H.B. 359 Health Care Preceptor Amendments

What this bill does

The bill would create a Preceptor Fund to pay clinicians who train healthcare students. The Department of Health and Human Services would make payments from the fund under rules it sets, and people could voluntarily donate to the fund when applying for or renewing a license.

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Every vote

• 11 yes, 0 no, 3 absentHouse Health and Human Services Committee: vote, which it did not pass · Feb 20, 2026Who voted how

Hearings and debates

• Feb 20, 2026 House Health and Human Services Committee▶ Watch
  Transcript (53 turns)

  1. Committee chair45:18

     and if not, we'll go to three. Okay. Representative Monson, the time is yours.

  2. Rep. Logan Monson45:30

     Sorry. Good. Alright, there we go. Thank you, committee for having me. And, um, and, and for moving us up, I have another committee to run to. I, um, I'm presenting today on House Bill 3 59. The Healthcare Preceptor Amendments. This bill, um, addresses one of the biggest bottlenecks in training new healthcare providers that we have here in the state. We don't just need more students in the programs, we also need more providers that are willing to train them. Um, what this bill does is it creates a simple, voluntary way to provide support for those programs. Um, the three kind of main things that it does, and I'll go through this quickly and then I'll let Theresa speak to this a little bit. Um, first it creates the Preceptor Fund. This is a dedicated account to support clinicians who train students. Second, it allows the Department of Health and Human Services to make payments from that fund, um, to those that are providing this training. And then third, it allows healthcare providers or, or really anyone to donate to the fund, um, but specifically when they apply for a or renew a license. That's it. There's no mandates in this. There's no new programs, just support for training, capacity and all that. Theresa, kind of speak a little bit and then we'll answer any questions. Tell 'em who you are and it should be on.

  3. Teresa Garrett, Utah Action Coalition46:51

     Good morning. Uh, my name is Theresa Garrett. I am the co-lead of the Utah Action Coalition and the Chair. This is a big old long title of the Utah Health Workforce Advisory Council's Legislative Review Subcommittee. Wow. I can say it in one breath. A mouthful. Um, I am also a faculty member at the University of Utah College of Nursing. Uh, I speak today as a private citizen, and I am not representing the University. Utah faces a growing crisis in training healthcare students. We lovingly call it the preceptor bottleneck. All healthcare students need at least two types of experiences. The classroom setting, where they engage with the content, and the didactic work, and the clinical setting where they gain hands-on training under the supervision of a mentor or a preceptor, uh, to meet graduation and practice requirements. Preceptors are typically experienced clinicians who volunteer their time and their expertise to gen, to mentor the next generation. Overall, about 60% of physicians and nurse practitioners from a recent study serve as preceptors for emerging health professionals. While preceptors are needed across all the health fields, there is a critical and growing shortage, especially in the primary care specialties and in rural communities. In 2024, the Utah Health Workforce Advisory Council focused on analyzing Utah's clinical preceptor landscape and de and developing actionable, actionable recommendations. In the summer of 2025, we had a clinical preceptor subcommittee, uh, with a variety of healthcare professionals. And HB 3 59 is a direct result of that group's efforts. Um, what we know is that when health profession students like physicians, PAs, and APRNs Train in Utah, they stay in Utah. You've probably heard that many, many times. Um, this, there are opportunities beyond this bill to build a comprehensive toolbox to help us, uh, expand our preceptor workforce. And by 2031, we will need 3000 more preceptorships than we have today. That's a 57% increase. Um, this bill helps us to, uh, create a funding mechanism and a framework to begin addressing the preceptor bottleneck and training pipeline for physicians, APRNs and physician assistants advanced practice, registered nurses, forgive me. Data from other states have, uh, that have used the stipend process that we are, uh, proposing through this bill, um, shows in promise in increasing the number of providers who serve as clinical preceptors. And I'd like to thank Representative Monson and also Representative Thurston for their support in moving this effort forward. Thank you. Yeah, we're happy to answer any questions or discussion that anybody has.

  4. Committee chair50:02

     Thank you for your presentation. We'll move to the committee for clarifying questions. I have a couple already. So, Representative Ward.

