Bill Text: CA SB1471 | 2015-2016 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Health professions development: loan repayment.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2016-11-30 - From Assembly without further action. [SB1471 Detail]

Download: California-2015-SB1471-Amended.html

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BILL NUMBER: SB 1471	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 14, 2016

INTRODUCED BY   Senator Hernandez

                        FEBRUARY 19, 2016

    An act to amend Section 1363.5 of the Health and Safety
Code, and to amend Section 10123.135 of the Insurance Code, relating
to health care coverage.   An act to amend Sections
1341.45, 128551, and 128552 of, and to add Section 128555.5 to, the
Health and Safety Code, relating to health professions de  
velopment. 



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1471, as amended, Hernandez.  Health care coverage:
services: authorization and denial.   Health professions
development: loan repayment.  
   Existing law establishes the Steven M. Thompson Physician Corps
Loan Repayment Program in the California Physician Corps Program
within the Health Professions Education Foundation, which provides
financial incentives, including repayment of educational loans, to a
physician and surgeon who practices in a medically underserved area,
as defined. Existing law establishes the Medically Underserved
Account for Physicians, a continuously appropriated account, within
the Health Professions Education Fund that is managed by the Health
Professions Education Foundation and the Office of Statewide Health
Planning and Development, to primarily provide funding for the
ongoing operations of the Steven M. Thompson Physician Corps Loan
Repayment Program.  
   Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the licensure and regulation of health care service
plans by the Department of Managed Health Care and imposes certain
requirements on health care service plans. Existing law imposes
various fines and administrative penalties on health care service
plans for certain violations of the act, which are deposited into the
Managed Care Administrative Fines and Penalties Fund. Existing law
requires the first $1,000,000 in the fund to be transferred each year
to the Medically Underserved Account for Physicians and to be used,
upon appropriation by the Legislature, for purposes of the Steven M.
Thompson Physician Corps Loan Repayment Program. Existing law
requires all remaining funds to be transferred each year to the Major
Risk Medical Insurance Fund and to be used, upon appropriation by
the Legislature, for purposes of the Major Risk Medical Insurance
Program.  
   This bill would expand the eligibility for loan repayment funds
under the Steven M. Thompson Physician Corps Loan Repayment Program
to include those physicians providing psychiatric services. The bill
would provide that continuously appropriated funds deposited into the
Medically Underserved Account for Physicians shall not be made
available under the Steven M. Thompson Physician Corps Loan Repayment
Program to fund the repayment of loans for those physicians
providing psychiatric services or those physicians whose primary
specialty is psychiatry, as specified.  
   The bill would instead require, after the first $1,000,000 is
transferred from the Managed Care Administrative Fines and Penalties
Fund to the Medically Underserved Account for Physicians, $1,000,000
to be transferred each year to the Major Risk Medical Insurance Fund
to be used, upon appropriation by the Legislature, for the Major Risk
Medical Insurance Program. The bill would require any amount
remaining over the amounts transferred to the Medically Underserved
Account for Physicians and the Major Risk Medical Insurance Fund to
be transferred each year to the Medically Underserved Account for
Physicians to be used, upon appropriation by the Legislature, for the
Steven M. Thompson Physician Corps Loan Repayment Program, and
provide that one-half of these moneys are to be used to fund the
repayment of loans for those physicians providing psychiatric
services or those physicians whose primary specialty is psychiatry
under the Steven M. Thompson Physician Corps Loan Repayment Program.
 
