Bill Text: CA AJR13 | 2011-2012 | Regular Session | Chaptered
Bill Title: Graduate medical education.
Spectrum: Partisan Bill (Democrat 23-0)
Status: (Passed) 2011-09-06 - Chaptered by Secretary of State - Res. Chapter 85, Statutes of 2011. [AJR13 Detail]
Download: California-2011-AJR13-Chaptered.html
BILL NUMBER: AJR 13 CHAPTERED
BILL TEXT
RESOLUTION CHAPTER 85
FILED WITH SECRETARY OF STATE SEPTEMBER 6, 2011
ADOPTED IN SENATE AUGUST 22, 2011
ADOPTED IN ASSEMBLY JUNE 20, 2011
INTRODUCED BY Assembly Member Lara
(Coauthors: Assembly Members Alejo, Allen, Bradford, Butler,
Campos, Carter, Cedillo, Davis, Eng, Fong, Furutani, Hueso, Mendoza,
Mitchell, Pan, Perea, V. Manuel Pérez, Solorio, Swanson, Torres,
Williams, and Yamada)
JUNE 2, 2011
Relative to health care.
LEGISLATIVE COUNSEL'S DIGEST
AJR 13, Lara. Graduate medical education.
This measure would urge the President and the Congress of the
United States to continue to provide resources to increase the supply
of physicians in California and to consider solutions that would
increase the number of graduate medical education residency
positions.
WHEREAS, Congress approved, and President Barack Obama signed, the
federal Patient Protection and Affordable Care Act (PPACA) of 2010
(Public Law 111-148), to expand health insurance coverage, reduce
health care costs, and address the growing shortage of physicians;
and
WHEREAS, The PPACA aims to specifically address shortages in
primary care through adjustments to the Medicare and Medicaid fee
schedules, reallotment of unused graduate medical education slots,
and a suite of grants, scholarships, loans, and loan forgiveness
programs; and
WHEREAS, Forty-two of California's 58 counties fall below the
Council on Graduate Medical Education's recommendations for minimum
primary care physician supply, and of these 42 counties, 16 have a
Latino population that exceeds 30 percent; and
WHEREAS, The PPACA encourages more physicians to practice in rural
settings, where Latinos can constitute 50 percent of the population,
through Rural Physician Training Grants for medical schools; and
WHEREAS, California's rural counties suffer from particularly low
physician practice rates, of the rural counties with the lowest
number of primary care physicians, three have a Latino population
over 50 percent; and
WHEREAS, The PPACA endeavors to create a more diverse and
culturally competent physician workforce by funding scholarships,
educational assistance, and loan repayment programs for minority
medical students, as well as by building diversity training curricula
for medical schools and continuing medical education programs; and
WHEREAS, California is a diverse state that demands a culturally
competent and multiethnic physician workforce. According to the 2010
Census, of the state's residents 40 percent are non-Hispanic White,
38 percent are Hispanic, 13 percent are Asian, 6 percent are African
American, 3 percent are multiracial, and approximately 1 percent are
American Indian; and
WHEREAS, Currently Latinos, African Americans, Samoans,
Cambodians, Hmong, and Laotians are underrepresented in California's
physician workforce. The underrepresentation of Latino physicians is
particularly dire: Latinos represent over one-third of the state's
population, but account for only 5 percent of the state's physicians;
and
WHEREAS, The majority of the state's ethnic communities enjoys a
ratio of 361 physicians per 100,000 residents, but African American
communities have only 178 physicians per 100,000 residents and Latino
communities have only 56 physicians per 100,000 residents; and
WHEREAS, The number of physicians retiring currently outpaces the
number of physicians entering the workforce in California, where, in
the last 15 years, the number of medical school graduates in
California has been at a plateau even though there has been a
population growth in the state of 20 percent; and
WHEREAS, The magnitude of this physician shortage will only
increase the cost of public health care in the health care
institutions of the state given that Latinos will constitute the
majority of Californians by the year 2040. Currently, to reach parity
with the non-Latino patient population, there would need to be
approximately 27,309 more Latino physicians in California; and
WHEREAS, The PPACA reforms graduate medical education by expanding
the scope of Medicare-recognized patient care settings, creating
funding for community-based graduate medical education training, and
establishing Teaching Health Centers development grants; and
WHEREAS, The increase of medical school debt is one of the primary
factors for a student not to pursue medical school because the
average medical student now graduates with about $150,000 in debt. If
that trend continues at the average rate, medical school debt will
amount to $750,000 by 2033; and
WHEREAS, It was reported that in 2009 there were over 45,500
applications to California's eight medical schools but that these
schools only offered a total of 1,084 spots; and
WHEREAS, The primary bottleneck in the United States' physician
training pipeline is at residency. California is host to 12 percent
of the United States' population, but only has 8.3 percent of the
country's medical residents. This means that in 2008, California had
9,200 medical residents, which was significantly below the national
average; and
WHEREAS, California is able to meet only 25 percent of its current
physician workforce needs with physicians who undergo graduate
medical education in-state; and
WHEREAS, The PPACA demonstrates an ongoing commitment to
evaluation and assessment of the physician workforce by establishing
the National Health Care Workforce Commission, Centers for Health
Care Workforce Analysis at the national, state, and regional levels,
and funding state health care workforce development grants; and
WHEREAS, The expansion of health insurance coverage under the
PPACA will further increase the need for physicians. Nearly 4.7
million nonelderly adults and children who were uninsured in all or
part of 2009 will qualify for coverage under the PPACA; now,
therefore, be it
Resolved by the Assembly and the Senate of the State of
California, jointly, That the Legislature urges the President and the
Congress of the United States to continue to provide resources to
increase the supply of physicians in California, in order to improve
access to care, particularly for Californians in rural areas and
members of underrepresented ethnic groups; and be it further
Resolved, That the Legislature encourages the President and the
Congress of the United States to consider solutions that would
increase the number of graduate medical education residency positions
to keep pace with the growing numbers of medical school graduates
and the growing need for physicians in California and the United
States; and be it further
Resolved, That the Chief Clerk of the Assembly transmit copies of
this resolution to the President and Vice President of the United
States, to the Speaker of the House of Representatives, to the
Majority Leader of the Senate, to each Senator and Representative
from California in the Congress of the United States, and to the
author for appropriate distribution.
