

101.13(4) Late renewal. If the renewal fee and renewal application are received within 30 days after the license renewal expiration date, the late fee for failure to renew before expiration shall be char ged. 101.13(5) When all requirements for license renewal are met, the licensee shall be sent a license renewal card by regular mail. 645—101.14 (272C) Inactive funeral establishment license or cr emation establishment license or both establishment licenses. 101.14(1) If the renewal application and fee are not postmarked within 30 days after the license expiration date, the funeral establishment license or cremation establishment license is inactive. To reactivate a funeral establishment license or a cremation establishment license, the reactivation application and fee shall be submitted to the board of fice. 101.14(2) A funeral establishment or a cremation establishment that has not renewed the funeral establishment license or cremation establishment license within the required time frame will have an inactive license and shall not provide mortuary science services until the license is reactivated. 645—101.15 (17A,147,272C) License r einstatement. For a funeral or cremation establishment license that has been revoked, suspended, or voluntarily surrendered, the owner must apply for and receive reinstatement of the license in accordance with 645—1 1.31(272C) and must apply for and be granted reactivation of the license in accordance with 101.14(272C) prior to of fering mortuary science services from that establishment in this state. 645—101.16 (272C) Reinstatement of a funeral establishment license or a cr emation establishment license or both establishment licenses. Rescinded IAB 1/4/06, ef fective 2/8/06. 645—101.17 (17A,147,272C) License denial. Rescinded IAB 1/4/06, ef fective 2/8/06. 645—101.18 (17A,147,272C) License r eactivation. T o apply for reactivation of an inactive license, a licensee shall: 101.18(1) Submit a reactivation application on a form provided by the board. 101.18(2) Pay the reactivation fee that is due as specified in 645—Chapter 105. 101.18(3) Provide verification of current competence to practice as a funeral director by satisfying one of the following criteria: a. If the license has been on inactive status for five years or less, an applicant must provide the following:

(1) Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board of fice. W eb-based verification may be substituted for verification from a jurisdiction’ s board of fice if the verification includes: 1. Licensee’ s name; 2. Date of initial licensure; 3. Current licensure status; and 4. Any disciplinary action taken against the license; and

(2) Verification of completion of 24 hours of continuing education that meet continuing education standards defined in 645—102.3(156,272C) within two years prior to filing the application for reactivation; and

(3) Verification of completion of 2 hours of continuing education in current Iowa law and rules covering mortuary science content areas including but not limited to Iowa law and rules governing the practice of mortuary science, cremation, vital statistics, cemeteries and preneed. These 2 hours shall be included as a part of the 24 hours required in 101.18(3) “a” (2). b. If the license has been on inactive status for more than five years, an applicant must provide the following: IAC 1 1/17/10 Professional Licensure[645] Ch 101, p. 9

(1) Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board of fice. W eb-based verification may be substituted for verification from a jurisdiction’ s board of fice if the verification includes: 1. Licensee’s name; 2. Date of initial licensure; 3. Current licensure status; and 4. Any disciplinary action taken against the license; and

(2) Verification of completion of 48 hours of continuing education that meet continuing education standards defined in 645—subrule 102.3(1) and 645—paragraphs 102.3(2) “a,” “b,” “c,” and “e,” within two years prior to filing the application for reactivation. Independent study identified in 645—paragraph 102.3(2) “f” shall not exceed 24 hours of the 48 hours; and

(3) Verification of completion of a college course of at least one semester hour or equivalent in current Iowa law and rules covering mortuary science content areas including but not limited to Iowa law and rules governing the practice of mortuary science, cremation, vital statistics, cemeteries and preneed. [ ARC 9239B , IAB 1 1/17/10, effective 12/22/10] 645—101.19 (17A,147,272C) License reinstatement. A licensee whose license has been revoked, suspended, or voluntarily surrendered must apply for and receive reinstatement of the license in accordance with 645—1 1.31(272C) and must apply for and be granted reactivation of the license in accordance with 101.18(17A,147,272C) prior to practicing as a funeral director in this state. The owner of a funeral home establishment whose establishment license has been revoked, suspended, or voluntarily surrendered must apply for and receive reinstatement of the establishment license and must apply for and be granted reactivation of the establishment license prior to reopening the funeral home establishment. INSURANCE DIVISION 191—1.1 (502,505) Organization. The insurance division is headed by the commissioner of insurance who is assisted by a first deputy commissioner and other deputy and assistant commissioners. The functions of the division are divided into five bureaus. 1.1(1) The administrative bureau provides staff support to the commissioner and is responsible for legal services, budgetary and personnel services. General oversight of the division operations is provided through interaction with the public, the insurance industry, and other state and federal agencies.

