1Amending the act of December 2, 1992 (P.L.741, No.113), entitled
2"An act providing a comprehensive plan for health care for
3uninsured children; providing for medical education
4assistance; making appropriations; and making repeals," in
5primary care to medically underserved areas, further
6providing for definitions and for loan forgiveness for
7primary health care practitioners.

8The General Assembly of the Commonwealth of Pennsylvania
9hereby enacts as follows:

10Section 1. Section 1301 of the act of December 2, 1992
11(P.L.741, No.113), known as the Children's Health Care Act, is
12amended by adding definitions to read:

13Section 1301. Definitions.

14The following words and phrases when used in this chapter
15shall have the meanings given to them in this section unless the
16context clearly indicates otherwise:

17* * *

18"Full-time." An employment period in which an employee works
19for a duration of:

1(1) no more than 12 hours per day in a 24-hour period;

2(2) no less than four days per week;

3(3) no less than 40 hours per week; and

4(4) no less than 45 weeks per year.

5Unless approved by the department, this term shall not include
6on-call time.

7"On-call time." Time spent by an employee who is not 
8currently working on the premises of the place of employment, 
9but who is compensated for availability or as a condition of 
10employment and has agreed to be available to return to the 
11premises of the place of employment on short notice if the need 
12arises.

13"Part-time." An employment period in which an employee works
14for a duration of:

15(1) no more than 12 hours per day in a 24-hour period;

16(2) no less than two days per week;

17(3) no less than 20 hours per week, but no more than 39
18hours per week; and

19(4) no less than 45 weeks per year.

20Unless approved by the department, this term shall not include
21on-call time.

22* * *

23Section 2. Section 1303(d), (e) and (f) of the act are
24amended and the section is amended by adding a subsection to
25read:

26Section 1303. Loan forgiveness for primary health care
27practitioners.

28* * *

29(d) Eligibility.--Consideration for loan repayment
30assistance shall be as follows:

1(1) The applicant must be one of the following:

2(i) An individual who:

3(A) has a medical degree from an accredited
4medical school or osteopathic medical college;

5(B) has completed an approved graduate training
6program in primary care medicine;

7(C) is licensed to practice medicine in this
8Commonwealth; and

9(D) is board eligible in a primary care
10specialty.

11(ii) An individual who is licensed to practice
12general dentistry in this Commonwealth.

13(iii) An individual who holds a nursing degree from
14an accredited nursing program and has completed a
15training program for nurse practitioners or nurse
16midwives.

17(iv) An individual who has graduated from an
18accredited program for physician assistants.

19(2) An applicant who is qualified under paragraph (1)
20must agree to serve in a designated medically underserved
21area of this Commonwealth as a primary health care
22practitioner for:

23(i) if employed as a primary health care
24practitioner part-time, not less than three years; or

25(ii) if employed as a primary health care 
26practitioner full-time, not less than three years.

27(e) Benefits for full-time health care practitioners.--The 
28following shall apply to a full-time health care practitioner:

29(1) A physician or dentist who is eligible under
30subsection (d) and works full-time shall be eligible to

1receive up to $64,000 in loan exonerations based on the
2following schedule:

3(i) Year one, 15%.

4(ii) Year two, 20%.

5(iii) Year three, 30%.

6(iv) Year four, 35%.

7(2) A nurse practitioner, physician assistant or nurse
8midwife who is eligible under subsection (d) and works full-
9time shall be eligible to receive up to $40,000 in loan
10exonerations based on the following repayment schedule:

11(i) Year one, 15%.

12(ii) Year two, 20%.

13(iii) Year three, 30%.

14(iv) Year four, 35%.

15(e.1) Benefits for part-time health care practitioners.--The
16following shall apply to a part-time health care practitioner:

17(1) A physician or dentist who is eligible under
18subsection (d) and works part-time shall be eligible to
19receive up to $32,000 in loan exonerations based on the
20following schedule:

21(i) Year one, 15%.

22(ii) Year two, 20%.

23(iii) Year three, 30%.

24(iv) Year four, 35%.

25(2) A nurse practitioner, physician assistant or nurse
26midwife who is eligible under subsection (d) and works part-
27time shall be eligible to receive up to $20,000 in loan
28exonerations based on the following repayment schedule:

29(i) Year one, 15%.

30(ii) Year two, 20%.

1(iii) Year three, 30%.

2(iv) Year four, 35%.

3(f) Contracts.--A recipient of loan repayment assistance
4shall enter into a contract with the agency and the Department
5of Health, which shall be considered a contract with the
6Commonwealth. Priority shall be given to those applicants who
7agree to engage in full-time primary health care practice a
8minimum of three years or more or part-time primary health care 
9practice a minimum of three years or more in a designated
10medically underserved area. Preference shall be given to
11residents of this Commonwealth, minority applicants and
12graduates of Pennsylvania institutions providing primary health
13care education. The contract shall include, but not be limited
14to, the following terms and conditions:

15(1) An unlicensed applicant shall apply for a license to
16practice in this Commonwealth at the earliest practicable
17opportunity.

18(2) Within six months after licensure and the completion
19of all requirements for the primary care specialty, an
20applicant shall engage in the practice of primary health care
21medicine in a designated medically underserved area approved
22by the Department of Health. The Department of Health shall
23provide applicants with a list of available designated
24medically underserved area sites and shall, to the extent
25possible, approve applicant selections in the order they are
26received.

27(3) The applicant shall agree to serve not less than
28three full years, if full-time, or not less than three years, 
29if part-time, in a designated medically underserved area at a
30repayment assistance schedule as provided in subsection (e)

1or (e.1).

2(4) The primary health care practitioner shall agree to
3treat patients in the area eligible for medical assistance
4and Medicare.

5(5) The primary health care practitioner shall agree to
6practice on a full-time basis or a part-time basis in the
7designated medically underserved area.

8(6) The primary health care practitioner shall permit
9the agency or the Department of Health to monitor the
10practice to determine compliance with the terms of the
11contract.

12(7) The agency shall certify compliance with the terms
13of the contract for purposes of receipt by the primary health
14care practitioner of loan repayment awards for years
15subsequent to the initial year of the loan.

16(8) The contract shall be renewable on an annual basis
17upon certification by the agency that the primary health care
18practitioner has complied with the terms of the contract.

19(9) Upon the recipient's death or total or permanent
20disability, the agency shall nullify the service obligation
21of the recipient.

22(10) If the recipient is convicted of, or pleads guilty
23or no contest to, a felony or misdemeanor or if the
24appropriate licensing board has determined that the recipient
25has committed an act of gross negligence in the performance
26of service obligations or has suspended or revoked the
27license to practice, the agency shall have the authority to
28terminate the recipient's service in the program and demand
29repayment of the assistance rendered to date.

30(11) Loan recipients who fail to begin or complete the

1obligations contracted for shall pay to the agency three
2times the amount of assistance received. Falsification or
3misrepresentation on an application or in verification of
4service shall be construed to be a default. Determination as
5to the time of breach of contract shall be made by the
6agency. Both the recipient and the agency shall make every
7effort to resolve conflicts in order to prevent a breach of
8contract.

9* * *

10Section 3. This act shall take effect in 60 days.