H.F. _____ Section 1. NEW SECTION . 261.117 Prescribing mental 1 health practitioner loan repayment program —— trust fund —— 2 appropriation. 3 1. Program established. The commission shall establish a 4 prescribing mental health practitioner loan repayment program 5 for the purposes of providing loan repayments for prescribing 6 mental health practitioners who agree to practice in service 7 commitment areas for at least five years and who meet the 8 requirements of this section. 9 2. Eligibility. An individual is eligible to apply to enter 10 into a program agreement with the commission if the individual 11 is enrolled full-time in and receives a recommendation from an 12 eligible university in a curriculum leading to licensure as a 13 prescribing mental health practitioner. 14 3. Program agreements. A program agreement shall be 15 entered into by an eligible student and the commission when 16 the eligible student begins the final year of study in an 17 academic program leading to eligibility for licensure as a 18 prescribing mental health practitioner. Under the agreement, 19 to receive loan repayments pursuant to subsection 5, an 20 eligible student shall agree to and shall fulfill all of the 21 following requirements: 22 a. Receive a graduate-level credential qualifying the 23 credential recipient for a license to practice as a prescribing 24 mental health practitioner. 25 b. Receive a license to practice as a prescribing mental 26 health practitioner in this state. 27 c. Complete any applicable residency or certification 28 program requirement with an Iowa-based residency or 29 certification program. 30 d. Within nine months of graduating from the applicable 31 professional program, residency program, or certification 32 program and receiving a permanent license in accordance with 33 paragraph “b” , engage in full-time practice as a prescribing 34 mental health practitioner for a period of five years in a 35 -1- LSB 5467YC (5) 89 pf/rh 1/ 8

H.F. _____ service commitment area. 1 4. Priority to Iowa residents. The commission shall give 2 priority to eligible students who are residents of Iowa upon 3 enrolling in the university. 4 5. Loan repayment amounts. 5 a. The amount of loan repayment an eligible student who 6 enters into an agreement pursuant to subsection 3 shall receive 7 if in compliance with obligations under the agreement shall be 8 as follows: 9 (1) For a psychiatrist, forty thousand dollars annually 10 with a maximum of two hundred thousand dollars for an eligible 11 loan, not to exceed the total loan amount. 12 (2) For a prescribing psychologist, eight thousand dollars 13 annually with a maximum of forty thousand dollars for an 14 eligible loan, not to exceed the total loan amount. 15 (3) For a psychiatric advanced registered nurse 16 practitioner, ten thousand dollars annually with a maximum of 17 fifty thousand dollars, not to exceed the total loan amount. 18 b. If the total amount of the eligible student’s loan 19 upon graduation is less than the maximum amount specified, 20 the commission shall divide the total amount of the eligible 21 student’s eligible loan by five to determine the annual amount 22 of loan repayment the loan recipient is eligible to receive. 23 c. Payments under this section may be made for each year of 24 eligible practice during a period of five consecutive years. 25 6. Refinanced loans. A loan repayment recipient who 26 refinances an eligible loan by obtaining a private educational 27 loan may continue to receive loan repayment under this section 28 if the amount of loan repayment does not exceed the lesser of 29 the amount specified in subsection 5 or the balance of the loan 30 repayment amount the loan repayment recipient qualified to 31 receive with the eligible loan. 32 7. Program agreement limitation. The commission shall 33 by rule determine the number of agreements entered into 34 annually based upon the funding available. The percentage of 35 -2- LSB 5467YC (5) 89 pf/rh 2/ 8

