Family medicine residency

AN ACT Relating to establishing the family medicine residency 1
training grant program; amending RCW 82.26.020; reenacting and 2
amending RCW 43.79A.040 and 43.79A.040; adding a new chapter to Title 3
70 RCW; creating a new section; providing an effective date; and 4
providing an expiration date. 5
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:6
NEW SECTION. Sec. 1. (1) The legislature finds that due to a 7
shortage of primary care physicians, many rural and economically 8
disadvantaged urban communities are medically underserved.9
(2) The legislature further finds that the Washington state 10
department of health has established individuals living in rural 11
areas of Washington state are more likely to suffer from preventable 12
conditions and engage in activities that threaten health, such as 13
smoking cigarettes, and according to the United States centers for 14
disease control and prevention, communities of color, who live in 15
greater numbers in underserved urban areas, experience higher rates 16
of obesity, cancer, diabetes, and AIDS. 17
(3) The legislature finds community health centers provide 18
valuable primary and preventive health care services for people 19
living in rural and urban medically underserved communities, and such 20
service is provided regardless of a patient's ability to pay.21
S-6040.1
SENATE BILL 6360
State of Washington 69th Legislature 2026 Regular Session
By Senator Hasegawa
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(4) The legislature further finds prevention education and access 1
to consistent primary health care can reduce health care costs in the 2
long term and improve general productivity. 3
(5) Consequently, it is to the benefit of not only underserved 4
communities but the state as a whole to invest in measures that 5
reduce primary care shortages and increase access to health care and 6
preventative medicine. 7
NEW SECTION. Sec. 2. Within funds appropriated to the 8
department of health for this purpose, and with the goal of 9
increasing the number of family medicine residency positions at 10
community health centers, and thereby increasing the number of family 11
medicine physicians working in underserved settings, a family 12
medicine residency training grant program is created. Grant funds 13
provided for the purpose of increasing the number of family medicine 14
residency positions at community health centers must be disbursed by 15
the department of health to at least three accredited, three-year 16
family medicine residency programs sponsored or sited at community 17
health centers in rural or urban medically underserved areas. In the 18
first year, and each subsequent year thereafter, family medicine 19
residency programs to which the grant funds are awarded shall offer 20
at least two first-year postgraduate residency positions in family 21
medicine. In the second year, and each subsequent year thereafter, 22
these family medicine residency programs shall also offer at least 23
two second-year postgraduate residency positions in family medicine. 24
In the third year, and each subsequent year thereafter, these family 25
medicine residency programs shall also offer at least two third-year 26
postgraduate residency positions in family medicine.27
NEW SECTION. Sec. 3. The joint legislative audit and review 28
committee shall conduct a performance audit and evaluation of the 29
family medicine residency training grant program created in section 2 30
of this act every five years. The first audit must be conducted by 31
December 31, 2033. The audit must include a comparison of family 32
medicine physicians who did their postgraduate family medicine 33
residency training at community health centers with those who did 34
their postgraduate family medicine residency training in other 35
programs to determine whether the location of the family medicine 36
residency training influenced or affected where the resident 37
ultimately chose to work.38
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NEW SECTION. Sec. 4. (1) The family medicine residency training 1
account is created in the custody of the state treasurer. No 2
appropriation is required for expenditures of funds from the account. 3
The account is not subject to allotment procedures under chapter 4
43.88 RCW except for moneys used for program administration.5
(2) The department of health shall deposit into the account all 6
moneys received from private contributions for the program. The 7
account must be self-sustaining and consist of private contributions 8
for the family medicine residency training grant program.9
(3) Expenditures from the account may be used solely for grants 10
to family medicine residency programs sponsored or sited in community 11
health centers in rural or urban medically underserved areas and 12
costs associated with program administration by the department of 13
health. 14
(4) Disbursements from the account may be made only on the 15
authorization of the department of health. 16
Sec. 5. RCW 82.26.020 and 2019 c 445 s 404 are each amended to 17
read as follows: 18
(1) There is levied and collected a tax upon the sale, handling, 19
or distribution of all tobacco products in this state at the 20
following rate: 21
(a) For cigars except little cigars, ninety-five percent of the 22
taxable sales price of cigars, not to exceed sixty-five cents per 23
cigar; 24
(b) For all tobacco products except those covered under separate 25
