An Act amending the act of April 9, 1929 (P.L.343, No.176), known as The Fiscal Code, providing for primary care workforce initiative; and making an appropriation.

PRIOR PRINTER'S NOS. 644, 1285 PRINTER'S NO. 1530
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No. 614
Session of
2025
INTRODUCED BY BROOKS, COMITTA, FONTANA, KEARNEY, STEFANO,
ROBINSON AND DUSH, APRIL 14, 2025
AS AMENDED ON THIRD CONSIDERATION, MARCH 23, 2026
AN ACT
Amending the act of April 9, 1929 (P.L.343, No.176), entitled
"An act relating to the finances of the State government;
providing for cancer control, prevention and research, for
ambulatory surgical center data collection, for the Joint
Underwriting Association, for entertainment business
financial management firms, for private dam financial
assurance and for reinstatement of item vetoes; providing for
the settlement, assessment, collection, and lien of taxes,
bonus, and all other accounts due the Commonwealth, the
collection and recovery of fees and other money or property
due or belonging to the Commonwealth, or any agency thereof,
including escheated property and the proceeds of its sale,
the custody and disbursement or other disposition of funds
and securities belonging to or in the possession of the
Commonwealth, and the settlement of claims against the
Commonwealth, the resettlement of accounts and appeals to the
courts, refunds of moneys erroneously paid to the
Commonwealth, auditing the accounts of the Commonwealth and
all agencies thereof, of all public officers collecting
moneys payable to the Commonwealth, or any agency thereof,
and all receipts of appropriations from the Commonwealth,
authorizing the Commonwealth to issue tax anticipation notes
to defray current expenses, implementing the provisions of
section 7(a) of Article VIII of the Constitution of
Pennsylvania authorizing and restricting the incurring of
certain debt and imposing penalties; affecting every
department, board, commission, and officer of the State
government, every political subdivision of the State, and
certain officers of such subdivisions, every person,
association, and corporation required to pay, assess, or
collect taxes, or to make returns or reports under the laws
imposing taxes for State purposes, or to pay license fees or
other moneys to the Commonwealth, or any agency thereof,
every State depository and every debtor or creditor of the
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Commonwealth," providing for FQHC primary care workforce
initiative; and making an appropriation.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of April 9, 1929 (P.L.343, No.176), known
as The Fiscal Code, is amended by adding an article to read:
ARTICLE I-M
FQHC PRIMARY CARE WORKFORCE INITIATIVE
Section 101-M. Definitions.
The following words and phrases when used in this article
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Accredited medical college." As follows:
(1) As defined under section 2 of the act of December
20, 1985 (P.L.457, No.112), known as the Medical Practice Act
of 1985.
(2) An osteopathic medical college as defined under
section 2 of the act of October 5, 1978 (P.L.1109, No.261),
known as the Osteopathic Medical Practice Act.
(3) An institution of higher education that meets the
requirements of section 6.1 of the act of May 22, 1951
(P.L.317, No.69), known as The Professional Nursing Law.
(4) A program at an institution of higher education that
meets the requirements of 49 Pa. Code § 18.131 (relating to
recognized educational programs/standards).
(5) A program at an institution of higher education that
meets the requirements of 49 Pa. Code § 25.151 (relating to
certification of physician assistant educational programs).
(6) An institution of higher education that meets the
requirements of section 3(c) of the act of May 1, 1933
(P.L.216, No.76), known as The Dental Law.
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"Certified registered nurse practitioner." An individual
licensed as a certified registered nurse practitioner under The
Professional Nursing Law.
"Dentist." An individual licensed in the practice of
dentistry under The Dental Law.
"Department." The Department of Health of the Commonwealth.
