Purpose

Appropriates $200,000 in FY 2001-2002 and FY 2002-2003 to the Department of Health Services (DHS) to establish a rural health care providers grant program.

Background

In 1993, a House Interim Rural Health Care Task Force visited various communities around the state, including Ajo, Bisbee, Flagstaff, Holbrook, Kearny, Kingman, Nogales, Parker and Yuma to develop health policy recommendations. The Task Force identified four general insufficiencies in these geographic areas: (1) a shortage of primary care health professionals; (2) a shortage of health care facilities; (3) a lack of transportation method; and (4) a lack of educational programs for rural communities to assist health care professionals.

Currently, the following programs attempt to reduce the barriers to receiving health care services in rural areas of Arizona:

a. primary care services: allocates tobacco tax revenue from the medically needy account for grants for equipment and salaries or to expand a nonprofit community based primary care clinic and expand primary care services in medically underserved areas.

b. qualifying community health center program: allocates tobacco tax revenue from the medically needy account for grants for qualifying community health centers to provide sliding fee scale primary care services to uninsured Arizona residents under 200 percent of the federal poverty level.

c. clinic construction program: allocates tobacco tax monies from the medically needy account for matching grants to construct, expand or renovate primary care clinics. (However, this program was not continued in legislation during the 2000 legislative session.)

d. primary care provider loan repayment program: uses state general fund monies for loan repayment of educational-related expenses to qualifying health care professionals who contract with the state to provide primary care services in medically underserved areas for a minimum of two years.

e. rural private primary care provider loan repayment program: uses tobacco tax monies from the medically needy account for loan repayment of educational-related expenses to certain health care professionals who contract with the state to provide sliding fee scale primary care services for medically uninsured individuals.

f. J-1 visa waiver program: allows foreign trained physicians to practice in the U.S. in exchange for working three years in an underserved area.

g. national health service corps: provides for assignment of scholarship recipients to work in federally designated underserved areas and provides for loan repayment to qualifying health care professionals to work in a federally designated underserved area. Each of these programs requires recipients to a commitment of at least two years.

Arizona medical student loan program: provides education-related loans to qualifying University of Arizona medical students who in turn agree to provide health services in an underserved area upon graduation from medical school.

S.B. 1040 attempts to provide incentives to health care providers to locate in rural areas of this state by offering a grant to rural health care professionals as follows:

Profession	Grant for a minimum of 20-32 hours per week*	Grant for a minimum of 32 hours per week*
Primary Care Physicians	$1000	$2000
Dentists	$1000	$2000
Optometrists	$1000	$2000
Mid-Level Providers	$500	$1000

*Grant contingent upon a minimum of 48 working weeks per calendar year.

Provisions

1. Establishes the rural health care providers grant program.

2. Requires DHS, subject to the availability of monies, to award grants to primary care physicians, dentists, optometrists and mid-level providers who have practiced during the calendar year in rural and federally designated health professional shortage areas.

3. Directs the amount of the grant to be based on the type of the health care professional and the amount of time spent in practice.

4. Allows DHS to adopt rules to administer the grant program.

5. Defines the following terms:

a) “Dentist” as a licensed person who has completed an accredited educational program and is practicing general dentistry.

b) “Mid-Level Provider” as a physician assistant, a registered nurse practitioner or a qualified nurse midwife.

c) “Optometrist” as a licensed person who is engaged in the general practice of optometry.

d) “Primary Care Physician” as a licensed person who has completed an accredited residency program and practices in obstetrics, gynecology, pediatrics, internal medicine, family practice or general practice.

6. Appropriates $200,000 in FY 2001-2002 and 2002-2003 to DHS for the grant program. Exempts the appropriation from lapsing, except monies that are unexpended and unencumbered by June 30, 2004.

7. Terminates the grant program on July 1, 2004.

8. Provides for a general effective date.

Amendments Adopted by Finance Committee

1. Terminates the program on July 1, 2011.

2. Caps the program by appropriating $958,000 in FY 2001-2002 to DHS.

3. Makes conforming changes.

4. Replaces the tax credit program for rural health care providers with a grant program under the administration of DHS.

Amendments Adopted by Appropriations Committee

1. Terminates the program on July 1, 2014.

2. Makes conforming changes.

3. Replaces the tax credit program for rural health care providers with a grant program under the administration of DHS.

4. Caps the program by appropriating $200,000 in FY 2001-2002 and FY 2002-2003.

5. Reverted monies that are unexpended and unencumbered by June 30, 2004 to the state general fund.

Senate Action

HEA 1/16/01 DP 8-0-0-0

FIN 1/22/01 DPA 7-1-0-0

APPROP 2/27/01 DPA 12-0-0-0

Prepared by Senate Staff

March 2, 2001

Assigned to HEA & FIN FOR CAUCUS & FLOOR ACTION

Purpose

Background

Amendments Adopted by Appropriations Committee