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During the 85^th legislative session, Methodist Healthcare Ministries tracked roughly 1,400 bills, supported over 500 bills, and worked to assist the passage of 224 laws that affect access to health care for Texas families. Keep up to date on how those laws are being effectively implemented and funded as intended through our legislative updates.

Interim Updates

• More women being served in Texas women’s health programs
• Members appointed to Judicial Commission on Mental Health
• Task Force of Border Health Officials identifies health issues
• Federal administration proposes $7B reduction in CHIP
• Laredo health care community collaborates on immunization policies
• CMS releases new report on Marketplace enrollments

Upcoming Meetings & Events

Health Care Policy News
 

View our 2017 Legislative Agenda

Advocacy Find your rep How the Texas Legislature works Policy Part 1: Access to Care Legislation Part 2: Behavioral Health Legislation Part 3: Children's and Women's Legislation Part 4: Health Care Workforce Legislation 85th Legislative Session Interim Charges Research 2017 State of Texas Children: RGV Report The Nonprofit Council: State of the Nonprofit Sector Report

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Interim Updates

More women being served in Texas women’s health programs
The Texas Health and Human Services Commission (HHSC) released a report highlighting the increasing number of women enrolled in Texas Health Programs, including the Healthy Texas Women program and the Family Planning Program. These programs provide a wide range of services to eligible individuals such as STD screening, mammograms, contraception coverage and much more. HHSC reports 122,406 clients were served in Healthy Texas Women in 2017, an increase from 70,366 clients in 2016. The Family Planning Program also saw an increase of 58,586 clients from 2016 to 2017. However, HHSC states that these enrollment numbers cannot be compared to the number of women accessing services prior to the massive budget cuts in 2011, due to changes in program eligibility and benefits.

HHSC notes that the Family Planning Program and the Healthy Texas Women program are projected to save millions of dollars on Medicaid and the Children’s Health Insurance Program. The report comes at a time when Texas is waiting to receive more than $400 million in federal funding over five years to fund the Healthy Texas Women program, which would further improve health outcomes. These programs play a critical role in increasing access to women’s health services, which is a legislative priority for Methodist Healthcare Ministries. 

Members appointed to Judicial Commission on Mental Health
Thirty-one newly appointed members of the Judicial Commission on Mental Health convened their first meeting earlier this month at the Texas Law Center in Austin. Created under the direction of the Texas Supreme Court and the Texas Court of Criminal Appeals, the statewide Commission is charged with developing a plan that recommends best practices in the administration of civil and criminal justice for individuals with mental illness. The Commission will also develop an outreach campaign to create awareness of its mission and organize a Judicial Summit on Mental Health in the fall of 2018.

Recognizing the importance of input from a broad spectrum of individuals involved in mental health, the Courts also called for the creation of a Collaborative Council, to provide the Commission with additional expertise and guidance. Methodist Healthcare Ministries’ Director of Governmental Affairs, Chris Yanas, was chosen as a member of the Collaborative Council and will take part in scheduled meetings throughout the remainder of 2018. The Commission will wrap up its work with a report of recommendations to members of the 86^th Legislature.

Task Force of Border Health Officials identifies health issues
The Task Force of Border Health Officials, formed by the passage of SB 1680 by Senator Eddie Lucio, brings focus and attention to the challenges and hardships that the entire border region faces every day. The task force will make recommendations to the Department of State Health Services (DSHS) commissioner for short-term and long-term border health improvement plans to enhance public health and create a healthy binational community. Since its inception in December, the task force has identified five key health issues: Border Public Health Infrastructure, Communicable Diseases, Arbovirus, Chronic Diseases, and Maternal and Child Health. Currently, the task force is working on creating issue statements and recommendations, which are due to DSHS by Nov. 1. Members include local health officials from Cameron County, Brownsville, Harlingen, McAllen, Hidalgo County and Laredo. Methodist Healthcare Ministries will continue to monitor task force meetings and look to develop legislative initiatives based on Task Force recommendations.

Federal administration proposes $7B reduction in CHIP
The federal administration has advanced proposals that look to rescind nearly $7 billion from the Children’s Health Insurance Program (CHIP). These changes have been proposed despite a bipartisan agreement earlier this year to extend CHIP funding for 10 years. Another $2 billion of the proposed cuts targets the Child Enrollment Contingency Fund, which is available to states that experience an unexpected surge in enrollment, such as natural disasters or economic downturn. Child advocates argue that these cuts would undermine historically bipartisan agreements designed to use these funds for future investment needs in other programs serving children and vulnerable families. Today, more than 400,000 low-income children in Texas get health insurance through CHIP, which provides for wellness check-ups, screenings and access to a provider for more serious illnesses. Methodist Healthcare Ministries has signed on to a national letter with the American Academy of Pediatrics in opposition to the White House’s proposal, urging members to protect the wellness of children and families.

