AN ACT TO DIRECT THE NORTH CAROLINA AREA HEALTH EDUCATION CENTERs PROGRAM to ESTABLISH INTERDISCIPLINARY HEALTH EDUCATION TEACHING HUBS AND TO STUDY IMPEDIMENTS TO THE AVAILABILITY OF COMMUNITY‑BASED PRECEPTORS FOR STUDENTS IN RURAL AND UNDERSERVED AREAS.

Whereas, North Carolina's health care workforce is maldistributed based on geography (urban vs. rural) and specialty (inpatient vs. outpatient); and

Whereas, health care professional trainees taught in rural and underserved areas are more likely to practice in similar settings upon graduation; and

Whereas, most clinical rotations in rural and underserved areas occur in outpatient community clinics; and

Whereas, most health professionals are compensated based on productivity; and

Whereas, training, specifically precepting, students requires time which reduces a health professional's productivity; and

Whereas, most health professionals in community settings receive little or no compensation or protected time to teach; and

Whereas, the lack of compensation or protected time to teach combined with lost productivity has made it increasingly and persistently difficult for health professionals in rural outpatient settings to teach; and

Whereas, health professional schools (medical, nursing, physician assistant, and others) have expressed concerns about an insufficient number of sites and that community teachers limit their ability to accept qualified applicants or sustain their program growths; and

Whereas, the need for more community teaching sites is coming at the exact time as the move to more care in lower‑cost outpatient settings as health care moves from a system of payment based on fee‑for‑service to one based on value; Now, therefore,

The General Assembly of North Carolina enacts:

SECTION 1.  Pilot Program Established. – The North Carolina Area Health Education Centers (NC AHEC) Program shall develop a two‑year pilot program (Pilot Program) to establish interdisciplinary health education teaching hubs in at least three safety net health care clinics, such as Federally Qualified Health Centers and rural health centers, to teach health professional students from at least three different disciplines, including medical students, nurse practitioner students, physician assistant students, pharmacy students, dental students, or nursing students. NC AHEC, in conjunction with the North Carolina Association of Health Centers, shall issue a request for proposal to select the three teaching sites for the Pilot Program. NC AHEC shall provide technical assistance, evaluate the results of the Pilot Program, and provide funds for significant clinical teaching time in the selected settings as provided for in Section 3 of this act. By December 1, 2023, NC AHEC shall submit a report to the Joint Legislative Education Oversight Committee and the Joint Legislative Oversight Committee on Health and Human Services on the findings of the Pilot Program.

SECTION 2.  Study. – NC AHEC shall also study the availability of community preceptors, or community health care professional teachers, in North Carolina and the demand for those preceptors, including factors that influence the supply for those preceptors in rural communities, and barriers that community‑based outpatient clinicians face in teaching health care professional students. NC AHEC shall report its findings on the study to the Joint Legislative Education Oversight Committee and the Joint Legislative Oversight Committee on Health and Human Services no later than December 1, 2022. NC AHEC shall consult with other health care professional organizations on the study of the supply of and demand for preceptors in North Carolina, including, but not limited to, the North Carolina Academy of Family Physicians, the North Carolina Academy of Physician Assistants, the North Carolina Healthcare Association, the North Carolina Independent Colleges and Universities, the North Carolina Medical Society, the North Carolina Nursing Association, the North Carolina Pediatric Society, and The University of North Carolina.

SECTION 3.  Appropriation. – There is appropriated from the General Fund to the Board of Governors of The University of North Carolina the sum of one million one hundred thousand dollars ($1,100,000) in nonrecurring funds for the 2021‑2022 fiscal year and one million dollars ($1,000,000) in nonrecurring funds for the 2022‑2023 fiscal year to be allocated to the University of North Carolina at Chapel Hill for the North Carolina Area Health Education Centers Program to fund the Pilot Program established in accordance with Section 1 of this act.

SECTION 4.  This act becomes effective July 1, 2021.