This bill creates a new family medicine residency training grant program administered by the Washington State Department of Health and establishes a new family medicine residency training account in the custody of the state treasurer. The program requires DOH to disburse grants to at least three accredited, three-year family medicine residency programs that are sponsored or sited at community health centers in rural or urban medically underserved areas. Grant recipients must offer at least two first-year, two second-year, and two third-year postgraduate family medicine residency positions in the applicable years and each subsequent year. The bill changes funding and fiscal procedures: it amends RCW 82.26.020 so that the first $7,000,000 collected annually under the tobacco products tax is deposited into the new account, with remaining tobacco tax revenues going to the state general fund. The account may receive private contributions, fund grants and DOH program administration, and expenditures from the account do not require a separate appropriation; the account is generally not subject to allotment procedures under chapter 43.88 RCW except for funds used for program administration. The bill reenacts and amends RCW 43.79A.040 to include the family medicine residency training account among accounts that receive a proportionate share of investment earnings from the treasurer’s trust fund and applies the statute’s monthly investment income distribution procedures and related rules. The bill also creates procedural requirements: the Joint Legislative Audit and Review Committee must perform a performance audit and evaluation of the program every five years, with the first audit due by December 31, 2033, and that first audit must compare physicians trained at community health center–based programs to those trained elsewhere to assess how training location influences work location. Sections 2–4 constitute a new chapter in Title 70 RCW; Section 6 of the act is set to expire July 1, 2030, and Section 7 takes effect July 1, 2030. Important implementation details are missing from the provided text, including grant application procedures, award amounts or selection criteria, reporting requirements for grantees, and the effective and expiration dates referenced in the bill heading.

If enacted, the bill would create a Department of Health‑run grant program that funnels at least the first $7 million a year from the tobacco products tax plus any private donations into a new account to expand family medicine residency positions at community health centers in rural or urban medically underserved areas. Grants must go to at least three accredited, three‑year family medicine residency programs sited or sponsored by community health centers, and each funded program must offer at least two residents in each postgraduate year, which means at minimum six PGY‑1, six PGY‑2, and six PGY‑3 slots across the three programs once they are operating at full scale. The account is held by the state treasurer, can earn and receive investment income under the treasurer’s rules, and DOH may authorize spending from it without a separate appropriation; DOH will also carry the administrative responsibility for the program. The groups most affected are the Department of Health (which gains a new program and oversight duties), community health centers and accredited family medicine residency programs (which must meet minimum slot requirements to receive funds and may need to expand capacity), and the state budget (the state general fund will receive $7 million less annually from the specified tobacco tax stream). The Joint Legislative Audit and Review Committee must evaluate the program starting by December 31, 2033 and every five years thereafter, creating reporting and evaluation obligations. Key implementation details—such as grant award amounts, application and selection rules, exact effective and expiration dates for related sections, and how Section 6’s temporary changes (noted to expire July 1, 2030) interact with the program—are not provided in the extracted material and remain unclear.