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SF 3523

as introduced - 92nd Legislature (2021 - 2022) Posted on 03/03/2022 11:28am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to health; modifying the health professional education loan forgiveness
program; appropriating money; amending Minnesota Statutes 2020, sections
144.1501, subdivision 4; 144.608, subdivision 1; Minnesota Statutes 2021
Supplement, section 144.1501, subdivisions 1, 2, 3.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2021 Supplement, section 144.1501, subdivision 1, is
amended to read:


Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply.

(b) "Advanced dental therapist" means an individual who is licensed as a dental therapist
under section 150A.06, and who is certified as an advanced dental therapist under section
150A.106.

(c) "Alcohol and drug counselor" means an individual who is licensed as an alcohol and
drug counselor under chapter 148F.

new text begin (d) "Allied health care technician" means an individual who has completed training and
received all licensing or certification necessary to perform duties as a medical laboratory
technologist, medical laboratory technician, respiratory therapist, radiology technologist,
or surgical technologist.
new text end

deleted text begin (d)deleted text endnew text begin (e)new text end "Dental therapist" means an individual who is licensed as a dental therapist under
section 150A.06.

deleted text begin (e)deleted text endnew text begin (f)new text end "Dentist" means an individual who is licensed to practice dentistry.

deleted text begin (f)deleted text endnew text begin (g)new text end "Designated rural area" means a statutory and home rule charter city or township
that is outside the seven-county metropolitan area as defined in section 473.121, subdivision
2, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.

deleted text begin (g)deleted text endnew text begin (h)new text end "Emergency circumstances" means those conditions that make it impossible for
the participant to fulfill the service commitment, including death, total and permanent
disability, or temporary disability lasting more than two years.

deleted text begin (h)deleted text endnew text begin (i)new text end "Mental health professional" means an individual providing clinical services in
the treatment of mental illness who is qualified in at least one of the ways specified in section
245.462, subdivision 18.

deleted text begin (i)deleted text endnew text begin (j)new text end "Medical resident" means an individual participating in a medical residency in
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

deleted text begin (j)deleted text endnew text begin (k)new text end "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
anesthetist, advanced clinical nurse specialist, or physician assistant.

deleted text begin (k)deleted text endnew text begin (l)new text end "Nurse" means an individual who has completed training and received all licensing
or certification necessary to perform duties as a licensed practical nurse or registered nurse.

deleted text begin (l)deleted text endnew text begin (m)new text end "Nurse-midwife" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse-midwives.

deleted text begin (m)deleted text endnew text begin (n)new text end "Nurse practitioner" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse practitioners.

deleted text begin (n)deleted text endnew text begin (o)new text end "Pharmacist" means an individual with a valid license issued under chapter 151.

deleted text begin (o)deleted text endnew text begin (p)new text end "Physician" means an individual who is licensed to practice medicine in the areas
of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

deleted text begin (p)deleted text endnew text begin (q)new text end "Physician assistant" means a person licensed under chapter 147A.

deleted text begin (q)deleted text endnew text begin (r)new text end "Public health nurse" means a registered nurse licensed in Minnesota who has
obtained a registration certificate as a public health nurse from the Board of Nursing in
accordance with Minnesota Rules, chapter 6316.

deleted text begin (r)deleted text endnew text begin (s)new text end "Qualified educational loan" means a government, commercial, or foundation
loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.

deleted text begin (s)deleted text endnew text begin (t)new text end "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.

Sec. 2.

Minnesota Statutes 2021 Supplement, section 144.1501, subdivision 2, is amended
to read:


Subd. 2.

Creation of account.

(a) A health professional education loan forgiveness
program account is established. The commissioner of health shall use money from the
account to establish a loan forgiveness program:

(1) for medical residents, mental health professionals, and alcohol and drug counselors
agreeing to practice in designated rural areas or underserved urban communities or
specializing in the area of pediatric psychiatry;

(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach
at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program
at the undergraduate level or the equivalent at the graduate level;

(3) for nurses who agree to practice in a Minnesota new text beginhealth care facility, health clinic, or
health care setting, including but not limited to a
new text endnursing homedeleted text begin;deleted text endnew text begin,new text end an intermediate care facility
for persons with developmental disabilitydeleted text begin;deleted text endnew text begin, ornew text end a hospital deleted text beginif the hospital owns and operates
a Minnesota nursing home and a minimum of 50 percent of the hours worked by the nurse
is in the nursing home; a housing with services establishment as defined in section 144D.01,
subdivision 4
deleted text end; or for a home care provider as defined in section 144A.43, subdivision 4; or
agree to teach at least 12 credit hours, or 720 hours per year in the nursing field in a
postsecondary program at the undergraduate level or the equivalent at the graduate level;

