19 33 advanced registered nurse practitioner, and a rural health
19 34 practitioner who is not a physician, physician assistant, or
19 35 advanced registered nurse practitioner, as members of the
Senate File 446 - Introduced continued
20 1 advisory committee. The advisory committee shall also include
20 2 as members two state representatives, one appointed by the
20 3 speaker of the house of representatives and one by the
20 4 minority leader of the house, and two state senators, one
20 5 appointed by the majority leader of the senate and one by the
20 6 minority leader of the senate.
20 7 The advisory committee shall regularly meet with the
20 8 administrative head of the center as well as the director of
20 9 the center for agricultural health and safety established
20 10 under section 262.78. The head of the center and the director
20 11 of the center for agricultural health and safety shall consult
20 12 with the advisory committee and provide the committee with
20 13 relevant information regarding their agencies.
20 14 A simple majority of the membership of the advisory
20 15 committee shall constitute a quorum. Action may be taken by
20 16 the affirmative vote of a majority of the advisory committee
20 17 membership.
20 18 2. The center for rural health and primary care shall do
20 19 all of the following:
20 20 a. Provide technical planning assistance to rural
20 21 communities and counties exploring innovative means of
20 22 delivering rural health services through community health
20 23 services assessment, planning, and implementation, including
20 24 but not limited to hospital conversions, cooperative
20 25 agreements among hospitals, physician and health practitioner
20 26 support, recruitment and retention of primary health care
20 27 providers, public health services, emergency medical services,
20 28 medical assistance facilities, rural health care clinics, and
20 29 alternative means which may be included in the long=term
20 30 community health services assessment and developmental plan.
20 31 The center for rural health and primary care shall encourage
20 32 collaborative efforts of the local boards of health, hospital
20 33 governing boards, and other public and private entities
20 34 located in rural communities to adopt a long=term community
20 35 health services assessment and developmental plan pursuant to
Senate File 446 - Introduced continued
21 1 rules adopted by the department and perform the duties
21 2 required of the Iowa department of public health in section
21 3 135B.33.
21 4 b. Provide technical assistance to assist rural
21 5 communities in improving Medicare reimbursements through the
21 6 establishment of rural health clinics, defined pursuant to 42
21 7 U.S.C. } 1395(x), and distinct part skilled nursing facility
21 8 beds.
21 9 c. Coordinate services to provide research for the
21 10 following items:
21 11 (1) Examination of the prevalence of rural occupational
21 12 health injuries in the state.
21 13 (2) Assessment of training and continuing education
21 14 available through local hospitals and others relating to
21 15 diagnosis and treatment of diseases associated with rural
21 16 occupational health hazards.
21 17 (3) Determination of continuing education support
21 18 necessary for rural health practitioners to diagnose and treat
21 19 illnesses caused by exposure to rural occupational health
21 20 hazards.
21 21 (4) Determination of the types of actions that can help
21 22 prevent agricultural accidents.
21 23 (5) Surveillance and reporting of disabilities suffered by
21 24 persons engaged in agriculture resulting from diseases or
21 25 injuries, including identifying the amount and severity of
21 26 agricultural=related injuries and diseases in the state,
21 27 identifying causal factors associated with
21 28 agricultural=related injuries and diseases, and indicating the
21 29 effectiveness of intervention programs designed to reduce
21 30 injuries and diseases.
21 31 d. Cooperate with the center for agricultural health and
21 32 safety established under section 262.78, the center for health
21 33 effects of environmental contamination established under
21 34 section 263.17, and the department of agriculture and land
21 35 stewardship. The agencies shall coordinate programs to the
Senate File 446 - Introduced continued
22 1 extent practicable.
22 2 e. Administer grants for farm safety education efforts
22 3 directed to rural families for the purpose of preventing
22 4 farm=related injuries to children.
