Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Higher Education Committee

ESSB 5502

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.

Brief Summary of Engrossed Substitute Bill

Establishes the Primary Care Physician Conditional Tuition Waiver Program and prescribes eligibility and repayment requirements.
Requires the University of Washington to provide medical school students with information about medical homes.
Tasks the University of Washington - Family Medicine Residency Network with making reasonable efforts to facilitate the establishment of additional new residency sites for training primary care physicians.

Background:

Many rural and urban communities, and economically disadvantaged and minority populations, are already medically underserved. The Health Resources and Services Administration predicts a national shortage of physicians by 2020.

Physicians in the United States are licensed by individual states, all of which require a degree as a medical doctor (M.D) or doctor of osteopathy (D.O.). Postgraduate training in a chosen area of specialty follows receipt of an M.D. or D.O. degree. During postgraduate residency programs, residents complete their training in their chosen specialty, providing patient care under the supervision of teaching physicians. A family medicine residency program trains physicians for work in primary care.

Accreditation is required of all residency sites. In order to be accredited, sponsoring and participating residency sites must provide all residents with appropriate financial support and benefits to ensure that they are able to fulfill the responsibilities of their residency program. At each participating site, there must be a sufficient faculty with documented qualifications to instruct and supervise all residents at that location.

Medicare dollars have historically provided a significant source of funding to offset some of the costs associated with educating medical residents. In 1997, a cap was placed on the number of residency positions that Medicare supports. The cap remains today, despite calls by the Association of American Medical Colleges and others for the elimination of the cap and an increase in residency positions in order to address the projected shortage of physicians.

A "medical home" is a site of care that provides comprehensive preventive and coordinated care centered on patient needs.

Summary of Bill:

Primary Care Physician Conditional Tuition Waiver Program.

The Primary Care Physician Conditional Tuition Waiver Program is established at the University of Washington (UW). To be eligible for the tuition waiver, a person must be: (1) a resident student with a declared major in primary care medicine; (2) registered for at least six credit hours; and, (3) making satisfactory academic progress. Eligibility also requires a declared intention to practice primary care medicine in Washington.

These conditional tuition waivers are subject to available funds. They may not exceed the amount of resident tuition and fees at the university. Participants are eligible to receive a conditional tuition waiver for a maximum of four years.

Recipients incur an obligation to repay the waivers, with interest, unless they are employed as a primary care physician in Washington for two years for every one year of tuition waived. The UW is responsible for adopting rules to define the terms of repayment, including applicable interest rates, fees, and deferments. The UW is also responsible for collection of repayments.

Medical Home.

The UW must provide medical school students with information about the growth of patient and family-centered primary care medical homes as a desirable and important strategy to improve quality of care.

Family Medicine Residency Sites.

The University of Washington - Family Medicine Residency Network will make every reasonable effort to work with community physicians to establish additional accredited new sites in underserved Washington to train primary care professionals including physicians in family medicine, internal medicine, or pediatrics.

The act expires July 1, 2019.