SECTION 1.
(a) The Legislature finds and declares all of the following:(1) California is facing a growing shortage of primary care physicians.
(2) It is projected that, by 2030, our state will face a skills gap of 1.1 million workers with bachelor’s degrees. Failure to keep up with demand for skilled workers will curtail economic growth, limit economic mobility, and increase inequality. The result will be a less productive California economy, limited social mobility, and lower incomes and tax revenue.
(3) In addition, our health care workforce continues to lose hundreds of thousands of doctors
and nurses each year, with the majority of them leaving before retirement age. Reducing attrition would change the projected shortages more than any other single factor.
(4) Our nation, along with the rest of the world, is currently experiencing the devastating effects of the COVID-19 pandemic. Future pandemics are not merely possible, but likely, and California is acutely at risk for these events due to the state’s global travel hubs and metropolitan population. Patients must have access to culturally competent care that they can trust, and that understands their experience and limitations.
(5) Attracting and keeping quality physicians in California is a constant challenge that has reached crisis proportions in some areas, and is a particularly acute challenge in rural areas.
(6) According to a 2017 report from the
University of California San Francisco Healthforce Center, California is predicted to see a shortage of over 4,000 primary care clinicians by 2030. In regions such as the central valley, the Inland Empire, and the Imperial Valley, communities are already experiencing the pains of a shortage. Patients in these regions face longer than average wait times to see a physician or extensive time to travel to the closest physician. These barriers discourage working families from seeking regular care. As a result, the state incurs higher costs to cover Medi-Cal patients who are pushed to utilize urgent care and emergency rooms once they are affected by more acute medical conditions that could have been prevented with earlier and more regular access to a primary care physician.
(7) Although the need is great in the Inland Empire, that region, unlike the San Joaquin Valley, has an established medical school with the University of California, Riverside,
School of Medicine. A second, privately funded medical school, the California University of Science and Medicine, was also recently accredited in 2018. By comparison, since 2015, the central valley region has only begun to establish a medical school presence through the University of California, San Francisco (UCSF), Fresno, and the San Joaquin Valley Program in Medical Education (PRIME) program. Only in the last year has the central valley region seen the establishment of a second medical school in this area with the privately funded California Health Sciences University, and the development of the University of California (UC), Merced, Center for Medical Education and Health Sciences.
(8) The central valley also has shown strong evidence of a partnership development to address preparing community college students through the existence of multiple health workforce pathways through the California Community Colleges’ Health Workforce Initiative,
the Rural Health Equity and Learning Collaborative (HEAL) program at Bakersfield College, the engagement of the University of California, the California State University, and community colleges through the Central Valley Higher Education Consortium, the new partnership between UC Merced and UCSF Fresno, and the San Joaquin Valley Coalition for Medical Education.
(9) As of 2015, the majority of California’s population has been made up of minority groups, with Latinos now estimated at over 39 percent of the total population according to the United States Census Bureau. With the COVID-19 pandemic, and according to the Centers for Disease Control and Prevention (CDC), minority groups, already disproportionately affected by longstanding social and health inequities including discrimination and limited access to quality services in health care, housing, and employment, resulting in higher rates of underlying health conditions such as diabetes,
asthma, heart conditions, or obesity are at higher risk of contracting COVID-19. The State Department of Public Health has reported that Latinos make up nearly 60 percent of all COVID-19 cases, and 49 percent of deaths, while African Americans, comprising only 6 percent of the state population, make up over 7 percent of deaths. Therefore, it is now critical that efforts to increase access to care are driven by efforts to increase the number of diverse physicians entering the practice.
(10) Latino, African American, Native American, and Pacific Islander physicians are significantly underrepresented across California. Researchers from the University of California, Los Angeles, Latino Policy & Politics Initiative (LPPI) reported in 2018 that the scarcity of Latino physicians in California has led to a deficit of 54,655 Latino physicians required to achieve parity with non-Latino white physicians. Should existing trends in recruitment and
training of physicians in the state efforts continue, LPPI researchers calculated it will take California five centuries to achieve parity. A total of six legislative districts have populations that are at least 65 percent African American, Latino, or Native American, and at least 15 percent noncitizen, including Congressional Districts 16 and 21, State Senate Districts 12 and 14, and State Assembly Districts 31 and 32.
