Tag: Legislative Updates

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In this issue:

State Updates

• 2020 Census Delay May Impact Texas Redistricting
• Bexar County Mental Health and Substance Use Services Receive $3 Million
• TEA Offers Special Education Grant for Students Impacted by Pandemic
• HHSC Extends Emergency SNAP Benefits Through February

Federal Updates

• COVID-19 Special Enrollment Period Begins February 15
• White House Contracts $230M for At-Home Rapid COVID-19 Tests

COVID-19 News

• Current COVID-19 Variants Explained
• COVID-19 Vaccine Allocations for Week 8 of Distribution

Upcoming Hearings

Upcoming Meetings & Events

Advocacy Find your Rep How the Texas Legislature Works In the news Methodist Healthcare Ministries Makes Case for Medicaid Expansion Movement to expand digital connectivity in Texas gains momentum RGV lack of internet connectivity contributes to lowest vaccination rate in the state Brownsville receives $90,000 from partners for broadband access Research The State of Obesity in Texas COVID-19 Dashboard COVID-19 Vaccine Information Texas Case Counts Trends by County

 

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State Updates

2020 Census Delay May Impact Texas Redistricting

The Census Bureau announced that the 2020 Census results will not be released until at least two months after the end of the ongoing 87^th Legislative Session. The Bureau estimates that the data will not be available until after July of this year.

The results of the 2020 Census have been delayed by several months as a result of the COVID-19 pandemic. Last year, census workers faced many challenges posed by the public health crisis, limited resources, and numerous changes in policy from Washington D.C. In most instances, the first set of census data is distributed by December 31 of the census year and the second set by mid-February the following year. The 2020 Census results are expected to reflect large population gains in Texas of over 4.2 million residents since 2010.

The latest census data is crucial to Texas legislators who will be undertaking redistricting during this year’s state legislative session. Redistricting takes place every decade to ensure adequate representation for the state’s population. The 87^thLegislature began on January 12^th and adjourns after 140 days. With the latest census data being delayed well into summer, Texas lawmakers can expect to be called back to the capitol for a special session later in the year to complete redistricting responsibilities. To read more on the issue, click here.

Bexar County Mental Health and Substance Use Services Receives $3 Million

On January 26, the Bexar County Commissioners Court approved $2.2 million in general funds for a contract with the The Center for Health Care Services for the delivery of mental health treatment services for eligible individuals so as to circumvent the criminal justice system. In addition to the CHCS grant allocation, the Commissioner’s Court also approved a $1.4 million contract with San Antonio Lifetime Recovery to finance substance abuse services as part of the county’s Treatment Alternatives to Incarceration Program.

The Center for Health Care Services, in partnership with the Bexar County Mental Health Court, provide services to individuals with mental health needs as an alternative to incarceration. The Center also works to identify and remove individuals who have already been incarcerated and are in need treatment. In the past three years, the Mental Health Court has graduated 110 individuals from the program.

San Antonio Lifetime Recovery is an inpatient treatment center with services ranging from 45 to 90 days. The facility is currently housing 28 individuals who have been diverted from the Bexar County Jail for substance use disorder treatment.

TEA Offers Special Education Grant for Students Impacted by Pandemic

On January 28, the Texas Education Agency released an online application for the Supplementary Special Education Services (SSES) program. The SSES program allows children with cognitive disabilities and complex educational needs to receive a $1,500 online credit to be used within the SSES marketplace.

The program will be accepting the applications of approximately 18,000 students with cognitive disabilities across the state. Qualifying recipients of the one-time $1,500 grant will be able to purchase a broad range of educational resources and services to ensure the continuation of their educational progress despite limitations caused by the ongoing COVID-19 pandemic.

The Texas Education Agency is requesting that school systems across Texas encourage eligible families of K-12 students to complete the online application through the secure portal. Additional program information, resources, and the application can be found here. Any program and related eligibility questions should be directed to the SSES team at ssesinfo@tea.texas.gov.

HHSC Extends Emergency SNAP Benefits Through February

On February 2, the Texas Health and Human Services Commission (HHSC), announced $300 million in emergency Supplemental Nutrition Assistance Program (SNAP) food benefits for the month of February.

In addition to the issuance of $204 million SNAP benefits in January of this year, Governor Greg Abbott and the HHSC have extended the emergency benefits through February. Emergency SNAP benefits have been vital to Texans struggling with hunger which has been exacerbated by the ongoing COVID-19 pandemic. Eligible SNAP recipients will continue to receive the maximum allowable benefit in addition to a 15% increase in their total benefit. These benefits will be distributed to recipients’ accounts by February 28 and will continue monthly until June 2021.

For more information on the Supplemental Nutrition Assistance Program, click here.

Federal Updates

COVID-19 Special Enrollment Period Begins February 15

President Joe Biden issued an Executive Order on January 28 announcing that the U.S. Department of Health and Human Services (HHS) will open a Special Enrollment Period (SEP) in response to the COVID-19 Public Health Emergency. The SEP will give families the opportunity to enroll in 2021 health insurance coverage beginning February 15 and ending May 15, 2021.

HHS stated that during the SEP, individuals who are Marketplace-eligible consumers will be able to apply for new coverage or update an existing application online, by phone, or in person at a direct enrollment site. Residents from states with state-based Marketplaces (SBMs) can find locations to apply for health coverage here. Coverage can be expected to begin within a month after completing an application.

The Centers for Medicare and Medicaid Services will promote awareness and utilization of the SEP through a paid advertising campaign. A direct customer outreach in several languages will also be available to ensure a diverse range of communities are able to take advantage of this opportunity. The Biden Administration has allocated $50 million for SEP outreach and education.

To determine if you are eligible to enroll in the SEP, click here. More information on the Health Insurance Marketplace can be accessed here.

White House Contracts $230M for At-Home Rapid COVID-19 Tests

On February 1, the Biden administration announced a $232 million contract to the Australian-based Ellume for the development of at-home COVID-19 test kits. The United States is currently in the process of developing an American manufacturing facility that is expected to be finalized this summer.

The Biden Administration has arranged for the Australian facility to produce and ship 100,000 kits per month to the United States beginning February and ending in July when the U.S. facility is complete. At full capacity, the U.S facility is projected to produce up to 19 million test kits per month. The test is 95% effective at detecting the SARS-CoV-2 virus in both symptomatic and asymptomatic cases with results being available in as little as 15 minutes. The test is conducted using a self-administered nasal swab and the results are delivered via Bluetooth to any smartphone device.

The introduction of an at-home rapid testing option is expected to aid in reducing the spread of COVID-19. With the ability to test safely at home, health experts are optimistic that this convenient new mode of testing will give the country greater access to fast and accurate COVID-19 test results which is crucial to effectively combatting the virus.

COVID-19 NEWS

Current COVID-19 Variants Explained

The Center for Disease Control and Prevention (CDC) has identified that the coronavirus has mutated to create the B.1.1.7 United Kingdom variant, B1.351 South African variant and the P.1 Brazilian variant. The CDC has expressed that current limited research has not identified the variants to be deadlier. However, they are still more contagious than the original coronavirus strain responsible for the global COVID-19 pandemic.

Variants of the virus are discovered through randomized analysis of COVID-19 test samples submitted by providers. The current process allows for the possibility of some circulating SARS-CoV-2 variants to be missed. Texas is currently only able to break down the virus and observe its structure through a process known as sequencing. This information is then sent to the Utah Public Health Lab for variant identification. The state is currently working on creating its own identification infrastructure.

Scientists have expressed concern about the Brazilian variant due to its ability to spread the fastest of all known variants and has been shown to avoid original COVID-19 antibodies. Research at this time is limited and is not sufficient to make any assumptions on how the virus can impact a vaccinated population. Current COVID-19 vaccines are expected to still offer a level of protection to individuals against these variants.

As the vaccine rollout continues within Texas, health experts have urged the public to continue to take precautions such as undergoing COVID-19 testing, wearing a double mask, and social distance to avoid contracting or spreading the virus and its variants.

COVID-19 Vaccine Allocations for Week 8 of Distribution

The Department of State Health Services (DSHS) published a news releaseannouncing that Texas can expect to receive 520,425 first COVID-19 vaccine doses during Week 8 of vaccine allocations beginning February 1. The Center for Disease Control and Prevention (CDC) was instructed by DSHS to ship these doses to 344 providers, including 82 hub providers across 166 Texas counties. 

Vaccines have been more available now that there is a 30% increase in the number of Moderna vaccines being allocated by the federal government. The Pharmacy Partnership for Long-Term Care Program ordered more vaccines than needed and will be returning roughly 126,750 Pfizer vaccine doses back to the state. DSHS will be allocating these doses to providers who have received allocations less than necessary to satisfy population rates, particularly within the suburban Dallas-Fort Worth and Houston areas. 

Texas is also ordering an additional 188,225 doses reserved as second doses for those who are scheduled to receive their second dose. Individuals are recommended to receive their second dose from the same provider that administered their first dose. Texas has administered roughly 2.2 million doses of the vaccine, in which over 1.75 million people received the first dose and over 410,000 people fully vaccinated. Access more DSHS COVID-19 information here.

Upcoming Hearings

• Posted Agendas for House Committees

• Posted Agendas for Senate Committees

 

Upcoming Meetings & Events

February 10 at 9:00 a.m. – Policy Council for Children and Families (PCCF) Agenda meeting

February 11 at 9:00 a.m. – Medical Care Advisory Committee (MCAC) Agenda meeting

February 11 at 1:00 p.m. – STAR+PLUS Pilot Program Workgroup (SPPPW) Agenda meeting

February 25 at 10:30 a.m. – State Medicaid Managed Care Advisory Committee Clinical Oversight and Administrative Simplification Subcommittee (SMMCAC) Agenda meeting

 

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

State Updates

• State Urging Faster Distribution of COVID-19 Vaccines
• Texas "Vaccination Hubs" Created to Distribute COVID-19 Vaccines
• The Texas 87th Legislative Session Reconvenes on January 12th
• Bills Filed Would Create State Health Literacy Plan 
• Trauma Informed Care Training and Education Bills Filed
• Pandemic Draws Attention to Vaccines 
• State Comptroller Releases Biennial Revenue Estimate

Federal Updates

• Second Round of Stimulus Checks on Their Way

COVID-19 News

• Scientists Debate Administering Half Doses of COVID-19 Vaccine

Advocacy Find your Rep How the Texas Legislature Works In the news Medicaid expansion a top priority for Texas health advocates in 2021 SA hospitals' owner taps former Federal Reserve advisor as new VP Podcast: How Jordana Barton became the Valley's champion for eliminating the digital divide COVID-19 Dashboard COVID-19 Vaccine Information Texas Case Counts Trends by County

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State Updates

State Urging Faster Distribution of COVID-19 Vaccines

Texas hospitals and healthcare providers are being urged by the state to administer ongoing shipments of the COVID-19 vaccines more promptly to eligible community residents. The vaccine distribution for Week 5 will provide vaccines to 234 healthcare providers across the state. 

Individuals who meet the criteria for vaccine eligibility can refer to the Vaccine Provider Location Map for access to the vaccine. The Pharmacy Partnership for Long-Term Care Program, a program that began to administer vaccines to staff and residents at 770 long-term care facilities, will be receiving 121,875 doses. Healthcare providers across Texas can also expect to receive 500,000 doses to be administered to individuals who are scheduled to receive their second vaccine dose. The Texas Hospital Association is currently in the process of producing digital messages for its hospital members to communicate vaccine procedures and availability to the public.

Vaccine allocations for Week 6 will be intended for healthcare providers who have not yet received vaccines or are located in rural communities. Current data show that there are 13,397 COVID-19 Texas hospitalizations, with only 8,687 hospitals beds and 614 intensive care unit beds available in Texas. Additional case counts and hospital data can be found here. Since vaccine supply is limited, DSHS encourages healthcare providers to administer the vaccines promptly to priority populations and report those doses to the state’s immunization registry, ImmTrac2.

Texas “Vaccination Hubs” Created to Distribute COVID-19 Vaccines

Roughly 158,825 COVID-19 vaccines will be received by large “vaccination hubs” this week across Texas. These “vaccination hubs” are known for their ability to vaccinate up to 100,000 individuals, which alleviates the strain from rising positive COVID-19 cases. A list of the identified 28 providers categorized as a hub can be found here. 

These hubs will also be responsible to continue vaccine administrations to group 1A, which includes healthcare workers, and members in nursing homes or long-term care facilities. As of late December, state officials encouraged hospitals to begin vaccine distribution to members in group 1B, which includes individuals who are 65 and older, and people with an increased risk of infection from existing medical conditions. 

The Texas Department of State Health Services has collaborated with the Centers for Disease Control and Prevention to deliver 38,300 doses to 104 providers statewide. This brings the total to 222 counties expected to continue vaccine distribution in Texas. As of Jan. 7^th, at least 475,000 Texans have received their first vaccine dose and 6,500 Texans have received the required two doses. State officials encourage the practice of COVID-19 safety precautions as vaccine supply is yet to meet demand.

The Texas 87th Legislative Session Reconvenes on January 12th

At 12:00 noon on Tuesday, January 12^th the Texas legislature officially gaveled in the 87^th Legislative Session in Austin for the biennial, 140-day legislative session. Both the House and Senate have developed safety protocols in response to the COVID-19 pandemic and last week’s protest at the US Capitol.

