<?xml version="1.0" encoding="utf-8"?> <rss xmlns:atom="http://www.w3.org/2005/Atom" version="2.0"><channel><title>The Texas Tribune: HEALTH &amp; HUMAN SERVICES</title><link>http://www.texastribune.org/health-and-human-services/</link><description>The latest articles about HEALTH &amp; HUMAN SERVICES</description><atom:link href="http://www.texastribune.org/feeds/sections/health-and-human-services/" rel="self"></atom:link><language>en-us</language><lastBuildDate>Thu, 02 Apr 2015 13:30:05 -0500</lastBuildDate><item><title>State Auditor: "Operational Defects" Led to 21CT Deal </title><link>http://www.texastribune.org/2015/04/02/state-audit-operational-defects-led-21ct-deal/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/04/02/state-audit-operational-defects-led-21ct-deal/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2015/01/09/JanekStick_jpg_312x1000_q100.jpg" alt="Texas Health and Human Services Commission Kyle Janek and former HHSC chief counsel, Jack Stick."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;&lt;sup&gt;*Editor's note: This story has been updated throughout.&lt;/sup&gt;&lt;/p&gt; &lt;p&gt;A scathing&amp;nbsp;&lt;a href="http://www.sao.state.tx.us/reports/main/15-031.pdf"&gt;state &lt;/a&gt;investigative report&amp;nbsp;of the Texas Health and Human Services Commission's much-maligned $20 million contract for fraud tracking software has revealed "operational defects" within the agency's procurement process.&lt;/p&gt; &lt;p&gt;According to the report, which was released&amp;nbsp;Thursday, the pricy software deal was left in the hands of the agency's deputy inspector general to direct. He had no prior contracting experience, and the contract was irregular in that the state paid hundreds of thousands of dollars for work and services that were not provided. The report didn&amp;rsquo;t identify the deputy by name, but the only deputy at the time was Jack Stick.&lt;/p&gt; &lt;p&gt;"The Commission and the [Office of Inspector General] did not form an agreement with 21CT that adequately protected the state&amp;rsquo;s interests and that ensured that the OIG received the goods and services it sought to procure," the report said.&lt;/p&gt; &lt;p&gt;The health commission&amp;rsquo;s handling of the 21CT contract has been scrutinized since December, when a $90 million extension was canceled after&amp;nbsp;&lt;a href="http://www.mystatesman.com/news/news/state-regional-govt-politics/texas-health-official-who-steered-deals-has-ties-t/njH4M/"&gt;news reports revealed that a lobbyist&lt;/a&gt;&amp;nbsp;for the company was a former business partner of Stick's.&lt;/p&gt; &lt;p&gt;The deal, finalized in December 2012, has resulted in the forced resignation of Stick and his former boss, Inspector General Doug Wilson. Stick, who did not immediately respond to a request for comment for this article, has denied any wrongdoing. And 21CT spokesman Mike Rosen said the company did nothing wrong.&lt;/p&gt; &lt;p&gt;&lt;span&gt;"21CT followed all contracting and procurement protocols as directed by state officials," he said.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;The health commission had little to say about the findings.&lt;/p&gt; &lt;p&gt;"The SAO report notes that the former OIG deputy inspector general for enforcement directed the procurement," said Stephanie Goodman, spokeswoman for the health commission. "The matter is still the subject of a criminal investigation so we cannot comment further."&lt;/p&gt; &lt;p&gt;Not only did the audit heap harsh criticism onto the commission, but it delivered new details about the contract, including how it is on hold while the agency quietly moves through legal channels to get a refund from 21CT.&lt;/p&gt; &lt;p&gt;Among the other problems revealed in the report:&amp;nbsp;&lt;/p&gt; &lt;ul&gt; &lt;li&gt;&lt;span style="line-height: 1.35;"&gt;Stick was not the only executive with a prior relationship with 21CT. As&amp;nbsp;&lt;/span&gt;&lt;a style="line-height: 1.35;" href="https://www.texastribune.org/2015/02/03/21ct-health-commission-recap/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;reported&lt;/a&gt;&lt;span style="line-height: 1.35;"&gt; by The Texas Tribune, a former commission executive knew 21CT chief executive Irene Williams when he and Stick discussed 21CT's software product. The report does not mention the executive by name but notes that the person "had an existing relationship with 21CT management, and that individual helped to foster a connection between 21CT and the Commission, the OIG and the former deputy IG." The Tribune has reported that that executive was Stanley Stewart.&lt;/span&gt;&amp;nbsp;&lt;/li&gt; &lt;/ul&gt; &lt;ul&gt; &lt;li&gt;&lt;span style="line-height: 1.35;"&gt;The 21CT deal was unusually structured. Instead of paying for goods and services provided by the Austin firm, the health commission paid 21CT in 11 installments. As a result, the commission paid 21CT $405,000 for laptop computers that were never received.&lt;/span&gt;&lt;/li&gt; &lt;/ul&gt; &lt;ul&gt; &lt;li&gt;&lt;span style="line-height: 1.35;"&gt;The 21CT contract was not logged into the health commission's contract database until eight months after the deal was signed. By not logging it in a timely fashion, the contract escaped some monitoring.&lt;/span&gt;&lt;/li&gt; &lt;/ul&gt; &lt;ul&gt; &lt;li&gt;&lt;span style="line-height: 1.35;"&gt;Stick's promotion to chief counsel violated the health commission's employment policy regarding conflicts of interest because his wife, Erica, was chief of staff to Executive Commissioner Kyle Janek. This is the first time any entity has announced that there was a violation of employment policy. "Reporting to a spouse represented a structural conflict of interest that undermined the effectiveness of the Commission's processes and was a violation of the Commission's employment policies," the audit said. Erica Stick was placed on&amp;nbsp;&lt;/span&gt;&lt;a style="line-height: 1.35;" href="http://www.texastribune.org/2014/12/19/perry-fires-hhsc-inspector-general/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;paid administrative leave&amp;nbsp;&lt;/a&gt;&lt;span style="line-height: 1.35;"&gt;in December, and she later resigned. There is no evidence connecting her to the 21CT deal.&lt;/span&gt;&lt;/li&gt; &lt;/ul&gt; &lt;ul&gt; &lt;li&gt;&lt;span style="line-height: 1.35;"&gt;Stick communicated directly with 21CT from his personal email account. He also emailed other Texas agencies and other states promoting 21CT's product.&lt;/span&gt;&lt;/li&gt; &lt;/ul&gt; &lt;ul&gt; &lt;li&gt;&lt;span style="line-height: 1.35;"&gt;The health commission misled the federal government. The audit points out, as the Tribune had&amp;nbsp;&lt;/span&gt;&lt;a style="line-height: 1.35;" href="http://www.texastribune.org/2015/02/10/did-hhsc-fudge-facts-get-18-million-feds/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;reported&lt;/a&gt;&lt;span style="line-height: 1.35;"&gt;&amp;nbsp;earlier, how the commission told the Centers for Medicare and Medicaid Services that the 21CT contract was competitively awarded in order to receive $18 million of the $20 million software price tag. There were no other bidders. Also, when it came time to apply for another $77 million in federal funds to pay for a contract extension with 21CT, the company was allowed to revise the health commission's pitch to the feds.