H.F. _____ agreements entered into by eligible students attending eligible 1 universities shall be evenly divided. However, if there are 2 fewer applicants at one eligible university, eligible student 3 applicants enrolled in other eligible universities may be 4 awarded the remaining agreements. 5 8. Selection of service commitment area. A loan repayment 6 recipient shall notify the commission of the recipient’s 7 service commitment area prior to beginning practice in the area 8 in accordance with subsection 3, paragraph “d” . The commission 9 may waive the requirement that the loan repayment recipient 10 practice in the same service commitment area for all five 11 years. 12 9. Rules for additional loan repayment. The commission 13 shall adopt rules to provide, in addition to loan repayment 14 provided to eligible students pursuant to this section and 15 subject to the availability of surplus funds, loan repayment 16 to a psychiatrist, prescribing psychologist, or psychiatric 17 advanced registered nurse practitioner, who, as provided in 18 subsection 3, received a degree from an eligible university, 19 obtained a license to practice in this state, and is engaged in 20 full-time practice in the respective profession in a service 21 commitment area. 22 10. Part-time practice —— agreement amended. A person who 23 entered into an agreement pursuant to subsection 3 may apply 24 to the commission to amend the agreement to allow the person 25 to engage in less than the full-time practice specified in the 26 agreement and under subsection 3, paragraph “d” . The commission 27 and the person may consent to amend the agreement under which 28 the person shall engage in less than full-time practice in a 29 service commitment area for an extended period of part-time 30 practice determined by the commission to be proportional to 31 the amount of full-time practice remaining under the original 32 agreement. For purposes of this subsection, “less than 33 the full-time practice” means at least seventy percent of a 34 forty-hour workweek. 35 -3- LSB 5467YC (5) 89 pf/rh 3/ 8

H.F. _____ 11. Postponement and satisfaction of service obligation. 1 a. The obligation to engage in practice in accordance with 2 subsection 3 shall be postponed for the following purposes: 3 (1) Active duty status in the armed forces, the armed forces 4 military reserve, or the national guard. 5 (2) Service in volunteers in service to America. 6 (3) Service in the federal peace corps. 7 (4) A period of service commitment to the United States 8 public health service commissioned corps. 9 (5) A period of religious missionary work conducted by an 10 organization exempt from federal income taxation pursuant to 11 section 501(c)(3) of the Internal Revenue Code. 12 (6) Any period of temporary medical incapacity during which 13 the person obligated is unable, due to a medical condition, to 14 engage in full-time practice as required under subsection 3, 15 paragraph “d” . 16 b. Except for a postponement under paragraph “a” , 17 subparagraph (6), an obligation to engage in practice under an 18 agreement entered into pursuant to subsection 3 shall not be 19 postponed for more than two years from the time the full-time 20 practice was to have commenced under the agreement. 21 c. An obligation to engage in full-time practice under 22 an agreement entered into pursuant to subsection 3 shall be 23 considered satisfied when any of the following conditions are 24 met: 25 (1) The terms of the agreement are completed. 26 (2) The person who entered into the agreement dies. 27 (3) The person who entered into the agreement, due to a 28 permanent disability, is unable to practice as a prescribing 29 mental health practitioner. 30 d. If a loan repayment recipient fails to fulfill 31 the obligation to engage in practice in accordance with 32 subsection 3, the recipient shall be subject to repayment to 33 the commission of the loan amount plus interest as specified 34 by rule. A loan repayment recipient who fails to meet the 35 -4- LSB 5467YC (5) 89 pf/rh 4/ 8

H.F. _____ requirements of the obligation to engage in practice in 1 accordance with subsection 3 may also be subject to repayment 2 of moneys advanced by the service commitment area as provided 3 in any agreement with the service commitment area. 4 12. Trust fund established. A prescribing mental health 5 practitioner loan repayment program trust fund is created in 6 the state treasury as a separate fund under the control of 7 the commission. The commission shall remit all repayments 8 made pursuant to this section to the trust fund. All moneys 9 deposited or paid into the trust fund are appropriated and 10 made available to the commission to be used for meeting the 11 requirements of this section. Moneys in the trust fund up 12 to the total amount that an eligible student may receive 13 for an eligible loan in accordance with this section and 14 upon fulfilling the requirements of subsection 3, shall be 15 considered encumbered for the duration of the agreement entered 16 into pursuant to subsection 3. Notwithstanding section 8.33, 17 any balance in the trust fund on June 30 of each fiscal year 18 shall not revert to the general fund of the state, but shall 19 be available for purposes of this section in subsequent fiscal 20 years. 21 13. Report. The commission shall submit in a report to 22 the general assembly by January 1, annually, the number of 23 individuals who received loan repayment pursuant to this 24 section, where the participants practiced, the amount paid to 25 each program participant, and other information identified by 26 the commission as indicators of outcomes of the program. 27 14. Rules. The commission shall adopt rules pursuant to 28 chapter 17A to administer this section. 29 15. Definitions. For purposes of this section: 30 a. “Advanced registered nurse practitioner” means a person 31 licensed as a registered nurse under chapter 152 or 152E who 32 is licensed by the board of nursing as an advanced registered 33 nurse practitioner. 34 b. “Eligible loan” means the recipient’s total federally 35 -5- LSB 5467YC (5) 89 pf/rh 5/ 8

