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With days to go before the start of the 86^th Legislative Session, Methodist Healthcare Ministries is gearing up to review hundreds of bills impacting the health and well-being of all Texans, especially our most vulnerable citizens. In this newsletter, we'll provide regular updates on filed bills, hearings and votes taken on issues impacting the health of our families.​

Interim Updates

• Texas Has Highest Uninsured Population in the Nation
• Affordable Care Act Ruled Unconstitutional by Federal Judge
• Supplemental Nutrition Assistance Program Protected by Passage of Farm Bill
• Vaccine Policies Protect Day Care Centers
• House Committee Studies Public Health Issues

Upcoming Meetings & Events

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Interim Updates

Texas Has Highest Uninsured Population in the Nation

A new report recently released by the Episcopal Health Foundation and Urban Institute estimates that 19 percent, or 4.7 million, of Texas’ nonelderly population remained uninsured in 2018 – the highest uninsured rate of any state in the country. Texas is a state with significant challenges in reducing the number of uninsured because of its size, racial and ethnic diversity and large number of noncitizen residents. Two-thirds of uninsured Texans live in working families and more than half are in families that include at least one full-time worker. About 60 percent of uninsured Texans include low-income families of four, earning less than $35,000 a year.

With the highest percentage of uninsured residents in the country, Texas needs to make substantial strides in increasing coverage and improving affordable care. Without statewide policy changes, the number and share of uninsured Texans will likely increase with time as health care costs continue to rise, making coverage less affordable for low- and middle-income families. Developing a state plan that could offer health insurance to low-income adults with incomes up to 138 percent of the Federal Poverty Level (FPL), would provide an estimated 1.3 million uninsured Texans with access to free or very low-cost coverage.

As part of its 86^th Legislative Agenda, Methodist Healthcare Ministries will be actively involved with statewide healthcare organizations in crafting an alternative coverage proposal that could garner leadership support and sustain federal waiver funding currently set to expire in the near future.

Affordable Care Act Ruled Unconstitutional by Federal Judge

A federal judge in Texas has ruled that the Affordable Care Act’s (ACA) individual coverage mandate is unconstitutional and that the rest of the law, therefore, cannot stand. U.S. District Court Judge Reed O’Connor believes the entire ACA cannot stand without its individual mandate penalty, which Congress zeroed out last year. However, the ACA will remain as current law while the judgment is appealed.

The invalidation of the ACA questions the future of health coverage for 20 million Americans in the marketplace exchange and in states that expanded Medicaid. The health care law has allowed young adults to stay on their parent’s plan until the age of 26, guaranteed access to coverage for people with preexisting conditions, made coverage more affordable and expanded coverage of Medicaid in 37 states. Should the law be found unconstitutional after the appeal, those 20 million people buying health insurance in the exchange would see these protections go away. Another group at risk will be individuals with pre-existing conditions. Without the protections from the ACA, insurers could return to denying coverage or charging more. The Kaiser Family Foundation estimates that 52 million adults from ages 18 to 64 would be rejected for coverage under the practices that were in effect in most states before the Affordable Care Act.

From here, the case will likely move to the Court of Appeals and up the Supreme Court. In the meantime, consumers can still expect that the ACA’s protections and regulations will continue to apply in every state. Methodist Healthcare Ministries will continue to advocate at the state and federal level for policies that increase access to health care for our state’s neediest families.

Supplemental Nutrition Assistance Program Protected by Farm Bill

After months of heated debate, the U.S. House and Senate have passed a bipartisan farm bill that protects food security programs such as the Supplemental Nutrition Assistance Program (SNAP). SNAP has been the nation’s most effective anti-hunger program and the new farm bill reauthorizes SNAP and provides for modest improvements to program integrity and administration. A report by the American Heart Association shared that the bill rejects proposed cuts and other harmful changes to SNAP that would have caused more than 7 million people to lose their benefits altogether or face reductions. 

While the bill does not address issues of SNAP households running low or out of food at the end of each month, it is a great building block for future farm bills and policies to improve diet quality. The final bipartisan bill continues to protect SNAP and makes fresh fruits and vegetables more accessible and affordable, providing opportunities for families to eat healthier.

At the state level, Methodist Healthcare Ministries will be supporting efforts to strengthen the impact of the SNAP program this legislative session by looking for ways that families can be rewarded for making healthy food choices with their current program allowances.

Vaccine Policies Protect Daycare Centers

A leading anti-vaccine group has made recent claims that daycares are breaking the law by denying kids who have not been vaccinated, but experts are saying that the group is misinterpreting the law. Texans for Vaccine Choice, a group focused on anti-vaccine policy, reports receiving hundreds of calls and emails from parents who were rejected by private child care facilities due to lack of vaccinations. Texas law mandates vaccine requirements for licensed child care centers, including cases around medical and conscience exemptions. Texans for Vaccine Choice has argued that facilities do not have the right to deny exemptions for vaccinations, but experts note that current law does not require daycare centers to enroll everyone, regardless of immunization status. Allison Winnike, president and CEO of The Immunization Partnership, states that private daycare centers are allowed to have additional admission requirements beyond the minimum set by state law, which may include requiring that every child enrolled be vaccinated. An increasing number of child care centers have additional vaccination requirements to encourage enrollment of medically fragile children. Methodist Healthcare Ministries is a strong advocate for policies that promote vaccinations and protect medically fragile children from being exposed to preventable diseases. These efforts are a part of MHM’s 86^th Legislative Session initiatives and legislation will be closely monitored to ensure all children remain protected.

House Committee Studies Public Health Issues

The Texas House Committee on Public Health has a significant interest in the health of Texans and has held a number of hearings this past year addressing some of the health care challenges impacting Texas communities. According to their Interim Report to the 86^th Texas Legislature, the committee studied a range of topics that encompassed women’s health, mental illness, housing instability, healthcare delivery in underserved areas, CPS involvement due to substance use or mental illness, and implementation of key health bills passed during the 85^th Legislative Session.

