An Act To Encourage Maine Residents To Attend Medical School and Practice in Maine
Maine Legislature, Session 124, LD 0853
Committee Amendment CA_A_S178 (Senate)
Amends: 20-A MRSA §12101, 20-A MRSA §12103, 20-A MRSA §12103-A, 20-A MRSA §1210, 20-A MRSA §12105

COMMITTEE AMENDMENT" 
"to S.P. 322, L.D. 853, Bill, "An Act To 
Encourage Maine Residents To Attend Medical School and Practice in Maine" 
Amend the bill by striking out everything after the title and before the summary and 
inserting the following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, Maine currently faces an acute shortage of primary care physicians, 
particularly in rural areas of the State, as a result of anum ber of factors; and 
Whereas, due to concerns regarding limited access and the high cost of medical 
education, Maine students who graduate from college are the least likely to enter medical 
school as compared to college graduates in other states; and 
Whereas, Maine is one of only 6 states in the nation without a state-supported, 
allopathic medical school; and 
Whereas, collaborative partnerships between the Tufts University School of 
Medicine and the Maine Medical Center and between the University of Vermont School 
of Medicine and the Eastern Maine Medical Center and involving the University of New 
England will encourage more Maine students to pursue careers in medicine and will 
develop support for the establishment of medical education programs in the State; and 
Whereas, leveraging the private resources of these universities and health care 
organizations to match funding available due to the enhanced Federal Medicaid 
Assistance Percentage provided in the American Recovery and Reinvestment Act of 2009 
will provide start-up funding for the establishment of a medical student scholarship fund; 
and 
Whereas, this innovative, pUblic-private funding model will result in the training of 
medical students in the State which will increase the likelihood that these physicians will 
remain in the State once their medical training is completed; and 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT" A" to S.P. 322, L.D. 853 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, 
'Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 20-A MRSA §12101, sub-§8-A is enacted to read: 
8-A. Qualifying Maine-based medical school program. "Qualifying Maine-based 
medical school program" means an allopathic or osteopathic medical school program 
affiliated with a medical school accredited by the Liaison Committee on Medical 
Education or its successor or the American Osteopathic Association or its successor in 
which: 
A. 
An educational or health care institution located in this State participates in 
curriculum development and the selection of students for admission; 
B. No fewer than 10 students per class year are enrolled and in which these students 
are required to complete not less than one academic year of the medical school 
curriculum at facilities located in this State; 
C. Funds are raised through philanthropic resources and the private sector to match 
100% of those funds appropriated or allocated by the State for scholarships under 
section 12103; and 
D. The program curriculum includes required clerkship experiences in and training 
and course completion in rural health care and primary care. 
Sec. 2. 20-A MRSA §12103, sub-§l, as amended by PL 1997, c. 765, § 1, is 
further amended to read: 
1. Positions. The Access to Medical Education Program is established under this 
section. Under this program, the chief executive officer shall secure up to 21 positions 
annually for Maine students at schools of allopathic, osteopathic or veterinary medical 
education up to an aggregate of 84 positions. 
Five positions are for students of 
osteopathic medicine, 15 positions are for students of allopathic medicine and one 
position is for students of veterinary medicine. If there is an insufficient number of 
qualified applicants for positions in either allopathic or osteopathic medicine, the chief 
executive officer may increase or decrease the number of positions available in either 
discipline. 
The allopathic and osteopathic medicine positions are available only to 
eligible students commencing professional education on or after January 1, 1993 and on 
or before September 30, 2009. Commencing January 1, 2010, the chief executive officer 
may not secure any new positions for students at schools of allopathic or osteopathic 
medicine and shall secure only the number of positions necessary to allow students 
already occupying such positions as of January 1, 2010 to complete their remaining 
medical education, up to 3 years, at the institution. Commencing July J, 2013, the chief 
executive officer may not secure any further positions at schools of allopathic or 
osteopathic medicine under this section. The veterinary medicine position is available to 
a student commencing medical education on or after January 1, 1999. 
