83R28434 KEL-D
	By: Nelson, et al.	S.B. No. 143
	(Branch, Zerwas)
	Substitute the following for S.B. No. 143:  No.

	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.  Subtitle A, Title 3, Education Code, is amended
	by adding Chapter 58A to read as follows:
	CHAPTER 58A. PROGRAMS SUPPORTING GRADUATE MEDICAL EDUCATION
	SUBCHAPTER A. GENERAL PROVISIONS
	Sec. 58A.001.  DEFINITION. In this chapter, "board" means
	the Texas Higher Education Coordinating Board.
	SUBCHAPTER B. GRADUATE MEDICAL EDUCATION
	RESIDENCY EXPANSION
	Sec. 58A.021.  ADMINISTRATION. The board shall allocate
	funds appropriated for purposes of this subchapter and may adopt
	necessary rules regarding the allocation of those funds.
	Sec. 58A.022.  PLANNING GRANTS. (a) The board shall award
	one-time planning grants to entities located in this state that:
	(1)  have never had a graduate medical education
	program; and
	(2)  are eligible for Medicare funding of graduate
	medical education.
	(b)  The board shall award planning grants on a competitive
	basis according to criteria adopted by the board. The board shall
	determine the number of grants awarded and the amount of each grant
	consistent with any conditions provided by legislative
	appropriation.  A grant received under this section must be used for
	the purpose of planning additional first-year residency positions.
	(c)  An application for a planning grant for a state fiscal
	year must be submitted to the board not later than July 15 preceding
	that fiscal year.  Not later than August 15, the board shall make
	decisions about grant awards for the following state fiscal year.
	(d)  An entity that is awarded a planning grant and
	establishes new first-year residency positions after receipt of the
	grant is eligible for additional funds for each such position
	established, as provided by appropriation.
	Sec. 58A.023.  GRANTS FOR UNFILLED RESIDENCY POSITIONS. (a)
	The board shall award grants to graduate medical education programs
	to enable those programs to fill accredited but unfilled first-year
	residency positions. The board shall determine the number of
	grants awarded and the amount of each grant consistent with any
	conditions provided by legislative appropriation.
	(b)  A grant received under this section must be expended to
	support the direct resident costs to the program, including the
	resident stipend and benefits.
	(c)  A grant application must include proof of the accredited
	but unfilled positions to which the application applies.  An
	application for a grant must be submitted to the board not later
	than October 1 preceding the period for which the grant is made.
	The board shall make decisions about grant awards not later than
	January 1 preceding the grant period.
	(d)  The board may distribute a grant amount for a residency
	position only on receiving verification that the applicable
	residency position has been filled.
	(e)  Grant amounts are awarded under this section for two
	consecutive state fiscal years. For each first-year residency
	position for which a program receives an initial grant amount in a
	fiscal year, the board shall award the program an equal grant amount
	for the following fiscal year.
	Sec. 58A.024.  GRANTS FOR PROGRAM EXPANSION OR NEW PROGRAM.
	(a) The board shall award grants to enable existing graduate
	medical education programs to increase the number of first-year
	residency positions or to provide for the establishment of new
	graduate medical education programs with first-year residency
	positions.  The board shall determine the number of grants awarded
	and the amount of each grant consistent with any conditions
	provided by legislative appropriation.
	(b)  A grant received under this section must be expended to
	support the direct resident costs to the program, including the
	resident stipend and benefits.
	(c)  A grant application must include a plan for receiving
	accreditation for the increased number of positions or for the new
	program, as applicable. An application for a grant must be
	submitted to the board not later than October 1 preceding the period
	for which the grant is made. The board shall make decisions about
	grant awards not later than January 1 preceding the grant period.
	(d)  The board may distribute a grant amount for a residency
	position only on receiving verification that the applicable
	residency position has been filled.
	(e)  Grant amounts are awarded under this section for three
	consecutive state fiscal years. For each first-year residency
	position for which a program receives an initial grant amount in a
	fiscal year, the board shall award the program an equal grant amount
	for the following two fiscal years.
	Sec. 58A.025.  PRIORITY GRANTS; ADJUSTMENT OF AMOUNTS. (a)
	If the board determines that the number of first-year residency
	positions proposed by eligible applicants under Sections 58A.023
	and 58A.024 exceeds the number authorized by appropriation, in
	awarding grants the board:
	(1)  may give priority for up to 50 percent of the
	funded first-year residency positions to be in primary care or
	other critical shortage areas in this state; and
	(2)  may not reduce grant amounts awarded per resident
	position, but may proportionately reduce the number of positions
	funded for each program.
	(b)  If the board determines that, based on applications
	received, the entire appropriation will not be awarded for that
	year for graduate medical education residency expansion under
	Sections 58A.023 and 58A.024, the board may transfer and use the
	funds for the purposes of Section 58A.022 and may adjust the number
	of grants awarded under that section accordingly.
	Sec. 58A.026.  GRANTS FOR ADDITIONAL YEARS OF RESIDENCY.
	(a) If the board determines that funds appropriated for purposes of
	this subchapter are available after all eligible grant applications
	under Sections 58A.022, 58A.023, and 58A.024 have been funded, the
	board shall award grants from excess funds to support residents:
	(1)  who have completed at least three years of
	residency; and
	(2)  whose residency program is in a field in which this
	state has less than 80 percent of the national average of physicians
	per 100,000 population, as determined by the board.
	(b)  Grants shall be awarded under this section in amounts,
	in the number, and in the residency fields determined by the board,
	subject to any conditions provided by legislative appropriation. A
	grant received under this section must be expended to support the
	direct resident costs to the program, including the resident
	stipend and benefits.
	(c)  The board may distribute grant amounts only on receiving
	verification that the applicable residency position has been
	filled.
	(d)  The board may award grants under this section only from
	funds appropriated for the state fiscal year beginning September 1,
	2016, or for a subsequent state fiscal year.
	SUBCHAPTER C. PRIMARY CARE INNOVATION PROGRAM
	Sec. 58A.051.  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
	administer innovative programs designed to increase the number of
	primary care physicians in this state.
	Sec. 58A.052.  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 program established under
	this subchapter.
	Sec. 58A.053.  RULES. In consultation with each medical
	school in this state, the board shall adopt rules for the
	administration of the program established under this subchapter.
	The rules must include:
	(1)  administrative provisions relating to the
	awarding of grants 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. 58A.054.  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.  FEDERAL MATCHING FUNDS. (a)  For the
	purposes of this subchapter, the Health and Human Services
	Commission shall seek any federal matching funds that are available
	for the purposes of this section.
	(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
	programs established under Chapter 58A, 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 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.