BILL NUMBER: SB 606	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Ducheny

                        FEBRUARY 27, 2009

   An act to amend Sections 2436.5 and 2455 of, and to add Section
2455.1 to, the Business and Professions Code, and to amend Section
128553 of the Health and Safety Code, relating to physicians and
surgeons, and making an appropriation therefor.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 606, as introduced, Ducheny. Physicians and surgeons: loan
repayment.
   Existing law establishes the Medically Underserved Account for
Physicians within the Health Professions Education Fund that is
managed by the Health Professions Education Foundation and the Office
of Statewide Health Planning and Development. Under existing law,
the primary purpose of the account is to fund the Steven M. Thompson
Physician Corps Loan Repayment Program, which provides for the
repayment of educational loans, as specified, obtained by a physician
and surgeon who practices in a medically underserved area of the
state, as defined. Under existing law, funds placed in the account
for those purposes are continuously appropriated to the Steven M.
Thompson Physician Corps Loan Repayment Program. Existing law
requires that applicants for the loan repayment program be licensed
by the Medical Board of California. Existing law imposes a $25
licensure fee on physicians and surgeons for purposes of the loan
repayment program.
   Existing law provides for the licensure and regulation of
osteopathic physicians and surgeons by the Osteopathic Medical Board
of California and imposes various fees on those licensees.
   This bill would make osteopathic physicians and surgeons eligible
for the loan repayment program and would require the Osteopathic
Medical Board of California to assess an additional $75 licensure fee
for that purpose. The bill would specify that payment of $25 of the
fee is mandatory and that payment of $50 of the fee would be a
voluntary contribution. The bill would also require the Medical Board
of California to assess an additional $50 fee for the loan repayment
program, which would also be a voluntary contribution. The bill
would direct the deposit of those fees into the Medically Underserved
Account for Physicians for purposes of the loan repayment program.
By increasing the amount of revenue in a continuously appropriated
fund, the bill would make an appropriation.
   Vote: majority. Appropriation: yes. Fiscal committee: yes.
State-mandated local program: no.


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

  SECTION 1.  Section 2436.5 of the Business and Professions Code is
amended to read:
   2436.5.  (a) In addition to the fees charged for the initial
issuance or biennial renewal of a physician and surgeon's certificate
pursuant to Section 2435, and at the time those fees are charged,
the board shall charge each applicant or renewing licensee an
additional twenty-five dollar ($25) fee for the purposes of this
section.
    (b)     This 
 The  twenty-five dollar ($25) fee shall be paid at the time
of application for initial licensure or biennial renewal  .
The twenty-five dollar ($25) fee   and  shall be
due and payable along with the fee for the initial certificate or
biennial renewal. 
   (b) (1) In addition to the fees charged pursuant to subdivision
(a), and at the time those fees are charged, the board shall charge
each applicant or renewing licensee an additional fifty dollars ($50)
for the purposes of this section. The board shall inform the
applicant or licensee that the fee is a tax deductible contribution.
 
