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  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.