PRIOR PRINTER'S NO. 3242 PRINTER'S NO. 3407
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 2382
Session of
2024
INTRODUCED BY RAPP, FRANKEL, ROWE, VENKAT, ZIMMERMAN, STEHR,
M. BROWN, SCHLOSSBERG, COOK, CAUSER, KINSEY, CONKLIN, MERSKI,
ROSSI, OBERLANDER, DALEY, PICKETT, GILLEN, KUZMA AND KHAN,
JUNE 5, 2024
AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES,
AS AMENDED, JUNE 26, 2024
AN ACT
1 Providing for grant awards to entities in rural counties and
2 designated medically underserved areas to pay for the
3 education debt of physicians and nurses PRACTITIONERS <--
4 employed at the entity.
5 The General Assembly of the Commonwealth of Pennsylvania
6 hereby enacts as follows:
7 Section 1. Short title.
8 This act shall be known and may be cited as the Rural Health
9 Care Grant Program Act.
10 Section 2. Legislative intent.
11 It is the intent of the General Assembly through this
12 legislation to:
13 (1) Allow entities in designated medically underserved
14 areas and rural areas to have an opportunity to recruit and
15 retain high quality physicians and nurses PRACTITIONERS. <--
16 (2) Have more physicians and nurses PRACTITIONERS <--
17 available to practice in designated medically underserved
 1 areas and rural areas.
2 (3) Give patients in designated medically underserved
3 areas and rural areas more access to physicians and nurses <--
4 PRACTITIONERS. <--
5 (4) Prevent the possible closure of entities in
6 designated medically underserved areas and rural areas due to
7 physician or nurse PRACTITIONER shortages. <--
8 Section 3. Definitions.
9 The following words and phrases when used in this act shall
10 have the meanings given to them in this section unless the
11 context clearly indicates otherwise:
12 "Birth center." As defined in section 802.1 of the act of
13 July 19, 1979 (P.L.130, No.48), known as the Health Care
14 Facilities Act.
15 "Department." The Department of Health of the Commonwealth.
16 "Designated medically underserved area." The term shall mean
17 the same as defined under section 1301 of the act of December 2,
18 1992 (P.L.741, No.113), known as the Children's Health Care Act.
19 "Education debt." Debt incurred for graduate-level <--
20 PROFESSIONAL schooling to practice as a physician or nurse <--
21 PRACTITIONER in this Commonwealth. <--
22 "Entity." A birth center, a federally qualified health
23 center, A RURAL HEALTH CLINIC or a hospital. <--
24 "Federally qualified health center." As defined in 42 U.S.C.
25 § 1396d(l)(2)(B) (relating to definitions). The term includes a
26 federally qualified health center look-alike.
27 "Full-time." A physician or nurse PRACTITIONER who works on <--
28 average more than 30 hours per week or more than 130 hours per
29 month.
30 "Grant." A sum of money that is awarded to an entity by the
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 1 department under this act.
2 "Hospital." A general acute care or specialty hospital
3 located in a designated medically underserved area or rural
4 county.
5 "Licensed practical nurse." An individual licensed to
6 practice practical nursing under the act of March 2, 1956 (1955
7 P.L.1211, No.376), known as the Practical Nurse Law.
8 "MIDWIFE OR NURSE-MIDWIFE." AS DEFINED IN SECTION 2 OF THE <--
9 ACT OF DECEMBER 20, 1985 (P.L.457, NO.112), KNOWN AS THE MEDICAL
10 PRACTICE ACT OF 1985.
11 "Nurse." A licensed practical nurse or registered nurse.
12 "Physician." Either:
13 (1) as defined in section 2 of the act of October 5,
14 1978 (P.L.1109, No.261), known as the Osteopathic Medical
15 Practice Act; or
16 (2) as defined in section 2 of the act of December 20, <--
17 1985 (P.L.457, No.112), known as the Medical Practice Act of
18 1985.
19 "PRACTITIONER." A PHYSICIAN, NURSE OR MIDWIFE OR NURSE- <--
20 MIDWIFE.
21 "Program." The Rural Health Care Grant Program established
22 under section 4.
23 "Registered nurse." An individual licensed to practice
24 professional nursing under the act of May 22, 1951 (P.L.317,
25 No.69), known as The Professional Nursing Law.
26 "Rural county." A county within this Commonwealth where the
27 population density is less than 284 persons per square mile as
28 defined by the Center for Rural Pennsylvania.
