BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:       SB 1416
          AUTHOR:        Rubio and Hernandez
          AMENDED:       April 16, 2012
          HEARING DATE:  April 25, 2012
          CONSULTANT:    Moreno

           SUBJECT  :  Medical residency training program grants: grants.
           
          SUMMARY  :  Creates the Graduate Medical Education (GME) Trust 
          Fund and requires moneys in the fund to be used by the Office of 
          Statewide Health Planning and Development (OSHPD) to fund grants 
          to medical residency training programs for the creation of 
          additional residency positions.  

          Existing law:
          1.Establishes the California Healthcare Workforce Policy 
            Commission (Commission) and requires the Commission to, among 
            other things, 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 OSHPD concerning the 
            funding of those programs that are submitted to the Health 
            Professions Development Program for participation in the state 
            medical contract program.

          2.Establishes the Health Professions Education Foundation 
            (Foundation) within OSHPD.  Requires the Foundation to solicit 
            and receive funds from foundations and other private and 
            public sources and to provide financial assistance in the form 
            of scholarships or loans to students in the health professions 
            who are from underrepresented groups. Provides that the 
            Foundation is governed by a board consisting of 13 members 
            appointed by the Governor, Speaker of the Assembly, and Senate 
            Rules Committee.

          3.Establishes, under the Foundation, scholarship, loan, and loan 
            repayment programs for registered nurses, vocational nurses, 
            geriatric nurse practitioners, clinical nurse specialists, and 
            mental health professionals who agree to practice for 
            specified periods of time in underserved areas and in 
                                                         Continued---



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            designated practice settings, as specified.  

          4.Establishes, under the Foundation, the Steven M. Thompson 
            Physician Corps Loan Repayment Program (STPCLRP), which 
            provides for the repayment of educational loans for licensed 
            physicians and surgeons who practice in medically underserved 
            areas of the state, as defined.   Requires the Foundation, in 
            administering the STPCLRP, to use and develop guidelines for 
            applicants that give preference to applicants who are best 
            suited to meet the cultural and linguistic needs of patients 
            in medically underserved populations, as specified, and who 
            agree to practice in geriatric care settings. Also allows the 
            Foundation to appoint a selection committee to provide policy 
            direction and guidance to the STPCLRP. Requires funds for loan 
            repayment under the STPCLRP to have a funding match from a 
            foundation or other private source. Establishes a Medically 
            Underserved Account for Physicians within the Fund, the 
            primary purpose of which is to provide funding for the 
            STPCLRP.  

          5.Establishes within OSHPD the Health Professions Education Fund 
            (Fund) to receive funds for scholarships and loans to students 
            from underrepresented groups who are enrolled in or accepted 
            to schools of medicine, dentistry, nursing, and other health 
            professions.  Provides that moneys in the Fund are 
            continuously appropriated.

          6.Establishes the Song-Brown Health Care Workforce Training Act 
            of 1973 (Song-Brown Act), administered by OSHPD to provide 
            financial support to family practice residency programs, nurse 
            practitioner and physician assistant programs, and registered 
            nurse education programs to increase the number of students 
            and residents receiving education and training in family 
            practice and nursing. The Song-Brown Act also encourages 
            universities and primary care health professionals to provide 
            health care in medically underserved areas.  
          
          This bill:
          1.Creates the GME Trust Fund and requires moneys in the fund to 
            be used by OSHPD to fund grants to medical residency training 
            programs for the creation of additional residency positions.  
            Requires additional residency positions funded pursuant to 
            this bill to be funded at the same rate as residency positions 
            funded through the Medicare Program.

          2.Requires the GME Trust Fund to consist of all private moneys 




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            donated by private individuals or entities to the Commission 
            for deposit into the fund, any amounts appropriated to the 
            fund by the Legislature, and any interest that accrues on 
            amounts in the fund. Requires all interest earned on the 
            moneys in the fund to be retained in the fund and used for 
            purposes consistent with the fund.

           FISCAL EFFECT  :  This bill has not been analyzed by a fiscal 
          committee.

