The California Academy of Family Physicians (CAFP), CaliforniaHealth+ Advocates and the California Medical Association (CMA), along with other statewide healthcare organizations, are cheering the historic support the Legislature and Governor have shown for their comprehensive budget proposal that will not only backfill the tens of millions of dollars in cuts facing primary care residency programs but also begin to address California’s primary care physician shortage in some of our most underserved areas. 

“We cannot thank legislative leaders enough for the action they’ve taken today,” said CAFP President Lee Ralph, M.D. “Their support of our proposal will ensure that California doesn’t fall off the primary care cliff. We’ve all worked hard to expand insurance coverage and we can now start building the primary care workforce needed to provide important preventive patient-centered care to the newly- and currently insured.”

The $100 million appropriation in the 2016-17 State Budget will support and expand primary care residency training and programs in medically underserved areas through the Song-Brown Workforce Training Program and targeted investment in Teaching Health Centers. The Legislature’s budget proposal, which was approved and sent to the Governor today, will be appropriated over six years to create a reliable and continuous funding stream that primary care residency programs in California so desperately need.  

Without this appropriation, California primary care training programs would face nearly $60 million in cuts as significant federal and private foundation grants have recently expired or are set to expire this year, including $18 million in federal Health Resources and Services Administration funding for the Primary Care Residency Expansion program, a $21 million California Endowment grant to the Song-Brown Program, and a one-time $4 million California Health Data and Planning Fund appropriation to Song-Brown. In addition, the federal Teaching Health Center program, which has already distributed more than $15 million to California primary care training programs, has cut grants by 40 percent and is set to expire in 2017.

Even if these cuts were replaced dollar for dollar, California would struggle to provide sufficient access to primary care. Only 36 percent of California’s active patient care physicians practice primary care, and, according to the Council on Graduate Medical Education (COGME), 23 of California’s 58 counties fall below the minimum required primary care physician-to-population ratio. That is why this new appropriation is so timely.

“The primary care workforce shortage has reached epic proportions in many areas of the state and a significant investment is necessary to ensure we don’t fall further behind, negatively impacting our ability to provide needed care to millions of Californians,” said Carmela Castellano-Garcia, President and CEO of CaliforniaHealth+ Advocates. “We applaud the Legislature for their commitment to our state’s primary care workforce with the inclusion of this ongoing investment. This will not completely address our state’s healthcare workforce shortage, but it is a significant step in the right direction.”

The Horizon 2030 report released earlier this year provided a sobering analysis of the state’s primary care workforce needs while detailing key opportunities to meet the needs of tomorrow. With six of nine California regions experiencing a primary care provider shortage, and a ratio of primary care physicians in Medicaid that is half the federal recommendation, California ranks 32nd in physician access. The report estimates that California will need 8,243 additional primary care physicians by 2030 and provides a stark reminder that the primary care workforce shortage has reached a critical point and will continue to devolve if California doesn’t take immediate action.

“A robust, well-trained primary care workforce is essential to meeting the health care demands of all Californians,” said CMA President Steven Larson, M.D., MPH. “The Legislature’s move to restore and stabilize funding for these programs is an important first step toward reversing the state’s shortage of primary care physicians, particularly in the underserved communities that need it the most.”

CAFP, CaliforniaHealth+ Advocates and CMA look forward to working with the Legislature and Governor Brown’s administration to implement this critically important workforce investment.