BILL NUMBER: SB 22 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 21, 2015
INTRODUCED BY Senator Roth
DECEMBER 1, 2014
An act to add Article 4 Chapter 6
(commencing with Section 128310) 128590)
to Chapter 4 of Part 3 of Division 107 of
the Health and Safety Code, relating to health care.
care, and making an appropriation therefor.
LEGISLATIVE COUNSEL'S DIGEST
SB 22, as amended, Roth. Medical residency training
program grants. Residency training.
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.
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.
The bill would create the Graduate
California Medical Education Trust
Residency Training Fund in the State Treasury, to
consist of funds from public-private partnerships created to fund
grants to 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 graduate
medical residency training programs 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. in medically underserved areas of the
state, as specified. By creating a continuously appropriated fund,
the bill would make an appropriation. The bill would require
the Office of Statewide Health Planning and 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. 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.
Vote: majority. Appropriation: no yes
. Fiscal committee: yes. State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Chapter 6 (commencing with
Section 128590) is added to Part 3 of Division 107 of the
Health and Safety Code , to read:
CHAPTER 6. CALIFORNIA MEDICAL RESIDENCY TRAINING FOUNDATION
128590. 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.
128591. (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.
128592. 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.
128593. 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.
128594. (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.
128595. 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.
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.