Sec. 3. 20-A MRSA §12103-A is enacted to read: 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT" A" to S.P. 322, L.D. 853 
§12103-A. Doctors for Maine's Future Scholarship Program 
There is established the Doctors for Maine's Future Scholarship Program, referred to 
in this section as "the scholarship program," to provide a tuition subsidy of 50% of the 
cost of attendance annually, up to a maximum of $25,000 per student annually, for 
eligible students who enter qualifying Maine-based medical school programs for the 
purpose of increasing the number of physicians in this State who practice in primary care, 
underserved specialties or underserved areas of the State. 
For the purposes of this 
section, "cost of attendance" means the tuition and fees applicable to an eligible student, 
together with estimated other expenses reasonably related to cost of attendance at a 
qualifying Maine-based medical school program. 
II 
1. Eligibility. For purposes of this section, "eligible student" means a student who 
meets eligibility requirements set by the authority by rule that include at least the 
following: 
A. The student is or will be enrolled in a qualifying Maine-based medical school 
program; and 
B. The student has a substantial connection to the State as evidenced by factors such 
as prior education in this State, parental residence in this State and at least one year of 
non-education-related residence in this State. 
2. Priority. In awarding scholarships, the authority shall give priority to an eligible 
student who meets at least 2 of the following provisions: 
A. The student has received a high school diploma, or its equivalent, in this State; 
B. 
The student has received a baccalaureate degree from a 4-year college or 
university in this State; and 
C. The legal residence of a parent of the student is in this State. 
3. Allocation. The total number of scholarships available under the scholarship 
program must be allocated equally among qualifying Maine-based medical school 
programs, except that a program may not be allocated more than the number of 
scholarships for which the program has raised matching funds as of January 1st 
immediately preceding the scholarship award. 
4. Matching funds. Commencing January I, 2013, if a qualifying Maine-based 
medical school program raises matching funds in an amount less than the amount of 
scholarship funds allocable to it under this section from the State for a given year or does 
not have a sufficient number of qualified applicants to fill the number of scholarships 
allocable to it, the number of scholarships allocated to that program must be reduced 
accordingly and scholarships must be reallocated for that year to students of other 
qualifying Maine-based medical school programs. 
Qualifying Maine-based medical 
school programs must use funds raised through philanthropic and private medical 
education fundraising to increase the number of scholarships available to eligible students 
and must use matching funds to provide no fewer than the number of scholarships 
allocated to the program by the State in a given academic year. 
5. Notification. For each student receiving a scholarship under this section, the 
student's qualifying Maine-based medical school program must notify the authority of the 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT" A" to S.P. 322, L.D. 853 
location of the student's medical residency, specialty and place of employment for each of 
the 8 years after the student's graduation from the school. 
6. Doctors for Maine's Future Scholarship Fund created. A nonlapsing, interest-
earning, revolving fund under the jurisdiction of the authority, known as the Doctors for 
Maine's Future Scholarship Fund, and referred to in this subsection as "the fund," is 
created to carry out the purposes of this section. Any unexpended balance in the fund 
carries over for continued use under this section. The authority may receive, invest and 
expend on behalf of the fund money from gifts, grants, bequests and donations or other 
sources in addition to money appropriated or allocated by the State. Money in the fund 
must be invested by the authority, as provided by law, with the earned income to be 
added to the fund. Money received by the authority on behalf of the fund, except interest 
income, must be used for the purposes of this section; interest income may be used for 
such purposes or to pay student financial assistance administrative costs incurred by the 
authority. 
Sec. 4. 20-A MRS A §12104, sub-§2-A is enacted to read: 
2-A. Access to Medical Education Program students. As long as the student is 
otherwise eligible, a student occupying a position at a school of allopathic or osteopathic 
medicine pursuant to section 12103 that was secured by the chief executive officer on or 
before June 30, 2009 continues to be eligible for loans under the program under this 
section through June 30, 2012. 
