Existing law establishes the University of California, under the administration of the Regents of the University of California, as one of the segments of postsecondary education in the state.

This bill would request the University of California to post, on or before December 1, 2026, and each December 1 thereafter, in a report on a publicly accessible internet website of the University of California, data on students enrolled in a University of California school of medicine. The bill would request the report to include, among other categories of data, the total number of first-generation students and the total number of federal Pell Grant recipients enrolled in a University of California school of medicine. The bill would repeal these provisions on January 1, 2035.

Existing law establishes the University of California, under the administration of the Regents of the University of California, as one of the segments of postsecondary education in the state.

This bill would request the University of California to post, on or before December 1, 2026, and each December 1 thereafter, in a report on a publicly accessible internet website of the University of California, data on students enrolled in a University of California school of medicine. The bill would request the report to include, among other categories of data, the total number of first-generation students and the total number of federal Pell Grant recipients enrolled in a University of California school of medicine. The bill would repeal these provisions on January 1, 2035.

Existing law establishes the University of California, under the administration of the Regents of the University of California, as one of the segments of postsecondary education in the state.

This bill would request the University of California to post, on or before December 1, 2026, and each December 1 thereafter, in a report on a publicly accessible internet website of the University of California, data on students enrolled in a University of California school of medicine. The bill would request the report to include, among other categories of data, the number of first-generation students and the number of federal Pell Grant recipients enrolled in a University of California school of medicine. The bill would repeal these provisions on January 1, 2035.

Existing law establishes the University of California, under the administration of the Regents of the University of California, as one of the segments of postsecondary education in the state.

This bill would request the University of California to post, on or before December 1, 2026, and each December 1 thereafter, in a report on a publicly accessible internet website of the University of California, data on students enrolled in a University of California school of medicine. The bill would request the report to include, among other categories of data, the number of first-generation students and the number of federal Pell Grant recipients enrolled in a University of California school of medicine. The bill would repeal these provisions on January 1, 2035.

Existing law establishes the University of California, under the administration of the Regents of the University of California, as one of the segments of postsecondary education in the state.

This bill would request the University of California to post, on or before December 1, 2026, and each December 1 thereafter, in a report on a publically publicly accessible internet website of the University of California, data on students enrolled in a University of California school of medicine. The bill would request the report to include, among other categories of data, the number of first-generation students and the number of federal Pell Grant recipients enrolled in a University of California school of medicine, as specified. medicine.

Existing law establishes the University of California, under the administration of the Regents of the University of California, as one of the segments of postsecondary education in the state.

Existing law establishes the University of California, under the administration of the Regents of the University of California, and independent institutions of higher education, as defined, as 2 as one of the segments of postsecondary education in the state.

This bill would request at least 3 University of California and independent institution of higher education medical schools to give schools, commencing with students starting medical school in the 202728 academic year, to give, as specified, admission preference to eligible applicants who speak one or more languages other than English. English that are underrepresented in the physician workforce and commonly spoken in California, as provided. The bill would request the Regents of the University of California and the governing boards of independent institutions of higher education to develop and implement procedures for purposes of the bills provisions.

Existing law establishes the University of California, under the administration of the Regents of the University of California, and independent institutions of higher education, as defined, as 2 segments of postsecondary education in the state.

This bill would request University of California and independent institution of higher education medical schools to give admission preference to eligible applicants who speak one or more languages other than English. The bill would request the Regents of the University of California and the governing boards of independent institutions of higher education to develop and implement procedures for purposes of the bills provisions.

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 2080

Author:(Arambula and Garcia)

As Amended Ver:August 23, 2024

Majority vote

SUMMARY

Requests the University of California (UC) to annually report and post on its website data on students enrolled in a UC school of medicine and requests the information reported comply with the federal Family Educational Rights and Privacy Act (FERPA) of 1974.

Senate Amendments

1. State the following findings and declarations of the Legislature:
   1. California's overall supply of physicians is insufficient to meet patient needs; 
   2. In particular, Latinx, African American, and Native American physicians are vastly underrepresented in California;
   3. California's physician workforce does not reflect the racial, ethnic, linguistic, or geographic characteristics of the patient population;
   4. California's physician pipeline lags behind the rest of the United States, with just 21.1 medical students per 100,000 persons in California, compared to the nationwide average of 37.9 medical students per 100,000 persons;
   5. Data shows that shared cultural and linguistic concordance between physician and patient improves communication, which increases patient trust and satisfaction with their healthcare and improves clinical outcomes;
   6. It is essential that California increase the number of physicians who can deliver culturally and linguistically competent healthcare; and,
   7. The UC enrollment data on key socioeconomic metrics will highlight the UC's progress in diversifying and increasing enrollment capacity of UC schools of medicine, and will inform future strategies to train a physician workforce that reflects the people of California.
2. Requests that the data on students enrolled in a UC school of medicine, that the UC, on or before December 1, 2026, and each December 1 thereafter, posts on a publicly accessible internet website of the UC, include, but not be limited to, the total number of all of the following:
   1. Enrolled students;
   2. First-generation students;
   3. Federal Pell Grant recipients;
   4. Multilingual students. The data described in this subparagraph shall be disaggregated by languages other than English that students speak, and shall highlight how many students speak languages that are underrepresented in California's physician workforce;
   5. Community college transfer students; and,
   6. Students with membership in a California Indian tribe or federally recognized tribe.
3. Requests the information posted, per 2) a)–f) inclusive above, to include all of the following information:
   1. The total number of applicants to a University of California school of medicine; and,
   2. Contextual data that the UC deems relevant to the report; and,
   3. A breakdown of both of the following:
      1. Postsecondary educational institutions where students received their baccalaureate degrees; and,
      2. Sexual orientation and gender identity of students of students, if available.
4. Make clarifying and technical changes.

COMMENTS

The UC Schools of Medicine (UC SOM). The UC has six SOM, located at UC Davis (UCD), UC Irvine, UC Los Angeles (UCLA), UC Riverside (UCR), UC San Diego (UCSD), and UC San Francisco (UCSF). Each SOM follows the best practices of the American Association of Medical Colleges (AAMC) and uses holistic review for their admissions process. Holistic review is an admissions process that considers each applicant individually by balancing their academic metrics with life experiences and attributes. These factors are viewed in combination to consider how an individual might contribute value, not only as a medical student, but also as a future physician. Nearly all medical schools report using some elements of holistic review. This allows schools to prioritize their mission and determine their individual priorities for admissions. This has also resulted in more diverse medical school classes.

According to the 2023 U.S. News and World Report rankings for most diverse medical schools, UC SOM had four in the top 15 ranked diverse medical schools: UCD at number 3; UCR at number 5; UCSF at number 9; and, UCLA at number 13.

Under the AAMC, UC SOM applicants are asked to add all languages that they speak, along with their proficiency and frequency of use in their childhood home for each (including English). The chart below, from the AAMC, shows the criteria that medical school applicants are asked to follow when selecting their level of language proficiency.

According to the UC, all SOM applications collect information on language proficiency from applicants. Currently, this data is not reported to the UC Office of the President.

Diversification efforts. According to the UC, the UC SOM have shown steady gains in the enrollment of students underrepresented in medicine (URiM) over the last 20 years. In 2024, 50% of first-year UC medical students are URiM compared to only 16% in 2000. The UC attributes this increase to several factors, including, but not limited to, UC Programs in Medical Education (PRIME), which is the UC's systemwide initiative focused on adding the physician workforce shortages and meeting the needs of underserve populations.

The first PRIME program began in 2004 and now there are 459 PRIME students enrolled across 10 programs which train highly motivated, socially conscious graduates who will become physician leaders committed to serving medically underserved groups and communities across the state. Each program includes a specified area of focus and combines structured activities ranging from student outreach and recruitment to specialized coursework, population-focused clinical training and research experiences, health care leadership and management training, community engagement experiences, master's degree educational opportunities, faculty mentoring, and sponsored events that are open to the broader campus community. Eighty-four percent of PRIME students are from groups that are URiM.

