Amended in Senate April 21, 2015

Senate Bill No. 22

Introduced by Senator Roth

December 1, 2014

An act to add begin delete Article 4 end delete begin insert Chapter 6 end insert (commencing with Section begin delete 128310) end delete begin insert 128590) end insert to begin delete Chapter 4 of end delete Part 3 of Division 107 of the Health and Safety Code, relating to health begin delete care. end delete begin insert care, and making an appropriation therefor. end insert

LEGISLATIVE COUNSEL’S DIGEST

SB 22, as amended, Roth. begin delete Medical residency training program grants. end delete begin insert Residency training. end insert

Existing law, the Song-Brown Family Physician Training Act, declares the intent of the Legislature to increase the number of students and residents receiving quality education and training in the specialty of family practice and as primary care physician’s assistants and primary care nurse practitioners. Existing law establishes, for this purpose, a state medical contract program with accredited medical schools, programs that train primary care physician’s assistants, programs that train primary care nurse practitioners, registered nurses, hospitals, and other health care delivery systems.

Existing law establishes the California Healthcare Workforce Policy Commission and requires the commission, among other things, to identify specific areas of the state where unmet priority needs for primary care family physicians and registered nurses exist, establish standards for family practice training programs, family practice residency programs, primary care physician assistants programs, and programs that train primary care nurse practitioners, and review and make recommendations to the Director of the Office of Statewide Health Planning and Development concerning the funding of those programs that are submitted to the Healthcare Workforce Development Division for participation in the state medical contract program.

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This bill would require the Office of Statewide Health Planning and Development to establish a nonprofit public benefit corporation, to be known as the California Medical Residency Training Foundation, to be governed by a board of trustees consisting of a total of 13 members, 9 members appointed by the Governor, one member appointed by the Speaker of the Assembly, one member appointed by the Senate Committee on Rules, and 2 members of the Medical Board of California appointed by the Medical Board of California.

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The bill would create the begin delete Graduate end delete begin insert California end insert Medical begin delete Education Trust end delete begin insert Residency Training end insert Fund in the State Treasury, begin delete to consist of funds from public-private partnerships created to fund grants to end delete begin insert a continuously appropriated fund, and would require the foundation to solicit and accept funds from business, industry, foundations, and other private or public sources for the purpose of establishing and funding new end insert graduate medical residency training programs begin delete and any interest that accrues on those moneys, and would require that moneys in the fund be used, upon appropriation by the Legislature, for those purposes, as specified. end delete begin insert in medically underserved areas of the state, as specified. By creating a continuously appropriated fund, the bill would make an appropriation. end insert The bill would require the Office of Statewide Health Planning and begin delete Development, in consultation with the California Healthcare Workforce Policy Commission, to develop criteria, upon receipt of private donations of sufficient moneys to develop the criteria, for distribution of available funds. end delete begin insert Development to, among other things, provide technical support and financial management for the foundation, establish criteria for ranking geographical areas with the highest need for primary care residencies, and give preference to funding residencies in those areas, as specified. end insert

Vote: majority. Appropriation:  begin delete no end delete begin insert yes end insert . Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

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begin insert SECTION end insert begin insert 1. end insert   

end insert

begin insert Chapter 6 (commencing with Section 128590) is
added to Part 3 of Division 107 of the end insert begin insert Health and Safety Code end insert begin insert , to
read: end insert

begin insert

 

Chapter   begin insert 6. end insert California Medical Residency Training
Foundation

 

begin insert 128590. end insert   

As used in this chapter:

(a) “Board” means the Board of Trustees of the California
Medical Residency Training Foundation.

(b) “Commission” means the California Healthcare Workforce
Policy Commission.

(c) “Director” means the Director of the Office of Statewide
Health Planning and Development.

(d) “Foundation” means the California Medical Residency
Training Foundation.

(e) “Fund” means the Medical Residency Training Fund.

(f) “Office” means the Office of Statewide Health Planning and
Development.

(g) “Primary care” means the medical practice areas of family
medicine, general surgery, internal medicine, obstetrics and
gynecology, pediatrics, and psychiatry.

(h) “Residency position” means a graduate medical education
residency position in the field of primary care.

begin insert 128591. end insert   

(a) (1) The office shall establish a nonprofit public
benefit corporation to be known as the California Medical
Residency Training Foundation.

(2) The foundation shall be governed by a board of trustees
consisting of a total of 13 members. Nine members shall be
appointed by the Governor, one member shall be appointed by the
Speaker of the Assembly, one member shall be appointed by the
Senate Committee on Rules, and two members of the Medical
Board of California shall be appointed by the Medical Board of
California.

