LB1062 LB1062
2024 2024
LEGISLATURE OF NEBRASKA
ONE HUNDRED EIGHTH LEGISLATURE
SECOND SESSION
LEGISLATIVE BILL 1062
Introduced by Ibach, 44; Brewer, 43; Erdman, 47; Halloran, 33; Holdcroft,
36; Hughes, 24; Murman, 38.
Read first time January 08, 2024
Committee: Health and Human Services
1 A BILL FOR AN ACT relating to the Rural Health Systems and Professional
2 Incentive Act; to amend sections 71-5650, 71-5651, 71-5652, 71-5653,
3 71-5654, 71-5655, and 71-5664, Reissue Revised Statutes of Nebraska,
4 and sections 71-5661, 71-5662, 71-5663, and 71-5668, Revised
5 Statutes Supplement, 2023; to restate legislative findings under and
6 the purposes of the Rural Health Systems and Professional Incentive
7 Act; to define a term; to change the purpose, duties, and members of
8 the Nebraska Rural Health Advisory Commission; to provide for
9 financial assistance in the form of repayment of qualified
10 educational debts owed by veterinarians as prescribed; to harmonize
11 provisions; and to repeal the original sections.
12 Be it enacted by the people of the State of Nebraska,
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1 Section 1. Section 71-5650, Reissue Revised Statutes of Nebraska, is
2 amended to read:
3 71-5650 Sections 71-5650 to 71-5670 and section 12 of this act shall
4 be known and may be cited as the Rural Health Systems and Professional
5 Incentive Act.
6 Sec. 2. Section 71-5651, Reissue Revised Statutes of Nebraska, is
7 amended to read:
8 71-5651 (1) The Legislature finds that (a) residents of rural
9 Nebraska frequently encounter difficulties in obtaining medical care due
10 to the lack of health care providers, facilities, and services, (b) many
11 rural communities experience problems in recruiting and retaining health
12 care providers, (c) rural residents are often required to travel long
13 distances in order to obtain health care services, (d) elderly and
14 uninsured persons constitute a high proportion of the population in rural
15 Nebraska, (e) many rural hospitals are experiencing declining patient
16 revenue and are being forced to reconsider the scope and nature of the
17 health care services they provide, (f) the physical and economic stresses
18 of rural living can lead to an increased need for mental health services
19 in rural Nebraska, (g) the conditions described in this section can lead
20 to situations in which residents of rural Nebraska receive a lower level
21 of health care services than their urban counterparts, and (h) some of
22 the conditions described in this subsection also exist in underserved
23 portions of metropolitan areas within the state.
24 (2) The Legislature further finds that the health care industry is a
25 vital component of the economic base of many rural communities and that
26 the maintenance and enhancement of this industry can play a significant
27 role in efforts to further the economic development of rural communities.
28 (3) The Legislature further finds that the inherent limitations
29 imposed upon health care delivery mechanisms by the rural environment can
30 be partially overcome through a greater emphasis on the development of
31 health care systems that emphasize the linkage and integration of health
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1 care resources in neighboring communities as well as the development of
2 new resources.
3 (4) The Legislature further finds that postsecondary education of
4 medical, dental, and mental health professionals is important to the
5 welfare of the state. The Legislature further recognizes and declares
6 that the state can help alleviate the problems of maldistribution and
7 shortages of medical, dental, and mental health personnel through
8 programs offering financial incentives to practice in areas of shortage.
9 (5) The Legislature further finds that the state can help alleviate
10 the problem of shortages in veterinary services for livestock in rural
11 areas.
12 Sec. 3. Section 71-5652, Reissue Revised Statutes of Nebraska, is
13 amended to read:
14 71-5652 The purposes of the Rural Health Systems and Professional
15 Incentive Act are to (1) create the Nebraska Rural Health Advisory
16 Commission and establish its powers and duties, (2) establish a student
17 loan program that will provide financial incentives to medical, dental,
18 master's level and doctorate-level mental health, and physician assistant
19 students who agree to practice their profession in a designated health
20 profession shortage area within Nebraska, (3) establish a loan repayment
21 program that will provide financial incentives to medical residents who
22 agree to practice their profession in a designated health profession
23 shortage area within Nebraska, and (4) establish a loan repayment program
24 that will require community matching funds and will provide financial
25 incentives to eligible health professionals who agree to practice their
26 profession in a designated health profession shortage area within
27 Nebraska, and (5) establish a loan repayment program to provide financial
28 incentives to eligible veterinarians who agree to provide at least fifty
29 percent of their veterinary services to livestock in rural areas within
30 Nebraska.
31 Sec. 4. Section 71-5653, Reissue Revised Statutes of Nebraska, is
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1 amended to read:
2 71-5653 For purposes of the Rural Health Systems and Professional
3 Incentive Act:
4 (1) Approved medical specialty means family practice, general
5 practice, general internal medicine, general pediatrics, general surgery,
6 obstetrics/gynecology, and psychiatry;
7 (2) Approved dental specialty means general practice, pediatric
8 dentistry, and oral surgery;
9 (3) Approved mental health practice program means an approved
10 educational program consisting of a master's or doctorate degree with the
11 focus being primarily therapeutic mental health and meeting the
12 educational requirements for licensure in mental health practice or
13 psychology by the department;
14 (4) Commission means the Nebraska Rural Health Advisory Commission;
15 (5) Department means the Division of Public Health of the Department
16 of Health and Human Services;
17 (6) Doctorate-level mental health student means a graduate student
18 enrolled in or accepted for enrollment in an approved mental health
19 practice program leading to a doctorate degree and meeting the
20 educational requirements for licensure in psychology by the department;
21 (7) Full-time practice means a minimum of forty hours per week;
22 (8) Health care means both somatic and mental health care services;
23 (9)(a) Livestock means a domesticated animal kept in an agricultural
24 setting (i) for the labor provided by such animal or (ii) to produce
25 products for consumption or use; and
26 (b) Livestock does not include any (i) dog, (ii) cat, or (iii)
27 animal kept for the purpose of being a pet;
28 (10) (9) Master's level mental health student means a graduate
29 student enrolled in or accepted for enrollment in an approved mental
30 health practice program leading to a master's degree and meeting the
31 educational requirements for licensure in mental health practice by the
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1 department;
2 (11) (10) Office means the Office of Rural Health;
3 (12) (11) Part-time practice means less than full-time practice but
4 at least twenty hours per week;
5 (13) (12) Qualified educational debts means government and
6 commercial student-loan loans obtained by students for postsecondary
7 education tuition, other educational expenses, and reasonable living
8 expenses, as determined by the department, but does not include loans
9 received under the act; and
10 (14) (13) Rural means located within any county in Nebraska having a
11 population of less than fifteen thousand inhabitants and not included
12 within a metropolitan statistical area as defined by the United States
13 Department of Commerce, Bureau of the Census.
14 Sec. 5. Section 71-5654, Reissue Revised Statutes of Nebraska, is
15 amended to read:
16 71-5654 The Nebraska Rural Health Advisory Commission is hereby
17 created as the direct and only successor to the Commission on Rural
18 Health Manpower. The Nebraska Rural Health Advisory Commission shall
19 consist of fourteen thirteen members as follows:
20 (1) The Director of Public Health of the Division of Public Health
21 or his or her designee and another representative of the Department of
22 Health and Human Services; and
23 (2)(a) Twelve (2) Eleven members to be appointed by the Governor
24 with the advice and consent of the Legislature as follows:
25 (i) (a) One representative of each medical school located in the
26 state involved in training family physicians and one physician in family
27 practice residency training; and
28 (ii) (b) From rural areas one physician, one consumer
29 representative, one hospital administrator, one nursing home
30 administrator, one nurse, one physician assistant, one mental health
31 practitioner or psychologist licensed under the requirements of section
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1 38-3114 or the equivalent thereof, and one dentist, and one veterinarian.
2 (b) All appointed members Members shall serve for terms of three
3 years. When a vacancy occurs, appointment to fill the vacancy shall be
4 made for the balance of the term. All appointed members shall be citizens
5 and residents of Nebraska. The appointed membership of the commission
6 shall, to the extent possible, represent the three congressional
7 districts equally.