Relating to women’s health, the Public Health Committee recommended establishing auto-enrollment for eligible women aging out of the children’s Medicaid and CHIP programs into the Healthy Texas Women’s program. They also provided recommendations for children’s mental health, such as increasing the learning opportunities regarding mental health for teachers and administrators and creating a subcommittee of the Texas Health and Human Services Commission to review and oversee coordination of all state and federal funding addressing mental and behavioral health of school-age children. Committee members also recommended further exploration in the benefits of expanding permanent supportive housing for more than 25,000 homeless individuals in Texas.

Methodist Healthcare Ministries closely monitored the House Committee on Public Health throughout the interim and strongly supports a number of recommendations, including auto-enrollment into the Healthy Texas Women program and increasing funding for mental health services across the continuum.

Upcoming Meetings & Events

Jan 8:  86^th Texas Legislature Convenes at 12:00 Noon (Austin)

Jan 10:  Texas Tribune: A Conversation with Comptroller Glenn Hegar (Austin)

Jan 18:  Texas Tribune: A Conversation with State Rep. Dennis Bonnen (Lake Jackson)

Feb 6:  2019 Texas Mental Health Capitol Day Rally and Advocacy Training (Austin)

Back to Top

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

• Methodist Healthcare Ministries Announces Selection of New President and CEO
• Health care stakeholders advocate for improving state’s Medicaid managed care system
• Survey shows health care is a priority for Texans
• Governor Abbott address mental health screenings after recent school shooting
• Texas opens applications for First Responder Mental Health Grant Program
• Healthy Futures of Texas achieves victory in class action
• Federal funding for opioid response programs available for rural communities

Upcoming Meetings & Events

Health Care Policy News
 

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State Updates

Methodist Healthcare Ministries of South Texas, Inc. Announces the Appointment of New President and CEO, Jaime Wesolowski
The Methodist Healthcare Ministries of South Texas, Inc. board of directors has selected Jaime Wesolowski as the organization’s next president and chief executive officer. Wesolowski, a healthcare executive with three decades of leadership experience, currently serves as president and CEO of the Methodist Healthcare System — the largest provider of health care in South and Central Texas. Read more.

Healthcare stakeholders advocate for improving state’s Medicaid managed care system
Seventeen Texas organizations, including Methodist Healthcare Ministries, signed on to a letter to state lawmakers this week, asking for their help in addressing serious concerns with access to quality healthcare under the state’s Medicaid managed care system. The current system relies on private and non-profit insurance companies to coordinate health care for children, people with disabilities, seniors, and others enrolled in the state’s Medicaid system.

The Dallas Morning News recent investigative reporting series – Pain & Profit – shed a critical light on the state’s Medicaid Managed Care System, and its failure to provide adequate care for the system’s most vulnerable patients. The powerful testimonies in the report shared stories of hardships faced by Texans when the system failed to deliver care. As a result of these news reports, members of the Texas House Human Services Committee came together in mid-June to take testimony from state health care agencies, contracted managed care organizations as well as those families impacted in the news report. Similar testimony continued at a separate Joint Hearing of the House Appropriations Subcommittee on Article II and Committee on General Investigation and Ethics. Lawmakers will focus on addressing these issues for the upcoming 86^th Legislative Session.

Survey shows health care is a priority for Texans
The Henry J Kaiser Foundation (KFF) released a report this month, highlighting the health policy priorities of Texan residents. Texas is one of the 17 states that did not expand Medicaid under the Affordable Care Act, and it continues to have the largest uninsured population in the nation. KFF partnered with the Episcopal Health Foundation and obtained survey results from nearly 1,400 Texas.

Survey results showed that health care is a priority for Texans with over half reporting that the state legislature should increase spending on services and programs. The KFF report noted that roughly two thirds of survey respondents believe state government is not doing enough to ensure low-income adults can get health care. The same percentage of individuals believe the state should expand the Medicaid program. The survey stated 70% of Texans report some connection to the Medicaid program and a majority believe that the program is working well for low-income individuals. Future KFF surveys will focus on Texans’ experience with health care affordability and access.

Governor Abbott address mental health screenings after recent school shooting
Mental health screenings in schools have become a serious topic since the recent Santa Fe ISD shooting. Governor Greg Abbott recently released recommendations for addressing school safety and stated that the Telemedicine Wellness, Intervention, Triage, and Referral Project (TWITR) could be an ideal model for the whole state. TWITR, initially funded through a grant program in the Governors’ Criminal Justice Division, is organized by The Texas Tech University Health Sciences Center (TTUHSC) and has provided mental health screenings to ten West Texas school districts. They plan to expand the program to an addition five school districts in the near future.

A new report highlights that since its inception, the project has triaged nearly 215 students via Telemedicine with the TTUHSC psychiatry department. The program had 25 students removed from school, 44 students placed in alternative schools and 38 students sent to a hospital due to their mental health. All the students were screened for multiple behavioral health concerns such as depression, anxiety and violent thoughts. Billy Philips, Executive Vice President for rural and community health at TTUHSC, stated that the project has been able to fill gaps in the lack of access to care in West Texas. Methodist Healthcare Ministries will monitor the Legislature’s implementation of the recommendations and continue to work with partners to address school mental health issues.

Texas opens applications for First Responder Mental Health Grant Program.
Texas Governor Greg Abbott’s office has established the First Responder Mental Health Resiliency Program which provides direct services to peace officers and other first responder agencies across the state. The program focuses on providing mental health services in a confidential and specialized method supported by trusted research, Funded projects under this fund source are expected to implement services that reduce stress for officers and first responders, improve coping strategies, and increase overall morale. Proposals are due on July 3, 2018 by 5:00 p.m. CST.

