House Bill 1121e2
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HB 1121, Second Engrossed
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; specifying that
30 the act be implemented as funded; providing an
31 effective date.
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HB 1121, Second Engrossed
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2 WHEREAS, the United States Department of Health and
3 Human Services has identified 67 regions in Florida, including
4 13 entire counties, most of them in rural North Florida, as
5 Health Professional Shortage Areas; and 40 percent of the
6 state's 67 counties have fewer than 100 doctors per 100,000
7 population, compared to the national average of 221 doctors
8 per 100,000 population, and
9 WHEREAS, in Florida, more than 3.2 million residents
10 are over the age of 60, more than 80 percent of patients who
11 visit a primary care physician are elder persons, and between
12 60 percent and 70 percent of persons seeking medical care are
13 age 60 and over; and Florida's continuing population growth,
14 especially among its older residents, is contributing to an
15 increasing shortage of physicians in the state, and
16 WHEREAS, Florida has large areas of medically
17 underserved minority populations, and
18 WHEREAS, there are hundreds of highly qualified
19 university students in Florida who seek, but cannot gain,
20 admission to medical school, and
21 WHEREAS, Florida currently imports a substantial number
22 of its doctors from other states or countries, and ranks third
23 highest, nationally, in the percentage of its total allopathic
24 physician workforce who are international medical graduates,
25 and
26 WHEREAS, Florida's existing medical education system
27 has an extremely limited capacity to serve the state's rapidly
28 growing population, which leaves the state vulnerable to
29 physician shortages at the national level, while at the same
30 time limiting opportunities for Florida's best students to
31 enter the medical field and serve their communities, and
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HB 1121, Second Engrossed
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, Second Engrossed
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, Second Engrossed
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, Second Engrossed
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, Second Engrossed
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) Lee Memorial Health System, Inc. in Fort Myers.
6 (i) Rural hospitals in the state.
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8 The College of Medicine shall also explore all alternatives
9 for cooperation with established graduate medical education
10 programs in the state to develop a plan to retain its
11 graduates in residency programs in Florida. To this end, the
12 Florida State University is directed to submit to the
13 Legislature, no later than November 30, 2001, a plan to
14 increase opportunities for Florida medical school graduates to
15 enter graduate medical education programs, including
16 residencies, in the state.
17 (6) ACCREDITATION.--The College of Medicine shall
18 develop a program which conforms to the accreditation
19 standards of the Liaison Committee on Medical Education
20 (LCME).
21 (7) CURRICULA; CLINICAL ROTATION TRAINING SITES.--
22 (a) The pre-clinical curriculum shall draw on the
23 Florida State University's Program in Medical Sciences (PIMS)
24 experience and national trends in basic and behavioral
25 sciences instruction, including use of technology for
26 distributed and distance learning. First-year instruction
27 shall include a lecture mode and problem-based learning. In
28 the second year, a small-group, problem-based learning
29 approach shall provide more advanced treatment of each
30 academic subject in a patient-centered context. Various
31 short-term clinical exposures shall be programmed throughout
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HB 1121, Second Engrossed
1 the pre-clinical years, including rural, geriatric, and
2 minority health, and contemporary practice patterns in these
3 areas.
4 (b) During the third and fourth years, the curriculum
5 shall follow a distributed, community-based model with a
6 special focus on rural health. Subgroups of students shall be
7 assigned to clinical rotation training sites in local
8 communities in roughly equal numbers, as follows:
9 1. Group 1 - Tallahassee.
10 2. Group 2 - Pensacola.
11 3. Group 3 - Orlando.
12 4. Group 4 - Sarasota.
13 5. Group 5 - Jacksonville.
14 6. Group 6 - To be determined prior to 2005, based on
15 emerging state needs.
16 7. Group 7 - Rural Physician Associate Program (RPAP).
17 (8) MEDICAL NEEDS OF THE ELDERLY.--The College of
18 Medicine shall develop a comprehensive program to ensure
19 training in the medical needs of the elderly and incorporate
20 principles embodied in the curriculum guidelines of the
21 American Geriatric Society. The College of Medicine shall
22 have as one of its primary missions the improvement of medical
23 education for physicians who will treat elder citizens. To
24 accomplish this mission, the College of Medicine shall
25 establish an academic leadership position in geriatrics,
26 create an external elder care advisory committee, and
27 implement an extensive faculty development plan. For student
28 recruitment purposes, the current Program in Medical Sciences
29 (PIMS) selection criteria shall be expanded to include
30 consideration of students who have expressed an interest in
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HB 1121, Second Engrossed
1 elder care and who have demonstrated, through life choices, a
2 commitment to serve older persons.
