2003 Legislative Compendium: Rural Health

[ Interagency Work Group | Rural Physician Relief Program | Rural Foundation | Temporarily Exempting Rural EMS Personnel from Legal Requirements | Visa Waivers for Physicians | Federally Qualified Health Centers | Rural Health Near Misses | Community Health Center Loan Program | Office of Rural Community Affairs ]


With the creation of the Office of Rural and Community Affairs (ORCA) came the establishment of an annual meeting of related agency heads. The purpose of this group is to work together on rural issues, discuss and coordinate programs and services offered to rural communities and residents, and develop regulatory and legislative recommendations that would eliminate duplication and combine program services. House Bill 649 by Reps. Bill Keffer (R-Dallas) and Jim Keffer (D-Eastland) clarified the purpose of the meeting and added agencies required to send a representative.


(See Workforce/Medical Education section .)


Due to the lack of physicians, attempting to find practice coverage for rural doctors continues to be extremely difficult. HB 1877 by Rep. Rick Hardcastle (R-Vernon) requires the Office of Rural and Community Affairs to instigate a state-supported rural physician relief program. The program will provide relief services to rural physicians to facilitate their taking time away from their practice. ORCA will assess an affordable fee to physicians utilizing the program as well as pay those providing coverage. ORCA also is commissioned to actively recruit physicians to participate as relief physicians within the program. TMA supported the passage of this bill.


The 77th legislature developed the nonprofit Rural Foundation to accept grants that prohibit a governmental entity from receiving grant money. During the drafting of this legislation, however, community and economic development programs were left out of the language, limiting the foundation to work only with health care grants. Now, Senate Bill 446 by Sen. Frank Madla (D-San Antonio) allows the foundation apply for three types of grants: health, community, and economic.


Rural emergency medical service (EMS) personnel sometimes are qualified to perform certain services but not certified to perform them because of the lack of nearby, cost-efficient educational opportunities. SB 529 by Senator Madla gives the Texas Department of Health (TDH) the authority to grant temporarily, on a case-by-case basis, administrative exemptions for rural EMS personnel. Once an exemption is granted, the EMS personnel, or appropriate EMS provider, must adopt a written plan under which the applicable requirement will be met as soon as possible. This bill also grants temporary exemption to EMS personnel who are applicants for certification at a higher level of training to temporarily practice at that higher level.


HB 1130 by Representative Hardcastle and Rep. Norma Chavez (D-El Paso) amends state law to expand eligible areas for J-1 Visa waiver physicians to practice under the federal Conrad-30 program to include federally designated Health Professional Shortage Areas. Current law limits eligibility to academic physicians on staff at the South Texas Regional Academic Health Center.


SB 610 by Sen. Jane Nelson (R-Flower Mound) allows TDH to make grants to establish or expand existing facilities to qualify for the federally qualified health centers (FQHC) program. The department may make planning, development, capital improvement, and transitional operating funds grants. It is hoped the establishment of more FQHCs throughout Texas' medically underserved and health professional shortage areas will alleviate the strain on these needy areas as well as provide relief to Texas' already overstressed emergency rooms.

Rural Health Near Misses


HB 770 by Reps. Jim Solis (D-Harlingen) and Richard Raymond (D-Laredo) would have allowed a joint project by two or more community health centers eligible for federal financing.


HB 2632 by Rep. Warren Chisum (R-Pampa) was an evaluation of the rural health programs under ORCA's jurisdiction with proposed changes, including statutory, to combine, streamline, or coordinate the programs to improve their flexibility and efficiency. Sections affecting physicians required them to return money received under a program if they fail to fulfill the term of the agreement with a rural community and required ORCA to establish a recruitment and retention program for physicians in rural areas of Texas.

HB 3297 by Representative Chavez would have officially renamed ORCA the Office of Rural and Border Community Affairs. Among other things, this bill would have established a Border Foundation that potentially would have pulled from funding earmarked by the federal government for the border regions of the United States.

Rural health TMA staff contacts:

-Jen Blake, health policy analyst, Office of Governmental Affairs, (512) 370-1376
-Stephen Brown, associate director, Legislative Affairs Department, (512) 370-1367

Overview Professional Liability Reform Patient Safety/Quality Improvement Managed Care/Insurance Reform Health Care Funding Health and Human Services Reorganization Scope of Practice Public Health Mental Health Medical Science Workers' Compensation Tax Reform Long-Term Care Workforce/Medical Education Abortion and Related Legislation Health Facility Regulation Transplantation/Organ Donation ]

Last Updated On

July 23, 2010

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