           COMMENTS  :  
           1.Author's statement.  According to the authors, California 
            currently has statewide workforce shortages in several major 
            health professions and these needs will increase dramatically 
            due to population aging, growth, and increasing diversity. 
            According to California Medical Association (CMA), over the 
            past 15 years, California's population has increased by 7 
            million while the number of medical school graduates has 
            remained stagnant. The most conservative reports estimate a 
            physician shortage of 17,000 by 2015. Additionally, the 
            physicians we do have are not evenly distributed throughout 
            the state, creating pockets of remarkably underserved regions. 
            In Kern County, for example, the ratio of population to 
            primary care providers is 1206:1 compared to the statewide 
            average of 847:1. This problem will be further compounded in 
            2014 by the 4.7 million new Californians that will be eligible 
            for health insurance as a result of the federal Patient 
            Protection Affordability Care Act (ACA). GME funding varies 
            nationwide. The majority of the funds come from Medicare but 
            states may provide direct payments for residency programs or 
            get a federal match through Medicaid, the second-largest 
            funding source for GME. But with no increase in Medicare GME 
            funding and tightening state budgets, academic health centers 
            are unable to expand residency programs to meet increasing 
            needs. This bill will help address these workforce shortages 
            by laying the groundwork for a permanent fund for residency 
            training slots that will be targeted at meeting the needs of 
            underserved regions of our state.  

          2.GME funding.  According to the Western Journal of Medicine, 
            Medicare is the largest source of federal funding for medical 
            education. Beginning in 1985, Medicare replaced its cost-based 
            funding formula with two types of payments: direct medical 
            education (DME) payments and indirect medical education (IME) 
            adjustments. DME payments are intended to defray the costs 




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            associated with program administration and salaries for 
            residents and teaching personnel. IME adjustments are intended 
            to cover the costs associated with the unnecessary procedures 
            that residents order and other inefficiencies of residents. In 
            2009, Medicare spent $9.5 billion on GME, $3 billion of which 
            was on DME payments and the remaining $6.5 billion was 
            directed towards IME adjustments. Other sources of federal 
            funding for medical education include Medicaid, the Department 
            of Veterans Affairs (VA), the Department of Defense, and the 
            Bureau of Health Professions. Most states (48 of 50 states) 
            fund GME through their Medicaid programs and receive federal 
            matching funds for this purpose.

          Several states and the VA are using innovative GME financing 
            approaches to take into account state or national physician 
            workforce needs in their decisions on how many GME programs to 
            support and in which specialties. Utah has created a system to 
            link Medicare and Medicaid payments to meet the state's 
            physician workforce needs; Texas lawmakers have authorized 
            state-formula funding to expand GME; Minnesota is pooling 
            multiple payment sources to offset the costs of clinical 
            training and to ensure health care research; and the VA is 
            increasing its support of the GME enterprise with a 
            multi-year, 2,000-position expansion of resident positions in 
            specialties of greatest need to US veterans.

          3.Workforce shortages.  In March 2012, the Senate Health 
            Committee held two initial hearings in a series on 
            California's health care workforce. The background paper, 
            prepared by the Senate Office of Research (SOR), stated that 
            statewide shortages of health care providers currently exist 
            in several major health professions. Additionally, health care 
            workforce needs are projected to increase dramatically due to 
            the aging of the general population as well as health care 
            providers, population growth, expanding diversity and 
            implementation of the ACA. Recent health care workforce 
            research indicates that health professional shortage, 
            distribution, and diversity issues impact access to primary, 
            allied, mental, and dental health care in California today. 
            The demand for these health care professions is also 
            forecasted to grow faster than professions in other 
            industries. According to the SOR paper, the scale and scope of 
            the problem is not well understood because data on the supply 
            and demand of health professionals is incomplete and is not 
            systematically or regularly updated.  





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          4.Physician shortages. According to a June 2009 report 
            commissioned by the California HealthCare Foundation (CHCF), 
            California is at the lower end of the range of need for 
            primary care physicians, and the distribution of these 
            physicians is poor. According to the report, in 2008 there 
            were 69,460 actively practicing physicians in California (this 
            includes Doctors of Medicine and Doctors of Osteopathic 
            Medicine), and 35 percent (or 24,124) of these physicians 
            reported practicing primary care. This equates to 63 active 
            primary care physicians in patient care per 100,000 
            population. According to the Council on Graduate Medical 
            Education, a range of 60 to 80 primary care physicians are 
            needed per 100,000 in order to adequately meet the needs of 
            the population. According to OSHPD data, only 16 of 
            California's 58 counties fall within the needed-supply range 
            for primary care physicians.  Those areas that meet the 
            recommended supply range include the Bay Area and Sacramento, 
            and Orange counties. Areas with a pronounced under supply of 
            primary care physicians include the Inland Empire and the San 
            Joaquin Valley.

