BILL ANALYSIS                                                                                                                                                                                                    �



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          Date of Hearing:  July 3, 2012

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
             SB 1416 (Rubio and Ed Hernandez) - As Amended:  May 29, 2012

           SENATE VOTE  :  38-0
           
          SUBJECT  :  Medical residency training program grants: grants.

           SUMMARY  :  Establishes the Graduate Medical Education (GME) Trust 
          Fund (Fund), administered by the Office of Statewide Health 
          Planning and Development (OSHPD) for the purpose of providing 
          grants to graduate medical education residency programs in 
          California.  Specifically,  this bill  :  

          1)Establishes the Fund in the State Treasury.  Requires moneys 
            in the Fund to be used solely for the purpose of providing 
            grants to graduate medical education residency programs in 
            California.  Requires all accrued interest on money in the 
            Fund to be retained in the Fund and used for purposes 
            consistent with the Fund.

          2)States that the Fund shall consist of all private moneys 
            donated to the California Healthcare Workforce Policy 
            Commission (Commission) for deposit into the Fund and any 
            interest that accrues.

          3)Prohibits the use of General Funds to implement this bill.

          4)Requires OSHPD, in consultation with the California Healthcare 
            Workforce Policy Committee, to develop criteria for 
            distribution of available moneys in the Fund upon receipt of 
            donations sufficient to cover the costs of developing the 
            criteria.

          5)Requires OSHPD in developing the criteria to give priority to 
            programs that meet the following specifications:

             a)   Are located in medically underserved areas (MUAs), as 
               specified;

             b)   Have a proven record of placing graduates in those MUAs;

             c)   Place an emphasis on training primary care providers; 








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               and, 

             d)   Place an emphasis on training physician specialties that 
               are most needed in the community in which the program is 
               located.

          6)Permits the Fund to be used to fund existing and new graduate 
            medical education residency slots.

          7)Specifies, whenever possible, OSHPD must utilize moneys 
            appropriated from the Fund to provide a match for available 
            federal funds for graduate medical education.   



           EXISTING LAW  :  

          1)Establishes OSHPD to, among other functions, collect data and 
            disseminate information about California's health care 
            infrastructure, promote equitable distribution of health care 
            outcomes, and publish information about health care outcomes.

          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, loans, or repayments of educational 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. 
             Authorizes the Foundation to develop criteria for evaluating 
            applicants for various scholarships or loans and to implement 
            the Steven M. Thompson Physician Corps Loan Repayment Program 
            (STPCLRP) and the Volunteer Physician Program, as specified.

          3)Establishes the 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 (PA) programs, and 
            programs that train primary care nurse practitioners (NPs); 
            and, review and make recommendations to OSHPD concerning the 
            funding of those programs that are submitted to the Health 








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            Professions Development Program for participation in the state 
            medical contract program.

          4)Establishes the Song-Brown Health Care Workforce Training Act 
            of 1973 (Song-Brown) 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, primary care NPs, and RNs and to maximize the 
            delivery of primary care family physician services to specific 
            areas of California where there is a recognized unmet priority 
            need.  Provides that Song-Brown is to be implemented through 
            contracts with accredited medical schools, and other programs 
            that train the above practitioners. 

           FISCAL EFFECT  :  According to the Senate Appropriations 
          Committee:

          1)One-time costs up to $150,000 to develop criteria for making 
            grants (Private Funds). The development of grant making 
            criteria is subject to the Administrative Procedures Act 
            (beginning at Section 11340 of the Government Code), which 
            typically requires substantial staff time.

          2)Unknown costs to make grants to medical residency programs 
            (Private Funds).

           COMMENTS  :

           1)PURPOSE OF THIS BILL  .  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 the California Medical Association (CMA), over 
            the past 15 years, California's population has increased by 
            seven 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 and Affordable Care Act (ACA).  GME funding varies 








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            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)BACKGROUND  .  

              a)   GME  .  According to the California Academy of Family 
               Physicians, GME or residency training, takes place after 
               medical school and prepares physicians for their medical 
               practice.  It can take anywhere from three to seven years 
               of residency training to instruct a physician in his or her 
               chosen specialty (such as family medicine, radiology, or 
               pediatrics).  Training occurs in teaching hospitals or 
               community-based residency programs, both of which serve a 
               critical role in the nation's health care system by 
               delivering care, training future health care professionals, 
               and conducting medical research.  GME is primarily funded 
               by Medicare payments to hospitals.  

             According to the Western Journal of Medicine, 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 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) fund GME through their Medicaid programs and 
               receive federal matching funds for this purpose.

             Several states and the VA are using innovative GME financing 








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               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.

              b)   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% (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, Sacramento, and Orange counties.  Areas with a 
               pronounced under supply of primary care physicians include 
               the Inland Empire and the San Joaquin Valley.

              c)   Healthcare Workforce Shortage  .  On March 23, 2010, 
               President Obama signed into law the ACA (Public Law (PL) 
               111-148), as amended by the Health Care and Education 
               Reconciliation Act of 2010 (PL 111-152).  Among other 
               provisions, the new law requires most US citizens and legal 
               residents to have health insurance; creates state-based 
               American Health Benefit Exchanges through which individuals 
               can purchase coverage, with premium and cost sharing 
               credits, as specified, and creates separate exchanges 
               through which small businesses can purchase coverage.  
               According to experts, implementation of the ACA will create 
               more pressures for an adequate healthcare workforce in 








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               California.  A 2011 study by the Center for the Health 
               Professions of the University of California, San Francisco 
               entitled "California's Health Care Workforce: Readiness for 
               the ACA Era" indicates that with California's 
               implementation of the ACA, four to six million more 
               Californians will obtain coverage.  As such, there is a 
               need not only for a sufficient number of providers but also 
               providers who can meet the needs of a diverse and changing 
               public.  Specifically, the study points out that primary 
               care will be the area most immediately affected because 
               preventive care and chronic disease management become 
               increasingly important.

