BILL NUMBER: SB 606	CHAPTERED
	BILL TEXT

	CHAPTER  600
	FILED WITH SECRETARY OF STATE  OCTOBER 11, 2009
	APPROVED BY GOVERNOR  OCTOBER 11, 2009
	PASSED THE SENATE  SEPTEMBER 11, 2009
	PASSED THE ASSEMBLY  SEPTEMBER 2, 2009
	AMENDED IN ASSEMBLY  JUNE 18, 2009
	AMENDED IN SENATE  MARCH 31, 2009

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 Sections
128330 and 128553 of the Health and Safety Code, relating to
physicians and surgeons, and making an appropriation therefor.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 606, 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. Existing law also authorizes using the account to
provide funding for the Physician Volunteer Program. Under existing
law, funds placed in the account for those purposes are continuously
appropriated for the repayment of loans and may be used for any other
authorized purpose. 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 $25 licensure fee
for that purpose. The bill would direct the deposit of those fees
into the Medically Underserved Account for Physicians for purposes of
the loan repayment program. The bill would specify that the $25 fee
paid by physicians and surgeons and osteopathic physicians and
surgeons shall not be used to provide funding for the Physician
Volunteer Program. By increasing the amount of revenue in a
continuously appropriated fund, the bill would make an appropriation.

   Appropriation: yes.


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.
   The twenty-five-dollar ($25) fee shall be paid at the time of
application for initial licensure or biennial renewal and shall be
due and payable along with the fee for the initial certificate or
biennial renewal.
   (b) 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.
Notwithstanding Section 128555 of the Health and Safety Code, these
funds shall not be used to provide funding for the Physician
Volunteer Program.
   (c) Up to 15 percent of the funds collected pursuant to 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 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) 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 128330 of the Health and Safety Code is amended to
read:
   128330.  As used in this article:
   (a) "Board" means the Board of Trustees of the Health Professions
Education Foundation.
   (b) "Commission" means the California Healthcare Workforce Policy
Commission.
   (c) "Director" means the Director of the Office of Statewide
Health Planning and Development.
   (d) "Foundation" means the Health Professions Education
Foundation.
   (e) "Health professions" or "health professionals" means
physicians and surgeons licensed pursuant to Chapter 5 (commencing
with Section 2000) of Division 2 of the Business and Professions Code
or pursuant to the Osteopathic Act, dentists, registered nurses, and
other health professionals determined by the office to be needed in
medically underserved areas.
   (f) "Office" means the Office of Statewide Health Planning and
Development.
   (g) "Underrepresented groups" means African-Americans, Native
Americans, Hispanic-Americans, or other persons underrepresented in
medicine, dentistry, nursing, or other health professions as
determined by the board. After January 1, 1990, the board, upon a
finding that the action is necessary to meet the health care needs of
medically underserved areas, may add a group comprising the
economically disadvantaged to those groups authorized to receive
assistance under this article.
  SEC. 5.  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.