| 47 | | - | SECTION 1. The legislature finds that there is a shortage of health care providers in the State, particularly primary care providers, which will be exacerbated by the projected retirements of current physicians, advanced practice registered nurses, pharmacists, and other health care workers. Furthermore, although students are interested in pursuing careers in Hawaii's health care service industry, in-state educational institutions are constrained by the lack of clinical education sites in the State and the limited supply of qualified preceptors. One way to encourage the participation of preceptors is to offer an income tax credit for health care professionals who serve as preceptors. The purpose of the existing healthcare preceptor income tax credit established under section 235-110.25, Hawaii Revised Statutes, is to incentivize volunteer preceptors to offer professional instruction, training, and supervision to students and residents seeking careers as health care providers in the State. During the implementation of the tax credit, many providers trained eligible students, but only a small subset met the eligibility requirements due to the primary care qualifying criterion for the preceptor. Thus, the legislature recognizes that programs training physicians, advanced practice registered nurses, pharmacists, and physician assistants in primary care also require training from specialty preceptors who support primary care, in addition to training from primary care providers. The legislature further recognizes that the health care workforce has shortages that extend beyond the current professions included in the tax credit whose workforce expansion is also limited by available preceptors, including social workers, physician assistants, and registered dieticians. The legislature also finds that the definition of "volunteer-based supervised clinical training rotation" can be clarified to facilitate the preceptor credit assurance committee's implementation of the tax credit. Therefore, the purpose of this Act is to: (1) Amend the definitions of "preceptor" and "volunteer-based supervised clinical training rotation" to improve accessibility for providers to receive income tax credits for acting as preceptors; (2) Add licensed dieticians, physician assistants, and social workers, to the list of preceptors; provided that any recognized preceptor may train any eligible student to become eligible for the preceptor tax credit; (3) Include dietitian, physician assistant, and social worker students in the definition of "eligible student"; and (4) Revise the membership of the preceptor credit assurance committee to include the director of health. SECTION 2. Section 235-110.25, Hawaii Revised Statutes, is amended as follows: 1. By amending its title and subsection (a) to read: "[[]§235-110.25[] Healthcare] Health care preceptor tax credit. (a) There shall be allowed to each taxpayer subject to the tax imposed by this chapter, a [healthcare] health care preceptor tax credit that shall be deductible from the taxpayer's net income tax liability, if any, imposed by this chapter for the taxable year in which the credit is properly claimed." 2. By amending subsection (g) to read: "(g) For the purposes of this section: "Academic program" means an academic degree granting program or graduate medical education program that: (1) Holds either its principal accreditation or a physical location in Hawaii; and (2) Provides education to students, of whom more than fifty per cent are residents of Hawaii. "Advanced practice registered nurse student" means an individual participating in a nationally accredited academic program that is for the education of advanced practice registered nurses and recognized by the state board of nursing pursuant to chapter 457. "Dietician student" means an individual participating in an academic program that is nationally accredited for the training of individuals to become licensed dieticians pursuant to chapter 448B. "Eligible professional degree or training certificate" means a degree or certificate that fulfills a requirement to be a dietician, pursuant to chapter 448B; a physician, [or] osteopathic physician, or physician assistant, pursuant to chapter 453[,]; an advanced practice registered nurse, pursuant to chapter 457[, or]; a pharmacist, pursuant to chapter 461[.]; or social worker, pursuant to chapter 467E. "Eligible student" means an advanced practice registered nurse student, dietician student, medical student, [or] pharmacy student, physician assistant student, or social work student, who is enrolled in an academic program. "Medical student" means an individual participating in a nationally accredited academic program leading to the medical doctor or doctor of osteopathy degree. "Medical student" includes graduates from nationally accredited academic programs who have continued their training, in the role of resident or fellow, to obtain the additional qualifications needed for medical licensure, pursuant to chapter 453, or specialty certification. "Nationally accredited" means holding an institutional accreditation by name to offer post-secondary medical primary care education. Accreditation for medical students shall be offered by the Liaison Committee on Medical Education or American Osteopathic Association Commission on Osteopathic College Accreditation. Accreditation for advanced practice registered nurse students shall be offered by the Commission on Collegiate Nursing Education. Accreditation for pharmacy students shall be offered by the Accreditation Council for Pharmacy Education. Accreditation for physician assistant students shall be offered by the Accreditation Review Commission on Education for the Physician Assistant, Inc. Accreditation for social work students shall be offered by the Council on Social Work Education. Accreditation for dietician students shall be offered by the Accreditation Council for Education in Nutrition and Dietetics. "Pharmacy student" means an individual participating in an academic program that is nationally accredited for the training of individuals to become registered pharmacists pursuant to chapter 461. "Physician assistant student" means an individual participating in an academic program that is nationally accredited for the education of physician assistants to become a nationally certified and licensed physician assistant pursuant to section 453-5.3. "Preceptor" means