1.1(2) The company regulation bureau is responsible for the following: a.Regulating of all domestic and foreign insurance companies licensed in Iowa through licensure, analysis and financial and market examinations. b.Examining the financial condition of Iowa insurance companies not less than once every five years. Foreign companies are examined as deemed appropriate. The bureau ensures compliance with National Association of Insurance Commissioners accreditation mandates, and financial examination and analysis standards. c.Serving as a general insurance information repository and resource for both insurers and consumers regarding, for example: insurance companies’ status, addresses, telephone numbers, certifications, and financial statements; statutory construction; guaranty fund calculations; powers of attorney; compilation of statistics; and publication of annual governor’s report. d.Reviewing and approving filed company transactions including, but not limited to, approval of acquisitions and mergers of domestic insurers, intercompany contractual agreements and assumption reinsurance agreements. e.Authorizing and overseeing individual and group workers’ compensation self-insurance. f.Authorizing, examining and analyzing benevolent associations. g.Authorizing and reviewing multiple employer welfare arrangements. h. Registering and verifying compliance for risk retention groups. i.Supervising the rehabilitation and liquidation of insurance companies. j.Auditing and monitoring premium tax remittances for admitted companies and supervising statutory deposits. k.Reviewing and approving admission applications for foreign surplus lines insurers as well as conducting premium tax audits associated with the nonadmitted insurance industry. 1.1(3) The market regulation bureau is responsible for the following: a.Ensuring fair treatment of consumers and preventing unfair or deceptive trade practices in the insurance and securities marketplaces. Inquiries from the public are answered and consumer complaints regarding insurance producers, insurers, broker-dealers, securities agents, investment advisers, and investment adviser representatives are received, reviewed, and investigated. Administrative actions are taken where appropriate, and criminal matters are referred to prosecutors for potential action. b.Operating the senior health insurance information program (SHIIP), which provides training to senior volunteers throughout the state. These volunteers then provide free, confidential health insurance counseling to Iowa seniors. Issues addressed include Medicare, Medicare subscription drug coverage, Medicare supplement insurance, long-term care insurance, insurance claims, and all other health insurance policies. This program is primarily funded by a Centers for Medicare and Medicaid Services grant. c. Reviewing, approving or disapproving property, casualty, life and health forms and, where provided by law, premium rates of certain types of insurance. d.Performing actuarial analysis of life and health insurance plans funded by certain public bodies.

e.Licensing insurance producers and overseeing the continuing education that insurance producers are required to complete. f.Monitoring surplus lines placement, registering purchasing groups, and overseeing the payment of premium taxes for surplus lines business including that which is placed through purchasing groups and risk retention groups. g. Registering managing general agents and legal expense insurers. h. Registering and monitoring third-party administrators. i. Registering and monitoring health maintenance organizations. j.Licensing advisory organizations. 1.1(4) The fraud bureau confronts the problem of insurance fraud by prevention, investigation, and prosecution of fraudulent insurance acts in an effort to reduce the amount of premium dollars used to pay fraudulent insurance claims, as set forth in Iowa Code chapter 507E. 1.1(5) The securities and regulated industries bureau is responsible for administering and enforcing the Iowa uniform securities Act through enforcement, licensing, and securities registration to ensure investor protection and a positive climate for capital formation. The bureau also is responsible for protecting the public by administering and enforcing rules related to motor vehicle service contracts, residential service contracts, retirement facilities, cemeteries, and preneed purchase agreements for cemetery merchandise, funeral merchandise and funeral services. 191—1.3 (22,502,505) Public information and inspection of records. 1.3(1) Definitions. As used in this chapter: "Agency" means the insurance division of the department of commerce. "Confidential records" are records which are not available as a matter of right for examination and copying by members of the public under law. Confidential records include records that the agency is prohibited by law from making available for examination by members of the public, and records that are specified as confidential by Iowa Code section 22.7, or other provisions of law, but that may be disclosed upon order of a court, the lawful custodian of the record, or by another person duly authorized to release the record. Mere inclusion in a record of information declared confidential by an applicable provision of law does not necessarily make that entire record a confidential record. "Custodian" means the agency or a person lawfully delegated authority by the agency to act for the agency in implementing Iowa Code chapter 22. "Open record" means a record other than a confidential record. "Personally identifiable information" means information about or pertaining to an individual which identifies the individual and which is contained in a record system and does not include information pertaining to corporations. "Record" means all or part of a “public record,” as defined in Iowa Code section 22.1 that is owned by or in the physical possession of the agency.