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Federal Updates

Healthy Futures of Texas achieves victory in class action
The U.S. District Court in D.C ruled in favor of Healthy Futures of Texas and 61 other organizations in a class action lawsuit against the U.S. Department of Health and Human Services (HHS) to continue evidence-based teen pregnancy prevention programs.

In the summer of 2017, HHS defunded the Teen Pregnancy Prevention (TPP) Program, nearly two years earlier than expected. The program has seen numerous successes in creating medically accurate and age appropriate programs to prevent teen pregnancy across the nation and led to the creation of multiple studies that have been successful in both rural and urban communities.

The ruling this past June held that HHS’s early termination of the program was unlawful and ordered the federal agency to reinstate the grant program for all 62 class members. With this victory, Healthy Futures of Texas and other organizations can continue to provide services essential to prevent teen pregnancy.

Federal funding for opioid response programs available for rural communitiesThe Federal Health Resources and Services Administration (HRSA) has released a notice of funding now available for opioid response programs. The Rural Communities Opioid Response Planning (RCORP) initiative for Fiscal Year 2018, will award 75 grants to rural communities. Successful awardees will receive approximately $200,000 for one year to develop plans to implement opioid use disorder prevention, treatment, and recovery interventions designed to reduce opioid overdoses in rural communities. Interested organizations can find more information here. Applications are due by July 30, 2018.

Upcoming Meetings & Events

July 21: Mental Illness and the Criminal Justice System: Addressing the Challenges (San Antonio)
Aug 9: Hospital Payment Advisory Committee
Aug 17: Medical Care Advisory Committee
Aug 21: Bexar County Opioid Task Force (San Antonio)
Sep 15: UTRGV School of Medicine Research Symposium (McAllen)
Sep 27-29: The Texas Tribune Festival (Austin)

Health Care Policy News

Children's Health
Texans Care for Children: Report highlights strategies to prevent teen pregnancy in foster care and support pregnant and parenting teens in foster care. 

2018 KIDS COUNT Data Book Released: Report looks at child well-being using indicators across four domains – health, education, economic well-being and family and community

Back to Top

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
 

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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

Back to Top

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
 

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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

Back to Top

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

• Methodist Healthcare Ministries’ COO appointed to state Hospital Payment Advisory Committee
• Methodist Healthcare Ministries releases bill summaries for children's and women's health legislation
• Robert Wood Johnson Foundation releases 2018 County Health Rankings
• Texas Statewide Health Coordinating Council includes health literacy and oral health in state health plan
• Texas E-Health Advisory Committee implements key telemedicine bills
• Texas Public Health Coalition applauds the City of San Antonio for Tobacco 21 ordinance

Upcoming Meetings & Events
Health Care Policy News
 

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Interim Updates

Methodist Healthcare Ministries’ COO appointed to state Hospital Payment Advisory Committee (HPAC)
Congratulations to Methodist Healthcare Ministries’ Chief Operating Officer, George Thomas, who has been selected to serve on the state Hospital Payment Advisory Committee for a six-year term. The Hospital Payment Advisory Committee functions as a sub-committee of the Medical Care Advisory Committee (MCAC) and advises MCAC and the Health and Human Services Commission (HHSC) about hospital reimbursement methodologies for inpatient hospital prospective payment and on adjustments for disproportionate share hospitals. The committee advises HHSC to ensure reasonable, adequate, and equitable payments to hospital providers and to address the essential role of rural hospitals. This distinguished appointment will assist Texas hospitals in receiving adequate funding for care for our most vulnerable families.

Methodist Healthcare Ministries releases bill summaries for children's and women's health legislation
During the 85th legislative session, Methodist Healthcare Ministries supported important health care initiatives to improve services and funding impacting children and women. Legislation that passed both houses and was signed by the Governor included: maternal mortality and morbidity, reform for Child Protective Services, children’s mental health, access to women’s health services and more. Overall, Methodist Healthcare Ministries supported 58 bills that became law in 2017-2018 and will make a difference in the lives of Texas children and women. View summaries of bills impacting Texas children and women.

Robert Wood Johnson Foundation releases 2018 County Health Rankings
The Robert Wood Johnson Foundation released its 2018 County Health Rankings Report, which measures counties on how well they do across various health and well-being measures. For the first time, the report examined how race and ethnicity intersect with a county’s health score and how the availability of affordable housing, safe neighborhoods, access to jobs and high-quality education can affect a county’s health numbers. Posting the lowest rankings out of 247 counties were Duval, Brooks, San Augustine, Hudspeth and Shelby counties.

Texas Statewide Health Coordinating Council includes health literacy and oral health in state health plan
The Texas Statewide Health Coordinating Council met on March 1 to discuss proposed updates to the Texas State Health Plan (TSHP) report. The council meets regularly to ensure health care services and facilities are available to all Texans through health planning activities. Proposed updates to the TSHP report will include analyses and recommendations in five new areas: oral health, clinical site availability, health literacy, hospital trauma designation and federally qualified health centers.

The council also received an activity report on the Texas Higher Education Coordinating Board’s efforts to implement SB 2118, passed in the 85th legislative session. The board reported nine junior colleges had applied to incorporate baccalaureate degree programs in areas that demonstrated a workforce need, including nursing and dental hygiene. Methodist Healthcare Ministries' legislative agenda targeted key initiatives impacting access to care, including health literacy and the state’s workforce shortage. We will continue to monitor the progress made by both state agencies and share updates as they develop.

