Amended in Senate April 21, 2016

Amended in Senate April 14, 2016

Senate Bill No. 1471

Introduced by Senator Hernandez

February 19, 2016

An act to amend Sections 1341.45, 128551, and 128552 begin delete of, and to add Section 128555.5 to, end delete begin insert of end insert the Health and Safety Code, relating to health professions development.

LEGISLATIVE COUNSEL’S DIGEST

SB 1471, as amended, Hernandez. Health professions development: loan repayment.

Existing law establishes the Steven M. Thompson Physician Corps Loan Repayment Program in the California Physician Corps Program within the Health Professions Education Foundation, which provides financial incentives, including repayment of educational loans, to a physician and surgeon who practices in a medically underserved area, as begin delete defined. end delete begin insert defined, and end insert begin insert who is trained in, and practices, in certain practice settings or primary specialities, as defined. Existing law authorizes the selection committee to fill up to 20% of the available positions with program applicants from specialities outside of the primary specialties, including psychiatry. end insert Existing law establishes the Medically Underserved Account for Physicians, a continuously appropriated account, within the Health Professions Education Fund that is managed by the Health Professions Education Foundation and the Office of Statewide Health Planning and Development, to primarily provide funding for the ongoing operations of the Steven M. Thompson Physician Corps Loan Repayment Program.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and imposes certain requirements on health care service plans. Existing law imposes various fines and administrative penalties on health care service plans for certain violations of the act, which are deposited into the Managed Care Administrative Fines and Penalties Fund. Existing law requires the first $1,000,000 in the fund to be transferred each year to the Medically Underserved Account for Physicians and to be used, upon appropriation by the Legislature, for purposes of the Steven M. Thompson Physician Corps Loan Repayment Program. Existing law requires all remaining funds to be transferred each year to the Major Risk Medical Insurance Fund and to be used, upon appropriation by the Legislature, for purposes of the Major Risk Medical Insurance Program.

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This bill would expand the eligibility for loan repayment funds under the Steven M. Thompson Physician Corps Loan Repayment Program to include those physicians providing psychiatric services. The bill would provide that continuously appropriated funds deposited into the Medically Underserved Account for Physicians shall not be made available under the Steven M. Thompson Physician Corps Loan Repayment Program to fund the repayment of loans for those physicians providing psychiatric services or those physicians whose primary specialty is psychiatry, as specified.

end delete

The bill would instead require, after the first $1,000,000 is transferred from the Managed Care Administrative Fines and Penalties Fund to the Medically Underserved Account for Physicians, $1,000,000 to be transferred each year to the Major Risk Medical Insurance Fund to be used, upon appropriation by the Legislature, for the Major Risk Medical Insurance Program. The bill would require any amount remaining over the amounts transferred to the Medically Underserved Account for Physicians and the Major Risk Medical Insurance Fund to be transferred each year to the Medically Underserved Account for Physicians to be used, upon appropriation by the Legislature, for the Steven M. Thompson Physician Corps Loan Repayment Program, and provide that one-half of these moneys begin delete are to be used end delete begin insert may be prioritized end insert to fund the repayment of loans for those begin delete physicians providing psychiatric services or those physicians whose primary specialty is psychiatry end delete begin insert program applicants who are trained in, and practice, psychiatry, end insert under the Steven M. Thompson Physician Corps Loan Repayment Program.

The bill would also delete a reference to an obsolete program and make other technical, nonsubstantive changes.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

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

SECTION 1.  

Section 1341.45 of the Health and Safety Code
is amended to read:

1341.45.  

(a) There is hereby created in the State Treasury the
Managed Care Administrative Fines and Penalties Fund.

(b) The fines and administrative penalties collected pursuant to
this chapter, on and after September 30, 2008, shall be deposited
into the Managed Care Administrative Fines and Penalties Fund.

(c) The fines and administrative penalties deposited into the
Managed Care Administrative Fines and Penalties Fund shall be
transferred by the department, annually, as follows:

(1) The first one million dollars ($1,000,000) shall be transferred
to the Medically Underserved Account for Physicians within the
Health Professions Education Fund and shall, upon appropriation
by the Legislature, be used for the purposes of the Steven M.
Thompson Physician Corps Loan Repayment Program, as specified
in Article 5 (commencing with Section 128550) of Chapter 5 of
Part 3 of Division 107 and, notwithstanding Section 128555, shall
not be used to provide funding for the Physician Volunteer
Program.

(2) Until January 1, 2017, any amount over the first one million
dollars ($1,000,000), including accrued interest, in the fund shall
be transferred to the Major Risk Medical Insurance Fund continued
pursuant to Section 15893 of the Welfare and Institutions Code
and shall, upon appropriation by the Legislature, be used for the
Major Risk Medical Insurance Program for the purposes specified
in Section 15894 of the Welfare and Institutions Code.

(3) On and after January 1, 2017, and annually thereafter, the
second one million dollars ($1,000,000) shall be transferred to the
Major Risk Medical Insurance Fund continued pursuant to Section
15893 of the Welfare and Institutions Code and shall, upon
appropriation by the Legislature, be used for the Major Risk
Medical Insurance Program for the purposes specified in Section
15894 of the Welfare and Institutions Code.

(4) (A) On and after January 1, 2017 any amount over the first
two million dollars ($2,000,000), including accrued interest, in the
fund shall be transferred to the Medically Underserved Account
for Physicians within the Health Professions Education Fund and
shall, upon appropriation by the Legislature, and subject to
subparagraph (B), be used for the purposes of the Steven M.
Thompson Physician Corps Loan Repayment Program, as specified
in Article 5 (commencing with Section 128550) of Chapter 5 of
Part 3 of Division 107 and, notwithstanding Section 128555, shall
not be used to provide funding for the Physician Volunteer
Program.

(B)  begin delete One-half end delete begin insert Up to one-half end insert of the moneys deposited into the
Medically Underserved Account for Physicians within the Health
Professions Education Fund under this paragraph begin delete shall, upon
appropriation by the Legislature, be used end delete begin insert may be prioritized end insert to
fund the repayment of begin delete loans end delete begin insert loans end insert begin insert pursuant to paragraph (2) of
subdivision (d) of Section 128553 end insert for those begin delete physicians providing
psychiatric services or those physicians whose primary specialty
is psychiatry end delete begin insert program applicants who are trained in, and practice,
psychiatry, end insert under the Steven M. Thompson Physician Corps Loan
Repayment begin delete Program, as specified in Article end delete begin insert Program (Article end insert 5
(commencing with Section 128550) of Chapter 5 of Part 3 of
Division begin delete 107. end delete begin insert 107). end insert

(d) Notwithstanding subdivision (b) of Section 1356 and Section
1356.1, the fines and administrative penalties authorized pursuant
to this chapter shall not be used to reduce the assessments imposed
on health care service plans pursuant to Section 1356.

SEC. 2.  

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 Health
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. 3.  

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 (commencing with
Section 5.1) 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 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 delete or psychiatric services end delete 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 delete psychiatry, end delete 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.

begin delete

SEC. 4.  

Section 128555.5 is added to the Health and Safety
Code, to read:

128555.5.  

Notwithstanding subdivision (e) of Section 128555,
funds deposited into the Medically Underserved Account for
Physicians shall not be made available to fund the repayment of
loans under the Steven M. Thompson Physician Corps Loan
Repayment Program for those physicians providing psychiatric
services or those physicians whose primary specialty is psychiatry,
except as provided in subparagraph (B) of paragraph (4) of
subdivision (c) of Section 1341.45.

end delete