By:  Sibley, West                                      S.B. No. 913

                                A BILL TO BE ENTITLED

                                       AN ACT

 1-1     relating to the operation and oversight of the medically

 1-2     underserved community-state matching incentive program.

 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-4           SECTION 1.  Chapter 46, Health and Safety Code, is

 1-5     redesignated as Subchapter E, Chapter 106, Health and Safety Code,

 1-6     and amended to read as follows:

 1-7             SUBCHAPTER  E [CHAPTER 46].  MEDICALLY UNDERSERVED

 1-8                 COMMUNITY-STATE MATCHING INCENTIVE PROGRAM

 1-9           Sec. 106.101 [46.001].  DEFINITIONS.  In this subchapter

1-10     [chapter]:

1-11                 (1)  "Medically underserved community" means:

1-12                       (A)  a community located in an area in this state

1-13     with a medically underserved population;

1-14                       (B)  a community located in an area in this state

1-15     designated by the United States Secretary of Health and Human

1-16     Services as an area with a shortage of personal health services;

1-17                       (C)  a population group designated by the United

1-18     States Secretary of Health and Human Services as having a shortage

1-19     of personal health services; or

1-20                       (D)  a community that meets criteria adopted by

1-21     the board by rule, considering relevant demographic, geographic,

1-22     and environmental factors.

1-23                 (2)  "Physician" means a person licensed to practice

 2-1     medicine in this state.

 2-2                 (3)  "Primary care" means physician services in family

 2-3     practice, general practice, internal medicine, pediatrics,

 2-4     obstetrics, or gynecology.

 2-5                 (4)  "Start-up money" means a payment made by a

 2-6     medically underserved community for reasonable costs incurred by a

 2-7     physician to establish a medical office and ancillary facilities

 2-8     for diagnosing and treating patients.

 2-9           Sec. 106.102 [46.002].  PROGRAM.  (a)  The executive

2-10     committee [board] shall establish and administer a program under

2-11     this subchapter [chapter] to increase the number of physicians

2-12     providing primary care in medically underserved communities.

2-13           (b)  A medically underserved community may sponsor a

2-14     physician who has completed a primary care residency program

2-15     [within seven years of application to this program] and has agreed

2-16     to provide primary care in the community by contributing to

2-17     start-up money for the physician and having that contribution

2-18     matched in whole or in part by state money appropriated to the

2-19     executive committee [board] for that purpose.

2-20           (c)  A participating medically underserved community may

2-21     provide start-up money to an eligible physician over a two-year

2-22     period.

2-23           (d)  The executive committee [board] may not pay more than

2-24     $25,000 to a community in a fiscal year unless the executive

2-25     committee [board] makes a specific finding of need by the

 3-1     community.

 3-2           (e)  The executive committee [board] shall prioritize the

 3-3     communities eligible for assistance under this subchapter [chapter]

 3-4     in order to assure that the neediest communities are provided

 3-5     grants.

 3-6           Sec. 106.103 [46.003].  ELIGIBILITY.  To be eligible to

 3-7     receive money from the executive committee [board], a medically

 3-8     underserved community must:

 3-9                 (1)  apply for the money; and

3-10                 (2)  provide evidence satisfactory to the executive

3-11     committee [board] that it has entered into an agreement with a

3-12     physician for the physician to provide primary care in the

3-13     community for at least two years.

3-14           Sec. 106.104 [46.004].  RULES.  The executive committee

3-15     [board] shall adopt rules necessary for the administration of this

3-16     subchapter [chapter], including:

3-17                 (1)  eligibility criteria for a medically underserved

3-18     community;

3-19                 (2)  eligibility criteria for a physician;

3-20                 (3)  minimum and maximum community contributions to the

3-21     start-up money for a physician to be matched with state money;

3-22                 (4)  conditions under which state money must be repaid

3-23     by a community or physician;

3-24                 (5)  procedures for disbursement of money by the

3-25     executive committee [board];

 4-1                 (6)  the form and manner in which a community must make

 4-2     its contribution to the start-up money; and

 4-3                 (7)  the contents of an agreement to be entered into by

 4-4     the parties to include at least:

 4-5                       (A)  a credit check for an eligible physician;

 4-6     and

 4-7                       (B)  community retention of interest in any

 4-8     property, equipment, or durable goods for seven years[; and]

 4-9                       [(C)  the requirement of full-time clinical

4-10     practice for participating physicians].

4-11           Sec. 106.105 [46.005].  FUNDING.  The executive committee

4-12     [board] may accept gifts, grants, and donations for the purposes of

4-13     this chapter.

4-14           SECTION 2.  (a)  The Texas Board of Health not later than

4-15     September 1, 1998, shall transfer the obligations, property, and

4-16     rights that the board had under former Chapter 46, Health and

4-17     Safety Code, as redesignated by this Act, to the Center for Rural

4-18     Health Initiatives.  The Center for Rural Health Initiatives

4-19     assumes all of the obligations, property, and rights of the Texas

4-20     Board of Health under Chapter 46, Health and Safety Code, as

4-21     exercised by the board immediately before the effective date of

4-22     this Act.  All unexpended funds appropriated to the Texas Board of

4-23     Health under Chapter 46, Health and Safety Code, are transferred to

4-24     the Center for Rural Health Initiatives.  The transfer of the

4-25     obligations, property, and rights of the Texas Board of Health

 5-1     under Chapter 46, Health and Safety Code, must be completed not

 5-2     later than September 1, 1998.

 5-3           (b)  All rules of the Texas Board of Health relating to

 5-4     Chapter 46, Health and Safety Code, are continued in  effect as

 5-5     rules of the Center for Rural Health Initiatives until superseded

 5-6     by a rule of the Center for Rural Health Initiatives.

 5-7           SECTION 3.  This Act takes effect September 1, 1997.

 5-8           SECTION 4.  The importance of this legislation and the

 5-9     crowded condition of the calendars in both houses create an

5-10     emergency and an imperative public necessity that the

5-11     constitutional rule requiring bills to be read on three several

5-12     days in each house be suspended, and this rule is hereby suspended.