  5. Rep. Raymond P. Ward50:09

     Thank you, Madam Vice-chair. So you used a, a number, you said like 3000 and more preceptor ships per year. So does that mean 3000 more slots at any given moment, or does that, I mean, a preceptor ship in my experience is often four weeks long or six weeks long as a student rotates through different settings. So does that, I mean, if you have 3000 more slots that are all open simultaneously, that's maybe 3000 times 12 positions over the course of the year. Does that make sense? What does that mean? That we need 3000 more? Um, well, looking at a medical student needing eight separate different kinds of rotations, right. Uhhuh and an A PRN needing five. Mm-hmm. I don't know the PA number, but there are people who can answer that question. Sure. Um, and then multiplying that by the number, the growth we expect across the new medical programs that are opening in the state, the expanding A PRN and PA programs, that's how we get that number. Okay. And then, and this would just be a kind of a cash payment back to an office that was willing to do it. That's the idea for a, for a, a given number of hours volunteered serving students, um, x number a, a stipend. So 160 hours, four weeks of, of mentoring and precepting would be about a thousand dollars. Is is the preliminary plan. Okay. It gets tricky, right? So, yeah. Um, having, there are some clinical settings where it's set up to ha to do this thing where maybe you have a few less patients. Um, and so you have a little bit of time to talk with the student. It, what seems to be happening is that we're seeking preceptorships out in, just in the wide world, in the private setting, where you're going as fast as you can to see patients, and it gets tricky to know how to regard it. It's like, well, I could probably do it as a favor once for one month out of the year, but it is extra time to visit with the student if you want to have them have a good experience. And anything that, if it, if you were seeing, um, if you were seeing 25 patients in that day, and as a result of having the student, you see 24, then a thousand will not cover by the end of the month, you'll, you'll still easily come out behind. You know, it's just hard to figure out how you work it in the rotation and still produce the amount of thing that you normally get paid for. So, um, thank you for working on it. Thank you.

  6. Committee chair52:44

     Thank you, Representative Abbott.

  7. Rep. Nelson T. Abbott52:46

     Thank you. I have a question, maybe more for the sponsor, but you know, as I look at this, I, I think I understand what you're, you're, you're trying to do. You're trying to say, we need more people in the healthcare industry and et cetera, et cetera. And so we want government to come in and step in and kind of push a lever on that. At the same time, we could say that about plumbers, electricians, insurance agents, insurance adjusters. What makes this a proper role of government to come in and say, we're going to take government money, or at least have government run a program with private money to supply, um, workforce to a largely private industry for profit. And, and so, I dunno, can you just address that for me? Yeah. I think, like you mentioned, the issue's complicated and we have lots of, um, I guess, restrictions on, on, on what the proper role of government should be in this. The idea is that we, we have to find ways to take care of people. Healthcare is, is a big deal. And, and maybe finding an opportunity to, um, increase access to healthcare is, is kind of the, the route we're taking on this. And definitely understand the concerns and trying to find a solution to providing access to more people. Thank you.

  8. Committee chair54:12

     Thank you. Um, representative Daley, Provo.

  9. Rep. Jennifer Dailey-Provost54:18

     Thank you, Madam Chair. Um, can you, I'm sorry, I'm a little bit hazy on the funding mechanism. Can you go back over that for me? What part? So, So how do we, how do we fund the program? So in, in the bill, it is just listing that there could be, um, donation. So volunteer, volunteer donations to the fund, um, through license renew. So, so when, when providers go to renew their license, they can volunteer voluntarily donate to the fund there, or this can be open to anybody, honestly, to, to donate to the fund. Okay. If I may follow up, Adam chair. Thank you. Um, so I, I'm having a hard, so since you don't have any way to control or anticipate what those funds are gonna be, how do you measure, how do you, how do you set up slots if you're not sure how many you can pay for and how, how would that be? Do how, who gets the payment? Ultimately, how do you decide who gets those preceptorship payments?

