AL
Alabama House Bill HB133

Alabama 2023 Regular Session

Alabama House Bill HB133 Compare Versions

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44 By Representatives Rafferty, Daniels
55 RFD: Ways and Means Education
66 First Read: 21-Mar-23
7-2023 Regular Session
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14-Enrolled, An Act,
15-Relating to state income tax; to establish the
16-Preceptor Tax Incentive Program to provide income tax credit
17-incentives for certain medical students who train in rural and
18-underserved counties in the state.
19-BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
20-Section 1. This act shall be known and may be cited as
21-the Preceptor Tax Incentive Program Act.
22-Section 2. For the purposes of this act, the following
23-terms have the following meanings:
24-(1) CLINICAL PRECEPTORSHIP. A clinical educational or
25-training rotation for a student in any of the following
26-programs that are physically located in this state and
27-approved by and provided through a qualified health
28-professions training program, for which the community-based
29-faculty preceptor, also physically located in this state, is
30-otherwise not compensated for the preceptorship:
31-a. A medical allopathic or osteopathic program.
32-b. A dental program.
33-c. An optometric program.
34-d. A physician assistant program.
35-e. An anesthesia assistant program.
36-f. A certified registered nurse practitioner program.
37-g. A certified nurse midwife program.
38-h. A certified registered nurse anesthetist program.
39-(2) COMMUNITY-BASED ADVANCE PRACTICE NURSE PRECEPTOR. A
13+SYNOPSIS:
14+This bill would establish the Preceptor Tax
15+Incentive Program to provide an opportunity for
16+students enrolled in certain health professions
17+training programs to train in rural and underserved
18+counties in the state and to address primary care
19+shortages in the state.
20+This bill would provide an income tax credit
21+incentive of $500 for each 160-hour clinical
22+preceptorship rotation per calendar year for an
23+otherwise unpaid community-based faculty preceptor
24+physician for the following types of students: Medical
25+allopathic or osteopathic, dental, and optometric.
26+This bill would also provide an income tax
27+credit incentive of $425 for each 160-hour clinical
28+preceptorship rotation per calendar year for an
29+otherwise unpaid community-based certified registered
30+nurse practitioner, certified nurse midwife, certified
31+registered nurse anesthetist, or physician assistant.
32+A BILL
33+TO BE ENTITLED
34+AN ACT
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69-certified registered advance practice nurse licensed under
70-Chapter 21 of Title 34, Code of Alabama 1975, who provides
71-medical services in a health care facility that is physically
72-located in this state and not owned or operated by a qualified
73-nursing, medical, or osteopathic school and who, through an
74-agreement with a qualified nursing school physically located
75-in this state, provides one or more clinical preceptorships
76-for training to students in a certified registered nurse
77-practitioner, certified nurse midwife, or certified registered
78-nurse anesthetist program for which he or she receives no
79-monetary compensation.
80-(3) COMMUNITY-BASED ASSISTANT TO PHYSICIAN PRECEPTOR.
81-An assistant to physician licensed under Chapter 24 of Title
82-34, Code of Alabama 1975, and practicing pursuant to a
83-registration agreement with a licensed physician, who provides
84-medical services in a health care facility that is physically
85-located in this state and not owned or operated by a qualified
86-medical, nursing, or osteopathic school and who, through an
87-agreement with a qualified health professions program
88-physically located in this state, provides one or more
89-clinical preceptorships for students in a physician assistant
90-or anesthesia assistant program for which he or she receives
91-no monetary compensation.
92-(4) COMMUNITY-BASED FACULTY PRECEPTOR. A
93-community-based advance practice nurse preceptor;
94-community-based assistant to physician preceptor; or
95-community-based physician, dentist, or optometrist preceptor.
96-(5) COMMUNITY-BASED PHYSICIAN, DENTIST, OR OPTOMETRIST
64+Relating to state income tax; to establish the
65+Preceptor Tax Incentive Program to provide income tax credit
66+incentives for certain medical students who train in rural and
67+underserved counties in the state.
68+BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
69+Section 1. (a) The Preceptor Tax Incentive Program is
70+created.
71+(b) For the purposes of this section, the following
72+terms shall have the following meanings:
73+(1) CLINICAL PRECEPTORSHIP. A clinical educational or
74+training rotation for a student in any of the following
75+programs, that are physically located in this state and
76+approved by and provided through a qualified health
77+professions training program, for which the clinical
78+preceptor, also physically located in this state, is otherwise
79+not compensated for the preceptorship:
80+a. A medical allopathic or osteopathic program.
81+b. A dental program.
82+c. An optometric program.
83+d. A physician assistant program.
84+e. A nurse practitioner program.
