Legislative Update, February 22

DW Admin on February 22, 2019

Legislative Updates

Upcoming Meetings & Events

View our 2019 Legislative Agenda

Advocacy

Bill Tracking

Research

 

___________________________________________________________________________________________

Legislative Updates

San Antonio Health Care Stakeholders Advocate for San Antonio State Hospital Funding

San Antonio State Hospital Stakeholders with Senator Pete Flores (R-Pleasanton) at the Texas Capitol in Austin, Texas

Methodist Healthcare Ministries led efforts this week at the state Capitol to promote reconstruction funding for the San Antonio State Hospital (SASH), estimated to cost $323 million. Jaime Wesolowski, CEO, and Tony LoBasso, CFO, of Methodist Healthcare Ministries joined University Health System, Clarity Child Guidance Center, The Center for Health Care Services, NAMI San Antonio, Haven for Hope and the Bexar County Mental Health Department in a discussion with Senator Pete Flores (R-Pleasanton), who sits on the powerful Senate Finance Committee, to discuss the significance of the new hospital and its value for the thousands of South Texas residents who suffer from severe mental illness. The Senate has currently allocated $300 million for state hospital construction in their supplemental budget bill.

During the 85thInterim, the SASH Executive Stakeholder Committee worked tirelessly to look at the physical replacement of SASH and examine how care would be integrated into the community through enhanced mental health crisis/response services. The Committee collaborated with eight Local Mental Health Authorities throughout SASH’s 54-county catchment area to understand the appropriate roles and functions of a redesigned SASH, current pathways to SASH and barriers to access for both adults and adolescents. The final report of findings was submitted to HHSC in January 2019, where it was reviewed by the agency staff for final submission to the 86th Legislature.

Full reconstruction funds for the San Antonio State Hospital is a legislative priority for Methodist Healthcare Ministries and members of the SASH Executive Committee. During the 86th Legislative Session, Methodist Healthcare Ministries will work with state leaders and stakeholders to ensure funding for SASH is appropriated, along with transition services and increased funding for staff recruitment and retention efforts.

Methodist Healthcare Ministries Testifies in House Appropriations Hearings

Methodist Healthcare Ministries testified to the House Appropriations Subcommittee on Article II on budget issues related to access to health coverage, behavioral health funding and women and children’s health. Chris Yanas, MHM’s Director of Governmental Affairs, stressed the importance of funding the reconstruction of the San Antonio State Hospital, along with salary increases for competitive recruitment and retention of hospital personnel, to operate a state-of-the-art facility that will enhance the recovery of thousands of South Texans in SASH’s 54-county service area. Testimony also included support to sustain the state’s mental health grant programs and increasing services for behavioral health and substance use disorders.

Methodist Healthcare Ministries, along with several other advocates, urged legislators to provide adequate resources for continuity of care for all Texans, including funding for 12-month continuous eligibility for children in the Medicaid program and the extension of postpartum women in the Medicaid program from 60 days to 12 months postpartum. Recommendations also included increased funding for women’s health programs to promote auto-enrollment from children aging out of the Children’s Health Insurance Program (CHIP) into the Healthy Texas Women program. Methodist Healthcare Ministries will continue to submit written and oral testimony during the session on priority issues impacting the health and wellness of its 74-county service area, especially rural communities.

Methodist Healthcare Ministries Supports Children’s Mental Health Legislation

Last week, Methodist Healthcare Ministries submitted testimony in support of Senate Bill 10 by Senator Jane Nelson (R-Flower Mound), relating to the creation of the Texas Mental Health Consortium within the Texas Higher Educating Coordinating Board. With one in five Texans estimated to be impacted by a mental illness, meeting the health care needs of the population requires a coordinated system that is effective and appropriate. The development of the consortium would promote state mental health initiatives and coordinate research efforts at 12 health-related academic centers of higher education across the state.

Senate Bill 10 would also direct the consortium to create a Child Psychiatry Access Program (CPAP) to enable pediatricians and primary care providers to consult with psychiatrists at Texas medical schools for guidance and expertise. The bill would look to reduce the psychiatry workforce shortage through the Behavioral Health Workforce Expansion Project, increase psychiatric residency training and promote the use of telemedicine to expand access to mental health services. Lastly, the bill would provide judicial instruction on mental health resources, which is critical at reducing the number of youths with a mental illness from entering the criminal justice system. Senate Bill 10 was voted out of the Senate Health and Human Services Committee and placed on the Senate Intent Calendar for Monday, Feb. 25.

With about 1.9 million youths in Texas in need of behavioral health services by the age of 14, access to early treatment is imperative. Methodist Healthcare Ministries supports the passage of Senate Bill 10, aimed at leveraging the expertise of health-related universities to improve the quality and availability of mental health services, improving access to early identification and access to treatment, addressing the psychiatry workforce shortage and strengthening judicial training on mental health.

Houston Lawmaker Files Bill on Adolescent Behavioral Health Research 

Texas House Public Health Committee Chairwoman Senfronia Thompson (D-Houston) filed House Bill 10 to create the Texas Mental and Behavioral Health Research Institute to be funded with voter approved bonds. HB 10 increases the number of child and adolescent psychiatrists and specialized nurses across the state, creates a telemedicine program to rapidly connect pediatricians and school health providers with trained mental health providers and creates the Texas Mental and Behavioral Health Research Institute that will focus on research to develop cures and treatments.

With more than 200 counties in Texas without a single child and adolescent psychiatrist, the legislation will create grants to incentivize newly graduated doctors and advanced practice nurses to specialize in the field. Additionally, the bill would establish a Child Psychiatric Access Line (CPAL) for mental and behavioral health care services through academic partnerships and peer-to-peer consultations. HB 10 will place Texas on the leading edge in discovering mental and behavioral health treatments through programs that research all aspects of mental health, from the brain’s structure to public health trends and medical interventions. The bill was referred to the House Public Health Committee Feb. 19 where it awaits a hearing.

Methodist Healthcare Ministries strongly supports HB 10, which will guide Texas to be a leader in addressing child and adolescent mental health issues through research, workforce development and mental health care targeted at our youth.

State Officials Confirm Measles Outbreak in Texas 

The Texas Department of State Health Services reported eight cases of measles across Texas counties, including Bell, Denton, Harris, Galveston and Montgomery. U.S. health officials declared the disease was eradicated in 2000 due to the development of the measles vaccine; however recent declines in vaccination rates have put Texas communities at risk. The highly contagious disease can result in brain damage, deafness and even death, urging health authorities to promote vaccination as the most effective method to prevent the illness.

The Public Health Dynamics Laboratory created a modeling system to demonstrate the outcome if a single student with measles attends school in a given county or metropolitan area. If the measles vaccination rate fell by 10 percent, in a worst-case scenario, the number of infections could potentially increase to 12,230 cases in San Antonio, 9,103 cases in McAllen, 6, 676 cases in Laredo, 1,498 cases in Victoriaand 3,673 cases in Corpus Christi. Supporting policies and legislation that protect all Texans from vaccine-preventable diseases is a top legislative priority for Methodist Healthcare Ministries.

