Second Regular Session
Seventy-third General Assembly
STATE OF COLORADO
REENGROSSED
This Version Includes All Amendments
Adopted in the House of Introduction
LLS NO. 22-0484.01 Pierce Lively x2059
HOUSE BILL 22-1005
House Committees Senate Committees
Health & Insurance
Finance
Appropriations
A BILL FOR AN ACT
C
ONCERNING MODIFICATIONS TO THE EXISTING TAX CREDIT FOR101
RURAL AND FRONTIER HEALTH -CARE PRECEPTORS.102
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
Under current law, for tax years commencing on or after January
1, 2017, but prior to January 1, 2023, the credit for health-care preceptors
working in rural and frontier areas offers an income tax credit in the
amount of $1,000 to health-care professionals who provide a
preceptorship, an uncompensated mentoring experience for eligible health
professional students that includes a specified minimum amount of
HOUSE
3rd Reading Unamended
April 25, 2022
HOUSE
Amended 2nd Reading
April 22, 2022
HOUSE SPONSORSHIP
McCluskie and Will, Amabile, Bernett, Bird, Bockenfeld, Caraveo, Cutter, Duran, Esgar,
Exum, Jodeh, Kennedy, Kipp, Lindsay, Lontine, McLachlan, Michaelson Jenet, Mullica,
Pelton, Ricks, Roberts, Soper, Titone, Valdez A., Valdez D., Weissman
SENATE SPONSORSHIP
Rankin,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing statute.
Dashes through the words indicate deletions from existing statute. personalized instruction, training, and supervision, during the applicable
income tax year.
The bill modifies the tax credit by:
! Extending the period for which the tax credit may be
claimed to tax years commencing prior to January 1, 2033;
! Allowing up to 300, rather than 200, preceptors to claim
the credit in any tax year;
! Expanding who may offer a preceptorship to include a
medical doctor, doctor of osteopathic medicine, advanced
practice nurse, physician assistant, doctor of dental surgery
or doctor of dental medicine, registered nurse, registered
dental hygienist, licensed clinical or counseling
psychologist, licensed clinical social worker, licensed
professional counselor, licensed marriage and family
therapist, psychiatric nurse specialist, licensed addiction
counselor, or certified addiction counselor working in an
outpatient clinical setting who has been licensed in his or
her primary health-care field in the state by the applicable
licensing authority;
! Expanding who may participate in a preceptorship to
include individuals matriculating at any accredited
Colorado institution of higher education seeking a degree
or certification in a primary health-care field;
! Allowing nonconsecutive days to be counted when
determining the eligibility of a preceptorship for the credit;
! Modifying the definitions of "rural areas", "preceptorship",
and "primary health-care" for purposes of the tax credit;
! Modifying the certification requirements for taxpayers who
claim the tax credit; and
! Providing a tax preference performance statement for the
tax credit.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 39-22-538, amend2
(1), (2)(d), (2)(e), (2)(f), (2)(g), (3), and (4); repeal (2)(c); and add3
(2)(c.5) as follows:4
39-22-538. Credit for health-care preceptors working in health5
professional shortage areas - legislative declaration - definitions.6
(1) (a) The general assembly finds, determines, and declares that:7
1005-2- (I) It is vital to the well-being, quality of life, and economic1
development of the entire state that excellent health care be available in2
all regions of the state, including rural and frontier areas;3
(II) Rural areas of the state currently suffer from a shortage of4
primary health- care providers and, as a result, these communities5
experience reduced access to such providers and poorer health-care6
outcomes; and7
(III) A consistent problem is a lack of professional instruction,8
training, and supervision in rural and frontier areas that allows students9
studying primary care to obtain the requisite professional mentoring and10
supervision to allow them to practice in such areas upon obtaining a11
