House Bill 1121
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Florida House of Representatives - 2000 HB 1121
By Representative Peaden
1 A bill to be entitled
2 An act relating to the Florida State University
3 College of Medicine; establishing a 4-year
4 allopathic medical school within the Florida
5 State University; providing legislative intent;
6 providing purpose; providing for transition,
7 organizational structure, and admissions
8 process; providing for partner organizations
9 for clinical instruction in a community-based
10 medical education program; specifying targeted
11 communities and hospitals; providing for
12 development of a plan for graduate medical
13 education in the state; providing for
14 accreditation; providing curricula; providing
15 for clinical rotation sites in local
16 communities; providing for training to meet the
17 medical needs of the elderly; providing for
18 training to address the medical needs of the
19 state's rural and underserved populations;
20 providing for increased participation of
21 underrepresented groups and socially and
22 economically disadvantaged youth; providing for
23 technology-rich learning environments;
24 providing for administration and faculty;
25 providing for collaboration with other
26 professionals for integration of modern health
27 care delivery concepts; authorizing the Florida
28 State University to negotiate and purchase
29 certain liability insurance; providing an
30 effective date.
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Florida House of Representatives - 2000 HB 1121
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1 WHEREAS, the United States Department of Health and
2 Human Services has identified 67 regions in Florida, including
3 13 entire counties, most of them in rural North Florida, as
4 Health Professional Shortage Areas; and 40 percent of the
5 state's 67 counties have fewer than 100 doctors per 100,000
6 population, compared to the national average of 221 doctors
7 per 100,000 population, and
8 WHEREAS, in Florida, more than 3.2 million residents
9 are over the age of 60, more than 80 percent of patients who
10 visit a primary care physician are elder persons, and between
11 60 percent and 70 percent of persons seeking medical care are
12 age 60 and over; and Florida's continuing population growth,
13 especially among its older residents, is contributing to an
14 increasing shortage of physicians in the state, and
15 WHEREAS, Florida has large areas of medically
16 underserved minority populations, and
17 WHEREAS, there are hundreds of highly qualified
18 university students in Florida who seek, but cannot gain,
19 admission to medical school, and
20 WHEREAS, Florida currently imports a substantial number
21 of its doctors from other states or countries, and ranks third
22 highest, nationally, in the percentage of its total allopathic
23 physician workforce who are international medical graduates,
24 and
25 WHEREAS, Florida's existing medical education system
26 has an extremely limited capacity to serve the state's rapidly
27 growing population, which leaves the state vulnerable to
28 physician shortages at the national level, while at the same
29 time limiting opportunities for Florida's best students to
30 enter the medical field and serve their communities, and
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Florida House of Representatives - 2000 HB 1121
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1 WHEREAS, a medical school is not required to have its
2 own teaching hospital in order to have a high-quality,
3 accredited medical education program, and
4 WHEREAS, community-based medical education programs are
5 significantly less expensive than teaching-hospital-based
6 medical education programs, do not involve the financial risks
7 associated with the operation of a hospital, and enable the
8 state to work with local hospitals, and
9 WHEREAS, a community-based medical education program
10 relies on clinical resources available in each community and
11 requires support by hospitals, private and public health
12 clinics, and other health care organizations willing to enter
13 into affiliation agreements to provide clinical education as
14 part of a medical education program, and
15 WHEREAS, a number of hospitals, private and public
16 health clinics, and other health care organizations in the
17 state have expressed an interest in affiliating with a Florida
18 State University community-based medical education program,
19 and
20 WHEREAS, the Florida State University's Tallahassee
21 location is near the center of the region of the state with
22 the greatest current shortage of physicians, and
23 WHEREAS, the Florida State University has, since 1971,
24 successfully operated a first-year medical school program in
25 concert with the University of Florida College of Medicine and
26 is noted for its success in attracting students who eventually
27 become primary care physicians, and
28 WHEREAS, the Florida State University has strong
29 research programs in the applied biomedical and behavioral
30 sciences, autism, cancer, chronic diseases, and geriatrics,
31 and
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Florida House of Representatives - 2000 HB 1121
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1 WHEREAS, there has been no new medical school
2 established in the United States in two decades despite the
3 large growth in the nation's population, particularly the
4 elderly population, and
5 WHEREAS, there is now an unusual opportunity to design
6 and operate an innovative medical education program in our
7 state, which takes advantage of the advances in medical and
8 communication technology, NOW, THEREFORE,
9
10 Be It Enacted by the Legislature of the State of Florida:
11
12 Section 1. Florida State University College of
13 Medicine.--
14 (1) CREATION.--There is hereby established a 4-year
15 allopathic medical school within the Florida State University,
16 to be known as the Florida State University College of
17 Medicine, with a principal focus on recruiting and training
18 medical professionals to meet the primary health care needs of
19 the state, especially the needs of the state's elderly, rural,
20 minority, and other underserved citizens.
