Health Policy and Legislative Affairs

Austin is back at it. The Texas Legislature gaveled into the first called special session at midday on Tuesday, July 18, to take up business that fell victim to the Mothers’ Day Massacre near the end of the 85th regular session.

Sine die—the last day of the regular session of the 85th Texas Legislature—arrived on Memorial Day, May 29. As we await word of a special session, I thought a review of where we’ve been and how our funding looks for the FY2018/2019 biennium would be helpful.

This week in Austin saw one of the most dramatic bill killings of all times. Pent up emotions found their way onto the House floor in what the media has termed the "Mother’s Day Massacre." The House Freedom Caucus, composed of very conservative members from north central Texas, used various parliamentary maneuvers Thursday evening and Friday to kill scores of bills.

Today (Thursday, May 11) is a magic day for this legislative session: when the clock strikes midnight tonight, the hundreds and hundreds of House bill that have made it through the laborious legislative process either live or die. If a bill has not cleared the hurdles of approval in the House by that time, it is dead. The only hope for resuscitation is to find a suitable bill that has cleared the House, and attach all or parts of the failed bill to the active bill as a floor amendment.

For the past several weeks, the sausage-making in Austin has ramped up. After much discussion over the different versions of the House budget and Senate budget, the two ended up with only a $500 million difference between them. Overall, that isn’t too bad for a budget that represents the 15th largest political economy in the world (after the nation of Spain).

While there is no question that the state faces budgetary challenges this session, there is also no question that the correctional health programs managed by UTMB for the past 23 years has provided a tremendous return on investment for Texas. We will continue to closely monitor how the budget for this important endeavor shapes up over the next couple of months.

Some say that “democracy” should be an action verb. And yet, many aren’t sure how to go about voicing kudos or concerns to their elected officials. Here are some tips for reaching Texas state legislators.

“Fast and furious” does not just apply to auto racing and movies! The House and Senate have worked at record speed to produce their respective budgets this session, finishing their work and sending it to their colleagues for approval mid-way through the legislative process.

Dr. David Callender, UTMB president, provided testimony before the Texas House Appropriations Committee’s subcommittee on Article III (Higher Education) on Tuesday, Feb. 21. After an introduction of UTMB's recent accomplishments, he acknowledged the $26.3 million in proposed budget reductions in the House’s budget bill (HB1) and asked the house to reconsider principle elements of the proposed reductions, including: formula funding, hospital formula, and special item funding.

The 85th Legislative session kicked into high gear last week and, as we suspected, promises to be anything but boring. In record time, the Senate released its proposed budget for the next biennium. It offers up $103 billion in state funding, which is less than the amount certified by the Comptroller. Within 24 hours, the House released its first-round budget, which proposes $108 billion for the next biennium.

On Tuesday, Jan. 10, 2017, the House and the Senate gaveled to order for the start of the 85th Texas Legislative Session. Led by Governor Greg Abbott and Lt. Governor Dan Patrick, 181 members of the Legislature will begin 140 days of deliberations that will impact the lives of Texans in ways they have not imagined.

It is often hard to hear the message because of the noise of the crowd, especially during the middle of political primary season. Perhaps you missed it several weeks ago when President Obama released his $4 trillion budget. The proposed budget would increase federal spending by 4.9 percent mainly driven by the nation’s mandatory programs (Social Security and the national debt interest). Discretionary spending would increase by less than 1 percent. Nevertheless, the President sent a loud and clear message to Congress regarding his priorities for the nation in his 8th and final budget.

The House Public Health Committee met on February 10th to consider their interim charge of studying and assessing the state’s preparedness for public health threats and emergencies including responding to natural disasters and highly infectious diseases.

UTMB’s Dr. Alex Vo testified before The House Public Health Committee on the current a future state of telemedicine in Texas.

The new Jennie Sealy Hospital is set to be dedicated on February 26th

Congress this fall enjoys the absolutely lowest ranking that it has ever had from the American voters. As a whole over 85% of Americans from both main political parties report that they are unsatisfied or very unsatisfied with the job that their elected representatives are doing in Washington.

Of the 181 seats in the Texas Legislature, 6 are occupied by physicians. And while that may not sound too impressive, that figure is actually good enough to make Texas the national leader in physician-legislators. Breaking it down even further, you’ll find that one-third of those doctors are UTMB graduates. Let’s take a minute to get to know our alumni-legislators.