85+f. A nurse midwife program.
86+g. A nurse anesthetist program.
87+(2) COMMUNITY-BASED FACULTY PRECEPTOR. A physician,
88+advanced practice nurse, or physician assistant who is
89+licensed in this state and receives no financial compensation
90+from any source for the teaching of students in a medical
91+program, dental program, optometric program, physician
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121+assistant program, or nurse practitioner, nurse midwife, or
122+nurse anesthetist program.
123+(3) COMMUNITY-BASED NURSE PRACTITIONER PRECEPTOR. A
124+certified registered nurse practitioner licensed under Chapter
125+21 of Title 34, Code of Alabama 1975, who provides medical
126+services in a health care facility that is physically located
127+in this state and not owned or operated by a qualified
128+nursing, medical, or osteopathic school and who, through an
129+agreement with a qualified nursing school physically located
130+in this state, provides one or more clinical preceptorships
131+for training to students in a nurse practitioner, nurse
132+midwife, or nurse anesthetist program for which he or she
133+receives no monetary compensation.
134+(4) COMMUNITY-BASED PHYSICIAN ASSISTANT PRECEPTOR. An
135+assistant to physician licensed under Chapter 24 of Title 34,
136+Code of Alabama 1975, who provides medical services in a
137+health care facility that is physically located in this state
138+and not owned or operated by a qualified medical, nursing, or
139+osteopathic school and who, through an agreement with a
140+qualified health professions program physically located in
141+this state, provides one or more clinical preceptorships for
142+students in a physician assistant program for which he or she
143+receives no monetary compensation.
144+(5) COMMUNITY-BASED PHYSICIAN, DENTIST, OR OPTOMETRY
126145 PRECEPTOR. A physician licensed under Chapter 24 of Title 34,
127146 Code of Alabama 1975; a dentist licensed under Chapter 9 of
128147 Title 34, Code of Alabama 1975; or an optometrist licensed
129148 under Chapter 22 of Title 34, Code of Alabama 1975, who
130-provides medical services in a health care facility that is
131-physically located in this state and not owned or operated by
132-a qualified medical, dental, optometric, nursing, or
133-osteopathic school and who, through an agreement with a
134-qualified medical school physically located in this state,
135-provides one or more clinical preceptorships for students in a
136-medical program, dental program, optometric program, physician
137-assistant program, anesthesia assistant program, or certified
138-registered nurse practitioner, certified nurse midwife, or
139-certified registered nurse anesthetist program for which he or
140-she receives no monetary compensation.
141-(6) MEDICALLY UNDERSERVED RURAL AREA. A primary care
142-service area with a deficit, or surplus of less than 2.0
143-primary-care physicians, as shown by the most-recent Status
144-Report of the Alabama Primary Care Physician Workforce from
145-the Office for Family Health Education and Research at the UAB
146-Huntsville Regional Medical Campus.
147-(7) PROGRAM. The Preceptor Tax Incentive Program.
148-(8) QUALIFIED HEALTH PROFESSIONS TRAINING PROGRAM. An
149-institution of higher education that is physically located in
150-this state and has an accredited educational program for
151-medicine, dentistry, optometry, physician assistants,
152-anesthesia assistants, or certified registered nurse
153-practitioners, certified nurse midwives, or certified
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183-registered nurse anesthetists.
184-Section 3. (a)(1)The Alabama Statewide Area Health
185-Education Center Program Office shall administer the program
186-and certify clinical preceptorships on behalf of all eligible
187-qualified health professions training programs.
188-(2) A clinical preceptorship may not be certified as
189-eligible under the program unless the clinical preceptorship
190-is performed in a medically underserved rural area.
191-(b)(1) Prior to the certification of any clinical
192-preceptorship, the Alabama Statewide Area Health Education
193-Center Program Office shall conduct a needs assessment of the
194-current number and current need for community-based faculty
195-preceptors in the state and submit a final report of the
196-assessment to the Governor, Speaker of the House of
197-Representatives, President Pro-Tempore of the Senate, the
198-Chairs of the Senate Healthcare and House Health Committees,
199-and the Chairs of the Senate Committee on Finance and Taxation
200-Education and the House Ways and Means Education Committees.
201-(2) The Alabama Statewide Area Health Education Center
202-Program Office shall consult with the Alabama Commission on
203-the Evaluation of Services to develop the appropriate measures
204-and methodology for conducting the needs assessment.
