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.