Bills Associated with Iowa Psychological Association

Revises and aligns the structure and administration of health and human services in Iowa by replacing 'behavioral health districts' with 'health and human services districts' as the basis for service delivery. It updates definitions, reassigns duties to administrative organizations, and consolidates planning and service areas for aging and disability services to match HHS districts. The bill also creates a new subunit for volunteerism within the Department of Health and Human Services and revises the administrative and liability structure for volunteer programs. It includes immediate effective dates and is contingent on federal approval for certain provisions.

Key Points & Impacts:

• Replaces 'behavioral health district' terminology with 'health and human services district' throughout relevant Iowa Code sections.

• Aligns boundaries for behavioral health, aging, and disability service areas to match newly defined HHS districts, consolidating service regions statewide.

• Removes outdated definitions and advisory councils, establishes new 'behavioral health district advisory councils' with updated membership and duties.

• Updates duties and powers of administrative services organizations, including plan development and compliance oversight for behavioral health services within HHS districts.

• Clarifies administrative procedures, including rulemaking authority and limits on judicial review for district boundary modifications.

• Creates a subunit for volunteerism within HHS, centralizing volunteer program administration and clarifying volunteer liability as state employees (with exceptions for guardians/conservators).

• Allows the Iowa commission on volunteer service to delegate nonpolicymaking duties to the new subunit and revises agency support and funding provisions.

• Makes several provisions effective immediately upon enactment; some changes regarding aging and disability services are contingent upon federal approval.

Realigns the health and human services system by designating 'health and human services districts' (HHS districts) for the statewide delivery of programs and services, replacing previous behavioral health districts. It updates terminology and structure throughout the code, consolidates planning and service areas for aging and disability services to match HHS district boundaries, and creates a new volunteerism subunit within HHS to support and coordinate volunteer activities and the Iowa commission on volunteer service. Other changes include clarifying advisory council composition and duties, and formalizing processes for designation, review, and modification of districts.

Key Points & Impacts:

• Replaces 'behavioral health districts' with 'health and human services districts' (HHS districts) for program delivery; initial HHS districts mirror existing behavioral health districts.

• Adds and updates definitions throughout the code, including creation of 'behavioral health district advisory councils' and 'behavioral health service system district plans'.

• Removes language that allowed judicial review of district boundary modifications by HHS; such decisions are now not subject to judicial review.

• Aligns planning and service areas for aging and disability services to exactly match new HHS district boundaries, contingent on federal approval.

• Revises the structure and duties of advisory councils for behavioral health districts, specifying membership requirements and functions.

• Creates a subunit for volunteerism within HHS to manage volunteer programs and provide support to the Iowa commission on volunteer service, including appointment of an executive director and staff.

• Clarifies that registered volunteers are considered state employees for liability purposes, with exceptions for volunteer guardians/conservators.

• Authorizes the commission on volunteer service to delegate nonpolicymaking administrative duties to the new subunit for volunteerism.

Enacts changes across health-related fields, including mandatory nutrition/metabolic health education for certain medical professionals, major reforms to the certificate of need process for health facilities, requirements for uninterrupted SNAP administration, authorizing ivermectin as an over-the-counter medication, banning certain food additives in school meals, and adopting the Psychology Interjurisdictional Compact. It also significantly raises taxes on cigarettes, tobacco, vapor, and consumable hemp products, and creates new excise taxes for vapor and hemp products, directing proceeds to the health care trust fund.

Key Points & Impacts:

• Mandates at least one hour of continuing education in nutrition and metabolic health every four years for physicians and physician assistants in specified fields as a condition of license renewal.

• Reforms the certificate of need (CON) process by striking certain facility and equipment exemptions, revising the application and public hearing process, and modifying limitations on beds for intermediate care facilities for persons with intellectual disabilities.

• Requires the state to continuously administer SNAP in accordance with USDA guidelines, ensuring uninterrupted benefits and defining eligible foods as those considered healthy by the state.

• Allows pharmacies and others to distribute ivermectin for human use without a prescription and protects them from penalties for doing so.

• Prohibits schools (including some charter/nonpublic schools) from serving or selling foods containing specified artificial dyes and additives as part of meal programs, with limited federal exceptions, effective July 2027.

• Enacts the Psychology Interjurisdictional Compact, allowing licensed psychologists in member states to practice telepsychology and temporary in-person services across state lines.

• Raises the cigarette tax from 6.8 cents to 10.05 cents per cigarette, increases the tobacco product tax from 50% to 55% of wholesale price, raises the cigar cap to 55 cents, changes snuff tax to 55% of wholesale price (from $1.19/oz), and imposes new excise taxes (15%) on vapor and consumable hemp products.

• Directs all new and increased tax revenues from cigarettes, tobacco, vapor, and consumable hemp products to the health care trust fund.

Raises excise taxes on cigarettes (from 6.8 to 10.05 cents per cigarette), tobacco products (from a combined 50% to 55% of wholesale price), snuff (from $1.19/oz to 55% of wholesale price), and cigars (tax cap from 50 to 55 cents per cigar). It imposes a new 15% excise tax on both vapor products and consumable hemp products at retail sale. The bill aligns definitions, enforcement, and reporting requirements for these products, and directs all related revenue into the health care trust fund. It also appropriates $1 million each to the Department of Health and Human Services (for the Double Up Food Bucks Program) and the Department of Justice (for human trafficking victim assistance grants).

Key Points & Impacts

• Increases cigarette tax from 6.8 cents to 10.05 cents per cigarette, raising the cost per pack from $1.36 to $2.01.

• Raises the tax on tobacco products (excluding cigarettes, little cigars, and snuff) from a combined 50% to 55% of the wholesale sales price; increases cigar tax cap from 50 to 55 cents per cigar.

• Changes snuff tax from $1.19 per ounce to 55% of the wholesale sales price, aligning it with other tobacco products.

• Establishes a new excise tax of 15% on the retail sales price of vapor products and consumable hemp products, collected at point of sale.

• Expands enforcement, reporting, and inventory tax requirements to include vapor and consumable hemp products, with all related definitions updated for consistency.

• Directs all new and increased excise tax revenues to the state health care trust fund, including specific provisions for vapor and hemp product taxes.

• Appropriates $1 million from the health care trust fund to the Department of Health and Human Services for the Double Up Food Bucks Program to improve access to fresh produce for SNAP recipients.

• Appropriates $1 million from the health care trust fund to the Department of Justice for grants to care providers serving human trafficking victims.

Allows a court to order treatment for a person experiencing psychiatric deterioration based on clear and convincing evidence.

Requires an individual who has been involuntarily committed for a substance use disorder or serious mental impairment be referred to the behavioral health administrative services organization (BH ASO) prior to discharge for system navigation. Requires the provider to provide 15 days of medication (all medications - not just BH meds) upon discharge. Providers are instructed to bill for medication not covered by Medicaid or private insurance to the BH system.

Redefines and separates the procedures for voluntary treatment of adults and minors with substance use disorders or mental illness. It authorizes parents, legal guardians, or custodians to commit a minor for substance use or mental health treatment without requiring judicial approval, unless both the minor and their parent/guardian/custodian object to admission. If a minor is admitted over their objection, the juvenile court must appoint an advocate for the minor. The bill makes conforming changes throughout the Iowa Code, updating terms and procedures, and establishing new sections specifically addressing the admission, discharge, confidentiality, and payment for minor patients.

Key Points & Impacts:

• Separates procedures for adults and minors seeking voluntary treatment for substance use and mental health disorders, introducing new sections specifically for minors (125.33A and 229.2B).

• Allows a parent, legal guardian, or custodian to admit a minor for substance use or mental health treatment without a court order, unless both the minor and the parent/guardian/custodian object.

• Removes the requirement for automatic juvenile court involvement and hearings, except in cases where both the minor and parent/guardian/custodian object to treatment.

• Requires appointment of a juvenile court advocate for minors admitted to treatment over their own objections.

• Clarifies confidentiality requirements: prohibits disclosure of treatment or admission information for minors, with penalties for unauthorized disclosure.

• Updates language throughout statutes to distinguish between 'adults' and 'minors,' and adjusts references to new and amended sections.

• Modifies procedures for discharge, family involvement, and post-discharge support for minors receiving treatment.

• Requires that costs for minor admissions to state mental health institutes be paid by the applicant, with collections credited to the general fund.

Establishes seven peer-run respite programs statewide. These programs are designed to offer non-clinical, voluntary, short-term support for individuals experiencing emotional or behavioral health distress, mental health crises, or significant personal life challenges. The bill defines 'life-altering challenge' and imposes requirements for program location, independence from clinical facilities, and majority peer governance on program boards. Limits are placed on the proportion of clinical mental health services offered. The Department must adopt administrative rules to implement these provisions.

Key Points & Impacts:

• Defines 'life-altering challenge' as a major stressor or event disrupting well-being and daily life that may require crisis prevention.

• Requires the Department of Health and Human Services to establish seven peer-run respite programs throughout the state.

• Programs must provide voluntary, short-term support for individuals in emotional distress, behavioral health distress, mental health crisis, or experiencing a life-altering challenge.

• Programs are prohibited from being located on the campus of clinical, medical, or mental health facilities and must operate independently from such clinics.

• Mandates that at least 51% of each program's board of directors must consist of individuals with lived experience of psychiatric or behavioral health conditions or life-altering challenges.

• Clinical mental health services, if provided, must make up less than 10% of the total services offered by any program.

• Requires the Department to adopt rules for the administration of these programs.

Increases the capacity for inpatient psychiatric treatment at each state mental health institute by at least 100% compared to their bed count as of June 30, 2025. Increase is to be achieved by July 1, 2027. Additionally, it requires the HHS to apply for a federal Medicaid waiver (specifically, for the institution for mental diseases exclusion) by October 1, 2026, allowing the state to utilize Medicaid funding for the additional beds.

Key Points & Impact:

• Requires doubling of inpatient psychiatric beds at each state mental health institute by July 1, 2027.

• The baseline for bed count is set as the number present on June 30, 2025.

• Mandates the Department of Health and Human Services to implement the increase.

• Requires application for a Medicaid waiver (institution for mental diseases exclusion) by October 1, 2026.

• The waiver would allow Medicaid funding to be used for the expanded inpatient psychiatric capacity.

• Targets improved access to inpatient psychiatric care statewide.

• Sets clear, enforceable deadlines for both the bed increase and the waiver application.

• Direct response to anticipated or identified psychiatric bed shortages in Iowa.

Requires that public schools issuing physical or electronic identification cards to students in grades 6 through 12 must include the crisis hotline telephone and text numbers, as well as the internet address for the Your Life Iowa program or its successor. For electronic IDs, this information must be provided via a link. The bill also allows, but does not require, schools to include this information on ID cards for students in grade 5. The requirements apply to student ID cards issued after the effective date, with an exception for schools using up existing unused physical ID card supplies.

Key Points & Impacts

• Expands mandatory inclusion of suicide prevention information on student IDs from grades 7–12 to grades 6–12.

• Requires both physical and electronic student identification cards to display or provide a link to the Your Life Iowa program internet address.

• Specifies that the suicide prevention information must be on the physical card and, for electronic cards, accessible via a link.

• Allows (but does not require) inclusion of this information on IDs for students in grade 5.

• Changes language from 'grades seven through twelve' to 'grades six through twelve' and from 'grades five and six' to 'grade five.'

• Clarifies that requirements apply only to new ID cards issued after the bill's effective date, allowing use of pre-existing physical ID card supplies.

• Explicitly includes the internet address as a required element along with the crisis hotline telephone and text numbers.

• Distinguishes between physical and electronic ID cards regarding how information must be provided.

Establishes strict requirements for chatbot disclosure and behavior, prohibits chatbot encouragement of self-harm or violence, creates significant civil penalties for violations, and directs appropriated penalties to the attorney general for enforcement. The attorney general is granted rulemaking authority for implementation.

Key Points & Impacts:

• Defines 'chatbot' and exempts narrowly scoped or entirely pre-programmed applications.

• Prohibits the design or deployment of chatbots that encourage, promote, or coerce self-harm, suicide, or violence against humans or animals.

• Requires chatbots to clearly disclose they are not human at the start of each conversation and at 30-minute intervals.

• Mandates chatbots to clarify they do not provide medical, legal, financial, or psychological services and advise users to consult licensed professionals, with regular disclosures.

• Requires chatbots to prevent claiming to be human or responding deceptively if asked about their nature.

• Prohibits chatbots from representing themselves as licensed professionals (e.g., therapist, physician, lawyer, financial advisor).

• Establishes civil penalties of up to $100,000 per violation, with penalties appropriated to the attorney general for enforcement activities.

• Grants the attorney general authority to enforce the act, seek penalties, restitution, and adopt implementation rules.

Revises and aligns the structure and administration of health and human services in Iowa by replacing 'behavioral health districts' with 'health and human services districts' as the basis for service delivery. It updates definitions, reassigns duties to administrative organizations, and consolidates planning and service areas for aging and disability services to match HHS districts. The bill also creates a new subunit for volunteerism within the Department of Health and Human Services and revises the administrative and liability structure for volunteer programs. It includes immediate effective dates and is contingent on federal approval for certain provisions.

Key Points & Impacts:

• Replaces 'behavioral health district' terminology with 'health and human services district' throughout relevant Iowa Code sections.

• Aligns boundaries for behavioral health, aging, and disability service areas to match newly defined HHS districts, consolidating service regions statewide.

• Removes outdated definitions and advisory councils, establishes new 'behavioral health district advisory councils' with updated membership and duties.

• Updates duties and powers of administrative services organizations, including plan development and compliance oversight for behavioral health services within HHS districts.

• Clarifies administrative procedures, including rulemaking authority and limits on judicial review for district boundary modifications.

• Creates a subunit for volunteerism within HHS, centralizing volunteer program administration and clarifying volunteer liability as state employees (with exceptions for guardians/conservators).

• Allows the Iowa commission on volunteer service to delegate nonpolicymaking duties to the new subunit and revises agency support and funding provisions.

• Makes several provisions effective immediately upon enactment; some changes regarding aging and disability services are contingent upon federal approval.