21 (2) LEGISLATIVE INTENT.--It is the intent of the
22 Legislature that the Florida State University College of
23 Medicine represent a new model for the training of allopathic
24 physician healers for the citizens of the state. In accordance
25 with this intent, the governing philosophy of the College of
26 Medicine should include the training of students, in a humane
27 environment, in the scientific, clinical, and behavioral
28 practices required to deliver patient-centered health care in
29 the 21st century. Key components of the College of Medicine,
30 which would build on the foundation of the 30-year-old Florida
31 State University Program in Medical Sciences (PIMS), would
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1 include: admission of diverse types of students who possess
2 good communication skills and are compassionate individuals,
3 representative of the population of the state; basic science
4 training utilizing medical problem-based teaching; and
5 clinical training at several dispersed sites throughout the
6 state in existing community hospitals, clinics, and doctors'
7 offices. The Legislature further intends that study of the
8 aging human be a continuing focus throughout the 4-year
9 curriculum and that use of information technology be a key
10 component of all parts of the educational program.
11 (3) PURPOSE.--The College of Medicine shall be
12 dedicated to: preparing physicians to practice primary care,
13 geriatric, and rural medicine, to make appropriate use of
14 emerging technologies, and to function successfully in a
15 rapidly changing health care environment; advancing knowledge
16 in the applied biomedical and behavioral sciences, geriatric
17 research, autism, cancer, and chronic diseases; training
18 future scientists to assume leadership in health care delivery
19 and academic medicine; and providing access to medical
20 education for groups which are underrepresented in the medical
21 profession.
22 (4) TRANSITION; ORGANIZATIONAL STRUCTURE; ADMISSIONS
23 PROCESS.--The General Appropriations Act for fiscal year
24 1999-2000 included initial funding for facilities and
25 operations to provide a transition from the Program in Medical
26 Sciences (PIMS) to a College of Medicine at the Florida State
27 University. For transitional purposes, the Program in Medical
28 Sciences (PIMS) in the College of Arts and Sciences at the
29 Florida State University shall be reorganized and
30 restructured, as soon as practicable, as the Institute of
31 Human Medical Sciences. At such time as the 4-year educational
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1 program development is underway and a sufficient number of
2 basic science and clinical faculty are recruited, the
3 Institute of Human Medical Sciences shall evolve into the
4 Florida State University College of Medicine, with appropriate
5 departments. The current admissions procedure utilized by the
6 Program in Medical Sciences (PIMS) shall provide the basis for
7 the design of an admissions process for the College of
8 Medicine, with selection criteria that focus on identifying
9 future primary care physicians who have demonstrated interest
10 in serving underserved areas. Enrollment levels at the College
11 of Medicine are planned to not exceed 120 students per class,
12 and shall be phased in from 30 students in the Program in
13 Medical Sciences (PIMS), to 40 students admitted to the
14 College of Medicine as the charter class in Fall 2001, and 20
15 additional students admitted to the College of Medicine in
16 each class thereafter until the maximum class size is reached.
17 (5) PARTNER ORGANIZATIONS FOR CLINICAL INSTRUCTION;
18 GRADUATE PROGRAMS.--To provide broad-based clinical
19 instruction in both rural and urban settings for students in
20 the community-based medical education program, the College of
21 Medicine shall seek affiliation agreements with health care
22 systems and organizations, local hospitals, and military
23 health care facilities in the following targeted communities:
24 Pensacola, Tallahassee, Orlando, Sarasota, Jacksonville, and
25 the rural areas of the state. Selected hospitals in the target
26 communities include, but are not limited to, the following:
27 (a) Baptist Health Care in Pensacola.
28 (b) Sacred Heart Health System in Pensacola.
29 (c) West Florida Regional Medical Center in Pensacola.
30 (d) Tallahassee Memorial Healthcare in Tallahassee.
31 (e) Florida Hospital Health System in Orlando.
