78R4552 MCK-F
By: Chisum H.B. No. 2632
A BILL TO BE ENTITLED
AN ACT
relating to the Office of Rural Community Affairs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 487.001, Government Code, is amended by
adding Subdivisions (3)-(7) to read as follows:
(3) "Rural community" means a community in a rural
area of this state as defined by the office.
(4) "Health care professional" means a person who
holds a license or other grant of authority issued by the state to
practice in a health care profession, including veterinary medicine
or other health care professions identified by office rule.
(5) "Physician" means a person licensed to practice
medicine in this state under Chapter 155, Occupations Code.
(6) "Hospital" means a public or private, general or
special hospital licensed under Chapter 241, Health and Safety
Code.
(7) "Medical school" has the meaning assigned by
Section 61.501, Education Code.
SECTION 2. Section 487.051, Government Code, is amended to
read as follows:
Sec. 487.051. POWERS AND DUTIES. The office shall:
(1) develop a rural policy for the state in
consultation with local leaders representing all facets of rural
community life, academic and industry experts, and state elected
and appointed officials with interests in rural communities;
(2) work with other state agencies and officials to
improve the results and the cost-effectiveness of state programs
affecting rural communities through coordination of efforts;
(3) develop programs to improve the leadership
capacity of rural community leaders;
(4) monitor developments that have a substantial
effect on rural Texas communities, especially actions of state
government, and compile an annual report describing and evaluating
the condition of rural communities;
(5) administer the federal community development
block grant nonentitlement program;
(6) administer programs supporting rural health care
as provided by this chapter [Subchapters D-H];
(7) perform research to determine the most beneficial
and cost-effective ways to improve the welfare of rural
communities;
(8) ensure that the office qualifies as the state's
office of rural health for the purpose of receiving grants from the
Office of Rural Health Policy of the United States Department of
Health and Human Services under 42 U.S.C. Section 254r; [and]
(9) manage the state's Medicare rural hospital
flexibility program under 42 U.S.C. Section 1395i-4;
(10) establish and administer, or contract for the
administration of, the programs in this chapter;
(11) adopt rules and set priorities for programs under
this chapter;
(12) make awards under programs governed by this
chapter on a priority basis according to rules adopted by the office
in any year available money is inadequate to provide grants,
stipends, loans, and loan guarantees to all eligible applicants for
the programs;
(13) enter into, enforce, and execute contracts and
deliver conveyances and other instruments necessary to make and
administer grants, stipends, loans, and loan guarantees under this
chapter;
(14) impose and collect reasonable fees and charges in
connection with grants, stipends, loans, and loan guarantees made
under this chapter and enforce reasonable penalties against a user
of a program who defaults on a loan, is delinquent in making loan
payments, or violates the terms of the program;
(15) deposit any amounts recovered for programs under
this chapter back into the fund from which the award money
originates;
(16) employ personnel and counsel necessary to
implement the programs under this chapter; and
(17) seek state and federal money available for
economic development in rural areas for programs under this
chapter.
SECTION 3. Section 487.053, Government Code, is amended by
adding Subsection (c) to read as follows:
(c) The expenditure of a gift, grant, donation, or other
contribution is subject to any limitation or requirement placed by
the person making the gift, grant, or donation.
SECTION 4. Section 106.026(b), Health and Safety Code, as
added by Section 2, Chapter 1221, Acts of the 77th Legislature,
Regular Session, 2001, is redesignated as Section 487.056(b),
Government Code, and Section 487.056, Government Code, is amended
to read as follows:
Sec. 487.056. REPORT TO LEGISLATURE. (a) Not later than
January 1 of each odd-numbered year, the office shall submit a
biennial report to the legislature regarding the activities of the
office, the activities of the Rural Foundation, and any findings
and recommendations relating to rural issues.
(b) The office [center] shall obtain information from each
county about indigent health care provided in the county and
information from each university, medical school, rural community,
or rural health care provider that has performed a study relating to
rural health care during the biennium. The office [center] shall
include the information obtained under this subsection in the
office's [center's] report to the legislature.
SECTION 5. Section 487.102, Government Code, is amended to
read as follows:
Sec. 487.102. PURPOSE; ADMINISTRATION. (a) The purpose of
the program is to encourage rural communities to recognize and
financially support students at institutions of higher education
who:
(1) pursue a degree in a health care profession; and
(2) agree to practice health care in a rural
community.
(b) The office shall administer or contract for the
administration of the program.