Individuals planning to enter the Capitol were expected to receive a mandatory COVID-19 test as advised by the Department of Public Safety. Lawmakers were directed to invite fewer guests than in past sessions and House members were required to wear face masks on the House floor as forms of added safety measures. The legislative session kicked off with the confirmed election of Rep. Dade Phelan (R-Beaumont) as the new House Speaker. In the Senate, Senator Brian Birdwell (R-Granbury) was also unanimously elected president pro tempore of the Senate. This position is usually held by senators who have the longest tenure. Some items that can be expected to be on the state’s priority discussion list include redistricting, crafting a two-year state budget and measures to tackle the pandemic. To date, 1,423 bills have been filed by legislators. For access to the 87^th legislative session livestream, click here.

Bills Filed Would Create State Health Literacy Plan  

Health literacy continues to be an important priority for Methodist Healthcare Ministries this legislative session. Ensuring that all individuals have the capacity to obtain, communicate, process and understand basic health information to make appropriate health decisions for themselves empowers patients to advocate for good health. 

In the Senate, Senate Bill 124 has been filed by Senator Nathan Johnson (D-Dallas). As drafted, SB 124 would add health literacy to the statewide health literacy plan and establish an advisory committee composed of representatives of relevant stakeholders, including physicians, hospitals, and nurses. The committee would develop a long-term plan focusing on identifying the primary factors contributing to low health literacy in the state, examine the methodologies of healthcare providers, the effectiveness of using quality measures in state health programs, and examine the impact that improved health literacy could have on patient safety. House Bill 578, a companion bill to SB 124, has been filed in the House by State Representative John Turner, (D-Dallas).

Trauma Informed Care Training and Education Bills Filed

This session, Methodist Healthcare Ministries will be supporting a number of bills that aim to establish Trauma Informed Care training and education requirements for public school curriculum, judges and attorneys that practice family law, and foster parents.

House Bill 564 by Rep. Ray Lopez (D-San Antonio) would require foster parents, adoptive parents, and kinship care-givers to complete a trauma informed care training course. Rep. Lopez has also filed House Bill 565 which would place training requirements on certain judges and attorneys that represent the state in a suit seeking the termination of a parent-child relationship or appointment of a conservator. Their training will be focused on the effects of trauma on children. Additionally, House Bill 566 by Rep. Lopez further outlines the requirements of trauma informed care training for certain attorneys. Any attorney who is acting as attorney ad litem for a child in a child protection case will only be qualified to represent the child after completing three hours of continuing legal education relating to the representation of a child each year.

In the Senate, Senate Bill 123 by Senator Nathan Johnson would require the development of public-school curriculum that is focused on the inclusion of social and emotional skills. This would include the development of student’s character traits, such as integrity, respect, reliability, and more. The bill would apply to students K-12 and aims to create a culture of respect and empathy for youth in their formative years.

Pandemic Draws Attention to Vaccines 

The focus on the COVID-19 pandemic and ensuing search for a life-saving vaccine has directed our attention to the importance of all vaccines and the historic role they have played in eliminating fatal diseases over our lifetime. 

Lawmakers have filed a number of immunization bills for the upcoming 87^th Legislative Session, including the need to expand our current registry system as well as require all students to be immunized against meningococcal meningitis.

House Bill 325 by Rep. Donna Howard (D-Austin) would allow for the development of a state immunization registry for the purposes of public health research. By developing a robust data infrastructure, the state will be better equipped to manage public health emergencies in the future. Immunizing students against meningococcal meningitis is the goal of House Bills 516, 591, and Senate Bill 138, all relating to the requirement of Texas students to be fully immunized against meningococcal meningitis and provide these records to the school district.

State Comptroller Releases Biennial Revenue Estimate

On January 11th, State Comptroller Glenn Hegar gave the biennial revenue estimate for the 2022-23 state budget. Comptroller Hegar shared that Texas find itself in unprecedented circumstances this year in developing state budget estimates. Before the pandemic, the state was maintaining $4.8 billion in general funds and state tax revenue was running ahead as well, poising Texas for another surplus year.

The COVID-19 pandemic has taken an enormous economic toll on the state. Travel, hospitality, and dining services that make up a large portion of the state’s tax revenue have taken a major hit. Texas employment peaked in February and rebounded slightly in May, but the state is currently maintaining a loss of more than 500,000 jobs and claims for unemployment benefits remain high. Despite the current economic climate, Hagar is forecasting economic growth in the next biennium as the state continues to slowly moves toward recovery, fueled by the recent approval and distribution of the Pfizer and Moderna vaccines.

Comptroller Hegar estimated that the state will maintain a balance of $112.53 billion in total revenue for general purpose spending, after the $5.83 billion in revenue reserved for transfer to the Economic Stabilization and State Highway Fund, as well as the transfer of $270 million to the Texas Tomorrow Fund. To view the slides used during the press conference click here.

Federal Updates

Second Round of Stimulus Checks on Their Way

The Treasury Department and IRS are expected to distribute roughly eight million stimulus payments in the form of either an Economic Impact Payment via prepaid debit card, direct deposit or check by mail. Millions of Americans can expect to receive their second round of payments of up to $600 through January 15.

People who qualify for a second round of stimulus payments in the amount of $600 include adults who earn no more than $75,000 and each child under the age of 17 filed as dependents. Individuals can expect to receive prepaid debit cards or checks in the mail if the Treasury does not have their banking information on file. The Treasury also noted that individuals will be able to get replacement cards without fees, if needed.

Supplemental unemployment payments in the amount of $300 will also be distributed to qualifying individuals for up to 11 weeks. Payments will be sent in white envelopes displaying the Treasury Department’s seal in response to confusion experienced by taxpayers in the first round who thought the payments were a possible scam. 

Although the president and U.S. House encouraged the passage of a $2,000 stimulus package, the U.S. Senate recently voted against it. With the Senate runoff elections confirmed in Georgia, resulting in an even split among both parties in the Senate, the passage of another round of stimulus checks in the amount of $2,000 or $1,400 will likely revisited by the new incoming administration

COVID-19 NEWS

Scientists Debate Administering Half Doses of COVID-19 Vaccine

With allocations of both COVID-19 vaccines underway, healthcare workers and scientists believe the vaccines are not being made available fast enough. As vaccine distribution seems to have slowed down amid rising COVID-19 cases, scientists are beginning to consider other strategic tactics to fight the spread of the virus as fast as possible.

In December, federal health officials claimed that 20 million people would receive their first vaccine by the end of 2020. Yet within the first days of January 2021, only 4.2 million individuals have received their doses. In effort to make the most of the current vaccine supply, a scientific adviser from Operation Warp Speed has suggested that the Moderna vaccine be administered as half doses to Americans. Given that the COVID-19 vaccines provide protection against the virus after the first dose, by only administering half a dose, twice the number of Americans will be protected within a shorter period.

Scientists opposed to this position argue that the vaccines were created to provide maximum protection against the virus from two full doses, and there is no guarantee that the first half dose would provide adequate protection after the three to four week waiting period for a booster dose. As the spread of the new COVID-19 variant quickens, and the current vaccine rollout steadily slows, scientists are considering several options that will increase vaccine efforts.

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

Federal Updates

• USDA Warns of Scam Targeting SNAP Recipients
• Federal Highway Administration Proposes “Dig Once” Rule to Expand Broadband
• Deadline to Claim Federal Stimulus Payments Fast Approaching
• USDA Extends Children’s Free Meal Programs

State Updates

• Texas Walks Back Proposed Budget Cuts on Access to Care for Women and Children
• Impact of COVID-19 on Texas Nonprofit Organizations
• Get out the Vote! Resources on How to Vote in the 2020 Election

COVID-19 News

• Missing Routine Pediatric Vaccines & the Importance of the 2020 Flu Vaccine
• University of Texas Study Models Social Distancing Levels Needed to Flatten the Curve

View our 2019 Legislative Outcomes & Analyses

Advocacy Find your Rep How the Texas Legislature Works In the news South Side resident appreciates U.S. Census outreach caravan in his neighborhood KENS CARES: Have you filled out the 2020 Census? Your response matters. GREAT DAY SA: Methodist Healthcare Ministries 2020 Census Construction begins on $357-million state hospital in San Antonio First United Methodist Church, Wesley nurses continue offering health care services during pandemic COVID-19 Dashboard Texas Case Counts Trends by County Complete the 2020 Census

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Federal Updates

USDA Warns of Scam Targeting SNAP Recipients

Text message scams have ramped up during the pandemic, with the latest scam targeting SNAP recipients to steal personal information. On Sept. 10, the USDA issued a notice warning SNAP recipients of fraud attempts using text messages.

The agency warned that the scam text messages were being used to steal personal information by posing as a SNAP official offering food stamps or SNAP benefits. The federal agency directed recipients of suspected scam texts to not respond and promptly delete them. Residents who are unsure if the SNAP request for information is legitimate can reach out to their local SNAP office.

Federal Highway Administration Proposes “Dig Once” Rule to Expand Broadband

A proposed new federal rule aims to efficiently coordinate broadband expansion with federal highway projects. If enacted, $126 billion could be saved in broadband deployment and expansion efforts.

The U.S. Department of Transportation Federal Highway Administration (FHA) has proposed a new rule to improve coordination efforts between construction of federally-funded roadways and installation of broadband technologies.

The “Dig Once” rule would mandate the inclusion of broadband conduit in road construction that would eliminate costly excavation of recently paved roads to expand broadband infrastructure. FHA reports indicate that 90% of high-speed internet installation costs lie with digging up roadways. By streamlining this coordination, FHA officials estimate improved access to broadband technology in rural areas will result.

Deadline to Claim Federal Stimulus Payments Fast Approaching

Nearly 1 million eligible Texans have yet to claim their federal stimulus payments and the Oct. 15 deadline is fast approaching.

Texans who regularly file their tax returns with the Internal Revenue Service received their stimulus payments via direct deposit or check as they would receive an income tax return. Low-income families who normally do not fill out a tax return form were required to take an additional step and file a separate online form to claim their stimulus payment. Every Texan, an MHM funded partner, has shared resources on how to get the word out to Texans to claim their stimulus checks before it’s too late.

USDA Extends Children’s Free Meal Programs

Free meal programs that normally only operate during the summer will now be allowed to continue to provide meals into the fall, thanks to a recent extension from the USDA.

Summer meal programs such as the Summer Food Service Program and Seamless Summer Option are critical to children facing food insecurity during the summer school break. With many children unable to attend school due to the pandemic, the USDA issued several flexibilities that would allow such programs to continue offering meal services through the end of the year or until funds are exhausted. The meals are served in all areas, at no cost, and can be served outside of typical settings including permitting parents and guardians to pick up meals for children at home. These programs have been a lifeline for families facing financial hardships during these unprecedented times.

State Updates

Texas Walks Back Proposed Budget Cuts on Access to Care for Women and Children

In June, the Texas Health & Human Services Commission (HHSC) issued a first draft in response to State requested budget cuts. Advocates have been vocal that the proposed cuts will negatively impact programs related to women’s health, family violence, and state enrollment systems for Supplemental Nutritiop Assistance Program (SNAP), Childrens Health Insurance Program (CHIP) and Medicaid.

Earlier this summer, the governor and state leadership directed state agencies to submit a plan for budget cuts up to 5% in response to the budget shortfall caused by the pandemic economic crisis. The agency stated that they assessed which areas to target based on “services directly impacting short-term mortality were prioritized over long-term health benefits; and services with limited impact on the direct health and well-being of Texans were prioritized last.”

In response, Texans Care for Children – a Methodist Healthcare Ministries Funded Partner – submitted a letter to state leadership in defense of the Early Childhood Intervention (ECI) Respite Care program slated to be among the cuts. The ECI program offers services to families with “children with developmental delays, disabilities or certain medical diagnoses that may impact development.” As a result of these advocacy efforts, HHSC announced on Sept. 8 that ECI funding would not be eliminated in the proposed budget cuts.

The following week, the Texas Health and Human Services Commission announced that they were rescinding the originally proposed cuts of $15 million to health and safety net programs in favor of making cuts to agency administrative budgets to meet the mandated budget reductions. 

While this is good news, the agency is still anticipating a negative impact on the effectiveness and quality of services provided as a result of the amended proposal’s budget cuts.

Impact of COVID-19 on Texas Nonprofit Organizations

A recent report from United Ways of Texas illustrates the impact of COVID-19 on nonprofit organizations and the ramifications for the communities they serve.

In a joint effort, United Ways of Texas and OneStar Foundation administered a statewide survey of 501(c)(3) organizations to better understand the full impact the COVID-19 pandemic has had on nonprofits and the communities they serve.

Unsurprisingly, organizations across the state consistently reported that the pandemic had crippled their sector’s ability to sustain their workforces and ability to provide critical services. Organizations also reported that they and the communities they serve need flexible financial resources at this time.

To ensure that Texas’s nonprofit sector withstands the pandemic and can continue in its important role in the state, the report recommended that nonprofits, funders, businesses and governments work together to mitigate both short and long-term impacts of the pandemic on the sector and the communities they serve. Additionally, the report stated that Texans must advocate for key decision-makers to include solutions for nonprofits and strengthen the resilience of served communities.

Get out the Vote! Resources on How to Vote in the 2020 Election

During the ongoing public health crisis, getting to the polls has become more difficult for voters across the state. Resources to help get out the vote are here to help to ensure you feel safe casting your ballot this November.

Here are some steps you can take to ensure your vote is cast this year.

1. Find out if you are already registered to vote – verify that you are registered to vote and all of your information is up-to-date. You can check online here.
2. Register to Vote– if you have not yet registered to vote or must re-register to vote in a new location, you can pick up a voter registration application at your library, any government office or download one from here. Mail your completed application to the Voter Registrar in your county. A voter registration certificate or card will be mailed with your name, address and the precinct number you will vote in. The last day to register to vote in Texas is Oct. 5.
3. Voting– you can check your local newspaper for polling place locations for your precinct or search online here. On Election Day, you must arrive at the polling site between 7 a.m. and 7 p.m. to cast your ballot – note that the hours may differ depending on the polling site. You will be required to provide one of seven (7) acceptable forms of photo identification. If you don’t possess one of these forms of identification, you may show a supporting form of identification to the election official.

