105100-105140

HEALTH AND SAFETY CODE
SECTION 105100-105140




105100.  The Legislature finds and declares all of the following:
   (a) In 1998, there were about 3.57 million Californians age 65 and
older, a 15 percent increase since 1990. This number will at least
increase to five million in 2010 and grow to seven million by 2020,
with those persons over age 85 representing the fastest growing
segment of the population.
   (b) By 2020, the numbers of Hispanic, African American, and other
minority older persons will more than quadruple to an estimated total
of at least 2.8 million.
   (c) The age group over 75 has the highest rate of health care
utilization of all groups.
   (d) The higher prevalence of chronic conditions in those age 65
and older results in greater use of physician services. On average,
they visit a physician nine times a year compared to five visits by
the general population. They are hospitalized over three times as
often as the younger population, stay 50 percent longer, and use
twice as many prescription drugs.
   (e) The knowledge and skill base in geriatrics, which is essential
to the provision of medical care to older patients, has not been
adequately integrated into the training of today's doctors and other
health care professionals.
   (f) If resources are not invested now for better training in
geriatrics, there will be an inadequate supply of doctors properly
trained to treat older patients by 2010.
   (g) The Academic Geriatric Resource Program was established in
1984 as a mechanism for developing within the University of
California new educational initiatives in geriatrics, gerontology,
and other disciplines relating to aging. The program originally was
funded at one million dollars ($1,000,000). Funding has not kept pace
with inflation or need. The program in 1999 was funded at one
million one hundred thousand dollars ($1,100,000).
   (h) The Association of American Medical Colleges acknowledged the
problem of inadequate medical education in geriatrics in December
1999 by launching a new program to enhance the gerontology and
geriatric curricula at United States medical schools. The association
recognized that geriatrics should "be represented in a more coherent
and comprehensive manner in the curricula of all U.S. medical
schools."



105101.  It is the intent of the Legislature that the University of
California provide academic courses and training in the field of
geriatrics for medical students and existing general internists and
family physicians in order to ensure that every general internist and
family physician, along with other professions, have the requisite
knowledge and skills to competently treat the older population by the
year 2010 when the baby boomer generation begins to retire.



105105.  It is the purpose of the Legislature, in enacting this
chapter, for the University of California to establish academic
geriatric resource programs and encourage the development of expanded
educational and community service programs in geriatric medicine at
its medical schools or other health science campuses. A
multidisciplinary approach shall be utilized in the development of
these programs. The programs shall include, but not be limited to,
one or more of the following elements:
   (a) Preclinical, clinical, or postgraduate educational programs in
geriatrics for health science students to instruct and train them in
recognizing and responding to the needs and dynamics of the health
care of older patients.
   (b) Provision of continuing education in geriatrics for health
care providers and the general public.
   (c) A teaching nursing home program to research nursing home
health care practices and to instruct and train health science
students about geriatric care.
   (d) Development and evaluation of the best practices for the
health care of older persons.
   (e) Development and evaluation of interdisciplinary models of
geriatric training.
   (f) Development and evaluation of innovative health care delivery
sites and programs for older persons.


105110.  For purposes of this chapter, the following definitions
apply:
   (a) "Academic geriatric resource program" means a program which
includes one of the elements specified in Section 105105.
   (b) "Nursing home" means a licensed skilled nursing or licensed
intermediate care facility, as defined by Section 1250.
   (c) "Teaching nursing home" means a licensed skilled nursing or
licensed intermediate care facility, as defined by Section 1250,
which is owned or operated by, or affiliated with, a University of
California or private university campus with a medical or health
sciences center, for the purpose of providing training, patient care,
research, and community service.



