2009 California Business and Professions Code - Section 3537.10-3537.50 :: Article 7.5. International Medical Graduate Physician Assistants

3537.10.  (a)  Subject to the other provisions of this article, the
Office of Statewide Health Planning and Development, hereafter in
this article referred to as the office, shall coordinate the
establishment of an international medical graduate physician
assistant training program, to be conducted at an appropriate
educational institution or institutions. The goal of the program
shall be to place as many international medical graduate physician
assistants in medically underserved areas as possible in order to
provide greater access to care for the growing population of
medically indigent and underserved. The method for accomplishing this
goal shall be to train foreign medical graduates to become licensed
as physician assistants at no cost to the participants in return for
a commitment from the participants to serve full-time in underserved
areas for a four-year period.
   (b) By February 1, 1994, or one month after federal funds to
implement this article become available, whichever occurs later, the
office shall establish a training program advisory task force. The
task force shall be comprised of representatives from all of the
following groups:
   (1) Physician assistant program directors.
   (2) Foreign medical graduates.
   (3) The California Academy of Physician Assistants.
   (4) Nonprofit community health center directors.
   (5) Physicians.
   (6) The committee, at the committee's option.
   The office may, instead, serve solely as a consultant to the task
force.
   (c) The task force shall do all of the following:
   (1) Develop a recommended curriculum for the training program that
shall be from 12 to 15 months in duration and shall, at a minimum,
meet curriculum standards consistent with the committee's
regulations. The program shall be subject to the committee's
approval. By April 1, 1994, or three months after federal funds to
implement this article become available, whichever occurs later, the
curriculum shall be presented by the office to the Committee on
Allied Health Education and Accreditation of the American Medical
Association, or its successor organization, for approval.
   (2) Develop recommended admission criteria for participation in
the pilot and ongoing program.
   (3) Assist in development of linkages with academic institutions
for the purpose of monitoring and evaluating the pilot program.

3537.15.  (a) Prior to establishment of an ongoing international
medical graduate physician assistant training program, the Office of
Statewide Health Planning and Development shall coordinate the
establishment of a pilot program commencing September 1, 1994, or
eight months after federal funds to implement this article become
available, whichever occurs later, to test the validity and
effectiveness of the recommended training curriculum developed by the
task force. The task force shall, with the advice and assistance of
the academic institutions offering the pilot program curriculum, and
subject to their approval, select 10 international medical graduates
to participate in the pilot program.
   (b) After two classes have graduated from the pilot program, the
task force, with the advice and assistance of the academic
institutions, shall evaluate the results of the pilot program, to
determine whether a permanent program should be established. The
office may modify curriculum as needed and make appropriate revisions
in order to ensure program integrity and compliance with established
standards. Any permanent international medical graduate physician
assistant training program shall commence at the beginning of the
year following the completion of the evaluation.

3537.20.  Any person who has satisfactorily completed the program
established by this article shall be eligible for licensure by the
committee as a "physician assistant" if the person has complied with
all of the following requirements:
   (a) Has successfully completed the written examination required
under Section 3517.
   (b) Has successfully completed the Test of English as a Foreign
Language (TOEFL).

3537.25.  Both the pilot and the ongoing training program shall
provide training at no cost to the participants in return for a
written, enforceable agreement by the participants to, upon obtaining
licensure under this article, serve a minimum of four years as a
full-time physician assistant in an area of California designated by
the Office of Statewide Health Planning and Development as a
medically underserved area pursuant to Section 3537.35.

