By: Nelson, Huffman, Schwertner S.B. No. 143
(In the Senate - Filed December 11, 2012; January 29, 2013,
read first time and referred to Committee on Higher Education;
April 9, 2013, reported adversely, with favorable Committee
Substitute by the following vote: Yeas 7, Nays 0; April 9, 2013,
sent to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 143 By: West
A BILL TO BE ENTITLED
AN ACT
relating to programs designed to enhance medical education in this
state.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 61, Education Code, is amended by adding
Subchapters I-1 and II to read as follows:
SUBCHAPTER I-1. PHYSICIAN RESIDENCY GRANTS
Sec. 61.511. RESIDENT PHYSICIAN EXPANSION GRANT PROGRAM.
(a) The board shall administer the Resident Physician Expansion
Grant Program as a competitive grant program to encourage the
creation of new graduate medical education positions through
community collaboration and innovative funding. The board shall
award grants to physician residency programs at teaching hospitals
and other appropriate health care entities according to the program
criteria established under Subsections (b) and (i).
(b) The board shall establish criteria for the grant program
in consultation with the executive commissioner of the Health and
Human Services Commission, with one or more physicians, teaching
hospitals, medical schools, independent physician residency
programs, and with other persons considered appropriate by the
board. The program criteria must:
(1) take into account the following factors:
(A) the characteristics of existing residency
positions that receive state funding;
(B) current and projected physician workforce
demographics; and
(C) state population trends and projections; and
(2) support the following goals:
(A) creating new residency positions, with an
emphasis on creating new first-year residency positions, without
adversely affecting existing residency positions;
(B) maximizing local or federal matching funds;
(C) developing accredited physician residency
programs at hospitals that have not previously offered residency
programs; and
(D) increasing residency positions with respect
to:
(i) medical specialties having shortages in
this state; and
(ii) medically underserved areas in this
state.
(c) The board may provide grants only to support a residency
position that:
(1) is created and accredited on or after January 1,
2014; or
(2) was created and accredited before January 1, 2013,
but as of that date had not yet been filled.
(d) A grant award may be used only to pay direct costs
associated with the position, including the salary of the resident
physician.
(e) Each grant application must specify:
(1) the number of residency positions expected to be
created with the grant money; and
(2) the grant amount requested for each year.
(f) The board shall award grants for all residency positions
awarded a grant under this section in the preceding year before
awarding a grant for a residency position that did not receive a
grant in the preceding year, provided that the applicable grant
recipient from the preceding year complies with all conditions of
the grant as described by Subsection (g).
(g) The board shall monitor physician residency programs
receiving grants as necessary to ensure compliance with the grant
program and shall require the return of any unused grant money by,
or shall decline to award additional grants to, a residency program
that receives a grant but fails to:
(1) create and fill, within a reasonable period, the
number of residency positions proposed in the program's grant
application; or
(2) satisfy any other conditions of the grant imposed
by the board.
(h) The board shall use money forfeited under Subsection (g)
to award grants to other eligible applicants. With respect to the
physician residency program forfeiting the grant, the board may
restore grant money or award additional grants, as applicable, to
the program as soon as practicable after the program satisfies all
conditions of the grant.
(i) The board shall adopt rules for the administration of
the grant program. The rules must include:
(1) administrative provisions governing:
(A) eligibility criteria for grant applicants;
(B) grant application procedures;
(C) guidelines relating to grant amounts;
(D) guidelines relating to the number of grants
to be awarded each year, subject to available funds;
(E) procedures for evaluating grant
applications; and
(F) procedures for monitoring the use of grants;
(2) methods for tracking the effectiveness of grants;
and
(3) any conditions relating to the receipt and use of a
grant as considered appropriate by the board.
(j) Not later than January 1 of each year, the board shall
prepare and submit to the governor, the lieutenant governor, the
speaker of the house of representatives, the standing committees of
the senate and house of representatives with responsibility for
oversight of health and human services issues, and the Legislative
Budget Board a report that:
(1) specifies each of the following with respect to
the preceding program year:
(A) the number of grants awarded under the
program;
(B) the amount of each grant awarded under the
program;
(C) the number of residency positions created
with the support of grant money;
(D) the medical specialty of the residency
positions created; and
(E) whether physicians who complete their
training through residency positions created under the program
choose to practice in this state and which medical specialties they
choose for their practices; and
(2) makes appropriate recommendations for legislative
changes as necessary.
Sec. 61.512. GRADUATE MEDICAL EDUCATION PLANNING GRANT
PROGRAM. (a) Subject to available funds, the board shall
administer a grant program under which the board awards incentive
payments to encourage medical schools, teaching hospitals, and
other appropriate health care entities to investigate the cost and
feasibility of developing accredited physician residency programs
at hospitals that have not previously offered residency programs.
(b) The board shall adopt rules for the administration of
the grant program. The rules must include:
(1) administrative provisions governing:
(A) eligibility criteria for medical schools,
teaching hospitals, and health care entities;
(B) grant application procedures;
(C) guidelines relating to grant amounts;
(D) procedures for evaluating grant
applications; and
(E) procedures for monitoring the use of grants;
and
(2) methods for tracking the effectiveness of grants.
Sec. 61.513. GIFTS, GRANTS, AND DONATIONS. In addition to
other money appropriated by the legislature, the board may solicit,
accept, and spend gifts, grants, and donations from any public or
private source for the purposes of the programs established under
this subchapter.
Sec. 61.514. ADMINISTRATIVE COSTS. A reasonable amount,
not to exceed three percent, of any money appropriated for purposes
of this subchapter may be used by the board to pay the costs of
administering this subchapter.