"Record system" means any group of records under the control of the agency from which a record may be retrieved by a personal identifier such as the name of the individual, number, symbol or other unique retriever assigned to the individual. 1.3(3) Requests for access to records. a. Location of record. A request for access to a record should be directed to the office of the bureau where the record is kept. If the location of the record is not known by the requester, the request shall be directed to the division’s receptionist at (515)281-5705 or toll-free at 1-877-955-1212 , or in writing to Iowa Insurance Division, 330 East Maple, Des Moines, Iowa 50319-0065. The division will forward the request to the appropriate person. b. Office hours. Records shall be made available from 8 a.m.to 4 p.m.daily, excluding Saturdays, Sundays and legal holidays. c. Telephone access. The general telephone number for the insurance division is (515) 281-5705 or toll-free at 1-877-955-1212 . d. Internet access. The division’s Internet Web site home page is www.iid.state.ia.us. The page from which the division’s bulletins are available ishttp://www.iid.state.ia.us/news_media/bulletins.asp. e. Request for access. Requests for access to open records may be made in writing, in person, or by telephone. Requests shall identify the particular records sought by name or description in order to facilitate the location of the record. Mail or telephone requests shall include the name, address, and telephone number of the person requesting the information. A person shall not be required to give a reason for requesting an open record. f. Response to requests. The division provides a public access room with photocopiers and work surfaces. Space is limited and advance reservations are requested. A location will be made available as soon as feasible. Subject to availability of the public access room or an alternative location in the division’s offices, access to an open record shall be provided promptly upon request unless the size or nature of the request makes prompt access infeasible. If the size or nature of the request for access to an open record requires time for compliance, the division shall comply with the request as soon as feasible. Access to an open record may be delayed for one of the purposes authorized by Iowa Code section 22.8(4) or 22.10(4), or to permit the division time to redact personally identifiable information from the record. The custodian shall promptly give notice to the requester of the reason for any delay in access to an open record and an estimate of the length of that delay and, upon request, shall promptly provide that notice to the requester in writing. The division may deny access to the record by members of the public only on the grounds that such denial is warranted under Iowa Code sections 22.8(4) and 22.10(4), or that it is a confidential record, or that its disclosure is prohibited by a court order. g. Fees. Copies of an open record may be made in the division’s public access room. Price schedules for published materials and for photocopies of records shall be determined by the division and prominently posted in the public access room. The payment of fees may be waived when the imposition of fees is inequitable or when a waiver is in the public interest. When the mailing of copies of records is requested, the actual costs of the mailing will be charged to the requester.

The following additional subrules are also adopted: 1.3(9) Data processing system.

The agency currently has certain data processing systems which match, collate or permit the comparison of personally identifiable information in one record system with personally identifiable information in another record system. 1.3(10) Agency records routinely available for public inspection. The agency collects and maintains the following records that are open records, some of which may contain personally identifiable information: a. Financial statements of insurers. b. Rate and policy form filings by insurers. c. The records of rule making, declaratory ruling, and contested case proceedings. d. Agent licensure records. e. The records of premium tax and fee collection. f. Insurer acquisition and reinsurance records. g. Securities issuer registration records, exemption filings, and agent or broker-dealer records, except those pertaining to a broker-dealer audit or investigation, unless released by the division at a hearing upon the broker-dealer’s registration. h. License, permit, registration, exemption, or other required filings in connection with membership sales, business opportunity promotions, residential service contracts, loan brokers, and motor vehicle service contracts. i. Various legal and technical publications related to insurance. j. All other records that are not confidential records under subrule 1.3(11). 1.3(11) Records which are confidential records. Confidential agency records are the following: a. Trade secrets recognized and protected by law. Iowa Code section 22.7(3). b. Records that represent and constitute the work product of an attorney, which are related to litigation or claim made by or against a public body. Iowa Code section 22.7(4). c. Reports made to the agency which, if released, would give advantage to competitors and serve no public purpose. Iowa Code section 22.7(6). Included in this category are insurer examination reports prior to expiration of the 20-day period set forth in rule 191—5.1(507) for requesting a hearing before the commissioner of insurance upon the report and if a hearing is requested, until the commissioner enters a decision upon the report, and reports of the National Association of Insurance Commissioners’ Insurance Regulatory Information System. d. Personal information in confidential personnel records of the division. Iowa Code section 22.7(10). e. Communications not required by law, rule, or procedure that are made to a government body or to any of its employees by identified persons outside of government, to the extent that the government body receiving those communications

