TO THE SENATE COMMITTEE ON
BUSINESS PROFESSIONS AND
ECONOMIC DEVELOPMENT THIS IS OUR
HEARING FOR AUGUST THIRTEENTH.
TWENTY EIGHTEEN WE HAVE ONE BILL
ARE FILE TODAY.
AND WE WILL BEGIN AS A
SUBCOMMITTEE SINCE WE DO NOT
HAVE A ESTABLISH QUORUM YET.
SO ASSEMBLY MEMBER GARCIA
WELCOME THANK IS SHARED THIS ON
IS AB EIGHTEEN AB EIGHTEEN THINK
SO MUCH AMENDED DOCTORS FROM HE
CO PILOT PROGRAM.
BY DOING THE LENGTH OF TIME FOR
THE IRRITATION PROGRAM FROM SIX
MONTHS TO A SPECIFIC PERIOD OF
TIME.
BASED ON SEVERAL DISCUSSIONS
THAT HAVE TAKEN IN THE LOT
TAKING PLACE IN THE LAST WEEK --
WITH THE INDIVIDUALS WHO
ACTUALLY WROTE THE CURRICULUM
WE'RE TALKING ABOUT --
UNIVERSITY OF A BERKELEY SCHOOL
OF PUBLIC HEALTH COVERAGE THE
UNIVERSITY OF LONG BEACH UC
DAVIS SCHOOL OF MEDICINE.
AND THAT UNIVERSAL LITERACY
ENOUGH IN I LOOKED ON MY THAT
MAKE HIKO --
WHO WORKED WITH THE MEDICAL
BOARD DE TO ADOPT TIS
CURRICULUM THAT JUST GOT
APPROVED --
WE BELIEVE THAT THAT REPLACE THE
SIX MONTHS TO A THREE MONTH
PERIOD.
AS DURATION FOR THIS ROTATION
PROGRAM ADDRESS SOME OF THE
ISSUES THAT HAVE BEEN RAISED
ALONG THE WAY --
THE PROJECT ALLOWS OF FOUR
THIRTY MEXICAN DOCTORS TO
RECEIVE THE CALIFORNIA MEDICAL
LICENSE FOR THREE YEARS. TO WORK
IN FEDERALLY FUNDED COMMUNITY
HEALTH CENTERS WHO ARE CREDITED
AT THE HIGHEST LEVEL A IN THE
UNITED STATES [inaudible]
THESE DOCTORS A MUST TAKE AN
ORIENTATION PROGRAM OF THE
STATE'S MEDICAL SYSTEM.
AND SPECIFIC PROCESSES THAT WILL
ENCOUNTER WHILE THAT THEY WILL
ENCOUNTER WHILE PRACTICING IN
THE STATE.
THE CURRICULUM WAS APPROVED I
JUST RECENTLY JULY TWENTY
SEVENTH TWO THOUSAND A BY THE
MEDICAL BOARD.
AND THE PROOF CURRICULUM IS A
HUNDRED HOURS HUNDRED ONE HOURS
AND IT IS OUR BELIEF AGAIN
ACCORDING TO THE SCHOOLS THAT
WE'VE BEEN WORKING WITH.
AND THAT THE CURRICULUM COULD BE
COMPLETED IN LESS THAN SIX
MONTHS.
IN FACT THE SIX MONTH TIMEFRAME
A AT THE TIME ACCORDING TO THOSE
WHO WORKED IN THE LEGISLATION.
AND THE OTHER STAKEHOLDERS WAS
SOMEWHAT OF AN ARBITRARY --
PHASE OR OR UPPER TIME PERIOD
THAT WAS CHOSEN.
WE'VE INTRODUCED THIS BILL TO
ENSURE THAT THIRTY SELECTED
DOCTORS THAT DO NOT DROP OUT AYE
AS WE HAVE COMMENCEMENT OF
INTEREST ALREADY LINED UP WITH.
FOR A HUGE SEIZE HERE IN
CALIFORNIA.
THIS BILL IS NECESSARY IN ORDER
TO DEAL WITH THE SERIOUS DOCTOR
SHORTAGES AND ROLLING.
FARMWORKER COMMUNTIES IN
CALIFORNIA.
THE SHORTAGE OF DOCTORS GREATER
IN TWO THOUSAND EIGHTEEN THAN IT
WAS IN TWO THOUSAND TWO WHEN
THIS PROGRAM WAS ADOPTED BY THE
CALIFORNIA STATE LEGISLATURE --
HOPING THAT THIS A PIECE
LEGISLATION WILL PASS.
IT WOULD ALLOW DISTRICTS LIKE
MINE I IMPERIAL AND COACHELLA
VALLEY THAT HAVE A HUGE A DOCTOR
SHORTAGE IN THE REGION --
ONE A DOCTOR PER WHEN THE THINK
THE STANDARD OF SOMEWHERE
BETWEEN ONE AND TWO ARE FOR OUR
POPULATION.
I WANT TO JUST TALK A LITTLE BIT
ABOUT THE THE CURRICULUM.
AND THE TIME FRAME I JUST TO
KIND OF PUT IT INTO PERSPECTIVE
HERE.
AT THE QUESTION IS HOW MUCH TIME
WILL IT TAKE A TO EFFECTIVELY
COVER THE HUNDRED ONE HOURS OF
MATERIAL IN THIS ORIENTATION --
BASED ON THE MATERIAL BEING
COVERED IT AND THE FACT THAT IT
IS AN ORIENTATION PROGRAM METAL
NOMS.
CONTINUING EDUCATION PROGRAM --
IT IS SAID THAT HUNDRED HOURS
CAN EASILY BE COVERED IN NO MORE
THAN TWO MONTHS.
OF THIS ASSESSMENT OF TIMES
BASED ON THE FACT THAT THESE ARE.
BOARD CERTIFIED DOCTORS WHO-CLEARLY HAVE A THOROUGH
UNDERSTANDING OF MEDICINE.
IT'S ALSO IMPORTANT UNDERSTOOD
THAT THESE DOCTORS WILL BE A SIX
MONTH PROBATION PERIOD WHICH
EACH OF THE CLINICS.
THAT THEY ULTIMATELY WILL BE
EMPLOYED AT AND SO YEAH WE WE
HAD THIS CONVERSATION WITH THEM
AND BELIEVE THAT IT'S A NULLITY
ORIENTATION.
EYES PUT IN PLACE --
IT'S CLEAR WHAT TIME FRAME OF
THAT COULD BE --
DELETING THE SIX MONTH THE
DURATION PERIOD I THINK --
REALLY HIGHLIGHTS THAT EFFORT
THAT WE HAVE UNDER WAY.
AND SO I RESPECTFULLY ASK FOR
UC'S CONSIDERATION ON THIS BILL.
THANK YOU VERY MUCH WITNESSES IN
SUPPORT.
MEMBERS THAT THANK YOU.
FOR ALLOWING US TO TESTIFY MY
NAME'S ARNOLD TOURISM
REPRESENTING THE FOR COMMUNITY
HEALTH CENTERS OF BRITAIN IN
SUPPORT OF THIS BILL IN THAT IF.
HIRED OR OFFERED EMPLOYMENT TO
THE THIRTY MEXICAN DOCTORS
THAT'S A CLINIC AS IF COMMUNITY
ALLEN VENTURA COUNTY.
CLINIC HAS INVITED SALINAS AND
MONTEREY --
CLEANING GUYS --
I STUDENTS COMMUNITY HEALTH
CENTERS IN TO LARRY COUNTY.
AND SENDING A HEALTH FOUNDATION
IN SAN BENITO COUNTY.
THESE ARE ALL FARMWORKERS
COUNTIES THAT HAVE.
AREA DESIGNATION A MEDICALLY
UNDERSERVED A POPULATION
DESIGNATION OR A HEALTH
PROFESSIONAL SHORTAGE AREA
POPULATION OR ALL THREE THESE
ARE ALL DESIGNATED BY THE
FEDERAL GOVERNMENT.
WHICH UNDERSCORES HOW BAD THE
PROBLEM IS OF ACCESS TO CARE.
THE PROBLEM --
WELL LET ME JUST START FROM THE
BEGINNING.
WHEN WE DID THIS BILL IN THE
START OF THE DISCUSSIONS OF THE
VERY FIRST BILL WE DID WAS AB?
TWENTY THREE NINETY FOUR THIS IS
THE REPORT THAT WAS DISTRIBUTED
IN ISSUED BY THE TO CO CHAIRS
THE DIRECTOR OF CONSUMER AFFAIRS
IN THE DEPARTMENT OF HEALTH CARE
SERVICES AT THE TIME.
THE CHAIR OF THE SPECIAL
COMMITTEE OR SUBCOMMITTEE IN
THIS TASK FORCE WAS DIANA BONTA
WAS DIRECTOR OF HEALTH CARE
SERVICES.
