Blog – Page 12 – Methodist Healthcare Ministries of South Texas, Inc.

Legislative Interim Update, March 2

DW Admin on March 2, 2018

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

View our 2017 Legislative Agenda

Advocacy

Policy

Research

___________________________________________________________________________________________

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.

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Legislative Interim Update, Feb. 14

DW Admin on February 14, 2018

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

View our 2017 Legislative Agenda

Advocacy

Policy

Research

___________________________________________________________________________________________

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 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.

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Investing in livelihood

DW Admin on February 13, 2018

These days, PowerPoint slide decks are relied upon to illustrate and guide the business stories we need to deliver to our audiences, yet it is often seen as a worthy effort if you can keep the number of slides to 10 or less. The challenge persists to include enough information to be useful, but not so much that your audiences’ eyes glaze over. So, I challenged myself to create what I call: “The one slide presentation.” It’s my way to counter-intuitively present a minimum of relevant information and narrative I hope will spark questions and conversation, and hopefully a deeper understanding of the focus area, and ideas to activate my audience. The slide includes a heading, a question, a number, and a 55-word story explaining the number. Oh, and two logos, a hashtag, and our brand colors. That is it.

I tried this approach for the first time during a cross-departmental meeting with colleagues at Methodist Healthcare Ministries and was thrilled with the results. What I hoped would happen, did – and more. (Again, we are talking about one slide and five minutes.)

The intention of the one slide presentation was to begin sharing numbers from mining the (non-rigorous evaluation) data from our federally-funded Sí Texas Project (now in year three of five) while telling the story of the data point. I am the program officer for this project, which is designed to implement and evaluate eight models in South Texas on Integrated Behavioral Health (IBH) and Primary Care in Behavioral Health (PCBH). My charge and challenge from the inception of the project has been to demonstrate our sub-grantee’s progress and change – with the unspoken expectation of explaining the barriers to that progress and change.

The question on the slide was: How many people are paid by the grant? The number was 114. The 55-word story was: “People are the power. They deliver services, build the culture, receive the investment of capacity building, sustain what is built, communicate and educate about the services offered through them in organizations, listen to and care for patients, and much more. They also have their own lives to build and sustain. Methodist Healthcare Ministries is investing in livelihood.” I intentionally chose the word “livelihood” because it means income, means of support, living, sustenance, nourishment, daily bread, occupation, and vocation – meanings that resonated with a faith-based organization such as ours. I explained that our project is an economic engine, but it is so much more.

I talked about how, in my lead-up to the meeting, I dropped by the office of a colleague and presented the question, number, and narrative. I told her how I wanted to mine our project’s data to get at numbers such as the average pay for certain positions. She asked how average pay was germane. Her question gave me the opportunity to explain how difficult it has been for most of our sub-grantees to offer competitive salaries to medical providers, especially smaller community-based clinics, resulting in the need to think differently about attraction and retention of personnel. I asked, open-endedly, if there was the possibility of appealing to mission-driven candidates. Our conversation led to how clinics could speak to the meaning of this work and appeal to spouses and families of providers, and how they might join a community and a culture—after all, selecting a job is often a family decision.

The presentation sparked thought-provoking questions and dialogue. One question in particular, about which positions were most difficult to fill, led to a discussion about the health care professional workforce shortage that is pervasive in Texas and across the nation.

I explained how our sub-grantees have been resourceful to fill functions such as nutritionists by shifting nurses or by expanding the role of community health workers, also known as ‘Promotores de Salud.’ I described how difficult it has been for some clinics to attract primary care providers, in one case, waiting several months for one provider’s contract to end at another clinic. In terms of IBH, I talked about the challenge of hiring and retaining behavioral health consultants, a critical function in IBH, especially in rural areas. In fact, it has been difficult to fill many key positions in rural communities, often creating hardship for current staff shifted to serve in outlying communities when they have family and must adjust for longer commutes and transporting their own children to school.

All of this quality content resulted from a question, a number, and a 55-word story.

We live in a complex world and health care is a complex industry. I believe the counterintuitive technique of offering one data point and an interpretation of the data enabled our team to focus on a topic and to dive deeper together into the story of our project and what we are learning.

What are some of the ways your organization is addressing these issues? And, what techniques are you finding effective at communicating these issues to your audiences?