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Florida House of Representatives - 2000 HB 1121
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1 (f) Sarasota Memorial Health Care System in Sarasota.
2 (g) Mayo Clinic in Jacksonville.
3 (h) Rural hospitals in the state.
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5 The College of Medicine shall also explore all alternatives
6 for cooperation with established graduate medical education
7 programs in the state to develop a plan to retain its
8 graduates in residency programs in Florida. To this end, the
9 Florida State University is directed to submit to the
10 Legislature, no later than November 30, 2001, a plan to
11 increase opportunities for Florida medical school graduates to
12 enter graduate medical education programs, including
13 residencies, in the state.
14 (6) ACCREDITATION.--The College of Medicine shall
15 develop a program which conforms to the accreditation
16 standards of the Liaison Committee on Medical Education
17 (LCME).
18 (7) CURRICULA; CLINICAL ROTATION TRAINING SITES.--
19 (a) The initial 2-year curriculum shall draw on the
20 Florida State University's Program in Medical Sciences (PIMS)
21 experience and national trends in basic science instruction,
22 including use of technology for distributed and distance
23 learning. First-year instruction shall include a lecture mode
24 and problem-based learning. In the second year, a small-group,
25 problem-based learning approach shall provide more advanced
26 treatment of each academic subject in a patient-centered
27 context. Various short-term clinical exposures shall be
28 programmed throughout the first 2 years, including rural,
29 geriatric, and minority health, and contemporary practice
30 patterns in these areas.
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1 (b) During the third and fourth years, the curriculum
2 shall follow a distributed, community-based model with a
3 special focus on rural health. Subgroups of students shall be
4 assigned to clinical rotation training sites in local
5 communities in roughly equal numbers, as follows:
6 1. Group 1 - Tallahassee.
7 2. Group 2 - Pensacola.
8 3. Group 3 - Orlando.
9 4. Group 4 - Sarasota.
10 5. Group 5 - Jacksonville.
11 6. Group 6 - To be determined prior to 2005, based on
12 emerging state needs.
13 7. Group 7 - Rural Physician Associate Program (RPAP).
14 (8) MEDICAL NEEDS OF THE ELDERLY.--The College of
15 Medicine shall develop a comprehensive program to ensure
16 training in the medical needs of the elderly and incorporate
17 principles embodied in the curriculum guidelines of the
18 American Geriatric Society. The College of Medicine shall
19 have as one of its primary missions the improvement of medical
20 education for physicians who will treat elder citizens. To
21 accomplish this mission, the College of Medicine shall
22 establish an academic leadership position in geriatrics,
23 create an external elder care advisory committee, and
24 implement an extensive faculty development plan. For student
25 recruitment purposes, the current Program in Medical Sciences
26 (PIMS) selection criteria shall be expanded to include
27 consideration of students who have expressed an interest in
28 elder care and who have demonstrated, through life choices, a
29 commitment to serve older persons.
30 (9) MEDICAL NEEDS OF UNDERSERVED AREAS.--To address
31 the medical needs of the state's rural and underserved
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1 populations, the College of Medicine shall develop a
2 Department of Family Medicine with a significant rural
3 training track that provides students with early and frequent
4 clinical experiences in community-based settings to train and
5 produce highly skilled primary care physicians. The College
6 of Medicine shall consider developing new, rural-based family
7 practice clinical training programs and shall establish a
8 partnership with the West Florida Area Health Education Center
9 to assist in developing partnerships and programs to provide
10 incentives and support for physicians to practice in primary
11 care, geriatric, and rural medicine in underserved areas of
12 the state.
13 (10) INCREASING PARTICIPATION OF UNDERREPRESENTED
14 GROUPS.--To increase the participation of underrepresented
15 groups and socially and economically disadvantaged youth in
16 science and medical programs, the College of Medicine shall
17 continue the outreach efforts of the Program in Medical
18 Sciences (PIMS) to middle and high school minority students,
19 including the Science Students Together Reaching Instructional
20 Diversity and Excellence (SSTRIDE), and shall build an
21 endowment income to support recruitment programs and
22 scholarship and financial aid packages for these students. To
23 develop a base of qualified potential medical school
24 candidates from underrepresented groups, the College of
25 Medicine shall coordinate with the undergraduate premedical
26 and science programs currently offered at the Florida State
27 University, develop relationships with potential feeder
28 institutions, including 4-year institutions and community
29 colleges, and pursue grant funds to support programs, as well
30 as support scholarship and financial aid packages. The College
31 of Medicine shall develop plans for a postbaccalaureate,
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1 1-year academic program that provides a second chance to a
2 limited number of students per year who have been declined
3 medical school admission, who are state residents, and who
4 meet established criteria as socially and economically
5 disadvantaged. The College of Medicine shall make every
6 effort, through recruitment and retention, to employ a faculty
7 and support staff that reflect the heterogeneous nature of the
8 state's general population.
