BILL NUMBER: AB 1045 CHAPTERED
BILL TEXT
CHAPTER 1157
FILED WITH SECRETARY OF STATE SEPTEMBER 30, 2002
APPROVED BY GOVERNOR SEPTEMBER 30, 2002
PASSED THE ASSEMBLY AUGUST 31, 2002
PASSED THE SENATE AUGUST 27, 2002
AMENDED IN SENATE AUGUST 22, 2002
AMENDED IN SENATE AUGUST 5, 2002
AMENDED IN SENATE JUNE 17, 2002
AMENDED IN SENATE MAY 28, 2002
AMENDED IN ASSEMBLY MAY 15, 2001
AMENDED IN ASSEMBLY MAY 3, 2001
AMENDED IN ASSEMBLY MAY 1, 2001
INTRODUCED BY Assembly Member Firebaugh
FEBRUARY 23, 2001
An act to repeal and add Section 853 of, and to add Sections 854
and 855 to, the Business and Professions Code, relating to healing
arts.
LEGISLATIVE COUNSEL'S DIGEST
AB 1045, Firebaugh. Healing arts: practice.
Existing law provides for a Task Force on Culturally and
Linguistically Competent Physicians and Dentists in the Department of
Consumer Affairs. Pursuant to existing law there is a subcommittee
within the task force to examine the feasibility of a pilot program
allowing Mexican and Caribbean licensed physicians and dentists to
practice in nonprofit community health centers in medically
underserved areas. Existing law requires the subcommittee to report
to the task force by March 1, 2001, and requires the report to be
forwarded to the Legislature by April 1, 2001, with any additional
comments.
This bill would delete the provisions for the subcommittee.
The bill would create the Licensed Physicians and Dentists from
Mexico Pilot Program. The bill would set forth the program's
provisions related to eligibility, licensing, location, and hiring.
The bill would also provide for an evaluation of the program, and for
funding of administrative and evaluation costs by philanthropic
entities. The bill would authorize a 3-year nonrenewable license for
physician participants and a 3-year nonrenewable dental permit for
participating dentists and would prohibit these medical licenses and
dental permits from being used as the standard for issuing a license
to practice medicine or dentistry in this state on a permanent basis.
The bill would additionally specify certain requirements
international medical graduates are required to meet to participate
in a separate pilot program and to receive an applicant status
letter. The bill would provide the Medical Board of California the
authority to issue a license to practice medicine to an international
medical graduate participating in the program if specified criteria
are met.
The bill would require the Medical Board of California and the
Dental Board of California, in consultation with other entities, to
provide oversight of these programs. The bill would require the
Medical Board of California to report to the Legislature every
January regarding the physicians program and the international
medical graduate program. The bill would also require the Dental
Board of California to report to the Legislature every January
regarding the dental program.
The bill would provide that these programs shall only be
implemented if the necessary amount of nonstate funding is obtained.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
The 2000 United States Census determined the population of
California to be over 35 million people with approximately 11 million
being Latino.
From July 1990 to July 1999, California's population increased by
approximately 4 million people. Approximately 61 percent of this
growth can be attributed to the growth in the Latino population. The
Latino population has increased at an average rate of 275,000
persons per year from 1990 to 1999. The Latino population is
estimated to have grown in virtually all counties over this period.
The United States General Accounting Office reports that the
United States Community Health Centers patients are comprised of 65
percent ethnic and racial minorities.
Title VI of the Civil Rights Act of 1964 requires any federally
funded health facility to ensure persons with limited English
proficiency may meaningfully access health care services. Persons
with limited English proficiency are often excluded from programs,
experience delays or denials of services, or receive care and
services based on inaccurate or incomplete information.
The Health Resources and Services Administration reports the
number of physicians in California grew 17 percent between 1989 and
1998.
The Health Resources and Services Administration found in 1998
that only 4 percent of active patient care physicians were Latino.
