Health Related

CANCER RESEARCH FUND

HB 14 by Keffer/Nelson - Relating to creating the Cancer Research Institute of Texas and abolishing the Texas Cancer Council; granting authority to issue bonds and HJR 90 by Keffer/Nelson - Proposing a constitutional amendment providing for the establishment of the Cancer Research Institute of Texas and authorizing the issuance of general obligation bonds for the purpose of scientific research of all forms of human cancer. HB14 would create the Cancer Prevention and Research Institute of Texas and would subsume the role of the Texas Cancer Council by absorbing it but maintaining all of functions and obligations. Following voter approval in November, the Institute would be created and funded with General Obligation Bonds in the amount of $3 billion for 10 years; the bonds would be issued incrementally, at no more than $300 million a year. The funding would be issued as grants to public or private entities to expand cancer research and to make Texas a global leader in the fight against cancer.

TAMHSC or the College of Medicine has one of 9 non-voting seats on the Scientific Review Committee.  Grant recipients must show 50% matching funds which can be direct funds or supporting infrastructure such as salaries, laboratory/equipment.

The program would be funded by the issuance of General Obligation bonds to be paid from the first available GR funds. This program will be the largest ever use of general obligation bonds to fund a non-infrastructure project.  There would be no fiscal impact in the 2008-09 biennium, but the state would expect to begin paying out of GR after the first bond is issued in FY 2010, at a cost of roughly $16 million, followed by an increase peak in 2020 and then a gradual decrease as the final issuance of bonds is paid off in 2030. 

77,000 Texans are diagnosed with cancer every year, and 35,000 die from the disease.  A 1998 study by the LBJ School for Public Affairs estimates $14 billion in both direct and indirect costs from the disease annually. In 2008, cancer would directly and indirectly cost Texans $30 billion.

MEDICAID & CHIP REFORM / ACCESS TO CARE

HB 109 by  Turner / Averitt - Relating to eligibility for and the administration of the child health plan program.  As of January 2007, CHIP is serving only 321,815 children when there are 1.4 million children in the state of Texas lacking health care coverage.  Out of those children, there are over 700,000 children that are currently eligible but not currently enrolled in CHIP. Currently, Texas is 18,000 children below CHIP budgeted caseloads for 2006. 

HB 109 provides statutory changes and appropriations to increase CHIP enrollment by 200,000 children.  Reinstates 12 months of continuous coverage instead of six months, and reinstates "income disregards" expenses that drop a family's income to the eligibility level, such as child care expenses or work related expenses. 

HB 109 eliminates the assets test, and will reinstate a community outreach and education campaign to utilize school-based health clinics, community based organizations and coalitions to provide information and educate the community on CHIP, and eliminate the 90-day waiting period during all stages of the application process, unless the child was previously covered under another health benefits plan.

HB 109 requires HHSC, during the sixth month following the date of initial enrollment or reenrollment of an individual whose family income exceeds 150 percent of the federal poverty level, to review the individual's family income, authorizing HHSC to use electronic technology if available and appropriate, and to continue to provide coverage if the individual's family income remains within the income eligibility limits.

SB 10 by Nelson / Delisi - Relating to the operation and financing of the medical assistance program and other programs to provide health care benefits and services to persons in this state.  SB 10 seeks to improve the health status of Medicaid recipients and reduce the number of uninsured in Texas through reforms to the Medicaid program.  There are 5.5 million uninsured Texans, and in general, half the population are either uninsured or have some form of public coverage. In addition, the bill provides mechanisms to allow the HHSC to identify state and local funds that can be verified to provide a match for available federal funds.  Texas currently leaves millions in available federal funds unclaimed and the commission is obviously looking for ways to maximize the state funds that can be listed to match federal funds.

SB 10 allows Medicaid-eligible workers to enroll in an insurance plan offered by an employer and use Medicaid dollars to help offset the cost.  Under the premium assistance program, the state is eligible for up to $1 billion annually in federal funds to help pay for private insurance.  This could help provide health insurance to insure more than 200,000 working, uninsured adults.

