BILL NUMBER: SB 22	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JUNE 2, 2015
	AMENDED IN SENATE  MAY 5, 2015
	AMENDED IN SENATE  APRIL 21, 2015

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  Family Physician 
 Health Care Workforce  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, to be appointed as specified.
   The bill would create the  California  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  specified areas
of the state, including  medically underserved  areas of
the state, as specified.   areas.  By creating a
continuously appropriated fund, the bill would make an appropriation.
The bill would require the Office of Statewide Health Planning and
 Development to, among other things,  
Development, among other responsibilities, to  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. 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.   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. 
   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  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.  
psychiatry, and related specialties and subspecialties as the office
deems appropriate. 
   (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  designated and nondesignated
 public  and   hospitals,  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 
three members   one member  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   three-year
 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  appointed by the Governor, the
Speaker of the Assembly, and the Senate Committee on Rules,  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 
and the Osteopathic Medical Board of California  shall serve
without compensation, but shall be reimbursed by the Medical Board of
California  and the Osteopathic Medical Board of California,
respectively,  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.   California or the Osteopathic 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.   state
described in subdivision (c). 
   (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.
  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.  
   (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.  
   (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:  
   (1) A service area that is designated as a primary care shortage
area by the office.  
   (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.  

   (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.  
   (d) Upon office approval of a recommendation, deposit into the
fund necessary moneys as required to establish and fund the residency
position. 
   (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,   solicited,  the amount of money deposited
from the foundation into the fund, the recommendations for the
location and fields of practice of  future 
residency positions,  total expenditures for the year,  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. 

   (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. 
   (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   Establish    a uniform
process  that requires that   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  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   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) 
    (3)  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. 
   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. 
  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  medically 
underserved areas of the state outweighs the interest in the public
disclosure of that information.