SHE RECOMMENDED APPROVAL --
OF A PILOT PROGRAM.
SO NOW YOU HAVE AB TEN FORTY
FIVE AM WHEN WAS THAT THIS
ISSUED THIS IS THE COVER LETTER
THAT WAS ISSUED ON NOVEMBER THE
1-920-003-0003 WE DID THIS BILL
IN TWO THOUSAND TWO GOVERNOR
DAVIS SIGNED THIS BILL IN
SEPTEMBER OF TWO THOUSAND TO THE
REASON WHY.
WE'VE GOTTEN THIS LONG TAKEN
THIS LONG IS BECAUSE NO MEDICAL
SCHOOL IN THE STATE OF
CALIFORNIA WANTED TO DO THE
ORIENTATION PROGRAM.
THE OPPOSITION TO THIS BILL
CONTINUES TO THIS DAY BY MANY
DOCTORS AND BY MANY MEDICAL
INSTITUTIONS.
WE WERE TOLL IN THE GAY AND YOU
CAN SEE THIS HEARING --
IN THIS RECORD --
EVERYBODY THE MEDICAL BOARD
MEDICAL THE UC SYSTEM ALL TOLD
US WE COULD DEAL WITH THE
PROBLEM.
THE PROBLEM FROM 200-022-00018.
I HAVE THIS.%
REPORTS FROM.
TWO THOUSAND FIFTEEN ON THE LACK
OF MEDICAL PROVIDERS IN SHORTAGE
AREAS IN RURAL AND FARMWORKERS
COMMUNITIES IN THE STATE OF
CALIFORNIA AND THE UNITED STATES
OF AMERICA.
THE PROBLEM IS GOTTEN WORSE.
WHEN WE DID THIS BILL?
CMA OPPOSED US VERY STRONGLY.
BUT CO MA DID NOT WORK AGAINST
THE BILL THEY RECOGNIZE THAT.
WE HAD A LEGITIMATE CONCERN
THEIR WARNING OF DOCTORS THAT
SPOKE SPANISH AND YOU THE
CULTURE.
THAT PROBLEM HAS BECOME EVEN
GREATER NOW IT'S NOT CHAU
SPANISH SPEAKERS THAT YOU'RE
DEALING WITH BUT WE'RE STILL
DEALING WITH THE PROBLEM MUCH
GREATER IN RURAL.
AND FONG WORK TO COMMUNITIES.
THESE DOCTORS WE HAD VERY VERY
SPECIFIC CRITERIA THESE DOCTORS
HAVE TO BE BOARD CERTIFIED
DOCTOR PAN IS A DOCTOR WHO KNOWS
WHAT BOARD CERTIFICATION
REQUIRES.
THAT MEANS YOU HAVE TO HAVE HAD
YOUR MEDICAL LICENSE IN MEXICO
YOU'VE DONE YOUR RESIDENCY
YOU'VE TAKEN THE NATIONAL EXAM
FOR MEXICO.
IN THE LEGISLATION IT SAYS
PASSED THE BOARD REVIEW COURSE
WITH THE SCORE EQUIVALENT TO
THAT REGISTERED BY UNITED STATES
APPLICANTS WHEN PASSING A BOARD
REVIEW COURSE. FOR THE UNITED
STATES CERTIFICATION EXAMINATION
[inaudible]
OKAY -- NAM
AND THE REPRESENTATIVES OF THE
FOUR COLLEGES OF MEXICO.
THAT --
COULD REPRESENT THE FOUR
SPECIALTIES OBE PIEDS.
INTERNAL MEDICINE AND FAMILY
PRACTICE ALL CAME TOGETHER MADE
A PRESENTATION TO THE MEDICAL
BOARD -- TWO
YEARS AGO IN MAY --
CONFIRMING AND COMPARING THE TWO
SYSTEMS AND ABSOLUTELY.
WAS ACCEPTED.
SO THE BOARD CERTIFICATION EXAMS
A VERY IMPORTANT STANDARD THE
OTHER REQUIREMENT IS.
THAT THEY HAVE TO TAKE THE
ORIENTATION PROGRAM [inaudible]
EXCUSE ME.
NO THE ORIENTATION PROGRAM HAS
TO BE TAKEN IN THE LAST ONE IS
THAT THEY HAVE TO BE ENROLLED IN
ENGLISH LANGUAGE CLASSES THIS
PROGRAM WILL BE DONE IN ENGLISH
LA IN THE ENGLISH LANGUAGE.
THE REASON FOR REDUCING THIS
PROGRAM IN THE REASON WHY WE DID
NOT COME EARLIER IS BECAUSE WE
NEED TO TO MAKE SURE THAT THE
CURRICULUM WAS APPROVED.
THAT CURRICULUM WAS APPROVED ON
JULY TWENTY SEVENTH FINALLY.
BY THE BOARD IT WAS APPROVED
UNANIMOUSLY BY THE BOARD.
THERE WAS NO ISSUE ON THAT HER
DOCTOR PAN BE IN A DOCTOR.
OF THIS WAS FORMATTED ON A
CERTIFICATION BASIS WHEN DOCTORS
GO OVERBOARD CERTIFICATION THERE
CERTAIN FORMAT THE COURSES THE
DOCTORS HAVE TO TAKE OR BASED ON
THAT.
THAT'S EXACTLY WHAT THIS
DISCOURSE IS BASED ON THE
ORIENTATION IS ABOUT CALIFORNIA
SYSTEM IT'S NOT TEACHING THE
DOCTORS ANYTHING ABOUT MEDICINE.
IT SIMPLY ORIENTING THEM TO
THESE AREAS.
SPECIFICALLY MEDICAL PROTOCOLS
COMMUNITY CLINIC HISTORY AND
OPERATIONS MEDICAL
ADMINISTRATION HOSPITAL
OPERATIONS AND PROTOCOLS MEDICAL
ETHICS CALIFORNIA MEDICAL
DELIVERY SYSTEM HEALTH
MAINTENANCE ORGANIZATIONS.
AND MANAGED CARE PRACTICES AND
PHARMACOLOGY DIFFERENCES WE
PROVIDE IT TO STAFF --
THIS --
DOCUMENT COURSE ORIENTATION IN
THE CALIFORNIA HEALTH CARE
DELIVERY SYSTEM THIS IS EXACTLY
WHAT WAS APPROVED BY THE MEDICAL
BOARD.
WE PROVIDE IT TO EVERYONE WHAT
HOW MANY HOURS FOR EACH MODULE.
FIRST A MODULE WAS TWELVE HOURS
THE SECOND MODULE.
IS FOURTEEN HOURS THE THIRD
MODULUS TWENTY TWO HOURS THE
FORD MODULE IS THIRTY FOUR HOURS
THE FIFTH MODULE IS TWENTY EIGHT
HOURS IN THE LAST MODULE.
IS FIFTEEN HOURS EXCUSE ME AND
THE MODEL SEVEN MODULE SEVEN
WITCHES CASE CASES CLINICAL
CASES IS FOUR HOURS.
THESE DOCTORS BECAUSE THEY ARE
BORDER SPOTS BOARD CERTIFIED
DOCTORS WILL TAKE THIS BASICALLY
ONE MODULE PER WEEK.
BUT BECAUSE OUR DISCUSSIONS WITH
THE MEDICAL BOARD A MEDICAL
BOARD WAS PRESENT AT THE HEARING --
WHEN THE MEDICAL?
MEDICAL ASSOCIATION WAS PRESSING
ON THE MEDICAL BOARD APPROVED
THE HEARING.
APPROVE THE CURRICULUM.
WAS CONCERNED ABOUT THE TIME
WITH THEY HAVE ENOUGH TIME TO
FINISH THE COURSE.
WE OBVIOUSLY BELIEVE THAT THEY
WOULD OTHERWISE THE CURRICULUM
WOULD HAVE NOT BEEN APPROVED.
WE ARE CONCERNED THAT IF WE
DON'T REDUCE THIS TIME FRAME
WE'RE GOING TO LOSE THESE
DOCTORS.
THE CLINICS WHO ARE GOING TO
EMPLOYEESDOCTORS OFFERED THEM
EMPLOYMENT TWO YEARS AGO COME
NOVEMBER.
THE DOCTORS HAVE BEEN WAITING
FOR TWO YEARS.
THEY HAVE NOT ACCEPTED FULL TIME
EMPLOYMENT PERMANENT EMPLOYMENT
IN MEXICO.
BECAUSE THEY'VE BEEN WAITING TO
COME TO FULFILL THEIR COMMITMENT --
AND THE OFFER OF EMPLOYMENT.
SO WE FELT THAT.
WHEN IT CAME TO A THE ISSUE OF
THE ORIENTATION ARE THIS IS NOT
ABOUT BEING A DOCTOR THIS IS
ABOUT UNDERSTANDING THE SYSTEM
IN CALIFORNIA?