Laredo health care community collaborates on immunization policies
Methodist Healthcare Ministries’ advocacy partner, The Immunization Partnership, held a stakeholder meeting in Laredo to discuss immunization policies and collaborate on efforts to increase access to vaccinations for Webb County residents. The data noted that Texas is doing better than the national average on most vaccinations, but numbers have exponentially declined within the last several years. There were approximately 50,000 conscientious objections to required vaccines last year, an increase from 2016.  

Providers and community leaders addressed the need for collaboration and communication about vaccinations in Laredo and surrounding areas. Clinic providers stated that they are unsure if students are getting vaccinated at school clinics because it is not recorded in an electronic database system and parents do not have proof. School officials and clinical staff stressed the need to input vaccination data on a timely basis. The Laredo community discussed several strategies to educate parents about vaccinations, such as providing training to providers on how to recommend vaccinations. The Immunization Partnership will be hosting a stakeholder meeting in Corpus Christi on May 30. You can register and obtain more information here. Methodist Healthcare Ministries will continue to work with partners to increase access to vaccinations and improve data collection processes at both the state and local level.

CMS releases new report on Marketplace enrollments 
In April, the Centers for Medicare and Medicaid Services (CMS) released their annual report on the Affordable Care Act (ACA) Marketplace enrollment period for 2018, highlighting the number of families and individuals who signed up for health insurance through the federal marketplace. The data shows that 1.1 million Texans selected a 2018 Marketplace plan, a decrease of 8 percent from 2017. The lower participation number is largely attributed to a cut in enrollment time and reduced funding for outreach and enrollment efforts. Given these obstacles, 8 percent is deemed a modest decrease due to the tireless efforts of in-person assisters, community groups and foundations.

The report also provides county-level enrollment numbers of the 10 most populous counties in Texas. Reductions found in the marketplace varied among Texas counties. Fort Bend and Bexar County saw a 2 percent and 9 percent decrease, respectively, whereas Denton County saw a 17 percent decrease. Supporting access to care through affordable health care coverage is a legislative priority for Methodist Healthcare Ministries.
 

Upcoming Meetings & Events

May 24: House Appropriations Committee Hearing (Austin)
May 30: The Immunization Partnership Stakeholder Meeting (Corpus Christi)
May 30-31: Telehealth at the Crossroads Conference (San Antonio)
May 31: HHSC Executive Council Meeting (Austin)
June 1: Texas Tribune: Austin & the Legislature (Austin)
June 12: Bexar County Opioid Task Force (San Antonio)
June 12: Texas Tribune: A Conversation with Sen. Menendez and Reps. Gutierrez & Minjarez (San Antonio)
Sept 27-29: The Texas Tribune Festival (Austin)

Health Care Policy News

Telemedicine 
Kaiser Health News: Telemedicine opening doors to specialty care for inmates

Health Care Systems
The Commonwealth Fund: 2018 Scorecard on state health system performance

Health Care Workforce
CBS DFW: Texas mental health counselors waiting months to be licensed

Child and Maternal Health
Texas Tribune: Panelists say more funding, education and access to care are needed to reduce Texas’ maternal mortality rate

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During the 85^th legislative session, Methodist Healthcare Ministries tracked roughly 1,400 bills, supported over 500 bills, and worked to assist the passage of 224 laws that affect access to health care for Texas families. Keep up to date on how those laws are being effectively implemented and funded as intended through our legislative updates.

Interim Updates

• Texas combats the opioid epidemic
• House Appropriations health care subcommittee reviews health care reform and 1115 Medicaid Waiver
• Mental health parity work group continues work to implement HB 10 provisions
• New Texas maternal mortality rates released
• Federal administration considers new rules for immigration status

Upcoming Meetings & Events

Health Care Policy News
 

View our 2017 Legislative Agenda

Advocacy Find your rep How the Texas Legislature works Policy Part 1: Access to Care Legislation Part 2: Behavioral Health Legislation Part 3: Children's and Women's Legislation Part 4: Health Care Workforce Legislation 85th Legislative Session Interim Charges Research 2017 State of Texas Children: RGV Report The Nonprofit Council: State of the Nonprofit Sector Report

___________________________________________________________________________________________

Interim Updates

Texas combats the opioid epidemic
The opioid crisis that has plagued the nation in recent years is no stranger to Texas. New data provided by several federal and state agencies stressed that comprehensive change is required to curb this epidemic. At the national level, the CDC reported that emergency department visits for opioid overdose rose 30% in all parts of the United States from 2016 to 2017. Similar trends are seen in Texas with the state’s health department reporting opioids are the main drugs related to admissions in emergency departments. In Bexar County, local county and city health officials formed the Bexar County Joint Opioid Task Force in the summer of 2017 to confront this public health emergency head-on. The interagency public-private collaboration is seeking to decrease the number of opioid deaths in Bexar County and develop strategies to address the opioid crisis in a comprehensive manner. At the state level, House Speaker Joe Straus created the Select Committee on Opioids and Substance Use. Committee members will meet over the next few months to take testimony from state and local health officials to develop a strategy of statewide proposals for the upcoming 86th Legislative Session. Methodist Healthcare Ministries is part of both local and state efforts and will develop a legislative initiative about the opioid epidemic in its 86th legislative agenda.