According the UC's most recent PRIME programs report (for fiscal year 2023-24), communities of color will make up over 65% of California's population by 2030, yet they are severely underrepresented in the health workforce and educational pathway. Language capabilities are also not aligned, with a large and growing public unable to effectively communicate with their health providers. For the physician workforce to better reflect California's diverse population, it will be critical that California medical schools continue to prioritize efforts to increase diversity among students, residents, and faculty. It is also well documented that physicians from groups underrepresented in medicine (URiM) are more likely to practice in shortage areas and to care for underserved and uninsured populations as compared to others.

Federal Family Educational Rights and Privacy Act (FERPA) of 1974. FERPA is a federal law enacted in 1974 that protects the privacy of student education records. FERPA applies to any public or private elementary, secondary, or postsecondary school, college or university. It also applies to any state or local education agency that receives funds under an applicable program of the US Department of Education.

The intent of this measure is to collect data to assess UC's progress towards diversifying California's healthcare workforce, particularly in relation to multilingual speakers. Further, this measure contains data collection on the number of first-generation, multilingual, and Pell Grant-eligible (low-income) students. Additionally, it requests that UC, in its report, provide a breakdown of the sexual orientation and gender identity of enrolled students. If UC decides to implement the provisions of this measure, the UC must comply with FERPA.

According to the Author

"Health care disparities occur across a broad range of dimensions, including race, socioeconomic status, gender, language, and many more. In particular, a physician's ability to speak the same language as their patient has been shown to improve quality of care and outcomes. Language concordance increases trust and patient satisfaction while decreasing poor clinical outcomes due to miscommunication."

The author contends that, "the inability of physicians to effectively communicate with their patients is devastating for non-English speakers. When controlling for other factors, non-English speaking patients experience adverse health outcomes ranging from moderate harm to death at twice the rate of their English-speaking counterparts. In addition, it is common for the family members of non-English speakers to serve as medical translators in times of crisis, putting patient's children at risk for anxiety and depression in adolescence and young adulthood."

Arguments in Support

According to Health Net, "California's physician workforce does not reflect the diversity of the state. Efforts are being made to improve it as studies have shown that health outcomes improve when a provider is able to bridge the language and cultural barrier with their patients. As medical school admissions have expanded over the past two decades, admissions have become slightly less diverse, but AB 2080 will improve admissions for underrepresented applicants. Health Net has leaned into opportunities to support our community partners to improve access to culturally sensitive services and providers. This includes supporting the implementation of the doula benefit in Medi-Cal, increasing the pipeline of Community Health Workers and promotoras, among others. However, more must be done to expand a diverse pipeline of culturally sensitive providers in California."

Arguments in Opposition

None on file.

FISCAL COMMENTS

According to the Senate Committee on Appropriations, the UC estimates one-time General Fund costs between $135,000 and $150,000 for all UC schools of medicine for information technology and infrastructure costs. The UC also estimates General Fund costs ranging from $380,000 to $410,000 each year for staff resources at the schools of medicine to collect the required data.

VOTES:

ASM HIGHER EDUCATION: 10-0-1

YES: Mike Fong, Ta, Arambula, Boerner, Chen, Essayli, Irwin, Jackson, Low, Muratsuchi

ABS, ABST OR NV: Quirk-Silva

ASM APPROPRIATIONS: 15-0-0

YES: Wicks, Sanchez, Arambula, Bryan, Calderon, Wendy Carrillo, Dixon, Mike Fong, Grayson, Haney, Hart, Jim Patterson, Pellerin, Ta, Villapudua

ASSEMBLY FLOOR: 73-0-7

YES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Chen, Connolly, Davies, Dixon, Essayli, Flora, Mike Fong, Vince Fong, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Hoover, Irwin, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Rendon, Reyes, Rodriguez, Blanca Rubio, Sanchez, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Weber, Wicks, Wilson, Wood, Zbur, Robert Rivas

ABS, ABST OR NV: Cervantes, Megan Dahle, Friedman, Gabriel, Holden, Mathis, Luz Rivas

SENATE FLOOR: 40-0-0

YES: Allen, Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Min, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk

UPDATED

VERSION: August 23, 2024

CONSULTANT: Jeanice Warden / HIGHER ED. / (916) 319-3960 FN: 0004769

 THIRD READING  

Bill No: AB 2080

Author: Arambula (D) and Garcia (D)

Amended: 8/23/24 in Senate

Vote: 21

SENATE EDUCATION COMMITTEE: 7-0, 7/3/24

AYES: Newman, Ochoa Bogh, Cortese, Glazer, Gonzalez, Smallwood-Cuevas, Wilk

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/15/24

AYES: Caballero, Jones, Ashby, Becker, Bradford, Seyarto, Wahab

ASSEMBLY FLOOR: 73-0, 5/21/24 - See last page for vote

SUBJECT: University of California: schools of medicine: report

SOURCE: Author

DIGEST:

This bill requests, until 2035, the University of California (UC) to annually report and post on its website data on students enrolled in a UC school of medicine and requests the information reported comply with the federal Family Educational Rights and Privacy Act (FERPA) of 1974.

Senate Floor Amendments of 8/23/24 reinstate reporting on sexual orientation and gender identity of students.

ANALYSIS:

Existing federal law:

FERPA imposes specific requirements on postsecondary institutions concerning the handling of educational records. The statute mandates that these institutions must not disclose education records or personally identifiable information without the consent of the student, except under specified exceptions. One such exception includes instances in which the disclosure is in connection with financial aid for which the student has applied. Furthermore, the Act conditions the receipt of federal funds on adherence to these privacy protections. Institutions in violation of FERPA may face penalties, including the possible loss of federal funding. (20 United States Code Annotated § 1232g)

Existing state law:

Establishes the UC, a public trust to be administered by the Regents of the UC and grants the Regents full powers of organization and government, subject only to such legislative control as may be necessary to insure security of its funds, compliance with the terms of its endowments, statutory requirements around competitive bidding and contracts, sales of property and the purchase of materials, goods and services. (Article IX, Section (9)(a) of the California Constitution)

This bill:

1. Requests, by December 1, 2026 and until January 1, 2035, that the UC post, an annual report on a publicly accessible UC website data on students enrolled in a UC School of Medicine.
2. Requests that the data on students enrolled in a UC School of Medicine include all of the following:
   1. Enrolled students.
   2. First-generation students.
   3. Federal Pell Grant recipients.
   4. Multilingual students that is disaggregated by languages other than English that students speak, and highlighted how many students speak languages that are underrepresented in California’s physician workforce.
   5. Community College transfer students.
   6. Students with membership in a California Indian tribe or federally recognized tribe.
3. Requests that the information posted in the report to include all of the following information:
   1. The total number of applicants to a UC School of Medicine.
   2. Contextual data that the UC deems relevant to the report.
   3. A breakdown of postsecondary educational institutions where students received their baccalaureate degrees.
   4. A breakdown of sexual orientation and gender identity of students, if available.
4. Requests that the information posted in the report:
   1. Be disaggregated by campus.
   2. Be for the academic year in which the report is due.
5. Requests that the information posted in the report is requested to be posted in compliance with FERPA and is requested to not include any personally identifiable information for any student.

Comments

1. Need for the bill. According to the author, “A physician’s ability to speak the same language as their patient is essential to improving patient health and happiness. The inability of physicians to effectively communicate with their patients is devastating for non-English speaking patients and their families. Non-English speaking patients experience adverse health outcomes ranging from moderate harm to death at twice the rate of their English-speaking counterparts.