Texas E-Health Advisory Committee implements key telemedicine bills
The Texas E-Health Advisory Committee met on March 2 to share updates on the latest policies and services impacting the use of health information technology, health information exchange systems, telemedicine, telehealth and home telemonitoring services. HHSC staff provided an update on the implementation of SB 1107, regarding protocols and reimbursement for telemedicine services. Proposed rules are on track to be available for review in the next 3-4 weeks.

Committee members also received an update on HB 1697, which involves the availability of pediatric telemedicine services in rural counties. The bill was passed in the 85th legislative session but failed to get state funding. HHSC has moved forward to develop a workgroup on tele-NICU and tele-ER to study the costs of transporting children from hospital NICU departments to other hospitals, and to study rural hospitals’ capacity and interest in telemedicine. Research data will evaluate the possibility of developing a pilot program in 2019. Methodist Healthcare Ministries will continue to monitor HHSC’s efforts in implementing telemedicine services that serve to increase access to care for rural and underserved areas of the state.

Texas Public Health Coalition applauds the City of San Antonio for Tobacco 21 ordinance
The Texas Public Health Coalition convened for its first meeting of the year on March 2. The statewide coalition works to reduce preventable disease by advancing effective public policies that promote healthy environments and healthy behaviors for Texas residents. Coalition members applauded the City of San Antonio on the recent passage of its Tobacco 21 ordinance and will follow up with a letter to City Council members thanking them for their efforts. Members also identified key priorities to develop for the upcoming 2019 legislative session, including community access to healthy food, maternal and infant health, and childhood immunizations. Methodist Healthcare Ministries is an active member of the coalition and will work to develop and promote efforts to improve public health in Texas communities.

Upcoming Meetings & Events

March 27: House Select Committee Hearing on Opioids & Substance Abuse
March 28: TexasAIM Webinar on Implementing AIM Maternal Safety Bundles in Texas
March 29: UTRGV M.A.S.S Lecture Series
March 31: Application for the Maternal Mortality and Morbidity Task Force
April 5-6: Texas Primary Care and Health Home Summit
April 13-14: RGV Medical Education Conference & Exposition
April 20-21: San Antonio Substance Use Symposium
April 24-25: Eliminate Tobacco Use Summit
April 26-27: Active for Life Health & Wellness Conference
 

Health Care Policy News

Women’s Health
The Texas Tribune: Four highlights from the Texas Tribune’s women’s symposium roundtables

Immunizations
MySA: Immunize our kids from HPV-related cancer

ACA Special Enrollment Periods
CPPP: New outreach materials for special enrollment periods

Spinal Screening
Texas Department of State Health Services: Spinal screening policy effective 2018-2019 school year

Eugene Washington PCORI Engagement Awards
PCORI: Funding Opportunities

Back to Top

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 Statewide Health Coordinating Council addresses the impact of health literacy
• Voluntary guidelines proposed for hospital emergency departments to minimize opioid misuse
• Federal administration considers rule targeting immigrants who receive public benefits 
• Statewide stakeholder meetings scheduled to address immunization policies

Upcoming Meetings & Events
Health Care Policy in the News
 

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Interim Updates

Texas Statewide Health Coordinating Council addresses the impact of health literacy
During the 85^th Legislative Session, Methodist Healthcare Ministries worked with Representative Diana Arévalo (D-San Antonio) and Senator Eddie Lucio (D-Brownsville) to draft HB 3682, which requires the statewide health coordinating council and state health plan to examine and report on the impact of low health literacy on consumers and the health care system. HB 3682 passed through the House Public Health Committee with bipartisan support, but died on the House Floor due to lack of time.

The Statewide Healthcare Coordinating Council, who identifies challenges and concerns that Texas faces in health care services, is working to incorporate the issue of health literacy into the state health plan. The full council met on March 1 to learn more about the impact of health literacy on consumers. Read the meeting agenda.

As part of our legislative initiative to increase access to quality health care, Methodist Healthcare Ministries focused on the issue of health literacy. Only 12 percent of adults have proficient health literacy, according to the National Assessment of Adult Literacy. Low literacy has been linked to poor health outcomes, such as higher rates of hospitalization and less frequent use of preventive services. Methodist Healthcare Ministries commends the Texas Health and Human Services Commission (HHSC) and members of the Statewide Healthcare Coordinating Council on being proactive and addressing the health care challenges associated with low literacy rates.

Voluntary guidelines proposed for hospital emergency departments to minimize opioid misuse
As part of its efforts to minimize the use of opioid painkillers in emergency rooms across Texas, the Texas Hospital Association (THA) has proposed voluntary recommendations to help reduce the number of opioid-related deaths in Texas. With input from the association’s behavioral health council, hospital physician executive committee and quality and patient safety council, the recommendations range from risk identification to prescribing guidelines.

Included in the recommendations are the development of processes for identifying patients both at risk for developing a substance use disorder and for those with a substance use disorder, including a protocol for treating pregnant and postpartum women. Hospitals should also consider adopting a multi-modal non-opioid medication model for acute pain management treatment and use short-acting opioids. The recommended guidelines are written in a way where hospitals can adjust them to fit their community’s needs, as reported by KXAN.

At the local level, Methodist Healthcare Ministries is taking part in Bexar County’s Opioid Task Force efforts. The issue will also be addressed by state lawmakers through upcoming hearings held by the House Select Committee on Opioids and Substance Abuse. 

Federal administration considers rule targeting immigrants who receive public benefits
The federal administration is considering new rules that would make it more difficult for immigrants to be admitted to the U.S. or to get green cards if they or their children receive certain public benefits, including some forms of Medicaid or Head Start. As defined in the proposed language, a public benefit includes cash benefits such as TANF, Head Start’s educational and developmental supports, CHIP coverage, financial help to purchase health coverage, SNAP assistance, WIC assistance, some housing support and transportation vouchers. The new rule does not exempt refugees and people seeking asylum from the public charge test. Read more on Reuters.

