CHAPTER 24
RURAL IOWA PRIMARY CARE LOAN REPAYMENT PROGRAM
283—24.1(261) Rural Iowa primary care loan repayment program. The rural Iowa primary care loan repayment program is a state-supported and administered loan repayment program for students who agree to practice as physicians in service commitment areas for five consecutive years and meet the requirements of these rules.
[ARC 1320C, IAB 2/19/14, effective 3/26/14; ARC 1685C, IAB 10/29/14, effective 12/3/14]
283—24.2(261) Definitions. As used in this chapter:
“Eligible loan” means the physician’s total subsidized, unsubsidized, and consolidated Federal Stafford Loan amount under the Federal Family Education Loan Program, Federal Direct Loan Program, federal Graduate PLUS Loan, or federal Perkins Loan, including principal and interest. Only the outstanding portion of a federal consolidation loan that was used to repay an eligible subsidized or unsubsidized Federal Stafford Loan qualifies for loan repayment.
“Eligible university” means either the State University of Iowa Carver College of Medicine or Des Moines University College of Osteopathic Medicine.
“Maximum award” means the maximum amount of loan repayments that the physician can receive after completing all obligations under the rural Iowa primary care loan repayment program, not to exceed a total of $200,000. The maximum award can be applied only to eligible loans; thus, payments cannot exceed the outstanding eligible loan balance at the time of payment.
“Physician” means an individual who holds a practitioner’s license issued by an agency or board under the Iowa department of public health and is employed in the practice of medicine and surgery or osteopathic medicine and surgery, specializing in family medicine, pediatrics, psychiatry, internal medicine, or general surgery.
“Residency program” means an accredited medical residency program located in the state of Iowa in which the residency is physically performed in the state of Iowa.
“Service commitment area” means a medically underserved Iowa city with a population of less than 26,000 that is located more than 20 miles from a city with a population of 50,000 or more. Each physician participating in the program must contract with the service commitment area to ensure the service commitment area provides a nonrefundable $20,000 contribution for deposit in the rural Iowa primary care trust fund. Payment of the nonrefundable contribution to the trust fund can be made by, but is not limited to, the following organizations: community agencies, hospitals, medical groups, municipalities, community foundations, local government entities, or other community entities. Locations and distances between cities will be consistently measured and verified by calculating the straight-line distance between main post offices.
[ARC 1320C, IAB 2/19/14, effective 3/26/14; ARC 1685C, IAB 10/29/14, effective 12/3/14]
283—24.3(261) Eligibility requirements.
	24.3(1) An eligible university will recommend up to ten applicants to the commission for loan repayment benefits. Priority will be given to students who are Iowa residents upon enrolling in the eligible university. The criteria used by the state board of regents to determine residency for tuition purposes, Iowa Administrative Code rule 681—1.4(262), are adopted for this program. The percentage of the agreements to be entered into by students attending each eligible university shall be evenly divided.
	a. 	The commission will annually determine and communicate the number of recommendations that can be funded at each eligible university.
	b. 	If fewer than the recommendations in 24.3(1)“a” are fulfilled by students at one eligible university, the commission may obtain additional recommendations from the other eligible university to award the remaining agreements.
	24.3(2) An applicant must enter into an agreement with the commission during the applicant’s final year of study leading to a doctor of medicine or osteopathy degree.
	24.3(3) An applicant must be enrolled on a full-time basis and graduate with a doctor of medicine or osteopathy degree from an eligible university. The commission may waive the full-time enrollment requirement for a temporary time frame only in the instance of a leave of absence approved by an eligible university. The applicant must request a waiver from the commission in writing.
	24.3(4) An applicant must apply for, enter, and complete a residency program in Iowa.
	24.3(5) Within nine months of graduating from the residency program, an applicant must receive a permanent license to practice medicine and surgery or osteopathic medicine and surgery in the state of Iowa and engage in full-time practice, as defined by the service commitment area, of medicine and surgery or osteopathic medicine and surgery specializing in family medicine, pediatrics, psychiatry, internal medicine, or general surgery for a period of five consecutive years in a service commitment area.
	24.3(6) An applicant must annually complete and return to the commission an affidavit of acceptance into and completion of residency programs and acceptance of and completion of employment obligations in a service commitment area.
	24.3(7) Prior to or upon engagement in full-time employment in a service commitment area, the physician must contract with a service commitment area to provide a nonrefundable $20,000 contribution for deposit in the rural Iowa primary care trust fund. Payment must be received by the commission from a service commitment area prior to payment of any loan repayment awards.
