00 CS FOR SENATE BILL NO. 93(HSS) 01 "An Act relating to a workforce enhancement program for health care professionals 02 employed in the state; and providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04  * Section 1. AS 18.29 is amended by adding new sections to read: 05 Article 2. Health Care Professionals Workforce Enhancement Program.  06 Sec. 18.29.100. Legislative intent. Student loan repayments and direct 07 incentive payments provided under this chapter are intended to increase the 08 availability of health care services throughout the state, especially to underserved 09 individuals or in health care professional shortage areas. 10 Sec. 18.29.105. Health care professionals workforce enhancement  11 program; purpose; advisory council. (a) The health care professionals workforce 12 enhancement program is established in the department for the purpose of addressing 13 the increasing shortage of certain health care professionals in the state by expanding 14 the distribution of health care professionals.  01 (b) The program established under this section must include 02 (1) employer payments, as described in AS 18.29.110; 03 (2) direct incentives, as described in AS 18.29.120; 04 (3) student loan repayments, as described in AS 18.29.125; 05 (4) procedures for the commissioner's designation and prioritization of 06 sites eligible for participation in the program; 07 (5) an application process for participation in the program as 08 (A) an eligible site; or 09 (B) a tier I, tier II, or tier III health care professional; 10 (6) provision of public information and notices relating to the program; 11 (7) a 12-year lifetime maximum for participation in the program by a 12 tier I, tier II, or tier III health care professional. 13 (c) The commissioner shall appoint an advisory council to advise the 14 department on the program. The advisory council consists of members with health 15 care expertise, including expertise in economic issues affecting the hiring and 16 retention of health care professionals in the state. An employee of the department may 17 serve only as a nonvoting member. Members of the advisory council serve at the 18 pleasure of the commissioner and without compensation but are entitled to per diem 19 and travel allowances authorized for boards and commissions under AS 39.20.180. 20 The advisory council shall provide oversight and evaluation of the program and make 21 recommendations, including recommendations relating to 22 (1) identification and monitoring of underserved and health care 23 professional shortage areas; 24 (2) eligible sites; 25 (3) an employer's ability to pay; 26 (4) prioritization of sites and health care professionals eligible for 27 participation in the program; 28 (5) contract award priorities; 29 (6) program capacities; 30 (7) strategic plans; and 31 (8) program data management. 01 (d) The commissioner shall, in consultation with the advisory council 02 established under (c) of this section, 03 (1) administer and implement the program; 04 (2) classify each eligible site as having either regular or very hard-to- 05 fill positions, or both; 06 (3) establish 07 (A) procedures for allowable leaves of absence; 08 (B) a civil penalty, not to exceed $1,000 for each violation by a 09 health care professional or employer of a provision of this chapter, a regulation 10 made under authority of this chapter, or a provision of a contract entered into 11 under this chapter; and 12 (C) a priority for participation in the program based on the 13 availability of funding. 14 (e) The department shall, on or before July 1 of each year, prepare and submit 15 to the advisory council a report that describes the participation rates, costs, and effect 16 on the availability of health care services to underserved individuals or in health care 17 professional shortage areas for the previous calendar year. 18 (f) The department may 19 (1) contract for payments under the program and for the services of a 20 consultant, expert, financial advisor, or other person the department considers 21 necessary for the exercise of its powers and functions and to perform its duties under 22 this chapter; 23 (2) adopt regulations necessary to implement the program. 24 Sec. 18.29.110. Employer payments. An employer approved for participation 25 in the program shall make a nonrefundable quarterly payment to the department for 26 the benefit of the employer's health care professional employee. The employer 27 payment may come from any available source, including a philanthropic institution, 28 health foundation, government agency, community organization, or private individual. 