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2019 - 2020 LEGISLATURE
April 18, 2019 - Introduced by Representatives Felzkowski, Riemer, Thiesfeldt,
Bowen, Duchow, Horlacher, Kolste, Kulp, Loudenbeck, Murphy, Mursau,
Myers, Rohrkaste, Skowronski, Spiros, Spreitzer, Steffen, C. Taylor,
Tusler, VanderMeer and Vining, cosponsored by Senators Darling, Bewley,
Carpenter and Cowles. Referred to Committee on Health.
AB178,1,4 1An Act to amend 36.60 (1) (ag), 36.60 (3) (a), 36.60 (3) (am), 36.60 (5) (b) (intro.),
236.61 (1) (am) and 36.61 (5) (b) (intro.); and to create 36.60 (1) (ah), 36.60 (5)
3(bm) and 36.61 (5) (bm) of the statutes; relating to: eligibility for physician,
4dentist, and health care provider educational loan assistance programs.
Analysis by the Legislative Reference Bureau
This bill makes physicians and dentists who agree to practice in free or
charitable clinics eligible to participate in an educational loan assistance program
administered by the Board of Regents of the University of Wisconsin System under
current law. The bill makes similar changes to an educational loan assistance
program for other health care professionals administered by the Board of Regents.
Physicians and dentists. If a physician agrees to practice at least 32 clinic
hours per week for three years in a rural area or “eligible practice area,” as defined
under current law, the physician is eligible to have some of his or her educational
loans repaid. Up to $100,000 may be repaid for practice in a rural area and up to
$50,000 may be repaid for practice in an eligible practice area. Current law defines
an “eligible practice area” as a primary care or mental health shortage area, as
determined under federal law, an American Indian reservation, or trust land of an
American Indian tribe. Under current law, a dentist is eligible for repayment if he
or she agrees to practice at least 32 clinic hours per week for three years in a rural
area or dental health shortage area, as determined under federal law. Up to $50,000
may be repaid for practice in a rural area or dental health shortage area.

The bill amends the definition of “eligible practice area” so that it also includes
a free or charitable clinic. The bill also makes a dentist who practices in a free or
charitable clinic eligible for educational loan repayment. As a result, if a physician
or dentist agrees to practice at least 32 clinic hours per week for three years in a free
or charitable clinic, the physician or dentist is eligible to have up to $50,000 of his
or her educational loans repaid. The bill defines “free or charitable clinic” as a
safety-net health care organization that uses volunteers and staff to serve
economically disadvantaged individuals who are uninsured, underinsured, or have
limited or no health care access. In addition, the organization must be exempt from
federal taxation or operate as a program component or affiliate of an organization
exempt from federal taxation. The organization must also provide services without
regard to a patient's ability to pay and charge either no fee or a nominal or sliding
fee for services.
Current law requires physicians and dentists who participate in the
educational loan assistance program to agree to care for patients who are insured or
receive health care benefits under governmental programs. The bill also requires
physicians and dentists to agree to care for patients who are uninsured or
underinsured. Current law also requires the Board of Regents to establish priorities
for repayments based on specified considerations if funding is not available to make
repayments to all applicants. Under the bill, if the Board of Regents determines that
a consideration does not apply to applicants who desire to practice in free or
charitable clinics, the Board of Regents must ensure that the priorities do not
disadvantage those applicants.
Other health care providers. Under current law, the following health care
providers are eligible to have up to $25,000 of their educational loans repaid if they
agree to practice at least 32 clinic hours per week for three years in a rural area or
eligible practice area: physician assistants, nurse-midwives, and nurse
practitioners. Dental hygienists are eligible for the same repayment if they agree to
practice at least 32 clinical hours per week for three years in a rural area or dental
health shortage area. Like physicians, the bill includes free or charitable clinics, as
defined above, in the definition of “eligible practice area.” The bill also includes a
mental health shortage area, as determined under federal law, in the definition of
“eligible practice area.” Unlike the program for physicians under current law, the
program for other health care providers under current law does not include mental
health shortage areas. As a result, in addition to eligibility under current law, any
of the foregoing health care professionals, except dental hygienists, is eligible for
educational loan repayment if he or she agrees to practice in a free or charitable clinic
or a mental health shortage area for the required time. In addition to eligibility
under current law, dental hygienists are eligible if they agree to practice in a free or
charitable clinic for the required time.
Like the program for physicians and dentists, current law requires the Board
of Regents to establish priorities for repayments based on specified considerations
if funding is not available to make repayments to all applicants. Under the bill, if
the Board of Regents determines that a consideration does not apply to applicants

who desire to practice in free or charitable clinics, the Board of Regents must develop
a mechanism to fairly assess all applicants under the priorities.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB178,1 1Section 1. 36.60 (1) (ag) of the statutes is amended to read:
AB178,3,42 36.60 (1) (ag) “Eligible practice area" means a free or charitable clinic, a
3primary care shortage area, a mental health shortage area, an American Indian
4reservation or trust lands of an American Indian tribe.
