By: Zaffirini S.B. No. 2243

(In the Senate - Filed March 13, 2009; March 31, 2009, read first time and referred to Committee on Higher Education; April 20, 2009, reported adversely, with favorable Committee Substitute by the following vote: Yeas 5, Nays 0; April 20, 2009, sent to printer.)

COMMITTEE SUBSTITUTE FOR S.B. No. 2243 By: West

A BILL TO BE ENTITLED

AN ACT

relating to the repayment of certain education loans for licensed physicians and dentists.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 61.531, Education Code, is amended by adding Subsection (a-1) to read as follows:

(a-1) Preference shall be given under the program to:

(1) primary care physicians; and

(2) pediatric or geriatric subspecialists.

SECTION 2. Section 61.532, Education Code, is amended to read as follows:

Sec. 61.532. ELIGIBILITY. (a) To be eligible to receive repayment assistance, a physician must:

(1) apply to the coordinating board [and have completed at least one year of medical practice:

[(1) in private practice in an economically depressed or rural medically underserved area of the state];

(2) at the time of application, have:

(A) an unrestricted license to practice medicine under Subtitle B, Title 3, Occupations Code;

(B) an authorization number that allows the physician to provide services to recipients under the medical assistance program authorized by Chapter 32, Human Resources Code; and

(C) if the physician is a subspecialist, be certified or eligible for certification by the appropriate subspecialty board approved by the American Board of Medical Specialties or the American Osteopathic Association or approved by the Texas Medical Board by rule [for one of the following state agencies:

[(A) Texas Department of Health;

[(B) Texas Department of Mental Health and Mental Retardation;

[(C) Texas Department of Corrections; or

[(D) Texas Youth Commission]; and [or]

(3) enter into a written contract with the state indicating the physician's commitment to:

(A) fulfill a four-year continuous service obligation; and

(B) during each year of the service obligation:

(i) provide to recipients under the medical assistance program authorized by Chapter 32, Human Resources Code, a targeted amount of services as established jointly under Subsection (b) by the board and the Health and Human Services Commission; or

(ii) practice in an underserved area, as defined by rule by the Health and Human Services Commission, and maintain a policy of providing the targeted amount of services to recipients under the medical assistance program as provided by Subparagraph (i) [for an approved family practice residency training program established under Subchapter I as a clinical faculty member and have completed training in an approved family practice residency training program on or after July 1, 1994].

(b) The board and the Health and Human Services Commission jointly shall establish for purposes of this subchapter target amounts for the provision of medical services to recipients under the medical assistance program authorized by Chapter 32, Human Resources Code. The board and commission shall establish specified target amounts for services provided to children and to adults [coordinating board may by rule provide for repayment assistance on a pro rata basis for physicians practicing part-time for an approved family practice residency training program established under Subchapter I of this chapter or a state agency specified in Subsection (a) of this section].

SECTION 3. Section 61.533, Education Code, is amended to read as follows:

Sec. 61.533. LIMITATION. A physician may receive repayment assistance grants for [each of] not more than four [five] years.

SECTION 4. Subsections (a) and (b), Section 61.534, Education Code, are amended to read as follows:

(a) The coordinating board may provide repayment assistance for the repayment of any student loan for education at a public or accredited private [an] institution of higher education in the United States, including loans for undergraduate, graduate, and medical education, received by a physician through any lender.

(b) The coordinating board may not provide repayment assistance for a student loan that is:

(1) in default at the time of the physician's application;

(2) consolidated with noneducation loans or with loans held by an entity other than the lender;

(3) subject to an existing service obligation or subject to any other state or federal student loan repayment or forgiveness program; or

(4) obtained by the physician during the physician's residency period, through the physician's insurance policy or pension plan, or from a person related to the physician within the third degree by consanguinity or the second degree by affinity, as determined under Subchapter B, Chapter 573, Government Code.

SECTION 5. Subsection (a), Section 61.535, Education Code, is amended to read as follows:

(a) After each year of the physician's applicable service, the [The] coordinating board shall deliver any repayment made under this subchapter in a lump sum payable:

(1) to both the [lender and the] physician and the lender or other holder of the affected loan; or

(2) directly to the lender or other holder of the loan on the physician's behalf[, in accordance with federal law].

SECTION 6. Section 61.536, Education Code, is amended to read as follows:

Sec. 61.536. ADVISORY COMMITTEES. The coordinating board may[:

[(1)] appoint advisory committees from outside the board's membership to assist the board in performing its duties under this subchapter[; and

[(2) request the assistance of the Family Practice Residency Advisory Committee in performing those duties].

SECTION 7. Section 61.537, Education Code, is amended to read as follows:

Sec. 61.537. RULES. (a) The coordinating board shall adopt rules necessary for the administration of this subchapter, including a rule that sets a maximum amount of repayment assistance that may be received by a physician in one year [and a rule that authorizes the Family Practice Residency Advisory Committee to establish priorities among eligible physicians for repayment assistance, by taking into account the degree of physician shortage, geographic locations, whether the physician is or will be providing service in a medically underserved area, and other criteria the committee considers appropriate].

(b) The coordinating board shall distribute to each medical unit [and appropriate state agency] and professional association copies of the rules adopted under this section and pertinent information in this subchapter.

SECTION 8. Section 61.538, Education Code, is amended to read as follows:

Sec. 61.538. TOTAL AMOUNT OF REPAYMENT ASSISTANCE. (a) The total amount of repayment assistance distributed by the board may not exceed the total amount of gifts and grants accepted by the board for repayment assistance, medical school tuition set aside under Section 61.539 of this code, and legislative appropriations for repayment assistance.

(b) The total amount of repayment assistance made under this subchapter to an individual physician may not exceed $140,000 during the four-year service period.