  10. Rep. Logan Monson55:23

      Yeah, so here in the, here in the bill, we have the, the, the department. So the rulemaking authority would go to the department to decide kind of the application process for receiving those funds, how they'll prioritize those funds. So we we're not, we don't have it spelled out yet. Okay. We, we give that rulemaking authority in Here. So theoretically, somebody could apply to the department and say, I am, if the money is available, I could do these, this many preceptorships. But they wouldn't be committed to doing the preceptorships until the department confirmed that they would receive payment

  11. Rep. Jennifer Dailey-Provost55:53

      Y. Yeah. Yeah. I mean, we're Okay. You're correct. Okay. Thanks. Thanks, Madam Chair.

  12. Committee chair55:58

      Thank you. Um, not seeing any more from the committee. I do have, I do have a question maybe for, um, for Theresa. So we do, we, I feel like we do give a lot of money to higher ed for, you know, education and, and stuff, even in graduate programs. Um, can you just speak to how, like, is there any of that money that goes already to these preceptors, and is there just not enough, like, or has it never really been funded? You probably have more background there than me, but

  13. Teresa Garrett, Utah Action Coalition56:40

      Thanks for the question. Representative Hall. Um, uh, certainly higher ed is a large part of the budget, no doubt about that. Uh, in the majority of, of the programs that this effort is targeted at, uh, from the public institutions, preceptors are not paid, uh, to preceptors out of like academic, um, healthcare outside of maybe the University of Utah, um, are not paid directly, uh, re to provide preceptorship. There are some instances where some, um, programs are paying preceptors. Our, this particular work is targeted to people who are not reimbursed or not paid to be a preceptor. Yeah. Okay. Okay. That's good to know. That's good information.

  14. Committee chair57:33

      All right. Thank you. All right. I'm not seeing any further questions, so we'll take it to the public for public comment.

  15. Committee chair57:38

      Anyone wanna make comment on this? Thanks. Okay. We'll have you guys come up and we'll do two minutes.

  16. Maryann Martindale, Utah Academy of Family Physicians57:50

      I can do it. Okay. Maryanne Martin Deta Academy Family Physicians, um, we like the concept of this preceptorship is critical to training, and it has been a problem to find enough preceptorships. Um, I don't think this bill's there yet. Uh, we've got some gaps. Um, we have one medical school that, based on the language in here, might not even qualify because it's not technically based in Utah. Uh, the funding mechanism is very vague and concerning that it's not going to, I mean, I don't, I don't know how many times you check a box to donate money, and what are we gonna get? You know, I just, I think that's concerning. Um, the other thing is, is preceptorship is complicated. Every different entity has their own rules about it. So like for the University of Utah, they prioritize only taking youth students first, so then they'll take other students if they have room. Um, they don't allow their physicians to get paid for preceptorships. IHC doesn't allow their physicians to get paid for preceptorships. I feel like there's a lot of areas in here that still need to be worked out. I think there's a kernel of a good bill in here. I would love to see this move to interim where we can actually work out all of these things with only about a week left to, to get these things across the line. I think we're kind of running out of time. Thank you.

  17. Committee chair58:59

      Thank you, Maryanne. All right.

  18. Karly Pippitt, family physician59:09

      Good morning. My name is Carly pt. I'm a family physician, uh, and I am here speaking in my capacity as a private citizen. As Marianne has noted, the preceptorship shortage is real. I would say, especially in primary care. This is something we struggle with, and we know that precept, that students are more likely to practice where they train. So, I'm a great example of this. I'm from Idaho. We rank 48 than the nation for primary care providers. Utah only ranks 47th. But, uh, I haven't left here since I trained here. So, uh, and I've always said, I'm gonna go back to Idaho. So how can we improve training slots so that more people are likely to stay here so that then we have more healthcare providers in the state? So I think there are some issues. If we can make some changes, I think this could be a good support. Thank

  19. Committee chair59:53

      You. Thank you, Carly. All right, go ahead.

