Session of 2023
SENATE BILL No. 98
By Committee on Education
1-24
AN ACT concerning postsecondary and postgraduate loan programs;
relating to the university of Kansas school of medicine; medical student
loan program and residency bridging program; encouraging the practice
of obstetrics and gynecology; establishing the OBGYN medical loan
repayment fund and the OBGYN medical residency bridging fund;
amending K.S.A. 76-381, 76-383, 76-385 and 76-387 and repealing the
existing sections; also repealing K.S.A. 76-386a.
Be it enacted by the Legislature of the State of Kansas:
Section 1. K.S.A. 76-381 is hereby amended to read as follows: 76-
381. As used in K.S.A. 76-380 through 76-386, and amendments thereto:
(a) "Act" means the medical student loan act;
(b) "approved postgraduate residency training program" means a
residency training program in general pediatrics, general internal
medicine, family medicine, family practice, emergency medicine,
obstetrics and gynecology, general psychiatry, child psychiatry or
fellowship training in geriatric medicine;
(c) "service commitment area" means: (1) Any community within any
county in Kansas other than Douglas, Johnson, Sedgwick, Shawnee or
Wyandotte county; (2) any state medical care facility or institution; (3) any
medical center operated by the veterans administration of the United
States; (4) the full-time faculty of the university of Kansas school of
medicine in family medicine, family practice, general psychiatry or child
psychiatry if serving as full-time faculty as provided in K.S.A. 76-384(c),
and amendments thereto; or (5) any community within Wyandotte county
for purposes of any practice obligation under an agreement entered into by
a person who is enrolled for the first time after July 1, 2004, in a course of
study leading to the medical degree; and
(d) "state medical care facility or institution" includes, but is not
limited to, the Kansas state school for the visually handicapped blind, the
Kansas state school for the deaf, any institution under the secretary for
aging and disability services, as defined by in K.S.A. 76-12a01, and
amendments thereto, any institution under the commissioner of juvenile
justice as defined by in K.S.A. 38-2302, and amendments thereto, the
Kansas soldiers' home, the Kansas veterans' home and any correctional
institution under the secretary of corrections, as defined by in K.S.A. 75-
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5202, and amendments thereto, but shall not include any state educational
institution under the state board of regents, as defined by in K.S.A. 76-711,
and amendments thereto, except as specifically provided by statute.
Sec. 2. K.S.A. 76-383 is hereby amended to read as follows: 76-383.
A medical student loan agreement entered into by the university of Kansas
school of medicine and an undergraduate student enrolled in or admitted to
the university of Kansas school of medicine in a course of instruction
leading to the degree of doctor of medicine for the purpose of receiving a
medical student loan under this act shall require that the person receiving
the loan:
(a) Complete the required course of instruction and receive the degree
of doctor of medicine and apply for, enter and complete an approved
postgraduate residency training program;
(b) apply for and obtain a license to practice medicine and surgery in
Kansas;
(c) except as otherwise provided in K.S.A. 76-384, and amendments
thereto, engage in the full-time practice of medicine and surgery for a
period of 12 months within a service commitment area, except as
otherwise provided in K.S.A. 76-384(c), and amendments thereto, for
service as a full-time faculty member of the university of Kansas school of
medicine in family medicine, family practice, general psychiatry or child
psychiatry;
(d) commence such full-time practice of medicine and surgery within
nine months after completion of an approved postgraduate residency
training program and licensure in a service commitment area and continue
such full-time practice in such service commitment area for a consecutive
period of months equal to the total number of months required under the
agreement;
(e) agree that the service commitment for each agreement entered into
under this act is in addition to the service commitment contained in any
other agreement which that has been or may be entered into under this act
for the purpose of obtaining a medical student loan or under other
agreements for the purpose of obtaining scholarship aid;
(f) maintain records and make reports to the university of Kansas
school of medicine to document the satisfaction of the obligation under
such agreement to engage in the full-time practice of medicine and surgery
within a service commitment area and to continue such full-time practice
in such service commitment area for a consecutive period of months equal
to the total number of months required under the agreement; and
(g) upon failure to satisfy an agreement to engage in the full-time
practice of medicine and surgery within a service commitment area for the
required period of time under any such agreement, the person receiving a
medical student loan under this act shall repay amounts to the university of
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Kansas school of medicine as provided in K.S.A. 76-385, and amendments
thereto.
