BILL ANALYSIS



S.B. 1280
By: Sibley (Delisi)
04-12-95
Engrossed
Committee Report (Unamended)

BACKGROUND

Texas has a shortage of primary care physicians.  Since 1983, the
state has funded a statewide family practice preceptorship program,
which assigns medical students to community-based family physicians
for a four-week period of observation and discussion.  The
statewide family practice preceptorship program is administered by
the Texas Higher Education Coordinating Board.  


PURPOSE

S.B. 1280 establishes statewide preceptorship programs in general
internal medicine and general pediatrics for Texas medical students
and expands primary care residency positions for community
settings.


RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly
grant any additional rulemaking authority to a state officer,
department, agency, or institution.


SECTION BY SECTION ANALYSIS

SECTION 1: Amends Chapter 58, Education Code, by adding Sections
58.006, 58.007 and 58.009 as follows:

     Sec. 58.006.  STATEWIDE PRECEPTORSHIP PROGRAMS.  (a)
Authorizes the Texas Higher Education Coordinating Board to
contract with one or more organizations to operate the statewide
preceptorship program in general internal medicine and the program
in general pediatrics for medical students enrolled in Texas
medical schools.

(b) Requires an organization eligible to qualify for exemption from
federal income tax under Section 501, Internal Revenue Code, or to
be operated by a state accredited medical school in accordance with
the definition stated in Section 61.501, Education Code to receive
funds under this subsection.

(c) Requires students eligible to indicate an interest in a primary
care career to participate in the programs under this subsection.

     Sec. 58.007.  ADVISORY COMMITTEE.  (a) Requires nothing in
this section or Section 58.006 or 58.008 to diminish or abolish the
activities of the Family Practice Residency Advisory Committee
established under Section 61.505.  Provides that it is not the
intent of this section to combine or assimilate advisory programs,
but only to add to and enhance the training of primary care
physicians in Texas.

(b)(1)       Creates the Primary Care Residency Advisory Committee
and requires the committee to consist of 12 members as follows:

     (A)  Requires seven members to be licensed physicians
appointed by certain organizations;

     (B)  Requires one member to be appointed by the Center for
Rural Health Initiatives;

     (C)  Requires one member to be appointed by the Bureau of
Community Oriented Primary Care at the Texas Department of Health;
and

     (D)  Requires three members to be members of the public, one
appointed by the governor, the lieutenant governor, and the speaker
of the house of representatives.

(2)  Requires no individual who has a direct financial interest in
primary care residency training programs to be appointed to serve
as a member of the committee.

     (c) Establishes the terms of office for members of the
Advisory Committee

     (d) Prohibits the members of the committee from being
compensated for their service.

     (e) Requires the Advisory Committee to meet at least once each
year and so often as requested by the coordinating board or called
into meeting by the committee chair.

     (f) Requires the Advisory Committee chair to be elected by the
members for the committee for a term of one year.

     (g) Requires the committee to review, for the coordinating
board, applications for approval and funding of primary care
residency training program expansion as described in Section 58.008
and related support programs, make recommendations to the board
relating to the standards and criteria for approval of residency
training and related support programs, and perform such other
duties as may be directed by the board.

     Sec. 58.008. Primary Care Residency Program Expansion.  (a)
Requires only residency positions in family practice, general
internal medicine, general pediatrics, and obstetrics and
gynecology to be eligible for the funds.

(b) Requires the committee to recommend to the board an allocation
of new primary care residency positions that are to receive state
support.  Requires the committee to take certain factors into
consideration in recommending an allocation among the four primary
care specialties designated for expansion.

(c) Requires the board to continue to award funds to support the
residency position for all three or four postgraduate years of the
residency training curriculum until the resident physician
appointed to that position has completed or left the program. 
Makes the position eligible for reallocation by the committee.

SECTION 2. Emergency clause. 
           Effective date:  upon passage.


SUMMARY OF COMMITTEE ACTION

S.B. 1280 was considered by the committee in a public hearing on
April 11, 1995.  The bill was reported favorably without amendment,
with the recommendation that it do pass and be printed, by a record
vote of 7 ayes, 0 nays, 0 pnv, 2 absent.