H.F. 2549 Section 1. NEW SECTION . 261.117 Mental health practitioner 1 loan repayment program —— trust fund —— appropriation. 2 1. Program established. The commission shall establish 3 a mental health practitioner loan repayment program for 4 the purposes of providing loan repayments for mental health 5 practitioners who agree to practice in service commitment areas 6 for at least five years and who meet the requirements of this 7 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 a curriculum leading to employment as 11 a mental health practitioner. A recipient of a loan repayment 12 award under section 261.113, 261.114, 261.115, or 261.116 shall 13 not be eligible for a loan repayment award under this chapter. 14 3. Program agreements. A program agreement shall be 15 entered into by an eligible student and the commission when the 16 eligible student begins the final year of study in an academic 17 program leading to eligibility for employment as a mental 18 health practitioner. Under the agreement, to receive loan 19 repayments pursuant to subsection 5, an eligible student shall 20 agree to and shall fulfill all of the following requirements: 21 a. Receive a graduate-level credential qualifying the 22 credential recipient for employment as a mental health 23 practitioner. 24 b. Receive a license to practice in this state. 25 c. Within nine months of meeting the requirements of a 26 mental health practitioner, engage in full-time practice as 27 a mental health practitioner for a period of five years in a 28 service commitment area. 29 d. During the five-year period of full-time practice, be 30 enrolled as an actively participating Medicaid provider. 31 4. Priorities in making awards. In making awards under this 32 section, the commission shall give priority to: 33 a. Eligible students who are residents of Iowa upon 34 enrolling in a university and who agree to practice in a 35 -1- HF 2549 (4) 89 pf/rh/md 1/ 7

H.F. 2549 service commitment area located in a mental health professional 1 shortage area. 2 b. Service commitment areas that are located in mental 3 health professional shortage areas. 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 psychologist or a mental health professional, 13 eight thousand dollars annually with a maximum of forty 14 thousand dollars for an eligible loan, not to exceed the total 15 loan amount. 16 (3) For a physician assistant practicing under the 17 supervision of a psychiatrist, or for a psychiatric advanced 18 registered nurse practitioner, ten thousand dollars annually 19 with a maximum of fifty thousand dollars, not to exceed the 20 total loan amount. 21 b. If the total amount of the eligible student’s loan 22 upon graduation is less than the maximum amount specified, 23 the commission shall divide the total amount of the eligible 24 student’s eligible loan by five to determine the annual amount 25 of loan repayment the loan recipient is eligible to receive. 26 c. Payments under this section may be made for each year of 27 eligible practice during a period of five consecutive years. 28 6. Refinanced loans. A loan repayment recipient who 29 refinances an eligible loan by obtaining a private educational 30 loan may continue to receive loan repayment under this section 31 if the amount of loan repayment does not exceed the lesser of 32 the amount specified in subsection 5 or the balance of the loan 33 repayment amount the loan repayment recipient qualified to 34 receive with the eligible loan. 35 -2- HF 2549 (4) 89 pf/rh/md 2/ 7

H.F. 2549 7. Program agreement limitation. The commission shall by 1 rule determine the number of agreements entered into annually 2 based upon the funding available. 3 8. Selection of service commitment area. A loan repayment 4 recipient shall notify the commission of the recipient’s 5 service commitment area prior to beginning practice in the area 6 in accordance with subsection 3, paragraph “c” . Priority shall 7 be given to recipients who select service commitment areas 8 located in mental health professional shortage areas. The 9 commission may waive the requirement that the loan repayment 10 recipient practice in the same service commitment area for all 11 five 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 to 16 a psychiatrist, a psychologist, a mental health professional, 17 a physician assistant practicing under the supervision of 18 a psychiatrist, or a psychiatric advanced registered nurse 19 practitioner, who, as provided in subsection 3, received a 20 degree from a university, obtained a license to practice 21 in this state, and is engaged in full-time practice in the 22 respective profession in a service commitment area. 23 10. Part-time practice —— agreement amended. A person who 24 entered into an agreement pursuant to subsection 3 may apply 25 to the commission to amend the agreement to allow the person 26 to engage in less than the full-time practice specified in the 27 agreement and under subsection 3, paragraph “c” . The commission 28 and the person may consent to amend the agreement under which 29 the person shall engage in less than full-time practice in a 30 service commitment area for an extended period of part-time 31 practice determined by the commission to be proportional to 32 the amount of full-time practice remaining under the original 33 agreement. For purposes of this subsection, “less than 34 the full-time practice” means at least seventy percent of a 35 -3- HF 2549 (4) 89 pf/rh/md 3/ 7

