Bill Text: TX HB1489 | 2015-2016 | 84th Legislature | Introduced


Bill Title: Relating to measures to enhance graduate medical education in this state.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2015-03-05 - Referred to Higher Education [HB1489 Detail]

Download: Texas-2015-HB1489-Introduced.html
  84R4796 KEL-D
 
  By: Howard H.B. No. 1489
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to measures to enhance graduate medical education in this
  state.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 58A, Education Code, is amended by
  adding Subchapters D, E, and F to read as follows:
  SUBCHAPTER D. CRITICAL SHORTAGE PHYSICIAN GRANT PROGRAM
         Sec. 58A.101.  DEFINITIONS. In this subchapter:
               (1)  "Center" means the comprehensive health
  professions resource center established under Chapter 105, Health
  and Safety Code.
               (2)  "Graduate medical residency training program"
  means a residency or other postgraduate medical training program:
                     (A)  participation in which may be counted toward
  certification in a medical specialty or subspecialty; and
                     (B)  that:
                           (i)  is accredited by the Accreditation
  Council for Graduate Medical Education or the American Osteopathic
  Association; or
                           (ii)  demonstrates eligibility to apply for
  and receive an accreditation described by Subparagraph (i).
               (3)  "Program" means the critical shortage physician
  grant program established under this subchapter.
               (4)  "Teaching hospital" means a teaching hospital
  affiliated with a medical school that is described as a medical and
  dental unit under Section 61.003.
         Sec. 58A.102.  ESTABLISHMENT OF PROGRAM. The board shall
  establish the critical shortage physician grant program to provide
  grants to teaching hospitals for graduate medical residency
  training programs to increase the number of physicians in the
  medical specialties and subspecialties that are determined by the
  board to be at a critical shortage level in this state.
         Sec. 58A.103.  RULES. (a) The board shall adopt rules to
  administer the program, including rules regarding:
               (1)  a grant application process;
               (2)  reporting requirements for grant recipients; and
               (3)  requirements and benchmarks for grant recipients
  to satisfy regarding the granting of additional program funding
  under Section 58A.106.
         (b)  The rules adopted under Subsection (a) must require
  grant recipients to submit reports at least quarterly, based on
  outcome measures established by the board in consultation with the
  Legislative Budget Board.
         Sec. 58A.104.  ELIGIBILITY. To be eligible to receive a
  grant under this subchapter, a teaching hospital must:
               (1)  provide a number of graduate medical residency
  positions in excess of both the cap on the number of positions
  funded by direct graduate medical education payments made under
  Section 1886(h), Social Security Act (42 U.S.C. Section 1395ww(h)),
  and the cap on the number of positions funded by indirect medical
  education payments made under Section 1886(d)(5)(B), Social
  Security Act (42 U.S.C. Section 1395ww(d)(5)(B)); and
               (2)  offer or seek to offer one or more graduate medical
  residency training programs in a specialty described by Section
  58.008(a) or in any other medical specialty or subspecialty
  determined by the board to be at a critical shortage level in this
  state.
         Sec. 58A.105.  USE OF FUNDS. In each state fiscal year, the
  board shall award grants for establishing new accredited graduate
  medical residency training programs or increasing the number of
  residency positions in existing accredited graduate medical
  residency training programs in specialties described by Section
  58.008(a) or in any other medical specialties or subspecialties
  determined by the board to be at a critical shortage level in this
  state.
         Sec. 58A.106.  ADDITIONAL USE: START-UP COSTS. (a) If in a
  state fiscal year excess program funds remain after funds are
  granted under Section 58A.105, the board may grant additional
  program funding to teaching hospitals to pay any start-up costs
  associated with establishing and seeking accreditation for a new
  graduate medical residency training program in a specialty
  described by Section 58.008(a) or in any other medical specialty or
  subspecialty determined by the board to be at a critical shortage
  level in this state, provided that no other federal or state funding
  is available for that program.
         (b)  To be eligible for funding under this section, start-up
  costs must be directly related to the establishment or
  accreditation of the new program.
         (c)  The board may grant program funding under this section
  to pay a percentage of the total amount of applicable start-up costs
  for the teaching hospital, not to exceed 20 percent.
         Sec. 58A.107.  REDUCTION IN FUNDING. The board shall limit
  or withhold funding from grant recipients that do not comply with
  reporting requirements or that use grant funds for a purpose not
  authorized by this subchapter. The board shall seek reimbursement
  with respect to any grant funds that are not used for purposes
  authorized by this subchapter.
         Sec. 58A.108.  CRITERIA FOR DETERMINING CRITICAL SHORTAGE
  LEVELS. (a) For purposes of this subchapter, the board shall
  determine critical shortage levels for medical specialties and
  subspecialties in this state according to criteria used by the
  United States Department of Health and Human Services Health
  Resources and Services Administration to designate health
  professional shortage areas.
         (b)  In its methodology for determining critical shortage
  levels under this section, the board shall include the results of
  the research conducted by the center under Section 105.009(a)(1),
  Health and Safety Code, and similar research performed by other
  appropriate entities.