EACH CLINIC THAT EMPLOYEES THESE
DOCTORS HAS TO BE JACO CREDITED
WHICH IS JOINT ACCREDITATION
COMMISSION.
THEY HAVE TO BE OUT OR THEY HAVE
TO BE NCQA NATIONAL QUALITY
ASSURANCE THAT CERTIFIED.
SO THEY HAVE THE HIGHEST
STANDARDS THEY'LL BE ON A SIX
MONTH PROBATION ANOTHER THESE
DOCTORS WORK OUT THEY WILL BE.
THERE AT FULL EMPLOYMENT WILL
NOT BE PERMITTED EMPLOYMENT WILL
NOT BE HONORED.
SO FOR US WE THINK THIS IS A
VERY VERY REASONABLE.
AGREEMENT THE MEDICAL BOARD'S
LETTER INDICATES A SIX MONTH
CURRICULUM THE SIX MONTHS WAS
NOT BASED ON ANY MODEL THAT WE
WERE LOOKING AT PREVIOUSLY.
THE MEDICAL BOARD'S POSITION
THAT IT'S IN SIX MONTHS IS NOT
BECAUSE THE MEDICAL BOARD CAME
TO US YEARS AGO WHEN HE DID THIS
BILL AND SAID.
IT MUST BE A SIX MONTH
ORIENTATION PROGRAM.
I WAS THE ONE ALONG WITH THE CMA
WHO SAID.
WILL SQUAT ABOUT A SIX MONTH
ORIENTATION PROGRAM.
SO NOT KNOWING AND NOT HAVING
ANY MODEL WE THOUGHT THIS MADE
THE MOST SENSE.
THE ONLY OTHER ISSUE THAT IS
RAISED A BY THE URINALYSIS THAT
WE WANTED TO MAKE SURE THAT WE
ADDRESS.
IS I HAVE WITH ME THE EMAIL THAT
LETTER THAT WAS SENT TO THE
MEDICAL BOARD TODAY OR FRIDAY.
WITH THE COPY OF THE CHECK FOR
TWO HUNDRED AND THIRTY TWO
THOUSAND FIVE HUNDRED AND TWENTY
FIVE DOLLARS.
THE MEDICAL BOARD NOW HAS ALL
THE FUNDING THAT IS REQUIRED
UNDER THE LAW THE MEDICAL BOARD
GAVE US A BUDGET --
THAT SAID NINE HUNDRED AND
TWENTY TWO THOUSAND FIVE HUNDRED
AND SEVENTY SIX DOLLARS FOR
THREE YEARS --
THE MONEY PLUS THE SEVENTY FIVE
THOUSAND BY THE COMMUNITY BY THE
CALIFORNIA HEALTHCARE FOUNDATION
TOTALS THREE HUNDRED AND SEVEN
THOUSAND FIVE HUNDRED AND FORTY
FIVE DOLLARS.
WE EASILY REACH THE OBJECTIVE OF
WHAT THIS LAW REQUIRED WHICH WE
RICK SAID WE DID NOT WANT
GENERAL FUND DOLLARS.
SO AGAIN WHAT'S AT STAKE HERE
MISTER CHAIRMAN AND MEMBERS IS
ARE CONCERNED THAT IF WE DO NOT --
REDUCE THIS TIME FRAME TO THREE
MONTHS A CURRICULUM THAT WOULD
BE DONE NESS IN ESSENCE A MODULE
PER WEEK WERE ST WILL GO TO
THREE MONTHS. TO EARL LA AS MANY
APPREHENSIONS THAT PEOPLE WOULD
HAVE BUT WE WANTED TO MAKE SURE
THAT PEOPLE UNDERSTAND THAT.
LET'S NOT RELITIGATE THE
LEGITIMACY OF THIS PROGRAM THIS
PROBLEM THIS PROGRAM IS A LAW.
THANK YOU CHAMBERS I APPRECIATE
AT ALL UNLESS ONE LAST THING
MISTER MEMBER MISTER CHAIRMAN I
WANTED TO LET YOU KNOW THAT WE
GET OUR HOME.
CALLED YOUR OFFICE TODAY YOU
KNOW MISTER ADEL WHO IN YOUR
DISTRICT HE'S WORKED ON SEVERAL
ISSUES WITH YOU ALONG WITH
OTHERS.
HE WAS NOT ABLE TO COME TO
TESTIFY IN SUPPORT OF THE BILL
BUT HE LIVES IN SAN BRUNO HAS A
RESTAURANT WORKS ON A LOT OF
ISSUES.
DEALING WITH HISPANIC COMMUNITY
RIGHT THANK YOU.
OTHERS IN SUPPORT.
IS YOUR ANYONE HERE IN
OPPOSITION.
PAY AND JENNIFER SUMMERS WITH
THE MEDICAL BOARD OF CALIFORNIA
RESPECTFULLY OPPOSED TO THIS
BILL TODAY --
THIS PROGRAM DOESN'T REQUIRE ANY
POST GRADUATE TRAINING FOR THESE
INDIVIDUALS SO WE THINK THAT THE
ORIENTATION PROGRAM SHOULD BE AT
LEAST SIX MONTHS.
I'M JUST TO RESPOND TO A COUPLE
OF THINGS THAT WERE SAID IT IS
TRUE THAT THE MEDICAL BOARD
APPROVE THE CURRICULUM AT A LOSS
FOR MEAN AND JULY BUT THEY
APPROVED IT AS A SIX MONTH
PROGRAM.
AND SO ARE MEDICAL CONSULTANTS
THAT LOOK TO THIS PROGRAM
ACTUALLY SAID THAT THE LEARNING
SESSIONS ARE APPROPRIATE IN
VOLUME AND METHOD IN PRACTICE OF
TEACHING FOR A SIX MONTH
ORIENTATION PROGRAM SO IT WAS
BASED ON THE FACT THAT THAT THAT
PROGRAM WOULD BE SIX MONTHS.
A LONG AND SO REGRETFULLY WE ARE
OPPOSED OF THIS TIME YOU CAN
TAKE TO OTHERS IN OPPOSITION.
YOU KNOW ONE BRING IT BACK TO
OUR COMMITTEE.
FOR QUESTIONS AGO IF I COULD
JUST START WITH A COUPLE AND
THEN OPEN IT UP. TO TO COMMITTEE
MEMBERS --
SO YOU'RE IN THE THREE MONTH
PERIOD IS BASED ON WHAT YOU
ASSUME IS THE AMOUNT OF TIME
NECESSARY FOR THE ORIENTATION.
AND AND THE CURRICULUM THAT HAS
BEEN ADOPTED BY THE MEDICAL.
THE CURRICULUM AS WAS PRESENTED
IN APPROVED BY THE MEDICAL BOARD.
OF THE RECOMMENDATION BY THE
CONSULTANT DID NOT INDICATE THAT
EACH MODULE WILL BE DONE A MONTH --
PER MODULE.
WHEN WE LOOK AT THE TIME FRAME
AND WE LOOK AT HOW MANY HOURS
ARE IN EACH MODULE?
THE DOCTORS WE KNOW BE ABLE TO
DO EACH MODULE IN ESSENCE ONE
PER ONCE PER WEEK AND FRANK
SUNNDAL BE ABLE TO DO LESS THAN
ONE PER WEEK.
SO WHEN YOU LOOK IT THE SEVEN
MODULES THAT ARE IN PLACE IT
WOULD BE SEVEN WEEKS.
BECAUSE THE CMA HAS RAISED THEIR
CONCERN TO US ABOUT THE TIME
FRAME AND BECAUSE WE DID HAVE
THIS DISCUSSION WITH THE CMA
WHEN WE FIRST AT THE BILL.
WE WANTED TO MAKE SURE THAT WE
WERE BEING AS CONSISTENT AS
POSSIBLE IN TERMS OF OUR
DISCUSSIONS WITH THEM.
SO IN VIEW OF THE FACT THAT YOU
HAVE A SIX MONTH VERY ARBITRARY
NUMBER WHICH IS REALLY NOT BASED
ON ANYTHING.
AND YOU'VE GOT A MUCH MORE
REALISTIC NUMBER OF SEVEN WEEKS
ONE WEEK PER MODULE.
AT WHICH WOULD TAKE US TO ALMOST
TWO MONTHS WE SAID OKAY THREE
MONTHS.
THERE'S NOTHING THAT WE CAN BASE
THIS ON THANK YOU --
THE THREE MONTH TIME FRAME AND
IF YOU SAW ON THE ANALYSIS THERE
ARE SOME.
AMENDMENTS OR AN AMENDMENT
RECOMMENDED TO ALLOW THE MEDICAL
BOARD.
TO USE ITS DISCRETION BASED ON
THE CURRICULUM BASED ON THE TIME
OF THAT TO FIND WHATEVER TIME IS
NECESSARY FOR THAT ARE YOU
COMFORTABLE WITH THAT TIME FRAME.
