HOUSE 3rd Reading Unamended March 23, 2015 HOUSE Amended 2nd Reading March 20, 2015First Regular Session Seventieth General Assembly STATE OF COLORADO REENGROSSED This Version Includes All Amendments Adopted in the House of Introduction LLS NO. 15-0370.01 Thomas Morris x4218 HOUSE BILL 15-1147 HOUSE SPONSORSHIP Ginal, SENATE SPONSORSHIP Todd, House Committees Senate Committees Health, Insurance, & Environment Finance Appropriations A BILL FOR AN ACT Concerning the regulation of genetic counselors, and, in connection therewith, making an appropriation. Bill Summary (Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://www.leg.state.co.us/billsummaries.) The bill enacts the "Genetic Counselor Licensure Act". On and after June 1, 2016, a person cannot practice genetic counseling without being licensed by the director of the division of professions and occupations in the department of regulatory agencies. To be licensed, a person must have graduated with an appropriate genetic counseling degree and have been certified by a national body, except that the director may issue a provisional license to a candidate for certification pursuant to requirements established by rule. The Act gives title protection to genetic counselors and standard licensing, rule-making, and disciplinary powers to the director. Genetic counselors must have insurance unless the director, by rule, finds that insurance is not reasonably available. The Act repeals on September 1, 2020. Genetic counselors are subject to the mandatory disclosures of the "Michael Skolnik Medical Transparency Act of 2010". Be it enacted by the General Assembly of the State of Colorado: SECTION 1. In Colorado Revised Statutes, add article 35.3 to title 12 as follows: ARTICLE 35.3 Genetic Counselor Licensure Act 12-35.3-101. Short title. This article shall be known and may be cited as the "Genetic Counselor Licensure Act". 12-35.3-102. Legislative declaration. (1) The general assembly hereby: (a) Finds that there is a public need for reliable and affordable genetic counseling services that can be provided by readily identifiable and competent practitioners; (b) Determines that a licensure requirement is necessary to meet this public need, including a defined scope of practice and title protection for licensed genetic counselors to assure consumers the right to choose those from whom they receive information and advice; and (c) Declares that: (I) Its intent in enacting this article is to establish minimum standards of education, experience, and examination for professional genetic counselors so that the public can readily identify those who meet these minimum standards; and (II) Enactment of this article will protect the health of the public by broadening affordable access to appropriate and reliable genetic counseling. 12-35.3-103. Definitions. As used in this article, unless the context otherwise requires: (1) "ABGC" means the American Board of Genetic Counseling or an organization that the director recognizes as being equivalent to, or a predecessor or successor of, the ABGC. (2) "ABMG" means the American Board of Medical Genetics or an organization that the director recognizes as being equivalent to, or a predecessor or successor of, the ABMG. (3) "ACGC" means the Accreditation Council for Genetic Counseling or an organization that the director recognizes as being equivalent to, or a predecessor or successor of, the ACGC. (4) "Active candidate status" means that a person has supplied the ABGC with all required documentation regarding the person's qualifications so as to enable the person to take the ABGC's certification examination. (5) "Director" means the director of the division of professions and occupations in the department of regulatory agencies, created in section 24-34-102, C.R.S., or the director's designee. (6) "Genetic counselor" means an individual who is licensed pursuant to this article. (7) "NSGC" means the National Society of Genetic Counselors or an organization that the director recognizes as being equivalent to, or a predecessor or successor of, the NSGC. (8) The "practice of genetic counseling" includes the following activities: (a) Obtaining and interpreting individual, family, and medical development histories; (b) Determining the mode of inheritance and risk of transmission of genetic conditions; (c) Discussing the inheritance, features, natural history, and means of diagnosis of genetic conditions; (d) Identifying, coordinating, ordering, and explaining genetic laboratory tests and other diagnostic studies; (e) Assessing psychosocial factors and recognizing social, educational, and cultural issues; (f) Evaluating the client's or the client's family's responses to the condition or risk of recurrence of a genetic condition and providing client-centered counseling and anticipatory guidance; (g) Communicating genetic information to clients in an understandable manner; (h) Facilitating informed decision-making about testing and management alternatives; (i) Identifying and effectively utilizing community resources that provide medical, educational, financial, and psychosocial support and advocacy; and (j) Providing accurate written documentation of medical, genetic, and counseling information for clients, their families, and health care professionals. 