BILL ANALYSIS Ó
AB 1288
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CONCURRENCE IN SENATE AMENDMENTS
AB 1288 (V. Manuel Pérez)
As Amended June 6, 2013
Majority vote
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|ASSEMBLY: |67-4 |(May 24, 2013) |SENATE: |32-0 |(July 8, 2013) |
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Original Committee Reference: B.,P. & C.P.
SUMMARY : Requires the Medical Board of California (Board) to
develop a priority review process for applicants for a physician
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.
Specifically, this bill :
1)Requires the Board to develop a process to give priority
review status to the application of an applicant for a
physician and surgeon's certificate who can demonstrate that
he or she intends to practice in a MUA or serve a MUP, as
defined.
2)Allows an applicant to demonstrate his or her intent to
practice in a MUA or serve a 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.
The Senate amendments require the Osteopathic Medical Board of
California to develop a process to give priority review status
to the application of an applicant for an osteopathic physician
and surgeon's certificate who can demonstrate that he or she
intends to practice in a MUA or serve a MUP, as defined, and
allow an applicant to demonstrate his or her intent to practice
in a MUA or serve a 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.
EXISTING LAW :
1)Establishes specified penalty provisions for any person who
practices or attempts to practice, or who advertises or holds
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himself or herself out as practicing any system or mode of
treating the sick or afflicted in this state or who diagnoses,
treats, operates for or prescribes for any ailment, blemish,
deformity, disease, disfigurement, disorder, injury or other
physical or mental condition of any person without having at
the time of doing a valid, unrevoked, or unsuspended
certificate, as specified. (Business and Professions Code
(BPC) Section 2052)
2)Requires each applicant for a physician's or surgeon's
certificate to show by official transcript or other official
evidence satisfactory to the Division of Licensing that he or
she has successfully completed a specified medical curriculum.
(BPC Section 2089)
3)Defines medically underserved population to mean "the persons
served by the Medi-Cal program, the Healthy Families Program
and uninsured populations." (Health and Safety Code (HSC)
Section 128585)
4)Defines medically underserved area "as an area defined as a
health professional shortage area as specified in 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
(Commission)." (HSC Section 128585)
5)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.
(BPC Section 2213)
6)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. (HSC Section 124765)
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS :
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1)Purpose of the bill . This bill aims to increase the number of
newly certified physicians and surgeons practicing in MUAs or
serving a MUP by requiring the Board to develop a priority
review process for applicants for a physician's and surgeon's
certificate for licensure that demonstrate an intent to do so.
This bill is sponsored by the California Medical Association.
2)Author's statement . According to the author, "The purpose of
this bill is to ensure that applicants who intend [to serve]
in an underserved area or an underserved population are
licensed in a timely manner. Although the Board currently
does not have a backlog processing license applications, there
have [been] instances where the Board was backlogged due to
budget actions and an influx of applications."
3)Licensing application process . The Board's initial review
process for license applications must be completed within 60
business days. According to the Board's Web site, the entire
process can be lengthy and individuals are encouraged to start
the application process at least six to nine months before
they intend to practice.
Once an application is reviewed, the applicant is notified in
writing of the application status and given an itemized list
of documents needed to complete the file. The missing
documents requested by the Board are reviewed in order of
receipt. Only about 10% of applications are found to be
complete at the initial review. The additional documents
required for a physician and surgeon certificate often must be
sent directly from hospitals or other entities, which may help
explain the high level of incompletion and the long delays.
If a file is complete upon initial review, the license will be
issued within seven to 10 days, as the Board issues licenses
twice a week. Currently, the Board completes an initial
review of applications within 45 calendar days, well under the
Board's mandated 60 business days. The Board does not request
any information regarding where an applicant plans to work
once licensed.
During fiscal year 2011-12, the Board received 6,623
applications and granted 5,351 licenses. Although the Board
is not currently experiencing a licensing backlog, this bill
will still require the Board to establish a priority review
process in order to streamline the application process for
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those physician and surgeon applicants who can demonstrate
their commitment in writing to working in MUAs or serving
MUPs.
4)Medically underserved areas and populations . MUAs are 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 where unmet medical needs persist.
According to the sponsor, "[r]ural 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 Norte,
Tulare and Kings Counties.
MUPs are areas where persons are served by the Medi-Cal or
Healthy Families programs, or where there is a large uninsured
population. Examples of areas that are designated by OSHPD as
MUPs are Mendocino County and portions of Lassen, Tulare,
Plumas and Riverside Counties.
5)Current programs to address physician shortages . Currently,
there are multiple programs designed to increase the number of
healthcare practitioners working in MUAs or serving MUPs. The
Health Professions Education Foundation under OSHPD provides
scholarships and loan repayments to aspiring and practicing
health professionals who agree to practice in a MUA.
Analysis Prepared by : Elissa Silva / B., P. & C.P. / (916)
319-3301
FN:
0001505
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