00 CS FOR HOUSE BILL NO. 392(HSS) 01 "An Act establishing a loan repayment program and employment incentive program for 02 certain health care professionals employed in the state; and providing for an effective 03 date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 14.43 is amended by adding new sections to read: 06 Article 8A. Health Care Professions Loan Repayment. 07 Sec. 14.43.430. Loan repayment; purpose. (a) The commission shall repay a 08 portion of education loans made by the state to eligible tier I and tier II health care 09 professionals under the health care professions loan repayment and employment 10 incentive program established in AS 18.29.010 and the loan repayment procedures 11 established under this section. 12 (b) The Department of Health and Social Services shall administer the health 13 care professions loan repayment program under AS 18.29.010 - 18.29.099. The 14 commission shall act as a disbursing agent in carrying out the provisions of 01 AS 14.43.430 - 14.43.449. 02 (c) Loan repayments under this section shall be made with funds appropriated 03 by the legislature for that purpose. The loan repayments made under this section do 04 not constitute a financial obligation of the corporation. 05 Sec. 14.43.435. Eligibility. To be eligible for loan repayment under 06 AS 14.43.430, an individual must 07 (1) meet eligibility and priority criteria established under 08 AS 18.29.030; 09 (2) have an unpaid balance on one or more education loans made by 10 the state and verified by the commission; and 11 (3) meet other criteria established by the commission. 12 Sec. 14.43.440. Conditions and limitations on loan payments. (a) A loan 13 repayment under AS 14.43.430 - 14.43.449 shall be in an amount not to exceed 33.3 14 percent of the unpaid loan balance existing in the first year of program participation, 15 multiplied by the percentage of full time equivalent employment for each of up to 16 three years of qualified employment less a matching loan or incentive amount from an 17 employer or other entity as determined under AS 18.29.020. 18 (b) The commission shall make a loan repayment under this section in 19 quarterly installments payable to the lending institution. A loan repayment made under 20 this section may not exceed the annual benefit amounts established under 21 AS 18.29.020(b). The commission may not make a loan repayment installment for an 22 employment period of less than one calendar quarter. 23 (c) A loan or interest on a loan is not eligible for repayment under this section 24 if the loan or interest is eligible for repayment from another source, including another 25 loan repayment or forgiveness program or an employer-sponsored repayment 26 program. 27 Sec. 14.43.449. Definitions. In AS 14.43.430 - 14.43.449, 28 (1) "qualified employment" has the meaning given in AS 18.29.099; 29 (2) "tier I health care professional" means a dentist, pharmacist, or 30 physician; 31 (3) "tier II health care professional" means a dental hygienist, 01 registered nurse, certified nurse practitioner, physician assistant, physical therapist, 02 clinical psychologist, or clinical social worker holding at least a master's degree in 03 social work. 04 * Sec. 2. AS 18 is amended by adding a new chapter to read: 05 Chapter 29. Health Care Professions Loan Repayment and Incentive Program. 06 Sec. 18.29.010. Health care professions loan repayment and incentive 07 program; purpose; advisory body. (a) The health care professions loan repayment 08 and incentive program is established in the department for the purpose of addressing 09 the worsening shortage of certain health care professionals in the state by increasing 10 the number and improving the distribution of health care professionals who provide 11 direct patient care. 12 (b) The program established under this section must include 13 (1) loan repayments made under AS 14.43.430 - 14.43.449; 14 (2) direct incentives paid under AS 18.29.020; 15 (3) procedures for the commissioner's designation and prioritization of 16 sites eligible for participation in the program; 17 (4) an application process for participation in the program as 18 (A) an eligible site; or 19 (B) a tier I or tier II health care professional; 20 (5) the dissemination of public information and notices pertinent to the 21 program; 22 (6) classification by the commissioner of each eligible site as having 23 either regular or very hard-to-fill positions, or both; 24 (7) a lifetime maximum period of six years for participation in the loan 25 repayment and direct incentive aspects of the program by a tier I or tier II health care 26 professional; and 27 (8) annual program evaluations and reports. 28 (c) Except as provided under AS 14.43.430, the program shall be administered 29 by the commissioner in consultation with an advisory body appointed by the 30 commissioner. The advisory body is made up of members with health care expertise, 31 including expertise in economic issues affecting the hiring and retention of health care 01 professionals in the state. Members of the advisory body serve at the pleasure of the 02 commissioner to provide recommendations for and oversight and evaluation of all 03 aspects of the program. The commissioner shall accept a recommendation of the 04 advisory body on a matter pertaining to the identification and monitoring of areas of 05 shortages, eligible sites, payment priorities, or evaluation of the program, unless the 06 commissioner finds, in writing, that the recommendation cannot be financially or 07 otherwise supported by the department. 