BILL ANALYSIS �
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Date of Hearing: March 19, 2013
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
ACR 1 (Medina) - As Introduced: December 3, 2012
SUBJECT : University of California: UC Riverside School of
Medicine.
SUMMARY : Declares that the UC Riverside (UCR) School of
Medicine serves an important role in training a diverse
workforce of physicians and providing healthcare to the
underserved communities of the Inland Empire region of
California. Specifically, this resolution :
1)Provides that the mission of the UCR School of Medicine is to
improve the health of the people of California, and to serve
Inland Southern California by training a diverse workforce of
physicians and by developing innovative research and health
care delivery programs that will improve the health of the
medically underserved in the region and become models to be
emulated through the state and the nation.
2)States that Inland Southern California is vastly undersupplied
with respect to physicians and this region of California has
the lowest supply of physicians per capita than any other
region of the state, according to the California HealthCare
Foundation (CHCF). Indicates that in primary care specialties
alone, many California counties have far fewer than the 60 to
80 primary care physicians per 100,000 people, which is
considered sufficient to meet demand; the Inland Empire has
approximately 40 primary care physicians per 100,000
residents. Further states that Latinos, African Americans,
and Native Americans are vastly underrepresented in the
physician workforce, and, in the Inland Empire alone, more
than 45% of the population is Latino, compared to just 5% of
the physicians in the region. States that the Inland Southern
California also faces a dire health situation, trailing behind
much of the state in several key health indicators, including
coronary heart disease and diabetes.
3)Indicates that the UCR School of Medicine has received
preliminary accreditation from the Liaison Committee on
Medical Education, the national accrediting body for
allopathic, or M.D.-granting medical schools, which enables
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the UCR School of Medicine to begin recruiting students to
enroll in an inaugural class in August 2013. States that to
meet the region's workforce needs and improve the health of
the population, the UCR School of Medicine will capitalize on
UCR's nationally recognized diversity and ethnic diversity of
the region by expanding the educational pipeline into
medicine. States that the UCR School of Medicine will also
expand UCR's strength in basic health sciences research to
build research expertise in population health and health
outcomes research.
4)Provides that the UCR is building its medical school from a
long history of training physicians in partnership with the
University of California, Los Angeles (UCLA) David Geffen
School of Medicine. States that the UCR/UCLA Thomas Haider
Program in Biomedical Sciences currently educates 28
first-year and 28 second-year medical students. Operating for
more than 30 years, this partnership with the UCLA School of
Medicine has produced more than 700 physicians. States that
drawing from UCR's diverse undergraduate population, the
UCR/UCLA Thomas Haider Program in Biomedical Sciences has
established a successful track record of recruiting,
retaining, and graduating highly qualified medical students
from groups that are underrepresented in medicine. A
significant number of programs and partnerships currently
exist that serve potential medical school applicants through
mentorship, pipeline programs, and leadership training.
5)States that the UCR School of Medicine will continue and
expand existing programs, build new programs and partnerships,
and track key data concerning the applicant pool and the
matriculating students of each class of 50 students. Provides
that as the UCR School of Medicine increases the class size to
50 students, drawing now from a much larger general applicant
pool, the UCR School of Medicine will continue to support
programs that enhance the pool of qualified applicants
considered for admission.
6)Indicates that the UCR School of Medicine will also partner
with existing health care providers for clinical rotations and
residency training, building on the relationships that UCR has
already established with the region's health care providers.
7)Provides that the full funding of the UCR School of Medicine
would ensure the execution of a vision of the first medical
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school to be developed in California in more than 40 years,
and the UCR School of Medicine is poised to transform medical
education by training physicians that will be more attuned to
the needs of increasingly diverse and underserved patients.
EXISTING LAW :
1)Establishes the Donahoe Higher Education Act, which among
other provisions, provides that public higher education
consists of: a) the California Community Colleges; b) the
California State University, and each campus, branch, and
function thereof; and, c) each campus, branch, and function of
the UC.
2)Indicates that the UC may provide undergraduate and graduate
instruction in the liberal arts and sciences and in the
professions, including the teaching professions; It shall have
exclusive jurisdiction in public higher education over
instruction in the profession of law and over graduate
instruction in the professions of medicine, dentistry, and
veterinary medicine; and, It has the sole authority in public
higher education to award the doctoral degree in all fields of
learning, except that it may agree with the California State
University to award joint doctoral degrees in selected fields.
States that the UC shall be the primary state-supported
academic agency for research.
