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