Amendment vs bill Ways and Means Education Amendment E134CC-1 vs Enrolled

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HB133 ENROLLED W12A9E-3 By Representatives Rafferty, Daniels RFD:
E134CC-1 04/04/2023 KMS (L)cr 2023-1353 Sub HB133 2 4 SYNOPSIS:
Ways and Means Education First Read:
This bill would establish the Preceptor Tax Incentive Program to provide an opportunity for students enrolled in certain health professions training programs to train in rural and underserved counties in the state and to address primary care shortages in the state.
21-Mar-23 2023 Regular Session Page 0 HB133 Enrolled Enrolled, An Act, 3 Relating to state income tax;
This bill would provide an income tax credit incentive of $500 for each 160-hour clinical preceptorship rotation per calendar year for an otherwise unpaid community-based faculty preceptor physician for the following types of students:
Medical allopathic or osteopathic, dental, and optometric.
This bill would also provide an income tax credit incentive of $425 for each 160-hour clinical preceptorship rotation per calendar year for an otherwise unpaid community-based certified registered nurse practitioner, certified nurse midwife, certified registered nurse anesthetist, or physician assistant.
A BILL TO BE ENTITLED AN ACT Page 1 Relating to state income tax;
This act shall be known and may be cited as the Preceptor Tax Incentive Program Act.
(a) The Preceptor Tax Incentive Program is created.
Section 2.
(b) For the purposes of this section, the following terms shall have the following meanings:
For the purposes of this act, the following terms have the following meanings:
A clinical educational or training rotation for a student in any of the following programs that are physically located in this state and approved by and provided through a qualified health professions training program, for which the community-based faculty preceptor, also physically located in this state, is otherwise not compensated for the preceptorship:
A clinical educational or training rotation for a student in any of the following programs, that are physically located in this state and approved by and provided through a qualified health professions training program, for which the clinical preceptor, also physically located in this state, is otherwise not compensated for the preceptorship:
An anesthesia assistant program.
An anesthesia assistant program f.
f.
(2) COMMUNITY-BASED ADVANCE PRACTICE NURSE PRECEPTOR.
(2) COMMUNITY-BASED FACULTY PRECEPTOR.
A Page 1 HB133 Enrolled certified registered advance practice nurse licensed under Chapter 21 of Title 34, Code of Alabama 1975, who provides medical services in a health care facility that is physically located in this state and not owned or operated by a qualified nursing, medical, or osteopathic school and who, through an agreement with a qualified nursing school physically located in this state, provides one or more clinical preceptorships for training to students in a certified registered nurse practitioner, certified nurse midwife, or certified registered nurse anesthetist program for which he or she receives no monetary compensation.
A physician, advanced practice nurse, or assistant to physician who is licensed in this state and receives no financial compensation from any source for the teaching of students in a medical Page 2 program, dental program, optometric program, physician assistant program, anesthesia assistant program, or certified registered nurse practitioner, certified nurse midwife, or certified registered nurse anesthetist program.
(3) COMMUNITY-BASED ASSISTANT TO PHYSICIAN PRECEPTOR.
(3) COMMUNITY-BASED NURSE PRACTITIONER PRECEPTOR.
An assistant to physician licensed under Chapter 24 of Title 34, Code of Alabama 1975, and practicing pursuant to a registration agreement with a licensed physician, who provides medical services in a health care facility that is physically located in this state and not owned or operated by a qualified medical, nursing, or osteopathic school and who, through an agreement with a qualified health professions program physically located in this state, provides one or more clinical preceptorships for students in a physician assistant or anesthesia assistant program for which he or she receives no monetary compensation.
A certified registered nurse practitioner licensed under Chapter 21 of Title 34, Code of Alabama 1975, and practicing pursuant to a collaboration agreement with a licensed physician, who provides medical services in a health care facility that is physically located in this state and not owned or operated by a qualified nursing, medical, or osteopathic school and who, through an agreement with a qualified nursing school physically located in this state, provides one or more clinical preceptorships for training to students in a certified registered nurse practitioner, certified nurse midwife, or certified registered nurse anesthetist program for which he or she receives no monetary compensation.
(4) COMMUNITY-BASED FACULTY PRECEPTOR.
(4) COMMUNITY-BASED ASSISTANT TO PHYSICIAN PRECEPTOR.
A community-based advance practice nurse preceptor;
An assistant to physician licensed under Chapter 24 of Title 34, Code of Alabama 1975, and practicing pursuant to a registration agreement with a licensed physician, who provides medical services in a health care facility that is physically located in this state and not owned or operated by a qualified medical, nursing, or osteopathic school and who, through an agreement with a qualified health professions program physically located in this state, provides one or more clinical preceptorships for students in a physician assistant or anesthesia assistant program for which he or she receives Page 3 no monetary compensation.
community-based assistant to physician preceptor;
(5) COMMUNITY-BASED PHYSICIAN, DENTIST, OR OPTOMETRY PRECEPTOR.
or community-based physician, dentist, or optometrist preceptor.
