Senate Study Bill 1042 - IntroducedA Bill ForAn Act 1relating to specialty areas, service commitment area
2distance requirements, and practice-related requirements
3under the rural Iowa primary care loan repayment program.
1   Section 1.  Section 261.113, subsection 3, paragraph d, Code
22021, is amended to read as follows:
   3d.  Within nine months of graduating from the residency
4program and receiving a permanent license in accordance with
5paragraph “b”, engage in the full-time practice of medicine
6and surgery or osteopathic medicine and surgery specializing
7in family medicine, pediatrics, psychiatry, internal medicine,
 8obstetrics and gynecology, or general surgery for a period of
9five consecutive years in the service commitment area specified
10under subsection 8, unless the loan repayment recipient
11receives a waiver from the commission to complete the years
12of practice required under the agreement in another service
13commitment area pursuant to subsection 8.
14   Sec. 2.  Section 261.113, subsection 10, Code 2021, is
15amended to read as follows:
   1610.  Part-time practice — agreement amended.  A person who
17entered into an agreement pursuant to subsection 3 may apply
18to the commission to amend the agreement to allow the person
19to engage in less than the full-time practice specified in
20the agreement and under subsection 3, paragraph “d”. If the
21commission determines exceptional circumstances exist, the
22 commission and the person may consent to amend the agreement
23under which the person shall engage in less than full-time
24practice of medicine and surgery or osteopathic medicine
25and surgery specializing in family medicine, pediatrics,
26psychiatry, internal medicine, obstetrics and gynecology, or
27general surgery in a service commitment area for an extended
28period of part-time practice determined by the commission to
29be proportional to the amount of full-time practice remaining
30under the original agreement. For purposes of this subsection,
31“less than the full-time practice” means at least seventy
32percent of a forty-hour workweek.

33   Sec. 3.  Section 261.113, subsection 13, paragraph c, Code
342021, is amended to read as follows:
   35c.  “Service commitment area” means a city in Iowa with a
-1-1population of less than twenty-six thousand that is located
2more than twenty miles from a city with a population of fifty
3thousand or more and which
 that provides a twenty thousand
4dollar contribution for deposit in the rural Iowa primary
5care trust fund for each physician in the community who is
6participating in the loan repayment program and which meets any
7of the following conditions:

   8(1)  Is a city within a federal mental health shortage
9area, as designated by the health resources and services
10administration of the United States department of health and
11human services, if the physician participating in the loan
12repayment program specializes in psychiatry
   13(2)  Is a city in Iowa with a population of less than
14twenty-six thousand that is located more than twenty miles from
15a city with a population of fifty thousand. The commission
16shall determine the distance between cities by calculating the
17most direct driving route.
19The inclusion of this explanation does not constitute agreement with
20the explanation’s substance by the members of the general assembly.
   21This bill modifies the requirements for the rural Iowa
22primary care loan repayment program.
   23The bill adds obstetrics and gynecology as an area of
24specialization that qualifies for loan repayment under the
   26Currently, a person can engage in less than full-time
27practice under the program if the person applies to the college
28student aid commission to amend their program agreement and the
29commission determines that exceptional circumstances exist.
30The bill eliminates the language relating to exceptional
31circumstances, thereby allowing the commission and the person
32to consent to amend the agreement to allow the person to engage
33in less than full-time practice for an extended period of
34part-time practice. Under the bill, “less than full-time”
35means at least 70 percent of a 40-hour workweek.
   1The bill modifies the definition of “service commitment
2area” to include a city within a designated federal mental
3health shortage area that provides a $20,000 contribution
4for deposit in the rural Iowa primary care trust fund for a
5physician specializing in psychiatry, and to require that the
6distance between a city with a population of less than 26,000
7that is located 20 miles from a city of at least 50,000 be
8calculated using the shortest driving distance between the