135.107 - CENTER FOR RURAL HEALTH AND PRIMARY CARE ESTABLISHED -- DUTIES.

        135.107  CENTER FOR RURAL HEALTH AND PRIMARY CARE
      ESTABLISHED -- DUTIES.
         1.  The center for rural health and primary care is established
      within the department.
         2.  The center for rural health and primary care shall do all of
      the following:
         a.  Provide technical planning assistance to rural communities
      and counties exploring innovative means of delivering rural health
      services through community health services assessment, planning, and
      implementation, including but not limited to hospital conversions,
      cooperative agreements among hospitals, physician and health
      practitioner support, recruitment and retention of primary health
      care providers, public health services, emergency medical services,
      medical assistance facilities, rural health care clinics, and
      alternative means which may be included in the long-term community
      health services assessment and developmental plan.  The center for
      rural health and primary care shall encourage collaborative efforts
      of the local boards of health, hospital governing boards, and other
      public and private entities located in rural communities to adopt a
      long-term community health services assessment and developmental plan
      pursuant to rules adopted by the department and perform the duties
      required of the Iowa department of public health in section 135B.33.

         b.  Provide technical assistance to assist rural communities
      in improving Medicare reimbursements through the establishment of
      rural health clinics, defined pursuant to 42 U.S.C. § 1395(x), and
      distinct part skilled nursing facility beds.
         c.  Coordinate services to provide research for the following
      items:
         (1)  Examination of the prevalence of rural occupational health
      injuries in the state.
         (2)  Assessment of training and continuing education available
      through local hospitals and others relating to diagnosis and
      treatment of diseases associated with rural occupational health
      hazards.
         (3)  Determination of continuing education support necessary for
      rural health practitioners to diagnose and treat illnesses caused by
      exposure to rural occupational health hazards.
         (4)  Determination of the types of actions that can help prevent
      agricultural accidents.
         (5)  Surveillance and reporting of disabilities suffered by
      persons engaged in agriculture resulting from diseases or injuries,
      including identifying the amount and severity of agricultural-related
      injuries and diseases in the state, identifying causal factors
      associated with agricultural-related injuries and diseases, and
      indicating the effectiveness of intervention programs designed to
      reduce injuries and diseases.
         d.  Cooperate with the center for agricultural health and
      safety established under section 262.78, the center for health
      effects of environmental contamination established under section
      263.17, and the department of agriculture and land stewardship.  The
      agencies shall coordinate programs to the extent practicable.
         e.  Administer grants for farm safety education efforts
      directed to rural families for the purpose of preventing farm-related
      injuries to children.
         3.  The center for rural health and primary care shall establish a
      primary care provider recruitment and retention endeavor, to be known
      as PRIMECARRE.  The endeavor shall include a community grant program,
      a primary care provider loan repayment program, and a primary care
      provider community scholarship program.  The endeavor shall be
      developed and implemented in a manner to promote and accommodate
      local creativity in efforts to recruit and retain health care
      professionals to provide services in the locality.  The focus of the
      endeavor shall be to promote and assist local efforts in developing
      health care provider recruitment and retention programs.
         a.  Community grant program.
         (1)  The center for rural health and primary care shall adopt
      rules establishing an application process to be used by the center to
      establish a grant assistance program as provided in this paragraph,
      and establishing the criteria to be used in evaluating the
      applications.  Selection criteria shall include a method for
      prioritizing grant applications based on illustrated efforts to meet
      the health care provider needs of the locality and surrounding area.
      Such assistance may be in the form of a forgivable loan, grant, or
      other nonfinancial assistance as deemed appropriate by the center.
      An application submitted shall contain a commitment of at least a
      dollar-for-dollar match of the grant assistance.  Application may be
      made for assistance by a single community or group of communities.
         (2)  Grants awarded under the program shall be subject to the
      following limitations:
         (a)  Ten thousand dollars for a single community or region with a
      population of ten thousand or less.  An award shall not be made under
      this program to a community with a population of more than ten
      thousand.
         (b)  An amount not to exceed one dollar per capita for a region in
      which the population exceeds ten thousand.  For purposes of
      determining the amount of a grant for a region, the population of the
      region shall not include the population of any community with a
      population of more than ten thousand located in the region.
         b.  Primary care provider loan repayment program.
         (1)  A primary care provider loan repayment program is established
      to increase the number of health professionals practicing primary
      care in federally designated health professional shortage areas of
      the state.  Under the program, loan repayment may be made to a
      recipient for educational expenses incurred while completing an
      accredited health education program directly related to obtaining
      credentials necessary to practice the recipient's health profession.

