2005 California Business and Professions Code Sections 2154-2154.7 Repayment Program

2154.  There is hereby established in the Division of Licensing of
the Medical Board of California, the Steven M. Thompson Physician
Corps Loan Repayment Program.  This program shall be known and may be
cited as the Steven M. Thompson Physician Corps Loan Repayment
Program.
2154.1.  It is the intent of this article that the Division of
Licensing, in consultation with the Office of Statewide Health
Planning and Development, the medical community, including ethnic
representatives, medical schools, health advocates representing
ethnic communities, primary care clinics, public hospitals and health
systems, statewide agencies administering state and federally funded
programs targeting underserved communities, and members of the
public with health care issue-area expertise shall develop and
implement the Steven M. Thompson Physician Corps Loan Repayment
Program.
2154.2.  The following definitions apply for the purposes of this
article:
   (a) "Division" means the Division of Licensing.
   (b) "Office" means the Office of Statewide Health Planning and
Development (OSHPD).
   (c) "Program" means the Steven M. Thompson Physician Corps Loan
Repayment Program.
   (d) "Medically underserved area" means an area as defined in Part
5 of Chapter 1 of Title 42 of the Code of Federal Regulations or an
area of the state where unmet priority needs for physicians exist as
determined by the California Healthcare Workforce Policy Commission
pursuant to Section 128225 of the Health and Safety Code.
   (e) "Medically underserved population" means the Medi-Cal, Healthy
Families, and uninsured populations.
   (f) "Practice setting" means either of the following:
   (1) A community clinic as defined in subdivision (a) of Section
1204 and subdivision (c) of Section 1206 of the Health and Safety
Code, a clinic owned or operated by a public hospital and health
system, or a clinic owned and operated by a hospital that maintains
the primary contract with a county government to fulfill the county's
role pursuant to Section 17000 of the Welfare and Institutions Code,
which is located in a medically underserved area and at least 50
percent of whose patients are from a medically underserved
population.
   (2) A medical practice located in a medically underserved area and
at least 50 percent of whose patients are from a medically
underserved population.
   (g) "Primary specialty" means family practice, internal medicine,
pediatrics, or obstetrics/gynecology.
   (h) "Medi-Cal threshold languages" means primary languages spoken
by limited-English-proficient (LEP) population groups meeting a
numeric threshold of 3,000, eligible LEP Medi-Cal beneficiaries
residing in a county, 1,000 Medi-Cal eligible LEP beneficiaries
residing in a single ZIP Code, or 1,500 LEP Medi-Cal beneficiaries
residing in two contiguous ZIP Codes.
   (i) "Fund" means the Contingent Fund of the Medical Board of
California.
   (j) "Account" means the Medically Underserved Account, which is
contained within the fund.
2154.3.  (a) Program applicants shall possess a current valid
license to practice medicine in this state issued by the board
pursuant to Section 2050.
   (b) The division, in accordance with Section 2154.1, shall develop
the guidelines for selection and placement of applicants.
   (1) Guidelines shall 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 shall
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 their license to practice medicine.
   (2) The guidelines shall include a process for determining the
needs for physician services identified by the practice setting.  At
a minimum, the practice setting shall meet the following criteria:
   (A) The practice setting shall be located in a medically
underserved area.
   (B) The practice setting shall ensure that the program participant
serves a patient population that consists of at least 50 percent
medically underserved populations.
   (3) The guidelines shall give preference to applicants who have
completed a three-year residency in a primary specialty.
   (4) Guidelines shall seek to place the most qualified applicants
under this section in the areas with the greatest need.
   (5) Guidelines shall include a factor ensuring geographic
distribution of placements.
   (c) The division may fill up to 20 percent of the available
positions with program applicants from specialties outside of the
primary care specialties.
   (d) Program applicants shall be working in or have a signed
agreement with an eligible practice setting.  The program participant
shall have full-time status.  Full-time status shall be defined by
the division and the division may establish exemptions to this
requirement on a case-by-case basis.