could reasonably believe that those persons would be discouraged from making them to the government body if they were available for general public examination. Notwithstanding this provision:

(1) The communication is a public record to the extent the person outside of government making that communication consents to its treatment as a public record.

(2) Information contained in the communication is a public record to the extent it can be disclosed without directly or indirectly indicating the identity of the person outside of government making it or enabling others to ascertain the identity of that person.

(3) Information contained in the communication is a public record to the extent it indicates the date, time, specific location, and immediate facts and circumstances surrounding the occurrence of a crime or other illegal act, except to the extent its disclosure would plainly and seriously jeopardize a continuing investigation or pose a clear and present danger to the safety of any person. In any action challenging the failure of the lawful custodian to disclose any particular information of the kind enumerated in this paragraph, the burden of proof is on the lawful custodian to demonstrate that the disclosure of that information would jeopardize an investigation or would pose a clear and present danger. Iowa Code section 22.7(18). f. Complaint files, investigation files, other investigative reports and other investigative information of the agency relating to discipline of licensed insurance agents, except as allowed under Iowa Code section 505.8(6), 505.17, 507A.10, or 507B.3. g. Insurance holding company system registration and holding company examination records unless the statutory determination in favor of publication is made. Iowa Code section 521A.7. h. Reports and recommendations by insurer guaranty associations regarding insolvent or impaired insurers. Iowa Code sections 508C.12(3), 508C.12(5), 515B.10(2). i. Investigation material in the possession of the superintendent of securities pertaining to violation of the securities laws unless released by the superintendent pursuant to statute. Iowa Code section 502.603(1)“c.” j. All records relating to prearranged funeral contracts except upon the approval of the commissioner of insurance or the attorney general. Iowa Code section 523A.2(1)“e.” k. Any other records made confidential by law.

Iowa Administrative Code/Human Services Department [441]

Chapter 9 PUBLIC RECORDS 441—9.10 (17A,22) Use and disclosure without consent of the subject. Open records are routinely disclosed without the consent of the subject. To the extent allowed by law, the department may also use and disclose confidential information without the consent of the subject or the subject’s representative. 9.10(1) Internal use. Confidential information may be disclosed to employees and agents of the department as needed for the performance of their duties. The custodian of the record shall determine what constitutes legitimate need to use confidential records.

People affected by this rule include:

1. County-paid staff, field work students, and volunteers working under the direction of the department. 2. Council and commission members. 3. Policy review and advisory committees. 4. Consultants to the department.

9.10(24) Disclosures to coroners, medical examiners, and funeral directors. a. Coroners and medical examiners. The department may disclose protected health information about a subject that is contained in the designated record set to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or other duties as authorized by law. b. Funeral directors. The department may disclose protected health information about a subject that is contained in the designated record set to funeral directors, consistent with applicable law, as necessary to carry out their duties with respect to the decedent. If necessary for funeral directors to carry out their duties, the department may disclose the protected health information before, and in reasonable anticipation of, the subject’s death. 9.10(25) Disclosures for cadaveric organ, eye or tissue donation purposes. The department may disclose protected health information about a subject that is contained in the designated record set to organ procurement organizations or other organizations engaged in the procurement, banking, or transplantation of cadaveric organs, eyes, or tissue for the purpose of facilitating organ, eye or tissue donation and transplantation. The department shall make a disclosure only when the disclosure has been approved by the deceased subject’s authorized legal representative and there is evidence that the decedent had given approval for organ, eye, or tissue donation procedures before the decedent’s death. 441—9.14 (17A,22) Special policies and procedures for protected health information. 9.14(1) Minimum necessary. When using or disclosing protected health information or when requesting protected health information from another covered entity, the department shall make reasonable efforts, as described in paragraphs 9.14(1)“a” through “e,” to limit protected health information to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request. a. This requirement does not apply in the following circumstances:

(1) Disclosures to or requests by a health care provider for treatment.