	24.3(8) Failure by the applicant to meet all eligibility requirements under this rule and in the agreement will result in forfeiture of all remaining unpaid payments.
[ARC 1320C, IAB 2/19/14, effective 3/26/14; ARC 1685C, IAB 10/29/14, effective 12/3/14]
283—24.4(261) Awarding of funds.
	24.4(1) Prior to accepting an offer of employment, the physician must notify the commission of the service commitment area in which the physician will be employed, and the commission will verify the eligibility of the service commitment area.
	24.4(2) The maximum award will be paid to the physician’s eligible loan holder in five equal installments, upon successful completion of each of five 12-month employment obligations. Failure to complete all, or any portion, of the five-consecutive-year employment obligation will result in the forfeiture of all remaining unpaid payments. A physician who fails to meet the requirements of these rules may also be subject to repayment of moneys advanced by the service commitment area as provided in any contract between the physician and the service commitment area.
	24.4(3) No loan repayment amounts will be paid until the service commitment area provides the nonrefundable $20,000 contribution for deposit into the rural Iowa primary care trust fund.
[ARC 1320C, IAB 2/19/14, effective 3/26/14; ARC 1685C, IAB 10/29/14, effective 12/3/14]
283—24.5(261) Waivers.
	24.5(1) Service commitment area. The commission may waive the requirement that the physician practice in the same service commitment area for five years. The physician must request a waiver from the commission in writing.
	24.5(2) Full-time employment. The commission may waive the requirement that the physician be employed full-time if the physician demonstrates exceptional circumstances. The physician must request a waiver from the commission in writing. If a waiver request is granted by the commission, the agreement will be amended to provide an allowance for part-time employment. The five-year employment obligation will be proportionally extended to ensure the physician is employed in a service commitment area for the equivalent of five full-time years.
	24.5(3) Postponement of physician employment. The physician obligation to engage in practice in accordance with 24.3(5) may be postponed for no more than two years from the time full-time practice was to commence. The physician must request a waiver from the commission in writing for one of the following purposes:
	a. 	Active duty service in the armed forces, the armed forces military reserve, or the national guard.
	b. 	Service in Volunteers in Service to America or the federal Peace Corps.
	c. 	A service commitment to the United States Public Health Service Commissioned Corps.
	d. 	A period of religious missionary work conducted by an organization exempt from federal income taxation pursuant to Section 501(c)(3) of the Internal Revenue Code.
The physician obligation to engage in practice in accordance with 24.3(5) may be postponed for a period exceeding two years for any period of temporary medical incapacity, including leave approved under the Family and Medical Leave Act, during which the physician is unable to engage in full-time practice. The physician must request a waiver from the commission in writing.
	24.5(4) Satisfaction of physician employment. All obligations under the rural Iowa primary care loan repayment program are considered to be satisfied when any of the following conditions are met:
	a. 	All terms of the agreement are met.
	b. 	The person who entered into the agreement dies.
	c. 	The person who entered into the agreement, due to permanent disability, is unable to meet the requirements of these rules.
	d. 	The person who entered into the agreement has no remaining eligible loan balance to repay.
[ARC 1320C, IAB 2/19/14, effective 3/26/14; ARC 1685C, IAB 10/29/14, effective 12/3/14]
283—24.6(261) Loan repayment cancellation.
	24.6(1) Within 30 days following withdrawal from an eligible university, or termination of employment from a residency program or as a physician in a service commitment area, the applicant must notify the commission.
	24.6(2) The applicant is responsible for notifying the commission immediately of a change in contact information including, but not limited to, name, telephone number, e-mail address, and place of employment.
[ARC 1320C, IAB 2/19/14, effective 3/26/14]
283—24.7(261) Restrictions. A physician who is in default on a Federal Stafford Loan, Grad PLUS Loan, SLS Loan, Perkins/National Direct/National Defense Student Loan, Health Professions Student Loan (HPSL), or Health Education Assistance Loan (HEAL) or who owes a repayment on any Title IV grant assistance or state award shall be ineligible for loan repayment. Eligibility may be reinstated upon payment in full of the delinquent obligation or by commission ruling on the basis of adequate extenuating evidence presented in appeal under the procedures set forth in 283—Chapters 4 and 5.
[ARC 1320C, IAB 2/19/14, effective 3/26/14]
These rules are intended to implement Iowa Code section 261.113 as amended by 2014 Iowa Acts, Senate File 2347.
[Filed ARC 1320C (Notice ARC 1121C, IAB 10/16/13), IAB 2/19/14, effective 3/26/14]
[Filed ARC 1685C (Notice ARC 1586C, IAB 8/20/14), IAB 10/29/14, effective 12/3/14]