S.F. 458 Section 1. NEW SECTION . 135.191 Psychiatric practitioner 1 loan repayment program. 2 1. For the purposes of this section: 3 a. “Psychiatric practitioner” means a psychiatrist licensed 4 pursuant to chapter 148, a psychiatric advanced registered 5 nurse practitioner as defined in section 125.2 or 229.1, or a 6 physician assistant with a certificate of added qualifications 7 in mental health or psychiatry or practicing under the 8 supervision of a psychiatrist. 9 b. “Qualified provider” means a community mental health 10 center designated in accordance with chapter 230A, a provider 11 designated to serve as the community mental health center by 12 the county in which the provider is located, or a health care 13 provider that is a nonprofit organization which is exempt from 14 federal income taxation pursuant to section 501(c)(3) of the 15 Internal Revenue Code serving patients of whom at least forty 16 percent are Medicaid program recipients that is located in an 17 area that is not a federally designated health professional 18 shortage area. 19 2. The department shall establish a psychiatric 20 practitioner loan repayment program to provide loan repayment 21 to psychiatric practitioners who comply with the requirements 22 of the program and are employed by qualified providers. 23 3. An applicant for loan repayment under this section shall, 24 in accordance with the rules of the department, do all of the 25 following: 26 a. Complete and file an application, including any 27 information required by the department. The applicant shall 28 be responsible for the prompt submission of any information 29 required by the department. 30 b. Complete and return, on a form approved by the 31 department, an affidavit of practice verifying that the 32 applicant is a psychiatric practitioner employed by a qualified 33 provider. 34 4. A program agreement shall provide that in order to 35 -1- LSB 2234SV (3) 87 pf/nh 1/ 5

S.F. 458 receive loan repayment under this section, the individual shall 1 agree to engage in practice as a psychiatric practitioner with 2 a qualified provider for a period of at least four consecutive 3 years. 4 5. a. A psychiatric practitioner who meets the requirements 5 of this section is eligible for loan repayments for not more 6 than four consecutive years. 7 b. The annual amount of loan repayment awarded to a 8 psychiatric practitioner under this section shall be based on 9 the amount of the psychiatric practitioner’s outstanding loans 10 and shall not exceed twenty-five thousand dollars for each 11 completed full-time work year which commences upon employment 12 with a qualified provider. For psychiatric practitioners who 13 work less than full-time, the loan repayment shall not exceed 14 an amount that is prorated according to the number of hours 15 worked. 16 c. A psychiatric practitioner receiving loan repayment 17 under this section shall file an initial application with the 18 department and shall submit information annually as required by 19 the department on the basis of which the applicant’s continued 20 eligibility for the loan repayment program will be evaluated 21 and determined. 22 6. Moneys appropriated for the program shall be deposited 23 in the health care workforce shortage fund created in section 24 135.175, and notwithstanding section 135.175, subsection 6, 25 paragraph “c” , are appropriated to the department specifically 26 to be used for the purposes of the program. 27 7. The department shall submit in a report to the general 28 assembly by January 1, annually, the number of psychiatric 29 practitioners who received loan repayments pursuant to this 30 section, the amount paid to each psychiatric practitioner under 31 this section, and any other information the department deems 32 appropriate. 33 8. The department shall adopt rules pursuant to chapter 17A 34 to administer this section. 35 -2- LSB 2234SV (3) 87 pf/nh 2/ 5

S.F. 458 Sec. 2. Section 135.175, subsection 6, paragraph b, Code 1 2017, is amended to read as follows: 2 b. State programs that may receive funding from the fund 3 and the accounts in the fund, if specifically designated for 4 the purpose of drawing down federal funding or if specifically 5 created to address health care workforce shortages in the 6 state , are the primary care recruitment and retention endeavor 7 (PRIMECARRE), the Iowa affiliate of the national rural 8 recruitment and retention network, the primary care office 9 shortage designation program, the state office of rural 10 health, and the Iowa health workforce center, administered 11 through the bureau of health care access of the department of 12 public health; the area health education centers programs at 13 Des Moines university —— osteopathic medical center and the 14 university of Iowa; the Iowa collaborative safety net provider 15 network established pursuant to section 135.153 ; any entity 16 identified by the federal government entity through which 17 federal funding for a specified health care workforce shortage 18 initiative is received; the psychiatric practitioner loan 19 repayment program created in section 135.191; and a program 20 developed in accordance with the strategic plan developed by 21 the department of public health in accordance with sections 22 135.163 and 135.164 . 23 EXPLANATION 24 The inclusion of this explanation does not constitute agreement with 25 the explanation’s substance by the members of the general assembly. 26 This bill directs the department of public health 27 (department) to establish a psychiatric practitioner loan 28 repayment program to be administered by the department to 29 provide repayment of loans to psychiatric practitioners who 30 comply with the requirements of the program and are employed 31 by a qualified provider. 32 The bill defines “psychiatric practitioner” as a 33 psychiatrist, psychiatric advanced registered nurse 34 practitioner, or a physician assistant with a certificate 35 -3- LSB 2234SV (3) 87 pf/nh 3/ 5

S.F. 458 of added qualifications in mental health or psychiatry or 1 practicing under the supervision of a psychiatrist; and 2 “qualified provider” as a community mental health center, a 3 provider designated to serve as the community mental health 4 center by the county in which the provider is located, or 5 a 501(c)(3) nonprofit mental health provider that serves 6 patients, of whom at least 40 percent are Medicaid program 7 recipients that is located in an area that is not a federally 8 designated health professional shortage area. 9 The bill requires an applicant to complete and file an 10 application, including any information required by the 11 department, and complete and return on a form approved by 12 the department, an affidavit of practice verifying that the 13 applicant is a psychiatric practitioner employed by a qualified 14 provider. 15 The program agreement is to provide that in order to 16 receive loan repayment, the individual shall agree to engage 17 in practice as a psychiatric practitioner with a qualified 18 provider for a period of at least four consecutive years. 19 A psychiatric practitioner is eligible for loan repayments 20 for not more than four consecutive years. The annual amount 21 of the loan repayment awarded shall be based on the amount of 22 the psychiatric practitioner’s outstanding loans and shall not 23 exceed $25,000 for each completed full-time work year which 24 commences upon employment with a qualified provider. For 25 psychiatric practitioners who work less than full-time, the 26 loan repayment shall not exceed an amount that is prorated 27 according to the number of hours worked. 28 A psychiatric practitioner receiving loan repayment shall 29 file an initial application and shall submit information, 30 annually, as required by the department on the basis of which 31 the applicant’s continued eligibility for the loan repayment 32 program will be evaluated and determined. 33 The bill provides that moneys appropriated for the program 34 shall be deposited in the health care workforce shortage fund 35 -4- LSB 2234SV (3) 87 pf/nh 4/ 5

S.F. 458 and are appropriated to the department specifically to be used 1 for the purposes of the program. 2 The bill requires the department to submit in a report to 3 the general assembly by January 1, annually, the number of 4 psychiatric practitioners who received loan repayments, the 5 amount paid to each psychiatric practitioner, and any other 6 information the department deems appropriate. 7 The department is required to adopt rules to administer the 8 bill. 9 -5- LSB 2234SV (3) 87 pf/nh 5/ 5