“In California, the most under-represented language groups in the physician workforce are Vietnamese, Thai/Lao, Tagalog, and Spanish. Of all languages, Spanish had the lowest ratio of Spanish speaking physicians relative to Spanish speaking patients. AB 2080 will provide meaningful data on each University of California school of medicine and their progress towards increasing the size and diversity of our healthcare workforce.

“As our state’s first Latino Physician elected to the Legislature, I’m proud to introduce AB 2080 to diversify our health care workforce and better serve communities like mine.”

1. Data collection captures demographic information on enrolled students. Given the author's statement above, the intent of this measure is to collect data to assess UC's progress towards diversifying California's healthcare workforce, particularly in relation to multilingual speakers. This bill contains data collection on the number of first-generation, multilingual, and Pell Grant-eligible (low-income) students. It additionally requests that UC, in its report, provide a breakdown of the sexual orientation and gender identity of enrolled students, if available. This information is collectable only to the extent that students voluntarily self-identify and disclose it in compliance with federal privacy rules. As noted in the background section of this analysis, federal statute mandates that institutions must not disclose education records or personally identifiable information without the consent of the student. If UC decides to implement the provisions of this bill, it must comply with FERPA.
2. UC school of medicine. The UC has six schools of medicine, located at UC Davis (UCD), UC Irvine, UC Los Angeles (UCLA), UC Riverside (UCR), UC San Diego (UCSD), and UC San Francisco (UCSF). Each school of medicine follows the best practices of the American Association of Medical Colleges (AAMC) and uses holistic review for their admissions process. Holistic review is an admissions process that considers each applicant individually by balancing their academic metrics with life experiences and attributes. These factors are viewed in combination to consider how an individual might contribute value, not only as a medical student, but also as a future physician. Nearly all medical schools report using some elements of holistic review. This allows schools to prioritize their mission and determine their individual priorities for admissions. This has also resulted in more diverse medical school classes.

According to the 2023 U.S. News and World Report rankings for most diverse medical schools, UC School of Medicine had four in the top 15 ranked diverse medical schools: UC Davis at number 3; UCR at number 5; UCSF at number 9; and, UCLA at number 13. Seemingly, the holistic review process and other efforts have contributed to diversifying the healthcare workforce.

1. Diversification efforts. According to UC, the UC Schools of Medicine have shown steady gains in the enrollment of students underrepresented in medicine (URiM) over the last 20 years. In 2024, 50% of first-year UC medical students are URiM compared to only 16% in 2000. The UC attributes this increase to several factors, including, but not limited to, UC Programs in Medical Education (PRIME), which is the UC’s systemwide initiative focused on adding to physician workforce shortages and meeting the needs of underserved populations.

The first PRIME program began in 2004, and now there are 459 PRIME students enrolled across 10 programs that train highly motivated, socially conscious graduates who will become physician leaders committed to serving medically underserved groups and communities across the state. Each program includes a specified area of focus and combines structured activities ranging from student outreach and recruitment to specialized coursework, population-focused clinical training and research experiences, health care leadership and management training, community engagement experiences, master’s degree educational opportunities, faculty mentoring, and sponsored events that are open to the broader campus community. Eighty-four percent of PRIME students are from URiM groups.

According to the UC’s most recent PRIME program report (for fiscal year 2023-24), communities of color will make up over 65% of California’s population by 2030, yet they are severely underrepresented in the health workforce and educational pathway. Language capabilities are also not aligned, with a large and growing public unable to effectively communicate with their health providers. For the physician workforce to better reflect California’s diverse population, it will be critical that California medical schools continue to prioritize efforts to increase diversity among students, residents, and faculty. It is also well documented that physicians from groups URiM are more likely to practice in shortage areas and to care for underserved and uninsured populations as compared to others.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Senate Appropriations Committee analysis, the bill would have the following fiscal impact, the UC estimates one-time General Fund costs between $135,000 and $150,000 for all UC schools of medicine for information technology and infrastructure costs. The UC also estimates General Fund costs ranging from $380,000 to $410,000 each year for staff resources at the schools of medicine to collect the required data.

SUPPORT: (Verified 8/26/24)

Samuel Merritt University

The Leukemia & Lymphoma Society

OPPOSITION: (Verified 8/26/24)

None received

ASSEMBLY FLOOR: 73-0, 5/21/24

AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Chen, Connolly, Davies, Dixon, Essayli, Flora, Mike Fong, Vince Fong, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Hoover, Irwin, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Rendon, Reyes, Rodriguez, Blanca Rubio, Sanchez, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Weber, Wicks, Wilson, Wood, Zbur, Robert Rivas

NO VOTE RECORDED: Cervantes, Megan Dahle, Friedman, Gabriel, Holden, Mathis, Luz Rivas

Prepared by: Olgalilia Ramirez / ED. / (916) 651-4105

8/26/24 11:53:14

**** END ****

 THIRD READING  

Bill No: AB 2080

Author: Arambula (D) and Garcia (D)

Amended: 8/21/24 in Senate

Vote: 21

SENATE EDUCATION COMMITTEE: 7-0, 7/3/24

AYES: Newman, Ochoa Bogh, Cortese, Glazer, Gonzalez, Smallwood-Cuevas, Wilk

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/15/24

AYES: Caballero, Jones, Ashby, Becker, Bradford, Seyarto, Wahab

ASSEMBLY FLOOR: 73-0, 5/21/24 - See last page for vote

SUBJECT: University of California: schools of medicine: report

SOURCE: Author

DIGEST:

This bill requests, until 2035, the University of California (UC) to annually report and post on its website data on students enrolled in a UC school of medicine and requests the information reported comply with the federal Family Educational Rights and Privacy Act (FERPA) of 1974.

Senate Floor Amendments of 8/21/2024 sunset the bill’s provisions on January 1, 2023, and strike the requirement to collect and report data on students’ sexual orientation and gender identity.

ANALYSIS:

Existing federal law, the FERPA imposes specific requirements on postsecondary institutions concerning the handling of educational records. The statute mandates that these institutions must not disclose education records or personally identifiable information without the consent of the student, except under specified exceptions. One such exception includes instances in which the disclosure is in connection with financial aid for which the student has applied. Furthermore, the Act conditions the receipt of federal funds on adherence to these privacy protections. Institutions in violation of FERPA may face penalties, including the possible loss of federal funding. (20 United States Code Annotated § 1232g)

Existing state law establishes the UC, a public trust to be administered by the Regents of the UC and grants the Regents full powers of organization and government, subject only to such legislative control as may be necessary to insure security of its funds, compliance with the terms of its endowments, statutory requirements around competitive bidding and contracts, sales of property and the purchase of materials, goods and services. (Article IX, Section (9)(a) of the California Constitution)

This bill:

1. Requests, by December 1, 2026 and until January 1, 2035, that the UC post, an annual report on a publicly accessible UC website data on students enrolled in a UC School of Medicine.
2. Requests that the data on students enrolled in a UC School of Medicine include all of the following:
   1. Enrolled students.
   2. First-generation students.
   3. Federal Pell Grant recipients.
   4. Multilingual students that is disaggregated by languages other than English that students speak, and highlighted how many students speak languages that are underrepresented in California’s physician workforce.
   5. Community College transfer students.
   6. Students with membership in a California Indian tribe or federally recognized tribe.
3. Requests that the information posted in the report to include all of the following information:
   1. The total number of applicants to a UC School of Medicine.
   2. Contextual data that the UC deems relevant to the report.
   3. A breakdown of postsecondary educational institutions where students received their baccalaureate degrees.
4. Requests that the information posted in the report:
   1. Be disaggregated by campus.
   2. Be for the academic year in which the report is due.
5. Requests that the information posted in the report is requested to be posted in compliance with FERPA and is requested to not include any personally identifiable information for any student.

Comments

1. Need for the bill. According to the author, “A physician’s ability to speak the same language as their patient is essential to improving patient health and happiness. The inability of physicians to effectively communicate with their patients is devastating for non-English speaking patients and their families. Non-English speaking patients experience adverse health outcomes ranging from moderate harm to death at twice the rate of their English-speaking counterparts.

