PRINTER'S NO. 99
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
157
Session of
2025
INTRODUCED BY RAPP, FRANKEL, TWARDZIK, SANCHEZ, ZIMMERMAN,
VENKAT, HOWARD, KHAN, CUTLER, GREINER, HILL-EVANS, FREEMAN,
PICKETT AND WEBSTER, JANUARY 14, 2025
REFERRED TO COMMITTEE ON HEALTH, JANUARY 14, 2025
AN ACT
Providing for grant awards to entities in rural counties and
designated medically underserved areas to pay for the
education debt of practitioners employed at the entity.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Rural Health
Care Grant Program Act.
Section 2. Legislative intent.
It is the intent of the General Assembly through this
legislation to:
(1) Allow entities in designated medically underserved
areas and rural areas to have an opportunity to recruit and
retain high quality practitioners.
(2) Have more practitioners available to practice in
designated medically underserved areas and rural areas.
(3) Give patients in designated medically underserved
areas and rural areas more access to practitioners.
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(4) Prevent the possible closure of entities in
designated medically underserved areas and rural areas due to
practitioner shortages.
Section 3. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Birth center." As defined in section 802.1 of the act of
July 19, 1979 (P.L.130, No.48), known as the Health Care
Facilities Act.
"Department." The Department of Health of the Commonwealth.
"Designated medically underserved area." The term shall mean
the same as defined under section 1301 of the act of December 2,
1992 (P.L.741, No.113), known as the Children's Health Care Act.
"Education debt." Debt incurred for professional schooling
to practice as a practitioner in this Commonwealth.
"Entity." A birth center, a federally qualified health
center, a rural health clinic or a hospital.
"Federally qualified health center." As defined in 42 U.S.C.
§ 1396d(l)(2)(B) (relating to definitions). The term includes a
federally qualified health center look-alike.
"Full-time." A practitioner who works on average more than
30 hours per week or more than 130 hours per month.
"Grant." A sum of money that is awarded to an entity by the
department under this act.
"Hospital." A general acute care or specialty hospital
located in a designated medically underserved area or rural
county.
"Licensed practical nurse." An individual licensed to
practice practical nursing under the act of March 2, 1956 (1955
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P.L.1211, No.376), known as the Practical Nurse Law.
"Midwife or nurse-midwife." As defined in section 2 of the
act of December 20, 1985 (P.L.457, No.112), known as the Medical
Practice Act of 1985.
"Nurse." A licensed practical nurse or registered nurse.
"Physician." Either:
(1) as defined in section 2 of the act of October 5,
1978 (P.L.1109, No.261), known as the Osteopathic Medical
Practice Act; or
(2) as defined in section 2 of the Medical Practice Act
of 1985.
"Practitioner." A physician, nurse or midwife or nurse-
midwife.
"Program." The Rural Health Care Grant Program established
under section 4.
"Registered nurse." An individual licensed to practice
professional nursing under the act of May 22, 1951 (P.L.317,
No.69), known as The Professional Nursing Law.
"Rural county." A county within this Commonwealth where the
population density is less than 284 persons per square mile as
defined by the Center for Rural Pennsylvania.
"Rural health clinic." As defined in 42 U.S.C. § 1395x(aa)
(2) (relating to definitions) and certified by Medicare.
Section 4. Establishment.
The Rural Health Care Grant Program is established in the
department to be administered by the department.
Section 5. Use of money.
(a) Duty of department.--The department shall distribute
grants to an entity in accordance with this act from money
appropriated for the program by the General Assembly.
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(b) Distribution by entity.--An entity shall use the grant
awarded under subsection (a) to pay for the education debt of
practitioners that the entity employs according to the
following:
(1) An entity shall pay the applicable creditor or
designated person of the education debt on behalf of the
practitioner.
(2) Within 30 days after disbursement of money to the
applicable creditor or designated person, an entity shall
report to the department the following:
(i) The date the payment was sent to the applicable
creditor or designated person.
(ii) The amount of the payment.
(iii) The name and address of the applicable
creditor or designated person.
(iv) The names of the practitioners whose education
debt was paid by the entity with the grant.
(c) Receipt.--A written or electronic receipt of payment of
education debt shall be issued to a practitioner employed by the
entity whose education debt was paid by a grant under this act.
Section 6. Grant awards.
(a) Criteria for grant from department.--The department
shall award a grant to an entity that is located in a designated
medically underserved area or rural county. Priority shall be
given to independent entities not owned by, managed by or
affiliated with any health care system, a legally separate
health care provider or other entity.
(b) Limitation of awards.--
(1) The department may not award more than $250,000 to
an entity in one calendar year.
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(2) The amount distributed to a practitioner may not
exceed the amount owed in education debt.
(c) Entity award.--An entity shall distribute the grant to
one or more chosen practitioners who are employed by the entity.
In order to receive a payment of education debt, a practitioner
must:
(1) Work a minimum of three years for the entity that
distributed the grant to pay for education debt.