When I turned on the computer early the morning of July 29, 2015, the “inbox” was filled with articles from multiple media sources with such headlines as:

Our state Capitol is a beautiful place. It is a majestic building with a grand dome that is beautiful inside and out. As one walks through the front gates at 11th and Congress (the south side), the full grandeur of the building and grounds makes quite an impression

Torrential rainfall wasn’t the only downpour in Austin this spring. The political analysts are all trying to enumerate the positives in this 84th Legislative Session.

Finally, the verdict is in on the conference committee report: Both chambers still have to vote on the budget, but the agreed-upon template from the committee members was released yesterday and more was revealed today. More details continue to dribble out in small amounts at a time; the decision-making continues to be a very fluid and iterative process.

For the past decade, UTMB has been dreaming of a new building to house its educational programs—specifically, an interprofessional educational center that focuses on shared lab, learning and simulation programs to provide the most appropriate learning environment in which to train future care providers. That vision is one more step closer to reality with action taken by the Senate on Tuesday.

The timer on my iPhone says there are 13 days left in the 84th Session of the Texas Legislature before adjournment, or sine die! At midnight on the 140th day (June 1), Cinderella’s coach turns back into a pumpkin, the horses are white mice again, and the excitement of the royal ball and the search for a wife for the prince all end abruptly. Such are the waning days of the legislative session.

During a recent Development Board meeting at UTMB, a number of questions were asked about the status of UTMB’s funding requests from the state legislature. Obtaining access to new members of the legislature is always difficult. I commented that I really could use some help in getting an appointment to see our new Lt. Governor, Dan Patrick.

In March, I had the opportunity to participate in a Government Relations Academy as a mentor for the America’s Essential Hospitals (AEH) group (formerly the National Association of Public Hospitals). Our UTMB executive vice president and Health System CEO Donna Sollenberger is on their Board of Directors. As a part of the Academy, we paid a visit to the office of Domestic Policy at the White House.

I recently had the pleasure of participating in a panel discussion on telemedicine during the Texas Tribune’s Symposium on Health Care.

There have been many specific questions related to the status of the CMC budget. Remember your civics and Texas government course? (Of course you do; you took it in the 7th grade.) The House and the Senate each produce a budget.

AKA: Leave a trail of bread crumbs so you can find your way back to reality! Politics are not going “as usual” in Austin this session.

We always have to keep one eye on Austin and the other one on Washington. This week, while the Texas Senate has been passing out a state budget that is vastly different from that passed out of the House several weeks back, the US Congress has also been at work – of sorts, considering that the Senate went on a two week vacation after the House had passed out the legislation.

he Texas Medical Board (TMB) delivered on its promise of a new set of rules defining the do’s and dont’s for the practice of telemedicine. The issue has been a highly charged one because the TMB has been in litigation with a private company related to the use of commercial telemedicine in the state.

For the 84th Session, January and February were spent congratulating other legislators; introducing constituents, friends, clubs and organizations visiting “your Capitol”; jockeying for committee appointments; and the usual meets, greets and speeches. Lots of fanfare and love during those first two months!

The past month has flown by for us working the Austin legislative shift. The month has been filled with subcommittee meetings related to the construction of the state’s future biennial budgets for 2016-2017. As you may recall, the House Appropriations Committee and the Senate Finance Committee are charged with developing their own versions of the state budget. Each does that by appointing subcommittees for each “Article” in the state’s adopted budget.

The 2015 Legislative Session got off to an accelerated start! We’ve hardly had time to respond to usual business with the massive number of meetings and hearings that abound. So what is different this time?

Midnight Monday, May 25, 2013, was supposed to herald the end of the 83rd Legislative Session. Some described the whole session as a very long Seinfeld episode—much talk, little action.

As I write this, we are 105 days into the 83rd Legislative Session. It is time to take stock of where we are and what we have to get done prior to Sine Die on May 28!

The past two weeks have been as busy as the proverbial bee hive at the Capitol. The House Appropriations Committee (HAC) and the Senate Finance Committee (SFC) have both allocated their work into subcommittee groups for each article in the state budget.

The Texas 83rd Legislative Session is well past its midpoint, and Senate and House financial leadership have crafted a straightforward, no-nonsense budget to take to their colleagues in the House and the Senate. The Senate voted out its budget this past week, and after several tweaks on the House side, their budget will be ready for consideration by the whole House on Thursday, April 4.

Over 90 UTMB students from the School of Medicine (SOM) and the School of Health Professions (SHP) stormed the Capitol on the first Tuesday of February.

