ARC 8402C

ARC 8402C

Proposing rulemaking related to rural Iowa primary care loan repayment program and
providing an opportunity for public comment

The Administrative Rules Coordinator provided preclearance for the publication of this Notice of Intended Action on September 12, 2024.

A Regulatory Analysis for this rulemaking was published in the Iowa Administrative Bulletin on August 21, 2024. A public hearing was held on the following date(s):

●September 10, 2024

No public comments on the Regulatory Analysis were received at the public hearing or in writing.

Any persons who intend to attend a public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Commission and advise of specific needs.

ITEM 1.Rescind 283—Chapter 24 and adopt the following new chapter in lieu thereof:

CHAPTER 24

RURAL IOWA PRIMARY CARE LOAN REPAYMENT PROGRAM

283—24.1(256) Definitions.

“Eligible applicant” means an individual who meets the criteria of Iowa Code sections 256.221(2) and 256.221(3), agrees to sign a program agreement, and agrees to complete the obligation. The eligible applicant completes an application on or before the date established by the commission and does not meet a condition in 283—subrule 10.3(1).

1.The program agreement specifies the obligation and other details pertaining to the program.

2.The obligation may be postponed or satisfied pursuant to Iowa Code section 256.221(11). Progression toward completion of the obligation is verified annually.

“Eligible loan” means the same as defined in Iowa Code section 256.221(13). Only the outstanding portion of a federal consolidation loan that was used to repay an eligible loan qualifies as an eligible loan. An eligible applicant who signs a program agreement and then refinances an eligible loan by obtaining a private education loan may continue to receive loan repayment awards.

“Eligible university” means the same as defined in Iowa Code section 256.221(13).

“Part-time practice” means at least an average of 28 hours per week serving clients in a service commitment area.

“Service commitment area” means the same as defined in Iowa Code section 256.221(13). Each eligible applicant participating in the program will contract with the service commitment area to ensure the service commitment area provides the nonrefundable contribution. Payment of the nonrefundable contribution to the trust fund can be made by but is not limited to the following organizations: community agencies, medical groups, municipalities, community foundations, local government entities, or other community entities. Locations and distances between cities will be consistently measured and verified by calculating the shortest travel distance on paved roads.

283—24.2(256) Awarding of funds.

24.2(1) Selection criteria. The commission will annually determine and communicate the number of recommendations that can be funded at each eligible university. Each eligible university will recommend the corresponding number of eligible applicants to the commission, prioritizing eligible applicants who were Iowa residents upon enrolling at the eligible university. If an eligible university cannot fill all of its recommendations, another eligible university will be allowed to fill those recommendations. If the eligible universities cannot fill all of the recommendations available, the commission may enter into additional agreements under the surplus funds provisions in rule 283—24.3(256).

24.2(2) Extent of award and maximum award. Eligible applicants may receive up to $200,000 upon completion of the obligation pursuant to Iowa Code section 256.221(5). The loan repayment award will not exceed the outstanding balance of the eligible applicant’s eligible loans.

24.2(3) Awarding process.

a.The commission will provide notice of the eligibility criteria and the number of recommendations to be filled to the eligible universities.

b.The eligible universities will send recommended eligible applicants to the commission.

c.The commission will work with eligible applicants to sign program agreements.

d.Prior to employment, the eligible applicant will notify the commission of the service commitment area in which the eligible applicant will be employed and the commission will verify the eligibility of the service commitment area.

e.The commission will track eligible applicants selected to receive awards through completion of their obligation.

f.The commission will pay the loan repayment award directly to the holder of the eligible applicant’s eligible loan only after verifying with the employer that a portion of the obligation has been completed and the nonrefundable contribution has been deposited in the trust fund.

283—24.3(256) Surplus funds. In the event that fewer than the total number of recommendations in subrule 24.2(1) are filled by students at the eligible universities, the commission may enter into additional agreements.

24.3(1) Surplus-funds-eligible applicant. A surplus-funds-eligible applicant will meet the following criteria:

a.Graduate with a doctor of medicine or osteopathy degree from an eligible university and complete a residency program.

b.Receive a permanent license to practice medicine and surgery or osteopathic medicine and surgery in the state of Iowa and engage in full-time or part-time practice of medicine and surgery or osteopathic medicine and surgery in a specialty defined in Iowa Code section 256.221(3)“d” for a period of five consecutive years in a service commitment area. The applicant will notify the commission of the applicant’s service commitment area prior to beginning practice in the service commitment area.

c.Agree to sign a program agreement and to complete the obligation.

d.Complete applications on or before the date established by the commission and have none of the restrictions listed in 283—subrule 10.3(1).

24.3(2) Priority for awards. In the event that the total amount of surplus funds is insufficient to award all eligible applicants, awards will be prioritized as follows:

a.Surplus-funds-eligible applicants employed in a state other than Iowa and individuals in their final year of residency or fellowship, by date of application.

b.All other surplus-funds-eligible applicants by date of application.

24.3(3) Awarding process.

a.The commission will provide notice of the availability of surplus funds, the eligibility criteria, and the application process to the eligible universities.

b.The eligible universities will notify alumni, and residency program contacts will notify residents of the availability of surplus funds.

c.The commission will work with surplus-funds-eligible applicants to sign program agreements.

d.Prior to employment, the surplus-funds-eligible applicant will notify the commission of the service commitment area in which the eligible applicant will be employed and the commission will verify the eligibility of the service commitment area.

e.The commission will track surplus-funds-eligible applicants selected to receive awards through completion of their obligation.

f.The commission will pay the loan repayment award specified in subrule 24.2(2) directly to the holder of the eligible applicant’s eligible loan only after employer verification that a portion of the obligation has been completed and the nonrefundable contribution has been deposited in the trust fund.

283—24.4(256) Failure to fulfill obligation. An eligible applicant who fails to fulfill the obligation pursuant to Iowa Code section 256.221(11) will forfeit all future loan repayment awards under the program and will be subject to repayment of any loan repayment awards paid under this chapter toward the eligible applicant’s eligible loans as specified in the program agreement.

283—24.5(256) Waivers. An eligible applicant will request a waiver in writing from the commission to change employment to a different service commitment area, to work part-time in accordance with Iowa Code section 256.221(10), or to postpone employment in accordance with Iowa Code section 256.221(11).

These rules are intended to implement Iowa Code chapter 256.