(2) Uses or disclosures made to the subject.

(3) Uses or disclosures made pursuant to an authorization.

(4) Disclosures made to the Secretary of Health and Human Services.

(5) Uses or disclosures that are required by law.

(6) Uses or disclosures that are required for compliance with this chapter.

b. The department shall take the following actions: (1) Identify those persons or classes of persons, as appropriate, in its workforce who need access to protected

health information to carry out their duties.

(2) For each person or class of persons, identify the category or categories of protected health information to which access is needed and any conditions appropriate to the access.

(3) Make reasonable efforts to limit the access of these persons or classes. c. For any type of disclosure that it makes on a routine and recurring basis, the department shall implement policies and procedures (which may be standard protocols) that limit the amount of the protected health information disclosed to that reasonably necessary to achieve the purpose of the disclosure.

For all other disclosures, the department shall develop criteria designed to limit the protected health information disclosed to the information reasonably necessary to accomplish the purpose for which disclosure is sought. The department shall review requests for disclosure on an individual basis in accordance with the criteria.

The department may rely, if reasonable under the circumstances, on a requested disclosure as the minimum necessary for the stated purpose when: (1) Making permitted disclosures to a public official, provided the public official indicates that the information requested is the minimum necessary for the stated purposes;

(2) The information is requested by another covered entity; or (3) The information is requested for the purpose of providing professional services to the department by a

professional who is a workforce member or business associate of the department if the professional indicates that the information requested is the minimum necessary for the stated purpose. d. Minimum necessary requests.

(1) When requesting information from other covered entities, the department shall limit any request for protected

health information to that which is reasonably necessary to accomplish the purpose for which the request is made.

(2) For a request that is made on a routine and recurring basis, the department shall implement policies and procedures (which may be standard protocols) that limit the protected health information requested to the amount reasonably necessary to accomplish the purpose for which the request is made.

(3) For all other requests, the department shall develop criteria designed to limit the request for protected health information to the information reasonably necessary to accomplish the purpose for which the request is made and to review requests for disclosure on an individual basis in accordance with the criteria. e. For all uses, disclosures, or requests to which the minimum necessary requirements apply, the department shall not use, disclose or request an entire medical record, except when the entire medical record is specifically justified as the amount that is reasonably necessary to accomplish the purpose of the use, disclosure, or request.

35B.13 Burial — expenses. The commission is responsible for the interment in a suitable cemetery of the body of any veteran, as

defined in section 35.1, or the spouse, surviving spouse, or child of the person, if the person has died without leaving sufficient means to defray the funeral expenses. The commission may pay the expenses in a sum not exceeding an amount established by the board of supervisors.

35B.14 County appropriation.

1. The board of supervisors of each county may appropriate moneys for training an executive director or administrator as provided in section 35B.6, and for the expenses for food, clothing, shelter, utilities, medical benefits, and a funeral for indigent veterans, as defined in section 35.1, as well as for their indigent spouses, surviving spouses, and minor children not over eighteen years of age, who legally reside in the county.

2. The appropriation shall be expended by the joint action and control of the board of supervisors and the county commission of veteran affairs.

135.43 Iowa child death review team established — duties. 1. An Iowa child death review team is established as part of the office of the state medical examiner.

The office of the state medical examiner shall provide staffing and administrative support to the team. 2. The membership of the review team is subject to the provisions of sections 69.16 and 69.16A,

relating to political affiliation and gender balance. Review team members who are not designated by another appointing authority shall be appointed by the state medical examiner. Membership terms shall be for three years. A membership vacancy shall be filled in the same manner as the original appointment. The review team shall elect a chairperson and other officers as deemed necessary by the review team. The review team shall meet upon the call of the state medical examiner or as determined by the review team. The members of the team are eligible for reimbursement of actual and necessary expenses incurred in the performance of their official duties. The review team shall include the following:

a. The state medical examiner or the state medical examiner’s designee. b. A certified or licensed professional who is knowledgeable concerning sudden infant death syndrome. c. A pediatrician who is knowledgeable concerning deaths of children. d. A family practice physician who is knowledgeable concerning deaths of children. e. One mental health professional who is knowledgeable concerning deaths of children. f. One social worker who is knowledgeable concerning deaths of children. g. A certified or licensed professional who is knowledgeable concerning domestic violence. h. A professional who is knowledgeable concerning substance abuse. i. A local law enforcement official. j. A county attorney. k. An emergency room nurse who is knowledgeable concerning the deaths of children. l. A perinatal expert. m. A representative of the health insurance industry. n. One other appointed at large. 3. The review team shall perform the following duties: a. Collect, review, and analyze child death certificates and child death data, including patient records or

other pertinent confidential information concerning the deaths of children under age eighteen, and other information as the review team deems appropriate for use in preparing an annual report to the governor and the general assembly concerning the causes and manner of child deaths. The report shall include analysis of factual information obtained through review and recommendations regarding prevention of child deaths.

