By Turner of Coleman                                   H.B. No. 246
         77R115 JAT-D                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the creation and funding of the Rural Communities
 1-3     Health Care Investment Program to attract and retain rural health
 1-4     care professionals.
 1-5           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-6           SECTION 1.  Chapter 106, Health and Safety Code, is amended
 1-7     by adding Subchapter H to read as follows:
 1-8       SUBCHAPTER H.  RURAL COMMUNITIES HEALTH CARE INVESTMENT PROGRAM
 1-9           Sec. 106.301.  DEFINITIONS. In this subchapter:
1-10                 (1)  "Health professional" means a person who holds a
1-11     license, certificate, registration, permit, or other form of
1-12     authorization required by law or a state agency rule that must be
1-13     obtained by an individual to practice in a health care profession.
1-14                 (2)  "Medically underserved community" means a
1-15     community that meets criteria adopted by the center by rule,
1-16     considering relevant demographic, geographic, and environmental
1-17     factors.
1-18           Sec. 106.302.  ADVISORY PANEL. The center shall appoint an
1-19     advisory panel to assist in the center's duties under this
1-20     subchapter.  The advisory panel must consist of at least:
1-21                 (1)  one representative from the Texas Higher Education
1-22     Coordinating Board;
1-23                 (2)  one representative from the institutions of higher
1-24     education having degree programs for the health professions
 2-1     participating in the programs under this subchapter;
 2-2                 (3)  one representative from a hospital in a medically
 2-3     underserved community;
 2-4                 (4)  one physician practicing in a medically
 2-5     underserved community;
 2-6                 (5)  one health professional, other than a physician,
 2-7     practicing in a medically underserved community; and
 2-8                 (6)  one public representative who resides in a
 2-9     medically underserved community.
2-10           Sec. 106.303.  LOAN REIMBURSEMENT PROGRAM. The executive
2-11     committee shall establish a program in the center to assist
2-12     communities in recruiting health professionals to practice in
2-13     medically underserved communities by providing loan reimbursement
2-14     for health professionals who agree to serve in those communities.
2-15           Sec. 106.304.  STIPEND PROGRAM. The executive committee shall
2-16     establish a program in the center to assist communities in
2-17     recruiting health professionals to practice in medically
2-18     underserved communities by providing a stipend to health
2-19     professionals who agree to serve in those communities.
2-20           Sec. 106.305.  CONTRACT REQUIRED. (a)  A health professional
2-21     may receive assistance under this subchapter only if the health
2-22     professional signs a contract agreeing to provide health care
2-23     services in a medically underserved community.
2-24           (b)  A student in a degree program preparing to become a
2-25     health professional may contract with the center for the loan
2-26     reimbursement program under Section 106.303 before obtaining the
2-27     license required to become a health professional.
 3-1           (c)  The center may contract with a health professional for
 3-2     part-time services under the stipend program established under
 3-3     Section 106.304.
 3-4           (d)  A health professional who participates in any loan
 3-5     reimbursement program is not eligible for a stipend under Section
 3-6     106.304.
 3-7           (e)  A contract under this section must provide that a health
 3-8     professional who does not provide the required services to the
 3-9     community or provides those services for less than the required
3-10     time is personally liable to the state for:
3-11                 (1)  the total amount of assistance the health
3-12     professional received from the center and the medically underserved
3-13     community;
3-14                 (2)  interest on the amount under Subdivision (1) at a
3-15     rate set by the executive committee; and
3-16                 (3)  the state's reasonable expenses incurred in
3-17     obtaining payment, including reasonable attorney's fees.
3-18           Sec. 106.306.  POWERS AND DUTIES OF CENTER. (a)  The
3-19     executive committee shall adopt rules necessary for the
3-20     administration of this subchapter, including guidelines for:
3-21                 (1)  developing contracts under which loan or stipend
3-22     recipients provide services to qualifying communities;
3-23                 (2)  identifying the duties of the state, state agency,
3-24     loan or stipend recipient, and medically underserved community
3-25     under the loan or stipend contract;
3-26                 (3)  determining a rate of interest to be charged under
3-27     Section 106.305(e)(2);
 4-1                 (4)  insuring that a loan reimbursement or stipend
 4-2     recipient provides Medicare or Medicaid patients access to health
 4-3     services in qualifying communities;
 4-4                 (5)  encouraging the use of telecommunications or
 4-5     telemedicine, as appropriate;
 4-6                 (6)  prioritizing the provision of loans and stipends
 4-7     to health professionals who do not have access to any other state
 4-8     loan forgiveness, loan repayment, or stipend program;
 4-9                 (7)  prioritizing the provision of loans and stipends
4-10     to health professionals who are graduates of health professional
4-11     degree programs in this state;
4-12                 (8)  encouraging a medically underserved community
4-13     served by a loan repayment or stipend recipient to contribute to
4-14     the cost of the loan reimbursement or stipend when making a
4-15     contribution is feasible; and
4-16                 (9)  requiring a medically underserved community served
4-17     by a loan repayment or stipend recipient to assist the center in
4-18     contracting with the loan or stipend recipient who will serve that
4-19     community.
4-20           (b)  The executive committee by rule may designate areas of
4-21     the state as medically underserved communities.
4-22           (c)  The executive committee shall make reasonable efforts to
4-23     contract with health professionals from a variety of different
4-24     health professions.
4-25           Sec. 106.307.  TRUST FUND. (a)  The rural communities health
4-26     care investment program trust fund is created as a trust fund with
4-27     the state comptroller and shall be administered by the center as
 5-1     trustee on behalf of medically underserved communities.
 5-2           (b)  The center, as trustee of the rural communities health
 5-3     care investment trust fund, may accept and administer gifts and
 5-4     grants from any public or private person or entity for the use and
 5-5     benefit of any program described or created under this chapter.
 5-6           SECTION 2.  Subchapter C, Chapter 61, Education Code, is
 5-7     amended by adding Section 61.0899 to read as follows:
 5-8           Sec. 61.0899.  ASSISTANCE IN CERTAIN RURAL HEALTH CARE LOAN
 5-9     FORGIVENESS PROGRAMS. The board shall, in cooperation with the
5-10     Center for Rural Health Initiatives and the center's advisory panel
5-11     established under Section 106.302, Health and Safety Code, develop
5-12     a program to ensure that the board and any institution of higher
5-13     education shall seek to obtain the maximum amount of funds from any
5-14     source, including federal funds, to support programs to provide
5-15     student loan reimbursement or stipends for graduates of degree
5-16     programs in this state who practice or agree to practice in a
5-17     medically underserved community.
5-18           SECTION 3.  This Act takes effect immediately if it receives
5-19     a vote of two-thirds of all the members elected to each house, as
5-20     provided by Section 39, Article III, Texas Constitution.  If this
5-21     Act does not receive the vote necessary for immediate effect, this
5-22     Act takes effect September 1, 2001.