The Association of American Medical Colleges in 1998 found only
6.8 percent of all graduates from United States medical schools were
of an ethnic or racial minority group.
In 1999 only 11 percent of dentists in California were a member of
a racial or ethnic minority group with 5 percent being classified as
Asian or Pacific Islanders.
In 1996 only 4 percent of dentists in California were Latino.
According to the Institute of Medicine report requested by the
United States Congress, research evidence suggests that
provider-patient communication is directly linked to patient
satisfaction, adherence, and subsequently health outcomes. Thus,
when sociocultural differences between the patient and the provider
are not appreciated, explored, understood, or communicated in the
medical encounter, the result is patient dissatisfaction, poor
adherence, poorer health outcomes, and racial and ethnic disparities
in health care.
A Commonwealth Fund of New York study found that: (1) one-third
of Latinos said they had problems communicating with their doctors
with barriers to this poor communication including language, cultural
traditions, and sensitivity; (2) communication is essential to
quality health care; and (3) inadequate communication can lead to the
perception of inhumane health care service delivery.
The Summit on Immigration Needs & Contributions of the Bridging
Borders in the Silicon Valley Project found that approximately 50
percent of participants reported that having a provider that speaks
his or her language will improve the quality of health care services
they receive.
Only two states in the country have reported cultural competency
standards for care.
No states in the country have reported foreign language
competencies for physicians or dentists.
According to the Dallas Morning News, many immigrants travel to
Mexico to receive health care due to the cultural and language
barriers they encounter in the United States health care system.
According to the San Jose Mercury News, 65 percent of the membership
of the largest medical association in California reported that if
they were required to pay for medical interpreters, they would stop
seeing patients that required interpretation services.
According to the Journal of the American Medical Association, in
1999, one medical school had a separate course covering cultural
diversity, 109 medical schools included cultural diversity content as
part of a required course or clerkship, and 84 medical schools
included information on cultural beliefs or practices related to
death or dying in a required course or clerkship.
SEC. 2. Section 853 of the Business and Professions Code is
repealed.
SEC. 3. Section 853 is added to the Business and Professions Code,
to read:
853. (a) The Licensed Physicians and Dentists from Mexico Pilot
Program is hereby created. This program shall allow up to 30
licensed physicians specializing in family practice, internal
medicine, pediatrics, and obstetrics and gynecology, and up to 30
licensed dentists from Mexico to practice medicine or dentistry in
California for a period not to exceed three years. The program shall
also maintain an alternate list of program participants.
(b) The Medical Board of California shall issue three-year
nonrenewable licenses to practice medicine to licensed Mexican
physicians and the Dental Board of California shall issue three-year
nonrenewable permits to practice dentistry to licensed Mexican
dentists.
(c) Physicians from Mexico eligible to participate in this program
shall comply with the following:
(1) Be licensed, certified or recertified, and in good standing in
their medical specialty in Mexico. This certification or
recertification shall be performed, as appropriate, by the Consejo
Mexicano de Ginocologia y Obstetricia, A.C., the Consejo Mexicano de
Certificacion en Medicina Familiar, A.C., the Consejo Mexicano de
Medicina Interna, A.C., or the Consejo Mexicano de Certificacion en
Pediatria, A.C.
(2) Prior to leaving Mexico, each physician shall have completed
the following requirements:
(A) Passed the board review course with a score equivalent to that
registered by United States applicants when passing a board review
course for the United States certification examination in each of his
or her specialty areas and passed an interview examination developed
by the National Autonomous University of Mexico (UNAM) for each
specialty area. Family practitioners who shall include obstetrics
and gynecology in their practice, shall also be required to have
appropriately documented, as specified by United States standards, 50
live births. Mexican obstetricians and gynecologists shall be
fellows in good standing of the American College of Obstetricians and
Gynecologists.
