SB 22, as amended, Roth. Residency training.
Existing law, the Song-Brown 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 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.
end deletebegin insertExisting law requires the Office of Statewide Health Planning and Development to establish the Health Professions Education Foundation to solicit and receive funds for the purpose of providing financial assistance in the form of scholarships or loans to medical students from underrepresented groups. Under existing law, the foundation also administers other programs for the advancement of health professions, including the Registered Nurse Education Program.end insert
This bill wouldbegin delete 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 trusteesend deletebegin insert
establish the Medical Residency Training Advisory Panel,end insert consisting of a total of 13begin delete members,end deletebegin insert membersend insert to be appointed asbegin delete specifiedend deletebegin insert specified, within the Health Professions Education Foundationend insert.
The bill would create the Medical Residency Training Fund in the State Treasury, a continuously appropriated fund, and would require thebegin delete foundationend deletebegin insert panelend insert 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. By creating a continuously appropriated fund, the bill would make an appropriation. The bill would require thebegin delete Office of Statewide Health Planning and Development, among other responsibilities,end deletebegin insert
foundationend insert to provide technical support and financial management for thebegin delete foundation, andend deletebegin insert panel and to approve and send panel recommendations for new residency programs to the Office of Statewide Health Planning and Development for implementation if specified requirements are met, including sufficient funding. The bill would require the officeend insert to enter into contracts with public and private sector institutions and other health agencies and organizations in order to fund and establishbegin insert recommendedend insert residency positions. The bill would authorize the Governor to include in the annual budget proposal an amount, as he or she deems reasonable, to be appropriated for this purpose. The bill,
if the Legislature appropriates money for this purpose, would require the office to hold the funds and distribute them into the fund, upon request of thebegin delete foundation,end deletebegin insert panel,end insert
in an amount matching the amount deposited into thebegin delete fund by the foundation.end deletebegin insert fund, as specified.end insert The bill would require money that was appropriated, but that has not been distributed to the fund at the end of each fiscal year, to be returned to the General Fund.
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:
Chapter 6 (commencing with Section 128590)
2is added to Part 3 of Division 107 of the Health and Safety Code,
3to read:
4
As used in this chapter:
9(a) “Board” means the Board of Trustees of the California
10Medical Residency Training Foundation.
11(b) “Commission” means the California Healthcare Workforce
12Policy Commission.
13(c) “Director” means the Director of Statewide Health Planning
14and Development.
15(d) “Foundation” means the California Medical Residency
16Training Foundation.
17(e) “Fund” means the Medical Residency Training Fund.
18(f) “Office” means the Office of Statewide Health Planning and
19Development.
20(g) “Primary care” means the medical practice areas of family
21medicine, general surgery, internal medicine, obstetrics and
P4 1gynecology, pediatrics, psychiatry, and related specialties and
2subspecialties as the office deems appropriate.
3(h) “Residency position” means a graduate medical education
4residency position in the field of primary care.
(a) (1) The office shall establish a nonprofit public
6benefit corporation to be known as the California Medical
7Residency Training Foundation.
8(2) The foundation shall be governed by a board of trustees
9consisting of a total of 13 members. Seven members shall be
10appointed by the Governor, one member shall be appointed by the
11Speaker of the Assembly, one member shall be appointed by the
12Senate Committee on Rules, two members of the Medical Board
13of California shall be appointed by the Medical Board of California,
14and two members of the Osteopathic Medical Board of California
15shall be appointed by the Osteopathic Medical Board of California.
16(3) The members of the foundation board appointed by the
17Governor, the Speaker of the Assembly, and the Senate Committee
18on Rules shall consist of representatives of designated and
19nondesignated public hospitals, private hospitals, community
20clinics, public and private health insurance providers, the
21pharmaceutical industry, associations of health care practitioners,
22and other appropriate members of health or related professions.
