BILL NUMBER: AB 565 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 10, 2013
INTRODUCED BY Assembly Member Salas
FEBRUARY 20, 2013
An act to amend Section 128553 Sections
128552 and 128553 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 would delete the requirement that the guidelines
seek to place the most qualified applicants in the areas of greatest
need. The bill would 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, and to applicants who
agree to practice in those areas and serve a medically underserved
population.
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.
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."
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 128552 of the Health
and Safety Code is amended to read:
128552. For purposes of this article, the following definitions
shall apply:
(a) "Account" means the Medically Underserved Account for
Physicians established within the Health Professions Education Fund
pursuant to this article.
(b) "Foundation" means the Health Professions Education
Foundation.
(c) "Fund" means the Health Professions Education Fund.
(d) "Medi-Cal threshold languages" means primary languages spoken
by limited-English-proficient (LEP) population groups meeting a
numeric threshold of 3,000, eligible LEP Medi-Cal beneficiaries
residing in a county, 1,000 Medi-Cal eligible LEP beneficiaries
residing in a single ZIP Code, or 1,500 LEP Medi-Cal beneficiaries
residing in two contiguous ZIP Codes.
(e) "Medically underserved area" means an area defined as a health
professional shortage area in Part 5 of Subchapter A of Chapter 1 of
Title 42 of the Code of Federal Regulations or an area of the state
where unmet priority needs for physicians exist as determined by the
California Healthcare Workforce Policy Commission pursuant to Section
128225.
(f) "Medically underserved population" means the Medi-Cal program,
Healthy Families Program, and uninsured populations.
(g) "Office" means the Office of Statewide Health Planning and
Development (OSHPD).
(h) "Physician Volunteer Program" means the Physician Volunteer
Registry Program established by the Medical Board of California.
(i) "Practice setting" means either of the following:
(1) A community clinic as defined in subdivision (a) of Section
1204 and subdivision (c) of Section 1206, a clinic owned or 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
pursuant to Section 17000 of the Welfare and Institutions Code, which
is located in a medically underserved area and at least 50 percent
of whose patients are from a medically underserved population ,
or a private practice that provides primary care located in a
medically underserved area and has a minimum of 30 percent
uninsured, Medi-Cal, or other publicly funded program that serves
patients who earn less than 250 percent of the federal poverty level
.
(2) A medical practice located in a medically underserved area and
at least 50 percent of whose patients are from a medically
underserved population.
(j) "Primary specialty" means family practice, internal medicine,
pediatrics, or obstetrics/gynecology.
(k) "Program" means the Steven M. Thompson Physician Corps Loan
Repayment Program.
(l) "Selection committee" means a minimum three-member committee
of the board, that includes a member that was appointed by the
Medical Board of California.
SECTION 1. SEC. 2. Section 128553 of
the Health and Safety Code is amended to read:
128553. (a) Program applicants shall possess a current valid
license to practice medicine in this state issued pursuant to Section
2050 of the Business and Professions Code or pursuant to the
Osteopathic Act.
(b) The foundation, in consultation with those identified in
subdivision (b) of Section 123551, shall use guidelines developed by
the Medical Board of California for selection and placement of
applicants until the office adopts other guidelines by regulation.
The foundation shall interpret the guidelines to apply to both
osteopathic and allopathic physicians and surgeons.
(c) The guidelines shall meet all of the following criteria:
(1) Provide priority consideration to applicants that are best
suited to meet the cultural and linguistic needs and demands of
patients from medically underserved populations and who meet one or
more of the following criteria:
(A) Speak a Medi-Cal threshold language.
(B) Come from an economically disadvantaged background.
(C) Have received significant training in cultural and
linguistically appropriate service delivery.
(D) Have three years of experience providing health care services
to medically underserved populations in a federally designated health
professional shortage area or medically underserved area.
(E) Have recently obtained a license to practice medicine.
(2) Include a process for determining the needs for physician
services identified by the practice setting and for ensuring that the
practice setting meets the definition specified in subdivision (h)
of Section 128552.
(3) Give preference to applicants who have completed a three-year
residency in a primary specialty.
(4) Give preference to applicants who agree to practice in a
federally designated health professional shortage area or medically
underserved area, and who agree to serve a medically underserved
population.
(5) Include a factor ensuring geographic distribution of
placements.
(6) Provide priority consideration to applicants who agree to
practice in a geriatric care setting and are trained in geriatrics,
and who can meet the cultural and linguistic needs and demands of a
diverse population of older Californians. On and after January 1,
2009, up to 15 percent of the funds collected pursuant to Section
2436.5 of the Business and Professions Code shall be dedicated to
loan assistance for physicians and surgeons who agree to practice in
geriatric care settings or settings that primarily serve adults over
the age of 65 years or adults with disabilities.
(d) (1) The foundation may appoint a selection committee that
provides policy direction and guidance over the program and that
complies with the requirements of subdivision (l) of Section 128552.
(2) The selection committee may fill up to 20 percent of the
available positions with program applicants from specialties outside
of the primary care specialties.
(e) Program participants shall meet all of the following
requirements:
(1) Shall be working in or have a signed agreement with an
eligible practice setting.
(2) Shall have full-time status at the practice setting. Full-time
status shall be defined by the board and the selection committee may
establish exemptions from this requirement on a case-by-case basis.
(3) Shall commit to a minimum of three years of service in a
medically underserved area. Leaves of absence shall be permitted for
serious illness, pregnancy, or other natural causes. The selection
committee shall develop the process for determining the maximum
permissible length of an absence and the process for reinstatement.
Loan repayment shall be deferred until the physician is back to
full-time status.
(f) The office shall adopt a process that applies if a physician
is unable to complete his or her three-year obligation.
(g) The foundation, in consultation with those identified in
subdivision (b) of Section 128551, shall develop a process for
outreach to potentially eligible applicants.
(h) The foundation may recommend to the office any other standards
of eligibility, placement, and termination appropriate to achieve
the aim of providing competent health care services in approved
practice settings.