SENATE COMMITTEE ON HEALTH SERVICES HELD FIRST INTERIM PUBLIC HEARING
AUSTIN - The Senate Committee on Health Services held its organizational meeting and first briefing on the new interim charges in the Senate Chamber, Thursday, November 4, 1999. Members of the committee include Senators Jane Nelson of Flower Mound, as chair, Mike Moncrief of Fort Worth, as vice-chair, Jon Lindsay of Houston, Frank Madla of San Antonio, and Drew Nixon of Carthage. Committee members were briefed by representatives from executive agencies and institutions of higher learning concerning issues related to the six interim charges issued by Lt. Governor Rick Perry.
The first charge deals in part with the implementation of the Texas Medicaid managed care system. Testimony was given by Don Gilbert, Commissioner of the Texas Health and Human Services Commission. Texas began the transition to managed care for certain recipients of Medicaid services in 1993. Today, of the 2.5 million Texans who receive Medicaid, over 415,000 are enrolled in a managed care plan. This number will continue to grow when the plan is implemented in Dallas and El Paso, bringing Medicaid managed care to a total of 52 counties in the state by the year 2000. Medicaid is financed by federal funds and matching state funds. One concern brought up during the meeting relates to the 140 hospitals in the state receiving a disproportionate amount of indigent patients. Nine contributing hospitals are sharing part of their funding until a better solution is found.
The first charge also asks the committee to examine how the state and Medicaid managed care are dealing with chronic illnesses and how to develop specific strategies for disease management for specific populations. Dr. William "Reyn" Archer, Commissioner of the Texas Department of Health, directed his attention to the extended problem of asthma and diabetes among the Hispanic population and strategies to prevent the growth of the problem. Study of the causes, preventive measures, early monitoring and a continuum of care to reduce hospitalization are some of the strategies. Dr. Archer expressed concern about school lunch programs where "even the water is fried," how schools miss the opportunity to teach kids about healthy food habits, and the dubious benefit of soda machines in schools. He said that instead of a reactive approach, Texas has to take a preventive and collective approach, or there will be even more serious health problems in the future.
The second charge focuses on pharmaceutical, biotechnologic and genetic research currently occurring in Texas, and how to maximize their benefits for the population. Invited testimony was provided by Tom Kowalski, President of Texas Healthcare and BioScience Institute, and William D. Neaves from U.T. Southwestern Medical Center at Dallas. Although Texas is a newcomer in the industry and lags behind other states in the nation, the future looks good. Promising medications are being developed by the industry and its statewide employment growth is superior to the nation's. Both witnesses praised our state's highly qualified learning and research institutions and the role they play in the advancement of the industry.
The third charge relates to patient specific medical information, including prescription data, and how to keep it private. Testimony was provided by Gay Dodson from the State Board of Pharmacy, Dr. Archer from the Texas Department of Health, and Rhonda Myron from the Texas Department of Insurance. Cases of pharmacists selling patient information to pharmaceutical companies have been reported, but violations are not the standard. The committee will continue investigating this issue as well as the other charges during the interim.
Dr. William "Reyn" Archer from the Texas Department of Health also briefed the committee about its fourth charge, regarding the physician voice in the Vaccines for Children (VFC) Program.
Charge number five asks the members to examine the preparedness of the Texas health care workforce in meeting the needs of Texans beyond the year 2000, including methods to retain Texas-trained medical personnel. Dr. Ben Raimer from the Texas Statewide Health Coordinating Council gave testimony about these topics. Demographic changes and the aging baby boomer population are issues of concern because of their impact on health services and the workforce. Another problem is Texas' high number of uninsured residents. The witnesses in attendance say at this point, nobody can assess how serious the problem can become, but Texas already suffers from a shortage of nurses. The Human Genome Project, telemedicine, prevention and the education of the population were mentioned as part of the solution to the problem in question. The need of a more diverse workforce was also mentioned.
The sixth charge asks to examine the implementation and status of the Children's Health Insurance Program (CHIP). Testimony was given by Don Gilbert and Jason Cook, both from the Health and Human Services Commission. The new program offers health insurance to children of low income families. The application process will begin April 3, 2000, and implementation will begin on May 1. Jason Cook, in charge of the program, was praised by witnesses and members for the quick and efficient development of the new program, which is currently on schedule.
The committee will hold a series of public hearings throughout the interim. The committee will submit its findings in the form of a report to be presented to the 77th Legislature which will convene in January of 2001.