&amp;nbsp;&lt;/span&gt;&lt;/li&gt; &lt;/ul&gt; &lt;p&gt;The auditor's office report follows the second of four investigations launched after &lt;a href="http://www.mystatesman.com/news/news/state-regional-govt-politics/texas-health-official-who-steered-deals-has-ties-t/njH4M/"&gt;news reports revealed Stick's former business partner&lt;/a&gt; was a lobbyist for 21CT. The state public integrity unit and the FBI are still both investigating whether the contract was bungled or officials broke laws. Three days ago, a team selected by Gov. Greg Abbott found the agency &lt;a href="https://www.texastribune.org/2015/03/30/strike-team-report-says-hhsc-should-not-consolidat/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;&amp;ldquo;has experienced a program failure"&lt;/a&gt; and that its contract with 21CT &amp;ldquo;skirted&amp;rdquo; the edge of state law.&lt;/p&gt; &lt;p&gt;Abbott, who called his team&amp;rsquo;s findings "deeply troubling,"&amp;nbsp;said he wanted time to consider the report before making any decisions about the agency. The Texas Legislature has also made &lt;a href="http://txlege.texastribune.org/topics/budget-and-taxes/contracting-and-procurement/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;reforming state contracting&lt;/a&gt; one of the top issues this session.&lt;/p&gt; &lt;p&gt;The report ends with a list of recommendations to the Legislature to beef up contracting oversight and avoid problematic contracts. It says lawmakers should require that any payments exceeding $1 million be approved in writing by the health agency's executive commissioner and that all future purchases should be competitively bid.&lt;/p&gt; &lt;p&gt;It also pointed out how the Texas Department of Information Resources' Cooperating Contracts program, which the health commission used to purchase 21CT's services, needs strengthening.&lt;/p&gt; &lt;p&gt;"The structure of the Cooperative Contracts program enabled the Commission and the OIG to misuse that program," the report stated.&lt;/p&gt; &lt;p&gt;The auditor's office pointed out how the Department of Information Resources relies on vendors &amp;mdash; rather than agencies &amp;mdash; to let them know when agencies make purchases from its vendor catalog.&amp;nbsp;&lt;/p&gt; &lt;p&gt;"Therefore, there is a risk that the Department of Information Resources may not become aware of all purchases made through cooperative contracts," the report said.&lt;/p&gt; &lt;p&gt;And although DIR recommends that agencies obtain three bids from three different vendors, the auditor's office recommends that three bids be required.&amp;nbsp;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Terri Langford and Aman Batheja</dc:creator><pubDate>Thu, 02 Apr 2015 13:30:05 -0500</pubDate><guid>http://www.texastribune.org/2015/04/02/state-audit-operational-defects-led-21ct-deal/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Rules Hurt Family Violence Programs, Nelson Says </title><link>http://www.texastribune.org/2015/04/01/family-violence-program-wants-exemption-hhsc-procu/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/04/01/family-violence-program-wants-exemption-hhsc-procu/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2013/02/19/_01F2456_jpg_312x1000_q100.jpg" alt="Sen. Jane Nelson, R-Flower Mound, during a Health and Human Services committee hearing on Feb. 19, 2013."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;Too much red tape is delaying funding for shelters and programs that help victims of family violence in Texas, threatening to disrupt the services they offer,&amp;nbsp;according to one state senator who wants to loosen state law to get money approved more quickly.&lt;/p&gt; &lt;p&gt;Ironically, state Sen. &lt;a href="http://www.texastribune.org/directory/jane-nelson/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Jane Nelson&lt;/a&gt;, R-Flower Mound, is among Texas lawmakers leading the charge to tighten up state contracting oversight amid a wave of scandals involving various state agencies.&lt;/p&gt; &lt;p&gt;But Nelson's &lt;a href="http://www.capitol.state.tx.us/BillLookup/Text.aspx?LegSess=84R&amp;amp;Bill=SB59"&gt;Senate Bill 59&lt;/a&gt; would undo a 2013 rule requiring the state's Family Violence Program to vet its contracts through the much larger Health and Human Services Commission. Instead, the program &amp;mdash; in consultation with the Texas Council on Family Violence &amp;mdash; would manage its own contracts, and would&amp;nbsp;not require competitive bidding.&lt;/p&gt; &lt;p&gt;"These are nonprofit entities that operate on&amp;nbsp;&lt;span class="il"&gt;shoestring&lt;/span&gt;&amp;nbsp;budgets," Nelson said in a statement. "Delayed funding can have a devastating impact on their ability to care for victims, including children."&lt;/p&gt; &lt;p&gt;&lt;span style="color: #000000;"&gt;&lt;span style="font-family: Georgia, Times, serif;"&gt;The Texas Council on Family Violence is a statewide nonprofit made up of more than 100 family violence programs. It acts as an intermediary between the state and service providers, but&amp;nbsp;&lt;/span&gt;&lt;/span&gt;does not receive funds directly. Instead, it advises the state on where money is best spent.&lt;/p&gt; &lt;p&gt;Last year, the Family Violence Program received $26.6 million in state and federal funds and contracted&amp;nbsp;with 68 shelters, 10 nonresidential centers and 16 special projects to help 84,430 clients. That's only a fraction of the need, TCFV says. It estimates that more than 5 million women in Texas have experienced domestic violence in their lifetime.&lt;/p&gt; &lt;p&gt;&lt;span&gt;The council has criticized the red tape that it says began delaying funds after the program was placed under more stringent procurement rules in 2013. In testimony before the Sunset Commission last year, they said the relatively small program had been wedged into a "one-size fits all" process.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span&gt;&lt;span&gt;"We had worked with HHSC for three or four years on this and just realized we needed a legislative fix," said&amp;nbsp;&lt;span&gt;Aaron Setliff, the council's public policy director.&amp;nbsp;&lt;/span&gt;&lt;br /&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&amp;ldquo;Having to go through this new procurement process, there were so many hoops to jump through,&amp;rdquo; said Shannon Trest, the executive director of the Women's Center in Longview, who said that her agency waited nine months for requested funds. &amp;ldquo;That puts a strain on staff, and especially in a small agency, it keeps them from offering service to victims.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Nelson's bill also eliminates a competitive bidding requirement for family violence centers seeking a contract with the state. Andrew Wheat, research director for the money-in-politics group Texans for Public Justice, questioned the need for the exemption.&lt;/p&gt; &lt;p&gt;&amp;ldquo;These funds move through HHSC, which has a long history of being oblivious to &amp;ndash; or indulgent of &amp;ndash; crony contracting. This does not inspire confidence,&amp;rdquo; said Wheat.&amp;nbsp;&amp;ldquo;I don't see anything in there that clarifies why this needs to be excluded from competitive bidding.&amp;rdquo;&lt;/p&gt; &lt;p&gt;&lt;span&gt;Nelson said the program's contracts will still be governed by &lt;/span&gt;&lt;span&gt;strict, competitive guidelines.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;Gloria Terry, the CEO of the Texas Council on Family Violence, said that internal contracting rules are sufficiently competitive. "&lt;span style="line-height: 1.35;"&gt;There are a number of requirements laid out ... that are incredibly competitive,&amp;rdquo; she said. &amp;ldquo;It is a lengthy, secure process to be able to become a provider of services. This does not eliminate the competitive process whatsoever.&amp;rdquo;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;Last week, the bill passed unanimously out of the Senate Business and Commerce Committee, and appears headed for the Senate's local and uncontested calendar.