BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2458
                                                                  Page  1

          Date of Hearing:   April 30, 2014

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                   AB 2458 (Bonilla) - As Amended:  April 10, 2014 

          Policy Committee:                              HealthVote:19-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill creates a fund and appropriates money for graduate  
          medical education residency programs.  Specifically, this bill:

          1)Creates the Graduate Medical Education (GME) Fund and  
            specifies moneys in the fund are to be used, upon  
            appropriation by the Legislature, to administer and fund  
            grants to graduate medical education residency programs  
            located in California hospitals or teaching health centers.

          2)Appropriates $25 million from the GF, and appropriates $2.84  
            million per year for three years, commencing 2014-15, from the  
            Health Data and Planning Fund, to the GME Fund

          3)Requires the Office of Statewide Health Planning and  
            Development, in consultation with the California Healthcare  
            Workforce Policy Commission, to develop criteria for  
            distribution of available moneys in the fund.
           
           FISCAL EFFECT  

          1)Expenditures of $25 million GF in 2014-15, and $2.84 million  
            per year for three years commencing with 2014-15 (Health Data  
            and Planning Fund), for purposes of increasing the number of  
            residency slots available in the state.  

          2)One-time administrative costs to OSHPD, likely less than  
            $100,000, to develop criteria for distribution of the  
            available money (Graduate Medical Education Fund).

          3)Total administrative costs to OSHPD of $1.6 million over the  
            time in which residency awards are made, assuming  








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            administrative costs of 5% of the amount provided (Graduate  
            Medical Education Fund).

           COMMENTS  

           1)Purpose  .  According to the author, funding for primary care  
            residency programs in California is inadequate.  This bill  
            establishes the Fund as a dedicated source to finance  
            additional slots in residency programs in California hospitals  
            and health centers. This bill builds on a proposed budget  
            investment by calling for an additional infusion of money from  
            the General Fund.  

           2)Budget Proposal  . As part of the governor's 2014-15 budget  
            proposal, OSHPD requested $2.84 million per year for three  
            years (Health Data Planning Fund) to expand its Song-Brown  
            Health Care Workforce Training Program to fund primary care  
            residency programs via the Song-Brown Program, and to expand  
            eligibility for Song-Brown residency program funding to  
            teaching health centers.  OSHPD notes the Health Data Planning  
            Fund will receive a $12 million repayment from a loan to the  
            General Fund in 2014-15.
                
            3)Song-Brown  . The Song-Brown Health Care Workforce Training Act  
            (Song-Brown Program) was established in 1973 to increase the  
            number of family physicians to provide needed medical services  
            to the people of California. The program provides financial  
            support to family practice residency, family nurse  
            practitioner, physician assistant, and registered nurse  
            education programs throughout California.  The Song-Brown  
            program is aided by the California Healthcare Workforce Policy  
            Commission, a 15-member citizen advisory board. Accredited  
            training programs submit applications to receive program  
            funding. At present, 30 California Family Practice Residency  
            Programs and 13 Physician Assistant/Family Nurse Practitioner  
            Programs receive ongoing support from the Song-Brown program.
                
            4)Related Legislation  .

             a)   AB 1176 (Bocanegra and Bonta) of 2013 established the  
               Medical Residency Training Program to fund GME residency  
               programs in California and required every health insurer or  
               health plan that provides health care coverage in this  
               state to pay an annual GME assessment of $5 for each  
               covered life.  AB 1176 was held on the Suspense File of  








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               this committee.

             b)   AB 565 (Salas), Chapter 378, Statutes of 2013, among  
               other things, revises the definition of a practice setting  
               for purposes of the Steven M. Thompson Physician Corps Loan  
               Repayment Program (STLRP) to include a physician owned and  
               operated medical practice setting that provides primary  
               care located in a medically underserved area.

             c)   AB 860 (Perea and Bocanegra) would have appropriated  
               $600,000 from the Managed Care Administrative Fines and  
               Penalties Fund to the Steven M. Thompson Medical School  
               Scholarship Program (STMSSP) Account within HPEF.  AB 860  
               was held on the Suspense File of this committee.

           5)Prior Legislation  . 

             a)   AB 589 (Perea), Chapter 339, Statutes of 2012,  
               establishes the STMSSP to promote the education of medical  
               doctors and doctors of osteopathy, as specified.

             b)   SB 635 (Ed Hernandez) of 2012 would have required funds  
               deposited into the Managed Care Administrative Fines and  
               Penalties Fund (Managed Care Fund) in excess of $1 million  
               to be transferred each year to OSHPD for the purpose of the  
               Song-Brown, as specified.  SB 635 was held on the Suspense  
               File of this committee.

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081