Although this rule is not final, if passed it would slow immigrants’ social and economic integration and raise public health issues. It would also deter people from seeking medical care when they need it most. Methodist Healthcare Ministries is working with its advocacy coalition partners to learn more about the proposed rule and educate state policymakers on the negative impact the rule would have on immigrant families.

Statewide stakeholder meetings scheduled to address immunization policies
Methodist Healthcare Ministries is working with The Immunization Partnership to hold several stakeholder meetings throughout the state to educate communities on current national and state immunization issues and policies. The meetings will be held in San Antonio on April 10 and in Laredo on May 10. There is no cost to attend, however, registration is required.

In Bexar County, only two-thirds of children are up-to-date on their immunizations, according to Texas Public Radio. The San Antonio Metro Health District has created multiple programs in place to make sure vaccines are accessible to the public, including free flu shots to the public.

This past legislative session, Methodist Healthcare Ministries supported legislation that would allow greater transparency with collection and access to immunization data. The bills were heard by the House Public Health Committee but failed to garner the necessary votes to pass.
 

Upcoming Meetings & Events

March 6: Texas Health and Human Services' Regional Community Partner Forum
Texas HHSC and the Community Partner Program (CPP) are hosting Regional Community Partner Forums around the state. Join them in San Antonio on March 6 for training and updates from HHSC, CPP, and YourTexasBenefits.com. Network with local community partners and develop relationships to connect clients to services. Learn more.

March 15: House Human Services Hearing
The House Human Services Committee will meet to review the history of Medicaid Managed Care in Texas and determine the impact on quality and cost of care. They'll also review initiatives that managed care organizations have implemented to improve quality of care, and review the Commission’s oversight of managed care organizations. View hearing notice.

March 15: Mental Health Awareness Art Contest
Texas HHSC invites students and adults to tell their stories about why mental health matters to them through poster art, writing, videos, and photography. Participants will have their work displayed and published across the state. The deadline to register is March 15.  View guidelines and entry form. 

March 20: Senate Finance
The Senate Finance Committee will meet to discuss options to increase investment earnings of the Economic Stabilization Fund and monitor the state’s progress in coordinating behavioral health services and expenditures across state government, including new local grant funding. View hearing notice.

March 21: RHP6 Stakeholder Forum
University Health System will present the draft RHP 6 Plan Update for Demonstration Year 7-8 of the Medicaid 1115 Waiver, and providers will share their transformation goals and strategies for the DSRIP program. The event is scheduled to begin at 1:00 p.m. at the San Antonio Food Bank. Register here.

March 22: Senate Health and Human Services
The Senate Health and Human Services Committee will meet to review child welfare issues and reviewing substance use prevention, intervention and recovery programs, including services for pregnant and postpartum women enrolled in Medicaid or Healthy Texas Women Program. View hearing notice.

April 20-21: San Antonio Substance Use Symposium
The San Antonio Substance Use Symposium will bring health care providers and community members to collaboratively identify opioid challenges and solutions to this public health crisis. Topics will include prescription monitoring programs, medication to treat opioid use disorder, and special populations. Learn more and register.
 

Health Care Policy in the News

Federal budget
How the President’s Proposed FFY 2019 Budget Impacts Critical State Health Programs (NASHP)
The Office of Management and Budget released the president’s FFY 2019 budget request that proposes $68.4 billion for health programs administered by the U.S Department of Health and Human Services, $17.9 billion less than 2017 funding levels. The budget proposal included an addendum designed to align the proposed White House budget with the recently passed Bipartisan Budget Act. Read more.

Mental health care services in the RGV
Mental health and treatment in the Rio Grande Valley (The Monitor)
The Rio Grande Valley is considered an underserved community of medical and mental health care, but some efforts have been made to abate this mental health care shortage. The local mental health authority, Tropical Texas Behavioral Health, has expanded its mental health programming with help from organizations, such as Methodist Healthcare Ministries, to provide low-cost mental health services to the community. Read more.

Back to Top

During the 85^th legislative period, 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 awards $27.5 million for local mental health programs
• Congress passes continuing resolution (CR) to fund Community Health Centers
• Methodist Healthcare Ministries releases bill summaries for new behavioral health laws
• Maternal mortality crisis in Texas
• Methodist Healthcare Ministries' advocacy partners share voter guides and toolkits
• The Nonprofit Council releases ‘State of the Nonprofit Sector’ report

Upcoming Meetings & Events
Health Care Policy in the News
 

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Interim Updates

Texas awards $27.5 million for local mental health programs 
The Texas Health and Human Services Commission (HHSC) recently announced it is awarding up to $27.5 million in grant funds through two grant programs that support local mental health services and programs. The Mental Health Grant Program will award up to $12.5 million to justice-involved individuals (SB 292), and the Community Mental Health Grant Program (HB 13) will award up to $15 million. Methodist Healthcare Ministries informed all funded partners of the grants and assisted interested organizations with the application process (read more).

Congratulations to our partners Border Region Behavioral Health Center, Center for Healthcare Services, Gulf Bend Center, and MHMR Services for the Concho Valley for being among the 25 local mental health authorities selected by HHSC as awardees for HB 13. All selected organizations will begin providing services pending execution of contracts. Final contract terms will be negotiated over the next few weeks with anticipated start dates in April.

All 14 local mental health authorities who submitted applications under SB 292 were chosen to receive funding.