b. Recommend to the governor and the general assembly interventions to prevent deaths of children based on an analysis of the cause and manner of such deaths.

c. Recommend to the agencies represented on the review team changes which may prevent child deaths. d. Except as authorized by this section, maintain the confidentiality of any patient records or other

confidential information reviewed.

e. Recommend to the department of human services, appropriate law enforcement agencies, and any other person involved with child protection, interventions that may prevent harm to a child who is related to or is living in the same home as a child whose case is reviewed by the team.

f. If the sharing of information is necessary to assist in or initiate a child death investigation or criminal prosecution and the office or agency receiving the information does not otherwise have access to the information, share information possessed by the review team with the office of the attorney general, a county attorney’s office, or an appropriate law enforcement agency. The office or agency receiving the information shall maintain the confidentiality of the information in accordance with this section. Unauthorized release or disclosure of the information received is subject to penalty as provided in this section.

g. In order to assist a division of the department in performing the division’s duties, if the division does not otherwise have access to the information, share information possessed by the review team. The division receiving the information shall maintain the confidentiality of the information in accordance with this section. Unauthorized release or disclosure of the information received is subject to penalty as provided in this section.

4. The review team shall develop protocols for a child fatality review committee, to be appointed by the state medical examiner on an ad hoc basis, to immediately review the child abuse assessments which involve the fatality of a child under age eighteen. The state medical examiner shall appoint a medical examiner, a pediatrician, and a person involved with law enforcement to the committee.

a. The purpose of the review shall be to determine whether the department of human services and others involved with the case of child abuse responded appropriately. The protocols shall provide for the committee to consult with any multidisciplinary team, as defined in section 235A.13, that is operating in the area in which the fatality occurred.

b. The committee shall have access to patient records and other pertinent confidential information and, subject to the restrictions in this subsection, may redisseminate the confidential information in the committee’s report.

c. Upon completion of the review, the committee shall issue a report which shall include findings concerning the case and recommendations for changes to prevent child fatalities when similar circumstances exist. The report shall include but is not limited to the following information, subject to the restrictions listed in paragraph “d”:

(1) The dates, outcomes, and results of any actions taken by the department of human services and others in regard to each report and allegation of child abuse involving the child who died.

(2) The results of any review of the case performed by a multidisciplinary team, or by any other public entity that reviewed the case.

(3) Confirmation of the department of human services receipt of any report of child abuse involving the child, including confirmation as to whether or not any assessment involving the child was performed in accordance with section 232.71B, the results of any assessment, a description of the most recent assessment and the services offered to the family, the services rendered to the family, and the basis for the department’s decisions concerning the case.

d. Prior to issuing the report, the committee shall consult with the county attorney responsible for prosecution of the alleged perpetrator of the child fatality. The committee’s report shall include child abuse information associated with the case and the child, but is subject to the restrictions applicable to the department of human services for release of information concerning a child fatality or near fatality in accordance with section 235A.15, subsection 9.

e. Following the completion of the trial of any alleged perpetrator of the child fatality and the appeal period for the granting of a new trial, the committee shall issue a supplemental report containing the

information that was withheld, in accordance with paragraph “d”, so as not to jeopardize the prosecution or the rights of the alleged perpetrator to a fair trial as described in section 235A.15, subsection 9, paragraphs “e” and “f”.

f. The report and any supplemental report shall be submitted to the governor and general assembly. g. If deemed appropriate by the committee, at any point in the review the committee may recommend to

the department of human services, appropriate law enforcement agencies, and any other person involved with child protection, interventions that may prevent harm to a child who is related to or is living in the same home as a child whose case is reviewed by the committee.

