HOUSE BILL 22-1005
BY REPRESENTATIVE(S) 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;
also SENATOR(S) Rankin, Donovan, Ginal, Gonzales, Hansen,
Jaquez Lewis, Lee, Moreno, Pettersen, Priola, Winter.
C
ONCERNING MODIFICATIONS TO THE EXISTING TAX CREDIT FOR RURAL AND
FRONTIER HEALTH
-CARE PRECEPTORS.
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. In Colorado Revised Statutes, 39-22-538, amend (1),
(2)(d), (2)(e), (2)(f), (2)(g), (3), and (4); repeal (2)(c); and add (2)(c.5) as
follows:
39-22-538. Credit for health-care preceptors working in health
professional shortage areas - legislative declaration - definitions.
(1) (a) The general assembly finds, determines, and declares that:
(I) It is vital to the well-being, quality of life, and economic
development of the entire state that excellent health care be available in all
NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
________
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act. regions of the state, including rural and frontier areas;
(II) Rural areas of the state currently suffer from a shortage of
primary health- care providers and, as a result, these communities
experience reduced access to such providers and poorer health-care
outcomes; and
(III) A consistent problem is a lack of professional instruction,
training, and supervision in rural and frontier areas that allows students
studying primary care to obtain the requisite professional mentoring and
supervision to allow them to practice in such areas upon obtaining a
professional degree.
(IV) THE COVID-19 PANDEMIC AND SUBSEQUENT ECONOMIC CRISIS
HAVE CAUSED SIGNIFICANT CHALLENGES FOR
COLORADO'S HEALTH-CARE
SYSTEM AND EXACERBATED THE WORKFORCE SHORTAGE ACROSS MULTIPLE
DISCIPLINES AND SECTORS OF THE HEALTH
-CARE INDUSTRY;
(V) W
HILE THE PANDEMIC HAS HAD LASTING IMPACTS ON THE
ENTIRE HEALTH
-CARE SYSTEM ACROSS THE STATE , RURAL COLORADO IS
EXPERIENCING THE MOST SEVERE WORKFORCE TURNOVER AND SHORTAGES
,
AND AS A RESULT THESE COMMUNITIES EXPERIENCE REDUCED ACCESS TO
PRIMARY CARE SERVICES AND EXHIBIT POORER HEALTH OUTCOMES
;
(VI) R
URAL COMMUNITIES OFTEN FACE CHALLENGES IN RECRUITING
AN ADEQUATE HEALTH WORKFORCE
, MAKING IT DIFFICULT TO PROVIDE
NEEDED PATIENT CARE OR TO MEET STAFFING REQUIREMENTS FOR THEIR
FACILITIES
. THEREFORE, RURAL HEALTH-CARE FACILITIES SHOULD BE
PROACTIVE AND STRATEGIC ABOUT RECRUITING AND RETAINING PRIMARY
CARE PERSONNEL
, WHICH INCLUDES PROFESSIONALS IN PHYSICAL , DENTAL,
BEHAVIORAL, AND MENTAL HEALTH.
