B 26-0754

MURIEL BOWSER
    MAYOR
July 9, 2026
The Honorable Phil Mendelson
Chairman
Council of the District of Columbia
John A. Wilson Building
1350 Pennsylvania Avenue, N.W., Suite 504
Washington, D.C. 20004
Dear Chairman Mendelson:
Please find attached the Health Professional Loan Repayment Amendment Act of 2026 for
enactment by the Council of the District of Columbia.
If enacted, the proposed legislation would amend the District of Columbia Health Professional
Recruitment Program Act of 2005, effective March 8, 2006 (D.C. Law 16-71; D.C. Official Code
§ 7-751.01 et seq.) to add certified addiction counselors to the definition of other health
professionals eligible to participate in the Health Professional Loan Repayment Program
(HPLRP). The proposed legislation also amends the Health Professional Recruitment Program
Act of 2005 to ensure DC Health can meet its contractual obligations for existing providers and
recruit new participants for the Program within funding limitations.
The proposed legislation clarifies that participants can have up to 100% of their total debt repaid
by the HPRLP, but not to exceed a specified amount based upon the health professional license
they hold. It also provides the Director of the Department of Health with the authority to modify
allocation procedures and total loan repayment amounts and based on available funding. This
legislation ensures that DC Health can effectively implement this program, which continues to
increase access to health care for District residents , especially those in Health Professional
Shortage Areas or Medically Underserved Areas.
I urge the Council to take prompt and favorable action on the enclosed legislation.
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                                                              -;a:;~~
                                                              Chairman Phil Mendelson
3at the request of the Mayor
4
5
6A BILL
7
8
9
10IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
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12
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14 To amend, on an emergency basis, the District of Columbia Health Professional
15Recruitment Program Act of 2005 to add certified addiction counselors as health
16professionals eligible to participate in the Health Professional Loan Repayment
17Program ("Program"), to increase the maximum loan repayment amounts under
18the Program, to clarify that the maximum loan repayment amounts are not
19mandatory loan repayment amounts, and to replace the statutory annual
20repayment schedule with a regulatory schedule.
21
22BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA,
23 That this act may be cited as the "Health Professional Loan Repayment Emergency
24 Amendment Act of 2026".
25Sec. 2. The District of Columbia Health Professional Recruitment Program Act of
26 2005, effective March 8, 2006 (D.C. Law 16-71; D.C. Official Code§ 7-751.01 et seq.),
27 is amended as follows:
28(a) Section 2(6) (D.C. Official Code § 7-751.01(6)) is amended by striking the
29 phrase "or physician assistants" and inserting the phrase "physician assistants, or certified
30 addiction counselors" in its place.
31(b) Section 9 (D.C. Official Code § 7-751.08) is amended as follows:
32(1) Subsection (a) is amended to read as follows:
33"(a) Physicians and dentists who are full-time participants in the Program shall be
34 eligible to have up to 100% of their total debt, not to exceed $165,000, repaid by the
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35 Program for up to 4 years of service. The maximum annual repayment amount for each
36 such participant shall be set forth in the contract between the participant and the Director
37 required by section 8.”.
38(2) Subsection (a-1) is amended to read as follows:
39“(a-1) Physicians who are full-time participants in the Program and who
40 specialize and practice in obstetrics and gynecology, psychiatry, or another medical
41 specialty identified by the Director or who sub-specialize and practice in oncology,
42 cardiology, neurology, infectious diseases, pulmonary diseases, nephrology,
43 endocrinology, podiatry, ophthalmology, or another medical sub-specialty identified by
44 the Director shall be eligible to have up to 100% of their total debt, not to exceed
45 $200,000, repaid by the Program for up to 4 years of service; provided, that the
46 participants practice in Ward 7 or 8 for the contractually required number of hours for
47 full-time service. The maximum annual loan repayment amount for each such participant
48 shall be set forth in the contract between the participant and the Director required by
49 section 8.”.
50(3) Subsection (b) is amended to read as follows:
51“(b) Other health professionals who are full-time participants in the Program shall
52 be eligible to have up to 100% of their total debt, not to exceed $90,000, repaid by the
53 Program for up to 4 years of service. The maximum annual loan repayment amount for
54 each such participant shall be set forth in the contract between the participant and the
55 Director required by section 8.”.
56(4) Subsection (c) is repealed.