Sec. 5. 20-A MRS A §12105, sub-§l, as amended by PL 2001, c. 479, §1, is 
further amended to read: 
1. 
Fund created. 
A nonlapsing, interest-earning, revolving fund under the 
jurisdiction of the a~thority is created to carry out the purposes of this chapter sections 
12103 and 12104 through June 30, 2012. From July 1, 2012, the fund must be used to 
carry out the purposes of section 12103 as it pertains to positions of veterinary medicine 
only and of section 12104. From July 1, 2009 to June 30, 2013, the authority shall use 
the portion of the fund allocated under section 12103 to secure positions only for students 
of veterinary medicine and to secure positions for students of allopathic or osteopathic 
medicine who occupied positions on September 30, 2009 as necessary to allow them to 
complete their remaining medical education, up to 3 years, at the institution. From July 
1, 2009, the authority shall use any unexpended balance of funds previously allocated for 
the purchase of positions of allopathic or osteopathic medicine under section 12103 to 
fund the scholarships described in section 12103-A. Any unexpended balance in the fund 
after the unused portion is reallocated to support the scholarships described in section 
12103-A carries over for continued use under this chapter section 12103, as it pertains to 
positions of veterinary medicine only, and section 12104. The authority may receive, 
invest and expend, on behalf of the fund, money from gifts, grants, bequests and 
donations, or other sources in addition to money appropriated or allocated by the State. 
Loan repayments under this chapter or other repayments to the authority under sections 
12103 or 12104 must be invested by the authority, as provided by law, with the earned 
income to be added to the fund. Money received by the authority on behalf of the fund, 
except interest income, must be used for such purposes; interest income may be used for 
such purposes or to pay student financial assistance administrative costs incurred by the 
authority. 
COMMITTEE AMENDMENT 
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COMMIITEE AMENDMENT" A" to S.P. 322, L.D. 853 
Sec. 6. 20-A MRSA §1210S, sub-§2, as enacted by PL 1991, c. 830, §4 and c. 
832, § 1 0, is amended to read: 
2. Separate account authorized. The authority may divide the fund each of the 
funds under subsection 1 and section 12103-A, subsection 6 into separate accounts it 
determines necessary or convenient for implementing this chapter, including, but not 
limited to, accounts reserved for the purchase of positions and accounts reserved for 
loans. 
Sec. 7. 20-A MRSA §12105, sub-§3, as enacted by PL 1991, c. 830, §4 and c. 
832, § 1 0, is amended to read: 
3. Allocation of repayments. The authority may allocate a portion of the annual 
loan repayments received under section 12104 for the purpose of recruiting primary 
health care physicians for designated health professional shortage areas. That portion 
may be used: 
A. 
To generate additional matching funds for recruitment of physicians for 
designated health professional shortage areas; or 
B. 
In accordance with criteria established by the authority, to encourage primary 
health care physicians to practice medicine in health professional shortage areas. 
Emergency clause. 
In view of the emergency cited in the preamble, this 
legislation takes effect when approved.' 
SUMMARY 
This amendment is the majority report of the Joint Standing Committee on Education 
and Cultural Affairs. The amendment strikes and replaces the bill to accomplish the 
following. 
1. It establishes the Doctors for Maine's Future Scholarship Program to provide a 
tuition subsidy of 50% of the cost of attendance annually, up to a maximum of $25,000 
per student annually, for eligible students who enter qualifying Maine-based medical 
school programs, for the purpose of increasing the number of physicians in the State who 
practice in primary care, underserved specialties or underserved areas of the State. 
2. It defines "qualifying Maine-based medical school program" as an allopathic or 
osteopathic medical school program in which an educational or health care institution 
located in the State participates in curriculum development, selects no fewer than 10 
students for admission per class year, requires that all students complete not less than one 
academic year of the medical school curriculum at facilities located in the State, raises 
funds through philanthropic resources and the private sector to match 100% of those 
funds appropriated or allocated by the State for scholarships and includes a required 
clerkship experience and a curriculum that focuses on rural health care and primary care. 