(B) (i) Satisfactorily completed a six-month orientation program
that addressed medical protocol, community clinic history and
operations, medical administration, hospital operations and protocol,
medical ethics, the California medical delivery system, health
maintenance organizations and managed care practices, and
pharmacology differences. This orientation program shall be approved
by the Medical Board of California to ensure that it contains the
requisite subject matter and meets appropriate California law and
medical standards where applicable.
(ii) Additionally, Mexican physicians participating in the program
shall be required to be enrolled in adult English as a Second
Language (ESL) classes that focus on both verbal and written subject
matter. Each physician participating in the program shall have
transcripts sent to the Medical Board of California from the
appropriate Mexican university showing enrollment and satisfactory
completion of these classes.
(C) Representatives from the National Autonomous University of
Mexico (UNAM) in Mexico and a medical school in good standing or a
facility conducting an approved medical residency training program in
California shall confer to develop a mutually agreed upon distant
learning program for the six-month orientation program required
pursuant to subparagraph (B).
(3) Upon satisfactory completion of the requirements in paragraphs
(1) and (2), and after having received their three-year
nonrenewable medical license, the Mexican physicians shall be
required to obtain continuing education pursuant to Section 2190 of
the Business and Professions Code. Each physician shall obtain an
average of 25 continuing education units per year for a total of 75
units for a full three years of program participation.
(4) Upon satisfactory completion of the requirements in paragraphs
(1) and (2), the applicant shall receive a three-year nonrenewable
license to work in nonprofit community health centers and shall also
be required to participate in a six-month externship at his or her
place of employment. This externship shall be undertaken after the
participant has received a license and is able to practice medicine.
The externship shall ensure that the participant is complying with
the established standards for quality assurance of nonprofit
community health centers and medical practices. The externship shall
be affiliated with a medical school in good standing in California.
Complaints against program participants shall follow the same
procedures contained in the Medical Practice Act (Chapter 5
(commencing with Section 2000)).
(5) After arriving in California, Mexican physicians participating
in the program shall be required to be enrolled in adult English as
a Second Language (ESL) classes at institutions approved by the
Bureau of Private Post Secondary and Vocational Education or
accredited by the Western Association of Schools and Colleges. These
classes shall focus on verbal and written subject matter to assist a
physician in obtaining a level of proficiency in English that is
commensurate with the level of English spoken at community clinics
where he or she will practice. The community clinic employing a
physician shall submit documentation confirming approval of an ESL
program to the Medical Board of California for verification.
Transcripts of satisfactory completion of the ESL classes shall be
submitted to the Medical Board of California as proof of compliance
with this provision.
(6) (A) Nonprofit community health centers employing Mexican
physicians in the program shall be required to have medical quality
assurance protocols and either be accredited by the Joint Commission
on Accreditation of Health Care Organizations or have protocols
similar to those required by the Joint Commission on Accreditation of
Health Care Organizations. These protocols shall be submitted to
the Medical Board of California prior to the hiring of Mexican
physicians.
(B) In addition, after the program participant successfully
completes the six-month externship program, a free standing health
care organization that has authority to provide medical quality
certification, including, but not limited to, health plans,
hospitals, and the Integrated Physician Association, shall be
responsible for ensuring and overseeing the compliance of nonprofit
community health centers medical quality assurance protocols,
conducting site visits when necessary, and developing any additional
protocols, surveys, or assessment tools to ensure that quality of
care standards through quality assurance protocols are being
appropriately followed by physicians participating in the program.
(7) Participating hospitals shall have the authority to establish
criteria necessary to allow individuals participating in this
three-year pilot program to be granted hospital privileges in their
facilities.
(8) The Medical Board of California shall provide oversight review
of both the implementation of this program and the evaluation
required pursuant to subdivision (j). The Board shall consult with
the medical schools applying for funding to implement and evaluate
this program, executive and medical directors of nonprofit community
health centers wanting to employ program participants, and hospital
administrators who will have these participants practicing in their
hospital, as it conducts its oversight responsibilities of this
program and evaluation. Any funding necessary for the implementation
of this program, including the evaluation and oversight functions,
shall be secured from nonprofit philanthropic entities.
