AN ACT Relating to family medicine residencies in health professional shortage areas; amending RCW 70.112.020 and 70.112.060; reenacting and amending RCW 70.112.010; adding a new section to chapter 44.28 RCW; adding new sections to chapter 70.112 RCW; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1.  It is the intent of the legislature to increase the number of family medicine physicians in shortage areas in the state by providing a fiscal incentive for hospitals and clinics to develop or expand residency programs in these areas. The legislature also intends to encourage family medicine residents to work in shortage areas by funding the health professional loan repayment and scholarship program.

NEW SECTION.  Sec. 2.  A new section is added to chapter 44.28 RCW to read as follows:

(1) The joint committee shall conduct a performance audit and evaluation of the family medicine residency programs created in chapter 70.112 RCW.

(2) The audit must:

(a) Determine the locations of the residency programs, whether the programs are in health professional shortage areas as defined in RCW 70.112.010, and how the distribution of programs changes over time;

(b) Compare the number of residents who attended an in-state versus an out-of-state medical school;

(c) Compare the number of residents in family medicine versus specialty areas; and

(d) Determine whether graduates of the residency programs in health professional shortage areas continue to work within shortage areas.

(3) The joint committee shall report to the appropriate legislative committees of the house of representatives and the senate the results of its findings by November 1, 2016, and November 1st every even year thereafter.

Sec. 3.  RCW 70.112.010 and 2010 1st sp.s. c 7 s 41 are each reenacted and amended to read as follows:

(1) "Advisory board" means the family medicine education advisory board created in section 6 of this act.

(2) "Affiliated" means established or developed in cooperation with the schools of medicine.

(((2)))(3) "Family ((practice))medicine unit" means the community facility or classroom used for training of ambulatory health skills within a residency training program.

(5) "Residency programs" ((mean[s]))means community-based ((family practice)) residency educational programs in family medicine, internal medicine, and related primary care areas, either in existence or established under this chapter and that are certified by the accreditation council for graduate medical education or by the American osteopathic association.

(((4)))(6) "Schools of medicine" means the University of Washington school of medicine located in Seattle, Washington; the Pacific Northwest University of Health Sciences located in Yakima, Washington; and any other such medical schools that are accredited by the liaison committee on medical education or the American osteopathic association's commission on osteopathic college accreditation, and that either locate their entire four-year medical program in Washington or are affiliated with the regional medical education program housed at the University of Washington.

Sec. 4.  RCW 70.112.020 and 2012 c 117 s 426 are each amended to read as follows:

(1) There is established a statewide medical education system for the purpose of training resident physicians in family ((practice))medicine.

(2) The deans of the schools of medicine shall be responsible for implementing the development and expansion of residency programs in cooperation with the medical profession, hospitals, and clinics located throughout the state. The ((chair of the department of family medicine in the)) schools of medicine shall ((determine where affiliated residency programs shall exist))support development of high quality, accredited, affiliated residency programs; 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 and prioritizing support for health professional shortage areas in the state.

(3) The medical education system shall provide financial support for residents in training for those programs which are affiliated with the schools of medicine and shall establish positions for appropriate faculty to staff these programs.

(5) The number of programs shall be determined by the board and be in keeping with the needs of the state.

Sec. 5.  RCW 70.112.060 and 1975 1st ex.s. c 108 s 6 are each amended to read as follows:

(1) The moneys appropriated for these statewide family medicine residency programs shall be in addition to all the income of the ((University of Washington and its)) schools of medicine and shall not be used to supplant funds for other programs under the administration of the schools of medicine.

(2) The allocation of state funds for the residency programs shall not exceed fifty percent of the total cost of the program.

(3) No more than twenty-five percent of the appropriation for each fiscal year for the affiliated programs shall be authorized for expenditures made in support of the faculty and staff of the school of medicine who are associated with the affiliated residency programs and are located at the school of medicine.

(4) No funds for the purposes of this chapter shall be used to subsidize the cost of care incurred by patients.

NEW SECTION.  Sec. 6.  A new section is added to chapter 70.112 RCW to read as follows:

There is created a family medicine education advisory board, which shall consist of eight members, with the deans of the schools of medicine serving as cochairs. Other members of the board will be:

(1) The chairs of the departments of family medicine at the schools of medicine;

(2) Two citizen members, one from west of the crest of the Cascade mountains and one from east of the crest of the Cascade mountains, to be appointed by the governor;

(3) A member appointed by the Washington state medical association;

(4) A member appointed by the Washington osteopathic medical association;

(5) A member appointed by the Washington state academy of family physicians;

(6) A hospital administrator representing those Washington hospitals with family medicine residency programs, appointed by the governor; and

(7) A director representing the directors of community-based family medicine residency programs, appointed by the governor.

NEW SECTION.  Sec. 7.  A new section is added to chapter 70.112 RCW to read as follows:

The deans and chairs of the departments of family medicine at the schools of medicine shall be permanent members of the advisory board. Other members will be initially appointed as follows: Terms of the two public members shall be two years; the member from the medical association and the hospital administrator, three years; and the remaining two members, four years. Thereafter, terms for the nonpermanent members shall be four years; members may serve two consecutive terms; and new appointments shall be filled in the same manner as for original appointments. Vacancies shall be filled for an unexpired term in the manner of the original appointment.

NEW SECTION.  Sec. 8.  A new section is added to chapter 70.112 RCW to read as follows:

The advisory board shall advise the deans and the chairs of the departments of family medicine in the implementation of the educational programs provided for in this chapter; including, but not limited to, the selection of the areas within the state where affiliate residency programs shall exist, the allocation of funds appropriated under this chapter, and the procedures for review and evaluation of the residency programs.

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