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
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
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
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
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
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
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
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.