CHAPTER 21Rural Iowa primary care loan repayment program — miscellaneous changesS.F. 129AN ACT relating to specialty areas, service commitment area distance requirements, and practice-related requirements under the rural Iowa primary care loan repayment program.Be It Enacted by the General Assembly of the State of Iowa:   Section 1.   Section 261.113, subsection 3, paragraph d, Code 2021, is amended to read as follows:   d.  Within nine months of graduating from the residency program and receiving a permanent license in accordance with paragraph “b”, engage in the full-time practice of medicine and surgery or osteopathic medicine and surgery specializing in family medicine, pediatrics, psychiatry, internal medicine, obstetrics and gynecology, or general surgery for a period of five consecutive years in the service commitment area specified under subsection 8, unless the loan repayment recipient receives a waiver from the commission to complete the years of practice required under the agreement in another service commitment area pursuant to subsection 8.   Sec. 2.   Section 261.113, subsection 10, Code 2021, is amended to read as follows:   10.  Part-time practice agreement amended.  A person who entered into an agreement pursuant to subsection 3 may apply to the commission to amend the agreement to allow the person to engage in less than the full-time practice specified in the agreement and under subsection 3, paragraph “d”. If the commission determines exceptional circumstances exist, the The commission and the person may consent to amend the agreement under which the person shall engage in less than full-time practice of medicine and surgery or osteopathic medicine and surgery specializing in family medicine, pediatrics, psychiatry, internal medicine, obstetrics and gynecology, or general surgery in a service commitment area for an extended period of part-time practice determined by the commission to be proportional to the amount of full-time practice remaining under the original agreement. For purposes of this subsection, “less than the full-time practice” means at least seventy percent of a forty-hour workweek.   Sec. 3.   Section 261.113, subsection 13, paragraph c, Code 2021, is amended to read as follows:   c.  “Service commitment area” means a city in Iowa with a population of less than twenty-six thousand that is located more than twenty miles from a city with a population of fifty thousand or more and which that provides a twenty thousand dollar contribution for deposit in the rural Iowa primary care trust fund for each physician in the community who is participating in the loan repayment program and which meets any of the following conditions:   (1)  Is a city within a federal mental health shortage area, as designated by the health resources and services administration of the United States department of health and human services, if the physician participating in the loan repayment program specializes in psychiatry.   (2)  Is a city in Iowa with a population of less than twenty-six thousand that is located more than twenty miles from a city with a population of fifty thousand. The commission shall determine the distance between cities by calculating the most direct driving route.Approved March 22, 2021