Upcoming Meetings & Events

Feb. 25:HHSC: State Medicaid Managed Care Advisory Committee (Austin)

Feb. 28: HHSC: Texas Statewide Health Coordinating Council (Austin)

Mar 1: HHSC: E-Health Advisory Committee (Austin)

Mar 1:San Antonio Substance Use Symposium (San Antonio)

Mar 4: Let the People Vote! Texas Rally for Medicaid Expansion (Austin)

Mar 5: Viva San Antonio Legislative Day at the Capitol (Austin)

Mar 6: Recovery Day at the Capitol (Austin)

Mar 6: Texans Care for Children’s 13thAnnual Founders Luncheon (Austin)

Mar 30: SASH Spring Thing 5K (San Antonio)

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Use Your Voice to Protect Our Community Through Life-Saving Vaccines

DW Admin on February 21, 2019

For the last 200 years, vaccinations have been responsible for many global public health achievements, including the eradication of smallpox and significant reductions of other serious infections like polio and measles. Despite their undisputed effectiveness, “anti-vaccine” movements are quickly gaining momentum in the United States, including in our great State of Texas. In addition to growing misinformation, factors related to religious beliefs, personal freedoms and individualism have contributed to a rising numbers of parents choosing not to vaccinate their children. In Bexar County, recent data by the Texas Department of State Health Services (DSHS), shows the percentage of students claiming nonmedical vaccine exemptions has more than doubled, from 0.32 percent in 2011 to 0.80 percent for the 2017-2018 school year, despite the fact that opting children out of vaccinations greatly increases the risk of preventable disease outbreaks.

My internship this past year with Methodist Healthcare Ministries allowed me the opportunity to study the history of vaccines, how effective they’ve been in eradicating deadly diseases, ones that I admit I’ve taken for granted, until now. I’m more aware of the detrimental consequences of vaccine exemptions, including what types of policy measures are being taken at the state and local level to address the recent outbreaks around the state.

Before 2003, parents were only able to opt out of vaccinations for their children for religious or medical exemptions. However, during the 2003 Legislative Session, House Bill 2292 expanded the exemption provision to include “reasons of conscience.” Texas is one of 18 states that allows exemptions due to personal, moral or other beliefs. Since the implementation of the HB 2292, more than 57,000 children in Texas have opted out of vaccines – representing a twentyfold increase in the past 15 years. Data show that unvaccinated children typically cluster, which poses a significant threat for outbreaks. According to the Public Library of Science PLOS Medicine Medical Journal, four counties in Texas – including Harris, Tarrant, Collin and Travis – are among the top 15 counties in the U.S. with the highest number of kindergarteners with nonmedical vaccine exemptions. This trend is worrisome not only for the safety of our children, but for our vulnerable populations. Medically fragile individuals, including infants and the elderly, are not able to receive vaccines, due to serious allergies or weakened immune systems and rely on what is known as “herd immunity,” the resistance to the spread of diseases due to a significant portion of the population being vaccinated, which protects them from being exposed to preventable diseases.

In September 2018, DSHS, the state agency responsible for vaccination efforts, released a report highlighting strategies to increase vaccine coverage levels at the state level. Their multifaceted approach for the improvement of vaccination levels includes providing free vaccines to the community, employing quality improvement efforts, performing educational outreach and engaging and collaborating with partners and stakeholders. Two programs that offer free vaccines to eligible children and adults include the Texas Vaccines for Children (TVFC) and the Adult Safety Net (ASN) program. Additionally, DSHS developed educational strategies such as Vaccine Education Online and “Every Dose Matters” in efforts to educate communities on the importance of immunizations. The state also collaborates with stakeholders through the Texas Immunization Stakeholder Working Group (TISWG) to identify local needs and successes. Going forward, DSHS will continue to evaluate the effectiveness of existing public health strategies and work to implement policies that increase vaccine coverage levels and reduce the prevalence of disease in Texas.

As part of its mission to influence public policy to improve access to care for all Texans, Methodist Healthcare Ministries partners with organizations, such as The Immunization Partnership, or TIP, to advocate for vaccination coverage and educate communities on the importance of immunizations. TIP aims to eradicate vaccine-preventable diseases by developing and coordinating community resources through public and private partnerships. As part of Methodist Healthcare Ministries' policy work for the 86th Legislative Session, the organization and TIP are readying to defend protections in current law and ensure the exemption infrastructure is not weakened. A strong piece of this work includes the Parent’s Right to Know legislation that would allow parents to be informed of exemption rates at their local school campuses. Right now, all schools are required to gather data on vaccinations and exceptions, but DSHS aggregates and releases the data at the district level. The Parents Right to Know legislation would allow the data to be shared at the local school level and allow parents to make timely decisions as the safety and wellness of their children.

This internship experience with Methodist Healthcare Miniistries has helped me become a stronger vocal public health advocate and I strongly urge the community to learn about the benefits of vaccinating our families to prevent diseases, disabilities and cancer. Vaccinations protect our public’s health by preventing outbreaks and resurgence of diseases that have not been around in many years. I challenge you to be an advocate for promoting the importance of routine immunizations and to join me in not only protecting our loved ones, but entire communities.

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Preparing the Next Generation of Healthcare Professionals

DW Admin on February 18, 2019

Abigail, an 11thgrade student at East Central Independent School District (ECISD), in San Antonio, isn’t shy about sharing her dreams for the future, especially when it comes to a career in healthcare.

“I want to become an obstetrician-gynecologist (OB-GYN) someday,” she said. “I believe I could reach that goal, especially after my experience at Methodist Healthcare Ministries.”

Abigail, 17, was among 22 other high school students from East Central ISD who participated in the school district’s Clinical Medical Assistant (CMA) rotations program, in partnership with Methodist Healthcare Ministries. The students rotated through 11 different departments at Methodist Healthcare Ministries’ Dixon Health & Wellness Center, located on 4212 E. Southcross, which is near where most of the students live and attend school.

“I’ve learned a lot during the program and even got to interact with patients,” said Abigail. “The rotations have helped me grow and confirm my interest in becoming a medical doctor. That’s what I’m passionate about.”

The students got to see healthcare in action as they rotated through services including dental, pharmacy, social work, medicine, physical therapy, lab, behavioral health, patient registration and administration. Students were also exposed to the high quality of care provided to the least served in the community by Methodist Healthcare Ministries, as well as inspired by the organization’s mission: “Serving Humanity to Honor God.”

“It was an eye-opener for me. I had no idea there was care like this for people who do not have access to healthcare. It’s great to see the care these patients receive,” said Anastacia, an 11thgrade student at East Central ISD. “I was also able to get a better picture of what I’m learning in my school books. Reading about it is one thing but to actually experience it, makes it real.”

It was the first time Methodist Healthcare Ministries participated in East Central ISD’s new program and it has proven to be a success.

“We’re glad they approached us to be part of this course because it’s the perfect match,” said Oanh Maroney-Omitade, vice president of clinical operations at Methodist Healthcare Ministries. “It’s great to be able to give these students a closer look at healthcare in action and to expose them to a caring and compassionate profession.”

Dolapo Sokunbi, a clinical administrator at Methodist Healthcare Ministries, said having the students rotate through the different departments has helped guide them in choosing their profession. “The students got to interact with our patients and learned how to meet their medical needs which includes physical, mental, emotional and spiritual care,” said Sokunbi. And, our team members were able to share their knowledge and experience with the students as well.”

Sokunbi said students were also able to take vital signs, assist with x-rays and lab work, as part of their experience and the program is designed to help students become better prepared for their CMA test this summer.

