txt

CSSB 93(HSS): "An Act relating to a workforce enhancement program for health care professionals employed in the state; and providing for an effective date."

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.