"FQHC." A federally qualified health center as defined under
42 U.S.C. § 1395x(aa)(4) (relating to definitions).
"ELIGIBLE ADMINISTRATIVE ENTITY." AN ORGANIZATION THAT:
(1) IS THE FEDERALLY DESIGNATED PRIMARY CARE ASSOCIATION
FOR THIS COMMONWEALTH UNDER 42 U.S.C. § 254B (RELATING TO
HEALTH CENTERS);
(2) REPRESENTS, SUPPORTS AND PROVIDES TECHNICAL
ASSISTANCE TO FQHCS OR FQHC LOOK-ALIKES IN THIS COMMONWEALTH;
AND
(3) HAS STATEWIDE MEMBERSHIP CONSISTING PRIMARILY OF
FQHCS OR FQHC LOOK-ALIKES.
"FACILITATING ENTITY." AN ENTITY THAT PARTICIPATES IN
COORDINATING, SUPPORTING OR FACILITATING CLINICAL ROTATION
PLACEMENTS UNDER THE INITIATIVE, INCLUDING THE DEPARTMENT, AN
FQHC, AN FQHC LOOK-ALIKE, A RURAL HOSPITAL, A RURAL HEALTH
CLINIC OR AN ELIGIBLE ADMINISTRATIVE ENTITY. THE TERM DOES NOT
INCLUDE A STUDENT OR PRECEPTOR.
"FEDERALLY QUALIFIED HEALTH CENTER" OR "FQHC." A HEALTH
CENTER THAT RECEIVES A FEDERAL PUBLIC HEALTH SERVICES GRANT
UNDER THE PUBLIC HEALTH SERVICE ACT (58 STAT. 682, 42 U.S.C. §
254B) OR ANOTHER HEALTH CENTER DESIGNATED BY THE UNITED STATES
HEALTH RESOURCES AND SERVICES ADMINISTRATION AS A FEDERALLY
QUALIFIED HEALTH CENTER.
"FQHC LOOK-ALIKE." A PUBLIC OR NOT-FOR-PROFIT HEALTH CENTER
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THAT MEETS THE ELIGIBILITY REQUIREMENTS TO RECEIVE A FEDERAL
PUBLIC HEALTH SERVICES GRANT UNDER THE PUBLIC HEALTH SERVICE ACT
BUT DOES NOT RECEIVE GRANT FUNDING.
"INITIATIVE." THE FACILITATING ENTITY PRIMARY CARE WORKFORCE
INITIATIVE ESTABLISHED IN SECTION 102-M.
"PARTICIPATING FQHC." AN FQHC OR FQHC LOOK-ALIKE THAT
PARTICIPATES IN THE INITIATIVE ESTABLISHED IN SECTION 102-M.
"Physician." A medical doctor licensed under the Medical
Practice Act of 1985 or a doctor of osteopathic medicine
licensed under the Osteopathic Medical Practice Act.
"Physician assistant." An individual licensed as a physician
assistant under the Medical Practice Act of 1985 or the
Osteopathic Medical Practice Act.
"Preceptor." A primary care practitioner supervising or
directing a student enrolled in the FQHC primary care workforce
initiative.
"Primary care practitioner." A physician, physician
assistant, certified registered nurse practitioner, dentist or
psychiatrist employed by a FQHC FACILITATING ENTITY .
"Student." An individual currently satisfying clinical
rotation from an accredited medical college at a FQHC and
enrolled in the FQHC primary care workforce initiative. WHO IS:
(1) ENROLLED IN AN ACCREDITED MEDICAL COLLEGE;
(2) FULFILLING THE REQUIREMENTS OF THE MEDICAL COLLEGE;
AND
(3) ENROLLED IN OR SEEKING TO BE ENROLLED IN THE
INITIATIVE.
Section 102-M. FQHC FACILITATING ENTITY primary care workforce
initiative.
(a) Establishment.-- Within one year of NOT LATER THAN ONE
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YEAR AFTER the effective date of this subsection, the department
shall establish the FQHC FACILITATING ENTITY primary care
workforce initiative within the department.