Marcus, a senior at East Central ISD, said the program boosted his confidence. “The program really helped me improve my confidence level. I gained confidence in my own abilities to learn about healthcare. It’s been a great experience for me.”

Anastasia agrees. She said the program has helped her become a better communicator, as well as inspired her to pursue a career in nursing. “I want to become a registered neonatal nurse. I really love working with people.”

“Our goal is to provide each student with the tools they need to move forward in their future careers,” said Brit Peek, manager of human resources at Methodist Healthcare Ministries. “We are so proud of these students for demonstrating a true passion for those in need of medical care in our community. We wish them the best as they continue their education.”

Peek said once students have passed their exam, they will become certified clinical medical assistants and qualified to apply for a CMA position anywhere they wish.

Maroney-Omitade said Methodist Healthcare Ministries hopes to continue equipping youths who are exploring a career in healthcare through the CMA training program at East Central ISD. But most importantly, she hopes each student takes what they learned and applies it, no matter where they decide to work.

Methodist Healthcare Ministries’ is dedicated to supporting initiatives designed to address the shortage of healthcare professionals in our communities. In 2018, we awarded $3.1M in grants to funded partners such as the Alamo Colleges District, UT Health San Antonio, and Texas A&M International University to support their efforts to address Texas’ healthcare workforce. Our Policy & Advocacy team also identified improving Texas’ healthcare workforce as one of the four key public policy priorities for the 86thTexas Legislative Session. Across the organization, we actively promote opportunities to improve the healthcare workforce that provides care for the least served in the community. To learn more, visit online at mhm.org.

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Legislative Update, February 15

DW Admin on February 15, 2019

Legislative Updates

Upcoming Meetings & Events

View our 2019 Legislative Agenda

Advocacy

Bill Tracking

Research

 

___________________________________________________________________________________________

Legislative Updates

Methodist Healthcare Ministries Leads Healthcare Visits for San Antonio Chambers’ Annual SA to DC trip

Dr. Penn Wickersham and Jaime Wesolowski meet with United States Navy Vice Admiral Raquel Bono in Washington, D.C. February 5th, 2019

Methodist Healthcare Ministries traveled to Washington, D.C. this past week with more than 180 members of San Antonio’s local business chambers to advocate for health coverage and graduate medical education funding, among other key issues impacting San Antonio businesses and local government organizations. Dr. Pendleton Wickersham, board member and Chair of the Methodist Healthcare Ministries’ Policy subcommittee, and Jaime Wesolowski, president and CEO of Methodist Healthcare Ministries were joined by MHM’s Department of Policy & Advocacy staff as they met with members of the Bexar County congressional delegation and Senate Finance Committee staff to share concerns with the lack of affordable health coverage for low-income families and the need for funded graduate medical education residency training slots. The group also expressed its gratitude to congressional leaders for federal funding for substance use treatment that has recently been awarded to Bexar County mental health providers.

The San Antonio delegation had the opportunity to hear from House Speaker Nancy Pelosi (D-San Francisco), House Minority Leader Kevin McCarthy (R-Bakersfield) and several San Antonio congressmen on critical healthcare and immigration issues affecting our country. Speaker Pelosi acknowledged the high cost of prescription drugs, stating that finding solutions to reduce these costs is a high priority for House leadership. Congressman Lloyd Doggett (D-San Antonio) expressed the need to increase funding to train healthcare personnel, noting Texas ranks 41st in the nation for physician to population ratio. He discussed his efforts to find bipartisan support to correct deficiencies within the Affordable Care Act, and protect key provisions that have served families well, such as covering individuals with pre-existing conditions.

The four-day trip to the nation’s Capitol by the large San Antonio delegation provided opportunities for key discussions and potential public/private collaborative opportunities. Methodist Healthcare Ministries staff has also been selected to lead chamber healthcare advocates for the upcoming Viva San Antonio Chamber Day at the Capitol coming up on March 5.

Governor Greg Abbott Prioritizes Mental Health

Texas Governor Greg Abbott focused on issues impacting mental health in schools in his State of the State Address this past Tuesday, setting the tone for his priority issues this legislative session. In his address to both chambers of the Legislature, the governor declared Senate Bill 10 by Senator Nelson (R- Flower Mound) an emergency item, which would allow academic institutions to collaborate on statewide mental health needs and increase access to behavioral health services for students.

Governor Abbott’s emergency designation allows legislators to take action on bills deemed a priority within the first 60 days. His other emergency items include school finance, property tax reform, school safety and disaster response. While it was not termed an emergency item, Governor Abbott also urged lawmakers to provide more mental health resources for veterans. As part of its 86th Legislative Agenda, Methodist Healthcare Ministries supports initiatives such as Senate Bill 10 to build upon mental health services for children and promote collaboration among medical schools that will address the mental health workforce shortage in Texas, especially in rural and underserved areas.

Senate Finance Committee Evaluates State Healthcare Funding

The Texas Senate Finance Committee met last week to discuss the current healthcare funding needs for Texas’ neediest residents. Dr. Courtney Phillips, Executive Commissioner of the Texas Health and Human Services Commission (HHSC) noted how 81 percent of the agency’s appropriations were spent on client services within the state’s Medicaid program. Newly elected Senator Pete Flores (R-San Antonio) took the opportunity to voice his support for state funding for the reconstruction of a new San Antonio State Hospital (SASH) facility and the addition of beds to address the current waitlist for services.

Several healthcare advocates testified on the significance of adequate funding for state services. Children’s advocacy organizations pointed to recent studies that indicated an increase in the number of uninsured children, a sobering concern, given that Texas already leads the nation with the highest percentage of uninsured children. They also asked senators to support Medicaid funding that would allow children to have 12 months of continuous coverage, a legislative priority for Methodist Healthcare Ministries. Several testimonies recommended funding for behavioral health services and women’s health services. Methodist Healthcare Ministries will continue to advocate for sufficient funding for the state’s healthcare services and its impact on our communities.

Texas Lawmaker Files Bill to Address Adverse Childhood Experiences

Representative Tan Parker (R-Flower Mound) filed HB 822 which would develop a five-year strategic plan to prevent and address Adverse Childhood Experiences (ACEs). The multiagency effort would include strategies to train and educate professionals on how to assess and treat ACEs, provide trauma-informed practices and develop parental support programs.

Representative Parker invited San Antonio community members, Christine Bryan, VP of Information Technology and Public Policy at Clarity Child Guidance Center, and Dr. Colleen Bridger, Director of San Antonio Metropolitan Health District, to take part in a stakeholder roundtable and provide recommendations on key provisions of the bill. The input will be used to develop a committee substitute once the bill secures a hearing. Mitigating the effects of ACEs is a priority for San Antonio children’s advocates, including Methodist Healthcare Ministries. In 2018, there were over 11,000 domestic violence cases in San Antonio alone.

House Appropriations Committee Receives Update on State Mental Health Hospitals

Mike Maples, Deputy Executive Commissioner of Health & Specialty Care System at Health and Human Services Commission (HHSC), provided an update to the House Appropriations Committee about decreasing the waitlist for mental health services in Texas through reconstruction of state inpatient mental health facilities, including San Antonio State Hospital. Mr. Maples noted that the Legislature would need to appropriate $323 million to reconstruct the 300-bed facility on the southside of San Antonio.