Implementation of this program may not proceed unless appropriate
funding is secured from nonprofit philanthropic entities. The
Medical Board of California shall report to the Legislature every
January during which the program is operational regarding the status
of the program and the ability of the program to secure the funding
necessary to carry out its required provisions. Notwithstanding
Section 11005 of the Government Code, the board may accept funds from
nonprofit philanthropic entities. The board shall, upon
appropriation in the annual Budget Act, expend funds received from
nonprofit philanthropic entities for this program.
(d) (1) Dentists from Mexico eligible to participate in this
program shall comply with the following:
(A) Be graduates from the National Autonomous University of Mexico
School of Faculty Dentistry (Facultad de Odontologia).
(B) Meet all criteria required for licensure in Mexico that is
required and being applied by the National Autonomous University of
Mexico School of Faculty Dentistry (Facultad de Odontologia),
including, but not limited to:
(i) A minimum grade point average.
(ii) A specified English language comprehension and conversational
level.
(iii) Passage of a general examination.
(iv) Passage of an oral interview.
(C) Enroll and complete an orientation program that focuses on the
following:
(i) Practical issues in pharmacology which shall be taught by an
instructor who is affiliated with a California dental school
approved by the Dental Board of California.
(ii) Practical issues and diagnosis in oral pathology which shall
be taught by an instructor who is affiliated with a California dental
school approved by the Dental Board of California.
(iii) Clinical applications which shall be taught by an instructor
who is affiliated with a California dental school approved by the
Dental Board of California.
(iii) Biomedical sciences which shall be taught by an instructor
who is affiliated with a California dental school approved by the
Dental Board of California.
(iv) Clinical history management which shall be taught by an
instructor who is affiliated with a California dental school
approved by the Dental Board of California.
(v) Special patient care which shall be taught by an instructor
who is affiliated with a California dental school approved by the
Dental Board of California.
(vi) Sedation techniques which shall be taught by an instructor
who is affiliated with a California dental school approved by the
Dental Board of California.
(vii) Infection control guidelines which shall be taught by an
instructor who is affiliated with a California dental school approved
by the Dental Board of California.
(viii) Introduction to health care systems in California.
(ix) Introduction to community clinic operations.
(2) Upon satisfactory completion to a competency level of the
requirements in paragraph (1), dentists participating in the program
shall be eligible to obtain employment in a nonprofit community
health center pursuant to subdivision (f) within the structure of an
extramural dental program for a period not to exceed three years.
(3) Dentists participating in the program shall be required to
complete the necessary continuing education units required by the
Dental Practice Act (Chapter 4 (commencing with Section 1600)).
(4) The program shall accept 30 participating dentists. The
program shall also maintain an alternate list of program applicants.
If an active program participant leaves the program for any reason,
a participating dentist from the alternate list shall be chosen to
fill the vacancy. Only active program participants shall be required
to complete the orientation program specified in subparagraph (C) of
paragraph (1) of this subdivision.
(5) (A) Additionally, an extramural dental facility may be
identified, qualified, and approved by the board as an adjunct to,
and an extension of, the clinical and laboratory departments of an
approved dental school.
(B) As used in this subdivision, "extramural dental facility"
includes, but is not limited to, any clinical facility linked to an
approved dental school for the purposes of monitoring or overseeing
the work of a dentist licensed in Mexico participating in this
program and that is employed by an approved dental school for
instruction in dentistry which exists outside or beyond the walls,
boundaries, or precincts of the primary campus of the approved dental
school, and in which dental services are rendered. These facilities
shall include nonprofit community heath centers.
(C) Dental services provided to the public in these facilities
shall constitute a part of the dental education program.