&amp;nbsp;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Eva Hershaw</dc:creator><pubDate>Wed, 01 Apr 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/2015/04/01/family-violence-program-wants-exemption-hhsc-procu/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Interactive: Demographics of State Doctors, Health Care Professionals </title><link>http://www.texastribune.org/2015/04/01/interactive-demographics-texas-health-professional/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/04/01/interactive-demographics-texas-health-professional/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/Stetho-Around-Texas_jpg_312x1000_q100.jpg" alt=""&gt; &lt;/a&gt; &lt;/div&gt; &lt;p dir="ltr"&gt;Texas may be a &lt;a href="https://www.census.gov/newsroom/releases/archives/population/cb12-90.html"&gt;majority-minority&amp;nbsp;&lt;/a&gt;state, but minorities are largely underrepresented among the state's health care professionals,&amp;nbsp;according to new &lt;a href="http://www.dshs.state.tx.us/chs/hprc/Publications/2014FactSheets.aspx"&gt;&lt;span&gt;figures&lt;/span&gt;&lt;/a&gt; published by the Texas Department of State Health Services.&lt;/p&gt; &lt;p dir="ltr"&gt;The makeup of the health care&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;industry contrasts significantly with the state&amp;rsquo;s demographics. Though whites make up less than half of the state population, a majority of physicians are white. Hispanics make up roughly 40 percent of the population, but hold only&amp;nbsp;a small percentage of positions as health care providers.&lt;span id="docs-internal-guid-30bfb979-71c9-6eae-be56-1b6a21f7e9c8"&gt;&lt;br /&gt;&lt;/span&gt;&lt;/p&gt; &lt;p dir="ltr"&gt;&lt;span&gt;&lt;span&gt;The data was collected by the state from professional licensing boards last fall.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;em&gt;Use these interactives to explore the demographics of some health professions by race/ethnicity, gender and age.&lt;/em&gt;&lt;/p&gt; &lt;p&gt;&lt;iframe src="http://graphics.texastribune.org/dailies/2015-health-prof-demos/race/" scrolling="no" frameborder="0" height="400px" width="100%"&gt;&lt;/iframe&gt; Whites dominate most of the&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;health professions analyzed by The Texas Tribune,&amp;nbsp;including physicians, registered nurses and physician assistants. Whites are only&amp;nbsp;the minority among community health workers.&lt;/p&gt; &lt;p&gt;Nursing is the only health profession in which the share of black workers is in line with the general population. Blacks made up just under 12 percent of Texas population in 2014, while 11.8 percent of registered nurses are black.&lt;/p&gt; &lt;p&gt;&lt;iframe src="http://graphics.texastribune.org/dailies/2015-health-prof-demos/gender/" scrolling="no" frameborder="0" height="400px" width="100%"&gt;&lt;/iframe&gt;&lt;/p&gt; &lt;p&gt;Women make up half of the population but are the minority gender among physicians. They&amp;nbsp;fill most jobs&amp;nbsp;among registered nurses, physician assistants and community health workers.&lt;/p&gt; &lt;p&gt;&lt;iframe src="http://graphics.texastribune.org/dailies/2015-health-prof-demos/age/" scrolling="no" frameborder="0" height="400px" width="100%"&gt;&lt;/iframe&gt;&lt;/p&gt; &lt;p&gt;&lt;span id="docs-internal-guid-30bfb979-71d3-b2b2-68ac-295470d6e4f1"&gt;&lt;span&gt;Psychiatry has the largest percentage of professionals 65 or older, while physicians are most likely to be middle-aged.&amp;nbsp;Roughly half of registered nurses, and a majority of physician assistants, are likely to be 45 or younger.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;sup&gt;Note: The data for &amp;ldquo;primary care physicians&amp;rdquo; is a subset of &amp;ldquo;direct patient care physicians&amp;rdquo; and only includes those&amp;nbsp;in general practice, family practice/medicine, internal medicine, pediatrics, obstetrics and gynecology, or geriatrics.&lt;/sup&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Alexa Ura</dc:creator><pubDate>Wed, 01 Apr 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/2015/04/01/interactive-demographics-texas-health-professional/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>After Ebola Scare, Senate Moves to Bolster Disease Response </title><link>http://www.texastribune.org/2015/03/31/senate-moves-bolster-infectious-disease-response/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/31/senate-moves-bolster-infectious-disease-response/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2014/10/01/EbolaTexas_1_jpg_312x1000_q100.jpg" alt=""&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;Months after three Ebola diagnoses stirred fears in Dallas, the Texas Senate on Tuesday approved legislation aiming to clarify how the state should respond to its next infectious disease outbreak.&lt;/p&gt; &lt;p&gt;The proposal,&amp;nbsp;&lt;a href="http://www.capitol.state.tx.us/BillLookup/History.aspx?LegSess=84R&amp;amp;Bill=SB538"&gt;Senate Bill 538&lt;/a&gt;, would allow the governor to declare a state of infectious disease emergency, create stockpiles of protective equipment, and grant health officials greater power to halt public transportation and detain individuals who may be infected.&amp;nbsp;&lt;/p&gt; &lt;p&gt;&amp;ldquo;The bill establishes a clear command structure for future emergency situations,&amp;rdquo; said Sen.&amp;nbsp;&lt;a title="" href="http://www.texastribune.org/directory/charles-schwertner/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Charles Schwertner&lt;/a&gt;, R-Georgetown, its sponsor. &amp;ldquo;This legislation is not simply a reaction to Ebola, but rather it&amp;rsquo;s a proactive action to protect our state from the next public disease threat.&amp;rdquo;&lt;/p&gt; &lt;p&gt;With a 26-4 vote, the Senate sent the bill to the House.&lt;/p&gt; &lt;p&gt;The legislation stems mostly from&amp;nbsp;recommendations by&amp;nbsp;&lt;a href="http://www.texastribune.org/2014/10/06/perry-says-feds-should-screen-ebola/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;a task force established&lt;/a&gt;&amp;nbsp;by then-Gov.&amp;nbsp;&lt;a title="" href="http://www.texastribune.org/directory/rick-perry/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Rick Perry&lt;/a&gt;&amp;nbsp;in October 2014 after a man in Dallas became the first person in the United States diagnosed with Ebola. The bill is designed&amp;nbsp;to fix problems &amp;mdash; highlighted by the Ebola scare &amp;mdash; with the state&amp;rsquo;s ability to respond to an outbreak.&lt;/p&gt; &lt;p&gt;Schwertner, the chairman of the Senate Health and Human Services Committee, said he was not aware of other states that have given governors similar powers on infectious diseases. &amp;ldquo;This can hopefully be a model for the rest of the country," he said.&amp;nbsp;&lt;/p&gt; &lt;p&gt;Thomas Eric Duncan was sent home from Texas Health Presbyterian Hospital in Dallas after his first visit in September, despite the fact that he had traveled in Liberia, an Ebola hot zone, and showed symptoms of the virus. Duncan returned to the hospital days later and was placed in intensive care, where he&amp;nbsp;&lt;a href="http://www.texastribune.org/2014/10/08/dallas-patient-diagnosed-ebola-dies/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;died&lt;/a&gt;&amp;nbsp;on Oct. 8.&lt;/p&gt; &lt;p&gt;Two nurses who treated Duncan contracted the virus &amp;mdash; they have since been declared Ebola-free &amp;mdash; and the hospital&amp;nbsp;&lt;a href="http://www.texastribune.org/2014/10/16/dallas-hospital-apologizes-mistakes-ebola-care/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;was criticized&lt;/a&gt;&amp;nbsp;for misdiagnosing Duncan and releasing him after his first visit.