By: Nelson, Huffman, Schwertner	S.B. No. 143
	(In the Senate - Filed December 11, 2012; January 29, 2013,
	read first time and referred to Committee on Higher Education;
	April 9, 2013, reported adversely, with favorable Committee
	Substitute by the following vote:  Yeas 7, Nays 0; April 9, 2013,
	sent to printer.)
	COMMITTEE SUBSTITUTE FOR S.B. No. 143	By:  West

	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.  Chapter 61, Education Code, is amended by adding
	Subchapters I-1 and II to read as follows:
	SUBCHAPTER I-1. PHYSICIAN RESIDENCY GRANTS
	Sec. 61.511.  RESIDENT PHYSICIAN EXPANSION GRANT PROGRAM.
	(a)  The board shall administer the Resident Physician Expansion
	Grant Program as a competitive grant program to encourage the
	creation of new graduate medical education positions through
	community collaboration and innovative funding. The board shall
	award grants to physician residency programs at teaching hospitals
	and other appropriate health care entities according to the program
	criteria established under Subsections (b) and (i).
	(b)  The board shall establish criteria for the grant program
	in consultation with the executive commissioner of the Health and
	Human Services Commission, with one or more physicians, teaching
	hospitals, medical schools, independent physician residency
	programs, and with other persons considered appropriate by the
	board. The program criteria must:
	(1)  take into account the following factors:
	(A)  the characteristics of existing residency
	positions that receive state funding;
	(B)  current and projected physician workforce
	demographics; and
	(C)  state population trends and projections; and
	(2)  support the following goals:
	(A)  creating new residency positions, with an
	emphasis on creating new first-year residency positions, without
	adversely affecting existing residency positions;
	(B)  maximizing local or federal matching funds;
	(C)  developing accredited physician residency
	programs at hospitals that have not previously offered residency
	programs; and
	(D)  increasing residency positions with respect
	to:
	(i)  medical specialties having shortages in
	this state; and
	(ii)  medically underserved areas in this
	state.
	(c)  The board may provide grants only to support a residency
	position that:
	(1)  is created and accredited on or after January 1,
	2014; or
	(2)  was created and accredited before January 1, 2013,
	but as of that date had not yet been filled.
	(d)  A grant award may be used only to pay direct costs
	associated with the position, including the salary of the resident
	physician.
	(e)  Each grant application must specify:
	(1)  the number of residency positions expected to be
	created with the grant money; and
	(2)  the grant amount requested for each year.
	(f)  The board shall award grants for all residency positions
	awarded a grant under this section in the preceding year before
	awarding a grant for a residency position that did not receive a
	grant in the preceding year, provided that the applicable grant
	recipient from the preceding year complies with all conditions of
	the grant as described by Subsection (g).
	(g)  The board shall monitor physician residency programs
	receiving grants as necessary to ensure compliance with the grant
	program and shall require the return of any unused grant money by,
	or shall decline to award additional grants to, a residency program
	that receives a grant but fails to:
	(1)  create and fill, within a reasonable period, the
	number of residency positions proposed in the program's grant
	application; or
	(2)  satisfy any other conditions of the grant imposed
	by the board.
	(h)  The board shall use money forfeited under Subsection (g)
	to award grants to other eligible applicants. With respect to the
	physician residency program forfeiting the grant, the board may
	restore grant money or award additional grants, as applicable, to
	the program as soon as practicable after the program satisfies all
	conditions of the grant.
	(i)  The board shall adopt rules for the administration of
	the grant program. The rules must include:
	(1)  administrative provisions governing:
	(A)  eligibility criteria for grant applicants;
	(B)  grant application procedures;
	(C)  guidelines relating to grant amounts;
	(D)  guidelines relating to the number of grants
	to be awarded each year, subject to available funds;
	(E)  procedures for evaluating grant
	applications; and
	(F)  procedures for monitoring the use of grants;
	(2)  methods for tracking the effectiveness of grants;
	and
	(3)  any conditions relating to the receipt and use of a
	grant as considered appropriate by the board.
	(j)  Not later than January 1 of each year, the board shall
	prepare and submit to the governor, the lieutenant governor, the
	speaker of the house of representatives, the standing committees of
	the senate and house of representatives with responsibility for
	oversight of health and human services issues, and the Legislative
	Budget Board a report that:
	(1)  specifies each of the following with respect to
	the preceding program year:
	(A)  the number of grants awarded under the
	program;
	(B)  the amount of each grant awarded under the
	program;
	(C)  the number of residency positions created
	with the support of grant money;
	(D)  the medical specialty of the residency
	positions created; and
	(E)  whether physicians who complete their
	training through residency positions created under the program
	choose to practice in this state and which medical specialties they
	choose for their practices; and
	(2)  makes appropriate recommendations for legislative
	changes as necessary.
	Sec. 61.512.  GRADUATE MEDICAL EDUCATION PLANNING GRANT
	PROGRAM. (a)  Subject to available funds, the board shall
	administer a grant program under which the board awards incentive
	payments to encourage medical schools, teaching hospitals, and
	other appropriate health care entities to investigate the cost and
	feasibility of developing accredited physician residency programs
	at hospitals that have not previously offered residency programs.
	(b)  The board shall adopt rules for the administration of
	the grant program. The rules must include:
	(1)  administrative provisions governing:
	(A)  eligibility criteria for medical schools,
	teaching hospitals, and health care entities;
	(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)  methods for tracking the effectiveness of grants.
	Sec. 61.513.  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. 61.514.  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.
	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 number of physicians
	who practice 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)  methods for tracking the effectiveness of grants
	that:
	(A)  using data reasonably available to the board,
	consider relevant information regarding the career paths of medical
	school graduates during the four-year period following their
	graduation; and
	(B)  evaluate 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 2.  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), after
	funds have been fully allocated for the program year to physicians
	qualifying under Paragraph (A); 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 applicable year or years, the
	physician provides health care services to a designated number 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.
	(c)  The board annually shall solicit and collect
	information regarding the specific number of patients described by
	Subsection (a)(4)(A) who are treated by each physician receiving
	loan repayment assistance under this subchapter.
	SECTION 3.  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 4.  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 5.  (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 Subchapters I-1 and II, Chapter
	61, Education Code, as added by this Act. The coordinating board
	may adopt the initial rules in the manner provided by law for
	emergency rules.
	(b)  Not later than October 1, 2013, the Texas Higher
	Education Coordinating Board shall establish the grant programs
	required by Subchapter I-1, Chapter 61, Education Code, as added by
	this Act, and shall begin to award grants under those programs not
	later than January 1, 2014.
	(c)  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.
	(d)  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 Subsection (b), Section 61.532, Education Code, as
	added by this Act. As soon as practicable after the date of the
	memorandum, the coordinating board shall begin awarding loan
	repayment assistance to physicians who establish eligibility under
	that subsection.
	SECTION 6.  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, 2013.
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