ONE NOT REALLY BUT NOT EXACTLY
BOB FOR THE REASONS HAVE BEEN
STATED BUT WE CERTAINLY
UNDERSTAND THAT THAT IS THE
CONCERN THAT YOU'VE RAISED IN
YOUR ANALYSIS AND OBVIOUSLY WANT
PROGRAM TO CONTINUE.
I THINK WE WANTED.
TO MAKE THE CASE THAT THERE IS
SOME RISK ASSOCIATED WITH THAT
AND THAT MEANS YOU KNOW
POTENTIALLY LOSING SOME OF THESE
DOCTORS THAT HAVE MADE THE
COMMITMENT I GUESS THAT RAISES
ANOTHER QUESTION IN TERMS OF
LOSING THE DOCTORS THE DOCTORS.
THE FUNDING THAT IS NOW
AVAILABLE WITHIN THE LAST WEEK
OR SO THAT THAT WE'VE YOU
INDICATED THE CHECK THAT HAS
BEEN SENT TO THE MEDICAL BOARD --
VIEW IT'S MY UNDERSTANDING THAT
AND THE ANALYSIS.
IDENTIFIES THE FACT THAT THAT
NOW GOES IN THE BUDGETING
PROCESS IN WOULDN'T BE AVAILABLE
TO BE USED UNTIL NEXT JULY NO
THAT'S NOT TRUE THERE'S A
SPECIAL ACCOUNT THAT'S BEEN --
CREATED BY THE DEPARTMENT OF
FINANCE FOR THIS PROGRAM.
SO IT IS AND THAT SPECIAL
ACCOUNT MY UNDERSTANDING IS WILL
NOT BE ALLOWED TO BE UTILIZED
UNTIL NEXT YEAR YOU CAN'T NO
MONEY INTO IT AND HAVE IT BE A
PRO THAT'S NOT CORRECT THAT'S
NOT AT ALL THE UNDERSTANDING WE
HAVE OF THE DEPARTMENT OF
FINANCE OR THE COMPTROLLER'S.
OFFICE WHEN WE CREATED THIS WITH
THE GOVERNOR'S OFFICE.
THAT'S ABSOLUTELY NOT THE CASE
FAMILIAR.
WITH THIS AT THE MEDICAL BOARD
SO THE LARGER SAY APART
APPROPRIATION IN THE BUDGET SO
WE WOULD HAVE TO WORK DEPARTMENT
OF FINANCE IN THE GOVERNOR'S
OFFICE BUT I THINK THERE'S AN
IMPORTANT THING TO POINT OUT
HERE WE'RE TALKING ABOUT THREE
MONTHS OR SIX MONTHS.
AND WE GOT THE LETTER ON FRIDAY
OR EXECUTIVE DOCTORS OUT AND YOU
KNOW ATTENDING --
ACTUALLY GIVING A SPEECH AND AND
LOS ANGELES AND SHE'S OUT AGAIN
LOS ANGELES A COURT TODAY SO
WHERE THE LETTER STILL UNDER
REVIEW.
BUT EVEN IF WE DO RECEIVE THAT
MONEY WE STILL HAVE A LOT OF
WORK TO DO TO IMPLEMENT THIS
PROGRAM SO WE THE ONLY THING
WE'VE DONE YET TO IMPLEMENT THIS
PROGRAM.
IS USED THE SEVENTY FIVE
THOUSAND DOLLARS THAT FOR THE
MEDICAL CONSULTANT ACTUALLY
REVIEW THE CURRICULUM BUT WE
STILL WE HAVE TO HIRE A PERSON
WE HAVE TO BASE TO CLICK.
COMPLY WITH ALL THE SUBJECTS IN
THE BILL YOU TO WORK WITH AND
WHATEVER UNIVERSITY DOES
EVALUATION PROGRAM EVALUATION
HAS TO BE UP AND RUNNING BEFORE
THE PROGRAM CAN START.
WE HAVE TO CREATE A NEW LICENSE
TYPE AND WE HAVE TO ACTUALLY
CREATE THIS PROGRAM WE HAVE TO
FIX OUR COMPUTER SYSTEMS TO BE
ABLE. TO TAKE MONEY FOR THIS
PROGRAM EMBRY SO WE HAVE A LOT
OF WORK IT'S IT'S GONNA TAKE AT
LEAST SIX MONTHS OF NOT LONGER
WE ARE STILL WORKING ON OUR
TIMELINES OF THESE HAVEN'T BEEN
DISCUSSED YET.
BUT IT REALLY DOESN'T MAKE A
DIFFERENCE THREE MONTHS VERSUS
SIX MONTHS BECAUSE WE HAVE A LOT
OF WORK TO DO ON OUR END TO
IMPLEMENT A WHOLE NEW PROGRAM
AND THE STATE OF CALIFORNIA SO.
MR HILL IF I CAN JUST RESPOND
VERY BRIEFLY [inaudible]
MR HILL.
WE'VE WAITED SEVENTEEN YEARS FOR
HIS ILL AND AN EXCELLENT ME
SPEAK TO THE POINT PLEASE AT IF
I MAY PLEASE.
OKAY I JUST FOR THIS I'LL BE
HAPPY TO GIVE YOU TIME AFTER TO
RESPOND TO THAT THANK YOU THANK
YOU -- IT IN
THE TERMS OF THE FINANCING AND
THE THE FUNDING SOURCES THE
BOARD THIS IS IN THE ORIGINAL
BILL.
THAT THE BOARD SHALL UPON
APPROPRIATION IN THE ANNUAL
BUDGET ACT.
EXPAND FUNDS RECEIVED FROM NON
PROFIT PHILANTHROPIC.
WHAT IS A VERY AND I AGREE AND --
THAT WE HAVE CREATED A FUNDS BUT
AS A BREED THAT WOULD LOOK LIKE
HAVE TO BE APPROPRIATE IN THE
BUDGET THAT AND SO.
ATOMS ARE UNDERSTAND YEAH AS
WELL MISTER HILL AYE WHICH IS
RESPOND TO YOU DEPARTMENT OF
FINANCE WHEN WE MET WITH THE
FINANCE AND THE GOVERNOR'S
OFFICE INDICATED THAT THIS DID
NOT HAVE TO GO THROUGH THAT
OTHERWISE WE WOULD HAVE BEEN IF
BILL A BILL IN TWO YEARS AGO.
REQUIRING AND PUTTING IT IN AS
AN APPROPRIATION ISSUE
DEPARTMENT OF FINANCE INDICATED
THAT THAT WAS NOT NECESSARY.
SO I'M JUST TELLING YOU DIRECTLY
FOR A MEETING THAT WE HAD WITH
THE DEPARTMENT OF FINANCE.
THE CONSUMER AGENCY --
AND THE GOVERNOR'S OFFICE AND
ALL WERE IN AGREEMENT INCLUDING
THE MEDICAL BOARD WHO WAS THERE
AT THE TIME.
SO ALL WE'RE TRYING TO CONVEY TO
YOU BY MISTER CHAIRMAN AND
MEMBERS OF THIS COMMITTEE IS
THAT.
WE'VE WAITED A TREMENDOUS AMOUNT
OF TIME WE CLEARED ALL OF THESE
HURDLES AND IT SEEMS IS SUPER
RELITIGATE IN THE LEGITIMACY OF
THIS PROGRAM AGAIN AS IF WERE
PUT IT OFF BECAUSE WE'RE DOING
MISTER TOURISM PLEASE.
IF YOU COULD --
RESPOND WHEN RECOGNIZED AND I'VE
HEARD THAT NOW THREE TIMES.
SO WE WERE WE'RE MOVING ON WITH
OTHER QUESTIONS AND INFORMATION
THAT WERE NOT RE LITIGATING THE
ISSUES OF THIS CRIME EVERITT OF
THE BILL AND THE THE ORIGINAL
BILL I'VE HEARD THAT THANK YOU.
WE'RE TRYING TO GET TO THE SOME
OF THE FACTIONS OF THE ISSUES
THAT ARE RESPONDED TO WOULD JUST
TALK ABOUT THE PHYSICAL ASPECT
OF THIS AND I HAVE TALKED TO THE
GOVERNOR'S OFFICE I'VE TALKED TO
THE GOVERNOR'S OFFICE ABOUT THE
REGARDING THIS BILL AS WELL.
IN THIS ISSUE --
WOOD SO WITH THE TIME FRAME THIS
NECESSARY TODAY THE MEDICAL
BOARD WOULD NOT BE.
SO WE'RE ACTUALLY OUR STAFF IS
WORKING ON A TIMELINE OF
ACTUALLY WHEN WE RECEIVE THE
MONEY IN MISTER TAURUSES RIGHT
WE RECEIVED A LETTER WE SAW TO
REVIEW THE LETTER WE'RE SUPPOSED
SUPPOSED TO BE GETTING THE
FINING AT SOME POINT TODAY THAT
WOULD BE DEPOSITED INTO THE FUND
WE SPOKE.