&lt;/p&gt; &lt;p&gt;Under current law, the head of the Department of State Health Services can order a potentially exposed or infectious person to remain at home, but the state can only enforce that order after the person has already broken it. The legislation would plug that gap.&lt;/p&gt; &lt;p&gt;&amp;ldquo;We saw a lack of clarity as far as who was calling the shots,&amp;rdquo; Schwertner said.&lt;/p&gt; &lt;p&gt;A few lawmakers expressed concerns on the Senate floor that the changes could complicate decisions at the local level or infringe on the civil liberties of Texans suspected of being contagious.&lt;/p&gt; &lt;p&gt;&amp;ldquo;This goes just a bit too far for me,&amp;rdquo; said Sen. &lt;a href="http://www.texastribune.org/directory/robert-nichols/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Robert Nichols&lt;/a&gt;, R-Jacksonville. &amp;ldquo;It allows the peace officers to detain without warrant, individuals &amp;ndash; to actually hold them &amp;ndash; without even telling them.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Aiming to address some concerns, the chamber approved an amendment by Sen.&amp;nbsp;&lt;a title="" href="http://www.texastribune.org/directory/lois-kolkhorst/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Lois Kolkhorst&lt;/a&gt;, R-Brenham, that tightened the bill&amp;rsquo;s definition of a disease that triggers an infectious disease emergency declaration.&lt;/p&gt; &lt;p&gt;The new definition says such a disease must have resulted in or be likely to result in "severe or life-threatening illness or death" for those infected. Also, the health officials must be unable to contain the disease through existing methods, resulting in a high rate of mortality.&lt;/p&gt; &lt;p&gt;&amp;ldquo;We want to make sure this is very tightly worded,&amp;rdquo; said Kolkhorst, a co-sponsor of the bill. &amp;ldquo;Texas leads in a lot of ways, and hopefully this is one of them.&amp;rdquo;&amp;nbsp;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Jim Malewitz</dc:creator><pubDate>Tue, 31 Mar 2015 14:28:28 -0500</pubDate><guid>http://www.texastribune.org/2015/03/31/senate-moves-bolster-infectious-disease-response/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>House Budget Debate to Tackle Hot-Button Issues </title><link>http://www.texastribune.org/2015/03/31/house-budget-debate-tackle-hot-button-issues/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/31/house-budget-debate-tackle-hot-button-issues/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/Bob_FloorHouse_jpg_312x1000_q100.jpg" alt=""&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;In what&amp;rsquo;s expected to be a marathon budget debate on the Texas House floor Tuesday, lawmakers are likely to veer into hot-button issues including abortion, gay marriage, illegal immigration, school vouchers, racism and gender equality.&lt;/p&gt; &lt;p&gt;House members filed 354 amendments to &lt;a href="http://txlege.texastribune.org/84/bills/HB1/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections" target="_blank"&gt;House Bill 1&lt;/a&gt;&amp;nbsp;ahead of the debate, which traditionally makes for one of the legislative session&amp;rsquo;s longest days for the House. Although state law prevents legislators from making law in the budget, changing the funding for state programs can effectively shift state policy on a host of issues. Such moves can also allow lawmakers to spotlight an issue.&lt;/p&gt; &lt;p&gt;&amp;ldquo;While [the amendments] may not pass because of the political math, this is how we get the thought inside the minds of the majority,&amp;rdquo; said state Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/trey-martinez-fischer/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Trey Martinez Fischer&lt;/a&gt;, D-San Antonio.&lt;/p&gt; &lt;p&gt;HB 1, from House Appropriations Chairman&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/john-otto/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;John Otto&lt;/a&gt;, R-Dayton, includes a $209.8 billion budget that spends&amp;nbsp;&lt;a href="http://www.texastribune.org/2015/03/24/budget-writers-send-2098-billion-budget-house-floo/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;$7.7 billion more than the current&amp;nbsp;two-year&amp;nbsp;budget&lt;/a&gt;&amp;nbsp;and would leave $8.4 billion on the table, along with billions more in the state&amp;rsquo;s savings account.&lt;/p&gt; &lt;p&gt;Lawmakers have room to spend about $2 billion more before hitting the state&amp;rsquo;s constitutional spending cap. Yet under the House&amp;rsquo;s rules for Tuesday&amp;rsquo;s debate, proposed amendments cannot grow the budget&amp;rsquo;s bottom line. Any increases in funding must be offset by decreases elsewhere.&lt;/p&gt; &lt;p&gt;In the Senate, Finance Chairwoman&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/jane-nelson/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Jane Nelson&lt;/a&gt;, R-Flower Mound, has said her committee will wait to&amp;nbsp;receive HB 1 from the House before voting her budget to the Senate floor.&lt;/p&gt; &lt;p&gt;The amendments filed in the House take aim at nearly every aspect of state government. Members filed amendments to defund or cripple agencies including the Racing Commission and the Lottery Commission, as well as controversial economic incentives programs like the Texas Enterprise Fund.&lt;/p&gt; &lt;p&gt;There are also amendments to boost funding for pre-kindergarten programs, expand mental health treatment for prisoners and create a center for Mexican-American studies at the University of Texas Rio Grande Valley. (Last session, then-Gov. &lt;a href="http://www.texastribune.org/directory/rick-perry/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Rick Perry&lt;/a&gt; &lt;a href="http://www.texastribune.org/2013/06/14/senator-perry-vetoed-equal-pay-bill/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;vetoed funding for such a center&lt;/a&gt; at the University of Texas at Austin.)&lt;/p&gt; &lt;p&gt;&lt;strong&gt;School Vouchers&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;Opponents of school voucher programs are hoping the budget debate will mirror the 2013 debate, in which an&amp;nbsp;&lt;a href="http://www.texastribune.org/2013/04/04/voucher-showdown-during-house-budget-debate/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;anti-voucher amendment&lt;/a&gt;&amp;nbsp;passed 103-43, with bipartisan support, signaling a broad disinterest in the lower chamber for such proposals.&lt;/p&gt; &lt;p&gt;This year,&amp;nbsp;&lt;a href="http://www.texastribune.org/2015/03/30/texas-house-vouchers/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;a similar amendment&lt;/a&gt;&amp;nbsp;from state Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/abel-herrero/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Abel Herrero&lt;/a&gt;, D-Corpus Christi, would deliver a blow to Lt. Gov.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/dan-patrick/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Dan Patrick&lt;/a&gt;&amp;nbsp;if it passes.&amp;nbsp;Patrick has thrown his weight behind getting legislation through this session that would provide state financial support to parents who want to send their children to private schools.&lt;/p&gt; &lt;p&gt;Democrats have filed a&amp;nbsp;&lt;a href="http://www.texastribune.org/2015/03/30/house-democrats-target-abortion-program-budget/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;flurry of amendments&lt;/a&gt;&amp;nbsp;that seek to defund the state's Alternatives to Abortion program,&amp;nbsp;which provides "pregnancy and parenting information&amp;rdquo; to low-income women. Under the program, the state contracts with the&amp;nbsp;&lt;a href="http://texaspregnancy.org/"&gt;Texas Pregnancy Care Network&lt;/a&gt;, a nonprofit charity organization with a network of crisis pregnancy resource centers that&amp;nbsp;provide counseling and adoption assistance. Two Republicans also filed measures to boost the program&amp;rsquo;s funding.