12-35.3-104. Use of titles restricted. Only a person licensed as a genetic counselor may use the title "genetic counselor", "licensed genetic counselor", "L.G.C.", "gene counselor", "genetic consultant", "genetic associate", or any combination of these terms or abbreviations or any other generally accepted term, letters, or figures that indicate that the person is a genetic counselor. 12-35.3-105. License required. On and after June 1, 2016, except as otherwise provided in this article, a person shall not practice genetic counseling or represent himself or herself as being able to practice genetic counseling in this state without possessing a valid license issued by the director in accordance with this article and rules adopted pursuant to this article. 12-35.3-106. Licensure of genetic counselors - application - qualifications - rules. (1) Educational and experiential requirements. (a) Every applicant for a license as a genetic counselor must: (I) Except as specified in paragraph (b) of this subsection (1), provide satisfactory evidence of having certification as a: (A) Genetic counselor by the ABGC or ABMG; or (B) Medical geneticist by the ABMG; and (II) Submit an application as specified in subsection (2) of this section. (b) The director shall establish, by rule, requirements relating to the issuance of a provisional license to practice genetic counseling to a candidate for licensure who has been granted active candidate status by the ABGC if the candidate meets the other qualifications for licensure. The rules must address at least the following: (I) The terms of, renewal of, and fees for provisional licenses; (II) Whether a genetic counselor working under a provisional license must be under the general supervision of a licensed health care provider and, if so, by whom and under what conditions; and (III) The automatic expiration of a provisional licensure upon a second or subsequent failure to pass the certification examination. (2) Application. (a) When an applicant has fulfilled the requirements of subsection (1) of this section, the applicant may apply for licensure upon payment of a license application fee in an amount determined by the director. (b) The application must be in the form and manner designated by the director. (3) Licensure. When an applicant has fulfilled the requirements of subsections (1) and (2) of this section, the director shall issue a license or, as appropriate, a provisional license, to the applicant; except that the director may deny a license if the applicant has committed any act that would be grounds for disciplinary action under section 12-35.3-110. (4) Licensure by endorsement. (a) An applicant for licensure by endorsement must file an application and pay a fee as prescribed by the director and must hold a current, valid license or registration in a jurisdiction that requires qualifications substantially equivalent to those required by subsection (1) of this section for licensure. (b) An applicant for licensure by endorsement must submit with the application verification that the applicant has actively practiced for a period of time or otherwise maintained competency as determined by the director. (c) Upon receipt of all documents required by paragraphs (a) and (b) of this subsection (4), the director shall review the application and make a determination of the applicant's qualification to be licensed by endorsement. (d) The director may deny the application for licensure by endorsement if the applicant has committed an act that would be grounds for disciplinary action under section 12-35.3-110. (5) License renewal. (a) A genetic counselor must renew his or her license issued under this article according to a schedule of renewal dates established by the director. The genetic counselor must submit an application in the form and manner designated by the director and must pay a renewal fee in an amount determined by the director. (b) Licenses are renewed or reinstated in accordance with the schedule established by the director, and the director shall grant a renewal or reinstatement pursuant to section 24-34-102 (8), C.R.S. The director may establish renewal fees and delinquency fees for reinstatement pursuant to section 24-34-105, C.R.S. If a genetic counselor fails to renew his or her license pursuant to the schedule established by the director, the license expires. A person whose license expires is subject to the penalties provided in this article or section 24-34-102 (8), C.R.S. (c) Applicants for licensure renewal must submit proof of completing thirty hours of NSGC-approved continuing education. (6) Fees. All fees collected under this article shall be determined, collected, and appropriated in the same manner as set forth in section 24-34-105, C.R.S., and periodically adjusted in accordance with section 24-75-402, C.R.S. 12-35.3-107. Scope of article - exclusions. (1) This article does not prevent or restrict the practice, services, or activities of: (a) A person licensed or otherwise regulated in this state by any other law from engaging in his or her profession or occupation as defined in the article under which he or she is licensed; (b) A person pursuing a course of study leading to a degree in genetic counseling or an equivalent degree, as authorized by the director, from an ACGC-accredited school or program, if: (I) The activities and services constitute a part of a supervised course of study; (II) The person is designated by a title that clearly indicates the person's status as a student; (III) The period of supervised practice does not exceed two years, unless the director