(c) The financial assistance provided under the program
includes awarding forgivable loans.
SECTION 6. Section 487.104(a), Government Code, is amended
to read as follows:
[(a)] The office [selection committee] shall select
outstanding rural scholars through a statewide competition
according to office rule.
SECTION 7. Section 487.105(a), Government Code, is amended
to read as follows:
[(a)] To be eligible to participate in the competition under
Section 487.104, an applicant [a high school student or an
undergraduate student at a postsecondary educational institution]
must:
(1) be nominated and sponsored by a rural community,
whose [which] sponsorship must include financial support; and
(2) be a Texas resident under Subchapter B, Chapter
54, Education Code[;
[(3) if the person is a high school student, be in the
upper 25 percent of the student's high school class, if the class
contains 48 or more students, and intend to enter a postsecondary
educational institution; and
[(4) if the person is an undergraduate student, be in
the upper 25 percent of the student's class or have a cumulative
grade average that is equal to or greater than the equivalent of a
3.0 on a 4.0 scale and be enrolled in a postsecondary educational
institution].
SECTION 8. Section 487.107(c), Government Code, is amended
to read as follows:
[(c)] If in any year the fund is inadequate to provide loans
to all eligible applicants, the executive committee shall award
forgivable loans on a priority basis [according to the applicants'
academic performance, test scores, and other criteria of
eligibility].
SECTION 9. Section 487.108(b), Government Code, is amended
to read as follows:
[(b)] An outstanding rural scholar may receive another
grant, loan, or scholarship for which the scholar is eligible in
addition to the receipt of a forgivable loan, provided [except]
that the total amount of funds received does [may] not exceed the
reasonable needs of the scholar.
SECTION 10. The heading for Subchapter F, Chapter 487,
Government Code, is amended to read as follows:
SUBCHAPTER F. RURAL [MEDICALLY UNDERSERVED] COMMUNITY-STATE
MATCHING INCENTIVE PROGRAM
SECTION 11. Section 487.201, Government Code, is amended by
amending Subdivisions (2) and (4) to read as follows:
(2) "Program [Physician]" means the rural community
matching incentive program [a person licensed to practice medicine
in this state].
(4) "Start-up money" means a payment made by a
medically underserved rural community for reasonable costs
incurred by a physician to be matched by the office to establish a
medical office and ancillary facilities for diagnosing and treating
patients.
SECTION 12. Section 487.202(a), (c), and (e), Government
Code, are amended to read as follows:
(a) The office [executive committee] shall establish and
administer a program under this subchapter to increase the number
of physicians providing primary care in rural [medically
underserved] communities.
(c) A participating rural [medically underserved] community
may provide start-up money to an eligible physician over a two-year
period.
(e) The office [executive committee] shall establish
priorities so that the neediest rural communities eligible for
assistance under this subchapter are assured the receipt of a
grant.
SECTION 13. Section 487.203, Government Code, is amended to
read as follows:
Sec. 487.203. ELIGIBILITY. To be eligible to receive money
from the office [executive committee], a rural [medically
underserved] community must[:
[(1) apply for the money; and
[(2)] provide evidence satisfactory to the office
[executive committee] that it has entered into an agreement with a
physician for the physician to provide primary care in the
community for at least two years.
SECTION 14. Section 487.204, Government Code, is amended to
read as follows:
Sec. 487.204. RULES. The executive committee shall adopt
rules necessary for the administration of this subchapter,
including rules requiring a physician to return any money received
under the program if the physician fails to fulfill the term of the
agreement with the community [addressing:
[(1) eligibility criteria for a medically underserved
community;
[(2) eligibility criteria for a physician;
[(3) minimum and maximum community contributions to
the start-up money for a physician to be matched with state money;
[(4) conditions under which state money must be repaid
by a community or physician;
[(5) procedures for disbursement of money by the
executive committee;
[(6) the form and manner in which a community must make
its contribution to the start-up money; and
[(7) the contents of an agreement to be entered into by
the parties, which must include at least:
[(A) a credit check for an eligible physician;
and
[(B) community retention of interest in any
property, equipment, or durable goods for seven years].
SECTION 15. Section 487.251, Government Code, is amended by
adding Subdivision (3) to read as follows:
(3) "Program" means the Texas health service corps
program.
SECTION 16. Section 487.252(a), Government Code, is amended
to read as follows:
[(a)] The executive committee shall establish a program in
the office to assist communities in recruiting and retaining
primary care physicians to practice in rural [medically
underserved] areas in the state.
