Article 1 - Song-Brown Health Care Workforce Training Act

California Health and Safety Code — §§ 128200-128235

Sections (5)

Amended by Stats. 2014, Ch. 31, Sec. 16. (SB 857) Effective June 20, 2014.

(a)This article shall be known and may be cited as the Song-Brown Health Care Workforce Training Act.
(b)(1)  The Legislature hereby finds and declares that physicians engaged in family medicine are in very short supply in California. The current emphasis placed on specialization in medical education has resulted in a shortage of physicians trained to provide comprehensive primary health care to families. The Legislature hereby declares that it regards the furtherance of a greater supply of competent family physicians to be a public purpose of great importance and further declares the establishment of the program pursuant to this article to be a desirable,

necessary, and economical method of increasing the number of family physicians to provide needed medical services to the people of California. The Legislature further declares that it is to the benefit of the state to assist in increasing the number of competent family physicians graduated by colleges and universities of this state to provide primary health care services to families within the state.

(2)The Legislature finds that the shortage of family physicians can be improved by the placing of a higher priority by public and private medical schools, hospitals, and other health care delivery systems in this state, on the recruitment and improved training of medical students and residents to meet the need for family physicians. To help accomplish this goal, each medical school in California is encouraged to organize a strong family medicine program or department. It is the intent of the Legislature that the programs or departments be headed

by a physician who possesses specialty certification in the field of family medicine, and has broad clinical experience in the field of family medicine.

(3)The Legislature further finds that encouraging the training of primary care physician’s assistants and primary care nurse practitioners will assist in making primary health care services more accessible to the citizenry, and will, in conjunction with the training of family physicians, lead to an improved health care delivery system in California.
(4)Community hospitals in general and rural community hospitals in particular, as well as other health care delivery systems, are encouraged to develop family medicine residencies in affiliation or association with accredited medical schools, to help meet the need for family physicians in geographical areas of the state with recognized family primary health care needs. Utilization of

expanded resources beyond university-based teaching hospitals should be emphasized, including facilities in rural areas wherever possible.

(5)The Legislature also finds and declares that nurses are in very short supply in California. The Legislature hereby declares that it regards the furtherance of a greater supply of nurses to be a public purpose of great importance and further declares the expansion of the program pursuant to this article to include nurses to be a desirable, necessary, and economical method of increasing the number of nurses to provide needed nursing services to the people of California.
(6)It is the intent of the Legislature to provide for a program designed primarily to increase the number of students and residents receiving quality education and training in the primary care specialties of family medicine, internal medicine, obstetrics and gynecology, and

pediatrics and as primary care physician’s assistants, primary care nurse practitioners, and registered nurses and to maximize the delivery of primary care family physician services to specific areas of California where there is a recognized unmet priority need. This program is intended to be implemented through contracts with accredited medical schools, teaching health centers, programs that train primary care physician’s assistants, programs that train primary care nurse practitioners, programs that train registered nurses, hospitals, and other health care delivery systems based on per-student or per-resident capitation formulas. It is further intended by the Legislature that the programs will be professionally and administratively accountable so that the maximum cost-effectiveness will be achieved in meeting the professional training standards and criteria set forth in this article and Article 2 (commencing with Section 128250).

Amended by Stats. 2022, Ch. 738, Sec. 7. (AB 204) Effective September 29, 2022.

As used in this article, and Article 2 (commencing with Section 128250), the following terms have the following meanings:

(a)“Family physician” means a primary care physician and surgeon who is prepared to and renders continued comprehensive and preventative health care services to individuals and families and who has received specialized training in an approved family medicine residency for three years after graduation from an accredited medical school.
(b)“Primary care physician” means a physician who is prepared to and renders continued comprehensive and preventative health care services, and has received specialized training in the areas of internal medicine, obstetrics and gynecology, or pediatrics.
(c)“Council” means the California Health Workforce Education and Training Council.
(d)“Graduate medical education” means residency programs for education or training in one or more specialties or subspecialties following graduation from medical school.
(e)“Health professions education and training” means any formal organized education or training undertaken for the purpose of gaining knowledge and skills necessary to practice a specific health profession or to provide a role in a health care setting. Health professions education and training includes any type of health professions training program, including shadowing programs, participating in rotations, affiliation agreements, and accredited or accreditation-eligible programs, at any educational level, including certificate, undergraduate, graduate, professional,

or postgraduate, and in any clinical discipline, excluding graduate medical education.