  20. Jared Spackman, University of Utah Physician Assistant Program59:57

      Good morning, honorable house, uh, representatives in HHS, uh, committee members. My name is Jared Spackman, and I'm speaking, uh, in favor of house bill three, uh, 59, and moving it to an interim, uh, status. Although I'm speaking as a private citizen, I'm also a licensed physician assistant, and I'm the director of the University of Utah Physician Assistant Program. Uh, a program that's nationally ranked, uh, for educational excellence. As such, our program trains 68 students a year each year in preparation for working in nearly every subspecialty within medicine. Our mission is primary care and underserved, and our students train in work in many underserved and rural communities in Utah. Like many health professions, PA programs have continued to proliferate as the need for those who, uh, has risen for those who provide care. Prior to 2015, there was only the University of Utah's program training PAs. Now, there are four programs in the state, the s Rocky Mountain University, UVU, and Weaver State, and we're glad to see them. Um, these programs have a combined enrollment of approximately 150 students a year, and during the clinical phase, require up to 1800 rotations alone in a given year. Representative Ward, those are rotation slots. So PAs have 12 four week, uh, preceptorships that are required. This, as well as numerous other medical education programs that put immense pressure on clinical training sites and preceptors. Our preceptor survey data confirms the data analysis provided by the Utah Health Workforce Advisory Committee, financial incentives, our primary drivers of preceptor recruitment and retention in the current landscape. That's sort of been an East coast thing that has been moving west in terms of seeing more, uh, requests for preceptor payment. Uh, medical systems currently do not, uh, contribute to MD nursing or PA training and financially meaningful ways. I'll, I'll wrap it quickly. Um, in actuality, the business and medicine disincentivizes precepting while valuing productivity related to patient billing. Uh, so we support the intent of this bill and we're willing to answer any questions.

  21. Rep. Raymond P. Ward1:02:05

      Thank you. I do have one question for you, Representative Ward. Oh, sorry. My hit it, But it did go. Thank you, madam. By chair. I mean, the last thing you said, I mean, certainly rings true. Uh, private clinics don't get paid to do this. And, and even when they want to volunteer to do it, it becomes a difficulty. It is an extra thing to try and do. That's correct. A busy day, you know, that's already there. Um, there's is, I'm not saying it should be this way, but should the students just be paying an extra, um, $10,000 of tuition every year and have that money used to offer the, to pay? Or what would be the drawbacks of that?

  22. Jared Spackman, University of Utah Physician Assistant Program1:02:52

      In some programs, that's already happening, so, uh, through, essentially the levy of a student rotation fee programs are already employing that and paying for clinical rotations in that way. The, the issue with that is, is that it raises education costs. Mm-hmm. And, you know, PAs that are gonna decide to work in rural underserved areas often are making decisions based on their education debt. And so they're more likely to choose subspecialty, they're more likely to choose urban settings, uh, because there's higher earning potential.

  23. Rep. Raymond P. Ward1:03:23

      Sure. Um, you know, provided what their education debt looks like.

  24. Jared Spackman, University of Utah Physician Assistant Program1:03:26

      So, uh, part of, I think part of the intent of this bill would be to lower, uh, education debt burden, uh, for, for those programs that are providing those incentives, uh, and, um, allow folks to end up in these settings where they're so desperately needed In those programs where the program does just charge a higher tuition to the students and then, and pays that fee.

  25. Rep. Raymond P. Ward1:03:49

      How, what's typical to pay for a preceptorship for a four week rotation?

  26. Jared Spackman, University of Utah Physician Assistant Program1:03:53

      It depends, you know, uh, programs hold that pretty tight. So, uh, in, in other words, if you ask a program, they will typically be cagey about it. But what I would tell you is it, it would appear that the going rate is somewhere between 750 and $2,000. Uh, private for-profit, uh, education programs tend to pay more, which can also increase pressure for sites.

  27. Rep. Raymond P. Ward1:04:19speaker not certain

      Sure. Okay. Thanks. You're Welcome.

  28. Committee chair1:04:22

      Thank you. Thank you. Okay.

