S.F. 117 Section 1. NEW SECTION . 261.7A Rural Iowa chiropractic care 1 loan repayment program —— fund —— appropriations. 2 1. Program established. A rural Iowa chiropractic care 3 loan repayment program is established to be administered by the 4 college student aid commission for purposes of providing loan 5 repayments for resident graduate students who agree to practice 6 as chiropractors in service commitment areas for five years and 7 meet the requirements of this section . 8 2. Eligibility. An individual is eligible to apply to enter 9 into a program agreement with the commission if the individual 10 is enrolled full-time in and receives a recommendation from an 11 eligible institution in a curriculum leading to a chiropractic 12 degree. 13 3. Program agreements. A program agreement shall be 14 entered into by an eligible student and the commission when 15 the eligible student begins the curriculum leading to a 16 chiropractic degree. Under the agreement, to receive loan 17 repayments pursuant to subsection 5 , an eligible student shall 18 agree to and shall fulfill all of the following requirements: 19 a. Receive a chiropractic degree from an eligible 20 institution and apply for, enter, and complete a residency 21 program approved by the commission. 22 b. Apply for and obtain a license to practice chiropractic 23 in this state. 24 c. Complete the residency program requirement with an 25 Iowa-based residency program. 26 d. Within nine months of graduating from the residency 27 program and receiving a permanent license in accordance with 28 paragraph “b” , engage in the full-time practice of chiropractic 29 for a period of sixty consecutive months in the service 30 commitment area specified under subsection 6 , unless the loan 31 repayment recipient receives a waiver from the commission to 32 complete the months of practice required under the agreement in 33 another service commitment area pursuant to subsection 6 . 34 4. Priority to Iowa residents. The commission shall give 35 -1- LSB 1038XS (7) 85 je/nh 1/ 6

S.F. 117 priority to eligible students who are residents of Iowa upon 1 enrolling in the institution. 2 5. Loan repayment amounts. 3 a. The amount of loan repayment an eligible student who 4 enters into an agreement pursuant to subsection 3 shall receive 5 upon fulfilling the requirements of subsection 3 shall be not 6 more than fifty thousand dollars annually for an eligible loan. 7 Payments under this section are limited to a four-year period 8 and shall not exceed a total of two hundred thousand dollars. 9 b. The commission shall not enter into more than twenty 10 program agreements annually. 11 6. Selection of service commitment area. A loan repayment 12 recipient shall notify the commission of the recipient’s 13 service commitment area prior to beginning practice in the area 14 in accordance with subsection 3 , paragraph “d” . The commission 15 may waive the requirement that the loan repayment recipient 16 practice in the same service commitment area for all sixty 17 months. 18 7. Rules for additional loan repayment. The commission 19 shall adopt rules to provide, in addition to loan repayment 20 provided to eligible students pursuant to this section and 21 subject to the availability of surplus funds, loan repayment 22 to a chiropractor who received a chiropractic degree from an 23 eligible institution as provided in subsection 2 , obtained a 24 license to practice chiropractic in this state, completed the 25 chiropractor’s residency program requirement with an Iowa-based 26 residency program, and is engaged in the full-time practice of 27 chiropractic as specified in subsection 3 , paragraph “d” . 28 8. Part-time practice —— agreement amended. A person who 29 entered into an agreement pursuant to subsection 3 may apply 30 to the commission to amend the agreement to allow the person 31 to engage in less than the full-time practice specified in 32 the agreement and under subsection 3 , paragraph “d” . If the 33 commission determines exceptional circumstances exist, the 34 commission and the person may consent to amend the agreement 35 -2- LSB 1038XS (7) 85 je/nh 2/ 6

S.F. 117 under which the person shall engage in less than full-time 1 practice of chiropractic in a service commitment area for 2 an extended period of part-time practice determined by the 3 commission to be proportional to the amount of full-time 4 practice remaining under the original agreement. 5 9. Postponement and satisfaction of service obligation. 6 a. The obligation to engage in practice in accordance with 7 subsection 3 shall be postponed for the following purposes: 8 (1) Active duty status in the armed forces, the armed forces 9 military reserve, or the national guard. 10 (2) Service in volunteers in service to America. 11 (3) Service in the federal peace corps. 12 (4) A period of service commitment to the United States 13 public health service commissioned corps. 14 (5) A period of religious missionary work conducted by an 15 organization exempt from federal income taxation pursuant to 16 section 501(c)(3) of the Internal Revenue Code. 17 (6) Any period of temporary medical incapacity during which 18 the person obligated is unable, due to a medical condition, to 19 engage in full-time practice as required under subsection 3 , 20 paragraph “d” . 21 b. Except for a postponement under paragraph “a” , 22 subparagraph (6), an obligation to engage in practice under an 23 agreement entered into pursuant to subsection 3 , shall not be 24 postponed for more than two years from the time the full-time 25 practice was to have commenced under the agreement. 26 c. An obligation to engage in full-time practice under 27 an agreement entered into pursuant to subsection 3 shall be 28 considered satisfied when any of the following conditions are 29 met: 30 (1) The terms of the agreement are completed. 31 (2) The person who entered into the agreement dies. 32 (3) The person who entered into the agreement, due to a 33 permanent disability, is unable to practice chiropractic. 34 10. Trust fund established. A rural Iowa chiropractic care 35 -3- LSB 1038XS (7) 85 je/nh 3/ 6

