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SB-1041 Physician assistants: licensure: Armenian medical graduate physician assistants.(2023-2024)

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Date Published: 04/08/2024 09:00 PM
SB1041:v98#DOCUMENT

Amended  IN  Senate  April 08, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill
No. 1041

Introduced by Senator Portantino

February 07, 2024

An act to add and repeal Article 9 7.6 (commencing with Section 3550) of 3538) to Chapter 7.7 of Division 2 of the Business and Professions Code, relating to healing arts.


LEGISLATIVE COUNSEL'S DIGEST


SB 1041, as amended, Portantino. Physician assistants: licensure: Armenian Doctor Pilot Program. medical graduate physician assistants.
Existing law, the Physician Assistant Practice Act, establishes the Physician Assistant Board to license and regulate physician assistants. Existing law requires the board to issue a license to practice as a physician assistant to an applicant who satisfies specified requirements, including successfully completing an approved program and passing a prescribed examination. Existing law also authorizes the board to issue a probationary license to an applicant in accordance with specified terms and conditions. Existing law makes a violation of certain provisions of the act a misdemeanor.
This bill would establish the Armenian Doctor Pilot Program, to be operative from January 1, 2025, to January 1, 2027, inclusive. Under the pilot program, up to 15 doctors who graduated from Yerevan State Medical University and have attained their medical degree and medical license in Armenia but have not practiced medicine in California within the 10 years preceding the operative date of the pilot program would be eligible to participate in the program. The bill would require participants in the program to be enrolled in a medical refresher course developed by Yerevan State Medical University and an accredited academic institution in California with an approved physician assistant program, which would be subject to approval by the board. The bill would require classes to be provided by Yerevan State Medical University and the approved California educational institution via a distance learning program. The bill would require the refresher course to include clinical training undertaken in a federally qualified health center that serves the Armenian community in southern California. The bill would require the board to issue a license to practice as a physician assistant in a federally qualified health center for 2 years to a participant who satisfies the requirements set forth in the bill. The bill, beginning April 1, 2025, would require federally qualified health centers to begin assessing the work of the participants of the pilot program. The bill would require the assessments to be submitted to the board, and would require the board to review the findings and discuss the future of the pilot program. The bill would repeal the pilot program on January 1, 2027. Medical Graduate Physician Assistant Training Program, to be conducted at an appropriate educational institution or institutions. The bill would require the board to establish a Training Program Advisory Task Force, which the bill would require to develop and recommend curriculum for a training program. The bill would make an Armenian medical graduate who is either a citizen or permanent resident of the United States and who has satisfactorily completed the training program eligible for licensure as a physician assistant if the person has also successfully completed a certain written examination. The bill would require that funding necessary for the implementation of the program to be secured from nonprofit philanthropic entities, as specified.
Because the bill would expand the scope of a crime, the bill would impose a state-mandated local program.
This bill would make legislative findings and declarations as to the necessity of a special statute for Armenian medical graduates who are either citizens or permanent residents of the United States.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 The Legislature finds and declares all of the following:
(a) Research in health care workforce shortage has found the primary care physicians workforce is unevenly distributed across the state.
(b) Some primary care physicians do not accept Medi-Cal patients.
(c) Primary care physicians are less racially, ethnically, and linguistically diverse than California’s population.
(d) As we see in the Armenian community, many physicians will likely retire within the next decade.
(e) Forecasts suggest that insufficient primary care physicians will enter the workforce to replace those who retire.
(f) There is also a significant treatment gap with multiple barriers at the individual level, especially dealing with engagement in behavioral health care; at the community level, with a lack of access to culturally and linguistically appropriate services; and at the systemic level, with a lack of social and economic resources and poor living conditions.
SEC. 2.Article 9 (commencing with Section 3550) is added to Chapter 7.7 of Division 2 of the Business and Professions Code, to read:
9.Armenian Doctor Pilot Program
3550.

(a)The Armenian Doctor Pilot Program is hereby created, to be operative from January 1, 2025, to January 1, 2027.

(b)For purposes of this article, “federally qualified health center” has the same meaning as in Section 1396d(l)(2) of Title 42 of the United States Code.

3551.

(a)Doctors who graduated from Yerevan State Medical University and have attained their medical degree and medical license in Armenia but have not practiced medicine in California within the 10 years preceding the operative date of the pilot program shall be eligible for the pilot program. The pilot program shall allow no more than 15 participants. Each candidate shall provide to the board the following documents from primary sources:

(1)Transcripts from Yerevan State Medical University showing the candidate’s enrollment and satisfactory medical program completion.