Requires the Iowa Supreme Court revise Iowa Rule of Criminal Procedure 2.22(8)(e)(1) to clarify that a lack of recent overt dangerous acts should not be the sole factor in evaluating the risk posed by defendants acquitted due to insanity. The bill outlines specific factors courts must assess, including the original offense, behavioral and psychiatric history, substance use history, institutional behavior, environmental influences, and expert testimony. The revised rules must be submitted for legislative council review by October 14, 2026.

Key Points & Impacts:

• Instructs the Supreme Court to revise criminal procedure rules for post-insanity acquittal commitment hearings.

• Specifies that absence of recent overt dangerous acts cannot be the sole factor in risk assessment.

• Requires courts to consider the nature and circumstances of the original offense.

• Mandates consideration of the defendant's behavioral history, including past violent acts regardless of recency.

• Requires assessment of psychiatric history, current mental status, and treatment adherence.

• Directs evaluation of substance use disorder history and its impact on behavior and risk.

• Includes requirements for considering institutional behavior, functioning in less structured environments, and adaptability.

• Mandates the use and consideration of expert testimony and validated risk assessment tools.

Revises the Iowa Rules of Criminal Procedure regarding commitment hearings following an acquittal based on insanity. Ensures that the absence of recent overt acts of dangerousness cannot be the only determining factor in whether a defendant is a risk to themselves or others, especially if such absence is due to a highly structured environment. Courts must consider a comprehensive list of factors, including original offense, behavioral and psychiatric history, substance use, institutional behavior, environmental influences, and expert assessments. The revised rules must be submitted for legislative review by October 14, 2026.

Key Points & Impact:

• Mandates the Iowa Supreme Court to revise criminal procedure rules for post-insanity acquittal commitment hearings.

• Bars courts from using the absence of recent overt acts of dangerousness as the sole determining factor in risk assessments, especially when the defendant is in a highly structured environment.

• Requires courts to consider the nature and circumstances of the original offense leading to the insanity acquittal.

• Requires evaluation of the defendant's behavioral history, including prior violent or dangerous acts, regardless of recent conduct.

• Includes consideration of psychiatric history, current mental status, and treatment adherence.

• Mandates assessment of substance use disorder history, its relationship to dangerousness, risk of relapse, and engagement in treatment.

• Requires examination of institutional behavior, independent functioning, and adaptability to less structured environments.

• Directs consideration of expert testimony, validated risk assessments, and environmental influences on behavior.

Introduces definitions for 'test data' and 'test materials' in line with the American Psychological Association's ethical standards. It restricts the disclosure of test materials, clarifies procedures for disclosing psychological test records to individuals through designated psychologists, and explicitly excludes 'test data' from these restrictions with new redaction requirements.

Key Points & Impacts:

• Defines 'test data' and 'test materials' as per the latest APA ethical standards.

• Prohibits disclosure of 'test materials' to any person, including the test subject, except in limited circumstances.

• Bars disclosure of test materials in administrative, judicial, or legislative proceedings.

• Allows individuals to request records of their psychological tests but only through a licensed psychologist designated by them; the request must be in writing.

• Clarifies that individuals do not have the right to inspect original test materials.

• Exempts 'test data' from the disclosure restrictions that apply to 'test materials.'

• Permits disclosure of test data even if it contains test materials, provided those materials are redacted before disclosure.

• Replaces and updates terminology in existing law to distinguish between 'test data' and 'test materials.'

Eliminates the 10-day limit on subacute mental health care services, mandates treatment planning within 24 hours of admission, sets clear deadlines for insurance authorization, and requires state departments to review and modify rules to improve access and operation of subacute mental health care facilities. It allows for emergency rulemaking and takes effect immediately upon enactment.

Key Points & Impacts:

• Strikes language limiting subacute mental health care to 10 days unless extended by the Department of Health and Human Services, removing this time cap.

• Requires subacute care facilities to create a written treatment care plan with residents within 24 hours of admission.

• Establishes new insurance authorization timeframes: 48 hours for urgent requests, 5 days for nonurgent, and 10 days for complex nonurgent requests.

• Directs the Departments of Health and Human Services and Inspections, Appeals, and Licensing to review, and eliminate rules that hinder the establishment, expansion, or access to subacute mental health care facilities and services.

• Requires rule changes to allow facilities to increase the number of beds without being classified as a mental health institution.

• Mandates that employment requirements at subacute facilities be less stringent than those for state mental health institutes.

• Enables emergency rulemaking to expedite implementation of these changes.

• The bill is effective immediately upon enactment.

Requires public schools serving grades 7-12 to provide information about the 'Your Life Iowa' program on their websites. The law already required certain crisis hotline information on student identification cards; this bill ensures the 'Your Life Iowa' program is included and extends resource availability online.

Key Points & Impacts

• Amends section 279.70A of the Iowa Code to update requirements for suicide prevention information.

• Changes the section title to focus more broadly on suicide prevention information rather than just student IDs.

• Requires that public schools serving grades 7-12 publish information on the 'Your Life Iowa' program (or its successor) on their websites as a resource.

• Clarifies that the crisis hotline and 'Your Life Iowa' program contact information must be included on student identification cards for grades 7-12, and may be included for grades 5-6.

• Expands the availability of suicide prevention and crisis resources by mandating online access in addition to physical ID cards.

• Ensures that both telephone/text numbers and internet addresses are provided for the 'Your Life Iowa' program.

• Targets increased student access to mental health and crisis intervention resources.

• Aligns online and physical dissemination of suicide prevention information in public schools.

Realigns the health and human services system by designating 'health and human services districts' (HHS districts) for the statewide delivery of programs and services, replacing previous behavioral health districts. It updates terminology and structure throughout the code, consolidates planning and service areas for aging and disability services to match HHS district boundaries, and creates a new volunteerism subunit within HHS to support and coordinate volunteer activities and the Iowa commission on volunteer service. Other changes include clarifying advisory council composition and duties, and formalizing processes for designation, review, and modification of districts.

Key Points & Impacts:

• Replaces 'behavioral health districts' with 'health and human services districts' (HHS districts) for program delivery; initial HHS districts mirror existing behavioral health districts.

• Adds and updates definitions throughout the code, including creation of 'behavioral health district advisory councils' and 'behavioral health service system district plans'.

• Removes language that allowed judicial review of district boundary modifications by HHS; such decisions are now not subject to judicial review.

• Aligns planning and service areas for aging and disability services to exactly match new HHS district boundaries, contingent on federal approval.

• Revises the structure and duties of advisory councils for behavioral health districts, specifying membership requirements and functions.

• Creates a subunit for volunteerism within HHS to manage volunteer programs and provide support to the Iowa commission on volunteer service, including appointment of an executive director and staff.

• Clarifies that registered volunteers are considered state employees for liability purposes, with exceptions for volunteer guardians/conservators.

• Authorizes the commission on volunteer service to delegate nonpolicymaking administrative duties to the new subunit for volunteerism.

Enacts the Psychology Interjurisdictional Compact, enabling Iowa to join other states in allowing licensed psychologists to practice telepsychology and provide temporary in-person services in other compact states. It establishes legal recognition for out-of-state psychologists, sets requirements for licensure and disciplinary action, creates a commission to oversee the compact, and details rulemaking, enforcement, and dispute resolution processes. The compact aims to improve access to psychological services and facilitate regulatory cooperation among participating states.

Key Points & Impacts:

• Authorizes Iowa to join the Psychology Interjurisdictional Compact (PSYPACT), allowing psychologists licensed in compact states to provide telepsychology and temporary in-person services across state lines.

• Establishes uniform eligibility requirements for psychologists to practice under the compact, including specific educational, licensure, and background check standards.

• Creates a governing commission with authority to promulgate rules, oversee compliance, and coordinate disciplinary actions among member states.

• Defines processes for adverse actions, including automatic revocation of telepsychology and temporary practice privileges if a psychologist's license is sanctioned in any compact state.

• Requires compact states to share licensure and disciplinary information through a coordinated database to enhance oversight and public protection.

• Allows compact states to issue subpoenas, enforce cease-and-desist orders, and take emergency actions regarding psychologists' privileges under the compact.

• Details procedures for state withdrawal, compact amendment, dispute resolution, and commission financing, ensuring ongoing interstate cooperation and regulatory adaptation.

• Explicitly states that the compact does not apply when a psychologist is licensed in both the home and receiving states, nor to permanent in-person practice.

Establishes strict requirements for chatbot disclosure and behavior, prohibits chatbot encouragement of self-harm or violence, creates significant civil penalties for violations, and directs appropriated penalties to the attorney general for enforcement. The attorney general is granted rulemaking authority for implementation.

Key Points & Impacts:

• Defines 'chatbot' and exempts narrowly scoped or entirely pre-programmed applications.

• Prohibits the design or deployment of chatbots that encourage, promote, or coerce self-harm, suicide, or violence against humans or animals.

• Requires chatbots to clearly disclose they are not human at the start of each conversation and at 30-minute intervals.

• Mandates chatbots to clarify they do not provide medical, legal, financial, or psychological services and advise users to consult licensed professionals, with regular disclosures.

• Requires chatbots to prevent claiming to be human or responding deceptively if asked about their nature.

• Prohibits chatbots from representing themselves as licensed professionals (e.g., therapist, physician, lawyer, financial advisor).

• Establishes civil penalties of up to $100,000 per violation, with penalties appropriated to the attorney general for enforcement activities.

• Grants the attorney general authority to enforce the act, seek penalties, restitution, and adopt implementation rules.

Creates requirements for the deployment and operation of chatbots (AI systems simulating human conversation), focusing on protecting minors and ensuring user safety. Deployers of chatbots must prioritize user well-being, limit data collection, and implement robust age verification to prevent minors from accessing chatbots, except in narrowly defined mental health contexts with multiple safeguards. The bill grants enforcement powers to the Attorney General and allows private actions for violations involving minors.

Key Points & Impacts

• Defines key terms including 'artificial intelligence,' 'chatbot,' 'deployer,' 'minor,' 'output,' and 'reasonable age verification.'

• Requires chatbot deployers to implement and maintain protocols to detect, respond to, report, and mitigate harm to users, prioritizing user safety.

• Limits deployers to collecting and storing only user information necessary for the chatbot's stated purpose.

• Mandates deployers to implement reasonable age verification to prohibit minors from using or purchasing chatbots, with exceptions for certain mental health applications.

• Allows exceptions for chatbots designed for mental health support, provided they meet strict requirements such as professional recommendation, clear disclaimers, clinical trial data, and risk mitigation protocols.

• Empowers the Attorney General to enforce provisions, seek injunctions, and pursue civil penalties up to $2,500 per violation, or $7,500 for violating an injunction.

• Directs that civil penalties collected go to the state general fund.

• Permits parents, guardians, or custodians of minors to pursue civil penalties or actual damages if a non-compliant chatbot is used by a minor.

Requires the Department of Education, in collaboration with the Department of Health and Human Services, to establish a working group to examine how school-provided technology (e.g., laptops, online learning systems, classroom presentations) affects students' cognitive function and academic performance. The group must include educators, mental health professionals, and parents. Members are responsible for their own expenses. A report with findings and recommendations, focusing on mitigating negative impacts on students' development and learning, is due to the legislature by December 31, 2026.

Key Points & Impacts

• Directs the Department of Education and Department of Health and Human Services to form a working group.

• Working group to study the impact of school-provided technology on student cognitive and academic outcomes.

• 'School-provided technology' includes laptops, online learning systems, and classroom presentations.

• Working group must include educators, mental health professionals, and parents of school-age children.

• Working group members and their represented entities are responsible for their own expenses.

• Findings and recommendations must be reported to the General Assembly by December 31, 2026.

• Report to include best practices for technology use and ways to mitigate negative impacts on students' social, behavioral, and learning outcomes.

• Focus on potential effects on social development, attention span, mental concentration, and learning ability.

Defines what constitutes a chatbot and excludes certain narrow, non-adaptive applications. It prohibits creating or providing chatbots that promote, encourage, or coerce users into self-harm or violence. The bill establishes strict disclosure requirements for chatbot interactions, mandates programming to prevent deceptive claims of human or professional status, and sets a maximum civil penalty of $100,000 per violation. Penalties collected are appropriated to the attorney general for enforcement. The attorney general is also granted rulemaking authority to implement these provisions.

Key Points & Impact:

• Defines 'chatbot' and carves out specific exceptions for limited-scope applications.

• Makes it unlawful to knowingly or recklessly provide chatbots that encourage or coerce users into suicide, self-injury, or violence against humans or animals.

• Requires chatbots to disclose their non-human status clearly at the start of conversations and every 30 minutes.

• Mandates that chatbots must not claim to be human or respond deceptively if asked about their nature.

• Requires disclosure that chatbots do not provide medical, legal, financial, or psychological services, and advises users to consult licensed professionals.

• Prohibits chatbots from representing themselves as licensed professionals (e.g., therapists, lawyers, physicians).

• Imposes civil penalties up to $100,000 per violation, with penalties appropriated to the attorney general for enforcement duties.

• Grants the attorney general authority to adopt rules and bring civil actions for enforcement, including seeking penalties and restitution.

Expands and clarifies the circumstances under which a child can be adjudicated as in need of assistance due to serious chemical dependency, mental, or behavioral health disorders. It broadens eligibility to include cases where parents have exhausted efforts to secure treatment, adds behavioral health disorders as grounds, and focuses on aggressive behavior toward others in the home or community. The bill removes language referencing emotional damage such as anxiety or depression and strikes one subsection from the code.

Key Points & Impact:

• Expands the grounds for CINA adjudication to include serious chemical dependency or behavioral health disorders, not just mental illness or disorder.

• Removes language about emotional damage evidenced by severe anxiety, depression, or withdrawal as criteria for adjudication.

• Limits aggressive behavior grounds to aggression toward others in the household or community (removes self-directed aggression).

• Adds that a child can qualify if the parent, guardian, or custodian is 'unable' to provide treatment, not just 'unwilling'.

• Includes cases where the parent/guardian/custodian's efforts to secure needed treatment have been 'exhausted and unsuccessful'.

• Adds 'behavioral health disorder that compromises the child’s safety' as an explicit criterion.