(D) Approved dental schools shall register extramural dental
facilities with the board. This registration shall be accompanied by
information supplied by the dental school pertaining to faculty
supervision, scope of treatment to be rendered, arrangements for
postoperative care, the name and location of the facility, the date
operations shall commence at the facility, and a description of the
equipment and facilities available. This information shall be
supplemented with a copy of the agreement between the approved dental
school and the affiliated institution establishing the contractual
relationship. Any change in the information initially provided to
the board shall be communicated to the board.
(6) The program shall also include issues dealing with program
operations, and shall be developed in consultation by representatives
of community clinics, approved dental schools, and the National
Autonomous University of Mexico School of Faculty Dentistry (Facultad
de Odontologia).
(7) The Dental Board of California shall provide oversight review
of the implementation of this program and the evaluation required
pursuant to subdivision (j). The Dental Board shall consult with
dental schools in California that have applied for funding to
implement and evaluate this program and executive and dental
directors of nonprofit community health centers wanting to employ
program participants, as it conducts its oversight responsibilities
of this program and evaluation. Implementation of this program may
not proceed unless appropriate funding is secured from nonprofit
philanthropic entities. The Dental Board of California shall report
to the Legislature every January during which the program is
operational regarding the status of the program and the ability of
the program to secure the funding necessary to carry out its required
provisions. Notwithstanding Section 11005 of the Government Code,
the board may accept funds from nonprofit philanthropic entities.
(e) Nonprofit community health centers that employ participants
shall be responsible for ensuring that participants are enrolled in
local English-language instruction programs and that the participants
attain English-language fluency at a level that would allow the
participants to serve the English-speaking patient population when
necessary and have the literacy level to communicate with appropriate
hospital staff when necessary.
(f) Physicians and dentists from Mexico having met the applicable
requirements set forth in subdivisions (c) and (d) shall be placed in
a pool of candidates who are eligible to be recruited for employment
by nonprofit community health centers in California, including, but
not limited to, those located in the Counties of Ventura, Los
Angeles, San Bernardino, Imperial, Monterey, San Benito, Sacramento,
San Joaquin, Santa Cruz, Yuba, Orange, Colusa, Glenn, Sutter, Kern,
Tulare, Fresno, Stanislaus, San Luis Obispo, and San Diego. The
Medical Board of California shall ensure that all Mexican physicians
participating in this program have satisfactorily met the
requirements set forth in subdivision (c) prior to placement at a
nonprofit community health center.
(g) Nonprofit community health centers in the counties listed in
subdivision (f) shall apply to the Medical Board of California and
the Dental Board of California to hire eligible applicants who shall
then be required to complete a six-month externship that includes
working in the nonprofit community health center and a corresponding
hospital. Once enrolled in this externship, and upon payment of the
required fees, the Medical Board of California shall issue a
three-year nonrenewable license to practice medicine and the Dental
Board of California shall issue a three-year nonrenewable dental
special permit to practice dentistry. For purposes of this program,
the fee for a three-year nonrenewable license to practice medicine
shall be nine hundred dollars ($900) and the fee for a three-year
nonrenewable dental permit shall be five hundred forty-eight dollars
($548). A licensee or permitholder shall practice only in the
nonprofit community health center that offered him or her employment
and the corresponding hospital. This three-year nonrenewable license
or permit shall be deemed to be a license or permit in good standing
pursuant to the provisions of this chapter for the purpose of
participation and reimbursement in all federal, state, and local
health programs, including managed care organizations and health
maintenance organizations.
(h) The three-year nonrenewable license or permit shall terminate
upon notice by certified mail, return receipt requested, to the
licensee's or permitholder's address of record, if, in the Medical
Board of California or Dental Board of California's sole discretion,
it has determined that either:
(1) The license or permit was issued by mistake.
(2) A complaint has been received by either board against the
licensee or permitholder that warrants terminating the license or
permit pending an investigation and resolution of the complaint.