         (2)  The center for rural health and primary care shall adopt
      rules relating to the establishment and administration of the primary
      care provider loan repayment program.  Rules adopted pursuant to this
      paragraph shall provide, at a minimum, for all of the following:
         (a)  Determination of eligibility requirements and qualifications
      of an applicant to receive loan repayment under the program,
      including but not limited to years of obligated service, clinical
      practice requirements, and residency requirements.  One year of
      obligated service shall be provided by the applicant in exchange for
      each year of loan repayment, unless federal requirements otherwise
      require.  Loan repayment under the program shall not be approved for
      a health provider whose license or certification is restricted by a
      medical regulatory authority of any jurisdiction of the United
      States, other nations, or territories.
         (b)  Identification of federally designated health professional
      shortage areas of the state and prioritization of such areas
      according to need.
         (c)  Determination of the amount and duration of the loan
      repayment an applicant may receive, giving consideration to the
      availability of funds under the program, and the applicant's
      outstanding educational loans and professional credentials.
         (d)  Determination of the conditions of loan repayment applicable
      to an applicant.
         (e)  Enforcement of the state's rights under a loan repayment
      program contract, including the commencement of any court action.
         (f)  Cancellation of a loan repayment program contract for
      reasonable cause.
         (g)  Participation in federal programs supporting repayment of
      loans of health care providers and acceptance of gifts, grants, and
      other aid or amounts from any person, association, foundation, trust,
      corporation, governmental agency, or other entity for the purposes of
      the program.
         (h)  Upon availability of state funds, determine eligibility
      criteria and qualifications for participating communities and
      applicants not located in federally designated shortage areas.
         (i)  Other rules as necessary.
         (3)  The center for rural health and primary care may enter into
      an agreement under chapter 28E with the college student aid
      commission for the administration of this program.
         c.  Primary care provider community scholarship program.
         (1)  A primary care provider community scholarship program is
      established to recruit and to provide scholarships to train primary
      health care practitioners in federally designated health professional
      shortage areas of the state.  Under the program, scholarships may be
      awarded to a recipient for educational expenses incurred while
      completing an accredited health education program directly related to
      obtaining the credentials necessary to practice the recipient's
      health profession.
         (2)  The department shall adopt rules relating to the
      establishment and administration of the primary care provider
      community scholarship program.  Rules adopted pursuant to this
      paragraph shall provide, at a minimum, for all of the following:
         (a)  Determination of eligibility requirements and qualifications
      of an applicant to receive scholarships under the program, including
      but not limited to years of obligated service, clinical practice
      requirements, and residency requirements.  One year of obligated
      service shall be provided by the applicant in exchange for each year
      of scholarship receipt, unless federal requirements otherwise
      require.
         (b)  Identification of federally designated health professional
      shortage areas of the state and prioritization of such areas
      according to need.
         (c)  Determination of the amount of the scholarship an applicant
      may receive.
         (d)  Determination of the conditions of scholarship to be awarded
      to an applicant.
         (e)  Enforcement of the state's rights under a scholarship
      contract, including the commencement of any court action.
         (f)  Cancellation of a scholarship contract for reasonable cause.