SECTION 17. Section 487.254(a), Government Code, is amended
to read as follows:
[(a)] The office may award a stipend to a physician under
this subchapter if the physician enters into a written contract to
provide services in a rural [medically underserved] area for at
least one year for each year that the physician receives the
stipend.
SECTION 18. Section 487.302, Government Code, is amended to
read as follows:
Sec. 487.302. POWERS OF OFFICE. The [In administering this
subchapter, the] office may:
(1) [enter into and enforce contracts and execute and
deliver conveyances and other instruments necessary to make and
administer grants, loans, and loan guarantees under this
subchapter;
[(2) employ personnel and counsel necessary to
implement this subchapter and pay them from money appropriated for
that purpose;
[(3) impose and collect reasonable fees and charges in
connection with grants, loans, and loan guarantees made under this
subchapter and provide reasonable penalties for delinquent payment
of fees, charges, or loan repayments;
[(4)] take and enforce a mortgage or appropriate
security interest in real or personal property that a loan
recipient acquires with the proceeds of a loan made under this
subchapter; and
(2) [(5)] adopt rules necessary to implement the
grant, loan, and loan guarantee program.
SECTION 19. Subchapter H, Chapter 106, Health and Safety
Code, as added by Section 1, Chapter 831, Acts of the 77th
Legislature, Regular Session, 2001, is redesignated as Subchapter
K, Chapter 487, Government Code, and amended to read as follows:
SUBCHAPTER K [H]. COMMUNITY HEALTHCARE AWARENESS AND MENTORING
PROGRAM FOR STUDENTS
Sec. 487.451 [106.251]. DEFINITION [DEFINITIONS]. In this
subchapter, "program"[:
[(1) "Health care professional" means:
[(A) an advanced nurse practitioner;
[(B) a dentist;
[(C) a dental hygienist;
[(D) a laboratory technician;
[(E) a licensed vocational nurse;
[(F) a licensed professional counselor;
[(G) a medical radiological technologist;
[(H) an occupational therapist;
[(I) a pharmacist;
[(J) a physical therapist;
[(K) a physician;
[(L) a physician assistant;
[(M) a psychologist;
[(N) a registered nurse;
[(O) a social worker;
[(P) a speech-language pathologist;
[(Q) a veterinarian;
[(R) a chiropractor; and
[(S) another appropriate health care
professional identified by the executive committee.
[(2) "Program"] means the community healthcare
awareness and mentoring program for students established under this
subchapter.
[(3) "Underserved urban area" means an urban area of
this state with a medically underserved population, as determined
in accordance with criteria adopted by the board by rule,
considering relevant demographic, geographic, and environmental
factors.]
Sec. 487.452 [106.252]. COMMUNITY HEALTHCARE AWARENESS AND
MENTORING PROGRAM FOR STUDENTS. [(a)] The executive committee
shall establish a community healthcare awareness and mentoring
program for students [to:
[(1) identify high school students in rural and
underserved urban areas who are interested in serving those areas
as health care professionals;
[(2) identify health care professionals in rural and
underserved urban areas to act as positive role models, mentors, or
reference resources for the interested high school students;
[(3) introduce interested high school students to the
spectrum of professional health care careers through activities
such as health care camps and shadowing of health care
professionals;
[(4) encourage a continued interest in service as
health care professionals in rural and underserved urban areas by
providing mentors and community resources for students
participating in training or educational programs to become health
care professionals; and
[(5) provide continuing community-based support for
students during the period the students are attending training or
educational programs to become health care professionals,
including summer job opportunities and opportunities to mentor high
school students in the community.
[(b) In connection with the program, the center shall
establish and maintain an updated medical resource library that
contains information relating to medical careers. The center shall
make the library available to school counselors, students, and
parents of students].
Sec. 487.453 [106.253]. ADMINISTRATION. (a) The office
[center] shall administer or contract for the administration of the
program.
(b) [The center may solicit and accept gifts, grants,
donations, and contributions to support the program.
[(c)] The office [center] may administer the program in
cooperation with other public and private entities.
(c) [(d)] The office [center] shall coordinate the program
with similar programs, including programs relating to workforce
development, scholarships for education, and employment of
students, that are administered by other agencies, such as the
Texas Workforce Commission and local workforce development boards.