5. a. The following individuals shall designate a liaison to assist the review team in fulfilling its responsibilities:

(1) The director of public health. (2) The director of human services. (3) The commissioner of public safety. (4) The attorney general. (5) The director of transportation. (6) The director of the department of education. b. In addition, the chairperson of the review team shall designate a liaison from the public at large to

assist the review team in fulfilling its responsibilities. 6. The review team may establish subcommittees to which the team may delegate some or all of the

team’s responsibilities under subsection 3. 7. a. The state medical examiner, the Iowa department of public health, and the department of human

services shall adopt rules providing for disclosure of information which is confidential under chapter 22 or any other provision of state law, to the review team for purposes of performing its child death and child abuse review responsibilities.

b. A person in possession or control of medical, investigative, assessment, or other information pertaining to a child death and child abuse review shall allow the inspection and reproduction of the information by the office of the state medical examiner upon the request of the office, to be used only in the administration and for the duties of the Iowa child death review team. Except as provided for a report on a child fatality by an ad hoc child fatality review committee under subsection 4, information and records produced under this section which are confidential under section 22.7 and chapter 235A, and information or records received from the confidential records, remain confidential under this section. A person does not incur legal liability by reason of releasing information to the department or the office of the state medical examiner as required under and in compliance with this section.

8. Review team members and their agents are immune from any liability, civil or criminal, which might otherwise be incurred or imposed as a result of any act, omission, proceeding, decision, or determination undertaken or performed, or recommendation made as a review team member or agent provided that the review team members or agents acted in good faith and without malice in carrying out their official duties in their official capacity. The state medical examiner shall adopt rules pursuant to chapter 17A to administer this subsection. A complainant bears the burden of proof in establishing malice or lack of good faith in an action brought against review team members involving the performance of their duties and powers under this section.

CHAPTER 263B STATE ARCHAEOLOGIST

263B.8 Cemetery for ancient remains. The state archaeologist shall establish, with the approval of the executive council, a cemetery on existing

state lands for the reburial of ancient human remains found in the state. The cemetery shall not be open to the public. The state archaeologist in cooperation with the department of natural resources shall be responsible for coordinating interment in the cemetery.

Ch 99, p.1Professional Licensure[645]IAC 7/5/06

FUNERAL DIRECTORS

CHAPTER 99 ADMINISTRATIVE AND REGULATORY AUTHORITY FOR

THE BOARD OF MORTUARY SCIENCE EXAMINERS

CHAPTER 100 PRACTICE OF FUNERAL DIRECTORS, FUNERAL

ESTABLISHMENTS, AND CREMATION ESTABLISHMENTS

CHAPTER 101 LICENSURE OF FUNERAL DIRECTORS

CHAPTER 102 CONTINUING EDUCATION FOR FUNERAL DIRECTORS

CHAPTER 103 DISCIPLINARY PROCEEDINGS

CHAPTER 104 ENFORCEMENT PROCEEDINGS AGAINST NONLICENSEES

CHAPTER 105 FEES

CHAPTER 99ADMINISTRATIVE AND REGULATORY AUTHORITY

FOR THE BOARD OF MORTUARY SCIENCE EXAMINERSIAC 7/5/06

645—99.1(17A) Definitions.“Board” means the board of mortuary science examiners.“Board office” means the office of the administrative staff.“Department” means the department of public health.“Disciplinary proceeding” means any proceeding under the authority of the board pursuant to

which licensee discipline may be imposed.“License” means a license to practice as a funeral director in the state of Iowa.“Licensee” means a person licensed to practice as a funeral director in the state of Iowa.“Overpayment” means payment in excess of the required fee. Overpayment of less than $10 re-

ceived by the board shall not be refunded.

645—99.2(17A) Purpose of board. The purpose of the board is to administer and enforce the provi-sions of Iowa Code chapters 17A, 147, 156 and 272C with regard to the practice of mortuary science.The mission of the board is to protect the public health, safety and welfare by licensing qualified indi-viduals who provide services to consumers and by fair and consistent enforcement of the statutes andthe rules of the licensure board. Responsibilities include, but are not limited to:

99.2(1) Licensing of qualified applicants by examination, renewal, endorsement, and reciprocity.99.2(2) Developing and administering a program of continuing education to ensure the continued

competency of individuals licensed by the board.99.2(3) Imposing discipline on licensees as provided by statute or rule.

