Chapter 7B. Health Professional Recruitment Program.
§ 7–751.01. Definitions.
For the purposes of this chapter, the term:
(1) “Commercial loans” means loans made by banks, credit unions, savings and loan associations, insurance companies, schools, and either financial or credit institutions that are subject to examination and supervision in their capacity as lenders by an agency of the United States or of the State or District in which the lender has its principal place of business.
(2) “Dentist” means a graduate of a an accredited dental school who has completed post-graduate training in specialties of general or pediatric dentistry.
(3) “Director” means Director of the Department of Health or his or her designee.
(4) “Health Professional Shortage Area” and “HPSA” mean a geographic area, population group, or facility in the District of Columbia designated by the United States Department of Health and Human Services as lacking a sufficient number of primary care, dental, mental health, specialty, or sub-specialty professionals to provide care for residents of the area or community.
(5) “Medically Underserved Area” and “MUA” mean a geographic area in the District of Columbia designated by the United States Department of Health and Human Services as medically underserved.
(6) “Other health professional” means a person who has graduated from an accredited program for registered nurses, nurse midwives, certified midwives, certified professional midwives, certified registered nurse practitioners, dental hygienists, clinical social workers, clinical psychologists, professional counselors, or physician assistants and has completed any required post-graduate training.
(7) "Physician" means a person who is licensed by the Board of Medicine to engage in the practice of medicine in the District and who is in good standing under such license.
(7A) "Program" means the District of Columbia Health Professional Recruitment Program established by § 7-751.02.
(8) “Reasonable educational expenses” means the costs of education, exclusive of tuition, which are considered to be required by the school’s degree program or an eligible program of study, such as fees for room, board, transportation and commuting costs, books, supplies, educational equipment and materials, or clinical travel, which were part of the estimated student budget of the school in which the participant was enrolled.
(9) "Service obligation site" means:
(A) A nonprofit entity located in a Health Professional Shortage Area or a Medically Underserved Area within the District that provides primary care, mental health, dental, or sub-specialty services to District residents regardless of their ability to pay;
(B) A Department of Health program;
(C) A Department of Behavioral Health program;
(D) A private practice setting that serves residents of a Medically Underserved Area, and accepts a minimum percentage or total number of patients, as determined by the Director, participating in Medicare, Medicaid, HealthCare Alliance, or similar public insurance programs at a threshold determined by the Department of Health; or
(E) Any other District program designated by the Director as a service obligation site.
§ 7–751.02. Establishment of Program.
(a) There is hereby established the District of Columbia Health Professional Recruitment Program (“Program”) to serve as a recruitment and retention tool for health professionals within the District of Columbia.
(b) Based on the availability of funds, the Program will pay for, among other expenses, the cost of education necessary to obtain a health professional degree. The Program will pay toward the outstanding principal, interest, and related expense of federal, state, or local government loans and commercial loans obtained by the participant for:
(1) School tuition and required fees incurred by the participant;
(2) Reasonable educational expenses; and
(3) Incentive payments that lead to the retention of existing Program participants to practice in Ward 7 or 8; provided, that retention incentives shall be limited to $15,000 per participant per year.
§ 7–751.03. Administration of the Program.
(a) The Department of Health shall administer the Program and shall:
(1) Establish an application process;
(2) Certify a list of acceptable service obligation sites on an annual basis and make the list publically available;
(3) Conduct regular surveys to ensure participant compliance with the Program;
(4) Disburse all awarded funds; and
(5) Administer any other functions necessary to the Program.
(b) The Department of Health reserves the right to conduct regular inspections to ensure that all service obligations sites meet the definition as set forth in § 7-751.01(9).
(c) The Director may impose additional requirements regarding the location of private practices or the acceptance of insurance types among those practices, as the Director considers appropriate to support the goal of an equitable distribution of healthcare providers among District residents.
§ 7–751.04. Eligibility requirements.
Individuals eligible for the Program must:
(a) Be a citizen or permanent resident of the United States;
(b) Be a physician, dentist, or other health professional as defined in § 7-751.01;
(c) Be licensed or eligible to practice in the District of Columbia;
(d) Submit a completed application to participate in the Program; and
(e) Have no other obligation for health professional service to the federal, state, or District government, unless such obligation will be completely satisfied prior to the beginning of service under the Program.