ABOUT BUT EVEN ONCE IT STARTS WE
HAVE A SIGNIFICANT AMOUNT OF
WORK TO DO BEFORE THIS PROGRAM
CAN BE UP AND RUNNING.
AND I DON'T ANTICIPATE THAT IT'S
GOING TO BE LESS THAN SIX MONTHS
WITH ALL OF IT CREATING CREATION
OF A WHOLE NEW PROGRAM.
AND ONCE WE COME UP WITH THAT
TIME WHEN WE WILL PROVIDE IT'S
ALL THE INTERESTED PARTIES AT
HAPPY BE HAPPY TO PROVIDE IT TO
YOUR OFFICE --
OF YOU KNOW KIND OF WEBER OUT OF
IT I DON'T THINK IT'S GOING TO
BE IN THREE MONTHS THAT WE'RE
GOING TO BE UP AND READY TO GO
WITH A NEW PROGRAM THINKING NOW
GO.
TO SENATOR PAN OF THIS TORRENT
OF QUESTION ABOUT IT IN TERMS OF
THE PHYSICIANS WHO ARE COMING TO
CALIFORNIA DO THEY JERRY.
V. SAYS THAT THAT WOULD BE
REQUIRED FOR THIS THE WAY THE
PROCESS WORKS MISTER HILL --
AND I DON'T THINK IT'S BEEN
DISCUSSED BEFORE --
YOU DON'T GET OF THESE UNLESS
YOU HAVE A MEDICAL LICENSE.
SO THAT MEDICAL LICENSE HAS TO
BE ISSUES BEFORE THE VISA
APPLICATION IS SUBMITTED.
I DON'T THINK THE GOVERNOR'S
DISCUSS THAT WITH ANYBODY EITHER.
OF THE PROCESS IS VERY SIMPLE
YOU HAVE A VERY DIFFICULT VISA
THAT WE'RE USING THE ó ONE
VISAS WHILE MOST DIFFICULT WANTS
TO GET.
WELL THAT IS --
ONE AND THE OWE ONE IS ISSUED
TWO VERY DISTINGUISHED PEOPLE
AND PROFESSIONS IN THEIR COUNTRY
OF ORIGIN --
THESE DOCTORS ARE VERY
DISTINGUISHED --
IT'S NOT GONNA BE EASY --
TO REPLACE ANY OF THEM IF --
IF THE DROP.
WE'RE CONCERNED THAT --
WITH THIS ADMINISTRATION IN THIS
CITY.
THEIR POSITION ON IMMIGRATION
WE'RE GOING TO HAVE N UP HILL
BATTLE ON THE PIECES TO BEGIN
WITH -- THAT
MEANS THAT THE SOONER THAT WE'RE
IT READY TO MOVE WITH THAT VISA
THE BETTER --
AND THAT IS WHY WE'RE VERY
CONCERNED ABOUT.
THE LENGTH OF TIME IF THIS IS A
SIX MONTH PROGRAM AND ALL OF THE
THINGS THAT THE DEPARTMENT SAYS
IT HAS TO DO.
ALL OF THOSE THINGS WILL SIMPLY
BE EXTENDED ONTO THE SIX MONTHS
SO WE'LL BE LOOKING AT EVEN
LONGER --
AGAIN I WE JUST THINK THAT THE
PROBLEM THAT WE HAVE ACCESS IN
THESE COMMUNITIES WHERE THESE
DOCTORS ARE GOING TO BE WORKING --
IS REALLY REALLY HURTING AND
IMPEDING ACCESS --
SO.
WE HAVE RAISED THESE CONCERNS
THE MEDICAL BOARD REPEATEDLY I'M
VERY DISAPPOINTED THAT THE
MEDICAL BOARD --
HAS REPRESENTED WHAT WE HAVE
DISCUSSED --
AND NOT IN THE SAME SPIRIT --
THAT I THOUGHT WE HAD --
BUT I THINK THIS IS THE
DIFFICULTY IN JUST GETTING THE
BILL AND ACCURATELY TOURISTS WHO
DOES IT RIPPING.
THANK YOU THANK YOU CHAIR HELL --
FIRST BY SOME REALLY APPRECIATE --
THE ISSUE YOU'RE TRYING TO DEAL
WITH AND AND CERTAINLY --
YOU KNOW WE DO HAVE CHALLENGES
WITH ACCESS --
TO TO CARE ACCESS TO PHYSICIANS --
BUT I'M ALSO NOTIFY --
ALSO VERY COGNIZANT OF THE
CHALLENGES THE MEDICAL BOARD
HASN'T IT IDO I DO HAVE A FEW
QUESTIONS I MEAN FIRST OF ALL --
SEVERAL TIMES THAT IS A QUOTE
BOARD CERTIFIED PHYSICIANS BUT
BOARD CERTIFICATE I MEAN ARE
THEY QUE BIEN* BOARD
CERTIFIED I DON'T BELIEVE ABMS
OPERATES IN MEXICO SO I I THINK
WE NEED TO BE CLEAR.
THAT THERE BOARD CERTIFICATIONS
NOT THE SAME.
AS NOT SAYING THAT APPEARANCE
pPROCESS AS IT IS AND THE UNITED
STATES IS A DIFFERENT TYPE OF
EXAM -- THE
EXAM THAT'S GIVEN FOR AND I AM
SPEAKING AS SOMEONE WHO.
IF YOU REFERENCE ME SEVERAL
TIMES YOUR TESTIMONY I MEAN NOT
ONLY POSITION BUT I HAVE YOU
KNOW IN THE PAST CHAIR OF THE
ANY COUNCIL MEDICAL EDUCATION.
VERY FAMILIAR WITH THE
TREPIDATIONS CERTIFICATION
PROCESS.
HERE AT NOW IN THIS COUNTRY BUT
ALSO I HAVE SOME FAMILIARITY OF
THAT OTHER COUNTRIES INCLUDING
MEXICO.
SO I I JUST WANT TO BE YOU KNOW
I I DON'T WANT TO CONFLATE
THINGS --
SOLO BE CLEAR THAT --
THE PHYSICIANS A DAY THERE ARE.
THEY AS FAR AS I KNOW BUT YOU
CAN TELL ME IF I'M WRONG BY THE
A BMS CERTIFIED.
POSITIONS ARE NOT AT NOON PARA
WOULD HAVE HAD TO HAVE TAKEN THE
EXAM HERE.
THAT'S WHY WE PUT IN THE
LEGISLATION PARADOX OF DANCE SO
SO I MEAN I SAW BECAUSE YOU KEEP
SAYING BOARD CERTIFIED THEY ARE
ALREADY.
BUT I'D BE CLEAR THAT THAT
BOARDS VACATIONS NOT THE SAME AS
BOARD CERTIFIED ADULTERY.
IF THAT MR FITNESS EQUIPMENT.
SO I APPRECIATE THE QUESTION
DOCTOR PAN AND I THINK.
YOU KNOW WHEN WHEN I THINK OF
OUR OUR WITNESS SO --
SPEAKS ABOUT NOT WANTING TO
LITIGATE.
THE LEGITIMACY OF THE PROGRAM I
THINK HERE YOUR QUESTION REALLY
LEADS TO ADD THE PREMISE OF WILL
IT'S NOT THE SAME AND WE ARE
TALKING ABOUT.
MEDICAL BOARD HERE OF CALIFORNIA
AND THE MEDICAL BOARD OF MEXICO
GETTING TO GET.
PROGRAM IN ORIENTATION PROGRAM
THAT IS OF A QUIBBLE INSITU WHAT
ANOTHER STANDARDS TO BE ABLE TO
THAT FACILITATE THE POSSIBILITY
OF BRINGING THESE DOCTORS AND SO
I YOU KNOW THE FACT THAT WILL WE
WOULD REGULARLY THAT I UP AT ISO
BECAUSE AND FOR ANY TO TEST THE
I ONLY.
ASKING BECAUSE THE TEST MALES
GIVEN THAT I WANTED.
CLEAR THAT WHEN BECAUSE THOSE
REPEATEDLY SAID THESE ARE BOARD
CERTIFIED THAT I WON'T BE CLEAR
THAT WE'RE TALKING ABOUT BOARD
CERTIFIED IN MEXICO WHICH IS
[inaudible]
NOT.
THAT SAY THE SAME ON THAT SAME
WAS VERY NEAR WRIGHT BUT IT'S A
DIFFERENT PROCESS THE
GRATIFICATION AT THIS WE SHOULD
NOT BE COMPLAINING THAT YOU WERE
NOT COMPLAINING WHEN I AM
LEARNING AND WHEN YOU LOOK AT IT
IF I MAY THROUGH THE CHAIR.