professional degree.12
(IV) T
HE COVID-19 PANDEMIC AND SUBSEQUENT EC ONOMIC13
CRISIS HAVE CAUSED SIGNIFICANT CHALLENGES FOR COLORADO'S14
HEALTH-CARE SYSTEM AND EXACERBATED THE WORKFORCE SHORTAGE15
ACROSS MULTIPLE DISCIPLINES AND SECTORS OF THE HEALTH -CARE16
INDUSTRY;17
(V) W
HILE THE PANDEMIC HAS HAD LASTING IMPACTS ON THE18
ENTIRE HEALTH-CARE SYSTEM ACROSS THE STATE , RURAL COLORADO IS19
EXPERIENCING THE MOST SEVERE WORKFORCE TURNOVER AND20
SHORTAGES, AND AS A RESULT THESE COMMUNITIES EXPERIENCE REDUCED21
ACCESS TO PRIMARY CARE SERVICES AND EXHIBIT POORER HEALTH22
OUTCOMES;23
(VI) R
URAL COMMUNITIES OFTEN FACE CHALLENGES IN24
RECRUITING AN ADEQUATE HEALTH WORKFORCE , MAKING IT DIFFICULT TO25
PROVIDE NEEDED PATIENT CARE OR TO MEET STAFFING REQUIREMENTS26
FOR THEIR FACILITIES. THEREFORE, RURAL HEALTH-CARE FACILITIES27
1005
-3- SHOULD BE PROACTIVE AND STRATEGIC ABOUT RECRUITING AND1
RETAINING PRIMARY CARE PERSONNEL , WHICH INCLUDES PROFESSIONALS2
IN PHYSICAL, DENTAL, BEHAVIORAL, AND MENTAL HEALTH.3
(VII) M
OST OF COLORADO'S FORTY-SEVEN RURAL AND FRONTIER4
COUNTIES ARE ALSO DESI GNATED AS PRIMARY CARE HEALTH5
PROFESSIONAL SHORTAGE AREAS BY THE COLORADO PRIMARY CARE6
OFFICE;7
(VIII) P
RECEPTORSHIP PROGRAMS ARE A CRITICAL COMPONENT OF8
CLINICAL TRAINING AND A PROVEN APPROACH TO DEVELOPING9
ONE-ON-ONE RELATIONSHIPS BETWEEN EXPERT PROFESSIONALS AND10
STUDENTS NEEDING TO DEVELOP THE CLINICAL SKILLS AND PRACTICAL11
EXPERIENCE OF WORKING WITH PATIENTS IN RURAL SETTINGS ;12
(IX) H
EALTH PROFESSIONAL STUDENTS WHO OBTAIN A13
SIGNIFICANT AMOUNT OF THEIR CLINICAL TRAINING IN RURAL14
COMMUNITIES AND UNDER THE GUIDANCE OF RURAL HEALTH -CARE15
PROVIDERS ARE MUCH MORE LIKELY TO LIVE AND WORK IN A RURAL OR16
FRONTIER AREA AFTER COMPLETING THEIR HEALTH PROFESSIONAL17
TRAINING;18
(X) R
ECENT STUDIES AND SURVEYS BY THE AMERICAN ACADEMY19
OF FAMILY PHYSICIANS HAVE SHOWN THAT PRIMARY CARE PHYSICIANS20
ARE MORE LIKELY TO ENGAGE IN PRECEPTORSHIPS WHEN PROFESSIONAL21
RECOGNITION AND FINANCIAL INCENTIVES ARE PROVIDED ; AND22
(XI) T
HE GENERAL ASSEMBLY THEREFORE FINDS THAT23
MAINTAINING A HIGHLY QUALIFIED AND SUSTAINABLE RURAL24
HEALTH-CARE WORKFORCE DEPENDS ON THE EXTENSION AND EXPANSION25
OF THE RURAL AND FRONTIER HEALTH -CARE PRECEPTOR TAX CREDIT TO26
PROVIDE SUFFICIENT FINANCIAL INCENTIVES TO PRECEPTORS STATEWIDE .27
1005
-4- (b) The general assembly intends that the tax credit created in this1
section is to be used to provide sufficient financial incentives to2
encourage preceptors to offer professional instruction, training, and3
supervision to students seeking careers as primary health-care providers4
in rural and frontier areas of the state.5
(c) The general assembly further intends that the tax credit provide6
sufficient financial incentives to encourage preceptors to offer7
professional instruction, training, and supervision to students8
matriculating at Colorado institutions of higher education seeking careers9
as primary health-care providers in rural and frontier areas of the state. 10
(d) I
N ACCORDANCE WITH SECTION 39-21-304 (1), WHICH11
REQUIRES EACH BILL THAT EXTENDS AN EXPIRING TAX EXPENDITURE TO12
INCLUDE A TAX PREFERENCE PERFORMANCE STATEMENT AS PART OF A13
STATUTORY LEGISLATIVE DECLARATION , THE GENERAL ASSEMBLY HEREBY14
FINDS AND DECLARES THAT:15
(I) T
HE GENERAL LEGISLATIVE PURPOSES OF THE TAX CREDIT16
ALLOWED BY THIS SECTION ARE:17
(A) T
O INDUCE CERTAIN DESIGNATED BEHAVIOR BY TAXPAYERS ,18
SPECIFICALLY THE OFFERING OF PROFESSIONAL INSTRUCTION , TRAINING,19
AND SUPERVISION TO STUDENTS SEEKING CAREERS AS PRIMARY20
HEALTH-CARE PROVIDERS IN RURAL AREAS AND FRONTIER AREAS OF THE21
STATE; AND22
(B) T
O PROVIDE TAX RELIEF TO PRECEPTORS IN RURAL AND23
FRONTIER AREAS OF THE STATE WHO OFFER THE PROFESSIONAL24
INSTRUCTION, TRAINING, AND SUPERVISION DESCRIBED IN SUBSECTION25
(1)(d)(I)(A)
OF THIS SECTION; AND26
(II) T
HE SPECIFIC LEGISLATIVE PURPOSE OF THE TAX CREDIT27
1005
-5- ALLOWED BY THIS SECTION IS TO ENCOURAGE PRECEPTORS TO OFFER1