Congress passes continuing resolution (CR) to fund Community Health Centers 
After technically allowing the federal government to shut down for five hours on Feb. 9, Congress passed a continuing resolution (CR) that will keep federal programs running through March 23. The CR includes a two-year funding extension for Community Health Centers, with an increase of $600 million for the program over the two-year period. It also includes funding for the Teaching Health Center Graduate Medical Education program which funds residency programs in community health centers and adds an additional four years to the Children’s Health Insurance Program bringing the total CHIP funding period to 10 years. The CR increases the budget caps by $300 billion for fiscal year 2018 and fiscal year 2019 and provides nearly $90 billion in hurricane disaster relief for Texas, Florida and Puerto Rico.

In Texas, more than 1.3 million residents were at risk of losing access to primary care services if the federal government had not renewed funding for community health centers. The budget impasse that began five months ago had forced many centers to freeze hiring, put off service expansions, and tap into financial reserves.

Methodist Healthcare Ministries releases bill summaries for new behavioral health laws 
Of the more than 1,400 bills tracked by our Policy & Advocacy department this past session, 34 bills impacting mental health services and funding were signed into law. View our bill summaries for behavioral health bills that impact programs and services for children, veterans, and homeless populations. In the coming weeks, we will share bill summaries on health care workforce shortage bills and women and children’s health bills.

Maternal mortality crisis in Texas 
Across the United States, maternal mortality jumped by 27 percent between 2000 and 2014. In Texas, researchers were stunned to learn that the maternal mortality rate had doubled between 2010 and 2012. However, the state’s maternal mortality rate is now a matter of public debate. Although the Department of State Health Services website currently shows that Texas’ maternal mortality rate was 35.2 deaths per 100,000 births between 2012 and 2015, agency officials now say that the number of mothers who died during that period is actually 30 percent lower — thanks to new methodology the state recently began using to calculate deaths. A study published by Birth this month analyzed CDC data from 2006 to 2015 and found that the state’s maternal death numbers are inflated. Marian MacDorman, a research professor with the Maryland Population Research Center and the Birth study’s lead author, stated that the new methodology is also flawed because it omits women who died after miscarriage or other complications that prevented them from giving birth.

Major causes of maternal deaths in Texas are often linked to overdose or a lack of access to health care before, during and after pregnancy. Texas moms often have difficulty getting prenatal care and other services they need due in large part to current state policies. Texas Medicaid typically doesn’t cover working-age adults unless they have a disability or are pregnant — making it harder for women to manage health conditions prior to pregnancy. Just two months after delivery, Texas Medicaid cuts off a new mom’s health care coverage at a time when it is needed most. Improving women’s access to health care will save the lives of mothers and ensure that more children get a healthy start in life.

Methodist Healthcare Ministries' advocacy partners share voter guides and toolkits 
In Texas, the most important election for many communities is the March primary election, due to the fact that the winning candidate often has no opposition in the general Nov. election. However, most Texans aren’t in the habit of voting in the critical March primaries. In 2014, only 10 percent of registered Texan voters took part in the Republican primary, and only 4 percent of registered voters voted in the Democratic primary. Primary campaigns provide the best chance for voters to declare which solutions and governing approaches best fit this moment in our state’s history. Below you'll find helpful voter guides and toolkits developed by Methodist Healthcare Ministries' advocacy partners:

The League of Women Voters has released its voter guide for the Texas primary election. The voter guide allows you to see the races on your ballot, compare candidates’ positions side-by-side, and print out a “ballot” indicating your preferences that you can take along with you on Election Day. Personalized information on candidates and issues, verification of registration status, and upcoming debates and forums can be found at vote411.org.

The Texas Hospital Association has helped increase engagement and participation in the March 6 primary election by sharing a voter toolkit with their hospital partners. The toolkit includes a sample CEO email to emphasize the importance of voting and provides resources and information to prepare for voting. It also contains imagery for emails, webpages, monitors, and digital posters for elevators and employee break rooms. Social media posts that advertise key deadlines and voter resources are included as well.

Texans Care for Children released a voter guide on children’s issues that state policy-makers will have to address if elected in 2018. The guide encourages voters to: ask candidates about urgent state policies, educate them on issues, and let them know what issues are important to them.

Important Primary Election Dates:

• Early voting: Feb. 20 to March 2, 2018
• Election day: March 6, 2018

The Nonprofit Council releases ‘State of the Nonprofit Sector’ report 
The Nonprofit Council released its “state of the sector” report, sharing an organizational snapshot of more than 421 nonprofits in Bexar County and 16 surrounding counties. Funded by Methodist Healthcare Ministries, the report concludes that nonprofit survey respondents provide services across a broad spectrum of areas; the largest are human services (22 percent); arts and culture (10 percent) and education. Human service organizations are the most financially stressed as they govern the gap between service costs and reimbursements. The most frequently expressed challenge, outside of funding issues, was the need to engage in community education and awareness. Read the report here.
 

Upcoming Meetings & Events

February: LUPE Mobile Clinic Calendar
La Union Del Pueblo Entero (LUPE) has released the monthly schedule for its Health on Wheels program. Funded by Methodist Healthcare Ministries, the Health on Wheels program seeks to broaden access to health care in the Rio Grande Valley — particularly in low-resource communities — by connecting border residents with local and accessible health care providers. View the schedule.

February 15: Medical Care Advisory Committee 
Texas HHSC’s Medical Care Advisory Committee will meet Feb. 15 at 9 a.m. in Austin, Texas to review the 1115 Medicaid Waiver DSRIP program amendments and mental health screenings. View the meeting agenda.

February 20: Mental Health Condition and Substance Use Disorder Parity Workgroup
Texas HHSC’s Mental Health Condition and Substance Use Disorder Parity Workgroup will meet Feb. 20 at 9 a.m. in Austin, Texas to hear updates from HHSC and the Texas Department of Insurance on parity violations. View the meeting agenda.

February 28: Members Sought for the Texas Brain Injury Advisory Council
Texas HHSC is accepting applications for membership to the Texas Brain Injury Advisory Council. The executive commissioner will appoint members to the council to serve a three-year term. Applications are due by Feb. 28. Download the application.