SECTION 9. Subsection (b), Section 61.539, Education Code, is amended to read as follows:

(b) The amount set aside shall be transferred to the comptroller of public accounts to be maintained in the state treasury for the sole purpose of repayment of student loans of a physician who satisfies the eligibility requirements provided by this subchapter [serving in a designated state agency or in an area of this state that is economically depressed or that is a medically underserved area or health professional shortage area, as designated by the United States Department of Health and Human Services, that has a current shortage of physicians]. Section 403.095, Government Code, does not apply to the amount set aside by this section.

SECTION 10. Section 61.902, Education Code, is amended to read as follows:

Sec. 61.902. ELIGIBILITY. (a) To be eligible to receive repayment assistance, a dentist must:

(1) apply to the board;

(2) at the time of application, have:

(A) an unrestricted license to practice dentistry under Subtitle D, Title 3, Occupations Code;

(B) an authorization number that allows the dentist to provide services to recipients under the medical assistance program authorized by Chapter 32, Human Resources Code; and

(C) if the dentist is a subspecialist, be certified or eligible for certification by the appropriate subspecialty board approved by the American Dental Association or approved by the State Board of Dental Examiners by rule; and

(3) enter into a written contract with the state indicating the dentist's commitment to:

(A) fulfill a four-year continuous service obligation; and

(B) during each year of the service obligation:

(i) provide to recipients under the medical assistance program authorized by Chapter 32, Human Resources Code, a targeted amount of services as established jointly under Subsection (b) by the board and the Health and Human Services Commission; or

(ii) practice in an underserved area, as defined by rule by the Health and Human Services Commission, and maintain a policy of providing the targeted amount of services to recipients under the medical assistance program as provided by Subparagraph (i) [and have completed at least one year of dental practice in an area of the state that is underserved with respect to dental care].

(b) The board and the Health and Human Services Commission jointly shall establish for purposes of this subchapter target amounts for the provision of dental services to recipients under the medical assistance program authorized by Chapter 32, Human Resources Code. The board and commission shall establish specified target amounts for services provided to children and to adults [by rule may provide for repayment assistance on a pro rata basis for dentists in part-time practice described by Subsection (a)].

SECTION 11. Subchapter V, Chapter 61, Education Code, is amended by adding Section 61.9035 to read as follows:

Sec. 61.9035. LIMITATION. A dentist may receive repayment assistance grants for not more than four years.

SECTION 12. Subsections (a) and (b), Section 61.904, Education Code, are amended to read as follows:

(a) The board may provide repayment assistance for the repayment of any student loan for education at a public or accredited private institution of higher education in the United States, including loans for undergraduate, graduate, and professional dental education, received by a dentist through any lender.

(b) The board may not provide [withhold] repayment assistance for a student loan that is:

(1) in default at the time of the dentist's application;

(2) consolidated with noneducation loans or with loans held by an entity other than the lender;

(3) subject to an existing service obligation or subject to any other state or federal student loan repayment or forgiveness program; or

(4) obtained by the dentist during the dentist's residency period, through the dentist's insurance policy or pension plan, or from a person related to the dentist within the third degree by consanguinity or the second degree by affinity, as determined under Subchapter B, Chapter 573, Government Code.

SECTION 13. Subsection (a), Section 61.905, Education Code, is amended to read as follows:

(a) After each year of the dentist's applicable service, the [The] coordinating board shall deliver any repayment made under this subchapter in a lump sum payable:

(1) to both the [lender and the] dentist and the lender or other holder of the affected loan; or

(2) directly to the lender or other holder of the loan on behalf of the dentist[, in accordance with any applicable federal law].

SECTION 14. Section 61.906, Education Code, is amended to read as follows:

Sec. 61.906. ADVISORY COMMITTEES. The board may[:

[(1)] appoint advisory committees from outside the board's membership to assist the board in performing its duties under this subchapter[; and

[(2) request the assistance of the Oral Health Services Advisory Committee in performing those duties].

SECTION 15. Section 61.908, Education Code, is amended to read as follows:

Sec. 61.908. RULES. (a) The board shall adopt rules necessary for the administration of this subchapter, including a rule that sets a maximum amount of repayment assistance that may be received by a dentist in one year. [The board may consult with the Oral Health Services Advisory Committee to assist the board in establishing priorities among eligible dentists for repayment assistance, taking into account the degree of an area's shortage of dental services, geographic locations, whether the dentist is or will be providing service in an underserved area with respect to dental services, and other criteria the board considers appropriate.]

(b) The coordinating board shall distribute to each dental school in this state [and to appropriate state agencies] and professional associations copies of the rules adopted under this section and other pertinent information relating to this subchapter.

SECTION 16. Section 61.909, Education Code, is amended to read as follows:

Sec. 61.909. TOTAL AMOUNT OF REPAYMENT ASSISTANCE. (a) The total amount of repayment assistance distributed by the board under this subchapter may not exceed the total amount of gifts and grants accepted by the board for repayment assistance, dental school tuition set aside under Section 61.910, legislative appropriations for repayment assistance, and other funds available to the board for purposes of this subchapter.

(b) The total amount of repayment assistance made under this subchapter to an individual dentist may not exceed $140,000 during the four-year service period.

SECTION 17. Subsections (b) and (c), Section 61.531, Education Code, are repealed.

SECTION 18. As soon as practicable after the effective date of this Act, the Texas Higher Education Coordinating Board shall adopt rules necessary to administer Subchapters J and V, Chapter 61, Education Code, as amended by this Act.

SECTION 19. This Act does not make an appropriation. This Act takes effect only if a specific appropriation for the implementation of the Act is provided in a general appropriations act of the 81st Legislature.

SECTION 20. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2009.

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