57(5) Subsection (d) is amended to read as follows:
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58“(d) Physicians and dentists who are part-time participants in the Program shall be
59 eligible to have up to 100% of their total debt, not to exceed $82,000, repaid by the
60 Program for up to 4 years of service. The maximum annual loan repayment amount for
61 each such participant shall be set forth in the contract between the participant and the
62 Director required by section 8.”.
63(6) Subsection (e) is amended to read as follows:
64“(e) Physicians who are part-time participants in the Program and who specialize
65 and practice in obstetrics and gynecology, psychiatry, or another medical specialty
66 identified by the Director or who sub-specialize and practice in oncology, cardiology,
67 neurology, infectious diseases, pulmonary diseases, nephrology, endocrinology, podiatry,
68 ophthalmology, or another medical sub-specialty identified by the Director shall be
69 eligible to have up to 100% of their total debt, not to exceed $100,000, repaid by the
70 Program for up to 4 years of service; provided, that the participants practice in Ward 7 or
71 8 for the contractually required number of hours for part-time service. The maximum
72 annual loan repayment amount for each such participant shall be set forth in the contract
73 between the participant and the Director required by section 8.”.
74(7) Subsection (f) is amended to read as follows:
75“(f) Other health professionals who are part-time participants in the Program shall
76 be eligible to have up to 100% of their total debt, not to exceed $45,000, repaid by the
77 Program for up to 4 years of service. The maximum annual loan repayment amount for
78 each such participant shall be set forth in the contract between the participant and the
79 Director required by section 8.”.
80(8) A new subsection (g) is added to read as follows:
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81“(g)(1) The Mayor may, by rule, annually increase the maximum total loan
82 repayment amounts set forth in this subsection by the annual percentage increase in the
83 consumer price index.
84“(2) The Mayor shall, by rule, establish the maximum percentage and
85 maximum dollar amount of a participant’s total debt that may be repaid annually. The
86 maximum annual percentage shall not exceed 30% of the participant’s total debt and the
87 maximum dollar amount shall not exceed 30% of the applicable maximum total loan
88 repayment amount.”.
89Sec. 3. Fiscal impact statement.
90The Council adopts the fiscal impact statement of the Chief Financial Officer as
91 the fiscal impact statement required by section 4a of the General Legislative Procedures
92 Act of 1975, approved October 16, 2006 (120 Stat. 2038; D.C. Official Code § 1-
93 301.47a).
94Sec. 4. Effective date.
95This act shall take effect following approval by the Mayor (or in the event of veto
96 by the Mayor, action by the Council to override the veto), and shall remain in effect for
97 no longer than 90 days, as provided for emergency acts of the Council of the District of
98 Columbia in section 412(a) of the District of Columbia Home Rule Act, approved
99 December 24, 1973 (87 Stat. 788; D.C. Official Code § 1-204.12(a)).
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                     Government of the District of Columbia
                       Office of the Chief Financial Officer
Glen Lee
Chief Financial Officer
MEMORANDUM
TO:  The Honorable Phil Mendelson
                      Chairman, Council of the District of Columbia
FROM:  Glen Lee
                      Chief Financial Officer
DATE:  June 11, 2026
SUBJECT:  Fiscal Impact Statement – Healthcare Facilities Amendment Act of 2026
REFERENCE:  Draft Introduction as provided to the Office of Revenue Analysis on
                      May 6, 2026
Conclusion
Funds are not sufficient in the proposed revised fiscal year 2026 budget and proposed fiscal year
2027 through fiscal year 2030 budget and financial plan to implement the bill. The Department of
Health (DC Health) requires $155,000 in fiscal year 2027 and $642,000 over the financial plan to
implement the bill.
Background
The bill makes several changes to the regulation and oversight of healthcare providers and facilities
in the District of Columbia. Specifically, the bill:
 •   Requires1 healthcare providers to report adverse events2 and cybersecurity incidents to DC
     Health within 48 hours of their occurrence or discovery;
1 By amending Section 202 of the Medical Malpractice Amendment Act of 2006, effective March 14, 2007 (D.C.
Law 16-263; D.C. Official Code § 7-161 et seq.).
2 An adverse event is defined in the bill as a preventable event, occurrence, or situation occurring in or under
the purview of a healthcare provider that results in death or contributes to harm that includes physical,
emotional, or psychological harm that requires major intervention, or impairs the individual’s ability to
perform activities of daily living. The term shall include any other events established by the Mayor through
rulemaking.