provisions of this subsection, ninety-five percent of the taxable 26
sales price. The tax imposed on a product under this subsection must 27
be reduced by fifty percent if that same product is issued a modified 28
risk tobacco product order by the secretary of the United States 29
department of health and human services pursuant to Title 21 U.S.C. 30
Sec. 387k (g)(1), or by twenty-five percent if that same product is 31
issued a modified risk tobacco product order by the secretary of the 32
United States department of health and human services pursuant to 33
Title 21 U.S.C. Sec. 387k (g)(2). The tax reduction applies during the 34
period the modified risk tobacco product order is in effect;35
(c) For moist snuff, as established in this subsection (1)(c) and 36
computed on the net weight listed by the manufacturer:37
(i) On each single unit consumer-sized can or package whose net 38
weight is one and two-tenths ounces or less, a rate per single unit 39
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that is equal to the greater of 2.526 dollars or eighty-three and 1
one-half percent of the cigarette tax under chapter 82.24 RCW 2
multiplied by twenty; or 3
(ii) On each single unit consumer-sized can or package whose net 4
weight is more than one and two-tenths ounces, a proportionate tax at 5
the rate established in (c)(i) of this subsection (1) on each ounce 6
or fractional part of an ounce; and 7
(d) For little cigars, an amount per cigar equal to the cigarette 8
tax under chapter 82.24 RCW. 9
(2) Taxes under this section must be imposed at the time the 10
distributor (a) brings, or causes to be brought, into this state from 11
without the state tobacco products for sale, (b) makes, manufactures, 12
fabricates, or stores tobacco products in this state for sale in this 13
state, (c) ships or transports tobacco products to retailers in this 14
state, to be sold by those retailers, or (d) handles for sale any 15
tobacco products that are within this state but upon which tax has 16
not been imposed. 17
(3)(a) The first $7,000,000 collected annually under this section 18
must be deposited into the family medicine residency training account 19
created in section 4 of this act.20
(b) The remaining moneys collected under this section must be 21
deposited into the state general fund. 22
Sec. 6. RCW 43.79A.040 and 2025 c 399 s 13 and 2025 c 190 s 3 23
are each reenacted and amended to read as follows:24
(1) Money in the treasurer's trust fund may be deposited, 25
invested, and reinvested by the state treasurer in accordance with 26
RCW 43.84.080 in the same manner and to the same extent as if the 27
money were in the state treasury, and may be commingled with moneys 28
in the state treasury for cash management and cash balance purposes.29
(2) All income received from investment of the treasurer's trust 30
fund must be set aside in an account in the treasury trust fund to be 31
known as the investment income account. 32
(3) The investment income account may be utilized for the payment 33
of purchased banking services on behalf of treasurer's trust funds 34
including, but not limited to, depository, safekeeping, and 35
disbursement functions for the state treasurer or affected state 36
agencies. The investment income account is subject in all respects to 37
chapter 43.88 RCW, but no appropriation is required for payments to 38
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financial institutions. Payments must occur prior to distribution of 1
earnings set forth in subsection (4) of this section.2
(4)(a) Monthly, the state treasurer must distribute the earnings 3
credited to the investment income account to the state general fund 4
except under (b), (c), and (d) of this subsection. 5
(b) The following accounts and funds must receive their 6
proportionate share of earnings based upon each account's or fund's 7
average daily balance for the period: The 24/7 sobriety account, the 8
Washington promise scholarship account, the Gina Grant Bull memorial 9
legislative page scholarship account, the Rosa Franklin legislative 10
internship program scholarship account, the Washington advanced 11
college tuition payment program account, the Washington college 12
savings program account, the accessible communities account, the 13
Washington achieving a better life experience program account, the 14
Washington career and college pathways innovation challenge program 15
account, the community and technical college innovation account, the 16
agricultural local fund, the American Indian scholarship endowment 17
fund, the behavioral health loan repayment and scholarship program 18
account, the Billy Frank Jr. national statuary hall collection fund, 19
the foster care scholarship endowment fund, the foster care endowed 20
scholarship trust fund, the contract harvesting revolving account, 21
the Washington state combined fund drive account, the county 911 22
excise tax account, the county road administration board emergency 23
loan account, the toll collection account, the developmental 24
disabilities endowment trust fund, the energy account, the energy 25
facility site evaluation council account, the fair fund, the family 26
and medical leave insurance account, the family medicine residency 27
training account, the Fern Lodge maintenance account, the fish and 28
wildlife federal lands revolving account, the natural resources 29
federal lands revolving account, the food animal veterinarian 30
