89th Legislature Regular Session

SB 2891

Overall Vote Recommendation
No
Principle Criteria
Free Enterprise
Property Rights
Personal Responsibility
Limited Government
Individual Liberty
Digest

SB 2891 establishes the Health Professions Workforce Coordinating Council in Texas and repeals the existing Statewide Health Coordinating Council and its Nursing Advisory Committee. The newly created council is administratively attached to the Department of State Health Services and is tasked with developing a comprehensive, strategic approach to addressing health workforce needs across the state. Its creation reflects growing concern about persistent and projected shortages in healthcare professionals and aims to centralize and streamline workforce data collection, analysis, and planning.

The council’s membership includes representatives from a wide range of state health and education agencies and licensing boards—ranging from the Texas Medical Board and Board of Nursing to the Texas Education Agency and Higher Education Coordinating Board. Additionally, the governor will appoint four members with expertise in healthcare workforce planning and data analysis. This multi-agency collaboration reflects a holistic approach to mapping out healthcare workforce dynamics and needs.

One of the council’s primary duties is to compile workforce data from state agencies and develop a biennial Health Professions Strategic Plan. This plan must include detailed projections of supply and demand across healthcare fields, identify current and anticipated shortages, assess educational capacity, and offer both short-term and long-term recommendations. The plan will also address systemic causes of workforce gaps and propose alignment strategies between education and labor markets to better meet Texas’s growing healthcare needs. To support this effort, the council will also establish a technical work group to aid in data modeling and analysis.

Overall, SB 2891 reflects a state-led, data-driven effort to modernize and align Texas’s healthcare workforce systems with future demands. It seeks to improve efficiency, coordination, and planning while replacing outdated advisory structures with a more integrated and strategic model.

The Committee Substitute for SB 2891 builds upon the originally filed version by refining the scope, implementation timeline, and administrative structure of the new Health Professions Workforce Coordinating Council. While the original bill laid the groundwork for replacing the Statewide Health Coordinating Council and its Nursing Advisory Committee, the substitute version enhances the bill's clarity, broadens representation, and adds implementation specificity.

One of the most notable differences is the expansion of council membership. The committee substitute adds the Texas Veterinary Medical Association to the list of participating entities, in addition to retaining the State Board of Veterinary Medical Examiners. This change extends the council’s focus to a wider spectrum of health professions and signals the inclusion of more practitioner voices in workforce planning. The substitute also reinforces the council’s authority by explicitly stating the administrative attachment to the Department of State Health Services and clarifies that the department will provide support, ensuring continuity as the new body replaces its predecessors.

The strategic planning process is also more detailed in the substitute. It mandates the publication of a biennial strategic plan by October 1 of each even-numbered year and outlines clearer expectations for the content of that plan, including long-term projections, systemic workforce analysis, and recommendations for realigning educational and workforce programs. These provisions, while implied in the original bill, are given sharper definition in the substitute to support greater transparency and accountability.

Finally, the substitute version introduces more structured transitional provisions. It specifies the deadlines for appointing members to the new council and for publishing the initial strategic plan. It also outlines the transfer of existing funds and responsibilities from the abolished councils to the Department of State Health Services. These additions ensure a smoother organizational transition and operational continuity, addressing practical concerns that were left ambiguous in the original bill. Overall, the Committee Substitute reflects a more operationally mature and inclusive version of the original proposal.

Author
Molly Cook
Co-Author
Charles Perry
Fiscal Notes

According to the Legislative Budget Board (LBB), the fiscal implications of SB 2891 reflect a modest but ongoing cost to the state’s General Revenue Fund. According to the Legislative Budget Board (LBB), the bill would result in a projected negative fiscal impact of approximately $2.87 million over the 2026–2027 biennium. These expenses are associated with the creation and operation of the newly established Health Professions Workforce Coordinating Council within the Department of State Health Services (DSHS)​.

To implement the bill’s requirements, DSHS would require nine additional full-time equivalent (FTE) positions. These include four Research Specialist V roles to analyze workforce trends and education outcomes, four Data Analyst V roles to manage and interpret large health workforce datasets, and one Director II to oversee strategic planning and operations of the council. The estimated cost for these positions is $1.27 million in FY2026 and $1.6 million annually thereafter. The initial year’s cost is lower due to an assumed phased hiring schedule.

The bill does not appropriate funds directly but provides the legal foundation for future appropriations. Additionally, other affected state agencies—such as the Attorney General’s Office, the Office of Court Administration, and the Health and Human Services Commission—indicated that any responsibilities stemming from the bill could be absorbed within existing resources. The Comptroller of Public Accounts anticipates no significant impact on state revenue collections, and there are no expected fiscal implications for local governments.

Overall, while the bill introduces ongoing costs, they are relatively limited in scope and are primarily directed toward staffing and administrative support for enhanced workforce data analysis and strategic planning functions within DSHS.

