Bill Text - SB500 (2024)

Establishing a primary care provider loan repayment program, and making an appropriation therefor.

Revision: Jan. 16, 2024, 4:48 p.m.

SB 500-FN-A - AS INTRODUCED

 

 

2024 SESSION

24-2968

05/10

 

SENATE BILL 500-FN-A

 

AN ACT establishing a primary care provider loan repayment program, and making an appropriation therefor.

 

SPONSORS: Sen. Perkins Kwoka, Dist 21; Sen. Fenton, Dist 10

 

COMMITTEE: Health and Human Services

 

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ANALYSIS

 

This bill establishes a primary care provider loan repayment program and fund in the department of health and human services and makes an appropriation to the department for this purpose.

 

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

24-2968

05/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty Four

 

AN ACT establishing a primary care provider loan repayment program, and making an appropriation therefor.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

1 New Section; Department of Health and Human Services; Primary Care Provider Loan Assistance Program. Amend RSA 126-A by inserting after section 18-a the following new section:

126-A:18-b  Primary Care Provider Loan Assistance Program.  

I.  The department of health and human services shall establish and administer a primary care provider loan assistance program.  The program shall provide student loan repayment assistance to eligible primary care providers in New Hampshire.  The program shall be administered by the department of health and human services as a separate program from the student loan repayment program.

II. The program shall be available to all primary care providers in New Hampshire not otherwise participating in the state office of rural health (SORH) loan repayment program.  Program administration and eligibility criteria shall be similar to that of the SORH program except that it shall be open to all primary care providers in New Hampshire regardless of geographic area of practice or demographic factors.

III.  There is established in the treasury a fund to be known as the primary care provider loan assistance fund.  The fund shall include any sums appropriated for such purpose.  In addition, the department of health and human services may accept public sector and private sector grants, gifts, or donations of any kind for the purpose of providing loan repayment assistance.  The fund shall be nonlapsing and continually appropriated to the department to award student loan repayment assistance in accordance with this section.  The state treasurer may invest moneys in the fund as provided by law, with interest received on such investment credited to the fund.

IV.  The commissioner shall adopt rules under RSA 541-A, as needed, relative to program administration, including application procedures, eligibility criteria, and fund disbursement.

2  New Subparagraph; Dedicated Fund.  Amend RSA 6:12, I(b) by inserting after subparagraph (394) the following new subparagraph:

(395)  Moneys deposited in the primary care provider loan assistance fund under RSA 126-A:18-b.

3  Appropriation.  For the biennium ending June 30, 2025, the sum of $500,000 is appropriated to the department of health and human services for deposit in the primary care provider loan assistance fund under RSA 126-A:18-b.  The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.

4  Effective Date.  This act shall take effect October 1, 2024.

 

LBA

24-2968

Revised 1/16/24

 

SB 500-FN-A- FISCAL NOTE

AS INTRODUCED

 

AN ACT establishing a primary care provider loan repayment program, and making an appropriation therefor.

 

FISCAL IMPACT:      [ X ] State              [    ] County               [    ] Local              [    ] None

 

 

Estimated State Impact - Increase / (Decrease)

 

FY 2024

FY 2025

FY 2026

FY 2027

Revenue

$0

$0

$0

$0

Revenue Fund(s)

None

Expenditures

$0

$17.4 million

$23.2 million

$23.2 million

Funding Source(s)

General Fund

Appropriations

$0

$0.5 million

$0

$0

Funding Source(s)

General Fund

• Does this bill provide sufficient funding to cover estimated expenditures? [X] No

• Does this bill authorize new positions to implement this bill? [X] No

 

METHODOLOGY:

This bill establishes a primary care provider loan repayment program, to be administered by the Department of Health and Human Services.  In addition, the bill establishes a new fund, which may accept gifts, grants, and donations.  The bill contains a general fund appropriation of $500,000 in the FY24/25 biennium.  Due to the bill's effective date of October 1, 2024, this appropriation will not be effective until FY25.

 

The Department assumes that 50 percent of eligible primary care providers will take advantage of the new program to its fullest extent, as well as 10 percent that exercise the option of extension contracts following the initial loan repayment contract.  According to data from the NH Health Professions Data Center, there are an estimated 2,047 primary care providers (1,108 physicians, 742 nurse practitioners, and 197 physician assistants) in New Hampshire.  All of these providers would be eligible for the new program.  At 50 percent uptake and assuming the same reimbursement limits offered for the existing State Loan Repayment Program, this results in the following:

 

  • 1,108 eligible physicians * 50 percent uptake = 554 applicants at $25,000 each per year for the first three years = $13,850,000 per year.  
  • 554 applicants eligible for contract extension * 10 percent extension rate = 55 extension contracts at $20,000 each per year for years four and five = $1,100,000 per year.
  • 939 eligible advanced practitioners * 50 percent uptake = 469 applicants at $15,000 each per year for three years = $7,035,000.  
  • 469 applicants eligible for contract extension * 10 percent extension rate = 46 extension contracts at $10,000 each per year for years four and five = $460,000 per year.

 

The Department further notes that, according to data from the NH Health Professions Data Center, an estimated 20 percent of active licensees choose to work in primary care.  On average, there are an additional 421 new APRN licensees each year and an average of 550 new physician licensees each year.  Assuming 20 percent of those new licensees choose to work in primary care the Department assumes 84 additional eligible APRNs per year and 110 additional eligible physicians per year.  Using the same assumptions made above, this results in the following:

 

  • 110 newly eligible physicians * 50 percent uptake = 55 applicants at $25,000 each per year for the first three years = $1,375,000 per year.  
  • 55 applicants eligible for contract extension * 10 percent extension rate = 5 extension contracts at $20,000 each per year for years four and five = $100,000 per year.
  • 84 newly eligible advanced practitioners * 50 percent uptake = 42 applicants at $15,000 each per year for three years = $630,000.  
  • 42 applicants eligible for contract extension * 10 percent extension rate = 4 extension contracts at $10,000 each per year for years four and five = $40,000 per year.

 

Following the initial three-year uptake, the Department anticipates that funding needs will reduce to approximately $2.5 million per year in years six and beyond to maintain the program at the eligibility and uptake figures noted in the above paragraphs.

 

The programmatic costs described above total $22.89 million per year in the first three years of the program's operation.  In addition, the Department anticipates it will need three new positions to administer the program, at the costs shown below:

 

  • Administrator I, LG27, Step 5: $74,276; Benefits: $36,985; Equipment: $3,000
  • Compliance Officer II, LG21, Step 5: $57,116; Benefits: $33,296; Equipment: $3,000
  • Administrative Assistant I, LG16, Step 5: $46,527; Benefits: $31,019; Equipment: $3,000

 

The three positions combined will cost approximately $290,000 per year, resulting in total program costs of approximately $23.2 million per year in the first three years of operation.  As the program has an effective date of October 1, 2024, this fiscal note assumes 75 percent of the cost, or $17.4 million, in FY25.

 

AGENCIES CONTACTED:

Department of Health and Human Services