1-1     By:  Madla                                             S.B. No. 126
 1-2           (In the Senate - Filed November 21, 2000; January 11, 2001,
 1-3     read first time and referred to Committee on Intergovernmental
 1-4     Relations; January 31, 2001, reported favorably, as amended, by the
 1-5     following vote:  Yeas 6, Nays 0; January 31, 2001, sent to
 1-6     printer.)
 1-7     COMMITTEE AMENDMENT NO. 1                                By:  Madla
 1-8           On page 1 line 34, strike Subdivision (2) and substitute the
 1-9     following new Subdivision (2):
1-10                 (2)  "Medically underserved community" means a
1-11     community:
1-12                       (A)  located in a county with a population not
1-13     greater than 50,000;
1-14                       (B)   designated under state or federal law as:
1-15                             (i)  a health professional shortage area;
1-16     or
1-17                             (ii)  a medically underserved area; or
1-18                       (C)  designated a medically underserved community
1-19     by the Center for Rural Health Initiatives.
1-20                            A BILL TO BE ENTITLED
1-21                                   AN ACT
1-22     relating to the creation and funding of a rural communities health
1-23     care investment program to attract and retain rural health care
1-24     professionals.
1-25           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-26           SECTION 1.  Chapter 106, Health and Safety Code, is amended
1-27     by adding Subchapter H to read as follows:
1-28       SUBCHAPTER H.  RURAL COMMUNITIES HEALTH CARE INVESTMENT PROGRAM
1-29           Sec. 106.301.  DEFINITIONS.  In this subchapter:
1-30                 (1)  "Health professional" means a person who holds a
1-31     license, certificate, registration, permit, or other form of
1-32     authorization required by law or a state agency rule that must be
1-33     obtained by an individual to practice in a health care profession.
1-34                 (2)  "Medically underserved community" means a
1-35     community that meets criteria adopted by the center by rule,
1-36     considering relevant demographic, geographic, and environmental
1-37     factors.
1-38           Sec. 106.302.  ADVISORY PANEL.  The center shall appoint an
1-39     advisory panel to assist in the center's duties under this
1-40     subchapter.  The advisory panel must consist of at least:
1-41                 (1)  one representative from the Texas Higher Education
1-42     Coordinating Board;
1-43                 (2)  one representative from the institutions of higher
1-44     education having degree programs for the health professions
1-45     participating in the programs under this subchapter;
1-46                 (3)  one representative from a hospital in a medically
1-47     underserved community;
1-48                 (4)  one physician practicing in a medically
1-49     underserved community;
1-50                 (5)  one health professional, other than a physician,
1-51     practicing in a medically underserved community; and
1-52                 (6)  one public representative who resides in a
1-53     medically underserved community.
1-54           Sec. 106.303.  LOAN REIMBURSEMENT PROGRAM.  The executive
1-55     committee shall establish a program in the center to assist
1-56     communities in recruiting health professionals to practice in
1-57     medically underserved communities by providing loan reimbursement
1-58     for health professionals who agree to serve in those communities.
1-59           Sec. 106.304.  STIPEND PROGRAM.  The executive committee
1-60     shall establish a program in the center to assist communities in
1-61     recruiting health professionals to practice in medically
1-62     underserved communities by providing a stipend to health
1-63     professionals who agree to serve in those communities.
 2-1           Sec. 106.305.  CONTRACT REQUIRED.  (a)  A health professional
 2-2     may receive assistance under this subchapter only if the health
 2-3     professional signs a contract agreeing to provide health care
 2-4     services in a medically underserved community.
 2-5           (b)  A student in a degree program preparing to become a
 2-6     health professional may contract with the center for the loan
 2-7     reimbursement program under Section 106.303 before obtaining the
 2-8     license required to become a health professional.
 2-9           (c)  The center may contract with a health professional for
2-10     part-time services under the stipend program established under
2-11     Section 106.304.
2-12           (d)  A health professional who participates in any loan
2-13     reimbursement program is not eligible for a stipend under Section
2-14     106.304.