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Border Security&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;House members are also bracing for floor battles on the state&amp;rsquo;s future role in securing the Texas-Mexico border. The House border security budget is about $565 million.&amp;nbsp;Some Republicans who feel that figure is too low have set their sights on getting more equipment for the Department of Public Safety. State Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/tony-dale/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Tony Dale&lt;/a&gt;, R-Cedar Park, will propose taking about $41.5 million from the Texas Health and Human Services Commission&amp;rsquo;s Consolidated System Support for more DPS aircraft.&lt;/p&gt; &lt;p&gt;&amp;ldquo;This is one of the top requests for DPS that was not funded and continuously, my constituents tell me that border security is one of the top priorities,&amp;rdquo; Dale said. &amp;ldquo;And I don&amp;rsquo;t have a lot of them saying that other departments are priorities.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Dale added that even if his amendment advances, the health commission will still have more funds than were appropriated in the current budget.&lt;/p&gt; &lt;p&gt;State Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/dan-huberty/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Dan Huberty&lt;/a&gt;, R-Houston, has multiple amendments that seek to add to the &lt;a href="https://www.txmf.us/"&gt;Texas Military Forces&lt;/a&gt;&amp;rsquo; funds.&lt;/p&gt; &lt;p&gt;One amendment would take $450,000 over the biennium from the Commission on the Arts for the Texas Military Forces&amp;rsquo; state training missions. Another amendment would take $3 million from the Texas Facilities Commission for the same purposes. Huberty said the money would fund training days and disaster recovery. He specified that it is not money to extend the Texas National Guard&amp;rsquo;s deployment on the Texas-Mexico border, which the Texas Senate&amp;rsquo;s budget seeks to do.&lt;/p&gt; &lt;p&gt;The guard &lt;a href="http://www.texastribune.org/2014/06/19/states-leadership-instructs-dps-increase-patrols-b/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;was deployed to the Rio Grande Valley last summer&lt;/a&gt; after tens of thousands of unaccompanied minors from Central America crossed into Texas and surrendered to law enforcement there.&lt;/p&gt; &lt;p&gt;Democrats are looking to shift some money from the DPS&amp;rsquo;s budget request to take home for their districts. State Rep. &lt;a href="http://www.texastribune.org/directory/poncho-nevarez/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections" target="_blank"&gt;Alfonso &amp;ldquo;Poncho&amp;rdquo; Nev&amp;aacute;rez&lt;/a&gt;, D-Eagle Pass, wants to divert $10 million appropriated for DPS recruitment and retention to fund local law enforcement.&lt;/p&gt; &lt;p&gt;&amp;ldquo;It ensures that the locals will be able to participate and have the resources and funds to do it, and it also ensures that the locals who suffer attrition as a result of this buildup would be able to keep sheriff&amp;rsquo;s deputies and local police,&amp;rdquo; he said. Local law enforcement officials have expressed concerns that the ranks of local police and sheriffs&amp;rsquo; offices will be depleted when DPS begins a massive recruitment and hiring campaign next year.&lt;/p&gt; &lt;p&gt;State Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/terry-canales/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Terry Canales&lt;/a&gt;, D-Edinburg, said he has high hopes an amendment that would take $2 million for DPS special operations for crime labs to help identify the remains of people who die on or near the border, specifically migrants who pass through.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Other Amendments&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;Other amendments that could spark contentious floor debates Tuesday include:&lt;/p&gt; &lt;p&gt;&amp;mdash; An amendment from state Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/stuart-spitzer/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Stuart Spitzer&lt;/a&gt;, R-Kaufman, would cut $2.5 million from the state's HIV and STD prevention&amp;nbsp;initiative&amp;nbsp;and put that money toward an abstinence education program.&lt;/p&gt; &lt;p&gt;&amp;mdash; An amendment from state Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/drew-springer/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Drew Springer&lt;/a&gt;, R-Muenster, would bar Texas school districts from offering benefits&amp;nbsp;to the same-sex partners of employees.&lt;/p&gt; &lt;p&gt;&amp;mdash; An amendment from Martinez Fischer requires public universities to&amp;nbsp;&lt;a href="http://www.texastribune.org/2015/03/30/rider-schools-will-report-discrimination-frats/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;report instances of gender, ethnicity or racial discrimination&lt;/a&gt;&amp;nbsp;to the Texas Higher Education Coordinating Board if it involved a university's students. Student groups including "fraternal or sorority organizations or athletic teams" would have to be reported as well.&lt;/p&gt; &lt;p&gt;&amp;mdash; Similarly, school districts would have to collect and report instances of discrimination against lesbian, gay, bisexual and transgender students or employees under an amendment from state Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/garnet-coleman/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Garnet Coleman&lt;/a&gt;, D-Houston.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&amp;mdash; The state comptroller would have to produce an annual report &amp;ldquo;comparing the salaries of men and women employed under the same job classification system at all Texas state agencies&amp;rdquo; under an amendment filed by state Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/mary-gonzalez/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Mary Gonz&amp;aacute;lez&lt;/a&gt;, D-Clint. The issue of a&amp;nbsp;&lt;a href="https://www.texastribune.org/2014/03/21/gender-wage-gap-prevalent-throughout-texas-governm/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;gender wage gap in state government&lt;/a&gt;&amp;nbsp;drew attention during last year&amp;rsquo;s gubernatorial race.&lt;/p&gt; &lt;p&gt;&amp;mdash; The future of a school finance lawsuit could also pop up in Tuesday's budget debate as lawmakers consider an amendment from Martinez Fischer that would allocate $50,000 to the attorney general to &amp;ldquo;strategize, mediate, and discuss settlement&amp;rdquo; of the suit.&lt;/p&gt; &lt;p&gt;&amp;mdash; An amendment by Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/cecil-bell-jr/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Cecil Bell Jr.&lt;/a&gt;,&amp;nbsp;R-Magnolia, would take away $13.6 million in funding from the University of Houston and give it to Prairie View A&amp;amp;M University instead.&amp;nbsp;&lt;/p&gt; &lt;p&gt;&amp;mdash; Several amendments filed would block the Texas Department of Transportation from pursuing future toll road projects.&lt;/p&gt; &lt;p&gt;&lt;i&gt;Juli&amp;aacute;n Aguilar, Bobby Blanchard, Morgan Smith, Alexa Ura and Edgar Walters contributed to this report.