By: Nelson S.B. No. 143
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. Sections 58.007(a), (b), and (g), Education
Code, are amended to read as follows:
(a) Nothing in this section or Section 58.006 or 58.008
shall diminish or abolish the activities of the Family Practice
Residency Advisory Committee established under Section 61.505. It
is not the intent of this section to combine or assimilate advisory
programs but only to add to and enhance the residency training of
primary care physicians in Texas.
(b)(1) The Primary Care Graduate Medical Education
Expansion Program [Residency] Advisory Committee is created and
shall consist of 12 members as follows:
(A) seven members shall be licensed physicians,
one appointed by each of the following:
(i) the Texas Medical Association;
(ii) the Texas Osteopathic Medical
Association;
(iii) the Texas Academy of Family
Physicians;
(iv) the Texas Society of the American
College of Osteopathic Family Physicians;
(v) the Texas Society of Internal Medicine;
(vi) the Texas Pediatric Society; and
(vii) the Texas Association of
Obstetricians and Gynecologists;
(B) one member shall be appointed by the Office
[Texas Department] of Rural Affairs;
(C) one member shall be appointed by [the Bureau
of Community Oriented Primary Care at] the Department of State
Health Services; and
(D) three members shall be members of the public,
one appointed by each of the following:
(i) the governor;
(ii) the lieutenant governor; and
(iii) the speaker of the house of
representatives.
(2) No individual who has a direct financial interest
in primary care residency training programs shall be appointed to
serve as a member of the advisory committee.
(g) The committee shall review for the Texas Higher
Education Coordinating Board applications for approval and funding
of the expansion of existing primary care graduate medical
education residency training programs or the establishment of new
Accreditation Council for Graduate Medical Education or American
Osteopathic Association nationally accredited primary care
residency programs [program expansion] as described in Section
58.008 [and related support programs], make recommendations to the
board relating to program funding [the standards and criteria for
approval of residency training and related support programs], and
perform such other duties as may be directed by the board.
SECTION 2. Section 58.008, Education Code, is amended to
read as follows:
Sec. 58.008. PRIMARY CARE GRADUATE MEDICAL EDUCATION
[RESIDENCY PROGRAM] EXPANSION PROGRAM. (a) Only primary care
residency programs [positions] in family practice, general
internal medicine, general pediatrics, and obstetrics and
gynecology shall be eligible for [these] funds under this section.
(b) The advisory committee created under Section 58.007
shall recommend to the Texas Higher Education Coordinating Board an
allocation of new primary care residency positions by residency
program that are to receive state support.
(c) In [The committee shall take into consideration in]
recommending an allocation among the four primary care specialties
designated for expansion, the committee shall:
(1) consider the following factors:
(A) [(1)] the current primary care specialties
mix of Texas physicians in direct practice;
(B) [(2)] projections for the primary care
specialties mix of Texas physicians in direct practice;
(C) [(3)] the current state-supported primary
care positions;
(D) [(4)] geographic shortages for primary care
physicians;
(E) [(5)] federally designated and
state-designated [state designated] medically underserved areas
and health professional shortage areas the boundaries of which
correspond to entire counties;
(F) [(6)] the demographics of the Texas
population; [and]
(G) [(7)] the infrastructure of existing
residency programs;
(H) the residency program's history of retention
and the program's success rate in placing physicians in communities
in this state following completion of residency training, with an
emphasis on the program's success rate in placing physicians in
underserved communities; and
(I) the amount of matching funds a residency
program receives or will receive from community collaborative
groups; and
(2) give priority to residency programs located in
community-based settings such as federally qualified health
centers, community health clinics, and rural hospitals.
(d) [(c)] Once funds are awarded to support a resident
position as part of a primary care residency program's expansion
efforts [of a particular residency program], the board shall
continue to award grant funds to support that residency position in
that specific residency program to maintain support for its
expansion efforts for all three or four postgraduate years of the
residency training curriculum until the resident physician
appointed to that position has completed or left the program. The
residency position would then be eligible for reallocation by the
Primary Care Graduate Medical Education Expansion Program
Residency Advisory Committee.
(e) A grant awarded under this section to an existing or new
primary care residency program may be used to pay the salaries of
resident physicians in an amount not to exceed $15,000 per resident
physician.
(f) The board shall adopt rules for the administration of
this section.
SECTION 3. Chapter 61, Education Code, is amended by adding
Subchapter II to read as follows:
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 graduation rates of
physicians who work 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) a method for tracking the effectiveness of grants
that:
(A) using data reasonably available to the board,
considers relevant information regarding the career paths of
medical school graduates during the four-year period following
their graduation; and
(B) evaluates 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 4. 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); 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 year or years, the physician
provides health care services to a designated percentage 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.
SECTION 5. 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 6. 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 7. (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 Subchapter II, Chapter 61,
Education Code, as added by this Act. The board may adopt the
initial rules in the manner provided by law for emergency rules.
(b) 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.
(c) 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 Section 61.532(b), Education Code, as added by this
Act. As soon as practicable after the date of the memorandum, the
board shall begin awarding loan repayment assistance to physicians
who establish eligibility under that subsection.
SECTION 8. This Act takes effect September 1, 2013.