Iowa Administrative Code

“Autopsy” means the external and internal postmortem examination of a deceased person. “County of appointment” means the county that requests a medical examiner to conduct an investigation, perform or order an autopsy, or prepare a report or reports in a death investigation case.…

Autopsies performed by the state medical examiner are provided on a fee-for-service basis. Costs of autopsies and related services and expenses are the responsibility of the county of appointment. The county of residence of the deceased shall reimburse the county of appointment. …

state medical examiner is utilized by an authorized tissue recovery agency, a fee of $400 per case will be assessed. The tissue recovery agency is responsible for this fee, payable to the office of the state medical examiner. [ARC 0148D, IAB 3/18/26, effective 7/1/26] These rules…

“Autopsy” means the external and internal postmortem examination of a deceased person. “Cause of death” means the disease or injury that sets in motion the chain of events that eventually results in the death of a person. The physician shall consider “but for” this injury or dise…

records pursuant to Iowa Code section 22.7(2), 22.7(5), and 22.7(41) and other provisions of Iowa law. Prior to releasing a medical examiner record or report to a member of the public, a county medical examiner may inform the appropriate law enforcement agency, the county attorne…

indemnify a county medical examiner and any properly appointed staff members to the extent provided in Iowa Code chapter 670. [ARC 0076D, IAB 2/18/26, effective 4/1/26] These rules are intended to implement Iowa Code chapters 331 and 691. [Filed May 10, 1966] [Filed emergency 7/1…

interest. 127.2(1) Jurisdiction. Upon receiving notification of a death that affects the public interest, a medical examiner shall notify any appropriate law enforcement agency not otherwise notified and take charge of the body of the decedent. The body shall not be disturbed or …

127.3(1) Autopsy required. A county medical examiner shall order that an autopsy be performed in the following cases: a. All cases of homicide or suspected homicide, irrespective of the period of survival following injury. b. All cases in which the manner of death is undetermined…

127.4(1) Payment of fee and expenses. a. A medical examiner receives from the county of appointment or the county of the decedent’s residence a fee for each preliminary investigation and report submitted in a case in which a death affects the public interest. A county medical exa…

127.5(1) Completion. The funeral director to whom the body is released shall complete the personal data on the death certificate. The medical examiner must complete the manner of death and cause of death sections of the death certificate within 72 hours after determination of the…

127.6(1) Permit obtained prior to cremation—cremation permit. A permit for cremation must be obtained from a county medical examiner or state medical examiner prior to cremation of a body of a decedent. Cremation permits must be completed in the electronic death registry system. …

127.7(1) Appointment. A county medical examiner may appoint one or more county medical examiner investigators upon approval by the board of supervisors and the state medical examiner. 127.7(2) Qualifications. a. Prior to appointment, a CME-I should possess a minimum of two years …

127.8(1) Appointment. A county medical examiner may appoint one or more DCMEs upon approval by the board of supervisors and the state medical examiner. 127.8(2) Qualifications. A DCME must be licensed in the state of Iowa as a medical or osteopathic physician or surgeon. 127.8(3)…

examiner, county medical examiner investigator, pathologist, or other physician fails to comply with these rules, the state medical examiner may provide written notice of the failure to comply to that individual, the appropriate county medical examiner, and the appropriate county…

“Advanced emergency medical technician” or “AEMT” means an individual who has successfully completed a course of study based on the U.S. Department of Transportation’s National Emergency Medical Services Education Standards (December 2021), has passed the Department or NREMT test…

131.2(1) An individual who has successfully completed the training program requirements at the EMR, EMT, AEMT or paramedic level and has a valid certification with NREMT shall submit the following to the department for initial Iowa emergency medical care provider certification: a…

be used in accordance with this policy to determine eligibility. All background check records will be stored in a secure location. Background check records will not be redisseminated by the department. [ARC 9123C, IAB 4/16/25, effective 6/1/25]

131.4(1) Authority of emergency medical care provider. An emergency medical care provider who holds an active Iowa certification issued by the department or has permission to practice in Iowa pursuant to Iowa Code chapter 147D may: a. As a member of a responding authorized servic…

131.5(1) Renewal of certification. a. An emergency medical care provider shall submit an application for renewal of an active Iowa EMS certification within 90 days prior to the certification expiration date. b. The renewal application and process are completed online via an indiv…

revocation of certificates or renewal. 131.6(1) This rule is not subject to waiver pursuant to 441—Chapter 6 or any other provision of law. 131.6(2) Prohibited grounds for discipline. The department will not suspend or revoke the certification of a person who is in default or is …

department may appeal the denial and request a hearing on the issues related to the licensure denial pursuant to 441—Chapter 7. [ARC 9123C, IAB 4/16/25, effective 6/1/25]

immediate danger to the public health, safety or welfare and consistent with the Constitution and other provisions of law, the department may issue a written order in compliance with Iowa Code section 17A.18 to suspend a certificate in whole or in part, order the cessation of any…

131.9(1) This rule is not subject to waiver pursuant to 441—Chapter 6 or any other provision of law. 131.9(2) All complaints regarding emergency medical care personnel, training programs or continuing education providers, or those purporting to be or operating as the same shall b…

“Advanced emergency medical technician level service” or “AEMT level service” means a service program that provides emergency medical care that does not exceed the scope of practice of a certified AEMT provider as outlined in 641—subrule 131.5(2). “Advanced registered nurse pract…

