SENATE COMMITTEE ON FINANCE 
                     Subcommittee on Graduate Medical Education 
                              Thursday, April 20, 2000 
                                     1:00 p.m. 
                           Capitol Extension, Room E1.036 
         Pursuant to a notice posted in accordance with Senate Rule  
         11.18, a public hearing of the Senate Committee on Finance  
         Interim Subcommittee on Graduate Medical Education was held on  
         Thursday, April 20, 2000, in the Capitol Extension, Room E1.036,  
         at Austin, Texas. 
         MEMBERS PRESENT:                        MEMBERS ABSENT: 
         Senator Mike Moncrief, Chairman         Senator Jon Lindsay 
         Senator John Carona                     Senator Royce West 
         Senator Carlos Truan 
         The chair called the meeting to order at 1:05 p.m.  There being  
         a quorum present, the following business was transacted:   
         The Chair made opening remarks and proceeded with the hearing as  
         Graduate Medical Education (GME) Issues 
         Sam Tessen, Executive Director for the Center for Rural Health  
         Initiatives, provided an overview of rural GME issues. 
         A panel consisting of the following medical school  
         representatives provided testimony on medical school efforts to  
         address rural GME issues: 
             Dr. Jim Guckian, representing the University of Texas  
             Dr. Ralph D. Feigin, representing Baylor College of  
             Dr. Patti Patterson, representing Texas Tech University  
         Health Sciences Center; 
             Dr. Nancy Dickey, representing Texas A&M College of  
         Medicine/Brazos Valley     
                Family Practice Residency; and 
             Dr. Deborah Blackwell, representing University of North  
         Texas Health Science Center. 
         Teri Flack, representing the Texas Higher Education Coordinating  
         Board (THECB) and Robert Price, representing the University of  
         Texas Health Science Center - San Antonio,  provided testimony  
         on the THECB Health-Related Formula Advisory Committee's  
         recommendations relating to GME. 
         Disproportionate Share Hospital (DSH) Funding 
         Joe DaSilva, representing the Texas Hospital Association,  
         Children's Hospital Association of Texas, Texas Conference of  
         Catholic Health Facilities, Texas Association of Public and  
         Non-Profit Hospitals, Texas Organization of Rural and Community  
         Hospitals, and Texas Urban Hospitals and Systems, provided an  
         update on Medicaid DSH Formula Negotiations.   
         After Mr. DaSilva answered questions of the committee, Chairman  
         Moncrief laid out the proposed recommendation for consideration: 
              For the FY 2001 allocation of Disproportionate Share funds,  
              the Health and Human Services Commission should proceed  
              with its proposed rule change, making adjustments to the  
              proposed rule to mitigate the impact on rural hospitals.   
              Prior to allocation of subsequent fiscal years'  
              Disproportionate Share funds, the Commission should make  
              necessary changes to further emphasize uncompensated  
              indigent care in the distribution formula.  At least every  
              two years the Commission should evaluate the  
              Disproportionate Share Hospital Funding Program and make  
              necessary rule changes to ensure the program's emphasis on  
              uncompensated care and provision of care in underserved  
              areas of the state. 
         Senator Truan moved to adopt Chairman Moncrief's proposed  
         recommendation.  The motion was seconded by Senator Carona.   
         Without objection, the recommendation was adopted. 
         There being no further business, at 3:20 p.m. Senator Truan  
         moved that the Committee stand recessed subject to the call of  
         the chair.  Without objection, it was so ordered.   
         Senator Mike Moncrief, Chair 
         Patricia Hicks, Clerk