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.