3537.30.  (a) The Legislature recognizes that the goal of this
program would be compromised if participants do not observe their
commitments under this program to provide the required service in a
medically underserved area. The goal of this program would not be met
if all that it accomplished was merely to license physician
assistants that served populations that are not medically
underserved.
   (b) Since damages would be difficult or impossible to ascertain in
the event of default by the participant, this section shall set
forth the extent of liquidated damages that shall be recoverable by
the program in the case of default.
   (c) In the case of default by a participant who has successfully
completed the program and has obtained licensure under this article,
the program shall collect the following damages from the participant:
   (1) The total cost expended by the program for the training of the
applicant, and interest thereon from the date of default.
   (2) The total amount needed for the program to seek cover as set
forth in subdivision (b) of Section 3537.35.
   (3) The costs of enforcement, including, but not limited to, the
costs of collecting the liquidated damages, the costs of litigation,
and attorney's fees.
   (d) The Attorney General may represent the office, or the
committee, or both in any litigation necessitated by this article,
or, if the Attorney General declines, the office, or the committee,
or both may hire other counsel for this purpose.
   (e) Funds collected pursuant to subdivision (c) shall be allocated
as follows:
   (1) Costs of training recovered pursuant to paragraph (1) of
subdivision (c) shall be allocated to the office to be used upon
appropriation for the continuing training program pursuant to this
article.
   (2) Costs of seeking cover recovered pursuant to paragraph (2) of
subdivision (c) shall be deposited in the Physician Assistant
Training Fund established pursuant to Section 3537.40 for the
purposes of providing grants pursuant to subdivision (c) of Section
3537.35.
   (3) Costs of enforcement recovered pursuant to paragraph (3) of
subdivision (c) shall be allocated between the office, and the
Attorney General, or other counsel, according to actual costs.

3537.35.  The Office of Statewide Health Planning and Development
shall, in addition to other duties described in this article, do all
of the following:
   (a) Determine those areas of the state that are medically
underserved in that they have a higher percentage of medically
underserved and indigent persons and would benefit from the services
of additional persons licensed as physician assistants.
   (b) Determine the total cost of seeking cover as specified in
paragraph (2) of subdivision (c) of Section 3537.30. To determine the
cost, the office shall study the market forces that are at work
creating the scarcity of these physician assistants in these
medically underserved areas, and determine the annual level of
additional funding that would be required by a health facility,
clinic, or other health care provider in those areas to motivate a
physician assistant to serve full-time in those underserved areas.
This amount shall be calculated so that when added to the prevailing
rate for these services in the underserved area, would make these
positions so attractive that physician assistants would be motivated
to serve in those areas. This amount, which shall equal the cost to
the office to place a qualified physician assistant in the
underserved area, times four years shall be the total cost of seeking
cover.
   (c) Provide grants, as funds become available in the Physician
Assistant Training Fund, to applicant health care providers that
provide services in medically underserved areas for the purpose of
funding additional full-time physician assistant positions in those
areas to provide services in lieu of defaulting physician assistants.
Participating providers shall use these grants to attract physician
assistants that are from outside the area and shall demonstrate that
the grant actually increases the number of physician assistants
serving the underserved population. The grantee shall demonstrate
that the grant did not merely shift a physician assistant from one
medically underserved area to another, but rather, resulted in a net
increase in the number of physician assistants serving the
underserved population as a whole. Licensees under this article shall
not directly or indirectly receive grants under this section.

3537.40.  The Physician Assistant Training Fund is hereby created in
the State Treasury for the purpose of receipt of funds collected
pursuant to paragraph (2) of subdivision (c) of Section 3537.30. The
Physician Assistant Training Fund shall be available to the Office of
Statewide Health Planning and Development for the purpose of
providing grants pursuant to subdivision (c) of Section 3537.35, upon
appropriation by the Legislature.

3537.45.  The program established pursuant to this article shall not
be funded, directly or indirectly, from an increase in the fees
charged to physician assistants, supervising physicians, or physician
assistant training programs pursuant to Section 3521, 3521.1, or
3521.2. This article does not excuse physician assistants trained
pursuant to this article or their supervising physicians from paying
the fees established pursuant to Section 3521 or 3521.1.

3537.50.  No General Fund revenues shall be expended to carry out
this article. The implementation of the pilot program and, if
applicable, the permanent program established by this article shall
be contingent upon the availability of federal funds, which do not
divert or detract from funds currently utilized to underwrite
existing physician assistant training programs or to fund existing
functions of the committee. The new funding shall be sufficient to
cover the full additional cost to the educational institution or
institutions that establish the program or programs, the cost of
tuition and attendance for the students in the program or programs,
and any additional costs, including enforcement costs, that the
office or the committee incurs as a result of implementing this
article. Nothing in this article shall be construed as imposing any
obligations upon the office, the committee, or any physician
assistant training program in the absence of adequate funding as
described in this section. Nothing in this article shall be construed
either as precluding applicants for the program established by this
article from seeking state or federal scholarship funds, or state and
federal loan repayment funds available to physician assistant
students, or as requiring that any applicants be granted preference
in the award of those funds. Nothing in this article shall be
construed as impairing the autonomy of any institution that offers a
physician assistant training program.