Texas House Bill 13, guiding funded partners with state mental health grants

DW Admin on February 9, 2018

It is widely known that Texas ranks near the bottom of the list nationally when it comes to mental health spending per capita. During the 85th Texas Legislative Session, however, a momentous move was made to correct this negative trend when House Bill 13 (HB 13) — a bill Methodist Healthcare Ministries supported throughout the session — was passed into law.

As a result of HB 13, the state of Texas will funnel $27.5 million into select mental health programs — over the course of two years — through a matching grant program to support community mental health programs providing services and treatment to individuals experiencing mental illness. A couple key aspects of the bill include greater organizational collaboration and the fact that, at a minimum, 50 percent of those funds will benefit rural communities with populations under 250,000. HB 13 is significant to Methodist Healthcare Ministries given its promise to increase access to mental health, promote organizational collaboration, and potentially aid our own funded partners and the communities we serve.

Because we are a not-for-profit organization with experience as both a grantor and grantee, we understand the challenges nonprofits might face when searching for funding opportunities like HB 13. Whenever possible, we offer funded partners unique insight and guidance on how to secure grant awards from other funders in order to create diverse revenue streams and additional sustainability. (Diversified revenue streams establish credibility and create the potential to attract even more funders because funders see that multiple entities believe in the organization’s cause and efforts.) With HB 13, we didn’t want common constraints — lack of development staff, time, state grant experience, etc.— to keep partners from benefiting from these grant funds to advance mental health care. So, as soon as the bill passed into law, Methodist Healthcare Ministries sprang into action.

To start, one of our advocacy partners, the Meadows Mental Health Policy Institute, hosted a conference call to provide information about HB 13 to our funded partners. Next, we sought to support those partners in their efforts to apply for HB 13 funding by hosting informational meetings, offering letters of support, maintaining open lines of communication and providing technical assistance to interested organizations to ensure they had the opportunity to apply for funding. Finally, we are continuing to support our funded partners in applying for grants similar to HB 13, because we know that when partners obtain funding outside of Methodist Healthcare Ministries, they open doors to more opportunities and organizational growth. By earning diverse sources of revenue and grants, a funded partner is positioned to expand services to a larger capacity in the communities they serve. This, in turn, contributes to our goal of creating more access to care.

The Texas Health and Human Services Commission (HHSC) implemented HB 13 through two procurements: a competitive Needs and Capacity Assessment distributed to Local Mental Health Authorities (LMHAs) and Local Behavioral Health Authorities (LBHAs), and a competitive Request for Applications (RFA) to be distributed more broadly to solicit applications from both nonprofit organizations and governmental entities. The recipients of the first round of funding were announced Jan. 23. Of the 39 LMHAs in Texas, 25 were selected to receive HB 13 funding — four of which are Methodist Healthcare Ministries partners (Border Region Behavioral Health Center, The Center for Health Care Services, Gulf Bend Center, and MHMR Services for the Concho Valley). Those four, as well as all other organizations selected by the state, will soon enter the negotiation stage to solidify their contracts for their proposed projects. Proposals for the second round of funding were due Jan. 31, and awards will be announced later this year. All projects, independent of which round, will begin in 2018.

Longevity of HB 13 is unknown; it may or may not become a project that Texas elects to continue funding for years to come. However, even if Texas decides to stop HB 13 funding, a benefit that selected partners have is that they can now establish a track record for properly managing a state grant. This proves to the state that the organization is a good investment for additional state grants for which the organization may wish to apply. Additionally, just by helping funded partners apply for the first time, we were able to help them obtain procedural experience on how to navigate a sometimes complicated and lengthy RFA — crafting the best application, and helping them find necessary attachments for application submission, along with other requirements.

It was validating to see a multitude of organizations support mental health funding since it is essential to the health of Texas communities. We appreciate that funded partners were open to this new opportunity, despite its challenges, and we’re proud that all our funded partners strive for excellence, improvement and innovation. These qualities are essential for improving South Texas’ capacity to provide top of the line health care services to individuals who otherwise might not have access to health care.

Legislative Interim Update

DW Admin on January 29, 2018

IN THIS ISSUE:

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.

View our 2017 Legislative Agenda

Advocacy

Policy

Research

2017 State of Texas Children: RGV Report

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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.

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.

Happy New Year! Read our top stories of 2017!

DW Admin on January 3, 2018

Happy 2018!

As we embark on a new year, Methodist Healthcare Ministries of South Texas, Inc. remains dedicated to its mission of "Serving Humanity to Honor God" by creating access to health care for uninsured, low-income families across South Texas.