PROFESSIONAL INSTRUCTION, TRAINING, AND SUPERVISION TO STUDENTS2
MATRICULATING AT COLORADO INSTITUTIONS OF HIGHER EDUCATION WHO3
ARE SEEKING CAREERS AS PRIMARY HEALTH -CARE PROVIDERS IN RURAL4
AND FRONTIER AREAS OF THE STATE. IN ORDER TO ALLOW THE GENERAL5
ASSEMBLY AND THE STATE AUDITOR TO MEASURE THE EFFECTIVENESS OF6
THE CREDIT, THE DEPARTMENT OF REVENUE , WHEN ADMINISTERING THE7
CREDIT, SHALL REQUIRE EACH TAXPAYER WHO CLAIMS THE CREDIT TO8
SUBMIT A CERTIFICATION FORM WITH EACH INCOME TAX RETURN FORM IN9
ACCORDANCE WITH SUBSECTION (4) OF THIS SECTION. THE CERTIFICATION10
FORM MUST VERIFY THAT THE TAXPAYER HAS SATISFIED THE11
REQUIREMENTS FOR ALLOWANCE OF THE TAX CREDIT AS SPECIFIED IN THIS12
SECTION AND STATE THE NUMBER OF ELIGIBLE HEALTH PROFESSIONAL13
STUDENTS THAT THE TAXPAYER HAS INSTRUCTED , TRAINED, OR14
SUPERVISED DURING THE APPLICABLE INCOME TAX YEAR .15
(2) As used in this section, unless the context otherwise requires:16
(c) "Graduate student" means an individual matriculating at the17
graduate level at any accredited Colorado institution of higher education18
seeking a degree either in the areas of doctor of medicine, doctor of19
osteopathy, advanced nursing practice, doctor of dental surgery, or doctor20
of dental medicine, or as a physician assistant.21
(c.5) "H
EALTH PROFESSIONAL STUDENT " MEANS AN INDIVIDUAL22
MATRICULATING AT ANY ACCREDITED COLORADO INSTITUTION OF HIGHER23
EDUCATION SEEKING A DEGREE OR CERTIFICATION IN A PRIMARY24
HEALTH-CARE FIELD.25
(d) "Preceptor" means a medical doctor, doctor of osteopathic26
medicine, advanced practice nurse, physician assistant, doctor of dental27
1005
-6- surgery, or doctor of dental medicine, REGISTERED NURSE, REGISTERED1
DENTAL HYGIENIST, PHARMACIST, LICENSED CLINICAL OR COUNSELING2
PSYCHOLOGIST, LICENSED CLINICAL SOCIAL WORKER , LICENSED3
PROFESSIONAL COUNSELOR, LICENSED MARRIAGE AND FAMILY THERAPIST ,4
PSYCHIATRIC NURSE SPECIALIST, LICENSED ADDICTION COUNSELOR , OR5
CERTIFIED ADDICTION COUNSELOR WORKING IN AN OUTPATIENT CLINICAL6
SETTING who has been licensed in his or her primary health-care field in7
the state by the applicable licensing authority.8
(e) "Preceptorship" means an uncompensated mentoring9
experience in which a preceptor provides a program of personalized10
instruction, training, and supervision for a total of not less than four11
CONSECUTIVE OR NONCONSECUTIVE working weeks or twenty12
CONSECUTIVE OR NONCONSECUTIVE business days per calendar year that13
is offered to eligible graduate
HEALTH PROFESSIONAL students to enable14
the students to obtain eligible professional degrees
OR CERTIFICATIONS.15
(f) "Primary health-care" means health care provided by a
16
health-care professional with whom a patient has initial contact, who is17
the principal point of continuing care for the patient, and who coordinates18
other specialist care that the patient may need THE PROVISION OF19
INTEGRATED, EQUITABLE, AND ACCESSIBLE HEALTH -CARE SERVICES20
PROVIDED BY CLINICIANS WHO ARE ACCOUNTABLE FOR ADDRESSING A21
LARGE MAJORITY OF PERSONAL HEALTH -CARE NEEDS, DEVELOPING A22
SUSTAINED PARTNERSHIP WITH PATIENTS , AND PRACTICING IN THE23
CONTEXT OF FAMILY AND COMMUNITY . INTEGRATED HEALTH -CARE24
ENCOMPASSES THE PROVISION OF COMPREHENSIVE , COORDINATED, AND25
CONTINUOUS SERVICES THAT PROVIDE A SEAMLESS PROCESS OF CARE .26
(g) "Rural area" means a county that is located in a27
1005
-7- nonmetropolitan area in the state that either has no municipality within its1
territorial boundaries with fifty thousand or more permanent residents2
based upon the most recent population estimates published by the United3
States census bureau or that satisfies alternate criteria for the designation4
of a rural area as may be promulgated by the federal office of5
management and budget AN AREA LISTED AS ELIGIBLE FOR RURAL HEALTH6
FUNDING BY THE FEDERAL OFFICE OF RURAL HEALTH POLICY .7
(3) (a) For income tax years commencing on or after January 1,8
2017, but prior to January 1, 2023 JANUARY 1, 2033, and subject to the9