Here is a listing of upcoming important election dates to mark your calendar. More information on how to vote by mail-in ballot can be found here.

COVID-19 NEWS

Missing Routine Pediatric Vaccines & the Importance of the 2020 Flu Vaccine

A report from the Center for Disease Control and Prevention released in May, found a troubling drop in routine childhood immunizations, the result of families adhering to public health guidance to limit unnecessary exposure to and spread of COVID-19.

The CDC report tallied cumulative doses and differences in the Vaccines for Children (VCF) – funded vaccines ordered by healthcare providers between January and April. VCF is a national program that provides federally purchased vaccines to approximately 50% of U.S. children. The results indicated a sizable decrease in vaccine orders in early March following the national public health emergency declaration.

Keeping up with childhood vaccine schedules is important to children’s health and in some cases is necessary for vaccine efficacy. Vaccine interruptions and delays could also result in the spread of preventable infectious diseases, especially as schools and businesses begin reopening across the country.

Public health officials are urging individuals to receive their annual flu shot as soon as possible. While it is always a good preventative measure against the spread of the flu, this year’s vaccine could have the added benefit of preventing overloading hospital systems given that symptoms for both the flu and COVID-19 are very similar. Officials have also noted that it is possible to be concurrently infected with both influenza and COVID-19 which could add further strain to health care systems, especially in the event of another surge in SARS-CoV-2 infections.

To navigate how to receive your flu shot, visit the Texas Department of State Health Services Vaccine Finder.

University of Texas Study Models Social Distancing Levels Needed to Flatten the Curve

Researchers have released projections on the level of social distancing required to effectively “flatten the curve” in 22 of Texas’ major metropolitan areas. .

Researchers from the University of Texas at Austin found that Texans reducing their social interactions by 50% was not enough to reduce the current surges in COVID-19 hospitalizations overwhelming hospital capacities in metro areas across the state. Instead, the study from a UT professor of Integrative Biology and Statistics, indicated that it would take individuals reducing social interactions by 90% to have any meaningful impact on the cases curve. Health experts continue to encourage residents to observe social distancing practices to prevent the spread of COVID-19 and overloading of healthcare systems.

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

Federal Updates

• Missouri Expands Medicaid
• HHS Expands Access to Childhood Vaccines
• Census Bureau Halts Counting Operation a Month Earlier than Expected

State Updates

• Flu Vaccine is Essential Amid the COVID-19 Pandemic
• Governor Abbott Provides Update on PPE Distribution to Texas Schools
• Legislators Urge Governor Abbott to Create Statewide Complete Count Committee

COVID-19 News

• COVID-19 Cases in U.S. Children on the Rise
• U.S. in “New Phase” of Coronavirus Pandemic
• National Call for Individuals Who Have Recovered From COVID-19 to Donate Blood Plasma

View our 2019 Legislative Outcomes & Analyses

Advocacy Find your Rep How the Texas Legislature Works In the news Nonprofit encourages the community to complete the 2020 census 2020 Census: Can we count you in? COVID-19 Dashboard Texas Case Counts Trends by County Complete the 2020 Census

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Federal Updates

Missouri Expands Medicaid

On Tuesday, Aug. 4, Missouri voters approved Medicaid expansion to close a large coverage gap for approximately 230,000 low-income residents. With 53% of voter approval, Missouri has become the sixth Republican-led state where voters have expanded Medicaid and the second to expand during the COVID-19 pandemic. .

The expansion of Medicaid will cover more lives and protect Missouri hospitals from devastating budget cuts, which ultimately result in the loss of jobs and health care services for everyone. In just the past six months, hospitals have either cut or kept vacant more than 3,000 jobs statewide. Expanding Medicaid will bring back these jobs and create thousands more for the state of Missouri. The ballot measure adds Medicaid expansion into the state constitution and requires Missouri to expand Medicaid by next July, and formally notify the federal government by March 1. Missouri is now the 38th state to expand Medicaid.

HHS Expands Access to Childhood Vaccines

On Aug. 19, the U.S. Department of Health and Human Services (HHS) issued a third amendment to the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) to increase access to lifesaving childhood vaccines and decrease the risk of vaccine-preventable disease outbreaks as children across the United States return to daycare, preschool and school. .

A May 2020 Centers for Disease Control and Prevention (CDC) report found a troubling drop in routine childhood immunizations as a result of families staying at home. This decrease in childhood-vaccination rates is a public health threat and a collateral harm caused by the COVID-19 pandemic. While subjected to several requirements, the amendment authorizes state-licensed pharmacists (and pharmacy interns acting under their supervision to administer vaccines, if the pharmacy intern is licensed or registered by his or her state board of pharmacy) to order and administer vaccines to individuals ages three through 18 years. Expanding access to childhood vaccines will prevent additional strains on the healthcare system and any further increase in avoidable adverse health consequences– particularly if such complications coincide with an additional resurgence of COVID-19.

Census Bureau Halts Counting Operation a Month Earlier than Expected

On Aug. 3, the U. S. Census Bureau announced the collection period for the U.S census has been cut short by one month, from October 31 to September 30. The shortened collection period coupled with the limitations presented by the current COVID-19 crisis make self-reporting a critical civic duty. Particularly problematic will be conducting in-person counts in minority communities as well as of students on college campuses, seniors in assisted living facilities and people experiencing homelessness. Not only are these groups at high risk for infection, they're also among those most in need of in-person outreach. .

Conducted every 10 years, the census is used to determine the number of seats each state has in the U.S. House of Representatives and how billions of dollars in federal funding are spent. Schools, roads, healthcare and other important programs in our community will gain — or lose — funding over the next 10 years, depending on this official population tally.

The Census Bureau will be conducting several outreach measures including phone calls, sending out a 7th Mailing/Paper Questionnaire, and emails to the lowest responding tracts. Additionally, the non-response follow-up anticipates 500,000 enumerators in the field. Standards have been set to ensure safety. If census takers visit your home, they will never ask to enter your home; they will identify themselves and wear a U.S Census Bureau badge; they will only ask questions that are on the questionnaire; and they will never request additional documentation. The 2020 Census does not ask about citizenship or status and will continue to count everyone.

Click here to respond to the 2020 U.S Census

State Updates

Flu Vaccine is Essential Amid the COVID-19 Pandemic

On Aug. 6, Governor Greg Abbott held a roundtable with medical experts, state legislators, and state agencies to discuss Texas' approach to flu season as the state and the country continue to deal with the COVID-19 pandemic. It’s been long feared that the U.S. could see an even worse surge of COVID-19 infections in the fall because of flu season, but whether that actually plays out could be up to Texans. .

During the roundtable, leaders focused on the importance of flu vaccines and discussed proactive strategies the state can utilize to mitigate the spread of both COVID-19 and the flu in our communities. Governor Abbott noted that getting COVID-19 cases and hospitalizations under control is key before flu season arrives. Flu cases normally begin to increase in October, with activity peaking between December and February, according to the Centers for Disease Control and Prevention. Texans should continue to practice social distancing, wearing masks and limiting social interactions. As for preventing a severe flu season, leaders emphasized the importance of getting a flu vaccine as early as possible this year, amid the COVID-19 pandemic. Dr. John Hellerstedt, Commissioner of the Texas Department of State Health Services, noted that this year’s flu vaccine has proven to be very effective in the Southern Hemisphere during its flu season.

State lawmakers have reasons to be concerned. If COVID-19 is not contained by the fall, and the flu season turns out to be a prolific one, hospital systems will continue to be overwhelmed in the coming months and personal protective equipment could become scarce. Nonetheless, a mild flu season is possible if Texans get their flu vaccines promptly and continue to practice safety measures like social distancing and wearing masks

Governor Abbott Provides Update on PPE Distribution to Texas Schools

On Aug. 4, Governor Abbott visited the Texas Division of Emergency Management’s (TDEM) Warehouse in San Antonio where he provided an update on the state’s distribution of Personal Protective Equipment (PPE) to Texas school districts for the 2020-2021 academic year. In preparation for the new school year, the state had distributed to schools more than 59 million masks, 24,000 thermometers, 565,000 gallons of hand sanitizer and 500,000 face shields. .

The Governor also discussed the Texas Education Agency’s (TEA) guidance for school openings—noting that local school boards have the ability to determine how and when to open for in-person instruction, not local governments. Under the state's guidance, local health officials can only intervene if there is an outbreak once students return to campus, at which point they can temporarily shut down a school. Even so, Governor Abbott stressed that the policy does not mean local health authorities cannot be involved in the reopening process. Local school boards remain free to consult with the health experts. As Texas approaches the school year, the state will continue to purchase and distribute PPE at no cost to the districts.

Legislators Urge Governor Abbott to Create Statewide Complete Count Committee

On Aug. 18, fifty-four members of the Texas House of Representatives sent Governor Abbott a letter urging him to create a statewide Complete Count Committee by August 30th. Currently Texas’s response rate is 6.1 points behind its final 2010 rate and experts estimate that Texas could face an undercount of over 1.49% (around 437,000 Texans) because of the new census deadline. .

In past years, Texas has endured the tangible consequences of a population undercount in the decennial census. An undercount of even 1% could result in a significant loss in federal funding for Texas of at least $300 million per year for the entire decade and could be the difference between two or three new Congressional seats. In the letter, legislators highlight efforts that had been made by former Texas Governors to achieve an accurate census count and encouraged Governor Abbott to follow their example.

COVID-19 NEWS

COVID-19 Cases in U.S. Children on the Rise

The CDC issued a new report this month on the impact of COVID-19 on children who are hospitalized with the SARS-CoV-2 infection. An analysis of pediatric COVID-19 hospitalization data from 14 states found that although the cumulative rate of COVID-19 associated hospitalizations among children (8.0 per 100,000 population) is low compared with that in adults (164.5), one in three hospitalized children was admitted to an intensive care unit. These findings confirm that children are very much at risk for severe COVID-19 and call on public health authorities and clinicians to continue to track these infections and reinforce prevention efforts, especially in congregate settings such as child care centers and schools. .

Another recent report from The American Academy of Pediatrics and The Children’s Hospital Association found that there has been a 90% increase in COVID-19 cases in U.S children over the past four weeks. Multiple factors have led to a recent increase in the number of coronavirus infections in children in the past couple of weeks, including increased testing, increased movement among children and a rise in infection among the general population.

In Texas, the number of COVID-19 tests administered has fallen sharply in recent weeks, while the rate of people testing positive has risen, a trend that has worried public health experts as officials consider sending children back to school. Governor Abbott shared most recently that the Texas Department of State Health Services is investigating.

U.S. in “New Phase” of Coronavirus Pandemic

Dr. Deborah Birx, U.S Global Aids Coordinator & Special Representative for Global Health Diplomacy, warned recently that the ‘U.S is in a new phase’ of the ongoing COVID-19 pandemic. Birx stated that what we are seeing today is much different from March and April; the virus is now extraordinarily widespread. .

Birx stressed the importance of following health recommendations, especially to those living in rural areas. Currently, we are seeing the second wave of COVID-19 devastating our rural communities. As states move closer and closer toward re-opening, Brix continues to stress the need to stop “super spreading events.” Like other public health officials, Dr. Birx is suggesting that each state needs a dramatically tailored approach with a set of guidelines based on what we are seeing at the community level. When asked if schools in states with a 5% positivity rate should remain closed or have distanced learning, Dr. Birx stated: “If you have high caseload and active community spread, just like we are asking people not to go to bars, not to have household parties, not to have large spreading events, we are asking people to distance learn at this moment so we can get this pandemic under control.” While deferring to current CDC guidelines regarding the reopening of schools, Dr. Birx suggested that it is still too early for students to safely return to classroom learning.

National Call for Individuals Who Have Recovered From COVID-19 to Donate Blood Plasma

The federal government recently announced a national call to action and campaign to encourage individuals who recover from COVID-19 to donate their plasma, which may contain antibodies that could help other patients fight the virus. As part of the effort, HHS released several public service announcements featuring public health experts. The Fight Is In Us campaign seeks to dramatically increase convalescent plasma donations by the end of August. .

In Bexar County, the South Texas Blood & Tissue center announced that Carabin Shaw PC and Wyatt Law Firm PLLC are providing $50,000 each in gift cards to encourage South Texans who have recovered from COVID-19 to donate convalescent plasma. These plasma donations will be used to treat patients with active cases. Nationally, blood centers collecting convalescent plasma are looking to double the 100,000 doses given to patients so far by the end of August. The South Texas Blood & Tissue Center provided more than 4,400 of those doses.