Sec. 3. K.S.A. 76-385 is hereby amended to read as follows: 76-385.
(a) (1) Except as otherwise provided in paragraphs (2), (3), (4) and (5)
through (6) or in K.S.A. 76-386, and amendments thereto, upon the failure
of any person to satisfy the obligation to engage in the full-time practice of
medicine and surgery within a service commitment area of this state for
the required period of time under any medical student loan agreement
entered into under this act, such person shall repay to the university of
Kansas school of medicine in accordance with subsection (b) an amount
equal to the total of: (A) The amount of money received by such person
pursuant to such agreement, or the amount of money determined under
rules and regulations of the university of Kansas; plus (B) annual interest
at a rate of 15% from the date such money was received.
(2) Any person who fails to apply for and enter an approved
postgraduate residency training program shall be required to repay all
moneys received pursuant to an agreement entered into for any such
medical student loan, plus accumulated interest at an annual rate of 15%
and shall commence such repayment in accordance with subsection (b)
within 90 days of graduation from the school of medicine or upon
termination or completion of a residency training program which that does
not comply with the provisions of this act, whichever is later.
(3) If at any time a person is failing to satisfy an obligation to engage
in the full-time practice of medicine and surgery in Kansas for the required
period of time under an agreement entered into under this act because such
person is engaged in the full-time practice of medicine and surgery in a
state other than Kansas, or within Kansas in an area that is not a service
commitment area or in the practice of medicine and surgery which does
not otherwise comply with the agreement entered into under this act, and if
such person is subject to or currently making repayments under this
section and if such person subsequently commences the practice of
medicine and surgery in this state which is in a service commitment area
or which otherwise complies with the agreement entered into under this
act, the balance of the repayment amount, including interest thereon, from
the time of such commencement of practice until the obligation of such
person is satisfied, or until the time such person again becomes subject to
repayments, shall be waived. All repayment amounts due prior to such
commencement of practice, including interest thereon, shall continue to be
payable as provided in this section. If subsequent to such commencement
of practice, the person fails to satisfy such obligation, the person again
shall be subject to repayments, including interest thereon, as otherwise
provided in this section.
(4) If, during the time a person is satisfying the service requirement
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of an agreement entered into under this act, such person desires to engage
in less than the full-time practice of medicine and surgery within a service
commitment area of the state and remain in satisfaction of such service
requirement, such person may make application to the chancellor of the
university of Kansas or the designee of the chancellor for permission to
engage in less than such full-time practice of medicine and surgery. Upon
a finding of exceptional circumstances made by the chancellor of the
university of Kansas, or the designee of the chancellor, such person may
be authorized to engage in less than the full-time practice of medicine and
surgery within a service commitment area of the state for the remaining
required period of time under such agreement and for an additional period
of time which shall be equal to the length of the originally required period
of time multiplied by the decimal fraction which is equal to the reduction
of the full-time practice of medicine and surgery to be authorized
hereunder, multiplied by two. In any such determination of the period
required to be engaged in the less than full-time practice of medicine and
surgery, the decimal fraction utilized shall not exceed 0.5 and any person
granted permission to engage in less than the full-time practice of
medicine and surgery in accordance with the provisions of this paragraph
shall be required to engage in at least the half-time practice of medicine
and surgery.
(5) Any person who enters but fails to complete an approved
postgraduate residency training program, or who enters and completes an
approved postgraduate residency training program but fails to satisfy the
obligation to engage in the full-time practice of medicine and surgery
within a service commitment area of this state for the required period of
time shall be required to repay all money received pursuant to an
agreement entered into under this act a for any such medical student loan,
plus accumulated interest at an annual rate of 15%, and shall commence
such repayment in accordance with subsection (b) within 90 days of failure
to complete an approved postgraduate residency training program or 90
days of failure to commence qualifying practice, whichever occurs first.