Vote Recommendation Notes

SB 2891 presents a well-meaning but ultimately problematic reorganization of Texas’s healthcare workforce planning infrastructure. While the bill aims to improve coordination across state agencies and address health professional shortages through a centralized strategic approach, it does so by expanding the size and scope of government in ways that raise principled concerns. Specifically, the creation of the Health Professions Workforce Coordinating Council—along with the establishment of new planning duties, a permanent workgroup, and an advisory nursing committee—represents a significant state-led intervention in what has traditionally been a market-influenced sector.

From a limited government perspective, SB 2891 introduces nine new full-time government positions at the Department of State Health Services, funded entirely by General Revenue. These include data analysts, research specialists, and a director, at a cost of approximately $2.87 million for the initial 2026–2027 biennium and over $1.6 million annually thereafter. While these roles are designed to enhance workforce planning, the cost is not offset by clear, measurable savings elsewhere in state government. For lawmakers concerned about fiscal restraint and administrative efficiency, this increased spending, without a defined sunset or cost-sharing mechanism, may be seen as unjustified and unsustainable over time.

Moreover, although the bill eliminates two entities (the Statewide Health Coordinating Council and its Nursing Advisory Committee), it does not reduce bureaucracy. Rather, it reconstitutes their roles under a broader, more expansive umbrella. The new council brings together representatives from at least 15 agencies and assigns them long-term strategic and planning tasks, with biennial reporting requirements and a broader purview than the structures it replaces. This shift may be viewed not as consolidation, but as bureaucratic reshaping that enlarges the government’s footprint in workforce policy without direct accountability to the public or private sector stakeholders who bear the downstream effects.

Importantly, the bill also reflects a central planning mindset that may be at odds with free market principles. By directing workforce strategies through a state council, rather than allowing schools, employers, and professionals to respond organically to labor market demands, it risks skewing supply and demand signals and encouraging top-down resource allocation. Even though SB 2891 is advisory in nature and does not impose new regulations, its centralized planning structure could establish a precedent for future interventions that constrain the autonomy of educational institutions and healthcare providers.

Finally, while the bill does not impose any new regulatory burdens on individuals or private businesses, its long-term implications could open the door to increased state influence over education pipelines, licensure prioritization, or funding distributions. For lawmakers concerned about creeping regulatory frameworks, the establishment of such a centralized strategic authority, even with no current enforcement power, warrants caution.

In conclusion, although SB 2891 is framed as a modernization effort, it expands government staffing, requires new taxpayer funding, centralizes decision-making, and invites future mission creep. These factors outweigh the potential benefits of improved coordination. For those committed to limiting the growth of state government, protecting free enterprise, and avoiding unfunded administrative expansion, Texas Policy Research encourages lawmakers to vote NO on SB 2891.

  • Individual Liberty: The bill's stated aim—to improve the strategic planning of the healthcare workforce in Texas—could support individual liberty by helping ensure that Texans have access to a robust and geographically distributed health provider network. In theory, more doctors, nurses, and other practitioners mean better access to care and greater freedom of choice. However, this benefit is indirect and hinges on the effectiveness of government planning, which historically has had mixed results. Moreover, centralizing decisions about workforce priorities could eventually limit the autonomy of health professionals or institutions through indirect state influence over program funding or credentialing priorities.
  • Personal Responsibility: By promoting data-driven policy and coordination among educational and workforce entities, the bill may improve transparency around labor market trends. That, in turn, could help students and professionals make better-informed career decisions, reinforcing personal responsibility. However, because the bill does not mandate individual behavior or shift responsibility away from individuals, its impact on this principle is positive but limited.
  • Free Enterprise: The bill introduces a centralized state planning body to assess and forecast workforce needs, which risks distorting labor market signals. While not directly regulatory, it effectively places the state in a quasi-managerial role over workforce development, territory traditionally governed by employer demand and individual career choice. This is antithetical to free enterprise, where voluntary transactions and decentralized responses to demand determine labor flows. The council's outputs could lead to top-down program expansions or funding allocations that outpace or misalign with actual market needs, creating inefficiencies or unintended disincentives.
  • Private Property Rights: The bill does not impact or infringe upon private property rights. It neither authorizes the taking nor regulation of private property nor interferes with property-based transactions. The council’s work is advisory and informational, with no enforcement power that could encroach on property ownership or control.
  • Limited Government: This principle is where the bill most clearly falls short. SB 2891 expands the administrative state by establishing a new, broad-scope council and creating nine new state positions—funded by General Revenue at nearly $3 million over the first biennium. While it eliminates two existing bodies, it replaces them with a more expansive and permanent infrastructure, without a defined sunset clause or cost controls. For those who believe government should perform only essential, constitutionally authorized functions, this expansion, especially into workforce planning, goes beyond limited governance.
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