S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4867
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                              March 28, 2019
                                ___________
 
 Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law,  in  relation  to  expanding  the
   Doctors Across New York program to include dentists
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (d) of subdivision 5-a of section 2807-m  of  the
 public  health  law,  as amended by section 6 of part H of chapter 57 of
 the laws of 2017, is amended to read as follows:
   (d) Physician AND DENTIST loan repayment  program.  One  million  nine
 hundred  sixty  thousand dollars for the period January first, two thou-
 sand eight  through  December  thirty-first,  two  thousand  eight,  one
 million  nine  hundred  sixty  thousand  dollars  for the period January
 first, two thousand nine through  December  thirty-first,  two  thousand
 nine,  one  million  nine  hundred sixty thousand dollars for the period
 January first, two thousand ten through December thirty-first, two thou-
 sand ten, four hundred ninety thousand dollars for  the  period  January
 first,  two  thousand  eleven  through  March thirty-first, two thousand
 eleven, one million seven hundred thousand  dollars  each  state  fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first,  two  thousand  fourteen, up to one million seven hundred five
 thousand dollars each state fiscal year for the period April first,  two
 thousand  fourteen  through  March thirty-first, two thousand seventeen,
 and up to one million seven hundred five  thousand  dollars  each  state
 fiscal  year  for the period April first, two thousand seventeen through
 March thirty-first, two thousand twenty, shall be set aside and reserved
 by the commissioner from the  regional  pools  established  pursuant  to
 subdivision  two  of this section and shall be available for purposes of
 physician AND DENTIST loan repayment in accordance with subdivision  ten
 of this section. Notwithstanding any contrary provision of this section,
 sections  one  hundred  twelve  and one hundred sixty-three of the state
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD04143-01-9

 S. 4867                             2
 
 finance law, or any other contrary provision of law, such funding  shall
 be  allocated  regionally with one-third of available funds going to New
 York city and two-thirds of available funds going to  the  rest  of  the
 state  and  shall  be  distributed  in  a manner to be determined by the
 commissioner without a competitive bid or request for  proposal  process
 as follows:
   (i) Funding shall first be awarded to repay loans of up to twenty-five
 physicians  who  train  in  primary care or specialty tracks in teaching
 general hospitals, and who enter and remain in primary care or specialty
 practices in underserved communities, as determined by the commissioner.
   (ii) After distributions in accordance with subparagraph (i)  of  this
 paragraph, all remaining funds shall be awarded to repay loans of physi-
 cians  OR  DENTISTS  who  enter  and remain in primary care or specialty
 practices in underserved communities, as determined by the commissioner,
 including but not limited to physicians OR DENTISTS working  in  general
 hospitals, or other health care facilities.
   (iii)  In no case shall less than fifty percent of the funds available
 pursuant to this paragraph be distributed in  accordance  with  subpara-
 graphs  (i) and (ii) of this paragraph to physicians OR DENTISTS identi-
 fied by general hospitals.
   (iv) In addition to the funds allocated under this paragraph, for  the
 period April first, two thousand fifteen through March thirty-first, two
 thousand  sixteen,  two  million  dollars  shall  be  available  for the
 purposes described in subdivision ten of this section;
   (v) In addition to the funds allocated under this paragraph,  for  the
 period April first, two thousand sixteen through March thirty-first, two
 thousand  seventeen,  two  million  dollars  shall  be available for the
 purposes described in subdivision ten of this section;
   (vi) Notwithstanding any provision of law to the contrary, and subject
 to the extension of the Health Care Reform Act of 1996, sufficient funds
 shall be available for the purposes described in subdivision ten of this
 section in amounts necessary to fund the remaining year commitments  for
 awards made pursuant to subparagraphs (iv) and (v) of this paragraph.
   §  2. Paragraph (e) of subdivision 5-a of section 2807-m of the public
 health law, as amended by section 6 of part H of chapter 57 of the  laws
 of 2017, is amended to read as follows:
   (e)  Physician AND DENTIST practice support. Four million nine hundred
 thousand dollars for  the  period  January  first,  two  thousand  eight
 through  December  thirty-first,  two  thousand eight, four million nine
 hundred thousand dollars annually for  the  period  January  first,  two
 thousand  nine  through  December  thirty-first,  two  thousand ten, one
 million two hundred twenty-five thousand dollars for the period  January
 first,  two  thousand  eleven  through  March thirty-first, two thousand
 eleven, four million three hundred thousand dollars  each  state  fiscal
 year for the period April first, two thousand eleven through March thir-
 ty-first,  two thousand fourteen, up to four million three hundred sixty
 thousand dollars each state fiscal year for the period April first,  two
 thousand  fourteen  through  March thirty-first, two thousand seventeen,
 and up to four million three hundred sixty  thousand  dollars  for  each
 state  fiscal  year  for  the period April first, two thousand seventeen
 through March thirty-first, two thousand twenty, shall be set aside  and
 reserved  by the commissioner from the regional pools established pursu-
 ant to subdivision two of  this  section  and  shall  be  available  for
 purposes  of physician AND DENTIST practice support. Notwithstanding any
 contrary provision of this section, sections one hundred twelve and  one
 hundred  sixty-three  of  the  state  finance law, or any other contrary