  SUBCHAPTER E. TEXAS TEACHING HEALTH CENTER
  GRADUATE MEDICAL EDUCATION GRANT PROGRAM
         Sec. 58A.121.  DEFINITIONS. In this subchapter:
               (1)  "Graduate medical residency training program"
  means a residency or other postgraduate medical training program:
                     (A)  participation in which may be counted toward
  certification in a medical specialty or subspecialty; and
                     (B)  that:
                           (i)  is accredited by the Accreditation
  Council for Graduate Medical Education or the American Osteopathic
  Association; or
                           (ii)  demonstrates eligibility to apply for
  and receive an accreditation described by Subparagraph (i).
               (2)  "Primary care residency program" means a graduate
  medical residency training program in a specialty described by
  Section 58.008(a).
               (3)  "Program" means the Texas teaching health center
  graduate medical education grant program established under this
  subchapter.
               (4)  "Teaching health center" means a community-based,
  ambulatory patient care center that operates a primary care
  residency program. The term includes:
                     (A)  a federally qualified health center, as
  defined by Section 1905(l)(2)(B), Social Security Act (42 U.S.C.
  Section 1396d(l)(2)(B));
                     (B)  a community mental health center, as defined
  by Section 1861(ff)(3)(B), Social Security Act (42 U.S.C. Section
  1395x(ff)(3)(B));
                     (C)  a rural health clinic, as defined by Section
  1861(aa)(2), Social Security Act (42 U.S.C. Section 1395x(aa)(2));
                     (D)  a health center operated by the Indian Health
  Service, an Indian tribe or tribal organization, or an urban Indian
  organization, as defined by Section 4, Indian Health Care
  Improvement Act (25 U.S.C. Section 1603); and
                     (E)  an entity receiving funds under Title X,
  Public Health Service Act (42 U.S.C. Section 300 et seq.).
         Sec. 58A.122.  ESTABLISHMENT OF PROGRAM. The board shall
  establish the Texas teaching health center graduate medical
  education grant program to award grants to teaching health centers
  for the purpose of establishing new primary care residency programs
  or increasing the number of residency positions in existing primary
  care residency programs.
         Sec. 58A.123.  RULES. (a) The board shall adopt rules to
  administer the program, including rules regarding:
               (1)  a grant application process;
               (2)  reporting requirements for grant recipients under
  Section 58A.128; and
               (3)  the amount of the payments for direct expenses and
  indirect expenses, as defined by and calculated in the same manner
  as those expenses are calculated under the federal rules described
  by Subsection (b).
         (b)  The rules adopted under this subchapter must be based as
  nearly as possible on the rules adopted under the federal teaching
  health centers development grant program established under Section
  5508, Patient Protection and Affordable Care Act of 2010 (Pub. L.
  No. 111-148).
         (c)  The rules adopted in relation to the reporting
  requirements under Section 58A.128 must also:
               (1)  authorize the board to conduct audits of grant
  recipients to the extent necessary to ensure the accuracy and
  completeness of their annual reports; and
               (2)  specify a mandatory amount of reduction in grant
  funds under Section 58A.127 for a failure to submit an accurate or
  complete report.
         Sec. 58A.124.  AMOUNT AND DURATION OF GRANT. Subject to
  Section 58A.127, the board may award grants under this subchapter
  for a term of not more than three years, and the maximum award to a
  recipient may not exceed $500,000 during each state fiscal year.
         Sec. 58A.125.  RELATIONSHIP OF GRANTS TO OTHER FEDERAL
  PAYMENTS FOR GRADUATE MEDICAL EDUCATION. A grant awarded by the
  board under this subchapter is in addition to any payments for:
               (1)  direct graduate medical education costs under
  Section 1886(h), Social Security Act (42 U.S.C. Section 1395ww(h));
               (2)  indirect medical education costs under Section
  1886(d)(5)(B), Social Security Act (42 U.S.C. Section
  1395ww(d)(5)(B)); and
               (3)  direct costs of medical education under Section
  1886(k), Social Security Act (42 U.S.C. Section 1395ww(k)).
         Sec. 58A.126.  USE OF FUNDS. A grant awarded under this
  subchapter may be used only to cover the costs of establishing a new
  primary care residency program at a teaching health center or the
  costs of increasing the number of residency positions in an
  existing primary care residency program, including costs
  associated with:
               (1)  curriculum development;
               (2)  recruitment, training, and retention of residents
  and faculty;
               (3)  obtaining accreditation by the Accreditation
  Council for Graduate Medical Education or the American Osteopathic
  Association; and
               (4)  faculty salaries during the development phase.
         Sec. 58A.127.  REDUCTION IN FUNDING. The board shall limit
  or withhold funding from grant recipients that do not comply with
  reporting requirements or that use grant funds for a purpose not
  authorized by this subchapter. The board shall seek reimbursement
  with respect to any grant funds that are not used for purposes
  authorized by this subchapter.
         Sec. 58A.128.  REPORTING. (a) A grant recipient shall
  submit an annual report that fully accounts for the use of a grant
  awarded under this subchapter.