• Removes Iowa Code Section 232.96A(13) entirely (content of subsection not specified in this excerpt).

• Clarifies and updates statutory language to reflect contemporary understanding of behavioral health.

Clarifies that actions taken to raise, guide, or instruct a child in a manner consistent with the child's sex—including use of pronouns and titles, seeking mental health services to align the child’s life with their sex, making health decisions based on sex, and declining consent for gender transition procedures—do not constitute child abuse or child endangerment. State agencies cannot deny foster or adoption licensure, nor can courts consider such practices as a negative factor in custody cases. The bill also amends procedures for child protection worker access and clarifies related immunity provisions.

Key Points & Impacts:

• Redefines 'child abuse' to specifically exclude actions taken to raise, guide, or instruct a child in a manner consistent with the child's sex, including refusing gender transition procedures.

• Specifies that 'child endangerment' does not include raising or guiding a child according to their sex as defined in the bill.

• Prevents the Department of Health and Human Services from denying foster care licensure based on an individual's intent to raise a child in accordance with the child's sex.

• Bars adoption rules from precluding individuals who intend to raise a child in a manner consistent with their sex from becoming adoptive parents.

• Prohibits courts from considering, as a negative factor for custody, a parent's intent to raise or instruct a child consistent with their sex.

• Clarifies that child protection workers must have access to children for investigations, and makes related changes to procedures and immunity for facilities and schools.

• Lists specific actions protected, including pronoun use, mental health service decisions, and refusal of gender transition procedures for a child.

• Adds procedural clarifications and updates terminology to ensure consistency with the new legal standards.

Implements significant changes to Iowa's human trafficking laws. It mandates annual stakeholder meetings and reports to develop legislative proposals, expands the definition of 'commercial sexual exploitation,' requires standardized screening of children for trafficking, and extends civil statute of limitations for survivors. The bill also amends procedures for prosecution and victim handling, clarifies restitution categories, and directs the Department of Health and Human Services to increase restoration facilities for juvenile victims. Some provisions take effect July 1, 2026.

Key Points & Impacts:

• Mandates annual stakeholder meetings on human trafficking with a wide range of participants and requires annual reports to the governor and general assembly through 2030.

• Defines 'commercial sexual exploitation' broadly to include any sexual abuse or exploitation of a child for financial or other value.

• Requires all juvenile complaints to be reviewed with a human trafficking indicator list and allows trauma-informed screening for commercial sexual exploitation.

• Obligates the Department of Health and Human Services to screen all children subject to abuse allegations for commercial sexual exploitation using standardized, evidence-based tools.

• Extends the civil statute of limitations for actions related to sexual abuse or human trafficking of minors to five years after reaching majority, with an additional five years from discovery for latent injuries.

• Expands the definition of 'human trafficking' to include patronizing or soliciting, not just participating in a venture.

• Prohibits arrest, charge, or prosecution for minors engaged in prostitution, mandating referral to protective services instead.

• Directs the Department of Health and Human Services to develop a plan to increase restoration facilities and protective services, including consideration of out-of-state housing for at-risk juvenile trafficking victims.

Revises current law regarding the commitment of defendants found incompetent to stand trial. It expands the options for court-ordered commitment, adding provisions for defendants whose competency is unlikely to be restored. The bill establishes procedures for the safekeeping, assessment, and annual review of such defendants, and clarifies the maximum duration of their confinement in relation to the alleged offense.

Key Points & Impacts:

• Adds new commitment option for defendants whose competency is unlikely to be restored due to cognitive or neurophysiological disabilities, allowing commitment as a safekeeper to the Department of Corrections or a designated treatment facility.

• Establishes a rebuttable presumption that such commitment will continue unless evidence warrants a hearing to reassess the defendant's danger to public safety.

• Requires annual threat assessments by qualified professionals for committed defendants, with access to all relevant records.

• Mandates treatment facilities to prepare annual reports on the defendant's status for the court.

• Requires the court to conduct annual reviews and, if warranted, set hearings on the defendant's status.

• Limits the duration of defendant's placement to no longer than the maximum term of confinement for the alleged criminal offense.

• Requires dismissal of the criminal complaint with prejudice when the maximum term of confinement is reached.

• Amends statutory language to include the new commitment option (paragraph 'c') alongside existing options.

Requires the Iowa Supreme Court revise Iowa Rule of Criminal Procedure 2.22(8)(e)(1) to clarify that a lack of recent overt dangerous acts should not be the sole factor in evaluating the risk posed by defendants acquitted due to insanity. The bill outlines specific factors courts must assess, including the original offense, behavioral and psychiatric history, substance use history, institutional behavior, environmental influences, and expert testimony. The revised rules must be submitted for legislative council review by October 14, 2026.

Key Points & Impacts:

• Instructs the Supreme Court to revise criminal procedure rules for post-insanity acquittal commitment hearings.

• Specifies that absence of recent overt dangerous acts cannot be the sole factor in risk assessment.

• Requires courts to consider the nature and circumstances of the original offense.

• Mandates consideration of the defendant's behavioral history, including past violent acts regardless of recency.

• Requires assessment of psychiatric history, current mental status, and treatment adherence.

• Directs evaluation of substance use disorder history and its impact on behavior and risk.

• Includes requirements for considering institutional behavior, functioning in less structured environments, and adaptability.

• Mandates the use and consideration of expert testimony and validated risk assessment tools.

Revises the Iowa Rules of Criminal Procedure regarding commitment hearings following an acquittal based on insanity. Ensures that the absence of recent overt acts of dangerousness cannot be the only determining factor in whether a defendant is a risk to themselves or others, especially if such absence is due to a highly structured environment. Courts must consider a comprehensive list of factors, including original offense, behavioral and psychiatric history, substance use, institutional behavior, environmental influences, and expert assessments. The revised rules must be submitted for legislative review by October 14, 2026.

Key Points & Impact:

• Mandates the Iowa Supreme Court to revise criminal procedure rules for post-insanity acquittal commitment hearings.

• Bars courts from using the absence of recent overt acts of dangerousness as the sole determining factor in risk assessments, especially when the defendant is in a highly structured environment.

• Requires courts to consider the nature and circumstances of the original offense leading to the insanity acquittal.

• Requires evaluation of the defendant's behavioral history, including prior violent or dangerous acts, regardless of recent conduct.

• Includes consideration of psychiatric history, current mental status, and treatment adherence.

• Mandates assessment of substance use disorder history, its relationship to dangerousness, risk of relapse, and engagement in treatment.

• Requires examination of institutional behavior, independent functioning, and adaptability to less structured environments.

• Directs consideration of expert testimony, validated risk assessments, and environmental influences on behavior.

Mandates that school districts implement policies to address students who disrupt the educational process or violate the student handbook. It authorizes teachers to take disciplinary action and, under certain circumstances, to remove disruptive students from class. The bill also sets procedures following repeated removals and prohibits retaliation against teachers for enforcing discipline. Takes effect December 31, 2026.

Key Points & Impact:

• Requires all school districts to adopt policies for disciplining students who disrupt the educational process or violate the student handbook.

• Authorizes teachers to take disciplinary action, including immediate classroom removal of students whose behavior is disruptive or poses a safety threat.

• Mandates that after a student's third classroom removal, the teacher and principal must confer about behavior patterns and possible disciplinary actions before new actions are taken.

• Requires a conference involving the teacher (or designee) and the student's parent/guardian (or the student if emancipated) before a student returns to class after a third removal, to discuss causes and potential solutions.

• Prohibits principals or administrators from discouraging, prohibiting, or retaliating against teachers for taking disciplinary action in accordance with district policies.

• Prevents school districts from adopting policies that restrict teachers' rights to discipline as outlined in the bill and prohibits retaliation against teachers for exercising these rights.

• Specifies that the bill does not allow teachers to violate district policies adopted under these provisions.

• Establishes the bill's effective date as December 31, 2026.

Requires additional oversight, training, and accountability regarding curriculum, educational materials, and training in public institutions of higher education and school districts. It expands the list of individuals responsible for ensuring compliance (including employees, contractors, and volunteers), prohibits the use of any funds or resources for violating activities, and allows for civil actions against school districts without demonstrating personal harm. It also mandates training for relevant personnel on these requirements and prohibitions.

Key Points & Impacts:

• Requires administrators of public higher education institutions to ensure all employees and contractors providing staff or student training receive training about legal requirements and prohibitions regarding specific defined concepts.

• Expands responsibility in school districts to include not only superintendents and employees, but also contractors and volunteers, in ensuring that no curricula, educational materials, or training teach, advocate, encourage, promote, or act upon specific stereotyping or scapegoating based on demographic group membership or identity.

• Prohibits school districts from using any funds (state appropriations or any other sources) to provide curriculum, materials, or training that violate the anti-stereotyping provisions, directly or indirectly.

• Bans the use of district resources, facilities, or staff/student time to support or encourage violations of anti-stereotyping requirements.

• Requires all employees, contractors, and volunteers involved in providing curriculum, materials, or training in school districts to undergo training on compliance with these legal requirements.

• Creates a new civil enforcement mechanism: parents/guardians of students, school district employees, or district residents may file for injunctive relief against districts violating these requirements without needing to show personal harm.

• Clarifies that the new civil enforcement right is an exception to previous limitations on enforceability of the law.

• Does not appropriate new funds, but restricts the use of existing funds for prohibited activities.

Establishes mandatory consequences for state entities and school districts that violate existing prohibitions on DEI offices or officers and on certain concepts in educational curricula and trainings. If a violation is proven in court, the individual responsible and their knowing supervisor must be terminated, and professional licenses or certifications are subject to mandatory revocation. The bill also imposes significant civil penalties on state entities or school districts, scaled by budget size, and provides new avenues for enforcement through actions by the attorney general or affected individuals. Conforming changes to licensing and revocation procedures are included.

Key Points & Impacts:

• Creates a new requirement for mandatory termination of employment for individuals who violate DEI prohibitions in state entities or school districts, and for supervisors who were aware and failed to act.

• Mandates revocation of professional licenses, certificates, authorizations, or statements of recognition for individuals terminated due to violations.

• Imposes civil penalties on state entities or school districts found in violation: $50,000 if the budget is under $100 million, $100,000 if $100 million or more, to be deposited in the state general fund.

• Allows the attorney general or affected parties (students, alumni, employees) to bring actions to enforce compliance and seek injunctive relief against violations by school districts.

• Establishes specific venue options for bringing civil actions related to school district violations.

• Requires licensing boards, the board of educational examiners, and the Iowa Supreme Court to revoke licenses or certifications when employment is terminated for these violations.

• Adds an exception in existing law to reference new enforcement provisions for school districts.

• Creates new sections of law detailing prohibited training/curriculum concepts, enforcement actions, penalties, and license revocation procedures.

Creates a nonrefundable individual income tax credit for recent graduates of Iowa Board of Regents institutions who paid nonresident tuition and are now Iowa residents employed as healthcare professionals, teachers, licensed veterinarians, or professional engineers. The credit equals the difference between nonresident and resident tuition rates for the years attended. Excess credit can be carried forward up to five years but cannot benefit those who become nonresidents. The Board of Regents is required to publish tuition data for transparency. The bill applies retroactively to tax years beginning on or after January 1, 2026.

Key Points & Impacts:

• Establishes a nonresident tuition tax credit for individuals who graduated from an Iowa Board of Regents institution within the past three years and are now employed in Iowa as a healthcare professional, teacher, licensed veterinarian, or professional engineer.

• The tax credit amount is 100% of the difference between nonresident and resident tuition paid by the graduate for each year of attendance.

• Credit is nonrefundable, but unused amounts may be carried forward for up to five years or until exhausted, whichever comes first.

• If the taxpayer becomes a nonresident, remaining credit cannot be applied to future tax liability.

• Married taxpayers filing separately must allocate the credit proportionally to earned income.

• Board of Regents must publish a decade's worth of tuition data for both resident and nonresident students at each institution.

• Applies retroactively to tax years beginning on or after January 1, 2026.

• Targets high-need professions (healthcare, teaching, veterinary, engineering) to encourage retention of graduates in Iowa.

Imposes a new annual tax on the endowment values exceeding $500 million for public and private colleges and universities. The tax rate is set at the highest corporate income tax rate (currently 7.1%). Revenues from public institutions go to the Iowa workforce grant incentive fund, while revenues from private institutions are deposited in a new account to supplement tuition grants for students in high-wage and high-demand job majors. The bill also caps gift processing fees at 5% and endowment management fees at 1% for institutions governed by the board of regents. New administrative rules and appropriations mechanisms are established to implement these changes.

Key Points & Impacts:

• Imposes an annual endowment tax on Iowa colleges/universities with endowments exceeding $500 million, at the highest corporate income tax rate.

• Defines 'endowment' and 'endowment value' for purposes of the tax, including assets held by related organizations.

• Tax revenues from public institutions (board of regents) are appropriated to the Iowa workforce grant incentive fund.

• Tax revenues from private institutions are appropriated to a new 'high-wage and high-demand jobs' account within the Iowa tuition grants fund.

• Funds in the new account are used to supplement tuition grants for students in majors leading to high-wage, high-demand jobs, as identified by state workforce authorities.

• Caps fees for processing gifts to institutions at 5% of gross proceeds, and annual endowment management fees at 1% of endowment value for board of regents institutions.

• Requires new administrative rules for the approval and awarding of supplemental tuition grants after January 1, 2028.

  • Establishes appropriations mechanisms to ensure funds do not revert to the state general fund and are available for future tuition grants.

Mandates that continuing education requirements for licensed professions, including those overseen by the board of education and the Iowa Supreme Court, must be directly related to the practice of the licensed profession unless otherwise required by law. It also removes the requirement that a person must graduate from an ABA-accredited law school prior to sitting for the Iowa bar examination. Boards and the Supreme Court are directed to update rules accordingly.

Key Points & Impacts

• Adds that continuing education requirements must relate directly to the licensed profession, unless otherwise required by law.

• Prohibits professional licensing boards from imposing continuing education requirements not directly related to the practice of the licensed profession.

• Amends attorney licensing rules to ensure continuing education for attorneys is limited to topics directly related to the practice of law, unless otherwise mandated by law.

