Bill > HSB191

Introduced Session

This bill relates to health care including a funding model for Iowa’s rural health system; health care-related award, grant, residency, and fellowship programs; establishment of a health care incentive program; Medicaid graduate medical education; the health facilities council; and the Iowa health information network. DIVISION I. This division requires the department of health and human services (HHS) to submit to the centers for Medicare and Medicaid services of the United States department of health S.F. _____ H.F. _____ and human services a request for approval for a health care hub-and-spoke partnership funding model for the purpose of improving Iowa’s rural health system. The division shall take effect upon enactment. DIVISION II. This division eliminates the primary care provider loan repayment program in Code section 135.107 and makes conforming changes. The primary care provider loan repayment program provides loan repayment to increase the number of health professionals practicing primary care in federally designated health professional shortage areas of the state. The bill creates a health care workforce and community support grant program fund in the state treasury under the control of HHS to be used for grant assistance under the health care workforce and community support grant program. HHS is required to make loan repayments pursuant to a loan repayment program contract entered into on or before June 30, 2025, to a recipient in compliance with the loan repayment program contract. HHS shall create an account for the deposit of encumbered or obligated moneys relating to the primary care provider loan repayment program as described in the bill. The division takes effect upon enactment. DIVISION III. This division eliminates certain health care-related programs. The rural Iowa primary care loan repayment program (Code section 256.221) is eliminated. The program provides loan repayment for medical students who agree to practice as physicians in certain service areas. The health care professional recruitment program (Code section 256.223) is also eliminated. The program provides loan repayment for students who graduate from a certain institution and become licensed as a health care professional. In addition, the health care award program (Code section 256.224) is eliminated. The program provides financial awards to registered nurses, advanced registered nurse practitioners, S.F. _____ H.F. _____ physician assistants, and nurse educators who practice in certain areas or teach in this state. Finally, the mental health professional loan repayment program (Code section 256.225) is eliminated. The program provides loan repayment for mental health professionals who agree to practice in certain practice areas. For all of the eliminated programs, the college student aid commission (commission) is required to make loan repayments and provide annual awards pursuant to program agreements and contracts entered into on or before June 30, 2025, as detailed in the bill. All unencumbered and unobligated moneys in the eliminated programs’ funds shall be transferred to the health care professional incentive program fund (program fund) created in division IV. HHS shall create accounts for the deposit of encumbered and obligated moneys for each eliminated program as detailed in the division. Upon the expiration of all program agreement, contract, and award disbursement periods, any unencumbered and unobligated moneys in the accounts shall be deposited in the program fund created in division IV. DIVISION IV. This division establishes a health care professional incentive program (incentive program) to recruit and retain eligible health care professionals (professionals) in eligible practice areas for employment in certain areas of the state by offering an award of a loan repayment or an income bonus. The commission, in coordination with HHS, shall administer the incentive program as detailed in the division. A professional is ineligible for the incentive program if the professional is currently participating in or has participated in certain health care-related award programs as identified in divisions II and III. The incentive program award shall be distributed annually by the commission as detailed in the division. The commission, in consultation with HHS, shall set the aggregate award amounts, not to exceed $200,000, for each profession for the applicable employment obligation. A program S.F. _____ H.F. _____ fund is created and moneys in the program fund are appropriated to the commission to be used for the incentive program. The moneys deposited in the program fund shall not revert and shall remain in the program fund at the end of the fiscal year. The commission may use the interest and earnings on the moneys in the fund for administrative costs. All moneys received by HHS or the commission from the health care-related programs eliminated in divisions II and III shall be deposited into the program fund. The commission, in coordination with HHS, shall adopt rules to administer the incentive program. The division shall take effect upon enactment. DIVISION V. This division eliminates certain health care-related grant, residency, and fellowship programs. Current law provides that the fulfilling Iowa’s need for dentists matching grant program may receive moneys through the health care workforce shortage fund or the fulfilling Iowa’s need for dentists