             In March 2012, the Senate Health Committee conducted two 
               informational hearings relating to healthcare workforce and 
               the ACA.  The hearings explored the supply, and expected 
               demand for various healing arts practitioners as part of 
               ACA implementation.  Additionally, several options were 
               discussed to address workforce needs.

              d)   Current Workforce Development Programs  .  The state 
               currently operates a number of programs designed to 
               increase the number of health care professionals practicing 
               in MUAs:

                i)     Foundation  .  The Foundation, within OSHPD, provides 
                 scholarships and loan repayments to aspiring and 
                 practicing health professionals who agree to practice in 
                 a MUA. Scholarships are offered to health professions 
                 students who are attending a California accredited 
                 college or university.  Loan repayment programs are 
                 offered to graduates who are pursuing a health 
                 professions 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 MUA.  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 MUAs of the 
                 state.  The STPCLRP is supported by a $25 licensure fee 
                 paid by physicians and limits loan repayment awards from 








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                 exceeding $105,000 per individual physician.

                ii)    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 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. 

                iii)   Song-Brown  .  Song-Brown, administered by OSHPD, was 
                 established in 1973 to increase the number of health 
                 professional training slots in established medical 
                 schools.  According to OSHPD, support is provided to 
                 institutions (not individual students) that provide 
                 clinical training for family medicine residents, family 
                 NPs (FNP), PAs and RNs.  Song-Brown funds are used to 
                 train and educate residents and students by providing 
                 clinical training in underserved areas (HSPAs, MUAs, 
                 Medically Underserved Populations, Primary Care Shortage 
                 Areas, and RN Shortage Areas), who provide health care to 
                 the state's underserved population.  This provides 
                 residents and students with experience and exposure, 
                 increases access to health care, and provides health care 
                 to the underserved.  OSHPD indicates that Song-Brown 
                 awards over $7.1 Million annually to institutions and 








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                 currently funds the following: (1) thirty out of 38 
                 family practice residency training programs; (2) seven 
                 out of 22 FNP programs; (3) five out of 10 PA programs; 
                 (4) one combined FNP/PA program; and, (5) thirty-two out 
                 of 132 RN education programs in the State which includes 
                 Associates, Baccalaureate, and Masters level programs.  
                 The outcomes for 2010-11 are as follows: 58% of family 
                 practice graduates practice in areas of unmet need; 62% 
                 of FNP/PA graduates practice in areas of unmet need; 58% 
                 of RN graduates practice in areas of unmet need; and, 
                 745,186 patient encounters were provided by Song-Brown 
                 funded family practice residents, FNPs, and PAs.

           3)SUPPORT  .  The Medical Board of California (MBC) supports this 
            bill because it may help to create more medical residency 
            slots using private funding and may help to address physician 
            shortages, which is especially important as provisions of the 
            federal health care reform take effect in 2014.  CMA states 
            that to address the current physician shortage, there is a 
            need to expand and strengthen the capacity of the state's 
            medical resident programs.  

           4)OPPOSITION  .  The California Right to Life Committee, Inc., 
            states that this bill may in the future be the basis for code 
            amendments and expansion to include PAs under the residency 
            program and even NPs and nurse-midwives, and is concerned that 
            grants under this bill may eventually include non-physicians 
            who are presently performing first trimester abortions.

           5)TECHNICAL AMENDMENT  .  On page 3 line 9 of the bill delete 
            "Committee" and replace with "Commission".

           6)RELATED LEGISLATION  .  SB 635 (Ed Hernandez) would require 
            funds deposited in the Managed Care Administrative Fines and 
            Penalties Fund in excess of $1,000,000 to be transferred each 
            year to OSHPD for the purposes of Song-Brown.  SB 635 is 
            pending in Assembly Appropriations 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. 








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           7)PREVIOUS LEGISLATION  .  AB 2551 (Hernandez) of 2010 would have 
            established the Health Workforce Development Fund to consist 
            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 died on the Senate Floor.

            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 to 
            assist OSHPD in the development of a health professions 
            workforce master plan for the state.  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 was nearly identical to AB 657 and 
            in addition, would have required the Legislative Analyst's 
            Office to prepare a report on health workforce data and data 
            collection capacity.  AB 2375 was held in the Senate 
            Appropriations Committee on suspense.

            AB 2439 (De La Torre), Chapter 640, Statutes of 2008, requires 
            the 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% 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, 
            transferred 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 








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            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 
            physicians and surgeons working in MUAs.


           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          American Federation of State, County and Municipal Employees, 
          AFL-CIO
          California Academy of Child & Adolescent Psychiatry
          California Academy of Family Physicians 
          California Medical Association
          Medical Board of California 
           
            Opposition 
           
          California Right to Life Committee, Inc.

           Analysis Prepared by  :    Rosielyn Pulmano / HEALTH / (916) 
          319-2097