Senate Bill No. 1204

Introduced by Senator Hernandez

February 18, 2016

An act to amend Sections 2436.5, 2455.1, 2987.2, 4984.75, and 4996.65 of, and to add Section 4999.121 to, the Business and Professions Code, and to amend Sections 128454, 128551, 128552, 128555, and 128556 of the Health and Safety Code, relating to health professions development, making an appropriation therefor, and declaring the urgency thereof, to take effect immediately.

LEGISLATIVE COUNSEL’S DIGEST

SB 1204, as introduced, Hernandez. Health professions development: loan repayment.

(1) Under existing law, the Medical Board of California licenses and regulates physicians and imposes various fees on those licensees. The Osteopathic Medical Board of California licenses and regulates osteopathic physicians and imposes various fees on those licensees. Existing law establishes the Medically Underserved Account for Physicians within the Health Professions Education Fund that is managed by the Health Professions Education Foundation and the Office of Statewide Health Planning and Development. The primary purpose of the account is to fund the Steven M. Thompson Physician Corps Loan Repayment Program, which provides for the repayment of educational loans, as specified, obtained by a physician who practices in a medically underserved area of the state, as defined. Funds placed in the account for those purposes are continuously appropriated for the repayment of loans. Physicians and osteopathic physicians are eligible for the loan repayment program, and the board assesses an additional $25 license charge at the time of the initial application for licensure and license renewal for purposes of funding the loan repayment program.

This bill would increase the license application and renewal charge to $50. The bill would increase the monetary limits for loan repayment, as specified, and would expand the eligibility for loan repayment funds to include those physicians providing psychiatric services. Because this bill would provide for the deposit of additional moneys in a continuously appropriated fund and would expand the purposes for which moneys in a continuously appropriated fund may be used, it would make an appropriation.

(2) The Psychology Licensing Law establishes the Board of Psychology to license and regulate the practice of psychology. That law establishes a biennial license renewal fee, and, in addition, a $10 fee at the time of renewal of a license for deposit in the Mental Health Practitioner Education Fund. Moneys in that fund are available, upon appropriation, for purposes of the Licensed Mental Health Service Provider Education Program.

This bill would increase that additional fee to $20.

(3) The Licensed Marriage and Family Therapist Act, the Clinical Social Worker Practice Act, and the Licensed Professional Clinical Counselor Act make the Board of Behavioral Sciences responsible for the licensure and regulation of marriage and family therapists, clinical social workers, and professional clinical counselors, respectively. Those acts require the board to establish and assess biennial license renewal fees, as specified. The Licensed Marriage and Family Therapist Act and the Clinical Social Worker Practice Act also require the board to collect an additional fee of $10 at the time of license renewal and directs the deposit of these additional fees in the Mental Health Practitioner Education Fund.

This bill would increase those existing additional fees under the Licensed Marriage and Family Therapist Act and the Clinical Social Worker Practice Act from $10 to $20, and would amend the Licensed Professional Clinical Counselor Act to require the Board of Behavioral Sciences to collect an additional $20 fee at the time of renewal of a license for a professional clinical counselor for deposit in the fund.

(4) Existing law authorizes any licensed mental health service provider, as defined, including a mental health service provider who is employed at a publicly funded mental health facility or a public or nonprofit private mental health facility that contracts with a county mental health entity or facility to provide mental health services, who provides direct patient care in a publicly funded facility or a mental health professional shortage area to apply for grants under the Licensed Mental Health Service Provider Education Program to reimburse his or her educational loans related to a career as a licensed mental health service provider, as provided.

This bill would add licensed professional clinical counselors to those licensed mental health service providers eligible for grants to reimburse educational loans.

This bill would also delete obsolete provisions.

(5) This bill would declare that it is to take effect immediately as an urgency statute.

Vote: ²⁄₃. Appropriation: yes. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

Section 2436.5 of the Business and Professions
Code is amended to read:

2436.5.  

(a) (1) In addition to the fees charged for the initial
issuance or biennial renewal of a physician and surgeon’s certificate
pursuant to Section 2435, and at the time those fees are charged,
the board shall charge each applicant or renewing licensee an
additional begin delete twenty-five-dollar ($25) end delete begin insert fifty end insert begin insert -dollar ($50) end insert fee for the
purposes of this section.

(2) The begin delete twenty-five-dollar ($25) end delete begin insert fifty end insert begin insert -dollar ($50) end insert fee shall be
paid at the time of application for initial licensure or biennial
renewal and shall be due and payable along with the fee for the
initial certificate or biennial renewal.