FISCAL EFFECT : None
COMMENTS :
1)PURPOSE OF THIS RESOLUTION . According to the author, this
resolution acknowledges that the UCR School of Medicine is a
vital institution to the state of California with respect to
job creation, creating medical access and proving education
opportunities for students interested in pursuing careers in
medicine.
2)BACKGROUND .
a) Physician Shortage . The CHCF, in a 2009 report, states
that the overall supply of physicians in the state is lower
than earlier estimates. Rural counties have fewer
physicians per capita than their urban counterparts and
also face the additional burden of an aging physician
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workforce coupled with difficulty recruiting younger
replacements. Moreover, the state has a diminishing supply
of primary care physicians but an abundance of specialists.
For example, only 34% of active physician reported
practicing primary care and only 16 of California's 58
counties are within the range of 60-80 primary care
physicians per 100,000 population and in eight counties the
number is less than half the recommended amount. Of all
active physicians in the state 67% reported being
non-primary care physicians and the number of specialists
per 100,000 is 115 in California, well above the target
range of 85-105.
The UC Office of Health Affairs and UC Health Sciences
Committee commissioned a report on California's physician
workforce conducted by the University of Albany's Center
for Health Workforce Studies. The population of California
is growing rapidly which will place great strains on the
healthcare delivery system and the physician workforce.
More than one-fourth of the state's practicing physicians
were over age 55 in 2000. In addition, the state has a
maldistribution of physicians with 60% of the current
physicians practicing in only five counties. In partial
response to this report, in 2006, the UC Board of Regents
approved the establishment of a new medical school at the
UCR. A 2008 report by the Center for California Health
Workforce Studies at the UC San Francisco shows that both
black and Latino physicians are underrepresented in the
workforce. In California, 40% of the population is black
or Latino but less than 10% of the physicians in the state
are. The state has a population of 35 million people and
only 2,000 black physicians and 3,000 Latino physicians are
currently practicing. The report points out that this lack
of diversity hurts access to care in underserved areas
since minority physicians play a crucial role in serving
these areas with 40% of ethnic physicians working in
primary care.
b) UCR School of Medicine . According to the UCR School of
Medicine Website, in 2003, then Chancellor France A.
C�rdova appointed a blue ribbon panel of renowned academics
and education leaders to advise the campus in expanding
medical education and health sciences research and to
initiate the planning for a four-year medical school at UC
Riverside. A year later, a group of deans reviewed initial
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plans of the medical school and provided recommendations to
guide further planning. In 2006, an external advisory
board was appointed to craft a distinctive academic vision
for the medical school and to guide UCR through the
planning process. Forecasted healthcare access
requirements and regional characteristics drove the
development of the preliminary proposal to establish a
medical school at UCR and began to give shape to a unique
and innovative mission and vision for the UCR School of
Medicine.
The campus submitted a preliminary proposal to Office of the
President in May 2006. In November of that year, the
preliminary proposal received the endorsement of the UC
Board of Regents. A proposed curriculum for the medical
school was drafted by the curriculum planning committee of
faculty and clinical instructors, in consultation with
leading administrators in the David Geffen School of
Medicine at UCLA. A business plan and final medical school
proposal was developed with the input of more than 80
faculty, staff, medical and community leaders, campus
administrators and alumni, as well as a community advisory
board. A Community Advisory Board was appointed to provide
a non-institutional perspective in the planning and
implementation of a new medical school.
In early 2008, the UCR Academic Senate unanimously supported
both the curriculum and the medical school proposal, with
the medical school proposal receiving the UC Board of
Regents endorsement in summer 2008. The UCR School of
Medicine will welcome its inaugural class of students in
August 2013.
3)SUPPORT . The California Medical Association states that the
UCR School of Medicine benefits California by improving access
to care for this medically underserved region, improves
education opportunities by providing a pipeline into the field
of medicine, and generates critical economic activity.
4)RELATED LEGISLATION : AB 27 (Medina) and SB 21 (Roth), would
appropriate $15 million from the General Fund to the UC
Regents for allocation, without regard to fiscal year, to the
UCR School of Medicine. AB 27 is pending in the Assembly
Higher Education Committee while SB 21 is pending in the
Senate Education Committee.
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5)PREVIOUS LEGISLATION . AB 1309 (Miller) of 2012, would have
appropriated $15 million to the UCR School of Medicine. AB
1309 died in the Senate.
REGISTERED SUPPORT / OPPOSITION :
Support
California Medical Association
University of California
Opposition
None on file.
Analysis Prepared by : Hammad Khan/Rosielyn Pulmano / HEALTH /
(916) 319-2097