Sec. 487.454 [106.254]. GRANTS; ELIGIBILITY. (a) Subject
to available funds, the executive committee shall develop and
implement, as a component of the program, a grant program to support
employment opportunities in rural [and underserved urban] areas in
this state for students participating in training or educational
programs to become health care professionals.
(b) In awarding grants under the program, the executive
committee shall give first priority to grants to training or
educational programs that provide internships or preceptorships to
students.
(c) [To be eligible to receive a grant under the grant
program, a person must:
[(1) apply for the grant on a form adopted by the
executive committee;
[(2) be enrolled or intend to be enrolled in a training
or educational program to become a health care professional;
[(3) commit to practice or work, after licensure as a
health care professional, for at least one year as a health care
professional in a rural or underserved urban area in this state; and
[(4) comply fully with any practice or requirements
associated with any scholarship, loan, or other similar benefit
received by the student.
[(d)] As a condition of receiving a grant under the program
the student must agree to repay the amount of the grant, plus a
penalty in an amount established by rule of the executive committee
[not to exceed two times the amount of the grant], if the student
becomes licensed as a health care professional and fails to
practice or work for at least one year as a health care professional
in a rural [or underserved urban] area in this state.
SECTION 20. Subchapter H, Chapter 106, Health and Safety
Code, as added by Section 1, Chapter 1112, Acts of the 77th
Legislature, Regular Session, 2001, is redesignated as Subchapter
L, Chapter 487, Government Code, and amended to read as follows:
SUBCHAPTER L [H]. RURAL PHYSICIAN RECRUITMENT PROGRAM
Sec. 487.501 [106.251]. DEFINITION [DEFINITIONS]. In this
subchapter, "program" means the rural physician recruitment
program[:
[(1) "Rural community" means a rural area as defined
by the center.
[(2) "Medical school" has the meaning assigned by
Section 61.501, Education Code].
[Sec. 106.252. GIFTS AND GRANTS. The center may accept
gifts, grants, and donations to support the rural physician
recruitment program.]
Sec. 487.502 [106.253]. RURAL PHYSICIAN RECRUITMENT
PROGRAM. (a) The office [center] shall establish a process in
consultation with the Texas Higher Education Coordinating Board for
selecting a Texas medical school to recruit students from rural
communities and encourage them to return to rural communities to
practice medicine.
(b) The Texas medical school selected by the office [center]
shall:
(1) encourage high school and college students from
rural communities to pursue a career in medicine;
(2) develop a screening process to identify rural
students most likely to pursue a career in medicine;
(3) establish a rural medicine curriculum;
(4) establish a mentoring program for rural students;
(5) provide rural students with information about
financial aid resources available for postsecondary education; and
(6) establish a rural practice incentive program.
SECTION 21. Subchapter H, Chapter 106, Health and Safety
Code, as added by Section 2, Chapter 435, Acts of the 77th
Legislature, Regular Session, 2001, is redesignated as Subchapter
M, Chapter 487, Government Code, and amended to read as follows:
SUBCHAPTER M [H]. RURAL COMMUNITIES HEALTH CARE INVESTMENT PROGRAM
Sec. 487.551 [106.301]. DEFINITION [DEFINITIONS]. In this
subchapter, "program" means the rural communities health care
investment program[:
[(1) "Health professional" means a person other than a
physician who holds a license, certificate, registration, permit,
or other form of authorization required by law or a state agency
rule that must be obtained by an individual to practice in a health
care profession].
[(2) "Medically underserved community" means a
community that:
[(A) is located in a county with a population of
50,000 or less;
[(B) has been designated under state or federal
law as:
[(i) a health professional shortage area;
or
[(ii) a medically underserved area; or
[(C) has been designated as a medically
underserved community by the center.
[Sec. 106.302. ADVISORY PANEL. The center shall appoint an
advisory panel to assist in the center's duties under this
subchapter. The advisory panel must consist of at least:
[(1) one representative from the Texas Higher
Education Coordinating Board;
[(2) one representative from the institutions of
higher education having degree programs for the health professions
participating in the programs under this subchapter;
[(3) one representative from a hospital in a medically
underserved community;
[(4) one physician practicing in a medically
underserved community;
[(5) one health professional, other than a physician,
practicing in a medically underserved community; and
[(6) one public representative who resides in a
medically underserved community].
Sec. 487.552 [106.303]. LOAN REIMBURSEMENT PROGRAM. The
executive committee shall establish a program in the office
[center] to assist communities in recruiting health professionals
to practice in rural [medically underserved] communities by
providing loan reimbursement for health professionals who serve in
those communities.