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

Federal Updates

• Congress Introduces Child Care is Essential Act
• Racial Health Disparities Exposed During COVID-19
• Telehealth Expansion Proposal Introduced in the Senate

State Updates

• Governor Greg Abbott Announces Cecile Young as Executive Commissioner of Texas Health and Human Services Commission
• Early Voting Period Extended for November 3rd Election
• State Broadband Fund for Rural Areas is Falling Short
• HHSC Announces Extension of Automatic SNAP Renewals
• Medicaid and CHIP Providers Urged to Apply for Federal COVID-19 Relief Funds
• State Extends Medicaid and CHIP Flexibilities through October 

COVID-19 News

• Study Finds Children May Carry Coronavirus at High Levels
• Population Point Prevalence of SARS-CoV-2
• Texas A&M Tapped to Produce COVID-19 Vaccine

 

View our 2019 Legislative Outcomes & Analyses

Advocacy Find your Rep How the Texas Legislature Works In the news Ayala: San Antonio has hit a census plateau and needs to get past a 61 percent response rate COVID-19 Dashboard Texas Case Counts Trends by County Complete the 2020 Census

___________________________________________________________________________________________

Federal Updates

Congress Introduces Child Care is Essential Act

On May 27, several U.S. Representatives introduced the “Child Care is Essential Act” to support child care providers affected by the coronavirus pandemic. According to analysis from the Center for American Progress, the COVID-19 pandemic could lead to a permanent loss of nearly 4.5 million child care slots, leaving millions of families without the child care they need to return to work. 

The Child Care Is Essential Act would create a $50 billion Child Care Stabilization Fund to provide grant funding to child care providers to stabilize the child care sector and support providers to safely reopen and operate. The measure would provide the funding through the Child Care and Development Block Grant (CCDBG) program as an emergency appropriation. Grants would be available to licensed, regulated or registered child care providers that are currently open or temporarily closed due to COVID-19, regardless of whether they had previously received funding through the CCDBG. 

As communities across the country move toward reopening and parents go back to work, it is more important than ever to ensure child care providers are supported to open their doors and continue serving their communities.

Racial Health Disparities Exposed During COVID-19 

On July 21, the U.S. Senate Special Committee on Aging held a hearing that focused on COVID-19’s disproportionate health impacts on racial and ethnic minority communities. According to a New York Times analysis, Black and Latino residents are infected with the virus at three times the rate of their white neighbors and are nearly twice as likely to die from COVID-19. 

Expert witnesses from various regions in the country provided testimony that addressed the reality of health disparities in America. The experts’ diverse background in health care provided the committee with solutions from different perspectives on how to bring about health equity for all Americans, amid the pandemic and for the future. 

Telehealth Expansion Proposal Introduced in the Senate

As the popularity and necessity for telehealth services continues to expand in response to the COVID-19 pandemic, Congress has boosted funding and streamlined access to telehealth for Medicare recipients for the duration of the pandemic. Oregon Senator Ron Wyden has responded to this need by releasing a proposal to expand telehealth services on a permanent basis. 

Wyden’s proposal would make those changes permanent, giving Medicare recipients the option to use telehealth for medical visits and mental health services. Wyden stated “Telehealth allows seniors, especially those with multiple chronic conditions, to stay on top of their medical care without taking unnecessary risks or the inconvenience of leaving home.” The COVID-19 pandemic has been a trial by fire, but the experience to date has made clear that the health care system is ready for broader access to telehealth on a permanent basis.

State Updates

Governor Greg Abbott Announces Cecile Young as Executive Commissioner of Texas Health and Human Services Commission

On July 27, Governor Greg Abbott announced Cecile Young as the new Executive Commissioner of Texas Health and Human Services Commission (HHSC). With over 30 years of experience in state government, Ms. Young has served in several positions for state Governors Bill Clements, George W. Bush, and Rick Perry. 

Ms. Young, who takes over in mid-August, will oversee an agency of nearly 37,000 employees as Texas battles a global pandemic and growing budget constraints. She has served as Director of the Medical Support Initiatives for the Offices of the Attorney General, as well as several other roles within the HHSC, including Acting Executive Commissioner, Chief Deputy Executive Commissioner, and Chief of Staff.

Early Voting Period Extended for Nov. 3 Election 

In response to the growing COVID-19 pandemic in many Texas counties, Governor Greg Abbott has issued a proclamation to extend the early voting period for the Nov. 3 election by almost a full week. 

Early voting by personal appearance will begin Tuesday, Oct. 13, and continue through Friday, Oct. 30. The order also extends the period in which marked mail-in ballots may be delivered to the early voting office; accepting ballots before and on the day of the election. 

Governor Abbott noted that by extending the early voting period and expanding time for mail-in ballots to be hand-delivered, Texans will have greater flexibility to cast their ballots, while at the same time protecting themselves and others from COVID-19.

State Broadband Fund for Rural Areas is Falling Short

State legislators representing rural areas are joining phone companies in asking utility regulators to increase the tax on interstate telecommunications services. This fee, which is allocated to the Texas Universal Service Fund (TUSF), provides rural telecommunications and internet services to about 55% of the state’s rural area. Covering approximately 8,344 square miles, this geographic area is larger than nine U.S. states. 

In early June, the Public Utility Commission (PUC) of Texas recommended raising the assessment rate from 3.3% to 6.4%, which would add about a dollar a month to customers’ telephone bills. The shift from traditional landline phones to internet-based phones has cut into company billings, which in turn has cut into tax proceeds. This past March, the PUC reported that the fund was falling short by $5 million to $7 million per month. Without the tax increase, the TUSF is expected to be depleted by the end of the 2020-21 state budget.

HHSC Announces Extension of Automatic SNAP Renewals 

On July 24, Governor Greg Abbott announced that the Health and Human Services Commission (HHSC) has received federal authorization to extend the certifications for Texas SNAP recipients whose benefits are up for renewal in July and August, extending benefits to approximately 276,000 households who have yet to file their renewal information for July and August. The state has also received federal approval to waive the interview and other waiver requirements for new and current beneficiaries. 

On July 28, Governor Abbott also shared news that the HHSC will extend the application deadline for the Pandemic-Electronic Benefit Program to Aug. 21. P-EBT is a one-time benefit of $285 per eligible child and can be used in the same way Supplemental Nutrition Assistance Program (SNAP) food benefits pay for groceries.

Medicaid and CHIP Providers Urged to Apply for Federal COVID-19 Relief Funds

Governor Greg Abbott and the Health and Human Services Commission (HHSC) are urging eligible Medicaid and Children’s Health Insurance providers to apply for $15 billion in federal COVID-19 relief funds before the Aug. 3 deadline. 

Applicants can receive approximately 2% of reported gross revenue from patient care. As of July 15, 2020, less than 5% of the state’s 27,351 eligible providers in Texas have applied. Failure to apply for, and secure relief funds will leave potentially billions of federal dollars otherwise available to Medicaid and CHIP providers in Texas, unused. 

State Extends Medicaid and CHIP Flexibilities through October 

On July 30, Governor Abbott announced that the HHSC is extending flexibilities to Medicaid and CHIP recipient providers through Oct. 23. 

These flexibilities were put in place to minimize face-to-face care to ensure the safety of clients and health care providers. They include extended timelines for clients to request and appeal fair hearings, the implementation of telehealth services for all managed care plans, and a suspension of requirements that out-of-state providers be licensed in the state where they are practicing. The extension also waives CHIP office visit copayments for all members for services provided from March 13, and physicians can temporarily use telemedicine for Texas Health Steps (THSteps) medical checkups of children older than 24 months through Oct. 23. In addition, physicians’ and providers’ Medicaid revalidation due dates will be extended 30 calendar days to prevent disenrollment. You can view your revalidation status on the Provider Information Management System (PIMS).

More information of Medicaid and CHIP flexibilities can be found here.

COVID-19 NEWS

Study Finds Children May Carry Coronavirus at High Levels

As the conversation on back to school policies continue, the narrative that young children are mostly spared by the coronavirus and don’t appear to spread it to others is now being challenged by a study recently introduced by Dr. Taylor Heald-Sargent, a pediatric infectious diseases expert at the Ann and Robert H. Lurie Children’s Hospital of Chicago. The study found that children younger than age five may host up to 100 times as much of the virus in the upper respiratory tract as adults. 

Dr. Heald-Sargent and her colleagues tested three mild/asymptomatic age groups: 46 children younger than age five, 51 children age 5 to 17, and 48 adults age 18 to 65. The study found that the older children and adults had similar cycle thresholds, C.T’s, with a median of 11 ranging up to 17. Children younger than five however, had significantly lower C.T’s of about 6.5. The lower value suggests that the children’s samples were teeming with the virus.

Population Point Prevalence of SARS-CoV-2

On July 24, The CDC released a report on population point prevalence of COVID-19 in Indiana. The report looked at active infections and past infections. Point prevalence of active infection at the time of testing was less than 2%; 44% of those people reported no symptoms two weeks before testing. 

The overall prevalence of current and previous infections of SARS-CoV-2 in Indiana was 2.79%. Greater prevalence’s were observed among Hispanic individuals and those who reported having a household contact who had previously been told by a health care provider that they had COVID-19. By late April, the number of past infections was 9 – 10 times higher than the number of reported, confirmed cases. The number of reported cases grossly underestimates the number of people who are estimated to be infected.

Given that many individuals remain susceptible, adherence to evidence-based public health mitigation measures (e.g., social distancing, consistent and correct use of face coverings, and hand hygiene) is needed to reduce surge in hospitalizations and prevent morbidity and mortality from COVID-19.

Texas A&M Tapped to Produce COVID-19 Vaccine

The federal government continues to award more contracts for the production of vaccines. On July 27, the Texas A&M University System was tapped by the federal government to mass produce COVID-19 vaccines. 

Texas A&M’s plan for COVID-19 vaccine will include nontraditional vaccinators, and plans are underway to ensure Texas can handle the volume of needed vaccinations and follow forthcoming guidance on prioritization. Texas A&M joins Pfizer, which has been contracted to produce 100,000 vaccines and Moderna, which has recently entered into phase three for its clinical trials.

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

Federal Updates

• Federal Stimulus Package Continues to be Negotiated
• Pfizer Secures Federal COVID-19 Vaccine Contract for 100 Million Doses
• States Getting Pressure from Feds to Reopen Schools

State Updates

• Texas Comptroller Projecting $4.6 Billion Shortfall for FY 2021
• U.S. Census Bureau Survey Data Highlights COVID-19’s Disparate Impacts on Texan
• State’s HHSC SNAP Incentive Study Group Begins Work on Pilot
• Senator Judith Zaffirini Hosts “Distanced but not Isolated: Maintaining Mental Health During the COVID – 19 Pandemic.”

View our 2019 Legislative Outcomes & Analyses

Advocacy Find your Rep How the Texas Legislature Works In the news Ayala: San Antonio has hit a census plateau and needs to get past a 61 percent response rate COVID-19 Dashboard Texas Case Counts Trends by County Complete the 2020 Census

___________________________________________________________________________________________

Federal Updates

Federal Stimulus Package Continues to be Negotiated

Provisions for the next round of federal stimulus spending continue to be negotiated in the Senate in what Senate Leader Mitch McConnell is calling CARES 2. As the additional $600 unemployment benefit period draws to a close this week for nearly 3 million Texans, negotiations between Democratic and Republican Party leaders as to the cost and scope of the next stimulus package are projected to be around $1 trillion. The Trump administration has supported the implementation of a payroll tax cut and a second stimulus check, but senate republicans worry that doing both may be too costly.

After the first week of negotiations, an agreement was reached to establish financial assistance to schools, funding toward testing and tracing, and favoring a second round of stimulus checks over a payroll tax cut. Treasury Secretary Steven Mnuchin confirmed the stimulus check in CARES 2 will match the stimulus check in the first Cares Act, a $1,200 one-time payment to all Americans who earn less than $75,000, including $500 for each dependent. Republican lawmakers are also set to propose a flat unemployment benefit of $100-$200 per week with benefits lasting through the end of the year. As the moratorium on evictions set by the Cares Act expired July 24, Republicans are set to repeat this figure, or even extend it. 

Pfizer Secures Federal COVID-19 Vaccine Contract for 100 Million Doses

On Wednesday, July 23, the U.S. Department of Health and Human Services (HHS) and Department of Defense announced a $1.95 billion contract with Pfizer to develop 100 million doses of a COVID-19 vaccine in the United States. This contract also gives the federal government the ability to acquire an additional 500 million doses as part of the “Operation Warp Speed” initiative launched by the Trump administration in May.

If the vaccine is successful and receives EUA or licensure, the HHS would begin nationwide delivery in the final quarter of 2020. More importantly, the Pfizer vaccine would be available to all Americans at no cost. To date, the federal agency has announced up to $1.2 billion in support of AstraZeneca’s candidate vaccine, with the first doses scheduled to be delivered as early as October 2020. An additional investment of $483 million has been made in support of Moderna’s candidate vaccine scheduled Phase 1 trials in March. Finally, the HHS has also reached an agreement totaling $456 million with Johnson & Johnson for its candidate vaccine that is scheduled to begin Phase 1 clinical trials sometime this summer.

Currently, Pfizer still needs to complete a large Phase 3 clinical trial to show the efficacy of the vaccine. The $1.95 billion investment in Pfizer is the latest news on the ongoing efforts to quickly and safely release a COVID-19 vaccine.

States Getting Pressure from Feds to Reopen Schools

As the new school year approaches, state lawmakers are facing a difficult decision between reopening school facilities and risking exposure to students, faculty and staff, or keeping doors closed to millions of children.

Pressures from the federal government are pushing states toward full reopening, but as many as 39 states are still recording growing COVID-19 caseloads. This growth has prompted many school districts to announce that they would rely mostly, if not exclusively, on online learning platforms. The standard of 5% daily infection rate set by the CDC to effectively control the spread of COVID-19 has become the accepted metric for school districts to safely return to normal operation.

Here in Texas, school systems will be able to temporarily limit access to on-campus instruction for the first four weeks of school. After the first four weeks, a school system can continue to limit access to on-campus instruction for an additional four weeks, if needed. To ensure that all Texas students have access to their virtual classroom, Governor Abbott, Lt. Governor Patrick, Speaker Bonnen, Senate Finance and House Appropriations Committee Chairs announced that the State of Texas will allocate $200 million in Coronavirus Aid, Relief and Economic Security (CARES) Act funding to the Texas Education Agency (TEA) for the purchase of eLearning devices and home internet solutions to enable remote learning during the COVID-19 pandemic for Texas students that lack connectivity.