(6) For any person who entered and completed an approved
postgraduate residency training program in obstetrics and gynecology, if
during the time such person is satisfying the service requirement of an
agreement entered into pursuant to this act, such person is employed by,
provides services at or establishes any clinic or facility as such terms are
defined in K.S.A. 65-4a01, and amendments thereto, or performs or
induces, or attempts to perform or induce, an abortion, except in the case
of a medical emergency as defined in K.S.A. 65-6701, and amendments
thereto, or in the case of a pregnancy resulting from rape or incest, such
person shall be deemed to have failed to complete such person's service
requirement and shall be required to repay all money received pursuant to
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an agreement entered into under this act for any such medical student
loan, plus accumulated interest at an annual rate of 15%, and shall
commence such repayment in accordance with subsection (b).
(b) For any repayment requirement under this section, the person
shall repay an amount totaling the entire amount to be repaid under all
such agreements for which such obligations are not satisfied, including all
amounts of interest at the rate prescribed. The repayment shall be made in
not more than 10 equal annual installment payments.
(c) All installment payments under this section shall commence six
months after the date of the action or circumstance that causes the failure
of the person to satisfy the obligations of such agreements, as determined
by the university of Kansas school of medicine based upon the
circumstances of each individual case. In all cases, if an installment
payment becomes 91 days overdue, the entire amount outstanding shall
become immediately due and payable, including all amounts of interest at
the rate prescribed.
(d) The total repayment obligation imposed under all agreements
entered into under this act may be satisfied by the person who entered into
the agreements at any time prior to graduation from the university of
Kansas school of medicine by making a single lump-sum payment equal to
the total of: (1) The entire amount to be repaid under all such agreements
upon failure to satisfy the obligations under such agreements to practice in
Kansas; plus (2) all amounts of interest thereon at the rate prescribed to the
date of payment.
(e) The university of Kansas school of medicine shall remit all
moneys received under this section to the state treasurer in accordance
with the provisions of K.S.A. 75-4215, and amendments thereto. Upon
receipt of each such remittance, the state treasurer shall deposit the entire
amount in the state treasury to the credit of the medical loan repayment
fund.
(f) There is hereby created in the state treasury the medical loan
repayment fund. All expenditures from the medical loan repayment fund
shall be for medical student loans under the medical student loan act and
for the expenses of administration of the medical student loan act and shall
be made in accordance with appropriation acts upon warrants of the
director of accounts and reports issued pursuant to vouchers approved by
the chancellor of the university of Kansas or by a person designated by the
chancellor, except that expenditures shall not be made from the medical
loan repayment fund for medical student loans for medical students who
intend to enter and complete an approved postgraduate residency training
program in obstetrics and gynecology, general psychiatry or child
psychiatry. On the effective date of this act, the director of accounts and
reports shall transfer all moneys in the medical scholarship and loan
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repayment fund to the medical loan repayment fund. On the effective date
of this act, all liabilities of the medical scholarship and loan repayment
fund are hereby imposed on the medical loan repayment fund and the
medical scholarship and loan repayment fund is hereby abolished.
Whenever the medical scholarship and loan repayment fund, or words of
like effect, is referred to or designated by any statute, contract or other
document, such reference or designation shall be deemed to apply to the
medical loan repayment fund.
(g) There is hereby established in the state treasury the psychiatry
medical loan repayment fund. All moneys credited to the psychiatry
medical loan repayment fund shall be expended only for medical student
loans for general psychiatry or child psychiatry students under the medical
student loan act and for the expenses of administration of the medical
student loan act associated with such students. All expenditures from the
psychiatry medical loan repayment fund shall be made in accordance with
appropriation acts upon warrants of the director of accounts and reports
issued pursuant to vouchers approved by the chancellor of the university of
Kansas or the chancellor's designee.
(h) There is hereby established in the state treasury the OBGYN
medical loan repayment fund. All moneys credited to the OBGYN medical
loan repayment fund shall be expended only for medical student loans for
medical students who intend to enter and complete an approved
postgraduate residency training program in obstetrics and gynecology
under the medical student loan act and for the expenses of administration
of the medical student loan act associated with such students. All
expenditures from the OBGYN medical loan repayment fund shall be made
in accordance with appropriation acts upon warrants of the director of
accounts and reports issued pursuant to vouchers approved by the
chancellor of the university of Kansas or the chancellor's designee.