22 5 3. The center for rural health and primary care shall
22 6 establish a primary care provider recruitment and retention
22 7 endeavor, to be known as PRIMECARRE. The endeavor shall
22 8 include a community grant program, a primary care provider
22 9 loan repayment program, and a primary care provider community
22 10 scholarship program. The endeavor shall be developed and
22 11 implemented in a manner to promote and accommodate local
22 12 creativity in efforts to recruit and retain health care
22 13 professionals to provide services in the locality. The focus
22 14 of the endeavor shall be to promote and assist local efforts
22 15 in developing health care provider recruitment and retention
22 16 programs. Eligibility under any of the programs established
22 17 under the primary care provider recruitment and retention
22 18 endeavor shall be based upon a community health services
22 19 assessment completed under subsection 2, paragraph "a". A
22 20 community or region, as applicable, shall submit a letter of
22 21 intent to conduct a community health services assessment and
22 22 to apply for assistance under this subsection. The letter
22 23 shall be in a form and contain information as determined by
22 24 the center. A letter of intent shall be submitted to the
22 25 center by January 1 preceding the fiscal year for which an
22 26 application for assistance is to be made. Assistance under
22 27 this subsection shall not be granted until such time as the
22 28 community or region making application has completed the
22 29 community health services assessment and adopted a long=term
22 30 community health services assessment and developmental plan.
22 31 In addition to any other requirements, a developmental plan
22 32 shall include a clear commitment to informing high school
22 33 students of the health care opportunities which may be
22 34 available to such students.
22 35 The center for rural health and primary care shall seek
Senate File 446 - Introduced continued
23 1 additional assistance and resources from other state
23 2 departments and agencies, federal agencies and grant programs,
23 3 private organizations, and any other person, as appropriate.
23 4 The center is authorized and directed to accept on behalf of
23 5 the state any grant or contribution, federal or otherwise,
23 6 made to assist in meeting the cost of carrying out the purpose
23 7 of this subsection. All federal grants to and the federal
23 8 receipts of the center are appropriated for the purpose set
23 9 forth in such federal grants or receipts. Funds appropriated
23 10 by the general assembly to the center for implementation of
23 11 this subsection shall first be used for securing any available
23 12 federal funds requiring a state match, with remaining funds
23 13 being used for the community grant program.
23 14 The center for rural health and primary care may, to
23 15 further the purposes of this subsection, provide financial
23 16 assistance in the form of grants to support the effort of a
23 17 community which is clearly part of the community's long=term
23 18 community health services assessment and developmental plan.
23 19 Efforts for which such grants may be awarded include, but are
23 20 not limited to, the procurement of clinical equipment,
23 21 clinical facilities, and telecommunications facilities, and
23 22 the support of locum tenens arrangements and primary care
23 23 provider mentor programs.
23 24 a. COMMUNITY GRANT PROGRAM.
23 25 (1) The center for rural health and primary care shall
23 26 adopt rules establishing an application process to be used by
23 27 the center to establish a grant assistance program as provided
23 28 in this paragraph, and establishing the criteria to be used in
23 29 evaluating the applications. Selection criteria shall include
23 30 a method for prioritizing grant applications based on
23 31 illustrated efforts to meet the health care provider needs of
23 32 the locality and surrounding area. Such assistance may be in
23 33 the form of a forgivable loan, grant, or other nonfinancial
23 34 assistance as deemed appropriate by the center. An
23 35 application submitted shall contain a commitment of at least a
Senate File 446 - Introduced continued
24 1 dollar=for=dollar match of the grant assistance. Application
24 2 may be made for assistance by a single community or group of
24 3 communities.
24 4 (2) Grants awarded under the program shall be subject to
24 5 the following limitations:
24 6 (1) (a) Ten thousand dollars for a single community or
24 7 region with a population of ten thousand or less. An award
24 8 shall not be made under this program to a community with a
24 9 population of more than ten thousand.
24 10 (2) (b) An amount not to exceed one dollar per capita for
24 11 a region in which the population exceeds ten thousand. For
24 12 purposes of determining the amount of a grant for a region,
24 13 the population of the region shall not include the population
24 14 of any community with a population of more than ten thousand
24 15 located in the region.
24 16 b. PRIMARY CARE PROVIDER LOAN REPAYMENT PROGRAM.