         (g)  Participation in federal programs supporting scholarships for
      health care providers and acceptance of gifts, grants, and other aid
      or amounts from any person, association, foundation, trust,
      corporation, governmental agency, or other entity for the purposes of
      the program.
         (h)  Upon availability of state funds, determination of
      eligibility criteria and qualifications for participating communities
      and applicants not located in federally designated shortage areas.
         (i)  Other rules as necessary.
         (3)  The center for rural health and primary care may enter into
      an agreement under chapter 28E with the college student aid
      commission for the administration of this program.
         4. a.  Eligibility under any of the programs established under
      the primary care provider recruitment and retention endeavor shall be
      based upon a community health services assessment completed under
      subsection 2, paragraph "a".  A community or region, as
      applicable, shall submit a letter of intent to conduct a community
      health services assessment and to apply for assistance under this
      subsection.  The letter shall be in a form and contain information as
      determined by the center.  A letter of intent shall be submitted to
      the center by January 1 preceding the fiscal year for which an
      application for assistance is to be made.
         b.  Assistance under this subsection shall not be granted
      until such time as the community or region making application has
      completed the community health services assessment and adopted a
      long-term community health services assessment and developmental
      plan.  In addition to any other requirements, a developmental plan
      shall include a clear commitment to informing high school students of
      the health care opportunities which may be available to such
      students.
         c.  The center for rural health and primary care shall seek
      additional assistance and resources from other state departments and
      agencies, federal agencies and grant programs, private organizations,
      and any other person, as appropriate.  The center is authorized and
      directed to accept on behalf of the state any grant or contribution,
      federal or otherwise, made to assist in meeting the cost of carrying
      out the purpose of this subsection.  All federal grants to and the
      federal receipts of the center are appropriated for the purpose set
      forth in such federal grants or receipts.  Funds appropriated by the
      general assembly to the center for implementation of this subsection
      shall first be used for securing any available federal funds
      requiring a state match, with remaining funds being used for the
      community grant program.
         d.  The center for rural health and primary care may, to
      further the purposes of this subsection, provide financial assistance
      in the form of grants to support the effort of a community which is
      clearly part of the community's long-term community health services
      assessment and developmental plan.  Efforts for which such grants may
      be awarded include but are not limited to the procurement of clinical
      equipment, clinical facilities, and telecommunications facilities,
      and the support of locum tenens arrangements and primary care
      provider mentor programs.
         5. a.  There is established an advisory committee to the
      center for rural health and primary care consisting of one
      representative, approved by the respective agency, of each of the
      following agencies:  the department of agriculture and land
      stewardship, the Iowa department of public health, the department of
      inspections and appeals, the national institute for rural health
      policy, the rural health resource center, the institute of
      agricultural medicine and occupational health, and the Iowa state
      association of counties.  The governor shall appoint two
      representatives of consumer groups active in rural health issues and
      a representative of each of two farm organizations active within the
      state, a representative of an agricultural business in the state, a
      practicing rural family physician, a practicing rural physician
      assistant, a practicing rural advanced registered nurse practitioner,
      and a rural health practitioner who is not a physician, physician
      assistant, or advanced registered nurse practitioner, as members of
      the advisory committee.  The advisory committee shall also include as
      members two state representatives, one appointed by the speaker of
      the house of representatives and one by the minority leader of the
      house, and two state senators, one appointed by the majority leader
      of the senate and one by the minority leader of the senate.
         b.  The advisory committee shall regularly meet with the
      administrative head of the center as well as the director of the
      center for agricultural health and safety established under section
      262.78.  The head of the center and the director of the center for
      agricultural health and safety shall consult with the advisory
      committee and provide the committee with relevant information
      regarding their agencies.
         c.  A simple majority of the membership of the advisory
      committee shall constitute a quorum.  Action may be taken by the
      affirmative vote of a majority of the advisory committee membership.
      
         Section History: Recent Form
         89 Acts, ch 304, § 702; 90 Acts, ch 1207, § 1, 2; 90 Acts, ch
      1223, § 18
         C93, § 135.13
         94 Acts, ch 1168, §2
         C95, § 135.107
         95 Acts, ch 67, § 10; 96 Acts, ch 1128, § 2, 3; 97 Acts, ch 23, §
      14; 97 Acts, ch 203, §14; 98 Acts, ch 1100, §15; 2000 Acts, ch 1058,
      §16, 17; 2000 Acts, ch 1140, §23--25; 2000 Acts, ch 1223, §20, 21;
      2005 Acts, ch 89, §5; 2009 Acts, ch 41, §41
         Referred to in § 262.78, 263.17
         Legislative findings; 94 Acts, ch 1168, § 1