(h)(i) Notwithstanding any other provision of law to the contrary, no
moneys shall be transferred from the comprehensive grant program
account of the state board of regents to the medical loan repayment fund,
the OBGYN medical loan repayment fund or the psychiatry medical loan
repayment fund or expended for any purposes related thereto.
Sec. 4. K.S.A. 76-387 is hereby amended to read as follows: 76-387.
(a) (1) There is hereby established the Kansas medical residency bridging
program at the university of Kansas school of medicine, which shall be
developed and implemented in order to provide encouragement,
opportunities and incentives for persons in primary care or mental health
care to:
(A) Enter and complete medical residency training programs in
general pediatrics, general internal medicine, family medicine, family
practice, obstetrics and gynecology, general psychiatry or child psychiatry
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that are operated by or affiliated with the university of Kansas school of
medicine or other such primary care or mental health care medical
residency training program that is operated in Kansas and approved by the
state board of healing arts; and a person under subsection (i) to
(B) locate their medical practice in rural Kansas communities upon
completion of such residency training.
(2) The Kansas medical residency bridging program shall be
administered by the institute for rural health care of the university of
Kansas school of medicine.
(b) Subject to the provisions of appropriation acts, the university of
Kansas school of medicine may enter into residency bridging loan
agreements, in accordance with the provisions of this section: (A) with any
person who has completed the first year of a primary care or mental health
care medical residency training program in general pediatrics, general
internal medicine, family medicine, family practice, obstetrics and
gynecology, general psychiatry or child psychiatry that is operated by or
affiliated with the university of Kansas school of medicine or other such
primary care or mental health care medical residency training program that
is operated in Kansas and approved by the state board of healing arts; and
(B) with a person under subsection (i).
(c) Subject to the provisions of appropriation acts, each person
entering into a residency bridging loan agreement under this section shall
receive a payment of $5,000 each year of primary care or mental health
care medical residency training, or any part of a year of such training, after
the date that the residency bridging loan agreement is entered into by the
resident and the university of Kansas school of medicine and, upon
completion of the primary care or mental health care medical residency
training program, a payment of $6,000.
(d) Each residency bridging loan agreement shall require that the
person receiving the loan:
(1) Complete the primary care or mental health care medical
residency training program;
(2) engage in the full-time practice of medicine and surgery in any
county in Kansas other than Douglas, Johnson, Sedgwick, Shawnee or
Wyandotte for three years under a practice commitment agreement;
(3) commence such full-time practice of medicine and surgery within
90 days after completing the primary care or mental health care medical
residency training program; and
(4) upon failure to satisfy the obligation to engage in the full-time
practice of medicine and surgery in accordance with the provisions of the
residency bridging loan agreement and this section, the person receiving
the loan under this section shall repay to the university of Kansas school of
medicine, within 90 days of such failure, the amount equal to the amount
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of money moneys received by such person from the university of Kansas
school of medicine, less credits earned, under such agreement plus interest
at the annual rate of 15% from the date such money was moneys were
received.
(e) An obligation to engage in the practice of medicine and surgery in
accordance with the provisions of a residency bridging loan agreement and
this section shall be postponed during: (1) Any period of temporary
medical disability during which the person obligated is unable to practice
medicine and surgery because of such medical disability; or (2) any other
period of postponement agreed to or determined in accordance with
criteria agreed to in the practice commitment agreement.
(f) Except as otherwise provided in subsection (g), an obligation to
engage in the practice of medicine and surgery in accordance with the
provisions of a residency bridging loan agreement and this section shall be
satisfied: (1) If the obligation to engage in the practice of medicine and
surgery in accordance with such agreement has been completed; (2) if the
person obligated dies; or (3) if, because of permanent physical disability,
the person obligated is unable to practice medicine and surgery.