2-15           (e)  A contract under this section must provide that a health
2-16     professional who does not provide the required services to the
2-17     community or provides those services for less than the required
2-18     time is personally liable to the state for:
2-19                 (1)  the total amount of assistance the health
2-20     professional received from the center and the medically underserved
2-21     community;
2-22                 (2)  interest on the amount under Subdivision (1) at a
2-23     rate set by the executive committee; and
2-24                 (3)  the state's reasonable expenses incurred in
2-25     obtaining payment, including reasonable attorney's fees.
2-26           Sec. 106.306.  POWERS AND DUTIES OF CENTER.  (a)  The
2-27     executive committee shall adopt rules necessary for the
2-28     administration of this subchapter, including guidelines for:
2-29                 (1)  developing contracts under which loan or stipend
2-30     recipients provide services to qualifying communities;
2-31                 (2)  identifying the duties of the state, state agency,
2-32     loan or stipend recipient, and medically underserved community
2-33     under the loan or stipend contract;
2-34                 (3)  determining a rate of interest to be charged under
2-35     Section 106.305(e)(2);
2-36                 (4)  insuring that a loan reimbursement or stipend
2-37     recipient provides Medicare or Medicaid patients access to health
2-38     services in qualifying communities;
2-39                 (5)  encouraging the use of telecommunications or
2-40     telemedicine, as appropriate;
2-41                 (6)  prioritizing the provision of loans and stipends
2-42     to health professionals who do not have access to any other state
2-43     loan forgiveness, loan repayment, or stipend program;
2-44                 (7)  prioritizing the provision of loans and stipends
2-45     to health professionals who are graduates of health professional
2-46     degree programs in this state;
2-47                 (8)  encouraging a medically underserved community
2-48     served by a loan repayment or stipend recipient to contribute to
2-49     the cost of the loan reimbursement or stipend when making a
2-50     contribution is feasible; and
2-51                 (9)  requiring a medically underserved community served
2-52     by a loan repayment or stipend recipient to assist the center in
2-53     contracting with the loan or stipend recipient who will serve that
2-54     community.
2-55           (b)  The executive committee by rule may designate areas of
2-56     the state as medically underserved communities.
2-57           (c)  The executive committee shall make reasonable efforts to
2-58     contract with health professionals from a variety of different
2-59     health professions.
2-60           Sec. 106.307.  TRUST FUND.  (a)  The rural communities health
2-61     care investment program trust fund is created as a trust fund with
2-62     the comptroller and shall be administered by the center as trustee
2-63     on behalf of medically underserved communities.
2-64           (b)  The center, as trustee of the rural communities health
2-65     care investment program trust fund, may accept and administer gifts
2-66     and grants from any public or private person or entity for the use
2-67     and benefit of any program described or created under this chapter.
2-68           SECTION 2.  Subchapter C, Chapter 61, Education Code, is
2-69     amended by adding Section 61.0899 to read as follows:
 3-1           Sec. 61.0899.  ASSISTANCE IN CERTAIN RURAL HEALTH CARE LOAN
 3-2     FORGIVENESS PROGRAMS.  The board shall, in cooperation with the
 3-3     Center for Rural Health Initiatives and the center's advisory panel
 3-4     established under Section 106.302, Health and Safety Code, develop
 3-5     a program to ensure that the board and any institution of higher
 3-6     education shall seek to obtain the maximum amount of funds from any
 3-7     source, including federal funds, to support programs to provide
 3-8     student loan reimbursement or stipends for graduates of degree
 3-9     programs in this state who practice or agree to practice in a
3-10     medically underserved community.
3-11           SECTION 3.  This Act takes effect immediately if it receives
3-12     a vote of two-thirds of all the members elected to each house, as
3-13     provided by Section 39, Article III, Texas Constitution.  If this
3-14     Act does not receive the vote necessary for immediate effect, this
3-15     Act takes effect September 1, 2001.
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