(i) All applicable employment benefits, salary, and policies
provided by nonprofit community health centers to their current
employees shall be provided to medical and dental practitioners from
Mexico participating in this pilot program. This shall include
nonprofit community health centers providing malpractice insurance
coverage.
(j) Beginning 12 months after this pilot program has commenced, an
evaluation of the program shall be undertaken with funds provided
from philanthropic foundations. The evaluation shall be conducted
jointly by one medical school and one dental school in California and
the National Autonomous University of Mexico in consultation with
the Medical Board of California and the Dental Board of California.
If the evaluation required pursuant to this section does not begin
within 15 months after the pilot project has commenced, the
evaluation may be performed by an independent consultant selected by
the Director of the Department of Consumer Affairs. This evaluation
shall include, but not be limited to, the following issues and
concerns:
(1) Quality of care provided by doctors and dentists licensed
under this pilot program.
(2) Adaptability of these licensed practitioners to California
medical and dental standards.
(3) Impact on working and administrative environment in nonprofit
community health centers and impact on interpersonal relations with
medical licensed counterparts in health centers.
(4) Response and approval by patients.
(5) Impact on cultural and linguistic services.
(6) Increases in medical encounters provided by participating
practitioners to limited English-speaking patient populations and
increases in the number of limited English-speaking patients seeking
health care services from nonprofit community health centers.
(7) Recommendations on whether the program should be continued,
expanded, altered, or terminated.
(8) Progress reports on available data listed shall be provided to
the Legislature on achievable time intervals beginning the second
year of implementation of this pilot program. An interim final
report shall be issued three months before termination of this pilot.
A final report shall be submitted to the Legislature at the time of
termination of this pilot program on all of the above data. The
final report shall reflect and include how other initiatives
concerning the development of culturally and linguistically competent
medical and dental providers within California and the United States
are impacting communities in need of these health care providers.
(k) Costs for administering this pilot program shall be secured
from philanthropic entities.
(l) Program applicants shall be responsible for working with the
governments of Mexico and the United States in order to obtain the
necessary three-year visa required for program participation.
SEC. 4. Section 854 is added to the Business and Professions Code,
to read:
854. Criteria for issuing three-year nonrenewable medical
licenses and dental permits under this article shall not be utilized
at any time as the standard for issuing a license to practice
medicine or a permit to practice dentistry in California on a
permanent basis.
SEC. 5. Section 855 is added to the Business and Professions Code,
to read:
855. (a) Up to 70 international medical graduates who have passed
their United States medical license examination on the first attempt
and who have been working in the medical field in the capacity of a
medical assistant, a nurse practitioner, a nurse-midwife, a physician
assistant, a dental hygienist, or a quality assurance and peer
review specialist for not less than three years, shall be selected to
participate in a pilot program. Preference shall be given to
international medical graduates who are residents of California, have
experience working in communities whose language is other than
English and whose culture is not from the dominant society, and have
a proven level of literacy in the foreign language of a medically
underserved community.
(b) If there are not 70 international medical graduates who meet
the criteria of subdivision (a), the remaining openings may be filled
by participants who have passed the United States medical license
examination on two or more attempts, have been working in the medical
field in the capacity of a medical assistant, a nurse practitioner,
a nurse-midwife, a physician assistant, a dental hygienist, or a
quality assurance and peer review specialist for not less than three
years, and who pass an additional test to be determined by the
medical facility and the medical school participating in the pilot
program. Preference shall be given to international medical
graduates who are residents of California, have experience working in
communities whose language is other than English and whose culture
is not from the dominant society, and have a proven level of literacy
in the foreign language of a medically underserved community.
(c) An international
medical graduate shall not be eligible for this program if he or she
has not graduated from a school in good standing that is recognized
by the Medical Board of California.
(d) Upon selection for the pilot program, participants may submit
an application to the International Medical Graduate Liaison of the
Medical Board of California's Division of Licensing, with the
appropriate fee, to initiate the medical licensing review process,
providing the participant time to remediate any deficiency during the
three-year international medical graduates pilot program.