645—99.3(17A,147,272C) Organization of board and proceedings.99.3(1) The board is composed of seven members appointed by the governor and confirmed by the

senate.99.3(2) The members of the board shall include four members who are licensed to practice mortu-

ary science, one member owning, operating, or employed by a crematory, and two members not li-censed to practice mortuary science and not a crematory owner, operator, or employee who shall repre-sent the general public.

99.3(3) The board shall elect a chairperson, vice chairperson, and secretary from its membership atthe first meeting after April 30 of each year.

99.3(4) The board shall hold at least one meeting annually.99.3(5) A majority of the members of the board shall constitute a quorum.

Ch 99, p.2 Professional Licensure[645] IAC 9/29/04, 7/5/06

99.3(6) Board meetings shall be governed in accordance with Iowa Code chapter 21, and theboard’s proceedings shall be conducted in accordance with Robert’s Rules of Order, Revised.

99.3(7) The division of professional licensure shall furnish the board with the necessary facilitiesand employees to perform the duties required by this chapter, but shall be reimbursed for all costs in-curred from funds appropriated to the board.

99.3(8) The board has the authority to:a. Develop and implement a program of continuing education to ensure continued competency

of individuals licensed by the board.b. Establish fees.c. Establish committees of the board, the members of which shall be appointed by the board

chairperson and shall not constitute a quorum of the board. The board chairperson shall appoint com-mittee chairpersons.

d. Hold a closed session if the board votes to do so in a public roll-call vote with an affirmativevote of at least two-thirds if the total board is present or a unanimous vote if fewer are present. Theboard will recognize the appropriate statute allowing for a closed session when voting to go into closedsession. The board shall keep minutes of all discussion, persons present, and action occurring at aclosed session and shall tape-record the proceedings. The records shall be stored securely in the boardoffice and shall not be made available for public inspection.

e. Investigate alleged violations of statutes or rules that relate to the practice of mortuary scienceupon receipt of a complaint or upon the board’s own initiation. The investigation will be based on in-formation or evidence received by the board.

f. Initiate and impose licensee discipline.g. Monitor licenses that are restricted by a board order.h. Perform any other function as authorized by a provision of law.

645—99.4(17A) Official communications.99.4(1) All official communications, including submissions and requests, may be addressed to the

Board of Mortuary Science Examiners, Professional Licensure Division, Fifth Floor, Lucas State Of-fice Building, Des Moines, Iowa 50319-0075.

99.4(2) Notice of change of address. Each licensee shall notify the board of a change of the licen-see’s current mailing address within 30 days after the change of address occurs.

99.4(3) Notice of change of name. Each licensee shall notify the board in writing of a change ofname within 30 days after changing the name.

645—99.5(17A) Office hours. The board office is open for public business from 8 a.m. to 4:30 p.m.,Monday to Friday of each week, except holidays.

645—99.6(21) Public meetings. Members of the public may be present during board meetings unlessthe board votes to hold a closed session. Dates and location of board meetings may be obtained fromthe board’s Web site (http://www.idph.state.ia.us/licensure) or directly from the board office.

99.6(1) At every regularly scheduled board meeting, time will be designated for public comment.During the public comment period, any person may speak for up to two minutes. Requests to speak fortwo minutes per person later in the meeting when a particular topic comes before the board should bemade at the time of the public comment period and will be granted at the discretion of the chairperson.No more than ten minutes will be allotted for public comment at any one time unless the chairpersonindicates otherwise.

99.6(2) Persons who have not asked to address the board during the public comment period mayraise their hands to be recognized by the chairperson. Acknowledgment and an opportunity to speakwill be at the discretion of the chairperson.IAC 9/29/04, 7/5/06

Ch 99, p.3Professional Licensure[645]IAC 7/5/06

99.6(3) The person presiding at a meeting of the board may exclude a person from an open meetingfor behavior that obstructs the meeting.

99.6(4) Cameras and recording devices may be used at open meetings provided the cameras andrecording devices do not obstruct the meeting. If the user of a camera or recording device obstructs themeeting by the use of such device, the person presiding at the meeting may request the user to discon-tinue use of the camera or device.

These rules are intended to implement Iowa Code chapters 17A, 147, 21, and 156.[Filed 9/12/02, Notice 7/10/02—published 10/2/02, effective 11/6/02][Filed 9/9/04, Notice 7/7/04—published 9/29/04, effective 11/3/04][Filed 6/9/06, Notice 4/12/06—published 7/5/06, effective 8/9/06]

IAC 7/5/06