          5.ACA.  The demand for primary care physicians will be further 
            strained; according to a February 2011 UCLA Center for Health 
            Policy Research brief, this existing shortage will only 
            intensify as about 4.7 million new Californians will be 
            eligible for health insurance, starting in 2014, as a result 
            of implementation of the ACA. Research has found that persons 
            who have health insurance use more health care services than 
            uninsured persons, particularly in the areas of primary care 
            and preventive services. According to a March 2009 Kaiser 
            Family Foundation report, this was found in Massachusetts, 
            which experienced a substantial increase in demand for primary 
            care services as a result of its 2006 health care reform. 
            Consequently, it is likely that there will be a substantial 
            increase in the demand for primary care services by these 
            newly insured. 

          6.Potential solutions.  According to the March 2012 SOR paper, 
            there are several strategies to address the barriers that may 
            be limiting the supply and utilization of the health care 
            workforce. These options, many of which are controversial, 
            should be considered with the following guiding principles in 
            mind: improving access to care, increasing the diversity and 
            cultural competency of the health care workforce, and ensuring 
            patient safety. With regard to education-based solutions, a 




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            number were cited, including increasing capacity at 
            higher-education institutions and encouraging a three-year 
            medical school within the University of California system.
          
          7.Current workforce development programs. The state currently 
            operates a number of programs designed to increase the number 
            of health care professionals practicing in medically 
            underserved areas:
             �    Health Professions Education Foundation.  The 
               Foundation, within OSHPD, provides scholarships and loan 
               repayments to aspiring and practicing health professionals 
               who agree to practice in a medically underserved area. 
               Scholarships are offered to health professional students 
               who are attending a California accredited college or 
               university.  Loan repayment programs are offered to 
               graduates who are pursuing a health professional career to 
               assist in the repayment of education debt. Scholarships are 
               offered to students and graduates in several allied health 
               professions, nursing, mental health, dentistry, and 
               medicine.  In exchange for financial assistance, awardees 
               are required to provide direct patient care in a medically 
               underserved area. Service obligations are typically one to 
               four years, and vary depending on the program. One of the 
               programs offered under the Foundation is the STPCLRP, which 
               provides assistance with the repayment of educational loans 
               for licensed physicians and surgeons who practice in 
               medically underserved areas of the state. The STPCLRP is 
               supported by a $25 licensure fee paid by physicians and 
               limits loan repayment awards from exceeding $105,000 per 
               individual physician.
             �    California State Loan Repayment Program.  The California 
               State Loan Repayment Program (CSLRP) provides educational 
               loan repayment assistance to primary health care 
               professionals who provide health care services in federally 
               designated Health Professional Shortage Areas (HPSAs). 
               Eligible health professionals include physicians 
               specializing in primary care fields, nurse practitioners, 
               certified nurse-midwives, general practice dentists, dental 
               hygienists, clinical or counseling psychologists, clinical 
               social workers, licensed counselors, psychiatric nurse 
               specialists, and marriage and family therapists. Eligible 
               health professionals also must be employed, or have 
               accepted employment, at an eligible site (which includes 
               county facilities, rural health clinics, community health 
               clinics, and federally qualified health centers) and must 
               commit to providing full-time primary care services in a 




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               HPSA for a minimum of two years. Health professionals may 
               receive $60,000 in exchange for a two-year service 
               obligation, $100,000 for a three-year service obligation, 
               and up to $170,000 over five years, the cost of which is 
               divided between state award amounts and matching funds from 
               the site in which the health professional will be 
               practicing. The CSLRP is funded through a grant from the 
               Bureau of Health Professions, National Health Service Corps 
               and is administered by OSHPD.
             �    Song-Brown Program.  The Song-Brown Health Care 
               Workforce Training Act was established in 1973 to address 
               the shortage of physicians engaged in family practice in 
               California by providing financial support to family 
               practice residency, nurse practitioner, physician 
               assistant, and registered nurse education programs 
               throughout California. It also encourages universities and 
               primary care health professionals to provide health care in 
               medically underserved areas. The Song-Brown program 
               currently funds 27 California family practice residency 
               programs, 16 physician assistant/nurse practitioner 
               programs, and 34 registered nurse education programs.  
          