132.2(1) Requirements for initial service program authorization. a. An entity that desires to provide emergency medical care services in the out-of-hospital setting in this state shall apply to the department for service program full authorization. b. Information for initial auth…

132.3(1) Ownership. a. Each service program will have a unique authorization number assigned by the department. b. A service program with satellites will have a single authorization number assigned by the department for all locations. c. A service program owner shall ensure compl…

compliance with Iowa Code chapter 147A and these rules, the department may grant a waiver. 132.4(1) The department may grant waivers of these rules to a currently authorized service program. 132.4(2) Requests for waivers shall apply only to the service program requesting the waiv…

suspension or revocation of service program authorization or renewal. 132.5(1) All complaints regarding the operation of authorized emergency medical care service programs, or those purporting to be or operating as the same, shall be reported to the department. 132.5(2) Complaint…

“Ambulance” means the same as defined in rule 641—132.1(147A). “Authorization certificate” means a permit issued to an emergency medical care provider that authorizes the use of a white flashing light. “Authorized vehicles” means any vehicles owned by members of the service progr…

133.2(1) White flashing lights may be used on emergency vehicles or other authorized vehicles utilized by emergency medical care providers and service programs for identification purposes only. 133.2(2) White flashing lights shall be used only on an authorized vehicle and shall n…

133.3(1) Authorization certificates will be issued by the service director for service vehicles and vehicles owned by emergency medical care providers who are members in good standing with the service. Authorization certificates are available from the department upon request. Veh…

133.4(1) The service director or the department may approve or deny an application and the department may place on probation, suspend or revoke an authorization certificate if the service director or the department finds reason to believe that the applicant or certificate holder:…

“ACS-COT” means the American College of Surgeons Committee on Trauma. “Categorization” means the same as defined in Iowa Code section 147A.21. “Certificate of verification” means a document awarded by the department that identifies a hospital or emergency care facility’s level an…

of trauma care facilities will be made by the department in accordance with Iowa Code section 147A.23. 134.2(1) Categorization applications shall be submitted by all hospitals. New hospitals and emergency care facilities shall submit a categorization application no later than 90 …

134.3(1) The department may deny verification as a trauma care facility or may give a citation and warning, place on probation, suspend, or revoke existing verification if the department finds reason to believe that the facility has not been operating or will not be operated in c…

“Out-of-Hospital Trauma Triage Destination Decision Protocols” means written directives to assist in trauma and triage decision-making, established and approved by the department, to be followed by the service program. “Service program” or “service” means the same as defined in I…

by the department assist personnel from each service program and trauma care facility. These protocols do not preclude service programs or trauma care facilities from making emergency revisions of the approved triage and transfer protocols when an incident overburdens medical car…

or deny authorization as a service program or may give a citation and warning, place on probation, suspend, or revoke existing trauma care facility verification or service program authorization if the department finds reason to believe that the facility or service program has not…

“Health care providers” for the purpose of this chapter includes licensed physicians, advanced registered nurse practitioners, physician assistants, and registered nurses. “Inclusion criteria” means criteria determined by the department and adopted by reference to determine which…

136.2(1) Trauma care facilities shall submit reportable patient data electronically to the department. Data shall be submitted in the trauma registry format approved by the department. The department may require those requesting the data to pay any or all of the reasonable costs …

pursuant to rule 641—134.3(147A). [ARC 9077C, IAB 4/2/25, effective 6/1/25] These rules are intended to implement Iowa Code section 147A.26. [Filed 11/14/96, Notice 10/9/96—published 12/4/96, effective 1/8/97] [Filed 1/13/05, Notice 11/24/04—published 2/2/05, effective 3/9/05] [F…

“Advanced registered nurse practitioner” or “ARNP” means a nurse as defined in rule 655—7.1(152). “Formal education” means education in standardized educational settings with a curriculum. “Licensed practical nurse” or “LPN” means an individual licensed pursuant to Iowa Code chap…

137.2(1) Trauma education is required of physicians, physician assistants, advanced registered nurse practitioners, registered nurses, and licensed practical nurses who are identified or defined as trauma team members by a trauma care facility and who participate directly in the …

trauma education for each provider category are as follows: 137.3(1) Physicians, PAs and ARNPs shall comply with education criteria specific to the level for which the trauma care facility is verified. Physicians, PAs and ARNPs at verified level I, II, and III trauma care facilit…

“Advanced emergency medical technician” or “AEMT” means the same as defined in rule 641—131.1(147A,147D,272C). “CAAHEP” means the same as defined in rule 641—131.1(147A,147D,272C). “CAPCE” means the same as defined in rule 641—131.1(147A,147D,272C). “CEH” means the same as define…

139.2(1) Initial application, inspection and approval. a. An applicant seeking initial authorization as an EMS training program shall complete and submit to the department an Iowa EMS training program self-assessment application. The application is available from the department u…

139.3(1) Education standards. A training program shall: a. Have a sponsoring institution that has received authorization from the department to conduct emergency medical care services training. b. Use the U.S. Department of Transportation’s National Emergency Medical Services Edu…

139.4(1) Application, inspection and approval. a. An out-of-state training program shall complete and submit to the department for review and approval the out-of-state training program self-assessment application. The application is available from the department upon request. b. …

may result in disciplinary action according to rule 641—139.8(147A). [ARC 9079C, IAB 4/2/25, effective 6/1/25]

temporarily causes a training program to be in noncompliance with these rules, the department may grant a temporary waiver. 139.6(1) Waivers of these rules may be granted by the department to a currently authorized training program. 139.6(2) Requests for waivers apply only to the…