  29. Mark Steinagel, Director, Utah Division of Professional Licensing1:04:25

      Thank you. Uh, mark Steinle, director of doppel. And, um, I also sit on the Health Workforce Advisory Council that, um, recommended this. Uh, the only thing that I wanted to raise, and I appreciate Representative Monson for visiting with me, um, prior to the meeting, um, we, we will be part of the collection of the volunteer funds as part of the renewal process. So I asked him, and he was amenable. If this does advance, if we could do a delayed effective date of, uh, January 1st, 2027, if the committee chooses to advance it, that would be helpful to us to administer it at the lowest cost possible.

  30. Committee chair1:04:59

      So, thank you so much. Alright. Thank You. Um, we have another

  31. Rep. Raymond P. Ward1:05:01

      question. Representative Ward, Just using up my entire allotment of questions I have, I sort of, and I don't know if you're the right person, mark, but I just have a different sort of question. So, on at least an anecdotal basis, I have heard stories of, of students who have come out of medical school, gone to residency, and according to other folks there at the residency, were very unprepared to be there, um, in part because they had gone through preceptorships that did not really do much for them. Mm-hmm. Is it our department of licensing, or even if we're paying for these things to happen, who is tracking whether the experience is even meaningful or useful to them, or whether we're just, I mean, you can go walk in an office and sit there for four weeks and come out and on the wiser mm-hmm. Who, who's keeping track of whether they really are getting the job done to, to give an actual good clinical experience to the students who, whether it's from this money or from their own pocket, are paying for it.

  32. Mark Steinagel, Director, Utah Division of Professional Licensing1:05:56

      Yeah, good question. I've heard similar anecdotal stories to what you have said. I don't think anybody is tracking it right now. At least as far as I know. The, the competency based training and education system that we currently have is primarily captured through an assumption that the residencies and preceptorships are providing it, and that the test, the exam captures some of the knowledge, which obviously is difficult with clinical knowledge. So,

  33. Rep. Raymond P. Ward1:06:24speaker not certain

      Okay. Thanks.

  34. Committee chair1:06:24

      Yep. Thank you. Thank you. All right. I'm not seeing any further comments in the room. So we'll go online to Dr. Jonathan Baird. Jonathan, if you can turn on your camera and introduce yourself and where you're calling from.

  35. Dr. Jonathan Baird, Rocky Mountain University of Health Professions1:06:46

      Okay. Here, here is the, uh, technology coming online, Dr. Jonathan Baird. I'm calling from Provo, Utah, and I am at Rocky Mountain University. We are a private for-profit university. Oh, madam, I'm sure, uh, uh, you'll have some leeway with me here 'cause I can answer a lot of questions that have been posed here. Um, the proper role of government in the preamble of our constitution, it says, the proper role of government is to provide for the common defense and promote the general welfare. We are all threatened by disease of one sort or another, and yet it is not the role of government in this case, to provide every, uh, person with their own personal medical physician or PA or np. However, it is the proper role of government to promote such. And I think that that's what this bill does. Is it a great bill? No, but it's a good bill, and let's not let great be the enemy of good. To the question about pain. Our students do pay for their, uh, preceptorships. And on contrary to the popular belief, we cannot, uh, uh, run up the, the tab and still be in business. So, uh, the number that, uh, Jared put forth earlier is about correct, and we're on the lower end of that. Unfortunately, there are simply just not people in Utah who will even take that. And as a result, we send a, a good number of our students. Uh, in fact, we tell all of our students to plan on traveling for their preceptorships because we do not just to, uh, representative ward's point, take anybody. Uh, we vet these programs thoroughly. And as our students go through those experiences, we track whether or not they are meeting competencies. And we are not reticent to pull a student from a, a place if it appears that they are not meeting, uh, competencies. And thus, uh, you know, we value our preceptors who are good and who can give those good experiences. As a result, we fight for them fiercely. We will pay for them to keep them on, uh, on, on tab. We are in favor of this bill. We hope that, uh, we can move this ball forward and let's continue to improve upon it.

  36. Committee chair1:09:00

      Thank you, Dr. Bird. All right. We'll go next to Lindsey. Lindsey, drew.

  37. Lindsey Drew, Noorda College of Osteopathic Medicine1:09:21

      Good morning. Can you hear me?

  38. Committee chair1:09:23

      Yes. Go ahead, Lindsay. Thank you.

