BILL ANALYSIS
SB 606
Page 1
Date of Hearing: July 7, 2009
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Mary Hayashi, Chair
SB 606 (Ducheny) - As Amended: June 18, 2009
SENATE VOTE : 34-1
SUBJECT : Physicians and surgeons: loan repayment.
SUMMARY : Requires the Osteopathic Medical Board of California
(OMBC) to charge a fee to osteopathic physicians and surgeons
(D.O.s) for the Steven M. Thompson Physician Corps Loan
Repayment Program (STLRP), and allows them to participate in the
STLRP. Specifically, this bill :
1)Requires the OMBC to charge $25 in addition to the license fee
for the STLRP.
2)Requires the OMBC to transfer all funds collected pursuant to
this bill, on a monthly basis, to the Medically Underserved
Account for Physicians (MUAP) for the STLRP, and prohibits the
funds collected in the MUAP from being used to fund the
Physician Volunteer Program (PVP).
3)Includes D.O.s in the Health Professions Education Foundation
(HPEF), which includes the STLRP and PVP.
EXISTING LAW :
1)Establishes the MUAP within the HPEF to provide funding for
the STLRP, which provides loan repayment assistance to
physicians and surgeons who agree to practice in a medically
underserved community.
2)Establishes the Osteopathic Act of 1922, by voter initiative,
to regulate the practice of osteopathic medicine. Establishes
the OMBC to license, regulate and discipline D.O.s. Specifies
that the policy of the state of California is that holders of
medical doctor (M.D.) degrees and D.O. degrees are to be
accorded equal professional status and privileges as licensed
physicians and surgeons.
3)Establishes a schedule of fees for D.O.s, including fees for
certificates and renewal of license. Requires the OMBC to
SB 606
Page 2
assess up to $400 for each applicant for an original or
reciprocity certificates, and up to $400 for a biennial
license fee.
4)Establishes the Medical Board of California (MBC) to license,
regulate, and discipline physicians and surgeons, and
specifies that the protection of the public is the highest
priority of the MBC.
5)Requires the MBC to assess a $25 licensure fee on physicians
and surgeons for the purpose of the STLRP.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author's office, "D.O.s
were originally excluded from the STLRP because the source of
funding originated with MDs, through the MBC. D.O.s are highly
interested in participating in the STPLRP and have offered to
contribute funding for the program. Because of the large
population of D.O.s who specialize in primary care practices,
osteopathic physicians and surgeons of California
disproportionately practice in rural and underserved areas.
Therefore, D.O.s eligibility in the STLRP will help to achieve
the purposes of the program."
Background .
Osteopathic Physicians and Surgeons . The Osteopathic Initiative
Act of 1922 created the OMBC to license and regulate the
practice of osteopathic medicine in California. Existing law
accords holders of medical degrees and osteopathic degrees equal
professional status and privileges. However, according to the
OPMC's website, D.O.s are slightly different from M.D.s in that
they put special emphasis on the role of the bones, muscles and
joints in the healthy functioning of the human body. D.O.s are
physicians who may be certified to specialize in family
medicine, obstetrics/gynecology, pediatrics, surgery, internal
medicine, and all other medical specialties and subspecialties.
Currently, there are over 5,000 D.O.s licensed and regulated by
the OMBC.
Steven M. Thompson Physician Corps Loan Repayment Program
(STLRP) . The STLRP is a grant program for licensed physicians
SB 606
Page 3
and surgeons that offers up to $105,000 to repay educational
debt in exchange for a three-year commitment to practice in a
medically underserved area (MUA) of the state.
According to the United States Health Resources and Services
Administration (HRSA), MUAs and medically underserved
populations are defined by their shortages of primary medical
care, dental or mental health providers. They may be designated
based on geographic (a county or service area) or demographic
(low income, Medicaid-eligible populations, cultural and/or
linguistic access barriers to primary medical care services)
criteria. According to HRSA, there are over 160 MUAs in 47
California counties.
According to information supplied by the author's office,
practice opportunities in underserved communities often provide
less compensation for new doctors than other areas of the state.
Unfortunately, financial considerations make it difficult for
young physicians repaying medical student loans to practice in
these areas. 25% of medical students have debt exceeding
$150,000, and many physicians finish their residency programs
with debt of over $350,000.
STLRP recipients work in a variety of underserved areas
throughout the state; eligible practice settings include
community health centers, migrant health centers, and public
housing centers. Current law requires that most participants be
selected from the specialty areas of family practice, internal
medicine, pediatrics, and obstetrics/gynecology, however, up to
20% of the participants may be selected from other specialties.
Recipients must also speak at least one Medi-Cal threshold
language, in addition to English.
Arguments in support . The California Medical Association (CMA)
writes, "The CMA is committed to addressing the crisis in
physician shortage with concrete, long-term solutions. The CMA
believes that SB 606 will be another tool that will be helpful
in addressing the physician shortage in our state."
REGISTERED SUPPORT / OPPOSITION :
Support
Association of California Healthcare Districts
California Medical Association
SB 606
Page 4
California Primary Care Association
Opposition
None on file.
Analysis Prepared by : Sarah Huchel / B. & P. / (916) 319-3301