BILL ANALYSIS Ó
SENATE COMMITTEE ON EDUCATION
Carol Liu, Chair
2013-2014 Regular Session
BILL NO: SB 841
AUTHOR: Cannella
INTRODUCED: January 7, 2014
FISCAL COMM: Yes HEARING DATE: March 19, 2014
URGENCY: No CONSULTANT: Daniel Alvarez
SUBJECT : University of California: medical education.
SUMMARY
This bill appropriates from the State General Fund to
Regents of the University of California (1) $1.86 million,
commencing with the 2015-16 fiscal year to support the
expansion of the San Joaquin Valley PRIME program; and (2)
$1 million during the 2014-15 fiscal year to support a
two-year planning effort geared toward the establishment of
a separate traditional medical school at the UC Merced
campus.
BACKGROUND
UC operates six Schools of Medicine (at Davis, Irvine, Los
Angeles, Riverside, San Diego, and San Francisco). In
2012-13, total enrollment in these programs was
approximately 3,000 medical students (roughly two-thirds of
the State's total) and more than 4,000 medical residents
and fellows (nearly half in the State).
Programs in Medical Education (PRIME). UC PRIME is an
innovative training program focused on meeting the needs of
California's underserved populations in both rural
communities and urban areas by combining specialized
coursework, structured clinical experiences, advanced
independent study and mentoring. These activities are
organized and structured to prepare highly motivated,
socially conscious students as future clinicians, leaders
and policymakers. Each new program has an area of focus
that is selected based upon faculty expertise, the
populations served by each school and its medical center,
and other local considerations. Each continues to develop
and improve its guidelines for admission and recruitment of
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students and its new curriculum designed to educate and
train future physician leaders, researchers and advocates
for the communities they will serve.
ANALYSIS
This bill appropriates from the State General Fund to
Regents of the University of California (1) $1.86 million,
commencing with the 2015-16 fiscal year to support the
expansion of the San Joaquin Valley PRIME program; and (2)
$1 million during the 2014-15 fiscal year to support a
two-year planning effort geared toward the establishment of
a separate traditional medical school at the UC Merced
campus. More specifically, this bill:
1) Makes findings and declarations in support of the
proposed appropriations.
2) Appropriates $1.855 million from the General Fund to
the UC Regents each fiscal year, commencing in 2015-16
for allocation to support expansion of the San Joaquin
Valley PRIME program to admit up to 12 students per
year and operate the program with up to 48 student
participants over the four-year curriculum annually.
3) Appropriates $1 million General Fund for allocation to
support a two-year planning effort geared toward the
establishment of a separate traditional medical school
at UC Merced.
4) Requires the medical school planning effort to include
determination of the necessary program components such
as basic and clinical science courses, curriculum,
capital needs, one-time and ongoing operational
funding, student support services, and other necessary
components.
5) Requires the UC to report to the appropriate policy
and fiscal committees of the Legislature by March 1,
2016, summarizing its medical school planning efforts
and providing recommendations and estimates for the
infrastructure, personnel, and funding, and time
necessary to establish and maintain such a program.
STAFF COMMENTS
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1) According to the author , California faces a shortage
in the number of physicians available to serve its
residents, and the San Joaquin Valley (SJV) is
disproportionately affected by this shortage, access
to health care in the SJV which extends from Stockton
to Bakersfield is already 31 percent lower than in the
rest of California. The state's physician shortage
trends will be exacerbated when the federal Affordable
Care Act expands health insurance coverage in 2014.
2) California Postsecondary Education Commission (CPEC) .
