Creation of the Office of Rural and
Community Affairs
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Rural Community Health System
|
Expedited BME Applications for Rural
Physicians
|
Limited State J-1 Visa Waiver
Program
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Medical School Rural Pilot Project
|
Rural Communities Health Care Investment
Program
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Rural Foundation
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EMS Providers in Rural Areas
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Texas A&M University: New Center for
Rural Public Health
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State Rural Locum Tenens Program
|
Expansions of Community Matching
Program
CREATION OF THE OFFICE OF RURAL AND
COMMUNITY AFFAIRS
Recognizing the interconnection between
health care and economic development, Rep. Warren Chisum
(R-Pampa) and Sen. David Sibley (R-Waco) sponsored HB 7,
establishing a new state agency for rural issues - the Office of
Rural and Community Affairs (ORCA).
The bill, endorsed by House Speaker Pete
Laney (D-Hale Center) and the House Rural Caucus, combines two
existing state agencies, the Center for Rural Health Initiatives
and Office of Community Affairs.
Overseeing ORCA is a new executive
committee consisting of nine members; three members will be
selected by the governor, three by the lieutenant governor, and
three by the speaker of the House. Outlined within HB 7 are
specific functions for ORCA, including:
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Work with other state agencies to
improve results and cost-effectiveness of state
programs;,
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Develop programs to improve leadership
capacity of rural leaders,
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Monitor developments that affect rural
areas and compile a report of the progress of the condition
of rural communities,
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Administer the Federal Community Block
Grant nonentitlement program,
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Research and report the most
cost-effective ways to improve the welfare of rural
communities,
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Ensure that the state qualifies for
federal grants from the U.S. Office of Rural Health Policy,
and
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Manage the state's Medicare rural
hospital flexibility program.
The bill allows ORCA to accept grants to
fund programs.
ORCA must hold an annual meeting of agency
heads to discuss rural issues and also develop, implement, and
update a Rural Health Work Plan.
For physicians and other health care
providers, the bill specifically authorizes ORCA to transfer
existing Center for Rural Health Initiatives programs to the
agency, including:
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Outstanding Rural Scholar Loan
Program,
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Health Careers Promotion and Education
Program,
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Medically Underserved Community-State
Matching Incentive Program,
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Texas Health Services Corps,
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Rural Health Facility Capital
Improvement Fund,
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Designating rural hospitals to qualify
for federal funds, and
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Breast Cancer Screening Program.
-
Additionally, HB 7 creates a process by
which all powers, duties, obligations, rights, contracts,
leases, records, property, and unspent and unobligated
appropriations and other funds of the Center for Rural Health
Initiatives are transferred to ORCA.
TMA supported HB 7.
RURAL COMMUNITY HEALTH SYSTEM
Senate Bill 1394 by Sen. Troy Fraser
(R-Horseshoe Bay) and Rep. Judy Hawley (D-Portland) authorizes
the Rural Community Health System (RCHS) to create a pilot
project to determine the effectiveness of exclusive provider
networks in the delivery of rural Medicaid and indigent care. The
RCHS was established in 1997 by the legislature to develop
community-based, physician-directed health care networks that
could respond to the growing presence of managed care in rural
Texas. However, a lack of funding for the RCHS precluded it
achieving its full potential. SB 1394 allows RCHS to test
new rural health care delivery models in partnership with
existing insurers and networks, thus relieving many of the
system's start up-costs. TMA supported the RCHS-enabling
legislation as well as SB 1394.
EXPEDITED BME APPLICATIONS FOR RURAL
PHYSICIANS
HB 1018 by Rep. Rick Hardcastle (R-Vernon)
and Sen. Tom Haywood (R-Wichita Falls) requires the Texas State
Board of Medical Examiners (TSBME) to expedite medical licensure
applications for physicians already licensed in another state or
country who are relocating to Texas to practice in a rural area.
Applications also will be expedited for physicians with an
affidavit showing that he or she intends to work at an entity
affiliated with a public graduate medical education (GME) program
located in an underserved community, serve on the faculty of a
public GME program, and engage in the practice of medicine and
teaching in a specialty that is necessary for the GME program to
obtain or maintain its accreditation.
LIMITED STATE J-1 VISA WAIVER
PROGRAM
Also within HB 1018 is a provision allowing
the South Texas Regional Academic Health Center (RAHC) to recruit
physicians with J-1 visas in specialties that are needed to
obtain accreditation approval from the Accreditation Committee on
Graduate Medical Education. The bill grants authority for the
Texas Department of Health to recommend federal approval of J-1
visa waivers for applicants meeting the above criterion and is
limited to the four counties served by the South Texas RAHC and
up to 20 physicians per year.