SB 10 provides seed funding for multi-share programs in which insurance is offered through partnerships between employers, employees and other entities.  The TAMHSC School of Rural Public Health is mobilizing to assist communities in taking advantage of this section of the law.

  SB 10 also allows pilot programs to encourage health behaviors among Medicaid recipients;  authorizes HHSC to implement Health Savings Accounts in Medicaid if the strategy is found to be cost-effective; allows HHSC to seek an 1115 waiver to provide tailored benefits packages under Medicaid, based on population needs; authorizes the use of co-payments for non-emergency visits to emergency rooms; includes a pilot program to promote the adoption of electronic medical records usage in Texas Medicaid; and includes language of SB1095, requiring a study by the Texas Health Policy Council, UT San Antonio Center for State Demographics, and Texas Medical Board on increasing medical residency programs. 

NURSING SHORTAGE REDUCTION

SB 138 by Nelson / S. King - Relating to promoting the retention and graduation of students enrolled in professional nursing programs.  SB 138 seeks to increase nursing graduation rates (currently 56% on average), by requiring the Texas Higher Education Coordinating Board (THECB) to consider and develop methods to promote retention and graduation of students enrolled in a professional nursing program, including recommendations on financial aid and other recommended methods.  In addition, SB 138 requires CB to establish a program to recognize nursing programs that reach a graduation rate of 85 percent or more.  SB 138 is of interest to TAMHSC as it seeks approval to create a College of Nursing and collaborates with nursing programs in the TAMU System. 

SB 139 by  Nelson / Kolkhorst - Relating to a study on improving the curricula of professional and vocational nursing education programs.  SB 139 requires the Texas Higher Education Coordinating Board (THECB), in consultation with the Board of Nurse Examiners, to conduct a study regarding nursing program curricula improvement.  SB 139 also requires the study to focus on methods to improve instruction on providing safe and high-quality nursing care to patients.  Report due 12/31/2008.

SB 289 by Nelson / Morrison - Relating to the use of professional nursing shortage reduction program grants to encourage clinical nursing instruction by part-time faculty at public or private institutions of higher education.  The nursing shortage in Texas is exacerbated by a shortage of quality nursing faculty.  Nursing schools have difficulty recruiting and retaining faculty, as many practicing nurses make higher salaries than faculty and wish to remain in active practice.  SB 289 encourages nursing schools to utilize more part-time or adjunct faculty by allowing professional nursing shortage reduction grants to be used for part-time faculty.  This will help schools recruit nurses to serve as faculty who wish to remain in practice but also have a desire to teach.

HEALTH POLICY

HB 1066 by Delisi / Nelson - Relating to electronic health information, electronic health records, and creating the Texas Health Service Authority Corporation.  HB 1066 creates the Texas Health Services Authority, a non-profit, public-private collaborative charged with implementing the state-level health information technology functions identified by the Texas Health Information Technology Advisory Committee.  

The corporation is charged with facilitating development of a seamless electronic health information infrastructure to support the health care system in the state and to improve patient safety and quality of care. The corporation is established to promote, implement, and facilitate the voluntary and secure electronic exchange of health information and create incentives to promote, implement, and facilitate the voluntary and secure electronic exchange of health information.

The corporation has no authority and shall not engage in any of the following: (1)  the collection and analysis of clinical data; (2)  the comparison of physicians to other physicians, including comparisons to peer group physicians, physician groups, and physician teams, and to national specialty society adopted quality measurements; (3)  the creation of a tool to measure physician performance.   

The corporation is governed by a board of 11 directors appointed by the governor, with the advice and consent of the senate.  The governor shall also appoint at least two ex officio, nonvoting members representing the Department of State Health Services. 

