AB 1396: Licensed Physicians and Dentists from Mexico Pilot Program: requirements.
- Session Year: 2023-2024
- House: Assembly
- Latest Version Date: 2023-02-17
Current Status:
Failed
(2024-02-01: From committee: Filed with the Chief Clerk pursuant to Joint Rule 56.)
Introduced
In Committee
First Chamber
In Committee
Second Chamber
Enacted
What does this bill do?
The bill lets the Medical Board issue a three‑year nonrenewable license to Mexican‑trained physicians in the Licensed Physicians and Dentists from Mexico Pilot Program even if they do not yet have a Social Security number or individual taxpayer ID, provided they apply for a proper three‑year visa and the Social Security number within 14 days of licensure and supply the Social Security number to the board within 10 days of receiving the card, and they may not practice until the board confirms compliance. It also lets the board extend the three‑year license when a physician cannot work because of medical reasons or visa delays if the physician provides documentation, and allows the board to use appropriated funds to monitor extensions.
The summary is provided by generative AI which can make mistakes. For original language, please view the details in the table below.
Existing law governs professions and vocations that are regulated by various boards within the Department of Consumer Affairs, including the Medical Board of California and the Dental Board of California. Existing law requires those boards to require a licensee, at the time of issuance of a license, to provide specified federal taxpayer information, including the applicants social security number or individual taxpayer identification number. Existing law prohibits a licensing board from processing an application for an initial license unless the applicant provides that information where requested on the application.
Existing law, the Licensed Physicians and Dentists from Mexico Pilot Program, allows licensed physicians and dentists from Mexico to be issued a license by the Medical Board of California or a permit by the Dental Board of California to practice medicine or dentistry in California for a period not to exceed 3 years and establishes requirements for the participants in the program, as specified.
This bill would, for purposes of the pilot program, notwithstanding the above-described requirements to provide specified federal taxpayer information, require the Medical Board of California to issue a 3-year nonrenewable license to an applicant who has not provided an individual taxpayer identification number or social security number if the applicant meets specified conditions.
This bill would require the applicant, pursuant to these conditions, to immediately seek an appropriate 3-year visa and social security number from the federal government within 14 days of being issued the medical license and immediately provide the medical board with their social security number within 10 days of issuance of that card by the federal government. The bill would prohibit the applicant from engaging in the practice of medicine until the board determines that these conditions have been met. The bill would require the board to notify the applicant of their eligibility to practice medicine if the board determines the applicant has met these conditions.
This bill would also authorize the Medical Board of California to extend the 3-year nonrenewable license period under specified circumstances, including during the timeframe in which a licensee is unable to work due to an ongoing medical condition or due to a delay in the visa application process, subject to providing sufficient documentation to the board for the extension. The bill would require the board, upon receipt of documentation from the licensee, to grant an extension for the timeframe in which the licensee was unable to work if that board determines that the licensee has satisfied the requirements for an extension. The bill would authorize the medical board, upon appropriation by the Legislature, to expend funds to cover staffing costs of monitoring the extensions, as specified.
(a)The Licensed Physicians and Dentists from Mexico Pilot Program is hereby created. This program shall allow up to 30 licensed physicians specializing in family practice, internal medicine, pediatrics, and obstetrics and gynecology, and up to 30 licensed dentists from Mexico to practice medicine or dentistry in California for a period not to exceed three years. years, in accordance with this section. The program shall also maintain an alternate list of program participants.
(b)The Medical Board of California shall issue three-year nonrenewable licenses to practice medicine to licensed Mexican physicians and the Dental Board of California shall issue three-year nonrenewable permits to practice dentistry to licensed Mexican dentists.
(c) Physicians from Mexico eligible to participate in this program shall comply with the following:
(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 Ginecologia 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 the physicians 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)(i)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.
(ii)Additionally, Mexican physicians participating in the program shall be required to be enrolled in adult English-as-a-second-language (ESL) classes that focus on both verbal and written subject matter. Each physician participating in the program shall have transcripts sent to the Medical Board of California from the appropriate Mexican university showing enrollment and satisfactory completion of these classes.