&lt;/i&gt;&lt;/p&gt; &lt;p&gt;&lt;i&gt;Disclosure: The University of Texas at Austin is a corporate sponsor of The Texas Tribune. The University of Houston was a corporate sponsor of the Tribune in 2012 and 2013. &amp;nbsp;&lt;/i&gt;&lt;i&gt;A complete list of Tribune donors and sponsors can be viewed&amp;nbsp;&lt;/i&gt;&lt;a href="http://www.texastribune.org/support-us/donors-and-members/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;&lt;i&gt;here&lt;/i&gt;&lt;/a&gt;&lt;i&gt;.&lt;/i&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Aman Batheja</dc:creator><pubDate>Tue, 31 Mar 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/2015/03/31/house-budget-debate-tackle-hot-button-issues/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>New in Trib+Health: When More Than Change is in the Wind </title><link>http://www.texastribune.org/plus/health/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="http://www.texastribune.org/plus/health/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2015/03/03/Trib-Plus-Health-leadart002_jpg_312x1000_q100.jpg" alt=""&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;&lt;span&gt;In this week's edition of the Trib+Health newsletter: A new study finds wind carrying antibiotic resistance bacteria from feedlots, a Dallas hospital targets infection control&amp;nbsp;&lt;/span&gt;&lt;span&gt;and an interview with&amp;nbsp;&lt;span&gt;Matteo Pasquali&amp;nbsp;&lt;/span&gt;&lt;span&gt;of Rice University.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">John Reynolds</dc:creator><pubDate>Tue, 31 Mar 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/plus/health/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>House Democrats Target Alternatives to Abortion Program </title><link>http://www.texastribune.org/2015/03/30/house-democrats-target-abortion-program-budget/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/30/house-democrats-target-abortion-program-budget/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2013/07/22/Protesters-Split_jpg_312x1000_q100.jpg" alt=""&gt; &lt;/a&gt; &lt;/div&gt; &lt;p dir="ltr"&gt;As the Texas House prepares for a floor fight Tuesday over its budget, a flurry of amendments filed by Democrats seeks to defund the state's &lt;a href="http://www.hhsc.state.tx.us/providers/FACS/#abortion" target="_blank"&gt;Alternatives to Abortion program&lt;/a&gt;.&lt;/p&gt; &lt;p dir="ltr"&gt;A group of Democratic lawmakers filed more than a dozen amendments to either reduce or eliminate funding for the program, which provides "pregnancy and parenting information&amp;rdquo; to low-income women. Under the program, the state contracts with the &lt;a href="http://texaspregnancy.org/" target="_blank"&gt;Texas Pregnancy Care Network&lt;/a&gt;, a nonprofit charity organization with a network of crisis pregnancy resource centers that &lt;span&gt;provide counseling and adoption assistance.&lt;/span&gt;&lt;/p&gt; &lt;p dir="ltr"&gt;Since September 2006, the program has served roughly 110,000 clients. The network&amp;nbsp;&lt;a href="http://texaspregnancy.org/program-data/"&gt;features&amp;nbsp;&lt;/a&gt;60 provider locations, including&amp;nbsp;crisis pregnancy centers, maternity homes and adoption agencies.&amp;nbsp;&lt;/p&gt; &lt;p dir="ltr"&gt;&lt;span&gt;State Rep. &lt;a href="http://www.texastribune.org/directory/jessica-farrar/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Jessica Farrar&lt;/a&gt;, D-Houston, said she filed an amendment to defund the entire program because the state is giving more money to &amp;ldquo;coerce women&amp;rdquo; into a &amp;ldquo;political ideology instead of providing information and services&amp;rdquo; at a time when Texas women&amp;rsquo;s access to health services is being reduced.&lt;/span&gt;&lt;/p&gt; &lt;p dir="ltr"&gt;&lt;span&gt;The proposed House budget allocates $9.15 million a year to the program in 2016 and 2017 &amp;mdash; up from $5.15 million in the last budget.&lt;/span&gt;&lt;/p&gt; &lt;p dir="ltr"&gt;&lt;span&gt;&amp;ldquo;I think it's troublesome that here we are going to almost double funding for a program that has not proven to be successful in any way,&amp;rdquo; said Farrar, chairwoman of the Women&amp;rsquo;s Health Caucus in the House. An additional amendment by Farrar would require an audit of the program.&lt;/span&gt;&lt;/p&gt; &lt;p dir="ltr"&gt;&lt;span&gt;Several House Democrats filed similar amendments, including &lt;a href="http://www.texastribune.org/directory/borris-miles/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Borris Miles&lt;/a&gt; of Houston, &lt;a href="http://www.texastribune.org/directory/celia-israel/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Celia Israel&lt;/a&gt; of Austin and &lt;a href="http://www.texastribune.org/directory/chris-turner/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Chris Turner&lt;/a&gt; of Grand Prairie, whose amendments would transfer more than $8 million from the Alternatives to Abortion program to family planning services and programs for people with disabilities.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&amp;ldquo;These facilities have very little regulation, no accountability and no requirement to offer actual medical services,&amp;rdquo; Turner said, adding that funding could be used for other medical programs. "My amendments are an attempt to address our state's real priorities and needs."&lt;/p&gt; &lt;p&gt;&lt;span&gt;Two Republicans, meanwhile, filed measures to boost the program&amp;rsquo;s funding.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;State Rep. &lt;/span&gt;&lt;a style="line-height: 1.35;" href="http://www.texastribune.org/directory/bryan-hughes/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Bryan Hughes&lt;/a&gt;&lt;span style="line-height: 1.35;"&gt;, R-Mineola, authored an amendment that would supplement the Alternatives to Abortion program with $3.35 million per year, funded by a cut to the Texas Commission on Environmental Quality. In a budget subcommittee, Hughes sought to&amp;nbsp;increase the program's funding by nearly $15 million&amp;nbsp;in the two-year budget, but that measure failed.&lt;/span&gt;&lt;/p&gt; &lt;p dir="ltr"&gt;&lt;span&gt;A separate amendment from state Rep. &lt;a href="http://www.texastribune.org/directory/dade-phelan/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Dade Phelan&lt;/a&gt;, R-Beaumont, &lt;span id="docs-internal-guid-7fa214e4-6c09-031d-2ebb-092b6bbf555f"&gt;&lt;span&gt;would boost the program&amp;rsquo;s funding by $3.35 million per year by cutting funding from a film and music marketing program in the governor&amp;rsquo;s office &amp;mdash; a move he hopes will help the Alternatives to Abortion program extend into East and South Texas.&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt; &lt;p dir="ltr"&gt;&lt;span&gt;"They've done a good job with what we&amp;rsquo;ve given over the last 10 years," Phelan said. "I think w&lt;/span&gt;&lt;span id="docs-internal-guid-317e88df-6c25-57d3-4319-ee1c450a7db9"&gt;hatever increase we can give them is well-warranted."&lt;/span&gt;&lt;/p&gt; &lt;p&gt;State Rep. &lt;a href="http://www.texastribune.org/directory/greg-bonnen/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Greg Bonnen&lt;/a&gt;, R-Friendswood, filed an amendment that would rename the program to Pregnancy and Parenting Services, which he said would defuse any controversy surrounding the program.&lt;/p&gt; &lt;p&gt;"There are individuals who seem to dislike the program, which I think is disappointing, because the program really isn&amp;rsquo;t about abortion rights or abortion restrictions," said Bonnen, a neurosurgeon. "I find it a little disheartening and disappointing that anyone would want to take resources away from pregnant women or newborn children."