08 Sec. 18.29.020. Direct incentives. (a) The department shall provide direct 09 incentives in the form of quarterly cash payments to eligible tier I and tier II health 10 care professionals engaged in qualified employment. The department may not make an 11 incentive payment 12 (1) before the employment period begins; 13 (2) for a period of qualified employment of less than three months; or 14 (3) under a contract term that is less than one calendar quarter. 15 (b) Payments made under this section, when combined with a loan repayment 16 amount paid under AS 14.43.440, if any, may not exceed 17 (1) $35,000 annually for a tier I health care professional employed in a 18 regular position; 19 (2) $47,000 annually for a tier I health care professional employed in a 20 very hard-to-fill position; 21 (3) $20,000 annually for a tier II health care professional employed in 22 a regular position; or 23 (4) $27,000 annually for a tier II health care professional employed in 24 a very hard-to-fill position. 25 (c) The commissioner shall calculate the annual incentive payment amount by 26 multiplying the annual maximum payment under (b) of this section by the percentage 27 of full time equivalent employment for each of not more than three years of qualified 28 employment less a matching payment amount as determined under (d) of this section 29 and loan repayment amount, if any, under AS 14.43.440. 30 (d) An employer or other entity that employs an eligible tier I or tier II health 31 care professional at an eligible site shall make nonrefundable quarterly matching 01 payments to the department. The payments must be in an amount that is 02 (1) not more than half of the combined annual incentive payment made 03 under (c) of this section and the loan repayment amount paid under AS 14.43.440(a), 04 as determined by the commissioner; and 05 (2) based on the employer's or entity's ability to pay, as determined by 06 the commissioner, in consultation with the program advisory body. 07 (e) A payment made under (d) of this section shall be combined with the 08 payment made to the professional by the department. 09 Sec. 18.29.025. Number of participants. (a) The number of participants to 10 whom the commissioner may provide a direct payment, loan repayment, or both under 11 the program established under AS 18.29.010 may not exceed 90 participants annually 12 as described in (b) of this section, regardless of whether the participant is a new or 13 continuing participant. 14 (b) The commissioner shall provide direct incentive payments, loan 15 repayments, or both, to not fewer than three participants employed in very hard-to-fill 16 positions at an eligible site in each of the 10 tier I and tier II health care professions. 17 Sec. 18.29.030. Eligibility and priority. (a) To be eligible for a direct 18 incentive payment under AS 18.29.020, an individual shall 19 (1) submit an application on a form approved by the commissioner; 20 (2) be engaged in qualified employment; 21 (3) be licensed as a tier I or tier II health care professional in the state 22 within 90 days after the first day of employment; 23 (4) meet a priority for payment established under (b) of this section; 24 and 25 (5) meet other criteria established by the commissioner. 26 (b) The commissioner shall establish priorities for payment of a loan and 27 incentive under the program based on the recommendations of the program advisory 28 body and the availability of funding. The commissioner shall prioritize eligible sites 29 based on the percentage of patients treated at the site who 30 (1) are uninsured; 31 (2) have or are eligible for medical assistance or Medicare coverage; or 01 (3) have or are eligible for other federal health program benefits. 02 Sec. 18.29.099. Definitions. In AS 18.29.010 - 18.29.099, 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 the 07 commissioner has designated as located in a health care services shortage area based 08 on a needs assessment and employment statistics for qualified tier I or tier II health 09 care professionals; 10 (4) "program" means the health care professions loan repayment and 11 incentive program; 12 (5) "qualified employment" means employment of a tier I or tier II 13 health care professional at an eligible site at which the health care professional is hired 14 and paid to work 15 (A) in a full-time or not less than half-time position; 16 (B) for a contract term that is not less than three years; and 17 (C) not less than 50 percent time on direct patient health care 18 services; 19 (6) "tier I health care professional" means a dentist, pharmacist, or 20 physician; 21 (7) "tier II health care professional" means a dental hygienist, 22 registered nurse, certified nurse practitioner, physician assistant, physical therapist, 23 clinical psychologist, or clinical social worker holding at least a master's degree in 24 social work. 25 * Sec. 3. This Act takes effect immediately under AS 01.10.070(c).