UTMB 80th Texas Legislative Session Wrap-Up
JULY 2, 2007--When the Texas Legislature met for its 80th session earlier this year, many agencies and programs across the state—including UTMB—were cautiously optimistic. For the past two sessions, the State Legislature, which meets every two years to review and make laws and set the state budget, had struggled with budget shortfalls. The resulting cuts affected us deeply at UTMB and others at agencies throughout Texas. This session, although there were more dollars available, elected officials faced long lists of needs and wants.
UTMB’s estimated budget for 2008 is $1.5 billion. The state provides direct support for approximately 21 percent of the university’s budget , with the lion’s share (57 percent) coming from earned clinical revenue, or payment for clinical services UTMB provides. There are many ways decisions at the state level—including those about the budget—affect the university’s operations and have an impact on us as care givers, educators, scientists, students and employees. The state is one of the large consumers of UTMB clinical services—our contract with the TDCJ being one important example. The fees we collect for providing care to approximately 80 percent of the state’s inmate population contributes significantly to the total number of state dollars that flow to the university.
When asked how UTMB fared during this funding cycle, President John Stobo gave the results a respectable “B” and thanked those who had worked so hard on the university’s behalf, including the region’s legislative delegation.
He also called attention to the message elected officials seemed to be sending regarding funding for health care of the uninsured: while UTMB has a recognized statewide service mission, the vast majority of uninsured patients we see come from the six counties surrounding UTMB.
Many legislators consider the issue of unsponsored care in Southeast Texas a regional issue that needs to be addressed locally rather than at the state level and, while they did not reduce the current level of support, it’s unlikely that additional state funds will be allocated for indigent care in this region in the future. UTMB remains committed to doing as much as it possibly can for the uninsured, by focusing on using limited resources to care for the greatest number of people, by being innovative and creative in approaches, and by strengthening existing partnerships and creating new ones.
Other key points from the 80th session:
- There was a total FY 08/09 General Revenue Appropriation to UTMB of $457.7 million. This represents a 4.9 percent increase over FY 06/07, including payments for clinical services. It also includes $9.9 million in formula funding increases for education and research, and $9.5 million in tuition revenue bond funding for the Galveston National Lab. Another $2 million in new special item funding for work supporting the Stark Diabetes Center was recently vetoed by Governor Perry.
- There was a one-time allocation for business revenue losses due to the Hurricane Rita evacuation ($13.1 million). Otherwise, there were no increases in UTMB hospital and indigent care appropriations.
- A new restriction was put on use of the $10 million per year unclaimed lottery appropriation for UTMB to provide indigent care. While funds remain available to care for unsponsored patients from across the state, UTMB can only access those funds for patients from Galveston, Harris, Brazoria, Jefferson, Montgomery, and Fort Bend counties if those counties raise their county indigent care program eligibility above 21 percent of the federal poverty level ($3,606 per year for a family of three).
- There was granted new authority for UTMB and other state-owned hospitals to work with the Health and Human Services Commission to reestablish Medicaid GME hospital payments (this funding was eliminated in 2003).
- Medicaid and Children’s Health Insurance Program (CHIP) rate increases for physicians and other providers statewide were approved; this represents the first rate increases since 2001 (up to 25 percent for children’s services and 10 percent for adult services).
- Medicaid rate increases for hospitals will start FY 09 (all hospital rates will be “rebased” rather than simply increased, meaning payment rates will be recalculated for all procedures at all hospitals).
- CHIP eligibility was restored to 12-months; it had been reduced to six months in 2003.
- A comprehensive Medicaid reform bill (SB 10) passed, which includes authorization for three-share programs. This bill is the basis for what will be substantial interim activity on health care: it authorizes pursuit of a federal waiver to redesign the state’s Medicaid program to provide tailored benefits packages, pilot health lifestyle programs, and support programs that decrease the number of uninsured. It also creates a Medicaid Reform Legislative Oversight Committee to oversee the reforms.
- There was passage of legislation to increase consumer access to health care provider and insurer information (SB 1731), and require new hospital infection reporting (SB 288).
- A state employee pay raise of two percent per year was passed, but it does not apply to those employed in higher education. However, the state’s financial contribution to group insurance costs for higher education increased by $18.2 million. For TRS, the retirement plan available to most UTMB employees, the higher education retiree insurance contribution rate increased from 6 to 6.58 percent, representing a state investment in the retirement plan of $122.3 million.