SB 5909

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

As Reported by Senate Committee On:

Health Care, February 19, 2015

Title: An act relating to increasing the health care workforce and increasing health care access across Washington state through expansion of undergraduate medical and dental education, graduate medical education, and health professional scholarship and loan repayment programming.

Brief Description: Concerning health care access and medical and dental education.

Sponsors: Senators Frockt, Becker, Pedersen, Habib and Keiser.

Brief History:

Committee Activity: Health Care: 2/19/15 [DPS-WM, DNP, w/oRec].


Majority Report: That Substitute Senate Bill No. 5909 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

Signed by Senators Becker, Chair; Dammeier, Vice Chair; Frockt, Ranking Minority Member; Cleveland, Conway, Jayapal and Keiser.

Minority Report: Do not pass.

Signed by Senators Angel, Bailey, Brown and Parlette.

Minority Report: That it be referred without recommendation.

Signed by Senators Baumgartner and Rivers.

Staff: Evan Klein (786-7483)

Background: WWAMI Program. In 1946 the University of Washington (UW) School of Medicine was founded. In the early 1970s, UW created a regional medical education program which today serves Washington, Wyoming, Alaska, Montana, and Idaho and is known as WWAMI. Universities from the five states partner with UW to offer basic sciences courses to first-year medical school students enrolled in WWAMI, including Washington State University (WSU).

Family Medicine. The Family Medicine Residency Network (FMRN) was established in 1975 to help train resident physicians in family medicine. The FMRN provides financial support to residents in programs affiliated with the UW School of Medicine and establishes positions for appropriate faculty to staff the programs. The dean of the UW School of Medicine is responsible to implement the development and expansion of residency programs in cooperation with the medical profession, hospitals, and clinics located throughout Washington.

The chair of the Department of Family Medicine at the UW School of Medicine determines where affiliated programs exist, giving consideration to communities in the state where the population, hospital facilities, number of physicians, and interest in medical education indicate the potential success of the residency program.

The amount of state funding for a residency program is limited to no more than 50 percent of the total cost of the program. No more than 25 percent of the state funding may be used for faculty and staff at the UW School of Medicine associated with affiliated residency programs. No funds may be used to subsidize the costs of patient care.

Washington State Health Professional Loan Repayment and Scholarship Program. The Washington State Health Professional Loan Repayment and Scholarship Program (Program) was established in 1989. The Program is administered by the Washington Student Achievement Council in collaboration with the Department of Health. The Program offers two funding sources: the state-funded Health Professional Loan Repayment Program; and the federally match-funded U.S. Department of Health and Human Services State Loan Repayment Program.

Summary of Bill (Recommended Substitute): UW must increase the number of medical students at its medical school in Spokane from 40 students per year to 120 students per year as quickly as practicable, but no later than the 2021-22 academic year. UW must also increase the number of dental students at its dental program in Spokane from eight students per year to 30 students per year as quickly as practicable, but no later than the 2019-20 academic year. All of the students accepted by UW for these two expansions must be Washington residents. Classroom and lab space must be provided on the Riverpoint campus in Spokane to accommodate the class size expansions.

The Legislature must approve any partnership agreements between UW and another entity, related to the WWAMI program.

Subject to available state funding, the medical education system must allocate funds to new or expanded residency programs. The funds must be prioritized for the following programs:

A family practice education advisory board is established, consisting of nine members with the dean of the UW School of Medicine serving as the chair. The other members include the following:

The dean and chair of Department of Family Medicine are permanent members of the board. All other members are appointed for specified term limits.

The advisory board must advise the dean and chair of the Department of Family Medicine in the implementation of the education programs provided for in the bill, including the selection of the areas within the state where affiliate residency programs should exist, the allocation of funds, and the procedures for review of the residency programs.

JLARC must conduct an audit of the UW WWAMI program and its partnership agreements with other entities and other states.

The sum of $4 million is appropriated to the Health Professional Loan Repayment and Scholarship Program Fund for both fiscal year 2016 and 2017.

EFFECT OF CHANGES MADE BY HEALTH CARE COMMITTEE (Recommended Substitute): JLARC must conduct an audit of the UW WWAMI program and its partnership agreements with other entities and other states. The Legislature must approve any WWAMI partnership agreements. The requirement that WSU transfer operating funds and capital facilities associated with the WWAMI program to UW is removed.

Appropriation: $8 million.

Fiscal Note: Requested on February 16, 2015.

Committee/Commission/Task Force Created: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Staff Summary of Public Testimony on Original Bill: PRO: This bill combines many aspects of the WWAMI program and family residency needs. It is a good faith effort to work on the WSU medical school issue while addressing a shortage of residencies and rural practitioners in this state. UW wants to ensure that current and future WWAMI students' education is not compromised due to a lack of funding for the program. This bill will also help get dentists to underserved areas of the state. Increasing the number of residencies in Washington is also very important to medical students in the state.

OTHER: There is concern with certain language in the bill that only applies to UW and not to other medical schools in the state. WSU is also concerned about being required to transfer capital space to UW.

Persons Testifying: PRO: Senator Frockt, prime sponsor; Nicholas Hasle, Brooke Lifland, Sanjay Srivatsan, Justin Gasper, UW School of Medicine; Judith Pauwels, WWAMI Family Medicine Residency Network, Physician Faculty; Kathryn Kolan, WA State Medical Assn.; Susie Tracy, WA Family Medicine Residency Network; Genesee Adkins, UW; Dr. Joel Berg, UW School of Dentistry; Ian Goodhew, UW Medicine; Austin Wright-Pettibone, Associated Students of UW, Government Relations Director.

OTHER: David Knutson, Pacific NW University of Health Sciences; Chris Mulick, WSU; Jim Hedrick, Greater Spokane Incorporated.