By Truan                                               S.B. No. 514
         77R3402 YDB-D                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to expanding grant programs formerly limited to physicians
 1-3     to include other health care professionals.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1. Section 106.101, Health and Safety Code, is
 1-6     amended to read as follows:
 1-7           Sec. 106.101.  DEFINITIONS. In this subchapter:
 1-8                 (1)  "Health care professional" means:
 1-9                       (A)  a physician assistant;
1-10                       (B)  an advanced nurse practitioner;
1-11                       (C)  a registered nurse;
1-12                       (D)  a radiologist; and
1-13                       (E)  any other professional who provides health
1-14     care services, as determined by the executive committee.
1-15                 (2)  "Medically underserved community" means:
1-16                       (A)  a community located in an area in this state
1-17     with a medically underserved population;
1-18                       (B)  a community located in an area in this state
1-19     designated by the United States Secretary of Health and Human
1-20     Services as an area with a shortage of personal health services;
1-21                       (C)  a population group designated by the United
1-22     States Secretary of Health and Human Services as having a shortage
1-23     of personal health services; or
1-24                       (D)  a community that meets criteria adopted by
 2-1     the board by rule, considering relevant demographic, geographic,
 2-2     and environmental factors.
 2-3                 (3) [(2)]  "Physician" means a person licensed to
 2-4     practice medicine in this state.
 2-5                 (4) [(3)]  "Primary care" means physician services in
 2-6     family practice, general practice, internal medicine, pediatrics,
 2-7     obstetrics, or gynecology.
 2-8                 (5) [(4)]  "Start-up money" means a payment made by a
 2-9     medically underserved community for reasonable costs incurred by a
2-10     physician to establish a medical office and ancillary facilities
2-11     for diagnosing and treating patients.
2-12           SECTION 2. Sections 106.102(a), (b), (c), and (d), Health and
2-13     Safety Code, are amended to read as follows:
2-14           (a)  The executive committee shall establish and administer a
2-15     program under this subchapter to increase the number of physicians
2-16     and health care professionals providing or assisting in the
2-17     provision of primary care in medically underserved communities.
2-18           (b)  A medically underserved community may sponsor a
2-19     physician who has completed a primary care residency program or a
2-20     health care professional if the physician or health care
2-21     professional [and] has agreed to provide or assist in the provision
2-22     of primary care in the community by contributing to start-up money
2-23     for the physician or the health care professional and having that
2-24     contribution matched in whole or in part by state money
2-25     appropriated to the executive committee for that purpose.
2-26           (c)  A participating medically underserved community may
2-27     provide start-up money to an eligible physician or health care
 3-1     professional over a two-year period.
 3-2           (d)  The executive committee may not pay more than the
 3-3     following amounts [$25,000] to a community in a fiscal year unless
 3-4     the executive committee makes a specific finding of need by the
 3-5     community:
 3-6                 (1)  $25,000 for eligible physicians; and
 3-7                 (2)  $25,000 for eligible health care professionals.
 3-8           SECTION 3. Section 106.103, Health and Safety Code, is
 3-9     amended to read as follows:
3-10           Sec. 106.103.  ELIGIBILITY. To be eligible to receive money
3-11     from the executive committee, a medically underserved community
3-12     must:
3-13                 (1)  apply for the money; and
3-14                 (2)  provide evidence satisfactory to the executive
3-15     committee that it has entered into an agreement with a physician or
3-16     a health care professional for the physician or the health care
3-17     professional to provide or assist in the provision of primary care
3-18     in the community for at least two years.
3-19           SECTION 4. Section 106.104, Health and Safety Code, is
3-20     amended to read as follows:
3-21           Sec. 106.104.  RULES. The executive committee shall adopt
3-22     rules necessary for the administration of this subchapter,
3-23     including:
3-24                 (1)  eligibility criteria for a medically underserved
3-25     community;
3-26                 (2)  eligibility criteria for a physician;
3-27                 (3)  eligibility criteria for health care
 4-1     professionals;
 4-2                 (4)  minimum and maximum community contributions to the
 4-3     start-up money for a physician to be matched with state money;
 4-4                 (5) [(4)]  conditions under which state money must be
 4-5     repaid by a community, [or]  physician, or health care
 4-6     professional;
 4-7                 (6) [(5)]  procedures for disbursement of money by the
 4-8     executive committee;
 4-9                 (7) [(6)]  the form and manner in which a community
4-10     must make its contribution to the start-up money; and
4-11                 (8) [(7)]  the contents of an agreement to be entered
4-12     into by the parties to include at least:
4-13                       (A)  a credit check for an eligible physician or
4-14     health care professional; and
4-15                       (B)  community retention of interest in any
4-16     property, equipment, or durable goods for seven years.