         (b)  The annual report must be made in the form and manner
  specified by the board and must include the following information
  for the most recent residency academic year completed immediately
  before the applicable state fiscal year:
               (1)  the types of primary care residency programs that
  the grant recipient provided for residents;
               (2)  the number of approved training positions in those
  programs for part-time or full-time residents;
               (3)  the number of part-time or full-time residents
  who:
                     (A)  completed their residency training in those
  programs at the end of the residency academic year; and
                     (B)  care for vulnerable populations living in
  underserved areas; and
               (4)  any other information considered appropriate by
  the board.
  SUBCHAPTER F. GRADUATE MEDICAL EDUCATION
  PARTNERSHIP GRANT PROGRAM
         Sec. 58A.151.  DEFINITIONS. In this subchapter:
               (1)  "Graduate medical education partnership" means a
  partnership entered into by a teaching health center and an
  accredited graduate medical residency training program offered by a
  hospital or medical school.
               (2)  "Graduate medical residency training program"
  means a residency or other postgraduate medical training program:
                     (A)  participation in which may be counted toward
  certification in a medical specialty or subspecialty; and
                     (B)  that:
                           (i)  is accredited by the Accreditation
  Council for Graduate Medical Education or the American Osteopathic
  Association; or
                           (ii)  demonstrates eligibility to apply for
  and receive an accreditation described by Subparagraph (i).
               (3)  "Primary care residency program" means a graduate
  medical residency training program in a specialty described by
  Section 58.008(a).
               (4)  "Program" means the graduate medical education
  partnership grant program established under this subchapter.
               (5)  "Teaching health center" means a community-based,
  ambulatory patient care center that operates a primary care
  residency program. The term includes:
                     (A)  a federally qualified health center, as
  defined by Section 1905(l)(2)(B), Social Security Act (42 U.S.C.
  Section 1396d(l)(2)(B));
                     (B)  a community mental health center, as defined
  by Section 1861(ff)(3)(B), Social Security Act (42 U.S.C. Section
  1395x(ff)(3)(B));
                     (C)  a rural health clinic, as defined by Section
  1861(aa)(2), Social Security Act (42 U.S.C. Section 1395x(aa)(2));
                     (D)  a health center operated by the Indian Health
  Service, an Indian tribe or tribal organization, or an urban Indian
  organization, as defined by Section 4, Indian Health Care
  Improvement Act (25 U.S.C. Section 1603); and
                     (E)  an entity receiving funds under Title X,
  Public Health Service Act (42 U.S.C. Section 300 et seq.).
         Sec. 58A.152.  ESTABLISHMENT OF PROGRAM. The board shall
  establish the graduate medical education partnership grant program
  to allow a teaching health center that is establishing and seeking
  accreditation for a new primary care residency program to partner
  with an accredited graduate medical residency training program
  offered by a hospital or medical school.
         Sec. 58A.153.  RULES. The board shall adopt rules to
  administer the program, including rules regarding a grant
  application process and reporting requirements for grant
  recipients.
         Sec. 58A.154.  USE OF FUNDS. The board shall award grants to
  each participant in a graduate medical education partnership to:
               (1)  facilitate a mentoring relationship between
  partners that will provide information and guidance for the
  participating teaching health center during the accreditation
  process; and
               (2)  assist the partners in building a collaborative
  working relationship for the future.
         Sec. 58A.155.  REDUCTION IN FUNDING. The board shall limit
  or withhold funding from grant recipients that do not comply with
  reporting requirements or that use grant funds for a purpose not
  authorized by this subchapter. The board shall seek reimbursement
  for any grant funds that are not used for purposes authorized by
  this subchapter.
         SECTION 2.  Chapter 105, Health and Safety Code, is amended
  by adding Section 105.009 to read as follows:
         Sec. 105.009.  RESEARCH REGARDING GRADUATE MEDICAL
  EDUCATION SYSTEM. (a) The comprehensive health professions
  resource center shall conduct research:
               (1)  to identify:
                     (A)  the ratio of primary care to non-primary care
  physicians that is necessary and appropriate to meet the current
  and future health care needs of this state; and
                     (B)  all medical specialties and subspecialties
  that are at critical shortage levels in this state, together with
  the geographic location of the physicians in those specialties and
  subspecialties; and
               (2)  regarding the overall supply of physicians in this
  state and any other issues that are relevant to the status of the
  state's graduate medical education system and the ability of that
  system to meet the current and future health care needs of this
  state.
         (b)  Not later than August 31 of each even-numbered year, the
  council shall report the results of the center's research to the
  Legislative Budget Board, the Texas Higher Education Coordinating
  Board, the office of the governor, and the standing committees of
  each house of the legislature with primary jurisdiction over state
  finance or appropriations.
         SECTION 3.  (a) Not later than December 31, 2015, the Texas
  Higher Education Coordinating Board shall adopt rules for the
  critical shortage physician grant program, the Texas teaching
  health center graduate medical education grant program, and the
  graduate medical education partnership grant program established
  under Subchapters D, E, and F, Chapter 58A, Education Code,
  respectively, as added by this Act.
         (b)  The board shall award grants under the programs
  described by Subsection (a) of this section beginning with the
  state fiscal year ending August 31, 2016.
         SECTION 4.  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, 2015.
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