   (e) Program participants shall commit to a minimum of three years
of service in a medically underserved area.  Leaves of absences will
be permitted for serious illnesses, pregnancy, or other natural
causes.  The division, in accordance with Section 2154.1, 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 division, in accordance with Section 2154.1, shall develop
the process should a physician be unable to complete his or her
three-year obligation.
   (g) The division, in accordance with Section 2154.1, shall develop
a process for outreach to potentially eligible applicants.
   (h) The division may adopt any other standards of eligibility,
placement, and termination appropriate to achieve the aim of
providing competent health care services in these approved practice
settings.
2154.4.  (a) The Medically Underserved Account is hereby created in
the Contingent Fund of the Medical Board of California.
   (b) The sum of three million four hundred fifty thousand dollars
($3,450,000) is hereby authorized to be expended from the Contingent
Fund of the Medical Board of California on this program. These moneys
are appropriated as follows:
   (1) One million one hundred fifty thousand dollars ($1,150,000)
shall be transferred from the Contingent Fund of the Medical Board of
California to the Medically Underserved Account on July 1, 2003. Of
this amount, one hundred fifty thousand dollars ($150,000) shall be
used by the Medical Board of California in the 2003-04 fiscal year
for operating expenses necessary to manage this program.
   (2) One million one hundred fifty thousand dollars ($1,150,000)
shall be transferred from the Contingent Fund of the Medical Board of
California to the Medically Underserved Account on July 1, 2004. Of
this amount, one hundred fifty thousand dollars ($150,000) shall be
used by the Medical Board of California in the 2004-05 fiscal year
for operating expenses necessary to manage this program.
   (3) One million one hundred fifty thousand dollars ($1,150,000)
shall be transferred from the Contingent Fund of the Medical Board of
California to the Medically Underserved Account on July 1, 2005. Of
this amount, one hundred fifty thousand dollars ($150,000) shall be
used by the Medical Board of California in the 2005-06 fiscal year
for operating expenses necessary to manage this program.
   (c) Funds placed into the Medically Underserved Account shall be
used by the board to repay the loans per agreements made with
physicians.
   (1) Funds paid out for loan repayment may have a funding match
from foundation or other private sources.
   (2) Loan repayments may not exceed one hundred five thousand
dollars ($105,000) per individual licensed physician.
   (3) Loan repayments may not exceed the amount of the educational
loans incurred by the physician applicant.
   (d) Notwithstanding Section 11005 of the Government Code, the
board may seek and receive matching funds from foundations and
private sources to be placed into the Medically Underserved Account.
The board also may contract with an exempt foundation for the receipt
of matching funds to be transferred to the Medically Underserved
Account for use by this program.
   (e) Funds in the Medically Underserved Account are continuously
appropriated for the repayment of loans per agreements made between
the board and the physicians.
2154.5.  The terms of loan repayment granted under this article
shall be as follows:
   (a) After a program participant has completed one year of
providing services as a physician in a medically underserved area,
the division shall provide up to twenty-five thousand dollars
($25,000) for loan repayment.
   (b) After a program participant has completed two consecutive
years of providing services as a physician in a medically underserved
area, the division shall provide up to an additional thirty-five
thousand dollars ($35,000) of loan repayment, for a total loan
repayment of up to sixty thousand dollars ($60,000).
   (c) After a program participant has completed three consecutive
years of providing services as a physician in a medically underserved
area, the division shall provide up to a maximum of an additional
forty-five thousand dollars ($45,000) of loan repayment, for a total
loan repayment of up to one hundred five thousand dollars ($105,000).
2154.6.  Pursuant to Section 2313, the division shall also include
the following in its annual report:
   (a) Number of the program participants.
   (b) Practice locations.
   (c) Amount expended for the program.
   (d) Information on annual performance reviews by the practice
settings and program participants.
2154.7.  (a) On January 1, 2003, applications from physicians for
program participation may be submitted.
   (b) The division shall report to the Legislature, no later than
October 1, 2004, the experience of the program since the inception,
an evaluation of its effectiveness in improving access to health care
for underserved populations, and recommendations for maintaining or
expanding its operation.
   (c) The division may promulgate emergency regulations to implement
the program.