• Removes the requirement that bar exam candidates must graduate from an ABA-accredited law school to be eligible to sit for the Iowa bar examination.

• Requires the Iowa Supreme Court to update court rules to reflect the new standards for attorney continuing education and bar exam eligibility.

• Maintains the exemption from renewal requirements for practitioners with at least ten years of employment and an advanced degree, except for those with evaluator approval endorsements.

Creates new responsibilities for school district teachers and staff who work with students with IEPs or Section 504 plans. Teachers must read the relevant plan and provide written confirmation to the appropriate staff member. School employees assisting in instruction must attend all related meetings unless a parent objects. The state mandates that costs for these requirements are to be covered by existing school foundation aid, and no additional state funding will be provided.

Key Points & Impacts:

• Teachers who instruct students with IEPs must read the IEP and provide written notice to the IEP team's special education teacher.

• Teachers who instruct students with Section 504 plans must read the plan and provide written notice to either the student's special education teacher or principal.

• All school district employees assisting in classroom instruction for students with IEPs or Section 504 plans are required to attend all related meetings for those students, unless objected to by a parent or guardian.

• These new requirements are established as a new section (279.89) in the Code.

• The bill specifies that school districts must use state school foundation aid to pay for costs associated with these requirements.

• No additional state funding will be provided for implementing these mandates; compliance is required with existing resources.

• The bill addresses both students with IEPs (special education) and those with Section 504 plans (disability accommodation).

• Parents or guardians retain the right to object to employee attendance at their child's meetings.

Makes it a fraudulent practice to falsely claim academic degrees or credentials for purposes of employment or personal gain. 

Key Points & Impact:

• Adds a new subsection (6A) to Iowa Code section 714.8 making it a fraudulent practice to falsely claim academic degrees or credentials for employment or personal gain.

• Defines the act of misrepresenting academic credentials as a criminal offense.

• Amends section 714.10 to include this new fraudulent practice (714.8(6A)) as a fraudulent practice in the second degree.

• Classifies the offense as a class 'D' felony, subject to existing penalties for that classification.

• Penalties for a class 'D' felony include up to five years imprisonment and a fine between $1,025 and $10,245.

• Targets individuals who use false academic credentials to obtain jobs or other personal benefits.

Prohibits school districts, charter schools, and innovation zone schools from providing any program, curriculum, test, survey, questionnaire, promotion, or instruction relating to gender theory or sexual orientation to students in kindergarten through grade 12. Previously, this prohibition applied only to students in kindergarten through grade 6. 

Key Points & Impact:

• Expands the prohibition on instruction, programs, or surveys related to gender theory or sexual orientation from grades K-6 to K-12 in all public, charter, and innovation zone schools.

• Amends curriculum requirements so that human growth and development instruction in grades 7-12 must comply with the prohibition on gender theory and sexual orientation content.

• Clarifies that any health education unit content options (e.g., personal health, nutrition, substance use, emotional health) must exclude gender theory and sexual orientation topics in grades K-12.

• Updates references and compliance requirements in statutes governing charter and innovation zone schools to align with the expanded prohibition.

• Requires all human growth and development instruction (including that on human sexuality, self-esteem, stress management, interpersonal relationships, and domestic abuse) for grades 7-12 to be subject to the new law.

• Replaces previous language referring to grades K-6 with grades K-12 in all relevant code sections.

• Ensures that the new restrictions apply equally across traditional public schools, charter schools, and innovation zone schools.

• Does not alter the requirement for age-appropriate and research-based health education, but subjects it to the new prohibitions.

Requires that public schools issuing physical or electronic identification cards to students in grades 6 through 12 must include the crisis hotline telephone and text numbers, as well as the internet address for the Your Life Iowa program or its successor. For electronic IDs, this information must be provided via a link. The bill also allows, but does not require, schools to include this information on ID cards for students in grade 5. The requirements apply to student ID cards issued after the effective date, with an exception for schools using up existing unused physical ID card supplies.

Key Points & Impacts

• Expands mandatory inclusion of suicide prevention information on student IDs from grades 7–12 to grades 6–12.

• Requires both physical and electronic student identification cards to display or provide a link to the Your Life Iowa program internet address.

• Specifies that the suicide prevention information must be on the physical card and, for electronic cards, accessible via a link.

• Allows (but does not require) inclusion of this information on IDs for students in grade 5.

• Changes language from 'grades seven through twelve' to 'grades six through twelve' and from 'grades five and six' to 'grade five.'

• Clarifies that requirements apply only to new ID cards issued after the bill's effective date, allowing use of pre-existing physical ID card supplies.

• Explicitly includes the internet address as a required element along with the crisis hotline telephone and text numbers.

• Distinguishes between physical and electronic ID cards regarding how information must be provided.

Requires, beginning July 1, 2027, that higher education institutions providing practitioner preparation programs remove all instruction, training, or frameworks in required coursework, practicums, seminars, or assessments that include or derive from diversity, equity, and inclusion (DEI) theories or practices, multiculturalism as a classroom management framework, or social and emotional learning (SEL) or behavior conditioning models. It also prohibits institutions from using these concepts to require, promote, or assess student competencies. The bill mandates these programs instead include explicit, skills-based training in firm, authority-centered classroom management and historical/traditional approaches. The State Board of Education must adopt rules requiring compliance review and notification by the Director of Education, with a 12-month remediation period for noncompliance before program approval may be rescinded.

Key Points & Impacts:

• Prohibits, beginning July 1, 2027, the inclusion of DEI theories/practices, multiculturalism as a management framework, and SEL in required practitioner preparation program content or assessments.

• Defines 'diversity, equity, and inclusion,' 'multiculturalism,' and 'social and emotional learning' for purposes of compliance.

• Mandates that higher education institutions do not require, promote, or assess student competencies using prohibited concepts.

• Requires programs to include explicit, skills-based training in firm, consistent, authority-centered classroom management practices (e.g., clear rules, assertive discipline, immediate correction of behavior, structured routines).

• Mandates training in historical or traditional classroom management approaches emphasizing teacher authority, order, discipline, and minimal behavioral ambiguity; may include pre-1990 models if compliant with law.

• Directs the State Board to adopt rules, by July 1, 2027, for Director of Education compliance review of practitioner preparation programs regarding new requirements, including notification to the institution and board.

• Institutions found noncompliant have 12 months to address deficiencies before the board must rescind program approval if compliance is not achieved.

• Applies to students admitted to practitioner preparation programs on or after July 1, 2027.

Expands prohibitions on teaching, advocating, or promoting stereotyping and scapegoating based on demographic group membership or identity within public institutions of higher education and school districts. It requires training for employees, contractors, and volunteers on these prohibitions, bans the use of any funding or resources for activities violating these rules, and allows parents, employees, or residents to bring civil actions to enforce compliance without showing harm. Additional tracking and quality standards for compliance training are established.

Key Points & Impacts:

• Expands responsibility for compliance to all school district employees, contractors, and volunteers—not just superintendents and contractors.

• Explicitly prohibits use of any funds or resources (including appropriations, grants, donations, tuition, etc.) for curriculum, educational materials, or training that violate anti-stereotyping/scapegoating provisions.

• Requires all employees, contractors, and volunteers in public higher education institutions and school districts to receive training on these legal requirements and prohibitions.

• Mandates that this compliance training be tracked and held to the same quality standards as other required professional development.

• Allows parents, employees, and residents to bring civil actions for injunctive relief against school districts violating these provisions, with no requirement to show personal harm.

• Clarifies that curriculum, educational materials, and training provided by any employee, contractor, or volunteer must not teach or promote the prohibited concepts.

• Prohibits the use of district resources, facilities, or staff/student time to violate or encourage violation of the anti-stereotyping provisions.

• Creates an explicit exception to allow civil actions for enforcement, despite a general bar on creating individual rights or benefits in this section.

Prohibits any courses or requirements containing DEI or CRT-related content from being included in undergraduate general education and core curricula at regents institutions. The board must review all existing requirements and ensure removal of such content or courses by December 31, 2026.

Key Points & Impact:

• Defines 'diversity, equity, inclusion, and critical race theory-related content' in detail, including topics such as systemic racism, whiteness, intersectionality, and more.

• Prohibits undergraduate general education requirements or core curricula from including courses or requirements with DEI or CRT-related content at regents institutions.

• Mandates the Board of Regents to establish and implement these prohibitions as formal policy.

• Requires a comprehensive review of all undergraduate general education and core curricula to identify and remove DEI/CRT-related content or requirements.

• Sets a deadline of December 31, 2026, for policy implementation and curriculum review and revision.

• Specifies that the restriction applies to course descriptions, objectives, outcomes, exams, assignments, or any requirements involving DEI/CRT content.

• Aims to prevent teaching or promoting concepts such as systemic or institutional racism, implicit bias, gender identity, social justice, and related topics in general education.

• Applies only to general education and core curriculum, not to all courses offered at institutions.

Requires public schools serving grades 7-12 to provide information about the 'Your Life Iowa' program on their websites. The law already required certain crisis hotline information on student identification cards; this bill ensures the 'Your Life Iowa' program is included and extends resource availability online.

Key Points & Impacts

• Amends section 279.70A of the Iowa Code to update requirements for suicide prevention information.

• Changes the section title to focus more broadly on suicide prevention information rather than just student IDs.

• Requires that public schools serving grades 7-12 publish information on the 'Your Life Iowa' program (or its successor) on their websites as a resource.

• Clarifies that the crisis hotline and 'Your Life Iowa' program contact information must be included on student identification cards for grades 7-12, and may be included for grades 5-6.

• Expands the availability of suicide prevention and crisis resources by mandating online access in addition to physical ID cards.

• Ensures that both telephone/text numbers and internet addresses are provided for the 'Your Life Iowa' program.

• Targets increased student access to mental health and crisis intervention resources.

• Aligns online and physical dissemination of suicide prevention information in public schools.

Requires the Department of Education, in collaboration with the Department of Health and Human Services, to establish a working group to examine how school-provided technology (e.g., laptops, online learning systems, classroom presentations) affects students' cognitive function and academic performance. The group must include educators, mental health professionals, and parents. Members are responsible for their own expenses. A report with findings and recommendations, focusing on mitigating negative impacts on students' development and learning, is due to the legislature by December 31, 2026.

Key Points & Impacts

• Directs the Department of Education and Department of Health and Human Services to form a working group.

• Working group to study the impact of school-provided technology on student cognitive and academic outcomes.

• 'School-provided technology' includes laptops, online learning systems, and classroom presentations.

• Working group must include educators, mental health professionals, and parents of school-age children.

• Working group members and their represented entities are responsible for their own expenses.

• Findings and recommendations must be reported to the General Assembly by December 31, 2026.

• Report to include best practices for technology use and ways to mitigate negative impacts on students' social, behavioral, and learning outcomes.

• Focus on potential effects on social development, attention span, mental concentration, and learning ability.

Requires new continuing education requirements in nutrition and metabolic health for certain medical professionals, significantly revises Iowa's certificate of need laws by altering definitions, exemptions, and procedural requirements, and establishes new standards for the administration of nutrition assistance and the composition of foods served in schools. It also restricts the use of specific artificial food dyes and additives in school meals and sales, affecting both public and nonpublic schools.

Key Points & Impacts

• Requires family medicine, internal medicine, pediatrics, psychiatry, endocrinology, gastroenterology, cardiology, oncology, rheumatology, neurology, nephrology, dermatology, pulmonology, surgery, immunology, hematology, obstetrics, and gynecology practitioners to complete at least one hour of continuing education on nutrition and metabolic health every four years for license renewal.

• Amends certificate of need (CON) laws by striking certain services from the definition of 'new institutional health service' and adding new categories requiring CON, including behavioral health outpatient facilities, open heart surgical services, organ transplantation services, certain replacement equipment, air transportation services, and permanent changes in certain bed capacities.

• Removes the previous cap on the number of Medicaid-certified intermediate care facility beds for persons with an intellectual disability, eliminating the 1,636-bed statewide ceiling.

• Replaces the requirement for a public hearing on CON applications with a period for written public comments; removes the provision allowing public hearings for CON extensions.

• Defines and addresses state participation in SNAP, requiring uninterrupted benefits and adherence to department-defined 'healthy foods' for eligibility; allows optional participation in the Summer EBT program for children under certain conditions.

• Prohibits school districts and certain charter schools from serving or selling foods containing blue dye 1, blue dye 2, green dye 3, potassium bromate, propylparaben, red dye 40, yellow dye 5, or yellow dye 6, except for USDA direct deliveries, during the school day or on campus during school hours.

• Requires nonpublic schools receiving state funds for breakfast or lunch programs to comply with the same prohibited ingredient requirements as public schools.

• School food and beverage restrictions take effect for school years beginning on or after July 1, 2027.

Imposes a 5% cap on indirect costs for all state-funded grants awarded or amended on or after July 1, 2026. It defines direct and indirect costs, prohibits reclassification to circumvent the cap, requires separate identification and documentation of costs in budgets, and mandates state departments to monitor compliance, recover disallowed costs, and adopt necessary administrative rules. Exceptions are allowed only if expressly authorized by law or when federal requirements apply to federal funds. Departments may set stricter caps if specified in grant documentation.

Key Points & Impacts:

• Imposes a 5% cap on the aggregate amount of indirect costs that can be charged to state-funded grants.

• Prohibits departments from approving grant budgets or reimbursements that would exceed the 5% indirect cost cap, unless specifically exempted by law.

• Prevents grantees from reclassifying indirect costs as direct costs or charging indirects on top of direct costs that already include allocable indirects.

• Requires grant budgets to separately identify and document direct and indirect costs, with a narrative explaining indirect cost calculations and certification of compliance.

• Mandates grantees to retain records substantiating indirect costs and allocation methodologies for at least 10 years after grant closeout.

• Directs state departments to incorporate these requirements into grant solicitations and agreements, and to monitor and enforce compliance, including recovery of disallowed costs.

• Allows departments to set stricter (lower) indirect cost caps for specific grants if justified and stated in grant documents.

• Clarifies that federal indirect cost requirements take precedence for portions of grants funded with federal money.

