Capitol Update: With time running out on the Legislature, special session “likely”

Tags: news, capitol update, legislature, budget, primary care coalition, advocacy, licensure, physician of the day, hospital, employment, international medical graduate

Capitol Update: With time running out on the Legislature, special session “likely”

posted 05.17.11
+ New law allows rural hospitals to hire physicians
+ IMG licensure bill heads to governor
+ Thanks to the Physicians of the Day

Now that two major House deadlines have passed, action in that chamber has calmed down substantially. Any House-originated bills that didn’t pass second and third reading on Thursday or Friday of last week are considered dead. Some of these “killed bills” will be resurrected through riders or amendments to Senate bills, which face a different set of deadlines. The Senate has until Wednesday, May 25, to consider bills for second or third reading, and the last day of the session is Monday, May 30.

For more on the legislative process in Texas, check out a new entry on the Texas Family Docs blog titled, “How a bill really becomes a law: A primer on the legislative process.”

The biggest newsmaker last week was House Bill 400, which would give flexibility to public schools by relaxing the student-teacher class-size ratio in early grades, authorizing teacher furloughs, and altering contract renewals. It met opposition for several reasons, but public health advocates in particular objected to measures that would have repealed school-based fitness requirements and coordinated school health education, effectively gutting health education programs at public schools aimed at curbing Texas’ obesity epidemic.

H.B. 400 missed the deadline for second reading on Thursday and is technically dead, but the bill’s author, Rep. Rob Eissler, R-The Woodlands, has said he will try to find another vehicle for the bill. Likely this will be its Senate companion, Senate Bill 22 by Sen. Florence Shapiro, R-Plano. Both bills impose significant cuts of $4 billion to $8 billion to public school districts.

A host of fiscal matters bills fell victim to House deadlines. They employ a variety of accounting maneuvers including delaying payments and speeding up tax collections to pool $3.5 billion for the 2012-13 biennium. Rep. Jim Pitts, chair of the House Committee on Appropriations, said that his committee would consider Senate Bill 1811—which finds non-tax revenue through similar methods to the House bills—next week.

Lawmakers deemed these “must-pass bills” for the state budget to work. Without a public school finance bill and a fiscal matters bill, experts predict the state will run out of money for public education by February 2013 and for Medicaid by March 2013.

As legislators work to pass bills essential to the budget, members of the budget conference committee are working to reconcile the House and Senate versions of the 2012-2013 appropriations bill. To meet printing deadlines, budget negotiators are shooting to release their report by today, Tuesday, May 17, but Sen. Ogden told the Houston Chronicle that it isn’t a hard deadline.

With equal representation from the House and Senate, the conferees are:

  • Sen. Robert Duncan, R-Lubbock;
  • Sen. Juan “Chuy” Hinojosa, D-McAllen;
  • Sen. Jane Nelson, R-Flower Mound;
  • Sen. Steve Ogden, R-Bryan;
  • Sen. Tommy Williams, R-The Woodlands;
  • Rep. Myra Crownover, R-Lake Dallas;
  • Rep. John Otto, R-Dayton;
  • Rep. Jim Pitts, R-Waxahachie;
  • Rep. Sylvester Turner, D-Houston; and
  • Rep. John Zerwas, R-Simonton.

The Primary Care Coalition, made up of the Texas Academy of Family Physicians, Texas Chapter of the American College of Physicians, and the Texas Pediatric Society, sent a letter last week to Chairman Pitts and the conferees asking them to support primary care funding, specifically in Medicaid and graduate medical education, to “ensure Texans have access to high-quality health care and to achieve proven cost savings to the state.”

The coalition asked the conferees to:

  • Maintain current payment rates for Medicaid and CHIP to stabilize physician participation and assure patients have access to timely, appropriate, and medically necessary care.
  • Restore funding for the Texas Statewide Preceptorship Program to build a robust primary care physician workforce.
  • Restore funding to the family medicine and primary care residency programs, which are funded through the Texas Higher Education Coordinating Board and are vital to training much-needed primary care physicians throughout the state to meet Texas’ future health care workforce needs.
  • Restore funding to the Physician Education Loan Repayment Program to maintain the incentive to draw primary care physicians to the rural and underserved areas that need them most.

With just two weeks remaining in the session, Sen. Ogden said in the Chronicle article that a special session is “pretty likely.” Lawmakers must make significant gains on major issues—especially the budget and redistricting—this week if they are to have the summer off. Stay connected to TAFP for the latest in how happenings at the Capitol affect your patients and your practices.

New law allows rural hospitals to hire physicians

On Thursday, May 12, Gov. Rick Perry signed a bill into law that allows rural hospitals to directly hire physicians. Advocates hope this will draw more doctors to underserved rural areas. S.B. 894 by Sen. Duncan and Rep. Garnet Coleman, D-Houston, allows critical access hospitals, sole community hospitals, and hospitals in counties of 50,000 or fewer to employ physicians.

Provisions in the bill preserve physicians’ clinical autonomy: it ensures all clinical matters are decided by medical staff, protects physicians’ independent medical judgment, requires hospitals to have a chief medical officer to report to the Texas Medical Board, and maintains physicians’ ability to choose their liability insurance.

IMG licensure bill heads to governor

The IMG licensure bill, H.B. 1380 by Rep. Vicki Truitt of Keller and S.B. 1022 by Sen. José Rodríguez, D-El Paso, has passed the House and the Senate and now heads to the governor to be signed into law. The bill would allow international medical graduates to receive a medical license after two years of residency instead of three.

Passing this legislation was one of TAFP’s priorities this legislative session. By removing the barriers to licensure, these physicians can start caring for patients as quickly as graduates of U.S. medical schools, thus improving Texans’ access to care. The legislation removes the incentive for practice-ready, Texas-trained physicians to leave the state in search of employment and removes related credentialing delays to allow them to be paid.

Read more in an article in the latest issue of Texas Family Physician magazine, “Brain drain: Licensure delay provides incentive for IMGs to leave Texas after residency training.”

Thanks to the Physicians of the Day

Thanks to the physicians who volunteered for the Physician of the Day program this week and last: Kanaka Paladugu, M.D. of Bastrop; Timothy Vachris, M.D., of Austin; Horacio Ramirez, M.D., of San Antonio; Richard Young, M.D., of Fort Worth; Jean-Jacques Carr, M.D., of Robstown; Thomas Shima, D.O., of Dallas: Julie Graves-Moy, M.D., of Austin; Love Paul, M.D., of Austin; Mark Eidson, M.D., of Weatherford; and Erica Swegler, M.D., of Keller.

The Physician of the Day program brings a family physician to the Capitol each day of the legislative session to provide health care to members of the Capitol community. All spots for the 82nd Legislative Session have been filled. If you have not had a chance to sign up this session and would like to be placed on a waiting list for a possible special session this July or the 83rd Legislative Session in 2013, e-mail

For more information, go to the Physician of the Day page of the TAFP website,