(C)Representatives from the UNAM in Mexico and a medical school in good standing or a facility conducting an approved medical residency training program in California shall confer to develop a mutually agreed upon distant learning program for the six-month orientation program required pursuant to subparagraph (B).
(3)Upon satisfactory completion of the requirements in paragraphs (1) and (2), and after having received their three-year nonrenewable medical license, the Mexican physicians shall be required to obtain continuing education pursuant to Section 2190. Each physician shall obtain an average of 25 continuing education units per year for a total of 75 units for a full three years of program participation.
(4)Upon satisfactory completion of the requirements in paragraphs (1) and (2), the applicant shall receive a three-year nonrenewable license to work in nonprofit community health centers and shall also be required to participate in a six-month externship at his or her the applicants place of employment. This externship shall be undertaken after the participant has received a license and is able to practice medicine. The externship shall ensure that the participant is complying with the established standards for quality assurance of nonprofit community health centers and medical practices. The externship shall be affiliated with a medical school in good standing in California. Complaints against program participants shall follow the same procedures contained in the Medical Practice Act (Chapter 5 (commencing with Section 2000)).
(5)After arriving in California, Mexican physicians participating in the program shall be required to be enrolled in adult ESL classes at institutions approved by the Bureau of Private Post Secondary and Vocational Education or accredited by the Western Association of Schools and Colleges. These classes shall focus on verbal and written subject matter to assist a physician in obtaining a level of proficiency in English that is commensurate with the level of English spoken at community clinics where he or she the physician will practice. The community clinic employing a physician shall submit documentation confirming approval of an ESL program to the board for verification. Transcripts of satisfactory completion of the ESL classes shall be submitted to the Medical Board of California as proof of compliance with this provision.
(6)(A)Nonprofit community health centers employing Mexican physicians in the program shall be required to have medical quality assurance protocols and either be accredited by the Joint Commission on Accreditation of Health Care Organizations or have protocols similar to those required by the Joint Commission on Accreditation of Health Care Organizations. These protocols shall be submitted to the Medical Board of California prior to the hiring of Mexican physicians.
(B)In addition, after the program participant successfully completes the six-month externship program, a free standing health care organization that has authority to provide medical quality certification, including, but not limited to, health plans, hospitals, and the Integrated Physician Association, is responsible for ensuring and overseeing the compliance of nonprofit community health centers medical quality assurance protocols, conducting site visits when necessary, and developing any additional protocols, surveys, or assessment tools to ensure that quality of care standards through quality assurance protocols are being appropriately followed by physicians participating in the program.
(7)Participating hospitals shall have the authority to establish criteria necessary to allow individuals participating in this three-year pilot program to be granted hospital privileges in their facilities.
(8)The Medical Board of California shall provide oversight review of both the implementation of this program and the evaluation required pursuant to subdivision (j). (l). The board shall consult with the medical schools applying for funding to implement and evaluate this program, executive and medical directors of nonprofit community health centers wanting to employ program participants, and hospital administrators who will have these participants practicing in their hospital, as it conducts its oversight responsibilities of this program and evaluation. Any funding necessary for the implementation of this program, including the evaluation and oversight functions, shall be secured from nonprofit philanthropic entities. Implementation of this program may not proceed unless appropriate funding is secured from nonprofit philanthropic entities. The board shall report to the Legislature every January during which the program is operational regarding the status of the program and the ability of the program to secure the funding necessary to carry out its required provisions. Notwithstanding Section 11005 of the Government Code, the board may accept funds from nonprofit philanthropic entities. The board shall, upon appropriation in the annual Budget Act, expend funds received from nonprofit philanthropic entities for this program.
(d)(1)Dentists from Mexico eligible to participate in this program shall comply with the following requirements or the requirements contained in paragraph (2):
(A)Be graduates from the National Autonomous University of Mexico School of Faculty Dentistry (Facultad de Odontologia).
