Legislature(2011 - 2012)CAPITOL 106
03/15/2011 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB1 | |
| HCR5 | |
| HB78 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 1 | TELECONFERENCED | |
| += | HB 78 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HCR 5 | TELECONFERENCED | |
HB 78-INCENTIVES FOR CERTAIN MEDICAL PROVIDERS
3:41:29 PM
CHAIR KELLER announced that the final order of business would be
HOUSE BILL NO. 78, "An Act establishing a loan repayment program
and employment incentive program for certain health care
professionals employed in the state; and providing for an
effective date." [In front of the committee was CSHB 78,
Version I, which had been adopted as the working draft by House
Health and Social Services Standing Committee on March 8, 2011.]
REPRESENTATIVE HERRON moved to adopt the proposed Committee
Substitute (CS) for HB 78, 27-LS0147\D, Mischel, 3/11/11, as the
working document. There being no objection, Version D was
before the committee.
3:42:26 PM
LIZ CLEMENT, Staff, Representative Bob Herron, Alaska State
Legislature, explained the changes from Version I to the
proposed Version D. She pointed out that Section 1 of Version I
had been deleted, as it was found to be unnecessary. She
directed attention to Version D, page 1, line 7, and said that
it had been reworded to clearly reflect the loan repayment plan.
She moved on in Version D, to page 3, lines 1-8, and explained
that this now consolidated criteria for the employers matching
payment from two places in Version I.
3:45:10 PM
MS. CLEMENT, referring to Version D, page 2, line 19,
established that a new (b)(9) had been added to direct the
Department of Health and Social Services (DHSS) to include
procedures for allowable leaves of absence for the providers
participating in the program. Continuing to discuss Version D,
she pointed to page 3, lines 11-30, which elaborated on the 12
year lifetime maximum for a medical provider program
participant. She said that this allowed, after the initial
three year period, for an additional three year cycle of
participation in the program should the provider like to
continue, and if DHSS agreed with the eligibility. She
clarified that even if a participant was in the program for all
six years, and then returned to school for further training,
that they could return upon completion of this training for an
additional three year period, with the possibility of another
three year renewal.
3:47:21 PM
REPRESENTATIVE SEATON, referring to page 3, line 15, asked if
there was a limitation to the three year renewal period.
MS. CLEMENT replied that the intent was for one initial period
and one renewal period, for a maximum of six years within the
first participation span.
REPRESENTATIVE SEATON asked if this was the only mention for the
maximum six year participation.
3:48:42 PM
REPRESENTATIVE HERRON, in response to Representative Seaton,
directed attention to page 3, line 27.
MS. CLEMENT, directing attention to page 3, line 31 through page
4, line 4, declared that new language ensured that DHSS will
have the capability to prorate loan repayments and direct
incentive payments to providers for the percentage of the
calendar quarter which they worked. She opined that it would
most likely be in effect during the first and the last quarter
of work. She confirmed that allowing payment on a calendar
quarterly basis would add efficiency.
3:50:23 PM
MS. CLEMENT indicated page 4, line 27, Version D, which now read
"education loans held by or made to eligible tier I and tier II
health care professionals..." She explained that this increased
the eligibility for the loan repayment portion of the program to
include loans other than those from the State of Alaska. She
announced that consultant remarks to this idea had ranged from
neutral to supportive.
3:51:22 PM
REPRESENTATIVE SEATON asked for a reason to include the
complexity of a loan repayment program, as opposed to an
incentive payment which would allow the participants to pay the
loans themselves.
MS. CLEMENT replied that other states with similar programs had
found that participants in loan repayment programs were
sometimes exempt from federal income tax on this repayment.
3:52:32 PM
MS. CLEMENT explained page 4, line 25, Version D, which added
"and loan repayment amount, if any, under AS 18.29.025." She
stated that this would allow the loan repayment participant to
complete a three year cycle, and if the loan repayment had been
completed, then to continue work for an additional three year
cycle, if eligible, under the direct incentive program.
3:53:44 PM
MS. CLEMENT, moving on to page 5, line 23, Version D, clarified
that eligibility was determined by the approval of the
application by the commissioner.
