PRINTER'S NO. 4634
No. 2975 Session of 2004
INTRODUCED BY B. SMITH, NOVEMBER 9, 2004
REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, NOVEMBER 9, 2004
AN ACT 1 Establishing a State loan repayment program for certain health 2 professionals; and conferring powers and imposing duties on 3 the Department of Health. 4 The General Assembly of the Commonwealth of Pennsylvania 5 hereby enacts as follows: 6 TABLE OF CONTENTS 7 Chapter 1. Preliminary Provisions 8 Section 101. Short title. 9 Section 102. Definitions. 10 Chapter 3. Loan Repayment Program 11 Section 301. Program establishment and purpose. 12 Section 302. Program administration and eligibility. 13 Section 303. Eligible loan repayment sites. 14 Section 304. Eligible health professionals and providers. 15 Section 305. Obligations of participants. 16 Chapter 5. Administration and Enforcement 17 Section 501. Responsibilities of department. 18 SEction 502. Procedure for loan repayment.
1 Section 503. Failure to complete obligated service. 2 Section 504. Suspension or waiver of obligation. 3 Chapter 11. Miscellaneous Provisions 4 Section 1101. Funding. 5 Section 1102. Effective date. 6 CHAPTER 1 7 PRELIMINARY PROVISIONS 8 Section 101. Short title. 9 This act shall be known and may be cited as the Health 10 Professional Loan Repayment Act. 11 Section 102. Definitions. 12 The following words and phrases when used in this act shall 13 have the meanings given to them in this section unless the 14 context clearly indicates otherwise: 15 "Department." The Department of Health of the Commonwealth. 16 "Health professional shortage area." An area designated as 17 such by the Secretary of Health and Human Services as provided 18 under 42 CFR Pt. 5 (relating to designation of health 19 professional(s) shortage areas). 20 "Program." The National Health Services Corps State loan 21 repayment program established under section 301. 22 "Qualifying educational loans." Government and commercial 23 loans for actual costs paid for tuition, reasonable education 24 expenses and reasonable living expenses related to the graduate 25 or undergraduate education of a health care professional. 26 CHAPTER 3 27 LOAN REPAYMENT PROGRAM 28 Section 301. Program establishment and purpose. 29 The department shall establish a National Health Services 30 Corps State loan repayment program authorized by section 3381 of 20040H2975B4634 - 2 -
1 the Public Health Service Act (58 Stat. 682, 42 U.S.C. § 254q- 2 1). The purpose of the program is to assist communities with the 3 recruitment and retention of health professionals in federally 4 designated health professional shortage areas. 5 Section 302. Program administration and eligibility. 6 (a) Duties of department.--The department shall administer 7 the program. The department shall: 8 (1) Ensure that Federal funds are used in accordance 9 with program requirements established by the Federal National 10 Health Services Corps. 11 (2) Notify potentially eligible loan repayment sites 12 about the program. 13 (3) Develop and disseminate application materials to 14 sites. 15 (4) Review and rank applications using the scoring 16 criteria approved by the Department of Health and Human 17 Services as part of the department's program application. 18 (5) Select sites that qualify for loan repayment based 19 upon the availability of Federal and State funding. 20 (6) Carry out other activities necessary to implement 21 and administer this act. 22 (7) Verify the eligibility of program participants. 23 (8) Sign a contract with each participant that specifies 24 the obligations of the participant and the Commonwealth. 25 (9) Arrange for loan repayment of qualifying educational 26 loans for program participants. 27 (10) Monitor the obligated service of program 28 participants. 29 (11) Waive or suspend service or payment obligations of 30 participants in appropriate situations. 20040H2975B4634 - 3 -
1 (12) Place participants who fail to meet their 2 obligations in default. 3 (13) Enforce penalties for default. 4 Section 303. Eligible loan repayment sites. 5 Nonprofit private and public entities located in and 6 providing health care services in federally designated primary 7 care health professional shortage areas are eligible to apply 8 for the program. The department shall develop a list of health 9 professional shortage areas in this Commonwealth in greatest 10 need of health care professionals and shall select loan 11 repayment sites from that list. The department shall ensure, to 12 the greatest extent possible, that the geographic distribution 13 of sites within this Commonwealth reflects the percentage of the 14 population living in rural and urban health professional 15 shortage areas. 16 Section 304. Eligible health professionals and providers. 17 (a) Eligible health professionals.--To be eligible to apply 18 to the department for the program, health professionals must: 19 (1) Be citizens or nationals of the United States. 20 (2) Not have any unserved obligations for service to a 21 Federal, State or local government or other entity. 22 (3) Have a current and unrestricted Pennsylvania license 23 to practice. 24 (4) Be ready to begin full-time clinical practice upon 25 signing a contract for obligated service. 26 (b) Eligible providers.--Eligible providers are those 27 specified by the Federal Bureau of Health Professions in the 28 policy information notice for the State's current Federal grant 29 application. A health professional selected for participation is 30 not eligible for loan repayment until the health professional 20040H2975B4634 - 4 -
