Eligibility for physician, dentist, and health care provider educational loan assistance programs. (FE)

If a physician agrees to practice at least 32 clinic hours per week for three years in a rural area or “eligible practice area,” as defined under current law, the physician is eligible to have some of his or her educational loans repaid. Up to $100,000 may be repaid for practice in a rural area and up to $50,000 may be repaid for practice in an eligible practice area. Current law defines an “eligible practice area” as a primary care or mental health shortage area, as determined under federal law, an American Indian reservation, or trust land of an American Indian tribe. Under current law, a dentist is eligible for repayment if he or she agrees to practice at least 32 clinic hours per week for three years in a rural area or dental health shortage area, as determined under federal law. Up to $50,000 may be repaid for practice in a rural area or dental health shortage area.

The bill amends the definition of “eligible practice area” so that it also includes a free or charitable clinic. The bill also makes a dentist who practices in a free or charitable clinic eligible for educational loan repayment. As a result, if a physician or dentist agrees to practice at least 32 clinic hours per week for three years in a free or charitable clinic, the physician or dentist is eligible to have up to $50,000 of his or her educational loans repaid. The bill defines “free or charitable clinic” as a safety-net health care organization that uses volunteers and staff to serve economically disadvantaged individuals who are uninsured, underinsured, or have limited or no health care access. In addition, the organization must be exempt from federal taxation or operate as a program component or affiliate of an organization exempt from federal taxation. The organization must also provide services without regard to a patient's ability to pay and charge either no fee or a nominal or sliding fee for services.

Current law requires physicians and dentists who participate in the educational loan assistance program to agree to care for patients who are insured or receive health care benefits under governmental programs. The bill also requires physicians and dentists to agree to care for patients who are uninsured or underinsured. Current law also requires the Board of Regents to establish priorities for repayments based on specified considerations if funding is not available to make repayments to all applicants. Under the bill, if the Board of Regents determines that a consideration does not apply to applicants who desire to practice in free or charitable clinics, the Board of Regents must ensure that the priorities do not disadvantage those applicants.

Other health care providers.

Under current law, the following health care providers are eligible to have up to $25,000 of their educational loans repaid if they agree to practice at least 32 clinic hours per week for three years in a rural area or eligible practice area: physician assistants, nurse-midwives, and nurse practitioners. Dental hygienists are eligible for the same repayment if they agree to practice at least 32 clinical hours per week for three years in a rural area or dental health shortage area. Like physicians, the bill includes free or charitable clinics, as defined above, in the definition of “eligible practice area.” The bill also includes a mental health shortage area, as determined under federal law, in the definition of “eligible practice area.” Unlike the program for physicians under current law, the program for other health care providers under current law does not include mental health shortage areas. As a result, in addition to eligibility under current law, any of the foregoing health care professionals, except dental hygienists, is eligible for educational loan repayment if he or she agrees to practice in a free or charitable clinic or a mental health shortage area for the required time. In addition to eligibility under current law, dental hygienists are eligible if they agree to practice in a free or charitable clinic for the required time.

Like the program for physicians and dentists, current law requires the Board of Regents to establish priorities for repayments based on specified considerations if funding is not available to make repayments to all applicants. Under the bill, if the Board of Regents determines that a consideration does not apply to applicants who desire to practice in free or charitable clinics, the Board of Regents must develop a mechanism to fairly assess all applicants under the priorities.