Title
a. Consider approving and authorizing the development, implementation, and administration at Natividad Medical Center of a six-month orientation program for participants in the Licensed Physicians and Dentists from Mexico Pilot Program, a pilot program created by Assembly Bill 1045 and allowing a specified number of Mexican national physicians to practice medicine for up to three years in nonprofit community health centers in underserved areas of California, subject to certain specified limitations; and
b. Authorize the Deputy Purchasing Agent for Natividad Medical Center to accept, administer, and execute documents to secure the funds from nonprofit philanthropic entities necessary for NMC’s development, implementation, and administration of the orientation program.
Report
RECOMMENDATION:
It is recommended the Board of Supervisors:
a. Approve and authorize the development, implementation, and administration at Natividad Medical Center (NMC) of a six-month orientation program for participants in the Licensed Physicians and Dentists from Mexico Pilot Program, a pilot program created by Assembly Bill 1045 and allowing a specified number of Mexican national physicians to practice medicine for up to three years in nonprofit community health centers in underserved areas of California, subject to the availability, receipt, and any necessary approvals by the State of California and County of Monterey of the amount of funds from nonprofit philanthropic entities required for the Pilot Program, including the amount of funds required for NMC’s development, implementation, and administration of the orientation program; and
b. Authorize the Deputy Purchasing Agent for Natividad Medical Center to accept, administer, and execute documents to secure the funds from nonprofit philanthropic entities necessary for NMC’s development, implementation, and administration of the orientation program.
SUMMARY/DISCUSSION:
Assembly Bill 1045 (AB 1045) was approved by the Governor in September of 2002. This bill provides for the creation of the Licensed Physicians and Dentists from Mexico Pilot Program and sets forth the program’s provisions related to eligibility, licensing, location, and hiring.
As referenced in AB 1045 from July 1990 to July 1999, California’s population increased by approximately 4 million people. Approximately 61 percent of this growth can be attributed to the growth in the Latino population. The Latino population increased at an average rate of 275,000 persons per year from 1990 to 1999. The Latino population is estimated to have grown in virtually all counties over this period. The United States General Accounting Office reports that the United States Community Health Centers patients are comprised of 65 percent ethnic and racial minorities.
Title VI of the Civil Rights Act of 1964 requires any federally funded health facility to ensure persons with limited English proficiency may meaningfully access health care services.
To be eligible for a three-year non-renewable medical license physicians must meet the following requirements:
1. Be licensed, certified or recertified, and in good standing in their medical specialty in Mexico. This certification or recertification shall be performed, as appropriate, by the Consejo Mexicano de Ginocologia y Obstetricia, A.C., the Consejo Mexicano de Certificacion en Medicina Familiar, A.C., the Consejo Mexicano de Medicina Interna, A.C., or the Consejo Mexicano de Certificacion en Pediatria, A.C.
2. Prior to leaving Mexico, each physician shall have completed the following requirements:
a. Passed the board review course with a score equivalent to that registered by United States applicants when passing a board review course for the United States certification examination in each of his or her specialty areas and passed an interview examination developed by the National Autonomous University of Mexico (UNAM) for each specialty area. Family practitioners who shall include obstetrics and gynecology in their practice, shall also be required to have appropriately documented, as specified by United States standards, 50 live births. Mexican obstetricians and gynecologists shall be fellows in good standing of the American College of Obstetricians and Gynecologists.
b. Satisfactorily completed a six-month orientation program that addressed medical protocol, community clinic history and operations, medical administration, hospital operations and protocol, medical ethics, the California medical delivery system, health maintenance organizations and managed care practices, and pharmacology differences. This orientation program shall be approved by the Medical Board of California to ensure that it contains the requisite subject matter and meets appropriate California law and medical standards where applicable.
Natividad Medical Center as an accredited institution providing postgraduate medical training has been asked to collaborate on the development of the required orientation program.
OTHER AGENCY INVOLVEMENT:
The NMC Board of Trustees received a presentation on June 3, 2016 regarding AB 1045 - Mexican National Physician Pilot Program from local supporter Dr. Max Cuevas, CEO of the Clinica De Salud Del Valle de Salinas located in Salinas, California, and from public policy consultant Arnoldo Torres from Sacramento.
FINANCING:
In addition to being authorized to approve the content of the orientation program component of the pilot program, the Medical Board of California is authorized under AB 1045 to provide oversight review of both the implementation of the pilot program and its evaluation. Any funding necessary for the implementation of the pilot program, including the evaluation and oversight functions, must be secured from nonprofit philanthropic entities. Implementation of the pilot program may not proceed unless appropriate funding is secured from nonprofit philanthropic entities. The Medical Board of California shall, upon appropriation in the State’s annual Budget Act, expend funds received from nonprofit philanthropic entities for this program. NMC will receive funding for this program from nonprofit philanthropic entities. NMC’s participation in the pilot program shall not impact the General Fund.
Prepared by: Steven Harrison, MD, Director of Family Medicine Residency 755-4201
Approved by: Gary R. Gray, DO, Chief Executive Officer, 783-2504
Attachments:
1. Copy of AB 1045
2. Convergence process: Certification and Recertification of Medical Specialists in the US and Mexico
3. Census Data on Latino Physicians in US between 1980-2010