“In California, the most under-represented language groups in the physician workforce are Vietnamese, Thai/Lao, Tagalog, and Spanish. Of all languages, Spanish had the lowest ratio of Spanish speaking physicians relative to Spanish speaking patients. AB 2080 will provide meaningful data on each University of California school of medicine and their progress towards increasing the size and diversity of our healthcare workforce.

“As our state’s first Latino Physician elected to the Legislature, I’m proud to introduce AB 2080 to diversify our health care workforce and better serve communities like mine.”

1. Data collection captures demographic information on enrolled students. Given the author's statement above, the intent of this measure is to collect data to assess UC's progress towards diversifying California's healthcare workforce, particularly in relation to multilingual speakers. This bill contains data collection on the number of first-generation, multilingual, and Pell Grant-eligible (low-income) students. It additionally requests that UC, in its report, students with membership in a California Indian tribe or federally

recognized tribe. Although not explicitly stated in this bill, information is collectable only to the extent that students voluntarily self-identify and disclose it in compliance with federal private rules. As noted in the background section of this analysis, federal statute mandates that institutions must not disclose education records or personally identifiable information without the consent of the student. If UC decides to implement the provisions of this bill, it must comply with FERPA.

1. UC school of medicine. The UC has six schools of medicine, located at UC Davis (UCD), UC Irvine, UC Los Angeles (UCLA), UC Riverside (UCR), UC San Diego (UCSD), and UC San Francisco (UCSF). Each school of medicine follows the best practices of the American Association of Medical Colleges (AAMC) and uses holistic review for their admissions process. Holistic review is an admissions process that considers each applicant individually by balancing their academic metrics with life experiences and attributes. These factors are viewed in combination to consider how an individual might contribute value, not only as a medical student, but also as a future physician. Nearly all medical schools report using some elements of holistic review. This allows schools to prioritize their mission and determine their individual priorities for admissions. This has also resulted in more diverse medical school classes.

According to the 2023 U.S. News and World Report rankings for most diverse medical schools, UC School of Medicine had four in the top 15 ranked diverse medical schools: UC Davis at number 3; UCR at number 5; UCSF at number 9; and, UCLA at number 13. Seemingly, the holistic review process and other efforts have contributed to diversifying the healthcare workforce.

1. Diversification efforts. According to UC, the UC Schools of Medicine have shown steady gains in the enrollment of students underrepresented in medicine (URiM) over the last 20 years. In 2024, 50% of first-year UC medical students are URiM compared to only 16% in 2000. The UC attributes this increase to several factors, including, but not limited to, UC Programs in Medical Education (PRIME), which is the UC’s systemwide initiative focused on adding to physician workforce shortages and meeting the needs of underserved populations.

The first PRIME program began in 2004, and now there are 459 PRIME students enrolled across 10 programs that train highly motivated, socially conscious graduates who will become physician leaders committed to serving medically underserved groups and communities across the state. Each program includes a specified area of focus and combines structured activities ranging from student outreach and recruitment to specialized coursework, population-focused clinical training and research experiences, health care leadership and management training, community engagement experiences, master’s degree educational opportunities, faculty mentoring, and sponsored events that are open to the broader campus community. Eighty-four percent of PRIME students are from URiM groups.

According to the UC’s most recent PRIME program report (for fiscal year 2023-24), communities of color will make up over 65% of California’s population by 2030, yet they are severely underrepresented in the health workforce and educational pathway. Language capabilities are also not aligned, with a large and growing public unable to effectively communicate with their health providers. For the physician workforce to better reflect California’s diverse population, it will be critical that California medical schools continue to prioritize efforts to increase diversity among students, residents, and faculty. It is also well documented that physicians from groups URiM are more likely to practice in shortage areas and to care for underserved and uninsured populations as compared to others.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Senate Appropriations Committee analysis, the bill would have the following fiscal impact, the UC estimates one-time General Fund costs between $135,000 and $150,000 for all UC schools of medicine for information technology and infrastructure costs. The UC also estimates General Fund costs ranging from $380,000 to $410,000 each year for staff resources at the schools of medicine to collect the required data.

SUPPORT: (Verified 8/21/24)

Samuel Merritt University

The Leukemia & Lymphoma Society

OPPOSITION: (Verified 8/21/24)

None received

ASSEMBLY FLOOR: 73-0, 5/21/24

AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Chen, Connolly, Davies, Dixon, Essayli, Flora, Mike Fong, Vince Fong, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Hoover, Irwin, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Rendon, Reyes, Rodriguez, Blanca Rubio, Sanchez, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Weber, Wicks, Wilson, Wood, Zbur, Robert Rivas

NO VOTE RECORDED: Cervantes, Megan Dahle, Friedman, Gabriel, Holden, Mathis, Luz Rivas

Prepared by: Olgalilia Ramirez / ED. / (916) 651-4105

8/22/24 16:10:26

**** END ****

 THIRD READING  

Bill No: AB 2080

Author: Arambula (D) and Garcia (D)

Amended: 6/24/24 in Senate

Vote: 21

SENATE EDUCATION COMMITTEE: 7-0, 7/3/24

AYES: Newman, Ochoa Bogh, Cortese, Glazer, Gonzalez, Smallwood-Cuevas, Wilk

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/15/24

AYES: Caballero, Jones, Ashby, Becker, Bradford, Seyarto, Wahab

ASSEMBLY FLOOR: 73-0, 5/21/24 - See last page for vote

SUBJECT: University of California: schools of medicine: report

SOURCE: Author

DIGEST:

This bill requests the University of California (UC) to annually report and post on its website data on students enrolled in a UC school of medicine and requests the information reported comply with the federal Family Educational Rights and Privacy Act (FERPA) of 1974.

ANALYSIS:

Existing federal law imposes, through FERPA, specific requirements on postsecondary institutions concerning the handling of educational records. The statute mandates that these institutions must not disclose education records or personally identifiable information without the consent of the student, except under specified exceptions. One such exception includes instances in which the disclosure is in connection with financial aid for which the student has applied. Furthermore, the Act conditions the receipt of federal funds on adherence to these privacy protections. Institutions in violation of FERPA may face penalties, including the possible loss of federal funding. (Title 20 United States Code Annotated § 1232g)

Existing state law establishes the UC, a public trust to be administered by the Regents of the UC and grants the Regents full powers of organization and government, subject only to such legislative control as may be necessary to insure security of its funds, compliance with the terms of its endowments, statutory requirements around competitive bidding and contracts, sales of property and the purchase of materials, goods and services. (Article IX, Section (9)(a) of the California Constitution)

This bill:

1. Requests, by December 1, 2026 and each year thereafter, that the UC post, in a report on a publicly accessible UC website data on students enrolled in a UC School of Medicine.
2. Requests that the data on students enrolled in a UC School of Medicine include all of the following:
   1. Enrolled students.
   2. First-generation students.
   3. Federal Pell Grant recipients.
   4. Multilingual students that is disaggregated by languages other than English that students speak, and highlighted how many students speak languages that are underrepresented in California’s physician workforce.
   5. Community College transfer students.
   6. Students with membership in a California Indian tribe or federally recognized tribe.
3. Requests that the information posted in the report to include all of the following information:
   1. The total number of applicants to a UC school of medicine.
   2. Contextual data that the UC deems relevant to the report.
   3. A breakdown of both of the following:
      1. Postsecondary educational institutions where students received their baccalaureate degrees.
      2. Sexual orientation and gender identity of students.
4. Requests that the information posted in the report:
   1. Be disaggregated by campus.
   2. Be for the academic year in which the report is due.
5. Requests that the information posted in the report is requested to be posted in compliance with FERPA and is requested to not include any personally identifiable information for any student.

