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 |
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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. |