29 "RURAL HEALTH CLINIC." AS DEFINED IN 42 U.S.C. § 1395X(AA) <--
30 (2) (RELATING TO DEFINITIONS) AND CERTIFIED BY MEDICARE.
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 1 Section 4. Establishment.
2 The Rural Health Care Grant Program is established in the
3 department to be administered by the department.
4 Section 5. Use of money.
5 (a) Duty of department.--The department shall distribute
6 grants to an entity in accordance with this act from money
7 appropriated for the program by the General Assembly.
8 (b) Distribution by entity.--An entity shall use money
9 granted under subsection (a) to pay for education debt of
10 physicians or nurses PRACTITIONERS that the entity employs <--
11 according to the following:
12 (1) An entity shall pay the applicable creditor or
13 designated person of the education debt on behalf of the
14 physician or nurse PRACTITIONER. <--
15 (2) Within 30 days after disbursement of money to the
16 applicable creditor or designated person, an entity shall
17 report to the department the following:
18 (i) The date the payment was sent to the applicable
19 creditor or designated person.
20 (ii) The amount of the payment.
21 (iii) The name and address of the applicable
22 creditor or designated person.
23 (iv) The names of the physicians and nurses <--
24 PRACTITIONERS whose education debt was paid by the entity <--
25 with the grant money.
26 (c) Receipt.--A written or electronic receipt of payment of
27 education debt shall be issued to a physician or nurse <--
28 PRACTITIONER employed by the entity whose education debt was <--
29 paid by a grant under this act.
30 Section 6. Grant awards.
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 1 (a) Criteria for grant from department.--The department
2 shall award a grant to an entity that is located in a designated
3 medically underserved area or rural county. Priority shall be
4 given to independent entities not owned by, managed by or
5 affiliated with any health care system, A LEGALLY SEPARATE <--
6 health care provider or other entity.
7 (b) Limitation of awards.--
8 (1) The department may not award more than $250,000 to
9 an entity in one calendar year.
10 (2) The amount distributed to a physician or nurse <--
11 PRACTITIONER may not exceed the amount owed in education <--
12 debt.
13 (c) Entity award.--An entity shall award the grant money
14 received from the department to one or more chosen physicians or <--
15 nurses PRACTITIONERS who are employed by the entity. In order to <--
16 receive a payment of education debt, a physician or nurse <--
17 PRACTITIONER must: <--
18 (1) Work a minimum of three years in the entity that
19 provides the grant money to pay for education debt.
20 (2) Be licensed to practice as a physician or nurse <--
21 PRACTITIONER in this Commonwealth under the applicable <--
22 licensing board of the Department of State.
23 (3) Begin work within six months of accepting a position
24 with the entity paying for the education debt.
25 (4) Be employed as a full-time physician or nurse <--
26 PRACTITIONER for the entity providing the grant. <--
27 Section 7. Entity application for a grant.
28 (a) General rule.--Applications shall:
29 (1) Be submitted by an entity to the department in a
30 manner the department deems appropriate.
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 1 (2) Be available electronically.
2 (3) Include documentation as deemed necessary by the
3 department.
4 (b) Certification.--An entity shall certify in good faith
5 that the information provided in the application and all
6 supporting documents and forms are true and accurate in all
7 material aspects. An entity, or an authorized representative of
8 the entity, that knowingly makes a false statement to obtain a
9 grant shall be subject to 18 Pa.C.S. § 4904 (relating to unsworn
10 falsification to authorities).
11 Section 8. Review of application.
12 (a) Selection.--The department shall select an appropriate
13 number of entities to receive a grant under this act each
14 calendar year, dependent upon the amount of money appropriated
15 for the program by the General Assembly.
16 (b) Approval or disapproval.--No later than 60 days after an
17 entity's submission OR RESUBMISSION of an application, the <--
18 department shall approve or deny the application for a grant.
19 The department shall provide a notice to the entity that:
20 (1) the application for a grant is approved for an
21 amount determined by the department; or
22 (2) the application for a grant is denied. The
23 department shall provide its reasons for denial of the
24 application. The entity may resubmit its application based
25 upon the department's reasons for denying the application.
26 Section 9. Grant agreements.
27 Upon approval of an application under section 8, the
28 department shall enter into a grant agreement with the entity to
29 award a grant under this act. The grant agreement shall explain
30 the terms and conditions of the grant, including the applicable
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 1 laws of this Commonwealth and all reporting requirements. The
2 department, an entity and any other necessary party, as
3 determined by the department, may enter into the grant agreement
4 via electronic signature.