§ 7–751.05. Release of information.
(a) Any applicant to the Program shall agree to execute a release to allow the Department access to loan records, credit information, and information from lenders necessary to verify eligibility and to determine loan repayments. The applicant is required to submit all requested loan documentation prior to approval by the Program.
(b) It is the responsibility of the participant to negotiate with each lending institution for the terms and conditions of the educational loan repayments. Any penalties associated with early repayment shall be the responsibility of the participant.
§ 7–751.06. Selection criteria.
(a) Applicants shall be competitively reviewed and selected for participation in the Program based upon the following criteria:
(1) Professional qualifications and relevant experience, including board eligibility or certification in his or her specialty, professional achievements, and other indicators of competency received from supervisors, department chairs, and program directors; and
(2) A demonstrated commitment to serve in a HPSA or MUA.
(b) Preferential consideration will be given to:
(1) Residents of the District of Columbia;
(2) Graduates of accredited District of Columbia health professions schools or program;
(3) Residents of a HPSA or MUA within the District of Columbia;
(4) Applicants that are immediately eligible and available for service;
(5) Applicants that commit to longer periods of service;
(6) Applicants whose service obligation site is also a qualified Medical Homes DC provider;
(7) Applicants who are fluent in Spanish, Chinese, Vietnamese, Korean, or Amharic; and
(8) Applicants who have experience at a community-based primary care facility or attended a community-based health profession educational institution.
(c) For applicants practicing at a service obligation site at the time of application to the Program, preferential consideration shall be given to those individuals who have less than 3 years of employment at the facility.
§ 7–751.07. Program participation.
(a) As a condition of participation in the Program, selected applicants shall enter into a contract with the Director and a representative of the service obligation site agreeing to the following terms and conditions:
(1) Participants shall provide a minimum of 2 years with a maximum of 4 years services at a service obligation site. Any service beyond the 2 year minimum requirement is dependent upon the availability of funds for the Program.
(2)(A) Full-time participants shall provide service of at least 1,800 hours per year. On-call status shall not count toward the annual 1,800 hour requirement. Exceptions to the 1,800 hour annual requirement or the on-call provision of this subparagraph may be approved by the Director prior to placement.
(B) Part-time participants shall provide service of at least 900 hours per year. On-call status does not count toward the annual 900 hour requirement. Exceptions to the 900 hour annual requirement or the on-call provision of this subparagraph may be approved by the Director prior to placement.
(3) Participants agree to provide reasonable, usual, and customary health services without discrimination and regardless of a patient’s ability to pay.
(4) No period of internship, residency, or other advanced clinical training may count toward satisfying a period of obligated service under this Program.
(5) Any participant who is found in breach of contract is deemed to have agreed, as a condition of contract, to all penalties as set forth in § 7-751.13.
(b) An existing contract may be renewed for one year at a time up to a maximum of 4 total years of service, as funds become available.
(c) The participant shall begin service no later than 12 months from entering into the contract. The effective start date of the obligated service is the date of employment or the date the Director signs the contract, whichever is later.
(d) Non-compete clauses are prohibited in all contracts for Program participation.
§ 7–751.08. Loan repayment.
(a) Physicians and dentists who are full-time participants in the Program shall be eligible to have 100% of their total debt, not to exceed $120,000, repaid by the Program over 4 years of service. For each year of participation, the Program will repay loan amounts according to the following schedule:
(1) For the 1st year of service, 18% of their total debt, not to exceed $21,600;
(2) For the 2nd year of service, 26% of their total debt, not to exceed $31,200;
(3) For the 3rd year of service, 28% of their total debt, not to exceed $33,600; and
(4) For the 4th year of service, 28% of their total debt, not to exceed $33,600.
