1999 Legislative Compendium: Medical Education

[ Medical Education  |  Medical Education Near Misses  |  Narrow Escapes ]

Medical School Expansion
SB 1288 by Senator Zaffirini and Rep. Henry Cuellar (D-Laredo) grants approval tothe UT Health Science Center at San Antonio to establish an extension campus on donated land in Laredo. Passage of this bill was contingent on the donation of land and funds to construct an administrative building. Three acres were donated by the City of Laredo and at least $3 million in local funds were committed.

The extension campus will operate through a Memorandum of Understanding between UTHSC-San Antonio and the Texas A&M University System. This will bring residency training programs to Laredo for the first time, but there will be no net increase in the medical school class size for the San Antonio medical school. Medical students from the San Antonio campus will attend clinical clerkships in Laredo. An extension campus differs from a Regional Academic Health Center in that medical students do not typically reside in the area for long periods of time, only long enough to complete individual clerkships.

Coastal Bend Health Education Center
SB 590 by Sen. Carlos Truan (D-Corpus Christi) authorizes the Coastal Bend Health Education Center as part of the Texas A&M University System to be established in Corpus Christi and surrounding counties. The new campus will offer educational programs for the training of allied health professionals and provide community health programs. The bill also allows for medical education to be provided as part of the new health education center. Texas A&M Medical School has plans to eventually develop community training programs for medical students in the Coastal Bend area. TMA supported the passage of this bill based on policy adopted by the TMA House of Delegates in May.

Degree-Granting Authority Extended to The University of Texas M.D. Anderson Cancer Center
Although the UT M. D. Anderson Cancer Center has offered allied health training programs for some time, it has not had degree-granting authority. HB 1314 (Representative Hochberg and Sen. Rodney Ellis (D-Houston) extends that authority to the cancer center, resulting in both reduced class hours and educational costs for its students.

Border Study on Medical Training Needs
SB 1378 by Senator Shapleigh directs the Coordinating Board to conduct a study and develop recommendations on medical training needs for health professionals in the border area based on an assessment by TDH of future border medical and health care services, and other needs requirements for this area. The Coordinating Board is directed to seek assistance from the Health Education Training Center Alliance, a federal- and state-funded alliance of area health education centers headquartered at UTHSC-San Antonio, and the area health education centers in conducting this study. Results are to be reported to the governor and the 77 th legislature by Jan. 1, 2001.

During committee hearings on this bill, Senator Shapleigh said this study would determine the need for a new medical school in the border area.

Formula Funding for Health-Related Institutions
As follow-up to an interim study, Sen. Bill Ratliff (R-Mt. Pleasant), chair of the Senate Finance Committee, successfully included in the appropriaions bill a conversion to a formula funding method for Texas medical schools and other health-related institutions, including UT M. D. Anderson Cancer Center and UT Health Center at Tyler. Previously, historical funding patterns and special requests have driven the medical school appropriations process. Under formulas, medical schools will be funded per student, with adjustments for infrastructure and research costs. Schools can also receive special item funding.

Most of the state's eight medical schools saw only slight increases, ranging from 2 percent to 7 percent, under the new funding method compared with last biennium. UTMB actually experienced a very slight decline (less than 1 percent) in state funding.

Because the formulas were designed to adjust for diseconomies of scale displayed by smaller schools or regional academic health centers (multi-campus arrangements), the state's two smallest medical schools, posted the largest gains. Texas A&M, and the University of North Texas Health Science Center (the state's only osteopathic medical school) received funding increases of 19 percent and 16 percent, respectively.

Using a formula method that funds schools on a per capita basis could be a disincentive for downsizing enrollments, should the need arise in the future in response to a physician oversupply.

Graduate Medical Education Funding to Texas Higher Education Coordinating Board
The Coordinating Board received $27 million to fund primary care residency training programs for each year of the next biennium. Although an increase of $2 million for the Family Practice Residency Program was sought by the Texas Academy of Family Physicians and approved by the Senate and House, the budget conference committee voted to maintain current appropriation levels, with no net increase in residency program funding.

Information on the Coordinating Board's $27 million funding request for primary care residency programs was included in TMA's legislative report, "The Physician Workforce in Texas: Implications for Medical Education." This report was distributed to all legislators during the session.

Restrictions on State Agency Spending on Membership Dues
SB 223 by Sen. Steve Ogden (R-Bryan) requires a state agency that pays membership dues on behalf of an employee to professional associations that conduct lobbying activities, such as TMA, to report the amount of the payment, the name of the organization, and the staff of the organization who conduct lobbying activities. This information is to be reported to the Legislative Budget Board, the Senate Finance Committee and the House Appropriations Committee.

