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

00                 HOUSE CS FOR CS FOR SENATE BILL NO. 93(FIN)                                                             
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 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 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 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.