House Bill 1121e1
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HB 1121, First Engrossed/ntc
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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HB 1121, First Engrossed/ntc
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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HB 1121, First Engrossed/ntc
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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HB 1121, First Engrossed/ntc
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,
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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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HB 1121, First Engrossed/ntc
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 and
4 behavioral sciences training utilizing medical problem-based
5 teaching; and clinical training at several dispersed sites
6 throughout the state in existing community hospitals, clinics,
7 and doctors' offices. The Legislature further intends that
8 study of the aging human be a continuing focus throughout the
9 4-year curriculum and that use of information technology be a
10 key 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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HB 1121, First Engrossed/ntc
1 program development is underway and a sufficient number of
2 basic and behavioral sciences and clinical faculty are
3 recruited, the Institute of Human Medical Sciences shall
4 evolve into the Florida State University College of Medicine,
5 with appropriate departments. The current admissions procedure
6 utilized by the Program in Medical Sciences (PIMS) shall
7 provide the basis for the design of an admissions process for
8 the College of Medicine, with selection criteria that focus on
9 identifying future primary care physicians who have
10 demonstrated interest in serving underserved areas. Enrollment
11 levels at the College of Medicine are planned to not exceed
12 120 students per class, and shall be phased in from 30
13 students in the Program in Medical Sciences (PIMS), to 40
14 students admitted to the College of Medicine as the charter
15 class in Fall 2001, and 20 additional students admitted to the
16 College of Medicine in each class thereafter until the maximum
17 class size is reached.
18 (5) PARTNER ORGANIZATIONS FOR CLINICAL INSTRUCTION;
19 GRADUATE PROGRAMS.--To provide broad-based clinical
20 instruction in both rural and urban settings for students in
21 the community-based medical education program, the College of
22 Medicine, through creation of nonprofit corporations, shall
23 seek affiliation agreements with health care systems and
24 organizations, local hospitals, medical schools, and military
25 health care facilities in the following targeted communities:
26 Pensacola, Tallahassee, Orlando, Sarasota, Jacksonville, and
27 the rural areas of the state. Selected hospitals in the target
28 communities include, but are not limited to, the following:
29 (a) Baptist Health Care in Pensacola.
30 (b) Sacred Heart Health System in Pensacola.
31 (c) West Florida Regional Medical Center in Pensacola.
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HB 1121, First Engrossed/ntc
1 (d) Tallahassee Memorial Healthcare in Tallahassee.
2 (e) Florida Hospital Health System in Orlando.
3 (f) Sarasota Memorial Health Care System in Sarasota.
4 (g) Mayo Clinic in Jacksonville.
5 (h) Rural hospitals in the state.
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7 The College of Medicine shall also explore all alternatives
8 for cooperation with established graduate medical education
9 programs in the state to develop a plan to retain its
10 graduates in residency programs in Florida. To this end, the
11 Florida State University is directed to submit to the
12 Legislature, no later than November 30, 2001, a plan to
13 increase opportunities for Florida medical school graduates to
14 enter graduate medical education programs, including
15 residencies, in the state.
16 (6) ACCREDITATION.--The College of Medicine shall
17 develop a program which conforms to the accreditation
18 standards of the Liaison Committee on Medical Education
19 (LCME).
20 (7) CURRICULA; CLINICAL ROTATION TRAINING SITES.--
21 (a) The pre-clinical curriculum shall draw on the
22 Florida State University's Program in Medical Sciences (PIMS)
23 experience and national trends in basic and behavioral
24 sciences instruction, including use of technology for
25 distributed and distance learning. First-year instruction
26 shall include a lecture mode and problem-based learning. In
27 the second year, a small-group, problem-based learning
28 approach shall provide more advanced treatment of each
29 academic subject in a patient-centered context. Various
30 short-term clinical exposures shall be programmed throughout
31 the pre-clinical years, including rural, geriatric, and
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HB 1121, First Engrossed/ntc
1 minority health, and contemporary practice patterns in these
2 areas.
3 (b) During the third and fourth years, the curriculum
4 shall follow a distributed, community-based model with a
5 special focus on rural health. Subgroups of students shall be
6 assigned to clinical rotation training sites in local
7 communities in roughly equal numbers, as follows:
8 1. Group 1 - Tallahassee.
9 2. Group 2 - Pensacola.
10 3. Group 3 - Orlando.
11 4. Group 4 - Sarasota.
12 5. Group 5 - Jacksonville.
13 6. Group 6 - To be determined prior to 2005, based on
14 emerging state needs.
15 7. Group 7 - Rural Physician Associate Program (RPAP).
16 (8) MEDICAL NEEDS OF THE ELDERLY.--The College of
17 Medicine shall develop a comprehensive program to ensure
18 training in the medical needs of the elderly and incorporate
19 principles embodied in the curriculum guidelines of the
20 American Geriatric Society. The College of Medicine shall
21 have as one of its primary missions the improvement of medical
22 education for physicians who will treat elder citizens. To
23 accomplish this mission, the College of Medicine shall
24 establish an academic leadership position in geriatrics,
25 create an external elder care advisory committee, and
26 implement an extensive faculty development plan. For student
27 recruitment purposes, the current Program in Medical Sciences
28 (PIMS) selection criteria shall be expanded to include
29 consideration of students who have expressed an interest in
30 elder care and who have demonstrated, through life choices, a
31 commitment to serve older persons.