23(4) All persons considered for appointment shall have an interest
24in increasing the number of medical residencies in the state, an
25interest in increasing access to health care in underserved areas of
26California, and the ability and desire to solicit funds for the
27purposes of this chapter, as determined by the appointing power.
28(5) The chairperson of the commission shall also be a nonvoting,
29ex officio member of the board.
30(b) The Governor shall appoint the president of the board from
31among those members appointed by the Governor, the Speaker of
32the Assembly, the Senate Committee on Rules, the Medical Board
33of California, and the Osteopathic Medical Board of California.
34(c) Of the members of the board first appointed by the Governor,
35three members shall be appointed to serve a one-year term, three
36members shall be appointed to serve a two-year term, and one
37member shall be appointed to serve a three-year term.
38(d) Of the members of the board first appointed by the Speaker
39of
the Assembly and the Senate Committee on Rules, each member
40shall be appointed to serve a three-year term.
P5 1(e) The members appointed by the Medical Board of California
2and the Osteopathic Medical Board of California shall be appointed
3to serve a four-year term.
4(f) Upon the expiration of the initial appointments to the board
5by the Governor, the Speaker of the Assembly, the Senate
6Committee on Rules, the Medical Board of California, and the
7Osteopathic Medical Board of California, each member shall be
8appointed to serve a four-year term.
9(g) The director, after consultation with the president of the
10board, may appoint a council of advisers comprised of up to nine
11members. The council shall advise the director and the board
on
12technical matters and programmatic issues related to the
13foundation.
14(h) (1) Members of the board appointed by the Governor, the
15Speaker of the Assembly, and the Senate Committee on Rules,
16and members of the council shall serve without compensation, but
17shall be reimbursed for any actual and necessary expenses incurred
18in connection with his or her duties as a member of the board or
19the council.
20(2) The members appointed by the Medical Board of California
21and the Osteopathic Medical Board of California shall serve
22without compensation, but shall be reimbursed by the Medical
23Board of California and the Osteopathic Medical Board of
24California, respectively, for any actual and necessary expenses
25incurred in connection with his or her duties as a
member of the
26foundation board.
27(i) Notwithstanding any law relating to incompatible activities,
28no member of the foundation board shall be considered to be
29engaged in activities inconsistent and incompatible with his or her
30duties solely as a result of membership on the Medical Board of
31California or the Osteopathic Medical Board of California.
32(j) The foundation shall be subject to the Nonprofit Public
33Benefit Corporation Law (Part 2 (commencing with Section 5110)
34of Division 2 of Title 2 of the Corporations Code), except that if
35there is a conflict with this chapter and the Nonprofit Public Benefit
36Corporation Law (Part 2 (commencing with Section 5110) of
37Division 2 of Title 2 of the Corporations Code), this chapter shall
38prevail.
The foundation shall do the following:
P6 1(a) Solicit and accept funds from business, industry, foundations,
2and other private or public sources for the purpose of establishing
3and funding new residency positions in areas of the state described
4in subdivision (c).
5(b) Encourage public and private sector institutions, including
6hospitals, colleges, universities, community clinics, and other
7health agencies and organizations to identify and provide locations
8for the establishment of new residency positions in areas of the
9state described in subdivision (c). The foundation shall solicit
10proposals for medical residency programs,
as described in
11subdivision (c), and provide the office a copy of all proposals it
12receives.
13(c) Upon the sufficient solicitation of funds and at the
14foundation’s discretion, approve proposals and recommend to the
15office the establishment of new residency positions. A
16recommendation shall include all pertinent information necessary
17for the office to enter into the necessary contracts to establish the
18residency positions. The foundation shall only approve and
19recommend to the office proposals that would establish residency
20positions that will serve in any of the following medical service
21areas:
22(1) A service area that is designated as a primary care shortage
23area by the office.
24(2) A service area that is designated as a health professional
25shortage area for primary care, by either population or geographic
26designation, by the Health Resources and Services Administration
27of the United States Department of Health and Human Services.