(g) For any person who completed a medical residency training
program in obstetrics and gynecology pursuant to this section, such
person's obligation to engage in the practice of medicine and surgery in
accordance with the provisions of a residency bridging loan agreement
and this section shall be deemed to not be satisfied if such person is
employed by, provides services at or establishes any clinic or facility as
such terms are defined in K.S.A. 65-4a01, and amendments thereto, or
performs or induces, or attempts to perform or induce, an abortion, except
in the case of a medical emergency as defined in K.S.A. 65-6701, and
amendments thereto, or in the case of a pregnancy resulting from rape or
incest, at any time in which such person is obligated to satisfy the
provisions of such person's loan agreement made pursuant to this section.
(g)(h) The university of Kansas school of medicine may adopt
additional provisions, requirements or conditions for participation in the
Kansas medical residency bridging program as are practicable and
appropriate to accomplish the purposes of the program or as may be
required for the implementation or administration of the program and, in
any case, as are not inconsistent with the provisions of this section or the
provisions of appropriation acts.
(h)(i) As used in this section, "practice commitment agreement"
means an agreement to commence the full-time practice of medicine and
surgery in a city located in any county in Kansas other than Douglas,
Johnson, Sedgwick, Shawnee or Wyandotte county, that:
(1) Was entered into: (A) by a person in a primary care or mental
health care medical residency training program in general pediatrics,
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general internal medicine, family medicine, family practice, obstetrics and
gynecology, general psychiatry or child psychiatry, that is operated by or
affiliated with the university of Kansas school of medicine or other such
primary care or mental health care medical residency training program that
is operated in Kansas and approved by the state board of healing arts; or
(B) by a person under subsection (i), with the city where such practice is to
commence or another contracting entity other than the university of
Kansas school of medicine that is representative of the interests of such
city; and
(2) provides benefits to such person that have an aggregate monetary
value equal to or greater than the aggregate amount of payments to such
person from the university of Kansas school of medicine under a residency
bridging loan agreement under this section.
(i) A person who graduated from the university of Kansas school of
medicine prior to July 1, 1992, who has completed the first year of a
primary care residency training program in family practice which is
operated outside the state of Kansas and who has entered into a practice
commitment agreement with the north central Kansas health care
foundation is eligible to enter into a residency bridging loan agreement
under this section.
(j) Notwithstanding any other provision of law to the contrary, no
moneys appropriated for the Kansas medical residency bridging program
at the university of Kansas school of medicine, except moneys
appropriated to the OBGYN medical residency bridging fund or the rural
health bridging psychiatry fund, shall be expended for residency bridging
loan agreements for medical residents training in obstetrics and
gynecology, general psychiatry or child psychiatry.
(k) Subject to appropriations, the university of Kansas school of
medicine shall enter into residency bridging loan agreements with three
medical residents training in general psychiatry or child psychiatry.
(l) There is hereby established in the state treasury the rural health
bridging psychiatry fund. All moneys credited to the rural health bridging
psychiatry fund shall be used only for purposes related to residency
bridging loan agreements for medical residents training in general
psychiatry or child psychiatry pursuant to K.S.A. 76-387, and amendments
thereto this section. All expenditures from the rural health bridging
psychiatry fund shall be made in accordance with appropriation acts upon
warrants of the director of accounts and reports issued pursuant to
vouchers approved by the chancellor of the university of Kansas or the
chancellor's designee.
(m) There is hereby established in the state treasury the OBGYN
medical residency bridging fund. All moneys credited to the OBGYN
medical residency bridging fund shall be used only for purposes related to
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residency bridging loan agreements for medical residents training in
obstetrics and gynecology pursuant to this section. All expenditures from
the OBGYN medical residency bridging fund shall be made in accordance
with appropriation acts upon warrants of the director of accounts and
reports issued pursuant to vouchers approved by the chancellor of the
university of Kansas or the chancellor's designee.
(m)(n) Notwithstanding any other provision of law to the contrary, no
moneys shall be transferred from the comprehensive grant program
account of the state board of regents to the rural health bridging psychiatry
fund or the OBGYN medical residency bridging fund or expended for any
purposes related to the Kansas medical residency bridging program.
Sec. 5. K.S.A. 76-381, 76-383, 76-385, 76-386a and 76-387 are
hereby repealed.
Sec. 6. This act shall take effect and be in force from and after its
publication in the statute book.
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