a dietician, licensed pursuant to 448B; a physician [or], osteopathic physician, or physician assistant, licensed pursuant to chapter 453[,]; an advanced practice registered nurse, licensed pursuant to chapter 457[, or]; a pharmacist, licensed pursuant to chapter 461[,]; or a social worker, licensed pursuant to chapter 467E, who is a resident of Hawaii [and who], maintains a professional [primary care] practice in [this] the State[.], and whose specialty supports the development and training of an eligible student in primary care. "Primary care" means the principal point of continuing care for patients provided by a [healthcare] health care provider, including health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses, and coordination of other specialist care that the patient may need. "Social work student" means an individual participating in an academic program that is nationally accredited for the training of individuals to become a social worker licensed pursuant to chapter 467E. "Volunteer-based supervised clinical training rotation" means [an uncompensated] a period of supervised clinical training [of] to an eligible student that totals at least eighty hours of supervisory time annually, in which a preceptor provides personalized instruction, training, and supervision to an eligible student to enable the eligible student to obtain an eligible professional degree or training certificate[.]; provided that, while a preceptor may be compensated for providing standard clinical services, the preceptor shall be: (1) Uncompensated for the clinical training above or beyond clinical salary or reimbursements for clinical services; or (2) Uncompensated for the provision of clinical training services from tuition funds or from state general funds." SECTION 3. Section 321-2.7, Hawaii Revised Statutes, is amended as follows: 1. By amending subsections (a) and (b) to read: "(a) There is established the preceptor credit assurance committee within the department of health. The committee shall develop and implement a plan for certifying [healthcare] health care preceptor tax credits under section 235-110.25, including: (1) Developing a process ensuring that requests for credit certification are reviewed and verifications are processed no later than thirty days following the close of each calendar year; and (2) Developing the documentation process for the committee to certify a preceptor for the tax credit; provided that the documentation to be collected shall include: (A) The preceptor's name, address, place of practice, and Hawaii provider license number; (B) Dates and hours of volunteer-based supervised clinical training rotation per eligible student; (C) Attestation that the preceptor is uncompensated for the volunteer-based supervised clinical training rotation; [and] provided that if the preceptor is compensated for providing standard clinical services, attestation that the preceptor is: (i) Uncompensated for the clinical training above or beyond clinical salary or reimbursements for clinical services; or (ii) Uncompensated for the provision of clinical training services from tuition funds or from state general funds; (D) Itemized specialties that support the development and training of the eligible student in primary care; and [(D)] (E) Other information deemed necessary by the committee. (b) The committee shall be composed of [representatives of]: (1) The director of health or the director's designee; and (2) Representatives of: [(1)] (A) The Hawaii/Pacific basin area health education center; [(2)] (B) The center for nursing; and [(3)] (C) Academic programs with eligible students." 2. By amending subsection (e) to read: "(e) As used in this section, "academic program", "eligible student", "preceptor", "primary care", and "volunteer-based supervised clinical training rotation" shall have the same meanings as in section 235-110.25." SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 5. This Act shall take effect on June 30, 3000; provided that section 2 of this Act shall apply to taxable years beginning after December 31, 2023. |
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| 47 | + | SECTION 1. The legislature finds that there is a shortage of primary care providers in the State, which will be exacerbated by the projected retirements of current physicians, advanced practice registered nurses, and pharmacists. Training for primary care requires precepting experiences with both primary care providers and specialist providers. Although students from Hawaii are interested in pursuing careers in the health care service industry in Hawaii, in-state educational institutions are constrained by the lack of clinical education sites in Hawaii and limited supply of qualified preceptors. One way to encourage the participation of preceptors is to offer an income tax credit for health care professionals who serve as preceptors. The purpose of the existing health care preceptor income tax credit established under section 235-110.25, Hawaii Revised Statutes, is to incentivize volunteer preceptors to offer professional instruction, training, and supervision to students and residents seeking careers as health care providers. During the first-year implementation of the tax credit, a large number of providers trained eligible students in 2019, but only a small subset met the eligibility requirements due to the primary care qualifying criteria. The legislature further finds that training physicians, advanced practice registered nurses, and pharmacists in primary care requires training from specialties that support primary care, in addition to training from primary care providers. The legislature also finds that the compensation limits for a preceptor providing a volunteer-based supervised clinical training rotation should be clarified to facilitate the preceptor credit assurance committee's implementation of the tax credit. Therefore, the purpose of this Act is to: (1) Clarify the limits of when a preceptor may be compensated for the provision of standard clinical services while providing a volunteer-based supervised clinical training rotation; (2) Amend the definition of "preceptor" to include specialty providers who support the development and training of students in primary care; and (3) Amend the membership of the preceptor credit assurance committee to include the director of health. SECTION 2. Section 235-110.25, Hawaii Revised Statutes, is