Sec. 487.553 [106.304]. STIPEND PROGRAM. [(a)] The
executive committee shall establish a program in the office
[center] to assist communities in recruiting health professionals
to practice in rural [medically underserved] communities by
providing a stipend to health professionals who agree to serve in
those communities.
[(b) A stipend awarded under this section shall be paid in
periodic installments.
[(c) A health professional who participates in the program
established under this section must establish an office and
residency in the medically underserved area before receiving any
portion of the stipend.]
Sec. 487.554 [106.305]. CONTRACT REQUIRED. (a) A health
professional may receive assistance under this subchapter only if
the health professional signs a contract agreeing to provide health
care services in a rural [medically underserved] community.
(b) [A student in a degree program preparing to become a
health professional may contract with the center for the loan
reimbursement program under Section 106.303 before obtaining the
license required to become a health professional.
[(c) The center may contract with a health professional for
part-time services under the stipend program established under
Section 106.304.
[(d)] A health professional who participates in any loan
reimbursement program is not eligible for a stipend under Section
487.553 [106.304].
(c) [(e)] A contract under this section must provide that a
health professional who does not provide the required services to
the community or provides those services for less than the required
time is personally liable to the state for[:
[(1) the total amount of assistance the health
professional received from the center and the medically underserved
community;
[(2) interest on the amount under Subdivision (1) at a
rate set by the executive committee;
[(3) the state's reasonable expenses incurred in
obtaining payment, including reasonable attorney's fees; and
[(4)] a penalty as established by the executive
committee by rule to help ensure compliance with the contract.
(d) Money [(f) Amounts] recovered under Subsection (c)
[(e)] shall be deposited in the permanent endowment fund for the
rural communities health care investment program under Section
487.556 [106.308].
Sec. 487.555 [106.306]. POWERS AND DUTIES OF OFFICE
[CENTER]. [(a)] The executive committee shall adopt rules
necessary for the administration of this subchapter[, including
guidelines for:
[(1) developing contracts under which loan
reimbursement or stipend recipients provide services to qualifying
communities;
[(2) identifying the duties of the state, state
agency, loan reimbursement or stipend recipient, and medically
underserved community under the loan reimbursement or stipend
contract;
[(3) determining a rate of interest to be charged
under Section 106.305(e)(2);
[(4) ensuring that a loan reimbursement or stipend
recipient provides access to health services to participants in
government-funded health benefits programs in qualifying
communities;
[(5) encouraging the use of telecommunications or
telemedicine, as appropriate;
[(6) prioritizing the provision of loan
reimbursements and stipends to health professionals who are not
eligible for any other state loan forgiveness, loan repayment, or
stipend program;
[(7) prioritizing the provision of loan
reimbursements and stipends to health professionals who are
graduates of health professional degree programs in this state;
[(8) encouraging a medically underserved community
served by a loan reimbursement or stipend recipient to contribute
to the cost of the loan reimbursement or stipend when making a
contribution is feasible; and
[(9) requiring a medically underserved community
served by a loan reimbursement or stipend recipient to assist the
center in contracting with the loan reimbursement or stipend
recipient who will serve that community].
[(b) The executive committee by rule may designate areas of
the state as medically underserved communities.
[(c) The executive committee shall make reasonable efforts
to contract with health professionals from a variety of different
health professions.
[Sec. 106.307. USE OF TELECOMMUNICATION AND TELEMEDICINE.
A health professional who participates in a program under this
subchapter may not use telecommunication technology, including
telemedicine, as the sole or primary method of providing services
and may not use telecommunication technology as a substitute for
providing health care services in person. A health professional
who participates in a program under this subchapter may use
telecommunication technology only to supplement or enhance the
health care services provided by the health professional.]
Sec. 487.556 [106.308]. PERMANENT ENDOWMENT FUND. (a) The
permanent endowment fund for the rural communities health care
investment program is a special fund in the treasury outside the
general revenue fund.
(b) The fund is composed of:
(1) money transferred to the fund at the direction of
the legislature;
(2) gifts and grants contributed to the fund;
(3) the returns received from investment of money in
the fund; and
(4) money [amounts] recovered under Section
487.554(c) [106.305(e)].
Sec. 487.557 [106.309]. ADMINISTRATION AND USE OF FUND.
(a) The office [center] may administer the permanent endowment
fund for the rural communities health care investment program. If
the office [center] elects not to administer the fund, the
comptroller shall administer the fund.
