84R7767 KEL/AJA-D
 
  By: Nelson, Hinojosa, Seliger S.B. No. 18
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to measures to support or enhance graduate medical
  education in this state, including the transfer of assets following
  the dissolution of the Texas Medical Liability Insurance
  Underwriting Association.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 58A, Education Code, is
  amended by adding Section 58A.002 to read as follows:
         Sec. 58A.002.  PERMANENT FUND SUPPORTING GRADUATE MEDICAL
  EDUCATION. (a)  In this section, "trust company" means the Texas
  Treasury Safekeeping Trust Company.
         (b)  The permanent fund supporting graduate medical
  education is a special fund in the treasury outside the general
  revenue fund.  The fund is composed of:
               (1)  money transferred or appropriated to the fund by
  the legislature;
               (2)  gifts and grants contributed to the fund; and
               (3)  the returns received from investment of money in
  the fund.
         (c)  The trust company shall administer the fund. The trust
  company shall determine the amount available for distribution from
  the fund, determined in accordance with a distribution policy that
  is adopted by the comptroller and designed to preserve the
  purchasing power of the fund's assets and to provide a stable and
  predictable stream of annual distributions. Expenses of managing
  the fund's assets shall be paid from the fund.  Except as provided
  by this section, money in the fund may not be used for any purpose.  
  Sections 403.095 and 404.071, Government Code, do not apply to the
  fund.
         (d)  In managing the assets of the fund, through procedures
  and subject to restrictions the trust company considers
  appropriate, the trust company may acquire, exchange, sell,
  supervise, manage, or retain any kind of investment that a prudent
  investor, 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.
         (e)  The amount available for distribution from the fund may
  be appropriated only to fund the programs created under this
  chapter and any other programs designed to support or enhance
  graduate medical education in this state.
         (f)  A public or private institution of higher education or
  other entity that may receive money under a program described by
  Subsection (e) may solicit and accept gifts and grants to the fund.
  A gift or grant to the fund must be distributed and appropriated for
  the purposes of the fund, subject to any limitation or requirement
  placed on the gift or grant by the donor or granting entity.
         SECTION 2.  Chapter 58A, Education Code, is amended by
  adding Subchapters D, E, and F to read as follows:
  SUBCHAPTER D. CRITICAL SHORTAGE PHYSICIAN GRANT PROGRAM
         Sec. 58A.101.  DEFINITIONS. In this subchapter:
               (1)  "Center" means the comprehensive health
  professions resource center established under Chapter 105, Health
  and Safety Code.
               (2)  "Graduate medical residency training program"
  means a residency or other postgraduate medical training program:
                     (A)  participation in which may be counted toward
  certification in a medical specialty or subspecialty; and
                     (B)  that:
                           (i)  is accredited by the Accreditation
  Council for Graduate Medical Education or the American Osteopathic
  Association; or
                           (ii)  demonstrates eligibility to apply for
  and receive an accreditation described by Subparagraph (i).
               (3)  "Program" means the critical shortage physician
  grant program established under this subchapter.
               (4)  "Teaching hospital" means a teaching hospital
  affiliated with a medical school that is described as a medical and
  dental unit under Section 61.003.
         Sec. 58A.102.  ESTABLISHMENT OF PROGRAM. The board shall
  establish the critical shortage physician grant program to provide
  grants to teaching hospitals for graduate medical residency
  training programs to increase the number of physicians in the
  medical specialties and subspecialties that are determined by the
  board to be at a critical shortage level in this state.
         Sec. 58A.103.  RULES. (a) The board shall adopt rules to
  administer the program, including rules regarding:
               (1)  a grant application process;
               (2)  reporting requirements for grant recipients; and
               (3)  requirements and benchmarks for grant recipients
  to satisfy regarding the granting of additional program funding
  under Section 58A.106.
         (b)  The rules adopted under Subsection (a) must require
  grant recipients to submit reports at least quarterly, based on
  outcome measures established by the board in consultation with the
  Legislative Budget Board.
         Sec. 58A.104.  ELIGIBILITY. To be eligible to receive a
  grant under this subchapter, a teaching hospital must:
               (1)  provide a number of graduate medical residency
  positions in excess of both the cap on the number of positions
  funded by direct graduate medical education payments made under
  Section 1886(h), Social Security Act (42 U.S.C. Section 1395ww(h)),
  and the cap on the number of positions funded by indirect medical
  education payments made under Section 1886(d)(5)(B), Social
  Security Act (42 U.S.C. Section 1395ww(d)(5)(B)); and
               (2)  offer or seek to offer one or more graduate medical
  residency training programs in a specialty described by Section
  58.008(a) or in any other medical specialty or subspecialty
  determined by the board to be at a critical shortage level in this
  state.