1 has an employment agreement or contract with an eligible loan 2 repayment site and has signed a contract for obligated service 3 with the department. 4 Section 305. Obligations of participants. 5 (a) Contract required.--Before starting the period of 6 obligated service, a participant must sign a contract with the 7 department that specifies the obligations of the participant and 8 the department. 9 (b) Obligated service.--A participant shall agree in the 10 contract to fulfill the period of obligated service by providing 11 primary health care services in full-time clinical practice. The 12 service must be provided in a nonprofit private or public entity 13 that is located in and providing services to a federally 14 designated health professional shortage area and that has been 15 designated as an eligible site by the department under the 16 program. 17 (c) Length of service.--Participants must agree to provide 18 obligated service for a minimum of two years. A participant may 19 extend a contract to provide obligated service for a third and 20 fourth year, subject to approval by the department and the 21 availability of Federal and State funding. 22 (d) Affidavit of service required.--Before receiving loan 23 repayment, annually thereafter, and as requested by the 24 department, a participant shall submit an affidavit to the 25 department stating that the participant is providing the 26 obligated service and which is signed by a representative of the 27 organizational entity in which the service is provided. 28 Participants must provide written notice to the department 29 within 30 days of: 30 (1) A change in name or address. 20040H2975B4634 - 5 -
1 (2) A decision not to fulfill a service obligation. 2 (3) Cessation of clinical practice. 3 (e) Tax responsibility.--The participant is responsible for 4 reporting on Federal income tax returns any amount paid by the 5 State on designated loans, if required to do so under Federal 6 law. 7 (f) Nondiscrimination requirements.--Participants are 8 prohibited from charging a higher rate for professional services 9 than the usual and customary rate prevailing in the area where 10 the services are provided. If a patient is unable to pay this 11 charge, a participant shall charge the patient a reduced rate or 12 not charge the patient. Participants must agree not to 13 discriminate on the basis of ability to pay or status as a 14 Medicare or medical assistance enrollee. Participants must agree 15 to accept assignment under the Medicare program and to serve as 16 an enrolled provider under medical assistance. 17 CHAPTER 5 18 ADMINISTRATION AND ENFORCEMENT 19 Section 501. Responsibilities of department. 20 Subject to the availability of Federal and State funds for 21 the program, the department shall pay all or part of the 22 qualifying education loans up to $30,000 annually for each 23 primary care physician participant that fulfills the required 24 service obligation. 25 Section 502. Procedure for loan repayment. 26 Program participants, at the time of signing a contract, 27 shall designate the qualifying loan or loans for which the 28 department is to make payments. The participant shall submit to 29 the department proof that all payments made by the department 30 have been applied toward the designated qualifying educational 20040H2975B4634 - 6 -
1 loans. The department shall make payments in accordance with the 2 terms and conditions of the State loan repayment grant agreement 3 or contract, in an amount not to exceed $30,000 when annualized. 4 If the amount paid by the department is less than $30,000 during 5 a 12-month period, the department shall pay during the twelfth 6 month an additional amount towards a loan or loans designated by 7 the participant, to bring the total paid to $30,000. The total 8 amount paid by the department must not exceed the amount of 9 principal and accrued interest of the designated loans. 10 Section 503. Failure to complete obligated service. 11 A program participant who fails to complete the required 12 years of obligated service shall repay the amount paid, as well 13 as a financial penalty specified by the Federal Bureau of Health 14 Professions in the policy information notice for the State's 15 current Federal grant application. The department shall report 16 to the appropriate health-related licensing board a participant 17 who fails to complete the service obligation and fails to repay 18 the amount paid or fails to pay any financial penalty owed under 19 this section. 20 Section 504. Suspension or waiver of obligation. 21 Payment or service obligations cancel in the event of a 22 participant's death. The department may waive or suspend payment 23 or service obligations in case of total and permanent disability 24 or long-term temporary disability lasting for more than two 25 years. The department shall evaluate all other requests for 26 suspension or waivers on a case-by-case basis. 27 CHAPTER 11 28 MISCELLANEOUS PROVISIONS 29 Section 1101. Funding. 30 Program loan repayments shall be made only to the extent that 20040H2975B4634 - 7 -
1 funds are available for that purpose and are sufficient to cover 2 administration of the program. 3 Section 1102. Effective date. 4 This act shall take effect in 60 days. H11L24BIL/20040H2975B4634 - 8 -