   (2) Notwithstanding paragraph (1), the board shall provide each
applicant or renewing licensee the option of deducting any portion of
the fifty dollar ($50) fee from the total amount due if the
applicant or renewing licensee elects not to contribute the fifty
dollars ($50). In the alternative, the board shall also provide each
applicant or renewing licensee the ability to contribute more than
fifty dollars ($50). 
   (c) The board shall transfer all funds collected pursuant to this
section, on a monthly basis, to the Medically Underserved Account for
Physicians created by Section 128555 of the Health and Safety Code
for the Steven M. Thompson Physician Corps Loan Repayment Program.
   (d) Up to 15 percent of the funds collected pursuant this section
shall be dedicated to loan assistance for physicians and surgeons who
agree to practice in geriatric care settings or settings that
primarily serve adults over the age of 65 years or adults with
disabilities. Priority consideration shall be given to those
physicians and surgeons who are trained in, and practice, geriatrics
and who can meet the cultural and linguistic needs and demands of
diverse populations of older Californians.
  SEC. 2.  Section 2455 of the Business and Professions Code is
amended to read:
   2455.  The amount of fees and refunds is that established by the
following schedule for any certificate issued by the Osteopathic
Medical Board of California. All other fees and refunds for any
certificate issued by the Osteopathic Medical Board of California
which are not prescribed in this schedule, are prescribed in 
Section   Sections 2455.1 and  2456. Any and all
fees received by the Osteopathic Medical Board of California shall be
for the sole purpose of the operation of the board and shall not be
used for any other purpose  , except as specified in  
Section 2455.1  .
   (a) Each applicant for an original or reciprocity Physicians and
Surgeons Certificate shall pay an application fee in a sum not to
exceed four hundred dollars ($400) at the time his or her application
is filed.
   (b) The biennial license fee, unless otherwise provided, shall be
set by the board on or before November 1 of each year for the ensuing
calendar year at a sum as the board determines necessary to defray
the expenses of administering this chapter, under the Osteopathic
Act, relating to the issuance of certificates to those applicants,
which sum, however, shall not exceed four hundred dollars ($400) nor
be less than twenty-five dollars ($25).
   (c) The board shall set a biennial license fee in an amount less
than that levied pursuant to subdivision (b) that shall be paid by
any applicant who indicates to the board in writing that he or she
does not intend to practice under the Osteopathic Act during the
current renewal period.
   (d) The fee for failure to pay the biennial license fee shall be
50 percent of the renewal fee but not more than two hundred dollars
($200).
  SEC. 3.  Section 2455.1 is added to the Business and Professions
Code, to read:
   2455.1.  (a) In addition to the fees charged pursuant to Section
2455, and at the time those fees are charged, the board shall charge
each applicant for an original or reciprocity certificate or for a
biennial license an additional twenty-five dollar ($25) fee for the
purposes of this section. This twenty-five dollar ($25) fee shall be
due and payable along with the fee for the original or reciprocity
certificate or the biennial license.
   (b) (1) In addition to the fees charged pursuant to subdivision
(a), and at the time those fees are charged, the board shall charge
each applicant for an original or reciprocity certificate or for a
biennial license an additional fifty dollars ($50) for the purposes
of this section. The board shall inform the applicant or licensee
that the fee is a tax deductible contribution.
   (2) Notwithstanding paragraph (1), the board shall provide each
applicant or renewing licensee the option of deducting any portion of
the fifty dollar ($50) fee from the total amount due if the
applicant or renewing licensee elects not to contribute the fifty
dollars ($50). In the alternative, the board shall also provide each
applicant or renewing licensee the ability to contribute more than
fifty dollars ($50).
   (c) The board shall transfer all funds collected pursuant to this
section, on a monthly basis, to the Medically Underserved Account for
Physicians created by Section 128555 of the Health and Safety Code
for the purposes of the Steven M. Thompson Physician Corps Loan
Repayment Program. Notwithstanding Section 128555 of the Health and
Safety Code, these funds shall not be used to provide funding for the
Physician Volunteer Program.
  SEC. 4.  Section 128553 of the Health and Safety Code is amended to
read:
   128553.  (a) Program applicants shall possess a current valid
license to practice medicine in this state issued pursuant to Section
2050 of the Business and Professions Code  or pursuant to the
Osteopathic Act  .
   (b) The foundation, in consultation with those identified in
subdivision (b) of Section 123551, shall use guidelines developed by
the Medical Board of California for selection and placement of
applicants until the office adopts other guidelines by regulation.
 The foundation shall interpret the guidelines to apply to both
osteopathic and   allopathic physicians and surgeons. 
   (c) The guidelines shall meet all of the following criteria:
   (1) Provide priority consideration to applicants that are best
suited to meet the cultural and linguistic needs and demands of
patients from medically underserved populations and who meet one or
more of the following criteria:
   (A) Speak a Medi-Cal threshold language.
   (B) Come from an economically disadvantaged background.
   (C) Have received significant training in cultural and
linguistically appropriate service delivery.
   (D) Have three years of experience working in medically
underserved areas or with medically underserved populations.
   (E) Have recently obtained a license to practice medicine.
   (2) Include a process for determining the needs for physician
services identified by the practice setting and for ensuring that the
practice setting meets the definition specified in subdivision (h)
of Section 128552.
   (3) Give preference to applicants who have completed a three-year
residency in a primary specialty.
   (4) Seek to place the most qualified applicants under this section
in the areas with the greatest need.
   (5) Include a factor ensuring geographic distribution of
placements.
   (6) Provide priority consideration to applicants who agree to
practice in a geriatric care setting and are trained in geriatrics,
and who can meet the cultural and linguistic needs and demands of a
diverse population of older Californians. On and after January 1,
2009, up to 15 percent of the funds collected pursuant to Section
2436.5 of the Business and Professions Code shall be dedicated to
loan assistance for physicians and surgeons who agree to practice in
geriatric care settings or settings that primarily serve adults over
the age of 65 years or adults with disabilities.
   (d) (1) The foundation may appoint a selection committee that
provides policy direction and guidance over the program and that
complies with the requirements of subdivision (l) of Section 128552.
   (2) The selection committee may fill up to 20 percent of the
available positions with program applicants from specialties outside
of the primary care specialties.
   (e) Program participants shall meet all of the following
requirements:
   (1) Shall be working in or have a signed agreement with an
eligible practice setting.
   (2) Shall have full-time status at the practice setting. Full-time
status shall be defined by the board and the selection committee may
establish exemptions from this requirement on a case-by-case basis.
   (3) Shall commit to a minimum of three years of service in a
medically underserved area. Leaves of absence shall be permitted for
serious illness, pregnancy, or other natural causes. The selection
committee shall develop the process for determining the maximum
permissible length of an absence and the process for reinstatement.
Loan repayment shall be deferred until the physician is back to
full-time status.
   (f) The office shall adopt a process that applies if a physician
is unable to complete his or her three-year obligation.
   (g) The foundation, in consultation with those identified in
subdivision (b) of Section 128551, shall develop a process for
outreach to potentially eligible applicants.
   (h) The foundation may recommend to the office any other standards
of eligibility, placement, and termination appropriate to achieve
the aim of providing competent health care services in approved
practice settings.