Amended in Senate June 2, 2015

Amended in Senate May 5, 2015

Amended in Senate April 21, 2015

Senate Bill No. 22

Introduced by Senator Roth

December 1, 2014

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

LEGISLATIVE COUNSEL’S DIGEST

SB 22, as amended, Roth. Residency training.

Existing law, the Song-Brown begin delete Family Physician end delete begin insert Health Care Workforce end insert 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 begin delete the Office of end delete 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, to be appointed as specified.

The bill would create the begin delete California end delete Medical Residency Training Fund in the State Treasury, 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 in begin insert specified areas of the state, including end insert medically underserved begin delete areas of the state, as specified. end delete begin insert areas. end insert By creating a continuously appropriated fund, the bill would make an appropriation. The bill would require the Office of Statewide Health Planning and begin delete Development to, among other things, end delete begin insert Development, among other responsibilities, to end insert provide technical support and financial management for the foundation, begin delete 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. The bill would require the Legislature to, for each fiscal year, authorize in the budget an amount, as determined in the budgetary process, to match the contributions deposited into the fund by the foundation in that fiscal year. end delete begin insert and to enter into contracts with public and private sector institutions and other health agencies and organizations in order to fund and establish residency positions. end insert

Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest.

This bill would make legislative findings to that effect.

Vote: majority. Appropriation: 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 begin delete the Office of end delete 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, begin delete and psychiatry. end delete begin insert psychiatry, and related
specialties and subspecialties as the office deems appropriate. end insert

(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. Seven 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, two members of the Medical Board
of California shall be appointed by the Medical Board of California,
and two members of the Osteopathic Medical Board of California
shall be appointed by the Osteopathic 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 shall consist of representatives of begin insert designated and
nondesignated end insert public begin delete and end delete begin insert hospitals, end insert 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, the Medical Board
of California, and the Osteopathic 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 begin delete three
members end delete begin insert one member end insert 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 begin delete four-year end delete begin insert three-year end insert term.

(e) The members appointed by the Medical Board of California
and the Osteopathic 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, the Medical Board of California, and the
Osteopathic 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 begin insert appointed by the Governor, the
Speaker of the Assembly, and the Senate Committee on Rules, end insert 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
begin insert and the Osteopathic Medical Board of California end insert shall serve
without compensation, but shall be reimbursed by the Medical
Board of California begin insert and the Osteopathic Medical Board of
California, respectively, end insert 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
begin delete California. end delete begin insert California or the Osteopathic Medical Board of
California. end insert

(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 begin delete medically underserved end delete
areas of the begin delete state. end delete begin insert state described in subdivision (c). end insert

(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 begin delete the medically
underserved end delete areas of the begin delete state. end delete begin insert state described in subdivision (c).
The foundation shall solicit proposals for medical residency
programs, as described in subdivision (c), and provide the office
a copy of all proposals it receives. end insert

begin delete

(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.

end delete begin insert

(c) Upon the sufficient solicitation of funds and at the
foundation’s discretion, approve proposals and recommend to the
office the establishment of new residency positions. A
recommendation shall include all pertinent information necessary
for the office to enter into the necessary contracts to establish the
residency positions. The foundation shall only approve and
recommend to the office proposals that would establish residency
positions that will serve the following medical service areas:

end insert begin insert

(1) A service area that is designated as a primary care shortage
area by the office.

end insert begin insert

(2) A service area that is designated as a health professional
shortage area for primary care, by either population or geographic
designation, by the Health Resources and Services Administration
of the United States Department of Health and Human Services.

end insert begin insert

(3) A service area that is designated as a medically underserved
area or medically underserved population by the Health Resources
and Services Administration of the United States Department of
Health and Human Services.

end insert begin insert

(d) Upon office approval of a recommendation, deposit into the
fund necessary moneys as required to establish and fund the
residency position.

end insert

(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 begin delete solicited from the private sector, end delete
begin insert solicited, end insert the amount of money deposited from the foundation into
the fund, the recommendations for the location and fields of
practice of begin delete future end delete residency positions, begin insert total expenditures for the
year, end insert and begin delete the end delete 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.

begin delete

(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:

end delete begin delete

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

end delete begin delete

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

end delete begin insert

(c)  Upon receipt of a recommendation made by the foundation
pursuant to subdivision (c) of Section 128592, approve the
recommendation if the recommendation fulfills the requirements
of subdivision (c) of Section 128592 and the recommendation
fulfills the goals of this chapter. Upon sufficient funds being
available, an approval shall signal the office’s intent to establish
the residency position.

end insert

(d)  begin delete 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 end delete begin insert Establish end insert a uniform process begin delete that requires that end delete begin insert by which
the foundation may solicit proposals 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 require that end insert 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. begin delete The director shall seek the recommendations of
the commission and foundation as to which proposals best fulfill
this chapter’s objective. end delete

(f)  begin delete Prior to the first distribution of funds for any new residency
position, ensure end delete begin insert Ensure end insert 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.

begin delete

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

end delete begin delete

(4)

end delete

begin insert (3) end insert  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.

128596.  

Notwithstanding any other law, the office may exempt
from public disclosure any document in the possession of the office
that pertains to a donation made pursuant to this chapter if the
donor has requested anonymity.

begin delete

128597.  

For each fiscal year, the Legislature shall authorize
in the budget an amount, as determined in the budgetary process,
to match the contributions deposited into the Medical Residency
Training Fund by the foundation in that fiscal year. The matching
funds may come from the General Fund or any other fund or source
approved in the budgetary process.

end delete

SEC. 2.  

The Legislature finds and declares that Section 1 of
this act, which adds Chapter 6 (commencing with Section 128590)
to Part 3 of Division 107 of the Health and Safety Code, imposes
a limitation on the public’s right of access to the meetings of public
bodies or the writings of public officials and agencies within the
meaning of Section 3 of Article I of the California Constitution.
Pursuant to that constitutional provision, the Legislature makes
the following findings to demonstrate the interest protected by this
limitation and the need for protecting that interest:

The need to protect individual privacy of donations made by a
donor to fund new residency positions in begin delete medically end delete underserved
areas of the state outweighs the interest in the public disclosure of
that information.