ARIZONA HOUSE OF REPRESENTATIVES

Fifty-sixth Legislature

First Regular Session

House: ED DPA 8-0-1-1

HB 2753: graduate medical education; residency programs

Sponsor: Representative Peņa, LD 23

Caucus & COW

Overview

Requires the Arizona Area Health Education System (System) to establish a program for qualifying health centers and rural health clinics that supports the expansion of primary care residency programs. Appropriates monies to the System for specified programs.

History

System

Established in the University of Arizona College of Medicine by the Arizona Board of Regents (ABOR), the System consists of six area health education centers, five of which represent a geographic area with identified populations that lack services by the health care professions and one representing the Indian health care delivery system. Each center conducts physician and other health professional education programs (such as undergraduate clinical training programs, graduate programs and postgraduate continuing education), programs to recruit and retain minority students in health professions and continuing education programs for health professionals. The System provides administrative services to each center (A.R.S. § 15-1643).

Primary Care Graduate Medical Education (GME)

Laws 2021, Chapter 81 directs the Arizona Health Care Cost Containment System (AHCCCS) to establish, contingent on approval by the Centers for Medicare and Medicaid Services, a separate GME program to reimburse qualifying community health centers and rural health clinics that have an approved primary care GME program. AHCCCS must distribute monies appropriated for GME to approved centers and clinics for the costs of approved primary care GME programs. Additionally, AHCCCS must coordinate with local, county and tribal governments and universities under ABOR's jurisdiction that provide funding (in addition to state General Fund (GF) monies appropriated for primary care GME) in order to qualify for additional matching federal monies.

A qualifying community health center is a community-based primary care facility that provides medical care in or to medically underserved areas or populations through the employment of specified health professionals (A.R.S. § 36-2907.06).

GME is a program that prepares a physician for the independent practice of medicine by providing didactic and clinical education in a medical discipline to a medical student who has completed  a recognized undergraduate medical education program (A.R.S. § 36-2901).

Provisions

System Program to Expand Primary Care Residency Programs

1.   ☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal NoteInstructs the System, by March 1, 2024, to establish a program for qualifying community health centers and rural health clinics that:

a)   supports and expands the number of primary care residency positions;

b)   provides support and technical assistance for starting or expanding primary care residency programs in rural areas and health professional shortage areas; and

c)   facilitates information and resource sharing and provides training and technical assistance to support the success of qualifying community health center and rural health clinic primary care residency programs. (Sec. 1)

2.   Defines primary care. (Sec. 1)

3.   Appropriates $5,000,000 onetime from the state GF in FY 2024 to the System for the program to expand primary care residency programs for qualifying community health centers and rural health clinics. (Sec. 2)

4.   Authorizes the System to use up to $500,000 of the appropriation to support a collaborative of qualifying community health centers' and rural health clinics' primary care residency programs. (Sec. 2)

5.   Exempts the appropriation from lapsing. (Sec. 2)

Primary Care GME at Qualifying Community Health Centers and Rural Health Clinics

6.   Appropriates $5,000,000 from the state General Fund in FYs 2024-2026 to AHCCCS for the direct and indirect costs of primary care GME at qualifying community health centers and rural health clinics. (Sec. 3)

7.   Exempts the appropriation from lapsing. (Sec. 3)

Miscellaneous

8.   Makes conforming changes. (Sec. 1)

Amendments

Committee on Education

1.   Changes the time the System must establish the program to expand primary care residency programs from March 1, 2024 to May 1, 2024.

2.   Adds tribal health facilities to the entities eligible to participate in the System program to expand primary care residency programs.

3.   Adds that the $5,000,000 appropriation in FYs 2024-2026 to AHCCCS may also be used for the costs of primary care GME at tribal health facilities.  

4.   Defines tribal health facility.

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8.                     HB 2753

9.   Initials CH Page 0 Caucus & COW

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