(b) The administrator of the fund shall invest the fund in a
manner intended to preserve the purchasing power of the fund's
assets and the fund's annual distributions. The administrator may
acquire, exchange, sell, supervise, manage, or retain, through
procedures and subject to restrictions the administrator considers
appropriate, any kind of investment of the fund's assets that
prudent investors, exercising reasonable care, skill, and caution,
would acquire or retain in light of the purposes, terms,
distribution requirements, and other circumstances of the fund then
prevailing, taking into consideration the investment of all the
assets of the fund rather than a single investment.
(c) The comptroller or the office [center] may solicit and
accept gifts and grants to the fund.
(d) Annual distributions for the fund shall be determined by
the investment and distribution policy adopted by the administrator
of the fund for the fund's assets.
(e) Except as provided by Subsection (f), money in the fund
may not be used for any purpose.
(f) The amount available for distribution from the fund,
including any gift or grant, may be appropriated only for providing
stipends and loan reimbursement under the programs authorized by
this subchapter and to pay the expenses of managing the fund. The
expenditure of a gift or grant is subject to any limitation or
requirement placed on the gift or grant by the donor or granting
entity.
(g) Sections 403.095 and 404.071, Government Code, do not
apply to the fund. Section 404.094(d), Government Code, applies to
the fund.
[Sec. 106.310. REPORTING REQUIREMENT. The center shall
provide a report on the permanent endowment fund for the rural
communities health care investment program to the Legislative
Budget Board not later than November 1 of each year. The report must
include the total amount of money the center received from the fund,
the purpose for which the money was used, and any additional
information that may be requested by the Legislative Budget Board.]
SECTION 22. Section 38.011(j), Education Code, as added by
Section 1, Chapter 1418, Acts of the 76th Legislature, Regular
Session, 1999, as amended by Section 4, Chapter 1424, Acts of the
77th Legislature, Regular Session, 2001, and as amended and
redesignated as Section 38.060(a), Education Code, by Section
4.005, Chapter 1420, Acts of the 77th Legislature, Regular Session,
2001, is reenacted to read as follows:
(a) This section applies only to a school-based health
center serving an area that:
(1) is located in a county with a population not
greater than 50,000; or
(2) has been designated under state or federal law as:
(A) a health professional shortage area;
(B) a medically underserved area; or
(C) a medically underserved community by the
Office of Rural Community Affairs.
SECTION 23. Section 51.949(b), Education Code, as added by
Chapter 1293, Acts of the 77th Legislature, Regular Session, 2001,
is amended to read as follows:
[(b)] On receipt of an application from a foreign applicant
for the expedited processing of a license under Section
155.1025(a)(2), Occupations Code, the Texas Department of Health
shall request the United States Department of State to recommend
the waiver of 8 U.S.C. Section 1182(e) under exceptions provided by
8 U.S.C. Section 1184(l) for [not more than 20] qualified alien
physicians [each year] who agree, beginning not later than the 90th
day after the date of approval of the waiver and continuing for at
least three years, to:
(1) accept employment with an entity:
(A) located in a rural community, as determined
by the Office of Rural Community Affairs or in a medically
underserved area or health professional shortage area, as
designated by the United States Department of Health and Human
Services[, within an eligible area]; or [and]
(B) affiliated with or participating in a public
university-sponsored graduate medical education program under
which employment the physician:
(i) serves [;(2) serve] on the faculty of
the public university-sponsored graduate medical education
program; and
(ii) engages [(3) engage] in the practice
of medicine and teaching in a specialty field of medicine that is
necessary to obtain or maintain the accreditation of the public
university-sponsored graduate medical education program by the
Accreditation Council for Graduate Medical Education; or [and]
(2) [(4)] join a medical practice located in a
medically underserved area or health professional shortage area, as
designated by the United States Department of Health and Human
Services, within an eligible area.
SECTION 24. Section 61.0899, Education Code, is amended to
read as follows:
Sec. 61.0899. ASSISTANCE IN CERTAIN RURAL HEALTH CARE LOAN
REIMBURSEMENT AND STIPEND PROGRAMS. The board shall, in
cooperation with the Office of Rural Community Affairs [Center for
Rural Health Initiatives and the center's advisory panel
established under Section 106.302, Health and Safety Code], ensure
that the board seeks to obtain the maximum amount of funds from any
source, including federal funds, to support programs to provide
student loan reimbursement or stipends for graduates of degree
programs in this state who practice or agree to practice in a rural
[medically underserved] community.