Texas inpatient mental health facilities have a high number of medically complex patients who need more structure than community services, but not as significant as state hospitals. The state lacks step-down or transitional options for these patients, which increases their length of stay and ties up capacity at state hospitals. HHSC is developing tiered residential transition options for these patients, as well as revising statutes related to forensic admissions in order to reduce the waitlists for the hospitals. Additionally, Mr. Maples expressed the need to fully fund HHSC’s exceptional item to increase salary for hospital staff $350 by position, which is vital for operation. During the 86th Legislative Session, Methodist Healthcare Ministries will educate lawmakers on the importance of full funding of San Antonio State Hospital and support transition services and salary increases at state hospitals.

Upcoming Meetings & Events

Feb 19: House Appropriations Subcommittee Article III Hearing – GME Funding (Austin)

Feb 19: House Appropriations Subcommittee Article III Hearing – Medical Institutions (Austin)

Feb 21-22: THA 2019 Annual Conference and Expo (Austin)

Mar 30: SASH Spring Thing 5K (San Antonio)

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Legislative Update, February 1

DW Admin on February 1, 2019

Legislative Updates

Upcoming Meetings & Events

View our 2019 Legislative Agenda

Advocacy

Bill Tracking

Research

 

___________________________________________________________________________________________

Legislative Updates

Methodist Healthcare Ministries Hosts Capitol Staff Lunch & Learn on SASH Redesign Project

This past Friday, Methodist Healthcare Ministries hosted a luncheon for Capitol staff members to share the latest information on the San Antonio State Hospital planning project, including the release of the final report, and efforts to secure an estimated $300 million for the construction of a new facility this session. 

Joining the Ministries to present an overview of the work done by the SASH Redesign Executive Committee were Clarity Child Guidance Center, The Center for Health Care Services and Meadows Mental Health Policy Institute. In 2017, Texas lawmakers implemented a three-phased approach to modernize state inpatient mental health facilities and allocate sufficient funding for the eventual construction of a new San Antonio State Hospital, all efforts to reduce chronic waitlists for beds and improve access to behavioral health services in SASH’s 54 county catchment area. The 2018 SASH final report was shared with legislative offices whose districts rely on services from the state hospital and includes feedback from the nine Local Mental Health Authorities on how SASH’s delivery system could be redesigned to serve the needs of their communities. 

This session, the Senate has currently identified $300 million for state hospital construction in its initial budget. Design plans recently released by the Texas Health and Human Services Commission estimate roughly $323 million would be needed for the reconstruction of a 296-bed psychiatric facility in San Antonio. The House’s preliminary budget does not currently include funds for state hospital construction, however Representative John Zerwas (R-Richmond), who chairs the House budget committee, noted in his opening comments this week that it is an important issue for members and will likely address in upcoming hearings. Securing the necessary funds for a new SASH facility is a top priority for Methodist Healthcare Ministries this session. Members of Policy & Advocacy team are meeting with legislators and their staff to educate them on its importance and need for full funding of the project. 

United Methodist Women meet in Austin to Advocate for Child and Maternal Health

Over 180 United Methodist women visited Texas lawmakers this week to educate them on policies that are needed to increase access to health insurance for women and children. The 2019 Legislative Event was held in Austin this week and sponsored by Methodist Healthcare Ministries.

Attendees learned about several initiatives related to healthcare coverage during a panel session with Patrick Bresette, Executive Director of Children’s Defense Fund Texas, and Representative Shawn Thierry (D-Houston), who explained how lack of access to quality healthcare can negatively impact a person’s well-being. They highlighted bills that would expand medical assistance for children and postpartum women, such as HB 342 by Representative Philip Cortez (D-San Antonio) that would authorize 12-month continuous eligibility for children’s Medicaid and HB 411 by Representative Thierry that proposed to extend Medicaid for postpartum women from 60 days to 12 months.

Methodist Healthcare Ministries strongly supports policy solutions, such as HB 342 and HB 411, which extend health coverage for women and children, therefore reducing maternal mortality and the high uninsured rate of children in Texas.

Methodist Healthcare Ministries Raises Awareness For Cardiovascular Health

On Wednesday, Methodist Healthcare Ministries joined the American Heart Association in promoting policies to improve cardiovascular health. Heart advocates urged legislators to support HB 749, more commonly known as Tobacco 21, by Representative John Zerwas (R-Richmond) to raise the minimum legal sale age of all tobacco products from 18 to 21. The group also educated lawmakers on policies that would update minimum standards for nutrition and fitness in daycare centers, ensure basic consumer protections for short-term health insurance plans and create a statewide pilot program that would double SNAP beneficiaries’ purchasing power for fresh produce. As part of its 2019 Legislative Agenda, Methodist Healthcare Ministries supports the American Heart Association’s policies that improve cardiovascular health through tougher tobacco laws, updated nutrition standards for daycares and incentivizing SNAP recipients to make healthier choices. 

Cancer Action Network Requests Sustainable Funding for CPRIT

Methodist Healthcare Ministries has joined the American Cancer Society Cancer Action Network (ACS CAN) in efforts to secure sustainable funding for the Cancer Prevention and Research Institute of Texas (CPRIT). HB 39 and HJR 12 by Representative John Zerwas (R-Richmond) authorize public approval of $3 billion in bonds in the state’s next general election and remove the Institute’s restriction to award new grants for 2023 and beyond. 

To date, CPRIT has invested $2.17 billion in cancer research, product development and prevention to enhance Texas’ competitive edge in the global fight against cancer. Without funding reauthorization, the state would lose access to prevention services especially those in rural and medically under-served areas. As a member of ACS CAN, Methodist Healthcare Ministries supports HB 39 and HJR 12 to ensure Texas remains a leader in the fight against cancer.

Healthcare in Rural Texas At Risk

A report conducted last year by the Episcopal Health Foundation and Texas A&M Rural and Community Health Initiatives reveals healthcare challenges in rural communities in the state. Out of the 254 counties in Texas, 35 counties lack physicians and 185 counties do not have access to a psychiatrist. Adding to these concerns is the closing of more than 20 hospitals in Texas, due to financial issues and lack of leadership recruitment.

Healthcare advocates propose the need to create innovative solutions, connecting telehealth and new types of healthcare workers with potential partnerships and healthcare delivery tools. HB 870 by Representative Price (R-Amarillo) requires managed care organizations to reimburse for telemedicine or telehealth services. In 2017, Methodist Healthcare Ministries supported legislation that expanded and funded telehealth programs and services, especially for rural counties, and will continue to support these policy changes this session. 

House Appropriations Committee Initiates Budget Review Hearings

The House Appropriations Committee began hearings this week to review their proposed budget, HB 1, as filed, with the Legislative Budget Board (LBB). The LBB provided an overview of Medicaid, statewide behavioral health services, child protective services, Hurricane Harvey’s fiscal impact on state agencies and state debt, among other priority issues. Representative John Zerwas (R-Richmond) reiterated that there is an overall increase of Medicaid funds due to higher matching rate from the federal government, easing state demand on the program.

The House budget allocates $7.48 billion in behavioral health services across 23 agencies, including $1.3 billion for community mental health services and $435.7 million for substance use services. Mental health services also received support via the Texas Education Agency through $12 million in state funds for Mental Health First Aid training, telemedicine, trauma-informed care, coordination of access to mental health providers and positive school culture programs. Securing adequate funding for mental health programs and services is a top priority for Methodist Healthcare Ministries this session.

