Indigent Care & Education Funding

Mar 22, 2017, 15:37 PM by Ben Raimer

Ben’s Blog 2017 (#5); Mar 22
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Budget Activity Picks Up Mid-Session

“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.

After each chamber debates the merits of the product before them, the budgets will go before a conference committee of designated leaders from each chamber. These select leaders will hammer out compromises related to revenue sources and the total agreed upon funding for each Article and line item within those Articles that compose the FY18/FY19 Texas State Budget.

With two months left in the session, the following numbers are not final. But they do paint a picture of how UTMB might be affected by state budget cuts, if the current proposed numbers hold. And a “final” budget is now just two months away.

 

First, the House

Looking at UTMB-related funding in the House Budget, not much has changed since January. Support for indigent health care from the Health and Human Services Commission Article II (Lottery Fund) is reduced by $8.9 million. If that cut remains in the final budget, UTMB will have to reduce the amount of care it provides to the uninsured and indigent people of Texas.

In Article III (which covers education funding), UTMB’s Formula Funding is reduced by over $5.6 million. Special Items in Article III are reduced by 60 percent or more. (An exception is the Bio-containment Critical Care Unit, which had only $410,000 of its $8.2 million budget reduced.) Total reductions in Special Items are more than $13.7 million; total losses to UTMB in Article II and III come to $22.7 million.

In the House budget, the news on Article V (TDCJ – Correctional Health Care) is even more concerning. The House proposed only adding funding to provide 30 days of medication to offenders upon release for correctional care and placed all of the other related items into Article XI, which is known as the “wish list”—and is rarely funded. If these proposed cuts are not restored in the final budget, correctional care in the future could be substantially different from the system we know today. The House did place $80 million in House Bill 2, which is for supplemental funding for expenditures in the past two years that were not covered under the FY16/FY17 budget.

Next, the Senate

The Senate budget has been built on a framework of cost-cutting efficiencies to break higher education’s dependence on Special Item funding in favor of metric-driven formulas. But in many respects, the work of our universities and health-related institutions (HRIs) isn’t formulaic. The HRIs each have different strengths and approaches in fulfilling their mission; they have a different set of exceptional faculty focused on differing aspects of education, research and clinical care. As a result, Texas has a diverse constellation of health institutions with rich and varied curricula, patient care offerings and research expertise. That is one reason why Texas is a health sciences powerhouse. The prior funding mechanisms have permitted that success to thrive and grow and allowed institutions the opportunity to collaborate in exceptional ways to enhance excellence. The system has brought real meaning to the old adage that “a rising tide floats all ships.”

In Article II (HHSC), the Senate also significantly cuts indigent health care funding, leaving $878,886 a year in the fund. That amount would provide only minimal treatment for about a dozen patients.  In contrast, in 2016, UTMB served over 22,000 individuals from 124 Texas counties who were unable to pay for their health care. If the cuts make it into the final state budget, our ability to continue this important part of our mission will be severely curtailed.

In Article III (Education), the Senate has used a formula of its own creation, resulting in a $29,032,270 increase in funding to UTMB. But, that chamber eliminated all Special Items, for a $29,353,294 loss. Combined with the Article II cut, UTMB’s funding on the Senate side has been reduced by $9,251,904. UTMB could opt to restore some Special Items from the increase in formula funding if it chose to do so.

 

UTMB works year-round to provide the best in health sciences education, to invest wisely in research programs that protect Texas and the entire world, and to train the most compassionate and qualified health care professionals in the state.  We have a 125-year-and-counting track record of success. We must have adequate investment in our mission to continue working wonders for health care in Texas.

 

Be on the lookout for the next Ben’s Blog, which will take a deeper look at what the Senate and House have proposed for correctional care.