BILL ANALYSIS
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UNFINISHED BUSINESS
Bill No: SB 606
Author: Ducheny (D)
Amended: 6/18/09
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEVELOP. COMM. : 8-1,
4/13/09
AYES: Negrete McLeod, Wyland, Corbett, Florez, Oropeza,
Romero, Walters, Yee
NOES: Aanestad
NO VOTE RECORDED: Correa
SENATE APPROPRIATIONS COMMITTEE : 11-0, 4/27/09
AYES: Kehoe, Cox, Corbett, Denham, DeSaulnier, Leno,
Oropeza, Runner, Walters, Wolk, Yee
NO VOTE RECORDED: Hancock, Wyland
SENATE FLOOR : 34-1, 5/11/09
AYES: Alquist, Ashburn, Benoit, Cogdill, Corbett, Correa,
Cox, Denham, DeSaulnier, Ducheny, Dutton, Florez,
Hancock, Harman, Huff, Kehoe, Leno, Liu, Lowenthal,
Maldonado, Negrete McLeod, Oropeza, Padilla, Pavley,
Romero, Runner, Steinberg, Strickland, Walters, Wiggins,
Wolk, Wright, Wyland, Yee
NOES: Aanestad
NO VOTE RECORDED: Calderon, Cedillo, Hollingsworth,
Simitian,
ASSEMBLY FLOOR : 71-4, 9/2/09 - See last page for vote
SUBJECT : Physicians and surgeons: loan repayment
CONTINUED
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SOURCE : Osteopathic Physicians and Surgeons of
California
California Medical Association
DIGEST : This bill requires the Osteopathic Medical Board
of California (OMBC) to assess an additional $25 fee from
an osteopathic physician and surgeon (D.O.) applying for
initial or reciprocity licensure, or for a biennial renewal
license. Requires the funds collected by the OMBC to be
transferred to the Medically Underserved Account for
Physicians for the Steven M. Thompson Physician Corps Loan
Repayment Program (STLRP). This bill allows osteopathic
physicians and surgeons to be eligible to apply for the
STLRP.
Assembly Amendments include D.O.s in the definition of
"health professions or health professionals" within the
Health Professions Education Foundation, which includes the
STLRP.
ANALYSIS : Existing law:
1. Establishes the Medically Underserved Account for
Physicians within the Health Professions Education Fund
to provide funding for the STLRP, which provides loan
repayment assistance to physicians and surgeons who
agree to practice in a medically underserved community.
2. Establishes the Osteopathic Act of 1922, by voter
initiative, to regulate the practice of osteopathic
medicine. Establishes the OMBC to license, regulate and
discipline D.O.s. Specifies that the policy of the
state of California is that holders of M.D. degrees and
D.O. degrees are to be accorded equal professional
status and privileges as licensed physicians and
surgeons.
3. Establishes a schedule of fees for D.O.s, including fees
for certificates and renewal of license. Requires the
OMBC to assess up to $400 for each applicant for an
original or reciprocity certificates, and up to $400 for
a biennial license fee.
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4. Establishes the Medical Board of California (MBC) to
license, regulate, and discipline physicians and
surgeons, and specifies that the protection of the
public is the highest priority of the MBC.
5. Requires the MBC to assess a $25 licensure fee on
physicians and surgeons for the purpose of the STLRP.
This bill:
1. Requires the OMBC to assess an additional $25 fee from a
D.O. applying for an original or reciprocity
certificate, or for a biennial renewal license.
Requires the funds collected to be used for the STLRP.
2. Allows osteopathic physicians and surgeons to be
eligible to apply to the STLRP.
3. Deletes existing law authorization for the use of the
STLRP to fund the Physician Volunteer Program.
4. Includes D.O.s in the definition of "health professions
or health professionals" within the Health Professions
Education Foundation.
