The Texas Medical Board told the House Appropriations subcommittee on March 5 that it needs additional funding to modernize enforcement systems, expand staff and stand up an ombudsman office to improve licensing turn‑around and complaint transparency.

"Our primary responsibility is to license qualified applicants and to do so efficiently and then process complaints and make sure that our licensees are safe to practice medicine," Deputy Executive Director Joe Estrada told the panel, describing growth in licensing and a need to modernize legacy enforcement platforms.

Estrada said the board's revenue collections exceed expenditures and that most of the agency's exceptional items could be funded from license fee revenue. Among the requests were inflation‑adjusted operational costs, targeted compensation increases for roles with high turnover (attorneys, nurse investigators, license specialists), and an IT modernization to provide real‑time complaint tracking and reduce reliance on paper mail.

Multiple members pressed TMB staff about policy and enforcement priorities. Representative Harrison questioned the board's actions on gender‑affirming care for minors, asking whether the board had authority and whether it had used rulemaking to restrict treatments. TMB staff said the agency is principally complaint‑driven and that it had not undertaken rulemaking in that area; staff pledged to follow up on complaint records from the committee.

Members also raised a separate concern after public reporting showed a recent TMB medical director had a long outside affiliation with Planned Parenthood. TMB witnesses said the board will review outside‑employment disclosures annually and that they had not been aware of the employment details until the director's curriculum vitae was publicized in court filings. The agency agreed to provide an attestation to the committee about current outside‑employment disclosures.

Lawmakers asked about telework levels and fee burdens. TMB said roughly 75% of staff engage in some form of telework, with field investigators working remotely, and that physician licensing fees have not increased since 2015. Medical association testimony supported TMB funding for staff and IT while urging efficient use of license revenue.

The subcommittee asked TMB to provide follow‑up information on complaint records related to gender‑affirming care, consultant spending, and confirmation that no other employees have potential conflicts of interest arising from work for regulated entities.