BILL ANALYSIS Ó
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UNFINISHED BUSINESS
Bill No: SB 1116
Author: Torres (D), et al.
Amended: 6/19/14
Vote: 21
SENATE BUSINESS, PROFESSIONS & ECON. DEV. COMM. : 8-0, 4/21/14
AYES: Lieu, Berryhill, Block, Corbett, Galgiani, Hernandez,
Hill, Padilla
NO VOTE RECORDED: Wyland
SENATE APPROPRIATIONS COMMITTEE : 6-0, 5/5/14
AYES: De León, Walters, Gaines, Hill, Lara, Steinberg
NO VOTE RECORDED: Padilla
SENATE FLOOR : 33-0, 5/12/14
AYES: Anderson, Beall, Berryhill, Block, Cannella, Corbett,
Correa, De León, DeSaulnier, Fuller, Galgiani, Hancock,
Hernandez, Hill, Hueso, Huff, Jackson, Lara, Leno, Lieu, Liu,
Mitchell, Monning, Morrell, Padilla, Pavley, Roth, Steinberg,
Torres, Vidak, Walters, Wolk, Wyland
NO VOTE RECORDED: Calderon, Evans, Gaines, Knight, Nielsen,
Wright, Yee
ASSEMBLY FLOOR : 75-0, 8/22/14 - See last page for votes
SUBJECT : Physicians and surgeons
SOURCE : Author
DIGEST : This bill requires the Medical Board of California
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(MBC) and the Osteopathic Medical Board of California (OMBC) to
develop a mechanism for a physician and surgeon to pay a
voluntary contribution, at the time of application for initial
licensure or biennial renewal, to the Steven M. Thompson
Physician Corps Loan Repayment Program (STLRP) on or before July
1, 2015.
Assembly Amendments delete language authorizing a physician and
surgeon to voluntary contribute an additional $75 to MBC and
OMBC to fund the STLRP; and, instead, require MBC and OMBC to
develop mechanisms for physicians and surgeons to pay voluntary
contributions to fund the STLRP.
ANALYSIS :
Existing law:
1. Establishes the Medically Underserved Account for Physicians
(Account) within the Health Professions Education Fund that
is managed by the Health Professions Education Foundation
(Foundation) and the Office of Statewide Health Planning and
Development (OSHPD), and specifies that the primary purpose
of the Account is to fund the STLRP.
2. Authorizes the Foundation to seek and receive matching funds
from foundations and private sources to be placed in the
Account.
3. Establishes the STLRP that provides for the repayment of
educational loans, as specified, obtained by a physician and
surgeon or osteopathic physician and surgeon who agrees to
practice in a medically underserved area of the state, as
defined.
4. Licenses and regulates physicians and surgeons by MBC, and
specifies that the protection of the public is the highest
priority of the MBC.
5. Requires MBC to assess a $25 licensure fee on physicians and
surgeons for the purpose of the STLRP.
6. Licenses and regulates osteopathic physicians and surgeons by
OMBC, and specifies that the protection of the public is the
highest priority of OMBC.
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7. Requires OMBC to assess a $25 licensure fee on physicians and
surgeons for the purpose of the STLRP.
This bill:
1. Requires, on or before July 1, 2015, MBC to develop a
mechanism for a physician and surgeon to pay a voluntary
contribution, at the time of application for initial
licensure or biennial renewal, to fund the STLRP.
2. Requires, on or before July 1, 2015, OMBC to develop a
mechanism for an osteopathic physician and surgeon to pay a
voluntary contribution, at the time of initial application
for licensure or biennial renewal, to fund the STLRP.
Background
STLRP . The STLRP, previously the California Physician Corps
Loan Repayment Program, was established in 2003 by AB 982
(Firebaugh, Chapter 1131, Statutes of 2002) to increase
accessibility to healthcare and to encourage physicians to
practice in medically underserved areas (MUA) of California by
authorizing a plan for repayment of their educational loans.
The STLRP is administered by OSHPD and allows licensed physician
graduates who are practicing direct patient care within
California to apply for a grant under the program. An awardee
may receive up to $105,000 to repay educational debt if he/she
commits to a three-year service obligation practicing in direct
patient care in an MUA in California.