AB178,2 5Section 2. 36.60 (1) (ah) of the statutes is created to read:
AB178,3,76 36.60 (1) (ah) “Free or charitable clinic” means a safety-net health care
7organization that satisfies all of the following:
AB178,3,118 1. The organization uses volunteers and staff to provide a range of medical,
9dental, pharmacy, vision, or behavioral health services to economically
10disadvantaged individuals who are uninsured, underinsured, or have limited or no
11access to primary, specialty, or prescription health care.
AB178,3,14122. The organization is exempt from taxation under section 501 (c) of the
13Internal Revenue Code or operates as a program component or affiliate of such an
14organization.
AB178,3,1615 3. The organization provides services without regard to a patient's ability to
16pay.
AB178,3,1817 4. The organization charges patients no fee for services or charges a nominal
18or sliding fee.
AB178,3 19Section 3 . 36.60 (3) (a) of the statutes is amended to read:
AB178,4,10
136.60 (3) (a) The board shall enter into a written agreement with the physician,
2in which the physician agrees to practice at least 32 clinic hours per week for 3 years
3in one or more eligible practice areas in this state or in a rural area, except that a
4physician specializing in psychiatry may only agree to practice psychiatry in a
5mental health shortage area or in a rural area and a physician in the expanded loan
6assistance program under sub. (9) may only agree to practice at a public or private
7nonprofit entity in a health professional shortage area. The physician shall also
8agree to care for patients who are insured, underinsured, or uninsured or for whom
9health benefits are payable under medicare, medical assistance, or any other
10governmental program.
AB178,4 11Section 4 . 36.60 (3) (am) of the statutes is amended to read:
AB178,4,1712 36.60 (3) (am) The board shall enter into a written agreement with the dentist,
13in which the dentist agrees to practice at least 32 clinic hours per week for 3 years
14in one or more dental health shortage areas in this state, in a free or charitable clinic,
15or in a rural area. The dentist shall also agree to care for patients who are insured,
16underinsured, or uninsured
or for whom dental health benefits are payable under
17medicare, medical assistance, or any other governmental program.
AB178,5 18Section 5 . 36.60 (5) (b) (intro.) of the statutes is amended to read:
AB178,4,2519 36.60 (5) (b) (intro.) If the cost of repaying the loans of all eligible applicants,
20when added to the cost of loan repayments scheduled under existing agreements,
21exceeds the total amount of funds transferred to the board under s. 20.505 (8) (hm)
226r., the contributions received and penalties assessed by the board, and the
23appropriation under s. 20.285 (1) (qj), then, subject to par. (bm), the board shall
24establish priorities among the eligible applicants based upon the following
25considerations:
AB178,6
1Section 6. 36.60 (5) (bm) of the statutes is created to read:
AB178,5,52 36.60 (5) (bm) If the board determines that a consideration under par. (b) does
3not apply to eligible applicants who desire to practice in free or charitable clinics, the
4board shall develop a mechanism to fairly assess all applicants under the priorities
5established under par. (b).
AB178,7 6Section 7. 36.61 (1) (am) of the statutes is amended to read:
AB178,5,117 36.61 (1) (am) “Eligible practice area" means a primary care shortage area, an
8American Indian reservation, or trust lands of an American Indian tribe
has the
9meaning given in s. 36.60 (1) (ag)
, except that with respect to a dental hygienist
10“eligible practice area" means a dental health shortage area or a free or charitable
11clinic
.
AB178,8 12Section 8 . 36.61 (5) (b) (intro.) of the statutes is amended to read:
AB178,5,1913 36.61 (5) (b) (intro.) If the cost of repaying the loans of all eligible applicants,
14when added to the cost of loan repayments scheduled under existing agreements,
15exceeds the total amount of funds transferred to the board under s. 20.505 (8) (hm)
166r., the contributions received and penalties assessed by the board, and the
17appropriation under s. 20.285 (1) (qj), then, subject to par. (bm), the board shall
18establish priorities among the eligible applicants based upon the following
19considerations:
AB178,9 20Section 9 . 36.61 (5) (bm) of the statutes is created to read:
AB178,5,2421 36.61 (5) (bm) If the board determines that a consideration under par. (b) does
22not apply to eligible applicants who desire to practice in free or charitable clinics, the
23board shall develop a mechanism to fairly assess all applicants under the priorities
24established under par. (b).
AB178,5,2525 (End)
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