00 Enrolled SB 93 01 Relating to a workforce enhancement program for health care professionals employed in the 02 state; and providing for an effective date. 03 _______________ 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 or rural 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 09 a health care professional or employer of a provision of this chapter, a 10 regulation made under authority of this chapter, or a provision of a contract 11 entered into 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 of the program on the availability of health care services to underserved individuals or 17 in health care professional shortage or rural 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) Except as provided in (d) of this section, the combined total amount of an 29 eligible health care professional's direct incentives and student loan repayments may 30 not exceed, 31 (1) for a tier I health care professional employed in a regular position, 01 $35,000 annually; 02 (2) for a tier I health care professional employed in a very hard-to-fill 03 position, $47,250 annually; 04 (3) for a tier II health care professional employed in a regular position, 05 $20,000 annually; 06 (4) for a tier II health care professional employed in a very hard-to-fill 07 position, $27,000 annually; 08 (5) for a tier III health care professional employed in a regular 09 position, $15,000 annually; 10 (6) for a tier III health care professional employed in a very hard-to-fill 11 position, $20,250 annually. 12 (d) The department may annually increase the annual maximum program 13 payment amounts in (c) of this section by the average percentage increase in the 14 Consumer Price Index for urban wage earners and clerical workers for Urban Alaska 15 during the previous five calendar years, as determined by the United States 16 Department of Labor, Bureau of Labor Statistics. 17 (e) The department shall prorate student loan repayments and direct incentive 18 payments based on the number of qualified employment hours the health care 19 professional worked in a calendar quarter. The department may not pay a student loan 20 repayment or direct incentive before the completion of a calendar quarter in which the 21 student loan repayment or incentive payment was earned. 22 (f) The department shall deposit employer payments received and civil 23 penalties collected under this chapter in the general fund. 24 (g) The department shall pay student loan repayments and direct incentives 25 with funds appropriated by the legislature for that purpose. The department may limit 26 the number of program participants based on available funding. If insufficient money 27 is appropriated to fully fund the program in a fiscal year, the department shall prorate 28 payments based on the number of approved participants in the program. 29 Sec. 18.29.120. Direct incentives. The department shall provide a direct 30 incentive in the form of quarterly cash payments to an eligible tier I, tier II, or tier III 31 health care professional engaged in qualified employment in an amount established by 01 the commissioner and that is provided by employers approved under the program. 02 Sec. 18.29.125. Student loan repayment. (a) The department shall repay a 03 portion of eligible student loans held by or made to an eligible tier I, tier II, or tier III 04 health care professional. 05 (b) A student loan is eligible for repayment if the student loan 06 (1) was issued to an eligible individual under AS 18.29.130; 07 (2) is a student loan as described in 26 U.S.C. 108(f)(2); and 08 (3) was used by the individual for a program for which the individual 09 received a certificate, license, or degree. 10 (c) A student loan repayment under this section may not exceed 33.3 percent 11 of the unpaid student loan balance existing in the first year of program participation 12 multiplied by the percentage of full-time equivalent employment for each year of 13 qualified employment, not to exceed three years. 14 (d) A student loan or interest on a student loan is not eligible for repayment 15 under this section if the student loan or interest is 16 (1) to be repaid by another source, including another loan repayment or 17 forgiveness program or an employer-sponsored loan repayment program; 18 (2) consolidated with a loan that is not eligible for repayment; or 19 (3) refinanced as a loan that is not eligible for repayment. 20 Sec. 18.29.130. Eligibility. (a) To be eligible for a direct incentive payment, an 21 individual must 22 (1) submit an application that is approved by the commissioner; 23 (2) be engaged in qualified employment at an eligible site with a 24 participating employer or entity; 25 (3) for a tier I or tier II health care professional, be licensed or exempt 26 from licensure as a tier I or tier II health care professional in the state; 27 (4) meet a participation priority established by the commissioner; and 28 (5) satisfy other criteria established by the commissioner. 