1-1 By: Sibley, Zaffirini S.B. No. 979
1-2 (In the Senate - Filed March 7, 1995; March 9, 1995, read
1-3 first time and referred to Committee on Education; March 29, 1995,
1-4 reported adversely, with favorable Committee Substitute by the
1-5 following vote: Yeas 11, Nays 0; March 29, 1995, sent to printer.)
1-6 COMMITTEE SUBSTITUTE FOR S.B. No. 979 By: Sibley
1-7 A BILL TO BE ENTITLED
1-8 AN ACT
1-9 relating to programs to increase the number of primary care
1-10 physicians and allied health personnel in medically underserved
1-11 areas of this state.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Subsection (c), Section 51.918, Education Code,
1-14 is amended to read as follows:
1-15 (c) The Center for Rural Health Initiatives shall develop
1-16 relief service programs for rural physicians and allied health
1-17 personnel <to facilitate ready access to continuing medical
1-18 education>.
1-19 SECTION 2. Section 61.506, Education Code, is amended to
1-20 read as follows:
1-21 Sec. 61.506. FAMILY PRACTICE RESIDENCY TRAINING PILOT
1-22 PROGRAMS. (a) The Family Practice Residency Advisory Committee
1-23 <and a statewide advisory committee established by the Texas Board
1-24 of Health under Section 31.017, Health and Safety Code,> shall work
1-25 <together> to enhance approved family practice residency programs
1-26 and to establish not less than three or more than five pilot
1-27 programs to provide a major source of indigent health care and
1-28 <also> to train family practice resident physicians.
1-29 (b) Each of the <three> pilot programs must provide
1-30 services to <be located in> an economically depressed
1-31 or rural medically underserved area of the state. One pilot
1-32 program must be located in an urban area, one pilot program must be
1-33 located in a rural area, and the remaining pilot program or
1-34 programs must be located in the border region as defined by Section
1-35 481.001, Government Code <area that reflects the diversity of this
1-36 state>.
1-37 (c) An approved family practice residency program that wants
1-38 to participate in or sponsor a pilot program must make a proposal
1-39 to the advisory committee <committees>.
1-40 (d) The advisory committee <committees> shall review all
1-41 proposals submitted under Subsection (c) of this section and shall
1-42 recommend to the board approved family practice residency programs
1-43 to participate in or sponsor pilot programs.
1-44 (e) The board shall select approved family practice
1-45 residency programs to participate in or sponsor pilot programs on
1-46 the basis of each program's commitment to indigent health care and
1-47 to training family practice resident physicians.
1-48 (f) The advisory committee <committees> shall use <the>
1-49 financial reports, audits, and performance evaluations currently
1-50 required under this subchapter or by board rule <and under Section
1-51 31.015, Health and Safety Code,> to assess annually the financial
1-52 feasibility and effective performance of the pilot programs. The
1-53 advisory committee <committees> may require additional reports as
1-54 necessary.
1-55 (g) The advisory committee <committees> shall send copies of
1-56 its <their> annual assessment of the pilot programs to the
1-57 comptroller and the state auditor for review.
1-58 (h) If the advisory committee determines <committees
1-59 determine> that a pilot program is not financially feasible or that
1-60 it does not perform effectively, the advisory committee
1-61 <committees> shall recommend to the board discontinuation of
1-62 funding for the pilot program.
1-63 SECTION 3. Section 61.531, Education Code, is amended to
1-64 read as follows:
1-65 Sec. 61.531. REPAYMENT AUTHORIZED. (a) The coordinating
1-66 board may provide, using funds appropriated for that purpose and in
1-67 accordance with this subchapter and rules of the board, assistance
1-68 in the repayment of student loans for physicians who apply and
2-1 qualify for the assistance.
2-2 (b) Not more than 20 percent of the physicians receiving
2-3 repayment assistance under this subchapter may be employed by the
2-4 state agencies listed in Section 61.532(a)(2).
2-5 (c) A physician who receives repayment assistance under this
2-6 subchapter may not receive assistance under Chapter 46, Health and
2-7 Safety Code.
2-8 SECTION 4. Subsection (a), Section 61.532, Education Code,
2-9 is amended to read as follows:
2-10 (a) To be eligible to receive repayment assistance, a
2-11 physician must apply to the coordinating board and have completed
2-12 at least one year of medical practice:
2-13 (1) in private practice in an economically depressed
2-14 or rural medically underserved area of the state;
2-15 (2) for one of the following state agencies:
2-16 (A) Texas Department of Health;
2-17 (B) Texas Department of Mental Health and Mental
2-18 Retardation;
2-19 (C) Texas Department of Corrections; or
2-20 (D) Texas Youth Commission; or
2-21 (3) for an approved family practice residency training
2-22 program established under Subchapter I of this chapter as a:
2-23 (A) clinical faculty member and have completed
2-24 training in an approved family practice residency training program
2-25 on or after July 1, 1994; or
2-26 (B) resident.