Subsequent legislation, SB 606 (Ducheny, Chapter 607, Statutes
of 2009), expanded participation in the program to osteopathic
physicians and surgeons. In 2005, AB 920 (Aghazarian, Chapter
317, Statutes of 2005) transferred administration of STLRP from
MBC to the Foundation. AB 2439 (De La Torre, Chapter 640,
Statutes of 2008) established a mandatory $25 fee physicians and
surgeons at the time of initial licensure or biennial renewal to
support the STLRP.
The Foundation must use guidelines developed by MBC for
selection of applicants to the STLRP. The guidelines must give
priority to applicants that have three years of experience
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working in MUAs or with medically underserved populations, and
to applicants from rural communities who agree to practice in a
physician owned and operated practice settings, as specified,
and who have recently obtained a license to practice medicine.
In its latest report to the Legislature on the STLRP (dated
March 2012), OSHPD indicates that since its establishment, the
STLRP has awarded $17 million to 223 individuals. In 2011, more
than $4.1 million was awarded to 76 physicians (out of 185
applicants requesting approximately $17.6 million in loan
repayments).
MUAs . According to OSHPD, MUAs are based on the evaluation of
criteria established through federal regulation to identify
geographic areas based on demographic data. MUAs and medically
underserved populations have shortages of primary medical care,
dental or mental health providers and may be designated based on
geographic (a county or service area), or demographic (low
income, Medicaid-eligible populations, cultural and/or
linguistic access barriers to primary medical care services)
criteria. According to OSHPD, there are 168 MUAs in 47
California counties and approximately 17% of Californians live
in an MUA.
Comments
The author states, "Since its inception, the STLRP has awarded
more than $28 million dollars to 338 individuals. The loan
repayment program continues to receive competitive and quality
applications. High demand for the program has resulted in only
one out of every three applicants successfully receiving
funding. From 2007 to 2011, the STLRP received 323 applications
and only awarded 135 physicians due to limited funding."
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Assembly Appropriations Committee:
Minor and absorbable costs to MBC and OMBC to modify forms,
processes and, if necessary, relevant regulations to allow
voluntary contributions (MBC Contingent Fund/OMBC Contingent
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Fund).
Potential unknown increased revenue to support the STLRP
(Health Professions Education Fund, Medically Underserved
Account for Physicians), to the extent physicians voluntarily
contribute additional funds for the program.
OSHPD, which administers the STLRP, could incur minor
additional administrative costs associated with an increased
number of awards (Health Professions Education Fund, Medically
Underserved Account for Physicians).
SUPPORT : (Verified 8/21/14)
California Chapter of the American College of Emergency
Physicians
California Arthritis Foundation Council
California Primary Care Association
California Rheumatology Alliance
Medical Board of California
ARGUMENTS IN SUPPORT : MBC writes, "This bill would allow for
additional funding for the STLRP, which will help allow for more
loans for the STLRP and more physicians to serve in underserved
areas. This bill would further support the Board's mission of
promoting access to care and [MBC] will continue to be
supportive of any measures that help fund or make improvements
to the STLRP."
ASSEMBLY FLOOR : 75-0, 8/22/14
AYES: Achadjian, Alejo, Allen, Ammiano, Bloom, Bocanegra,
Bonilla, Bonta, Bradford, Brown, Buchanan, Ian Calderon,
Campos, Chau, Chávez, Chesbro, Conway, Cooley, Dababneh,
Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox, Frazier,
Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,
Gray, Grove, Hagman, Harkey, Roger Hernández, Holden, Jones,
Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,
Medina, Melendez, Mullin, Muratsuchi, Nazarian, Nestande,
Olsen, Pan, Patterson, Perea, John A. Pérez, V. Manuel Pérez,
Quirk, Quirk-Silva, Rendon, Rodriguez, Salas, Skinner, Stone,
Ting, Wagner, Waldron, Weber, Wieckowski, Wilk, Williams,
Yamada, Atkins
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NO VOTE RECORDED: Bigelow, Hall, Mansoor, Ridley-Thomas
MW:d 8/22/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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