With a backdrop of cold, gray, rainy skies, the Texas 83rd Legislature got under way on Jan. 8. Right away, a long-anticipated challenge for the Speaker of the House position evaporated as a lone competitor withdrew from consideration. A quick line of nominations and seconds propelled Speaker Joe Straus (San Antonio) back into that leadership role by acclamation (and without a roll call vote).

The House and Senate have released HB1 and SB1, which are their preliminary versions of the 2014-2015 state budget.

For those legislators and staff who were planning on leaving the tumult in the capitol behind them, 5 p.m. Monday shocked many back to reality. The 82nd Session had ended just as prescribed after 140 days of deliberations and debate.

The 82nd Legislative Session has been quite a roller coaster ride — and it’s not over yet, with a special session starting today because the major fiscal matters bill needed to fund the budget died in a Senate filibuster Sunday night.

As the number of days on the session calendar grows shorter, the Conference Committee members from the House and Senate finally came together to present their recommendations for all Articles in the state budget, with the exception of Article III (education).

It is hard to find the words to describe this past week in the Capitol. Unusual? Tense? A cliff hanger? A nail biter!

I've written a lot about the state legislative budget process and its impact on UTMB over the past couple of months. Looking beyond our own focused interests, the Legislature is also dealing with a wide array of other issues that will certainly impact every Texan. There is much that bears watching as the session reaches its final days.

Under the leadership of Senate Finance Chairman Steve Ogden and Vice Chairman Juan “Chuy” Hinojosa, this past week witnessed some watershed moments in the legislative process.

I began the week with heartburn so bad that I thought I must be having a heart attack. It started late last weekend and progressed.

The Ides of March have come and gone, and so has the midpoint of this 140-day legislative session. The House of Representatives Appropriations Committee has worked at a feverish pace to produce HB1 and the supplemental funding bill.

More than 10 years ago, the Statewide Health Coordinating Council (SHCC) launched several initiatives designed to improve the method for collecting and tracking the number and demographics of health practitioners in Texas. It is impossible to predict and address future needs without that information.

After all, it is South by Southwest week in Austin, and there is as much to see in the session as at the annual music festival.

I am frequently asked for more detail regarding just what goes on in Austin during the legislative session. As I tell our students, “It is a messy process, like watching sausage being made.”

It has been a little bit like that old TV series “Wagon Train.” Now if you remember that TV show, you are dating yourself to a time just after a television became an essential household furnishing. Nevertheless, in times of impending trouble, the wagon master would order the drivers to “circle the wagons.”

Another eventful week has come and almost gone in Austin. As both chambers continue marathon meetings dealing with the state budget, the House found time to debate the Sonogram Bill that has already passed out of the Senate.

Given the limited pot of money, unavailability of the Rainy Day Fund, and significant growth in the number of people needing state services, balancing the budget may seem impossible at times.

Keeping pace with the rush of hearings, committee meetings, and sub-committee meetings, the UTMB team met with TDCJ, TYC, and other stakeholder groups for hearings before the House Appropriations Sub-Committee.

The pace is fast and frantic here at the Capitol. The Senate has worked feverishly on the Governor’s “emergency” legislation agenda and so far has passed legislation on voter identification, the requirement of sonograms prior to abortions, sanctuary cities, and other items.

The precipitation in Austin has been intense here of late. With the introduction of the Legislative Budget Board’s budget guidance, the filing of the House’s budget in HB-1 and the Senate’s budget in SB-1, and now the introduction of the Governor’s Budget it seems to be “Raining Budgets.

There was definitely a big chill in the air as Tom Seuhs, Executive Commissioner of the state’s Health and Human Services Commission, presented his services budget to the Senate Finance Committee.

As the budget deliberations progress in Austin, there are some provisions that we need to monitor closely because of their potential impact to UTMB

My grandmother used to say “Be careful what you ask for — because you just might get it!”

There’s been a lot of it in Austin over the past couple of weeks. First, the state watched as the Governor and Lt. Governor were “sworn” into office on the Capitol steps. The inauguration events were scaled down this year as compared to prior events in deference to the economic issues facing the state.

The 82nd Legislative session got off to a somewhat gloomy start Tuesday. After the budget projections issued on Monday by the Comptroller, the mood was not exactly bright.

The 82nd Legislature officially convenes itself for the next 140 days to conduct the people’s business today. If the past 23 hours of political intrigue is any indication, the session will hold plenty of surprises and intrigue.

Hello World! This is my first blog post from UTMB’s Office of Health Policy and Legislative Affairs.