Carrying out that mission took many forms in 2017, and we want to invite you to reflect with us on some of our top stories and videos from last year.

Bishop Ernest T. Dixon, Jr. Clinic to relocate to a familiar address in Southeast San Antonio

“Congratulations, you have diabetes” – how Marco overcame Type 2 diabetes

Methodist Healthcare Ministries first-ever CEO to retire after two decades of service

Methodist Healthcare Ministries assists Hurricane Harvey relief efforts and donates $100,000 to Rio Texas Conference’s Disaster Response Fund

Methodist Healthcare Ministries awards $26.7 million in health care grants

Award Winning 2017 Fiesta Medal Announced

Wesley Nurse program celebrates 20 years of faith community nursing

Coffee with Cassandra: Coats for a comfortable Christmas

DW Admin on December 20, 2017

Before you start your workday, enjoy your morning coffee with brew from Methodist Healthcare Ministries. This is your daily dose of stories that speak to the heart of our organization, paired with your favorite cup of joe!

Earlier this month, some of us in South Texas were treated to a truly white Christmas. Snow fell across the region to the delight of many children—but in turn, it served as a reminder that not all kids are blessed with a coat to keep them warm.

I spoke with Alicia Herrera, front office supervisor and Debra Burton-Ibarra, social work case manager at our School Based Health Center at Schertz Elementary. They shared how the clinic was inspired to collect coats for children during this special time of the year. Tune in to also hear from a few of the children who received coats and how it made them feel.

Coffee with Cassandra: Our unique care model

DW Admin on December 14, 2017

We serve 74 counties across South Texas with the same quality, compassionate care to each of our patients and clients. From direct services, to grantmaking and community partnerships, we live by our mission of “Serving Humanity to Honor God.”

I recently spoke with Oanh Maroney-Omitade, our vice president of clinical operations, about the different ways we help to create access to care for low-income and uninsured patients. Oanh provides us a broad scope of the services we offer and how our holistic care model is integral to improving the physical, mental and spiritual health of those we serve.

Coffee with Cassandra: Enrolling in the affordable care act

DW Admin on December 1, 2017

As an organization dedicated to creating access to care, we at Methodist Healthcare Ministries know there are many barriers low-income and uninsured families face when trying to find affordable health care services. The Affordable Care Act has given many uninsured people options to find affordable healthcare coverage, giving them access to preventive services and routine care, not to mention having coverage when urgent or critical care is needed.

I had the chance to sit down with Andy Hernandez, our community development manager, at our Wesley Health & Wellness Center which serves San Antonio’s Southside community, to discuss the timely topic of the Affordable Care Act.

Coffee with Cassandra: Being a quality organization

DW Admin on November 17, 2017

Methodist Healthcare Ministries is a faith-based organization guided by our mission of “Serving Humanity to Honor God.” At the core of that mission is a commitment to ensure the services we provide our patients and clients are the safest and highest in quality.

I had an opportunity to sit down with Dawn Wilder, our director of quality, safety & compliance. Dawn dives into the meaning and importance of quality improvement and why it’s integral to the work of Methodist Healthcare Ministries.

“Congratulations, you have diabetes” – how Marco overcame Type 2 diabetes

DW Admin on November 10, 2017

“Congratulations, you have diabetes! ” … Those were the words my childhood friend, Marco, remembers being told by his physician when he was diagnosed with Type 2 diabetes in 2010. He was only 35 years old. By the time Marco was officially diagnosed with diabetes, his doctor concluded he had been suffering from a developed case for several years. Marco estimates he was feeling symptoms related to Type 2 diabetes for about four years before seeing a doctor; symptoms like chronic fatigue, having a hard time staying awake after meals, major changes in vision, neuropathy, blurred vision, frequent urination, intense cravings for sugary foods and constant hunger. He even noticed a dark patch of skin forming around his neck. The medical name for this is Acanthosis Nigricans and it is often a sign of a serious health problem, like Type 2 diabetes. Marco had also gained a significant amount of weight.

Marco and I grew up together. When we were in high school, Marco was a 5’6” powerhouse hovering at about 180 lbs. He was fast, lean, and could bench press nearly 300 lbs. He played fullback on the football team; when he carried the ball, he was like a red flash running by. You felt sorry for anyone who got in his way because when Marco put his shoulder into you, it felt like getting hit by a wrecking ball. Marco was the kind of athlete that didn’t only work hard when he was carrying the ball, he was that guy coaches all encouraged us to be — the guy that would give 100 percent every single play from whistle to whistle and still take the time to motivate and encourage the rest of the team.