9 (11) TECHNOLOGY.--To create technology-rich learning
10 environments, the College of Medicine shall build on the
11 considerable infrastructure that already supports the many
12 technology resources of the Florida State University and shall
13 expand the infrastructure to conduct an effective medical
14 education program, including connectivity between the main
15 campus, community-based training locations, and rural clinic
16 locations. Additional technology programs shall include
17 extensive professional development opportunities for faculty,
18 an on-line library of academic and medical resources for
19 students, faculty, and community preceptors, and
20 technology-sharing agreements with other medical schools to
21 allow for the exchange of technology applications among
22 medical school faculty for the purpose of enhancing medical
23 education. The College of Medicine shall explore the
24 opportunities afforded by Mayo Clinic in Jacksonville through
25 clerkships, visiting professors or lectures through the
26 existing telecommunications systems, and collaboration in
27 research activities at the Mayo Clinic's Jacksonville campus.
28 (12) ADMINISTRATION; FACULTY.--Each of the major
29 community-based clinical rotation training sites described in
30 subsection (7) shall have a community dean and a student
31 affairs/administrative officer. Teaching faculty for the
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1 community-based clinical training component shall be community
2 physicians serving part-time appointments. Sixty faculty
3 members shall be recruited to serve in the basic and
4 behavioral sciences department. The College of Medicine shall
5 have a small core staff of on-campus, full-time faculty and
6 administrators at the Florida State University, including a
7 dean, a senior associate dean for educational programs, an
8 associate dean for clinical education, a chief
9 financial/administrative officer, an admissions/student
10 affairs officer, an instructional resources coordinator, a
11 coordinator for graduate and continuing medical education, and
12 several mission focus coordinators.
13 (13) COLLABORATION WITH OTHER PROFESSIONALS.--To
14 provide students with the skills, knowledge, and values needed
15 to practice medicine in the evolving national system of health
16 care delivery, the College of Medicine shall fully integrate
17 modern health care delivery concepts into its curriculum. For
18 this purpose, the College of Medicine shall develop a
19 partnership with one or more health care organizations in the
20 state and shall recruit faculty with strong health care
21 delivery competencies. Faculty from other disciplines at the
22 Florida State University shall be utilized to develop
23 team-based approaches to core competencies in the delivery of
24 health care.
25 (14) INDEMNIFICATION FROM LIABILITY.--This section
26 shall be construed to authorize the Florida State University,
27 for and on behalf of the Board of Regents, to negotiate and
28 purchase policies of insurance to indemnify from any liability
29 those individuals or entities providing sponsorship or
30 training to the students of the medical school, professionals
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1 employed by the medical school, and students of the medical
2 school.
3 Section 2. This act shall take effect upon becoming a
4 law.
5
6 *****************************************
7 HOUSE SUMMARY
8
Establishes a 4-year allopathic medical school within the
9 Florida State University. Provides legislative intent and
purpose. Provides for transition from the university's
10 Program in Medical Sciences (PIMS). Provides for
evolution of an organizational structure and for an
11 admissions process. Provides for partner organizations
for clinical instruction in a community-based medical
12 education program through affiliation agreements with
health care systems and organizations, local hospitals,
13 and military health care facilities in specified target
communities. Provides for development of a plan for
14 graduate medical education in the state, to be submitted
to the Legislature by November 30, 2001. Provides for
15 accreditation. Provides for certain curricula. Provides
for clinical rotation sites in local communities.
16 Provides for training to meet the medical needs of the
elderly. Provides for training to address the medical
17 needs of the state's rural and underserved populations.
Provides for programs and efforts to increase
18 participation of underrepresented groups and socially and
economically disadvantaged youth. Provides for
19 technology-rich learning environments and programs.
Provides for administration and faculty at the Florida
20 State University and major community-based clinical
rotation sites. Provides for collaboration with other
21 professionals for integration of modern health care
delivery concepts. Authorizes the Florida State
22 University to purchase certain liability insurance.
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