Revises and aligns the structure and administration of health and human services in Iowa by replacing 'behavioral health districts' with 'health and human services districts' as the basis for service delivery. It updates definitions, reassigns duties to administrative organizations, and consolidates planning and service areas for aging and disability services to match HHS districts. The bill also creates a new subunit for volunteerism within the Department of Health and Human Services and revises the administrative and liability structure for volunteer programs. It includes immediate effective dates and is contingent on federal approval for certain provisions.

Key Points & Impacts:

• Replaces 'behavioral health district' terminology with 'health and human services district' throughout relevant Iowa Code sections.

• Aligns boundaries for behavioral health, aging, and disability service areas to match newly defined HHS districts, consolidating service regions statewide.

• Removes outdated definitions and advisory councils, establishes new 'behavioral health district advisory councils' with updated membership and duties.

• Updates duties and powers of administrative services organizations, including plan development and compliance oversight for behavioral health services within HHS districts.

• Clarifies administrative procedures, including rulemaking authority and limits on judicial review for district boundary modifications.

• Creates a subunit for volunteerism within HHS, centralizing volunteer program administration and clarifying volunteer liability as state employees (with exceptions for guardians/conservators).

• Allows the Iowa commission on volunteer service to delegate nonpolicymaking duties to the new subunit and revises agency support and funding provisions.

• Makes several provisions effective immediately upon enactment; some changes regarding aging and disability services are contingent upon federal approval.

Gives health care providers and institutions the right not to participate in or pay for a health care service that violates the provider's or institution's conscience. Provides whistleblower protections for those taking action relating to a suspected violation.

Requires health care providers and hospitals to publicly disclose the prices for their most common services. Providers must list the prices for their 25 most common services, while hospitals must list prices for their 75 most common inpatient and 75 most common outpatient services. The price lists must be updated regularly and include plain language descriptions and coding. All disclosed prices must carry a disclaimer stating they are estimates, not binding, and subject to change based on specific circumstances. 

Key Points & Impact:

• Health care providers must publicly disclose the prices for their 25 most common services, prior to discounts and absent medical complications.

• Hospitals must publicly disclose prices for their 75 most common inpatient and 75 most common outpatient services, grouped by Medicare diagnosis-related group, also prior to discounts and absent complications.

• Disclosures must be made available in a single document, electronically or via conspicuous website posting.

• All services must be identified by both a national billing code and a plain language description.

• Providers must update price information at least annually; hospitals must update quarterly.

• All disclosed prices must include a disclaimer that they are estimates and not legally binding, with charges subject to actual circumstances.

• The Department of Health and Human Services will adopt rules to align these requirements with existing federal price disclosure laws and avoid duplication.

• No appropriations or direct funding are contained in this bill.

Regulates how cost sharing (copayments, coinsurance, deductibles) is applied for enrollees in group insurance and accident/health insurance who have HSAs and qualified HDHPs. If the cost sharing could jeopardize HSA eligibility under federal law, it must only be applied to the HDHP after the enrollee meets the required minimum deductible, except for preventive care as defined by federal law. The bill aligns state requirements with federal tax code provisions for HSAs.

Key Points & Impacts:

• Adds new sections to Iowa law specifically addressing cost sharing for HSAs and qualified HDHPs.

• Prohibits application of copayments, coinsurance, or deductibles before the enrollee's minimum deductible is satisfied, unless for preventive care.

• Ensures state law does not cause enrollees to lose HSA eligibility due to improper cost sharing practices.

• Defines preventive care according to the federal Internal Revenue Code, Section 223(c)(2)(C).

• Applies to both group insurance and accident/health insurance policies.

• Aligns Iowa’s insurance cost sharing requirements with federal HSA eligibility standards.

• Provides clarification for insurers and enrollees regarding when cost sharing can be applied under qualified HDHPs.

• Does not alter cost sharing for preventive care, which can be covered before the deductible is met.

Prevents licensing boards and employers from imposing restrictions that deter pharmacists or practitioners from prescribing, ordering, dispensing, or administering medications or treatments within their lawful scope of practice and best professional judgment. Any such employer restriction—whether in contracts, handbooks, or otherwise—is unenforceable and cannot be grounds for disciplinary action. Pharmacists or practitioners acting within these parameters are protected from licensee discipline.

Key Points & Impacts:

• Prohibits licensing boards and employers from restricting a pharmacist's or practitioner's authority to prescribe, order, dispense, or administer medications or treatments within their scope of practice and best professional judgment.

• Applies to all boards created under chapter 147 that license pharmacists or practitioners, as well as their employers.

• Restrictions by employers—whether written or unwritten—are unenforceable and cannot be used as the basis for disciplinary action.

• Protects pharmacists and practitioners from licensee discipline when acting within scope and professional judgment, as allowed by law.

• Ensures that the determination of appropriate medication or treatment remains with the licensed professional, not employers or boards, unless otherwise restricted by law.

• Covers all relevant documentation forms, including contracts, agreements, employee handbooks, amendments, or any other means of imposing restrictions.

• Does not expand scope of practice, but clarifies that only statutory limitations apply, not employer-imposed deterrents.

• Provides legal protection for professional autonomy in medication and treatment decisions.

Creates a nonrefundable individual income tax credit for recent graduates of Iowa Board of Regents institutions who paid nonresident tuition and are now Iowa residents employed as healthcare professionals, teachers, licensed veterinarians, or professional engineers. The credit equals the difference between nonresident and resident tuition rates for the years attended. Excess credit can be carried forward up to five years but cannot benefit those who become nonresidents. The Board of Regents is required to publish tuition data for transparency. The bill applies retroactively to tax years beginning on or after January 1, 2026.

Key Points & Impacts:

• Establishes a nonresident tuition tax credit for individuals who graduated from an Iowa Board of Regents institution within the past three years and are now employed in Iowa as a healthcare professional, teacher, licensed veterinarian, or professional engineer.

• The tax credit amount is 100% of the difference between nonresident and resident tuition paid by the graduate for each year of attendance.

• Credit is nonrefundable, but unused amounts may be carried forward for up to five years or until exhausted, whichever comes first.

• If the taxpayer becomes a nonresident, remaining credit cannot be applied to future tax liability.

• Married taxpayers filing separately must allocate the credit proportionally to earned income.

• Board of Regents must publish a decade's worth of tuition data for both resident and nonresident students at each institution.

• Applies retroactively to tax years beginning on or after January 1, 2026.

• Targets high-need professions (healthcare, teaching, veterinary, engineering) to encourage retention of graduates in Iowa.

Requires the Board of Regents to create a policy banning noncompete clauses in employment contracts between physicians and the University of Iowa Hospitals and Clinics. These clauses, which restrict a physician's right to practice after leaving employment, will be prohibited in new, renewed, or extended contracts from the bill's effective date onward. The law takes effect immediately upon passage.

Key Points & Impacts:

• Requires the Board of Regents to develop a policy prohibiting noncompete clauses in employment contracts for physicians at University of Iowa Hospitals and Clinics (UIHC).

• Defines 'noncompete clause' as any restriction on a physician's right to practice in any geographic area or for a defined period following contract termination with UIHC.

• Defines 'physician' as an individual licensed under chapter 148.

• Applies the prohibition to all relevant employment contracts entered into, extended, or renewed on or after the effective date of the Act.

• The Act takes effect immediately upon enactment.

• Aims to increase physician mobility by preventing UIHC from using noncompete agreements.

Requires health insurance policies, contracts, or plans providing third-party payment or prepayment of health or medical expenses in Iowa to offer a special enrollment period for pregnant women. This period allows a pregnant woman to enroll after pregnancy is certified by a health care professional, up to 16 weeks gestation, without any enrollment fee or penalty. Coverage becomes effective on the first day of the month in which pregnancy is certified, or the following month if the woman chooses. The bill specifies which types of insurance are included and excluded from this requirement and authorizes the insurance commissioner to adopt administrative rules.

Key Points & Impacts:

• Mandates a special enrollment period for pregnant women in specified health insurance policies, contracts, and plans.

• Enrollment is allowed after certification of pregnancy by a licensed health care professional, up to 16 weeks gestation.

• Prohibits fees or penalties for special enrollment of pregnant women.

• Coverage becomes effective on the first day of the month of certification or optionally the following month.

• Applies to individual and group accident and sickness insurance, hospital or medical service contracts, HMO contracts, and public employee plans.

• Excludes certain policies (e.g., accident-only, specified disease, dental/vision, Medicare supplement, long-term care, workers’ compensation, automobile medical payment insurance).

• Effective for policies delivered, issued, continued, or renewed in Iowa on or after January 1, 2027.

• Authorizes the commissioner of insurance to adopt rules to administer the new requirements.

Amends and expands requirements for health insurance carriers and utilization review organizations. Key provisions include strict timelines for processing and auditing claims, reimbursement for administrative costs of audits, expanded definitions of covered entities, new standards of conduct prohibiting certain penalties and unfair contract terms, and detailed requirements for prior authorization denials and appeals. The bill also exempts certain cancer-related and emergency health services from prior authorization. Civil penalties and litigation cost recovery are provided for violations, and the insurance commissioner is directed to adopt rules for enforcement.

Key Points & Impacts

• Requires health carriers to pay or deny clean claims within 30 days (electronic) or 45 days (paper), and prohibits retroactive denial/reduction/recoupment after payment without evidence of fraud, misrepresentation, or duplication.

• Mandates reimbursement to health care providers for reasonable administrative costs incurred in responding to audits of clean claims by carriers.

• Establishes strict notice and completion deadlines for health carrier audits (initiation notice within 15 days, completion within 45 days of receiving documentation, 14 days for appeal determinations).

• Automatic approval and prompt payment (with 10% interest) of claims when carriers violate audit process timelines.

• Prohibits carriers from penalizing, reducing reimbursement, charging fees, or terminating providers for referring to or affiliating with out-of-network providers, and bars interference in staffing/referral decisions.

• Bars enforcement of unreasonable or unconscionable contract terms with providers and requires opportunity for negotiation on agreements or amendments.

• Sets requirements that only clinical peers or qualified reviewers may deny or downgrade prior authorization requests, and mandates written, detailed rationale and credentials for such determinations, plus timely consultation and independent appeals.

• Exempts cancer-related screenings/services (per national guidelines) and urgent inpatient conditions from prior authorization or additional utilization review requirements.

Revises the credentialing process for health insurers by replacing references to specific provider types (physicians, ARNPs, physician assistants) with the broader term "health care professional." Health insurers must now apply credentialing timelines, retrospective payment rules, and denial notification requirements to all health care professionals, as defined by Iowa law. 

Key Points & Impact:

• Replaces references to 'physician,' 'advanced registered nurse practitioner,' and 'physician assistant' with 'health care professional' throughout the section, expanding application to a wider range of provider types.

• Requires health insurers to respond within 56 days to credentialing requests from any health care professional, not just the previously listed provider types.

• Mandates that health insurers provide written reasons for denial of credentialing to any health care professional.

• Requires retrospective payment of clean claims for all health care professionals during the credentialing period, once credentialed.

• Removes specific definitions for 'advanced registered nurse practitioner,' 'physician,' and 'physician assistant' from the statute.

• Adds a cross-reference definition for 'health care professional' aligning with section 514J.102, encompassing a broad range of licensed, certified, or accredited practitioners.

• Updates definitions for 'clean claim,' 'credentialing,' and 'credentialing period' to use the broader 'health care professional' term.

• Streamlines the statutory language and reduces redundancy by consolidating provider types.

Creates the Iowa rural health transformation fund, which will be managed by the Department of Health and Human Services and will consist of monies from the federal rural health transformation program. The fund is to be used for purposes authorized by the Centers for Medicare and Medicaid Services under federal law. The department must report quarterly to the legislature on fund expenditures by city and transmit federal program reports. The bill is repealed October 1, 2032.

Key Points & Impacts:

• Establishes the Iowa rural health transformation fund in the state treasury, separate from the general fund.

• Funds consist of monies received from the federal rural health transformation program (One Big Beautiful Bill Act, Pub. L. No. 119-211).

• Money in the fund is appropriated to the Department of Health and Human Services for uses permitted by federal law and CMS guidance.

• Interest and earnings on the fund remain in the fund; funds do not revert to the general fund.

• Quarterly reporting to the legislature is required, detailing expenditures and locations by city.

• All federal financial and performance reports must be shared with the general assembly.

• The fund and its provisions are repealed on October 1, 2032.

• Includes appropriations for the Department of Health and Human Services from the fund.

Prohibits employers from enforcing contractual clauses that restrict health care providers from practicing at rural hospitals or facilities, or at hospitals designated as critical access hospitals, after leaving employment. The bill applies to all such agreements regardless of when they were made. However, it does not affect provisions that limit a provider's ability to solicit former or current patients.

Key Points & Impacts:

• Declares void and unenforceable any contract provision that limits a health care provider's right to practice at rural or critical access hospitals after employment ends.

• Applies to agreements made before, on, or after the bill's effective date.

• Covers a wide range of licensed health care professionals, including physicians, nurses, dentists, and others authorized to provide health care in Iowa.

• Does not invalidate contract provisions restricting the solicitation of current or former patients by health care providers.

• Specifically protects provider mobility in rural areas or federally designated critical access hospitals as defined by federal regulation.

• Seeks to increase access to health care in rural areas by removing non-compete style restrictions for providers.

• Does not retroactively affect provisions unrelated to practice location, such as trade secrets or patient solicitation clauses.

• May affect employer strategies for recruitment and retention of health care providers in rural settings.

Enacts changes across health-related fields, including mandatory nutrition/metabolic health education for certain medical professionals, major reforms to the certificate of need process for health facilities, requirements for uninterrupted SNAP administration, authorizing ivermectin as an over-the-counter medication, banning certain food additives in school meals, and adopting the Psychology Interjurisdictional Compact. It also significantly raises taxes on cigarettes, tobacco, vapor, and consumable hemp products, and creates new excise taxes for vapor and hemp products, directing proceeds to the health care trust fund.

Key Points & Impacts:

• Mandates at least one hour of continuing education in nutrition and metabolic health every four years for physicians and physician assistants in specified fields as a condition of license renewal.