28(3) A service area that is designated as a medically underserved
29area or medically underserved population by the Health Resources
30and Services Administration of the United States Department of
31Health and Human Services.
32(d) Upon office approval of a recommendation, deposit into the
33fund necessary moneys as required to establish and fund the
34residency position.
35(e) Recommend to the director that a portion of
the funds
36solicited from the private sector be used for the administrative
37requirements of the foundation.
38(f) Prepare and submit an annual report to the Legislature
39documenting the amount of money
solicited, the amount of money
40deposited from the foundation into the fund, the recommendations
P7 1for the location and fields of practice of residency positions, total
2expenditures for the year, and prospective fundraising goals.
The office shall do all of the following:
4(a) Provide technical and staff support to the foundation in
5meeting all of its responsibilities.
6(b) Provide financial management for the foundation.
7(c) Upon receipt of a recommendation made by the foundation
8pursuant to subdivision (c) of Section 128592, approve the
9recommendation if the recommendation fulfills the requirements
10of subdivision (c) of Section 128592 and the recommendation
11fulfills the goals of this chapter. Upon sufficient funds being
12available, an approval shall signal the office’s intent to establish
13the
residency position.
14(d) Establish a uniform process by which the foundation may
15solicit proposals from public and private sector institutions,
16including hospitals, colleges, universities, community clinics, and
17other health agencies and organizations that train primary care
18residents. The office shall require that these proposals contain all
19necessary and pertinent information, including, but not limited to,
20all of the following:
21(1) The location of the proposed residency position.
22(2) The medical practice area of the proposed residency position.
23(3) Information that demonstrates the area’s need for the
24proposed residency position and for additional primary
care
25practitioners.
26(4) The amount of funding required to establish and operate the
27residency position.
28(e) Enter into contracts with public and private sector
29institutions, including hospitals, colleges, universities, community
30clinics, and other health agencies and organizations in order to
31fund and establish residency positions at, or in association with,
32these institutions.
33(f) Ensure that the residency position has been, or will be,
34approved by the Accreditation Council for Graduate Medical
35Education.
36(g) Provide all of the following information to the board:
37(1) The
areas of the state that are deficient in primary care
38services.
P8 1(2) The areas of the state that have the highest number of
2Medi-Cal enrollees and persons eligible to enroll in Medi-Cal, by
3proportion of population.
4(3) Other information that the office or board finds relevant to
5assist the board in making its recommendations on possible
6locations for new residency positions.
7(h) Monitor the residencies established pursuant to this chapter.
8(i) (1) Prepare and submit an annual report to the foundation
9and the Legislature documenting the amount of money contributed
10to the fund by the foundation, the amount of money expended from
11the fund, the
purposes of those expenditures, the number and
12location of residency positions established and funded, and
13recommendations for the location of future residency positions.
14(2) The report pursuant to paragraph (1) shall be made to the
15Legislature pursuant to Section 9795 of the Government Code.
(a) The Medical Residency Training Fund is hereby
17created within the State Treasury.
18(b) The primary purpose of the fund is to allocate funding for
19new residency positions throughout the state. Money in the fund
20shall also be used to pay for the cost of administering the goals of
21the foundation, and for any other purpose authorized by this
22chapter.
23(c) The level of expenditure by the office for the administrative
24support of the foundation is subject to review and approval annually
25through the
state budget process.
26(d) The office and foundation may solicit and accept public and
27private donations to be deposited into the fund. All money in the
28fund is continuously appropriated to the office for the purposes of
29this chapter. The office shall manage this fund prudently in
30accordance with applicable laws.
Any regulations the office adopts to implement this
32chapter shall be adopted as emergency regulations in accordance
33with Section 11346.1 of the Government Code, except that the
34regulations shall be exempt from the requirements of subdivisions
35(e), (f), and (g) of that section. The regulations shall be deemed to
36be emergency regulations for the purposes of Section 11346.1 of
37the Government Code.