          1.Related legislation. SB 635 (Hernandez) would require funds 
            deposited in the Managed Care Administrative Fines and 
            Penalties Fund in excess of $1,000,000 be transferred each 
            year to OSHPD for the purposes of the Song-Brown Program. SB 
            635 is pending in the Assembly Health Committee. 

            AB 589 (Perea) would establish the Steven M. Thompson Medical 
            School Scholarship Program and would provide that the program 
            is open to persons who agree in writing, prior to entering an 
            accredited medical or osteopathic school, to serve in an 
            eligible practice setting, as defined, for at least three 
            years. AB 589 is on the Senate Appropriations Committee 
            suspense file.

          2.Prior legislation.  AB 2551 (Hernandez) of 2010 would have 
            established the Health Workforce Development Fund, consisting 
            of moneys received from federal and private sources, as 
            specified; would have authorized the Fund to be used, upon 
            appropriation by the Legislature, for prescribed purposes 
            relating to health workforce development, and would have 
            required the California Workforce Investment Board and OSHPD 
            to report specified information to the Legislature annually, 
            as specified. AB 2551 failed passage on the Senate Floor.




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            AB 657 (Hernandez) of 2009 would have required OSHPD, in 
            collaboration with the California Workforce Investment Board, 
            to establish the Health Professions Workforce Task Force, 
            composed of specified members, to assist in the development of 
            a health professions workforce master plan for the state and 
            would have prescribed the functions and duties of the task 
            force in that regard. AB 657 was vetoed by the Governor, who 
            stated, in part, that the bill was unnecessary and duplicative 
            of efforts already underway.

            AB 2375 (Hernandez) of 2008 would have required OSHPD to 
            establish the Health Professions Workforce Task Force, as 
            specified, to assist in the development of a health 
            professions workforce master plan. AB 2375 was held in the 
            Senate Appropriations Committee on suspense.

            AB 2439 (De La Torre), Chapter 640, Statutes of 2008, requires 
            the Medical Board of California (MBC) to assess an additional 
            $25 fee for the initial license and license
            renewal of a physician or surgeon to support the STPCLRP.  
            Requires up to 15 percent of the funds collected from the 
            additional $25 fee to be dedicated to loan assistance for
            physicians who agree to practice in geriatric care settings, 
            as specified.

            AB 327 (De La Torre), Chapter 293, Statutes of 2005, requires 
            the MBC to assess an applicant a $50 fee for the issuance and 
            renewal of a physician and surgeon's certificate. Specifies 
            that payment of the fee is voluntary and directs the fees to 
            the Medically Underserved Account for the STPCLRP.

            AB 920 (Aghazarian), Chapter 317, Statutes of 2005, provides 
            for the transfer of the
            STPCLRP and the Physician Volunteer Program from the MBC to 
            the California Physician Corps Program within the Foundation, 
            effective July 1, 2006.

            AB 1403 (Nunez), Chapter 367, Statutes of 2004, renames the 
            California Physician Corps Loan Repayment Program of 2002 as 
            the STPCLRP.

            AB 982 (Firebaugh), Chapter 1131, Statutes of 2002, creates 
            the California Physician Corps Loan Repayment Program of 2002. 
             This program is administered by the Division of Licensing of 
            MBC for the purpose of granting loan repayment awards to 




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            physicians and surgeons working in medically underserved 
            communities.
            
          3.Support.  CMA writes that for far too long, federal funding 
            for California's GME has remained stagnant and as a result, 
            the state has inadequately supplied the physician workforce. 
            CMA states that the most effective way to address this deficit 
            is by expanding and strengthening the capacity of California's 
            medical resident programs, and this bill lays the groundwork 
            to achieve this goal. 

          4.Amendments.  This bill creates a GME Fund for the purposes of 
            providing grants to medical residency training programs for 
            the creation of residency positions; however, it does not 
            contain details on how those grants will be administered. The 
            authors intend to amend this bill in Committee to provide 
            guidance for those parameters. 
          
          SUPPORT AND OPPOSITION  :
          Support:  California Medical Association

          Oppose:   None received.

                                      -- END --