• Reforms the certificate of need (CON) process by striking certain facility and equipment exemptions, revising the application and public hearing process, and modifying limitations on beds for intermediate care facilities for persons with intellectual disabilities.

• Requires the state to continuously administer SNAP in accordance with USDA guidelines, ensuring uninterrupted benefits and defining eligible foods as those considered healthy by the state.

• Allows pharmacies and others to distribute ivermectin for human use without a prescription and protects them from penalties for doing so.

• Prohibits schools (including some charter/nonpublic schools) from serving or selling foods containing specified artificial dyes and additives as part of meal programs, with limited federal exceptions, effective July 2027.

• Enacts the Psychology Interjurisdictional Compact, allowing licensed psychologists in member states to practice telepsychology and temporary in-person services across state lines.

• Raises the cigarette tax from 6.8 cents to 10.05 cents per cigarette, increases the tobacco product tax from 50% to 55% of wholesale price, raises the cigar cap to 55 cents, changes snuff tax to 55% of wholesale price (from $1.19/oz), and imposes new excise taxes (15%) on vapor and consumable hemp products.

• Directs all new and increased tax revenues from cigarettes, tobacco, vapor, and consumable hemp products to the health care trust fund.

Creates a state-based health insurance exchange, including the submission of a state innovation waiver application by the insurance commissioner. It establishes a dedicated fund in the state treasury to support the exchange, outlines the use of appropriated and other available funds, and sets forth confidentiality rules for exchange-related information. The bill gives the commissioner authority to adopt rules, including emergency rules, and is effective immediately upon enactment.

Key Points & Impacts:

• Authorizes the commissioner of insurance to develop, implement, and operate a state-based health insurance exchange upon direction of the governor.

• Requires the commissioner to submit an application for a federal state innovation waiver by December 31, 2026.

• Creates a state-based exchange fund in the state treasury, funded by legislative appropriations, federal funds, user fees, and grants.

• Allows funds in the state-based exchange fund to carry over from year to year and credits interest earned to the fund.

• Establishes that most documents and information related to the exchange are confidential and not subject to public records laws, subpoenas, or discovery, with limited exceptions.

• Permits the commissioner to share and receive confidential information with other state and federal authorities under certain conditions.

• Authorizes the commissioner to adopt rules and emergency rules to implement the bill's provisions.

• Bill takes effect immediately upon enactment.

Prohibits discrimination, requirements, or penalties based on a person's status regarding medical interventions (e.g., vaccination, treatment) by businesses, educational institutions, and government entities, with limited exceptions for foreign jurisdiction travel requirements. It repeals or amends statutes mandating or tracking immunizations, and significantly curtails state authority to order medical interventions during public health emergencies. Enforcement is provided via civil action by the attorney general or county attorney, and compliance is tied to licensure. The bill takes effect immediately upon enactment.

Key Points & Impacts:

• Strikes and replaces Section 27C.2 to prohibit businesses, schools, and government from requiring or discriminating based on medical intervention status (e.g., vaccination), with narrow exceptions for foreign jurisdiction jobs.

• Prohibits businesses, ticket issuers, educational institutions, and government from denying services, admission, employment, or compensation based on medical intervention status.

• Allows one-time incentives for medical interventions but bans ongoing compensation differences based on intervention status.

• Explicitly bars healthy individuals from being excluded from any public or private activity based on medical intervention status.

• Removes state authority to order or administer treatment or prophylaxis (including vaccinations) during public health disasters, allowing only isolation or quarantine of infected, unwilling individuals and recommendations for exposed persons.

• Repeals requirements for childhood immunizations (striking Section 139A.8 and related reporting/verification statutes for schools and child care) and repeals employer COVID-19 vaccination mandates/waivers and related unemployment provisions.

• Prohibits compelled use of personal protective equipment authorized solely by emergency use authorization, while still allowing standard PPE requirements per workplace safety laws.

• Mandates enforcement via civil actions with attorney fees for successful prosecution and ties compliance to licensure for businesses, schools, and government entities; applies at all times, including during emergencies.

Realigns the health and human services system by designating 'health and human services districts' (HHS districts) for the statewide delivery of programs and services, replacing previous behavioral health districts. It updates terminology and structure throughout the code, consolidates planning and service areas for aging and disability services to match HHS district boundaries, and creates a new volunteerism subunit within HHS to support and coordinate volunteer activities and the Iowa commission on volunteer service. Other changes include clarifying advisory council composition and duties, and formalizing processes for designation, review, and modification of districts.

Key Points & Impacts:

• Replaces 'behavioral health districts' with 'health and human services districts' (HHS districts) for program delivery; initial HHS districts mirror existing behavioral health districts.

• Adds and updates definitions throughout the code, including creation of 'behavioral health district advisory councils' and 'behavioral health service system district plans'.

• Removes language that allowed judicial review of district boundary modifications by HHS; such decisions are now not subject to judicial review.

• Aligns planning and service areas for aging and disability services to exactly match new HHS district boundaries, contingent on federal approval.

• Revises the structure and duties of advisory councils for behavioral health districts, specifying membership requirements and functions.

• Creates a subunit for volunteerism within HHS to manage volunteer programs and provide support to the Iowa commission on volunteer service, including appointment of an executive director and staff.

• Clarifies that registered volunteers are considered state employees for liability purposes, with exceptions for volunteer guardians/conservators.

• Authorizes the commission on volunteer service to delegate nonpolicymaking administrative duties to the new subunit for volunteerism.

Requires new continuing education requirements in nutrition and metabolic health for certain medical professionals, significantly revises Iowa's certificate of need laws by altering definitions, exemptions, and procedural requirements, and establishes new standards for the administration of nutrition assistance and the composition of foods served in schools. It also restricts the use of specific artificial food dyes and additives in school meals and sales, affecting both public and nonpublic schools.

Key Points & Impacts

• Requires family medicine, internal medicine, pediatrics, psychiatry, endocrinology, gastroenterology, cardiology, oncology, rheumatology, neurology, nephrology, dermatology, pulmonology, surgery, immunology, hematology, obstetrics, and gynecology practitioners to complete at least one hour of continuing education on nutrition and metabolic health every four years for license renewal.

• Amends certificate of need (CON) laws by striking certain services from the definition of 'new institutional health service' and adding new categories requiring CON, including behavioral health outpatient facilities, open heart surgical services, organ transplantation services, certain replacement equipment, air transportation services, and permanent changes in certain bed capacities.

• Removes the previous cap on the number of Medicaid-certified intermediate care facility beds for persons with an intellectual disability, eliminating the 1,636-bed statewide ceiling.

• Replaces the requirement for a public hearing on CON applications with a period for written public comments; removes the provision allowing public hearings for CON extensions.

• Defines and addresses state participation in SNAP, requiring uninterrupted benefits and adherence to department-defined 'healthy foods' for eligibility; allows optional participation in the Summer EBT program for children under certain conditions.

• Prohibits school districts and certain charter schools from serving or selling foods containing blue dye 1, blue dye 2, green dye 3, potassium bromate, propylparaben, red dye 40, yellow dye 5, or yellow dye 6, except for USDA direct deliveries, during the school day or on campus during school hours.

• Requires nonpublic schools receiving state funds for breakfast or lunch programs to comply with the same prohibited ingredient requirements as public schools.

• School food and beverage restrictions take effect for school years beginning on or after July 1, 2027.

Requires state agencies and regents institutions to use the federal E-Verify system to confirm employment eligibility for new hires. It creates a SAVE program clearinghouse within the Department of Inspections, Appeals, and Licensing to verify citizenship/immigration status for professional licensing, mandating denial or revocation for individuals unlawfully present in the U.S. The bill disqualifies unauthorized aliens from voter registration and requires a new oath on voter registration forms. It also extends the statute of limitations for election misconduct in the first degree. For pretrial detention, the bill establishes rebuttable presumptions against bail for those charged with forcible felonies and for unauthorized aliens charged with indictable offenses.

Key Points & Impacts:

• Mandates use of E-Verify by state agencies and regents institutions to confirm employment eligibility for all new hires.

• Establishes a SAVE program clearinghouse to verify citizenship and immigration status for all professional license applicants, requiring denial/revocation if lawful presence cannot be verified.

• Licensing boards must use the SAVE clearinghouse and cannot issue or renew professional licenses for individuals not lawfully present in the U.S.; appeals go to the department director.

• Adds 'unauthorized alien' as a defined term for voting and licensure disqualifications; unauthorized aliens are disqualified from voter registration and voting.

• Requires new voter registration oath affirming U.S. citizenship, with penalties for false statements including potential deportation and criminal liability.

• Extends the statute of limitations for prosecution of election misconduct in the first degree from three to five years.

• Creates a rebuttable presumption against bail for persons charged with forcible felonies; such persons may be detained without bail unless they can rebut the presumption.

• Creates a presumption against bail for unauthorized aliens charged with indictable offenses, requiring them to demonstrate that conditions of release will ensure court appearance.

Regulates how cost sharing (copayments, coinsurance, deductibles) is applied for enrollees in group insurance and accident/health insurance who have HSAs and qualified HDHPs. If the cost sharing could jeopardize HSA eligibility under federal law, it must only be applied to the HDHP after the enrollee meets the required minimum deductible, except for preventive care as defined by federal law. The bill aligns state requirements with federal tax code provisions for HSAs.

Key Points & Impacts:

• Adds new sections to Iowa law specifically addressing cost sharing for HSAs and qualified HDHPs.

• Prohibits application of copayments, coinsurance, or deductibles before the enrollee's minimum deductible is satisfied, unless for preventive care.

• Ensures state law does not cause enrollees to lose HSA eligibility due to improper cost sharing practices.

• Defines preventive care according to the federal Internal Revenue Code, Section 223(c)(2)(C).

• Applies to both group insurance and accident/health insurance policies.

• Aligns Iowa’s insurance cost sharing requirements with federal HSA eligibility standards.

• Provides clarification for insurers and enrollees regarding when cost sharing can be applied under qualified HDHPs.

• Does not alter cost sharing for preventive care, which can be covered before the deductible is met.

Requires health insurance policies, contracts, or plans providing third-party payment or prepayment of health or medical expenses in Iowa to offer a special enrollment period for pregnant women. This period allows a pregnant woman to enroll after pregnancy is certified by a health care professional, up to 16 weeks gestation, without any enrollment fee or penalty. Coverage becomes effective on the first day of the month in which pregnancy is certified, or the following month if the woman chooses. The bill specifies which types of insurance are included and excluded from this requirement and authorizes the insurance commissioner to adopt administrative rules.

Key Points & Impacts:

• Mandates a special enrollment period for pregnant women in specified health insurance policies, contracts, and plans.

• Enrollment is allowed after certification of pregnancy by a licensed health care professional, up to 16 weeks gestation.

• Prohibits fees or penalties for special enrollment of pregnant women.

• Coverage becomes effective on the first day of the month of certification or optionally the following month.

• Applies to individual and group accident and sickness insurance, hospital or medical service contracts, HMO contracts, and public employee plans.

• Excludes certain policies (e.g., accident-only, specified disease, dental/vision, Medicare supplement, long-term care, workers’ compensation, automobile medical payment insurance).

• Effective for policies delivered, issued, continued, or renewed in Iowa on or after January 1, 2027.

• Authorizes the commissioner of insurance to adopt rules to administer the new requirements.

Amends and expands requirements for health insurance carriers and utilization review organizations. Key provisions include strict timelines for processing and auditing claims, reimbursement for administrative costs of audits, expanded definitions of covered entities, new standards of conduct prohibiting certain penalties and unfair contract terms, and detailed requirements for prior authorization denials and appeals. The bill also exempts certain cancer-related and emergency health services from prior authorization. Civil penalties and litigation cost recovery are provided for violations, and the insurance commissioner is directed to adopt rules for enforcement.

Key Points & Impacts

• Requires health carriers to pay or deny clean claims within 30 days (electronic) or 45 days (paper), and prohibits retroactive denial/reduction/recoupment after payment without evidence of fraud, misrepresentation, or duplication.

• Mandates reimbursement to health care providers for reasonable administrative costs incurred in responding to audits of clean claims by carriers.

• Establishes strict notice and completion deadlines for health carrier audits (initiation notice within 15 days, completion within 45 days of receiving documentation, 14 days for appeal determinations).

• Automatic approval and prompt payment (with 10% interest) of claims when carriers violate audit process timelines.

• Prohibits carriers from penalizing, reducing reimbursement, charging fees, or terminating providers for referring to or affiliating with out-of-network providers, and bars interference in staffing/referral decisions.

• Bars enforcement of unreasonable or unconscionable contract terms with providers and requires opportunity for negotiation on agreements or amendments.

• Sets requirements that only clinical peers or qualified reviewers may deny or downgrade prior authorization requests, and mandates written, detailed rationale and credentials for such determinations, plus timely consultation and independent appeals.

• Exempts cancer-related screenings/services (per national guidelines) and urgent inpatient conditions from prior authorization or additional utilization review requirements.

Creates a state-based health insurance exchange, including the submission of a state innovation waiver application by the insurance commissioner. It establishes a dedicated fund in the state treasury to support the exchange, outlines the use of appropriated and other available funds, and sets forth confidentiality rules for exchange-related information. The bill gives the commissioner authority to adopt rules, including emergency rules, and is effective immediately upon enactment.

Key Points & Impacts:

• Authorizes the commissioner of insurance to develop, implement, and operate a state-based health insurance exchange upon direction of the governor.

• Requires the commissioner to submit an application for a federal state innovation waiver by December 31, 2026.

• Creates a state-based exchange fund in the state treasury, funded by legislative appropriations, federal funds, user fees, and grants.

• Allows funds in the state-based exchange fund to carry over from year to year and credits interest earned to the fund.

• Establishes that most documents and information related to the exchange are confidential and not subject to public records laws, subpoenas, or discovery, with limited exceptions.

• Permits the commissioner to share and receive confidential information with other state and federal authorities under certain conditions.

• Authorizes the commissioner to adopt rules and emergency rules to implement the bill's provisions.

• Bill takes effect immediately upon enactment.

