LSL H.B. 2192 75(R) BILL ANALYSIS PUBLIC HEALTH H.B. 2192 By: Rangel 4-2-97 Committee Report (Unamended) BACKGROUND Texas is comprised of 58 urban counties and 196 rural counties. Nearly 80 percent of Texas residents live in these urban areas, while 20 percent reside in rural settings. As of December 1996, Texas had 228 federally-designated Medically Underserved Areas (MUAs) and 193 federally-designated Health Professional Shortage Areas (HPSAs), which includes 12 prison sites. Of the 181 non-prison HPSA designations defined as "urban" and "metropolitan areas" by the U.S. Office of Management and Budget, 121 (67%) are rural and 60 (33%) are urban. Currently, Texas has two incentive programs to encourage physicians to practice in underserved areas of the state. The first one is known as the Physician Education Loan Repayment Program and is administered by the Texas Higher Education Coordinating Board. The second is the recently created Underserved Community-State Matching Incentive Program for Primary Care Physicians and is under the Center for Rural Health Initiatives. Theses initiatives act as a "marriage broker" for small communities seeking physicians and physicians seeking to locate their practices in underserved areas of the state. PURPOSE HB 2192 creates an incentive program to encourage physicians to practice in medically underserved areas of the state. This program is called the Texas Health Service Corps Program for Medically Underserved Areas. RULEMAKING AUTHORITY It is the committee's opinion that this bill expressly grants additional rulemaking authority to the executive committee of the Center for Rural Health Initiatives in SECTION 1 (Chapter 106, Health and Safety Code, Subchapter E., Sec. 106.102(b) and Sec. 106.103(a)). SECTION BY SECTION ANALYSIS SECTION 1. Amends Chapter 106, Health and Safety Code, by adding Subchapter E, entitled "TEXAS HEALTH SERVICE CORPS PROGRAM FOR MEDICALLY UNDERSERVED AREAS" as follows:. Sec. 106.101 defines "medically underserved area" and "physician." Sec. 106.102. establishes the Texas Health Service Corps Program. Subsection (a) requires the executive committee of the Center for Rural Health Initiatives to establish a program, as specified, to assist in recruiting and retaining physicians to practice in MUAs. Subsection (b) requires the executive committee, by rule, to establish certain criteria, procedures, guidelines, and priorities as specified in this subsection. Sec. 106.103 ADMINISTRATION. Subsection (a) requires the executive committee to adopt rules necessary to administer this subchapter, and requires the center to administer the program in accordance with those rules. Subsection (b) requires the center to conduct field research, collect information, and prepare statistical and other reports relating to the need for the program. Subsection (c) prohibits the center from spending more than 10% of the amount appropriated for administrative costs to administer this subchapter. Sec. 106.104. REQUIRED CONTRACT. Subsection (a) allows the center to award a stipend to a physician, under this subchapter, if the physician enters into a written contract to provide services in a MUA for at least one year for each year that the physician receives the stipend. Subsection (b) requires the contract to include provisions that the physician is personally liable to the state as outlined in this subsection, for failure to provide required services in the MUA or for providing those services for less than the required term. Sec. 106.105. STIPENDS. Subsection (a) requires the center to award stipends to physicians for one-year periods. Stipulates that the stipend amount not exceed $15,000 annually. Subsection (b) allows the center to renew a stipend used to assist a particular physician. Subsection (c) provides that a physician is not eligible for a stipend for a period longer than is ordinarily and customarily required for the completion of residency training for first board eligibility. Subsection (d) prohibits the physician receiving a stipend, under this subchapter, from receiving additional assistance under a state educational loan repayment program or other state incentive program. Sec. 106.106. FUNDING. Allows the center to seek, receive, and spend money received through an appropriation, grant, donation, or reimbursement from any public or private source to administer this subchapter. SECTION 2. Emergency Clause. Establishes that this Act take effect upon passage.