Notwithstanding any other law, the office may exempt
39from public disclosure any document in the possession of the office
P9 1that pertains to a donation made pursuant to this chapter if the
2donor has requested anonymity.
(a) The Governor may include in the annual budget
4proposal an amount, as he or she deems reasonable, to be
5appropriated to the office to be used as provided in this chapter.
6(b) If the Legislature appropriates money for purposes of this
7chapter, the money shall be appropriated to the office, which shall
8hold the money for distribution to the fund.
9(c) Funds appropriated to the office shall be paid into the fund,
10upon request of the foundation, in an amount matching the amount
11deposited into the fund by the foundation for the purposes of this
12chapter. Any money that was appropriated to the office and that
13has not been distributed to the fund at the end of each fiscal year
14
shall be returned to the General Fund.
begin insertArticle 7 (commencing with Section 128590) is
16added to Chapter 5 of Part 3 of Division 107 of the end insertbegin insertHealth and
17Safety Codeend insertbegin insert, to read:end insert
18
As used in this article:
22(a) “Director” means the Director of Statewide Health Planning
23and Development.
24 (b) “Foundation” means the Health Professions Education
25Foundation.
26(c) “Fund” means the Medical Residency Training Fund.
27(d) “Office” means the Office of Statewide Health Planning
28and Development.
29(e) “Panel” means the Medical Residency Training Advisory
30Panel, established pursuant to Section 128591.
31(f) “Primary care” means the medical
practice areas of family
32medicine, general surgery, internal medicine, obstetrics and
33gynecology, pediatrics, psychiatry, and related specialties and
34subspecialties as the office deems appropriate.
35(g) “Residency position” means a graduate medical education
36residency position in the field of primary care.
(a) (1) There is established within the foundation the
38Medical Residency Training Advisory Panel.
39(2) The panel shall consist of 13 members. Seven members shall
40be appointed by the Governor, one member shall be appointed by
P10 1the Speaker of the Assembly, one member shall be appointed by
2the Senate Committee on Rules, two members of the Medical Board
3of California shall be appointed by the Medical Board of
4California, and two members of the Osteopathic Medical Board
5of California shall be appointed by the Osteopathic Medical Board
6of California.
7(3) The members of the panel appointed by the Governor, the
8Speaker of the Assembly, and the Senate Committee on
Rules shall
9consist of representatives of designated and nondesignated public
10hospitals, private hospitals, community clinics, public and private
11health insurance providers, the pharmaceutical industry,
12associations of health care practitioners, and other appropriate
13members of health or related professions.
14(4) All persons considered for appointment shall have an interest
15in increasing the number of medical residencies in the state, an
16interest in increasing access to health care in underserved areas
17of California, and the ability and desire to solicit funds for the
18purposes of this article, as determined by the appointing power.
19(b) The Governor shall appoint the president of the panel from
20among those members appointed by the Governor, the Speaker of
21the Assembly, the Senate Committee on Rules, the Medical Board
22of California, and the Osteopathic Medical Board of
California.
23(c) (1) Of the members of the panel first appointed by the
24Governor, three members shall be appointed to serve a one-year
25term, three members shall be appointed to serve a two-year term,
26and one member shall be appointed to serve a three-year term.
27(2) Each member of the panel first appointed by the Speaker of
28the Assembly and the Senate Committee on Rules shall be
29appointed to serve a three-year term.
30(3) Each member of the panel appointed by the Medical Board
31of California and the Osteopathic Medical Board of California
32shall be appointed to serve a four-year term.
33(4) Upon the expiration of the initial appointments to the panel
34by the Governor, the Speaker of the Assembly, the Senate
35Committee on Rules, the Medical
Board of California, and the
36Osteopathic Medical Board of California, each member shall be
37appointed to serve a four-year term.
38(d) (1) Members of the panel appointed by the Governor, the
39Speaker of the Assembly, and the Senate Committee on Rules shall
40serve without compensation, but shall be reimbursed for any actual
P11 1and necessary expenses incurred in connection with their duties
2as members of the panel.