provides written approval; and (IV) The individual is supervised by an individual licensed under this article or a physician; (c) A person who is employed by the United States or a state government or any of its bureaus, divisions, or agencies while in the discharge of the employee's official duties; or (d) A legally qualified genetic counselor from another state or country when providing services on behalf of a temporarily absent genetic counselor licensed in this state, if the unlicensed genetic counselor is acting in accordance with rules established by the director. The unlicensed practice must not be of more than four weeks' duration, and a person shall not undertake unlicensed practice more than once in any twelve-month period. (2) (a) Nothing in this article authorizes a genetic counselor to engage in the practice of medicine, as defined in section 12-36-106, or any other form of healing or counseling except as authorized by this article. (b) If in the course of providing a genetic counseling service to a client, a genetic counselor finds any indication of a disease or condition that requires medical assessment, the genetic counselor shall refer the client to a physician licensed to practice medicine. 12-35.3-108. Grounds for discipline - disciplinary proceedings - judicial review. (1) The director may take disciplinary action against a licensee if the director finds that the licensee has represented himself or herself as a licensed genetic counselor after the expiration, suspension, or revocation of his or her license. (2) The director may revoke, suspend, deny, or refuse to renew a license; place a licensee on probation; issue a letter of admonition to a licensee; or issue a cease-and-desist order to a licensee in accordance with this section upon proof that the licensee: (a) Has engaged in a sexual act with a person receiving services while a therapeutic relationship existed or within six months immediately following termination of the therapeutic relationship. For the purposes of this paragraph (a): (I) "Sexual act" means sexual contact, sexual intrusion, or sexual penetration, as defined in section 18-3-401, C.R.S. (II) "Therapeutic relationship" means the period beginning with the initial evaluation and ending upon the written termination of treatment. (b) Has falsified information in an application or has attempted to obtain or has obtained a license by fraud, deception, or misrepresentation; (c) Is an excessive or habitual user or abuser of alcohol or habit-forming drugs or is a habitual user of a controlled substance, as defined in section 18-18-102, C.R.S., or other drugs having similar effects; (d) (I) Has failed to notify the director, as required by section 12-35.3-113 (1), of a physical or mental condition or illness that impacts the licensee's ability to provide genetic counseling services with reasonable skill and safety or that may endanger the health or safety of individuals receiving services; (II) Has failed to act within the limitations created by a physical or mental illness or condition that renders the person unable to practice genetic counseling with reasonable skill and safety or that may endanger the health or safety of persons under his or her care; or (III) Has failed to comply with the limitations agreed to under a confidential agreement entered into pursuant to section 12-35.3-113 (2); (e) Has violated this article or aided or abetted or knowingly permitted any person to violate this article, a rule adopted under this article, or any lawful order of the director; (f) Has had a license or registration suspended or revoked in another jurisdiction for actions that would violate this article or would constitute grounds for discipline under this article if committed in Colorado; (g) Has been convicted of or pled guilty or nolo contendere to a felony or committed an act specified in section 12-35.3-111. A certified copy of the judgment of a court of competent jurisdiction of the conviction or plea is conclusive evidence of the conviction or plea. In considering the disciplinary action, the director is governed by section 24-5-101, C.R.S. (h) Has fraudulently obtained, furnished, or sold any genetic counseling diploma, certificate, license, or renewal of a license or other professional credential; (i) Has failed to notify the director of the suspension or revocation of the person's past or currently held license, certificate, or registration required to practice genetic counseling in this or any other jurisdiction; (j) Has refused to submit to a physical or mental examination when ordered by the director pursuant to section 12-35.3-110; (k) Has engaged in any of the following activities and practices: (I) Ordering or performing, without clinical justification, demonstrably unnecessary laboratory tests or studies; (II) Administering treatment, without clinical justification, that is demonstrably unnecessary; or (III) An act or omission that is contrary to generally accepted standards of the practice of genetic counseling; (l) Has failed to provide adequate or proper supervision of a provisionally licensed genetic counselor or any unlicensed person in the practice of genetic counseling; or (m) Has otherwise violated this article or any lawful order or rule of the director. (3) Except as otherwise provided in subsection (2) of this section, the director need not find that the actions that are grounds for discipline were willful but may consider