(5) COMMUNITY-BASED PHYSICIAN, DENTIST, OR OPTOMETRIST Page 2 HB133 Enrolled PRECEPTOR.
(6) MEDICALLY UNDERSERVED RURAL AREA.
(6) HEALTH PROFESSIONAL SHORTAGE AREA.
A primary care service area with a deficit, or surplus of less than 2.0 primary-care physicians, as shown by the most-recent Status Report of the Alabama Primary Care Physician Workforce from the Office for Family Health Education and Research at the UAB Huntsville Regional Medical Campus.
Areas of the state that are designated by the Health Resources and Services Administration of the United States Department of Health and Human Services as having shortages of primary medical care, dental care, or mental health care providers.
(7) PROGRAM.
A shortage area may be geographic-based, population-based, or facility-based.
Health professional shortage area scores are based on discipline-specific methodology, however, three scoring criteria are common across all health professional shortage area disciplines:
a.
Population to provider ratio.
Page 4 b.
Percentage of the population below 100 percent of the federal poverty level.
c.
Travel time to the nearest source of care outside the designated shortage area.
(7) MEDICALLY UNDERSERVED AREA and MEDICALLY UNDERSERVED POPULATION.
a.
An area or population in this state identified by the Health Resources and Services Administration Agency of the United States Department of Health and Human Services as a geographic area and population with a lack of access to primary care services based on the following established indicators:
1.
Provider per 1,000 population ratio.
2.
Percentage of population at 100 percent of the federal poverty level.
3.
Percentage of population age 65 and older.
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4.
Infant mortality rate.
b.
A calculated index of medical underservice score of 62.0 or below qualifies for designation as a medically underserved area or medically underserved population.
(8) PROGRAM.
(8) QUALIFIED HEALTH PROFESSIONS TRAINING PROGRAM.
(9) QUALIFIED HEALTH PROFESSIONS TRAINING PROGRAM.
An institution of higher education that is physically located in this state and has an accredited educational program for medicine, dentistry, optometry, physician assistants, anesthesia assistants, or certified registered nurse practitioners, certified nurse midwives, or certified Page 3 HB133 Enrolled registered nurse anesthetists.
An institution of higher education that is physically located in this state and has an accredited educational program for medicine, dentistry, optometry, physician assistants, anesthesia assistants, or certified registered nurse practitioners, certified nurse midwives, and certified registered nurse anesthetists.
Section 3.
Page 5 (10) RURAL AREA.
(a)(1)The Alabama Statewide Area Health Education Center Program Office shall administer the program and certify clinical preceptorships on behalf of all eligible qualified health professions training programs.
As defined by the United States Census Bureau, in the context of health care, health data, and the location of health care services, all population, housing, and territory not included within a state-urbanized area with a population of 50,000 or more.
(2) A clinical preceptorship may not be certified as eligible under the program unless the clinical preceptorship is performed in a medically underserved rural area.
(c)(1) Beginning with the 2024 tax year, a community-based physician, dentist, or optometry preceptor, community-based assistant to physician preceptor, or community-based nurse practitioner, nurse midwife, or nurse anesthetist preceptor physically located in this state shall be allowed a credit against the tax imposed by Section 40-18-2, Code of Alabama 1975, if he or she conducts an unpaid clinical preceptorship, in the following amounts:
(b)(1) Prior to the certification of any clinical preceptorship, the Alabama Statewide Area Health Education 95 Center Program Office shall conduct a needs assessment of the current number and current need for community-based faculty preceptors in the state and submit a final report of the assessment to the Governor, Speaker of the House of Representatives, President Pro-Tempore of the Senate, the Chairs of the Senate Healthcare and House Health Committees, and the Chairs of the Senate Committee on Finance and Taxation Education and the House Ways and Means Education Committees.
(2) The Alabama Statewide Area Health Education Center Program Office shall consult with the Alabama Commission on the Evaluation of Services to develop the appropriate measures and methodology for conducting the needs assessment.
Section 4.
(a)(1) Beginning with the 2024 tax year, a community-based faculty preceptor, if he or she conducts a clinical preceptorship, shall be allowed a credit against the tax imposed by Section 40-18-2, Code of Alabama 1975, in the following amounts:
A community-based physician, dentist, or optometrist Page 4 HB133 Enrolled preceptor shall be allowed a credit of five hundred dollars ($500) per rotation, up to an annual maximum of six thousand dollars ($6,000).
A community-based physician, dentist, or optometrist preceptor shall be allowed a credit of five hundred dollars ($500) per rotation, up to an annual maximum of six thousand dollars ($6,000).