         Sec. 58A.105.  USE OF FUNDS. In each state fiscal year, the
  board shall award grants for establishing new accredited graduate
  medical residency training programs or increasing the number of
  residency positions in existing accredited graduate medical
  residency training programs in specialties described by Section
  58.008(a) or in any other medical specialties or subspecialties
  determined by the board to be at a critical shortage level in this
  state.
         Sec. 58A.106.  ADDITIONAL USE: START-UP COSTS. (a) If in a
  state fiscal year excess program funds remain after funds are
  granted under Section 58A.105, the board may grant additional
  program funding to teaching hospitals to pay any start-up costs
  associated with establishing and seeking accreditation for a new
  graduate medical residency training program in a specialty
  described by Section 58.008(a) or in any other medical specialty or
  subspecialty determined by the board to be at a critical shortage
  level in this state, provided that no other federal or state funding
  is available for that program.
         (b)  To be eligible for funding under this section, start-up
  costs must be directly related to the establishment or
  accreditation of the new program.
         (c)  The board may grant program funding under this section
  to pay a percentage of the total amount of applicable start-up costs
  for the teaching hospital, not to exceed 20 percent.
         Sec. 58A.107.  REDUCTION IN FUNDING. The board shall limit
  or withhold funding from grant recipients that do not comply with
  reporting requirements or that use grant funds for a purpose not
  authorized by this subchapter. The board shall seek reimbursement
  with respect to any grant funds that are not used for purposes
  authorized by this subchapter.
         Sec. 58A.108.  CRITERIA FOR DETERMINING CRITICAL SHORTAGE
  LEVELS. (a) For purposes of this subchapter, the board shall
  determine critical shortage levels for medical specialties and
  subspecialties in this state according to criteria used by the
  United States Department of Health and Human Services Health
  Resources and Services Administration to designate health
  professional shortage areas.
         (b)  In its methodology for determining critical shortage
  levels under this section, the board shall include the results of
  the research conducted by the center under Section 105.009(a)(1),
  Health and Safety Code, and similar research performed by other
  appropriate entities.
  SUBCHAPTER E. TEXAS TEACHING HEALTH CENTER
  GRADUATE MEDICAL EDUCATION GRANT PROGRAM
         Sec. 58A.121.  DEFINITIONS. In this subchapter:
               (1)  "Graduate medical residency training program"
  means a residency or other postgraduate medical training program:
                     (A)  participation in which may be counted toward
  certification in a medical specialty or subspecialty; and
                     (B)  that:
                           (i)  is accredited by the Accreditation
  Council for Graduate Medical Education or the American Osteopathic
  Association; or
                           (ii)  demonstrates eligibility to apply for
  and receive an accreditation described by Subparagraph (i).
               (2)  "Primary care residency program" means a graduate
  medical residency training program in a specialty described by
  Section 58.008(a).
               (3)  "Program" means the Texas teaching health center
  graduate medical education grant program established under this
  subchapter.
               (4)  "Teaching health center" means a community-based,
  ambulatory patient care center that operates a primary care
  residency program. The term includes:
                     (A)  a federally qualified health center, as
  defined by Section 1905(l)(2)(B), Social Security Act (42 U.S.C.
  Section 1396d(l)(2)(B));
                     (B)  a community mental health center, as defined
  by Section 1861(ff)(3)(B), Social Security Act (42 U.S.C. Section
  1395x(ff)(3)(B));
                     (C)  a rural health clinic, as defined by Section
  1861(aa)(2), Social Security Act (42 U.S.C. Section 1395x(aa)(2));
                     (D)  a health center operated by the Indian Health
  Service, an Indian tribe or tribal organization, or an urban Indian
  organization, as defined by Section 4, Indian Health Care
  Improvement Act (25 U.S.C. Section 1603); and
                     (E)  an entity receiving funds under Title X,
  Public Health Service Act (42 U.S.C. Section 300 et seq.).