 

Upcoming Meetings & Events

Feb 4: Texas School Health Advisory Committee Meeting (Austin)

Feb 4: House Appropriations Committee Hearing: School Safety (Austin)

Feb 5: Senate Finance Committee Hearing: Article II – Health and Human Services (Austin)

Feb 5: Policy Council for Children and Families (Austin)

Feb 5: House Appropriations Committee Hearing: Correctional Managed Health Care and School Safety (Austin)

Feb 6: Senate Finance Committee Hearing: Article II – Health and Human Services Public Testimony (Austin)

Feb 6: House Appropriations Committee Hearing: Medicaid, HHSC Contracting, State Hospitals and CPS (Austin)

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

Feb 7: Texans Care for Children: Providing Kids a Healthy Start (Austin)

Feb 7: Texas Tribune: A Conversation With New Democratic Members of the Texas House (Austin)

Feb 7: Hospital Payment Advisory Committee (Austin)

Feb 11: Senate Finance Committee Hearing: Article III – Public Education (Austin)

Feb 12: Senate Finance Committee Hearing: Article III – Higher Education (Austin)

Feb 13: Senate Finance Committee Hearing: Article III – Higher Education (Austin)

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Legislative Update, January 25th

DW Admin on January 25, 2019

Legislative Updates

Upcoming Meetings & Events

View our 2019 Legislative Agenda

Advocacy

Bill Tracking

Research

 

___________________________________________________________________________________________

Legislative Updates

Speaker Bonnen Appoints House Committees

Texas House Speaker Dennis Bonnen (R-Angleton) released House Committee assignments for the 86th Legislative Session this week, appointing new leadership to oversee the lower chamber’s 34 powerful committees. While Speaker Bonnen retained Representative John Zerwas (R-Richmond) to chair the Appropriations Committee, he selected Representative Senfronia Thompson (D-Houston) as the new Chair of the Public Health Committee and Representative James Frank (R-Wichita Falls) to lead the Human Services Committee for the first time. Former Public Health Chairman, Representative Four Price (R-Amarillo) was awarded with the Chair of the powerful House Calendars Committee, which controls the bills that are formally considered on the House floor. The session will begin to pick up the pace now as legislation begins to be referred to the respective committees for discussion over the next two weeks. 

Senate Finance Committee Kicks Off Budget Hearings

The Texas Senate Finance Committee did not waste any time to start its review of the proposed budget, scheduling hearings to take testimony on all state agencies over the next three weeks. On Tuesday, the committee held its first meeting to outline the hearings schedule and review the projected state revenue estimates from Texas Comptroller Glen Hegar. Comptroller Hegar warned senators to remain cautiously optimistic about the state’s growth rate over the coming year, due to the fluctuation in oil prices and sales tax revenue.

During the hearing, Chair Nelson (R-Flower Mound) addressed critical funding issues related to school safety and state hospitals, as well as the Medicaid shortfall and Hurricane Harvey expenses in her supplemental bill, Senate Bill 500. The bill, as filed, includes $300 million for state hospital construction through the Economic Stabilization Fund and $2.1 billion in state funds to cover the Medicaid shortfall. Methodist Healthcare Ministries’ legislative priorities include securing sufficient funding for the construction of a new San Antonio State Hospital and programs that will increase access to healthcare services for our communities.

Federal Court Rules Against Planned Parenthood in Texas

A federal appeals court has lifted the order that blocked Texas from excluding Planned Parenthood out of the Women’s Health Program. In February 2017, U.S. District Judge Sam Sparks ruled the state could not block Planned Parenthood from the federal-state insurance program, after edited videos were publicly released claiming the organization had sold fetal tissue for profit. The order by the 5th U.S. Circuit Court of Appeals declared Judge Sparks had used the wrong standard by not considering the findings of the Texas Office of Inspector General, the agency that initially made the decision to terminate state contracts with Planned Parenthood.

In 2016, Planned Parenthood received $3.5 million in reimbursements for providing contraceptives and women’s preventive healthcare services to 70,000 low-income Texans. Organization officials state the federal appeals court’s decision threatens the healthcare of Texas’ most vulnerable patients, noting the decline in access to women’s health services will put their health in jeopardy. Attorney General Ken Paxton, whose office fought the case against Judge Sparks, defended the order in court and was confident the state would prevail when the case returns to the U.S. District Court. Methodist Healthcare Ministries is monitoring the case throughout the legal process, noting its importance to provide access to quality women’s healthcare services.

Texas’ ACA Enrollment Drops 3.6 Percent

Texas’ 2019 enrollment in the Affordable Care Act’s health insurance plans dropped 3.6 percent from last year’s enrollment period. An estimated 1.09 million Texans signed up through the federal marketplace during the open enrollment period, compared to 1.13 million people who enrolled last year. On a national level, marketplace enrollment decreased by 4 percent.

Several advocates expressed concern that contradicting messages and funding cuts prevented consumers from signing up for health insurance. The federal administration significantly reduced funding for the marketplace and enrollment outreach support two years in a row. Moreover, lawsuits and attempts by Congress to repeal the Affordable Care Act worked to confuse consumers about the fate of the law. Methodist Healthcare Ministries provided funding for ads and marketing this past enrollment period to ensure consumers were aware of the available health plan coverage for eligible families. 

State Agencies Launch Opioid Education Website

The Office of the Texas Attorney General, the Texas Health and Human Services Commission, and the Texas Department of State Health Services launched a comprehensive website, Dose of Reality, this week to educate individuals about the dangers of misusing prescription drugs. Dose of Reality informs the public about opioid-related resources and approaches to prevent substance use. The website also provides details on proper pain management, safe storage, guidelines on responding to an overdose and a statewide map of safe disposal locations.

In 2017, 464,000 Texans abused illicit drugs, including nearly 3,000 people who died due to drug overdose. Drug overdose is also the leading cause of maternal deaths. The abuse of prescription drugs costs lives, devastates families and is a public safety concern throughout the state. As part of its 86th Legislative Agenda, Methodist Healthcare Ministries supports state and local efforts to reduce opioid misuse through public policies that increase access and awareness to substance use treatment. 

Upcoming Meetings & Events

Jan 27-29: United Methodist Women Legislative Event 2019 (Austin)

Jan 28: HHSC Community Conversations on Peer Support (San Antonio)

Jan 28: Senate Finance Committee Hearing: Article V – Public Safety and Criminal Justice (Austin) 

Jan 28: House Appropriations Committee Hearing: Overview of Budget (Austin)

Jan 30: House Appropriations Committee Hearing: Healthcare (Austin)

Jan 31: Texans Care for Children: Keeping Kids Safe & Helping Them Succeed (Austin)

Jan 31: CPPP Legislative Briefing: State Budget (Austin)

Feb 5: Senate Finance Committee Hearing: Article II – Health and Human Services(Austin)

Feb 6: Senate Finance Committee Hearing: Article II – Health and Human Services Public Testimony (Austin)

Feb 7: Texans Care for Children: Providing Kids a Healthy Start (Austin)

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Key Strategies to Pursue Health Equity

DW Admin on January 22, 2019

Systems change efforts sometimes grapple with a tension between: a) urgency to address brokenness that continues to do harm, and b) patience to gather enough resources and the right leaders to be effective and successful. Strategies to reduce health disparities and promote health equity can address both sides of this tension.

