BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 27
                                                                  Page  1

          Date of Hearing:   March 19, 2013

                       ASSEMBLY COMMITTEE ON HIGHER EDUCATION
                                 Das Williams, Chair
                     AB 27 (Medina) - As Amended:  March 13, 2013
           
          SUBJECT  :   University of California: UC Riverside Medical  
          School: funding.

           SUMMARY  :   Appropriates $15 million annually from the General  
          Fund (GF) to the Regents of the University of California for  
          allocation to the School of Medicine at the University of  
          California, Riverside (UCR).  

           FISCAL EFFECT  :   Annual appropriation of $15 million (GF).

           COMMENTS  :    Background  .  The foundation of the School of  
          Medicine at UCR dates to 1974, when the UCR/UCLA Thomas Haider  
          Program in Biomedical Sciences was established.  This program  
          has enabled approximately 700 students to complete their first  
          two years of medical school at UCR and their last two years at  
          the David Geffen School of Medicine at UCLA, which confers their  
          medical degrees.  

           Timeline of events  .  In May 2006, UCR proposed to establish an  
          independent four-year School of Medicine that would serve the  
          medically underserved in the Inland Empire.  In July 2008, the  
          UC Board of Regents officially approved establishment of a  
          School of Medicine at UCR, which paved the road for the state's  
          first new public medical school in more than four decades.  In  
          the summer of 2011, UCR failed to gain accreditation for an  
          independent four-year medical school from the Liaison Committee  
          on Medical Education (LCME), the national accrediting body for  
          educational programs leading to the Medical Doctor degree in the  
          United States and Canadian medical schools.  LCME withheld  
          preliminary accreditation due to a lack of recurring state  
          funding support for the school. 

          In April 2012, after securing substantial new funding from a  
          variety of non-state funding sources, UCR submitted a second  
          accreditation application.  In June 2012, a second accreditation  
          site visit took place and in October 2012, UCR received  
          notification that its planned medical school received  
          "preliminary accreditation."  Preliminary accreditation from  
          LCME enables prospective students to begin applying to the UCR  








                                                                  AB 27
                                                                  Page  2

          School of Medicine in order to potentially enroll in the  
          inaugural class in August 2013.

           Purpose of this bill  .  According to the author "Studies show  
          that the highest indicator of where a physician practices is  
          where he or she attends medical school. The region [Inland  
          Empire] trails behind much of the state in several key health  
          indicators, including coronary heart disease and diabetes."  The  
          establishment of a medical school in the Inland Empire will help  
          to ensure more physicians are trained and remain in the Inland  
          Empire.  The author contends that one of the areas that will aid  
          in the UCR School of Medicine receiving final accreditation from  
          LCME and meeting the medical needs of the Inland Empire is for  
          the School to receive a steady funding source; this bill seeks  
          to fulfill that need. 

           Need for the bill  . According the Public Policy Institute of  
          California, the Inland Empire is the fastest-growing region of  
          the state.  The Inland Empire of Riverside and San Bernardino  
          Counties has a population larger than the state of Oregon.  With  
          the expectation of the Affordable Care Act to be fully  
          implemented in 2014, it is estimated that more than 300,000  
          residents of the Inland Empire will have health insurance  
          coverage extended to them.  However, the coverage does not  
          necessarily translate into care.  

          The Association of American Medical Colleges estimates that in  
          2015 the country will have 62,900 fewer doctors than needed;  
          that number will more than double by 2025 as the expansion of  
          insurance coverage and the aging of the baby boomers drive up  
          the demand for care.  In the Inland Empire, the shortage of  
          doctors is already severe. The U.S. Department of Health and  
          Human Services' Council on Graduate Medical Education recommends  
          that a given region have 60 to 80 primary care physicians per  
          100,000 residents and 85 to 105 specialists.  The Inland Empire  
          has about 40 primary care doctors and 70 specialists per 100,000  
          residents - the worst shortage in California, in both cases.

          The UCR School of Medicine plans to enroll its first students in  
          August 2013, and is planning a number of policies to encourage  
          its graduates to remain in the Inland Empire and practice  
          primary care medicine.   

           Urgency clause  .  The author intends to request the committee to  
          adopt an urgency clause.








                                                                 AB 27
                                                                  Page  3

           
          Related legislation  .  SB 21 (Roth), pending in the Senate  
          Education Committee, is identical to this bill.

          Several budget bills in the last few years initially contained  
          funding for the UCR School of Medicine but failed to secure  
          passage.  Most recently, AB 1309 (Miller, 2012) would have  
          appropriated $15 million of an expected settlement to the UC for  
          the UCR School of Medicine. This measure was held on the  
          Suspense File in the Senate Appropriations Committee.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Department of Insurance
          California Medical Association
          City of Riverside
          Enterprise Media
          Riverside County Superintendent of Schools, Kenneth M. Young
          Southwest California Legislative Council
          University of California at Riverside
          UCR Alumni Association
          UCR Board of Trustees
          Two Individuals 

           Opposition 
           
          None on file.
           

          Analysis Prepared by  :    Jeanice Warden / HIGHER ED. / (916)  
          319-3960