H.F. 2549 forty-hour workweek. 1 11. Postponement and satisfaction of service obligation. 2 a. The obligation to engage in practice in accordance with 3 subsection 3 shall be postponed for the following purposes: 4 (1) Active duty status in the armed forces, the armed forces 5 military reserve, or the national guard. 6 (2) Service in volunteers in service to America. 7 (3) Service in the federal peace corps. 8 (4) A period of service commitment to the United States 9 public health service commissioned corps. 10 (5) A period of religious missionary work conducted by an 11 organization exempt from federal income taxation pursuant to 12 section 501(c)(3) of the Internal Revenue Code. 13 (6) Any period of temporary medical incapacity during which 14 the person obligated is unable, due to a medical condition, to 15 engage in full-time practice as required under subsection 3, 16 paragraph “c” . 17 b. Except for a postponement under paragraph “a” , 18 subparagraph (6), an obligation to engage in practice under an 19 agreement entered into pursuant to subsection 3 shall not be 20 postponed for more than two years from the time the full-time 21 practice was to have commenced under the agreement. 22 c. An obligation to engage in full-time practice under 23 an agreement entered into pursuant to subsection 3 shall be 24 considered satisfied when any of the following conditions are 25 met: 26 (1) The terms of the agreement are completed. 27 (2) The person who entered into the agreement dies. 28 (3) The person who entered into the agreement, due to a 29 permanent disability, is unable to practice as a mental health 30 practitioner. 31 d. If a loan repayment recipient fails to fulfill 32 the obligation to engage in practice in accordance with 33 subsection 3, the recipient shall be subject to repayment to 34 the commission of the loan amount plus interest as specified 35 -4- HF 2549 (4) 89 pf/rh/md 4/ 7

H.F. 2549 by rule. A loan repayment recipient who fails to meet the 1 requirements of the obligation to engage in practice in 2 accordance with subsection 3 may also be subject to repayment 3 of moneys advanced by the service commitment area as provided 4 in any agreement with the service commitment area. 5 12. Trust fund established. A mental health practitioner 6 loan repayment program trust fund is created in the state 7 treasury as a separate fund under the control of the 8 commission. The commission shall remit all repayments made 9 pursuant to this section to the trust fund. All moneys 10 deposited or paid into the trust fund are appropriated and 11 made available to the commission to be used for meeting the 12 requirements of this section. Moneys in the trust fund up 13 to the total amount that an eligible student may receive 14 for an eligible loan in accordance with this section and 15 upon fulfilling the requirements of subsection 3, shall be 16 considered encumbered for the duration of the agreement entered 17 into pursuant to subsection 3. Notwithstanding section 8.33, 18 any balance in the trust fund on June 30 of each fiscal year 19 shall not revert to the general fund of the state, but shall 20 be available for purposes of this section in subsequent fiscal 21 years. 22 13. Report. The commission shall submit in a report to 23 the general assembly by January 1, annually, the number of 24 individuals who received loan repayment pursuant to this 25 section, where the participants practiced, the amount paid to 26 each program participant, and other information identified by 27 the commission as indicators of outcomes of the program. 28 14. Rules. The commission shall adopt rules pursuant to 29 chapter 17A to administer this section. 30 15. Definitions. For purposes of this section: 31 a. “Advanced registered nurse practitioner” means a person 32 licensed as a registered nurse under chapter 152 or 152E who 33 is licensed by the board of nursing as an advanced registered 34 nurse practitioner. 35 -5- HF 2549 (4) 89 pf/rh/md 5/ 7

H.F. 2549 b. “Eligible loan” means the recipient’s total federally 1 guaranteed Stafford loan amount under the federal family 2 education loan program or the federal direct loan program, the 3 recipient’s federal grad plus loans, or the recipient’s federal 4 Perkins loan, including principal and interest. 5 c. “Mental health practitioner” means a psychiatrist, 6 a psychologist, a mental health professional, a physician 7 assistant practicing under the supervision of a psychiatrist, 8 or a psychiatric advanced registered nurse practitioner. 9 d. “Mental health professional” means an individual who 10 meets all of the following qualifications: 11 (1) The individual holds at least a master’s degree in 12 a mental health field, including psychology, counseling and 13 guidance, social work, marriage and family therapy, or mental 14 health counseling. 15 (2) The individual holds a current Iowa license if 16 practicing in a field covered by an Iowa licensure law. 17 (3) The individual has at least two years of post-degree 18 clinical experience, supervised by another individual in the 19 mental health field, in assessing mental health needs and 20 problems and in providing appropriate mental health services. 21 e. “Mental health professional shortage area” means a mental 22 health health professional shortage area designated by the 23 health resources and services administration of the United 24 States department of health and human services. 25 f. “Psychiatric advanced registered nurse practitioner” 26 means an individual currently licensed as a registered nurse 27 under chapter 152 or 152E who holds a national certification in 28 psychiatric mental health care and who is licensed by the board 29 of nursing as an advanced registered nurse practitioner. 30 g. “Service commitment area” means a city in Iowa that 31 provides the following contribution amounts for deposit in the 32 mental health practitioner loan repayment trust fund for each 33 loan recipient in the community who is participating in the 34 loan repayment program: 35 -6- HF 2549 (4) 89 pf/rh/md 6/ 7

H.F. 2549 (1) For a psychiatrist, twenty thousand dollars. 1 (2) For a psychologist or a mental health professional, four 2 thousand dollars. 3 (3) For a physician assistant practicing under the 4 supervision of a psychiatrist, or for a psychiatric advanced 5 registered nurse practitioner, five thousand dollars. 6 Sec. 2. MENTAL HEALTH PRACTITIONER LOAN REPAYMENT PROGRAM 7 TRUST FUND —— APPROPRIATION. There is appropriated from the 8 general fund of the state to the college student aid commission 9 for the fiscal year beginning July 1, 2022, and ending June 10 30, 2023, the following amounts, or so much thereof as is 11 necessary, to be used for the purposes designated: 12 For deposit in the mental health practitioner loan repayment 13 program trust fund established pursuant to section 261.117, to 14 be used for the purposes of the program: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,500,000 16 -7- HF 2549 (4) 89 pf/rh/md 7/ 7