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1 (9) MEDICAL NEEDS OF UNDERSERVED AREAS.--To address
2 the medical needs of the state's rural and underserved
3 populations, the College of Medicine shall develop a
4 Department of Family Medicine with a significant rural
5 training track that provides students with early and frequent
6 clinical experiences in community-based settings to train and
7 produce highly skilled primary care physicians. The College
8 of Medicine shall consider developing new, rural-based family
9 practice clinical training programs and shall establish a
10 partnership with the West Florida Area Health Education Center
11 to assist in developing partnerships and programs to provide
12 incentives and support for physicians to practice in primary
13 care, geriatric, and rural medicine in underserved areas of
14 the state.
15 (10) INCREASING PARTICIPATION OF UNDERREPRESENTED
16 GROUPS.--To increase the participation of underrepresented
17 groups and socially and economically disadvantaged youth in
18 science and medical programs, the College of Medicine shall
19 continue the outreach efforts of the Program in Medical
20 Sciences (PIMS) to middle and high school minority students,
21 including the Science Students Together Reaching Instructional
22 Diversity and Excellence (SSTRIDE), and shall build an
23 endowment income to support recruitment programs and
24 scholarship and financial aid packages for these students. To
25 develop a base of qualified potential medical school
26 candidates from underrepresented groups, the College of
27 Medicine shall coordinate with the undergraduate premedical
28 and science programs currently offered at the Florida State
29 University, develop relationships with potential feeder
30 institutions, including 4-year institutions and community
31 colleges, and pursue grant funds to support programs, as well
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HB 1121, First Engrossed/ntc
1 as support scholarship and financial aid packages. The College
2 of Medicine shall develop plans for a postbaccalaureate,
3 1-year academic program that provides a second chance to a
4 limited number of students per year who have been declined
5 medical school admission, who are state residents, and who
6 meet established criteria as socially and economically
7 disadvantaged. The College of Medicine shall make every
8 effort, through recruitment and retention, to employ a faculty
9 and support staff that reflect the heterogeneous nature of the
10 state's general population.
11 (11) TECHNOLOGY.--To create technology-rich learning
12 environments, the College of Medicine shall build on the
13 considerable infrastructure that already supports the many
14 technology resources of the Florida State University and shall
15 expand the infrastructure to conduct an effective medical
16 education program, including connectivity between the main
17 campus, community-based training locations, and rural clinic
18 locations. Additional technology programs shall include
19 extensive professional development opportunities for faculty,
20 an on-line library of academic and medical resources for
21 students, faculty, and community preceptors, and
22 technology-sharing agreements with other medical schools to
23 allow for the exchange of technology applications among
24 medical school faculty for the purpose of enhancing medical
25 education. The College of Medicine shall explore the
26 opportunities afforded by Mayo Clinic in Jacksonville through
27 clerkships, visiting professors or lectures through the
28 existing telecommunications systems, and collaboration in
29 research activities at the Mayo Clinic's Jacksonville campus.
30 (12) ADMINISTRATION; FACULTY.--Each of the major
31 community-based clinical rotation training sites described in
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HB 1121, First Engrossed/ntc
1 subsection (7) shall have a community dean and a student
2 affairs/administrative officer. Teaching faculty for the
3 community-based clinical training component shall be community
4 physicians serving part-time appointments. Sixty faculty
5 members shall be recruited to serve in the basic and
6 behavioral sciences department. The College of Medicine shall
7 have a small core staff of on-campus, full-time faculty and
8 administrators at the Florida State University, including a
9 dean, a senior associate dean for educational programs, an
10 associate dean for clinical education, a chief
11 financial/administrative officer, an admissions/student
12 affairs officer, an instructional resources coordinator, a
13 coordinator for graduate and continuing medical education, and
14 several mission focus coordinators.
15 (13) COLLABORATION WITH OTHER PROFESSIONALS.--To
16 provide students with the skills, knowledge, and values needed
17 to practice medicine in the evolving national system of health
18 care delivery, the College of Medicine shall fully integrate
19 modern health care delivery concepts into its curriculum. For
20 this purpose, the College of Medicine shall develop a
21 partnership with one or more health care organizations in the
22 state and shall recruit faculty with strong health care
23 delivery competencies. Faculty from other disciplines at the
24 Florida State University shall be utilized to develop
25 team-based approaches to core competencies in the delivery of
26 health care.
27 (14) INDEMNIFICATION FROM LIABILITY.--This section
28 shall be construed to authorize the Florida State University,
29 for and on behalf of the Board of Regents, to negotiate and
30 purchase policies of insurance to indemnify from any liability
31 those individuals or entities providing sponsorship or
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HB 1121, First Engrossed/ntc
1 training to the students of the medical school, professionals
2 employed by the medical school, and students of the medical
3 school.
4 Section 2. This act shall take effect upon becoming a
5 law.
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