         1350 Pennsylvania Avenue, NW, Suite 203, Washington, DC 20004 (202)727-2476
                                       www.cfo.dc.gov
The Honorable Phil Mendelson
FIS: “Healthcare Facilities Amendment Act of 2026,” Draft Introduction as provided to the Office of Revenue
Analysis on May 6, 2026
   •   Requires3 healthcare providers to submit a root cause analysis and corrective action plan to
       DC Health within 45 days of an adverse event;
   •   Requires4 DC Health to maintain a centralized system to collect and analyze adverse event
       data, enabling improved patient safety monitoring and public health responses;
   •   Requires5 healthcare providers to actively participate with recognized patient safety
       organizations and submit annual proof of participation;
   •   Classifies6 adverse event reports and documents as confidential and protected from legal
       discovery, unless court-ordered in a felony case or for regulatory agency use;
   •   Updates7 the healthcare facility licensure processes allows for periodic fee adjustments, and
       imposes stricter penalties for non-compliance, including fines for violations that put patients
       at risk;
   •   Allows8 new assisted living facilities to apply for provisional licenses;
   •   Updates9 staff training requirements for direct care workers in assisted living facilities
       with broader District standards and update licensure and food safety compliance procedures;
   •   Clarifies10 what constitutes a change in control, ownership, or material change in healthcare
       facility operations that triggers certificate of need requirements;
   •   Incorporates11 applicable federal requirements for participation and standards for health-
       insurance and medical-assistance programs as minimum standards for the operation of
       health care facilities and agencies in the District;
   •   Enhances12 the District’s ability to levy fines in a manner commensurate with the severity of
       an established violation by a facility or agency that presents an immediate danger to the life
       and safety of patients, residents, or clients; and
   •   Exempts13 healthcare facilities and agencies from certificate of clean hands requirements
       during license renewals to prevent abrupt closures that would jeopardize the health and
       safety of vulnerable patients and residents.
Financial Plan Impact
Funds are not sufficient in the proposed revised fiscal year 2026 budget and proposed fiscal year
2027 through fiscal year 2030 budget and financial plan to implement the bill. DC Health requires
$155,000 in fiscal year 2027 and $642,000 over the financial plan to implement the bill.
3 By amending Section 202 of the Medical Malpractice Amendment Act of 2006.
4 Id.
5 Id.
6 Id.
7 Id.
8 By amending The Assisted Living Residence Regulatory Act of 2000, effective June 24, 2000 (D.C. Law 13-
127; D.C. Official Code § 44-101.01 et seq.).
9 Id.
10 By amending The Health Services Planning Program Re-establishment Act of 1996, effective April 9, 1997
(D.C. Law 11-191; D.C. Official Code § 44-401 et seq.).
11 By amending The Health-Care and Community Residence Facility, Hospice and Home Care Licensure Act of
1983, effective February 24, 1984 (D.C. Law 5-48; D.C. Official Code § 44-501 et seq.).
12 Id.
13 By amending The Clean Hands Before Receiving a License or Permit Act of 1996, effective May 11, 1996
(D.C. Law 11-118; D.C. Official Code § 47-2861 et seq.).
                                                                                            Page 2 of 3
The Honorable Phil Mendelson
FIS: “Healthcare Facilities Amendment Act of 2026,” Draft Introduction as provided to the Office of Revenue
Analysis on May 6, 2026
DC Health must hire one Nurse Specialist to conduct inspections that result from an increase in
adverse event reporting. DC Health requires additional investigative capacity to review adverse
event reports and assist with investigations. DC Health already maintains a centralized system to
catalog adverse event reports, so no additional resources are needed to procure one. The Nurse
Specialist salary and fringe benefit costs are $155,000 in fiscal year 2027 and $642,000 over the
financial plan. DC Health can implement the provisions in the bill that do not pertain to adverse event
reporting with existing resources.
                       Healthcare Facilities Amendment Act of 2026
                                        Total Costs
               FY 2027        FY 2028  FY 2029  FY 2030  Total
 Salary(a)  $125,970       $128,489  $131,059        $133,680  $519,199
 Fringe(b)  $28,847  $30,116  $31,440        $32,822  $123,225
 Total  $154,817       $158,605  $162,499        $166,502  $642,423
Table Notes:
    (a) Assumes one Grade 11, Step 10 Nurse Specialist and a salary growth rate of two percent.
    (b) Assumes fringe rate of 22.9 percent and a fringe growth rate of 2.35 percent.
                                                                                             Page 3 of 3
                 GOVERNMENT OF THE DISTRICT OF COLUMBIA
                       OFFICE OF THE ATTORNEY GENERAL
BRIAN L. SCHWALB  PRIVILEGED AND CONFIDENTIAL
ATTORNEY GENERAL  ATTORNEY-CLIENT COMMUNICATION
LEGAL COUNSEL DIVISION
MEMORANDUM
TO:  Tomás Talamante
         Director
         Office of Policy and Legislative Affairs
FROM:  Adele El-Khouri
         Deputy Attorney General
         Legal Counsel Division
DATE:  April 7, 2026
SUBJECT:    Legal Sufficiency Review of Draft Bill, the “Healthcare Facilities Amendment Act of
       2026” (AE-26-216)
_____________________________________________________________________________________
This is to Certify that the Office of the Attorney General has reviewed the
above-referenced legislation and found it to be legally sufficient. If you have any questions in this
regard, please do not hesitate to call me at (202) 262-6402.
_________________________________
Adele El-Khouri
                    1350 Pennsylvania Avenue, N.W., Suite 409, Washington, D.C. 20004
                          Phone (202) 262-6402 Email: adele.el-khouri@dc.gov