whether such actions were willful when determining the nature of disciplinary sanctions to be imposed. (4) (a) The director may commence a proceeding to discipline a licensee when the director has reasonable grounds to believe that the licensee has committed an act enumerated in this section or has violated a lawful order or rule of the director. (b) In any proceeding under this section, the director may accept as evidence of grounds for disciplinary action any disciplinary action taken against a licensee or registrant in another jurisdiction if the violation that prompted the disciplinary action in the other jurisdiction would be grounds for disciplinary action under this article. (5) Disciplinary proceedings shall be conducted in accordance with article 4 of title 24, C.R.S., and the hearing and opportunity for review shall be conducted pursuant to that article by the director or by an administrative law judge, at the director's discretion. The director has the authority to exercise all powers and duties conferred by this article during the disciplinary proceedings. (6) (a) No later than thirty days following the date of the director's action, the director shall notify a genetic counselor disciplined under this section, by a first-class letter to the most recent address provided to the director by the genetic counselor, of the action taken, the specific charges giving rise to the action, and the genetic counselor's right to request a hearing on the action taken. (b) Within thirty days after the director sends the notification, the genetic counselor may file a written request with the director for a hearing on the action taken. Upon receipt of the request the director shall grant a hearing to the genetic counselor. If the genetic counselor fails to file a written request for a hearing within thirty days, the action of the director becomes final on that date. (c) Failure of the genetic counselor to appear at the hearing without good cause is a withdrawal of his or her request for a hearing, and the director's action becomes final on that date. Failure, without good cause, of the director to appear at the hearing is cause to dismiss the proceeding. (7) (a) The director may request the attorney general to seek an injunction, in any court of competent jurisdiction, to enjoin a person from committing an act prohibited by this article. When seeking an injunction under this paragraph (a), the attorney general is not required to allege or prove the inadequacy of any remedy at law or that substantial or irreparable damage is likely to result from a continued violation of this article. (b) (I) In accordance with article 4 of title 24, C.R.S., and this article, the director may investigate, hold hearings, and gather evidence in all matters related to the exercise and performance of the powers and duties of the director. (II) To aid the director in any hearing or investigation instituted pursuant to this section, the director or an administrative law judge appointed pursuant to paragraph (c) of this subsection (7) may administer oaths, take affirmations of witnesses, and issue subpoenas compelling the attendance of witnesses and the production of all relevant records, papers, books, documentary evidence, and materials in any hearing, investigation, or other matter before the director or an administrative law judge. (III) Upon failure of any witness or licensee to comply with a subpoena or process, the district court of the county in which the subpoenaed person or licensee resides or conducts business, upon application by the director with notice to the subpoenaed person or licensee, may issue to the person or licensee an order requiring that person or licensee to appear before the director; produce the relevant papers, books, records, documentary evidence, or materials if so ordered; or give evidence touching the matter under investigation or in question. If the person or licensee fails to obey the order of the court, the court may hold the person or licensee in contempt of court. (c) The director may appoint an administrative law judge pursuant to part 10 of article 30 of title 24, C.R.S., to conduct hearings, take evidence, make findings, and report the findings to the director. (8) (a) The director, a member of the director's staff, a person acting as a witness or consultant to the director, a witness testifying in a proceeding authorized under this article, and a person who lodges a complaint pursuant to this article is immune from liability in any civil action brought against him or her for acts occurring while acting in his or her capacity as director, staff, consultant, witness, or complainant, respectively, if the individual was acting in good faith within the scope of his or her respective capacity, made a reasonable effort to obtain the facts of the matter as to which he or she acted, and acted in the reasonable belief that the action taken by him or her was warranted by the facts. (b) A person participating in good faith in making a complaint or report or in an investigative or administrative proceeding pursuant to this section is immune from any civil or criminal liability that otherwise might result by reason of the participation. (9) A final action of the director is subject to judicial review by the court of appeals pursuant to section 24-4-106 (11), C.R.S. (10) When a complaint or an investigation discloses an instance of misconduct that, in the opinion of the