Legislative Update, April 8
- Texas Budget Bill Moves Through House and Senate
- Committee Looks at Incentivizing Healthy Food Purchases for SNAP Families
- Nurse Practitioner Bill Aims to Increase Access to Care
- House Bill Allows Dentists to Delegate Delivery of Anesthesia to Licensed Hygienists
Texas lawmakers worked until the late hours of the night on March 27 to debate the Texas budget for FY 2020-2021. As the only bill that must pass during the 140-day legislative session, lawmakers had one more opportunity to amend the proposed budget before it heads to the Senate and ultimately the conference committee negotiating process. More than 350 amendments were filed, however a large number were withdrawn by the authors or ruled out on a technicality. Ultimately, the House passed a $251 billion budget with $87.6 billion dedicated to health and human services programs.
Methodist Healthcare Ministries expresses its thanks to State Representative Roland Gutierrez (D – San Antonio) for filing an amendment to fully fund the reconstruction of the San Antonio State Hospital, estimated at $323 million for the 300-bed facility. The amendment was ultimately placed in Article XI of the House budget, essentially a wish list of proposals that are not formally adopted but do remain in play during conference committee negotiations.
House Bill 1 proceeded to the Senate Finance Committee last week and was heard Wednesday, April 4. The Senate Committee Substitute to House Bill 1 (CSHB 1) was voted out unanimously and is scheduled to be voted on by the full Senate Tuesday, April 9. CSHB 1 currently includes $248 billion with $92.2 billion allocated for health and human services. Specific initiatives in the Senate version include:
- $948 million for community mental health services for adults and children
- $315 million for Women’s Health Programs
- $313 million for early childhood intervention services
- $252 million for EMS and trauma care systems
- $167 million for immunizations initiatives for adults and children
With only seven weeks remaining in the 86thLegislative Session, Methodist Healthcare Ministries continues its efforts to advocate for programs and funding that impact the healthcare of our neediest families.
The Senate Health and Human Services Committee heard testimony this week on legislation that would direct the state to study local programs across communities working to incentivize the purchase of fruits and vegetables through the Supplemental Nutrition Assistance Program (SNAP). Senate Bill 1834 by Representative Carol Alvarado (D – Houston) would give low-income Texans access to affordable healthy foods through a state pilot program that would stretch current SNAP benefits even further.
Passage of the federal Agricultural Improvement Act of 2018, more commonly known as the Farm Bill, appropriated roughly $250 million over five years for SNAP incentive programs to encourage fresh produce consumption. Texas has started to take steps to promote the availability of SNAP incentive programs, such as the popular Sustainable Food Center’s Double Dollars program, which provides SNAP recipients an extra dollar for every dollar of SNAP benefits spent on locally grown fresh fruits and vegetables. A number of incentive programs exist at the local level, but to date, no state-level programming or investment has been made.
Farmers, grocery store owners, local vendors, and small retail stores would also benefit from higher sales of locally grown produce. Testifying on behalf of the Sustainable Food Center, Alex Canepa spoke in favor of SB 1834, stating his farmers markets currently support incentive programs. He noted that Texas is lagging other states who are already implementing successful programs, giving Michigan as an example.
SNAP benefits are 100 percent federally funded and assist millions of low-income families with the purchase of groceries. Studies show that many of these same low-income families are disproportionately struggling with obesity and Type 2 diabetes. Nearly 30 percent of all Texas children benefit from the SNAP program and over half of SNAP recipients in Texas are under the age of 18. Methodist Healthcare Ministries joined efforts with the American Heart Association and the Partnership for a Healthy Texas coalition to support the passage of SB 1834. The bill was left pending in the Senate Health and Human Services Committee by Chair Lois Kolkhorst.
Access to care advocates testified before members of the House Public Health Committee in support of House Bill 1792 by Representative Stephanie Klick (R-Fort Worth) which looks to expand access to primary care by providing a pathway to full practice for nurse practitioners, certified nurse midwives and clinical nurse specialists. The bill would require at least one year of experience under a delegating physician and increase the required continuing education requirements for APRNs from 20 to 48 hours, the equivalent of physician continuing education requirements.
Current Texas law prevents advanced practice registered nurses from providing health care to the full extent of their licensure and training. Today, APRNs must sign a delegation agreement with a collaborating physician to practice, even though the partnering physician is not required to be on-site or see any of the patients. Advocates testified this delegation agreement adds to health care bureaucracy and red tape, taking time away from patients and increasing costs for businesses and providers. Twenty-four states, the Veterans Administration and all branches of military have repealed laws that include these delegation agreements to increase access to care for their patients.
Testifying in opposition were physicians representing the Texas Medical Association as well as other independent providers, who shared that the extensive level of education and experience of a medical doctor were needed to ensure the necessary oversight and safety of patients. HB 1792 was left pending in committee.
Members of the House Public Health Subcommittee on Health Professions also heard testimony on House Bill 2275 by Representative Stephanie Klick (R-Fort Worth). The bill, as filed, would allow dentists to delegate to a licensed hygienist the ability to deliver an anesthetic in the presence of a dentist. The delegation provision is optional and does not create a mandate.
Witnesses testifying in support noted that this practice is currently allowed in 48 other states. The Texas Dental Hygienist Association registered in support of HB 2275 and shared the different levels of training and education necessary for accreditation. Dr. David Reeves, a member of the Texas Dental Association Periodontists and an instructor at the VA testified in support of the bill, stating that local anesthesia is safe when proper dosages and techniques are utilized. Testifying in opposition to the bill was a representative of the Texas Dental Association who stated the bill lowered the standards of care and was unnecessary. HB 2275 was left pending in committee. Methodist Healthcare Ministries signed up in support of HB 2275 which increases access to oral health in Texas.
Apr 15-16: TX Campaign to Prevent Teen Pregnancy 8thAnnual Symposium– Sponsored by Methodist Healthcare Ministries (Austin)
For more information on health care research, policy or advocacy, please contact Chris Yanas at firstname.lastname@example.org.