(b) Purpose.--The FQHC primary care workforce initiative
shall be a voluntary program to offer a clinical rotation
placement at a FQHC THROUGH WHICH A PARTICIPATING FQHC, FQHC
LOOK-ALIKE, RURAL HOSPITAL OR RURAL HEALTH CLINIC OFFERS
CLINICAL ROTATION PLACEMENTS AT THEIR RESPECTIVE FACILITIES for
a student attending an accredited medical college.
(c) Funding.--The department shall make grant funding
available if sufficient Federal funds, made available from the
One Big Beautiful Bill Act (Public Law 119-21, 139 Stat. 72),
have been appropriated.
(C) FUNDING.--
(1) THE DEPARTMENT SHALL MAKE GRANT FUNDING AVAILABLE
FOR THE INITIATIVE IF SUFFICIENT FEDERAL FUNDS, MADE
AVAILABLE FROM THE ONE BIG BEAUTIFUL BILL ACT (PUBLIC LAW
119-21, 139 STAT. 72), HAVE BEEN APPROPRIATED.
(2) NOT LESS THAN 50% OF FUNDS EXPENDED EACH FISCAL YEAR
UNDER THE INITIATIVE SHALL BE USED FOR PRECEPTORSHIPS
INVOLVING STUDENTS DESCRIBED UNDER PARAGRAPH (1) OR (2) OF
THE DEFINITION OF "STUDENT" IN SECTION 101-M. IF SUFFICIENT
APPLICANTS FROM STUDENTS DESCRIBED UNDER PARAGRAPH (1) OR (2)
OF THE DEFINITION OF "STUDENT" IN SECTION 101-M ARE NOT
FILLED AFTER EVERY REASONABLE RECRUITMENT EFFORT BY THE
DEPARTMENT AT FACILITATING ENTITIES AND PARTICIPATING
TRAINING SITES, THE REMAINING FUNDS MAY BE ALLOCATED TO OTHER
ELIGIBLE STUDENTS PARTICIPATING IN THE INITIATIVE.
(D) ADMINISTRATION FOR FQHCS AND FQHC LOOK-ALIKES.--FOR
ADMINISTRATION OF THE INITIATIVE WITH RESPECT TO PARTICIPATING
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FQHCS AND FQHC LOOK-ALIKES, THE DEPARTMENT MAY AWARD GRANTS TO
ELIGIBLE ADMINISTRATIVE ENTITIES TO ADMINISTER AND FACILITATE
STUDENT PLACEMENT, PRECEPTOR SUPPORT, REPORTING AND OTHER
FUNCTIONS NECESSARY TO IMPLEMENT THE INITIATIVE.
(d) (E) Sustainability.--The department and any
participating hospital AND THE ELIGIBLE FACILITATING ENTITY
shall make every effort to combine funding available under
subsection (c) with grants or other funding available through
hospitals, local governments, nonprofit organizations,
philanthropic public or private partnerships or State-level
continuation funding to ensure the long-term sustainability of
the program INITIATIVE . Grants awarded under this section shall
be conditioned on the submission of a sustainability plan that
demonstrates how clinical placements will continue beyond five
years from the date the grant was awarded, including evidence of
public-private or philanthropic partnership support.
(e) Geographic distribution.--The department
(F) GEOGRAPHIC DISTRIBUTION.--
(1) THE DEPARTMENT shall ensure that clinical rotation
placements funded under this section are geographically
distributed in a manner that strengthens rural health care
workforce pipelines, with priority given to any FQHC
FACILITATING ENTITY operating in, or primarily serving
populations of, a rural county. The COUNTY.
(2) FOR THE PURPOSES OF THIS SUBSECTION, THE term "rural
county" shall mean a county located within this Commonwealth
with a population density of less than 291 persons per square
mile as defined by the Center for Rural Pennsylvania.
(f) Residency preference.--Any hospital in a rural area
shall have the first right to extend offers of residency
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placement to students who complete clinical rotations funded
under this section, where appropriate.