(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
hours per year in their designated field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level. The commissioner, in consultation with the
Healthcare Education-Industry Partnership, shall determine the health care fields where the
need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory
technology, radiologic technology, and surgical technology;

(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses
who agree to practice in designated rural areas; deleted text beginand
deleted text end

(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
encounters to state public program enrollees or patients receiving sliding fee schedule
discounts through a formal sliding fee schedule meeting the standards established by the
United States Department of Health and Human Services under Code of Federal Regulations,
title 42, section deleted text begin51, chapter 303.deleted text endnew text begin 51c.303; and
new text end

new text begin (7) for allied health care technicians who agree to practice in a Minnesota health care
facility, health clinic, or health care setting.
new text end

(b) Appropriations made to the account do not cancel and are available until expended,
except that at the end of each biennium, any remaining balance in the account that is not
committed by contract and not needed to fulfill existing commitments shall cancel to the
fund.

Sec. 3.

Minnesota Statutes 2021 Supplement, section 144.1501, subdivision 3, is amended
to read:


Subd. 3.

Eligibility.

(a) To be eligible to participate in the loan forgiveness program, an
individual must:

(1) be a medical or dental resident; a licensed pharmacist; or be enrolled in a training or
education program to become a dentist, dental therapist, advanced dental therapist, mental
health professional, alcohol and drug counselor, pharmacist, public health nurse, midlevel
practitioner, registered nurse, deleted text beginor adeleted text end licensed practical nursenew text begin, or allied health care techniciannew text end.
The commissioner may also consider applications submitted by graduates in eligible
professions who are licensed and in practice; and

(2) submit an application to the commissioner of health.

(b) new text beginExcept as provided in paragraphs (c) and (d), new text endan applicant selected to participate
must sign a contract to agree to serve a minimum three-year full-time service obligation
according to subdivision 2, which shall begin no later than March 31 following completion
of required trainingdeleted text begin, with the exception ofdeleted text endnew text begin.
new text end

new text begin (c) An applicant who isnew text end a nursedeleted text begin, whodeleted text endnew text begin and is selected to participatenew text end must new text beginsign a contract
to
new text endagree to serve a minimum two-year full-time service obligation according to subdivision
2, which shall begin no later than March 31 following completion of required training.

new text begin (d) An applicant who is an allied health care technician and is selected to participate
must sign a contract to agree to serve a minimum two-year full-time service obligation
according to subdivision 2, which shall begin no later than March 31 following completion
of required training.
new text end

Sec. 4.

Minnesota Statutes 2020, section 144.1501, subdivision 4, is amended to read:


Subd. 4.

Loan forgiveness.

new text begin(a) new text endThe commissioner of health may select applicants each
year for participation in the loan forgiveness program, within the limits of available funding.
In considering applications, the commissioner shall give preference to applicants who
document diverse cultural competencies.

new text begin (b)new text end The commissioner shall distribute available funds for loan forgiveness proportionally
among the eligible professions according to the vacancy rate for each profession in the
required geographic area, facility type, teaching area, patient group, or specialty type specified
in subdivision 2. The commissioner shall allocate funds for physician loan forgiveness so
that 75 percent of the funds available are used for rural physician loan forgiveness and 25
percent of the funds available are used for underserved urban communities and pediatric
psychiatry loan forgiveness. If the commissioner does not receive enough qualified applicants
each year to use the entire allocation of funds for any eligible profession, the remaining
funds may be allocated proportionally among the other eligible professions according to
the vacancy rate for each profession in the required geographic area, patient group, or facility
type specified in subdivision 2. deleted text beginApplicants are responsible for securing their own qualified
educational loans.
deleted text end The commissioner shall select participants based on their suitability for
practice serving the required geographic area or facility type specified in subdivision 2, as
indicated by experience or training. The commissioner shall give preference to applicants
closest to completing their training.

new text begin (c) Applicants are responsible for securing their own qualified educational loans.
new text end

new text begin (d) Except as provided in paragraph (e),new text end for each year that a participant meets the service
obligation required under subdivision 3, up to a maximum of four years, the commissioner
shall make annual disbursements directly to the participant equivalent to 15 percent of the
average educational debt for indebted graduates in their profession in the year closest to the
applicant's selection for which information is available, not to exceed the balance of the
participant's qualifying educational loans.

