Legislative Update, December 14th
With less than a month to go before the start of the 86th Legislative Session, Methodist Healthcare Ministries is gearing up to review hundreds of bills impacting the health and well-being of all Texans, especially our most vulnerable citizens. In this newsletter, we will provide regular updates on filed bills, hearings, and votes taken on issues impacting the health of our families.
- Bill Filing for 86th Legislative Session Begins
- State of Texas Children Report Reveals Poverty and Health Risk Among Texas Kids
- House Select Committee Combats Opioid and Substance Use Epidemic
- Texas Day Care Investigation Reveals Abuse and Neglect
- HHSC Identifies New Strategies to Increase Quality Care for Family Planning
Texas’ 86th Legislative Session does not officially start until Tuesday, January 8, 2019, but lawmakers were able to get a head start on filing legislation as of November 12, 2018. Texas lawmakers filed more than 4,000 bills by the end of the first filing date and some of the filed legislation looks to affect access to healthcare for Texans. House Bill 80, by Linda Ortega (El Paso), would require a report relating to shortages in certain health professions. On the Senate side, Senator Jose Menendez (San Antonio) filed Senate Bill 105 to create a mental health jail diversion and crisis stabilization unit five year pilot program in Bexar County to evaluate, stabilize, and redirect individuals to the most appropriate and least restrictive setting. Methodist Healthcare Ministries is in the process of reviewing legislation impacting the healthcare of all Texans and will provide updates in its weekly newsletter throughout the 86th Legislative Session. Click here to sign up for Legislative Updates.
Methodist Healthcare Ministries and the Center for Public Policy Priorities (CPPP) released the 2018 State of Texas Children report showing that Texas children lag behind their peers across the country in access to health care and educational opportunities. The report lays out the challenges Texas children and families face and offers key policy solutions for state leaders to consider. According to the report, Health insurance rates have improved since the passage of the Affordable Care Act, but 671,000 Texas kids remain uninsured, and significant barriers to health insurance coverage for Hispanic children persist. The report recommended that policymakers protect and expand comprehensive and affordable health insurance coverage for Texas families.
The 2018 State of Texas Children report was released at a briefing in San Antonio on November 15. Over 250 advocates, service providers, public officials and concerned Texans attended the event, which also featured a policy discussion with State Representative Diego Bernal, CPPP Legislative and Policy Director Luis Figueroa and journalist Bekah McNeel. At the briefing, several community members supported expanding access to health insurance and family planning services and protecting Medicaid and CHIP from cuts. Jaime Wesolowski, president and CEO at Methodist Healthcare Ministries, addressed the group and reminded the audience that Texas has consistently ranked in the bottom ten states for child well-being. Ensuring that lawmakers have the latest data and policy recommendations for the upcoming legislative session is an important role that s been spearheaded by the Ministries for many years to ensure that Texas kids are on a path to a bright future through policies that improve the conditions of all Texas kids and put them on the road to success.
In 2016, more than 2,800 Texans died due to a drug overdose. The following year, 90 out of 172 child fatalities involved with the Texas Department of Protective Services were caused by abuse or neglect and involved a parent or caregiver actively using a substance and/or under the influence. This substance use crisis in Texas prompted the Texas House of Representatives’ Speaker Joe Straus to appoint the Select Committee on Opioids and Substance Abuse to provide recommendations to the upcoming 86th Legislative Session for combating the abuse of opioids and other drugs. Over the past 18 months, the Select Committee has reviewed the prevalence and impact of substance use disorders throughout different populations, studied policies and guidelines to monitor and prevent abuse of prescription drugs in state programs, identified the impact of opioids in the healthcare field and examined the impact of substance use disorders in Texas.