&lt;/p&gt; &lt;p&gt;&lt;em&gt;This story was produced in partnership with&amp;nbsp;&lt;a href="http://www.kaiserhealthnews.org/"&gt;Kaiser Health News&lt;/a&gt;, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.&lt;/em&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Alexa Ura and Edgar Walters</dc:creator><pubDate>Mon, 30 Mar 2015 15:04:52 -0500</pubDate><guid>http://www.texastribune.org/2015/03/30/house-democrats-target-abortion-program-budget/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Health Commission Experienced a Program Failure, Report Says </title><link>http://www.texastribune.org/2015/03/30/strike-team-report-says-hhsc-should-not-consolidat/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/30/strike-team-report-says-hhsc-should-not-consolidat/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/Janek-Listens_jpg_312x1000_q100.jpg" alt="Executive Commissioner of the Texas Health and Human Services Commission Dr. Kyle Janek"&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;&lt;sub&gt;*Editor's note: This story has been updated throughout.&lt;/sub&gt;&lt;/p&gt; &lt;p&gt;Serious missteps by the Texas Health and Human Services Commission&amp;rsquo;s management resulted in a $20 million software contract that &amp;ldquo;skirted&amp;rdquo; the edge of state law and revealed problems that should delay a planned agency consolidation, according to a &amp;ldquo;strike force&amp;rdquo; appointed by Gov. &lt;a href="http://www.texastribune.org/directory/greg-abbott/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Greg Abbott&lt;/a&gt;.&lt;/p&gt; &lt;p&gt;The health commission &amp;ldquo;has experienced a program failure,&amp;rdquo; the team said in its report, which was released Monday. It pinned the blame mostly on a lack of leadership from current management overseen by Executive Commissioner Kyle Janek. The report said he over-relied on a &amp;ldquo;kitchen cabinet&amp;rdquo; of close associates who kept him insulated from bigger problems that surfaced with existing work and kept the rest of staff in the dark about many major decisions.&lt;/p&gt; &lt;p&gt;Abbott praised the team&amp;rsquo;s work but was blunt about the report&amp;rsquo;s findings.&lt;/p&gt; &lt;p&gt;"The report&amp;rsquo;s findings are deeply troubling,&amp;rdquo; the governor said in a statement. &amp;ldquo;It is now more clear than ever that the Texas Health and Human Services Commission has been riddled with operational, managerial, structural and procedural problems that go far beyond any individual or contract. That is unacceptable.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Abbott added that he wants time to consider the findings before making any decisions about the agency.&lt;/p&gt; &lt;p&gt;Those decisions will probably include whether Janek, who has said he was misled by staffers about the state&amp;rsquo;s software contract with Austin firm 21CT, remains at the helm.&lt;/p&gt; &lt;p&gt;In January, Abbott had dispatched the team &amp;mdash; led by Billy Hamilton, executive vice chancellor and chief financial officer of the Texas A&amp;amp;M University System &amp;mdash; to conduct an outside review of the commission&amp;rsquo;s management operations and contracting methods after revelations that a $20 million fraud-tracking software contract with 21CT was not competitively awarded.&lt;/p&gt; &lt;p&gt;"While the 21CT controversy was the product of a near-perfect storm of circumstances &amp;mdash; a lax procurement process, aggressive pursuit of a single vendor, internal control weaknesses at HHSC and poor contracting &amp;mdash; the real problem was&amp;nbsp;&lt;em&gt;leadership&lt;/em&gt;," the report stated.&amp;nbsp;&lt;/p&gt; &lt;p&gt;The 21CT deal was struck in 2012, before Janek, an anesthesiologist and former state senator, landed the top job. But Janek&amp;rsquo;s failure to intervene with bigger questions about how the software was selected and how it was on track to receive a $90 million extension was cited as just one example of the agency&amp;rsquo;s leadership vacuum.&lt;/p&gt; &lt;p&gt;&amp;ldquo;The 21CT agreement as it developed could have been stopped by one correct decision at several points along the way, but it was not,&amp;rdquo; the report stated. The health commission canceled the contract last December after questions were raised about it.&lt;/p&gt; &lt;p&gt;Mike Rosen, a 21CT spokesman, issued a statement criticizing Abbott's team for never talking to officials at the company.&amp;nbsp;&lt;/p&gt; &lt;p&gt;"The Strike Force never contacted 21CT to discuss the findings, or how the state can continue to utilize the solutions we provided even after the contract ended," Rosen said in a statement. "It is disturbing the Strike Force interviewed&amp;nbsp;&amp;lsquo;a segment of the vendor community,&amp;rsquo; yet ignored the vendor whose contract is in question."&amp;nbsp;&lt;/p&gt; &lt;p&gt;The strike force report, based on interviews with commission employees and news reports, detailed how Janek&amp;rsquo;s group of close aides kept other key officials out, even on decisions involving their departments or agencies.&lt;/p&gt; &lt;p&gt;One example cited in the report was how the head of the Department of State Health Services told Abbott&amp;rsquo;s team that the agency knew nothing of the competitive bid process that had begun to privatize the management of Terrell State Hospital until very late in the bidding process.&lt;/p&gt; &lt;p&gt;That process &amp;ldquo;subsequently became another major problem for HHSC and the subject of another State Auditor review,&amp;rdquo; the report stated.&lt;/p&gt; &lt;p&gt;The report&amp;rsquo;s release comes as the Legislature is debating whether to move forward with&amp;nbsp;an ambitious &amp;mdash; and controversial &amp;mdash; plan to restructure the state&amp;rsquo;s five health and human services agencies, including the massive health commission, and combine them into one &amp;ldquo;mega-agency.&amp;rdquo; This month, Senate Finance Chairwoman Jane Nelson&amp;nbsp;&lt;a href="http://www.texastribune.org/2015/03/18/after-scandal-lawmakers-change-gears-health-agency/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;suggested slowing down that consolidation&lt;/a&gt;&amp;nbsp;in light of concerns about contracting at HHSC.&lt;/p&gt; &lt;p&gt;"A strong case can be made that the public health and child and adult protective services functions, at minimum, should remain at separate agencies under HHSC oversight," the report said.&amp;nbsp;"They will be more likely to attract and retain the sort of leadership they need at separate agencies rather than two divisions within a 'mega-agency.'"&amp;nbsp;&lt;/p&gt; &lt;p&gt;State Rep. &lt;a href="http://www.texastribune.org/directory/garnet-coleman/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Garnet Coleman&lt;/a&gt;, D-Houston, has been a vocal critic of consolidation since last year. He was among a group of state lawmakers who were privately briefed about the report before it was handed out to reporters.&lt;/p&gt; &lt;p&gt;&amp;ldquo;It&amp;rsquo;s what I thought,&amp;rdquo; Coleman said of the report&amp;rsquo;s findings about management problems and how they should delay consolidation until they are fixed. &amp;ldquo;At least I know my gut still works.&amp;rdquo;&lt;/p&gt; &lt;p&gt;In recent months, several state lawmakers have called on Janek to resign in light of the contracting scandal. Abbott has said he wouldn't make a decision on Janek's future&amp;nbsp;&lt;a href="http://www.texastribune.org/2015/01/15/whitmire-calls-janeks-resignation/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;until after the release of the report&lt;/a&gt;. But the governor's office declined to give a timetable on the decision-making process.