(11) Researchers have also found that African American and Latino doctors are more likely to practice in communities that reflect their cultural background. Further studies have found evidence that the gaps in mortality between African American and white patients can be reduced when African American patients are treated by African American physicians. Without a comprehensive, statewide strategy to increase the number of diverse doctors, the existing realities of continuing disparities in care and other indicators of well-being
for communities of color hamper the state’s bold leadership in actually improving health outcomes for our most vulnerable populations.
(12) Doctor shortage is a significant deterrent to recruitment. Doctors are facing an enormous amount of debt when finishing medical school. This profession requires extensive education, training, and skills. In addition to bringing more young people into the profession, we must also find ways to keep quality doctors in California.
(13) Currently, the California Community Colleges do not offer a pipeline for students that would facilitate their ability to attend medical school.
(14) The California Community Colleges comprise the largest system of higher education in the nation, with 2.1 million students attending 115 colleges.
(15) While our state’s universities offer extensive and innovative health and science programs, many communities are not geographically close to a four-year university that offers the courses for students entering medical school.
(16) Existing and proposed pipeline programs for increasing the diversity and capacity of the health care workforce, including UC PRIME and the proposed California Health Careers Opportunity Program, have provided exemplary lessons to date in support of medical students to serve minority populations and fill critical gaps in the overall need for health workers.
(17) Across the segments of higher education in California, the diversity in the state’s community colleges most closely reflects the diversity of the state’s population. Among aspiring and enrolled medical school students, research from
the Healthforce Center at UCSF has found that the cost of higher education proved to be one of the single greatest barriers to underrepresented minorities seeking to pursue a medical degree. With the steadily rising cost of tuition in the University of California, the California State University, and among private, not-for-profit colleges in California, coupled with rising costs of living across the state, first-generation and underrepresented minority students are increasingly choosing to start their postsecondary education in community colleges despite being academically competitive applicants to those institutions. Among first-time postsecondary Latino and African American enrollees in California’s higher education institutions, nearly two-thirds enter via the community colleges.
(18) The California Community Colleges have made notable gains in improving their infrastructure for on-time transfer and career preparation in health-training
pathways as a result of recent state legislation and state-funded initiatives, including the California Guided Pathways Project and the Strong Workforce Program. While these initiatives have improved the capacity of the community colleges to support underrepresented minorities to transfer or pursue health care workforce opportunities, those initiatives have not yet led to specific practices to adopt advisory or other resources to initiate premedical training for students who may wish to consider a path to transfer and to eventually apply to medical school.
(19) In light of the overall increases in postsecondary enrollment among first-time college students, if the state seeks to expand its physician pool, building this pathway opportunity from the community college system is a natural first step. National studies in 2014 and 2018 conducted by the University of California, Davis, School of Medicine have also found that over 25 percent of United
States medical school graduates utilize a community college at some point in their higher education path. Furthermore, these studies found that graduates who attended community college while in high school, in a traditional post-high school transfer pathway, or after completion from a four-year undergraduate college or university, were more likely to train in family medicine than medical graduates who did not attend a community college.
(b) Therefore, it is the intent of the Legislature to create the California Medicine Scholars Program, a pilot program, to build upon existing programs to improve the premedical infrastructure by creating a pipeline from the California Community Colleges system, the second largest and most diverse higher education system in the world, to the practice of primary medicine. The California Medicine Scholars Program, as established by this act, will help produce physicians, and, upon completion of their training,
these physicians will care for patients in vulnerable and underserved communities. These physicians will also come from backgrounds that will help provide them with an understanding of the way of life in those communities, which is integral to enabling them to help stop or limit the impact of future pandemics.