3(2) The members appointed by the Medical Board of California
4and the Osteopathic Medical Board of California shall serve
5without compensation, but shall be reimbursed by the Medical
6Board of California and the Osteopathic Medical Board of
7California, respectively, for any actual and necessary expenses
8incurred in connection with their duties as members of the panel.
9(e) Notwithstanding any law
relating to incompatible activities,
10no member of the panel shall be considered to be engaged in
11 activities inconsistent and incompatible with his or her duties
12solely as a result of membership on the Medical Board of
13California or the Osteopathic Medical Board of California.
14(f) The panel shall be subject to the Nonprofit Public Benefit
15Corporation Law (Part 2 (commencing with Section 5110) of
16Division 2 of Title 2 of the Corporations Code), except that if there
17is a conflict with this article and the Nonprofit Public Benefit
18Corporation Law (Part 2 (commencing with Section 5110) of
19Division 2 of Title 2 of the Corporations Code), this article shall
20prevail.
The panel shall do all of the following:
22(a) Solicit and accept funds from business, industry, foundations,
23and other private or public sources for the purpose of establishing
24and funding new residency positions in areas of the state described
25in subdivision (c).
26(b) Encourage public and private sector institutions, including
27hospitals, colleges, universities, community clinics, and other
28health agencies and organizations to identify and provide locations
29for the establishment of new residency positions in areas of the
30state described in subdivision (c). The panel shall solicit proposals
31for medical residency programs, as described in subdivision (c),
32and shall provide to the foundation a copy of
all proposals it
33receives.
34(c) Upon the sufficient solicitation of funds and at the panel’s
35discretion, recommend to the foundation the establishment of new
36residency positions. A recommendation shall include all pertinent
37information required to enter into the necessary contracts to
38establish the residency positions. The panel shall only approve
39and recommend to the foundation proposals that would establish
P12 1residency positions that will serve in any of the following medical
2service areas:
3(1) A service area that is designated as a primary care shortage
4area by the office.
5(2) A service area that is designated as a health professional
6shortage area for primary care, by either population or geographic
7designation, by the Health Resources and Services Administration
8of the United States Department of Health and Human
Services.
9(3) A service area that is designated as a medically underserved
10area or medically underserved population by the Health Resources
11and Services Administration of the United States Department of
12Health and Human Services.
13(d) Upon foundation approval of a recommendation, deposit
14into the fund necessary moneys required to establish and fund the
15residency position.
16(e) Recommend to the director that a portion of the funds
17solicited from the private sector be used for the administrative
18requirements of the panel and the foundation.
19(f) Prepare and submit an annual report to the Legislature
20documenting the amount of money solicited, the amount of money
21deposited by the panel into the fund, the recommendations for the
22location and fields of practice
of residency positions, total
23expenditures for the year, and prospective fundraising goals.
The foundation shall do all of the following:
25(a) Provide technical and staff support to the panel in meeting
26all of its responsibilities.
27(b) Upon receipt of a recommendation made by the panel
28pursuant to subdivision (c) of Section 128592, approve the
29recommendation if the recommendation fulfills the requirements
30of subdivision (c) of Section 128592 and the recommendation
31fulfills the goals of this article. Upon sufficient funds being
32available, an approval shall be sent to the office for implementation
33pursuant to Section 128594.
The office shall do all of the following:
35(a) Establish a uniform process by which the panel may solicit
36proposals from public and private sector institutions, including
37hospitals, colleges, universities, community clinics, and other
38health agencies and organizations that train primary care
39residents. The office shall require that the proposals contain all
P13 1necessary and pertinent information, including, but not limited to,
2all of the following:
3(1) The location of the proposed residency position.
4(2) The medical practice area of the proposed residency
5position.
6(3) Information that demonstrates the area’s need for the
7proposed residency position and for additional primary care
8practitioners.