While the American Academy of Pediatrics recommends that “all policy considerations for the coming school year should start with the goal of having students physically present in school,” the association has also stated that “schools in areas with high levels of COVID-19 should not be compelled to reopen against the judgement of local experts.” In the meantime, the CDC has released guidelines for school districts that are returning to full and partial capacity to ensure that the spread and transmission of COVID-19 can be managed as schools phase back into full capacity. 

 

State Updates

Texas Comptroller Projecting $4.6 Billion Shortfall for FY 2021

On July 20, Texas Comptroller Glenn Hegar released a revised revenue estimate that projects a budget deficit of $4.58 billion at the end of the 2021 fiscal year. This marks a decrease from the $2.89 billion surplus originally projected in October 2019.

Hegar stated in a letter to state leadership that Texas will have $110.19 billion in general revenue, a decrease from the original projection of $121.76 billon. Hegar attributes this revised budget deficit to the impact of COVID-19 on the state economy; consumer spending makes up the largest portion of general revenue for the state. Hegar also attributes losses to the volatility of the oil market. The state also has an additional $8.8 billion in the Economic Stabilization Fund to lean on in the event of crisis.

Hegar clarified for lawmakers that these projections are subject to change based on the continuation and severity of the COVID-19 pandemic. While Texas is ready for a moderate recessionary period, consumer confidence must return to boost the economic outlook of the state in the foreseeable future.

U.S. Census Bureau Survey Data Highlights COVID-19’s Disparate Impacts on Texan

Beginning April 23, the U.S. Census Bureau began conducting a weekly survey to measure the impact of COVID-19 on American households. The initial findings show massive losses in reported income and high rates of unemployment in some of Texas’s most vulnerable populations – households with children, non-college degree holders and communities of color.  

Of the first survey, 47% of respondents reported losses of income since March 13, and an additional 41% expected to see losses continue into the next four weeks. Hispanic and Black respondents reported loss of income at a rate of 60% and 57%, respectively. White and Asian respondents have reported income losses of 41% and 44%. In this same time period, roughly 8.7 million Texans were unemployed. This number has now increased to 10.1 million in the eight weeks following the initial survey.

This sharp growth in unemployment has led to even greater disparity in the percentage of Texans with health insurance. Before the declaration of the pandemic, the health insurance rate in Texas was among the worst in the U.S at 18%. As of July 10, survey data has shown approximately 20% of respondents are currently uninsured.

State’s HHSC SNAP Incentive Study Group Begins Work on Pilot

The Health and Human Services Commission’s SNAP Incentive Study Workgroup has begun to look at ways that will provide low-income Texans with better access to affordable healthy food. We’re proud to announce Stephanie Luster, grants program officer with Methodist Healthcare Ministries was selected to serve on the workgroup.

The SNAP Incentive Workgroup, established through the passage of Senate Bill 1834, will assist HHSC with the study of existing programs that incentivize the purchase of Texas-grown fruits or vegetables under SNAP and, as applicable, provide input for the establishment of a pilot program.

Per capita consumption of fruits and vegetables from 1970-2017 shows a decline in U.S produce consumption beginning around the year 2000. This trend is directly correlated to steadily increasing rates of obesity throughout the U.S., a serious concern for health care providers treating food related illnesses. The SNAP benefits program is developing a broad outreach and incentive program to improve the eating habits of low-income Texans.

The Fair Food Network’s Double Up Food Program offers a dollar-to-dollar match up to $30 maximum for the purchase of fresh fruit and veggies for all SNAP beneficiaries as well as various deals and bundles to make fruit and vegetables more affordable. The agency also offers a health incentive programthat allows SNAP participants to receive an incentive of $0.30 for every $1 of SNAP benefits spent on fruit and vegetables, capped at $60 per month per household. The SNAP program is continuing to expand and develop strategies to increase accessibility of healthy food options and increase business outlook of specialty crop producers in Texas. 

Senator Judith Zaffirini Hosts “Distanced but not Isolated: Maintaining Mental Health During the COVID – 19 Pandemic.”

On July 15, State Senator Judith Zaffirini (D-Laredo) hosted a webinar that brought together a panel of statewide experts to discuss how to cope with anxieties and stressors caused by the COVID-19 pandemic. The panel included presentations from Dr. John Burrus, psychiatrist and CEO of Metrocare; Nelson Jarrin with the Meadows Mental Health Policy Institute and Sonja Gaines, Deputy Executive Commissioner at the Texas Health and Human Services Commission. Texans who are experiencing anxiety, stress or emotional challenge because of the pandemic should contact the statewide COVID-19 Mental Health Support Line. The support line has answered over 4,900 phone calls, and has talked with Texans from 159 counties.  

On Wednesday, July 29, Senator Zaffirini will host another webinar, “Back to School? The ABCs of Covid-19." The event will address questions that parents and caregivers may have pertaining to their child going back to school.

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

Federal Updates

• Pregnant Women May Have Increased Risk for Severe Covid-19 Illness
• 2020 Census Update & COVID-19 Complications 
• Broadband Emergency Expansion Much Needed During the Pandemic 

State Updates

• Repeal of Outdated Health Care Regulation Would Benefit All Texans 
• Texas Extends Deadline for Food Benefits for Families Affected by COVID-19 School Closures 
• Health TEKS Up for Review for the First Time Since the 1990s

View our 2019 Legislative Outcomes & Analyses

Advocacy Find your Rep How the Texas Legislature Works In the news Methodist Healthcare Ministries awards $32 Million in annual health care grants Methodist Healthcare Ministries Awards $22,662 in emergency grant funding to UT Health San Antonio School of Dentistry Methodist Healthcare Ministries Awards $1.1 Million as part of COVID-19 Relief Efforts COVID-19 Dashboard Texas Case Counts Trends by County

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Federal Updates

Pregnant Women May Have Increased Risk for Severe Covid-19 Illness

According to a recent Centers for Disease Control and Prevention (CDC) report, pregnant women with COVID-19 may be more likely to experience a more severe level of illness than women who are not pregnant. The findings come from an analysis of data on 91,412 women of reproductive age who tested positive for COVID-19, of whom 9% were pregnant.

CDC used COVID-19 federal surveillance data from Jan. 22–June 7 to conduct a study that compared the risks and symptoms of COVID-19 among pregnant and non-pregnant women. After adjusting for age, presence of underlying conditions, and race/ethnicity, pregnant women were 5.4 times more likely to be hospitalized, 1.5 times more likely to be admitted to the ICU, and 1.7 times more likely to receive mechanical ventilation. These findings suggest that among women of reproductive age with COVID-19, pregnancy is associated with a greater likelihood of hospitalization, admission to the intensive care unit (ICU) and mechanical ventilation. While evidence is limited, clinicians are encouraged to counsel pregnant women about the risks and how to protect themselves

Additionally, CDC’s report points out the need for more data to fully understand both the risk for severe illness from COVID-19 during pregnancy, as well as the effects of COVID-19 on maternal and paternal outcomes. Thus, CDC, in collaboration with health departments, has initiated COVID-19 pregnancy surveillance to report pregnancy-related information and outcomes among pregnant women. 

2020 Census Update & COVID-19 Complications 

Severe virus-related limitations on mobility and personal contact have completely upended a decade of census outreach planning, especially in hard to reach communities throughout our state. The U.S. Census Bureau and its countless partners are continually working to ensure everyone is counted and have been quick to implement and share strategies to protect people’s health while sustaining the focus and motivation of achieving an accurate count. 

As many Americans have shifted their attention to seeking economic relief and taking all precautions to avoid contracting the coronavirus, it is critically important for us to share a friendly reminder to participate in the census as it helps determine how billions of dollars from the federal government are invested across the country especially throughout these unfortunate times. It is these types of instances that should motivate Texans to spend three minutes at home to complete the online survey. As of July 5, Texas has a 56.7% response rate to the census which poses a serious threat to receiving much needed aid. 

Normally the finished census would have to be on the president’s desk by Dec. 31, but due to the coronavirus, lawmakers have asked for an extension that would require a change in federal law. The extra time would ensure organizations such as Texas Counts continue to have ample time to extend their efforts throughout the state. 

This past spring, Methodist Healthcare Ministries gifted the Hogg Foundation for Mental Health a $210,000 grant to support four community partners that were selected for the Texas Communities Count Initiative. The primary focus of Texas Communities Count is to aid collaborative approaches that will reach traditionally hard-to-count (HTC) populations, communities and geographic areas throughout the state. An additional three South Texas organizations were directly funded $195,420, by Methodist Healthcare Ministries to conduct census outreach in over 37 counties.

Broadband Emergency Expansion Much Needed During the Pandemic 

Due to COVID-19, private broadband companies have pledged to the Federal Communications Commission (FCC) not to disconnect service due to lack of payment during the crisis, as well as working to offer emergency broadband expansion to those in need. 

Many residents are having to adjust to working from home especially in rural communities where there is a lack of internet service providers. For those living in the larger metropolitan areas of the state, the high cost of cable and internet services is often the barrier for low income families. Before the COVID-19 pandemic, the lack of broadband connectivity was more of an inconvenience, however once stay-at-home orders were enforced, internet access became a necessity for roughly 2 million Texas households who currently don’t have access. With individuals losing their jobs and needing to apply for unemployment benefits, students participating in e-learning with teachers, employees adjusting to working from home and healthcare professionals providing telehealth services for patients, the need is more substantial than ever before. 

While the digital divide is not a new story for our state, it is newly pertinent now as real interactions among people are limited and virtual interactions are vital. Recent waivers and funding from the state and federal government have allowed telemedicine to become more accessible amid the pandemic. Some of these temporary changes could prove to be extremely useful in rural areas if communities are provided with fast, reliable access to broadband service. 

In 2019, the Texas Legislature passed HB 1960 by Rep. Four Price (R-Amarillo). The bill created the Governor’s Broadband Development Council and is charged with conducting research and identifying solutions that overcome barriers to broadband access, especially in underserved and rural areas. The council’s report is due to members of the legislature by Nov. 1, 2020.

State Updates

Repeal of Outdated Health Care Regulation Would Benefit All Texans 

The Coalition for Healthcare Access, a group of 27 business, consumer and health organizations, is actively working to remove unnecessary red-tape and barriers and expand Texans’ access to care. In an op ed by Methodist Healthcare Ministries’ President & CEO Jaime Wesolowski, coalition members urge the Texas Legislature to take action this coming legislative session and adopt recommendations released in Lt. Governor Dan Patrick’s Texans Back to Work Task Force Report,  waiving current law requiring advanced practice registered nurses (APRNs) to obtain a contract with a physician before they can provide care. Read the full op ed here.

Texas Extends Deadline for Food Benefits for Families Affected by COVID-19 School Closures 

Last week, Governor Greg Abbott announced that the Texas Health and Human Services Commission (HHSC) has extended the application deadline for the federal Pandemic- Electronic Benefit Transfer program (P-EBT) to July 31. Texas has already issued nearly $700 million to families through the P-EBT program, benefiting more than 2.5 million children.  

In May, Texas received approval from the U.S. Department of Agriculture to provide more than $1 billion in pandemic food benefits. The P-EBT program is intended for families with children who have temporarily lost access to free or discounted school meals due to COVID-19-related school closures. More than 3 million children in Texas were certified to receive free or reduced-price meals at school during the 2019-2020 school year. The program is a one-time benefit of $285 per eligible child and can be used in the same way as Supplemental Nutrition Assistance Program (SNAP) food benefits to pay for groceries. Extending the application deadline helps ensure that more Texas families will have access to nutritious food as the state continues to combat COVID-19.

Health TEKS Up for Review for the First Time Since the 1990s

For the first time since 1998, the State Board of Education (SBOE) will revise the Texas Essential Knowledge and Skills (TEKS) for Health Education. TEKS, which outlines the minimal standards for what students are to learn in each course or grade, are periodically reviewed and revised for each subject area to ensure that Texas students attain the essential knowledge and skills for a bright future. 

Since August, members of the SBOE, in collaboration with selected content advisors and review committees, have been working toward updating the state’s 22-year-old standards on health education. To guide this process, Texas education commissioner, Mike Morath, released a report that provided a framework for members to build on. In addition to developing recommendations based on Morath’s report, members from the review committees have proposed a new health education high school course. The new course would address topics such as navigating the health care system and accessing care in communities. 

Currently, school districts must teach to the health TEKS within the overall curriculum for kindergarten through Grade 8. While high schools also have health TEKS to follow, Texas is one of 26 states that does not require health education for high school graduation. Even so, most school districts teach the class in high school, either as an elective or as a local graduation requirement. The final adoption of revisions to the TEKS for health education will take place in November.