(B)Meet all criteria required for licensure in Mexico that is required and being applied by the National Autonomous University of Mexico School of Faculty Dentistry (Facultad de Odontologia), including, but not limited to:
(i)A minimum grade point average.
(ii)A specified English language comprehension and conversational level.
(iii)Passage of a general examination.
(iv)Passage of an oral interview.
(C)Enroll and complete an orientation program that focuses on the following:
(i)Practical issues in pharmacology that shall be taught by an instructor who is affiliated with a California dental school approved by the Dental Board of California.
(ii)Practical issues and diagnosis in oral pathology that shall be taught by an instructor who is affiliated with a California dental school approved by the Dental Board of California.
(iii)Clinical applications that shall be taught by an instructor who is affiliated with a California dental school approved by the Dental Board of California.
(iv)Biomedical sciences that shall be taught by an instructor who is affiliated with a California dental school approved by the Dental Board of California.
(v)Clinical history management that shall be taught by an instructor who is affiliated with a California dental school approved by the Dental Board of California.
(vi)Special patient care that shall be taught by an instructor who is affiliated with a California dental school approved by the Dental Board of California.
(vii)Sedation techniques that shall be taught by an instructor who is affiliated with a California dental school approved by the Dental Board of California.
(viii)Infection control guidelines which that shall be taught by an instructor who is affiliated with a California dental school approved by the Dental Board of California.
(ix)Introduction to health care systems in California.
(x)Introduction to community clinic operations.
(2)(A)Graduate within the three-year period prior to enrollment in the program, from a foreign dental school that has received provisional approval or certification by November of 2003 from the Dental Board of California under the Foreign Dental School Approval Program.
(B)Enroll and satisfactorily complete an orientation program that focuses on the health care system and community clinic operations in California.
(C)Enroll and satisfactorily complete a course taught by an approved foreign dental school on infection control approved by the Dental Board of California.
(3)Upon satisfactory completion to a competency level of the requirements in paragraph (1) or (2), dentists participating in the program shall be eligible to obtain employment in a nonprofit community health center pursuant to subdivision (f) within the structure of an extramural dental program for a period not to exceed three years.
(4)Dentists participating in the program shall be required to complete the necessary continuing education units required by the Dental Practice Act (Chapter 4 (commencing with Section 1600)).
(5)The program shall accept 30 participating dentists. The program shall also maintain an alternate list of program applicants. If an active program participant leaves the program for any reason, a participating dentist from the alternate list shall be chosen to fill the vacancy. Only active program participants shall be required to complete the orientation program specified in subparagraph (C) of paragraph (1).
(6)(A)Additionally, an extramural dental facility may be identified, qualified, and approved by the board as an adjunct to, and an extension of, the clinical and laboratory departments of an approved dental school.
(B)As used in this subdivision, extramural dental facility includes, but is not limited to, any clinical facility linked to an approved dental school for the purposes of monitoring or overseeing the work of a dentist licensed in Mexico participating in this program and that is employed by an approved dental school for instruction in dentistry that exists outside or beyond the walls, boundaries, or precincts of the primary campus of the approved dental school, and in which dental services are rendered. These facilities shall include nonprofit community health centers.
(C)Dental services provided to the public in these facilities shall constitute a part of the dental education program.
(D)Approved dental schools shall register extramural dental facilities with the board. This registration shall be accompanied by information supplied by the dental school pertaining to faculty supervision, scope of treatment to be rendered, arrangements for postoperative care, the name and location of the facility, the date operations shall commence at the facility, and a description of the equipment and facilities available. This information shall be supplemented with a copy of the agreement between the approved dental school and the affiliated institution establishing the contractual relationship. Any change in the information initially provided to the board shall be communicated to the board.
(7)The program shall also include issues dealing with program operations, and shall be developed in consultation by representatives of community clinics, approved dental schools, or the National Autonomous University of Mexico School of Faculty Dentistry (Facultad de Odontologia).