         Sec. 58A.122.  ESTABLISHMENT OF PROGRAM. The board shall
  establish the Texas teaching health center graduate medical
  education grant program to award grants to teaching health centers
  for the purpose of establishing new primary care residency programs
  or increasing the number of residency positions in existing primary
  care residency programs.
         Sec. 58A.123.  RULES. (a) The board shall adopt rules to
  administer the program, including rules regarding:
               (1)  a grant application process;
               (2)  reporting requirements for grant recipients under
  Section 58A.128; and
               (3)  the amount of the payments for direct expenses and
  indirect expenses, as defined by and calculated in the same manner
  as those expenses are calculated under the federal rules described
  by Subsection (b).
         (b)  The rules adopted under this subchapter must be based as
  nearly as possible on the rules adopted under the federal teaching
  health centers development grant program established under Section
  5508, Patient Protection and Affordable Care Act of 2010 (Pub. L.
  No. 111-148).
         (c)  The rules adopted in relation to the reporting
  requirements under Section 58A.128 must also:
               (1)  authorize the board to conduct audits of grant
  recipients to the extent necessary to ensure the accuracy and
  completeness of their annual reports; and
               (2)  specify a mandatory amount of reduction in grant
  funds under Section 58A.127 for a failure to submit an accurate or
  complete report.
         Sec. 58A.124.  AMOUNT AND DURATION OF GRANT. Subject to
  Section 58A.127, the board may award grants under this subchapter
  for a term of not more than three years, and the maximum award to a
  recipient may not exceed $500,000 during each state fiscal year.
         Sec. 58A.125.  RELATIONSHIP OF GRANTS TO OTHER FEDERAL
  PAYMENTS FOR GRADUATE MEDICAL EDUCATION. A grant awarded by the
  board under this subchapter is in addition to any payments for:
               (1)  direct graduate medical education costs under
  Section 1886(h), Social Security Act (42 U.S.C. Section 1395ww(h));
               (2)  indirect medical education costs under Section
  1886(d)(5)(B), Social Security Act (42 U.S.C. Section
  1395ww(d)(5)(B)); and
               (3)  direct costs of medical education under Section
  1886(k), Social Security Act (42 U.S.C. Section 1395ww(k)).
         Sec. 58A.126.  USE OF FUNDS. A grant awarded under this
  subchapter may be used only to cover the costs of establishing a new
  primary care residency program at a teaching health center or the
  costs of increasing the number of residency positions in an
  existing primary care residency program, including costs
  associated with:
               (1)  curriculum development;
               (2)  recruitment, training, and retention of residents
  and faculty;
               (3)  obtaining accreditation by the Accreditation
  Council for Graduate Medical Education or the American Osteopathic
  Association; and
               (4)  faculty salaries during the development phase.
         Sec. 58A.127.  REDUCTION IN FUNDING. The board shall limit
  or withhold funding from grant recipients that do not comply with
  reporting requirements or that use grant funds for a purpose not
  authorized by this subchapter. The board shall seek reimbursement
  with respect to any grant funds that are not used for purposes
  authorized by this subchapter.
         Sec. 58A.128.  REPORTING. (a) A grant recipient shall
  submit an annual report that fully accounts for the use of a grant
  awarded under this subchapter.
         (b)  The annual report must be made in the form and manner
  specified by the board and must include the following information
  for the most recent residency academic year completed immediately
  before the applicable state fiscal year:
               (1)  the types of primary care residency programs that
  the grant recipient provided for residents;
               (2)  the number of approved training positions in those
  programs for part-time or full-time residents;
               (3)  the number of part-time or full-time residents
  who:
                     (A)  completed their residency training in those
  programs at the end of the residency academic year; and
                     (B)  care for vulnerable populations living in
  underserved areas; and
               (4)  any other information considered appropriate by
  the board.
  SUBCHAPTER F. GRADUATE MEDICAL EDUCATION
  PARTNERSHIP GRANT PROGRAM
         Sec. 58A.151.  DEFINITIONS. In this subchapter:
               (1)  "Graduate medical education partnership" means a
  partnership entered into by a teaching health center and an
  accredited graduate medical residency training program offered by a
  hospital or medical school.
               (2)  "Graduate medical residency training program"
  means a residency or other postgraduate medical training program:
                     (A)  participation in which may be counted toward
  certification in a medical specialty or subspecialty; and
                     (B)  that:
                           (i)  is accredited by the Accreditation
  Council for Graduate Medical Education or the American Osteopathic
  Association; or
                           (ii)  demonstrates eligibility to apply for
  and receive an accreditation described by Subparagraph (i).