TMA assisted community representatives and
administrators of the RAHC in gaining legislative approval for
the RAHC to participate in a limited J-1 visa waiver
program.
MEDICAL SCHOOL RURAL PILOT PROJECT
A pilot program to offer incentives to a
Texas medical school to prepare more students for rural practice
was approved by the legislature. This TMA-initiated bill, HB 2421
by Representative Hawley, did not receive the $200,000 in annual
funding needed to establish the pilot project; thus,
implementation of the bill will require a medical school to
pursue federal grants or non-government funding.
RURAL COMMUNITIES HEALTH CARE INVESTMENT
PROGRAM
A new loan repayment and stipend program is
created by SB 126 by Sen. Frank Madla (D-San Antonio) for health
care professionals other than physicians who agree to practice in
underserved rural areas. The program, to be administered by the
Center for Rural Health Initiatives, was developed in response to
shortages of some health professionals in rural areas of the
state. Graduates of Texas programs receive priority status for
loan repayment and stipends under the program. The legislature
allocated $5 million for this new initiative.
RURAL FOUNDATION
SB 115 by Senator Madla and Representative
Hawley creates a Rural 5.01(c)(3) Foundation within the Center
for Rural Health Initiatives to assist rural communities and
health professionals with raising money for local projects. The
new foundation will provide grant-writing assistance for funds
available through government entities, foundations, and other
sources that fund local rural health projects.
EMS PROVIDERS IN RURAL AREAS
In its interim report to the 77th Texas
Legislature, the House Committee on Public Health examined the
requirements imposed on emergency medical service (EMS) providers
in rural areas to determine whether individual requirements
encourage or hinder the provision of services. HB 2446 by Rep.
Bob Glaze (D-Gilmer) and Senator Madla addresses the
recommendations outlined in the interim report including:
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Allowing an advisory council to advise
the Texas Board of Health on emergency medical
services,
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Allowing counties to reimburse EMS
providers under the Indigent Health Care and Treatment Act at
Medicaid rates, and
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Considering the standardization and
simplification of EMS terminology and classification of
providers.
-
The bill also addresses recommendations
offered by TDH:
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Establishing a peer assistance program,
and
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Providing confidentiality for the
regional advisory council's quality improvement and data
process.
TEXAS A&M UNIVERSITY: NEW CENTER FOR
RURAL PUBLIC HEALTH
HB 910 by Rep. Roberto Gutierrez
(D-McAllen) establishes the Texas A&M University System
Health Science Center South Texas Center for Rural Public Health
to deliver health education outreach programs, provide
community-based instructional sites for the education of public
health professionals, and address the need to overcome the
limited access of rural residents to public health professionals.
The center was appropriated $2 million for the biennium.
The legislation further requires the Texas Higher Education
Coordinating Board to prepare an impact statement examining the
initial implementation of the bill by Aug. 31, 2002.
Rural Health Near Misses
STATE RURAL LOCUM TENENS PROGRAM
VETOED
Gov. Rick Perry vetoed a bill that would
have offered discounted, temporary coverage of a physician's
rural medical practice. The Center for Rural Health
Initiatives would have administered the program to make it easier
for rural physicians to obtain continuing medical education and
take a break from their practices. It was intended to promote
rural medical practice and prevent career burnout among rural
physicians.
During the final days of the session, an
amendment was added to the bill that would have enabled certain
physicians to become licensed in the state even though they
failed one part of the United States Medical Licensing Exam more
than six times.
TMA strongly supported the program, which
was developed by an interim committee comprising rural
physicians, rural hospitals, medical schools, private locum
tenens organizations, and state agency officials.
EXPANSIONS OF THE TEXAS HEALTH SERVICE
CORPS AND MEDICALLY UNDERSERVED COMMUNITY STATE MATCHING
INCENTIVE PROGRAM
A bill did not advance to final stages that
would have opened up two rural physician incentive programs
initiated by TMA during the 1990s to
any
health professional identified by the Center for Rural Health
Initiatives. SB 514 by Sen. Carlos Truan (D-Corpus Christi) would
have allowed $25,000 in state money matched by $25,000 in
community funds to be given to pharmacists, registered nurses,
and other health professionals as "start-up" money.
Rural Health TMA Staff Contacts
Overview
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Health Care Funding
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Long-Term Care and End-of-Life
Issues
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Market Fairness/Managed Care Reform
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Medicaid
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Medical Education
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Medical Licensure and Discipline
|
Medical Privacy
|
Public Health and Science
|
Scope of Practice
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Tort Reform/Medical Liability
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Workers' Compensation