No one has a greater sense of urgency to improve health outcomes than those who are directly impacted by health disparities. Participatory designs in which marginalized communities identify their own health challenges, help design interventions, and assist in assessing the success of those interventions benefit from the urgency of and accountability provided by their participants.

Along those same lines, urgency is enhanced in coalitions and collective impact initiatives when non-professional community members are clearly and deeply involved in decision-making processes and equity is established as a primary goal from the outset.

The chart below from the Centers for Disease Control and Prevention (CDC) is a helpful tool to assess community participation and involvement. As work shifts more to the right, stronger partnerships and more ambitious outcomes become possible – equity becomes not only an end, but also a means to that same end.

(Source: American Association of American Medical Colleges) 

Practical recommendation 1: Abide by the phrase “with, not for” – do things with the people you are serving, not for them

On the other hand, a long-term approach (patience) is strengthened by perpetual efforts to build trust and deepen relationships, not only to generate resources (i.e., sustainable funding) but also to identify and develop leaders from and within marginalized communities. For example, training and hiring community members as promotores de salud (community health workers) increases leadership capacity and enhances collective efficacy. Similarly, organizations can implement programs providing training and real opportunities for patients and community members to exercise leadership in the promotion of community health.

Developing long-term community leadership for health equity – whether through community-based organizations, churches, or other associations – means that leaders rooted in the community will be prepared and in place when the time is right to move into action. Outside (or even inside) professionals should never be the first, last, and only line of defense!

Practical recommendation 2: Working towards health equity includes ensuring the people you serve have the resources and abilities necessary to continue the work – how you can develop leadership and capacity among the people you serve? How can you strengthen the human assets of the community?

As we strive for the highest level of health for all people, let us remember that this is everyone’s business. As a society, health equity is in our best interest socially and economically; for Methodist Healthcare Ministries, it is also a moral and theological imperative as we provide leadership to improve the wellness of the least served.

Tim Barr is the Collective Impact Strategy Manager for Methodist Healthcare Ministries. He supports, develops, and facilitates collaborative efforts in South Texas. Tim is also a member of the Climate Equity workgroup for the City of San Antonio’s Climate Action and Adaptation Plan.

To see part 1 of this blog series, click here.

To see part 2 of this blog series, click here.​

 

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Here’s to Your Health!

DW Admin on January 14, 2019

By now, you’ve probably seen and heard plenty of advertisements on how to get fit in 2019. For many, it’s a goal set at the start of the new year. However, making too many resolutions can be overwhelming which is why some folks often break them early on, said Dr. Edward Dick, senior vice president of Integrated Health Services at Methodist Healthcare Ministries.

“Some people make too many resolutions to improve their health. Try to make no more than three resolutions or goals, then identify why you’re setting those goals,” said Dr. Dick. “Consider starting with short-term goals. This will help maintain them. Longer-term goals can follow the quick win-wins.”

Dr. Dick said goals need to be attainable, measurable, and should always include grace along the way. And, as people try to reach their goals to shed extra pounds this year, Dr. Dick said to make sure to have a practical plan in place.

“The important thing is to keep moving by walking or doing some form of physical exercise. Walking is actually underrated but it’s extremely valuable.” He said walking is a highly effective form of physical activity and can help you reach your goal to lose weight, not to mention being inexpensive.

Here are some valuable tips, provided by Dr. Dick, to help jump-start your way to a healthier 2019:

  • Draft a plan with reasonable health goals. You may want to include an accountability buddy to help motivate and encourage you.
  • Start exercising. Consider walking and taking the stairs, if you can. Exercising can help maintain a healthy weight and fight against diseases like type 2 diabetes and heart disease.
  • Eat smarter by including more fruits and vegetables in your daily dishes. The fiber in many fruits and vegetables can help reduce the risk of high blood pressure, heart disease and stroke.
  • Drink more water and less sugary drinks. Water will help keep you hydrated, energized, focused and balances blood sugar.
  • Get a good night’s sleep. Establish a regular bed time and adopt simple steps for promoting good sleep. You can visit sleepfoundation.org for a list of tips for improving sleep and treating insomnia.
  • Consider joining a support group to help build mind, body and spiritual health.
  • Consult your doctor if you have chronic or serious medical conditions that might worsen with unsupervised exercise. And as always, consult your medical professional for any questions before starting your fitness plan.

Dr. Dick said if you lose momentum, don’t quit. Give yourself grace and start again. “It’s important to live in grace and not give up. We were designed by God to stay active. It’s good for us—­­­­physically, mentally and spiritually.”

He said as you go out and reach your goals to get healthier this year, keep in mind that moderation, watered with grace is the key! Happy New Year!

Methodist Healthcare Ministries is dedicated to creating access to healthcare for the uninsured through direct services, community partnerships and strategic grant-making in 74 counties across South Texas. Guided by its mission of "Serving Humanity to Honor God," the organization’s vision is to be the leader for improving wellness of the least served. The mission also includes Methodist Healthcare Ministries' one-half ownership of the Methodist Healthcare System, the largest healthcare system in South Texas, which creates a unique avenue to ensure that it continues to be a benefit to the community by providing quality care to all and charitable care when needed. For more information, visit www.mhm.org. 

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Legislative Update, January 7th

DW Admin on January 4, 2019

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With days to go before the start of the 86th 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

Upcoming Meetings & Events

View our 2017 Legislative Agenda

Advocacy

Research

 

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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 86th 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 86th 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 86th 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 85th 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:  86th 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)

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Hope wrapped in a Christmas tree

DW Admin on December 21, 2018

Tears of joy rolled down Maria’s face, as she touched one of the glittery ornaments on her new Christmas tree. Maria, a client at Methodist Healthcare Ministries’ Wesley Health & Wellness Center, is one of the sixty-five individuals and families who received a beautifully decorated tree at Methodist Healthcare Ministries Annual Christmas tree giveaway event on Dec. 14.

“It’s been a hard year and I know we’re not supposed to lose hope. I had lost the spirit of Christmas,” said Maria. “Just seeing the Christmas tree decorated has helped give me hope. I know that God provides. It’s a gift.”

For the past six years, Methodist Healthcare Ministries has partnered with Methodist Healthcare System for this event. This year, Methodist Hospital and Methodist Children's Hospital decorated dozens of 6-foot Christmas trees with fun and sparkly ornaments and displayed them at the beginning of the holiday season. After hospital patients had the chance to enjoy them, the trees were packed up and shipped to Methodist Healthcare Ministries’ Wesley Health & Wellness Center, where they were displayed in a winter wonderland themed setting.

“It’s very emotional and overwhelming to see the faces of our clients, as they are given a Christmas tree. I feel blessed that we can do this for them,” said Margie Rodriguez, one of the family wellness program specialists with Methodist Healthcare Ministries. “It means a lot to them because these families would not have a Christmas tree in their home if we didn’t give them one. It’s a wonderful feeling.”

Helen Rodriguez, a volunteer at Methodist Healthcare Ministries’ Wesley Health & Wellness Center, agrees. “It feels so good to be able to give to others when they need it,” she said. “That’s what I love about this place. Everyone is so giving and caring. And, people need to feel supported.”

Methodist Healthcare Ministries’ Wesley Café also served hot chocolate, cookies, and filled the room with holiday music to help make the day extra special for the least served in our community.