(8)The Dental Board of California shall provide oversight review of the implementation of this program and the evaluation required pursuant to subdivision (j). (l). The board shall consult with dental schools in California that have applied for funding to implement and evaluate this program and executive and dental directors of nonprofit community health centers wanting to employ program participants, as it conducts its oversight responsibilities of this program and evaluation. Implementation of this program may not proceed unless appropriate funding is secured from nonprofit philanthropic entities. The board shall report to the Legislature every January during which the program is operational regarding the status of the program and the ability of the program to secure the funding necessary to carry out its required provisions. Notwithstanding Section 11005 of the Government Code, the board may accept funds from nonprofit philanthropic entities.
(e)Nonprofit community health centers that employ participants shall be responsible for ensuring that participants are enrolled in local English-language instruction programs and that the participants attain English-language fluency at a level that would allow the participants to serve the English-speaking patient population when necessary and have the literacy level to communicate with appropriate hospital staff when necessary.
(f)Physicians and dentists from Mexico having met the applicable requirements set forth in subdivisions (c) and (d) shall be placed in a pool of candidates who are eligible to be recruited for employment by nonprofit community health centers in California, including, but not limited to, those located in the Counties of Ventura, Los Angeles, San Bernardino, Imperial, Monterey, San Benito, Sacramento, San Joaquin, Santa Cruz, Yuba, Orange, Colusa, Glenn, Sutter, Kern, Tulare, Fresno, Stanislaus, San Luis Obispo, and San Diego. The Medical Board of California shall ensure that all Mexican physicians participating in this program have satisfactorily met the requirements set forth in subdivision (c) prior to placement at a nonprofit community health center.
(g)Nonprofit community health centers in the counties listed in subdivision (f) shall apply to the Medical Board of California and the Dental Board of California to hire eligible applicants who shall then be required to complete a six-month externship that includes working in the nonprofit community health center and a corresponding hospital. Once enrolled in this externship, and upon payment of the required fees, the Medical Board of California shall issue a three-year nonrenewable license to practice medicine and the Dental Board of California shall issue a three-year nonrenewable dental special permit to practice dentistry. For purposes of this program, the fee for a three-year nonrenewable license to practice medicine shall be nine hundred dollars ($900) and the fee for a three-year nonrenewable dental permit shall be five hundred forty-eight dollars ($548). A licensee or permitholder shall practice only in the nonprofit community health center that offered him or her the licensee or permitholder employment and the corresponding hospital. This three-year nonrenewable license or permit shall be deemed to be a license or permit in good standing pursuant to the provisions of this chapter for the purpose of participation and reimbursement in all federal, state, and local health programs, including managed care organizations and health maintenance organizations.
(h)The three-year nonrenewable license or permit shall terminate upon notice by certified mail, return receipt requested, to the licensees or permitholders address of record, if, in the Medical Board of California or Dental Board of Californias sole discretion, it has determined that either:
(1)The license or permit was issued by mistake.
(2)A complaint has been received by either board against the licensee or permitholder that warrants terminating the license or permit pending an investigation and resolution of the complaint.
(i)(1)Notwithstanding subdivisions (a) to (d), inclusive, of Section 30, the Medical Board of California shall issue a three-year nonrenewable license pursuant to this section to an applicant who has not provided an individual taxpayer identification number or social security number if the board staff determines the applicant is otherwise eligible for a license only under the Licensed Physicians from Mexico Pilot Program pursuant to this section, subject to the following conditions:
(A)The applicant shall immediately seek both an appropriate three-year visa and the accompanying social security number from the United States government within 14 days of being issued a medical license under this section.
(B)The applicant shall immediately provide to the Medical Board of California a social security number obtained in accordance with subparagraph (A) within 10 days of the federal government issuing the social security card related to the issued visa.
(C)The applicant shall not engage in the practice of medicine pursuant to this section until the Medical Board of California determines that the conditions in subparagraphs (A) and (B) have been met.
(2)The Medical Board of California, if it determines that an applicant has met the conditions in paragraph (1), shall notify the applicant that the applicant may engage in the practice of medicine under the license in accordance with this section.
