SENATE BILL REPORT

2SHB 1668

As Passed Senate - Amended, April 16, 2019

Title: An act relating to creating the Washington health corps to support health care professionals who provide service in underserved communities.

Brief Description: Creating the Washington health corps to support health care professionals who provide service in underserved communities.

Sponsors: House Committee on Appropriations (originally sponsored by Representatives Slatter, Jinkins, DeBolt, Macri, Frame, Robinson, Tharinger, Bergquist, Senn, Cody, Pollet, Young, Davis, Kloba, Ortiz-Self, Lekanoff, Steele, Harris, Ormsby, Stanford, Goodman, Doglio, Fey, Leavitt, Valdez and Hudgins).

Brief History: Passed House: 3/05/19, 97-1.

Committee Activity: Higher Education & Workforce Development: 3/19/19, 4/02/19 [DP-WM].

Ways & Means: 4/08/19, 4/09/19 [DPA].

Floor Activity:

Passed Senate - Amended: 4/16/19, 48-0.

Majority Report: Do pass and be referred to Committee on Ways & Means.

Signed by Senators Palumbo, Chair; Randall, Vice Chair; Holy, Ranking Member; Brown, Liias and Wellman.

Staff: Kellee Gunn (786-7429)

Majority Report: Do pass as amended.

Signed by Senators Rolfes, Chair; Frockt, Vice Chair, Operating, Capital Lead; Mullet, Capital Budget Cabinet; Braun, Ranking Member; Brown, Assistant Ranking Member, Operating; Honeyford, Assistant Ranking Member, Capital; Bailey, Becker, Billig, Carlyle, Conway, Darneille, Hasegawa, Hunt, Keiser, Liias, Palumbo, Pedersen, Schoesler, Van De Wege, Wagoner and Warnick.

Staff: Daniel Masterson (786-7454)

Background: Health Professional Loan Repayment Program. The HPLRP and Conditional Scholarship Program were created by the Legislature to address health professional shortages in rural and underserved urban communities. The HPLRP provides financial support to eligible licensed health professionals through loan repayment or conditional scholarships. The Washington Student Achievement Council's (WSAC) Office of Student Assistance administers and publicizes 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.

The total award amount for each health professional is $75,000, with a contract service obligation minimum of three years. Less than full-time employment is allowed at qualifying sites in rural and underserved urban communities. DOH, WSAC, and the Department of Social and Health Services determine the eligible credentialed health care professions for the purpose of the HPLRP and conditional scholarship. Participants who do not serve the required service obligation incur a penalty.

Health professionals in the following disciplines currently qualify: 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.

Summary of Amended Bill: Washington Health Corps. The Washington Health Corps is established to encourage health care professionals to work in underserved communities. The Washington Health Corps consists of the HPLRP and the new BHLRP.

Behavioral Health Loan Repayment Program. The BHLRP is established for credentialed health professionals serving in underserved behavioral health areas. An 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 DOH.

The planning committee convened by WSAC for the HPLR and Conditional Scholarship Program is expanded to determine the eligible credentialed health care professions for the BHLRP.

The BHLRP shall be administered by WSAC similar to the HPLRP. The BHLRP account is created in the custody of the state treasurer and is subject to allotment procedures, but an appropriation is not required for expenditures.

Penalties. Washington Health Corps participants who fail to complete the service obligation shall incur an equalization fee based on the remaining unforgiven balance. The equalization fee shall be added to the remaining balance and repaid by the participant. HLPRP participants who serve less than the required service obligation are no longer obligated to pay a penalty equal to twice the unsatisfied portion of the principal. WSAC shall set the maximum period for repayment by rule.

Appropriation: The bill contains a null and void clause requiring specific funding be provided in an omnibus appropriation act.

Fiscal Note: Available.

Creates Committee/Commission/Task Force that includes Legislative members: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Staff Summary of Public Testimony (Higher Education & Workforce Development): PRO: There is a shortage of behavioral health professionals. This is a workforce bill that would allow other medical professionals to serve in underserved behavioral health areas. Jails would qualify as an underserved area. This does not change the administrative structure of the current program. This also includes a grant program study on supervised hours for licensure as we know social workers need supervised work experience but have to pay for them themselves. The study would provide information on how to support them. The exploration of paying for the supervision of the clinical social worker is innovative. The candidate for social work is required to pay thousands of dollars for the supervised clinical work for their license, after they have paid for their masters’ degree.

The change in penalties will help current participants. The demand for behavioral health workforce is only going to grow. Some of the providers are able to provide better salaries and locations than others. The current HPLRP covers all medical professionals, but this looks at the problem of recruiting and retaining behavioral health professionals.

Persons Testifying (Higher Education & Workforce Development): PRO: Representative Vandana Slatter, Prime Sponsor; J. Lee Schultz, Washington Student Achievement Council; Len McComb, Washington State Hospital Association; Bob Cooper, National Association of Social Workers, Washington Chapter.

Persons Signed In To Testify But Not Testifying (Higher Education & Workforce Development): No one.

Staff Summary of Public Testimony (Ways & Means): The committee recommended a different version of the bill than what was heard. PRO: This bill speaks to the fact that behavioral health actually touches everyone in health professions. The most positive thing for the social workers is the study about how the state might be able to pick up some of the cost of supervised practice on the way to full licensure. A clinical social worker has to have 4000 hours of experience, with 130 of those directly supervised. The cost is often upwards of $50 an hour or more. This is not a particularly lucrative profession, but we do need more people in behavioral health. At community health centers we recruit behavioral health providers and all kinds of other licensed providers, with the underlying Health Professional Loan Repayment Program. We know it works well and we think having a pool dedicated for the increasing behavioral health needs of the policies passed by this legislature makes sense at this time. We also appreciate the underlying technical fixes to some of the penalties for repayment. This will help with recruitment.

Persons Testifying (Ways & Means): PRO: Bob Cooper, National Association of Social Workers, Washington Chapter; Kate White Tudor, Washington Association for Community Health.

Persons Signed In To Testify But Not Testifying (Ways & Means): No one.