2-27 SECTION 5. Subsection (b), Section 61.539, Education Code,
2-28 is amended to read as follows:
2-29 (b) The amount set aside shall be transferred to the
2-30 comptroller of public accounts to be maintained in the state
2-31 treasury for the sole purpose of repayment of student loans of
2-32 physicians serving in designated state agencies or economically
2-33 depressed or rural medically underserved areas of the state as
2-34 specified by this subchapter. Sections 403.094(h) and 403.095,
2-35 Government Code, do not apply to the amount set aside by this
2-36 section.
2-37 SECTION 6. Subtitle B, Title 2, Health and Safety Code, is
2-38 amended by adding Chapter 46 to read as follows:
2-39 CHAPTER 46. MEDICALLY UNDERSERVED COMMUNITY-STATE
2-40 MATCHING INCENTIVE PROGRAM
2-41 Sec. 46.001. DEFINITIONS. In this chapter:
2-42 (1) "Medically underserved community" means:
2-43 (A) a community located in an area in this state
2-44 with a medically underserved population;
2-45 (B) a community located in an area in this state
2-46 designated by the United States Secretary of Health and Human
2-47 Services as an area with a shortage of personal health services;
2-48 (C) a population group designated by the United
2-49 States Secretary of Health and Human Services as having a shortage
2-50 of personal health services; or
2-51 (D) a community that meets criteria adopted by
2-52 the board by rule, considering relevant demographic, geographic,
2-53 and environmental factors.
2-54 (2) "Physician" means a person licensed to practice
2-55 medicine in this state.
2-56 (3) "Primary care" means physician services in family
2-57 practice, general practice, internal medicine, pediatrics,
2-58 obstetrics, or gynecology.
2-59 (4) "Start-up money" means a payment made by a
2-60 medically underserved community for reasonable costs incurred by a
2-61 physician to establish a medical office and ancillary facilities
2-62 for diagnosing and treating patients.
2-63 Sec. 46.002. PROGRAM. (a) The board shall establish and
2-64 administer a program under this chapter to increase the number of
2-65 physicians providing primary care in medically underserved
2-66 communities.
2-67 (b) An eligible community may sponsor a physician who has
2-68 agreed to provide primary care in the community by contributing to
2-69 start-up money for the physician and having that contribution
2-70 matched in whole or in part by state money appropriated to the
3-1 board for that purpose.
3-2 (c) A participating medically underserved community may
3-3 provide start-up money to an eligible physician over a two-year
3-4 period.
3-5 (d) The board may not pay more than $25,000 to a community
3-6 in a fiscal year unless the board makes a specific finding of need
3-7 by the community.
3-8 Sec. 46.003. ELIGIBILITY. To be eligible to receive money
3-9 from the board, a medically underserved community must:
3-10 (1) apply for the money; and
3-11 (2) provide evidence satisfactory to the board that it
3-12 has entered into an agreement with a physician for the physician to
3-13 provide primary care in the community for at least two years.
3-14 Sec. 46.004. RULES. The board may adopt rules necessary for
3-15 the administration of this chapter, including:
3-16 (1) eligibility criteria for a medically underserved
3-17 community;
3-18 (2) eligibility criteria for a physician;
3-19 (3) minimum and maximum community contributions to the
3-20 start-up money for a physician to be matched with state money;
3-21 (4) conditions under which state money must be repaid
3-22 by a community or physician;
3-23 (5) procedures for disbursement of money by the board;
3-24 (6) the form and manner in which a community must make
3-25 its contribution to the start-up money; and
3-26 (7) the contents of an agreement to be entered into by
3-27 the parties.
3-28 Sec. 46.005. FUNDING. The board may accept gifts, grants,
3-29 and donations for the purposes of this chapter.
3-30 SECTION 7. Not later than December 1, 1996, the Texas Higher
3-31 Education Coordinating Board shall report to the legislature on:
3-32 (1) the allocation of money to the family practice
3-33 residency training pilot programs established under Section 61.506,
3-34 Education Code, as amended by this Act; and
3-35 (2) the progress of those programs in:
3-36 (A) training family practice resident
3-37 physicians; and
3-38 (B) providing indigent health care.
3-39 SECTION 8. This Act takes effect September 1, 1995.
3-40 SECTION 9. The importance of this legislation and the
3-41 crowded condition of the calendars in both houses create an
3-42 emergency and an imperative public necessity that the
3-43 constitutional rule requiring bills to be read on three several
3-44 days in each house be suspended, and this rule is hereby suspended.
3-45 * * * * *