HOUSE BILL REPORT

HB 2109

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 House Committee On:

Higher Education

Title: An act relating to family practice residencies.

Brief Description: Concerning the development of residency training programs to recruit and retain primary care physicians in rural and underserved areas of the state.

Sponsors: Representatives Haler, Klippert and Van De Wege.

Brief History:

Committee Activity:

Higher Education: 1/17/14, 1/22/14 [DPS].

Brief Summary of Substitute Bill

  • Recognizes the severe shortage of family medicine physicians in rural and underserved areas of the state and that the lack of residencies is one factor limiting the recruitment of physicians.

  • Recognizes that partnerships between the School of Medicine at the University of Washington (UW) and licensed hospitals or medical clinics support the development and expansion of residencies.

  • Replaces the requirement that the Chair of the Department of Family Medicine determines where affiliated residency programs shall exist with a requirement to support the development of high quality, accredited, affiliated residency programs.

  • Directs the Dean of the School of Medicine to support the development of residency training programs in southeastern Washington in partnership with qualified hospitals.

  • Directs that $6.6 million be appropriated for the fiscal year ending June 30, 2015 from the State General Fund for the School of Medicine at the UW.

HOUSE COMMITTEE ON HIGHER EDUCATION

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 19 members: Representatives Seaquist, Chair; Pollet, Vice Chair; Haler, Ranking Minority Member; Zeiger, Assistant Ranking Minority Member; Gregerson, Hansen, Hargrove, Johnson, Magendanz, Muri, Reykdal, Sawyer, Scott, Sells, Smith, Tarleton, Walkinshaw, Walsh and Wylie.

Staff: Madeleine Thompson (786-7304).

Background:

A number of state and national reports have estimated shortages of physicians and other health care providers due to demographic changes resulting from an aging population and an aging health care workforce. In Washington, a 2012 research brief by the Office of Financial Management, found that at the sub-state regional level, there is insufficient primary care physician capacity to meet Medicaid expansion needs. The brief reported that for five non-urban regions there is an insufficient capacity ranging from 20 to 60 percent. Another factor affecting primary care capacity, and the availability of family medicine physicians, is the declining interest of medical students in family medicine and the increasing interest in specialty training.

A 2010 report of the Washington, Wyoming, Alaska, Montana, and Idaho Rural Health Research Center (RHRC) finds that family physicians provide the majority of physician-directed medical care to rural and underserved areas. Due to this, the supply of rural physicians depends largely on the number and capacity of family medicine residency training programs. The RHRC report found that the volume of family medicine residency training has not kept pace with rural population growth or recent expansion of medical schools.

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Summary of Substitute Bill:

The Legislature recognizes the severe shortage of family medicine physicians in rural and underserved areas of the state and the challenges in recruiting and retaining these physicians in addition to other health care providers. It is acknowledged that one factor limiting the recruitment of physicians is the lack of residencies available in the state and in certain rural and underserved areas. The Legislature recognizes that partnerships between the School of Medicine at the University of Washington (UW) and licensed hospitals or medical clinics willing to sponsor residencies will support the development and expansion of family medicine residencies in rural and underserved areas, such as southeastern Washington, and throughout the state.

The requirement that the Chair of the Department of Family Medicine (Department) in the School of Medicine at the UW determines where affiliated residency programs exist is replaced with a requirement that the Chair of the Department support the development of high quality, accredited, affiliated residency programs.

The Dean of the School of Medicine at the UW is directed to support the development of residency training programs in southeastern Washington in partnership with qualified hospitals licensed in the state that are willing to sponsor primary care training. A sum of $6.6 million is appropriated for the fiscal year ending June 30, 2015 from the State General Fund to the School of Medicine at the UW. Of the total amount appropriated, $4 million is for expanding family medicine residencies in southeastern Washington and $2.6 million is for expanding family medicine residences throughout the state.

Substitute Bill Compared to Original Bill:

The Pacific Northwest University of Health Sciences in Yakima is added to the definition of "school of medicine" for the purposes of the development of residency programs. Specific direction that the Dean of the School of Medicine at the University of Washington (UW) shall be responsible for the development and expansion of residency programs in the state and in southeastern Washington is replaced with a direction that the school of medicine shall be responsible. Specific direction that the Chair of the Family Medicine Department at the UW support accredited, high quality residency programs is replaced with a direction to the school of medicine.

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Appropriation: The sum of $6.6 million is appropriated from the State General Fund to the School of Medicine at the University of Washington. The sum of $4 million is for expanding family medicine residences in southeastern Washington and $2.6 million is for expanding family medicine residences throughout the state.

Fiscal Note: Available.

Effective Date of Substitute Bill: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony:

(In support) There is a severe shortage of family practice physicians in southeastern Washington. This supports a partnership between the public sector and the private sector. These residency programs will accept both medical doctor (MD) students and students from doctor of osteopathy (DO) programs. This program is needed for children and adults in the area to be healthy and prosperous. Last year, over 500 medical school graduates were unable to find residency programs. Sixty-five percent of people in residency programs stay and work in the areas where they did their residency.

(Opposed) None.

Persons Testifying: Representative Haler, prime sponsor; Representative Klippert; and Jim Hall, Rand Wortman, Dale Hoekema, and Amy Carrasco, Kadlec Health System.

Persons Signed In To Testify But Not Testifying: Nova Gattman, Health Care Personnel Shortage Task Force; Dave Knutson, Pacific Northwest University of Health Sciences; Mary Clogston, Washington Academy of Family Physicians; Sherry Krainick, Washington State Parent & Teacher Association; Margaret Shepherd, University of Washington; and Chris Erickson, University of Washington Graduate and Professional Students.