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

Federal Updates

• Appeals Court Rules ACA Mandates Unconstitutional
• House Passes Healthcare Provisions in Fiscal Year 2020 Appropriations Act
• House Passes Legislation to Lower Drug Pricing
• House Energy & Commerce Committee Pushes to Extend Coverage for Moms

State Updates

• Texas House and Senate Release Interim Charges
• House Select Committee on Statewide Health Care Costs
• HHS Releases Blueprint for a Healthy Texas
• New Report Shows High Poverty Rates for Children in Webb County
• RGV Equal Voice Network Hosts Access to Specialty Care Summit

Upcoming Hearings

Upcoming Events

View our 2019 Legislative Outcomes & Analyses

Advocacy Find your Rep How the Texas Legislature Works Bill Tracking Access to Care Behavioral Health Healthcare Workforce Women & Children's Health Research 2018 State of Texas Children: The Road to a Brighter Future 2019 State of Texas Children: Child Well-Being in Webb County

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Federal Updates

Appeals Court Rules ACA Mandates Unconstitutional

Since its inception in 2010, the Affordable Care Act (ACA) has sought to address gaps in the health coverage system by making it more accessible to low-income individuals and adding key provisions that keep children covered longer and guarantee coverage for those with preexisting conditions, just to name a few. On Dec. 18, a federal appeals court in New Orleans struck down a major part of the Affordable Care Act, a decision that could jeopardize health insurance for millions of Americans. The court, in a 2-to-1 decision, ruled that the ACA’s individual mandate provision is unconstitutional, but punted on deciding whether the rest of the landmark healthcare law should be tossed out. Rather than strike down the entire law, the appeals court sent the case back to district court for additional analysis on whether the individual mandate can be severed from the rest of the statute. For now, it’s important that consumers know they are not affected by the court’s ruling this past week.

The case is expected to progress to the Supreme Court, which previously upheld the ACA in a narrowly divided 2012 ruling. The requirement for coverage, often referred to as an individual mandate, was inserted into the law to provide insurers a wide pool of customers since they were now required to cover people with chronic medical conditions. The impact of this healthcare repeal lawsuit could be devastating to many Texans. If courts move to strike down the ACA, roughly 1.7 millionTexans would stand to lose their healthcare coverage.

House Passes Healthcare Provisions in Fiscal Year 2020 Appropriations Act

On Dec. 17, House lawmakers voted 297-120 in favor of H.R.1865 “Further Consolidated Appropriations Act, 2020,” that appropriates $540.4 billion in discretionary funds to federal agencies and programs. Barring any unforeseen circumstances, the Senate must approve the legislation before the Dec. 20 funding deadline to prevent a government shutdown. 

This governmentwide spending package is covered by eight appropriation bills for fiscal year 2020 and would include increasing funding for numerous programs and agencies such as the Centers for Medicare and Medicaid Services (CMS), Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC), the National Institute of Health (NIH), and medication-assisted treatment programs. The largest healthcare appropriation made under H.R. 1865 was $828.3 billion for CMS and $475.6 million for opioid overdose prevention and surveillance at the CDC. The bill continues to support critical research initiatives including Alzheimer’s disease research, suicide prevention, and increasing funding to improve maternal and child health.

Methodist Healthcare Ministries continues to demonstrate their commitment to advocate for public policy that ensures the longevity and ability for agencies and programs to provide access to healthcare services to Texans most in need.

House Passes Legislation to Lower Drug Pricing

The rising costs in prescription drugs, according to Health Affairs, can be blamed primarily on price increases, not from expensive improvements to existing drugs or new therapies as pharmaceutical companies often claim. On Dec. 12, House Democrats passed H.R. 3, the “Elijah E. Cummings Lower Drug Costs Act,” that would restrain the cost of prescriptions by allowing the government for the first time to negotiate the price of drugs. Senate Majority Leader Mitch McConnell, however, quickly declared the bill dead in the Senate saying the bill would result in dozens of fewer therapies coming to market. With a House version passed, it is now up to the Senate to pass its own drug pricing reform alternative.

The House vote on the bill passed 230 to 192, with two republicans breaking rank in support. H.R. 3 reinvests in improving Medicare for seniors and people with disabilities by placing out-of-pocket limits for prescription drugs, requiring manufacturers to adjust prices based on inflation, and allowing the government to negotiate prices for 50 to 250 drugs using an international price index. The price determined by the negotiation process would then be available to the commercial market, not just Medicare beneficiaries, ensuring out-of-pocket costs for all Americans are contained. In addition, the House bill would expand Medicare benefits to include dental, vision and hearing aid coverage. Projected cost savings would appropriate the additional funding to the National Institute of Health Innovation Projects, the FDA, and the Opioid Epidemic Response Fund. The bill would improve the overall health and well-being of millions of working families by removing the barrier of having to decide between lifesaving treatment and paying their bills.

House Energy & Commerce Committee Pushes to Extend Coverage for Moms

An estimated 700 women in the United States annually die from pregnancy-related complications within the first year after giving birth, despite 60 percent of these deaths being preventable with appropriate care. On Nov. 20, the House Energy and Commerce Committee advanced legislation by voice vote, H.R. 4996 , “Helping Medicaid Offer Maternity Services Act” (Helping MOMS Act). In an effort to prevent maternal mortality, the bill incentivizes states to extend Medicaid or CHIP coverage for up to one year for low-income mothers by offering a 5 percent federal match in the first year. 

Last year, Texas’ health department and the Texas Maternal Mortality and Morbidity Review Committee found that almost 400 Texas mothers died between 2012 and 2015. The committee created by the Governor and the Texas Legislature concluded that extending Medicaid coverage from 60 days to a full year would help more Texas mothers’ gain access to primary, specialty and behavioral care during a critical window of time following the birth of their baby. In support of the continuation of funding and strengthening of current programs to achieve healthy outcomes for women and children, Methodist Healthcare Ministries has co-signed a letter of support in collaboration with our funded partner, Texans Care for Children, advocating to increase coverage for low-income mothers and encouraging the House to include the Helping MOMS Act in its end of year bill package.

State Updates

Texas House and Senate Release Interim Charges

Following the conclusion of the 86^th legislative session earlier this year, Lieutenant Governor Dan Patrick and Speaker of the House Dennis Bonnen have published their respective Senate and House interim committee charges. Over the course of the next year, the Texas House of Representatives and Senate committees will meet to discuss and hear from stakeholders on key issues in preparation for the next legislative session. Their findings will affect actions taken during the 87^th Texas Legislative Session which begins Jan. 12, 2021. 

Methodist Healthcare Ministries submitted topics for consideration to the state delegation related to improving access to healthcare services for Texas families. To deliver care for our uninsured and underserved families, we will continue to monitor charges and legislation during the interim that affects our four priority areas: access to care, behavioral health, healthcare workforce and women in children. A key priority for Methodist Health Care Ministries is addressing the rising cost of healthcare. We will be monitoring charges related to increasing access to affordable and quality healthcare, access to mental health care services through telehealth and the progression of the San Antonio State Hospital (SASH) Phase II committee work, expanding Texas’ current and future workforce pipeline to closing skill gaps, as well as providing recommendations to developing a postpartum care package for new mothers to develop strategies to ensure continuity of care.

House Select Committee on Statewide Health Care Costs

House Speaker Bonnen also moved to create and appoint Texas House members to the House Select Committee on Statewide Health Care Costs . The committee is comprised of 11 members that will examine the primary drivers of increased health care costs in Texas, study opportunities to better coordinate how public dollars are spent on healthcare, as well as identify emerging and proven delivery system improvements and sustainable financing models that could reduce the cost of healthcare. The committee is required to submit a final report on their findings before the start of the 2021 legislative session.

HHS Releases Blueprint for a Healthy Texas

The Texas Health and Human Services (HHS) unveiled its inaugural business plan in November 2019, Blueprint of a Healthy Texas, which provides measurable initiatives to improve the lives of more than 7 million Texans who rely on the services provided by the agency. The business plan includes 12 initiatives and 72 goals focused on providing a transparent framework for how HHS will move forward and improve services to Texans. 

It is estimated that one in five Texans have mental health needs, with more than 1 million suffering from a Serious Mental Illness (SMI). Meeting the mental healthcare needs of Texans requires critical policy analyses to ensure coordinated systems of support and services are effective and appropriate. The HHS business plan hopes to address the gaps in behavioral health and meet a person’s need in the most integrated settings.

The inaugural business plan works to improve health outcomes for women, mothers, and children by enhancing access to long-acting reversible contraception, increasing prenatal and well-child visits, and addressing disparities in breastfeeding and breast cancer. Additionally, FY 2020 initiatives also focus on improving accountability and sustainability of supplemental and directed payment programs to achieve positive outcomes.

New Report Shows High Poverty Rates for Children in Webb County

In a new report commissioned by Methodist Healthcare Ministries and produced by the Center for Public Policy Priorities, data findings conclude children in Webb County are not faring as well as Texas children overall, lacking access to health care at greater rates and scoring poorer on many indicators of health, education and financial security. 

The 2019 State of Texas Children in Webb County report highlights that although Webb County is a vibrant binational landscape and has one of the best employment rates across the state, nearly 70 percent of children live in high poverty neighborhoods (compared to 17 percent in Texas overall). As a result, children are less likely to have access to doctors, quality schools and groceries. Additionally, children living in Webb County were three times as likely to be undercounted in the census as in Texas overall. An undercount of children in the upcoming 2020 census could mean fewer federal dollars flowing into the county for education, Head Start, SNAP and Medicaid/CHIP programs.

The report noted Webb County can capitalize on its strengths and invest in child-well-being by ensuring workers receive family-sustaining wages, expanding access to comprehensive health insurance, improving access to family planning, and promoting an accurate 2020 census. Working with local officials and state lawmakers to support equity-focused policies will ensure all children have access to the basic building blocks to reach their full potential. On Nov. 21, Methodist Healthcare Ministries and CPPP shared the report's findings with the Laredo Health Coalition, City of Laredo Health Department, Webb County Commissioner Rosaura Tijerina and other elected officials.

RGV Equal Voice Network Hosts Access to Specialty Care Summit

Rio Grande Valley residents continue to face challenges in accessing health care due to serious economic barriers, a shortage of providers, and a lack of health insurance coverage. Many low-income working families rely on the local safety net clinics to receive low-cost primary care. However, when patients are referred to specialists for more serious ailments, such as cancer, surgery or dental care, nearly two out of five residents said they could not access the specialty care they needed.  On Dec. 12, the RGV Equal Voice Network Health Working Group held a summit in Weslaco, Texas, where they laid out 18 recommendations to help address the lack of access to specialty care in the RGV. Over 150 healthcare administrators, community organizers and regional leaders were in attendance, including State Representative Armando Martinez, Hidalgo County Judge Richard Cortez, and Hidalgo County Commissioner Ellie Torres. 

Rep. Armando “Mando” Martinez delivers keynote address at EVN’s Access to Specialty Care Summit.

During the summit, the EVN Health Working Group identified the economic and environmental barriers limiting access to specialty health care services. The data gathered from over 600 individual surveys and 12 focus groups found that most individuals needed referrals to obstetrics/gynecology, dental and optometry/ophthalmology. They also found that three-fourths of households stated cost as the primary barrier to seeing a specialist. Proposed solutions included increasing collaboration between safety net clinics and the UTRGV School of Medicine, increasing residency training slots, increasing transportation options for patients living in rural areas and studying the feasibility of establishing a public hospital district in the RGV. Details on these recommendations will be shared in a white paper scheduled to be released this coming spring.

This project, funded by Methodist Healthcare Ministries and the Marguerite Casey Foundation, will help elected officials and community organizations develop robust public health agendas with concrete goals and actions aimed at reducing inequities and increasing access to care for vulnerable individuals living in Texas’ Rio Grande Valley region.

Upcoming Hearings

• Posted Agendas for House Committees

• Posted Agendas for Senate Committees

 

Upcoming Events

Jan. 26-27: Texas Impact – United Methodist Women Legislative Event (Austin)

Jan. 29: The Texas Tribune – Future of Health Care: A Daylong Exploration of Health Care in Texas (Edinburg)

Feb. 3-6: San Antonio Chamber of Commerce – 2020 SA to DC (Washington, D.C.)

Feb. 13-14: Texas Hospital Association – Annual Conference and Expo (San Antonio)

Feb. 16-18: Texas Impact – Texas Interfaith Advocacy Day Conference (Austin)

Mar. 2: Texas Association of City & County Health Officials – 2020 Premier Public Health Conference (Houston)

 

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

State Updates

• End of Session Wrap Up
• Policy Work Continues During the Legislative Interim
• We Remain Thankful to the Work and Contributions Made by All

86th Legislative Session Summary Reports

Upcoming Hearings

Upcoming Events

View our 2019 Legislative Agenda

Advocacy Find your Rep How the Texas Legislature Works Bill Tracking Access to Care Behavioral Health Healthcare Workforce Women & Children's Health Research 2018 State of Texas Children: The Road to a Brighter Future

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State Updates

End of Session Wrap Up

The 140-day Texas legislative session came to a close over the May 27 Memorial Day holiday with Governor Greg Abbott and legislative leaders celebrating significant victories related to school finance and property tax reform. Before swinging the final gavel, lawmakers fulfilled their constitutional duty and passed a balanced budget allocating $250.7 billion for the 2020-2021 biennium, a 16 percent increase over the 2018-2019 budget. Included in the final budget is $84.4 billion for health and human services programs, up just 1 percent from the previous biennium. As has been the custom in past sessions, lawmakers included a $900 million cut to the state Medicaid program through a cost containment rider in the state budget bill. The state’s health care services agency will direct the program reductions over the next two years to achieve these savings.

A total of 7,324 bills were filed this legislative session, with 1,373 bills ultimately becoming law. In a rare move from previous governors, Governor Abbott signed the two-year budget into law without any line-item vetoes.