               (3)  "Primary care residency program" means a graduate
  medical residency training program in a specialty described by
  Section 58.008(a).
               (4)  "Program" means the graduate medical education
  partnership grant program established under this subchapter.
               (5)  "Teaching health center" means a community-based,
  ambulatory patient care center that operates a primary care
  residency program. The term includes:
                     (A)  a federally qualified health center, as
  defined by Section 1905(l)(2)(B), Social Security Act (42 U.S.C.
  Section 1396d(l)(2)(B));
                     (B)  a community mental health center, as defined
  by Section 1861(ff)(3)(B), Social Security Act (42 U.S.C. Section
  1395x(ff)(3)(B));
                     (C)  a rural health clinic, as defined by Section
  1861(aa)(2), Social Security Act (42 U.S.C. Section 1395x(aa)(2));
                     (D)  a health center operated by the Indian Health
  Service, an Indian tribe or tribal organization, or an urban Indian
  organization, as defined by Section 4, Indian Health Care
  Improvement Act (25 U.S.C. Section 1603); and
                     (E)  an entity receiving funds under Title X,
  Public Health Service Act (42 U.S.C. Section 300 et seq.).
         Sec. 58A.152.  ESTABLISHMENT OF PROGRAM. The board shall
  establish the graduate medical education partnership grant program
  to allow a teaching health center that is establishing and seeking
  accreditation for a new primary care residency program to partner
  with an accredited graduate medical residency training program
  offered by a hospital or medical school.
         Sec. 58A.153.  RULES. The board shall adopt rules to
  administer the program, including rules regarding a grant
  application process and reporting requirements for grant
  recipients.
         Sec. 58A.154.  USE OF FUNDS. The board shall award grants to
  each participant in a graduate medical education partnership to:
               (1)  facilitate a mentoring relationship between
  partners that will provide information and guidance for the
  participating teaching health center during the accreditation
  process; and
               (2)  assist the partners in building a collaborative
  working relationship for the future.
         Sec. 58A.155.  REDUCTION IN FUNDING. The board shall limit
  or withhold funding from grant recipients that do not comply with
  reporting requirements or that use grant funds for a purpose not
  authorized by this subchapter. The board shall seek reimbursement
  for any grant funds that are not used for purposes authorized by
  this subchapter.
         SECTION 3.  Chapter 105, Health and Safety Code, is amended
  by adding Section 105.009 to read as follows:
         Sec. 105.009.  RESEARCH REGARDING GRADUATE MEDICAL
  EDUCATION SYSTEM. (a) The comprehensive health professions
  resource center shall conduct research:
               (1)  to identify:
                     (A)  the ratio of primary care to non-primary care
  physicians that is necessary and appropriate to meet the current
  and future health care needs of this state; and
                     (B)  all medical specialties and subspecialties
  that are at critical shortage levels in this state, together with
  the geographic location of the physicians in those specialties and
  subspecialties; and
               (2)  regarding the overall supply of physicians in this
  state and any other issues that are relevant to the status of the
  state's graduate medical education system and the ability of that
  system to meet the current and future health care needs of this
  state.
         (b)  Not later than August 31 of each even-numbered year, the
  council shall report the results of the center's research to the
  Legislative Budget Board, the Texas Higher Education Coordinating
  Board, the office of the governor, and the standing committees of
  each house of the legislature with primary jurisdiction over state
  finance or appropriations.
         SECTION 4.  Chapter 2203, Insurance Code, is amended by
  adding Subchapter J to read as follows:
  SUBCHAPTER J. DISSOLUTION OF ASSOCIATION; REACTIVATION OF
  ASSOCIATION BY COMMISSIONER
         Sec. 2203.451.  DISSOLUTION DATE. The association shall
  cease all operations before and is dissolved on August 31, 2017.
         Sec. 2203.452.  DISSOLUTION PLAN. (a) The board of
  directors, in consultation with the department, shall develop a
  dissolution plan to:
               (1)  wind down and cease the association's operations
  before the dissolution date established by this subchapter; and
               (2)  transfer to the commissioner and the department:
                     (A)  any obligations of the association that
  survive the association's dissolution;
                     (B)  any rights of the association that:
                           (i)  accrued before the association's
  dissolution and survive the association's dissolution; or
                           (ii)  accrue after the association's
  dissolution with respect to coverage issued by the association
  before the association's dissolution;
                     (C)  any authority previously held by the
  association the continuation of which is necessary or appropriate;
  and
                     (D)  subject to Section 2203.456, any association
  assets.