new text begin (e) For each year that a nurse or health care technician who agrees to teach in the nurse's
or technician's designated field meets the service obligation required under subdivision 3,
or for each year that an allied health care technician meets the service obligation required
under subdivision 3, the commissioner shall make annual disbursements directly to the
nurse, health care technician, or allied health care technician equivalent to 30 percent of the
average educational debt for indebted graduates in their profession in the year closest to the
nurse's, health care technician's, or allied health care technician's selection for which
information is available, not to exceed the balance of the nurse's, health care technician's,
or allied health care technician's qualifying educational loans.
new text end

new text begin (f)new text end Before receiving loan repayment disbursements and as requested, the participant
must complete and return to the commissioner a confirmation of practice form provided by
the commissioner verifying that the participant is practicing as required under subdivisions
2 and 3. The participant must provide the commissioner with verification that the full amount
of loan repayment disbursement received by the participant has been applied toward the
designated loans. After each disbursement, verification must be received by the commissioner
and approved before the next loan repayment disbursement is made. Participants who move
their practice remain eligible for loan repayment as long as they practice as required under
subdivision 2.

Sec. 5.

Minnesota Statutes 2020, section 144.608, subdivision 1, is amended to read:


Subdivision 1.

Trauma Advisory Council established.

(a) A Trauma Advisory Council
is established to advise, consult with, and make recommendations to the commissioner on
the development, maintenance, and improvement of a statewide trauma system.

(b) The council shall consist of the following members:

(1) a trauma surgeon certified by the American Board of Surgery or the American
Osteopathic Board of Surgery who practices in a level I or II trauma hospital;

(2) a general surgeon certified by the American Board of Surgery or the American
Osteopathic Board of Surgery whose practice includes trauma and who practices in a
designated rural area as defined under section 144.1501, subdivision 1, paragraph deleted text begin(e)deleted text endnew text begin (g)new text end;

(3) a neurosurgeon certified by the American Board of Neurological Surgery who
practices in a level I or II trauma hospital;

(4) a trauma program nurse manager or coordinator practicing in a level I or II trauma
hospital;

(5) an emergency physician certified by the American Board of Emergency Medicine
or the American Osteopathic Board of Emergency Medicine whose practice includes
emergency room care in a level I, II, III, or IV trauma hospital;

(6) a trauma program manager or coordinator who practices in a level III or IV trauma
hospital;

(7) a physician certified by the American Board of Family Medicine or the American
Osteopathic Board of Family Practice whose practice includes emergency department care
in a level III or IV trauma hospital located in a designated rural area as defined under section
144.1501, subdivision 1, paragraph deleted text begin(e)deleted text endnew text begin (g)new text end;

(8) a nurse practitioner, as defined under section 144.1501, subdivision 1, paragraph deleted text begin(l)deleted text endnew text begin
(n)
new text end, or a physician assistant, as defined under section 144.1501, subdivision 1, paragraph
deleted text begin (o)deleted text endnew text begin (q)new text end, whose practice includes emergency room care in a level IV trauma hospital located
in a designated rural area as defined under section 144.1501, subdivision 1, paragraph deleted text begin(e)deleted text endnew text begin
(g)
new text end;

(9) a physician certified in pediatric emergency medicine by the American Board of
Pediatrics or certified in pediatric emergency medicine by the American Board of Emergency
Medicine or certified by the American Osteopathic Board of Pediatrics whose practice
primarily includes emergency department medical care in a level I, II, III, or IV trauma
hospital, or a surgeon certified in pediatric surgery by the American Board of Surgery whose
practice involves the care of pediatric trauma patients in a trauma hospital;

(10) an orthopedic surgeon certified by the American Board of Orthopaedic Surgery or
the American Osteopathic Board of Orthopedic Surgery whose practice includes trauma
and who practices in a level I, II, or III trauma hospital;

(11) the state emergency medical services medical director appointed by the Emergency
Medical Services Regulatory Board;

(12) a hospital administrator of a level III or IV trauma hospital located in a designated
rural area as defined under section 144.1501, subdivision 1, paragraph deleted text begin(e)deleted text endnew text begin (g)new text end;

(13) a rehabilitation specialist whose practice includes rehabilitation of patients with
major trauma injuries or traumatic brain injuries and spinal cord injuries as defined under
section 144.661;

(14) an attendant or ambulance director who is an EMT, EMT-I, or EMT-P within the
meaning of section 144E.001 and who actively practices with a licensed ambulance service
in a primary service area located in a designated rural area as defined under section 144.1501,
subdivision 1
, paragraph deleted text begin(e)deleted text endnew text begin (g)new text end; and

(15) the commissioner of public safety or the commissioner's designee.

Sec. 6. new text beginAPPROPRIATION.
new text end

new text begin $5,000,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of health for the health professional education loan forgiveness program under Minnesota
Statutes, section 144.1501. The base for this appropriation is $5,000,000 in fiscal year 2024,
$5,000,000 in fiscal year 2025, $5,000,000 in fiscal year 2026, and $0 in fiscal year 2027.
new text end