Working alongside lawmakers and state health advocates over the five-month session, Methodist Healthcare Ministries weighed in on more than 200 new state laws, helping deliver on a number of regional priorities important to families in our 74-county service area. Despite healthcare receiving little attention this legislative session, there were a number of notable accomplishments related to access to care, mental health and women’s and children’s health. Highlights of key bills include:

• Access to Care
  • Reducing transportation barriers to health care treatment by allow ridesharing companies to provide nonmedical transportation services under Medicaid. (HB 1576)
  • Preventing cancer by raising the statewide minimum age to purchase all tobacco products, including e-cigarettes, from 18 to 21 years of age (exempts military). (SB 21)
  • Continuing to support cancer prevention & research initiatives by passing a constitutional amendment which will ask voters on the Nov. 5 ballot for the authority to issue another $3 billion in bonds for the continuation of the Cancer Prevention & Research Institute of Texas (CPRIT). (HB 39 and HJR 12)
  • Incentivizing the purchase of fruits and vegetables by creating a SNAP pilot program and studying existing incentive programs throughout the state. (SB 1834)
  • Creating greater flexibility and efficiency for local hospital districts allowing them to better serve uninsured Texans by creating local healthcare provider participation funds programs (LPPFs) in Bexar County and Nueces County. (SB 1545 and SB 2315)
• Behavioral Health
  • Securing $190.3 million to begin construction on a new San Antonio State Hospital, a 300-bed campus that will improve care for those living in South Texas with behavioral health needs. (SB 500)
  • Improving mental health capacity in rural areas through regional coordination between local mental health authorities (LMHAs), requiring them to develop mental health service development plans. (HB 633)
  • Increasing access to intensive home-based and community-based mental health services for children enrolled in Medicaid by giving managed care organizations flexibility to provide more cost-effective and evidence-based services as deemed medically appropriate. (SB 1177)
  • Improving school safety and mental health promotion by allocating $100 million to create a Child Mental Health Consortium that will leverage the expertise of health-related educational institutions to improve the child mental health care system in Texas and increase access to child psychiatry through telemedicine, and by allocating $100M to create a School Safety Allotment to assist with school safety and security training, prevention and treatment programs related to Adverse Childhood Experiences (ACEs) and suicide prevention in school. (SB 11)
  • Increasing the capacity of school districts and school personnel to support mental health and the healthy development of students by establishing training, policy and planning requirements, use of trauma-informed practices, social and emotional skill development, and comprehensive suicide prevention. (HB 18)
• Women and Children’s Health
  • Improving access to maternal health care services by creating a pilot program that will allow children to ride with their pregnant or postpartum mothers to their medical appointments under the Medicaid Transportation Program. (HB 25)
  • Improving maternal and newborn health for women and children with a drug dependency by expanding the Texas AIM program for hospitals to include bundles for maternal opioid abuse disorder. (SB 436)
  • Increasing access to healthcare services after a women’s 60-day Medicaid for Pregnant Women coverage expires by notifying them of their eligibility for the Healthy Texas Women (HTW) program. (SB 2132)
  • Improving access to postpartum services by developing a limited postpartum care service package for women enrolled in HTW for up to 12 months postpartum (SB 750), and creating a 5-year strategic plan to improve access to postpartum screenings, treatment and support. (HB 253)
  • Helping children stay active and healthy by updating existing nutrition and active play minimum standards at daycare centers & registered family homes to align with recommendations from the American Academy of Pediatrics. (SB 952)

Policy Work Continues During the Legislative Interim

Without a doubt, there was little political will this session to address comprehensive health care for our state’s low-income families. Notably, Texas continues to have the highest number of uninsured adults and children in the country, with little talk of a permanent fix or a backup plan to protect patients if Texas succeeds in repealing the Affordable Care Act. Identifying sound proposals that aim to secure healthcare coverage for the millions of uninsured Texans remains a top priority for Methodist Healthcare Ministries as we continue to advocate on behalf of the underserved in our 74-county service region.

We Remain Thankful to the Work and Contributions Made by All

Methodist Healthcare Ministries extends a heartfelt thank you to all of our hardworking elected officials in the Texas Legislature, especially our 10 Senate and 44 House members representing MHM’s 74-county service region. We appreciate allowing us the countless office visits made with lawmakers and Capitol staff, as well as their public endorsement of legislation and policies drafted to improve the health of Texas families. Our efforts were greatly strengthened and expertly led by our funded health care advocacy partners, including The Center for Public Policy Priorities, Children’s Defense Fund, Council for a Strong America, Healthy Futures of Texas, Meadows Mental Health Policy Institute, National Alliance on Mental Illness – Texas, National Association of Social Workers – Texas, Texas Impact, Texas Doctors for Social Responsibility, Texas Pediatric Society, Texans Care for Children and The Immunization Partnership.

 

86th Legislative Session Summary Reports

Below are links to additional excellent summaries by our advocacy partners.

· Center for Public Policy Priorities

· National Association of Social Workers – Texas

· Texas Coalition for Healthy Minds

· Texas Pediatric Society

· Texas Hospital Association

· Texans Care for Children

· Texas Impact (Blog)

 

Upcoming Hearings

• Posted Agendas for House Committees

• Posted Agendas for Senate Committees

 

Upcoming Events

Sept. 19-20: Center for Public Policy Priorities & Texas Association of Community Health Plans – Texas State of Enrollment Conference (San Antonio)

Sept. 26-27: Meadows Mental Health Policy Institute – Engage & Excel Conference (Austin)

Sept. 26-28: The Texas Tribune – TribFestival (Austin)

Oct. 3-4: Health Literacy Collaborative – TX Health Literacy Conference (San Antonio)

Nov. 8-9: NAMI Texas – Road to Resilience Conference (Houston)

 

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

• On Their Way to the Governor’s Desk
• Legislature Approves Extension of Cancer Prevention & Research Institute of Texas
• House Extends Health Care Coverage for Medicaid Mothers
• Bill Addressing Adverse Childhood Experiences Moves Forward
• Bill Promotes Best Practices for Physical Activity in Schools
• Senate Passes Medical Transportation Pilot Program for New Mothers

Upcoming Hearings for the week of May 20

Upcoming Events

View our 2019 Legislative Agenda

Advocacy Find your Rep How the Texas Legislature Works Bill Tracking Access to Care Behavioral Health Healthcare Workforce Women & Children's Health Research 2018 State of Texas Children: The Road to a Brighter Future

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State Updates

On Their Way to the Governor’s Desk

With a little more than a week left in the 86^th Legislative Session, bills are making their way to the Governor’s desk for his signature. Here are just a few that impact the delivery of health care for the communities we serve. 

HB 125 – Prohibits the state from publishing the home address of licensed mental health professionals online.

HB 2225 – requires birthing facilities to inform parents of deaf and hard of hearing infants about public resources available to them, including early childhood intervention (ECI) services.

SB 999 – develops a state plan to identify best practices related to the awareness, treatment and prevention of Alzheimer's disease.

SB 1142 – allows the Travis County Healthcare District (Central Health) to employ physicians to better provide medical care for indigent and needy residents.

SB 1378 – requires institutions of higher education planning to increase enrollment to medical degree programs to submit a specific plan to increase the number of corresponding first-year residency positions.

SB 2132 – provides women auto-enrolled into the state’s Healthy Texas Women (HTW) program with information about the program and a list of health care providers in the woman's geographic area.

Legislature Approves Extension of Cancer Prevention & Research Institute of Texas  

Approximately half of all cancers can be prevented through evidence-based prevention intervention services. Established in 2009, the Cancer Prevention and Research Institute of Texas (CPRIT) provides an infrastructure that supports and enhances the networks delivering cancer prevention services and conducting groundbreaking research throughout the state. On May 10, the Texas Senate passed House Bill 39 and House Joint Resolution 12 which will extend the CPRIT program and ask voters to amend the Texas Constitution to authorize $3 billion in general obligation bonds.

CPRITs investment in prevention grants makes it possible for the state to fully capitalize on its longstanding investment in Texas’ fight against cancer. Since 2010, CPRIT grantees have provided nearly 251,000 prevention vaccinations, 230,000 tobacco cessation services and 1,300,000 screening and diagnostics for breast, cervical, HPV-related, liver and colorectal cancers. Additionally, CPRIT has invested nearly 11 percent of its research portfolio – twice the national average – toward more than 150 cancer research projects aimed at improving survival rates and preventing children and adolescents from developing cancer. Methodist Healthcare Ministries worked with the American Cancer Society this legislative session to secure the reauthorization of CPRIT and ensure Texans receive lifesaving prevention clinical services and expedite innovation in childhood cancer research.

House Extends Health Care Coverage for Medicaid Mothers

The 2018 Texas Maternal Mortality and Morbidity Task Force Biennial Report found that 56 percent of maternal deaths between 2012 and 2015 occurred after 60 days postpartum. The most common contributing factor to maternal mortality included underlying medical conditions, such as diabetes and heart disease, due to the lack of access to quality care during the year after pregnancy and throughout the interconception period. On May 10, the Texas House voted 87-43 to pass House Bill 744 by Representative Toni Rose, which adopts the Task Force’s number one recommendation – to extend access to health care coverage from 60 days to 12 months following delivery.

The current 60-day postpartum coverage provided by maternal Medicaid does not allow women time to secure postpartum outpatient care and ensure access to interconception care services. Enabling eligible women to access and maintain continuous healthcare coverage is essential to help women identify and address health issues early on. HB 744 aims at improving the health of women, facilitate continuity of care, enable effective care transitions and promote safe birth spacing. Methodist Healthcare Ministries supports extending Medicaid coverage for women up to 12 months postpartum to ensure continuity of care, allowing women to receive treatment services for conditions such as substance use, diabetes and hypertension. House Bill 744 moves to the Senate where it awaits referral to committee and further action.

Bill Addressing Adverse Childhood Experiences Moves Forward

Texas ranks 30th in the nation for the number of children who have experienced two or more childhood traumas. Experiencing multiple stressful or traumatic events during childhood, known as adverse childhood experiences (ACEs), have shown to have profound effects on an individual’s cognitive, social and biological development. With nearly 24 percent of Texas children having experienced multiple ACEs, the Texas House voted 131-14 in favor of House Bill 4183 by Representative Tan Parker (R- Flower Mound), directing the state to develop a five-year strategic plan to address the social, health and economic impacts of adverse childhood experiences.

Studies have found that as the number of ACEs increases so do the risks of poor physical health, mental health and behavioral health outcomes. Using a public health framework, HB 4183 develops a strategic plan that identifies best practices and promotes the development of early intervention and prevention strategies to mitigate the impact of ACEs. Methodist Health Ministries supports empowering struggling families, promoting safe relationships and environments and building resiliency in children and families. On Wednesday, May 15, HB 4183 was heard by the Senate Committee on Health and Human Services and was left pending, awaiting further action.

Bill Promotes Best Practices for Physical Activity in Schools

Texas has the seventh-highest obesity rate in the country for youths between the ages of 10 and 17, with more than 600,000 youths considered obese. Children who are overweight or obese are five times more likely to be overweight or obese as adults and have an increased likelihood of developing chronic diseases, including diabetes and heart disease. On May 9, the Senate Committee on Education heard House Bill 455 by Representative Alma Allen (D-Houston), which provides guidance to school districts on adequate recess time while maximizing the effectiveness of outdoor physical activity.

Daily recess is shown to have health, social and academic benefits for students. Currently, the state does not provide school districts with specific guidance as to the best-practices for constructive physical activity and outdoor play time. HB 455 directs the Texas School Health Advisory Committee to develop age-appropriate model recess policies that encourage constructive outdoor play time. Methodist Healthcare Ministries provided written testimony to the Senate Education Committee in support of preventing obesity early in a child’s life to improve their health and productivity into adulthood. The bill was left pending in committee and awaits further action.

Senate Passes Medical Transportation Pilot Program for New Mothers

For many mothers in rural and urban areas, transportation to medical appointments is a significant barrier resulting in forgone health care or missed appointments. Missed appointments delay care which is associated with disrupted patient care, increased medical costs and increased emergency room visits. On Thursday, May 16, the Texas Senate voted overwhelmingly in support of House Bill 25 by Representative Mary Gonzalez (D-Clint), which creates a pilot program allowing pregnant and postpartum women to ride with their children to their pregnancy-related medical appointments under the Medicaid medical transportation program.

Currently, state and federal funds are not allowed to be used to transport a person who is not a Medicaid beneficiary to a medical appointment. This results in mothers having to travel without their children if they are going to a prenatal or postpartum appointment. HB 25 would allow health plans to leverage existing partnerships with ridesharing services to arrange for transportation for mothers and their children. The pilot program seeks to determine if the program reduces pregnancy-related complications, improves access to medical care and decreases missed appointments. Methodist Healthcare Ministries supported HB 25 as it worked through the House and Senate committee process. The bill, as amended in the Senate, heads back to the House for concurrence.

Upcoming Hearings for the week of May 20

• Posted Agendas for House Committees

• Posted Agendas for Senate Committees

Upcoming Events

Monday, May 27 – Last day of the 86th Legislative Session (Sine Die)

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

• State Trauma Program Funding Bill Moves Forward
• House Tackles Property Tax Reform
• Bexar County House Freshman Ray Lopez Files Bills Protecting Vulnerable Youths
• Adequate Physical Activity Key to Future of National Security

Upcoming Hearings for the week of May 6

View our 2019 Legislative Agenda

Advocacy Find your Rep How the Texas Legislature Works Bill Tracking Access to Care Behavioral Health Healthcare Workforce Women & Children's Health Research 2018 State of Texas Children: The Road to a Brighter Future

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State Updates

State Trauma Program Funding Bill Moves Forward

Every four minutes someone in Texas is faced with an unexpected traumatic injury – annually resulting in over 130,000 trauma hospitalizations and costing designated trauma centers nearly $300 million in unreimbursed trauma care services. To help offset the unreimbursed costs and sustain the state’s trauma care system, the Texas Legislature created the Driver Responsibility Program (DRP) in 2003. Over the course of the 16-year program, however, the DRP has received growing opposition for its impact on low-income drivers and families. On May 1, Representative John Zerwas (R-Fulshear) laid out House Bill 2048 for consideration on the House floor, which repeals the DRP and proposes a new funding source for the state’s entire trauma care system.