(3)  On or before July 1, 2015, the board shall develop a
mechanism for a physician and surgeon to pay a voluntary
contribution, at the time of application for initial licensure or
biennial renewal, for the purposes of this section.

(b) The board shall transfer all funds collected pursuant to this
section, on a monthly basis, to the Medically Underserved Account
for Physicians created by Section 128555 of the Health and Safety
Code for the Steven M. Thompson Physician Corps Loan
Repayment Program. Notwithstanding Section 128555 of the
Health and Safety Code, these funds shall not be used to provide
funding for the Physician Volunteer Program.

(c) Up to 15 percent of the funds collected pursuant to this
section shall be dedicated to loan assistance for physicians and
surgeons who agree to practice in geriatric care settings or settings
that primarily serve adults over 65 years of age or adults with
disabilities. Priority consideration shall be given to those physicians
and surgeons who are trained in, and practice, geriatrics and who
can meet the cultural and linguistic needs and demands of diverse
populations of older Californians.

SEC. 2.  

Section 2455.1 of the Business and Professions Code
is amended to read:

2455.1.  

(a) In addition to the fees charged pursuant to Section
2455, and at the time those fees are charged, the board shall charge
each applicant for an original or reciprocity certificate or for a
biennial license an additional begin delete twenty-five-dollar ($25) end delete begin insert fifty end insert begin insert -dollar
($50) end insert fee for the purposes of this section. This begin delete twenty-five-dollar
($25) end delete begin insert fifty end insert begin insert -dollar ($50) end insert fee shall be due and payable along with
the fee for the original or reciprocity certificate or the biennial
license.

(b) On or before July 1, 2015, the board shall develop a
mechanism for an osteopathic physician and surgeon to pay a
voluntary contribution, at the time of initial application for
licensure or biennial renewal, for the purposes of this section.

(c) The board shall transfer all funds collected pursuant to this
section, on a monthly basis, to the Medically Underserved Account
for Physicians created by Section 128555 of the Health and Safety
Code for the purposes of the Steven M. Thompson Physician Corps
Loan Repayment Program. Notwithstanding Section 128555 of
the Health and Safety Code, these funds shall not be used to
provide funding for the Physician Volunteer Program.

SEC. 3.  

Section 2987.2 of the Business and Professions Code
is amended to read:

2987.2.  

In addition to the fees charged pursuant to Section
2987 for the biennial renewal of a license, the board shall collect
an additional fee of begin delete ten end delete begin insert twenty end insert dollars begin delete ($10) end delete begin insert ($20) end insert at the time of
renewal. The board shall transfer this amount to the Controller
who shall deposit the funds in the Mental Health Practitioner
Education Fund.

SEC. 4.  

Section 4984.75 of the Business and Professions Code
is amended to read:

4984.75.  

In addition to the fees charged pursuant to Section
4984.7 for the biennial renewal of a license pursuant to Section
4984, the board shall collect an additional fee of begin delete ten end delete begin insert twenty end insert dollars
begin delete ($10) end delete begin insert ($20) end insert at the time of renewal. The board shall transfer this
amount to the Controller who shall deposit the funds in the Mental
Health Practitioner Education Fund.

SEC. 5.  

Section 4996.65 of the Business and Professions Code
is amended to read:

4996.65.  

In addition to the fees charged pursuant to Section
4996.6 for the biennial renewal of a license, the board shall collect
an additional fee of begin delete ten end delete begin insert twenty end insert dollars begin delete ($10) end delete begin insert ($20) end insert at the time of
renewal. The board shall transfer this amount to the Controller
who shall deposit the funds in the Mental Health Practitioner
Education Fund.

SEC. 6.  

Section 4999.121 is added to the Business and
Professions Code, to read:

4999.121.  

In addition to the fees charged pursuant to Section
4999.120 for the biennial renewal of a license, the board shall
collect an additional fee of twenty dollars ($20) at the time of
renewal. The board shall transfer this amount to the Controller
who shall deposit the funds in the Mental Health Practitioner
Education Fund.

SEC. 7.  

Section 128454 of the Health and Safety Code is
amended to read:

128454.  

(a) There is hereby created the Licensed Mental Health
Service Provider Education Program within the Health Professions
Education Foundation.

(b) For purposes of this article, the following definitions shall
apply:

(1) “Licensed mental health service provider” means a
psychologist licensed by the Board of Psychology, registered
psychologist, postdoctoral psychological assistant, postdoctoral
psychology trainee employed in an exempt setting pursuant to
Section 2910 of the Business and Professions Code, or employed
pursuant to a State Department of Health Care Services waiver
pursuant to Section 5751.2 of the Welfare and Institutions Code,
marriage and family therapist, marriage and family therapist intern,
licensed clinical social worker, begin delete and end delete associate clinical social begin delete worker. end delete
begin insert worker, and licensed professional clinical counselor. end insert

(2) “Mental health professional shortage area” means an area
designated as such by the Health Resources and Services
Administration (HRSA) of the United States Department of Health
and Human Services.

