The House Appropriations Committee heard testimony and overviews on the House Budget Recommendations on the following agenda items:
Graduate Medical Education
Greg Owens, Higher Education Team, Legislative Budget Board
- GME residency programs are accredited through the ACGME and/or the American Osteopath Association – funding included in Article III of Recommendations for 2016-2017 in HB1
- 2016-2017 Recommendations include $12.7 million for unfilled position grants, $15.9 million for new and expanded grants and $2.1 million for a Primary Care Innovation program
- Resident Physician Expansion program, grants for additional years of residency and planning grants were not included in HB1 Recommendations for funding
- Additionally, HB1 Recommendations include the following:
- $12.8 million for the Family Practice Residency Program (FMRP) to support rural and public health rotations
- $4.5 million for the Emergency and Trauma Care Education Program to provide support for partnerships between hospitals and graduate nursing programs
- GME Formula requested $70.2 million for funding to the Health Related Institutions and Baylor College of Medicine
- Government Effectiveness and Efficiency Report recommended the following:
- Improve the mix and geographic distribution of doctors by identifying the types of doctors that are in critical supply and fund residency programs in these disciplines;
- Add more residency slots, with a focus on rural and underserved areas;
- Bring together established residency programs with new and developing residency programs so the established programs can mentor the new programs during the accreditation process which can be difficult to navigate; and
- Ensure well-trained faculty are available to teach residents
- Rep. Gonzalez asked if GME’s dedicated account 5111 used proceeds from the Driver Responsibility Program which was initially established to fund trauma centers
- GME is currently funded by program, but GME could also be funded by General Revenue instead of dedicated account
- Rep. Sheffield questioned the future of Medicare’s role in GME funding (i.e. increase, decrease or remain neutral)
- Institute of Medicine issued report stating Congress should keep Medicare funding stable for ten years while implementing recommendations
- Rep. Price asked if there were more residency programs being developed in rural areas
- Recommended program will bring providers and physicians to hospital centers in underserved and rural areas – modeled after the federal Teaching Health Center program
- Chairman Otto asked for the total recommended dollar amount for GME spending in introduced bill
- HB1 has asked for a total of $118.2 million
- Chairman Otto recognized the lasting commitment established once first-year slots are created – not a one-time funding commitment
- Vice-Chairman Turner noted proceeds from Driver’s Responsibility Program were not being used for their intended purpose
- HB 7 last session approved for a portion of DRP funding to be used towards GME
- Vice-Chairman Turner noted trauma centers lack resources to meet performance standards and should receive greater portion of DRP funding
State Contracting Procedures
Sarah Keyton, Assistant Director, Legislative Budget Board
- Chairman Otto questioned who would have oversight of documentation regarding emergency purchases subject to audit
- TPASS would have oversight and promulgate the forms and rules that specified documentation would entail
- Vice-Chairman Turner asked for cost range of Department of Information Resources (DIR) programs
- State and local solutions – Xerox contract for $1.1 billion over eight years (2012-2020)
- Bulk printing and mail services – Xerox contract for $54 million over six years (2012-2018)
- Oversight services and management service integration – Capgemini contract for $127 million over six years (2012-2018)
- Vice-Chairman Turner asked if contract costs have escalated since initial agreement
- The amount listed above was an estimation cost and actual costs have not been provided
- $1.3 billion has been spent since 2012 which adds up to more than was originally appropriated
- Rep. Gonzalez encouraged the Committee to more closely consider RFPs and change orders
Jennifer Wiederhold, Project Manager, State Auditor’s Office
- Rep. Rodriguez requested for the State Auditor’s Office to include recommendations in future reports
- Rep. Munoz asked who decides whether or not an audit should be conducted
- Quality and assurance team conducts audits on projects over $1 million
- Rep. Munoz asked for requirement exemptions regarding higher education and healthcare to be included in future reports
Transportation Funding
Thomas Galvan, Business and Economic Development, Legislative Budget Board
- Proposition One will transfer up to $2.6 billion of revenue to the Texas State Highway Fund for the upcoming biennium
- Rep. Munoz asked if the $2.6 billion will be sent to the regular source of funding for TxDOT
- HB1 intended for the legislator to delegate unassigned funding to non-toll public roadways
- In comparison to the last biennium, how does the current TxDOT compare now
- There has been a 2.5 percent increase from the FY14 base-level funding of $23.1 billion
- 2.5 increase for FY15
- Rep. Koop noted a large source of revenue comes from the motor-vehicle sales tax
- Vice Chairman Turner recommended half of motor-vehicle sales tax surplus balance should be distributed to TxDOT – Chairman Otto encouraged Vice Chairman Turner to investigate idea
- Rep. Burkett noted it might be more beneficial to pay off debt before placing the money on reserve
Overview of Trusteed Funds
Lara Bell, General Government, Legislative Budget Board
- HB1 does not include contingency funding for MIIIP incentive awards – Strategy, Film and Music Marketing retains $10 million in GR for program operations in the 2016-2017 biennium
- Rep. Burkett asked for the return of investment in investing in the film industry
- From 2009- 2014, $126.8 million in grants were provided to incentivize film projects, and the spending by these projects totaled up to $881.2 million
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