director, warrants formal action, the director shall not resolve the complaint by a deferred settlement, action, judgment, or prosecution. (11) (a) If it appears to the director, based upon credible evidence as presented in a written complaint by any person, that a licensee is acting in a manner that is an imminent threat to the health and safety of the public, or a person is acting or has acted without the required license, the director may issue an order to cease and desist the activity. The director shall set forth in the order the statutes and rules alleged to have been violated, the facts alleged to have constituted the violation, and the requirement that all unlawful acts or unlicensed practices immediately cease. (b) Within ten days after service of the order to cease and desist pursuant to paragraph (a) of this subsection (11), the respondent may request a hearing on the question of whether acts or practices in violation of this article have occurred. The hearing shall be conducted pursuant to sections 24-4-104 and 24-4-105, C.R.S. (12) (a) If it appears to the director, based upon credible evidence as presented in a written complaint by any person, that a person has violated any provision of this article, then, in addition to exercising any other power granted by this article, the director may issue to the person an order to show cause as to why the director should not issue a final order directing the person to cease and desist from the unlawful act or unlicensed practice. (b) The director shall promptly notify a person against whom an order to show cause has been issued pursuant to paragraph (a) of this subsection (12) of the issuance of the order along with a copy of the order, the factual and legal basis for the order, and the date set by the director for a hearing on the order. The director may serve the notice by personal service, by first-class, postage prepaid United States mail, or in another manner as may be practicable. Personal service or mailing of an order or document pursuant to this paragraph (b) constitutes notice of the order to the person. (c) (I) The hearing on an order to show cause shall be held no sooner than ten and no later than forty-five calendar days after the date of transmission or service of the notification by the director as provided in paragraph (b) of this subsection (12). The hearing may be continued by agreement of all parties based upon the complexity of the matter, number of parties to the matter, and legal issues presented in the matter, but in no event shall the hearing be held later than sixty calendar days after the date of transmission or service of the notification. (II) If a person against whom an order to show cause has been issued pursuant to paragraph (a) of this subsection (12) does not appear at the hearing, the director may present evidence that notification was properly sent or served on the person pursuant to paragraph (b) of this subsection (12) and such other evidence related to the matter as the director deems appropriate. The director shall issue the order within ten days after the director's determination related to reasonable attempts to notify the respondent, and the order becomes final as to that person by operation of law. The hearing shall be conducted pursuant to sections 24-4-104 and 24-4-105, C.R.S. (III) If the director reasonably finds that the person against whom the order to show cause was issued is acting or has acted without the required license, or has engaged or is about to engage in acts or practices constituting violations of this article, the director may issue a final cease-and-desist order directing the person to cease and desist from further unlawful acts or unlicensed practices. (IV) The director shall provide notice, in the manner set forth in paragraph (b) of this subsection (12), of the final cease-and-desist order within ten calendar days after the hearing conducted pursuant to this paragraph (c) to each person against whom the final order has been issued. The final order issued pursuant to subparagraph (III) of this paragraph (c) is effective when issued and is a final order for purposes of judicial review. (13) The director may enter into a stipulation with a person if it appears to the director, based upon credible evidence presented to the director, that the person has engaged or is about to engage in an unlicensed act or practice; an act or practice constituting a violation of this article, a rule promulgated pursuant to this article, or an order issued pursuant to this article; or an act or practice constituting grounds for administrative sanction pursuant to this article. (14) If a person fails to comply with a final cease-and-desist order or a stipulation, the director may request the attorney general or the district attorney for the judicial district in which the alleged violation exists to bring, and if so requested the attorney shall bring, suit for a temporary restraining order and for injunctive relief to prevent any further or continued violation of the final order. (15) A person aggrieved by the final cease-and-desist order may seek judicial review of the director's determination or of the director's final order as provided in subsection (9) of this section. (16) (a) The director may send a letter of admonition to a licensee when a complaint or investigation discloses an instance of misconduct that, in the opinion of the director, does not warrant formal action but