Directs the Department of Health and Human Services to adopt rules establishing a standardized process for claim submission and reimbursement for medical assistance services effective July 1, 2027. All existing and future managed care contracts must be amended or written to require adherence to this process. The bill also updates the procedure for setting reimbursement levels, prioritizing efficiency, federal compliance, appropriations, and actual provider costs, and clarifies terminology related to claims.

Key Points & Impact:

• Defines 'managed care contract' as an agreement between the department and an MCO to administer the medical assistance program.

• Defines 'managed care organization' as a health maintenance organization acting under a managed care contract.

• Requires HHS to adopt rules for a standardized claim submission and reimbursement process for all medical assistance services provided on or after July 1, 2027.

• Mandates that all existing managed care contracts be amended to require MCOs to follow the standardized process, subject to contractual terms.

• Requires all new, extended, or renewed managed care contracts on or after July 1, 2027, to include the standardized process requirement.

• Modifies reimbursement rulemaking by striking language about 'method' and instead requiring establishment of a standardized process and specific consideration of certain factors (efficiency, compliance, appropriations, provider costs).

• Clarifies that 'claim' refers to a formal request for reimbursement by a provider for benefits or services delivered to a recipient.

• Updates the prioritization and structure of considerations for setting reimbursement levels, with a more explicit weighing of efficiency, compliance, appropriations, and provider costs.

Restricts the timeframe for post-payment audits of Medicaid provider claims to within 12 months of payment, unless fraud or misrepresentation is involved. Claims identified as overpayments after 12 months will not require repayment or offset. The bill excludes retroactive cost settlements and allows providers to resubmit claims as adjustments. The legislation becomes effective immediately upon enactment.

Key Points & Impacts:

• Limits post-payment review of Medicaid claims to those paid within the last 12 months, unless fraud or misrepresentation is involved.

• Prohibits repayment or offset for provider overpayments identified more than 12 months after claim payment.

• Excludes retroactive Medicaid cost settlements or rate changes based on cost reports from these limitations.

• Allows providers to resubmit claims as adjustments if improper payments are identified during review.

• Applies to both Medicaid fee-for-service and managed care claims.

• Overrides any contrary provisions of current law regarding post-payment review timeframes.

• Aims to provide greater certainty and financial protection for Medicaid providers regarding claim audits and repayments.

• The bill takes effect immediately upon enactment.

Creates the Iowa rural health transformation fund, which will be managed by the Department of Health and Human Services and will consist of monies from the federal rural health transformation program. The fund is to be used for purposes authorized by the Centers for Medicare and Medicaid Services under federal law. The department must report quarterly to the legislature on fund expenditures by city and transmit federal program reports. The bill is repealed October 1, 2032.

Key Points & Impacts:

• Establishes the Iowa rural health transformation fund in the state treasury, separate from the general fund.

• Funds consist of monies received from the federal rural health transformation program (One Big Beautiful Bill Act, Pub. L. No. 119-211).

• Money in the fund is appropriated to the Department of Health and Human Services for uses permitted by federal law and CMS guidance.

• Interest and earnings on the fund remain in the fund; funds do not revert to the general fund.

• Quarterly reporting to the legislature is required, detailing expenditures and locations by city.

• All federal financial and performance reports must be shared with the general assembly.

• The fund and its provisions are repealed on October 1, 2032.

• Includes appropriations for the Department of Health and Human Services from the fund.

Requires quarterly and annual reporting for SNAP and Medicaid payment error rates, requires the Department of Health and Human Services (HHS) to request federal waivers for certain SNAP administrative rules, and expands Medicaid eligibility for employed persons with disabilities. The bill increases the Medicaid income threshold, introduces electronic premium payments, and sets new rules for asset disregards. It also institutes residency verification for public assistance applicants, mandates use of federal verification systems for citizenship and immigration status, and applies new cost-sharing and fee rules to the Iowa Health and Wellness Plan. The Department must ensure cost-neutrality for Medicaid waivers unless legislatively approved. Additional provisions include restricting WIC participation to citizens and qualified aliens, authorizing provider no-show fees, and establishing new reporting on public assistance fraud and high-acuity pediatric care needs.

Key Points & Impacts:

• Requires quarterly error rate reporting for SNAP and Medicaid, and an annual report on Medicaid waivers (exceptions to policy).

• Directs HHS to seek federal waivers for SNAP to exclude certain student income, automate verification, allow quicker benefit expungement, alter error reporting, and simplify application requirements.

• Raises Medicaid eligibility for employed persons with disabilities from 250% to 300% FPL and allows electronic premium payments; disregards pension accounts as assets.

• Mandates HHS to verify 12 months of residency for certain public assistance applicants, with exceptions for Social Security beneficiaries.

• Requires immigration and citizenship checks using the federal SAVE system for public assistance eligibility determinations.

• Establishes new cost-sharing and copayment rules for Iowa Health and Wellness Plan members, including fees for noncompliance with wellness activities and nonattendance at appointments.

• Mandates cost-neutrality analysis for Medicaid waivers; non-neutral waivers require legislative approval before federal submission.

• Restricts WIC participation to citizens/qualified aliens, allows no-show fees for health providers, and sets new reporting on fraud and high-acuity pediatric home health needs.

Eliminates the requirement for a 30-day advance notice and preliminary hearing before the Iowa DOT can suspend a driver's license on the grounds of physical or mental incapacity. Instead, the DOT may suspend the license immediately upon determination of incapacity, with notice deemed served when mailed or delivered. Affected individuals can still obtain a special instruction permit under certain conditions. 

Key Points & Impact:

• Removes the requirement for 30 days' advance notice and preliminary hearing before suspending a driver's license due to physical or mental incapacity.

• Creates a new subsection (3) in Section 321.210 authorizing immediate suspension of a driver's license based on sufficient evidence of incapacity.

• Amends references throughout code sections to replace 'subsection 1, paragraph a, subparagraph (3)' with the new 'subsection 3' for incapacity-based suspensions.

• Clarifies that petitions for judicial review do not stay suspensions imposed under the new incapacity process.

• Allows peace officers to serve immediate notice of suspension and collect the physical license for return to the DOT.

• Special instruction permits may still be issued to eligible individuals whose licenses are suspended for incapacity, with updated cross-references to the new legal structure.

• No reinstatement fee is required for licenses suspended for incapacity under the new subsection 3, maintaining prior fee exemptions.

• Removes obsolete statutory language and cross-references related to the prior process for incapacity-based license suspension.

Provides enhanced confidentiality for communications between public safety officers and peer support group counselors. The bill prohibits the disclosure or use of confidential communications in administrative, disciplinary, or Brady-Giglio proceedings, except under specified exceptions such as plans to commit a crime, threats of harm, or legal mandatory reporting. The new chapter defines key terms, outlines the scope of privilege, and clarifies that employers retain authority to require employee assistance or fitness-for-duty evaluations. The legislation seeks to promote candid and confidential peer support services for public safety professionals.

Key Points & Impacts:

• Adds a new subsection to prohibit the use or disclosure of confidential peer support communications in informal or formal investigations, disciplinary proceedings, or Brady-Giglio determinations.

• Repeals and replaces current evidentiary privilege language in Section 622.10(9), specifying that peer support group counselors cannot testify or disclose confidential communications from officers except as allowed by new law.

• Creates new Code Chapter 622C, defining 'confidential communication,' 'officer,' and 'peer support group counselor.'

• Establishes a strong privilege for peer support group counselors, prohibiting testimony or disclosure of confidential communications except for crime plans, threats of harm, or mandatory legal disclosures.

• Prevents confidential peer support communications from being used or introduced in formal administrative investigations, disciplinary proceedings, or Brady-Giglio disclosures except as allowed.

• Specifies that the new confidentiality protections do not limit an employer's authority to require employee assistance program participation or fitness-for-duty evaluations.

• Mandates liberal construction of the chapter to encourage open and confidential peer support communications among public safety personnel.

• Focuses on law enforcement, firefighters, EMS personnel, corrections officers, and other public safety employees certified and employed by governmental agencies.

Requires use of the federal Systematic Alien Verification for Entitlements (SAVE) system to verify immigration/citizenship for all public assistance applicants. It sets the SNAP income threshold at 160% FPL, mandates inclusion of all household members’ income/resources (even ineligible members), and restricts SNAP eligibility to citizens, nationals, and certain lawfully present aliens. For Medicaid and the Iowa Health and Wellness Plan, the bill shortens retroactive eligibility (pending federal approval) and establishes new annual reporting requirements. It also mandates cost neutrality analysis for all Medicaid waivers or amendments expanding coverage, requiring legislative approval if not cost neutral. Effective immediately upon enactment, with some provisions contingent on federal waiver approval.

Key Points & Impacts

• Mandates verification of immigration/citizenship status for public assistance applicants using the SAVE online service.

• Sets SNAP gross income threshold at 160% of the federal poverty level and requires counting all household members’ income/resources, including those ineligible for SNAP.

• Restricts SNAP eligibility to U.S. citizens, nationals, certain lawful permanent residents, Cuban/Haitian entrants, and certain compact residents; others are ineligible.

• Requires notification to USDA if immigration/citizenship status of any SNAP household member cannot be verified.

• All Medicaid benefits must be delivered via managed care, except for those exempt as of July 1, 2026.

• Shortens Medicaid retroactive eligibility to two months (from three), and Iowa Health and Wellness Plan retroactive eligibility to one month (from three), contingent on federal approval.

• Establishes annual reporting by HHS on retroactive eligibility impacts and fiscal effects, with reports made publicly available.

• Mandates cost neutrality analysis for all Medicaid waivers/plan amendments expanding coverage; non-cost-neutral proposals require legislative approval.

Prevents licensing boards and employers from imposing restrictions that deter pharmacists or practitioners from prescribing, ordering, dispensing, or administering medications or treatments within their lawful scope of practice and best professional judgment. Any such employer restriction—whether in contracts, handbooks, or otherwise—is unenforceable and cannot be grounds for disciplinary action. Pharmacists or practitioners acting within these parameters are protected from licensee discipline.

Key Points & Impacts:

• Prohibits licensing boards and employers from restricting a pharmacist's or practitioner's authority to prescribe, order, dispense, or administer medications or treatments within their scope of practice and best professional judgment.

• Applies to all boards created under chapter 147 that license pharmacists or practitioners, as well as their employers.

• Restrictions by employers—whether written or unwritten—are unenforceable and cannot be used as the basis for disciplinary action.

• Protects pharmacists and practitioners from licensee discipline when acting within scope and professional judgment, as allowed by law.

• Ensures that the determination of appropriate medication or treatment remains with the licensed professional, not employers or boards, unless otherwise restricted by law.

• Covers all relevant documentation forms, including contracts, agreements, employee handbooks, amendments, or any other means of imposing restrictions.

• Does not expand scope of practice, but clarifies that only statutory limitations apply, not employer-imposed deterrents.

• Provides legal protection for professional autonomy in medication and treatment decisions.

Mandates that continuing education requirements for licensed professions, including those overseen by the board of education and the Iowa Supreme Court, must be directly related to the practice of the licensed profession unless otherwise required by law. It also removes the requirement that a person must graduate from an ABA-accredited law school prior to sitting for the Iowa bar examination. Boards and the Supreme Court are directed to update rules accordingly.

Key Points & Impacts

• Adds that continuing education requirements must relate directly to the licensed profession, unless otherwise required by law.

• Prohibits professional licensing boards from imposing continuing education requirements not directly related to the practice of the licensed profession.

• Amends attorney licensing rules to ensure continuing education for attorneys is limited to topics directly related to the practice of law, unless otherwise mandated by law.

• Removes the requirement that bar exam candidates must graduate from an ABA-accredited law school to be eligible to sit for the Iowa bar examination.

• Requires the Iowa Supreme Court to update court rules to reflect the new standards for attorney continuing education and bar exam eligibility.

• Maintains the exemption from renewal requirements for practitioners with at least ten years of employment and an advanced degree, except for those with evaluator approval endorsements.

Overhauls the administration and regulation of licensed professions in Iowa. It centralizes licensing, renewal, fee setting, and disciplinary authority under the Department of Inspections, Appeals, and Licensing (DIAL), replaces detailed statutory provisions for numerous professions with uniform, department-driven procedures, and modernizes terms and requirements across many codes. The bill adds new processes for temporary and reciprocal licenses, expands definitions, removes outdated requirements, and repeals numerous sections to streamline governance. Appropriations and fee retention are consolidated into a single licensing and regulation fund.

Key Points & Impacts:

• Transfers authority for setting license terms, renewals, fees, and many disciplinary actions from individual professional boards to DIAL, standardizing processes across all licensed professions.

• Authorizes DIAL and boards to issue temporary licenses, establish rules for licensure by reciprocity, and accept voluntary license surrenders with the force of revocation.

• Centralizes fee collection and appropriations by requiring all professional licensing fees to be deposited in the licensing and regulation fund, and requires DIAL to annually review and adjust fees as necessary.

• Standardizes definitions such as 'quorum' (majority of current members) and 'apprentice,' and updates references to training programs registered by the Iowa Office of Apprenticeship.

• Removes or consolidates numerous board-specific requirements, such as confidentiality of licensee home addresses, application forms, and board composition details, in favor of general DIAL rules.

• Expands enforcement and disciplinary provisions, including allowing DIAL to employ investigators with peace officer status, issue cease-and-desist orders, and impose civil penalties for unlicensed practice.

• Replaces 'peer review' with 'attest and compilation services review' for public accountancy, aligning terminology and confidentiality provisions, and repeals outdated board and examination procedures for multiple professions.

• Repeals and strikes large numbers of obsolete or duplicative statutory sections across a broad range of professions (medicine, engineering, real estate, architecture, etc.), consolidating governance under DIAL rules.

Enacts changes across health-related fields, including mandatory nutrition/metabolic health education for certain medical professionals, major reforms to the certificate of need process for health facilities, requirements for uninterrupted SNAP administration, authorizing ivermectin as an over-the-counter medication, banning certain food additives in school meals, and adopting the Psychology Interjurisdictional Compact. It also significantly raises taxes on cigarettes, tobacco, vapor, and consumable hemp products, and creates new excise taxes for vapor and hemp products, directing proceeds to the health care trust fund.

