BILL ANALYSIS Ó
-----------------------------------------------------------------
|SENATE RULES COMMITTEE | AB 1288|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
-----------------------------------------------------------------
THIRD READING
Bill No: AB 1288
Author: V. Manuel Pérez (D)
Amended: 6/6/13 in Senate
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMM. : 10-0, 6/17/13
AYES: Lieu, Emmerson, Block, Corbett, Galgiani, Hernandez,
Hill, Padilla, Wyland, Yee
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 67-4, 5/24/13 - See last page for vote
SUBJECT : Medical Board of California and Osteopathic Medical
Board of California: licensing: application
processing
SOURCE : California Medical Association
DIGEST : This bill requires the Medical Board of California
(MBC) and the Osteopathic Medical Board of California (OMBC) to
develop a priority review process for applicants for a
physician's and surgeon's certificate who demonstrate their
intent to practice in a medically underserved area (MUA) or
serve a medically underserved population (MUP), as specified.
ANALYSIS :
Existing law:
CONTINUED
AB 1288
Page
2
1. Licenses and regulates physicians and surgeons under the
Medical Practice Act (Medical Act) by the MBC within the
Department of Consumer Affairs (DCA) and states that the
protection of the public is the highest priority of the MBC
in exercising its functions.
2. Requires each applicant for a physician's and surgeon's
certificate to show by official transcript or other official
evidence satisfactory to the Division of Licensing that
he/she has successfully completed a specified medical
curriculum.
3. Licenses and regulates osteopathic physicians and surgeons
under the Osteopathic Act by the OMBC within DCA and states
that the protection of the public is the highest priority of
the OMBC in exercising its functions.
4. Establishes a 15-member California Healthcare Workforce
Policy Commission (Commission) and requires the Commission
to, among other things, identify specific areas of the state
where unmet priority needs for primary care family physicians
and registered nurses exist.
5. Defines (a) "medically underserved area" to mean an area
defined as a health professional shortage area under
specified federal regulations or an area of the state where
unmet priority needs for physicians exist as determined by
the Commission; and (b) "medically underserved population" to
mean those served by the Medi-Cal program, the Healthy
Families Program and uninsured populations.
6. Requires the Commission to prioritize areas of the state that
are deficient in primary care services and the degree to
which these areas are underserved. Requires a study to be
updated biennially and be the basis for notifying loan
recipients of areas which will satisfy the loan repayment
provisions of the Physician and Surgeon Incentive Pilot
Program, as specified.
7. Requires the Commission, in coordination with the Rural
Health Section of the Department of Health Care Services, to
designate rural areas with unmet priority needs for medical
services.
CONTINUED
AB 1288
Page
3
This bill:
1. Requires the MBC and the OMBC to each develop a process to
give priority review status to the application for a
physician and surgeon's certificate or an osteopathic
physician and surgeon's certificate from an applicant who can
demonstrate that he/she intends to practice in an MUA or
serve an MUP, as defined.
2. Authorizes an applicant to demonstrate the intent to practice
in an MUA area or serve an MUP by providing proper
documentation including, but not limited to, a letter from an
employer indicating that the applicant has accepted
employment and specifying the start date.
Background
MUAs and MUPs . An MUA is defined as a healthcare shortage area
as specified in federal regulations or an area of the state
where unmet needs for physicians exist as determined by the
Commission under the Office of Statewide Health Planning and
Development (OSHPD). The Commission reviews and designates
priority geographic areas in California to address the unequal
distribution of healthcare services where unmet medical needs
persist.
The bill's sponsor states that, "Rural counties suffer in
particular from low physician practice rates and from a
diminishing supply of primary care physicians. In general,
rural counties tend to have far fewer physicians per capita than
urban counties, with the Central Valley and the Inland Empire
experiencing a particularly low supply of physicians."
Among the areas that are designated as MUAs are Modoc County and
portions of Trinity, Inyo, Riverside, Shasta, Del Note, Tulare
and Kings Counties. MUPs are areas where persons are served by
the Medi-Cal or Healthy Families programs, or where there is an
uninsured population. Examples of areas that are designated by
OSHPD as MUPs are Mendocino County and portions of Lassen,
Tulare, Plumas and Riverside counties.
Comments
The author states, "The purpose of this bill is to ensure that
CONTINUED
AB 1288
Page
4
applicants who intend on serving in an underserved area or serve
an underserved population are licensed in a timely manner.
Although the [MBC] currently does not have a backlog processing
license applications, there have instances where the [MBC] was
backlogged due to budget actions and an influx of applications."
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 7/1/13)
California Medical Association (source)
Association of California Healthcare Districts
California Optometric Association
ARGUMENTS IN SUPPORT : The bill's sponsor, the California
Medical Association (CMA), states, "The problem of primary care
physician shortages is a complex one, and California needs to
implement a multi-faceted approach to reach a solution. AB 1288
will require the Medical Board of California to develop a
process to give priority review status to the application of an
applicant who can demonstrate that he or she intends to practice
in a medically underserved area or serve a medically underserved
population. AB 1288 will not change the vigorous standards of
the Medical Practice Act but will instead focus the Board's
resources on the areas and populations with the greatest need."
The CMA cites the New England Journal of Medicine, stating that
"California communities with high concentrations of low income
and minority residents are especially likely to have physician
shortages. Without decisive action, the future erosion of the
supply of primary care physicians will likely disproportionately
impact these already disadvantaged communities."
The California Optometric Association (COA) states that there
are currently over 517 designated Health Professional Shortage
Areas with over 5.5 million people in California. The COA
"believes a multipronged approach is needed to address the
provider gap that is only expected to get worse when millions
more individuals are expected to obtain health coverage in 2014
and beyond." COA argues this bill "will expand access to health
care in medically underserved areas, and bring providers into
these communities in an expeditious manner."
The Association of California Healthcare Districts (ACHD)
CONTINUED
AB 1288
Page
5
supports long-term solutions to increase the access of
healthcare within all areas of the state, and states that in
many parts of California, Healthcare Districts are the "sole
provider of health care services in their communities." The
ACHD indicates that many Healthcare Districts located in rural
areas have a difficult time attracting physicians, and that by
increasing the ease of the application process, this bill
enables Healthcare Districts to offer their communities
increased access to care. The ACHD further believes that by
streamlining the licensing application process, this bill
creates a pathway to bring qualified physicians and surgeons to
areas that are challenged in recruiting physicians.
ASSEMBLY FLOOR : 67-4, 5/24/13
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,
Blumenfield, Bocanegra, Bonilla, Bradford, Brown, Buchanan,
Ian Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,
Dahle, Daly, Dickinson, Fong, Fox, Frazier, Garcia, Gatto,
Gomez, Gordon, Gorell, Gray, Hagman, Hall, Harkey, Roger
Hernández, Jones-Sawyer, Levine, Linder, Lowenthal,
Maienschein, Mansoor, Medina, Melendez, Mitchell, Morrell,
Mullin, Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson,
Perea, V. Manuel Pérez, Quirk, Quirk-Silva, Rendon, Salas,
Stone, Ting, Wagner, Weber, Wieckowski, Williams, Yamada, John
A. Pérez
NOES: Donnelly, Beth Gaines, Jones, Logue
NO VOTE RECORDED: Bonta, Eggman, Grove, Holden, Skinner,
Waldron, Wilk, Vacancy, Vacancy
MW:k 7/1/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****
CONTINUED