Prior to 2011, CPEC was charged, among other things,
with reviewing proposals for new academic and
vocational programs at California's public colleges
and universities and with making recommendations to
the Legislature and Governor. In 1999, the CPEC found
that the University of California at Merced be
approved as the tenth campus of the University of
California system; however, at that time CPEC's
analysis ended with the projections on enrollment and
capital outlay through 2010-11. CPEC typically
reviewed new programs through, at a minimum, the prism
of societal need, student demand, existing programs,
total costs of the program, and appropriateness to the
institution and system mission. Since the de-funding
of CPEC in 2011, no additional state program reviews
have occurred. The Legislature is now placed in the
position of examining and reviewing the academic,
programmatic, and fiscal implications of "new"
programs, a function that the Legislature is
ill-equipped for.
3) UC Merced in a Broader Context . In 2005, the tenth UC
campus in Merced opened with 875 students and 60
faculty. In 2012-13, enrollment at the Merced campus
reached approximately 5,900 full-time students. The
Office of the President has been providing interim
supplemental support for the campus; given its size,
the campus is not yet able to realize economies of
scale required to absorb growth and instructional
needs without continued support for enrollment growth.
The campus is faced with a growing gap between strong
student demand for admission and the campus' limited
capacity to provide capital facilities and
infrastructure needed to support that demand. The
need to fund the infrastructure necessary for the
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future success of the overall campus and its
priorities for various academic, research and public
service initiatives is critical.
The UC has moved forward with a multi-year plan for
the development of future health sciences programs;
resources that must include those necessary to support
the basic sciences (e.g., laboratories for both
research and instruction in the basic sciences, which
are core requirements for medical education) for the
Merced campus. It is critical that the underlying
infrastructure (both programmatically and capital
outlay) for basic sciences is secured and functional.
Devoting limited state General Fund resources for the
long-term planning necessary for a medical school,
though admirable, seems premature and will likely
divert energy and resources (budgetary and academic)
from the development of the core infrastructure
necessary for the overall campus to grow and excel,
particularly health science programs.
The UC Merced campus is still growing and maturing as
a comprehensive undergraduate and graduate
institution, and has yet to achieve its goal of having
10,000 full-time students, be self-sustaining, and
being fully weaned from any supplemental funding.
Therefore, staff recommends amendments that eliminate
the $1 million appropriation and accompanying language
in the findings and declaration section of the measure
in support of planning for a medical school.
4) Immediate Benefits from San Joaquin Valley PRIME .
Building on the success of the PRIME program at all UC
medical schools and its medical education programs
throughout the state, the UC Regents approved the UC
Merced San Joaquin Valley PRIME (SJV PRIME) program in
September 2010 to help provide a unique solution to
the healthcare issues of the central valley.
The newest addition to the systemwide program is
collaboration between UC Davis, UC Merced and the UCSF
Fresno Medical Education Program to strengthen the
recruitment and retention of new physicians in the San
Joaquin Valley - one of California's most medically
underserved areas.
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Recognizing the population health problems in the
valley, the program will partner with communities to
reverse long-standing health inequities and to address
the social determinants of health disparities. The
new program will also actively promote inter-
professional education as a pathway toward improved
health and health care. The program is expected to be
fully enrolled with a total of approximately 20
students in 2014-15. The first five students
matriculated in the fall of 2011.
5) Related legislation . Chapter 203, 2014 (SB 21, Roth)
requested the School of Medicine at the University of
California, Riverside to develop a program, 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 to apply for physician
retention programs, as specified.
The 2013 Budget Act approved trailer bill language
that requires UC to allocate $15 million for planning
and startup costs associated with academic programs to
be offered by the School of Medicine at the University
of California, Riverside, and trailer bill language
that requires regular reporting on a variety of
metrics, including funding, recruitment, hiring, and
outcomes, as well as operating and capital budgets
detailed by fund source.
6) Past legislation . AB 1309 (Miller, 2012) would have
appropriated $15 million, from an expected settlement,
to the UC for the UCR School of Medicine. This
measure was held in the Senate Appropriations
Committee.
SUPPORT
AFSCME - American Federation of State, County and Municipal
Employees
Association of California Healthcare Districts
California Medical Association
Golden Valley Health Centers
Merced County Board of Supervisors
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OPPOSITION
None on file.