The Governor shall appoint as voting board members individuals who represent consumers, clinical laboratories, health benefit plans, hospitals, regional health information exchange initiatives, pharmacies, physicians, or rural health providers, or who possess expertise in any other area the governor finds necessary for the successful operation of the corporation.

(Definition of “physician” includes a medical school or medical and dental unit, as defined or described by Section 61.003, 61.501, or 74.601, Education Code, that employs or contracts with physicians to teach or provide medical services or employs physicians and contracts with physicians in a practice plan.) 

HB 2542 by Kolkhorst / Estes - Relating to the continuation and functions of the Office of Rural Community Affairs.  HB 2542 enacts the recommendations of the Sunset Advisory Commission (commission) by creating a new 11-member board, continuing the agency for an eight-year period, and including several changes in law to address additional areas needing improvement within the office.  HB 2542 requires the office to:

  • assist rural communities in the key areas of economic development, community development, rural health, and rural housing, 
  • serve as a clearinghouse for information and resources on all state and federal programs affecting rural communities,
  • identify and prioritize policy issues and concerns affecting rural communities in the state while in consultation with certain individuals and groups,
  • make recommendations to the legislature to address the concerns affecting rural communities. 

SB 140 by Nelson / Kolkhorst - Relating to a study of the feasibility of providing immunizations to certain students enrolled in health professional degree programs.  SB 140 requires the Department of State Health Services (DSHS) and the Texas Higher Education Coordinating Board (THECB) to conduct a joint study regarding the feasibility of providing free or discounted immunizations to economically disadvantaged students enrolled in health professional degree programs at institutions of higher education in Texas.  The bill also requires the study to examine potential methods of providing those immunizations, and requires DSHS and THECB to submit a joint report including findings of the study and recommendations to the legislature no later than January 15, 2009. 

SB 415 by Lucio / McReynolds - Relating to a risk assessment program for Type 2 diabetes and the creation of the Type 2 Diabetes Risk Assessment Program Advisory Committee.  SB 415 enhances the diabetes risk assessment program, (ancanthosis nigricans (AN) screening program in certain elementary schools), which is administered by the Border Health Office of UT-Pan America. Currently, the program serves public school students throughout the state and has assessed more than 2 million children for the visual markers of the disease.  SB 415 establishes the Type 2 Diabetes Risk Assessment Program Advisory Committee to advise the on the program conducted under the chapter, and it designates a list of representatives that may be appointed to the advisory committee by the executive commissioner and it also provides a list of representatives appointed by the chairman of the council.

SB 530 by Nelson / Eissler - Relating to physical activity requirements and physical fitness assessment for certain public school students.  SB 530 provides that a school district shall require a student enrolled in kindergarten or a grade level below grade six to participate in moderate or vigorous daily physical activity for at least 30 minutes throughout the school year as part of the district's physical education curriculum or through structured activity during a school campus's daily recess.  A school district shall require students enrolled in grade levels six, seven, and eight to participate in moderate or vigorous daily physical activity for at least 30 minutes for at least four semesters during those grade levels as part of the district's physical education curriculum.

SB 1058 by West / Hodge - Relating to the creation of a reintegration counseling program for certain veterans and service members.  SB 1058 requires the Department of State Health Services and the Health and Human Services Commission to develop a directory of services and other resources, tools, and counseling programs available to aid veterans and their immediate families in the reintegration process.  SB 1058 also requires the adjutant general's department to develop a program to provide referrals to service members for reintegration services.  It requires the department, in developing the program, to consult with the state military forces, the National Guard Bureau, the United States Veterans Health Administration, the Texas A&M Health Science Center College of Medicine, and The University of Texas Health Science Center at San Antonio.

SB 1601 by West / F. Brown - Relating to the operation of the Joint Admission Medical Program and to admission to the program.  SB1601 clarifies the operation the Joint Admission Medical Program by changing deadline dates and criteria for admissions to the program. Fifteen percent of the eligible positions are to be reserved for sophomore-level students (to accommodate students entering from community colleges).