conditional scholarship account, the forest health revolving account, 31
the fruit and vegetable inspection account, the educator conditional 32
scholarship account, the game farm alternative account, the GET ready 33
for math and science scholarship account, the Washington global 34
health technologies and product development account, the grain 35
inspection revolving fund, the Washington history day account, the 36
industrial insurance rainy day fund, the law enforcement officers' 37
and firefighters' plan 2 expense fund, the local tourism promotion 38
account, the low-income home rehabilitation account, the medication 39
for people living with HIV rebate revenue account, the homeowner 40
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recovery account, the multiagency permitting team account, the 1
northeast Washington wolf-livestock management account, the pollution 2
liability insurance program trust account, the public use general 3
aviation airport loan revolving account, the regional transportation 4
investment district account, the rural rehabilitation account, the 5
Washington sexual assault kit account, the stadium and exhibition 6
center account, the youth athletic facility account, the self-7
insurance revolving fund, the children's trust fund, the Washington 8
horse racing commission Washington bred owners' bonus fund and 9
breeder awards account, the Washington horse racing commission class 10
C purse fund account, the individual development account program 11
account, the Washington horse racing commission operating account, 12
the life sciences discovery fund, the Washington state library-13
archives building account, the reduced cigarette ignition propensity 14
account, the center for deaf and hard of hearing youth account, the 15
school for the blind account, the public employees' and retirees' 16
insurance reserve fund, the school employees' benefits board 17
insurance reserve fund, the public employees' and retirees' insurance 18
account, the school employees' insurance account, the long-term 19
services and supports trust account, the radiation perpetual 20
maintenance fund, the Indian health improvement reinvestment account, 21
the department of licensing tuition recovery trust fund, the student 22
achievement council tuition recovery trust fund, the tuition recovery 23
trust fund, the industrial insurance premium refund account, the 24
mobile home park relocation fund, the natural resources deposit fund, 25
the Washington state health insurance pool account, the federal 26
forest revolving account, the Washington saves administrative trust 27
account, and the library operations account. 28
(c) The following accounts and funds must receive 80 percent of 29
their proportionate share of earnings based upon each account's or 30
fund's average daily balance for the period: The advance right-of-way 31
revolving fund, the advanced environmental mitigation revolving 32
account, the federal narcotics asset forfeitures account, the high 33
occupancy vehicle account, the local rail service assistance account, 34
and the miscellaneous transportation programs account.35
(d) Any state agency that has independent authority over accounts 36
or funds not statutorily required to be held in the custody of the 37
state treasurer that deposits funds into a fund or account in the 38
custody of the state treasurer pursuant to an agreement with the 39
office of the state treasurer shall receive its proportionate share 40
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of earnings based upon each account's or fund's average daily balance 1
for the period. 2
(5) In conformance with Article II, section 37 of the state 3
Constitution, no trust accounts or funds shall be allocated earnings 4
without the specific affirmative directive of this section.5
Sec. 7. RCW 43.79A.040 and 2025 c 399 s 14 and 2025 c 190 s 4 6
are each reenacted and amended to read as follows: 7
(1) Money in the treasurer's trust fund may be deposited, 8
invested, and reinvested by the state treasurer in accordance with 9
RCW 43.84.080 in the same manner and to the same extent as if the 10
money were in the state treasury, and may be commingled with moneys 11
in the state treasury for cash management and cash balance purposes.12
(2) All income received from investment of the treasurer's trust 13
fund must be set aside in an account in the treasury trust fund to be 14
known as the investment income account. 15
(3) The investment income account may be utilized for the payment 16
of purchased banking services on behalf of treasurer's trust funds 17
including, but not limited to, depository, safekeeping, and 18
disbursement functions for the state treasurer or affected state 19
agencies. The investment income account is subject in all respects to 20
chapter 43.88 RCW, but no appropriation is required for payments to 21
financial institutions. Payments must occur prior to distribution of 22
earnings set forth in subsection (4) of this section.23
(4)(a) Monthly, the state treasurer must distribute the earnings 24
credited to the investment income account to the state general fund 25
except under (b), (c), and (d) of this subsection.26
(b) The following accounts and funds must receive their 27
proportionate share of earnings based upon each account's or fund's 28
average daily balance for the period: The 24/7 sobriety account, the 29
Washington promise scholarship account, the Gina Grant Bull memorial 30