3 (9) MEDICAL NEEDS OF UNDERSERVED AREAS.--To address
4 the medical needs of the state's rural and underserved
5 populations, the College of Medicine shall develop a
6 Department of Family Medicine with a significant rural
7 training track that provides students with early and frequent
8 clinical experiences in community-based settings to train and
9 produce highly skilled primary care physicians. The College
10 of Medicine shall consider developing new, rural-based family
11 practice clinical training programs and shall establish a
12 partnership with the West Florida Area Health Education Center
13 to assist in developing partnerships and programs to provide
14 incentives and support for physicians to practice in primary
15 care, geriatric, and rural medicine in underserved areas of
16 the state.
17 (10) INCREASING PARTICIPATION OF UNDERREPRESENTED
18 GROUPS.--To increase the participation of underrepresented
19 groups and socially and economically disadvantaged youth in
20 science and medical programs, the College of Medicine shall
21 continue the outreach efforts of the Program in Medical
22 Sciences (PIMS) to middle and high school minority students,
23 including the Science Students Together Reaching Instructional
24 Diversity and Excellence (SSTRIDE), and shall build an
25 endowment income to support recruitment programs and
26 scholarship and financial aid packages for these students. To
27 develop a base of qualified potential medical school
28 candidates from underrepresented groups, the College of
29 Medicine shall coordinate with the undergraduate premedical
30 and science programs currently offered at the Florida State
31 University, develop relationships with potential feeder
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HB 1121, Second Engrossed
1 institutions, including 4-year institutions and community
2 colleges, and pursue grant funds to support programs, as well
3 as support scholarship and financial aid packages. The College
4 of Medicine shall develop plans for a postbaccalaureate,
5 1-year academic program that provides a second chance to a
6 limited number of students per year who have been declined
7 medical school admission, who are state residents, and who
8 meet established criteria as socially and economically
9 disadvantaged. The College of Medicine shall make every
10 effort, through recruitment and retention, to employ a faculty
11 and support staff that reflect the heterogeneous nature of the
12 state's general population.
13 (11) TECHNOLOGY.--To create technology-rich learning
14 environments, the College of Medicine shall build on the
15 considerable infrastructure that already supports the many
16 technology resources of the Florida State University and shall
17 expand the infrastructure to conduct an effective medical
18 education program, including connectivity between the main
19 campus, community-based training locations, and rural clinic
20 locations. Additional technology programs shall include
21 extensive professional development opportunities for faculty,
22 an on-line library of academic and medical resources for
23 students, faculty, and community preceptors, and
24 technology-sharing agreements with other medical schools to
25 allow for the exchange of technology applications among
26 medical school faculty for the purpose of enhancing medical
27 education. The College of Medicine shall explore the
28 opportunities afforded by Mayo Clinic in Jacksonville through
29 clerkships, visiting professors or lectures through the
30 existing telecommunications systems, and collaboration in
31 research activities at the Mayo Clinic's Jacksonville campus.
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HB 1121, Second Engrossed
1 (12) ADMINISTRATION; FACULTY.--Each of the major
2 community-based clinical rotation training sites described in
3 subsection (7) shall have a community dean and a student
4 affairs/administrative officer. Teaching faculty for the
5 community-based clinical training component shall be community
6 physicians serving part-time appointments. Sixty faculty
7 members shall be recruited to serve in the basic and
8 behavioral sciences department. The College of Medicine shall
9 have a small core staff of on-campus, full-time faculty and
10 administrators at the Florida State University, including a
11 dean, a senior associate dean for educational programs, an
12 associate dean for clinical education, a chief
13 financial/administrative officer, an admissions/student
14 affairs officer, an instructional resources coordinator, a
15 coordinator for graduate and continuing medical education, and
16 several mission focus coordinators.
17 (13) COLLABORATION WITH OTHER PROFESSIONALS.--To
18 provide students with the skills, knowledge, and values needed
19 to practice medicine in the evolving national system of health
20 care delivery, the College of Medicine shall fully integrate
21 modern health care delivery concepts into its curriculum. For
22 this purpose, the College of Medicine shall develop a
23 partnership with one or more health care organizations in the
24 state and shall recruit faculty with strong health care
25 delivery competencies. Faculty from other disciplines at the
26 Florida State University shall be utilized to develop
27 team-based approaches to core competencies in the delivery of
28 health care.
29 (14) INDEMNIFICATION FROM LIABILITY.--This section
30 shall be construed to authorize the Florida State University,
31 for and on behalf of the Board of Regents, to negotiate and
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HB 1121, Second Engrossed
1 purchase policies of insurance to indemnify from any liability
2 those individuals or entities providing sponsorship or
3 training to the students of the medical school, professionals
4 employed by the medical school, and students of the medical
5 school.
6 Section 2. This act shall be implemented as provided
7 in the General Appropriations Act.
8 Section 3. This act shall take effect upon becoming a
9 law.
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