Comments

1. Need for the bill. According to the author, “A physician’s ability to speak the same language as their patient is essential to improving patient health and happiness. The inability of physicians to effectively communicate with their patients is devastating for non-English speaking patients and their families. Non-English speaking patients experience adverse health outcomes ranging from moderate harm to death at twice the rate of their English-speaking counterparts.

“In California, the most under-represented language groups in the physician workforce are Vietnamese, Thai/Lao, Tagalog, and Spanish. Of all languages, Spanish had the lowest ratio of Spanish speaking physicians relative to Spanish speaking patients. AB 2080 will provide meaningful data on each University of California school of medicine and their progress towards increasing the size and diversity of our healthcare workforce.

“As our state’s first Latino Physician elected to the Legislature, I’m proud to introduce AB 2080 to diversify our health care workforce and better serve communities like mine.”

1. Data collection captures demographic information on enrolled students. Given the author's statement above, the intent of this measure is to collect data to assess UC's progress towards diversifying California's healthcare workforce, particularly in relation to multilingual speakers. This bill contains data collection on the number of first-generation, multilingual, and Pell Grant-eligible (low-income) students. It additionally requests that UC, in its report, provide a breakdown of the sexual orientation and gender identity of enrolled students. Although not explicitly stated in this bill, information is collectable only to the extent that students voluntarily self-identify and disclose it in compliance with federal private rules. As noted in the background section of this analysis, federal statute mandates that institutions must not disclose education records or personally identifiable information without the consent of the student. If UC decides to implement the provisions of this bill, it must comply with FERPA.
2. UC school of medicine. The UC has six schools of medicine, located at UC Davis (UCD), UC Irvine, UC Los Angeles (UCLA), UC Riverside (UCR), UC San Diego (UCSD), and UC San Francisco (UCSF). Each school of medicine follows the best practices of the American Association of Medical Colleges (AAMC) and uses holistic review for their admissions process. Holistic review is an admissions process that considers each applicant individually by balancing their academic metrics with life experiences and attributes. These factors are viewed in combination to consider how an individual might contribute value, not only as a medical student, but also as a future physician. Nearly all medical schools report using some elements of holistic review. This allows schools to prioritize their mission and determine their individual priorities for admissions. This has also resulted in more diverse medical school classes.

According to the 2023 U.S. News and World Report rankings for most diverse medical schools, UC School of Medicine had four in the top 15 ranked diverse medical schools: UC Davis at number 3; UCR at number 5; UCSF at number 9; and, UCLA at number 13. Seemingly, the holistic review process and other efforts have contributed to diversifying the healthcare workforce.

1. Diversification efforts. According to UC, the UC Schools of Medicine have shown steady gains in the enrollment of students underrepresented in medicine (URiM) over the last 20 years. In 2024, 50% of first-year UC medical students are URiM compared to only 16% in 2000. The UC attributes this increase to several factors, including, but not limited to, UC Programs in Medical Education (PRIME), which is the UC’s systemwide initiative focused on adding to physician workforce shortages and meeting the needs of underserved populations. The first PRIME program began in 2004, and now there are 459 PRIME students enrolled across 10 programs that train highly motivated, socially conscious graduates who will become physician leaders committed to serving medically underserved groups and communities across the state. Each program includes a specified area of focus and combines structured activities ranging from student outreach and recruitment to specialized coursework, population-focused clinical training and research experiences, health care leadership and management training, community engagement experiences, master’s degree educational opportunities, faculty mentoring, and sponsored events that are open to the broader campus community. Eighty-four percent of PRIME students are from URiM groups.

According to the UC’s most recent PRIME program report (for fiscal year 2023-24), communities of color will make up over 65% of California’s population by 2030, yet they are severely underrepresented in the health workforce and educational pathway. Language capabilities are also not aligned, with a large and growing public unable to effectively communicate with their health providers. For the physician workforce to better reflect California’s diverse population, it will be critical that California medical schools continue to prioritize efforts to increase diversity among students, residents, and faculty. It is also well documented that physicians from groups URiM are more likely to practice in shortage areas and to care for underserved and uninsured populations as compared to others.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Senate Appropriations Committee analysis, the bill would have the following fiscal impact, The UC estimates one-time General Fund costs between $135,000 and $150,000 for all UC schools of medicine for information technology and infrastructure costs. The UC also estimates General Fund costs ranging from $380,000 to $410,000 each year for staff resources at the schools of medicine to collect the required data.

SUPPORT: (Verified 8/15/24)

Samuel Merritt University

The Leukemia & Lymphoma Society

OPPOSITION: (Verified 8/15/24)

None received

ASSEMBLY FLOOR: 73-0, 5/21/24

AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Chen, Connolly, Davies, Dixon, Essayli, Flora, Mike Fong, Vince Fong, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Hoover, Irwin, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Rendon, Reyes, Rodriguez, Blanca Rubio, Sanchez, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Weber, Wicks, Wilson, Wood, Zbur, Robert Rivas

NO VOTE RECORDED: Cervantes, Megan Dahle, Friedman, Gabriel, Holden, Mathis, Luz Rivas

Prepared by: Olgalilia Ramirez / ED. / (916) 651-4105

8/18/24 8:51:23

**** END ****

SENATE COMMITTEE ON APPROPRIATIONS

Senator Anna Caballero, Chair

2023 - 2024 Regular Session

AB 2080 (Arambula) - University of California: schools of medicine: report

Bill Summary:

This bill requests the University of California (UC) to annually report and post on its website data on students enrolled in a UC school of medicine and requests the information reported comply with the federal Family Educational Rights and Privacy Act (FERPA) of 1974.

Fiscal Impact:

The UC estimates one-time General Fund costs between $135,000 and $150,000 for all UC schools of medicine for information technology and infrastructure costs. The UC also estimates General Fund costs ranging from $380,000 to $410,000 each year for staff resources at the schools of medicine to collect the required data.

Background:

Existing state law establishes the UC, a public trust to be administered by the Regents of the UC and grants the Regents full powers of organization and government, subject only to such legislative control as may be necessary to insure security of its funds, compliance with the terms of its endowments, statutory requirements around competitive bidding and contracts, sales of property and the purchase of materials, goods and services.

Proposed Law:

This bill requests, by December 1, 2026 and each year thereafter, that the UC post, in a report on a publicly accessible UC website data on students enrolled in a UC school of medicine. The bill requests that the data on students enrolled in a UC School of Medicine include all of the following:

1. Enrolled students.
2. First-generation students.
3. Federal Pell Grant recipients.
4. Multilingual students that is disaggregated by languages other than English that students speak, and highlighted how many students speak languages that are underrepresented in California’s physician workforce.
5. Community College transfer students.
6. Students with membership in a California Indian tribe or federally recognized tribe.

This bill requests that the information posted in the report to include all of the following information:

1. The total number of applicants to a UC school of medicine.
2. Contextual data that the UC deems relevant to the report.
3. A breakdown of postsecondary educational institutions where students received their baccalaureate degrees and sexual orientation and gender identity of students.

This bill requests that the information posted in the report be disaggregated by campus and be for the academic year in which the report is due.

This bill requests that the information posted in the report is requested to be posted in compliance with FERPA and is requested to not include any personally identifiable information for any student.

Staff Comments:

The UC has six schools of medicine, located at UC Davis (UCD), UC Irvine, UC Los Angeles (UCLA), UC Riverside (UCR), UC San Diego (UCSD), and UC San Francisco (UCSF). Each school of medicine follows the best practices of the American Association of Medical Colleges (AAMC) and uses holistic review for their admissions process. Holistic review is an admissions process that considers each applicant individually by balancing their academic metrics with life experiences and attributes. These factors are viewed in combination to consider how an individual might contribute value, not only as a medical student, but also as a future physician. Nearly all medical schools report using some elements of holistic review which allows them to prioritize their mission and determine their individual priorities for admissions. This has also resulted in more diverse medical school classes.

