HOUSE BILL NO. 6010

September 26, 2024, Introduced by Rep. Fitzgerald and referred to the Committee on Regulatory Reform.

A bill to amend 1978 PA 368, entitled

"Public health code,"

by amending sections 2701, 2705, and 2711 (MCL 333.2701, 333.2705, and 333.2711), sections 2701 and 2711 as amended by 2022 PA 38 and section 2705 as amended by 2022 PA 37.

the people of the state of michigan enact:

Sec. 2701. As used in this part:

(a) "Board certified" means certified to practice in a particular medical specialty by a national board recognized by the American Board of Medical Specialties or the American Osteopathic Association.

(b) "Certified nurse midwife" means an individual who is licensed as a registered professional nurse under part 172 who has been granted a specialty certification in the practice of nurse midwifery by the Michigan board of nursing under section 17210.

(c) "Certified nurse practitioner" means an individual who is licensed as a registered professional nurse under part 172 who has been granted a specialty certification as a nurse practitioner by the Michigan board of nursing under section 17210.

(d) "Clinical nurse specialist-certified" means an individual who is licensed as a registered professional nurse under part 172 who has been granted a specialty certification as a clinical nurse specialist by the Michigan board of nursing under section 17210.

(e) "Dental school" means an accredited program for the training of individuals to become dentists.

(f) "Dentist" means an individual who is licensed to engage in the practice of dentistry under part 166.

(g) "Designated advanced practice registered nurse" means a certified nurse midwife, certified nurse practitioner, or clinical nurse specialist-certified.

(h) "Designated mental health professional" means an individual who is qualified in the area of mental illness or developmental disabilities and who is 1 of the following:

(i) A nurse.

(ii) A psychologist.

(iii) A licensed master's social worker.

(iv) A licensed professional counselor.

(v) A marriage and family therapist.

(i) "Designated physician" means a physician qualified in 1 of the physician specialty areas identified described in section 2711.2711(1).

(j) "Designated professional" means a designated physician, designated advanced practice registered nurse, dentist, physician's assistant, or designated mental health professional.

(k) "Health resource shortage area" means a geographic area, population group, or health facility designated by the department under section 2717.

(l) "Licensed master's social worker" means an individual who is licensed under part 185 to engage in the practice of social work at the master's level.

(m) "Licensed professional counselor" means an individual who is licensed under part 181 to engage in the practice of counseling without supervision.

(n) "Marriage and family therapist" means an individual who is licensed under part 169 to engage in the practice of marriage and family therapy.

(o) "Medicaid" means benefits under the program of medical assistance established under title XIX of the social security act, 42 USC 1396 to 1396w-6, 1396w-8, and administered by the department under the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b.

(p) "Medical school" means an accredited program for the training of individuals to become physicians.

(q) "Medicare" means benefits under the federal Medicare program established under title XVIII of the social security act, 42 USC 1395 to 1395lll.

(r) "Mental health professional program" means an accredited program for the training of individuals to become a designated mental health professional.

(s) "National Health Service Corps" means the agency established under 42 USC 254d.

(t) "Nurse" means an individual who is licensed to engage in the practice of nursing under part 172.

(u) "Nursing program" means an accredited program for the training of individuals to become nurses.

(v) "Physician" means an individual who is licensed as a physician under part 170 or part 175.

(w) "Physician's assistant" means an individual who is licensed as a physician's assistant under part 170 or part 175.

(x) "Physician's assistant program" means an accredited program for the training of individuals to become physician's assistants.

(y) "Psychologist" means an individual licensed to engage in the practice of psychology under part 182.

(z) "Public health graduate degree program" means an accredited program for the training of individuals to become medical directors of local health departments through the completion of 1 of the following degrees:

(i) Master of public health.

(ii) Master of science in public health.

(aa) (z) "Service obligation" means the contractual obligation undertaken by an individual under section 2705 or section 2707 to provide health care services for a determinable time period at a site designated by the department.

Sec. 2705. (1) The department shall administer an essential health provider repayment program for designated professionals who have incurred a debt or expenses as a result of a loan taken to attend a medical school, a dental school, a mental health professional program, a nursing program for the training of certified nurse midwives, certified nurse practitioners, or clinical nurse specialists-certified, or a physician's assistant program, or a public health graduate degree program, or as a result of providing services in a health resource shortage area. The department may each year repay all or part of a designated professional's debt or expenses, but the amount repaid in any 1 year shall not exceed the amount described in subsection (3). The department shall repay a debt or expenses only for a designated professional who has entered into a written contract with the department that requires the designated professional to engage in the full-time practice of health care services in a health resource shortage area to which he or she the designated professional is assigned by the department for a period equal in years to the number of years for which the department has agreed in the contract to make a debt or expense repayment, or for a period of 2 years, whichever is greater.

(2) A debt or expense repayment on behalf of a designated professional under subsection (1) for fulfilling a service obligation for a particular year must be paid in a lump sum at the completion of the service obligation for that year. A designated professional who does not fulfill a service obligation for a particular year forfeits his or her the designated professional's right to the debt or expense repayment or any part of it for that year and the department may treat an agreement for further debt or expense repayment in a subsequent year as void. In its sole discretion, the department may make a debt or expense repayment before or during each year of service if there are extenuating circumstances. In its sole discretion, the department may pay a pro rata amount of an agreed debt or expense repayment to a designated professional or his or her the designated professional's estate if 1 of the following occurs before the completion of the designated professional's service obligation:

(a) The designated professional dies.

(b) The designated professional is unable, by reason of permanent disability, to render the service.

(c) Other circumstances prevail that are considered by the department to constitute a compelling reason to consider the service obligation fulfilled.

(3) In any year of a debt or expense repayment program, the maximum amount of a debt or expense repayment is $40,000.00 per year. The maximum amount of debt or expense repayment the department may pay on behalf of a designated professional is $300,000.00, paid over a period of 10 years or more. The written contract described in subsection (1) must include the amount the department shall pay on behalf of a designated professional and the amount payable for each year of service.

(4) The department may accept funds from any source for the operation of the essential health provider repayment program, and the department shall distribute those funds in a manner consistent with this section.

(5) The department shall give the essential health provider repayment program created by this section priority over the other programs created under this part.

Sec. 2711. (1) For the programs created in sections 2705 and 2707, the department shall only recruit physicians who are qualified, or students who are training to become qualified, in 1 or more of the following designated physician specialty areas:

(a) General practice.

(b) Family practice.

(c) Obstetrics.

(d) Pediatrics.

(e) Emergency medicine.

(f) Internal medicine.

(g) Preventive medicine or public health.

(h) Psychiatry or behavioral sciences.

(i) Geriatrics.

(2) When enrolling individuals to participate in the programs created in sections 2705 and 2707, the department may give preference to an individual who is qualified or studying in 1 or more of the specific designated physician specialty areas of general practice, family practice, obstetrics, pediatrics, or internal medicine over an individual who is qualified or studying in another designated physician specialty area described in subsection (1).

(3) As used in this section, "qualified" means board certified or eligible for board certification.