IF UP IF WE'RE LOOKING AT THESE
TWO MEDICAL BOARDS ON BOTH SIDES
OF THE ISSUE.
WORK WHERE WE'RE BASICALLY
SAYING THE RIGHT SIZE BOARD
CERTIFICATION SEPARATE FROM
LICENSURE WHICH IS WHAT THE
MEDICAL BOARD DOES THAT THAT'S
CORRECT OKAY EDIT BUT AGAIN I
JUST WANT TO MAKE SURE THAT YOU
KNOW WHAT WE'RE NOT REALLY.
BUT IT WENT INTO THE DIRECTION
OF WHETHER OR NOT IT'S THE SAME
MORE LESS OF ME.
WHAT WERE IN I UNDERSTAND THAT
YEAH I GUESS WHAT I AM GOING TO
YOUR POINT MR TAURUS IF NOT RE
LITIGATING THE ISSUE AND I DON'T
THINK ANYONE WANTS TO BUT THE
ISSUE WAS LITIGATED AT A TIME?
AND A SIX MONTH ORIENTATON
PROGRAM WAS ESTABLISHED BASED ON
THE CURRICULUM BASED ON THE THE
THE PLAN AND PROPOSAL THAT WAS
PUT FORTH IN THE LAW AS IT WAS
ADOPTED.
NO I AGREE ARBITRARILY SIX
MONTHS UNIT WELL AS HAVE A
FOLLOW UP ON THAT.
TOO IT'S NOT SO ARBITRARY WHAT
WHAT LIMIT IS IT TO THE SIX
MONTH PERIOD OF TIME THAT WAS
ESTABLISHED FOR THAT.
THE CONCERNS WERE NOT REALLY.
LITIGATING AT BUT WHAT WE DO
NEED TO DO IS MAKE SURE THAT.
WHATEVER THAT SIX MONTHS WAS
GOING TO BE ESTABLISHED TO
PROVIDE INFORMATION TO THE
MEDICAL BOARD WAS GOING TO COVER.
THEIR DUE DILIGENCE WHEN YOU
LOOK AT THE DIFFERENCES AND
THERE ARE DIFFERENCES BETWEEN
WHAT GRADUATES OF INTERNATIONAL
MEDICAL SCHOOLS NOT IN THE U. S.
AND CANADA I MEAN THEY HAVE A
TWO YEARS POST GRADUATE TRAINING.
THERE'S NONE REQUIRED IN THIS
PROGRAM IS A SIX MONTH
ORIENTATION THAT WE'RE TALKING
ABOUT OR AN ORIENTATION NOT
NECESSARILY SIX MONTHS IS WHAT
WE'RE ASKING FOR TODAY TO GIVE
THEM THE TIME TO DEVELOP THAT
AND AND MAKE IT.
WORK IF IT'S LESS THAN SIX
MONTHS I THINK THAT YOU.
WE WANT TO MAKE SURE IT'S OUR
RESPONSE ABILITY ADMITTED IS OUR
RESPONSE ABILITY TO MAKE SURE
THAT THAT.
THAT THE ALTERNATIVE IF IT'S NOT
THE SIX MONTHS EQUALS THE SAME
AMOUNT AND THAT WE'RE NOT LOSING
SOMETHING IN THAT TIME FRAME I
APPRECIATE THAT MISTER CHAIRMAN
SO LET ME LET ME ADDRESS WHEN
YOU JUST SAID AND WHAT MISTER.
DOCTOR PAN THE SAID THE THE
STATUTE READS PASSED THE BOARD
REVIEW COURSE WITH A SCORE
EQUIVALENT TO THAT REGISTERED.
BY UNITED STATES APPLICANT WHEN
PASSING A BOARD REVIEW COURSE
FOR THE UNITED STATES
CERTIFICATION EXAMINATION.
IN AND IN EACH OF HIS OR HER
SPECIALTY AREA.
ACTUALLY SO IF I IF I MAY FINISH
WITH DOCTOR PAN SO I DON'T
UNDERSTAND YOUR QUESTION BECAUSE
THAT PROVISION WAS SPECIFICALLY
WRITTEN. TO ADDRESS PRECISELY
THE QUESTION THAT YOU JUST ASKED.
WERE NOT GOING TO HAVE DOCTORS
FROM MEXICO COMING INTO THE INTO
UNITED STATES PASSING THE BOARD
CERTIFICATION EXAM SO WE SAID.
THEY'D HAVE TO PASS IT WITH THE
SCORE EQUIVALENT THAT
PRESENTATION AND STUDY IN
COMPARISON WAS DONE.
SO THAT THE EXAM IN MEXICO IS IN
FACT EQUIVALENT TO THE VERY SAME
EXAM THAT IS STANDING CAL IN THE
UNITED STATES.
THE REQUIREMENTS FOR FOR SIX
CERTIFICATION NOT ONLY INCLUDE
THE EXAM.
SO THAT'S ONE ISSUE BUT THE
OTHER QUESTION I HAVE IS IS THAT --
ARE ARE THESE APPLICANTS SO FOR
EXAMPLE NOR TO GET A LICENSE.
AND IN THE STATE OF CALIFORNIA
OR ACTUALLY.
BACK TO ANY OTHER STATE.
THIS COUNTRY UP WILL THEY HAVE
TO BE REQUIRED TO TAKE AND PASS.
NOT TOWARDS OF WITCHES BOARD
CERTIFICATION WHICH IS A
DIFFERENT TACTIC EXAM BUT THE
USMLE WHICH IS THE UNITED STATES
MEDICAL LICENSING.
THAT IS THAT IS THAT EXAMPLE YOU
HAVE TO TAKE AND FRANKLY IF YOU
DON'T PASS THAT YOU DON'T GET
RESIDENTS CELL WHICH IS A
REQUIREMENT ALSO FOR LICENSURE
SELLERS THAT ALSO REQUIRED.
DO YOU SEE MISTER CHAIRMAN WHAT
WE'RE DOING WE ARE WE LITIGATING
THESE ARE THE ISSUES THAT WE
DISCUSSED WHEN WE FIRST AT THIS
BILL.
AND I DECIDE HAVE QUESTIONS TO
GET CLARIFICATION WERE SIMPLY
I'M TRYING TO ANSWER YOUR
QUESTION BUT THAT UNFORTUNATELY
THE QUESTION.
THE QUESTION IS IS BASICALLY
ASKING US THAT POINTING OUT THAT
THE DOCTORS IN MEXICO DO NOT
MEET THE REQUIREMENTS OF DOCTOR
PAN IS REFERENCING.
THAT'S WHY THIS WAS A PILOT
PROGRAM AND IT WAS MADE LAW BY
THE STATE OF CALIFORNIA AND THE
GOVERNOR SIGNED IT BUT NOW WE
HAVE AN ISSUE THAT'S BEEN RAISED
THAT
THESE DOCTORS DON'T HAVE WITH
DOCTOR PAN HAS GIVEN TO EXAMPLES
OF NOW.
BUT THAT'S NOT THE DEBATE THE
DEBATE IS ABOUT A WEEK
ORIENTATION PROGRAM BUT WE'RE
NOW DISCUSSING STANDARDS THAT
ARE NOT PART OF THE BILL
SUBSECTION OF THE FOLLOW UP AND
THEN WE CAN ESTIMATE ó WOULD.
SO OKAY SO WE ESTABLISH THOSE
TWO ISSUES THEN THE OTHER
QUESTION IS THIS BROUGHT UP THAT
SIX MONTHS IS ARBITRARY AND OF
COURSE I WASN'T IN THE
LEGISLATURE AND TWO THOUSAND AND
TWO BUT I WILL POINT OUT --
AND I THINK --
IF I HAD SOME INVOLVEMENT
BECAUSE I WAS AND YOU KNOW AND
INVOLVED IN.
CMA BUT PREAMP WHEN THE IN HERE
IN THE UNITED STATES SO.
IT'S ONE FOR WE UNDERSTAND WHAT
HAPPENS HERE IN THIS COUNTRY
WHEN IT COMES TO PEOPLE GAIN
LICENSES AND BEING PERMITTED --
TO TO TO PRACTICE OUT HERE NAY
NOT STATES IF YOU WANT YOU
GRADUATE MEDICAL SCHOOL.
AND YOU DO A RESIDENCY CELLS
RESIDENCY DIRECTOR.
UP FOR THE FIRST SIX MONTHS
[inaudible] SIX MONTHS.
BY OUR STANDARDS ESTABLISHED BY
THE FEDERAL GOVERNMENT YOU HAVE
TO BE SUPERVISED IN YOUR
CLINICAL PRACTICE YOU CANNOT --
SO I CANNOT HAVE MY INTERNS GO
AND SEE A PATIENT WITHOUT ME BY
GOING AND AND YOU KNOW CHECKING
UP AND AND IT PERSONALLY EXAMINE
THE PATIENT MYSELF TO BE SURE
THAT THERE.