This bill requires the UC schools of medicine to report information on their enrollees, including whether a student was eligible for a federal Pell Grant and a “first-generation” student.

-- END --

SENATE COMMITTEE ON EDUCATION

Senator Josh Newman, Chair

2023 - 2024 Regular

Bill No: Hearing Date: July 3, 2024

Subject: .

SUMMARY

This bill requests the University of California (UC) to annually report and post on its website data on students enrolled in a UC school of medicine and requests the information reported comply with the federal Family Educational Rights and Privacy Act (FERPA) of 1974.

BACKGROUND

1. Existing state law establishes the UC, a public trust to be administered by the Regents of the UC and grants the Regents full powers of organization and government, subject only to such legislative control as may be necessary to insure security of its funds, compliance with the terms of its endowments, statutory requirements around competitive bidding and contracts, sales of property and the purchase of materials, goods and services. (Article IX, Section (9)(a) of the California Constitution)
2. Under federal law, the FERPA imposes specific requirements on postsecondary institutions concerning the handling of educational records. The statute mandates that these institutions must not disclose education records or personally identifiable information without the consent of the student, except under specified exceptions. One such exception includes instances in which the disclosure is in connection with financial aid for which the student has applied. Furthermore, the Act conditions the receipt of federal funds on adherence to these privacy protections. Institutions in violation of FERPA may face penalties, including the possible loss of federal funding. (20 United States Code Annotated § 1232g)

ANALYSIS

This bill:

1. Requests, by December 1, 2026 and each year thereafter, that the UC post, in a report on a publicly accessible UC website data on students enrolled in a UC school of medicine.
2. Requests that the data on students enrolled in a UC School of Medicine include all of the following:
   1. Enrolled students.
   2. First-generation students.
   3. Federal Pell Grant recipients.
   4. Multilingual students that is disaggregated by languages other than

English that students speak, and highlighted how many students speak languages that are underrepresented in California’s physician workforce.

• 1. Community College transfer students.
  2. Students with membership in a California Indian tribe or federally

recognized tribe.

1. Requests that the information posted in the report to include all of the following information:
   1. The total number of applicants to a UC school of medicine.
   2. Contextual data that the UC deems relevant to the report.
   3. A breakdown of both of the following:
      1. Postsecondary educational institutions where students received

their baccalaureate degrees.

• • 1. Sexual orientation and gender identity of students.

1. Requests that the information posted in the report:
   1. Be disaggregated by campus.
   2. Be for the academic year in which the report is due.
2. Requests that the information posted in the report is requested to be posted in compliance with FERPA and is requested to not include any personally identifiable information for any student.

STAFF COMMENTS

1. Need for the bill. According to the author, “A physician’s ability to speak the same language as their patient is essential to improving patient health and happiness. The inability of physicians to effectively communicate with their patients is devastating for non-English speaking patients and their families. Non-English speaking patients experience adverse health outcomes ranging from moderate harm to death at twice the rate of their English-speaking counterparts.

“In California, the most under-represented language groups in the physician workforce are Vietnamese, Thai/Lao, Tagalog, and Spanish. Of all languages, Spanish had the lowest ratio of Spanish speaking physicians relative to Spanish speaking patients. AB 2080 will provide meaningful data on each University of California school of medicine and their progress towards increasing the size and diversity of our healthcare workforce.

“As our state’s first Latino Physician elected to the Legislature, I’m proud to introduce AB 2080 to diversify our health care workforce and better serve communities like mine.”

1. Data collection captures demographic information on enrolled students. Given the author's statement above, the intent of this measure is to collect data to assess UC's progress towards diversifying California's healthcare workforce, particularly in relation to multilingual speakers. This bill contains data collection on the number of first-generation, multilingual, and Pell Grant-eligible (low-income) students. It additionally requests that UC, in its report, provide a breakdown of the sexual orientation and gender identity of enrolled students. Although not explicitly stated in this bill, information is collectable only to the extent that students voluntarily self-identify and disclose it in compliance with federal private rules. As noted in the background section of this analysis, federal statute mandates that institutions must not disclose education records or personally identifiable information without the consent of the student. If UC decides to implement the provisions of this bill, it must comply with FERPA.
2. UC school of medicine. The UC has six schools of medicine, located at UC Davis (UCD), UC Irvine, UC Los Angeles (UCLA), UC Riverside (UCR), UC San Diego (UCSD), and UC San Francisco (UCSF). Each school of medicine follows the best practices of the American Association of Medical Colleges (AAMC) and uses holistic review for their admissions process. Holistic review is an admissions process that considers each applicant individually by balancing their academic metrics with life experiences and attributes. These factors are viewed in combination to consider how an individual might contribute value, not only as a medical student, but also as a future physician. Nearly all medical schools report using some elements of holistic review. This allows schools to prioritize their mission and determine their individual priorities for admissions. This has also resulted in more diverse medical school classes.

According to the 2023 U.S. News and World Report rankings for most diverse medical schools, UC School of medicine had four in the top 15 ranked diverse medical schools: UC Davis at number 3; UCR at number 5; UCSF at number 9; and, UCLA at number 13. Seemingly, the holistic review process and other efforts have contributed to diversifying the healthcare workforce.

1. Diversification efforts. According to UC, the UC schools of medicine have shown steady gains in the enrollment of students underrepresented in medicine (URiM) over the last 20 years. In 2024, 50% of first-year UC medical students are URiM compared to only 16% in 2000. The UC attributes this increase to several factors, including, but not limited to, UC Programs in Medical Education (PRIME), which is the UC’s systemwide initiative focused on adding to physician workforce shortages and meeting the needs of underserved populations.

The first PRIME program began in 2004, and now there are 459 PRIME students enrolled across 10 programs that train highly motivated, socially conscious graduates who will become physician leaders committed to serving medically underserved groups and communities across the state. Each program includes a specified area of focus and combines structured activities ranging from student outreach and recruitment to specialized coursework, population-focused clinical training and research experiences, health care leadership and management training, community engagement experiences, master’s degree educational opportunities, faculty mentoring, and sponsored events that are open to the broader campus community. Eighty-four percent of PRIME students are from URiM groups.

According to the UC’s most recent PRIME program report (for fiscal year 2023-24), communities of color will make up over 65% of California’s population by 2030, yet they are severely underrepresented in the health workforce and educational pathway. Language capabilities are also not aligned, with a large and growing public unable to effectively communicate with their health providers. For the physician workforce to better reflect California’s diverse population, it will be critical that California medical schools continue to prioritize efforts to increase diversity among students, residents, and faculty. It is also well documented that physicians from groups URiM are more likely to practice in shortage areas and to care for underserved and uninsured populations as compared to others.

SUPPORT

Samuel Merritt University

The Leukemia & Lymphoma Society

OPPOSITION

None received

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 2080

Author:(Arambula and Garcia)

As Amended Ver:April 25, 2024

Majority vote

SUMMARY

Requests, beginning December 1, 2026, the University of California (UC) to annually report the number of first-generation students and the number of federal Pell Grant recipients enrolled in a UC school of medicine. Specifies that the information be disaggregated by campus.

Major Provisions

See summary above.

COMMENTS

UC SOM. The UC has six SOM, located at UC Davis (UCD), UC Irvine, UC Los Angeles (UCLA), UC Riverside (UCR), UC San Diego (UCSD), and UC San Francisco (UCSF). Each SOM follows the best practices of the American Association of Medical Colleges (AAMC) and uses holistic review for their admissions process. Holistic review is an admissions process that considers each applicant individually by balancing their academic metrics with life experiences and attributes. These factors are viewed in combination to consider how an individual might contribute value, not only as a medical student, but also as a future physician. Nearly all medical schools report using some elements of holistic review. This allows schools to prioritize their mission and determine their individual priorities for admissions. This has also resulted in more diverse medical school classes.