(VII) M
OST OF COLORADO'S FORTY-SEVEN RURAL AND FRONTIER
COUNTIES ARE ALSO DESIGNATED AS PRIMARY CARE HEALTH PROFESSIONAL
SHORTAGE AREAS BY THE
COLORADO PRIMARY CARE OFFICE ;
(VIII) P
RECEPTORSHIP PROGRAMS ARE A CRITICAL COMPONENT OF
CLINICAL TRAINING AND A PROVEN APPROACH TO DEVELOPING ONE
-ON-ONE
RELATIONSHIPS BETWEEN EXPERT PROFESSIONALS AND STUDENTS NEEDING
TO DEVELOP THE CLINICAL SKILLS AND PRACTICAL EXPERIENCE OF WORKING
PAGE 2-HOUSE BILL 22-1005 WITH PATIENTS IN RURAL SETTINGS;
(IX) H
EALTH PROFESSIONAL STUDENTS WHO OBTAIN A SIGNIFICANT
AMOUNT OF THEIR CLINICAL TRAINING IN RURAL COMMUNITIES AND UNDER
THE GUIDANCE OF RURAL HEALTH
-CARE PROVIDERS ARE MUCH MORE LIKELY
TO LIVE AND WORK IN A RURAL OR FRONTIER AREA AFTER COMPLETING
THEIR HEALTH PROFESSIONAL TRAINING
;
(X) R
ECENT STUDIES AND SURVEYS BY THE AMERICAN ACADEMY OF
FAMILY PHYSICIANS HAVE SHOWN THAT PRIMARY CARE PHYSICIANS ARE
MORE LIKELY TO ENGAGE IN PRECEPTORSHIPS WHEN PROFESSIONAL
RECOGNITION AND FINANCIAL INCENTIVES ARE PROVIDED
; AND
(XI) THE GENERAL ASSEMBLY THEREFORE FINDS THAT MAINTAINING
A HIGHLY QUALIFIED AND SUSTAINABLE RURAL HEALTH
-CARE WORKFORCE
DEPENDS ON THE EXTENSION AND EXPANSION OF THE RURAL AND FRONTIER
HEALTH
-CARE PRECEPTOR TAX CREDIT TO PROVIDE SUFFICIENT FINANCIAL
INCENTIVES TO PRECEPTORS STATEWIDE
.
(b) The general assembly intends that the tax credit created in this
section is to be used to provide sufficient financial incentives to encourage
preceptors to offer professional instruction, training, and supervision to
students seeking careers as primary health-care providers in rural and
frontier areas of the state.
(c) The general assembly further intends that the tax credit provide
sufficient financial incentives to encourage preceptors to offer professional
instruction, training, and supervision to students matriculating at Colorado
institutions of higher education seeking careers as primary health-care
providers in rural and frontier areas of the state.
(d) IN ACCORDANCE WITH SECTION 39-21-304 (1), WHICH REQUIRES
EACH BILL THAT EXTENDS AN EXPIRING TAX EXPENDITURE TO INCLUDE A
TAX PREFERENCE PERFORMANCE STATEMENT AS PART OF A STATUTORY
LEGISLATIVE DECLARATION
, THE GENERAL ASSEMBLY HEREBY FINDS AND
DECLARES THAT
:
(I) T
HE GENERAL LEGISLATIVE PURPOSES OF THE TAX CREDIT
ALLOWED BY THIS SECTION ARE
:
PAGE 3-HOUSE BILL 22-1005 (A) TO INDUCE CERTAIN DESIGNATED BEHAVIOR BY TAXPAYERS ,
SPECIFICALLY THE OFFERING OF PROFESSIONAL INSTRUCTION , TRAINING, AND
SUPERVISION TO STUDENTS SEEKING CAREERS AS PRIMARY HEALTH
-CARE
PROVIDERS IN RURAL AREAS AND FRONTIER AREAS OF THE STATE
; AND
(B) TO PROVIDE TAX RELIEF TO PRECEPTORS IN RURAL AND FRONTIER
AREAS OF THE STATE WHO OFFER THE PROFESSIONAL INSTRUCTION
,
TRAINING, AND SUPERVISION DESCRIBED IN SUBSECTION (1)(d)(I)(A) OF THIS
SECTION
; AND
(II) THE SPECIFIC LEGISLATIVE PURPOSE OF THE TAX CREDIT
ALLOWED BY THIS SECTION IS TO ENCOURAGE PRECEPTORS TO OFFER
PROFESSIONAL INSTRUCTION
, TRAINING, AND SUPERVISION TO STUDENTS
MATRICULATING AT
COLORADO INSTITUTIONS OF HIGHER EDUCATION WHO
ARE SEEKING CAREERS AS PRIMARY HEALTH
-CARE PROVIDERS IN RURAL AND
FRONTIER AREAS OF THE STATE
. IN ORDER TO ALLOW THE GENERAL
ASSEMBLY AND THE STATE AUDITOR TO MEASURE THE EFFECTIVENESS OF
THE CREDIT
, THE DEPARTMENT OF REVENUE , WHEN ADMINISTERING THE
CREDIT
, SHALL REQUIRE EACH TAXPAYER WHO CLAIMS THE CREDIT TO
SUBMIT A CERTIFICATION FORM WITH EACH INCOME TAX RETURN FORM IN
ACCORDANCE WITH SUBSECTION
(4) OF THIS SECTION. THE CERTIFICATION
FORM MUST VERIFY THAT THE TAXPAYER HAS SATISFIED THE REQUIREMENTS
FOR ALLOWANCE OF THE TAX CREDIT AS SPECIFIED IN THIS SECTION AND
STATE THE NUMBER OF ELIGIBLE HEALTH PROFESSIONAL STUDENTS THAT THE
TAXPAYER HAS INSTRUCTED
, TRAINED, OR SUPERVISED DURING THE
APPLICABLE INCOME TAX YEAR
.