(f)“Programs that train postgraduate primary care physician’s assistants” means a program that provides postgraduate fellowships for clinical training in primary care. Programs shall be affiliated with a community-based ambulatory patient care center within underserved communities.
(g)“Programs that train primary care physician’s assistants” means a program that has been approved for the training of primary care physician assistants pursuant to Section 3513 of the Business and Professions Code.
(h)“Programs that train postgraduate primary care nurse practitioners” means a program that provides postgraduate fellowships for clinical training in primary care. Programs shall be affiliated with a community-based ambulatory patient care center within underserved communities.
(i)“Programs that train primary care nurse practitioners” means a program that is operated by a California school of medicine or nursing, or that is authorized by the Regents of the University of California or by the Trustees of the California State University, or that is approved by the Board of Registered Nursing.
(j)“Programs that train registered nurses” means a program that is operated by a California school of nursing and approved by the Board of Registered Nursing, or that is authorized by the Regents of the University of California, the Trustees of the California State University, or the Board of Governors of the California Community Colleges, and that is approved by the Board of Registered Nursing.
(k)“Programs that train midwives” means programs that train certified nurse-midwives and programs that train licensed midwives, as those terms are defined in Section 128297.
(l)“Teaching health center” means a community-based ambulatory patient care center that operates a primary care residency program. Community-based ambulatory patient care settings include, but are not limited to, federally qualified health centers, community mental health centers, rural health clinics, health centers operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, and entities receiving funds under Title X of the federal Public Health Service Act (Public Law 91-572).

Amended by Stats. 2022, Ch. 738, Sec. 8. (AB 204) Effective September 29, 2022.

There is hereby created a state medical contract program with accredited medical schools, hospitals and other health care delivery systems, teaching health centers, programs that train postgraduate primary care physician’s assistants, programs that train primary care physician’s assistants, programs that train postgraduate primary care nurse practitioners, programs that train primary care nurse practitioners, programs that train registered nurses, and programs that train midwives to increase the number of students and residents receiving quality education and training in the primary care specialties of family medicine, internal medicine, obstetrics and gynecology, midwifery, and pediatrics, or in nursing and to maximize the delivery of primary care and family physician services to specific areas of California where there is a recognized unmet priority need for those services.

Amended by Stats. 2022, Ch. 738, Sec. 9. (AB 204) Effective September 29, 2022.

When funding primary care and family medicine programs or departments, primary care and family medicine residencies, and programs for the training of postgraduate primary care physician’s assistants, primary care physician assistants, postgraduate primary care nurse practitioners, primary care nurse practitioners, certified nurse-midwives, licensed midwives, or registered nurses, the department shall give priority to

programs that have demonstrated success in the following areas:

(a)Graduating individuals who practice in medically underserved areas.
(b)Enrolling members of underrepresented groups in medicine to the program.
(c)Locating the program’s main training site in a medically underserved area.
(d)Operating a main training site at which the majority of the patients are Medi-Cal recipients.

Amended by Stats. 2022, Ch. 738, Sec. 10. (AB 204) Effective September 29, 2022.

Pursuant to this article and Article 2 (commencing with Section 128250), the Director of the Department of Health Care Access and Information shall do all of the following:

(a)Develop application and contract criteria based on health care workforce needs and priorities.
(b)Determine whether primary care and family medicine, postgraduate primary care physician’s assistant training proposals, primary care physician’s assistant training program proposals,

postgraduate primary care nurse practitioner training program proposals, primary care nurse practitioner training program proposals, registered nurse training program proposals, and proposals from programs that train midwives submitted to the department for participation in the state medical contract program established by this article and Article 2 (commencing with Section 128250) meet established standards.

(c)Select and contract on behalf of the state with accredited medical schools, teaching health centers, hospitals and other health care delivery systems, programs that train postgraduate

primary care physician’s assistants, programs that train primary care physician’s assistants, programs that train postgraduate primary care nurse practitioners, programs that train primary care nurse practitioners, and programs that train midwives for the purpose of training undergraduate medical students and residents in the specialties of internal medicine, obstetrics and gynecology, pediatrics, and family medicine. Contracts shall be awarded to those institutions that best demonstrate the ability to provide quality education and training and to retain students and residents in specific areas of California where there is a recognized unmet priority need for primary care family physicians. Contracts shall be in conformity with the contract criteria developed by the Department of Health Care Access and Information.

(d)Select and contract on behalf of the state with programs that train registered nurses. Contracts shall be awarded to those institutions that best

demonstrate the ability to provide quality education and training and to retain students and residents in specific areas of California where there is a recognized unmet priority need for registered nurses. Contracts shall be in conformity with the contract criteria developed by the Department of Health Care Access and Information.

(e)Terminate, upon 30 days’ written notice, the contract of any institution whose program does not meet the standards established or that otherwise does not maintain proper compliance with this part, except as otherwise provided in contracts entered into by the director pursuant to this article and Article 2 (commencing with Section 128250).