Today's Law As Amended

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AB-2018 Mental health workforce planning: loan forgiveness, loan repayment, and scholarship programs.(2017-2018)



SECTION 1.
 The Legislature finds and declares all of the following:
(a) Despite escalating tuition costs, medical students across the nation are willing to take on more and more loan debt. This has led to a median indebtedness of $190,000 in 2016; compared with $32,000 in 1986 ($70,000 in 2017 dollars), according to a survey published in the Journal of the American Medical Association, Internal Medicine on September 5, 2017.
(b) It is not unusual in California to find psychiatric residents in training with debt loads that exceed $200,000.
(c) Student indebtedness solutions are a high priority issue for many medical students, driving career choices towards higher paying specialties or practice settings and away from practice settings in underserved and community mental health systems.
(d) California’s 58 counties consistently have one psychiatrist vacancy for every four psychiatrist positions in county-operated community mental health systems.
(e) Effective debt relief options are part of a comprehensive strategy to recruit medical students to a career in psychiatry, and steering psychiatric residents into training as community psychiatry specialists.
(f) An effective loan repayment or forgiveness strategy acts as an incentive to attract medical students to specialize in psychiatry, and psychiatric residents in training to further specialize in community psychiatry. This will help increase access to psychiatric care in community mental health systems.
(g) One innovative practice is to provide access to early loan repayment during the pendency of training to trainees in psychiatry who are committed to working in the community mental health system.
(h) The Legislature intends the changes made by this act to clarify that the Office of Statewide Health Planning and Development is authorized to provide for early loan repayment under current law and to emphasize the importance of this option.

SEC. 2.

 Section 128552 of the Health and Safety Code is amended to read:

128552.
 For purposes of this article, the following definitions shall apply:
(a) “Account” means the Medically Underserved Account for Physicians established within the Health Professions Education Fund pursuant to this article.
(b) “Foundation” means the Health Professions Education Foundation.
(c) “Fund” means the Health Professions Education Fund.
(d) “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.
(e) “Medically underserved area” means an area defined as a health professional shortage area in Part 5 of Subchapter A 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.
(f) “Medically underserved population” means the Medi-Cal program, Healthy Families Program, and uninsured populations.
(g) “Office” means the Office of Statewide Health Planning and Development (OSHPD).
(h) “Physician Volunteer Program” means the Physician Volunteer Registry Program established by the Medical Board of California.
(i) “Practice setting,” for the purposes of this article only, means either any  of the following:
(1) A community clinic as defined in subdivision (a) of Section 1204 and subdivision (c) of Section 1206, 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 physician owned and operated medical practice setting that provides primary care located in a medically underserved area and has a minimum of 50 percent of patients who are uninsured, Medi-Cal beneficiaries, or beneficiaries of another publicly funded program that serves patients who earn less than 250 percent of the federal poverty level.
(3) A program or facility operated by, or contracted to, a county mental health plan.
(j) “Primary specialty” means family practice, internal medicine, pediatrics, or obstetrics/gynecology.
(k) “Program” means the Steven M. Thompson Physician Corps Loan Repayment Program.
(l) “Selection committee” means a minimum three-member committee of the board, that includes a member that was appointed by the Medical Board of California.

SEC. 4.SEC. 3.

 Section 5822 of the Welfare and Institutions Code is amended to read:

5822.
 The Office of Statewide Health Planning and Development shall include in the five-year plan:
(a) Expansion plans for the capacity of postsecondary education to meet the needs of identified mental health occupational shortages.
(b) Expansion plans for loan forgiveness and scholarship programs offered in return for a commitment to employment in California’s public mental health system.
(b) (c)  Expansion plans for the forgiveness and scholarship programs offered in return for a commitment to employment in California’s public mental health system and make  making  loan forgiveness programs available to current employees of the mental health system who want to obtain Associate of Arts, Bachelor of Arts, master’s degrees, or doctoral degrees.
(c) (d)  Creation of a stipend program modeled after the federal Title IV-E program for persons enrolled in academic institutions who want to be employed in the mental health system.
(d) (e)  Establishment of regional partnerships between the mental health system and the educational system to expand outreach to multicultural communities, increase the diversity of the mental health workforce, to  reduce the stigma associated with mental illness, and to  promote the use of web-based technologies,  Internet Web-based technologies  and distance learning techniques.
(e) (f)  Strategies to recruit high school students for mental health occupations, increasing the prevalence of mental health occupations in high school career development programs such as health science academies, adult schools, and regional occupation centers and programs, and increasing the number of human service academies.
(f) (g)  Curriculum to train and retrain staff to provide services in accordance with the provisions and principles of Part 3 (commencing with Section 5800), Part 3.2 (commencing with Section 5830), Part 3.6 (commencing with Section 5840), and Part 4 (commencing with Section 5850) of this division.
(g) (h)  Promotion of the employment of mental health consumers and family members in the mental health system.
(h) (i)  Promotion of the meaningful inclusion of mental health consumers and family members and incorporating their viewpoint and experiences in the training and education programs in subdivisions (a) through (f). (g). 
(i) (j)  Promotion of meaningful inclusion of diverse, racial, and ethnic community members who are underrepresented in the mental health provider network.
(j) (k)  Promotion of the inclusion of cultural competency in the training and education programs in subdivisions (a) through (f). (g).