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.