(j)(1)The three-year nonrenewable license period may nonetheless be extended by the Medical Board of California under the following circumstances:
(A)During the timeframe in which a licensee is unable to treat patients and provide medical services for more than 30 days of work due to an ongoing condition, including, but not limited to, pregnancy, serious illness, credentialing by health plans, or serious injury that renders the licensee incapable of serving patients.
(B)During the timeframe in which a licensee is unable to work due to a delay in the visa application process beyond the established time line by the United States Customs and Immigration Services.
(2)To be eligible for an extension under this subdivision, the licensee shall provide sufficient documentation to the Medical Board of California demonstrating that the licensee meets the requirements of this subdivision.
(3)Upon receipt of documentation from the licensee, the Medical Board of California shall grant an extension for the timeframe in which the licensee was unable to work if that board determines that the licensee has satisfied the requirements for an extension under this subdivision.
(4)If the license extensions require staff of the Medical Board of California to monitor licensees under the program, the board may, upon appropriation by the Legislature, expend special fund monies to cover those costs.
(j)(k)All applicable employment benefits, salary, and policies provided by nonprofit community health centers to their current employees shall be provided to medical and dental practitioners from Mexico participating in this pilot program. This shall include nonprofit community health centers providing malpractice insurance coverage.
(j)(l)Beginning 12 months after this pilot program has commenced, an evaluation of the program shall be undertaken with funds provided from philanthropic foundations. The evaluation shall be conducted jointly by one medical school and one dental school in California and either UNAM or a foreign dental school approved by the Dental Board of California, in consultation with the Medical Board of California. If the evaluation required pursuant to this section does not begin within 15 months after the pilot project has commenced, the evaluation may be performed by an independent consultant selected by the Director of the Department of Consumer Affairs. This evaluation shall include, but not be limited to, the following issues and concerns:
(1)Quality of care provided by doctors and dentists licensed under this pilot program.
(2)Adaptability of these licensed practitioners to California medical and dental standards.
(3)Impact on working and administrative environment in nonprofit community health centers and impact on interpersonal relations with medical licensed counterparts in health centers.
(4)Response and approval by patients.
(5)Impact on cultural and linguistic services.
(6)Increases in medical encounters provided by participating practitioners to limited-English-speaking patient populations and increases in the number of limited-English-speaking patients seeking health care services from nonprofit community health centers.
(7)Recommendations on whether the program should be continued, expanded, altered, or terminated.
(8)Progress reports on available data listed shall be provided to the Legislature on achievable time intervals beginning the second year of implementation of this pilot program. An interim final report shall be issued three months before termination of this pilot program. A final report shall be submitted to the Legislature at the time of termination of this pilot program on all of the above data. The final report shall reflect and include how other initiatives concerning the development of culturally and linguistically competent medical and dental providers within California and the United States are impacting communities in need of these health care providers.
(k)(m)Costs for administering this pilot program shall be secured from philanthropic entities.
(l)(n)Program applicants shall be responsible for working with the governments of Mexico and the United States in order to obtain the necessary three-year visa required for program participation.
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Date
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Status
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| Feb 1, 2024 | From committee: Filed with the Chief Clerk pursuant to Joint Rule 56. |
| Jan 31, 2024 | Died pursuant to Art. IV, Sec. 10(c) of the Constitution. |
| May 10, 2023 | In committee: Hearing postponed by committee. |
| Apr 26, 2023 | From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (April 25). Re-referred to Com. on APPR. |
| Mar 23, 2023 | Referred to Com. on B. & P. |
| Feb 18, 2023 | From printer. May be heard in committee March 20. |
| Feb 17, 2023 | Read first time. To print. |
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Date
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Description
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Location
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Votes
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| Apr 25, 2023 | Do pass and be re-referred to the Committee on [Appropriations] | Assembly Standing Committee on Business and Professions |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
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Organization
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Position
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Date
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| Central Coast Health Network | * Support | Apr 25, 2023 |
| Community Health Centers and Clinics | ** Support | Apr 25, 2023 |
Date of Hearing: April 25, 2023
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Marc Berman, Chair
ABPCA Bill Id:AB 1396
Author:(Garcia) – As Introduced Ver:February 17, 2023
SUBJECT: Licensed Physicians and Dentists from Mexico Pilot Program: requirements.