March 6: Texas Health and Human Services' Regional Community Partner Forum
Texas HHSC and the Community Partner Program (CPP) are hosting Regional Community Partner Forums around the state. Join them in San Antonio on March 6 for training and updates from HHSC, CPP, and YourTexasBenefits.com. Network with local community partners and develop relationships to connect clients to services. Learn more.

March 14: Fourth Annual San Antonio Food Bank Food IQ Nutrition Summit
The San Antonio Food Bank will host its fourth annual nutrition summit, "Preventing Food Waste: Initiatives to Decrease & Recover Wasted Food," March 14 from 7:30 a.m. to 2 p.m. The summit will propose initiatives to address food waste reduction from the government to households. The event is free to attend. Register now.

April 16-18: The Texas Campaign to Prevent Teen Pregnancy’s 7th Annual Symposium
Texas Campaign to Prevent Teen Pregnancy’s Annual Symposium will bring together professionals from across the state to participate in panel discussions, presentations and professional development workshops. The event will focus on creating change and improving adolescent health in Texas. Register by March 31 for a discounted rate. Scholarships are available to assist with travel costs. Register now.

April 17: Bexar County Joint Opioid Task Force Meeting
The Joint Opioid Task Force is seeking to decrease the number of opioid deaths in Bexar County and develop strategies to address the opioid crisis in a comprehensive manner. The next meeting will be held April 17 at 9:30 a.m. Meetings are held at the Robert B. Greene Pavilion (903 West Martin Street). Learn more.
 

Health Care Policy in the News

Texas Healthy Women Program
Abbott Requests Federal Medicaid Exemption for Texas Healthy Women Program (Texas Public Radio)
Gov. Greg Abbott appealed to the federal administration for federal money to help fund the state’s Healthy Texas Women’s program. The proposal, submitted through a federal 1115 waiver, would allow the state to receive and re-distribute federal Medicaid dollars for women’s health care services. Read more.

Foster Care
Texas Should Begin Implementing Parts of the Foster Care Order Now (Texans Care for Children)
On Jan. 19, Judge Janis Jack issued her final order instructing the state of Texas to improve child safety in the foster care system managed by Child Protective Services and overseen by the state legislature. The order was based on years of testimony in a federal lawsuit against the state of Texas. Read more.

Back to Top

During the 85^th legislative period, 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

• Children’s Health Insurance Program (CHIP) reauthorized for six years
• Methodist Healthcare Ministries releases bill summaries for 'Access to Care' legislation
• Texas granted Medicaid 1115 waiver extension for five years
• Federal administration announces work requirements for state Medicaid recipients
• Methodist Healthcare Ministries’ coalition partners aid in enrollment outreach
• Mental health parity law gains traction in Texas
• Methodist Healthcare Ministries supports state and local efforts to increase tobacco age to 21

Upcoming Meetings & Events

Health Care Policy in the News

• Maternal Mortality in Texas

Action Center

• Medicaid work requirements make no sense for Texas – or other states.

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Interim Updates

Children’s Health Insurance Program (CHIP) reauthorized for six years
Families in the Children’s Health Insurance Program breathed a sigh of relief after Congress voted to end the government shutdown and extend CHIP for six years. The decision secures health care coverage for more than 400,000 children in Texas. Funding for the program had originally expired at the end of September 2017, forcing states to rely on reserve funds to keep the program going until December when Congress moved to approve an additional $3 billion for CHIP. This would have carried states through March to maintain coverage for an estimated 9 million children. The Valley Morning Star reports that the Congressional Budget Office estimated a 10-year extension of CHIP would decrease the federal deficit by $6 billion, as it would be more expensive for the government to pay for health coverage through Medicaid or subsidies on the health care marketplace. According to National Public Radio, some advocates worry that the months of uncertainty around CHIP may have already caused children to drop out of the program, thus increasing the uninsured rate among children. View Texas CHIP enrollment data by county.

Methodist Healthcare Ministries releases bill summaries for 'Access to Care' legislation
During the 85th Legislative Session, Methodist Healthcare Ministries tracked over 1,400 health care bills, of which 220 were signed into law. View summaries for 48 bills impacting access to care for Texas’ working families. Summaries of bills related to health care workforce, behavioral health, and women and children’s health will be made available in the next few weeks.

Texas granted Medicaid 1115 waiver extension for five years
Late December, the Centers for Medicare & Medicaid Services approved a new five-year, $25 billion Medicaid 1115 waiver for Texas. The waiver preserves critical funding for the state’s safety net system of hospitals, clinics and providers. The Texas Health and Human Services Commission has developed a summary of the renewal, specifying changes to the Uncompensated Care (UC) funding pool and Delivery System Reform Incentive Payment (DSRIP) funding pool. Methodist Healthcare Ministries will follow the implementation of the waiver and share any updates and developments.

Federal administration announces work requirements for state Medicaid recipients
On Jan. 11, the federal administration announced that states can now apply to add work requirements to their Medicaid programs. Ten states have already applied, but Texas isn’t one of them. The Dallas Morning News reports that requiring its Medicaid recipients to work wouldn’t have much of an impact because Texas didn’t expand its program to include more people under the Affordable Care Act. Out of roughly 4 million Medicaid recipients in Texas, there are only about 150,000 impoverished adults covered by Medicaid who aren’t pregnant, elderly or disabled, according to the San Antonio Express-News. State Senator Charles Schwertner, who chairs the chamber’s Health and Human Services Committee, states that the federal policy change gives states more control over their own Medicaid programs. On the contrary, State Senator Carlos Uresti, vice chair of the committee, said the Legislature should further study the issue before making any decisions that could unnecessarily drive families and children further into poverty.