5 Section 10. Disbursement of grants.
6 The following shall apply to the disbursement of grants:
7 (1) The department shall determine the number of grants
8 to be awarded with the money appropriated by the General
9 Assembly.
10 (2) The FOR APPROVED GRANTS, THE department shall award <--
11 a grant to an entity in $10,000 increments. INCREMENTS OF <--
12 $10,000 UP TO THE LIMIT UNDER SECTION 6(B)(1). THE DEPARTMENT
13 MAY AWARD A GRANT OF LESS THAN $10,000 IF THE DEPARTMENT
14 DETERMINES THAT A DECREASE IS NECESSARY TO PRESERVE ADEQUATE
15 FUNDING FOR MORE GRANTS.
16 (3) An entity shall report to the department the initial
17 date of employment for each physician or nurse PRACTITIONER <--
18 who receives payment of education debt and the departure from
19 employment date for each physician or nurse PRACTITIONER, if <--
20 applicable.
21 (4) The department shall begin disbursement of grant
22 money to an entity within 60 90 days after the approval of an <--
23 entity's application.
24 Section 11. Reports.
25 (a) Content.--No later than December 31 of each year, the
26 department shall publish a report on its publicly accessible
27 Internet website that contains the following information:
28 (1) The number of grants awarded under this act.
29 (2) The number of physicians and nurses PRACTITIONERS <--
30 who received a payment of their education debt.
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 1 (3) The license type and practice area of each physician <--
2 and nurse PRACTITIONER, as applicable. <--
3 (4) The name and address of each entity that received a
4 grant under this act.
5 (5) The amount of each grant awarded.
6 (6) The total amount of the appropriation distributed
7 each calendar year.
8 (7) An aggregate total for each designated medically
9 underserved area or rural county where a physician or nurse <--
10 PRACTITIONER awarded grant money is employed by an entity. <--
11 (b) Confidentiality.--The name, address and other personal
12 information of a physician or nurse PRACTITIONER who received <--
13 money from an entity awarded a grant by the department may not
14 be listed on the department's publicly accessible Internet
15 website and may not be considered accessible under the act of
16 February 14, 2008 (P.L.6, No.3), known as the Right-to-Know Law.
17 (c) Submission.--The department shall submit the report
18 under subsection (a) to the following:
19 (1) The chair and minority chair of the Appropriations
20 Committee of the Senate.
21 (2) The chair and minority chair of the Appropriations
22 Committee of the House of Representatives.
23 (3) The chair and minority chair of the Health and Human
24 Services Committee of the Senate.
25 (4) The chair and minority chair of the Health Committee
26 of the House of Representatives.
27 (d) Final report.--After disbursement of all money
28 appropriated for the program, the department shall publish a
29 final report with the information listed under this section
30 within six months.
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 1 Section 12. Tax applicability.
2 Grants awarded under this act may not be considered taxable
3 income to an entity, physician or nurse OR PRACTITIONER under <--
4 the act of March 4, 1971 (P.L.6, No.2), known as the Tax Reform
5 Code of 1971.
6 Section 13. Compliance.
7 (a) Reimbursement for noncompliance.--The department shall
8 determine compliance with the requirements of this act. If an
9 entity, physician or nurse OR PRACTITIONER fails to comply with <--
10 the requirements of this act, the entity, physician or nurse OR <--
11 PRACTITIONER shall reimburse the Commonwealth for the amount of
12 the grant received or awarded BASED ON THE PERIOD OF <--
13 NONCOMPLIANCE, including interest accrued, as determined by the
14 department based on a determination of which party violated this
15 act. The department, entity, physician or nurse AND PRACTITIONER <--
16 shall make every effort to resolve conflicts in order to prevent
17 a breach of the program requirements established by the
18 department.
19 (b) Agreement between entity and employee.--An entity that
20 receives a grant under this act may require a physician or nurse <--
21 PRACTITIONER awarded money to enter into an agreement <--
22 established by the entity and determine any compliance, <--
23 including the timing of disbursement of the grant money, AS <--
24 APPROPRIATE TO FACILITATE THE PURPOSES AND INTENT OF THIS ACT
25 AND subject to the requirements of this act.
26 Section 14. Effective date.
27 This act shall take effect in 120 days.
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