(c) Commencing January 1, 2005, any licensed mental health
service provider, including a mental health service provider who
is employed at a publicly funded mental health facility or a public
or nonprofit private mental health facility that contracts with a
county mental health entity or facility to provide mental health
services, who provides direct patient care in a publicly funded
facility or a mental health professional shortage area may apply
for grants under the program to reimburse his or her educational
loans related to a career as a licensed mental health service
provider.

(d) The Health Professions Education Foundation shall make
recommendations to the director of the office concerning all of the
following:

(1) A standard contractual agreement to be signed by the director
and any licensed mental health service provider who is serving in
a publicly funded facility or a mental health professional shortage
area that would require the licensed mental health service provider
who receives a grant under the program to work in the publicly
funded facility or a mental health professional shortage area for
at least one year.

(2) The maximum allowable total grant amount per individual
licensed mental health service provider.

(3) The maximum allowable annual grant amount per individual
licensed mental health service provider.

(e) The Health Professions Education Foundation shall develop
the program, which shall comply with all of the following
requirements:

(1) The total amount of grants under the program per individual
licensed mental health service provider shall not exceed the amount
of educational loans related to a career as a licensed mental health
service provider incurred by that provider.

(2) The program shall keep the fees from the different licensed
providers separate to ensure that all grants are funded by those
fees collected from the corresponding licensed provider groups.

(3) A loan forgiveness grant may be provided in installments
proportionate to the amount of the service obligation that has been
completed.

(4) The number of persons who may be considered for the
program shall be limited by the funds made available pursuant to
Section 128458.

SEC. 8.  

Section 128551 of the Health and Safety Code is
amended to read:

128551.  

(a) It is the intent of this article that the Health
Professions Education Foundation and the office provide the
ongoing program management of the two programs identified in
subdivision (b) of Section 128550 as a part of the California
Physician Corps Program.

(b)  For purposes of subdivision (a), the foundation shall consult
with the Medical Board of California, Office of Statewide begin insert Health end insert
Planning and Development, and shall establish and consult with
an advisory committee of not more than seven members, that shall
include two members recommended by the California Medical
Association and may include other members of the medical
community, including ethnic representatives, medical schools,
health advocates representing ethnic communities, primary care
clinics, public hospitals, and health systems, statewide agencies
administering state and federally funded programs targeting
underserved communities, and members of the public with
expertise in health care issues.

SEC. 9.  

Section 128552 of the Health and Safety Code is
amended to read:

128552.  

For purposes of this article, the following definitions
shall apply:

(a) “Account” means the Medically Underserved Account for
Physicians established within the Health Professions Education
Fund pursuant to this article.

(b) “Foundation” means the Health Professions Education
Foundation.

(c) “Fund” means the Health Professions Education Fund.

(d) “Medi-Cal threshold languages” means primary languages
spoken by limited-English-proficient (LEP) population groups
meeting a numeric threshold of 3,000, eligible LEP Medi-Cal
beneficiaries residing in a county, 1,000 Medi-Cal eligible LEP
beneficiaries residing in a single ZIP Code, or 1,500 LEP Medi-Cal
beneficiaries residing in two contiguous ZIP Codes.

(e) “Medically underserved area” means an area defined as a
health professional shortage area in Part 5 begin insert (commencing with
Section 5.1) end insert of Subchapter A of Chapter 1 of Title 42 of the Code
of Federal Regulations or an area of the state where unmet priority
needs for physicians exist as determined by the California
Healthcare Workforce Policy Commission pursuant to Section
128225.

(f) “Medically underserved population” means the Medi-Cal
program begin delete , Healthy Families Program, end delete and uninsured populations.

(g) “Office” means the Office of Statewide Health Planning and
Development (OSHPD).

(h) “Physician Volunteer Program” means the Physician
Volunteer Registry Program established by the Medical Board of
California.

(i) “Practice setting,” for the purposes of this article only, means
either of the following:

(1) A community clinic as defined in subdivision (a) of Section
1204 and subdivision (c) of Section 1206, a clinic owned or
operated by a public hospital and health system, or a clinic owned
and operated by a hospital that maintains the primary contract with
a county government to fulfill the county’s role pursuant to Section
17000 of the Welfare and Institutions Code, which is located in a
medically underserved area and at least 50 percent of whose
patients are from a medically underserved population.

