Legislative Priorities

• 2009 OAFP Legislative Agenda

  PRIMARY CARE WORKFORCE
  Loan repayment for rural health professionals
  The Rural Health Services loan repayment program is a tool that helps rural communities attract health professionals.  Physicians, dentists, pharmacists, nurse practitioners and physician assistants all qualify for the program, administered by the Oregon Student Assistance Commission.  The maximum loan repayment amount is $100,000 per individual.
  
  The program was created in 1989 and funded with $400,000 per biennium.  Funding remains at that level today. 

  It is not uncommon for a physician or dentist to graduate with debts of up to $200,000.  If they qualified for this program, all $200,000 would be sequestered and paid out over three to five years.  But that means, there is only enough money for a few awards each year.  In 2007, there were 27 applicants, and six awards.
  
  If the Oregon Health Fund results in universal coverage, there will be a desperate need for primary care physicians in rural areas.  This is the best tool available to attract those medical professionals.

  Proposal:  Increase funding to $1.5 million per year.  This would allow the program to make loan repayment awards to 15 to 30 health care professionals each year.   This could be a valuable tool for rural communities to attract and retain health care professionals
  
  Move the loan repayment for rural health professionals to the Office of Rural Health
  It’s been difficult getting increased funding for the loan repayment program, and the current economic climate won’t make it any easier in 2009.  However, there are private foundations that are very interested in the program, but those foundations will not awards grants to state agencies.  The Oregon Student Assistance Commission is a state agency and therefore is ineligible.  But the Office of Rural Health is not a state agency, so it is eligible for these foundation grants. 
  
  The Loan Repayment program has never been a good fit in the Oregon Student Assistance Commission.  It is one of the only repayment program administered by the Commission.  All of the others are scholarships for students to go to college.  OSAC is supportive of moving the loan repayment program to the Office of Rural Health.
  
  Support legislation to move the loan repayment for rural health professionals to the Office of Rural Health.
  
  Student loan tax credit for working in medically underserved area
  LC 1435 would provide a $12,000 per year tax credit to help pay off student loans for physicians, physician assistants, dentists, pharmacists and nurse practitioners who work in medically underserved areas.
  
  This is seen as a compliment to, not a replacement for, the loan repayment program. 
  
  It targets a slightly different population because it would apply to those working in medically underserved areas instead of rural areas. 
  
  Because it is a tax credit, it would help everyone who qualifies, where the loan repayment program works only for a small percentage of those who apply.

• Proposal: Support tax credit to help pay off student loans for health practitioners working in medically underserved areas (LC 1435). 

  Oregon Health Fund

  OAFP has taken an active role in development of the Oregon Health Fund plan with several OAFP members participating on the sub-committees.

  The 2009 session will consider whatever plan the Oregon Health Fund Board proposes.  Any new revenue proposals are likely to be referred to the ballot in November 2009.  One new revenue source being considered is a broad-based provider tax.

  OAFP will continue taking an active role in developing and supporting the expansion of health and dental coverage to all Oregonians.  OAFP will work with the Health Fund Board on development of revenue sources that are equitable and workable.  OAFP will focus on specific areas of the OHF proposal where family physicians have special expertise or that impact us family physicians directly, e.g., payment reform, medical home, emphasis on preventive medicine and chronic disease management.

  Medical Home / Primary Care Home

  The 2008 special session funded two medical home pilot projects.  The Oregon Health Fund legislation is likely to include funding strategies to increase the number of Oregonians who have a medical home.

  OAFP will monitor developments and outcomes of the medical home pilot projects.  OAFP will work with the 2009 legislature to include a medical home funding structure that works in small rural clinics as well as large urban centers.

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Oregon Academy of Family Physicians
809 N. Russel St. #204
Portland, Oregon 97227
Telephone: (503) 528-0961 Fax: (503) 528-0996
E-mail: kg@oafp.org