By: Zaffirini S.B. No. 2243
A BILL TO BE ENTITLED
AN ACT
relating to the repayment of certain education loans for licensed
physicians and dentists and to requirements for family practice
residency programs.
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) for a service obligation described by
Subdivision (3)(B)(i) or (ii) or as otherwise required by the
physician's practice, 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;
(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);
(iii) practice in primary care or in a
medical specialty of acute physician shortage, as determined by the
coordinating board in consultation with the Department of State
Health Services, and in:
(a) a hospital or clinic with a
patient population of whom at least 50 percent are uninsured or are
recipients under the medical assistance program authorized by
Chapter 32, Human Resources Code; or
(b) a public hospital, as defined by
Section 61.002, Health and Safety Code; or
(iv) practice in a county that has a
population of 50,000 or less and that has been designated under
federal law as a health professional shortage area [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 the service obligations
described by Subsection (a)(3)(B)(i) or (ii), 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. Subsection (b), Section 51.918, Education Code,
is amended to read as follows:
(b) The Texas Higher Education Coordinating Board shall:
(1) encourage and coordinate the creation or expansion
of a rural preceptor program among medical schools, teaching
hospitals, nursing schools, and schools of allied health sciences;
and
(2) require family practice residency programs to
provide an opportunity for residents to have a one-month rotation
through:
(A) a rural setting; [and]
(B) a public health setting; and
(C) an oncology setting.
SECTION 18. Subsections (b) and (c), Section 61.531,
Education Code, are repealed.
SECTION 19. 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 20. This Act does not make an appropriation. A
provision in this Act that creates a new governmental program,
creates a new entitlement, or imposes a new duty on a governmental
entity is not mandatory during a fiscal period for which the
legislature has not made a specific appropriation to implement the
provision.
SECTION 21. 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.