8 Sec. 6. Section 71-5655, Reissue Revised Statutes of Nebraska, is
9 amended to read:
10 71-5655 The purposes purpose of the commission shall be (1) to
11 advise the department, the Legislature, the Governor, the University of
12 Nebraska, and the citizens of Nebraska regarding all aspects of rural
13 health care and rural veterinary services and (2) to advise the office
14 regarding the administration of the Rural Health Systems and Professional
15 Incentive Act.
16 Sec. 7. Section 71-5661, Revised Statutes Supplement, 2023, is
17 amended to read:
18 71-5661 (1) The financial incentives provided by the Rural Health
19 Systems and Professional Incentive Act shall consist of (a) student loans
20 to eligible students for attendance at an eligible school as determined
21 pursuant to section 71-5662, (b) the repayment of qualified educational
22 debts owed by physicians and psychiatrists in an approved medical
23 specialty residency program in Nebraska as determined pursuant to section
24 71-5662, and (c) the repayment of qualified educational debts owed by
25 eligible health professionals and veterinarians as determined pursuant to
26 section 71-5662. Funds for such incentives shall be appropriated from the
27 General Fund to the department for such purposes.
28 (2) The Rural Health Professional Incentive Fund is created. The
29 fund shall be used to carry out the purposes of the act, except that
30 transfers may be made from the fund to the General Fund at the direction
31 of the Legislature. Money credited pursuant to section 71-5670.01 and
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1 payments received pursuant to sections 71-5666, 71-5668, and 71-5669.01
2 and section 12 of this act shall be remitted to the State Treasurer for
3 credit to the Rural Health Professional Incentive Fund. Any money in the
4 fund available for investment shall be invested by the state investment
5 officer pursuant to the Nebraska Capital Expansion Act and the Nebraska
6 State Funds Investment Act.
7 Sec. 8. Section 71-5662, Revised Statutes Supplement, 2023, is
8 amended to read:
9 71-5662 (1) To be eligible for a student loan under the Rural Health
10 Systems and Professional Incentive Act, an applicant or a recipient shall
11 be enrolled or accepted for enrollment in an accredited medical or dental
12 education program or physician assistant education program or an approved
13 mental health practice program in Nebraska.
14 (2) To be eligible for the medical resident incentive under the act,
15 an applicant or a recipient shall be enrolled or accepted for enrollment
16 in an approved medical specialty residency program in Nebraska.
17 (3) To be eligible for loan repayment under the act, an applicant or
18 a recipient shall be:
19 (a) A a pharmacist, a dentist, a physical therapist, an occupational
20 therapist, a mental health practitioner, a psychologist licensed under
21 the requirements of section 38-3114 or the equivalent thereof, a nurse
22 practitioner, a physician assistant, a psychiatrist, or a physician in an
23 approved specialty and shall be licensed to practice in Nebraska, not be
24 enrolled in a residency program, not be practicing under a provisional or
25 temporary license, and enter practice in a designated health profession
26 shortage area in Nebraska; or .
27 (b) A veterinarian licensed under the Veterinary Medicine and
28 Surgery Practice Act whose patients serviced in his or her practice are
29 composed of not less than fifty percent livestock in rural areas within
30 Nebraska. Each head of livestock counts as a separate patient.
31 Sec. 9. Section 71-5663, Revised Statutes Supplement, 2023, is
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1 amended to read:
2 71-5663 (1) The amount of financial assistance provided through
3 student loans pursuant to the Rural Health Systems and Professional
4 Incentive Act shall be limited to thirty thousand dollars for each
5 recipient for each academic year and, except as provided in subdivision
6 (4)(a) of this section, shall not exceed one hundred twenty thousand
7 dollars per medical, dental, or doctorate-level mental health student or
8 thirty thousand dollars per master's level mental health or physician
9 assistant student.
10 (2) The amount of financial assistance provided through the medical
11 resident incentive program pursuant to the act shall be limited to forty
12 thousand dollars for each recipient for each year of residency and,
13 except as provided in subdivision (4)(b) of this section, shall not
14 exceed one hundred twenty thousand dollars.
15 (3) The amount of financial assistance provided by the state through
16 loan repayments pursuant to the act for:
17 (a) Physicians for physicians, psychiatrists, dentists, and
18 psychologists is shall be limited to thirty thousand dollars per
19 recipient per year of full-time practice in a designated health
20 profession shortage area and, except as provided in subdivision (4)(c) of
21 this section, shall not exceed ninety thousand dollars per recipient; and
22 (b) Physician for physician assistants, nurse practitioners,
23 pharmacists, physical therapists, occupational therapists, and mental
24 health practitioners is shall be limited to fifteen thousand dollars per
25 recipient per year of full-time practice in a designated health
26 profession shortage area and, except as provided in subdivision (4)(c) of