According to the 2023 U.S. News and World Report rankings for most diverse medical schools, UC SOM had four in the top 15 ranked diverse medical schools: UCD at number 3; UCR at number 5; UCSF at number 9; and, UCLA at number 13.

Under the AAMC, UC SOM applicants are asked to add all languages that they speak, along with their proficiency and frequency of use in their childhood home for each (including English). The chart below, from the AAMC, shows the criteria that medical school applicants are asked to follow when selecting their level of language proficiency.

According to the UC, all SOM applications collect information on language proficiency from applicants. Currently, this data is not reported to the UC Office of the President.

Diversification efforts. According to the UC, the UC SOM have shown steady gains in the enrollment of students underrepresented in medicine (URiM) over the last 20 years. In 2024, 50% of first-year UC medical students are URiM compared to only 16% in 2000. The UC attributes this increase to several factors, including, but not limited to, UC Programs in Medical Education (PRIME), which is the UC's systemwide initiative focused on adding the physician workforce shortages and meeting the needs of underserve populations.

The first PRIME program began in 2004 and now there are 459 PRIME students enrolled across 10 programs which train highly motivated, socially conscious graduates who will become physician leaders committed to serving medically underserved groups and communities across the state. Each program includes a specified area of focus and combines structured activities ranging from student outreach and recruitment to specialized coursework, population-focused clinical training and research experiences, health care leadership and management training, community engagement experiences, master's degree educational opportunities, faculty mentoring, and sponsored events that are open to the broader campus community. Eighty-four percent of PRIME students are from groups that are URiM.

According the UC's most recent PRIME programs report (for fiscal year 2023-24), communities of color will make up over 65% of California's population by 2030, yet they are severely underrepresented in the health workforce and educational pathway. Language capabilities are also not aligned, with a large and growing public unable to effectively communicate with their health providers. For the physician workforce to better reflect California's diverse population, it will be critical that California medical schools continue to prioritize efforts to increase diversity among students, residents, and faculty. It is also well documented that physicians from groups underrepresented in medicine (URiM) are more likely to practice in shortage areas and to care for underserved and uninsured populations as compared to others.

According to the Author

"Health care disparities occur across a broad range of dimensions, including race, socioeconomic status, gender, language, and many more. In particular, a physician's ability to speak the same language as their patient has been shown to improve quality of care and outcomes. Language concordance increases trust and patient satisfaction while decreasing poor clinical outcomes due to miscommunication."

The author contends that, "the inability of physicians to effectively communicate with their patients is devastating for non-English speakers. When controlling for other factors, non-English speaking patients experience adverse health outcomes ranging from moderate harm to death at twice the rate of their English-speaking counterparts. In addition, it is common for the family members of non-English speakers to serve as medical translators in times of crisis, putting patient's children at risk for anxiety and depression in adolescence and young adulthood."

Arguments in Support

According to Health Net, "California's physician workforce does not reflect the diversity of the state. Efforts are being made to improve it as studies have shown that health outcomes improve when a provider is able to bridge the language and cultural barrier with their patients. As medical school admissions have expanded over the past two decades, admissions have become slightly less diverse, but AB 2080 will improve admissions for underrepresented applicants. Health Net has leaned into opportunities to support our community partners to improve access to culturally sensitive services and providers. This includes supporting the implementation of the doula benefit in Medi-Cal, increasing the pipeline of Community Health Workers and promotoras, among others. However, more must be done to expand a diverse pipeline of culturally sensitive providers in California."

Arguments in Opposition

None on file.

FISCAL COMMENTS

According to the Assembly Committee on Appropriations, likely minor, ongoing General Fund costs to UC schools of medicine to collect and report certain information annually.

VOTES

ASM HIGHER EDUCATION: 10-0-1

YES: Mike Fong, Ta, Arambula, Boerner, Chen, Essayli, Irwin, Jackson, Low, Muratsuchi

ABS, ABST OR NV: Quirk-Silva

ASM APPROPRIATIONS: 15-0-0

YES: Wicks, Sanchez, Arambula, Bryan, Calderon, Wendy Carrillo, Dixon, Mike Fong, Grayson, Haney, Hart, Jim Patterson, Pellerin, Ta, Villapudua

UPDATED

VERSION: April 25, 2024

CONSULTANT: Jeanice Warden / HIGHER ED. / (916) 319-3960 FN: 0003208

Date of Hearing: May 8, 2024

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Buffy Wicks, Chair

ABPCA Bill Id:AB 2080

Author:(Arambula) – As Amended Ver:April 25, 2024

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill requires, beginning December 1, 2026, the University of California (UC) to annually report the number of first-generation students and the number of federal Pell Grant recipients enrolled in a UC school of medicine.

The bill requires the information to be disaggregated by campus.

FISCAL EFFECT:

Likely minor, ongoing General Fund costs to UC schools of medicine to collect and report certain information annually.

Because this bill has the primary purpose of creating a report, it is eligible for the committee’s suspense file, consistent with the committee’s rules and practice.

COMMENTS:

1. Purpose. According to a supporter of this bill, the California Primary Care Association:

The physician shortage has reached a critical stage in the United States and, in particular, in California…This of particular concern for the Latinx community in California. The Latinx community comprises 40% of the state’s population but only seven percent of all physicians. This lack of physician diversity is not only an issue within the profession but exacerbates disparities for hard-to reach Latinx communities.

1. Background. The UC has six schools of medicine. They are located at UC Davis, UC Irvine, UC Los Angeles, UC Riverside, UC San Diego, and UC San Francisco. In admitting students, the schools of medicine follow the best practices of the American Association of Medical Colleges, which uses holistic review for admitting candidates.

This bill requires UC schools of medicine to report information on their enrollees related to whether a student (a) was eligible for a federal Pell Grant, which is a federal financial aid program for low-income students, and (b) was a “first-generation” student, meaning they were the first in their family to attend a university.

1. Related Legislation. AB 3081 (Arambula) annually provides $15 million to the UC Merced Medical Education Collaborative to continue and expand its programming. The bill is pending in this committee.

AB 2357 (Bains) creates an endowment fund at the State Treasury to collect funding with the goal of supporting a branch campus of a UC School of Medicine in Kern County. The bill is pending in this committee.

Analysis Prepared by: Natasha Collins / APPR. / (916) 319-2081

Date of Hearing: April 23, 2024

ASSEMBLY COMMITTEE ON HIGHER EDUCATION

Mike Fong, Chair

ABPCA Bill Id:AB 2080 (

Author:Arambula) – As Amended Ver:April 9, 2024

SUBJECT: University of California: medical school admissions: preference.

SUMMARY: Requests at least three University of California (UC) schools of medicine (SOM), commencing with students starting medical school in the 2027-28 academic year (AY), to give, as specified, admission preference to eligible applicants who speak one or more languages other than English that are underrepresented in the physician workforce and commonly spoken in California. Specifically, this bill:

1. States the following findings and declarations of the Legislature:
   1. According to the United States Census Bureau, nearly 44% of California’s households speak a language other than English;
   2. Nearly seven million Californians report speaking English “less than very well;”
   3. In an analysis using the most commonly spoken languages in California, researchers determined that the most underrepresented language groups in the physician workforce were Vietnamese, Thai/Lao, Filipino/Tagalog, and Spanish. Spanish-speaking physicians were the most underrepresented language group in the physician workforce;
   4. Data shows that a medical provider’s ability to speak the same language as the patient increases trust and patient satisfaction while decreasing poor clinical outcomes due to miscommunication; and,
   5. It is critical to increase the number of physicians in California who can deliver health care services in a language other than English.
2. Requests that the UC, for at least three SOM, beginning with students starting medical school in the 2027-28 AY, give, among the other factors that the medical school considers when giving preference to applicants for admission, admission preference to eligible applicants who speak one or more languages, other than English, that are underrepresented in the physician workforce and commonly spoken in California, including, but not limited to, any of the following languages:
   1. Spanish;
   2. Filipino/Tagalog;
   3. Thai/Lao;
   4. Vietnamese; and,
   5. Indigenous languages, including, but not limited to, languages associated with either of the following:
      1. A California Indian tribe on the contact list maintained by the Native American Heritage Commission, as specified; and,
      2. Mesoamerica.
3. Requests the UC Regents to develop and implement procedures for purposes of implementing this measure.