SUMMARY: Requires the Medical Board of California (MBC) to issue a license to applicants for participation in the Licensed Physicians and Dentists from Mexico Pilot Program who do not currently possess federal documentation but otherwise meet the pilot program’s requirements, and authorizes the MBC to extend a pilot program participant’s license under certain conditions.
EXISTING LAW:
- Establishes the Medical Practice Act, which provides for the licensure and regulation of physicians and surgeons. (Business and Professions Code (BPC) §§ 2000 et seq.)
- Establishes the MBC, a regulatory board within the Department of Consumer Affairs comprised of 15 appointed members. (BPC § 2001)
- Requires all continuing medical education courses to contain curriculum that includes cultural and linguistic competency in the practice of medicine and the understanding of implicit bias. (BPC § 2190.1)
- Establishes the Licensed Physicians and Dentists from Mexico Pilot Program, which allows up to 30 physicians from Mexico specializing in family practice, internal medicine, pediatrics, and obstetrics and gynecology to practice medicine in California. (BPC § 853(a))
- Provides that the MBC shall issue three-year nonrenewable licenses to practice medicine to licensed Mexican physicians who are eligible to participate in the pilot program. (BPC § 853(b))
- Requires physicians from Mexico to comply with various requirements to participate in the pilot program, including education and practice requirements. (BPC § 853(c))
- Requires all boards under the Department of Consumer Affairs to require individual applicants for licensure to provide a social security number (SSN) or, for certain individuals who do not have an SSN, an individual taxpayer identification number (ITIN). (BPC § 30)
THIS BILL:
- Requires the MBC to issue a three-year nonrenewable license to an applicant for participation in the pilot program who has not provided an ITIN or SSN, if the MBC determines the applicant is otherwise eligible for that license.
- Requires applicants for the pilot program who receive a license without submitting an ITIN or SSN to immediately seek both a three-year visa and the accompanying SSN from the United States government within 14 days.
- Further requires applicants to immediately provide the MBC with their SSN within 10 days of the federal government issuing the social security card related to the issued visa.
- Prohibits applicants from engaging in the practice of medicine until the MBC determines that they have met the above requirements.
- Requires the MBC to notify applicants once it has determined that the applicant may engage in the practice of medicine.
- Authorizes the MBC to extend a pilot program participant’s three-year nonrenewable license under the following circumstances:
- During the timeframe in which a licensee is unable to treat patients and provide medical services for more than 30 days of work due to an ongoing condition, including, but not limited to, pregnancy, serious illness, credentialing by health plans, or serious injury that renders the licensee incapable of serving patients.
- During the timeframe in which a licensee is unable to work due to a delay in the visa application process beyond the established time line by the United States Customs and Immigration Services.
- Requires a participant to provide documentation to the MBC demonstrating that it meets the requirements to receive an extension on their license to participate in the pilot program.
- Requires the MBC to grant an extension for the timeframe in which the licensee was unable to work if that MBC determines that the applicant has satisfied the requirements.
- Authorizes the MBC to expend special fund monies to cover the costs of monitoring participants who have received an extension on their license.
FISCAL EFFECT: Unknown; this bill is keyed fiscal by the Legislative Counsel.
COMMENTS:
Purpose. This bill is sponsored by the author. According to the author:
“AB 1395 is necessary to streamline the process in which Doctors are able to obtain their medical license. As it stands in order for doctors to get their medical license they must have a social security number of Individual Tax identification number (ITIN), right now the process to get an ITIN number 3 to 5 months. This bill includes an urgency clause to specifically allow the remaining doctors from the program to be able to get their medical license without a social security number or ITIN.”
Background.
Over the past several decades, there has been an acknowledged decline in the number of accessible primary care physicians, both in California and nationally. This physician shortage has disproportionately impacted communities with concentrated populations of immigrant families and people of color. A recent study found that between 2010 and 2019, the number of primary care physicians in proportion to population remained largely unchanged nationally, and that counties with a high proportion of minorities saw a decline during that period.