SECTION 25. Section 110.001, Health and Safety Code, as
added by Chapter 1221, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
Sec. 110.001. CREATION OF FOUNDATION. (a) The Office of
Rural Community Affairs [Center for Rural Health Initiatives] shall
establish the Rural Foundation as a nonprofit corporation that
complies with the Texas Non-Profit Corporation Act (Article
1396-1.01 et seq., Vernon's Texas Civil Statutes), except as
otherwise provided by this chapter, and qualifies as an
organization exempt from federal income tax under Section
501(c)(3), Internal Revenue Code of 1986, as amended.
(b) The Office of Rural Community Affairs [Center for Rural
Health Initiatives] shall ensure that the Rural Foundation operates
independently of any state agency or political subdivision of the
state.
SECTION 26. Section 110.002(c), Health and Safety Code, as
added by Chapter 1221, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
(c) The Rural Foundation shall develop and implement
policies and procedures that clearly separate the responsibilities
and activities of the foundation from the Office of Rural Community
Affairs [Center for Rural Health Initiatives].
SECTION 27. Section 110.003(a), Health and Safety Code, as
added by Chapter 1221, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
(a) The Rural Foundation is governed by a board of five
directors appointed by the executive committee of the Office of
Rural Community Affairs [Center for Rural Health Initiatives] from
individuals recommended by the executive director of the Office of
Rural Community Affairs [Center for Rural Health Initiatives].
SECTION 28. Section 110.005(c), Health and Safety Code, as
added by Chapter 1221, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
(c) If the executive director of the Office of Rural
Community Affairs [Center for Rural Health Initiatives] has
knowledge that a potential ground for removal exists, the executive
director shall notify the presiding officer of the board of
directors of the Rural Foundation of the potential ground. The
presiding officer shall then notify the governor and the attorney
general that a potential ground for removal exists. If the
potential ground for removal involves the presiding officer, the
executive director shall notify the next highest ranking officer of
the board of directors, who shall then notify the governor and the
attorney general that a potential ground for removal exists.
SECTION 29. Section 110.010, Health and Safety Code, as
added by Chapter 1221, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
Sec. 110.010. MEMORANDUM OF UNDERSTANDING. The Rural
Foundation and the Office of Rural Community Affairs [Center for
Rural Health Initiatives] shall enter into a memorandum of
understanding that:
(1) requires the board of directors and staff of the
foundation to report to the executive director and executive
committee of the Office of Rural Community Affairs [Center for
Rural Health Initiatives];
(2) allows the Office of Rural Community Affairs
[Center for Rural Health Initiatives] to provide staff functions to
the foundation;
(3) allows the Office of Rural Community Affairs
[Center for Rural Health Initiatives] to expend funds on the
foundation; and
(4) outlines the financial contributions to be made to
the foundation from funds obtained from grants and other sources.
SECTION 30. Section 110.011(a), Health and Safety Code, as
added by Chapter 1221, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
(a) The Rural Foundation shall maintain financial records
and reports independently from those of the Office of Rural
Community Affairs [Center for Rural Health Initiatives].
SECTION 31. Section 110.012, Health and Safety Code, as
added by Chapter 1221, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
Sec. 110.012. REPORT TO OFFICE OF RURAL COMMUNITY
AFFAIRS [CENTER FOR RURAL HEALTH INITIATIVES]. Not later than the
60th day after the last day of the fiscal year, the Rural Foundation
shall submit to the Office of Rural Community Affairs [Center for
Rural Health Initiatives] a report itemizing all income and
expenditures and describing all activities of the foundation during
the preceding fiscal year.
SECTION 32. Section 155.1025(a), Occupations Code, is
amended to read as follows:
(a) The board shall adopt rules for expediting any
application for a license under this subtitle made by a person who
is licensed to practice medicine in another state or country and who
submits an affidavit with the application stating that:
(1) the applicant intends to practice in a rural
community, as determined by the Office of Rural Community Affairs
[Center for Rural Health Initiatives]; or
(2) the applicant intends to:
(A) accept employment with an entity located in a
medically underserved area or health professional shortage area,
designated by the United States Department of Health and Human
Services, and affiliated with or participating in a public
university-sponsored graduate medical education program;
(B) serve on the faculty of the public
university-sponsored graduate medical education program; and
(C) engage in the practice of medicine and
teaching in a specialty field of medicine that is necessary to
obtain or maintain the accreditation of the public
university-sponsored graduate medical education program by the
Accreditation Council for Graduate Medical Education.
