SB1677

Regular Session

Relating to a study on prevention and reduction of diabetes-related amputation.

LowStandard timeline

Low Cost

Effective:2025-09-01

Enforcing Agencies

Texas Higher Education Coordinating Board (THECB) • Department of State Health Services (DSHS)

Compliance Analysis

Key implementation requirements and action items for compliance with this legislation

Implementation Timeline

Effective Date: September 1, 2025
Compliance Deadline: September 1, 2026 (Deadline for the designated University to submit the report; industry stakeholders must submit data/testimony prior to this date to influence findings).
Agency Rulemaking: No immediate rulemaking. However, the period between September 2025 and August 2026 serves as a "shadow rulemaking" phase where the designated University and DSHS will define "evidence-supported" therapies.

Immediate Action Plan

Identify the Lead Institution: Monitor THECB announcements in September 2025 to determine which Research 1 University (e.g., UT, A&M, UH) is awarded the study.
Prepare the Evidence Package: Compile a white paper summarizing your organization's data on amputation prevention and cost-savings to present to the study group by January 2026.
Engage the Researchers: Direct Government Affairs to secure a meeting with the lead researchers immediately after the study commences.
Monitor DSHS: Watch for interim announcements from the Department of State Health Services regarding the "consultation" process mentioned in Subsection (d).

Operational Changes Required

Contracts

Payer-Provider Agreements: No immediate amendments required. However, General Counsels for hospital systems and insurers should draft contingency language for 2027 renewals, anticipating new reimbursement models tied to "amputation reduction" metrics derived from this study.
University Collaboration: If your organization is a medical device manufacturer, prepare standard Memoranda of Understanding (MOUs) for data sharing with the designated Research 1 University to ensure your proprietary efficacy data is considered.

Hiring/Training

Government Affairs: Reallocate resources to monitor the Texas Higher Education Coordinating Board (THECB) selection process. You must identify the lead University immediately upon designation.
Clinical Data Teams: Task internal medical affairs teams with aggregating existing efficacy data for diabetic foot ulcer treatments to prepare for submission to the study committee.

Reporting & Record-Keeping

Voluntary Data Submission: While no statutory reporting is required for private business, failing to submit your device or therapy's success rates to the study effectively excludes you from future "best practice" definitions.
Audit Trails: Maintain a record of all correspondence with the designated University to establish a paper trail of cooperation should the final report exclude your therapy arbitrarily.

Fees & Costs

No Statutory Fees: There are no new state fees or taxes associated with this bill.
Lobbying/Research Costs: Budget for increased government relations and clinical data analysis expenses in Q1 and Q2 of 2026.

Strategic Ambiguities & Considerations

"Evidence-Supported Medical Tools": The bill does not define the evidentiary standard (e.g., FDA clearance vs. peer-reviewed journals vs. real-world evidence). If the University adopts a narrow definition, emerging technologies may be excluded from future reimbursement recommendations.
"Incentivize Quality Care": It is unclear if the study will recommend financial bonuses ("carrots") or reimbursement reductions for high amputation rates ("sticks"). Providers must advocate for the former during the consultation phase.
"Topical Oxygen Therapy": This therapy is explicitly named in the statute, giving it a strategic advantage. Competitors with alternative wound care modalities must aggressively lobby to ensure their treatments are given equal weight in the study.

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Legislative Timeline

This bill's path through the Texas Legislature

TopicsHealth Health--other Diseases & Medical Conditions Diabetes State Health Services, Department of Interim Studies Higher Education Coordinating Board, Texas Education Education--higher Education--higher--health Institutions

Official Analysis

View HRO Analysis View All Bill Documents

BILL ANALYSIS

Senate Research Center	S.B. 1677
89R14224 AB-D	By: Men�ndez
	Health & Human Services
	3/20/2025
	As Filed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

According to the American Diabetes Association, diabetes-related amputations are on the rise. In some cases, diabetes may lead to complications, including nerve damage, which if left unaddressed may require amputation of the affected limb. Each year, over 160,000 Americans undergo amputation with approximately 80 percent of amputations of lower limbs being caused by diabetes complications. While amputations are needed to prevent further complications, an individual who has had an amputation is less likely to survive the five years following the amputation. Furthermore, certain counties in Texas have higher rates of diabetes-related amputations, with Bexar County having higher hospitalization rates for these amputations than any other county.