205-Section 4. (a)(1) Beginning with the 2024 tax year, a
206-community-based faculty preceptor, if he or she conducts a
207-clinical preceptorship, shall be allowed a credit against the
208-tax imposed by Section 40-18-2, Code of Alabama 1975, in the
209-following amounts:
210-a. A community-based physician, dentist, or optometrist
178+provides medical services in a health care facility that is
179+physically located in this state and not owned or operated by
180+a qualified medical, dental, optometric, nursing, or
181+osteopathic school and who, through an agreement with a
182+qualified medical school physically located in this state,
183+provides one or more clinical preceptorships for students in a
184+medical program, dental program, optometric program, physician
185+assistant program, or nurse practitioner, nurse midwife, or
186+nurse anesthetist program for which he or she receives no
187+monetary compensation.
188+(6) HEALTH PROFESSIONAL SHORTAGE AREA. Areas of the
189+state that are designated by the Health Resources and Services
190+Administration as having shortages of primary medical care,
191+dental care, or mental health care providers. A shortage area
192+may be geographic-based, population-based, or facility-based.
193+Health professional shortage area scores are based on
194+discipline-specific methodology, however, three scoring
195+criteria are common across all health professional shortage
196+area disciplines:
197+a. Population to provider ratio.
198+b. Percentage of the population below 100 percent of
199+the federal poverty level.
200+c. Travel time to the nearest source of care outside
201+the designated shortage area.
202+(7) MEDICALLY UNDERSERVED AREA and MEDICALLY
203+UNDERSERVED POPULATION.
204+a. An area or population in this state identified by
205+the Health Resources and Services Administration Agency of the
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240-preceptor shall be allowed a credit of five hundred dollars
241-($500) per rotation, up to an annual maximum of six thousand
242-dollars ($6,000).
243-b. A community-based assistant to physician preceptor
244-shall be allowed a credit of four hundred twenty-five dollars
245-($425) per rotation, up to an annual maximum of five thousand
246-one hundred dollars ($5,100).
247-c. A community-based advance practice nurse preceptor
248-shall be allowed a credit of four hundred twenty-five dollars
249-($425) per rotation, up to an annual maximum of five thousand
250-one hundred dollars ($5,100).
251-(2) An individual may not accrue more than 12 clinical
252-preceptorships in any combination of the above categories in
253-one calendar year.
254-(b) A community-based faculty preceptor may not earn
255-hours credited toward the tax credit pursuant to subsection
256-(a) unless the clinical preceptorship has been certified by
257-the Alabama Statewide Area Health Education Center Program
258-Office as eligible for the credit.
259-(c)(1) To receive the credit provided by this act, a
260-community-based faculty preceptor shall claim the credit on
261-his or her state income tax return for the tax year in which
262-he or she completed the clinical preceptorship rotation; shall
263-certify that he or she, and the health care center or facility
264-through which he or she is employed, did not receive monetary
265-payment during the tax year from any source for the training
266-of medical, optometry, dental, physician assistant, anesthesia
267-assistant, or certified registered nurse practitioner,
235+United States Department of Health and Human Services as a
236+geographic area and population with a lack of access to
237+primary care services based on the following established
238+indicators:
239+1. Provider per 1,000 population ratio.
240+2. Percentage of population at 100 percent of the
241+federal poverty level.
242+3. Percentage of population age 65 and older.
243+4. Infant mortality rate.
244+b. A calculated index of medical underservice score of
245+62.0 or below qualifies for designation as a medically
246+underserved area or medically underserved population.
247+(8) PROGRAM. The Preceptor Tax Incentive Program.
248+(9) QUALIFIED HEALTH PROFESSIONS TRAINING PROGRAM. An
249+institution of higher education that is physically located in
250+this state and has an accredited educational program for
251+medicine, dentistry, optometry, physician assistants, or nurse
252+practitioners, nurse midwives, and nurse anesthetists.
253+(10) RURAL AREA. As defined by the United States Census
254+Bureau, in the context of health care, health data, and the
255+location of health care services, all population, housing, and
256+territory not included within a state-urbanized area with a
257+population of 50,000 or more.
258+(c)(1) Beginning with the 2023 tax year, a
259+community-based physician, dentist, or optometry preceptor,
260+community-based physician assistant preceptor, or
261+community-based nurse practitioner, nurse midwife, or nurse
262+anesthetist preceptor physically located in this state shall
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297-certified nurse midwife, and certified registered nurse
298-anesthetist students; and shall submit supporting
299-documentation, including certification obtained from the
300-Alabama Statewide Area Health Education Center Program Office,
301-to the Department of Revenue.
302-(2) Failure to provide the required documents shall
303-result in the automatic denial of the credit.
304-(d) In no event shall the total amount of the tax
305-credit provided by this section for a taxable year exceed the
306-income tax liability of the taxpayer. No tax credit shall be
307-allowed the taxpayer against his or her tax liability for
308-prior or succeeding years.