24 17 (1) A primary care provider loan repayment program is
24 18 established to increase the number of health professionals
24 19 practicing primary care in federally designated health
24 20 professional shortage areas of the state. Under the program,
24 21 loan repayment may be made to a recipient for educational
24 22 expenses incurred while completing an accredited health
24 23 education program directly related to obtaining credentials
24 24 necessary to practice the recipient's health profession.
24 25 (2) The center for rural health and primary care shall
24 26 adopt rules relating to the establishment and administration
24 27 of the primary care provider loan repayment program. Rules
24 28 adopted pursuant to this paragraph shall provide, at a
24 29 minimum, for all of the following:
24 30 (a) Determination of eligibility requirements and
24 31 qualifications of an applicant to receive loan repayment under
24 32 the program, including but not limited to years of obligated
24 33 service, clinical practice requirements, and residency
24 34 requirements. One year of obligated service shall be provided
24 35 by the applicant in exchange for each year of loan repayment,
Senate File 446 - Introduced continued
25 1 unless federal requirements otherwise require. Loan repayment
25 2 under the program shall not be approved for a health provider
25 3 whose license or certification is restricted by a medical
25 4 regulatory authority of any jurisdiction of the United States,
25 5 other nations, or territories.
25 6 (b) Identification of federally designated health
25 7 professional shortage areas of the state and prioritization of
25 8 such areas according to need.
25 9 (c) Determination of the amount and duration of the loan
25 10 repayment an applicant may receive, giving consideration to
25 11 the availability of funds under the program, and the
25 12 applicant's outstanding educational loans and professional
25 13 credentials.
25 14 (d) Determination of the conditions of loan repayment
25 15 applicable to an applicant.
25 16 (e) Enforcement of the state's rights under a loan
25 17 repayment program contract, including the commencement of any
25 18 court action.
25 19 (f) Cancellation of a loan repayment program contract for
25 20 reasonable cause.
25 21 (g) Participation in federal programs supporting repayment
25 22 of loans of health care providers and acceptance of gifts,
25 23 grants, and other aid or amounts from any person, association,
25 24 foundation, trust, corporation, governmental agency, or other
25 25 entity for the purposes of the program.
25 26 (h) Upon availability of state funds, determine
25 27 eligibility criteria and qualifications for participating
25 28 communities and applicants not located in federally designated
25 29 shortage areas.
25 30 (i) Other rules as necessary.
25 31 (3) The center for rural health and primary care may enter
25 32 into an agreement under chapter 28E with the college student
25 33 aid commission for the administration of this program.
25 34 c. PRIMARY CARE PROVIDER COMMUNITY SCHOLARSHIP PROGRAM.
25 35 (1) A primary care provider community scholarship program
Senate File 446 - Introduced continued
26 1 is established to recruit and to provide scholarships to train
26 2 primary health care practitioners in federally designated
26 3 health professional shortage areas of the state. Under the
26 4 program, scholarships may be awarded to a recipient for
26 5 educational expenses incurred while completing an accredited
26 6 health education program directly related to obtaining the
26 7 credentials necessary to practice the recipient's health
26 8 profession.
26 9 (2) The department shall adopt rules relating to the
26 10 establishment and administration of the primary care provider
26 11 community scholarship program. Rules adopted pursuant to this
26 12 paragraph shall provide, at a minimum, for all of the
26 13 following:
26 14 (a) Determination of eligibility requirements and
26 15 qualifications of an applicant to receive scholarships under
26 16 the program, including but not limited to years of obligated
26 17 service, clinical practice requirements, and residency
26 18 requirements. One year of obligated service shall be provided
26 19 by the applicant in exchange for each year of scholarship
26 20 receipt, unless federal requirements otherwise require.
26 21 (b) Identification of federally designated health
26 22 professional shortage areas of the state and prioritization of
26 23 such areas according to need.
26 24 (c) Determination of the amount of the scholarship an
26 25 applicant may receive.
26 26 (d) Determination of the conditions of scholarship to be
26 27 awarded to an applicant.
26 28 (e) Enforcement of the state's rights under a scholarship
26 29 contract, including the commencement of any court action.