29 (b) To be eligible for student loan repayment, an individual must 30 (1) satisfy the requirements of (a) of this section; and 31 (2) have an unpaid balance on one or more eligible student loans 01 verified by the Alaska Commission on Postsecondary Education or the department. 02 Sec. 18.29.190. Definitions. In AS 18.29.100 - 18.29.190, 03 (1) "commissioner" means the commissioner of health and social 04 services; 05 (2) "department" means the Department of Health and Social Services; 06 (3) "eligible site" means a service area or health care facility that 07 provides health care services to underserved individuals or in health care professional 08 shortage or rural areas and that satisfies the criteria for eligibility established by the 09 commissioner; 10 (4) "employer payment" means the payment an employer makes to the 11 department for participation in the program; 12 (5) "program" means the health care professionals workforce 13 enhancement program; 14 (6) "qualified employment" means employment of a tier I, tier II, or 15 tier III health care professional at an eligible site at which the health care professional 16 is hired or contracted and paid to work 17 (A) in a full-time or not less than half-time position; 18 (B) for a term that is not less than three years; 19 (7) "rural" means a community with a population of 5,500 or less that 20 is not connected by road or rail to Anchorage or Fairbanks or with a population of 21 1,500 or less that is connected by road or rail to Anchorage or Fairbanks; 22 (8) "tier I health care professional" means a person who spends not less 23 than 50 percent of the person's time on direct patient health care services and who is 24 licensed or exempt from licensure in the state as a dentist, pharmacist, physician, 25 doctor of nursing practice, clinical psychologist, counseling psychologist, or other 26 health care professional as determined by the commissioner; 27 (9) "tier II health care professional" means a person who spends not 28 less than 50 percent of the person's time on direct patient health care services and who 29 is licensed or exempt from licensure in the state as a dental hygienist, advanced 30 practice registered nurse, registered nurse, physician assistant, physical therapist, 31 professional counselor, board certified behavior analyst, marital and family therapist, 01 clinical social worker, or other health care professional as determined by the 02 commissioner; 03 (10) "tier III health care professional" means a person who is 04 employed at an eligible site who is not otherwise eligible as a tier I or tier II health 05 care professional; 06 (11) "underserved individual" means an individual who 07 (A) is uninsured; 08 (B) receives or is eligible to receive medical assistance; or 09 (C) receives or is eligible to receive health care benefits 10 directly, through insurance, or through other means, from a plan or program 11 funded directly, in whole or in part, by the federal government, except for the 12 federal employee health benefits program under 5 U.S.C. 8903. 13 * Sec. 2. If AS 18.29.010, 18.29.015, 18.29.020, 18.29.025, 18.29.030, 18.29.035, and 14 18.29.099 are in effect on July 1, 2019, AS 18.29.010, 18.29.015, 18.29.020, 18.29.025, 15 18.29.030, 18.29.035, and 18.29.099 are repealed. 16 * Sec. 3. The uncodified law of the State of Alaska is amended by adding a new section to 17 read: 18 APPLICABILITY. This Act applies to an application or contract relating to a student 19 loan repayment or direct incentive under AS 18.29 submitted or entered into on or after 20 July 1, 2019. 21 * Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 22 read: 23 TRANSITION. Notwithstanding AS 18.29.100 - 18.29.190, added by sec. 1 of this 24 Act, the advisory body for the health care professions loan repayment and incentive program 25 shall act as a transition council. The transition council exists only until the initial health care 26 professionals workforce enhancement program advisory council is appointed by the 27 commissioner under AS 18.29.105(c). 28 * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 29 read: 30 RETROACTIVITY. If sec. 1 of this Act takes effect after July 1, 2019, sec. 1 of this 31 Act is retroactive to July 1, 2019. 01 * Sec. 6. Section 5 of this Act takes effect immediately under AS 01.10.070(c). 02 * Sec. 7. Except as provided in sec. 6 of this Act, this Act takes effect July 1, 2019.