9(4) The amount of funding required to establish and operate
10the residency position.
11(b) Enter into contracts with public and private sector
12institutions, including hospitals, colleges, universities, community
13clinics, and other health agencies and organizations in order to
14fund and establish residency positions at, or in association with,
15these institutions.
16(c) Ensure that the residency position has been, or will be,
17approved by the Accreditation Council for Graduate Medical
18Education.
19(d) Provide all of the following information to the panel and
20the foundation as requested:
21(1) The areas of the state that are deficient in primary care
22services.
23(2) The areas of the state that have the highest number of
24Medi-Cal enrollees and persons eligible to enroll in Medi-Cal, by
25proportion of population.
26(3) Other information relevant to assist the panel and the
27foundation in making recommendations on possible locations for
28new residency positions.
29(e) Monitor the residencies established pursuant to this article.
30(f) (1) Prepare and submit an annual report to the panel, the
31foundation, and the Legislature documenting the amount of money
32contributed to the fund by the panel, the amount of money expended
33from the fund, the purposes of those expenditures,
the number and
34location of residency positions established and funded, and
35recommendations for the location of future residency positions.
36(2) The report pursuant to paragraph (1) shall be made to the
37Legislature pursuant to Section 9795 of the Government Code.
(a) The Medical Residency Training Fund is hereby
39created within the State Treasury.
P14 1(b) The primary purpose of the fund is to allocate funding for
2new residency positions throughout the state. Money in the fund
3shall also be used to pay for the cost of administering the goals of
4the panel and the foundation as established by this article, and for
5any other purpose authorized by this article.
6(c) The level of expenditure by the office for the administrative
7support of the panel and the foundation is subject to review and
8approval annually through the state budget process.
9(d) In addition to funds raised by the
panel, the office and the
10foundation may solicit and accept public and private donations to
11be deposited into the fund. All money in the fund is continuously
12appropriated to the office for the purposes of this article. The office
13shall manage this fund prudently in accordance with applicable
14laws.
Any regulations the office adopts to implement this
16article shall be adopted as emergency regulations in accordance
17with Section 11346.1 of the Government Code, except that the
18regulations shall be exempt from the requirements of subdivisions
19(e), (f), and (g) of that section. The regulations shall be deemed
20to be emergency regulations for the purposes of Section 11346.1
21of the Government Code.
Notwithstanding any other law, the office may exempt
23from public disclosure any document in the possession of the office
24that pertains to a donation made pursuant to this article if the
25donor has requested anonymity.
(a) The Governor may include in the annual budget
27proposal an amount, as he or she deems reasonable, to be
28appropriated to the office to be used as provided in this article.
29(b) If the Legislature appropriates money for purposes of this
30article, the money shall be appropriated to the office, which shall
31hold the money for distribution to the fund.
32(c) Funds appropriated to the office shall be paid into the fund,
33upon request of the panel, in an amount matching the amount
34deposited into the fund by the panel or by the foundation and office
35pursuant to subdivision (d) of Section 128595 for the purposes of
36this article. Any money that was appropriated to the office and
37that has
not been distributed to the fund at the end of each fiscal
38year shall be returned to the General Fund.
The Legislature finds and declares that Section 1 of
40this act, which addsbegin delete Chapter 6end deletebegin insert Article 7end insert (commencing with Section
P15 1128590) tobegin insert Chapter 5 ofend insert Part 3 of Division 107 of the Health and
2Safety Code, imposes a limitation on the public’s right of access
3to the meetings of public bodies or the writings of public officials
4and agencies within the meaning of Section 3 of Article I of the
5California Constitution. Pursuant to that constitutional provision,
6
the Legislature makes the following findings to demonstrate the
7interest protected by this limitation and the need for protecting
8that interest:
9The need to protect individual privacy of donations made by a
10donor to fund newbegin insert medicalend insert residency positions in underserved
11areas of the state outweighs the interest in the public disclosure of
12that information.
O
94