(2) Be licensed to practice as a practitioner in this
Commonwealth under the applicable licensing board of the
Department of State.
(3) Begin work within six months of accepting a position
with the entity paying for the education debt.
(4) Be employed as a full-time practitioner for the
entity providing the grant.
Section 7. Entity application for a grant.
(a) Requirements.--Applications shall:
(1) Be submitted by an entity to the department in a
manner the department deems appropriate.
(2) Be available electronically.
(3) Include documentation as deemed necessary by the
department.
(b) Certification.--An entity shall certify in good faith
that the information provided in the application and all
supporting documents and forms are true and accurate in all
material aspects. An entity, or an authorized representative of
the entity, that knowingly makes a false statement to obtain a
grant shall be subject to 18 Pa.C.S. § 4904 (relating to unsworn
falsification to authorities).
Section 8. Review of application.
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(a) Selection.--The department shall select an appropriate
number of entities to receive a grant under this act each
calendar year, dependent upon the amount of money appropriated
for the program by the General Assembly.
(b) Approval or disapproval.--No later than 60 days after an
entity's submission or resubmission of an application, the
department shall approve or deny the application for a grant.
The department shall provide a notice to the entity that:
(1) the application for a grant is approved for an
amount determined by the department; or
(2) the application for a grant is denied. The
department shall provide its reasons for denial of the
application. The entity may resubmit its application based
upon the department's reasons for denying the application.
Section 9. Grant agreements.
Upon approval of an application under section 8, the
department shall enter into a grant agreement with the entity to
award a grant under this act. The grant agreement shall explain
the terms and conditions of the grant, including the applicable
laws of this Commonwealth and all reporting requirements. The
department, an entity and any other party, as deemed necessary
by the department, may enter into the grant agreement via
electronic signature.
Section 10. Disbursement of grants.
The following shall apply to the disbursement of grants:
(1) The department shall determine the number of grants
to be awarded with the money appropriated by the General
Assembly.
(2) For approved grants, the department shall award a
grant to an entity in increments of $10,000 up to the limit
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under section 6(b)(1). The department may award a grant of
less than $10,000 if the department determines that a
decrease is necessary to preserve adequate funding for more
grants.
(3) An entity shall report to the department the initial
date of employment for each practitioner who receives payment
of education debt and the date of departure from employment
for each practitioner, if applicable.
(4) The department shall begin disbursement of grant
money to an entity within 90 days after the approval of an
entity's application.
Section 11. Reports.
(a) Content.--No later than December 31 of each year, the
department shall publish a report on the department's publicly
accessible Internet website that contains the following
information:
(1) The number of grants awarded under this act.
(2) The number of practitioners who received a payment
of their education debt.
(3) The license type and practice area of each
practitioner, as applicable.
(4) The name and address of each entity that received a
grant under this act.
(5) The amount of each grant awarded.
(6) The total amount of the appropriation distributed
each calendar year.
(7) An aggregate total for each designated medically
underserved area or rural county where a practitioner awarded
grant money is employed by an entity.
(b) Confidentiality.--The name, address and other personal
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information of a practitioner who received a payment of
education debt from an entity may not be listed on the
department's publicly accessible Internet website and may not be
considered accessible under the act of February 14, 2008 (P.L.6,
No.3), known as the Right-to-Know Law.
(c) Submission.--The department shall submit the report
under subsection (a) to the following:
(1) The chair and minority chair of the Appropriations
Committee of the Senate.
(2) The chair and minority chair of the Appropriations
Committee of the House of Representatives.
(3) The chair and minority chair of the Health and Human
Services Committee of the Senate.
(4) The chair and minority chair of the Health Committee
of the House of Representatives.
(d) Final report.--After disbursement of all money
appropriated for the program, the department shall publish a
final report with the information listed under this section
within six months.
Section 12. Tax applicability.
Grants awarded under this act may not be considered taxable
income to an entity or practitioner under the act of March 4,
1971 (P.L.6, No.2), known as the Tax Reform Code of 1971.
Section 13. Compliance.
(a) Reimbursement for noncompliance.--The department shall
determine compliance with the requirements of this act. If an
entity or practitioner fails to comply with the requirements of
this act, the entity or practitioner shall reimburse the
Commonwealth for the amount of the grant received or awarded
based on the period of noncompliance, including interest
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accrued, as determined by the department based on a
determination of which party violated this act. The department,
entity and practitioner shall make every effort to resolve
conflicts in order to prevent a breach of the program
requirements established by the department.
(b) Agreement between entity and practitioner.--An entity
that receives a grant under this act may require a practitioner
awarded money to enter into an agreement established by the
entity and determine compliance, including the timing of
disbursement of the grant money, as appropriate to facilitate
the purposes and intent of this act and subject to the
requirements of this act.
Section 14. Effective date.
This act shall take effect in 120 days.
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