The current DRP levies fines and surcharges over a three-year period for reckless driving and moving violations such as DWIs ($1,000 a year), driving without an insurance or valid ID ($250 a year) and driving with an expired license ($100 a year). When Texans are unable to pay the DRP fines, their driver’s licenses are revoked, resulting in more than 1.4 million drivers losing their licenses since the inception of the program. HB 2048 proposes reinstating revoked driver’s licenses due to unpaid fines, repealing the program, and replacing the funding using three different mechanisms: increasing state traffic fines from $30 to $50, imposing a $4 fee on auto insurance policies, and raising the fees for DWI to $3,000, $4,500, and $6,000 for subsequent convictions, respectively. The bill was amended on the House floor, including the addition of a provision that increases the amounts allocated to Emergency Medical Services and the Regional Advisory Councils by 2 percent and 1 percent, respectively.

House Bill 2048 received broad support from health care stakeholders, including the Texas Hospital Association, Texas Sheriff’s Association, HCA Healthcare, CHRISTUS Healthcare, University Health System, Doctors Hospital at Renaissance and the San Antonio Police Department. HB 2048 was voted out by the House on a vote of 143-0 and sent to the Senate where it awaits to be referred to committee. Methodist Healthcare Ministries supports the passage of HB 2048 and its efforts to develop a sustainable and equitable funding stream for the state’s trauma care system.

House Tackles Property Tax Reform

Property tax and education reform bills have been the top policy issues of the 2019 legislative session. Legislators have routinely heard from constituents who have voiced concerns with rising property taxes, and confusing tax systems. On April 30, the Texas House debated Senate Bill 2, sponsored in the House by Representative Dustin Burrow (R-Lubbock), who stressed to House members that the intent of SB 2 is to make the tax process more transparent, though the bill does not aim to lower property tax rates.

The House approved Senate Bill 2 by a vote of 107-40, with 20 members of the Democratic party voting in favor of the bill. As passed, the bill requires cities, counties and emergency service districts to hold an election to raise property tax revenue above 3.5 percent from the previous year, matching the version passed by the Senate last week. Both versions also allow taxing units to include indigent health care costs into their revenue growth calculations, although with slightly different mechanisms. Efforts to add amendments that would exclude flood risk mitigation, public safety expenses and economic development expenditures from the revenue growth calculations were voted down.

State leadership applauded the bill’s passage, despite strong opposition from cities and counties. Local government officials fear the unintended consequences of the reform will restrict both short term and long term growth needs without providing meaningful tax relief for its residents. Senate Bill 2 has moved to conference committee where conferees will negotiate final terms.

Bexar County House Freshman Ray Lopez Files Bills Protecting Vulnerable Youths

Newly sworn-in House member, Representative Ray Lopez (D-San Antonio), was given the opportunity to debate his bill, House Bill 4753, last week in the House Committee on International Relations and Economic Development. The bill calls for a study to examine the growing cost of child care affecting hard-working families throughout the state. Lopez, a former member of the San Antonio City Council, won a special election runoff to replace former state Representative Justin Rodriguez, who gave up his seat to accept an appointment as Bexar County Commissioner.

Lopez shared with committee members that some families are forced to spend up to 30 percent of their annual income on child care, much higher than the 7 percent level recommended by financial analysts. The disparity, disproportionately affecting single-family households with low incomes, recognizes that children of parents with limited incomes consequently lack access to child care resources. Representative Lopez stressed that investing in child care was the first step toward ensuring a child’s success and healthy development. HB 4753 was left pending in committee, where it will likely remain due to legislative session deadlines.

Representative Lopez also introduced House Bill 4757 which looks to improve access to healthcare coverage for youths in foster care. Under current law, youths aging out of foster care have access to state healthcare coverage until the age of 26, however many lose their coverage after they age out due to the difficult renewal processes and application forms that must be submitted annually. HB 4757 would streamline the redetermination process and create an auto-renewal process for youths after leaving state conservatorship to prevent any disruption in services, treatment or medication. Methodist Healthcare Ministries supports Representative Lopez’s initiative to protect the underserved and ensure access to healthcare coverage for all vulnerable populations.

Adequate Physical Activity Key to Future of National Security

Nearly 33 percent of youths in Texas are too overweight to serve in the military, and obesity is one of the leading reasons why 73 percent of young adults in Texas are ineligible to serve in the military. On May 1, Methodist Healthcare Ministries’ advocacy partners, Mission: Readiness and the Partnership for a Healthy Texas, held a press conference highlighting the importance of increasing physical activity in schools to curb the obesity epidemic. Senator Campbell (R-San Antonio) and Senator Kirk Watson (D-Austin) noted in their comments that this was a national security concern and both supported the implementation of obesity prevention strategies, such as the passage of Senate Bill 364 to ensure recess policies are adopted in all schools.

Dr. Deanna Hoelscher, Regional Dean of the UTHealth School of Public Health at Austin, explained that childhood obesity is estimated to cost an additional $12,900 in medical care per overweight child, placing a significant burden on the healthcare system. Retired U.S. Army Major General Rick Noriega added that engaging in meaningful recess and physical activity in schools would ensure Texas develops a healthy workforce and strong military. With the obesity rate of fourth-grade students in Texas currently 44 percent higher than the national average, the time to act is now.

Methodist Healthcare Ministries remains a staunch advocate in preventing childhood obesity. It supports an upstream approach which includes supporting the Partnership for a Healthy Texas’ Senate Bill 1834, which creates a pilot program to incentivize the purchasing of healthy foods for individuals using SNAP benefits and Senate Bill 952, which creates standards for nutrition, physical activity and screen time in licensed child care facilities. Both bills have passed the Senate and are waiting to be heard in the House Committee on Human Services.

Upcoming Hearings for the week of May 6

• Posted Agendas for House Committees

• Posted Agendas for Senate Committees

 

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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In this issue:

• Knowing the Immunization Status of Students in a School Campus Matters

• Increasing the Physician Loan Repayment CapHelps Rural and Underserved Areas

• APRNs and PAs Prescribing Authority Improves Access to Care

• State Property Tax Cap Bill Weakens Local Health Care Safety Net Systems

Upcoming Hearings for the week of April 29

Upcoming Meetings & Events

 

View our 2019 Legislative Agenda

Advocacy Find your Rep How the Texas Legislature Works Bill Tracking Access to Care Behavioral Health Healthcare Workforce Women & Children's Health Research 2018 State of Texas Children: The Road to a Brighter Future

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State Updates

Knowing the Immunization Status of Students in a School Campus Matters

Texas has seen a twentyfold increase since 2003 in the number of nonmedical exemptions for school vaccination requirements. Vaccination exemptions tend to cluster geographically, create pockets of under-vaccinated children, and leave communities vulnerable to disease outbreaks, such as measles and whooping cough. On April 23, Senator Kel Seliger (R-Midland) laid out Senate Bill 329, also known as the “Parent’s Right to Know Bill,” in the Senate Health and Human Services Committee. The bill aims to improve community awareness on the importance of vaccinations and improve the state’s ability to identify pockets of disease and implement timely public health interventions.

Immunization exemption data currently collected by the state of Texas is aggregated at the school district level. Parents in support of SB 329 contend that sharing the data at the local campus level will improve community awareness and allow families to make informed decisions when enrolling their children in school. Testimony shared with committee members pointed out that parents of children with compromised immune systems need access to the data collected by the government on their child’s immediate surroundings so that they can make decisions related to their child’s health and well-being. Rekha Lakshmanan, with The Immunization Partnership, testified in support of SB 329, noting the bill ultimately seeks to provide greater transparency regarding the number of immunization exemptions which puts Texans unnecessarily at risk of vaccine-preventable diseases. Witnesses opposed to the bill claimed improving transparency would result in a backlash against unvaccinated individuals.

Organizations signing up in support of SB 329 included the Texas PTA, Williamson County Health District, Texas Public Health Coalition and Texas Medical Association, which explained how the school campus data would be invaluable in responding quickly to disease outbreaks. Methodist Healthcare Ministries supports SB 329 and is a longtime advocate of immunization policies that protect children and their families. The bill was left pending in committee.

Increasing the Physician Education Loan Repayment Cap

Texas ranks 47th in the nation in its ratio of primary care physicians to total population. The low ratio of primary care providers impacts access to care, especially for the 6 million Texans living in 123 counties with a full primary care professional shortage area designation. To encourage new physicians to work in underserved communities, Texas currently pays up to $160,000 of a physician’s student loan in return for a four-year commitment to practice in an underserved area and care for patients enrolled in the CHIP and Medicaid programs. Over the last five years, the program, known as the Physician Education Loan Repayment Program (PELRP), has enrolled 750 physicians caring for patients in rural communities, urban community health centers and correctional facilities. On April 23, the Senate Higher Education Committee took testimony on Senate Bill 998 by Senator Chuy Hinojosa (D-McAllen), which revamps the PELRP by increasing the maximum available loan repayment amount to each participating physician by $20,000 over a four-year term for a maximum of $180,000. This increased amount more closely reflects the educational debt load of recent medical graduates.

According to the Association of American Medical Colleges, 76 percent of medical students graduate with student debt and their total debt load has increased significantly over the past decade. The average educational debt of a new physician has grown from $173,000 in 2011 to $190,000 in 2016. Testifying in support of SB 998, Alan Schalscha, Chief Medical Officer of CommUnityCare, emphasized that the increased loan repayment amount is necessary to remain competitive with actual physician debt and will assist in attracting physicians to practice in medically underserved areas. The bill received support from many stakeholders, including the Texas Association of Community Health Centers, the Teaching Hospitals of Texas and the Texas Medical Association. Methodist Healthcare Ministries works to secure physicians for rural clinics who are often unable to successfully recruit providers for their communities. Passage of SB 998 will strengthen the PELRP and allow medically underserved areas to competitively recruit physicians for necessary medical care. The bill was left pending in committee.

APRNs and PAs Prescribing Authority Improves Access to Care

In Texas today, there are 206 counties designated as a mental health professional shortage area, with 73 percent of these counties lacking a single psychiatrist. As a result, patients must often wait several weeks or drive several hours for an appointment to see a psychiatrist. Currently, only psychiatrists can prescribe schedule II controlled substances, such as ADHD medication, pain medication or even opioid treatment medications. However, 42 other states already allow advanced practice registered nurses (APRNs) and physician assistants (PAs) to prescribe these drugs under a physician’s supervision. On April 24, the House Public Health Committee heard testimony on House Bill 2250 by Representative Eddie Lucio, III (D-San Benito), which looks to improve continuity of care, increase access to care and reduce administrative burdens for hospitals.

The future of health care depends on a team-based approach to patient care. Under the current law, a supervising physician must be present for an APRN or PA to prescribe or adjust a Schedule II drug. Testifying in support of House Bill 2250, Sharon Hilgartener, with Texas Nurse Practitioners, stated that changing the dosage of pain medication while the patient is in the hospital is currently within her scope of practice. However, upon discharge, if the dosage on a patient’s prescription needs to change, a physician must sign off. The inability to reach a physician often results in delayed patient discharge, decreased throughput, decreased patient satisfaction scores and ultimately lower reimbursement rates. The Texas Medical Association also went on record in support of HB 2250. Methodist Healthcare Ministries values a patient-centered system of care that reflects the patients’ needs and improves access to health care services. The bill was left pending in committee.

State Property Tax Cap Bill Weakens Local Health Care Safety Net Systems

Texas’ rapid population increase places an unparalleled demand on its police, firefighters, paramedics and other local community services. As the cost of providing these services continues to rise, local governments rely on their ability to raise funds through property tax revenues to meet the needs of their residents. Under current law, local governments may raise property tax revenue by up to 8 percent without holding a local election. On April 15, the Texas Senate passed Senate Bill 2 by Senator Paul Bettencourt (R-Houston), which seeks to limit the capacity of local governments and special purpose districts to raise taxes by more than 3.5 percent above the previous year’s revenue and retains a 2.5 percent revenue cap for school districts. Reducing the property tax cap restricts local governments from providing necessary services, such as building and maintaining essential infrastructure, investing in schools and protecting against public health threats.

Local government officials and health care advocates from across the state are opposed to the current language in the Senate’s property tax cap legislation. The legislation threatens to weaken an already vulnerable health care safety net system, especially for providers in rural communities, who cannot rely on state and federal reimbursement to remain viable. Property tax revenues are also used to maintain the underfunded Texas trauma system as well as to offset the state’s share of Medicaid payments to hospitals.

Senate Bill 2 differs from the House’s property tax bill, House Bill 2 by Representative Dustin Burrows (R-Lubbock), which will be debated April 30 on the House floor. The current proposal places a 2.5 percent revenue cap on counties, cities and special purpose districts; however, the bill exempts local hospital districts and school districts from the revenue cap.

Methodist Healthcare Ministries remains engaged in tracking state legislation that restricts local governments from meeting their basic obligations to citizens. Texas needs a fully funded and sustainable health care safety net system to serve the uninsured and underserved of this state.

Upcoming Hearings for the week of April 29

• Posted Agendas for House Committees

• Posted Agendas for Senate Committees

Upcoming Meetings & Events

Saturday, May 4 at 10:30 – Minds Matter Conference; Breaking the Silence on Suicide (San Antonio College)​

For more information on health care research, policy or advocacy, please contact Chris Yanas at cyanas@mhm.org.

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