BILL NUMBER: SB 22 AMENDED
BILL TEXT
AMENDED IN SENATE JANUARY 25, 2016
AMENDED IN SENATE JUNE 4, 2015
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 Article 7 (commencing with
Section 128590) to Chapter 5 of 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 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.
Existing 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.
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
establish the Medical Residency Training Advisory Panel,
consisting of a total of 13 members, members
to be appointed as specified specified,
within the Health Professions Education Foundation .
The bill would create the Medical Residency Training Fund in the
State Treasury, a continuously appropriated fund, and would require
the foundation panel 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 the Office of Statewide Health
Planning and Development, among other responsibilities,
foundation to provide technical support and financial
management for the foundation, and 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 office to enter
into contracts with public and private sector institutions and other
health agencies and organizations in order to fund and establish
recommended 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 the foundation, panel,
in an amount matching the amount deposited into the
fund by the foundation. fund, as specified. 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:
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 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, 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
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 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 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
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 areas of the 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 areas of the
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) 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 in any of 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, the amount of money
deposited from the foundation into the fund, the recommendations for
the location and fields of practice of residency positions, total
expenditures for the year, and 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) 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) Establish a uniform process 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.
(f) 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) 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. (a) The Governor may include in the annual budget
proposal an amount, as he or she deems reasonable, to be appropriated
to the office to be used as provided in this chapter.
(b) If the Legislature appropriates money for purposes of this
chapter, the money shall be appropriated to the office, which shall
hold the money for distribution to the fund.
(c) Funds appropriated to the office shall be paid into the fund,
upon request of the foundation, in an amount matching the amount
deposited into the fund by the foundation for the purposes of this
chapter. Any money that was appropriated to the office and that has
not been distributed to the fund at the end of each fiscal year shall
be returned to the General Fund.
SECTION 1. Article 7 (commencing with Section
128590) is added to Chapter 5 of Part 3 of Division 107 of the
Health and Safety Code , to read:
Article 7. California Medical Residency Training Program
128590. As used in this article:
(a) "Director" means the Director of Statewide Health Planning and
Development.
(b) "Foundation" means the Health Professions Education
Foundation.
(c) "Fund" means the Medical Residency Training Fund.
(d) "Office" means the Office of Statewide Health Planning and
Development.
(e) "Panel" means the Medical Residency Training Advisory Panel,
established pursuant to Section 128591.
(f) "Primary care" means the medical practice areas of family
medicine, general surgery, internal medicine, obstetrics and
gynecology, pediatrics, psychiatry, and related specialties and
subspecialties as the office deems appropriate.
(g) "Residency position" means a graduate medical education
residency position in the field of primary care.
128591. (a) (1) There is established within the foundation the
Medical Residency Training Advisory Panel.
(2) The panel shall consist 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 panel appointed by the Governor, the
Speaker of the Assembly, and the Senate Committee on Rules shall
consist of representatives of designated and nondesignated public
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 article, as determined by the appointing power.
(b) The Governor shall appoint the president of the panel 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) (1) Of the members of the panel 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 one
member shall be appointed to serve a three-year term.
(2) Each member of the panel first appointed by the Speaker of the
Assembly and the Senate Committee on Rules shall be appointed to
serve a three-year term.
(3) Each member of the panel appointed by the Medical Board of
California and the Osteopathic Medical Board of California shall be
appointed to serve a four-year term.
(4) Upon the expiration of the initial appointments to the panel
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.
(d) (1) Members of the panel appointed by the Governor, the
Speaker of the Assembly, and the Senate Committee on Rules shall
serve without compensation, but shall be reimbursed for any actual
and necessary expenses incurred in connection with their duties as
members of the panel.
(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 their duties as members of the panel.
(e) Notwithstanding any law relating to incompatible activities,
no member of the panel 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
or the Osteopathic Medical Board of California.
(f) The panel 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 article and the Nonprofit Public Benefit
Corporation Law (Part 2 (commencing with Section 5110) of Division 2
of Title 2 of the Corporations Code), this article shall prevail.
128592. The panel shall do all of 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 areas of the 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 areas of the
state described in subdivision (c). The panel shall solicit proposals
for medical residency programs, as described in subdivision (c), and
shall provide to the foundation a copy of all proposals it receives.
(c) Upon the sufficient solicitation of funds and at the panel's
discretion, recommend to the foundation the establishment of new
residency positions. A recommendation shall include all pertinent
information required to enter into the necessary contracts to
establish the residency positions. The panel shall only approve and
recommend to the foundation proposals that would establish residency
positions that will serve in any of 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 foundation approval of a recommendation, deposit into the
fund necessary moneys 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 panel and the foundation.
(f) Prepare and submit an annual report to the Legislature
documenting the amount of money solicited, the amount of money
deposited by the panel into the fund, the recommendations for the
location and fields of practice of residency positions, total
expenditures for the year, and prospective fundraising goals.
128593. The foundation shall do all of the following:
(a) Provide technical and staff support to the panel in meeting
all of its responsibilities.
(b) Upon receipt of a recommendation made by the panel 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
article. Upon sufficient funds being available, an approval shall be
sent to the office for implementation pursuant to Section 128594.
128594. The office shall do all of the following:
(a) Establish a uniform process by which the panel 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 the 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.
(b) 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.
(c) Ensure that the residency position has been, or will be,
approved by the Accreditation Council for Graduate Medical Education.
(d) Provide all of the following information to the panel and the
foundation as requested:
(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) Other information relevant to assist the panel and the
foundation in making recommendations on possible locations for new
residency positions.
(e) Monitor the residencies established pursuant to this article.
(f) (1) Prepare and submit an annual report to the panel, the
foundation, and the Legislature documenting the amount of money
contributed to the fund by the panel, 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.
128595. (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
panel and the foundation
as established by this article, and for any other purpose
authorized by this article.
(c) The level of expenditure by the office for the administrative
support of the panel and the foundation is subject to review and
approval annually through the state budget process.
(d) In addition to funds raised by the panel, the office and the
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 article. The
office shall manage this fund prudently in accordance with applicable
laws.
128596. Any regulations the office adopts to implement this
article 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.
128597. 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 article if the donor has
requested anonymity.
128598. (a) The Governor may include in the annual budget
proposal an amount, as he or she deems reasonable, to be appropriated
to the office to be used as provided in this article.
(b) If the Legislature appropriates money for purposes of this
article, the money shall be appropriated to the office, which shall
hold the money for distribution to the fund.
(c) Funds appropriated to the office shall be paid into the fund,
upon request of the panel, in an amount matching the amount deposited
into the fund by the panel or by the foundation and office pursuant
to subdivision (d) of Section 128595 for the purposes of this
article. Any money that was appropriated to the office and that has
not been distributed to the fund at the end of each fiscal year shall
be returned to the General Fund.
SEC. 2. The Legislature finds and declares that Section 1 of this
act, which adds Chapter 6 Article 7
(commencing with Section 128590) to Chapter 5 of 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 medical residency positions in
underserved areas of the state outweighs the interest in the public
disclosure of that information.