Amended in Assembly April 10, 2013

California Legislature—2013–14 Regular Session

Assembly BillNo. 565


Introduced by Assembly Member Salas

February 20, 2013


An act to amendbegin delete Section 128553end deletebegin insert Sections 128552 and 128553end insert of the Health and Safety Code, relating to physicians and surgeons.

LEGISLATIVE COUNSEL’S DIGEST

AB 565, as amended, Salas. California Physician Corps Program.

Existing law establishes the Steven M. Thompson Physician Corps Loan Repayment Program in the California Physician Corps Program within the Health Professions Education Foundation, which provides financial incentives, as specified, to a physician and surgeon for practicing in a medically underserved community. Existing law authorizes the Office of Statewide Health Planning and Development to adopt guidelines by regulation and requires the foundation to use guidelines for selection and placement of program applicants. These guidelines provide priority consideration to applicants who meet specified criteria, including that the applicant has 3 years of experience working in medically underserved areas or with medically underserved populations. The guidelines also must seek to place the most qualified applicants in the areas with the greatest need.

This bill wouldbegin insert delete the requirement that the guidelines seek to place the most qualified applicants in the areas of greatest need. The bill wouldend insert require the guidelines for the selection and placement of program applicants to include criteria that would give priority consideration to program applicants who have 3 years of experience providing health care services to medically underserved populations in a federally designated health professional shortage area or medically underserved area, andbegin insert to applicantsend insert who agree to practice in those areas and serve a medically underserved population.

begin insert

Existing law defines “practice setting,” for these purposes, to include a community clinic, as defined, a clinic owned and operated by a public hospital and health system, or a clinic owned and operated by a hospital that maintains the primary contract with a county government to fulfill the county’s role to serve its indigent population and that is located in a medically underserved area and has at least 50% of its patients from that population.

end insert
begin insert

This bill would include a private practice that provides primary care located in a medically underserved area and has a minimum of 30% uninsured, Medi-Cal, or other publicly funded program that serves patients who earn less than 250% of the federal poverty level, within this definition of “practice setting.”

end insert

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1begin insert

begin insertSECTION 1.end insert  

end insert

begin insertSection 128552 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
2amended to read:end insert

3

128552.  

For purposes of this article, the following definitions
4shall apply:

5(a) “Account” means the Medically Underserved Account for
6Physicians established within the Health Professions Education
7Fund pursuant to this article.

8(b) “Foundation” means the Health Professions Education
9Foundation.

10(c) “Fund” means the Health Professions Education Fund.

11(d) “Medi-Cal threshold languages” means primary languages
12spoken by limited-English-proficient (LEP) population groups
13meeting a numeric threshold of 3,000, eligible LEP Medi-Cal
14beneficiaries residing in a county, 1,000 Medi-Cal eligible LEP
15beneficiaries residing in a single ZIP Code, or 1,500 LEP Medi-Cal
16beneficiaries residing in two contiguous ZIP Codes.

17(e) “Medically underserved area” means an area defined as a
18health professional shortage area in Part 5 of Subchapter A of
19Chapter 1 of Title 42 of the Code of Federal Regulations or an
20area of the state where unmet priority needs for physicians exist
P3    1as determined by the California Healthcare Workforce Policy
2Commission pursuant to Section 128225.

3(f) “Medically underserved population” means the Medi-Cal
4program, Healthy Families Program, and uninsured populations.

5(g) “Office” means the Office of Statewide Health Planning and
6Development (OSHPD).

7(h) “Physician Volunteer Program” means the Physician
8 Volunteer Registry Program established by the Medical Board of
9California.

10(i) “Practice setting” means either of the following:

11(1) A community clinic as defined in subdivision (a) of Section
121204 and subdivision (c) of Section 1206, a clinic owned or
13operated by a public hospital and health system,begin delete orend delete a clinic owned
14and operated by a hospital that maintains the primary contract with
15a county government to fulfill the county’s role pursuant to Section
1617000 of the Welfare and Institutions Code, which is located in a
17medically underserved area and at least 50 percent of whose
18patients are from a medically underserved populationbegin insert, or a private
19practice that provides primary care located in a medically
20underserved area and has a minimum of 30 percent uninsured,
21Medi-Cal, or other publicly funded program that serves patients
22who earn less than 250 percent of the federal poverty levelend insert
.