This means health-related institutions, including medical schools that pay TMA dues for physicians in administrative or faculty positions, will be required to report this activity to three state entities. This could serve as a disincentive for medical schools to cover TMA dues for physicians, possibly resulting in a decline in the number of academic members in TMA. A new subcommittee for academic physicians has been placed under the TMA Council on Medical Education to help inform faculty physicians of the benefits offered by TMA, and to focus on the unique needs and interests of academic physicians. One of the primary charges of the new subcommittee is membership development.

Salary Increase for Non-Faculty and Faculty of Higher Education Institutions
The Appropriations Act provides funds for a $100 per month salary increase for non-faculty employees of institutions of higher education in fiscal year 2000. If state funds are available, a salary increase of 3 percent may be given to faculty of higher education institutions, including health science centers, in fiscal year 2001. Should the additional funds be available, this could be helpful to medical schools in hiring and retaining faculty members.

Bid by Texas Chiropractic College to Become Part of A State University System
SB 1651 by Sen. Mike Jackson (R-La Porte) and Rep. John Davis (R-Houston) would allow the Texas Chiropractic College in Pasadena, a non-profit, private institution, to become part of a state university system, if a system can be found to accept the college and the transfer wins approval from the Coordinating Board. This non-profit college is said to be seeking to become a state institution to mainstream chiropractic medicine and facilitate research in this field.

The college was appropriated $250,000 to cover state retirement benefits for personnel and other conversion costs should the college be accepted by a state university system. Over the last two years, no university system has been willing to accept the college into their system.

In addition, both of the state's chiropractic colleges will receive $125,000 in state support for chiropractic training during 2000 and 2001, more than 10 times the amount received last biennium, but far less than the $2 million requested by Sen. Royce West (D-Dallas).

State Funding for Pharmacy Residency Program
SB 931 by Senator Madla and Representative Van de Putte establishes the Roberta High Memorial Residency Program to provide up to $10,000 per resident position in stipends if pharmacy residency programs are established. Currently, there are no pharmacy residency programs in the state. Half of the resident positions receiving the stipends must be in community settings.

This program is to be funded in fiscal year 2000 by $850,000 in funds transferred from the Texas State Board of Pharmacy. No state funding is authorized for 2001.

 Medical Education Near Misses

Transfer of Patient Care Revenues Generated by Academic Physicians to State General Revenue Fund
A rider was introduced but failed to win Senate Finance Committee support to force teaching programs to turn over patient care revenues generated by academic physicians to the state general revenue fund. Some of the revenues would have been returned to teaching programs for prescribed activities.

TMA Council on Medical Education was strongly opposed to this rider because of financial implications for the state's medical schools and teaching hospitals and this opposition was relayed to the TMA Council on Legislation.

New Admission and Scholarship Criteria for Disadvantaged Students
HB 2770 by Rep. Irma Rangel (D-Kingsville) would have mandated new admission and scholarship guidelines for higher education programs, including medical schools. Schools would have been required to consider non-academic factors and scores on standardized tests could only have been used if compared with scores for applicants of similar socioeconomic background. This bill was not approved by the House or Senate.

Support for Research in Biotechnology and Biogenetics
Additional support for basic research in biotechnology and biogenetics at various institutions was the purpose of HB 2803 by Rep. Kenn George (R-Dallas). It would have established an advisory committee at the Coordinating Board to assist the board in administering the initiative. This bill could have provided additional research dollars to Texas academic health centers. The bill was approved by the House Higher Education Committee but not the full House.

Narrow Escapes

Limits on Affiliation Agreements for Higher Education Institutions
The original version of SB 1431 Sen. Robert Duncan (R-Lubbock) and Representative Rangel would have severely limited the ability of higher education institutions to enter affiliation agreements with other educational programs. This would have required medical schools to obtain approval from the Coordinating Board and the legislature to enter affiliation agreements with residency programs. It also may have prevented schools from making arrangements with community physicians to serve as preceptors. The bill was amended to tighten up the language to cover affiliations that would greatly expand the school's mission or similar types of expansions. With this amendment, this bill no longer applied to residency program affiliation agreements or physician preceptors.

Medical Education Staff Contacts:
-Bridget Horton, Medical Education: (512) 370-1404
-Marcia Collins, Medical Education: (512) 370-1451 

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