There have been additional concerns that those physicians who are accessible in vulnerable communities do not necessarily possess the linguistic or cultural competence to appropriately treat all patients. A 2018 study published by the Latino Policy & Politics Initiative at the University of California, Los Angeles found that while nearly 44 percent of the California population speaks a language other than English at home, many of the state’s most commonly spoken languages are underrepresented by the physician workforce, including Spanish, Filipino, Thai/Lao, and Vietnamese as underrepresented languages.
In part to address the primary care physician shortage and to increase the number of physicians who already possess cultural and linguistic competence in the treatment of communities with high proportions of immigrant families from countries like Mexico, the Legislature enacted Assembly Bill 1045 (Firebaugh) in 2002. This bill created the Licensed Physicians and Dentists from Mexico Pilot Program. The pilot program allows a limited number of qualifying physicians and dentists to come to California and practice for a limited time under a three-year nonrenewable license.
The first annual progress report on the pilot program, submitted to the Legislature by the University of California, Davis in August 2022, found that many patients had positive experiences with physicians practicing through the pilot program. In particular, patients reportedly had substantially positive experiences communicating with their doctor, and frequently felt welcome. While the overall efficacy of the pilot program is still under review, initial reports appear positive.
However, there have been reports of certain barriers in the process through which physicians from Mexico receive approval to participate in the pilot program. As noncitizens, applicants typically will not have an ITIN or SSN, which is required by all regulatory boards, including the MBC, as a condition of receiving a license. However, applicants typically cannot apply to receive a visa and accompanying SSN without proof that they may legally work in California, which they cannot demonstrate without a license from the MBC.
This bill would resolve the above issue by creating a process through which the MBC grants a license to applicants who meet all requirements except the ability to submit an ITIN or SSN. The applicant may then use that license to apply for and obtain the needed documentation, at which point they would submit that documentation to the MBC in order to finalize approval of their participation in the pilot program. The physicians would be prohibited from engaging in the practice of Medicine in California until the MBC determines that they have completed all the requirements of participation, including submission of the required documentation.
This bill would also allow the MBC to extend the three-year nonrenewable license of a participant in the pilot program who is unable to provide services during the period of time they were licensed. Specifically, the bill would authorize an extension of a license when the physician was unable to work due to a delay in the visa application process beyond the established time line by the federal Customs and Immigration Services. The MBC would also be authorized to extend a license if the physician was unable to treat patients for more than 30 days due to an ongoing condition, including pregnancy, serious illness, credentialing by health plans, or serious injury.
Current Related Legislation. AB 1395 (Garcia) is substantially similar to this proposal. This bill is pending the Assembly Committee on Appropriations.
AB 470 (Valencia) would update continuing medical education standards to further promote cultural and linguistic competency and enhance the quality of physician-patient communication. This bill is pending the Assembly Committee on Appropriations.
Prior Related Legislation. AB 1045 (Firebaugh, Chapter 1157, Statutes of 2002) established the Licensed Physicians and Dentists from Mexico Pilot Program.
POLICY ISSUE(S) FOR CONSIDERATION:
Unclear Degree of Board Discretion. Currently, this bill provides that the MBC may extend the license of a participant in the pilot program based on certain conditions. However, it then states that the MBC shall extend the license if those conditions are deemed to exist. The author may wish to clarify that the MBC maintains discretion as to whether to grant an extension of any license.
Length of Extension. This bill is currently silent as to how long a participant’s license may be extended for, except that the extension is to be for the timeframe in which the licensee was unable to work. The author may wish to provide some parameters as to how long a license may be extended. The author may also wish to specify that an extension may only be granted once for each license.
REGISTERED SUPPORT:
None on file.
REGISTERED OPPOSITION:
None on file.
Analysis Prepared by: Robert Sumner / B. & P. / (916) 319-3301
Discussed in Hearing
2MIN
Assembly Standing Committee on Business and Professions
Bill Author
Bill Co-Author(s):