By 2010, years after graduating high school, Marco gained over 60 lbs. When I asked him why he never went to the doctor — even though he was having symptoms related to Type 2 diabetes — he said he had intended to go, but during that time life was just too busy. He and his wife, Jenny, were both embarking on opening small businesses, buying a house and raising a young child. Along with these life stressors, Marco didn’t have health insurance. It was too expensive — many of us can relate to this experience, I know I can. Unfortunately, there were major consequences for not having seen a doctor at the first sign of symptoms, and by the time he was diagnosed with Type 2 diabetes, Marco was already very sick.

This is a common scenario in the Rio Grande Valley where Marco lives. Located at the southernmost tip of Texas, the Rio Grande Valley lies along the northern bank of the Rio Grande river, which separates Mexico from the United States. It has one of the largest populations of people with diabetes in the nation, and unfortunately, by the time people get to see a doctor and get tested, they are already very sick and have had diabetes for several years. A good number of these individuals are even suffering from kidney failure by the time they’re diagnosed. According to the Kaiser Family Foundation, Texas has the highest rate of uninsured individuals in the nation. About one in four people in Texas, 25 percent, do not have health insurance; however, the rate of uninsured in the Rio Grande Valley is even higher. In 2013, the Kaiser Family Foundation estimated the rate of uninsured individuals in the Rio Grande Valley was about 38 percent. There is a large body of research that suggests not having health insurance makes a difference in people’s access to necessary medical care and their financial security. Uninsured individuals are less likely to receive preventive care, and more likely to be hospitalized for conditions that are preventable. Furthermore, uninsured individuals can quickly gain insurmountable levels of debt from medical bills.

So, what was the last straw for Marco? What finally sent him to the doctor? He suddenly couldn’t see! He was suffering from diabetic retinopathy. His on-and-off blurred vision had progressed, and while driving home from work one day, his vision went blurry and stayed that way. Marco said it truly scared him; that day he sat at home terrified because he didn’t know what was happening to him. The following day he went to see a doctor, and the doctor suspected it was retinopathy due to diabetes. He had to have emergency surgery to correct his vision.

On the day Marco was officially diagnosed, his blood sugar was sky high — the glucometer read 530! When his blood work came back confirming he was diabetic, his doctor said to him, “Congratulations, you have diabetes.” Marco was given a prescription and was sent on his way. This all took place before the Affordable Care Act was established, so since Marco now had a preexisting condition, the monthly premium to insure him was tremendously high. Despite his diagnosis, Marco still couldn’t get health insurance. Besides being handed a script for his medication, Marco was not offered any health education or nutrition information. Marco knew he needed to cut out sugar and watch what he ate, so his blood sugar wouldn’t get so high. Other than that, he wasn’t sure what else he should do.

Nearly a year after taking prescribed medication and dieting, Marco’s blood sugar was still out of control so his doctor added insulin to his treatment. That was the proverbial straw — Marco had had enough. He couldn’t imagine managing the rest of his life that way. He was taking a bunch of medicine, trying to eat right, spending a lot of money on prescriptions and doctors, and he still wasn’t feeling any better, so he was resolved to make a change.

Sometime in 2011, Marco started walking every day. He walked 2 miles nearly every day for six months. He lost a few pounds and noticed his blood sugar was getting a bit easier to control. Then, he dusted off the bicycle in his garage and braved the blistering Valley heat. He cycled to and from work, a 10-mile round trip. Marco also cut nearly all sugar from his diet and stopped drinking sodas and beer. He primarily ate chicken, fish and vegetables. He would add some grains on occasion but mainly kept to a diet consisting of meat and greens. His dedication paid off and his doctor told him he could stop taking insulin, but he had to continue taking his other prescribed medication. By this time, Marco’s family and friends were noticing a change in him. He was dropping weight and was a lot less temperamental. Marco said he stayed motivated because his wife, Jenny, and his son, Ethan, were super supportive and they too adopted his more active lifestyle. Marco carried around his lab results and showed them to friends and family to show them how well he was doing; receiving praise from his family, friends, and even his surprised doctors motivated him. Yet, despite his great success, Marco was still frustrated by having to take prescribed diabetes medication, but he figured it was something he was going to have to accept.