23(2) A medical practice located in a medically underserved area
24and at least 50 percent of whose patients are from a medically
25underserved population.

26(j) “Primary specialty” means family practice, internal medicine,
27pediatrics, or obstetrics/gynecology.

28(k) “Program” means the Steven M. Thompson Physician Corps
29Loan Repayment Program.

30(l) “Selection committee” means a minimum three-member
31committee of the board, that includes a member that was appointed
32by the Medical Board of California.

33

begin deleteSECTION 1.end delete
34begin insertSEC. 2.end insert  

Section 128553 of the Health and Safety Code is
35amended to read:

36

128553.  

(a) Program applicants shall possess a current valid
37license to practice medicine in this state issued pursuant to Section
382050 of the Business and Professions Code or pursuant to the
39Osteopathic Act.

P4    1(b) The foundation, in consultation with those identified in
2subdivision (b) of Section 123551, shall use guidelines developed
3by the Medical Board of California for selection and placement
4of applicants until the office adopts other guidelines by regulation.
5The foundation shall interpret the guidelines to apply to both
6osteopathic and allopathic physicians and surgeons.

7(c) The guidelines shall meet all of the following criteria:

8(1) Provide priority consideration to applicants that are best
9suited to meet the cultural and linguistic needs and demands of
10patients from medically underserved populations and who meet
11one or more of the following criteria:

12(A) Speak a Medi-Cal threshold language.

13(B) Come from an economically disadvantaged background.

14(C) Have received significant training in cultural and
15linguistically appropriate service delivery.

16(D) Have three years of experience providing health care
17services to medically underserved populations in a federally
18designated health professional shortage area or medically
19underserved area.

20(E) Have recently obtained a license to practice medicine.

21(2) Include a process for determining the needs for physician
22services identified by the practice setting and for ensuring that the
23practice setting meets the definition specified in subdivision (h)
24of Section 128552.

25(3) Give preference to applicants who have completed a
26three-year residency in a primary specialty.

27(4) Give preference to applicants who agree to practice in a
28federally designated health professional shortage area or medically
29underserved area, and who agree to serve a medically underserved
30population.

31(5) Include a factor ensuring geographic distribution of
32placements.

33(6) Provide priority consideration to applicants who agree to
34practice in a geriatric care setting and are trained in geriatrics, and
35who can meet the cultural and linguistic needs and demands of a
36diverse population of older Californians. On and after January 1,
372009, up to 15 percent of the funds collected pursuant to Section
382436.5 of the Business and Professions Code shall be dedicated
39to loan assistance for physicians and surgeons who agree to practice
P5    1in geriatric care settings or settings that primarily serve adults over
2the age of 65 years or adults with disabilities.

3(d) (1) The foundation may appoint a selection committee that
4provides policy direction and guidance over the program and that
5complies with the requirements of subdivision (l) of Section
6128552.

7(2) The selection committee may fill up to 20 percent of the
8available positions with program applicants from specialties outside
9of the primary care specialties.

10(e) Program participants shall meet all of the following
11requirements:

12(1) Shall be working in or have a signed agreement with an
13eligible practice setting.

14(2) Shall have full-time status at the practice setting. Full-time
15status shall be defined by the board and the selection committee
16may establish exemptions from this requirement on a case-by-case
17basis.

18(3) Shall commit to a minimum of three years of service in a
19medically underserved area. Leaves of absence shall be permitted
20for serious illness, pregnancy, or other natural causes. The selection
21committee shall develop the process for determining the maximum
22permissible length of an absence and the process for reinstatement.
23Loan repayment shall be deferred until the physician is back to
24full-time status.

25(f) The office shall adopt a process that applies if a physician
26is unable to complete his or her three-year obligation.

27(g) The foundation, in consultation with those identified in
28subdivision (b) of Section 128551, shall develop a process for
29outreach to potentially eligible applicants.

30(h) The foundation may recommend to the office any other
31standards of eligibility, placement, and termination appropriate to
32achieve the aim of providing competent health care services in
33approved practice settings.



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