3:54:32 PM
REPRESENTATIVE SEATON asked if the intent was for an applicant
to submit an application which, after meeting all the criteria,
could then be approved by the commissioner.
MS. CLEMENT concurred.
3:55:06 PM
MS. CLEMENT directed attention to page 6, line 2, Version D, and
explained that eligibility for the loan repayment program was
contingent on the applicant having an unpaid balance on one or
more eligible educational loans, as verified by the Alaska
Commission on Postsecondary Education (ACPE).
3:55:55 PM
REPRESENTATIVE SEATON asked to clarify that ACPE would gather
data and verify it to be an eligible education loan, even if the
loan did not originate from ACPE.
MS. CLEMENT agreed, and shared that ACPE had suggested this
process.
REPRESENTATIVE SEATON referred to page 5, line 30, noted the
definition of eligibility for loan repayment, and asked if there
was a definition for an eligible education loan.
3:57:43 PM
MS. CLEMENT replied that proposed HB 78 did not contain a
written definition for an eligible education loan, and she
offered to supply one.
3:59:36 PM
MS. CLEMENT reviewed page 6, line 6, Version D, and stated that
this would allow DHSS to prioritize sites, and the physicians at
those sites, for eligibility of participation in the program
based on remoteness and/or a percentage of federal health care,
Medicaid, or Medicare program beneficiaries.
4:01:26 PM
REPRESENTATIVE SEATON asked if the prioritization was in
conflict with the definition for eligible site on page 6, line
18-20.
CHAIR KELLER requested that the question be held for later
response.
4:02:24 PM
MS. CLEMENT directed attention to page 6, line 31 through page
7, line 5, Version D, and shared that the words "licensed or
exempt from licensure in the state" had been added to both
definitions. She said that this would ensure the program was
open to qualified, trained health care providers. She noted
that Indian Health Services health care providers were exempt
from licensure in the state.
4:03:42 PM
MS. CLEMENT pointed out that a few grammatical changes with no
impact had also been changed in proposed HB 78.
4:03:53 PM
MARGARET SODEN, Pharmacist, Alaska Pharmacist Association,
offered her belief that proposed HB 78 would encourage medical
professionals to come to Alaska to work. She expressed her
support of proposed HB 78.
CHAIR KELLER closed public testimony.
4:07:02 PM
REPRESENTATIVE SEATON, pointing to page 6, asked about the
prioritization criteria and the criteria for site eligibility.
He asked if the needs assessment and the employment statistics
required for site eligibility would also be considered in the
prioritization criteria.
4:08:42 PM
MS. CLEMENT replied that this was not intended and she offered
to clarify this section. She opined that the needs assessment
would be included in the consideration for remoteness of site
and the percentage of underserved patients.
4:09:35 PM
CHAIR KELLER, referring to page 6, line 29, asked if it would be
more appropriate for qualified employment to include not less
than 70 percent of time on direct patient health care services,
as opposed to 50 percent as currently written.
REPRESENTATIVE HERRON agreed that there was room for
clarification, but that smaller clinics required that a medical
professional do more than direct patient services.
4:11:10 PM
REPRESENTATIVE SEATON reminded the Chair of his earlier request
for further clarification on eligible education loans. He
referred to page 2, line 19, and asked for an explanation on the
procedures for allowable leaves of absence.
4:12:39 PM
REPRESENTATIVE HERRON asked that the DHSS respond to this.
4:13:02 PM
CHAIR KELLER, indicating page 3, line 4, asked why the employer
would not pay more than 50 percent of the combined incentive.
4:13:32 PM
MS. CLEMENT replied that the value of up to 50 percent was a
carryover from previous versions of the bill. She suggested
that the percentage could be increased to match the ability of a
facility to pay.
REPRESENTATIVE HERRON relayed that the range could be as broad
as 0 percent to 100 percent.
CHAIR KELLER reflected that this was aligned with the needs
assessment by the Commissioner of DHSS.
4:15:16 PM
CHAIR KELLER moved to adopt Amendment 1, labeled 27-LS0147\D.1,
Mishcel, 3/15/11, which read:
Page 3, line 2, following "department":
Insert "for deposit in the general fund"
Page 3, line 10, following "department":
Insert "from money appropriated for the purpose"
Page 4, following line 6:
Insert a new subsection to read:
"(i) Direct incentive payments, loan repayments,
and matching payments shall be made with funds
appropriated by the legislature for that purpose."