A community-based advance practice nurse preceptor shall be allowed a credit of four hundred twenty-five dollars ($425) per rotation, up to an annual maximum of five thousand one hundred dollars ($5,100).
A community-based nurse practitioner, certified nurse midwife, or certified registered nurse anesthetist preceptor shall be allowed a credit of four hundred twenty-five dollars ($425) per rotation, up to an annual maximum of five thousand one hundred dollars ($5,100).
(2) An individual may not accrue more than 12 clinical preceptorships in any combination of the above categories in one calendar year.
(2) An individual shall not accrue more than 12 clinical preceptorships of any of the above categories in one Page 6 calendar year.
(b) A community-based faculty preceptor may not earn hours credited toward the tax credit pursuant to subsection (a) unless the clinical preceptorship has been certified by the Alabama Statewide Area Health Education Center Program Office as eligible for the credit.
(3) A community-based faculty preceptor shall not be eligible to earn hours credited toward a clinical preceptorship tax credit if he or she has not registered with the Alabama Statewide Area Health Education Center Program Office in Birmingham, Alabama.
(c)(1) To receive the credit provided by this act, a community-based faculty preceptor shall claim the credit on his or her state income tax return for the tax year in which he or she completed the clinical preceptorship rotation;
(4) The Alabama Statewide Area Health Education Center Program Office shall administer the program and certify clinical preceptorship rotations on behalf of all eligible public and private training programs for medicine, optometry, and dental physician assistant, anesthesia assistant, or certified registered nurse practitioner, certified nurse midwife, and certified registered nurse anesthetist programs physically located in this state.
shall certify that he or she, and the health care center or facility through which he or she is employed, did not receive monetary payment during the tax year from any source for the training of medical, optometry, dental, physician assistant, anesthesia assistant, or certified registered nurse practitioner, Page 5 HB133 Enrolled certified nurse midwife, and certified registered nurse anesthetist students;
(5) To receive the credit provided by this section, a community-based faculty preceptor shall claim the credit on his or her state income tax return for the tax year in which he or she completed the clinical preceptorship rotation;
and shall submit supporting documentation, including certification obtained from the Alabama Statewide Area Health Education Center Program Office, to the Department of Revenue.
shall certify that he or she, and the health care center or facility through which he or she is employed, did not receive monetary payment during the tax year from any source for the training of medical, optometry, dental, physician assistant, anesthesia assistant, or certified registered nurse practitioner, certified nurse midwife, and certified registered nurse anesthetist students;
(2) Failure to provide the required documents shall result in the automatic denial of the credit.
and shall submit supporting documentation to the Department of Revenue.
(d) In no event shall the total amount of the tax credit provided by this section for a taxable year exceed the income tax liability of the taxpayer.
(6) In no event shall the total amount of the tax credit provided by this section for a taxable year exceed the Page 7 income tax liability of the taxpayer.
(e) Adjudication of possible filing errors or violations of this act shall be determined by the Department of Revenue.
(d) Adjudication of possible filing errors or violations of the law shall be determined by the Department of Revenue.
Section 5.
(e) The Alabama Statewide Area Health Education Center Program Office shall do both of the following:
The Alabama Statewide Area Health Education Center Program Office shall do both of the following:
Section 6.
(f) The certification obtained from the Alabama Statewide Area Health Education Center Program Office, and any other documentation required, shall be submitted by the taxpayer with his or her annual tax return on which the credit is being claimed.
(a) Annually, on or before the first day of December, the Alabama Statewide Area Health Education Center Program Office shall report on the condition, performance, and Page 6 HB133 Enrolled accomplishments of the program to the Governor, Speaker of the House of Representatives, President Pro-Tempore of the Senate, the Chairs of the Senate Healthcare and House Health Committees, and the Chairs of the Senate Committee on Finance and Taxation Education and the House Ways and Means Education Committees.
Failure to provide the required documents shall result in the automatic denial of the credit.
(b) The Alabama Statewide Area Health Education Center Program Office shall consult with the Alabama Commission on the Evaluation of Services to develop performance metrics and other measures of success to include in the annual report required pursuant to subsection (a).
(g) The Department of Revenue may adopt rules for the implementation and administration of this section.
During the 2030 fiscal year, the program shall undergo an evaluation by the Alabama Commission on the Evaluation of Services to determine whether the program is impacting the determined measures of success.
Section 2.
Section 7.
The Department of Revenue may adopt rules for the implementation and administration of this act.
Section 8.
This act shall be repealed on September 29, 2031, unless extended by act of the Legislature Section 9.
Page 7 HB133 Enrolled ________________________________________________ Speaker of the House of Representatives ________________________________________________ President and Presiding Officer of the Senate House of Representatives I hereby certify that the within Act originated in and was passed by the House 25-Apr-23, as amended.
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John Treadwell Clerk Senate 01-Jun-23 Passed House 06-Jun-23 Passed Page 8