    The bill would also delete a reference to an obsolete program and
make other technical, nonsubstantive changes.  
    Existing law, the Knox-Keene Health Care Service Plan Act of
1975, provides for the licensure and regulation of health care
service plans by the Department of Managed Health Care, and makes a
willful violation of its provisions a crime. Existing law provides
for the regulation of health insurers by the Department of Insurance.
Existing law requires health care service plans and insurers to
disclose or provide for the disclosure to specified entities persons
and the process that the plan uses to authorize or deny health care
services under the benefits provided by the plan, including coverage
for subacute care, transitional inpatient care, or care provided in
skilled nursing facilities.  
   This bill would expand the above requirement to include disclosure
of the process the plan uses to authorize or deny behavioral health
treatment. By changing the definition of an existing crime with
respect to health care service plans, this bill would impose a
state-mandated local program.  
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.  
   This bill would provide that no reimbursement is required by this
act for a specified reason. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program:  yes   no  .


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 1341.45 of the  
Health and Safety Code   is amended to read: 
   1341.45.  (a) There is hereby created in the State Treasury the
Managed Care Administrative Fines and Penalties Fund.
   (b) The fines and administrative penalties collected pursuant to
this chapter, on and after September 30, 2008, shall be deposited
into the Managed Care Administrative Fines and Penalties Fund.
   (c) The fines and administrative penalties deposited into the
Managed Care Administrative Fines and Penalties Fund shall be
transferred by the department,  beginning September 1, 2009,
and annually thereafter,   annually,  as follows:
   (1) The first one million dollars ($1,000,000) shall be
transferred to the Medically Underserved Account for Physicians
within the Health Professions Education Fund and shall, upon
appropriation by the Legislature, be used for the purposes of the
Steven M. Thompson Physician Corps Loan Repayment Program, as
specified in Article 5 (commencing with Section 128550)  or
  of  Chapter 5 of Part 3 of Division 107 and,
notwithstanding Section 128555, shall not be used to provide funding
for the Physician Volunteer Program.
   (2)  Any   Until January 1, 2017, any 
amount over the first one million dollars ($1,000,000), including
accrued interest, in the fund shall be transferred to the Major Risk
Medical Insurance Fund continued pursuant to Section 15893 of the
Welfare and Institutions Code and shall, upon appropriation by the
Legislature, be used for the Major Risk Medical Insurance Program for
the purposes specified in Section 15894 of the Welfare and
Institutions Code. 
   (3) On and after January 1, 2017, and annually thereafter, the
second one million dollars ($1,000,000) shall be transferred to the
Major Risk Medical Insurance Fund continued pursuant to Section 15893
of the Welfare and Institutions Code and shall, upon appropriation
by the Legislature, be used for the Major Risk Medical Insurance
Program for the purposes specified in Section 15894 of the Welfare
and Institutions Code.  
   (4) (A) On and after January 1, 2017 any amount over the first two
million dollars ($2,000,000), including accrued interest, in the
fund shall be transferred to the Medically Underserved Account for
Physicians within the Health Professions Education Fund and shall,
upon appropriation by the Legislature, and subject to subparagraph
(B), be used for the purposes of the Steven M. Thompson Physician
Corps Loan Repayment Program, as specified in Article 5 (commencing
with Section 128550) of Chapter 5 of Part 3 of Division 107 and,
notwithstanding Section 128555, shall not be used to provide funding
for the Physician Volunteer Program.  
   (B) One-half of the moneys deposited into the Medically
Underserved Account for Physicians within the Health Professions
Education Fund under this paragraph shall, upon appropriation by the
Legislature, be used to fund the repayment of loans for those
physicians providing psychiatric services or those physicians whose
primary specialty is psychiatry under the Steven M. Thompson
Physician Corps Loan Repayment Program, as specified in Article 5
(commencing with Section 128550) of Chapter 5 of Part 3 of Division
107. 
   (d) Notwithstanding subdivision (b) of Section 1356 and Section
1356.1, the fines and administrative penalties authorized pursuant to
this chapter shall not be used to reduce the assessments imposed on
