Gov. Reynolds signs bill addressing Iowa's health care workforce shortage, rural access

GUTHRIE CENTER — As the country grapples with a health care workforce shortage, health care facilities across Iowa, especially in rural areas, will see some assistance under legislation signed Wednesday by Gov. Kim Reynolds.

Flanked by health care providers at Guthrie County Hospital in Guthrie Center, Reynolds signed House File 972, which aims to create more medical residency slots and increase access to rural health care in the state.

Iowa is not the only state facing a health care workforce shortage as the projected national physician shortfall could reach as high as 86,000 physicians by 2036, according to the Association of American Medical Colleges.

But compared to other states, Iowa’s physician shortage is one of the most dire. Iowa ranked 44th in the nation for patient-to-physician ratio, according to the Iowa Medical Society.

“Iowa ranks 40 in the number of residency slots for medical students, which means many of our graduates from Iowa medical schools don't get a chance to continue their education and training here,” Reynolds said. “These improvements will empower us to operate more efficiently and more effectively on behalf of Iowa taxpayers, and most importantly, support a high-performing health system that provides high-quality care for Iowans.”

A main focus of Reynolds’ proposed plan is to draw in and keep medical students in Iowa to help combat the health care worker shortage. The proposal includes consolidating five student loan repayment programs into one program to incentivize health care workers to work in rural and underserved areas of the state. It also will increase program funding to $8 million, prioritizing high-demand specialties and positions.

The law will repeal existing residency and fellowship programs and direct the Iowa Department of Health and Human Services to partner with the University of Iowa Health Care and Broadlawns Medical Center in Des Moines to draw down $150 million in federal money to train medical residents in hospitals across the state and create 115 new residency spots.

Guthrie County Hospital CEO Chris Stipe stressed the facility’s need for more health care workers.

“Workforce shortages are one of our biggest challenges in rural health care, and since the pandemic, shortages have grown only more severe,” Stipe said. “If we are to continue to effectively care for our rural Iowa communities, critical strategies such as loan forgiveness programs and graduate medical education programs must be funded and expanded and run efficiently again.”

The proposal also would request federal approval for a health care “hub and spoke” partnership funding model to establish regional collaboration between health care providers in rural areas.

“These measures build on Iowa's strong foundation to ensure quality health care reaches every corner of our state,” Republican Rep. Carter Nordman, of Dallas Center, who chairs the Iowa House Health and Human Services Committee, said. “As the governor signs House File 972 into law today, we celebrate a bright future for rural health care in Iowa, a future where every family has access to care they need when they need it.”

Reynolds’ proposal also focuses on accessibility to maternal health care in the state by unbundling Medicaid rates and increasing reimbursement for medically complex pregnancies and births.

Iowa has the fewest OB-GYNs per capita of any state, according to the American College of Obstetricians and Gynecologists, and is one of the five states with the highest losses of access to obstetric care over the past 13 years.

Bill protects health facility workers, volunteers against assault

Reynolds also signed House File 310, which provides those working, volunteering or participating in an educational course of instruction at an Iowa health care facility the same protections against assault in the workplace as other health care providers.

Under current law, assaulting a health care provider can be charged as a serious misdemeanor, an aggravated misdemeanor, or a Class D felony. A serious misdemeanor is punishable by up to one year of confinement and a fine of between $430 and $2,560. An aggravated misdemeanor is punishable by confinement for up to two years and a fine of between $855 and $8,540. A Class D felony is punishable by confinement for up to five years and a fine of between $1,025 and $10,245.

“I think we can all agree that health care workers do not feel safe at work,” Stipe said. “It makes it even more difficult to recruit and retain talented health care workers to rural hospitals, really, in all our hospitals in Iowa.”

Health care workforce grant program announced

Under a program also launched by Reynolds on Wednesday, health care facilities across the state, including in some rural areas, will receive grants for boosting the workforce.

The Iowa Healthcare Credentialing Grant, which Reynolds announced in her Condition of the State address in January, will allocate $2.94 million toward health care facilities that create pathways for high-demand jobs. This may include facilities that help employees obtain registered nursing training and licensure while working, and add positions for health care technicians.

The 14 grant recipients include facilities in Atlantic, Waterloo, Cedar Falls, Clear Lake and Cedar Rapids. The program is estimated to train or upskill 399 participants across the state, according to the governor’s office.

Tom Barton of The Gazette contributed to this report.