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