26 30 (f) Cancellation of a scholarship contract for reasonable
26 31 cause.
26 32 (g) Participation in federal programs supporting
26 33 scholarships for health care providers and acceptance of
26 34 gifts, grants, and other aid or amounts from any person,
26 35 association, foundation, trust, corporation, governmental
Senate File 446 - Introduced continued
27 1 agency, or other entity for the purposes of the program.
27 2 (h) Upon availability of state funds, determination of
27 3 eligibility criteria and qualifications for participating
27 4 communities and applicants not located in federally designated
27 5 shortage areas.
27 6 (i) Other rules as necessary.
27 7 (3) The center for rural health and primary care may enter
27 8 into an agreement under chapter 28E with the college student
27 9 aid commission for the administration of this program.
27 10 4. a. Eligibility under any of the programs established
27 11 under the primary care provider recruitment and retention
27 12 endeavor shall be based upon a community health services
27 13 assessment completed under subsection 2, paragraph "a". A
27 14 community or region, as applicable, shall submit a letter of
27 15 intent to conduct a community health services assessment and
27 16 to apply for assistance under this subsection. The letter
27 17 shall be in a form and contain information as determined by
27 18 the center. A letter of intent shall be submitted to the
27 19 center by January 1 preceding the fiscal year for which an
27 20 application for assistance is to be made.
27 21 b. Assistance under this subsection shall not be granted
27 22 until such time as the community or region making application
27 23 has completed the community health services assessment and
27 24 adopted a long=term community health services assessment and
27 25 developmental plan. In addition to any other requirements, a
27 26 developmental plan shall include a clear commitment to
27 27 informing high school students of the health care
27 28 opportunities which may be available to such students.
27 29 c. The center for rural health and primary care shall seek
27 30 additional assistance and resources from other state
27 31 departments and agencies, federal agencies and grant programs,
27 32 private organizations, and any other person, as appropriate.
27 33 The center is authorized and directed to accept on behalf of
27 34 the state any grant or contribution, federal or otherwise,
27 35 made to assist in meeting the cost of carrying out the purpose
Senate File 446 - Introduced continued
28 1 of this subsection. All federal grants to and the federal
28 2 receipts of the center are appropriated for the purpose set
28 3 forth in such federal grants or receipts. Funds appropriated
28 4 by the general assembly to the center for implementation of
28 5 this subsection shall first be used for securing any available
28 6 federal funds requiring a state match, with remaining funds
28 7 being used for the community grant program.
28 8 d. The center for rural health and primary care may, to
28 9 further the purposes of this subsection, provide financial
28 10 assistance in the form of grants to support the effort of a
28 11 community which is clearly part of the community's long=term
28 12 community health services assessment and developmental plan.
28 13 Efforts for which such grants may be awarded include but are
28 14 not limited to the procurement of clinical equipment, clinical
28 15 facilities, and telecommunications facilities, and the support
28 16 of locum tenens arrangements and primary care provider mentor
28 17 programs.
28 18 5. a. There is established an advisory committee to the
28 19 center for rural health and primary care consisting of one
28 20 representative, approved by the respective agency, of each of
28 21 the following agencies: the department of agriculture and
28 22 land stewardship, the Iowa department of public health, the
28 23 department of inspections and appeals, the national institute
28 24 for rural health policy, the rural health resource center, the
28 25 institute of agricultural medicine and occupational health,
28 26 and the Iowa state association of counties. The governor
28 27 shall appoint two representatives of consumer groups active in
28 28 rural health issues and a representative of each of two farm
28 29 organizations active within the state, a representative of an
28 30 agricultural business in the state, a practicing rural family
28 31 physician, a practicing rural physician assistant, a
28 32 practicing rural advanced registered nurse practitioner, and a
28 33 rural health practitioner who is not a physician, physician
28 34 assistant, or advanced registered nurse practitioner, as
28 35 members of the advisory committee. The advisory committee
Senate File 446 - Introduced continued
29 1 shall also include as members two state representatives, one
29 2 appointed by the speaker of the house of representatives and
29 3 one by the minority leader of the house, and two state
|