3. It establishes the Doctors for Maine's Future Scholarship Fund as a nonlapsing, 
interest-earning, revolving fund under the jurisdiction of the Finance Authority of Maine. 
The authority is authorized to receive, invest and expend money from gifts, grants, 
bequests and donations or other sources in addition to funds appropriated or allocated by 
the State to the Doctors for Maine's Future Scholarship Program. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to S.P. 322, L.D. 853 
4. It provides for the gradual phaseout of the Access to Medical Education Program 
by establishing that, beginning January 1, 2010, the Chief Executive Officer of the 
Finance Authority of Maine may not secure any additional new positions at schools of 
allopathic or osteopathic medicine under this program and shall secure only the number 
of positions necessary to allow students already occupying such positions as of January 1, 
2010 to complete their remaining one to 3 years of medical education at their respective 
institutions. It also provides that, beginning July 1,2013, the Chief Executive Officer of 
the Finance Authority of Maine may not secure any further positions at schools of 
allopathic or osteopathic medicine under the Access to Medical Education Program. 
5. 
It provides that students occupying positions at schools of osteopathic or 
allopathic medicine through the Access to Medical Education Program on or before 
September 30, 2009 remain eligible for loans through the Health Professions Loan 
Program through June 30, 2012. It further provides that the existing revolving fund that 
supports the Access to Medical Education Program and the Health Professions Loan 
Program must continue to support students eligible for these programs through June 30, 
2012. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
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Approved: 05/01/09 MaC! 
LD853 
LR 1234(02) 
An Act To Encourage Maine Residents To Attend Medical School and Practice in Maine 
Fiscal Note for Bill as Amended by Committee Amendment ,14" 
Committee: Education and Cultural Affairs 
Fiscal Note Required: Yes 
Fiscal Note 
Undetermined current biennium cost increase - General Fund 
Fiscal Detail and Notes 
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This bill establishes the Doctors for Maine's Future Scholarship Fund as a non lapsing, interest-earning, revolving fund 
within the Finance Authority of Maine to provide scholarships for qualifying Maine students, up to a maximum of 
$25,000 per student per year who enter a qualifying Maine-based medical school program. The cost of providing the 
scholarship can not be determined at this time and will depend on the number of students who qualify for the program 
each year. 
Since this legislation does not identify a funding source for the program, it is unclear whether or not any funds will be 
available to support the costs of the program beginning in fiscal year 2009-10. The Governor has proposed, as part of 
a larger package, appropriating $1,750,000 in fiscal year 2009-10 and $1,750,000 in fiscal year 2010-11 from General 
Fund monies "freed up" as a result of the enhanced Federal Medical Assistance Percentage provided in the American 
Recovery and Reinvestment Act (ARRA) of2009 to fund this initiative. The proposal was presented to the Joint 
Standing Committee on Appropriations and Financial Affairs in mid-March. However, no action has been tak~n by 
the Committee to-date and the proposal is included in the latest change package issued in response to the lowered 
revenue forecast from the Revenue Forecasting Committee. Public Law 2009, chapter 1 requires legislative approval 
for use of these funds. 
This bill requires the gradual phase-out of the Access to Medical Education program effective June 30, 2013 and 
provides that provides that any unexpended fund balances in that program beginning in fiscal year 2009-10 be used to 
fund the Doctors for Maine's Future Scholarship program. The Finance Authority of Maine estimates the savings as a 
result of the phasing out of the Access to Medical Education program to be $100,000 in fiscal year 2010-11, $200,000 
in fiscal year 2011-12, $300,000 in fiscal year 2012-13 and $400,000 in fiscal year 2013-14. 
LR1234(02) - Fiscal Note - Page I of 1