ARE NOW MERELY THESE POSITIONS
ARE NOT NO --
AND IT THAT RESIDENTS BUT I
WOULD POINT OUT THAT'S TO ENSURE
THAT THEIR LEVEL THIS IS AFTER
YOU GRADUATE FROM MEDICAL SCHOOL
HAVE PASSED.
YOU'RE USMLE YOU STILL HAVE TO
BE SUPERVISED FOR SIX MONTHS.
SOTHE SIX MONTHS IS UNNECESSARY
ARBITRARY IN THAT SENSE NOW I
DON'T KNOW TERMS LEGISLATION BUT
I WILL TELL YOU THAT AT LEAST IN
MEDICAL PRACTICE IN TERMS OF
TRAINING.
THAT IS THAT IS WAS REQUIRED BY
US -- IN
TERMS OF SUPERVISION AT TO
ASSURE THAT THE PERSON WHO'S NOW
GRETA MEDICAL SCHOOL IS AND NOT
IS NOT GOING TO PRESENT A AYE
DANGER ARE --
YEAH TO TO TO THE PATIENT THAT
YOU HAVE TO DO DIRECT
OBSERVATION BECAUSE YOU CAN PASS
THE TEST.
BUT WE WANT TO SEE HOW YOU
ACTION AND IT'S ONE THING TO
PASS A TEST NOTHING TO TAKE CARE
OF PATIENTS.
AND SO I GUESS ONE QUESTION IS
IS THAT IS THERE REQUIREMENTS
SIX MONTHS OF SUPERVISION.
THEY WERE ASKING THE MEDICAL
BOARD OKAY CLUB THERE IS NOT A
AND THEY HAVE TO WORK IN THE
CLINIC IN THE CLINIC AND WOULD
BE OVERSEEN BY THERE'S ON A
DIRECT SUPERVISION REQUIREMENT
THAT DOCTOR PAN IS TALKING ABOUT.
IT WE'RE DEAD AT ANOTHER VISIT
AS LICENSE FULLY LICENSED
PHYSICIAN HAS TO SIGN OFF ON
OKAY [inaudible]
EXTERNSHIP.
THERE'S AN EXTERNSHIP
PROGRAMMERS OR ANY OF SORRY
THERE'S AN EXTERNSHIP PROGRAM
THERE'S ORIENTATION PROGRAM
THERE'S AN EVALUATION THAT WOULD
TAKE PLACE BUT THERE'S NOT A
DIRECT.
SUPERVISION LIKE SIGNING OFF ON
EACH PATIENT LIKE DOCTOR
PENICILLIN I'M MENTIONING.
THEM IS A CHAIR FROM. ONE ARE
TALKING ABOUT NEW DOCTORS OUT OF
MEDICAL SCHOOL.
WE'RE TALKING ABOUT PHYSICIANS
HAVE BEEN PRACTICING.
AND AGAIN BASED ON THE MEDICAL
BOARD.
AND THE BOARD OF THE MEXICAN
GOVERNMENT WHO OVERSEES YOU KNOW
HE'S PRACTICING DOCTORS HAVE
AGREED THIS.
ORIENTATION CURRICULUM IS A
SUFFICIENT. TO BE ABLE TO
PREPARE THESE DOCTORS TO COMMON
PRACTICE IN THESE UNDERSERVED
COMMUNITIES AND SO.
I I ALTHOUGH I I UNDERSTAND --
THE QUESTIONS.
THAT THE DOCTOR PAN --
IS RAISING ANY I WHEN IT COMES
TO THIS THAT THERE'S NO QUESTION
ABOUT THAT.
I THINK THOUGH THAT IT DOES I
REALLY TRIGGER --
MUCH OF THE DISCUSSIONS THAT
TOOK PLACE IN TWO THOUSAND TWO
ON WHETHER OR NOT THERE'S A A
SENSE OF KIND OF INFERIORITY --
WITH DOCTORS COMING FROM ANOTHER
COUNTRY TO SERVE --
TO THE STANDARD THAT WE'VE SAID
HERE AND SO THAT REALLY.
IMPACT TRIGGERS OTHER TYPES OF
SENTIMENTS AND OTHER TYPES OF
CONCERNS RIGHT WE SIMPLY BELIEVE
THAT THIS ORIENTATION THAT HAS
BEEN SET AT SIX MONTHS CAN BE
DONE QUICKER.
AND BY DOING SO WILL BE ABLE TO
BRING SOMEBODY STOPPED AS FAR
SOONER TO ADDRESS THE NEEDS OF
UNDERSERVED COMMUNITIES LIKE THE
ONES THAT I REPRESENT.
IN I THINK WHAT WE'RE SAYING IS
RELEASED THE COMMITTEE'S
POSITION AT THIS POINT IS.
IS THAT WE UNDERSTAND THAT WE DO
NOT WANT TO REHASH THAT DECISION
WAS MADE BY THE PREVIOUS
LEGISLATURE HAS LAW TODAY'S.
TO THE PHYSICIAN OF THE PILOT
PROGRAM COMING TO THOSE
DISADVANTAGED AREAS.
BUT I THINK IT IS IMPORTANT FOR
US.
AND IT'S OUR RESPONSIBILITY IT
TO PROTECT PATIENTS REGARDLESS
OF WHETHER THEY'RE IN A
DISADVANTAGED COMMUNITY AND WE
DON'T WANT TO SEE THEM GET LESS.
PROFESSIONAL CARE THAN ANY PLACE
ELSE AND THAT'S THE KEY ISSUE
HERE WHATEVER ORIENTATION IS
ADOPTED ESTABLISHED BY THE
MEDICAL BOARD.
THAT'D BE ENOUGH TO MEET THE
NEEDS IN THE STANDARDS THAT ARE
PUT THAT ARE WITHIN THE
LEGISLATION THAT WE HAVE AND
THAT'S WHY WE SUGGESTED THAT IF
SIX MONTHS IS AN ARBITRARY
NUMBER ARE NUMBER THAT WAS
ESTABLISHED.
IF THAT IS NOT A NUMBER THAT
PEOPLE ARE COMFORTABLE WITH THAT
WE ALLOW THE MEDICAL BOARD TO
USE THEIR GOOD JUDGMENT AND
DISCRETION TO ESTABLISH A TIME
FRAME AROUND THAT THAT'S THE
SUGGESTED AMENDMENT AND I WOULD
HOPE YOU WOULD.
BE WILLING TO ACCEPT YET WE WE
SAID WE WHAT WE SAID WE WHAT WE
WANTED TO SHARE WITH YOU.
OF THE OUR THOUGHTS ABOUT --
HOW WE FELT BASED ON THE
CONVERSATION WITH THOSE WHO?
DRAFTED THE CURRICULUM AND THOSE
WE'VE THAT COMPETITION WITH THAT
THE MEDICAL BOARD IN TERMS OF
ITS ADOPTION.
THEY COULD BE DONE SOONER AND
THAT WHICH IS WHY THE PROPOSED
THREE MONTH PERIOD WAS SET
FORWARD IF IT COULD BE DONE.
SOONER THAN SIX MONTH WITHOUT IT
BEING.
CHANGE WE CERTAINLY HOPE SO WE
HEARD TODAY THAT IT'S GOING TO
TAKE A BIT LONGER THAN THAT JUST
TO GET THE PROGRAM UP AND GOING
BEFORE WE EVEN START.
THE ORIENTATION WHICH MEANS THAT --
IT EXTENSIVE PERIOD OF TIME THAT
WE HAVE THESE OF CIRCUMSTANCES
AND SPECIFIC PARTS OF THE STATE
THAT.
EARLIER WOULD DEALING WITH ON A
DAILY BASIS DIRECTLY WE COULD
ALSO ALWAYS --
AND CERTAINLY PRIDE IN AND
CERTAINLY SUPPORT THE THE
MEDICAL BOARD'S EFFORTS TO
EXPEDITE WHATEVER WORK THEY'RE
DOING. TO TO GET IT DONE IN A IN
A TIMELY MANNER RATHER THAN THAN
ESTABLISHING A TIME FRAME.
OF BUT IF YOU IF THERE'S A
CONCERN THAT GO BEYOND THE SIX
MONTHS MAYBE WE SHOULD LEAVE THE
BILL THE WAY IT IS THE LAW THE
WAY IT IS IN ALL OF THE SIX
MONTHS IS THE TIME FRAME BUT I'M.
YOU KNOW WE DID SUGGEST THAT
AMENDMENT TO ALLOW THEM THAT
DISCRETION AND TO ESTABLISH THE
TIME AND A IF YOU'RE COMFORTABLE
WITH THAT THEN THE BE HAPPY TO
TO MOVE FORWARD ON THAT BASIS.
