BILL ANALYSIS                                                                                                                                                                                                    



          SENATE COMMITTEE ON EDUCATION
                              Senator Carol Liu, Chair
                                2015 - 2016  Regular 

          Bill No:               AB 174              
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          |Author:     |Gray                                                 |
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          |Version:    |June 1, 2015                             Hearing     |
          |            |Date:     July 8, 2015                               |
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          |Urgency:    |No                    |Fiscal:     |Yes             |
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          |Consultant: |Olgalilia Ramirez                                    |
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          Subject:  University of California:  medical education

            SUMMARY
          
          This bill commencing with the 2016-17 fiscal year, appropriates  
          $1.25 million from the State General Fund to the Regents of the  
          University of California (UC) to support the expansion of the  
          San Joaquin Valley (SJV) Program in Medical Education (PRIME).

            BACKGROUND
          
          UC operates six schools of medicine at Davis, Irvine, Los  
          Angeles, Riverside, San Diego, and San Francisco. In 2014-15,  
          total enrollment in these programs was approximately 3,000  
          medical students and more than 5,000 medical residents. Nearly  
          50% of medical students and medical residents in California are  
          trained by the UC. 

          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 students  







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          and its new curriculum designed to educate and train future  
          physician leaders, researchers and advocates for the communities  
          they will serve.  

            ANALYSIS
          
       1)This bill commencing with the 2016-17 fiscal year, appropriates  
            $1.25 million from the State General Fund to the Regents of  
            the UC to support the expansion of SJV PRIME. Specifically,  
            this bill:

               a)    Makes findings and declarations in support of the  
               proposed appropriations.

               b)    Appropriates funds to support expansion of the SJV  
               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.

          STAFF COMMENTS
          
       1)Need for the bill.  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. Furthermore  
            access to health care in the SJV which extends from Stockton  
            to Bakersfield is already well below the recommended level of  
            primary care physicians with a patient to doctor ratio that is  
            31 percent less than the rest of California.  The author also  
            asserts that despite its numerous benefits for the SJV, the  
            Program in Medical Education (PRIME) program lacks ongoing  
            funding for its current enrollment as well as the financial  
            resources needed to expand capacity as an interim step to  
            meeting the region's health care needs. This bill seeks to  
            expand the number of physicians that can serve the state and  
            address the need of quality health care in SJV. 

       2)SJV PRIME Program.  Building on the success of the PRIME program  
            at all University of California (UC) medical schools and its  
            medical education programs throughout the state, the UC  
            Regents approved the UC Merced SJV PRIME program in September  
            2010 to help provide a unique solution to the healthcare  
            issues of the central valley. 









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            The program is a collaboration between UC Davis, UC Merced,  
            and the University of San Francisco's Fresno Medical Education  
            Program and intended to strengthen the recruitment and  
            retention of new physicians in the SJV - one of California's  
            most medically underserved areas. The SJV PRIME program allows  
            a small number of students to enroll in the UC Davis Medical  
            School and complete the clinic portion of their degree in SJV  
            clinics thereby strengthening the desire for new physicians to  
            practice in the area. 

            Recognizing the health problems in the valley, the program  
            partners with communities to reverse long-standing health  
            inequities and address the social determinants of health  
            disparities.  The program also actively promotes  
            inter-professional education as a pathway toward improved  
            health and health care. For the 2015 academic year, only eight  
            students were admitted to SJV PRIME and overall enrollment in  
            the program stands at 27 students. This bill would appropriate  
            funds to support 12 students per year and operate the SJV  
            PRIME program with up to 48 student participants. 

       3)Related Budget Activity.  The Budget Act of 2015 includes  
            language requiring the University of California to continue  
            planning for a School of Medicine at the Merced campus in  
            accordance with the action approved by the UC Regents on May  
            14, 2008, and requires the UC to allocate up to $1 million  
            from the budget appropriation or other funds available to the  
            university for this purpose. 

       4)Related and prior legislation.
               
            SB 131 (Cannella, 2015) identical to this bill, appropriates  
            the $1.2 million to the UC from the General Fund for the SJV  
            PRIME program. The bill was held on suspense in the Senate  
            Appropriations Committee. 

            SB 841 (Canella, 2014) as introduced was identical to AB 174  
            but was subsequently amended to remove the appropriation for  
            the University of California, Merced Medical School. This bill  
            was held in the Senate Appropriations Committee.

            SUPPORT
          
          California Chapter of the American College of Emergency  








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          Physicians  
          CAPG
          Insurance Commissioner, Dave Jones

            OPPOSITION
           
           None received. 

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