BILL ANALYSIS Ó AB 27 Page 1 ASSEMBLY THIRD READING AB 27 (Medina) As Amended May 24, 2013 2/3 vote. Urgency HIGHER EDUCATION 12-0 APPROPRIATIONS 16-1 ----------------------------------------------------------------- |Ayes:|Williams, Chávez, Bloom, |Ayes:|Gatto, Harkey, Bocanegra, | | |Fox, Jones-Sawyer, | |Bradford, Ian Calderon, | | |Levine, Linder, Medina, | |Campos, Donnelly, Eggman, | | |Hagman, Quirk-Silva, | |Gomez, Hall, Ammiano, | | |Weber, Wilk | |Linder, Pan, Quirk, | | | | |Wagner, Weber | |-----+--------------------------+-----+--------------------------| | | |Nays:|Bigelow | | | | | | ----------------------------------------------------------------- SUMMARY : Appropriates $15 million annually from the General Fund (GF) to the Regents of the University of California (UC) for allocation to the School of Medicine at the University of California, Riverside (UCR); places expenditure control methods on the funds for the sole purpose of being used for the School of Medicine at UCR; and, adds reporting requirements, as specified. Specifically, this bill : 1)Specifies that the UC Regents shall use the money appropriated by this act for the sole purpose of funding the School of Medicine at UCR and that it cannot be used to supplant other funding of the Regents for the School of Medicine at UCR. 2)Specifies that funds provided shall be available for planning and startup costs associated with academic programs to be offered by the School of Medicine at UCR, including all of the following: a) Academic planning activities, support of academic program offerings, and faculty recruitment; b) Acquisition of instructional materials and equipment; and, c) Ongoing operating support for faculty, staff, and other annual operating expenses for the School of Medicine at UCR. 3)Specifies the School of Medicine at UCR shall develop a program, AB 27 Page 2 consistent with its mission, in conjunction with the health facilities of its medical residency programs, to identify eligible medical residents and to assist those medical residents apply for physician retention programs, including, but not limited to, the Steven M. Thompson Physician Corps Loan Repayment Program. 4)Requires, on or before April 1 of each year, that the UC shall provide progress reports to the relevant policy and fiscal committees of the Legislature pertaining to funding, recruitment, hiring, and outcomes for the School of Medicine at UCR and specifies that the report shall include, but not be limited to, information consistent with the published mission and vision for the School of Medicine at UCR in the following areas: a) The number of students who have applied, been admitted, or been enrolled, broken out by race, ethnicity, and gender; b) The number of full-time faculty, part-time faculty, and administration, broken out by race, ethnicity, and gender; c) Funding and progress of ongoing medical education pipeline programs, including the UCR/UCLA Thomas Haider Program in Biomedical Sciences; d) Operating and capital budgets, including detail by fund source, and an explanation of how such funding affects base funding for other university purposes. The operating budget shall include a breakdown of research activities, instruction costs, administration, and executive management; e) Efforts to meet the health care delivery needs of California and the Inland Empire of the state, including, but not limited to, the percentage of clinical placements, graduate medical education slots, and medical school graduates in primary care specialties who are providing service within California's medically underserved areas and populations; and, f) A description of faculty research activities, including information regarding the diversity of doctoral candidates, and identifying activities that focus on high priority research needs with respect to addressing California's medically underserved areas and populations. 5)Lists a variety of legislative findings and declarations. AB 27 Page 3 FISCAL EFFECT : According to the Assembly Appropriations Committee, costs for this measure would be an annual $15 million GF appropriation for the medical school, which would become part of UC's base budget. COMMENTS : This measure has an urgency clause allowing the bill to take effect immediately upon enactment. 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 School of Medicine in order to potentially enroll in the inaugural class in August 2013. 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 AB 27 Page 4 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. 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 have 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. According to the California State Office of Statewide Health Planning and Development, the Steven M. Thompson Physician Corps Loan Repayment Program encourages recently licensed physicians to practice in Health Professional Shortage Areas in California. The program authorizes a plan for repaying up to $105,000 in educational loans in exchange for full-time service for a minimum of three years. 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. Related legislation: SB 21 (Roth), pending in the Senate, is identical to this bill. Several budget bills in the last few years initially contained AB 27 Page 5 funding for the UCR School of Medicine but failed to secure passage. Most recently, AB 1309 (Miller) of 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. Analysis Prepared by : Jeanice Warden / HIGHER ED. / (916) 319-3960 FN: 0000869