(3) The members of the foundation board appointed by the
Governor, the Speaker of the Assembly, and the Senate Committee
on Rules may include representatives of public and private
hospitals, community clinics, public and private health insurance
providers, the pharmaceutical industry, associations of health care
practitioners, and other appropriate members of health or related
professions.

(4) All persons considered for appointment shall have an interest
in increasing the number of medical residencies in the state, an
interest in increasing access to health care in underserved areas
of California, and the ability and desire to solicit funds for the
purposes of this chapter, as determined by the appointing power.

(5) The chairperson of the commission shall also be a nonvoting,
ex officio member of the board.

(b) The Governor shall appoint the president of the board from
among those members appointed by the Governor, the Speaker of
the Assembly, the Senate Committee on Rules, and the Medical
Board of California.

(c) Of the members of the board first appointed by the Governor,
three members shall be appointed to serve a one-year term, three
members shall be appointed to serve a two-year term, and three
members shall be appointed to serve a three-year term.

(d) Of the members of the board first appointed by the Speaker
of the Assembly and the Senate Committee on Rules, each member
shall be appointed to serve a four-year term.

(e) The members appointed by the Medical Board of California
shall be appointed to serve a four-year term.

(f) Upon the expiration of the initial appointments to the board
by the Governor, the Speaker of the Assembly, the Senate
Committee on Rules, and the Medical Board of California, each
member shall be appointed to serve a four-year term.

(g) The director, after consultation with the president of the
board, may appoint a council of advisers comprised of up to nine
members. The council shall advise the director and the board on
technical matters and programmatic issues related to the
foundation.

(h) (1) Members of the board and members of the council shall
serve without compensation, but shall be reimbursed for any actual
and necessary expenses incurred in connection with his or her
duties as a member of the board or the council.

(2) The members appointed by the Medical Board of California
shall serve without compensation, but shall be reimbursed by the
Medical Board of California for any actual and necessary expenses
incurred in connection with his or her duties as a member of the
foundation board.

(i) Notwithstanding any law relating to incompatible activities,
no member of the foundation board shall be considered to be
engaged in activities inconsistent and incompatible with his or her
duties solely as a result of membership on the Medical Board of
California.

(j) The foundation shall be subject to the Nonprofit Public
Benefit Corporation Law (Part 2 (commencing with Section 5110)
of Division 2 of Title 2 of the Corporations Code), except that if
there is a conflict with this chapter and the Nonprofit Public Benefit
Corporation Law (Part 2 (commencing with Section 5110) of
Division 2 of Title 2 of the Corporations Code), this chapter shall
prevail.

begin insert 128592. end insert   

The foundation shall do the following:

(a) Solicit and accept funds from business, industry, foundations,
and other private or public sources for the purpose of establishing
and funding new residency positions in medically underserved
areas of the state.

(b) Encourage public and private sector institutions, including
hospitals, colleges, universities, community clinics, and other
health agencies and organizations to identify and provide locations
for the establishment of new residency positions in the medically
underserved areas of the state.

(c) Make recommendations to the director on the establishment
of new residency positions, including the locations, fields of
practice, and levels of funding in order to fulfill the goals of this
chapter.

(d) Recommend to the director the disbursement of moneys
deposited in the California Medical Residency Training Fund to
establish and fund residency positions.

(e) Recommend to the director that a portion of the funds
solicited from the private sector be used for the administrative
requirements of the foundation.

(f) Prepare and submit an annual report to the Legislature
documenting the amount of money solicited from the private sector,
the amount of money deposited from the foundation into the fund,
the recommendations for the location and fields of practice of
future residency positions, and the prospective fundraising goals.

begin insert 128593. end insert   

The office shall do all of the following:

(a) Provide technical and staff support to the foundation in
meeting all of its responsibilities.

(b) Provide financial management for the foundation.

(c) Establish, with the recommendation of the board, criteria
for ranking the geographical areas of the state that have the highest
need for primary care residencies, and give preference to proposals
that would establish residency positions in these areas. These
criteria shall be based on both of the following:

(1) The size of an area’s population that is enrolled in, or
eligible for, Medi-Cal.

(2) The shortage of primary care physicians in the area.