amended as follows: 1. By amending its title and subsections (a) and (b) to read: "[[]§235-110.25[] Healthcare] Health care preceptor tax credit. (a) There shall be allowed to each taxpayer subject to the tax imposed by this chapter, a [healthcare] health care preceptor tax credit that shall be deductible from the taxpayer's net income tax liability, if any, imposed by this chapter for the taxable year in which the credit is properly claimed. (b) The amount of the credit shall be equal to $1,000 for each volunteer-based supervised clinical training rotation supervised by the taxpayer, up to a maximum of $5,000 per taxable year, regardless of the number of volunteer-based supervised clinical training rotations supervised by the taxpayer. A taxpayer who is a preceptor may be compensated for providing standard clinical services; provided that the taxpayer shall be uncompensated for the volunteer-based supervised clinical training rotation: (1) Above or beyond clinical salary or reimbursements for clinical services; or (2) From tuition funds or state general funds." 2. By amending subsection (g) to read: "(g) For the purposes of this section: "Academic program" means an academic degree granting program or graduate medical education program that: (1) Holds either its principal accreditation or a physical location in Hawaii; and (2) Provides education to students, of whom more than fifty per cent are residents of Hawaii. "Advanced practice registered nurse student" means an individual participating in a nationally accredited academic program that is for the education of advanced practice registered nurses and recognized by the state board of nursing pursuant to chapter 457. "Eligible professional degree or training certificate" means a degree or certificate that fulfills a requirement to be a physician or osteopathic physician, pursuant to chapter 453, an advanced practice registered nurse, pursuant to chapter 457, or a pharmacist, pursuant to chapter 461. "Eligible student" means an advanced practice registered nurse student, medical student, or pharmacy student who is enrolled in an academic program. "Medical student" means an individual participating in a nationally accredited academic program leading to the medical doctor or doctor of osteopathy degree. "Medical student" includes graduates from nationally accredited academic programs who have continued their training, in the role of resident or fellow, to obtain the additional qualifications needed for medical licensure, pursuant to chapter 453, or specialty certification. "Nationally accredited" means holding an institutional accreditation by name to offer post-secondary medical primary care education. Accreditation for medical students shall be offered by the Liaison Committee on Medical Education or American Osteopathic Association Commission on Osteopathic College Accreditation. Accreditation for advanced practice registered nurse students shall be offered by the Commission on Collegiate Nursing Education. "Pharmacy student" means an individual participating in an academic program that is nationally accredited for the training of individuals to become registered pharmacists pursuant to chapter 461. "Preceptor" means a physician or osteopathic physician[,] licensed pursuant to chapter 453, an advanced practice registered nurse[,] licensed pursuant to chapter 457, or a pharmacist[,] licensed pursuant to chapter 461, who is a resident of Hawaii [and who], maintains a professional [primary care] practice in this State[.], and whose specialty supports the development and training of an eligible student in primary care. "Primary care" means the principal point of continuing care for patients provided by a [healthcare] health care provider, including health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses, and coordination of other specialist care that the patient may need. "Volunteer-based supervised clinical training rotation" means [an uncompensated] a period of supervised clinical training [of] to an eligible student that totals at least eighty hours of supervisory time annually, in which a preceptor provides personalized instruction, training, and supervision to an eligible student to enable the eligible student to obtain an eligible professional degree or training certificate." SECTION 3. Section 321-2.7, Hawaii Revised Statutes, is amended as follows: 1. By amending subsections (a) and (b) to read: "(a) There is established the preceptor credit assurance committee within the department of health. The committee shall develop and implement a plan for certifying [healthcare] health care preceptor tax credits under section 235-110.25, including: (1) Developing a process ensuring that requests for credit certification are reviewed and verifications are processed no later than thirty days following the close of each calendar year; and (2) Developing the documentation process for the committee to certify a preceptor for the tax credit; provided that the documentation to be collected shall include: (A) The preceptor's name, address, place of practice, and Hawaii provider license number; (B) Dates and hours of volunteer-based supervised clinical training rotation per eligible student; (C) Attestation that the preceptor is uncompensated for the volunteer-based supervised clinical training rotation[; and]: (i) Above or beyond clinical salary or reimbursements for clinical services; or (ii) From tuition funds or state general funds; (D) Itemized specialties that support the development and training of the eligible student in primary care; and [(D)] (E) Other information deemed necessary by the committee. (b) The committee shall be composed of [representatives of]: (1) The director of health or the director's designee; and (2) Representatives of: [(1)] (A) The Hawaii/Pacific basin area health education center; [(2)] (B) The center for nursing; and [(3)] (C) Academic programs with eligible students." 2. By amending subsection (e) to read: "(e) As used in this section, "academic program", "eligible student", "preceptor", "primary care", and "volunteer-based supervised clinical training rotation" shall have the same meanings as in section 235-110.25." SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 5. This Act, upon its approval, shall apply to taxable years beginning after December 31, 2022. INTRODUCED BY: _____________________________ |
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