Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

College & Workforce Development Committee

HB 1668

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Summary of Bill

Establishes the Washington Health Corps to encourage health care professionals to work in underserved areas by providing student loan repayment.
Establishes the Behavioral Health Loan Repayment Program to provide student loan repayment to health care professionals who serve in underserved behavioral health areas.
Requires the Washington Student Achievement Council, in consultation with the Department of Health, to study the need, feasibility, and design of a grant program for behavioral health students completing unpaid internships and supervised hours for licensure.

Background:

Health Professional Loan Repayment Program.

The Health Professionals Loan Repayment Program (HPLRP) provides licensed health care professionals with student loan repayment if the professional agrees to serve in a rural or underserved urban area with a designated shortage. The HPLRP provides up to $75,000 in loan repayment for a minimum three-year service obligation. The participants need to work a minimum of a 24-hour work week, and if the participants default on their service obligation, the penalty is double the amount received by the participant plus interest.

The 2019 eligible health care professionals include Doctors of Medicine, Doctors of Osteopathic Medicine, Naturopathic Doctors, Doctors of Dental Surgery, Doctors of Medicine in Dentistry, Registered Dental Hygienists, Nurse Practitioners, Registered Nurses, Licensed Practical Nurses, Certified Nurse Midwifes, Licensed Midwifes, Pharmacists, Licensed Clinical Psychologists, Licensed Independent Clinical Social Workers, Licensed Marriage and Family Therapists, and Licensed Mental Health Counselors.

Federal-State Loan Repayment Program.

The Federal-State Loan Repayment Program (FSLRP) also provides student loan repayment awards to health care professionals who agree to serve at not-for-profit providers who have implemented sliding fee schedules and are located in federal Health Professional Shortage Areas. The FSLRP is funded with federal dollars and state match dollars. The FSLRP provides up to $70,000 in loan repayment for a minimum two-year service obligation, with a minimum 40 hour work week. If a participant fails to complete the service obligation, the penalty is the number of months not served multiplied by $7,500 per month, plus interest. The FSLRP includes the same eligible health professionals as the HPLRP, minus Naturopathic Doctors, Licensed Practical Nurses, and Licensed Midwifes.

Selection Process.

The Washington Student Achievement Council (WSAC) administers the HPLRP in collaboration with the Department of Health (DOH). A planning committee consisting of the WSAC, DOH, and a variety of health care representatives determines the eligible provider sites and eligible health care professions for each award cycle. First, the planning committee determines eligible sites by considering a variety of factors, weighting each factor by significance, and then scoring each site. Second, the planning committee determines which health care professions are in shortage and decides how much funding to allocate to each profession based on requests from eligible sites.

Health care professionals who apply for loan repayment complete a single application, and the WSAC determines awards for both the HPLRP and FSLRP simultaneously. During the 2018 award cycle, there were 392 applicants total. Of those applicants, 81 health care professionals received a HPLRP award and an additional 17 received an award through the FSLRP.

Summary of Bill:

Washington Health Corps.

The Washington Health Corps is established to encourage health care professionals to work in underserved communities by providing loan repayment. The Washington Health Corps consists of the HPLRP and a new Behavioral Health Loan Repayment Program (BHLRP).

Behavioral Health Loan Repayment Program.

The BHLRP provides loan repayment for credentialed health care professionals who serve in underserved behavioral health areas. "Underserved behavioral health area" is defined as a geographic area, population, or facility that has a shortage of health care professionals providing behavioral health services, as determined by the DOH.

The BHLRP is administered by the WSAC using the same administrative structure and selection process as the HPLRP. The DOH, in consultation with the WSAC and DSHS, must determine: (1) which credentialed health care professionals qualify for the BHLRP; and (2) the underserved behavioral health areas for each of the eligible credentialed health care professions. Representatives from the institutions of higher education and the behavioral health and public health fields are added to the planning committee which develops criteria for the selection of participants for both loan repayment programs.

The WSAC has the same responsibilities for the BHLRP as the HPLRP, such as establishing the annual award amounts and the required service obligation. In addition, the WSAC is responsible for collecting payments for those participants who fail to complete their service obligation. For participants who do not complete the service obligation, the penalty is an amount equal to the unsatisfied portion of the service obligation, plus interest and an equalization fee.

The BHLRP account is created in the custody of the state treasurer.

Grant Program Study.

The WSAC, in consultation with the DOH, must study the need, feasibility, and potential design of a grant program for behavioral health students completing unpaid pre-graduation internships and post-graduation supervised hours for licensure. The study must review potential demand for such a program, what students would be eligible, if grants should be need or merit-based, the types of internships and supervised hours for licensure that would qualify, grant amounts, and whether the program should have a service component. A report on the study is due to the Legislature by December 1, 2019.