         (b)  The dissolution plan may provide that the obligations,
  rights, authority, and, subject to Section 2203.456, assets
  transferred to the commissioner and department may be transferred
  to a liquidator appointed by the commissioner.
         (c)  The dissolution plan must be adopted by the commissioner
  by rule.
         Sec. 2203.453.  ISSUANCE AND RENEWAL OF INSURANCE COVERAGE;
  TERMINATION OF POLICIES. The association may not issue or renew
  an insurance policy on or after the effective date of this
  subchapter. A policy issued or renewed by the association before
  that date shall continue in force until terminated in accordance
  with the terms and conditions of the policy.
         Sec. 2203.454.  ACCEPTANCE AND DISPOSITION OF CLAIMS. (a)
  The association may continue to accept claims under association
  policies until:
               (1)  the dissolution date established by this
  subchapter; or
               (2)  an earlier claims acceptance deadline established
  in the dissolution plan.
         (b)  The dissolution plan must establish processes to ensure
  that, to the maximum extent reasonably possible, claims made under
  association policies before the dissolution date established by
  this subchapter are processed and paid or otherwise appropriately
  disposed of before the dissolution date established by this
  subchapter.
         (c)  The dissolution plan must provide that the department or
  a liquidator appointed in accordance with the dissolution plan
  will:
               (1)  take over the processing and disposition of any
  claims under association policies accepted by the association that
  are outstanding on the dissolution date established by this
  subchapter; and
               (2)  accept, process, and dispose of any claims under
  association policies that are made after the latest date on which
  the association accepts claims under Subsection (a).
         Sec. 2203.455.  POST-DISSOLUTION CLAIMS. (a)  The
  dissolution plan must provide for a reasonable and actuarially
  sound arrangement, through retention of reserves, purchase of
  reinsurance, or otherwise, to ensure that sufficient resources
  remain available to pay liability of the association that may arise
  in connection with claims made under association policies on or
  after the dissolution date established by this subchapter.
         (b)  If the arrangement provided under Subsection (a) proves
  inadequate, the claims that cannot be satisfied shall be treated as
  claims against an insolvent insurer liquidated under Chapter 443.
         Sec. 2203.456.  TRANSFER OF ASSETS. (a) Not later than
  October 1, 2017, association assets not retained by the department
  under Subsection (b) or otherwise transferred or applied in
  accordance with this section shall be transferred to the permanent
  fund supporting graduate medical education established under
  Section 58A.002, Education Code.
         (b)  The department shall retain assets sufficient to pay
  claims under association policies that are outstanding on the asset
  transfer date established by Subsection (a). The department shall
  retain, transfer, or apply association assets as necessary for the
  portion of the dissolution plan required by Section 2203.455(a).
         (c)  If a liquidator is appointed under the dissolution plan,
  the department may transfer assets to the liquidator in accordance
  with the dissolution plan.
         (d)  Assets of the policyholder's stabilization reserve fund
  for nursing homes and assisted living facilities established under
  Section 2203.303 shall be transferred to the general revenue fund
  to be appropriated as provided by Section 2203.303(e).
         Sec. 2203.457.  ANNUAL REPORT. The department shall, as
  part of each annual report made under Section 32.021 after the asset
  transfer date established by Section 2203.456(a):
               (1)  account for assets retained under Section
  2203.456(b) or transferred under Section 2203.456(c) or (d); and
               (2)  report on the receipt, processing, and disposition
  of claims under association policies.
         Sec. 2203.458.  REACTIVATION OF ASSOCIATION. (a) After the
  dissolution of the association and the transfer of the
  association's assets in accordance with this subchapter, the
  commissioner may, after notice and hearing, order the reactivation
  of the association and authorize the association to resume
  operations in accordance with the provisions of this chapter other
  than this subchapter.
         (b)  A hearing to determine the need to reactivate the
  association shall be held:
               (1)  on petition of:
                     (A)  the Texas Medical Association;
                     (B)  the Texas Podiatric Medical Association;
                     (C)  the Texas Hospital Association; or
                     (D)  at least 15 physicians or health care
  providers practicing or operating in this state; or
               (2)  on a finding by the commissioner that physicians
  or health care providers, or any category of physicians or health
  care providers, in this state are threatened with the possibility
  of being unable to secure medical liability insurance.