(2) As used in this section, unless the context otherwise requires:
(c) "Graduate student" means an individual matriculating at the
graduate level at any accredited Colorado institution of higher education
seeking a degree either in the areas of doctor of medicine, doctor of
osteopathy, advanced nursing practice, doctor of dental surgery, or doctor
of dental medicine, or as a physician assistant.
(c.5) "HEALTH PROFESSIONAL STUDENT " MEANS AN INDIVIDUAL
MATRICULATING AT ANY ACCREDITED
COLORADO INSTITUTION OF HIGHER
EDUCATION SEEKING A DEGREE OR CERTIFICATION IN A PRIMARY
HEALTH
-CARE FIELD.
PAGE 4-HOUSE BILL 22-1005 (d) "Preceptor" means 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
, PHARMACIST, 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.
(e) "Preceptorship" means an uncompensated mentoring experience
in which a preceptor provides a program of personalized instruction,
training, and supervision for a total of not less than four
CONSECUTIVE OR
NONCONSECUTIVE
working weeks or twenty CONSECUTIVE OR
NONCONSECUTIVE
business days per calendar year that is offered to eligible
graduate
HEALTH PROFESSIONAL students to enable the students to obtain
eligible professional degrees
OR CERTIFICATIONS.
(f) "Primary health-care" means health care provided by ahealth-care professional with whom a patient has initial contact, who is the
principal point of continuing care for the patient, and who coordinates other
specialist care that the patient may need THE PROVISION OF INTEGRATED,
EQUITABLE, AND ACCESSIBLE HEALTH -CARE SERVICES PROVIDED BY
CLINICIANS WHO ARE ACCOUNTABLE FOR ADDRESSING A LARGE MAJORITY
OF PERSONAL HEALTH
-CARE NEEDS, DEVELOPING A SUSTAINED PARTNERSHIP
WITH PATIENTS
, AND PRACTICING IN THE CONTEXT OF FAMILY AND
COMMUNITY
. INTEGRATED HEALTH-CARE ENCOMPASSES THE PROVISION OF
COMPREHENSIVE
, COORDINATED, AND CONTINUOUS SERVICES THAT PROVIDE
A SEAMLESS PROCESS OF CARE
.
(g) "Rural area" means a county that is located in a nonmetropolitan
area in the state that either has no municipality within its territorial
boundaries with fifty thousand or more permanent residents based upon the
most recent population estimates published by the United States census
bureau or that satisfies alternate criteria for the designation of a rural area
as may be promulgated by the federal office of management and budget AN
AREA LISTED AS ELIGIBLE FOR RURAL HEALTH FUNDING BY THE FEDERAL
OFFICE OF RURAL HEALTH POLICY
.
PAGE 5-HOUSE BILL 22-1005 (3) (a) For income tax years commencing on or after January 1,
2017, but prior to January 1, 2023 JANUARY 1, 2033, and subject to the
requirements of subsection (3)(b) of this section, a taxpayer is allowed a
credit against the income taxes imposed by this article 22 in an amount
equal to one thousand dollars for a preceptorship provided by him or her
THE TAXPAYER during the applicable income tax year for which the credit
is claimed.