309-(e) Adjudication of possible filing errors or
310-violations of this act shall be determined by the Department
311-of Revenue.
312-Section 5. The Alabama Statewide Area Health Education
313-Center Program Office shall do both of the following:
314-(1) Issue to an eligible taxpayer a credit certificate
315-to indicate the number of approved preceptor rotations and
316-other information required by the Department of Revenue to
317-certify the credit being claimed.
318-(2) Submit an annual informational report to the
319-Department of Revenue by January 31 annually, which provides
320-all taxpayer issued certificates with information required by
321-the Department of Revenue for credit verification.
322-Section 6. (a) Annually, on or before the first day of
323-December, the Alabama Statewide Area Health Education Center
324-Program Office shall report on the condition, performance, and
292+be allowed a credit against the tax imposed by Section
293+40-18-2, Code of Alabama 1975, if he or she conducts an unpaid
294+clinical preceptorship, in the following amounts:
295+a. A community-based physician, dentist, or optometrist
296+preceptor shall be allowed a credit of five hundred dollars
297+($500) per rotation, up to an annual maximum of six thousand
298+dollars ($6,000).
299+b. A community-based physician assistant preceptor
300+shall be allowed a credit of four hundred twenty-five dollars
301+($425) per rotation, up to an annual maximum of five thousand
302+one hundred dollars ($5,100).
303+c. A community-based nurse practitioner, certified
304+nurse midwife, or certified registered nurse anesthetist
305+preceptor shall be allowed a credit of four hundred
306+twenty-five dollars ($425) per rotation, up to an annual
307+maximum of five thousand one hundred dollars ($5,100).
308+(2) An individual shall not accrue more than 12
309+clinical preceptorships of any of the above categories in one
310+calendar year.
311+(3) A community-based faculty preceptor shall not be
312+eligible to earn hours credited toward a clinical
313+preceptorship tax credit if he or she has not registered with
314+the Alabama Statewide Area Health Education Center Program
315+Office in Birmingham, Alabama.
316+(4) The Alabama Statewide Area Health Education Center
317+Program Office shall administer the program and certify
318+clinical preceptorship rotations on behalf of all eligible
319+public and private training programs for medicine, optometry,
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354-accomplishments of the program to the Governor, Speaker of the
355-House of Representatives, President Pro-Tempore of the Senate,
356-the Chairs of the Senate Healthcare and House Health
357-Committees, and the Chairs of the Senate Committee on Finance
358-and Taxation Education and the House Ways and Means Education
359-Committees.
360-(b) The Alabama Statewide Area Health Education Center
361-Program Office shall consult with the Alabama Commission on
362-the Evaluation of Services to develop performance metrics and
363-other measures of success to include in the annual report
364-required pursuant to subsection (a). During the 2030 fiscal
365-year, the program shall undergo an evaluation by the Alabama
366-Commission on the Evaluation of Services to determine whether
367-the program is impacting the determined measures of success.
368-Section 7. The Department of Revenue may adopt rules
369-for the implementation and administration of this act.
370-Section 8. This act shall be repealed on September 29,
371-2031, unless extended by act of the Legislature
372-Section 9. This act shall become effective on the first
349+and dental physician assistant, or nurse practitioner, nurse
350+midwife, and nurse anesthetist programs physically located in
351+this state.
352+(5) To receive the credit provided by this section, a
353+community-based faculty preceptor shall claim the credit on
354+his or her state income tax return for the tax year in which
355+he or she completed the clinical preceptorship rotation; shall
356+certify that he or she, and the health care center or facility
357+through which he or she is employed, did not receive monetary
358+payment during the tax year from any source for the training
359+of medical, optometry, and dental physician assistant, or
360+nurse practitioner, nurse midwife, and nurse anesthetist
361+students; and shall submit supporting documentation to the
362+Department of Revenue.
363+(6) In no event shall the total amount of the tax
364+credit provided by this section for a taxable year exceed the
365+income tax liability of the taxpayer. No tax credit shall be
366+allowed the taxpayer against his or her tax liability for
367+prior or succeeding years.
368+(d) Adjudication of possible filing errors or
369+violations of the law shall be determined by the Department of
370+Revenue.
371+Section 2. This act shall become effective on the first
373372 day of the third month following its passage and approval by
374373 the Governor, or its otherwise becoming law.
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397-________________________________________________
398-Speaker of the House of Representatives
399-________________________________________________
400-President and Presiding Officer of the Senate
401-House of Representatives
402-I hereby certify that the within Act originated in and
403-was passed by the House 25-Apr-23, as amended.
404-John Treadwell
405-Clerk
406-Senate 01-Jun-23 Passed
407-House 06-Jun-23 Passed
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