  39. Lindsey Drew, Noorda College of Osteopathic Medicine1:09:25

      Chair Hall and members of the committee. Um, I do wanna thank you for the opportunity to speak. Um, I am the dean of the Nordic College of Osteopathic Medicine here in Provo. Um, I appre appreciate the intent behind House Bill 3 59, um, and the recognition that preceptors are essential to training Utah's healthcare workforce clinical education simply does not happen without practicing physicians and other clinicians who are willing to teach the next generation. So this bill does move the conversation forward by acknowledging that precepting, uh, has value, and that we should be intentional about how we support it as we, uh, continue in this work. Hopefully, in the interim, I would encourage us to think even bigger. Um, the preceptor challenge is not isolated to one profession, as you've heard here today. Um, but it also encompasses healthcare learners across the state with health hospitals, health systems, and community clinics that are all navigating capacity pressures. So a logical next step could be a statewide preceptor consortium that brings together the training programs, the healthcare systems, workforce leaders, to all coordinate efforts, um, and align the incentives, reduce the administrative burden, and strategically expand the capacity, especially in the primary care and rural communities. So hopefully, um, h HB 3 59 can be an important starting point, and I look forward to continuing and collaborate collaboration so that Utah can build a coordinated and sustainable clinical training in infrastructure for the future. Thank you.

  40. Committee chair1:10:59

      Thank you. Lindsey, would you mind just, um, stating your name for the record as well?

  41. Lindsey Drew, Noorda College of Osteopathic Medicine1:11:02

      Lindsey Drew. Thank you. All right.

  42. Committee chair1:11:05

      I'm not seeing any further comments, so we'll come back to the committee for any discussion or action. Representative gracious.

  43. Rep. Stephanie Gricius1:11:12

      Thank you, Madam Chair. I would move that we push this to interim study.

  44. Committee chair1:11:17

      That motion is, I think maybe, do you wanna do a motion, a different motion

  45. Rep. Stephanie Gricius1:11:26

      To hold, a motion to hold and include intent that we refer this to interim study?

  46. Committee chair1:11:32

      Is that better? Yeah, that motion is in order. Great. Would you like to speak to it?

  47. Rep. Stephanie Gricius1:11:36

      Um, I really appreciate what the sponsor's trying to do with this. I just don't know that we're, we're quite there and given the amount of time, we have less left in the session, I think it warrants a larger conversation.

  48. Committee chair1:11:46

      Thank you. We'll bring it to the committee for any discussion on that motion. I'm not seeing, but I'll, I'll make, um, or actually, I think I go to the sponsor first on that.

  49. Rep. Logan Monson1:11:58

      Yes. Thank you, Madam Chair. I, um, hear the concerns. I, I hear the, the, the need that we have. And I, and I, and I do think that we understand the need. I think that the, the access that we could gain through finding some solutions that would expand and, and, and just give us more, um, providers in our communities is, is something we should work for. I think doing things the same way over and over and expecting the same results is not working. And, and we have to find ways to do that. And, and I appreciate the opportunity to keep working on this. It sounds like, um, we have lots of good people that are invested in this and, and want to come to the table, and we need to get that ball moving sooner rather than later. So, so we'll make sure we, we, we do that.

  50. Committee chair1:12:44

      Thank you. Thank you. We'll bring it back to the committee for any comment on that.

  51. Unknown speaker1:12:48speaker not certain

      Um, I, I will make a comment. I, I think that's a really good idea, and I wanna thank you for the work that you've done on this so far, and all those that have commented. I think the interim is a great place for this, um, to, to put some more work into it, see what needs to be done. Um, you've definitely high highlighted an area where, where we need, we need something clearly. Um, with the education programs growing so much, we definitely need something. So I think that's great. All right.

  52. Committee chair1:13:16

      So I'll bring it back to this maker of the motion. I'll wave. All right. So the motion is to hold HP 3 59. All in favor say aye. Aye. Aye. Any opposed? All right. That motion passes. Thank you.

  53. Committee chair1:13:34

      Thank you, Representative Monson. All right.