Key Points & Impacts:

• Mandates at least one hour of continuing education in nutrition and metabolic health every four years for physicians and physician assistants in specified fields as a condition of license renewal.

• Reforms the certificate of need (CON) process by striking certain facility and equipment exemptions, revising the application and public hearing process, and modifying limitations on beds for intermediate care facilities for persons with intellectual disabilities.

• Requires the state to continuously administer SNAP in accordance with USDA guidelines, ensuring uninterrupted benefits and defining eligible foods as those considered healthy by the state.

• Allows pharmacies and others to distribute ivermectin for human use without a prescription and protects them from penalties for doing so.

• Prohibits schools (including some charter/nonpublic schools) from serving or selling foods containing specified artificial dyes and additives as part of meal programs, with limited federal exceptions, effective July 2027.

• Enacts the Psychology Interjurisdictional Compact, allowing licensed psychologists in member states to practice telepsychology and temporary in-person services across state lines.

• Raises the cigarette tax from 6.8 cents to 10.05 cents per cigarette, increases the tobacco product tax from 50% to 55% of wholesale price, raises the cigar cap to 55 cents, changes snuff tax to 55% of wholesale price (from $1.19/oz), and imposes new excise taxes (15%) on vapor and consumable hemp products.

• Directs all new and increased tax revenues from cigarettes, tobacco, vapor, and consumable hemp products to the health care trust fund.

Reorganizes and standardizes the regulation of more than 40 licensed professions in Iowa. Key changes include centralizing fee setting and licensing processes under the Department of Inspections, Appeals, and Licensing; updating terms, renewals, and reinstatement procedures for all licenses; modifying board compositions; expanding the department’s enforcement powers; clarifying confidentiality, data, and disciplinary processes; and repealing many outdated or redundant statutory sections. The bill also expands reciprocity, temporary licensing, and voluntary surrender processes, and makes technical and conforming changes throughout related Code chapters.

Key Points & Impacts:

• Centralizes the setting of all professional licensing, renewal, and related fees to the Department of Inspections, Appeals, and Licensing, replacing individual board authority.

• Standardizes license terms, renewals, reactivations, and reinstatements for all regulated professions, with department rulemaking authority to set intervals (no license renewal interval to exceed five years).

• Expands and standardizes processes for temporary licenses, reciprocal licenses, and voluntary license surrender across all boards; adds new provisions for licensure by reciprocity and temporary licensure.

• Redefines board composition and quorum requirements for many professions, consolidating and updating membership criteria within Code chapter 147 and removing detailed composition provisions from individual chapters.

• Significantly expands the department’s enforcement and investigative authority, including the power to issue cease and desist orders, impose civil penalties, and employ personnel as peace officers for investigation and inspection.

• Moves accounting, architecture, engineering, land surveying, real estate, appraisers, landscape architecture, and interior design under health-related professions in the Code, and modernizes related definitions, board appointments, and title protections.

• Eliminates requirements for boards to keep licensee home addresses confidential in registries, strikes citizenship requirements for licensure, and removes requirements for photographs on applications.

• Repeals and strikes numerous sections relating to outdated board operations, reporting, application procedures, board member compensation, and examination logistics, streamlining the Code.

Requires new continuing education requirements in nutrition and metabolic health for certain medical professionals, significantly revises Iowa's certificate of need laws by altering definitions, exemptions, and procedural requirements, and establishes new standards for the administration of nutrition assistance and the composition of foods served in schools. It also restricts the use of specific artificial food dyes and additives in school meals and sales, affecting both public and nonpublic schools.

Key Points & Impacts

• Requires family medicine, internal medicine, pediatrics, psychiatry, endocrinology, gastroenterology, cardiology, oncology, rheumatology, neurology, nephrology, dermatology, pulmonology, surgery, immunology, hematology, obstetrics, and gynecology practitioners to complete at least one hour of continuing education on nutrition and metabolic health every four years for license renewal.

• Amends certificate of need (CON) laws by striking certain services from the definition of 'new institutional health service' and adding new categories requiring CON, including behavioral health outpatient facilities, open heart surgical services, organ transplantation services, certain replacement equipment, air transportation services, and permanent changes in certain bed capacities.

• Removes the previous cap on the number of Medicaid-certified intermediate care facility beds for persons with an intellectual disability, eliminating the 1,636-bed statewide ceiling.

• Replaces the requirement for a public hearing on CON applications with a period for written public comments; removes the provision allowing public hearings for CON extensions.

• Defines and addresses state participation in SNAP, requiring uninterrupted benefits and adherence to department-defined 'healthy foods' for eligibility; allows optional participation in the Summer EBT program for children under certain conditions.

• Prohibits school districts and certain charter schools from serving or selling foods containing blue dye 1, blue dye 2, green dye 3, potassium bromate, propylparaben, red dye 40, yellow dye 5, or yellow dye 6, except for USDA direct deliveries, during the school day or on campus during school hours.

• Requires nonpublic schools receiving state funds for breakfast or lunch programs to comply with the same prohibited ingredient requirements as public schools.

• School food and beverage restrictions take effect for school years beginning on or after July 1, 2027.

Prohibits discrimination, requirements, or penalties based on a person's status regarding medical interventions (e.g., vaccination, treatment) by businesses, educational institutions, and government entities, with limited exceptions for foreign jurisdiction travel requirements. It repeals or amends statutes mandating or tracking immunizations, and significantly curtails state authority to order medical interventions during public health emergencies. Enforcement is provided via civil action by the attorney general or county attorney, and compliance is tied to licensure. The bill takes effect immediately upon enactment.

Key Points & Impacts:

• Strikes and replaces Section 27C.2 to prohibit businesses, schools, and government from requiring or discriminating based on medical intervention status (e.g., vaccination), with narrow exceptions for foreign jurisdiction jobs.

• Prohibits businesses, ticket issuers, educational institutions, and government from denying services, admission, employment, or compensation based on medical intervention status.

• Allows one-time incentives for medical interventions but bans ongoing compensation differences based on intervention status.

• Explicitly bars healthy individuals from being excluded from any public or private activity based on medical intervention status.

• Removes state authority to order or administer treatment or prophylaxis (including vaccinations) during public health disasters, allowing only isolation or quarantine of infected, unwilling individuals and recommendations for exposed persons.

• Repeals requirements for childhood immunizations (striking Section 139A.8 and related reporting/verification statutes for schools and child care) and repeals employer COVID-19 vaccination mandates/waivers and related unemployment provisions.

• Prohibits compelled use of personal protective equipment authorized solely by emergency use authorization, while still allowing standard PPE requirements per workplace safety laws.

• Mandates enforcement via civil actions with attorney fees for successful prosecution and ties compliance to licensure for businesses, schools, and government entities; applies at all times, including during emergencies.

Creates an individual tax credit for purchasing firearm safety devices. Applies to devices purchase after the effective date, and applies to the 2025 tax year.

Creates a nonrefundable individual income tax credit for recent graduates of Iowa Board of Regents institutions who paid nonresident tuition and are now Iowa residents employed as healthcare professionals, teachers, licensed veterinarians, or professional engineers. The credit equals the difference between nonresident and resident tuition rates for the years attended. Excess credit can be carried forward up to five years but cannot benefit those who become nonresidents. The Board of Regents is required to publish tuition data for transparency. The bill applies retroactively to tax years beginning on or after January 1, 2026.

Key Points & Impacts:

• Establishes a nonresident tuition tax credit for individuals who graduated from an Iowa Board of Regents institution within the past three years and are now employed in Iowa as a healthcare professional, teacher, licensed veterinarian, or professional engineer.

• The tax credit amount is 100% of the difference between nonresident and resident tuition paid by the graduate for each year of attendance.

• Credit is nonrefundable, but unused amounts may be carried forward for up to five years or until exhausted, whichever comes first.

• If the taxpayer becomes a nonresident, remaining credit cannot be applied to future tax liability.

• Married taxpayers filing separately must allocate the credit proportionally to earned income.

• Board of Regents must publish a decade's worth of tuition data for both resident and nonresident students at each institution.

• Applies retroactively to tax years beginning on or after January 1, 2026.

• Targets high-need professions (healthcare, teaching, veterinary, engineering) to encourage retention of graduates in Iowa.

Imposes a new annual tax on the endowment values exceeding $500 million for public and private colleges and universities. The tax rate is set at the highest corporate income tax rate (currently 7.1%). Revenues from public institutions go to the Iowa workforce grant incentive fund, while revenues from private institutions are deposited in a new account to supplement tuition grants for students in high-wage and high-demand job majors. The bill also caps gift processing fees at 5% and endowment management fees at 1% for institutions governed by the board of regents. New administrative rules and appropriations mechanisms are established to implement these changes.

Key Points & Impacts:

• Imposes an annual endowment tax on Iowa colleges/universities with endowments exceeding $500 million, at the highest corporate income tax rate.

• Defines 'endowment' and 'endowment value' for purposes of the tax, including assets held by related organizations.

• Tax revenues from public institutions (board of regents) are appropriated to the Iowa workforce grant incentive fund.

• Tax revenues from private institutions are appropriated to a new 'high-wage and high-demand jobs' account within the Iowa tuition grants fund.

• Funds in the new account are used to supplement tuition grants for students in majors leading to high-wage, high-demand jobs, as identified by state workforce authorities.

• Caps fees for processing gifts to institutions at 5% of gross proceeds, and annual endowment management fees at 1% of endowment value for board of regents institutions.

• Requires new administrative rules for the approval and awarding of supplemental tuition grants after January 1, 2028.

  • Establishes appropriations mechanisms to ensure funds do not revert to the state general fund and are available for future tuition grants.

Institutes wide-ranging reforms across health, nutrition, and tax policy. It mandates continuing education in nutrition and metabolic health for specified medical professionals; revises certificate of need (CON) requirements, removing certain restrictions and adding new exemptions and inclusions; compels ongoing participation in SNAP and allows for summer EBT with healthy foods requirements; authorizes over-the-counter sales of ivermectin; imposes new prohibitions on specific food additives in school meals; adopts the Psychology Interjurisdictional Compact for telepractice and temporary in-person practice; and substantially increases excise taxes on cigarettes, tobacco products, vapor products, and consumable hemp products, directing new revenues to the health care trust fund.

Key Points & Impacts

• Mandates at least one hour of continuing education on nutrition/metabolic health every four years for various health professionals as a license renewal condition (new requirements for MDs, PAs, and others).

• Revises Certificate of Need law: eliminates certain categories from CON requirements, adds new exemptions (e.g., outpatient behavioral health facilities, open heart surgery, organ transplants, certain equipment), and removes the cap on intermediate care facility beds for persons with intellectual disabilities; replaces public hearings with written comment periods for CON applications.

• Requires uninterrupted state participation in SNAP and allows summer EBT participation only if eligible foods meet newly defined 'healthy foods' criteria set by the state.

• Allows pharmacists and others to distribute ivermectin for human use without a prescription, with immunity from professional or legal penalties for such distribution.

• Bans serving or selling foods containing certain artificial dyes and additives in school meals (public, charter, innovation zone, and nonpublic schools receiving state funds), effective July 2027.

• Enacts the Psychology Interjurisdictional Compact, enabling cross-state telepsychology and temporary in-person practice by licensed psychologists, while establishing compact governance and discipline mechanisms.

• Raises the cigarette tax from 6.8¢ to 10.05¢ per cigarette (pack of 20 increases from $1.36 to $2.01); increases tobacco product tax rate from 50% to 55% of wholesale price; increases cigar tax cap and switches snuff tax to 55% of wholesale price; imposes 15% excise tax on vapor products and consumable hemp products at retail; all new revenues directed to the health care trust fund.

• Makes extensive conforming amendments to tax administration, reporting, enforcement, and inventory tax provisions to cover vapor and consumable hemp products and ensure collections flow to the health care trust fund.

Creates a nonrefundable individual income tax credit for recent graduates of Iowa Board of Regents institutions who paid nonresident tuition and are now Iowa residents employed as healthcare professionals, teachers, licensed veterinarians, or professional engineers. The credit equals the difference between nonresident and resident tuition rates for the years attended. Excess credit can be carried forward up to five years but cannot benefit those who become nonresidents. The Board of Regents is required to publish tuition data for transparency. The bill applies retroactively to tax years beginning on or after January 1, 2026.

Key Points & Impacts:

• Establishes a nonresident tuition tax credit for individuals who graduated from an Iowa Board of Regents institution within the past three years and are now employed in Iowa as a healthcare professional, teacher, licensed veterinarian, or professional engineer.

• The tax credit amount is 100% of the difference between nonresident and resident tuition paid by the graduate for each year of attendance.

• Credit is nonrefundable, but unused amounts may be carried forward for up to five years or until exhausted, whichever comes first.

• If the taxpayer becomes a nonresident, remaining credit cannot be applied to future tax liability.

• Married taxpayers filing separately must allocate the credit proportionally to earned income.

• Board of Regents must publish a decade's worth of tuition data for both resident and nonresident students at each institution.

• Applies retroactively to tax years beginning on or after January 1, 2026.

• Targets high-need professions (healthcare, teaching, veterinary, engineering) to encourage retention of graduates in Iowa.

Prohibits employers from enforcing contractual clauses that restrict health care providers from practicing at rural hospitals or facilities, or at hospitals designated as critical access hospitals, after leaving employment. The bill applies to all such agreements regardless of when they were made. However, it does not affect provisions that limit a provider's ability to solicit former or current patients.

Key Points & Impacts:

• Declares void and unenforceable any contract provision that limits a health care provider's right to practice at rural or critical access hospitals after employment ends.

• Applies to agreements made before, on, or after the bill's effective date.

• Covers a wide range of licensed health care professionals, including physicians, nurses, dentists, and others authorized to provide health care in Iowa.

• Does not invalidate contract provisions restricting the solicitation of current or former patients by health care providers.

• Specifically protects provider mobility in rural areas or federally designated critical access hospitals as defined by federal regulation.

• Seeks to increase access to health care in rural areas by removing non-compete style restrictions for providers.

• Does not retroactively affect provisions unrelated to practice location, such as trade secrets or patient solicitation clauses.

• May affect employer strategies for recruitment and retention of health care providers in rural settings.