Office of House Bill AnalysisS.B. 516
By: Madla
Public Health
Committee Report (Amended)


The 76th Legislature directed the Center for Rural Health Initiatives
(center) to conduct a study to determine the need for a program using
physicians and physician residents as temporary replacements for full-time
physicians in rural areas.  Survey results and data provided by the Texas
Medical Association showed that 54 percent of solo practitioners have been
unable to leave their practice due to the lack of physicians to care for
their patients.  The center concludes that rural Texas physicians have
demonstrated a need for a state-supported rural physician relief program,
and that such support would help preserve the rural health care
infrastructure, and help improve access to care for rural Texans.  Senate
Bill 516 requires the center to establish a program to provide rural
physicians with temporary relief from their practice. 


It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 


Senate Bill 516 amends the Health and Safety Code to require the Center for
Rural Health Initiatives (center) to create a program to provide affordable
relief services to rural physicians practicing in the fields of general
family medicine, general internal medicine, and general pediatrics to
facilitate the ability of these physicians to take time away from their
practice.  The bill requires the center to charge a fee for rural
physicians to participate in the program, and requires the collected fees
to be deposited in a special account in the general revenue fund that are
to be used only for the administration of the program.  The bill requires
the center to pay a physician providing relief under the program with fees
collected by the center.  In support of the program, the bill authorizes
the center to solicit and accept gifts, grants, donations, and

S.B. 516 requires the center to prioritize relief in the following order:
solo practitioners in rural areas, counties with fewer than seven residents
per square mile, counties that have been designated under federal law as a
health professional shortage area, counties that do not have a hospital,
and counties that have a hospital without a continuously staffed hospital
emergency room.  When determining where to assign relief physicians, the
bill requires the center to consider the number of physicians in the area
available to provide relief services and the distance in that area to the
nearest physician that practices in the same specialty.  At the request of
the center, residency program directors are authorized to assist the center
in coordinating the assignment of relief physicians. 

S.B. 516 requires the center to actively recruit physicians to participate
in the program as relief physicians, and to concentrate on recruiting
physicians involved in an accredited residency program in general
pediatrics, general internal medicine, and general family medicine,
physicians registered on the center's locum tenens registry, physicians
employed at a medical school, and physicians working for private locum
tenens groups. (Locum tenens means a person who temporarily takes the place
of another.)  The bill sets forth the composition of the rural physician
relief advisory committee that is required to assist the center in the
program's administration. 

September 1, 2001.


Committee Amendment No. 1 includes an administrator or a chief executive
officer of a hospital located in a rural county among the membership of the
rural physician relief advisory committee.