S.F. 117 trust fund is created in the state treasury as a separate fund 1 under the control of the commission. The commission shall 2 remit all repayments made pursuant to this section to the rural 3 Iowa chiropractic care trust fund. All moneys deposited or 4 paid into the trust fund are appropriated and made available 5 to the commission to be used for meeting the requirements of 6 this section . Moneys in the fund up to the total amount that an 7 eligible student may receive for an eligible loan in accordance 8 with this section and upon fulfilling the requirements of 9 subsection 3 , shall be considered encumbered for the duration 10 of the agreement entered into pursuant to subsection 3 . 11 Notwithstanding section 8.33 , any balance in the fund on June 12 30 of each fiscal year shall not revert to the general fund of 13 the state, but shall be available for purposes of this section 14 in subsequent fiscal years. 15 11. Definitions. For purposes of this section : 16 a. “Eligible institution” means an Iowa chiropractic college 17 or university that meets the requirements for approval under 18 section 151.4. 19 b. “Eligible loan” means the chiropractor’s total federally 20 guaranteed Stafford loan amount under the federal family 21 education loan program or the federal direct loan program, 22 including principal and interest. 23 c. “Service commitment area” means a city in Iowa with a 24 population of less than twenty-six thousand that is located 25 more than twenty miles from a city with a population of fifty 26 thousand or more and which provides a twenty thousand dollar 27 contribution for deposit in the rural Iowa chiropractic care 28 trust fund for each chiropractor in the community who is 29 participating in the loan repayment program. 30 EXPLANATION 31 This bill establishes a rural Iowa chiropractic care loan 32 repayment program to be administered by the college student aid 33 commission for purposes of providing loan repayment to resident 34 graduate students who agree to practice as chiropractors in 35 -4- LSB 1038XS (7) 85 je/nh 4/ 6

S.F. 117 service commitment areas for five years, and establishes a 1 rural Iowa chiropractic care trust fund. 2 An individual is eligible to apply to the commission to enter 3 into a program agreement with the commission if the individual 4 is enrolled in an Iowa chiropractic college or university in a 5 curriculum leading to a chiropractic degree. 6 Under the agreement, the eligible student will receive up 7 to $50,000 per year for a four-year period of loan repayment 8 for an eligible loan if the eligible student receives a 9 chiropractic degree; applies for, enters, and completes a 10 residency program approved by the commission; applies for and 11 obtains a license to practice chiropractic in this state; and, 12 within nine months of receiving a license, engages in the 13 full-time practice of chiropractic for 60 consecutive months 14 in the service commitment area, unless the loan repayment 15 recipient receives a waiver from the commission to complete 16 the months of practice required under the agreement in another 17 service commitment area. 18 A service commitment area is defined to mean a city in Iowa 19 with a population of less than 26,000 that is located more than 20 20 miles from a city with a population of 50,000 or more and 21 which provides a $20,000 contribution for deposit in the fund 22 for each chiropractor in the community who is participating in 23 the program. 24 The bill defines “eligible loan” to mean a federally 25 guaranteed Stafford loan. 26 The commission shall give priority to eligible students who 27 are residents of Iowa upon enrolling in the institution. 28 Not more than 20 program agreements may be entered into 29 annually. 30 A person may apply to the commission to amend the agreement 31 to allow the person to engage in less than full-time practice. 32 If the commission determines exceptional circumstances 33 exist, the commission and the person may consent to amend 34 the agreement to provide for an extended period of part-time 35 -5- LSB 1038XS (7) 85 je/nh 5/ 6

S.F. 117 practice determined by the commission to be proportional to 1 the amount of full-time practice remaining under the original 2 agreement. 3 The obligation shall be considered satisfied when the 4 terms of the agreement are completed, the person dies, or the 5 person, due to a permanent disability, is unable to practice 6 chiropractic. 7 The bill directs the commission to adopt rules to provide, 8 subject to the availability of surplus funds, loan repayment 9 to a chiropractor who did not enter into an agreement as a 10 resident graduate student but who meets the other relevant 11 requirements of the program. 12 -6- LSB 1038XS (7) 85 je/nh 6/ 6