In addition, San Antonio Spurs guard Marco Belinelli and the Spurs Coyote, stopped by to help spread some extra holiday cheer, as well as pose with families for photos.

“I feel very blessed today and I’m very grateful to those who donated these beautiful trees. They are so beautiful. I love mine,” smiled Maria, as she prepared to take her tree home.

CLICK HERE to see Christmas tree giveaway event.

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Moving from Abstract to Concrete: Health Disparities = Indicators of Health Inequity

DW Admin on December 21, 2018

Since the first Europeans set foot in the Americas, racism has been a defining factor in the health and well-being of people inhabiting this land. As long as some people continue to benefit from a conscious or subconscious belief that they are superior to others because of their race, racism will continue to benefit some groups and disadvantage others. Despite significant progress toward civil rights, research consistently identifies significant racial health disparities in the United States, including life expectancy, diabetes, and depression.

Practical recommendation 1: Be aware of your own implicit bias – take a quick implicit association test from Harvard University (click “Go” to enter Project Implicit Social Attitudes as a guest, and after reading/agreeing to the preliminary information, select “Race IAT”)

In respect to healthcare services, one of the ways in which racism continues to contribute to health disparities is through the implicit bias of providers. This includes both the courses of treatment that are recommended (for example, the likelihood of receiving a limb amputation for peripheral arterial disease: African-American patients are 77% more likely to have the limb amputated compared to White patients) as well as how those recommendations are communicated. Lower levels of patient trust and perceptions that care is not patient-centered are both tied to lower levels of patient adherence and ultimately, poorer health.

Specific to South Texas, a recent study in the Rio Grande Valley found significantly higher rates of children with post-traumatic stress disorder (PTSD) regardless of immigration status – almost 1 in 5, compared to 1 in 20 in the US – raising questions about implicit bias along the border and its impact on child and family health.

Practical recommendation 2: When feeling stressed, slow down and become aware of yourself (practice mindfulness) – we are more likely to communicate poorly and erode trust with patients when we are rushed and not balanced

There is a growing body of research into the ways in which experiences of racial discrimination are linked to decreased mental health, lowered life expectancy, and increased likelihood to smoke or use drugs. Not surprisingly, research also shows that Latinx and African-American individuals are more likely to experience adverse childhood experiences, which are also clearly tied to poorer health outcomes. As illustrated by the “Pair of Aces” image below, many adverse childhood experiences are rooted in adverse community environments, which include poor housing quality, lack of social mobility, and poverty.

In truth, many health disparities are intersectional, meaning that those who are disadvantaged tend to be impacted by more than one form of social inequity. To attain equity, the health impacts of gender, classism, and material poverty must be addressed in addition to racism.

Practical recommendation 3: Use a mapping tool to learn about your community’s health disparities; for example, check out PolicyMap.

Focusing on income, research reveals clear disparities: a consistent gradient of decreasing health status for adults with lower income levels along a variety of indicators, including life expectancy, coronary heart disease, and limited activity due to chronic disease. Individuals with lower levels of income are less likely to have a college degree or attend graduate school, and research shows a clear gradient of decreasing health status for lower levels of education indicated through infant mortality, self-reported health status, and obesity. Furthermore, economically disadvantaged individuals are more likely to be inactive and less likely to use leisure time for physical activity, which has been linked to lower perceptions of control over time and safety.

As you examine data about your patients and the larger community, what does the data reveal about health disparities? How do those revelations inform your work? In our next post, we turn to strategies to support our efforts to build greater health equity.

Tim Barr is the Collective Impact Strategy Manager for Methodist Healthcare Ministries. He supports, develops, and facilitates collaborative efforts in South Texas. Tim is also a member of the Climate Equity workgroup for the City of San Antonio’s Climate Action and Adaptation Plan.

To see part 1 of this blog series, click here.

To see part 3 of this blog series, click here.

References

Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuk, E. (2010). Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us. American Journal of Public Health, 100(S1), S186-S196. doi:10.2105/AJPH.2009.166082

Choi, M. Y., Lichter, D. T., Meara, E., Vargas, C., Gaydosh, L., Harris, K. M., . . . Gilbert, K. (2018, February 23). The Lack of a College Degree is a Public-Health Crisis. Here's What Higher Ed Can Do About It. Chronicle of Higher Education, p. 2.

Guinn, B., Vincent, V., Jorgensen, L., Dugas, D., & Semper, T. (2007). Predicting Physical Activity Among Low-Income Mexican American Women: Application of the Theory of Planned Behavior. American Journal of Health Behavior, 31(2), 115-122.

Human Impact Partners and La Unión Del Pueblo Entero (2018, October). The Effects of Forced Family

Separation in the Rio Grande Valley: A Family Unity, Family Health Research Update. Accessed at https://familyunityfamilyhealth.org/.

Penner, L. A., Blair, I. V., Albrecht, T. L., & Dovidio, J. F. (2014, October). Reducing Racial Health Care Disparities: A Social Psychological Analysis. Policy Insights from the Behavioral and Brain Sciences, 1(1), 204-212. doi:10.1177/2372732214548430

Slopen, N., Shonkoff, J. P., Albert, M. A., Yoshikawa, H., Jacobs, A., Stoltz, R., & Williams, D. R. (2016). Racial Disparities in Child Adversity in the U.S.: Interactons with Family Immigration History and Income. American Journal of Preventive Medicine, 50(1), 47-56. doi: 10.1016/j.amepre.2015.06.013

Williams, D. R., & Mohammed, S. A. (2009, February). Discrimination and racial disparities in health: evidence and needed research. Journal of Behavioral Medicine, 32(1), 20. doi:10.1007/s10865-008-9185-0

Williams, D. R., & Sternthal, M. (2010). Understanding racial-ethnic disparities in health: sociological

contributions. Journal of health and social behavior, 51 Suppl(Suppl), S15-27.

doi:10.1177/0022146510383838

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Legislative Update, December 14th

DW Admin on December 14, 2018

With less than a month to go before the start of the 86th 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 will provide regular updates on filed bills, hearings, and votes taken on issues impacting the health of our families.

Interim Updates

Upcoming Meetings & Events

Health Care Policy News

Action Center

View our 2017 Legislative Agenda

Advocacy

Research

 

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Interim Updates

Bill Filing for 86th Legislative Session Begins

Texas’ 86th Legislative Session does not officially start until Tuesday, January 8, 2019, but lawmakers were able to get a head start on filing legislation as of November 12, 2018. Texas lawmakers filed more than 4,000 bills by the end of the first filing date and some of the filed legislation looks to affect access to healthcare for Texans. House Bill 80, by Linda Ortega (El Paso), would require a report relating to shortages in certain health professions. On the Senate side, Senator Jose Menendez (San Antonio) filed Senate Bill 105 to create a mental health jail diversion and crisis stabilization unit five year pilot program in Bexar County to evaluate, stabilize, and redirect individuals to the most appropriate and least restrictive setting. Methodist Healthcare Ministries is in the process of reviewing legislation impacting the healthcare of all Texans and will provide updates in its weekly newsletter throughout the 86th Legislative Session. Click here to sign up for Legislative Updates. 

