Public Health Committee

JOINT FAVORABLE REPORT

Bill No.:

SB-250

Title:

AN ACT CONCERNING CLINICAL PLACEMENTS FOR IN-STATE MEDICAL STUDENTS.

Vote Date:

3/24/2017

Vote Action:

Joint Favorable Substitute

PH Date:

2/17/2017

File No.:

SPONSORS OF BILL:

Public Health Committee

REASONS FOR BILL:

This bill requires each hospital that provides clinical clerkship programs for medical students to work in good faith with each Connecticut medical school to provide clerkships to Connecticut medical students. Starting by September 1, 2017, the bill also requires hospitals to annually report on the (1) number and nature of each clinical clerkship program at the hospital during the previous academic year and (2) name of the medical school for each student participating in a clinical clerkship during the academic year.

The reporting requirement applies to each hospital that in any academic year provides more than 50% of its clinical clerkships to students enrolled in a medical school outside of Connecticut.

RESPONSE FROM ADMINISTRATION/AGENCY:

Senator Len Fasano:

By placing a priority on the clinical placement of in-state students at in-state hospitals, SB 250 meets the concerns with the physician shortages by making in-state medical students more likely to remain in-state. With less competition from out-of-state schools, some of which do not meet the same accreditation standards as Connecticut schools, Connecticut's hospitals will be able to employ quality, Connecticut students.

NATURE AND SOURCES OF SUPPORT:

Michelle M. Kalis, Ph.D., Provost, University of Saint Joseph:

SB 250 would be helpful to fight rising competition between the programs at the University of Saint Joseph and other medical schools, especially out-of-state, and help ensure public wellbeing.

Laima Karosas, Ph.D., APRN, Chair, Graduate Nursing Program, Quinnipiac School of Nursing:

SB 250 would ease the limit on the ability of educational programs to increase the supply of medical providers. It has become more difficult to place nurse practitioner students into clinical rotations, and the bill should be expanded to include those students.

Meredith Wallace Kazer, Ph.D., APRN, FAAN, Dean, Fairfield University Marion Peckham Egan School of Nursing and Health Studies:

I urge support of SB 250 with the addition of Registered Nurses and Advanced Practice Registered Nurses. Potential RNs and APRNs are applying to Connecticut schools in record numbers and are limited by the number of quality clinical placements.

Bruce Liang, Dean, UConn School of Medicine:

SB 250 will ensure that Connecticut has a secure source of future doctors and other medical professionals who practice here. The limits on the clinical placements of students make it difficult for those students to meet their educational requirements. Out-of-state and offshore medical schools pay large amounts to gain access to the clinical placements, and UConn School of Medicine would be forced to raise tuition in order to ensure clinical placements without priority for in-state students.

Linda M. Perfetto MS, RN, CNE, CNOR, FAADN, CT-CCNP, CSCU:

I support SB 250 and request that Registered Nurse undergraduate, graduate, and doctor programs (including Advanced Practice Registered Nurse, Certified Registered Nurse Anesthesist, and Doctor of Nursing Practice) be added. The Connecticut Community College Nursing Program provides greater than 30% of Connecticut's new nurses per year, and without full access to clinical learning opportunities, Connecticut healthcare education will be compromised.

E. Carol Polifroni, Dean, UConn School of Nursing:

SB 250 should address nursing as well as medicine as it is vital to the health of Connecticut's residents that sufficient numbers of doctors and nurses are educated in-state. With four schools of medicine and nineteen schools of nursing, competition in-state is high, and students need to meet in-demand clinical requirements to be credentialed.

Jason P. Prevelige, MHS, PA-C, Connecticut Academy of Physician Assistants:

I would like to offer support for SB 250 if the bill is revised to include physician assistant students. Clinical placements that Connecticut physician assistant students were receiving are increasingly being filled by out-of-state students, with a report by one program stating that they had lost approximately twenty per cent of their clinical placements to out of state programs.

Marcia B. Proto, M.Ed, CAS, Executive Director, Connecticut League of Nursing:

I support SB 250 and request that Registered Nurse undergraduate, graduate, and doctor programs (including Advanced Practice Registered Nurse, Certified Registered Nurse Anesthesist, and Doctor of Nursing Practice) be added to the bill. Nurses are the largest profession in Connecticut's healthcare workforce and there are thousands of students enrolled in nursing programs.

Lynn Rapsilber, DNP APRN, ANP-BC FAANP, Chair, Coalition of Advanced Practice Nurses:

SB 250 should be expanded to include advanced practice registered nurse and registered nursing programs. Clinical placements are growing harder to achieve due to growing competition, and SB 250 makes it more likely that those programs can generate a greater pool of health care providers in Connecticut.

Mark Thompson, Executive Vice President and Provost, Quinnipiac University:

The Netter School in North Haven, Connecticut is only able to fill seventy-two per cent of its seats because of the clinical placement opportunities available, and is not able to help ease the shortage of health care professionals in Connecticut. Clinical placement spots are taken by students from offshore, for-profit medical schools which pay a premium for the placements, despite the schools not necessarily meeting the same quality standards and eligibility requirements of medical schools like Quinnipiac, Yale, and UConn.

Janice Watts, Chair, Department of Nursing, Goodwin College:

I support SB 250 and believe that it must be amended to include nursing education due to the existing competition for clinical placements for nursing students of all levels.

NATURE AND SOURCES OF OPPOSITION:

Yale University:

Yale University devotes considerable time in securing an adequate number of high-quality clinical placements. Through that experience, the quality of the relationship between the school and its partners in clinical teaching is paramount. State policy should enable schools to recruit the most talented students and to offer the highest quality education. Yale University is concerns that this legislation may not be the best means of achieving that aim.

Heidi Chumley, Dean, American University of the Caribbean School of Medicine:

Medical schools like the American University of the Caribbean exist to help ease the physician shortage. The payment by schools like the American University of the Caribbean is to ensure that the taxpayers don't hold any burden for the training of its students. By creating preferences for in-state students rather than increasing the clinical capacity for clinical placements, the possibility of having a diverse workforce diminishes.

Neal Simon, President, American University of Antigua:

SB 250 will increase the physician shortage because the number of quality medical professionals trained in the state will diminished. The American University of Antigua is accredited by a review board named by the United States as comparable to those of the LCME. According to the AAMC, eighty-one per cent of students who attend Connecticut medical schools leave the state to practice elsewhere, and the Connecticut residents who attend international schools and train in Connecticut more often return home.

Connecticut Hospital Association:

Any solution to the challenges faced by medical students in ensuring clinical placements should ensure that Connecticut can still attract and retain the best and brightest medical students regardless of where they go to medical school. CHA is concerns that legislation may not be the best way to accomplish that goal.

Reported by: Alexander Schick

Date: 4/6/2017