(b) Notwithstanding any other provision of this section:
(I) The aggregate amount of the credit awarded to any one taxpayer
under this section shall not exceed one thousand dollars for any one income
tax year regardless of the number of preceptorships undertaken by the
taxpayer during the applicable income tax year or the number of eligible
graduate
HEALTH PROFESSIONAL students the taxpayer instructs, trains, or
supervises during the applicable income tax year;
(II) A taxpayer is eligible to claim the credit allowed by this section
if he or she THE TAXPAYER performs a preceptorship that lasts a total of not
less than four
CONSECUTIVE OR NONCONSECUTIVE working weeks or twenty
CONSECUTIVE OR NONCONSECUTIVE business days during the income tax
year in which the credit is claimed and the preceptor is practicing in his orher THE PRECEPTOR'S primary health-care field in a rural or frontier area;
and
(III) Not more than two THREE hundred preceptors are entitled to
claim the credit authorized by this section for any one income tax year. The
department shall promulgate by rule, in accordance with article 4 of title 24,
C.R.S.,
a method for determining the manner in which taxpayers who have
obtained certification under subsection (4) of this section are able to claim
the tax credit.
(4) To qualify for the credit provided by this section, the taxpayer
shall submit a certification form with each income tax return. Certification
may be provided by either the institution for which the taxpayer teaches,
whether it is an institution of higher education or a hospital, clinic, or other
medical facility, or by the particular regional office of the AHEC program
with jurisdiction over the area in which the preceptor's medical practice is
located. In the case of certification by an institution for which the taxpayer
teaches, the institution must execute the form certifying that the taxpayer
PAGE 6-HOUSE BILL 22-1005 has satisfied the requirements for allowance of the tax credit as specified in
this section
AND IDENTIFYING THE NUMBER OF ELIGIBLE HEALTH
PROFESSIONAL STUDENTS THAT THE TAXPAYER HAS INSTRUCTED
, TRAINED,
OR SUPERVISED DURING THE APPLICABLE INCOME TAX YEAR THROUGH ALL
PRECEPTORSHIPS PROVIDED BY THE TAXPAYER
. In the case of certification
by the AHEC program, the certification form must be obtained from the
particular regional office of the AHEC program with jurisdiction over the
area in which the preceptor is practicing, which office shall certify that the
taxpayer has satisfied the requirements for allowance of the tax credit as
specified in this section
AND IDENTIFY THE NUMBER OF ELIGIBLE HEALTH
PROFESSIONAL STUDENTS THE TAXPAYER HAS INSTRUCTED
, TRAINED, OR
SUPERVISED DURING THE APPLICABLE INCOME TAX YEAR THROUGH ALL
PRECEPTORSHIPS PROVIDED BY THE TAXPAYER
. The AHEC program may
charge the taxpayer a reasonable fee for providing such certification, which
fee shall not exceed the actual costs incurred by the AHEC in completing
the certification.
SECTION 2. Act subject to petition - effective date. This act
takes effect at 12:01 a.m. on the day following the expiration of the
ninety-day period after final adjournment of the general assembly; except
that, if a referendum petition is filed pursuant to section 1 (3) of article V
of the state constitution against this act or an item, section, or part of this act
within such period, then the act, item, section, or part will not take effect
unless approved by the people at the general election to be held in
PAGE 7-HOUSE BILL 22-1005 November 2022 and, in such case, will take effect on the date of the official
declaration of the vote thereon by the governor.
____________________________ ____________________________
Alec Garnett Steve Fenberg
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Robin Jones Cindi L. Markwell
CHIEF CLERK OF THE HOUSE SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
(Date and Time)
_________________________________________
Jared S. Polis
GOVERNOR OF THE STATE OF COLORADO
PAGE 8-HOUSE BILL 22-1005