WELL AS I SAID WE WOULD ACCEPT
YOUR AMENDMENT --
AND WE WOULD LIKE TO KIND OF
KEEP A CLOSE EYE ON THIS ISSUE
BEEN HAPPY TO WORK WITH YOU AYE
IT AS WAS MENTIONED.
FROM 200-022-2000 EIGHTEEN THE
DOCTOR SHORTAGES AND ARTISTIC
CALIFORNIA HAVING GOTTEN ANY
BETTER.
AND SO THAT I WORKED AT WHAT
YEAH THAT'S THE POINT.
I JUST WANT TO CLOSE MISTER
CHAIRMAN BY SAYING THE AUDITOR'S
ARI.
THERE ARE PLENTY.
SO -- I JUST
YOU KNOW.
I THINK ONE OF THE THINGS THAT
AS WE'RE LOOKING AT THIS ISSUE
AND I'VE CERTAINLY WORKED WITH
SEVERAL EXCELLENT --
POSITIONS FROM MEXICO AND IS
THAT IT IT'S NOT ABOUT SAYING
THAT WELL IT'S A DIFFERENT
COUNTRY AND THEREFORE IT'S
INFERIOR AND WEIRD LOOKING.
IT'S ACTUALLY TRYING TO HOLD
EVERYONE TO THE SAME STANDARD
AND I THINK YOU KNOW THE REASON
WHY I AM SAYING IS THESE ARE THE
STANDARDS THAT ARE MET.
BY PEOPLE WHO SEEK LICENSURE.
THE MEMORABLE BOARD OF
CALIFORNIA I MEAN WHO.
IN IN IN IN IF YOU CAN IF.
YOU KNOW ANY OF OUR CHILDREN WHO
COME UP ND THAT THAT'S WHAT
THEY HAVE TO MEET THIS IS THE
SAME STANDARD WE'RE NOT.
SAYING THAT --
AND I AND I THINK THAT YOU KNOW
CERTAINLY AND MY FATHER WAS A OF
MY GRANDFATHER ACTUALLY MY
FATHER'S NOT AS MY GRANDFATHER
WAS A NATIONAL MEDICAL GRADUATE
AND SO.
NOW HE HAD BEEN THE PRACTICE IN
TAIWAN FOR AWHILE AND THEN WHEN
HE CAME TO THE UNITED STATES AND
TO THE CHALLENGES IS THAT FOR
ANYONE WHO IS.
RESPONSIBLE --
FOR ASSURING THE FOR DOING
LICENSURE AND AND AND IS THAT --
YOU KNOW IT ARE TRYING BE SURE
YOU GET ARE ACCURATE.
INFORMATION AB BECAUSE
ULTIMATELY IT'S THE JOB OF THE
MEDICAL BOARD CALIFORNIAN WE IS
THIS COMMITTEE TO AND AND TURNED
OUR SUPERVISORY ROLE --
TO ASSURE THE SAFETY OF THE
PEOPLE OF CALIFORNIA AND WE'VE
ESTABLISHED STANDARDS --
FOR EDUCATION AND TRAINING AND
AND OVERSIGHT AND SO --
WE HAVE I THINK WE HAVE TO BE
CAUTIOUS ABOUT --
THAT THEY'RE APPLIED IN A WAY TO
TO ENSURE.
THAT SAFETY AYE NO MATTER WHICH
POPULATION AND I CERTAINLY
BELIEVE ME I I I I UNDERSTAND
AND AND AND AND AND THE
CHALLENGES ABOUT --
YOU KNOW.
WE HAVE COMMUNITIES TO HAVE WHO
HAVE PROBLEMS WITH ACCESS --
BUT I'M NOT SURE THE ANSWER IS --
TO TO SAY THAT --
WE'RE GOING --
TO A YOUNG CHANGE THE STANDARDS
FOR JUST FOR THOSE PARTICULAR
COMMUNITY SO --
YET THAT THAT'S THAT IS MIKE MY
CONCERN IS IS THAT AYE.
IS ABOUT THIS AND I'M NOT TRYING
TO RELITIGATE THE OLD
LEGISLATION TAX IT WASN'T AROUND
WHEN IT'S PAST BUT I DO I'LL BE
SURE THAT DON'T FOR EXAMPLE I'D
I JUST HAPPEN TO KNOW THOSE
MEDICAL EDUCATOR.
IT'S NOT JUST ENOUGH FOR ME TO
TAKE A LOOK AT SOME OF THE
TRANSCRIPT AND THEIR TEST SCORES
TO SAY THAT THEY'RE OKAY IS A
DOCTOR.
THAT -- WE
NEED TO OBSERVE THEM AND
PRACTICE IT OUT BECAUSE EVEN IF
THEY DIDN'T PRACTICE SOMEWHERE
ELSE BECAUSE UNFORTUNATELY WE'VE
HAD HAD A CHANCE TO SEE HOW THEY
PERFORM.
IN THIS PARTICULAR AND THEY KIND
OF FIREMEN THAT WE HAVEN'T
PRACTICE HERE IN THE UNITED
STATES SO IT'S GREAT THAT THEY
HAVE TO TAKE A TEST AND LEARN
ABOUT HIPAA WHICH IS THE US LAW
THAT THE LEARN ABOUT HESE OTHER
THINGS.
BUT HOW THEY ACTUALLY PRACTICE
IS SOMETHING THAT I THINK IS
THAT IT THAT IT IS AN IMPORTANT
ELEMENT OUT BEFORE WE ALLOW THEM
TO PRACTICE INDEPENDENTLY
WITHOUT SUPERVISION.
WHICH I WAS JUST GOING TO
CONCLUDE WAT ST THAT WE
RESPECTFULLY ASK FOR GUY VOTE
LOOKS AT THE AMENDMENT THIS IS
ABOUT THAT DELETING THE LENGTH
OF TIME FOR YOUR TEACHER PROGRAM.
FOR SIX MONTHS OUT TO NO
SPECIFIC PERIOD.
THAT'S REALLY WHAT'S BEFORE US
NOT THE PROGRAM NOT THE MERITS
OF QUALIFICATION STANDARDS
SIMPLY.
LUCK COMPRESSING THE ORIENTATION
IS I THANK YOU VERY MUCH
ASSEMBLYMEMBER GARCIA AND I
APPRECIATE THAT AND WE CAN
TOWARDS.
I JUST WANT TO REMIND YOU PLEASE
THAT.
IN THE FUTURE WHEN YOU SPEAK TO
COMMITTEE CONSULTANTS OR STAFF
YOU DO IT IN A CIVIL AND
RESPECTFUL MANNER PLEDGE HOPE
THAT WOULD [inaudible]
PICKING THE OF WE DO NOT HAVE A
QUORUM SO WE WILL TAKE THE
MOTION WILL BE TO PASS WITH THE
UNDERSTANDING AMENDMENTS WILL
TAKEN APPROPRIATIONS AT THE
APPROPRIATE TIME. TO HOLD THE
THANK YOU.
YEAH DOT ORG OPEN IF I I'M SORRY.
YOU KNOW WHO IT WILL TAKE A ROLL
CALL VOTE TO ESTABLISH QUORUM
HEALTH.
HERE HELL HERE FULLER ALLEN.
ALLEN HERE DODD GALGIANI GOT
JUNK HERE GLAZER GLAZER HERE
HERNANDEZ PAN HERE AND HERE WILK
[inaudible]
GOOD [inaudible]
JEFF.
VERY THANK YOU.
THANK YOU VERY MUCH SENATOR
LATER WE DO HAVE A MOTION PLEASE
CALL FOR ALL FLESH AS TO PASS
THE SENATE APPROPRIATIONS
COMMITTEE HILL.
AYE HILL AYE FULLER.
ALAN [inaudible]
I ALSO.
ALLEN AYE DODD [inaudible]
GALGIANI.
GALGIANI AYE GLAZER.
GLAZER AYE HERNANDEZ.
PAN [inaudible]
I THINK [inaudible]
WILK.
WHAT?
DO WE WILL UP THE BILL HAS FOR
VOTE TO UPHOLD THE RULE BUT FOR
ABSENT MEMBERS THANK YOU VERY
MUCH AFTER
.
PROFESSIONS AND ECONOMIC
DEVELOPMENT COMMITTEE FOR TODAY
AND A CALL THE ROLL.
OPEN THE RULES AGAIN ON A ON A.
B. EIGHTEEN WHICH WILL BE ABSENT
MEMBERS LUSHNESS TO PASS THE
SENATE APPROPRIATIONS COMMITTEE
FULLER.
DODD AYE DODD AYE [inaudible]
HERNANDEZ [inaudible]
AND WILK.
THE BILL HAS FIVE VOTES IT IS
OUT AND THAT CONCLUDES THE
BUSINESS OF OUR COMMITTEE TODAY
WE ARE AFTER