EXISTING LAW: Establishes the UC, a public trust to be administered by the Regents of the UC and grants the Regents full powers of organization and government, subject only to such legislative control as may be necessary to insure security of its funds, compliance with the terms of its endowments, statutory requirements around competitive bidding and contracts, sales of property and the purchase of materials, goods and services (Article IX, Section (9)(a) of the California Constitution).

FISCAL EFFECT: Unknown

COMMENTS: Purpose of this measure. According to the author, “health care disparities occur across a broad range of dimensions, including race, socioeconomic status, gender, language, and many more. In particular, a physician’s ability to speak the same language as their patient has been shown to improve quality of care and outcomes. Language concordance increases trust and patient satisfaction while decreasing poor clinical outcomes due to miscommunication.”^[1]

Data provided by the author shows that, in California, the most under-represented language groups in the physician workforce are Vietnamese, Thai/Lao, Tagalog, and Spanish. Data suggests that of all languages, Spanish has the lowest ratio of Spanish speaking physicians relative to Spanish speaking patients. In fact, in California there are five times as many English speaking physicians as those who speak Spanish.^[2]

The author contends that, “the inability of physicians to effectively communicate with their patients is devastating for non-English speakers. When controlling for other factors, non-English speaking patients experience adverse health outcomes ranging from moderate harm to death at twice the rate of their English-speaking counterparts.^[3] In addition, it is common for the family members of non-English speakers to serve as medical translators in times of crisis, putting patient’s children at risk for anxiety and depression in adolescence and young adulthood.”^[4]

UC SOM. The UC has six SOM, located at UC Davis (UCD), UC Irvine, UC Los Angeles (UCLA), UC Riverside (UCR), UC San Diego (UCSD), and UC San Francisco (UCSF). Each SOM follows the best practices of the American Association of Medical Colleges (AAMC) and uses holistic review for their admissions process. Holistic review is an admissions process that considers each applicant individually by balancing their academic metrics with life experiences and attributes. These factors are viewed in combination to consider how an individual might contribute value, not only as a medical student, but also as a future physician. Nearly all medical schools report using some elements of holistic review. This allows schools to prioritize their mission and determine their individual priorities for admissions. This has also resulted in more diverse medical school classes.

According to the 2023 U.S. News and World Report rankings for most diverse medical schools, UC SOM had four in the top 15 ranked diverse medical schools: UCD at number 3; UCR at number 5; UCSF at number 9; and, UCLA at number 13.

Committee Staff understands that under the AAMC, UC SOM applicants are asked to add all languages that they speak, along with their proficiency and frequency of use in their childhood home for each (including English). The chart below, from the AAMC, shows the criteria that medical school applicants are asked to follow when selecting their level of language proficiency.

According to the UC, all SOM applications collect information on language proficiency from applicants. Currently, this data is not reported to the UC Office of the President.

This measure, in part, requests that the UC, for at least three SOM, beginning with students starting medical school in the 2027-28 AY, give, among the other factors that the medical school considers when giving preference to applicants for admission, admission preference to eligible applicants who speak one or more languages, other than English, that are underrepresented in the physician workforce and commonly spoken in California.

Diversification efforts. According to the UC, the UC SOM have shown steady gains in the enrollment of students underrepresented in medicine (URiM) over the last 20 years. In 2024, 50% of first-year UC medical students are URiM compared to only 16% in 2000. The UC attributes this increase to several factors, including, but not limited to, UC Programs in Medical Education (PRIME), which is the UC’s systemwide initiative focused on adding the physician workforce shortages and meeting the needs of underserve populations.

The first PRIME program began in 2004 and now there are 459 PRIME students enrolled across 10 programs which train highly motivated, socially conscious graduates who will become physician leaders committed to serving medically underserved groups and communities across the state. Each program includes a specified area of focus and combines structured activities ranging from student outreach and recruitment to specialized coursework, population-focused clinical training and research experiences, health care leadership and management training, community engagement experiences, master’s degree educational opportunities, faculty mentoring, and sponsored events that are open to the broader campus community. Eighty-four percent of PRIME students are from groups that are URiM.

According the UC’s most recent PRIME programs report (for fiscal year 2023-24), communities of color will make up over 65% of California’s population by 2030, yet they are severely underrepresented in the health workforce and educational pathway. Language capabilities are also not aligned, with a large and growing public unable to effectively communicate with their health providers. For the physician workforce to better reflect California’s diverse population, it will be critical that California medical schools continue to prioritize efforts to increase diversity among students, residents, and faculty. It is also well documented that physicians from groups underrepresented in medicine (URiM) are more likely to practice in shortage areas and to care for underserved and uninsured populations as compared to others.

Committee comments and amendments. As referenced in the UC SOM section of this analysis, UC SOM, like virtually all medical schools in the nation, follow the best practices of the AAMC for admissions. This measure requests that three UC SOM deviate from their current best practices in order to give preference to students who speak more than one language, other than English. However, the bill is silent as to how admission officers will be able to verify an applicant’s fluency in other languages. Further, while applicants may be fluent in any of the listed languages, it does not necessary mean that applicants are URiM individuals.

Additionally, as currently drafted, this measure appears to be a pilot, however, none of the components of a typical pilot are included in the bill; there is no data collection requirement and no sunset. Additionally, how will the UC select the three SOM to participate?

While this measure requests the UC to provide preference to applicants who speak another language other than English, and while the act of providing preference based on language may not necessarily violate Proposition 209, it is presently unclear if the implementation of this measure could violate Proposition 209.

To address the policy concerns, Committee Staff recommends, and the author has agreed to accept, the following amendments, which delete the current version of the bill and instead:

66207.5. (a) Commencing with the 2025-26 academic year, the University of California is requested to annually report by posting on a public-facing website, the number of first-generation students and the number of Pell Grant recipients, disaggregated by campus, currently enrolled in a University of California school of medicine.

(b) The University of California is requested to post the annual report, pursuant to paragraph (a), by December 1 of each year.

Arguments in support. According to Health Net, “California’s physician workforce does not reflect the diversity of the state. Efforts are being made to improve it as studies have shown that health outcomes improve when a provider is able to bridge the language and cultural barrier with their patients. As medical school admissions have expanded over the past two decades, admissions have become slightly less diverse, but AB 2080 will improve admissions for underrepresented applicants.”

Prior legislation. AB 470 (Valencia), Chapter 330, Statutes of 2023, in part, authorizes associations that accredit continuing medical education courses to update standards, in conjunction with an advisory group that has expertise in cultural and linguistic competency issues and is informed of federal and state statutory threshold language requirements, with prioritization of languages in proportion to the state population’s most prevalent primary languages spoken by 10% or more of the state population, as well as to ensure program standards meet the needs of California’s changing demographics and properly address language disparities as they emerge.

REGISTERED SUPPORT / OPPOSITION:

Support

Altamed Health Services Corporation
Health Net
The Leukemia & Lymphoma Society

Opposition

None on file.

Analysis Prepared by: Jeanice Warden / HIGHER ED. / (916) 319-3960

1. A Case Study of the Impact of Language Concordance on Patient Care, Satisfaction, and Comfort with Sharing Sensitive Information During Medical Care - PMC (nih.gov) ↑

2. Language_Concordance_Policy_Brief (altamed.org) ↑

3. Implications of Language Barriers for Healthcare: A Systematic Review ↑

4. Why We Shouldn't Ask Kids to Interpret for Their Parents ↑