In their Interim Report to the 86th Texas Legislature, the Select Committee identified key recommendations to combat the opioid and substance use challenges through prevention, intervention and treatment and recovery efforts. One key finding is to continue the emphasis on integrated care, which provides care for the whole person and does not separate physical health from mental health. Advocates expressed the challenges of siloed care and the lack of ability to charge for varied services in a single visit to a facility on the same date, as opposed to integrated care. The committee also studied the prevalence of substance use disorders in specific populations and supported efforts to establish substance use treatment programs through other health programs for specific populations, such as Medicaid for Pregnant Women and Texas Veterans + Family Alliance Grant Program. They recommended looking into a funding mechanism to improve recovery housing initiatives for families, veterans, homeless and those with mental illnesses. More than 70 recommendations were included in the report to improve prevention practices and education, enhance prescription monitoring, increase supply management/medication disposal programs and expand treatment options for substance use disorders. Methodist Healthcare Ministries monitored the Select Committee hearings throughout the interim and supports the funding of additional substance use programs throughout the state, especially in rural areas.
In a news report released by the Austin American Statesmen this week, investigative reporters found more than 450 children were sexually abused and 88 others died of abuse and neglect in Texas day care facilities in the last decade. The year-long investigation details the dangerous conditions that exist inside many Texas day care sites, leaving hundreds of children with serious injuries since 2007. The Statesman analyzed 40,000 inspection records and found that more than 450 children – almost one a week – suffered sexual abuse inside a day care facility during the past 10 years. Nearly half of the 88 children who died of abuse and neglect were in illegal centers. Reporters insist that state regulators have failed to take the necessary steps to ensure child safety, reduce surveillance of illegal centers or utilize data to identify preventable problems.
After reviewing the report, Texas Governor Greg Abbott and other state legislators pledged to address day care safety during the upcoming legislative session. Senator Judith Zaffirini (Laredo) is proposing a statewide study that would assess whether Texas’ staff-to-child ratios in day care centers lead to a more dangerous child care environment. Senator Kirk Watson (Austin) is looking at ways that the state can reestablish the Department of Family and Protective Services Investigative Unit, which was disbanded in 2017, to shut down illegal day care centers. Methodist Healthcare Ministries will continue to monitor this issue during the 86th Legislative Session and will support legislative recommendations that aim to protect and ensure the safety of Texas children.
Texas has the fourth highest birth rate in the United States with more than 400,000 births in 2016. Of those, 52.5% of all state births were funded by the state’s Medicaid program. Data shows that 34.6% of women report their pregnancy was unintended, which can have significant consequences for individual women and their families. Research states that births resulting from unintended or closely spaced pregnancies link to adverse maternal and child health outcomes and numerous social and economic challenges. To address this problem, the Texas Health and Human Services Commission (HHSC) released a Long-Acting Reversible Contraception Strategic Plan that discusses the efficacy and benefits of long-acting reversible contraception (LARC) devices, billing and reimbursement challenges, accomplishments and measures to ensure quality care is provided.
In order to reduce unintended pregnancies and promote better birth outcomes, Texas is working to increase access to LARC devices, which are highly effective for preventing pregnancy and can last for several years. The report outlines several strategies to increase education and access to LARC devices, such as increasing efforts focused on educating women on available services in Texas and identifying best practices for reimbursing immediate postpartum LARC devices. Currently, state reimbursement does not always align with the acquisition cost since Medicaid rates and manufacturer rates are not updated at the same time. In their strategic plan, HHSC has identified improvements that can be made to ensure adequate statewide access. Methodist Healthcare Ministries supports HHSC’s efforts to reduce existing barriers to LARC devices while increasing education and access statewide.
Dec 19: HHSC Proposed Amendments for Early Childhood Intervention Services Rules (San Antonio)
Jan 8: First Day of 86th Legislative Session (Austin)
Jan 19: State of D19 Senatorial Address with State Senator Pete Flores (San Antonio)
Jan 24: Children’s Health Coverage Coalition Legislative Briefing (Austin)
Children's HealthTexans Care for Children: Report highlights strategies to prevent teen pregnancy in foster care
Access to Care
Kaiser Family Foundation: How Many of the Uninsured Can Purchase a Marketplace Plan for Free?
Houston Chronicle: Both men and women say state must spend more on health care, study says