         (c)  Not later than the 15th day before the date set for a
  hearing under this section, notice of the hearing shall be given to
  each insurer that would be a member of the association under Section
  2203.055 if the association were reactivated.
         (d)  If the commissioner finds the reactivation of the
  association is in the public interest, the commissioner shall order
  the reactivation of the association. In making a determination
  under this section, the commissioner shall consider the potential
  impact on and harm or benefit to consumers of health care,
  physicians and health care providers, and the overall availability
  of medical liability insurance in this state. The order must:
               (1)  designate the category or categories of physicians
  or health care providers who are eligible to secure medical
  liability insurance coverage from the association; and
               (2)  specify a date that is not fewer than 15 or more
  than 60 days after the date of the order on which the provisions of
  this chapter other than this subchapter become effective.
         (e)  If an order of reactivation is made under this section,
  the provisions of this chapter other than this subchapter shall
  take effect as if they had been enacted into law with the effective
  date specified in the commissioner's order.
         (f)  The commissioner's order shall specify a deadline for
  the initial election and appointment of members of the board of
  directors under Section 2203.052. Notwithstanding Section
  2203.052, the initial term for each director elected or appointed
  under this section expires on the first October 1 that follows the
  election and appointment deadline specified in the order.
         Sec. 2203.459.  DISSOLUTION AFTER REACTIVATION. (a) After
  reactivation of the association under Section 2203.458, the
  commissioner may, after notice and hearing, order the dissolution
  of the association. Dissolution of the association under this
  section shall be done in accordance with the provisions of this
  subchapter that governed the dissolution of the association on the
  dissolution date established by Section 2203.451.
         (b)  A hearing to determine whether to dissolve the
  association under this section shall be held only at the
  commissioner's discretion.
         (c)  The commissioner shall issue an order to dissolve the
  association under this section if the commissioner finds that:
               (1)  there is no category of physicians or health care
  providers in this state threatened with the possibility of being
  unable to secure medical liability insurance; and
               (2)  dissolution of the association is in the public
  interest.
         (d)  In making a determination under Subsection (c)(2), the
  commissioner shall consider the potential impact on and harm or
  benefit to consumers of health care, physicians and health care
  providers, and the overall availability of medical liability
  insurance in this state.
         (e)  The commissioner's order must:
               (1)  prescribe:
                     (A)  a dissolution date;
                     (B)  a date on and after which the association may
  not issue or renew insurance policies; and
                     (C)  an asset transfer date; and
               (2)  direct the board of directors to develop a
  dissolution plan in accordance with this subchapter.
         (f)  A dissolution plan developed under this section must be
  adopted by the commissioner by rule.
         (g)  On the asset transfer date prescribed by the
  commissioner's order, association assets not retained by the
  department or otherwise transferred or applied in accordance with
  Section 2203.456(b) or (c) shall be transferred to the general
  revenue fund. After that date, the department shall report on
  assets and claims as prescribed by Section 2203.457.
         SECTION 5.  Sections 2203.303(d) and (e), Insurance Code,
  are amended to read as follows:
         (d)  The [Notwithstanding Sections 11, 12, and 13, Article
  21.49-3, the] policyholder's stabilization reserve fund under this
  section may be terminated only by law.
         (e)  On  [Notwithstanding Section 11, Article 21.49-3, on]
  termination of the policyholder's stabilization reserve fund under
  this section, all assets of the fund shall be transferred to the
  general revenue fund to be appropriated for purposes related to
  ensuring the provision of the kinds of liability insurance coverage
  that the association may provide under this chapter to nursing
  homes and assisted living facilities.
         SECTION 6.  Articles 21.49-3 and 21.49-3a, Insurance Code,
  are repealed.
         SECTION 7.  (a) Not later than December 31, 2015, the Texas
  Higher Education Coordinating Board shall adopt rules for the
  critical shortage physician grant program, the Texas teaching
  health center graduate medical education grant program, and the
  graduate medical education partnership grant program established
  under Subchapters D, E, and F, Chapter 58A, Education Code,
  respectively, as added by this Act.
         (b)  The board shall award grants under the programs
  described by Subsection (a) of this section beginning with the
  2016-2017 state fiscal year.
         SECTION 8.  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, 2015.