Page 4, lines 30 - 31:
Delete all material.
Reletter the following subsections accordingly.
Page 5, following line 20:
Insert a new subsection to read:
"(c) If insufficient funds are appropriated in a
fiscal year, the department shall prorate payments
based on the number of approved participants in the
program."
REPRESENTATIVE HERRON objected for discussion.
CHAIR KELLER clarified that this was not the conceptual
amendment [Included in members' packets.]
CHAIR KELLER, explaining proposed Amendment 1 and referring to
page 3, line 1, asked if the "nonrefundable quarterly matching
payments to the department" could be construed as either a tax
or a dedicated fund. He suggested that "for deposit in the
general fund" be inserted on page 3, line 2.
4:18:18 PM
REPRESENTATIVE SEATON asked that if the money were paid to the
general fund, would the funds then not be available until the
legislature appropriated the money.
CHAIR KELLER asked to leave the question open.
4:18:57 PM
CHAIR KELLER opined that adding "from money appropriated for the
purpose" following "department" on page 3, line 10 would better
clarify it.
4:19:07 PM
CHAIR KELLER, continuing his discussion of proposed Amendment 1,
moved on to page 4, line 6, where he proposed to add a new
subsection (i).
4:19:32 PM
CHAIR KELLER suggested deletion of all the material on page 4,
line 30-31.
4:19:51 PM
CHAIR KELLER endorsed that proposed Amendment 1 add a new
subsection (c) on page 5, following line 20. He suggested that
proposed Amendment 1 answered Representative Seaton's question.
4:20:48 PM
REPRESENTATIVE SEATON asked for an explanation for the proposal
to delete lines 30-31 on page 4, and he asked if that had been
deleted elsewhere.
CHAIR KELLER, in response, explained that proposed Amendment 1
inserted a new subsection (i), on page 4, following line 6, as
well as a new subsection (c) on page 5, following line 20. He
confirmed that the proposed deletion had been from the loan
repayment section, but was now included in the description of
the entire program.
4:22:51 PM
REPRESENTATIVE HERRON asked if deleting it from AS 18.29.025 and
inserting it into AS 18.29.015 accomplished the same thing. He
opined that the drafter of the amendment would not do something
which they should not do.
CHAIR KELLER replied that Legislative Legal and Research
Services would need to answer that.
4:23:29 PM
CHAIR KELLER announced that proposed HB 78 and proposed
Amendment 1 would be held over. He offered to work with the
bill sponsor on the amendment, and he asked Representative
Seaton to further investigate the questions regarding leave of
absence.
4:24:28 PM
DIANE BARRANS, Executive Director, Alaska Commission on
Postsecondary Education, offered her belief that it would be
beneficial to include a definition for "eligible loans." She
confirmed that similar definitions were contained in related
federal loan repayment programs.
4:25:09 PM
MS. BARRANS, in response to Chair Keller, said that she did not
know about leave of absence.
4:25:35 PM
CHAIR KELLER suggested that Representative Herron, as the bill
sponsor, work with Ms. Barrans and Representative Seaton to
formulate a definition.
4:26:04 PM
REPRESENTATIVE SEATON asked about the quarterly repayment of
loans, especially in conjunction with leaves of absence.
4:26:53 PM
PAT CARR, Chief, Health Planning and Infrastructure, Division of
Health Care Services, Department of Health and Social Services,
explained that quarterly payments were more efficient. She
agreed that a mid quarter entrance or departure to the program
allowed the department to pro rate that quarterly payment, which
would be the same for any unpaid leave of absence.
REPRESENTATIVE SEATON clarified that payments for the calendar
quarter defined when the payments were to be made, and that they
would be prorated to the actual time. He established that
unpaid leaves of absence were allowed under special conditions,
such as an emergency or a medically necessity.
[HB 78 was held over.]
| Document Name | Date/Time | Subjects |
|---|---|---|
| CS HCR 5.pdf |
HHSS 3/15/2011 3:00:00 PM |