83R28434 KEL-D
By: Nelson, et al. S.B. No. 143
(Branch, Zerwas)
Substitute the following for S.B. No. 143: No.
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. Subtitle A, Title 3, Education Code, is amended
by adding Chapter 58A to read as follows:
CHAPTER 58A. PROGRAMS SUPPORTING GRADUATE MEDICAL EDUCATION
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 58A.001. DEFINITION. In this chapter, "board" means
the Texas Higher Education Coordinating Board.
SUBCHAPTER B. GRADUATE MEDICAL EDUCATION
RESIDENCY EXPANSION
Sec. 58A.021. ADMINISTRATION. The board shall allocate
funds appropriated for purposes of this subchapter and may adopt
necessary rules regarding the allocation of those funds.
Sec. 58A.022. PLANNING GRANTS. (a) The board shall award
one-time planning grants to entities located in this state that:
(1) have never had a graduate medical education
program; and
(2) are eligible for Medicare funding of graduate
medical education.
(b) The board shall award planning grants on a competitive
basis according to criteria adopted by the board. The board shall
determine the number of grants awarded and the amount of each grant
consistent with any conditions provided by legislative
appropriation. A grant received under this section must be used for
the purpose of planning additional first-year residency positions.
(c) An application for a planning grant for a state fiscal
year must be submitted to the board not later than July 15 preceding
that fiscal year. Not later than August 15, the board shall make
decisions about grant awards for the following state fiscal year.
(d) An entity that is awarded a planning grant and
establishes new first-year residency positions after receipt of the
grant is eligible for additional funds for each such position
established, as provided by appropriation.
Sec. 58A.023. GRANTS FOR UNFILLED RESIDENCY POSITIONS. (a)
The board shall award grants to graduate medical education programs
to enable those programs to fill accredited but unfilled first-year
residency positions. The board shall determine the number of
grants awarded and the amount of each grant consistent with any
conditions provided by legislative appropriation.
(b) A grant received under this section must be expended to
support the direct resident costs to the program, including the
resident stipend and benefits.
(c) A grant application must include proof of the accredited
but unfilled positions to which the application applies. An
application for a grant must be submitted to the board not later
than October 1 preceding the period for which the grant is made.
The board shall make decisions about grant awards not later than
January 1 preceding the grant period.
(d) The board may distribute a grant amount for a residency
position only on receiving verification that the applicable
residency position has been filled.
(e) Grant amounts are awarded under this section for two
consecutive state fiscal years. For each first-year residency
position for which a program receives an initial grant amount in a
fiscal year, the board shall award the program an equal grant amount
for the following fiscal year.
Sec. 58A.024. GRANTS FOR PROGRAM EXPANSION OR NEW PROGRAM.
(a) The board shall award grants to enable existing graduate
medical education programs to increase the number of first-year
residency positions or to provide for the establishment of new
graduate medical education programs with first-year residency
positions. The board shall determine the number of grants awarded
and the amount of each grant consistent with any conditions
provided by legislative appropriation.
(b) A grant received under this section must be expended to
support the direct resident costs to the program, including the
resident stipend and benefits.
(c) A grant application must include a plan for receiving
accreditation for the increased number of positions or for the new
program, as applicable. An application for a grant must be
submitted to the board not later than October 1 preceding the period
for which the grant is made. The board shall make decisions about
grant awards not later than January 1 preceding the grant period.
(d) The board may distribute a grant amount for a residency
position only on receiving verification that the applicable
residency position has been filled.
(e) Grant amounts are awarded under this section for three
consecutive state fiscal years. For each first-year residency
position for which a program receives an initial grant amount in a
fiscal year, the board shall award the program an equal grant amount
for the following two fiscal years.
Sec. 58A.025. PRIORITY GRANTS; ADJUSTMENT OF AMOUNTS. (a)
If the board determines that the number of first-year residency
positions proposed by eligible applicants under Sections 58A.023
and 58A.024 exceeds the number authorized by appropriation, in
awarding grants the board:
(1) may give priority for up to 50 percent of the
funded first-year residency positions to be in primary care or
other critical shortage areas in this state; and
(2) may not reduce grant amounts awarded per resident
position, but may proportionately reduce the number of positions
funded for each program.
(b) If the board determines that, based on applications
received, the entire appropriation will not be awarded for that
year for graduate medical education residency expansion under
Sections 58A.023 and 58A.024, the board may transfer and use the
funds for the purposes of Section 58A.022 and may adjust the number
of grants awarded under that section accordingly.
Sec. 58A.026. GRANTS FOR ADDITIONAL YEARS OF RESIDENCY.
(a) If the board determines that funds appropriated for purposes of
this subchapter are available after all eligible grant applications
under Sections 58A.022, 58A.023, and 58A.024 have been funded, the
board shall award grants from excess funds to support residents:
(1) who have completed at least three years of
residency; and
(2) whose residency program is in a field in which this
state has less than 80 percent of the national average of physicians
per 100,000 population, as determined by the board.
(b) Grants shall be awarded under this section in amounts,
in the number, and in the residency fields determined by the board,
subject to any conditions provided by legislative appropriation. A
grant received under this section must be expended to support the
direct resident costs to the program, including the resident
stipend and benefits.
(c) The board may distribute grant amounts only on receiving
verification that the applicable residency position has been
filled.
(d) The board may award grants under this section only from
funds appropriated for the state fiscal year beginning September 1,
2016, or for a subsequent state fiscal year.
SUBCHAPTER C. PRIMARY CARE INNOVATION PROGRAM
Sec. 58A.051. 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
administer innovative programs designed to increase the number of
primary care physicians in this state.
Sec. 58A.052. 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 program established under
this subchapter.
Sec. 58A.053. RULES. In consultation with each medical
school in this state, the board shall adopt rules for the
administration of the program established under this subchapter.
The rules must include:
(1) administrative provisions relating to the
awarding of grants 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. 58A.054. 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. FEDERAL MATCHING FUNDS. (a) For the
purposes of this subchapter, the Health and Human Services
Commission shall seek any federal matching funds that are available
for the purposes of this section.
(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
programs established under Chapter 58A, 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 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.