H.F. _____ guaranteed Stafford loan amount under the federal family 1 education loan program or the federal direct loan program, the 2 recipient’s federal grad plus loans, or the recipient’s federal 3 Perkins loan, including principal and interest. 4 c. “Eligible university” means a college or university that 5 meets the requirements of section 261.2, subsection 10, and 6 is an institution of higher learning under the control of the 7 state board of regents or an accredited private institution as 8 defined in section 261.9. 9 d. “Federal mental health shortage area” means a federal 10 mental health shortage area designated by the health resources 11 and services administration of the United States department of 12 health and human services. 13 e. “Prescribing mental health practitioner” means a 14 psychiatrist, a prescribing psychologist, or a psychiatric 15 advanced registered nurse practitioner. 16 f. “Prescribing psychologist” means the same as defined in 17 section 154B.1. 18 g. “Psychiatric advanced registered nurse practitioner” 19 means an individual currently licensed as a registered nurse 20 under chapter 152 or 152E who holds a national certification in 21 psychiatric mental health care and who is licensed by the board 22 of nursing as an advanced registered nurse practitioner. 23 h. “Service commitment area” means a city in Iowa located 24 within a federal mental health shortage area that provides 25 a twenty thousand dollar contribution for deposit in the 26 prescribing mental health practitioner loan repayment 27 trust fund for each loan recipient in the community who is 28 participating in the loan repayment program. 29 Sec. 2. PRESCRIBING MENTAL HEALTH PRACTITIONER LOAN 30 REPAYMENT PROGRAM TRUST FUND —— APPROPRIATION. There is 31 appropriated from the general fund of the state to the college 32 student aid commission for the fiscal year beginning July 1, 33 2022, and ending June 30, 2023, the following amounts, or so 34 much thereof as is necessary, to be used for the purposes 35 -6- LSB 5467YC (5) 89 pf/rh 6/ 8

H.F. _____ designated: 1 For deposit in the prescribing mental health practitioner 2 loan repayment program trust fund established pursuant to 3 section 261.117, to be used for the purposes of the program: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 5 EXPLANATION 6 The inclusion of this explanation does not constitute agreement with 7 the explanation’s substance by the members of the general assembly. 8 This bill establishes a prescribing mental health 9 practitioner loan repayment program, and provides an 10 appropriation. 11 The bill requires the Iowa student aid commission to 12 establish a prescribing mental health practitioner loan 13 repayment program for the purposes of providing loan repayments 14 for prescribing mental health practitioners who agree to 15 practice in service commitment areas for at least five years 16 and meet the requirements of the bill. “Prescribing mental 17 health practitioner” means a psychiatrist, a prescribing 18 psychologist, or a psychiatric advanced registered nurse 19 practitioner. 20 The bill includes provisions, similar to those for other 21 loan repayment and loan forgiveness programs for health 22 professionals under Code chapter 261, including the rural Iowa 23 primary care loan repayment program, relating to eligibility, 24 program agreements, program priority for Iowa residents, 25 loan repayment amounts, refinanced loans, program agreement 26 limitations, the selection of the service commitment area, 27 rules for loan repayment, rules for additional loan repayment, 28 part-time practice agreement amendments, postponement and 29 satisfaction of service obligations, the establishment of a 30 trust fund for the program, the submission of annual reports 31 regarding the program, and the adoption of administrative rules 32 for the program. 33 Under the bill, the loan repayment amount for a psychiatrist 34 is $40,000 annually with a maximum of $200,000 for an eligible 35 -7- LSB 5467YC (5) 89 pf/rh 7/ 8

H.F. _____ loan, not to exceed the total loan amount; for a prescribing 1 psychologist is $8,000 annually with a maximum of $40,000 for 2 an eligible loan, not to exceed the total loan amount; and for 3 a psychiatric advanced registered nurse practitioner is $10,000 4 annually with a maximum of $50,000 not to exceed the total loan 5 amount. 6 The bill provides definitions for the purposes of the bill 7 and provides for an appropriation from the general fund of the 8 state to the college student aid commission for FY 2022-2023 to 9 be deposited in the prescribing mental health practitioner loan 10 repayment program trust fund established under the bill to be 11 used for the purposes of the program. 12 -8- LSB 5467YC (5) 89 pf/rh 8/ 8