requirements of subsection (3)(b) of this section, a taxpayer is allowed a10
credit against the income taxes imposed by this article 22 in an amount11
equal to one thousand dollars for a preceptorship provided by him or her12
THE TAXPAYER during the applicable income tax year for which the credit13
is claimed.14
(b) Notwithstanding any other provision of this section:15
(I) The aggregate amount of the credit awarded to any one16
taxpayer under this section shall not exceed one thousand dollars for any17
one income tax year regardless of the number of preceptorships18
undertaken by the taxpayer during the applicable income tax year or the19
number of eligible graduate HEALTH PROFESSIONAL students the taxpayer20
instructs, trains, or supervises during the applicable income tax year;21
(II) A taxpayer is eligible to claim the credit allowed by this22
section if he or she THE TAXPAYER performs a preceptorship that lasts a23
total of not less than four
CONSECUTIVE OR NONCONSECUTIVE working24
weeks or twenty
CONSECUTIVE OR NONCONSECUTIVE business days during25
the income tax year in which the credit is claimed and the preceptor is26
practicing in his or her
THE PRECEPTOR'S primary health-care field in a27
1005
-8- rural or frontier area; and1
(III) Not more than two THREE hundred preceptors are entitled to2
claim the credit authorized by this section for any one income tax year.3
The department shall promulgate by rule, in accordance with article 4 of4
title 24, C.R.S., a method for determining the manner in which taxpayers5
who have obtained certification under subsection (4) of this section are6
able to claim the tax credit.7
(4) To qualify for the credit provided by this section, the taxpayer8
shall submit a certification form with each income tax return.9
Certification may be provided by either the institution for which the10
taxpayer teaches, whether it is an institution of higher education or a11
hospital, clinic, or other medical facility, or by the particular regional12
office of the AHEC program with jurisdiction over the area in which the13
preceptor's medical practice is located. In the case of certification by an14
institution for which the taxpayer teaches, the institution must execute the15
form certifying that the taxpayer has satisfied the requirements for16
allowance of the tax credit as specified in this section
AND IDENTIFYING17
THE NUMBER OF ELIGIBLE
HEALTH PROFESSIONAL STUDENTS THAT THE18
TAXPAYER HAS INSTRUCTED , TRAINED, OR SUPERVISED DURING THE19
APPLICABLE INCOME TAX YEAR THROUGH ALL PRECEPTORSHIPS PROVIDED20
BY THE TAXPAYER. In the case of certification by the AHEC program, the21
certification form must be obtained from the particular regional office of22
the AHEC program with jurisdiction over the area in which the preceptor23
is practicing, which office shall certify that the taxpayer has satisfied the24
requirements for allowance of the tax credit as specified in this section25
AND IDENTIFY THE NUMBER OF ELIGIBLE
HEALTH PROFESSIONAL STUDENTS26
THE TAXPAYER HAS INSTRUCTED , TRAINED, OR SUPERVISED DURING THE27
1005
-9- APPLICABLE INCOME TAX YEAR THROUGH ALL PRECEPTORSHIPS PROVIDED1
BY THE TAXPAYER. The AHEC program may charge the taxpayer a2
reasonable fee for providing such certification, which fee shall not exceed3
the actual costs incurred by the AHEC in completing the certification.4
SECTION 2. Act subject to petition - effective date. This act5
takes effect at 12:01 a.m. on the day following the expiration of the6
ninety-day period after final adjournment of the general assembly; except7
that, if a referendum petition is filed pursuant to section 1 (3) of article V8
of the state constitution against this act or an item, section, or part of this9
act within such period, then the act, item, section, or part will not take10
effect unless approved by the people at the general election to be held in11
November 2022 and, in such case, will take effect on the date of the12
official declaration of the vote thereon by the governor.13
1005
-10-