BILL ANALYSIS


                                                     C.S.S.B. 979
                                                       By: Sibley
                                                        Education
                                                         03-30-95
                                   Committee Report (Substituted)
BACKGROUND

Finding convenient health care is a struggle for many Texans in
rural and other underserved communities.  Currently, 25 Texas
counties are without a primary care physician and 229 Texas
counties are designated medically underserved areas/medically
underserved populations by the federal government.  Furthermore,
Texas has 134 full and partial counties which are federally
designated primary care health professional shortage areas.

PURPOSE

As proposed, C.S.S.B. 979 creates the Medically Underserved
Community-State Matching Incentive Program to help increase the
number of primary care physicians in medically underserved areas of
this state.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is granted
to the Texas Board of Health under SECTION 7 (Sec.  46.004, Health
and Safety Code) of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 51.918(c), Education Code, to require the
Center for Rural Health Initiatives to develop relief service
programs for rural physicians and allied health personnel.

SECTION 2. Amends Section 61.506, Education Code, as follows:

     Sec.  61.506.  FAMILY PRACTICE RESIDENCY TRAINING PILOT
     PROGRAMS.  (a)  Requires the Family Practice Residency
     Advisory Committee (advisory committee) to work to enhance
     approved family practice residency programs and to establish
     not less than three or more than five pilot programs
     (programs) to provide a major source of indigent health care
     and to train family practice resident physicians.
     
     (b)  Requires each of the programs to provide services to an
       economically depressed or rural medically underserved area
       of the state.  Requires one program to be located in an
       urban area, one program to be located in a rural area, and
       one program to be located in the border region as defined by
       Section 481.001, Government Code.
       
       (c)-(h) Make conforming changes.  SECTION 3.    Amends Section 61.531, Education Code, as follows:

     Sec.  61.531.  REPAYMENT AUTHORIZED.  (a)  Authorizes the
     board to provide, using funds appropriated for that purpose
     and in accordance with this subchapter and rules of the board,
     assistance in the repayment of student loans for physicians
     who apply and qualify for the assistance.  
       (b)  Provides that not more than 20 percent of physicians
       receiving repayment assistance may be employed by the state
       agencies listed in Section 61.532(a)(2).
       (c)  Prohibits a physician who receives repayment assistance
       from receiving assistance under Chapter 46, Health and
       Safety Code.
SECTION 4. Amends Section 61.532(a), Education Code, to require a
physician to apply to the coordinating board and have completed at
least one year of medical practice in a certain private practice,
state agency or an approved program, having completed training in
an approved program by July 1, 1994, or resident, to be eligible to
receive payment assistance.
SECTION 5. Amends Section 61.539(b), Education Code, to provide
that Sections 403.094(h) and 403.095, Government Code, do not apply
to the funds set aside in this section.

SECTION 6. Amends Title 2B, Health and Safety Code, by adding
Chapter 46, as follows:

   CHAPTER 46.  MEDICALLY UNDERSERVED COMMUNITY-STATE MATCHING 
                        INCENTIVE PROGRAM

     Sec.  46.001.  DEFINITIONS.  Defines "medically underserved
     community," "physician," "primary care," and "start-up money."
     
     Sec.  46.002.   PROGRAM.  (a)  Requires the Texas Board of
     Health (board) to establish and administer a program under
     this chapter to increase the number of physicians providing
     primary care in medically underserved communities
     (communities).  
     
     (b)  Authorizes an eligible community to sponsor a physician
       who has agreed to provide primary care in the community by
       contributing to start-up money for the physician and having
       that contribution matched in whole or in part by state money
       appropriated to the board for that purpose.  
       
       (c)  Authorizes a participating community to provide start-up money to an eligible physician over a two-year period.
       
       (d)  Prohibits the board from paying more than $25,000 to a
       community in any fiscal year, unless the board makes a
       specific finding on need by the community.
     Sec.  46.003.  ELIGIBILITY.  (a)  Requires a community to
     apply for money and provide evidence satisfactory to the board
     that it has entered into an agreement with a physician that
     the physician provide primary care in the community for a
     period of at least two years to be eligible to receive funds
     from the board.
     
     Sec.  46.004.  RULES.  Authorizes the board to adopt rules
     necessary for the administration of this subchapter, including
     but not limited to certain eligibility criteria and
     conditions.
     
     Sec.  46.005.  FUNDING.  Authorizes the board to accept gifts,
     grants, and donations for the purposes of this subchapter.  
SECTION 7. Requires the coordinating board to report to the
legislature on the allocation of money to the programs and the
progress of those programs.
     SECTION 8.     Effective date: September 1, 1995.

SECTION 9. Emergency clause.