1-1     By:  Sibley                                            S.B. No. 913

 1-2           (In the Senate - Filed March 4, 1997; March 6, 1997, read

 1-3     first time and referred to Committee on Health and Human Services;

 1-4     April 7, 1997, reported adversely, with favorable Committee

 1-5     Substitute by the following vote:  Yeas 11, Nays 0; April 7, 1997,

 1-6     sent to printer.)

 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 913                   By:  Nelson

 1-8                            A BILL TO BE ENTITLED

 1-9                                   AN ACT

1-10     relating to the operation and oversight of the medically

1-11     underserved community-state matching incentive program.

1-12           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-13           SECTION 1.  Chapter 46, Health and Safety Code, is

1-14     redesignated as Subchapter E, Chapter 106, Health and Safety Code,

1-15     and amended to read as follows:

1-16             SUBCHAPTER  E [CHAPTER 46].  MEDICALLY UNDERSERVED

1-17                 COMMUNITY-STATE MATCHING INCENTIVE PROGRAM

1-18           Sec. 106.101 [46.001].  DEFINITIONS.  In this subchapter

1-19     [chapter]:

1-20                 (1)  "Medically underserved community" means:

1-21                       (A)  a community located in an area in this state

1-22     with a medically underserved population;

1-23                       (B)  a community located in an area in this state

1-24     designated by the United States Secretary of Health and Human

1-25     Services as an area with a shortage of personal health services;

1-26                       (C)  a population group designated by the United

1-27     States Secretary of Health and Human Services as having a shortage

1-28     of personal health services; or

1-29                       (D)  a community that meets criteria adopted by

1-30     the board by rule, considering relevant demographic, geographic,

1-31     and environmental factors.

1-32                 (2)  "Physician" means a person licensed to practice

1-33     medicine in this state.

1-34                 (3)  "Primary care" means physician services in family

1-35     practice, general practice, internal medicine, pediatrics,

1-36     obstetrics, or gynecology.

1-37                 (4)  "Start-up money" means a payment made by a

1-38     medically underserved community for reasonable costs incurred by a

1-39     physician to establish a medical office and ancillary facilities

1-40     for diagnosing and treating patients.

1-41           Sec. 106.102 [46.002].  PROGRAM.  (a)  The executive

1-42     committee [board] shall establish and administer a program under

1-43     this subchapter [chapter] to increase the number of physicians

1-44     providing primary care in medically underserved communities.

1-45           (b)  A medically underserved community may sponsor a

1-46     physician who has completed a primary care residency program

1-47     [within seven years of application to this program] and has agreed

1-48     to provide primary care in the community by contributing to

1-49     start-up money for the physician and having that contribution

1-50     matched in whole or in part by state money appropriated to the

1-51     executive committee [board] for that purpose.

1-52           (c)  A participating medically underserved community may

1-53     provide start-up money to an eligible physician over a two-year

1-54     period.

1-55           (d)  The executive committee [board] may not pay more than

1-56     $25,000 to a community in a fiscal year unless the executive

1-57     committee [board] makes a specific finding of need by the

1-58     community.

1-59           (e)  The executive committee [board] shall prioritize the

1-60     communities eligible for assistance under this subchapter [chapter]

1-61     in order to assure that the neediest communities are provided

1-62     grants.

1-63           Sec. 106.103 [46.003].  ELIGIBILITY.  To be eligible to

1-64     receive money from the executive committee [board], a medically

 2-1     underserved community must:

 2-2                 (1)  apply for the money; and

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

 2-4     committee [board] that it has entered into an agreement with a

 2-5     physician for the physician to provide primary care in the

 2-6     community for at least two years.

 2-7           Sec. 106.104 [46.004].  RULES.  The executive committee

 2-8     [board] shall adopt rules necessary for the administration of this

 2-9     subchapter [chapter], including:

2-10                 (1)  eligibility criteria for a medically underserved

2-11     community;

2-12                 (2)  eligibility criteria for a physician;

2-13                 (3)  minimum and maximum community contributions to the

2-14     start-up money for a physician to be matched with state money;

2-15                 (4)  conditions under which state money must be repaid

2-16     by a community or physician;

2-17                 (5)  procedures for disbursement of money by the

2-18     executive committee [board];

2-19                 (6)  the form and manner in which a community must make

2-20     its contribution to the start-up money; and

2-21                 (7)  the contents of an agreement to be entered into by

2-22     the parties to include at least:

2-23                       (A)  a credit check for an eligible physician;

2-24     and

2-25                       (B)  community retention of interest in any

2-26     property, equipment, or durable goods for seven years[; and]

2-27                       [(C)  the requirement of full-time clinical

2-28     practice for participating physicians].

2-29           Sec. 106.105 [46.005].  FUNDING.  The executive committee

2-30     [board] may accept gifts, grants, and donations for the purposes of

2-31     this chapter.

2-32           SECTION 2.  (a)  The Texas Board of Health not later than

2-33     September 1, 1998, shall transfer the obligations, property, and

2-34     rights that the board had under former Chapter 46, Health and

2-35     Safety Code, as redesignated by this Act, to the Center for Rural

2-36     Health Initiatives.  The Center for Rural Health Initiatives

2-37     assumes all of the obligations, property, and rights of the Texas

2-38     Board of Health under Chapter 46, Health and Safety Code, as

2-39     exercised by the board immediately before the effective date of

2-40     this Act.  All unexpended funds appropriated to the Texas Board of

2-41     Health under Chapter 46, Health and Safety Code, are transferred to

2-42     the Center for Rural Health Initiatives.  The transfer of the

2-43     obligations, property, and rights of the Texas Board of Health

2-44     under Chapter 46, Health and Safety Code, must be completed not

2-45     later than September 1, 1998.

2-46           (b)  All rules of the Texas Board of Health relating to

2-47     Chapter 46, Health and Safety Code, are continued in  effect as

2-48     rules of the Center for Rural Health Initiatives until superseded

2-49     by a rule of the Center for Rural Health Initiatives.

2-50           SECTION 3.  This Act takes effect September 1, 1997.

2-51           SECTION 4.  The importance of this legislation and the

2-52     crowded condition of the calendars in both houses create an

2-53     emergency and an imperative public necessity that the

2-54     constitutional rule requiring bills to be read on three several

2-55     days in each house be suspended, and this rule is hereby suspended.

2-56                                  * * * * *