State of Texas Children Report Reveals Poverty and Health Risk Among Texas Kids

Methodist Healthcare Ministries and the Center for Public Policy Priorities (CPPP) released the 2018 State of Texas Children report showing that Texas children lag behind their peers across the country in access to health care and educational opportunities. The report lays out the challenges Texas children and families face and offers key policy solutions for state leaders to consider. According to the report, Health insurance rates have improved since the passage of the Affordable Care Act, but 671,000 Texas kids remain uninsured, and significant barriers to health insurance coverage for Hispanic children persist. The report recommended that policymakers protect and expand comprehensive and affordable health insurance coverage for Texas families.

 

The 2018 State of Texas Children report was released at a briefing in San Antonio on November 15. Over 250 advocates, service providers, public officials and concerned Texans attended the event, which also featured a policy discussion with State Representative Diego Bernal, CPPP Legislative and Policy Director Luis Figueroa and journalist Bekah McNeel. At the briefing, several community members supported expanding access to health insurance and family planning services and protecting Medicaid and CHIP from cuts. Jaime Wesolowski, president and CEO at Methodist Healthcare Ministries, addressed the group and reminded the audience that Texas has consistently ranked in the bottom ten states for child well-being. Ensuring that lawmakers have the latest data and policy recommendations for the upcoming legislative session is an important role that s been spearheaded by the Ministries for many years to ensure that Texas kids are on a path to a bright future through policies that improve the conditions of all Texas kids and put them on the road to success.

House Select Committee Combats Opioid and Substance Use Epidemic

In 2016, more than 2,800 Texans died due to a drug overdose. The following year, 90 out of 172 child fatalities involved with the Texas Department of Protective Services were caused by abuse or neglect and involved a parent or caregiver actively using a substance and/or under the influence. This substance use crisis in Texas prompted the Texas House of Representatives’ Speaker Joe Straus to appoint the Select Committee on Opioids and Substance Abuse to provide recommendations to the upcoming 86th Legislative Session for combating the abuse of opioids and other drugs. Over the past 18 months, the Select Committee has reviewed the prevalence and impact of substance use disorders throughout different populations, studied policies and guidelines to monitor and prevent abuse of prescription drugs in state programs, identified the impact of opioids in the healthcare field and examined the impact of substance use disorders in Texas.

In their Interim Report to the 86th Texas Legislature, the Select Committee identified key recommendations to combat the opioid and substance use challenges through prevention, intervention and treatment and recovery efforts. One key finding is to continue the emphasis on integrated care, which provides care for the whole person and does not separate physical health from mental health. Advocates expressed the challenges of siloed care and the lack of ability to charge for varied services in a single visit to a facility on the same date, as opposed to integrated care. The committee also studied the prevalence of substance use disorders in specific populations and supported efforts to establish substance use treatment programs through other health programs for specific populations, such as Medicaid for Pregnant Women and Texas Veterans + Family Alliance Grant Program. They recommended looking into a funding mechanism to improve recovery housing initiatives for families, veterans, homeless and those with mental illnesses. More than 70 recommendations were included in the report to improve prevention practices and education, enhance prescription monitoring, increase supply management/medication disposal programs and expand treatment options for substance use disorders. Methodist Healthcare Ministries monitored the Select Committee hearings throughout the interim and supports the funding of additional substance use programs throughout the state, especially in rural areas.  

Texas Day Care Investigation Reveal Abuse and Neglect 

In a news report released by the Austin American Statesmen this week, investigative reporters found more than 450 children were sexually abused and 88 others died of abuse and neglect in Texas day care facilities in the last decade. The year-long investigation details the dangerous conditions that exist inside many Texas day care sites, leaving hundreds of children with serious injuries since 2007. The Statesman analyzed 40,000 inspection records and found that more than 450 children – almost one a week – suffered sexual abuse inside a day care facility during the past 10 years. Nearly half of the 88 children who died of abuse and neglect were in illegal centers. Reporters insist that state regulators have failed to take the necessary steps to ensure child safety, reduce surveillance of illegal centers or utilize data to identify preventable problems.

After reviewing the report, Texas Governor Greg Abbott and other state legislators pledged to address day care safety during the upcoming legislative session. Senator Judith Zaffirini (Laredo) is proposing a statewide study that would assess whether Texas’ staff-to-child ratios in day care centers lead to a more dangerous child care environment. Senator Kirk Watson (Austin) is looking at ways that the state can reestablish the Department of Family and Protective Services Investigative Unit, which was disbanded in 2017, to shut down illegal day care centers. Methodist Healthcare Ministries will continue to monitor this issue during the 86th Legislative Session and will support legislative recommendations that aim to protect and ensure the safety of Texas children.

HHSC Identifies New Strategies to Increase Quality Care for Family Planning

Texas has the fourth highest birth rate in the United States with more than 400,000 births in 2016. Of those, 52.5% of all state births were funded by the state’s Medicaid program. Data shows that 34.6% of women report their pregnancy was unintended, which can have significant consequences for individual women and their families. Research states that births resulting from unintended or closely spaced pregnancies link to adverse maternal and child health outcomes and numerous social and economic challenges. To address this problem, the Texas Health and Human Services Commission (HHSC) released a Long-Acting Reversible Contraception Strategic Plan that discusses the efficacy and benefits of long-acting reversible contraception (LARC) devices, billing and reimbursement challenges, accomplishments and measures to ensure quality care is provided.

In order to reduce unintended pregnancies and promote better birth outcomes, Texas is working to increase access to LARC devices, which are highly effective for preventing pregnancy and can last for several years. The report outlines several strategies to increase education and access to LARC devices, such as increasing efforts focused on educating women on available services in Texas and identifying best practices for reimbursing immediate postpartum LARC devices. Currently, state reimbursement does not always align with the acquisition cost since Medicaid rates and manufacturer rates are not updated at the same time. In their strategic plan, HHSC has identified improvements that can be made to ensure adequate statewide access. Methodist Healthcare Ministries supports HHSC’s efforts to reduce existing barriers to LARC devices while increasing education and access statewide.

Upcoming Meetings & Events

Dec 19: HHSC Proposed Amendments for Early Childhood Intervention Services Rules (San Antonio)

Jan 8: First Day of 86th Legislative Session (Austin)

Jan 19: State of D19 Senatorial Address with State Senator Pete Flores (San Antonio)

Jan 24: Children’s Health Coverage Coalition Legislative Briefing (Austin)

Health Care Policy News

Children's HealthTexans Care for Children: Report highlights strategies to prevent teen pregnancy in foster care

Access to Care

Kaiser Family Foundation: How Many of the Uninsured Can Purchase a Marketplace Plan for Free?

Houston Chronicle: Both men and women say state must spend more on health care, study says

 

Action Center

 

 

 

 

 

 

 

Source: Out2Enroll

 

 

 

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Jaime Wesoloski

President & Chief Executive Officer

Jaime Wesolowski is the President and Chief Executive Officer at Methodist Healthcare Ministries. A healthcare executive with three decades of leadership experience, Jaime is responsible for the overall governance and direction of Methodist Healthcare Ministries. Jaime earned his Master’s Degree in Healthcare Administration from Xavier University, and his Bachelor’s of Science from Indiana University in Healthcare Administration. As a cancer survivor, Jaime is a staunch supporter of the American Cancer Society. He serves as Chair of the American Cancer Society’s South Texas Area board of directors and he was appointed as Chair to the recently created South Region Advisory Cabinet, covering eight states from Arizona through Alabama. Jaime believes his personal experience as a cancer survivor has given him more defined insight and compassion to the physical, emotional, and spiritual needs of patients and their families.