(e) All program participants shall be required to have the foreign
language fluency and the cultural knowledge necessary to serve the
non-English-speaking community at the nonprofit community health
center where they practice.
(f) The Medical Board of California shall issue an applicant
status letter to participating and qualifying international medical
graduates.
(g) International medical graduates shall be required to
participate and satisfactorily complete a six-month orientation
program that will address medical protocol, community clinic history
and operations, medical administration, hospital operations and
protocol, medical ethics, the California medical delivery system,
health maintenance organizations and managed care practices, and
pharmacology differences. International medical graduates who have
passed the Educational Commission for Foreign Medical Graduates
(ECFMG) language exam shall not be required to be enrolled in English
language classes. However, if a participating international medical
graduate has not passed the ECFMG language exam, he or she shall be
enrolled in English language acquisition classes until he or she
obtains a level of English language proficiency equivalent to the
ECFMG language exam.
(h) (1) Upon satisfactorily completing the orientation program and
the one-year residency training program, international medical
graduates shall be selected by nonprofit community health centers to
work in nonprofit community health centers and disproportionate share
hospitals whose service areas include federally designated Health
Professional Shortage Areas, Dental Professional Shortage Areas,
Medically Underserved Areas, and Medically Underserved Populations
for a period not to exceed three years.
(2) There shall be two residency programs operated under the
auspices of a medical school in good standing, with one in southern
California and one in northern California. These residency programs
shall be in family practice, internal medicine, or obstetrics and
gynecology.
(3) After successfully completing the one-year residency program,
the training institution for the one-year residency program for
international medical graduates may transfer the program participant
into an approved residency program.
(i) (1) All program participants shall be required to satisfy the
medical curriculum requirements of Section 2089, the clinical
instruction requirements of Section 2089.5, and the examination
requirements of Section 2170 prior to being admitted into an approved
residency program.
(2) Those international medical graduates who are transferred into
an approved residency program shall be required to work in nonprofit
community health centers or disproportionate share hospitals whose
service areas include federally designated Health Professional
Shortage Areas, Dental Professional Shortage Areas, Medically
Underserved Areas, and Medically Underserved Populations for not less
than three years after being fully licensed.
(j) For individuals in this program as specified in this section,
the applicant status letter shall be deemed a license in good
standing pursuant to the provisions of this article for the purpose
of participation and reimbursement in all federal, state, and local
health programs, including managed care organizations and health
maintenance organizations.
(k) (1) The Director of General Medical Education or an equivalent
position in the training institution of the one-year residency
program for international medical graduates shall have the authority
to make a recommendation to the Medical Board of California for the
full medical licensure of an international medical graduate who has
successfully completed the one-year residency program if the director
believes, based on the performance and competency of international
medical graduate, that the international medical graduate should be
fully licensed.
(2) After reviewing the recommendation for full licensure from the
director, the Medical Board of California shall have the authority
to issue a permanent license to practice medicine in this state to
the international medical graduate.
(l) If an international medical graduate desires to secure a
permanent license to practice medicine from the board, he or she
shall, among other things, be required to be admitted into an
approved residency program.
(m) The Medical Board of California, in consultation with medical
schools located in California, executive and medical directors of
nonprofit community health centers, and with hospital administrators,
shall provide oversight review of the implementation of this
program. The Medical Board of California shall ensure that funding
proposals by appropriate institutions to implement these provisions
meet the necessary funding thresholds to fulfill the intent of this
program. Implementation of this program shall not proceed unless
appropriate funding is secured. The Medical Board of California
shall report to the Legislature every January the program is
operational regarding the status of the program and the ability of
the program to secure the funding necessary to carry out its required
provisions.
SEC. 6. The programs in Sections 853 and 855 of the Business and
Professions Code shall be implemented only if the necessary amount of
nonstate resources are obtained. General Fund moneys shall not be
used for these programs.