29 The payment amount 30 (1) must be equal to the health care professional's program payment 31 amount established by the commissioner; 01 (2) may be adjusted based on the employer's ability to pay, as 02 determined by the commissioner and in consultation with the advisory council; and 03 (3) must include the fee established under AS 44.29.022 for services 04 provided under this chapter. 05 Sec. 18.29.115. Initial and renewal payments. (a) The department may 06 approve student loan repayment and direct incentive payments for a qualified 07 applicant for an initial period of three years and may approve a maximum of three 08 renewal periods of three years each if the applicant 09 (1) submits an application on a form approved by the department for 10 (A) student loan repayments and, for student loan repayment 11 renewal, demonstrates that the applicant has 12 (i) a continuing student loan obligation on the same 13 student loan that was subject to repayment under the program during 14 the initial three-year period; or 15 (ii) incurred additional student loan debt that qualifies 16 for repayment; 17 (B) direct incentive payments; or 18 (C) payments under both (A) and (B) of this paragraph; 19 (2) is otherwise eligible under the program; and 20 (3) does not exceed the 12-year lifetime maximum for participation in 21 the program. 22 (b) The department shall combine an eligible health care professional's direct 23 incentives and pay the total amount to the eligible health care professional in the form 24 of one quarterly cash payment. The department shall combine an eligible health care 25 professional's student loan repayments and pay the total amount to the lending 26 institution or to the eligible health care professional in the form of one quarterly 27 payment. 28 (c) The combined total amount of an eligible health care professional's direct 29 incentives and student loan repayments may not exceed, 30 (1) for a tier I health care professional employed in a regular position, 31 $35,000 annually; 01 (2) for a tier I health care professional employed in a very hard-to-fill 02 position, $47,250 annually; 03 (3) for a tier II health care professional employed in a regular position, 04 $20,000 annually; 05 (4) for a tier II health care professional employed in a very hard-to-fill 06 position, $27,000 annually; 07 (5) for a tier III health care professional employed in a regular 08 position, $15,000 annually; 09 (6) for a tier III health care professional employed in a very hard-to-fill 10 position, $20,250 annually. 11 (d) The department shall prorate student loan repayments and direct incentive 12 payments based on the number of qualified employment hours the health care 13 professional worked in a calendar quarter. The department may not pay a student loan 14 repayment or direct incentive before the completion of a calendar quarter in which the 15 student loan repayment or incentive payment was earned. 16 (e) The department shall deposit employer payments received and civil 17 penalties collected under this chapter in the general fund. 18 (f) The department shall pay student loan repayments and direct incentives 19 with funds appropriated by the legislature for that purpose. The department may limit 20 the number of program participants based on available funding. If insufficient money 21 is appropriated to fully fund the program in a fiscal year, the department shall prorate 22 payments based on the number of approved participants in the program. 23 Sec. 18.29.120. Direct incentives. The department shall provide a direct 24 incentive in the form of quarterly cash payments to an eligible tier I, tier II, or tier III 25 health care professional engaged in qualified employment in an amount established by 26 the commissioner and that is provided by employers approved under the program. 27 Sec. 18.29.125. Student loan repayment. (a) The department shall repay a 28 portion of eligible student loans held by or made to an eligible tier I, tier II, or tier III 29 health care professional. 30 (b) A student loan is eligible for repayment if the student loan was issued for 31 student loan debt of a participant eligible under AS 18.29.130, the student loan is a 01 student loan as described in 26 U.S.C. 108(f)(2), and the student loan resulted in a 02 certificate, license, or degree. 03 (c) A student loan repayment under this section may not exceed 33.3 percent 04 of the unpaid student loan balance existing in the first year of program participation 05 multiplied by the percentage of full-time equivalent employment for each year of 06 qualified employment, not to exceed three years. 07 (d) A student loan or interest on a student loan is not eligible for repayment 08 under this section if the student loan or interest is 09 (1) to be repaid by another source, including another loan repayment or 10 forgiveness program or an employer-sponsored loan repayment program; 11 (2) consolidated with a loan that is not eligible for repayment; or 12 (3) refinanced as a loan that is not eligible for repayment. 