(a-1) Physicians who are full-time participants in the Program and who specialize and practice in obstetrics and gynecology, psychiatry, or another medical specialty identified by the Director or who sub-specialize and practice in oncology, cardiology, neurology, infectious diseases, pulmonary diseases, nephrology, endocrinology, podiatry, ophthalmology, or another medical sub-specialty identified by the Director shall be eligible to have 100% of their total debt, not to exceed $200,000, repaid by the Program over 4 years of service; provided, that the participants provide full-time service in Ward 7 or 8. For each year of participation, the Program will repay loan amounts according to the following schedule:
(1) For the first year of service, 18% of their total debt, not to exceed $36,000;
(2) For the second year of service, 26% of their total debt, not to exceed $52,000;
(3) For the third year of service, 28% of their total debt, not to exceed $56,000; and
(4) For the fourth year of service, 28% of their total debt, not to exceed $56,000.
(b) Other health professionals who are full-time participants in the Program shall be eligible to have 100% of their total debt, not to exceed $66,000, repaid by the Program over 4 years of service. For each year of participation, the Program will repay loan amounts according to the following schedule:
(1) For the 1st year of service, 18% of their total debt, not to exceed $11,800;
(2) For the 2nd year of service, 26% of their total debt, not to exceed $17,200;
(3) For the 3rd year of service, 28% of their total debt, not to exceed $18,500;
(4) For the 4th year of service, 28% of their total debt, not to exceed $18,500.
(c) The Director is permitted to increase the dollar amount of the total loan repayment annually to adjust for inflation. All quarterly disbursements shall be adjusted accordingly.
(d) Physicians and dentists who are part-time participants in the Program shall be eligible to have 100% of their total debt, not to exceed $60,000, repaid by the Program over 4 years of service. For each year of participation, the Program will repay loan amounts according to a schedule set by the Mayor.
(e) Physicians who are part-time participants in the Program and who specialize and practice in obstetrics and gynecology, psychiatry, or another medical specialty identified by the Director or who sub-specialize and practice in oncology, cardiology, neurology, infectious diseases, pulmonary diseases, nephrology, endocrinology, podiatry, ophthalmology, or another medical sub-specialty identified by the Director shall be eligible to have 100% of their total debt, not to exceed $100,000, repaid by the Program over 4 years of service; provided, that the participants provide part-time service in Ward 7 or 8. For each year of participation, the Program will repay loan amounts according to a schedule set by the Mayor.
(f) Other health professionals who are part-time participants in the Program shall be eligible to have 100% of their total debt, not to exceed $33,000, repaid by the Program over 4 years of service. For each year of participation, the Program will repay loan amounts according to a schedule set by the Mayor.
(g) The Director may only add to the list of priority specialties or sub-specialties identified in this section based on the health care needs of District residents.
§ 7–751.09. Disbursement procedure.
(a) The Department of Health shall disburse loan repayment funds to a participant in a 2-year lump sum payment for each contract entered into pursuant to § 7-751.07 within 90 days of the start of the performance under the contract.
(b) For each year of participation beyond the original term of the contract, whether by renewal or continuation of a contract longer than 2 years, the Department of Health shall disburse to the participant a one-year lump sum payment within 90 days of the start of each additional year.
§ 7–751.10. Compensation during service.
Each participant is responsible for negotiating his or her own compensation package directly with the service obligation site.
§ 7–751.11. Tax implications.
(a) Repealed.
(b) For purposes of the District of Columbia Office of Tax and Revenue, all loan repayment awards shall not be considered income and are therefore not taxable.
§ 7–751.12. Monitoring during service.
(a) Participants are required to submit service verification forms to the Department of Health at the conclusion of each 6-month period of participation in the Program. Service verification forms shall contain the following:
(1) A statement attesting to continuous full-time service as required by the Program;
(2) The signature of the participant;
(3) The signature of a representative of the service obligation site; and
(4) Any additional information required by the terms and conditions of the participant’s service contract.
(b) The Department of Health reserves the right to conduct regular participant surveys to ensure compliance with the terms and conditions of the Program.
§ 7–751.13. Breach of contract.
