BILL ANALYSIS


                                                    C.S.S.B. 1280
                                                       By: Sibley
                                                        Education
                                                         03-30-95
                                   Committee Report (Substituted)
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 program
is administered by the Texas Higher Education Coordinating Board. 
However, preceptorship programs in general internal medicine and
general pediatrics do not mirror the existing program. 

PURPOSE

As proposed, C.S.S.B. 1280 establishes statewide 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 grant any
additional rulemaking authority to a state officer, institution, or
agency.

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
     (coordinating board) to contract with one or more
     organizations to operate the statewide preceptorship program
     (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 (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
       committee.
       
       (d)  Prohibits the members of the committee from being
       compensated for their service.
       
       (e)  Requires the committee to meet at least annually and so
       often as requested by the coordinating board or called into
       meeting by the committee chair.  
       
       (f)  Requires the committee chair to be elected by the
       members of 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.