4-17           SECTION 5. Section 106.151, Health and Safety Code, is
4-18     amended to read as follows:
4-19           Sec. 106.151.  DEFINITIONS. In this chapter:
4-20                 (1)  "Health care professional" means:
4-21                       (A)  a physician assistant;
4-22                       (B)  an advanced nurse practitioner;
4-23                       (C)  a registered nurse;
4-24                       (D)  a radiologist; and
4-25                       (E)  any other professional who provides health
4-26     care services as determined  by the executive committee.
4-27                 (2)  "Medically underserved area" means an area
 5-1     designated by the United States Secretary of Health and Human
 5-2     Services as having:
 5-3                       (A)  a shortage of personal health services or a
 5-4     population group that has such a shortage as provided by 42 U.S.C.
 5-5     Section 300e-1(7); or
 5-6                       (B)  a health professional shortage as provided
 5-7     by 42 U.S.C. Section 254e(a)(1).
 5-8                 (3) [(2)]  "Physician" means a resident physician who
 5-9     is enrolled in an accredited residency training program in this
5-10     state in the specialty of:
5-11                       (A)  family practice;
5-12                       (B)  general internal medicine;
5-13                       (C)  general pediatric medicine; or
5-14                       (D)  general obstetrics and gynecology.
5-15           SECTION 6. Section 106.152(a), Health and Safety Code, is
5-16     amended to read as follows:
5-17           (a)  The executive committee shall establish a program in the
5-18     center to assist communities in recruiting and retaining physicians
5-19     and health care professionals to practice in medically underserved
5-20     areas.
5-21           SECTION 7. Section 106.154, Health and Safety Code, is
5-22     amended to read as follows:
5-23           Sec. 106.154.  REQUIRED CONTRACT. (a)  The center may award a
5-24     stipend to a physician or a health care professional under this
5-25     subchapter if the physician or the health care professional enters
5-26     into a written contract to provide services in a medically
5-27     underserved area for at least one year for each year that the
 6-1     physician or the health care professional receives the stipend.
 6-2           (b)  The contract must provide that if the physician or the
 6-3     health care professional does not provide the required services in
 6-4     the medically underserved area or provides those services for less
 6-5     than the required term, the physician or the health care
 6-6     professional is personally liable to the state for:
 6-7                 (1)  the total amount of the stipend the physician or
 6-8     the health care professional receives;
 6-9                 (2)  interest on that total amount for the period
6-10     beginning on the date the physician or the health care professional
6-11     signs the contract and ending on the date the physician or the
6-12     health care professional repays the amount of the stipend computed
6-13     at a rate equal to the sum of:
6-14                       (A)  the auction average rate quoted on a bank
6-15     discount basis for 26-week treasury bills issued by the United
6-16     States government, as published by the Federal Reserve Board, for
6-17     the week preceding the week in which the contract is signed; and
6-18                       (B)  five percent; and
6-19                 (3)  the state's reasonable expenses incurred in
6-20     obtaining payment, including reasonable attorney's fees.
6-21           SECTION 8. Sections 106.155(a), (b), and (d), Health and
6-22     Safety Code, are amended to read as follows:
6-23           (a)  The center shall award stipends to physicians or health
6-24     care professionals for one-year periods.  A stipend awarded under
6-25     this subchapter may not exceed $15,000 each year.
6-26           (b)  The center may renew a stipend used to assist a
6-27     particular physician or health care professional.
 7-1           (d)  A physician or a health care professional who receives a
 7-2     stipend under this subchapter is not eligible to receive assistance
 7-3     under a state educational loan repayment program or other state
 7-4     incentive program.
 7-5           SECTION 9. This Act takes effect September 1, 2001.