92720-92726
EDUCATION CODE
SECTION 92720-92726
92720. The Legislature hereby finds and declares, as follows: (a) There is an inadequate supply of physicians, family nurse practitioners, and physician assistants who provide primary care to individuals and families in low-income urban and rural areas of California. (b) Current training for health professionals, which occurs almost exclusively in clinics and hospitals, rarely provides students with opportunities to provide community-based medical care to families in low-income neighborhoods. As a result, relatively few health professionals choose to practice in low-income neighborhoods after completion of their training. (c) Most medical graduates are unprepared to deal with the complex interwoven social, cultural, economic, environmental, and educational aspects of disease prevention and health promotion. As a result, health professionals frequently have limited impact on the prevention or treatment of entrenched community health problems, including teen pregnancy, substance abuse, and domestic violence. (d) Community-based education for health professionals has proven successful in other states, including Washington and Kentucky, in doing all of the following: (1) Increasing the number of primary care health professionals practicing in low-income areas. (2) Promoting the use of multi-disciplinary teams composed of health and human services professionals to jointly address community health problems. (e) It is in the state's best interest that California medical schools be encouraged to develop coursework and practice for community-based education as a part of professional training for physicians, nurse practitioners, and physician assistants. It is further in the state's best interest that community-based education programs be evaluated to determine their effects on increasing the number of health care professionals practicing in low-income, medically underserved communities. 92721. (a) There is hereby established the Community-Based Health Professions Education Partnership Program to be administered by the University of California. (b) The purpose of the program shall be to encourage the development of undergraduate medical and other health professional clerkships in primary care that combine health education, human services, and community involvement. The Legislature's goal, through these clerkships, is to increase the number of medical students who choose to enter residencies in primary care and to increase the number of health professionals who practice in primary care in low-income communities and medically underserved areas after their training programs are completed. 92722. The university is requested to incorporate the following into the program: (a) A primary care clerkship as part of the undergraduate curriculum. (b) Opportunities for nurse practitioners and physician assistants that combine clinical experience with participation in multidisciplinary teams that include other health, education, and human services professionals charged with identifying and addressing community health problems. (c) Opportunities for students to be exposed to a comprehensive array of primary care health services--curative and preventive medicine, health promotion, and rehabilitation. (d) Opportunities that allow participants to serve as members of a multiservice health and human resource committee, or a comparable arrangement, that includes members from other public and private human services and educational agencies, for the purpose of offering integrated, comprehensive health, education, and human services to children and their families living in the community. (e) Opportunities that place students in community or neighborhood primary care clinics in low-income communities, as determined by the university, or medically underserved areas, as determined by the Office of Statewide Health Planning and Development, and that have a working relationship with an advisory board that is made up of representatives from the community being served. (f) Community involvement in the design and operation of the clerkship program, based on the identification of community needs and resources. (g) Culturally appropriate program governance, staff, and services. 92723. The university is requested to track and report all of the following factors: (a) The percentage of medical students participating, after residency, in primary care in low-income communities, as determined by the university, or medically underserved areas, as determined by the Office of Statewide Health Planning and Development. (b) The rate of nurse practitioners and physician assistants who, after training, are employed in primary care practice or low-income communities, as determined by the university, or medically underserved areas, as determined by the Office of Statewide Health Planning and Development. (c) Whether the program has resulted in an increase in the rate of graduates practicing in low-income communities, as determined by the university, or medically underserved areas, as determined by the Office of Statewide Health Planning and Development. 92724. The university shall evaluate and report all of the following to the Legislature and the Governor, commencing July 1, 1997, and biennially thereafter: (a) The percentage of medical student participants in the program who do either, or both, of the following: (1) Choose residencies in primary care. (2) After residency, practice in primary care. (b) The utilization of primary care medical facilities included in the program. (c) The historical utilization of emergency room facilities in neighborhoods served by the program one year prior to and one year after the implementation of the program. (d) The cost of providing health services to families served by the program. (e) The effectiveness of clinical and multidisciplinary training as components of professional education for physicians and surgeons, nurse practitioners, and physician assistants. 92725. (a) The program shall be considered successful if, after implementation of the program, all of the following occur: (1) There is a 10 percent or greater increase in the rate of program graduates who choose to practice primary care over the average number of program graduates who chose to practice primary care during the previous five years. (2) There is a decrease in the use of emergency room facilities for nonemergency procedures by persons served by the program from the use of emergency room facilities for nonemergency procedures during the previous five years. (3) Families served by the program have received expanded health services without an increase in per capita health costs. (b) Based on the evaluation of the program by the university pursuant to Section 92724, the Office of Statewide Health Planning and Development, in consultation with the California Healthcare Workforce Policy Commission, shall recommend to the Legislature on or before January 1, 1998, whether funding for the program should be expanded to include other medical schools. (c) If the recommendation is made to expand the program pursuant to subdivision (b), it is the intent of the Legislature that the program be expanded to allow private medical schools and private schools of nursing to participate in the program in order to permit substantially all students who are training to become physicians and surgeons, nurse practitioners, or physician assistants to receive a portion of their training in a community-based education program. 92726. This chapter shall not apply to the University of California unless the Regents of the University of California, by resolution, make it applicable.