should not be dismissed as being without merit. (b) When the director sends a letter of admonition to a licensee, the director shall notify the licensee of the licensee's right to request in writing, within twenty days after receipt of the letter, that formal disciplinary proceedings be initiated to adjudicate the propriety of the conduct described in the letter of admonition. (c) If the licensee timely requests adjudication, the director shall vacate the letter of admonition and process the matter by means of formal disciplinary proceedings. (17) The director may send a confidential letter of concern to a licensee when a complaint or investigation discloses an instance of conduct that does not warrant formal action by the director and, in the opinion of the director, should be dismissed, but the director has noticed conduct by the licensee that could lead to serious consequences if not corrected. (18) A person whose license is revoked or who surrenders his or her license to avoid discipline under this section is ineligible to apply for a license under this article for at least two years after the date the license is revoked or surrendered. 12-35.3-109. Unauthorized practice - penalties. A person who practices or offers or attempts to practice genetic counseling without an active license as required by and issued under this article for genetic counselors commits a class 2 misdemeanor and shall be punished as provided in section 18-1.3-501, C.R.S., for the first offense. For the second or any subsequent offense, the person commits a class 1 misdemeanor and shall be punished as provided in section 18-1.3-501, C.R.S. This section does not apply to a person who is exempted by this article or another article of this title from being licensed pursuant to this article. 12-35.3-110. Mental and physical examination of licensees. (1) If the director has reasonable cause to believe that a licensee is unable to practice with reasonable skill and safety, the director may order the licensee to take a mental or physical examination administered by a physician or other licensed health care professional designated by the director. Except where due to circumstances beyond the licensee's control, if the licensee fails or refuses to undergo a mental or physical examination, the director may suspend the licensee's license until the director has made a determination of the licensee's fitness to practice. The director shall proceed with an order for examination and shall make his or her determination in a timely manner. (2) In an order requiring a licensee to undergo a mental or physical examination, the director shall state the basis of the director's reasonable cause to believe that the licensee is unable to practice with reasonable skill and safety. For purposes of a disciplinary proceeding authorized under this article, the licensee is deemed to have waived all objections to the admissibility of the examining physician's or licensed health care professional's testimony or examination reports on the grounds that they are privileged communication. (3) The licensee may submit to the director testimony or examination reports from a physician chosen by the licensee and pertaining to any condition that the director has alleged may preclude the licensee from practicing with reasonable skill and safety. The director may consider the testimony and reports submitted by the licensee in conjunction with, but not in lieu of, testimony and examination reports of the physician designated by the director. (4) The results of a mental or physical examination ordered by the director shall not be used as evidence in any proceeding other than one before the director, are not a public record, and shall not be made available to the public. 12-35.3-111. Confidential agreement to limit practice - violation - grounds for discipline. (1) If a genetic counselor has a physical or mental illness or condition that renders the person unable to practice genetic counseling with reasonable skill and safety to clients, the genetic counselor shall notify the director of the illness or condition in a manner and within a period determined by the director. The director may require the genetic counselor to submit to an examination pursuant to section 12-35.3-110 to evaluate the extent of the illness or condition and its impact on the genetic counselor's ability to practice genetic counseling with reasonable skill and safety to clients. (2) (a) Upon determining that a genetic counselor with a physical or mental illness or condition is able to render limited services with reasonable skill and safety to clients, the director may enter into a confidential agreement with the genetic counselor in which the genetic counselor agrees to limit his or her practice based on the restrictions imposed by the illness or condition, as determined by the director. (b) As part of the agreement, the genetic counselor is subject to periodic reevaluation or monitoring as determined appropriate by the director. (c) The parties may modify or dissolve the agreement as necessary based on the results of a reevaluation or of monitoring. (3) By entering into an agreement with the director pursuant to this section to limit his or her practice, a genetic counselor is not engaging in activities that are grounds for discipline pursuant to section 12-35.3-108. The agreement does not constitute a restriction or discipline by the director. However, if the genetic counselor fails to comply with the terms of the agreement, the failure constitutes a prohibited activity pursuant to section 12-35.3-108 (2) (d), and the genetic counselor is subject to discipline in accordance with section 12-35.3-108. (4) This section does not apply to a genetic counselor subject to discipline for prohibited activities as described in section 12-35.3-108 (2) (c). 