 S. 4867                             3
 
 provision of law, such funding shall be allocated regionally  with  one-
 third of available funds going to New York city and two-thirds of avail-
 able  funds going to the rest of the state and shall be distributed in a
 manner to be determined by the commissioner without a competitive bid or
 request for proposal process as follows:
   (i)  Preference in funding shall first be accorded to teaching general
 hospitals for up to twenty-five awards, to  support  costs  incurred  by
 physicians OR DENTISTS trained in primary or specialty tracks who there-
 after  establish or join practices in underserved communities, as deter-
 mined by the commissioner.
   (ii) After distributions in accordance with subparagraph (i)  of  this
 paragraph,  all  remaining  funds  shall  be  awarded  to  physicians OR
 DENTISTS to support the cost of establishing  or  joining  practices  in
 underserved  communities,  as  determined  by  the  commissioner, and to
 hospitals and other health care providers to recruit new  physicians  OR
 DENTISTS  to  provide services in underserved communities, as determined
 by the commissioner.
   (iii) In no case shall less than fifty percent of the funds  available
 pursuant  to  this  paragraph  be  distributed  to  general hospitals in
 accordance with subparagraphs (i) and (ii) of this paragraph.
   § 3. Subdivision 10 of section 2807-m of the public health  law,    as
 added by section 75-e of part C of chapter 58 of the laws of 2008, para-
 graphs  (a)  and (c) as amended by section 13 of part B of chapter 58 of
 the laws of 2010, is amended to read as follows:
   10. Physician AND DENTIST loan repayment program.  (a) Beginning Janu-
 ary first, two thousand eight, the commissioner  is  authorized,  within
 amounts  available  pursuant  to  subdivision five-a of this section, to
 make loan repayment awards to primary care physicians  AND  DENTISTS  or
 other  physician  AND DENTIST specialties determined by the commissioner
 to be in short supply, licensed to practice medicine OR DENTISTRY in New
 York state, who agree to practice for at least five years in  an  under-
 served  area,  as  determined  by  the  commissioner.  Such physician OR
 DENTIST shall be eligible for a  loan  repayment  award  of  up  to  one
 hundred  fifty  thousand  dollars over a five year period distributed as
 follows: fifteen percent of total loan debt not to exceed  twenty  thou-
 sand  dollars for the first year; fifteen percent of total loan debt not
 to exceed twenty-five thousand  dollars  for  the  second  year;  twenty
 percent  of  total  loan debt not to exceed thirty-five thousand dollars
 for the third year; and twenty-five percent of total loan  debt  not  to
 exceed  thirty-five  thousand  dollars per year for the fourth year; and
 any unpaid balance of the total loan debt  not  to  exceed  the  maximum
 award amount for the fifth year of practice in such area.
   (b)  Loan  repayment awards made to a physician OR DENTIST pursuant to
 paragraph (a) of this subdivision shall not exceed the total  qualifying
 outstanding debt of the physician OR DENTIST from student loans to cover
 tuition and other related educational expenses, made by or guaranteed by
 the  federal  or  state  government, or made by a lending or educational
 institution approved under title IV of the federal higher education act.
 Loan repayment awards shall be used solely  to  repay  such  outstanding
 debt.
   (c) In the event that a five-year commitment pursuant to the agreement
 referenced  in  paragraph  (a) of this subdivision is not fulfilled, the
 recipient shall be responsible for repayment in amounts which  shall  be
 calculated  in  accordance with the formula set forth in subdivision (b)
 of section two hundred fifty-four-o of title  forty-two  of  the  United
 States Code, as amended.

 S. 4867                             4
 
   (d)  The  commissioner  is authorized to apply any funds available for
 purposes of paragraph (a) of this subdivision for use as matching  funds
 for federal grants for the purpose of assisting states in operating loan
 repayment  programs  pursuant to section three hundred thirty-eight I of
 the public health service act.
   (e)  The  commissioner may postpone, change or waive the service obli-
 gation and repayment amounts  set  forth  in  paragraphs  (a)  and  (c),
 respectively of this subdivision in individual circumstances where there
 is compelling need or hardship.
   (f)(i)  When  a  physician OR DENTIST is not actually practicing in an
 underserved area, he or she shall be  deemed  to  be  practicing  in  an
 underserved  area if he or she practices in a facility or physician's OR
 DENTIST'S office that primarily  serves  an  underserved  population  as
 determined by the commissioner, without regard to whether the population
 or  the  facility  or  physician's  OR DENTIST'S office is located in an
 underserved area.
   (ii) In making criteria and determinations as to whether an area is an
 underserved area or whether  a  facility  or  physician's  OR  DENTIST'S
 office  primarily serves an underserved population, the commissioner may
 make separate criteria and determinations for different specialties.
   § 4. This act shall take effect immediately.