SECTION 33. The section heading for Section 204.104,
Occupations Code, is amended to read as follows:
Sec. 204.104. RURAL PHYSICIAN ASSISTANT LOAN REPAYMENT
[REIMBURSEMENT] PROGRAM.
SECTION 34. Section 204.104(a), Occupations Code, is
amended to read as follows:
(a) A program shall be established to provide student loan
repayment [reimbursement] for graduates of physician assistant
training programs from any state who practice in rural [health
professional shortage areas and medically underserved] areas in the
state as defined by the Office of Rural Community Affairs
[identified by the Texas Department of Health]. The physician
assistant board shall fund the program by designating annually a
portion of the revenue generated under this chapter from physician
assistant licensing fees.
SECTION 35. Section 531.02172, Government Code, as amended
by Chapters 661 and 959, Acts of the 77th Legislature, Regular
Session, 2001, is reenacted and amended to read as follows:
Sec. 531.02172. TELEMEDICINE ADVISORY COMMITTEE. (a) The
commissioner shall establish an advisory committee to assist the
commission in:
(1) evaluating policies for telemedical consultations
under Section 531.0217;
(2) evaluating policies for telemedicine medical
services or telehealth services pilot programs established under
Section 531.02171;
(3) ensuring the efficient and consistent development
and use of telecommunication technology for telemedical
consultations and telemedicine medical services or telehealth
services reimbursed under government-funded health programs;
(4) monitoring the type of programs receiving
reimbursement under Sections 531.0217 and 531.02171; and
(5) coordinating the activities of state agencies
concerned with the use of telemedical consultations and
telemedicine medical services or telehealth services.
(b) The advisory committee must include:
(1) representatives of health and human services
agencies and other state agencies concerned with the use of
telemedical consultations in the Medicaid program and the state
child health plan program, including representatives of:
(A) the commission;
(B) the Texas Department of Health;
(C) the Office of Rural Community Affairs [Center
for Rural Health Initiatives];
(D) the Telecommunications Infrastructure Fund
Board;
(E) the Texas Department of Insurance;
(F) the Texas State Board of Medical Examiners;
(G) the Board of Nurse Examiners; and
(H) the Texas State Board of Pharmacy;
(2) representatives of health science centers in this
state;
(3) experts on telemedicine, telemedical
consultation, and telemedicine medical services or telehealth
services; and
(4) representatives of consumers of health services
provided through telemedical consultations and telemedicine
medical services or telehealth services.
(c) A member of the advisory committee serves at the will of
the commissioner.
SECTION 36. The following sections are repealed:
(1) Sections 487.101(1), (3), and (5), Government
Code;
(2) Section 487.103, Government Code;
(3) Sections 487.104(b), (c), (d), and (e), Government
Code;
(4) Section 487.105(b), Government Code;
(5) Section 487.106, Government Code;
(6) Sections 487.107(a) and (b), Government Code;
(7) Section 487.108(a), Government Code;
(8) Sections 487.109(b) and (c), Government Code;
(9) Sections 487.110(c), (d), and (e), Government
Code;
(10) Section 487.111, Government Code;
(11) Subchapter E, Chapter 487, Government Code;
(12) Sections 487.201(1) and (3), Government Code;
(13) Sections 487.202(b) and (d), Government Code;
(14) Sections 487.251(1) and (2), Government Code;
(15) Section 487.252(b), Government Code;
(16) Section 487.253(b), Government Code;
(17) Section 487.254(b), Government Code;
(18) Section 487.255, Government Code;
(19) Section 487.256, Government Code;
(20) Section 487.301, Government Code;
(21) Section 51.949(a), Education Code, as added by
Chapter 1293, Acts of the 77th Legislature, Regular Session, 2001;
(22) Section 106.025(a), Health and Safety Code, as
amended by Section 1, Chapter 435, Acts of the 77th Legislature,
Regular Session, 2001;
(23) Section 106.029, Health and Safety Code, as added
by Section 1, Chapter 1113, Acts of the 77th Legislature, Regular
Session, 2001; and
(24) Section 106.043(b), Health and Safety Code, as
amended by Section 10, Chapter 874, Acts of the 77th Legislature,
Regular Session, 2001.
SECTION 37. This Act takes effect September 1, 2003.