(g) Grant awards.--Grants awarded by the department under
this section shall be equal amounts to each FQHC in this
Commonwealth that is enrolled in the FQHC primary care workforce
initiative as a stipend to support a preceptor or student.
(G) RESIDENCY PLACEMENT PREFERENCE.--A FACILITATING ENTITY
MAY PROMOTE AND ASSIST STUDENTS UNDER SUBSECTION (I) IN PURSUING
EARLY OR ALTERNATIVE RESIDENCY PLACEMENT PATHWAYS PERMITTED
OUTSIDE A NATIONAL RESIDENCY MATCHING PROCESS OR SUCCESSOR
SYSTEM AND SHALL HAVE THE FIRST OPPORTUNITY TO OFFER OR
FACILITATE RESIDENCY PLACEMENT TO THOSE STUDENTS.
(H) GRANT AWARDS.--GRANTS AWARDED BY THE DEPARTMENT UNDER
THIS SECTION, INCLUDING GRANTS ADMINISTERED THROUGH AN ELIGIBLE
ADMINISTRATIVE ENTITY:
(1) SHALL BE EQUAL AMOUNTS TO EACH FACILITATING ENTITY,
INCLUDING AN FQHC, FQHC LOOK-ALIKE, RURAL HOSPITAL OR RURAL
HEALTH CLINIC ENROLLED IN THE INITIATIVE.
(2) MAY ONLY BE USED AS A STIPEND TO SUPPORT A PRECEPTOR
OR STUDENT.
(I) FUNDING PRIORITY.--A FACILITATING ENTITY MAY GIVE
HIGHEST FUNDING PRIORITY TO PRECEPTORSHIPS INVOLVING STUDENTS
WHO:
(1) HAVE COMPLETED AT LEAST ONE PRIOR TERM OR PLACEMENT
THROUGH THE PROGRAM; OR
(2) ARE ENROLLED IN THEIR PENULTIMATE OR FINAL ACADEMIC
YEAR OF THEIR EDUCATIONAL PROGRAM.
(J) REPORTING REQUIREMENT.--
(1) NOT LATER THAN FOUR YEARS AFTER THE EFFECTIVE DATE
OF THIS SUBSECTION AND ANNUALLY THEREAFTER, THE DEPARTMENT
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SHALL COLLECT DATA AND SUBMIT A REPORT ON THE RESULTS OF THE
INITIATIVE TO THE CHAIR AND MINORITY CHAIR OF THE HEALTH AND
HUMAN SERVICES COMMITTEE OF THE SENATE AND THE CHAIR AND
MINORITY CHAIR OF THE HEALTH COMMITTEE OF THE HOUSE OF
REPRESENTATIVES. THE REPORT SHALL INCLUDE:
(I) THE TOTAL AMOUNT OF MONEY AWARDED AND EXPENDED
UNDER THE INITIATIVE;
(II) THE NUMBER OF STUDENTS WHO APPLIED FOR,
PARTICIPATED IN OR COMPLETED CLINICAL ROTATIONS THROUGH
THE INITIATIVE;
(III) OUTCOME DATA, INCLUDING THE NUMBER OF
PARTICIPATING STUDENTS WHO SUBSEQUENTLY COMPLETE THEIR
DEGREE REQUIREMENTS AND BECOME EMPLOYED IN THE FIELD FOR
WHICH THEY GRADUATED IN A RURAL COUNTY; AND
(IV) ANY ADDITIONAL INFORMATION THE DEPARTMENT DEEMS
RELEVANT TO EVALUATING THE EFFECTIVENESS AND
SUSTAINABILITY OF THE INITIATIVE.
(2) A FACILITATING ENTITY SHALL MAINTAIN RECORDS
NECESSARY FOR REPORTING AND SHALL COOPERATE WITH THE
DEPARTMENT AND PROVIDE SUCH DATA AND INFORMATION AS THE
DEPARTMENT DETERMINES NECESSARY AND REASONABLE TO PREPARE THE
REPORT.
Section 2. This act shall take effect immediately.
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