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.