(d) Solicit proposals for new residency positions from public
and private sector institutions, including hospitals, colleges,
universities, community clinics, and other health agencies and
organizations that train primary care residents. The office shall
establish a uniform process that requires that these proposals
contain all necessary and pertinent information, including, but
not limited to, all of the following:

(1) The location of the proposed residency position.

(2) The medical practice area of the proposed residency
position.

(3) Information that demonstrates the area’s need for the
proposed residency position and for additional primary care
practitioners.

(4) The amount of funding required to establish and operate
the residency position.

(e) Enter into contracts with public and private sector
institutions, including hospitals, colleges, universities, community
clinics, and other health agencies and organizations in order to
fund and establish residency positions at, or in association with,
these institutions. The director shall seek the recommendations of
the commission and foundation as to which proposals best fulfill
this chapter’s objective.

(f) Prior to the first distribution of funds for any new residency
position, ensure that the residency position has been, or will be,
approved by the Accreditation Council for Graduate Medical
Education.

(g) Provide all of the following information to the board:

(1) The areas of the state that are deficient in primary care
services.

(2) The areas of the state that have the highest number of
Medi-Cal enrollees and persons eligible to enroll in Medi-Cal, by
proportion of population.

(3) The proposals received from institutions that train primary
care physicians pursuant to subdivision (d).

(4) Other information that the office or board finds relevant to
assist the board in making its recommendations on possible
locations for new residency positions.

(h) Monitor the residencies established pursuant to this chapter.

(i) (1) Prepare and submit an annual report to the foundation
and the Legislature documenting the amount of money contributed
to the fund by the foundation, the amount of money expended from
the fund, the purposes of those expenditures, the number and
location of residency positions established and funded, and
recommendations for the location of future residency positions.

(2) The report pursuant to paragraph (1) shall be made to the
Legislature pursuant to Section 9795 of the Government Code.

begin insert 128594. end insert   

(a) The Medical Residency Training Fund is hereby
created within the State Treasury.

(b) The primary purpose of the fund is to allocate funding for
new residency positions throughout the state. Money in the fund
shall also be used to pay for the cost of administering the goals of
the foundation, and for any other purpose authorized by this
chapter.

(c) The level of expenditure by the office for the administrative
support of the foundation is subject to review and approval
annually through the State Budget process.

(d) The office and foundation may solicit and accept public and
private donations to be deposited into the fund. All money in the
fund is continuously appropriated to the office for the purposes of
this chapter. The office shall manage this fund prudently in
accordance with applicable laws.

begin insert 128595. end insert   

Any regulations the office adopts to implement this
chapter shall be adopted as emergency regulations in accordance
with Section 11346.1 of the Government Code, except that the
regulations shall be exempt from the requirements of subdivisions
(e), (f), and (g) of that section. The regulations shall be deemed
to be emergency regulations for the purposes of Section 11346.1
of the Government Code.

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SECTION 1.  

Article 4 (commencing with Section 128310) is
added to Chapter 4 of Part 3 of Division 107 of the Health and
Safety Code, to read:

 

Article 4.  Medical Residency Training Program Grants

 

128310.  

(a) The Graduate Medical Education Trust Fund is
hereby created in the State Treasury.

(b) Moneys in the fund, upon appropriation by the Legislature,
shall be used solely for the purpose of funding grants to graduate
medical education residency programs in California.

(c) Notwithstanding Section 16305.7 of the Government Code,
all interest earned on the moneys that have been deposited into the
fund shall be retained in the fund and used for purposes consistent
with the fund.

(d) The fund shall consist of all of the following:

(1) Funds from public-private partnerships created for the
purpose of funding grants to graduate medical education residency
programs in California.

(2) Any interest that accrues on amounts in the fund.

(e) (1) The Office of Statewide Health Planning and
Development, in consultation with the California Healthcare
Workforce Policy Commission, shall develop criteria for
distribution of available moneys in the fund.

(2) The office shall develop criteria only upon receipt of
donations sufficient to cover the costs of developing the criteria.

(f) In developing the criteria, the office shall give priority to
programs that meet the following specifications:

(1) Are located in medically underserved areas, as defined in
Section 128552.

(2) Have a proven record of placing graduates in those medically
underserved areas.

(3) Place an emphasis on training primary care providers.

(4) Place an emphasis on training physician specialties that are
most needed in the community in which the program is located.

(g) Moneys appropriated from the fund may also be used to
fund existing graduate medical education residency slots as well
as new graduate medical education residency slots.

(h) Whenever applicable, the office shall utilize moneys
appropriated from the fund to provide a match for available federal
funds for graduate medical education.

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