legislative page scholarship account, the Rosa Franklin legislative 31
internship program scholarship account, the Washington advanced 32
college tuition payment program account, the Washington college 33
savings program account, the accessible communities account, the 34
Washington achieving a better life experience program account, the 35
Washington career and college pathways innovation challenge program 36
account, the community and technical college innovation account, the 37
agricultural local fund, the American Indian scholarship endowment 38
fund, the behavioral health loan repayment and scholarship program 39
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account, the Billy Frank Jr. national statuary hall collection fund, 1
the foster care scholarship endowment fund, the foster care endowed 2
scholarship trust fund, the contract harvesting revolving account, 3
the Washington state combined fund drive account, the county 911 4
excise tax account, the county road administration board emergency 5
loan account, the toll collection account, the developmental 6
disabilities endowment trust fund, the energy account, the energy 7
facility site evaluation council account, the fair fund, the family 8
and medical leave insurance account, the family medicine residency 9
training account, the Fern Lodge maintenance account, the fish and 10
wildlife federal lands revolving account, the natural resources 11
federal lands revolving account, the food animal veterinarian 12
conditional scholarship account, the forest health revolving account, 13
the fruit and vegetable inspection account, the educator conditional 14
scholarship account, the game farm alternative account, the GET ready 15
for math and science scholarship account, the Washington global 16
health technologies and product development account, the grain 17
inspection revolving fund, the Washington history day account, the 18
industrial insurance rainy day fund, the law enforcement officers' 19
and firefighters' plan 2 expense fund, the local tourism promotion 20
account, the low-income home rehabilitation account, the medication 21
for people living with HIV rebate revenue account, the homeowner 22
recovery account, the multiagency permitting team account, the 23
northeast Washington wolf-livestock management account, the public 24
use general aviation airport loan revolving account, the regional 25
transportation investment district account, the rural rehabilitation 26
account, the Washington sexual assault kit account, the stadium and 27
exhibition center account, the youth athletic facility account, the 28
self-insurance revolving fund, the children's trust fund, the 29
Washington horse racing commission Washington bred owners' bonus fund 30
and breeder awards account, the Washington horse racing commission 31
class C purse fund account, the individual development account 32
program account, the Washington horse racing commission operating 33
account, the life sciences discovery fund, the Washington state 34
library-archives building account, the reduced cigarette ignition 35
propensity account, the center for deaf and hard of hearing youth 36
account, the school for the blind account, the public employees' and 37
retirees' insurance reserve fund, the school employees' benefits 38
board insurance reserve fund, the public employees' and retirees' 39
insurance account, the school employees' insurance account, the long-40
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term services and supports trust account, the radiation perpetual 1
maintenance fund, the Indian health improvement reinvestment account, 2
the department of licensing tuition recovery trust fund, the student 3
achievement council tuition recovery trust fund, the tuition recovery 4
trust fund, the industrial insurance premium refund account, the 5
mobile home park relocation fund, the natural resources deposit fund, 6
the Washington state health insurance pool account, the federal 7
forest revolving account, the Washington saves administrative trust 8
account, and the library operations account. 9
(c) The following accounts and funds must receive 80 percent of 10
their proportionate share of earnings based upon each account's or 11
fund's average daily balance for the period: The advance right-of-way 12
revolving fund, the advanced environmental mitigation revolving 13
account, the federal narcotics asset forfeitures account, the high 14
occupancy vehicle account, the local rail service assistance account, 15
and the miscellaneous transportation programs account.16
(d) Any state agency that has independent authority over accounts 17
or funds not statutorily required to be held in the custody of the 18
state treasurer that deposits funds into a fund or account in the 19
custody of the state treasurer pursuant to an agreement with the 20
office of the state treasurer shall receive its proportionate share 21
of earnings based upon each account's or fund's average daily balance 22
for the period. 23
(5) In conformance with Article II, section 37 of the state 24
Constitution, no trust accounts or funds shall be allocated earnings 25
without the specific affirmative directive of this section.26
NEW SECTION. Sec. 8. Sections 2 through 4 of this act 27
constitute a new chapter in Title 70 RCW.28
NEW SECTION. Sec. 9. Section 6 of this act expires July 1, 29
2030.30
NEW SECTION. Sec. 10. Section 7 of this act takes effect July 31
1, 2030.32
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