(2) A physician owned and operated medical practice setting
that provides primary care begin insert or psychiatric services end insert located in a
medically underserved area and has a minimum of 50 percent of
patients who are uninsured, Medi-Cal beneficiaries, or beneficiaries
of another publicly funded program that serves patients who earn
less than 250 percent of the federal poverty level.

(j) “Primary specialty” means family practice, internal medicine,
pediatrics, begin insert psychiatry, end insert or obstetrics/gynecology.

(k) “Program” means the Steven M. Thompson Physician Corps
Loan Repayment Program.

(l) “Selection committee” means a minimum three-member
committee of the board, that includes a member that was appointed
by the Medical Board of California.

SEC. 10.  

Section 128555 of the Health and Safety Code is
amended to read:

128555.  

(a) The Medically Underserved Account for
Physicians is hereby established within the Health Professions
Education Fund. The primary purpose of this account is to provide
funding for the ongoing operations of the Steven M. Thompson
Physician Corps Loan Repayment Program provided for under
this article. This account also may be used to provide funding for
the Physician Volunteer Program provided for under this article.

begin delete

(b) All moneys in the Medically Underserved Account contained
within the Contingent Fund of the Medical Board of California
shall be transferred to the Medically Underserved Account for
Physicians on July 1, 2006.

end delete begin delete

(c)

end delete

begin insert (b) end insert  Funds in the account shall be used to repay loans as follows
per agreements made with physicians:

(1) Funds paid out for loan repayment may have a funding match
from foundations or other private sources.

(2) Loan repayments may not exceed begin delete one hundred five thousand
dollars ($105,000) end delete begin insert one hundred fifty thousand dollars ($150,000) end insert
per individual licensed physician.

(3) Loan repayments may not exceed the amount of the
educational loans incurred by the physician participant.

begin delete

(d)

end delete

begin insert (c) end insert  Notwithstanding Section 11105 of the Government Code,
begin delete effective January 1, 2006, end delete the foundation may seek and receive
matching funds from foundations and private sources to be placed
in the account. “Matching funds” shall not be construed to be
limited to a dollar-for-dollar match of funds.

begin delete

(e)

end delete

begin insert (d) end insert  Funds placed in the account for purposes of this article,
including funds received pursuant to subdivision (d), are,
notwithstanding Section 13340 of the Government Code,
continuously appropriated for the repayment of loans. This
subdivision shall not apply to funds placed in the account pursuant
to Section 1341.45.

begin delete

(f)

end delete

begin insert (e) end insert  The account shall also be used to pay for the cost of
administering the program and for any other purpose authorized
by this article. The costs for administration of the program may
be up to 5 percent of the total state appropriation for the program
and shall be subject to review and approval annually through the
state budget process. This limitation shall only apply to the state
appropriation for the program.

begin delete

(g)

end delete

begin insert (f) end insert  The office and the foundation shall manage the account
established by this section prudently in accordance with the other
provisions of law.

SEC. 11.  

Section 128556 of the Health and Safety Code is
amended to read:

128556.  

The terms of loan repayment granted under this article
shall be as follows:

(a) After a program participant has completed one year of
providing services as a physician in a medically underserved area,
up to begin delete twenty-five thousand dollars ($25,000) end delete begin insert forty thousand dollars
($40,000) end insert for loan repayment shall be provided.

(b) After a program participant has completed two consecutive
years of providing services as a physician in a medically
underserved area, an additional amount of loan repayment up to
begin delete thirty-five thousand dollars ($35,000) end delete begin insert fifty thousand dollars
($50,000) end insert shall be provided, for a total loan repayment of up to
begin delete sixty thousand dollars ($60,000). end delete begin insert ninety thousand dollars
($90,000). end insert

(c) After a program participant has completed three consecutive
years of providing services as a physician in a medically
underserved area, an additional amount of loan repayment up to
begin delete forty-five thousand dollars ($45,000) end delete begin insert sixty thousand dollars
($60,000) end insert shall be provided, for a total loan repayment of up to
begin delete one hundred five thousand dollars ($105,000). end delete begin insert one hundred fifty
thousand dollars ($150,000). end insert

SEC. 12.  

This act is an urgency statute necessary for the
immediate preservation of the public peace, health, or safety within
the meaning of Article IV of the Constitution and shall go into
immediate effect. The facts constituting the necessity are:

In order to address the urgent need for physicians and licensed
mental health practitioners in medically underserved areas, it is
necessary that this act take effect immediately.