SENATE COMMITTEE ON FINANCE 
                     Subcommittee on Graduate Medical Education 
                              Thursday, March 16, 2000 
                                     10:30 a.m. 
                           Capitol Extension, Room E1.036 
         Pursuant to a notice posted in accordance with Senate Rule  
         11.18, a public hearing of the Senate Committee on Finance  
         Interim Subcommittee on Graduate Medical Education was held on  
         Thursday, March 16, 2000, in the Capitol Extension, Room E1.036,  
         at Austin, Texas. 
         MEMBERS PRESENT:                        MEMBERS ABSENT: 
         Senator Mike Moncrief, Chairman         Senator John Carona 
         Senator Carlos Truan 
         Senator Jon Lindsay 
         Senator Royce West 
         The chair called the meeting to order at 10:35 a.m.  There being  
         a quorum present, the following business was transacted:   
         The Chair made opening remarks regarding the subcommittee's  
         charge to examine the Disproportionate Share Hospital (DSH)  
         Program.  The Chair explained to members that the purpose of the  
         hearing was to gain a clear understanding of the issues  
         surrounding DSH funding.  He then recognized other members to  
         make opening remarks.  Senator Truan encouraged groups working  
         on DSH funding problems to include the medically under served  
         rural areas in their deliberations to ensure that the problem is  
         not compounded. 
         Invited Testimony 
         The Chair recognized Don Gilbert, Commissioner of the Health and  
         Human Services Commission, to provide an overview of the  
         Medicaid DSH Program.  Marina Henderson, of the Health and Human  
         Services Commission, joined Commissioner Gilbert in answering  
         questions of the committee. 
         The following witness provided testimony regarding hospital  
         perspectives on the DSH Program and recent formula proposals: 
              Mr. Joe Dasilva, representing the Texas Hospital  
         The committee recessed at 12:00 p.m. and reconvened at 12:40  
         The chair recognized the following witnesses to resume invited  
         testimony on the DSH Program and recent formula proposals: 
              Mr. Jeff Turner, representing the Texas Association of  
              Public and Nonprofit Hospitals (TAPNH); 
              Mr. Kevin Reed, representing the Texas Organization of  
              Rural and Community Hospitals (TORCH); 
              Mr. Larry Tonn, representing Texas Urban Voluntary  
              Hospitals and Systems (TUVHS); 
              Linda Rushing, representing the Texas Conference of  
              Catholic Health Facilities (CCHF);  
              Mr. Mark Wallace, representing Children's Hospital  
              Association of Texas (CHAT). 
         The Chair told members of the subcommittee that Governor Perry  
         would be traveling to Washington, D.C. to talk to members of the  
         Texas delegation and leadership.  The Chair will draft a letter  
         on behalf of the members of the subcommittee outlining the  
         severity of the DSH problem and the concerns of the  
         subcommittee.  The Chair asked the Health and Human Services  
         Commission and hospital associations to continue their dialogue  
         on possible solutions and keep the subcommittee abreast of their  
         progress.  The Chair announced that the next subcommittee  
         hearing on Graduate Medical Education will take place on  
         Thursday, April 20, 2000 at 1:00 p.m.  At that time, the Chair  
         would like the DSH working group to report on their progress. 
         There being no further business, at 2:05 p.m. Senator Moncrief  
         announced that the Committee would stand recessed subject to the  
         call of the chair.  Without objection, it was so ordered.   
         Senator Mike Moncrief, Chair 
         Patricia Hicks, Clerk