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An Act relative to financial incentives for primary care physician recruitment. |
Be it enacted by the Senate and House
of Representatives in General Court assembled, and by the authority of the
same, as follows:
SECTION 1. Chapter 15A of the General Laws is hereby amended by adding the following section:-
Section 42. (a) Subject to appropriation, there shall be a physician loan repayment program, administered by the board. The program shall provide repayment assistance for medical school loans to participants who:- (i) are graduates of medical schools, (ii) specialize in family medicine, internal medicine, pediatrics, or obstetrics/gynecology, (iii) commit to providing those specialties in medically underserved areas for a minimum of 2 years, (iv) demonstrate competency in health information technology including, use of electronic medical records, computerized physician order entry and e-prescribing, and (v) meet other eligibility criteria, including service requirements, established by the board.
(b) The board shall promulgate regulations to effectuate the purposes of this section. The board may establish penalties and repayment procedures if a participant fails to comply with the program’s requirements.
The board, in consultation with the health care workforce council and the public health council, shall establish criteria to identify medically underserved areas within the commonwealth. These criteria shall consist of quantifiable measures, which may include the availability of primary care medical services within reasonable traveling distance, poverty levels, and disparities in health care access or health outcomes.
(c) The program shall include periodic evaluation, including exit interviews of participants to determine their post-program service plans and to solicit program improvement recommendations.
(d) The board shall file a report annually with the governor, the clerk of the house of representatives, the clerk of the senate, the house committee on ways and means, the senate committee ways and means, the joint committee on health care financing, and the joint committee on public health. The report shall include annual data and historical trends of:-
(i) the number of applicants, the number accepted, and the number of participants by race, gender, medical specialty, medical school, residence prior to medical school, and where they plan to practice after program completion;
(ii) the service placement locations and length of service commitments by participants;
(iii) the number of participants who fail to fulfill the program requirements and the reason for the failure;
(iv) the number of former participants who continue to serve in underserved areas; and
(v) program expenditures.
SECTION 2. Chapter 23 of the General Laws is hereby amended by adding the following section:-
Section 25. (a) There shall be a healthcare workforce council within, but not subject to the control of, the department of labor and workforce development.
The council shall assess and make recommendations on the capacity of the healthcare workforce to provide timely, effective, culturally competent, quality physician and nursing services.
(b) The council shall consist of 21 members and shall be comprised of:- (i) the following 5 ex-officio members, the secretary of labor and workforce development, who shall serve as chair; the secretary of health and human services, the commissioner of education, the commissioner of public health, the chancellor of higher education, or their designees; (ii) 3 physicians who shall be appointed by the chair, 1 of whom shall have a primary care specialty designation and practice in a rural area; 1 of whom shall have a primary care specialty and practice in an urban area; and 1 of whom shall have a medical subspecialty; (iii) 3 nurses who shall be appointed by the chair, 1 of whom shall be an advanced practice nurse, authorized under section 80B of said chapter 112, and practice in a rural area; 1 of whom shall be an advanced practice nurse, authorized under section 80B of said chapter 112, and practicing in an urban area; and 1 of whom shall be a registered nurse, registered under section 74 of said chapter 112; (iv) 8 persons designated by the chair, 1 each from a list of nominees submitted by each of the following organizations: the Massachusetts Academy of Family Physicians; the Massachusetts Workforce Board Association; the Massachusetts League of Community Health Centers, Inc.; the Massachusetts Medical Society; the Massachusetts Center for Nursing, Inc.; the Massachusetts Nurses Association; the Massachusetts Hospital Association, Inc.; and Health Care For All, Inc.; and (v) 1 member of the house of representatives appointed by the speaker of the house, and 1 member of the senate appointed by the senate president.
The members of the council designated from nongovernmental organizations shall serve staggered 3-year terms. Vacancies of unexpired terms shall be filled within 60 days by the appropriate appointing authority.
The council shall meet at least bimonthly, at other times as determined by its rules, and when requested by either by the chair or by any 11 members.
(c) The council shall monitor trends in access to primary care and physician subspecialties and nursing services; review existing data relative to the workforce, including patient access and regional disparities in access to physicians or nurses; physician and nursing satisfaction, existing laws, regulations, policies, contracting or reimbursement practices; and other factors that influence recruitment and retention of physicians and nurses; projections on the ability of the workforce to meet the needs of patients over time; and strategies currently being employed to address workforce needs, shortages, recruitment and retention.
The council shall design pilot programs and make regulatory and legislative proposals to address workforce needs, shortages, recruitment and retention.
The council shall make short-term and long-term programmatic and policy recommendations to improve workforce performance, address identified workforce shortages and recruit and retain physicians and nurses.
The council shall advise the board of higher education in developing and administering the physician loan repayment program.
Subject to appropriation and subject to chapter 30B, the council may contract with an organization to conduct additional data collection needed to assess workforce needs, shortages, recruitment and retention.
Subject to appropriation, the council may disburse funds in the form of grants or loans to members of the health care industry to implement or evaluate existing or pilot programs that address workforce needs, shortages, recruitment and retention.
The council shall maintain ongoing communication and coordination with the health care quality and cost council, established by section 16K of chapter 6A, and the health disparities council, established by section 16O of said chapter 6A.
(d) The council shall submit a report, annually by March 1, to the governor; the health care quality and cost council, established by section 16K of chapter 6A, the health disparities council, established by section 16O of chapter 6A; and the general court, by filing the report with the clerk of the house of representatives, the clerk of the senate, the joint committee on labor and workforce development, the joint committee on health care financing, and the joint committee on public health. The report shall include: (i) data on patient access and regional disparities in access to physicians, by specialty and sub-specialty, and nurses, (ii) data on factors influencing recruitment and retention of physicians and nurses, (iii) short and long-term projections of physician and nurse supply and demand, (iv) strategies being employed by the council or other entities to address workforce needs, shortages, recruitment and retention, (v) recommendations for designing, implementing and improving programs or policies to address workforce needs, shortages, recruitment and retention, (vi) proposals for statutory or regulatory changes to address workforce needs, shortages, recruitment and retention.
(e) The council shall receive staff assistance from the department and may, subject to appropriation, employ such additional staff or consultants as it deems necessary.
The members of the council shall not receive a salary or per diem allowance for serving as members of the council but shall be reimbursed for actual and necessary expenses reasonably incurred in the performance of their duties. The expenses may include reimbursement for reasonable travel and living expenses while engaged in council business.
SECTION 3. The first report required by section 25 of chapter 23 shall be made no later than March 1, 2009 and shall focus on the primary care workforce, defined as physicians with a medical specialty in family medicine, internal medicine, pediatrics, or obstetrics/gynecology.