Given the prevalence of this issue in Texas, more data is needed to understand the state of diabetes-related amputations in Texas. Creating an interdisciplinary panel to study this issue and make recommendations on prevention, increase public awareness, create best practices for reducing amputations, and make policy recommendations for the state will help Texas save lives and limbs.

S.B. 1677 would direct the Department of State Health Services to conduct a study on the prevention and reduction of diabetes-related amputation. This study must be conducted in consultation with an interdisciplinary panel of experts on diabetes and related amputations, including an endocrinologist, podiatrists, vascular surgeon, nurse who specializes in diabetes education, at least three individuals with lived experience, among others. This report must be submitted to the governor and legislature no later than September 1, 2026.

As proposed, S.B. 1677 amends current law relating to a study by the Department of State Health Services on prevention and reduction of diabetes-related amputation.

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency.

SECTION BY SECTION ANALYSIS

SECTION 1. (a) Defines "department."

(b) Requires the Department of State Health Services (DSHS) to conduct a study on the prevention and reduction of diabetes-related amputation.

(c) Requires DSHS, in conducting the study, to identify and examine information on amputations resulting from diabetes and develop recommendations regarding certain subjects.

(d) Requires DSHS, in conducting the study, to consult with certain individuals.

(e) Requires DSHS, not later than September 1, 2026, to prepare and submit to the governor and the legislature a report summarizing the results of the study and containing recommendations for legislative or other action. Requires DSHS to post the report on DSHS's Internet website. Requires that the post include the information on which the DSHS's determinations and recommendations is based and the methodologies the DSHS used to conduct the study.

SECTION 2. Provides that this Act expires September 1, 2027.

SECTION 3. Effective date: September 1, 2025.

Senate Authors

Sen. Jose MenendezDemocrat · Primary Author

House Sponsors

Rep. Gary VandeaverRepublican · Primary Sponsor

Cosponsors (2)

Bill Text(with markup)