13 Sec. 18.29.130. Eligibility. (a) To be eligible for a direct incentive payment, an 14 individual must 15 (1) submit an application that is approved by the commissioner; 16 (2) be engaged in qualified employment at an eligible site with a 17 participating employer or entity; 18 (3) for a tier I or tier II health care professional, be licensed or exempt 19 from licensure as a tier I or tier II health care professional in the state; 20 (4) meet a participation priority established by the commissioner; and 21 (5) satisfy other criteria established by the commissioner. 22 (b) To be eligible for student loan repayment, an individual must 23 (1) satisfy the requirements of (a) of this section; and 24 (2) have an unpaid balance on one or more eligible student loans 25 verified by the Alaska Commission on Postsecondary Education or the department. 26 Sec. 18.29.190. Definitions. In AS 18.29.100 - 18.29.190, 27 (1) "commissioner" means the commissioner of health and social 28 services; 29 (2) "department" means the Department of Health and Social Services; 30 (3) "eligible site" means a service area or health care facility that 31 provides health care services to underserved individuals or in health care professional 01 shortage areas and that satisfies the criteria for eligibility established by the 02 commissioner; 03 (4) "employer payment" means the payment an employer makes to the 04 department for participation in the program; 05 (5) "program" means the health care professionals workforce 06 enhancement program; 07 (6) "qualified employment" means employment of a tier I, tier II, or 08 tier III health care professional at an eligible site at which the health care professional 09 is hired or contracted and paid to work 10 (A) in a full-time or not less than half-time position; 11 (B) for a term that is not less than three years; 12 (7) "tier I health care professional" means a person who spends not less 13 than 50 percent of the person's time on direct patient health care services and who is 14 licensed or exempt from licensure in the state as a dentist, pharmacist, physician, or 15 other health care professional as determined by the commissioner; 16 (8) "tier II health care professional" means a person who spends not 17 less than 50 percent of the person's time on direct patient health care services and who 18 is licensed or exempt from licensure in the state as a dental hygienist, registered nurse, 19 advanced practice registered nurse, physician assistant, physical therapist, clinical 20 psychologist, counseling psychologist, professional counselor, board certified 21 behavior analyst, marital and family therapist, clinical social worker, or other health 22 care professional as determined by the commissioner; 23 (9) "tier III health care professional" means a person who is employed 24 at an eligible site who is not otherwise eligible as a tier I or tier II health care 25 professional; 26 (10) "underserved individual" means an individual who 27 (A) is uninsured; 28 (B) receives or is eligible to receive medical assistance; or 29 (C) receives or is eligible to receive health care benefits 30 directly, through insurance, or through other means, from a plan or program 31 funded directly, in whole or in part, by the federal government, except for the 01 federal employee health benefits program under 5 U.S.C. 8903. 02  * Sec. 2. If AS 18.29.010, 18.29.015, 18.29.020, 18.29.025, 18.29.030, 18.29.035, and 03 18.29.099 are in effect on July 1, 2019, AS 18.29.010, 18.29.015, 18.29.020, 18.29.025, 04 18.29.030, 18.29.035, and 18.29.099 are repealed. 05  * Sec. 3. The uncodified law of the State of Alaska is amended by adding a new section to 06 read: 07 APPLICABILITY. This Act applies to an application or contract relating to a student 08 loan repayment or direct incentive under AS 18.29 submitted or entered into on or after 09 July 1, 2019. 10  * Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 11 read: 12 TRANSITION. Notwithstanding AS 18.29.100 - 18.29.190, added by sec. 1 of this 13 Act, the advisory body for the health care professions loan repayment and incentive program 14 shall act as a transition council. The transition council exists only until the initial health care 15 professionals workforce enhancement program advisory council is appointed by the 16 commissioner. 17  * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 18 read: 19 RETROACTIVITY. If sec. 1 of this Act takes effect after July 1, 2019, sec. 1 of this 20 Act is retroactive to July 1, 2019. 21  * Sec. 6. Section 5 of this Act takes effect immediately under AS 01.10.070(c). 22  * Sec. 7. Except as provided in sec. 6 of this Act, this Act takes effect July 1, 2019.