The Subcommittee met to consider Article III of the General Appropriations bill. This report focuses solely on the discussion of graduate medical education
Greg Owens, Legislative Budget Board
- Chair Trent Ashby wants to focus on distinction between GME formula funding and GME funding provided through coordinating board. What does each pay for and why is each important?
- GME, also known as residency, ranges from 3 to 7 years and usually occurs in hospitals
- GME funding included in Article III of Recommendations for ’16-’17 in House Bill 1
- GR funds trusteed to Higher Education Coordinating Board (THECB)
- GR funds allocated to Health-Related Institutions through GME Formula
- HB 2550 enacted by 83rd Legislature created new programs to support GME
- Planning Grants are intended to increase available first-year residency programs by helping entities without GME programs investigate the feasibility of establishing a program. HB 1 does not include funding for planning grants.
- Unfilled Position Grants provide support for existing accredited GME programs that have approved, but unfilled first-year positions. They provide funding for direct resident costs and benefits. HB1 includes $12.7 million for these grants.
- New and Expanded Grants provide support for expansion of number of accreditor approved first-year residency programs. ’16-’17 recommendation in HB1 includes $15.9 billion for these grants.
- Unfilled Position Grants is to support residents who have completed at least three years of residency and are in residency programs in which the state has less than 80% of the national average of physicians. HB1 does not include funding for these grants.
- HB 2550 restricts these grants to the fiscal year beginning September 1, 2016 or subsequent years contingent on the appropriation of funds
- Resident Physician Expansion Program provides awards on a competitive basis to encourage creation of new GME positions. HB1 does not include funding for this program
- Primary Care Innovation Program provides awards on competitive basis to medical schools that administer innovative programs designed to increase the number of physicians in the state. HB1 includes $2.1 million for this program.
- Ashby asks how much allocated for Planning Grants in the current biennium
- Owens refers Chair Ashby to THECB report on how funds were allocated
- Family Practice Residency Program (FMRP) provides grants to Texas’ 26 nationally accredited family medicine residency programs based on number of residents training in approved family practice residency programs. HB1 includes $12.8 million for this program.
- Emergency and Trauma Care Education Program provides funding to support partnerships between hospitals and GME programs that increase the number of emergency medicine and trauma care physician residents. HB1 includes $4.5 million for this program
- GME Formula
- Allocates funding on a per medical resident basis in accredited program
- ’16-’17 recommendations in HB1 include $70.2 million for the GME formula
- GEER Report includes 10 recommendations that would do the following:
- Improve mix and geographic distribution of doctors by identifying types of doctors in critical supply and funding residency programs in these disciplines
- Add more residency slots with a focus on rural and underserved areas
- Bring together established residency programs and developing programs so established residency programs can mentor new programs
- Ensure well-trained faculty are available to teach residents
- Biennial impact to implement report’s recommendations is $59.3 million and would require statutory changes
Stacy Silverman, THECB
- GME or residency training is the final educational training for a physician to enter a specialty
- Once a student finds a residency program they are contractually bound to that program
- Medical schools increased class sizes in response to a national call to increase physician numbers
- Since 2002, Texas medical graduates have increased by 30%; GME slots need to increase significantly to keep up with these rates
- Family Practice Residency program is Texas’ oldest residency program
- THECB has an exceptional item asking for an additional $14 million for the family practice program; would bring levels up to 2002-2003 adjusted funding levels
- Last session HB 1025 created several funding streams to support increase in first year residency programs; planning grants were designed to allow entities to investigate the feasibility of establishing a residency program; ten grants were funded; four have already achieved accreditation
- Unfilled residency grant program; would fund 25 unfilled positions at entities around the state; filled all of those
- New and expanded residency programs; will fund 9 different programs and 53 new first year residency programs
- Will be funded after the match process in March
- Rep. Marisa Marquez asked how THECB determines where the GME slots are placed
- Invited various programs to apply; not new locations necessarily
- Marquez asked if any applications were submitted from West of I-35 besides Texas Tech
- No; there were 7 applicants for the unfilled program and 12 for the new and expanded program; they all received funding
- Resident expansion program; have received 8 applications which are currently under review
- Grants for additional residency program years; established last session to fund residents who have completed at least three years of residency training in a field where Texas is below the national average