Background
Osteopathic Physicians and Surgeons . The Osteopathic
Initiative Act of 1922 was established through the
initiative process and created the OMBC to license and
regulate the practice of osteopathic medicine in
California. Existing law states that holders of medical
degrees and osteopathic degrees are accorded equal
professional status and privileges as licensed physicians
and surgeons. According to the website of the OPSC,
osteopathic physicians put special emphasis on the role of
the bones, muscles and joints in the healthy functioning of
the human body. D.O.s are physicians who may be certified
to specialize in family medicine, obstetrics/gynecology,
pediatrics, surgery, internal medicine, and all other
medical specialties and subspecialties. Osteopathic
Manipulative Treatment (OMT) is incorporated in the
training and practice of osteopathic physicians, and allows
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D.O.s to use their hands to diagnose injury and illness.
Currently, there are over 5,000 D.O.s licensed and
regulated by the OMBC.
Steven M. Thompson Physician Corps Loan Repayment Program
(STLRP) . The STLRP was established to encourage physicians
to practice in medically underserved areas (MUAs) of
California by authorizing a plan for repayment of their
educational loans. The STLRP is administered by the Office
of Statewide Health Planning and Development and allows
licensed physician graduates who are practicing direct
patient care within the State of California to apply for a
grant. An awardee may receive up to $105,000 to repay
educational debt if he or she commits to a three-year
service obligation practicing in direct patient care in a
MUA in California. According to the U.S. Health Resources
and Services Administration (HRSA), MUAs and medically
underserved populations have shortages of primary medical
care, dental or mental health providers and may be
designated based on geographic (a county or service area),
or demographic (low income, Medicaid-eligible populations,
cultural and/or linguistic access barriers to primary
medical care services) criteria. According to HRSA, there
are over 160 MUAs in 47 California counties. Current law
allows using funds from the STLRP to provide funding for
the Physician Volunteer Program which is a registry of
volunteer physicians who provide voluntary, unpaid service
to a public agency, not-for-profit agency, institution, or
corporation that provides medical services to indigent
patients in medically underserved or critical-need
population areas of the state.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11
2011-12 Fund
Increased fee ($37.5) ($75)
($81)Special*
revenue
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*Medically Underserved Account for Physicians
SUPPORT : (Verified 9/3/09)
Osteopathic Physicians and Surgeons of California
(co-source)
California Medical Association (co-source)
Association of Health Care Districts
California Primary Care Association
American Federation of State, County and Municipal
Employees
ARGUMENTS IN SUPPORT : According to the Osteopathic
Physicians and Surgeons of California (OPSC) and the
California Medical Association (CMA), the Sponsors of this
bill, this measure is another tool in addressing the
shortage of physicians in underserved areas of the state.
OPSC and CMA indicate that D.O.s are recognized under state
law as equivalent to physicians and surgeons licensed by
the MBC. They point out that D.O.s were originally
excluded from the STLRP because the source of funding
originated with physicians and surgeons licensed by the
MBC. OPSC claims that D.O.s are highly interested in
participating in the STLRP and through this bill offers
additional funding for the STLRP. There is a large
population of D.O.s who specialize in primary care and
practice in rural and underserved areas and this bill
advances the primary purposes of the STLRP.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Arambula, Beall, Bill Berryhill, Tom
Berryhill, Blakeslee, Block, Blumenfield, Brownley,
Caballero, Charles Calderon, Carter, Chesbro, Conway,
Cook, Coto, Davis, De La Torre, De Leon, Emmerson, Eng,
Evans, Feuer, Fletcher, Fong, Fuentes, Fuller, Furutani,
Galgiani, Garrick, Gilmore, Hagman, Harkey, Hayashi,
Hernandez, Hill, Huber, Huffman, Jeffries, Jones,
Krekorian, Lieu, Logue, Bonnie Lowenthal, Ma, Mendoza,
Monning, Nava, Nestande, Niello, Nielsen, John A. Perez,
V. Manuel Perez, Portantino, Ruskin, Salas, Saldana,
Silva, Skinner, Smyth, Solorio, Audra Strickland,
Swanson, Torlakson, Torres, Torrico, Tran, Villines,
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Yamada, Bass
NOES: Anderson, DeVore, Knight, Miller
NO VOTE RECORDED: Buchanan, Duvall, Gaines, Hall
JA:nl 9/3/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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