SUBCHAPTER II. GRANT PROGRAMS TO SUPPORT
PRIMARY CARE IN THIS STATE
Sec. 61.9821. PRIMARY CARE PHYSICIAN INCENTIVE PROGRAM.
Subject to available funds, the board shall establish a grant
program under which the board awards incentive payments to medical
schools that demonstrate improvement in the number of physicians
who practice in primary care in this state following completion of
their residency training.
Sec. 61.9822. PRIMARY CARE INNOVATION PROGRAM. Subject to
available funds, the board shall establish a grant program under
which the board awards incentive payments to medical schools that
develop innovative programs designed to increase the number of
primary care physicians in this state.
Sec. 61.9823. GIFTS, GRANTS, AND DONATIONS. In addition to
other money appropriated by the legislature, the board may solicit,
accept, and spend gifts, grants, and donations from any public or
private source for the purposes of the programs established under
this subchapter.
Sec. 61.9824. RULES. In consultation with each medical
school in this state, the board shall adopt rules for the
administration of the programs established under this subchapter.
The rules must include:
(1) administrative provisions relating to each type of
grant under this subchapter, such as:
(A) eligibility criteria for medical schools;
(B) grant application procedures;
(C) guidelines relating to grant amounts;
(D) procedures for evaluating grant
applications; and
(E) procedures for monitoring the use of grants;
and
(2) methods for tracking the effectiveness of grants
that:
(A) using data reasonably available to the board,
consider relevant information regarding the career paths of medical
school graduates during the four-year period following their
graduation; and
(B) evaluate whether and for how long those
graduates work in primary care in this state.
Sec. 61.9825. ADMINISTRATIVE COSTS. A reasonable amount,
not to exceed three percent, of any money appropriated for purposes
of this subchapter may be used by the board to pay the costs of
administering this subchapter.
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;
(2) at the time of application, be licensed to
practice medicine under Subtitle B, Title 3, Occupations Code;
(3) have completed one, two, three, or four
consecutive years of practice:
(A) in a health professional shortage area
designated by the Department of State Health Services; or
(B) in accordance with Subsection (b), after
funds have been fully allocated for the program year to physicians
qualifying under Paragraph (A); and
(4) provide health care services to:
(A) recipients under the medical assistance
program authorized by Chapter 32, Human Resources Code;
(B) enrollees under the child health plan program
authorized by Chapter 62, Health and Safety Code; or
(C) persons committed to a secure correctional
facility operated by or under contract with the Texas Juvenile
Justice Department [Youth Commission] or persons confined in a
secure correctional facility operated by or under contract with any
division of the Texas Department of Criminal Justice.
(b) A physician may complete one or more years of practice
required by Subsection (a)(3) in a location other than a health
professional shortage area designated by the Department of State
Health Services if, during the applicable year or years, the
physician provides health care services to a designated number of
patients who are recipients under the medical assistance program
authorized by Chapter 32, Human Resources Code, or the Texas
Women's Health Program according to criteria established by the
board in consultation with the Health and Human Services
Commission. The Health and Human Services Commission shall verify
a physician's compliance with this subsection, and the board and
the commission shall enter into a memorandum of understanding for
that purpose.
(c) The board annually shall solicit and collect
information regarding the specific number of patients described by
Subsection (a)(4)(A) who are treated by each physician receiving
loan repayment assistance under this subchapter.
SECTION 3. Section 61.5391, Education Code, is amended by
amending Subsection (a) and adding Subsection (c) to read as
follows:
(a) The physician education loan repayment program account
is an account in the general revenue fund. The account is composed
of:
(1) gifts and grants contributed to the account;
(2) earnings on the principal of the account; and
(3) other amounts deposited to the credit of the
account, including:
(A) money deposited under Section 61.539(b) or
61.5392;
(B) legislative appropriations; and
(C) money deposited under Section 155.2415, Tax
Code.
(c) Money deposited to the credit of the account under
Section 61.5392 may be used only to provide loan repayment
assistance to physicians who establish eligibility for the
assistance under Section 61.532(a)(4)(A) or (b).
SECTION 4. Subchapter J, Chapter 61, Education Code, is
amended by adding Section 61.5392 to read as follows:
Sec. 61.5392. MEDICAID MATCHING FUNDS. (a) For the
purposes of this subchapter, the Health and Human Services
Commission shall seek any federal matching funds that are available
to support Medicaid services in this state.
(b) Any amount received under Subsection (a) shall be
transferred to the comptroller to be deposited in the physician
education loan repayment program account established under Section
61.5391. Section 403.095, Government Code, does not apply to any
amount deposited under this section.
SECTION 5. (a) As soon as practicable after the effective
date of this Act, the Texas Higher Education Coordinating Board
shall adopt rules for the implementation and administration of the
grant programs established under Subchapters I-1 and II, Chapter
61, Education Code, as added by this Act. The coordinating board
may adopt the initial rules in the manner provided by law for
emergency rules.
(b) Not later than October 1, 2013, the Texas Higher
Education Coordinating Board shall establish the grant programs
required by Subchapter I-1, Chapter 61, Education Code, as added by
this Act, and shall begin to award grants under those programs not
later than January 1, 2014.
(c) Not later than January 1, 2014, the Texas Higher
Education Coordinating Board shall establish the grant programs
required by Subchapter II, Chapter 61, Education Code, as added by
this Act, and shall begin to award grants under those programs not
later than September 1, 2014.
(d) Not later than October 1, 2013, the Texas Higher
Education Coordinating Board and the Health and Human Services
Commission shall enter into the memorandum of understanding
required by Subsection (b), Section 61.532, Education Code, as
added by this Act. As soon as practicable after the date of the
memorandum, the coordinating board shall begin awarding loan
repayment assistance to physicians who establish eligibility under
that subsection.
SECTION 6. 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, 2013.
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