12-35.3-112. Professional liability insurance required - rules. (1) (a) Except as specified in paragraph (b) of this subsection (1), a person shall not practice genetic counseling unless the person purchases and maintains, or is covered by, professional liability insurance in an amount determined by the director by rule that covers all acts within the scope of practice of the genetic counselor. (b) The director may exempt, on a case-by-case basis or by rule, an individual or class of individuals from the insurance requirement of this section if the director finds that insurance is not reasonably available, and the director may later rescind the exemption if the director finds that insurance has become reasonably available. (2) This section does not apply to a genetic counselor who is a public employee acting within the course and scope of the public employee's duties and who is granted immunity under the "Colorado Governmental Immunity Act", article 10 of title 24, C.R.S. 12-35.3-113. Rule-making authority. The director shall promulgate rules as necessary for the administration of this article. 12-35.3-114. Repeal of article - review of functions. This article is repealed, effective September 1, 2020. Prior to the repeal, the department of regulatory agencies shall review the director's powers, duties, and functions under this article as provided in section 24-34-104, C.R.S. SECTION 2. In Colorado Revised Statutes, 12-43-215, amend (10) as follows: 12-43-215. Scope of article - exemptions. (10) The provisions of This article do does not apply to: (a) A professional coach, including a life coach, executive coach, personal coach, or business coach, who has had coach-specific training and who serves clients exclusively as a coach, as long as the professional coach does not engage in the practice of psychology, social work, marriage and family therapy, licensed professional counseling, psychotherapy, or addiction counseling, as those practices are defined in this article; or (b) A genetic counselor who is licensed under article 35.3 of this title. SECTION 3. In Colorado Revised Statutes, 24-34-104, add (51.5) (j) as follows: 24-34-104. General assembly review of regulatory agencies and functions for termination, continuation, or reestablishment. (51.5) The following agencies, functions, or both, terminate on September 1, 2020: (j) The regulation of genetic counselors by the director of the division of professions and occupations under article 35.3 of title 12, C.R.S. SECTION 4. In Colorado Revised Statutes, 24-34-110, amend (3) (a) (XXVIII) and (3) (a) (XXIX); and add (3) (a) (XXX) as follows: 24-34-110. Medical transparency act of 2010 - disclosure of information about health care licensees - fines - rules - short title - legislative declaration. (3) (a) As used in this section, "applicant" means a person applying for a new, active license, certification, or registration or to renew, reinstate, or reactivate an active license, certification, or registration to practice: (XXVIII) As a surgical assistant or surgical technologist pursuant to article 43.2 of title 12, C.R.S.; and (XXIX) Naturopathic medicine pursuant to article 37.3 of title 12, C.R.S.; and (XXX) As a genetic counselor pursuant to article 35.3 of title 12, C.R.S. SECTION 5. Appropriation. (1) For the 2015-16 state fiscal year, $58,587 is appropriated to the department of regulatory agencies. This appropriation is from the division of professions and occupations cash fund created in section 24-34-105 (2) (b) (I), C.R.S. To implement this act, the department may use this appropriation as follows: (a) $39,137 for use by the division of professions and occupations for personal services, which amount is based on an assumption that the division will require an additional 0.5 FTE; (b) $5,273 for use by the division of professions and occupations for operating expenses; and (c) $14,177 for the purchase of legal services. (2) For the 2015-16 state fiscal year, $14,177 is appropriated to the department of law. This appropriation is from reappropriated funds received from the department of regulatory agencies under paragraph (c) of subsection (1) of this section. To implement this act, the department of law may use this appropriation to provide legal services for the department of regulatory agencies. SECTION 6. Act subject to petition - effective date - applicability. (1) This act takes effect at 12:01 a.m. on the day following the expiration of the ninety-day period after final adjournment of the general assembly (August 5, 2015, if adjournment sine die is on May 6, 2015); except that, if a referendum petition is filed pursuant to section 1 (3) of article V of the state constitution against this act or an item, section, or part of this act within such period, then the act, item, section, or part will not take effect unless approved by the people at the general election to be held in November 2016 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor. (2) This act applies to conduct occurring on or after the applicable effective date of this act.