House Appropriations health care subcommittee reviews health care reform and 1115 Medicaid Waiver
The Texas House Committee on Appropriations met on April 4 to address some of the biggest challenges facing the Texas Medicaid program, including changes to federal policy, substantive reforms to the program and ongoing fiscal challenges from increasing costs. Testimony was shared by hospital providers expressing concerns over the federal administration’s unwillingness to make supplemental payments to cover Medicaid shortfall costs (about $2 billion per year for Texas hospitals). Several providers highlighted the transition and elimination of the Delivery System Reform Payments (DSRIP) under the renewed 1115 Medicaid waiver (learn more).

The effectiveness of adding Medicaid work requirements in Texas was also addressed. States that have adopted work requirements will reduce program coverage, including Kentucky, which is planning to reduce enrollment rates by 95,000 people. Data shared by the Center for Public Policy Priorities (CPPP) argued that work requirements would not get people off Medicaid because one in eight working Texas families live in poverty. The state’s Medicaid program plays an important role in securing access to care for Texas working families and is a legislative priority for Methodist Healthcare Ministries.

Mental health parity work group continues work to implement HB 10 provisions
In health insurance, the term “parity” describes the equal treatment of mental health conditions and substance use disorders in insurance plans, when compared to coverage for medical or surgical health care. This past legislative session, Methodist Healthcare Ministries worked to pass HB 10, which called for stronger insurance laws to ensure providers complied with equal access to both services.  

Since the bill’s passage, HHSC has formed the Mental Health Condition and Substance Use Parity Work Group and made several stakeholder presentations on the implementation of parity laws. The work group has established protocols to monitor parity complaints and provider compliance, and subcommittees that review enforcement, investigations and education efforts. HHSC is currently in the process of creating a website designed for behavioral health rights and is working with the Texas Department of Insurance to develop a formal complaint process. Methodist Healthcare Ministries is closely tracking the state’s efforts to ensure that more Texans gain equal access to mental health and other health care services needed to achieve recovery.

New Texas maternal mortality rates released
A new study by researchers at the Texas Department of State Health Services is reporting that the number of maternal deaths in Texas in 2012 was actually less than half the number previously reported. The research determined there were 56 maternal deaths among Texas residents compared with the 147 reported in national statistics. The study shows dozens of women were identified on their death certificates as being pregnant at the time of their deaths when they were not. The misclassification most likely occurred because people certifying the deaths selected the wrong pregnancy option in the electronic system used to register deaths. The more accurate, verified data is an important part of state efforts to improve maternal health, including the ability to implement and assess ways to reduce maternal deaths and other severe pregnancy complications.

This new study shows why the work of the Texas Maternal Mortality and Morbidity Task Force is so incredibly important. The Task Force and DSHS crosscheck a variety of sources to confirm a pregnancy-related death, not just a reporting mistake. Texas has important opportunities for improvement to reduce maternal death and severe morbidity. DSHS is testing out new solutions such as implementing the Texas Alliance for Innovation on Maternal Health (Texas AIM) program to help hospitals and communities improve maternal safety by implementing best practices. More than 100 hospitals have expressed interest in adopting the Texas AIM bundles for hypertension, opioid use, and severe hemorrhage. Methodist Healthcare Ministries monitors the task force and maternal mortality in Texas.

Federal Updates

Federal administration considers new rules for immigration status
On March 29, the draft regulation on public charge was sent to the Office of Management and Budget. Public charge is a ground of inadmissibility (to the U.S.) if non-citizen applicants are likely to rely on the government for subsistence in the future. Under current policy, immigration officials must look at all factors that relate to non-citizens’ ability to support themselves, including income, assets, family support and need for monthly cash assistance. The proposed rule would instruct immigration agents to consider whether an immigrant or a member of their family is likely to participate in any government assistance program (including CHIP, Medicaid and SNAP) when determining who can enter the U.S or become a permanent resident.

Administration officials state that these changes would protect taxpayers by ensuring foreign nationals seeking to enter in the U.S are self-sufficient. On the other side, critics argue that the proposed changes would represent a major step backward, pulling the entire safety net out from under taxpaying immigrant families and putting them at greater risk of falling into poverty. Methodist Healthcare Ministries will continue to monitor the proposed rules.
 

Upcoming Meetings & Events

May 5: Mental Health and Addiction Awareness Fiesta (San Antonio)
May 9: State of Texas Active Response to ZIKA (McAllen)
May 9:  House Human Services Committee Hearing (Austin)
May 10: Hospital Payment Advisory Committee (Austin)
May 30-31: Telehealth at the Crossroads Conference (San Antonio)

Health Care Policy News

Health Care Funding
The McAllen Monitor: RGV’s Rep. Longoria appointed to powerful LBB

Prescription Drug Prices
To the Point: Policy Prescriptions for High Drug Cost: Experts Weight In

Children’s Therapy Services
The Texas Tribune: Texas children’s therapy providers face dilemma over offering services

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