BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2232
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          Date of Hearing:   April 1, 2014

                       ASSEMBLY COMMITTEE ON HIGHER EDUCATION
                                 Das Williams, Chair
                  AB 2232 (Gray) - As Introduced:  February 21, 2014
           
          SUBJECT  :  University of California: medical education. 

           SUMMARY  :   Would appropriate funding to the University of  
          California (UC) to support the UC Merced Programs in Medical  
          Education Program (PRIME) and a study of the creation of a  
          permanent medical school at UC Merced.  Specifically,  this bill  :  
           

          1)Finds and declares that the federal Patient Protection and  
            Affordable Care Act will result in millions of previously  
            uninsured Californians seeking health services, resulting in a  
            projected physician shortfall of 17,000 by 2015; the San  
            Joaquin Valley faces health care access 31% lower than the  
            rest of the state and many regions are designated Medically  
            Underserved Areas (MUAs); funding the UC Merced Program in  
            Medical Education (PRIME) is key to meeting the region's  
            needs.

          2)Appropriates $1,855,000 from the General Fund to UC each  
            fiscal year, commencing with the 2015-16 fiscal year, for  
            allocation to the UC San Joaquin Valley PRIME to admit up to  
            12 students per year and operate the program with up to 48  
            participants from across the four-year curriculum.

          3)Appropriates $1,000,000 from the General Fund to UC to support  
            a two-year planning effort geared toward the establishment of  
            a traditional medical school at UC Merced.  UC would be  
            required to submit a report to the Legislature by March 1,  
            2016 regarding planning efforts and recommendations for  
            infrastructure, personnel, and funding necessary for creation.  
             

           FISCAL EFFECT  :  At least $2,855,000 from the General Fund in  
          direct appropriations to support the programs outlined in this  
          bill.

           COMMENTS  :   Background  .  Currently, UC operates 18 health  
          professional schools and programs; six are medical schools  
          (Davis, Irvine, Los Angeles, Riverside, San Diego, and San  








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          Francisco). In 2012-13, total enrollment in UC medical schools  
          was approximately 3,000 medical students and more than 4,000  
          medical residents and fellows.  


          UC PRIME is a training program focused on meeting the needs of  
          California's underserved populations in both rural communities  
          and urban areas by combining specialized coursework, structured  
          clinical experiences, advanced independent study and mentoring.  
          UC Irvine launched the first UC PRIME program in 2004 focusing  
          on the growing needs of California's Latino communities.  Three  
          other UC schools (Davis, San Diego and San Francisco) admitted  
          their first classes in fall 2007 in programs focused on rural  
          health and telemedicine (Davis), health equity (San Diego), and  
          the urban underserved (San Francisco).  In 2008, UCLA launched  
          its PRIME program, training physicians to proactively address  
          the needs of diverse disadvantaged communities by delivering  
          culturally competent clinical care, providing leadership for  
          health delivery systems and conducting research on health  
          disparities.



          UC Merced currently offers degrees in fields that satisfy  
          medical school preparatory requirements and is developing plans  
          intended to lead to a School of Medicine.  In 2011, UC Merced  
          opened a PRIME program in partnership with the UC Davis School  
          of Medicine and UCSF focused the health needs of the San Joaquin  
          Valley.
           
          Purpose of this bill  .  According to the author, "despite its  
          numerous benefits for the region PRIME lacks an ongoing source  
          of funding for its current enrollment as well as the financial  
          resources to expand capacity to meet the needs of the valley.   
          Additionally, state support is vital to the continued expansion  
          of the campus of UC Merced and to lay the foundation of a new UC  
          Medical School."    

           Evaluation of new programs  .  Prior to 2011, the California  
          Postsecondary Education Commission (CPEC) was charged with  
          reviewing and making recommendations regarding proposals for new  
          programs at California's public colleges and universities.   
          Specifically, CPEC's review was intended to determine whether  
          the costs of a program are justified by societal need and  
          student demand for that program.  Since the de-funding of CPEC  








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          in 2011, no additional state program reviews have occurred.  The  
          Legislature is now placed in the position of examining and  
          reviewing the academic, programmatic, and fiscal implications of  
          new programs.  

           UC Position  .  UC has not taken a position on this bill; however,  
          UC has indicated that based on the current status of UC Merced,  
          it is a higher priority to build the general campus rather than  
          develop a medical program.  UC notes that accreditation by the  
          Liaison Committee for Medical Education (LCME) is required for  
          all Doctor of Medicine programs and that the resources required  
          for accreditation standards are considerable.  Based on the  
          experience with the UC Riverside medical school, UC does not  
          believe that LCME would accredit UC Merced for a medical program  
          without a significant financial contribution UC indicates that  
          this proposal lies outside of budget priorities established by  
          the Regents in November 2013.         

          Related legislation  .  SB 841 (Cannella), as introduced, was  
          identical to this bill but was amended by the Senate Education  
          Committee to remove the appropriation and accompanying language  
          in support of planning for a medical school.  

           Prior legislation  .  SB 21 (Roth), Chapter 203, Statutes of 2014,  
          requested the School of Medicine at UC Riverside develop a  
          program, consistent with its mission, in conjunction with the  
          health facilities of its medical residency programs, to identify  
          eligible medical residents and to assist those medical residents  
          to apply for physician retention programs, as specified.   
           
           The 2013 Budget Act approved trailer bill language that requires  
          UC to allocate $15 million for planning and startup costs  
          associated with academic programs to be offered by the School of  
          Medicine at UC Riverside, and trailer bill language that  
          requires regular reporting on a variety of metrics, including  
          funding, recruitment, hiring, and outcomes, as well as operating  
          and capital budgets detailed by fund source. 

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Medical Association
          California Primary Care Association
          California Psychiatric Association








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           Opposition 
           
          None on file.
           

          Analysis Prepared by  :    Laura Metune / HIGHER ED. / (916)  
          319-3960