S.B. No. 1677

View bill text in multiple formats on Texas Legislature website

Fiscal NoteView Original

	AN ACT
	relating to a study on prevention and reduction of diabetes-related
	amputation.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1. (a) In this Act:
	(1) "Department" means the Department of State Health
	Services.
	(2) "Institution of higher education" has the meaning
	assigned by Section 61.003, Education Code.
	(b) The Texas Higher Education Coordinating Board shall
	designate an institution of higher education to conduct a study on
	the prevention and reduction of diabetes-related amputation, using
	existing institutional resources. The institution must have a
	Research Activity Designation: Research 1: Very High Research
	Spending and Doctorate Production under the 2025 Carnegie
	Classification of Institutions of Higher Education.
	(c) In conducting the study, the institution of higher
	education designated under Subsection (b) of this section shall:
	(1) collaborate with the department;
	(2) identify and examine information on amputations
	resulting from diabetes; and
	(3) develop recommendations regarding:
	(A) amputation prevention related to diabetic
	foot ulcers and peripheral artery disease;
	(B) methods for increasing public awareness of
	diabetes-related amputation;
	(C) best practices for reducing the number of
	amputations performed; and
	(D) policy solutions for ensuring access to
	treatments to assist with preventing amputation, including:
	(i) insurance coverage for therapies
	designed to treat diabetic foot ulcers, including topical oxygen
	therapy;
	(ii) timely and equitable access to
	evidence-supported medical tools, technologies, and services to
	assist with the prevention of avoidable amputations;
	(iii) methods to improve and incentivize
	quality care to avoid amputations when possible; and
	(iv) methods to promote collaboration and
	cooperation among interested persons.
	(d) In conducting the study, the institution of higher
	education designated under Subsection (b) of this section shall
	consult with the following individuals:
	(1) the commissioner of state health services;
	(2) a physician licensed in this state who specializes
	in endocrinology;
	(3) a nurse licensed in this state with expertise in
	diabetes education;
	(4) a vascular surgeon with expertise in amputation
	prevention;
	(5) a physician, physician assistant, or advanced
	practice registered nurse with expertise in amputation prevention;
	(6) a podiatrist with expertise in treating diabetic
	foot ulcers;
	(7) a podiatrist or vascular surgeon affiliated with
	the United States Department of Veterans Affairs;
	(8) a representative of a public health provider;
	(9) at least three individuals diagnosed with diabetes
	or who have experienced diabetes-related amputation;
	(10) a representative of the American Diabetes
	Association; and
	(11) other individuals as the institution determines
	necessary.
	(e) Not later than September 1, 2026, the institution of
	higher education designated under Subsection (b) of this section
	shall prepare and submit to the department a report summarizing the
	results of the study and containing recommendations for legislative
	or other action. The department shall post the report on the
	department's Internet website. The post must include:
	(1) the information on which the institution's
	determinations and recommendations are based; and
	(2) the methodologies the institution used to conduct
	the study.
	SECTION 2. This Act expires September 1, 2027.
	SECTION 3. This Act takes effect September 1, 2025.

LEGISLATIVE BUDGET BOARD
Austin, Texas

FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION


March 25, 2025

TO:	Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services

FROM:	Jerry McGinty, Director, Legislative Budget Board

IN RE:	SB1677 by Menéndez (Relating to a study by the Department of State Health Services on prevention and reduction of diabetes-related amputation.), As Introduced

No significant fiscal implication to the State is anticipated.

The Department of State Health Services (DSHS) has indicated conducting the study on prevention and reduction of diabetes-related amputation would require additional temporary staff time and resources. The report summarizing the results of the study and subsequent recommendations for legislative or other action would be required to be completed and submitted to the Governor and legislature not later than September 1, 2026.

It is assumed that any costs associated with the bill could be absorbed using existing resources.

Local Government Impact

No fiscal implication to units of local government is anticipated.

Source Agencies:

537 State Health Services, Department of

LBB Staff:

JMc, NPe, ER, APA

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Frequently Asked Questions

Common questions about SB1677

What does Texas SB1677 do?

SB 1677 initiates a state-mandated study on diabetes amputation prevention that will serve as the evidentiary foundation for insurance mandates and standard-of-care revisions in the 2027 legislative session. Medical device manufacturers (specifically wound care and topical oxygen therapy) and health insurers must engage immediately to influence the "best practice" recommendations that will define future reimbursement models. Implementation Timeline Effective Date: September 1, 2025 Compliance Deadline: September 1, 2026 (Deadline for the designated University to submit the report; industry stakeholders must submit data/testimony prior to this date to influence findings).

Who authored SB1677?

SB1677 was authored by Texas Senator Jose Menendez during the Regular Session.

When was SB1677 signed into law?

SB1677 was signed into law by Governor Greg Abbott on June 20, 2025.

Which agencies enforce SB1677?

SB1677 is enforced by Texas Higher Education Coordinating Board (THECB) and Department of State Health Services (DSHS).

How urgent is compliance with SB1677?

The compliance urgency for SB1677 is rated as "low". Businesses and organizations should review the requirements and timeline to ensure timely compliance.

What is the cost impact of SB1677?

The cost impact of SB1677 is estimated as "low". This may vary based on industry and implementation requirements.

What topics does SB1677 address?

SB1677 addresses topics including health, health--other diseases & medical conditions, diabetes, state health services, department of and interim studies.

Legislative data provided by LegiScanLast updated: November 25, 2025

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