health care service plans pursuant to Section 1356. 
   (e) The amendments made to this section by the act adding this
subdivision shall become operative on July 1, 2014. 
   SEC. 2.    Section 128551 of the   Health
and Safety Code   is amended to read:
   128551.  (a) It is the intent of this article that the Health
Professions Education Foundation and the office provide the ongoing
program management of the two programs identified in subdivision (b)
of Section 128550 as a part of the California Physician Corps
Program.
   (b)  For purposes of subdivision (a), the foundation shall consult
with the Medical Board of California, Office of Statewide 
Health  Planning and Development, and shall establish and
consult with an advisory committee of not more than seven members,
that shall include two members recommended by the California Medical
Association and may include other members of the medical community,
including ethnic representatives, medical schools, health advocates
representing ethnic communities, primary care clinics, public
hospitals, and health systems, statewide agencies administering state
and federally funded programs targeting underserved communities, and
members of the public with expertise in health care issues.
   SEC. 3.    Section 128552 of the  Health and
Safety Code   is amended to read: 
   128552.  For purposes of this article, the following definitions
shall apply:
   (a) "Account" means the Medically Underserved Account for
Physicians established within the Health Professions Education Fund
pursuant to this article.
   (b) "Foundation" means the Health Professions Education
Foundation.
   (c) "Fund" means the Health Professions Education Fund.
   (d) "Medi-Cal threshold languages" means primary languages spoken
by limited-English-proficient (LEP) population groups meeting a
numeric threshold of 3,000, eligible LEP Medi-Cal beneficiaries
residing in a county, 1,000 Medi-Cal eligible LEP beneficiaries
residing in a single ZIP Code, or 1,500 LEP Medi-Cal beneficiaries
residing in two contiguous ZIP Codes.
   (e) "Medically underserved area" means an area defined as a health
professional shortage area in Part 5  (commencing with Section
5.1)  of Subchapter A of Chapter 1 of Title 42 of the Code of
Federal Regulations or an area of the state where unmet priority
needs for physicians exist as determined by the California Healthcare
Workforce Policy Commission pursuant to Section 128225.
   (f) "Medically underserved population" means the Medi-Cal 
program, Healthy Families Program,   program  and
uninsured populations.
   (g) "Office" means the Office of Statewide Health Planning and
Development (OSHPD).
   (h) "Physician Volunteer Program" means the Physician Volunteer
Registry Program established by the Medical Board of California.
   (i) "Practice setting," for the purposes of this article only,
means either of the following:
   (1) A community clinic as defined in subdivision (a) of Section
1204 and subdivision (c) of Section 1206, a clinic owned or operated
by a public hospital and health system, or a clinic owned and
operated by a hospital that maintains the primary contract with a
county government to fulfill the county's role pursuant to Section
17000 of the Welfare and Institutions Code, which is located in a
medically underserved area and at least 50 percent of whose patients
are from a medically underserved population.
   (2) A physician owned and operated medical practice setting that
provides primary care  or psychiatric services  located in a
medically underserved area and has a minimum of 50 percent of
patients who are uninsured, Medi-Cal beneficiaries, or beneficiaries
of another publicly funded program that serves patients who earn less
than 250 percent of the federal poverty level.
   (j) "Primary specialty" means family practice, internal medicine,
pediatrics,  psychiatry,  or obstetrics/gynecology.
   (k) "Program" means the Steven M. Thompson Physician Corps Loan
Repayment Program.
   (  l  ) "Selection committee" means a minimum
three-member committee of the board, that includes a member that was
appointed by the Medical Board of California.
   SEC. 4.    Section 128555.5 is added to the 
 Health and Safety Code   , to read:  
   128555.5.  Notwithstanding subdivision (e) of Section 128555,
funds deposited into the Medically Underserved Account for Physicians
shall not be made available to fund the repayment of loans under the
Steven M. Thompson Physician Corps Loan Repayment Program for those
physicians providing psychiatric services or those physicians whose
primary specialty is psychiatry, except as provided in subparagraph
(B) of paragraph (4) of subdivision (c) of Section 1341.45.  All
matter omitted in this version of the bill appears in the bill as
introduced in the Senate, February 19, 2016. (JR11)