105112.  (a) It is the intent of the Legislature that University of
California medical students complete a definable curriculum in
geriatric medicine over the course of their medical school training
to meet recommended core competencies for the care of older persons.
It is the intent of the Legislature that this curriculum instill the
attitudes, knowledge, and skills that physicians need to provide
competent and compassionate care for older persons, including both
didactic and clinical experiences encompassing the spectrum of health
status of older persons and community-based sites for clinical
training.
   (b) It is the intent of the Legislature that University of
California medical residents in internal medicine, family practice,
and psychiatry complete a definable curriculum in geriatric medicine
over the course of their residency training. It is the intent of the
Legislature that this curriculum instill the attitudes, knowledge,
and skills that physicians practicing these specialties need to
provide competent and compassionate care for older persons. This
curriculum should encompass the spectrum of health status of older
persons and include community-based sites for clinical training.
   (c) It is the intent of the Legislature that the University of
California be responsible for developing, implementing, maintaining,
and evaluating the geriatric medicine content needed in the
curriculum. The curriculum shall take into consideration the
recommendations of the Institute of Medicine of the National Academy
of Sciences, the American Geriatric Society, and other nationally
recognized medical organizations. The expanded geriatric medicine
program and curriculum should be developed and implemented at each
University of California school of medicine as soon as possible, but
no later than September 1, 2003.
   (d) The Legislature requests that, no later than March 30, 2003,
the Regents of the University of California submit a progress report
on the status of the implementation of a definable curriculum in
geriatric medicine at each campus in accordance with this act.
   (e) The Legislature requests that, no later than March 30, 2004,
the Regents of the University of California submit a report on the
status of the implementation of a definable curriculum in geriatric
medicine at each campus. The report should include the total number
of hours of geriatric instruction to be given at each school of
medicine and the number of weeks of that instruction or experience
provided at each medical school. This report should be written by a
committee that is specifically charged with reporting on the status
of the implementation of this section. The majority of committee
members should be national experts in the geriatric field who are not
University of California employees.
   (f) The Legislature requests that every 5 years, commencing no
later than June 30, 2005, the Regents of the University of California
submit a report describing progress in geriatrics training and
related initiatives at each campus in accordance with the act. This
report should be written by a committee that is specifically charged
with evaluating this progress. The majority of committee members
should be national experts in the geriatric field who are not
University of California employees.
   (g) Copies of the reports requested in subdivisions (d), (e), and
(f) are to be submitted to the members of the Assembly Committee on
Aging and Long-Term Care, the members of the Senate Health and Human
Services Subcommittee on Aging and Long-Term Care, and the
Chairpersons of the Assembly Committee on Budget and the Senate
Committee on Budget and Fiscal Review.
   (h) It is the intent of the Legislature that the professors
occupying the University of California endowed chairs in geriatric
medicine funded in the 2000-01 Budget Act provide leadership in
developing and implementing the expanded geriatric medicine programs
and curriculum at the University of California, and that one-time
funds provided to the Academic Geriatric Resource Program in the
Budget Act of 2000 also be used to expand geriatric medicine programs
and curriculum at the university to implement subdivisions (a) and
(b).


105115.  The Regents of the University of California shall be the
agency with the responsibility for making grants for the Academic
Geriatric Resource Program.



105120.  The Legislature requests that, on March 30, 2001, and
biennially thereafter, the Regents of the University of California
submit a progress report to the Legislature, including copies to the
members of the Assembly Committee on Aging and Long-Term Care, the
members of the Senate Health and Human Services Subcommittee on Aging
and Long-Term Care, and the Chairpersons of the Assembly Committee
on Budget and the Senate Committee on Budget and Fiscal Review,
regarding the grant programs established pursuant to this chapter.
The report should include, but not be limited to, all of the
following elements:
   (a) A description of the progress made in implementing and
maintaining the programs.
   (b) The number of academic geriatric resource programs
established.
   (c) The characteristics and costs of the programs.
   (d) A summary of the progress towards developing and implementing
educational and community service programs in geriatric medicine at
each campus.
   (e) An evaluation of the program's effectiveness at each campus,
including identification of problems and limitations, and strategies
to overcome them.
   The report should separately delineate the information required
pursuant to this section with respect to each medical or health
science campus that receives funding under a grant program
established pursuant to this chapter.



105125.  No provision of this chapter shall be applicable to the
University of California unless the Regents of the University of
California, by resolution, make that provision applicable.



105130.  The department shall seek any Medicaid waivers necessary to
implement this chapter.



105140.  (a) In addition to the other programs provided under this
chapter, it is the intent of the Legislature to encourage the Regents
of the University of California to monitor existing physician
licensing requirements, and any additional requirements developed in
response to Section 105135. It is also the intent of the Legislature
that the regents review programs and offerings in the schools of
medicine to ensure that graduates of those schools are adequately
prepared to meet the licensing requirements in geriatric medicine and
any other educational requirements in geriatric medicine deemed
appropriate by the regents.
   (b) It is the intent of the Legislature that the regents request
the medical and other health science schools of the University of
California to consider the need for additional emphasis on geriatrics
in their curricula.