BILL ANALYSIS Ó
AB 174
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Date of Hearing: March 3, 2015
ASSEMBLY COMMITTEE ON HIGHER EDUCATION
Medina, Chair
AB
174 (Gray) - As Amended February 9, 2015
SUBJECT: University of California: medical education
SUMMARY: Would appropriate funding to the University of
California (UC) to support the UC Merced Programs in Medical
Education Program (PRIME) and a study of the creation of a
permanent medical school at UC Merced. Specifically, this bill:
1)Finds and declares that the federal Patient Protection and
Affordable Care Act provides millions of previously uninsured
Californians access to health services. A result of this
increased demand is a projected physician shortfall of 17,000
by 2015; the San Joaquin Valley faces health care access 31%
lower than the rest of the state and many regions are
designated Medically Underserved Areas (MUAs); funding the UC
Merced Program in Medical Education (PRIME) is key to meeting
the region's needs.
2)Appropriates $1,855,000 from the General Fund to UC each
fiscal year, commencing with the 2016-17 fiscal year, for
allocation to the UC San Joaquin Valley PRIME to admit up to
12 students per year and operate the program with up to 48
participants from across the four-year curriculum.
3)Appropriates $1,000,000 from the General Fund to UC to support
a two-year planning effort geared toward the establishment of
a traditional medical school at UC Merced. UC would be
required to submit a report to the Legislature by March 1,
2019 regarding planning efforts and recommendations for
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infrastructure, personnel, and funding necessary for creation.
FISCAL EFFECT: Unknown. However, at least $2,855,000 from the
General Fund in direct appropriations to support the programs
outlined in this bill.
COMMENTS: Background on PRIME. Currently, UC operates the
largest health sciences instructional program in the nation,
enrolling more than 14,000 students across 17 schools at seven
campuses; six are medical schools (Davis, Irvine, Los Angeles,
Riverside, San Diego, and San Francisco).
In 2004, UC launched a systemwide medical education initiative,
Programs in Medical Education (PRIME), intended to help address
state needs and focus on the needs of medically underserved
communities. UC Irvine launched the first UC PRIME focusing on
the growing needs of California's Latino communities. Three
other UC schools (Davis, San Diego and San Francisco) admitted
their first classes in fall 2007 in programs focused on rural
health and telemedicine (Davis), health equity (San Diego), and
the urban underserved (San Francisco). In 2008, UCLA launched
its PRIME program, training physicians to proactively address
the needs of diverse disadvantaged communities by delivering
culturally competent clinical care, providing leadership for
health delivery systems and conducting research on health
disparities.
UC Merced currently offers degrees in fields that satisfy
medical school preparatory requirements and is developing plans
intended to lead to a School of Medicine. In 2010, UC Merced
opened a PRIME program in partnership with the UC Davis School
of Medicine and UCSF focused the health needs of the San Joaquin
Valley. Students admitted to UC Merced PRIME spend their first
two years at the UC Davis campus in Sacramento. The groups'
third and fourth years are spent conducting clinical rotations
at San Joaquin Valley clinics and hospitals.
According to UC, as of the 2014-15 academic year, UC will enroll
333 medical students in PRIME. UC notes, however, that only 78
PRIME positions are currently funded by the state. UC indicates
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that a permanent funding source must be identified to continue
this enrollment level for PRIME. This bill would appropriate
$1,855,000 from the General Fund to UC each fiscal year,
commencing with the 2016-17 fiscal year, for allocation to the
UC San Joaquin Valley PRIME to admit up to 12 students per year
and operate the program with up to 48 participants from across
the four-year curriculum.
Background on UC Merced. UC Merced opened with 875 students and
60 faculty in 2005, as the tenth UC campus. As of Fall 2014,
enrollment at the Merced campus reached 6,300 students. The UC
Office of the President has been providing interim supplemental
support for the campus as the campus grows. In order to meet
the goal of 10,000 students by 2020, UC Merced has embarked on a
major initiative to further expand and develop the campus. The
"2020 Project" will require a significant investment of state
resources.
This bill appropriates $1,000,000 from the General Fund to UC to
support a two-year planning effort geared toward the
establishment of a traditional medical school at UC Merced.
Devoting limited state General Fund resources for the long-term
planning necessary for a medical school could divert energy and
resources from the development of the core infrastructure
necessary for the overall campus to grow.
Evaluation of new programs. Prior to 2011, the California
Postsecondary Education Commission (CPEC) was charged with
reviewing and making recommendations regarding proposals for new
programs at California's public colleges and universities.
Specifically, CPEC's review was intended to determine whether
the costs of a program are justified by societal need and
student demand for that program. 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.
Purpose of this bill. According to the author, "despite its
numerous benefits for the region PRIME lacks an ongoing source
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of funding for its current enrollment as well as the financial
resources to expand capacity to meet the needs of the valley.
Additionally, state support is vital to the continued expansion
of the campus of UC Merced and to lay the foundation of a new UC
Medical School."
UC position. UC has not taken a position on this bill.
However, on prior legislation regarding a medical school at UC
Merced, UC indicated that it is a higher priority to build the
general campus rather than develop a medical program. UC noted
that accreditation by the Liaison Committee for Medical
Education (LCME) is required for all Doctor of Medicine programs
and that the resources required for accreditation standards are
considerable. Based on the experience with the UC Riverside
medical school, UC did not believe that LCME would accredit UC
Merced for a medical program without a significant financial
contribution.
Related and prior legislation. SB 131 (Canella) is virtually
identical to this bill and is currently pending in the Senate.
AB 2232 (Gray) and SB 841 (Cannella), of 2014, as introduced,
were identical to this bill but subsequently amended to remove
the appropriation and accompanying language in support of
planning for a medical school. Both bills were held in the
Senate Appropriations Committee. SB 21 (Roth), Chapter 203,
Statutes of 2014, requested the School of Medicine at UC
Riverside 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.
REGISTERED SUPPORT / OPPOSITION:
Support
American Federation of State, County and Municipal Employees
(AFSCME), AFL-CIO
Opposition
None on File
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Analysis Prepared
by: Laura Metune/HIGHER ED./(916) 319-3960