To add variety to his exercise routine, Marco joined a gym in 2014 with an old friend — a competitive powerlifter. Marco began waking up at 5 a.m., five times a week, to go lift weights before heading to work. Marco loved getting back into weightlifting. He worked out daily with competitive weightlifters and pushed himself to new limits. After working out for several months, his workout buddies encouraged him to sign up for competitions. Now he competes regularly as a competitive powerlifter regularly sends me text messages with updates on how much he benches, its inspiring. He recently let me know that he had bench pressed 300 lbs. — twice! It’s amazing considering Marco is 42 years old, 5’6,” and now keeps his weight between 210 and 220 lbs. Even more impressive than his bench press, is the fact that Marco no longer takes any medications to manage his blood sugar. Since 2014, Marco has not taken a single pill or had to endure a single injection to manage his diabetes. It took him four years of incremental lifestyle changes and hard work to get well, and he managed to do that without health insurance and minimal support from his doctors. With his improved health, Marco finally was able to afford health insurance in 2014 when the Affordable Care Act came into play. His pre-existing condition was no longer a factor in the cost of coverage, so he was able to take advantage of a plan.

Marco’s story is about as rare as a unicorn, but there are aspects of his experience that are important and need to be examined closely by policymakers. Relative to what it costs to treat an individual with diabetes on a yearly basis, the interventions Marco used to get well were relatively cheap. According to research published in 2013 by the American Diabetes Association, people with diabetes have health care expenditures 2.3 times higher than individuals without diabetes — $13,741 versus $5,853 per year. So, if you have diabetes, your yearly health care expenditures are nearly $8,000 more per year.

If you think about Marco’s story, it wasn’t medication that made him better, nor did he undergo some special medical procedure to get well. Instead, it was incremental lifestyle changes that made the difference. He focused on diet and exercise. If you ask Marco, he’ll tell you the first year after being diagnosed, he focused primarily on diet, but he did not see significant improvements in his blood sugar readings until he began exercising. He saw the biggest improvement in his blood sugar regulation after he added weightlifting to his exercise routine. He feels it was the weightlifting that ultimately helped him cross the bridge to no longer needing any medication.

Another major factor in Marco’s recovery was the support he had from his family. It is important to mention that Jenny and Ethan supported Marco by trying to eat the same things he ate and avoiding keeping sugary foods and drinks in their home. Initially, this was challenging, but over the years they said it has gotten easier.

I wonder if Marco would have focused on his health immediately after his diagnosis, had his doctor written him prescriptions for the things he actually needed: family support, health education, walking shoes, a bicycle and a gym membership. If that’s the remedy for successfully battling diabetes, why are we and our health care system primarily focused on medication and doctor’s visits? Wouldn’t it be great if your insurance plan covered the things you need to make healthy lifestyle changes? Our health care system and policymakers must work together to provide communities with safe, affordable, and accessible places for people to exercise.

It’s also important to note, Marco was really sick when he found out he had diabetes and he hadn’t been to a doctor in years. Imagine if Marco would have had access to affordable health insurance and would have taken advantage of preventive health screenings. His diabetes progression could have potentially been avoided. If we really want to put a dent in successfully reducing the number of individuals with diabetes, there needs to be a focus on prevention.

Since 2014, Methodist Healthcare Ministries has been working with Rio Grande Valley stakeholders in a collective impact initiative called Unidos Contra la Diabetes (UCD). By working collectively, health care providers in the region are working to align their efforts and place more focus on diabetes prevention, not just treatment. There is still a lot of work to be done, but efforts like UCD are important. Even more important, I believe, are stories like Marco’s that elicit hope, because too many people and health care providers in these high-diabetic communities are feeling hopeless. You rarely hear about the success stories, so here is one of them.

Congratulations, Marco! You overcame diabetes!

Coffee with Cassandra: Understanding our Sí Texas Project

DW Admin on November 2, 2017

The approach Methodist Healthcare Ministries’ takes to our work is as diverse as the communities in South Texas that we serve; from health care services to grant-making and advocacy, we are dedicated to improving health outcomes for all our patients and clients.

Our Sí Texas Project is one example of how we are looking for solutions to improve both physical and behavioral health together in communities struggling with multiple risk factors. I am excited to sit down with Stephanie McClain, our Sí Texas Project impact manager, at our Corporate Headquarters in San Antonio to talk about this initiative.