(a) The following shall constitute a breach of contract:
(1) The failure to begin or complete the required period of service obligation as set forth in the Program contract;
(2) The falsification or misrepresentation of information on the Program application, service verification forms, or other required documents;
(3) The termination of employment at a service obligation site for good cause, as determined by the employer and confirmed by the Director;
(4) The failure to transfer within 6 months to another approved service obligation site upon termination for reasons beyond the participant’s control, as described in § 7-751.14(b).
(5) The failure to provide all reasonable, usual, and customary full-time health care service as set forth in the Program contract; or
(6) The failure to comply with any other terms as set forth by this chapter or the Director.
(b) Within one year of the date of a breach of contract, the participant found in breach of contract shall repay the District the greater of $31,000 or an amount equal to the sum of the following:
(1) The amount of the loan repayments paid to the participant for any period of obligated service not completed;
(2) An amount equal to the product of the number of months of obligated service not completed by the participant multiplied by $7,500; and
(3) Interest on the amounts specified in paragraphs (1) and (2) of this subsection at the maximum legal prevailing rate, as determined by the Treasurer of the United States, from the date of the breach.
(c) A participant found in breach of contract shall pay a monetary penalty to the District of Columbia of 50% of funds received as a participant in the Program.
(d) Damages are not dischargeable in bankruptcy. Any financial obligation of a participant for payment of damages may not be released by discharge in bankruptcy under Title 11 of the United States Code.
(e) The Department of Health may pursue any additional legal remedies against a participant found to be in breach of contract, including the garnishment of wages and civil penalties.
§ 7–751.14. Change of practice site.
(a) Any change of service obligation site by a Program participant must receive prior authorization from the Director.
(b) If the employment of a participant is terminated for reasons beyond the participant’s control, such as, for example, the closure of a service obligation site, the participant shall transfer to another approved service obligation site within 6 months of termination. The failure to transfer within 6 months shall be considered a breach of the Program contract.
§ 7–751.15. Suspension, waiver, and termination of contract.
(a)(1) The service obligation of a participant may be suspended without penalty, for a limited period of time, if a participant requires leave beyond the allotted 7 weeks, such as, for example, extended illness, family leave, maternity leave, suspension from practice pending an investigation, not to exceed 12 months, or termination of employment requiring job search and relocation to another eligible practice site.
(2) A suspension shall not relieve the participant of the responsibility to complete the remaining portion of the obligation. A suspension shall not be permitted as a matter of course, but may be allowed at the discretion of the Director.
(b) A waiver of Program contract terms and conditions shall be granted in the following situations:
(1) If the participant suffers from a physical or mental disability resulting in the total and permanent inability of the participant to perform the obligated service, as determined by the Director; or
(2) Repealed.
(c) An obligation of an individual for service or payment of damages shall be terminated upon the death of the individual.
(d) The Director may terminate a contract under the Program with a participant if, not later than August 16 of the year in which the contract became effective, the participant:
(1) Submits a signed written request to terminate the contract; and
(2) Repays all amounts of loan repayments paid to the participant under the contract.
§ 7–751.15a. Health Professional Recruitment Fund.
(a) There is established as a nonlapsing fund the Health Professional Recruitment Fund (“Fund”). All funds deposited into the Fund, and any interest earned on those funds, shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time, but shall be continually available for the sole purpose of providing loan repayments and retention incentives pursuant to the Program without regard to fiscal year limitation, subject to authorization by Congress.
(b) The Mayor shall deposit in the Fund:
(1) All general revenue funds appropriated by a line item in the budget submitted pursuant to § 1-204.46, and authorized by Congress for the purpose of the Program;
(2) All fees and penalties generated pursuant to the Program; and
(3) Any other funds received on behalf of the Fund for the purpose of the Program.
(c) The Department of Health shall administer the Fund from its appropriated operating budget.
(d) The Department of Health shall segregate the $1.5 million local funds enhancement provided in the Fiscal Year 2021 budget into a separate subaccount, which shall only be expended for:
(1) Section 7-751.02(b)(3); or
(2) Section 7-751.08(a-1).
§ 7–751.16. Rulemaking.
The Mayor is authorized to promulgate rules necessary to implement this chapter.
§ 7–751.17. Applicability. [Repealed]
Repealed.