matching grant program account (Code section 135.175). The division eliminates the fund and the account. The health care workforce support initiative (Code section 135.175) is eliminated. The initiative provides for the coordination and support of various efforts to address the health care workforce shortage in the state. Additionally, the medical residency training state matching grants program (Code section 135.176) is eliminated. The program provides matching state funding to sponsors of accredited graduate medical education residency programs in the state to establish, expand, or support medical residency training programs. The nurse residency state matching grants program (Code section 135.178) is also eliminated. The program provides matching state funding to sponsors of nurse residency programs in the state to establish, expand, or support nurse residency programs. Moreover, the state-funded family medicine obstetrics fellowship program (Code section 135.193) is eliminated. The S.F. _____ H.F. _____ program provides funding for fellowships to increase access to family medicine obstetrics practitioners in rural and underserved areas of the state. The division appropriates from the general fund of the state to HHS for deposit in the account for rural psychiatric residencies created in this division, $600,000 for FY 2025-2026, $400,000 for FY 2026-2027, and $200,000 for FY 2027-2028. The moneys are appropriated to fund rural psychiatric residencies as described in the bill until all residents have completed or left the residencies. For all of the programs eliminated in the division, HHS is required to provide matching state funding and fund residency and fellowship positions awarded on or before June 30, 2025, as detailed in the bill. All unencumbered and unobligated moneys related to the programs eliminated in the division shall be transferred to HHS to fund Medicaid graduate medical education efforts. HHS shall create accounts for the deposit of encumbered and obligated moneys for each eliminated program as detailed in the division. Upon the expiration of all grant, residency, and fellowship periods, any unencumbered and unobligated moneys in the account shall be appropriated to HHS for Medicaid graduate medical education efforts. DIVISION VI. This division eliminates the state-funded psychiatry residency and fellowship positions (positions) (Code section 135.180) administered by the university of Iowa hospitals and clinics (U of I). The positions provide financial support for up to seven residents and up to two fellows annually. The board of regents (regents) shall direct the U of I to distribute moneys for positions approved and awarded on or before June 30, 2025, until all residents and fellows have completed or left the positions. The regents must also direct the U of I to create an account for the deposit of moneys encumbered and obligated relating to the positions. Upon the expiration of all residency and fellowship periods, S.F. _____ H.F. _____ any unencumbered and unobligated moneys in the account shall be appropriated to HHS for Medicaid graduate medical education efforts. Any unobligated or unencumbered moneys in the psychiatry residency and fellowship positions fund are also appropriated to HHS to fund Medicaid graduate medical education efforts. DIVISION VII. This division eliminates the health facilities council, and transfers the council’s duties to the department of inspections, appeals, and licensing. DIVISION VIII. This division makes conforming changes to the Code related to the elimination of health facilities council and the transfer of the applicable Code sections. DIVISION IX. This division eliminates the board of directors (board) that governs and administers the Iowa health information network (network) and transfers the board’s administrative duties to the designated entity. The division creates an exchange advisory committee (committee), appointed by the director of HHS, to govern the network and the designated entity. The division requires HHS to conduct a competitive process every eight years to select a designated entity. Current law prohibits a single industry from being disproportionately represented as voting members of the board, and requires the director of HHS and the director of the Medicaid program or the directors’ designees to act as voting members. The commissioner of insurance is required to serve on the board as a nonvoting member, and individuals serving in a nonvoting capacity on the board are not included in the total number of authorized members on the board. The division strikes these member requirements. Current law requires the board to ensure the designated entity enters into contracts with each state agency necessary for state reporting requirements, and to develop, implement, and enforce a single patient identifier or alternative mechanism to share secure patient information that is utilized by all health care professionals. The division eliminates these duties for the S.F. _____ H.F. _____ committee. The division requires the committee to advise HHS regarding the needs relating to the exchange of health information, and to ensure HHS develops, and the designated entity complies with, the standards, requirements, policies, and procedures related to the network.

Committee Categories

No sponsors listed

Other Sponsors (1)

Committee report approving bill, renumbered as HF 754. (on 03/05/2025)

Official Document