(2)The candidate’s medical license, regardless of when it was obtained.

(3)The date on which the candidate was last employed as a medical practitioner in Armenia.

(b)Each participant in the pilot program shall be required to enroll in a medical refresher course that shall review the critical medical subjective matter most pertinent to functioning as a physician assistant and was included in the medical curriculum during this course of study for a medical degree. This refresher course shall also include clinical training in California for three months. This clinical training shall be undertaken at a federally qualified health center that serves the Armenian community in southern California.

(c)The refresher course shall be developed in conjunction by Yerevan State Medical University and an accredited academic institution in California with an approved physician assistant program. Classes shall be provided by Yerevan State Medical University and the approved California educational institution via a distance learning program. Participants shall pass the refresher course and satisfactorily meet the standards established for the clinical training program. Yerevan State Medical University and the approved academic institution in California shall provide a certificate of satisfactory completion of the refresher course and transmit this documentation to the board.

(d)The refresher course described in subdivisions (b) and (c) shall be subject to approval by the board to ensure that it contains the requisite subject matter and complies with the appropriate laws of this state and medical standards, where applicable.

(e)Notwithstanding any other provision of this chapter, upon satisfactory completion of the requirements in subdivisions (a), (b), and (c), a participant in the pilot program shall receive a physician assistant license for two years that authorizes the holder to practice as a physician assistant in a federally qualified health center.

3552.

(a)Beginning April 1, 2025, the federally qualified health center shall begin assessing the following aspects of the work of the participants employed as physician assistants:

(1)Quality of care provided by doctors under this pilot program.

(2)Adaptability of these licensed practitioners to California medical standards.

(3)Impact on the working and administrative environment in federally qualified health centers and impact on interpersonal relations with medically licensed counterparts in the federally qualified health center.

(4)Response and approval by patients.

(5)Impact on cultural and linguistic services.

(6)Increases in medical encounters provided by participating practitioners to limited-English-speaking patient populations and increases in the number of limited-English-speaking patients seeking health care services from federally qualified health centers.

(b)The assessment of each physician assistant of the issues identified in paragraphs (1) to (6), inclusive, of subdivision (a) shall be submitted to the board. The board shall review the findings conveyed in less than two meetings of the board to discuss the future of the pilot program.

3553.

This article shall remain in effect only until January 1, 2027, and as of that date is repealed.

SEC. 2.

 Article 7.6 (commencing with Section 3538) is added to Chapter 7.7 of Division 2 of the Business and Professions Code, to read:
Article  7.6.  Armenian Medical Graduate Physician Assistant Training Program

3538.
 (a) The board shall establish an Armenian Medical Graduate Physician Assistant Training Program, to be conducted at an appropriate educational institution or institutions.
(b) The goal of the program shall be to establish a pathway for licensure as a physician assistant and place as many Armenian medical graduate physician assistants who are either citizens or permanent residents of the United States in medically underserved areas as possible in order to provide greater access to care for Armenian patients.

3538.1.
 (a) The board shall establish a Training Program Advisory Task Force.
(b) The task force shall be comprised of representatives from all of the following groups:
(1) Physician assistant program directors from accredited academic institutions in California with an approved physician assistant program.
(2) Armenian medical graduates.
(3) The California Academy of Physician Assistants.
(4) Federally qualified health center directors.
(c) The task force shall develop a recommended curriculum for a training program that shall be from 12 to 15 months in duration and shall, at a minimum, meet curriculum and clinical training standards consistent with existing law and the board’s regulations.

3538.2.
 An Armenian medical graduate who is either a citizen or permanent resident of the United States and who has satisfactorily completed the training program established by this article shall be eligible for licensure as a physician assistant if the person has also successfully completed the written examination required under Section 3517.

3538.3.
 (a) Any funding necessary for the implementation of the program established by this article shall be secured from nonprofit philanthropic entities.
(b) The program established by this article shall not be implemented unless appropriate funding is secured from nonprofit philanthropic entities.
(c) Notwithstanding Section 11005 of the Government Code, the board may accept moneys from nonprofit philanthropic entities to fund the program established by this article.
(d) The board shall, upon appropriation in the annual Budget Act, expend funds received from nonprofit philanthropic entities for the program established by this article.

SEC. 3.

 The Legislature finds and declares that a special statute is necessary and that a general statute cannot be made applicable within the meaning of Section 16 of Article IV of the California Constitution because of the unique need to provide doctors familiar with the language and culture of Armenian people.

SEC. 3.SEC. 4.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.