Methodist Healthcare Ministries’ coalition partners aid in enrollment outreach
Enrollment for health insurance under the Affordable Care Act soared in the final days before the federal sign-up deadline, bringing 2017's total within a few percentage points of the total number in 2016, when the enrollment period was twice as long. With the help of Cover Texas Now, 1.1 million Texans signed up for health insurance for 2018, according to Public News Service. Nationally, total enrollment in 2017 topped 8.8 million people, 4 percent below the 2016 total of 9.2 million, even while battling confusion among many potential enrollees regarding the fate of the law. More than 4.1 million people signed up in the final week alone.  Despite enrollment numbers, Texas will likely continue to have the highest rate of uninsured people in the country in 2018, according to the Austin American Statesman. People needing marketplace coverage will continue to face uncertainty, as some members of Congress continue their efforts to repeal the Affordable Care Act.

Mental health parity law gains traction in Texas 
The Texas legislature passed House Bill 10 during the 85th Legislative Session, which prevents health insurance companies from offering mental health benefits differently from medical benefits and offers more help for consumers who believe their insurance is wrongly denying them from coverage. Methodist Healthcare Ministries worked closely with the bill's author, Representative Four Price, and mental health stakeholders, to change how mental health and substance use care are provided through private insurance health plans.

Although HB 10 took effect September 1, 2017, the implementation process is ongoing. The legislation addresses parity from four different angles: regulation, data collection, collaboration, and consumer assistance. These different pieces are moving ahead in different stages. Mental health parity laws hold a great promise in helping Texans access needed health care to achieve recovery, but that promise of parity has not been fully realized. HB 10 helps to address ongoing challenges with oversight, data collection, cross-agency collaboration, and consumer assistance. All of these pieces will help ensure that more Texans have equal access to mental health, as well as other health care services through their health plans.

The Hogg Foundation created a fact sheet with information on how parity works and what you can do if you believe you or a loved one has experienced a parity violation. Methodist Healthcare Ministries’ advocacy partner, Center for Public Policy Priorities, released a brief on mental health parity history and implementation.

Methodist Healthcare Ministries supports state and local efforts to increase tobacco age to 21 
During this past legislative session, the House Committee on Public Health considered House Bill 1908, by Representative John Zerwas, to raise the minimum tobacco age in Texas from 18 to 21. The bill was approved by the committee but did not make it to the House floor for a vote. On Jan. 11, after two hours of deliberation and testimony from more than 30 people, the San Antonio City Council approved a new law prohibiting merchants in the city limits from selling tobacco products to anyone under 21 years old, reported by the San Antonio Express-News. San Antonio is the first city in Texas to enact such a law. The new ordinance, which city officials discussed since August, passed by a 9 to 2 vote. The “Tobacco 21” ordinance will take effect Oct. 1, 2018, allowing the San Antonio Metropolitan Health District more time to implement provisions and gather input from surrounding cities. 

The city of San Antonio will work to educate the public and retailers about the new law. New signage will be placed in stores, and if a retailer is suspected of selling tobacco products to someone under the age of 21, the city’s health department may check compliance. If a retailer is caught violating the law, a citation with a maximum fine of $500 will be issued.

As reported in the San Antonio Current, according to Colleen Bridger, director of San Antonio Metro Health, 95% of smokers begin before the age of 21, during a period of time when the brain is especially susceptible to addiction. An online survey of more than 5,000 San Antonians showed that 77.5% of participants supported the age hike. Supporters included physicians, cancer survivors, health insurance companies, the San Antonio Chamber of Commerce, high school students and teen ambassadors. Several opposed the changes including convenience store owners and the Association of Convenience Store Retailers in San Antonio due to lack of input from merchants and potential financial consequences. KXAN reports that ordinances like Tobacco 21 are critical to reduce and eventually eliminate tobacco’s toll, especially considering that nationally about 95% of adult smokers started before they turned 21.

Upcoming Meetings & Events

January 31: Medicaid Waivers: Work Requirements and Beyond
Join Families USA for a free presentation on how state advocates can address Medicaid waiver proposals that include work requirements and other restrictions. Experts will review recent HHS approvals of work requirements for Medicaid, and the tools available, for state advocates to address similar proposals. The webinar will start at 1 p.m. CST. Register now.

February 3: 11th Annual Community Service Learning (CSL) Conference
Join Methodist Healthcare Ministries and UT Health San Antonio at the Annual CSL Conference to share best practices in service learning and recognize excellence within the UT Health System. There is no cost to attend, but registration is required. Register now.

February 28: Members Sought for the Texas Brain Injury Advisory Council
HHSC is accepting applications for membership on the Texas Brain Injury Advisory Council. The HHSC executive commissioner will appoint members to the council to serve a three-year term. Applications are due by Feb. 28 at 11:59 p.m. View the application.

April 16-18: The Texas Campaign to Prevent Teen Pregnancy’s 7th Annual Symposium
Texas Campaign to Prevent Teen Pregnancy’s Annual Symposium will bring together professionals from across the state to participate in panel discussions, presentations and professional development workshops. The event will focus on creating change and improving adolescent health in Texas. Register by January 31 for a discounted rate. Register now.

Health Care Policy in the News

Maternal Mortality in Texas 
It’s impossible to solve Texas’ maternal mortality problem with faulty state data (Dallas News)
Texas has a problem: Deaths of women linked to pregnancy and childbirth are increasing. How bad is the problem? We don’t know. That’s another problem. A new study in the medical journal, Birth, suggests that the reporting and data collection system in Texas is inaccurate, making it impossible to develop a clear picture of how many women are dying of childbirth-related complications. Read more.

Action Center

Medicaid work requirements make no sense for Texas – or other states. 

Read more by Cover Texas Now.