&lt;/p&gt; &lt;p&gt;The report describes Janek as a manager who, while affable and knowledgeable, was &amp;ldquo;insulated from many issues by his immediate staff and not always well-served by them.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Janek did not respond to a direct call for comment. His agency released a letter he wrote to Lt. Gov. &lt;a href="http://www.texastribune.org/directory/dan-patrick/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Dan Patrick&lt;/a&gt; in which he thanked Abbott and the strike force for its &amp;ldquo;thorough report&amp;rdquo; that outlines how to rebuild the agency.&lt;/p&gt; &lt;p&gt;&amp;ldquo;That is a vision I share and am committed to achieving,&amp;rdquo; Janek wrote.&lt;/p&gt; &lt;p&gt;Abbott&amp;rsquo;s team could not reach a conclusion on one thing: whether HHSC&amp;rsquo;s deal with 21CT was illegally steered in 2012 by Jack Stick, who was then deputy inspector general.&lt;/p&gt; &lt;p&gt;The company was selected outside a competitive bidding process from a list of vendors compiled by the Texas Department of Information Resources. Last fall, the &lt;i&gt;Austin American-Statesman&lt;/i&gt; found that Stick, who eventually became HHSC&amp;rsquo;s chief counsel, &lt;a href="http://www.mystatesman.com/news/news/state-regional-govt-politics/texas-health-official-who-steered-deals-has-ties-t/njH4M/"&gt;was once a business partner&lt;/a&gt; of 21CT&amp;rsquo;s lobbyist, James Frinzi.&lt;/p&gt; &lt;p&gt;While the team found that executive staff at the office of inspector general &amp;ldquo;exercised judgment so poor that it put HHSC's credibility at risk," it left the decision about whether anything illegal occurred to another investigation team at the state&amp;rsquo;s public integrity unit, which is still investigating.&lt;/p&gt; &lt;p&gt;Last December, the commission's inspector general, Doug Wilson, and Stick were &lt;a href="http://www.statesman.com/news/news/state-regional-govt-politics/top-health-offficials-resigns-over-contract-concer/njRMB/"&gt;forced to resign&lt;/a&gt; after the connection between Stick and the lobbyist were revealed.&lt;/p&gt; &lt;p&gt;That same month, the Texas Sunset Advisory Commission&amp;nbsp;voted in support of consolidating&amp;nbsp;the five social services agencies into one entity. HHSC oversees four other state agencies &amp;mdash; the Department of Aging and Disability Services, Department of Family and Protective Services, Department of State Health Services and Department of&amp;nbsp;Assistive and Rehabilitative Services. Together they are $34 billion entity, about a third of the state budget.&lt;/p&gt; &lt;p&gt;The team behind the HHSC report also included Heather Griffith Peterson, chief financial officer of the Texas Department of Agriculture; Scott McCown, clinical professor and director of the&amp;nbsp;&lt;a href="http://www.utexas.edu/law/clinics/childrens/"&gt;Children&amp;rsquo;s Rights Clinic&lt;/a&gt;&amp;nbsp;at the University of Texas School of Law; and former state Rep. &lt;a href="http://www.texastribune.org/directory/talmadge-heflin/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Talmadge Heflin&lt;/a&gt;, director of the Center for Fiscal Policy at the Texas Public Policy Foundation.&lt;/p&gt; &lt;p&gt;&lt;em&gt;Aman Batheja contributed to this report.&lt;/em&gt;&lt;/p&gt; &lt;p&gt;&lt;em&gt;Disclosure: The Texas A&amp;amp;M University System, University of Texas at Austin and the Texas Public Policy Foundation are corporate sponsors of The Texas Tribune.&amp;nbsp;&lt;/em&gt;&lt;i&gt;A complete list of Tribune donors and sponsors can be viewed&amp;nbsp;&lt;/i&gt;&lt;a href="http://www.texastribune.org/support-us/donors-and-members/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;&lt;i&gt;here&lt;/i&gt;&lt;/a&gt;&lt;i&gt;.&lt;/i&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Terri Langford</dc:creator><pubDate>Mon, 30 Mar 2015 09:25:59 -0500</pubDate><guid>http://www.texastribune.org/2015/03/30/strike-team-report-says-hhsc-should-not-consolidat/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Texas Scientists Find Antibiotic Resistance Blowing in Wind </title><link>http://www.texastribune.org/2015/03/29/scientists-find-antibiotic-resistance-blowing-nort/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/29/scientists-find-antibiotic-resistance-blowing-nort/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2015/03/17/IMG_8630_jpg_312x1000_q100.jpg" alt="Thousands of cattle spend their final months at feed yards like this one, located in Hale Center."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p class="western"&gt;&lt;span style="line-height: 1.35;"&gt;COTTON CENTER &amp;ndash; After years spent studying the dust that blows across the southern Great Plains, Phil Smith no longer looks at the dark haboobs that routinely rise over Lubbock without a healthy dose of apprehension.&lt;/span&gt;&lt;/p&gt; &lt;p class="western"&gt;&lt;span style="line-height: 1.35;"&gt;&lt;span&gt;In&lt;/span&gt;&lt;span&gt;&amp;nbsp;a&amp;nbsp;&lt;/span&gt;&lt;span&gt;&lt;span lang="zxx"&gt;&lt;span&gt;&lt;a href="http://ehp.niehs.nih.gov/1408555/"&gt;study&lt;/a&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;span&gt;&amp;nbsp;slated for publication next month, he and Texas Tech University colleague Greg Mayer may have made their biggest discovery yet: DNA from antibiotic-resistant bacteria&amp;nbsp;in cattle feedlots is&amp;nbsp;airborne.&lt;/span&gt;&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;&lt;/span&gt;&amp;nbsp;&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;For years, scientists have known that humans can contract antibiotic-resistant bacteria by consuming&lt;/span&gt;&lt;strong style="line-height: 1.35;"&gt;&amp;nbsp;&lt;/strong&gt;&lt;span style="line-height: 1.35;"&gt;contaminated meat or water. The findings by Smith and Mayer indicate&amp;nbsp;that humans could also be exposed to so-called "super bugs" or "super bacteria" traveling through the air.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;"This is the first test to open our eyes to the fact that we could be breathing these things," said Smith, an environmental toxicologist at Texas Tech.&lt;/span&gt;&amp;nbsp;&lt;/p&gt; &lt;p&gt;&lt;span lang="en-US"&gt;Antibiotics are commonly used on cows in&amp;nbsp;industrial feedlots to treat disease and, more controversially, as a growth promoter added to cattle feed. It is estimated that up to 80 percent of antibiotics sold in the United States are used on livestock.&amp;nbsp;&lt;/span&gt;&lt;/p&gt; &lt;p class="western"&gt;The study may help explain how bacteria that no longer respond to antibiotics could be spreading and causing hard-to-treat infections in humans. Two&amp;nbsp;million Americans&amp;nbsp;&lt;a href="http://www.cdc.gov/drugresistance/threat-report-2013/"&gt;are infected&lt;/a&gt; by antibiotic-resistant bacteria each year, while 23,000 die as a direct result of these infections, according to the&amp;nbsp;Centers for Disease Control and Prevention.&lt;/p&gt; &lt;p class="western"&gt;The cattle industry is pushing back, saying the report misrepresents the risk of super bacteria&amp;nbsp;to human health. Dr. Sam Ives, a veterinarian working with the Texas Cattle Feeders Association, said antibiotic use in the industry is "judicious."&lt;/p&gt; &lt;p class="western"&gt;"If I truly thought that the usage of these products was putting anyone at danger, I wouldn't be using them," Ives said.&lt;/p&gt; &lt;p&gt;&lt;span lang="en-US"&gt;The study focused on feedlots in Texas' Panhandle and South Plains, each holding tens of thousands of cattle, where animals spend the last few months of their lives gaining weight before slaughter. Feedlots were an ideal place to study antibiotic resistance because bacteria there are exposed to high levels of antibiotics.&lt;/span&gt;&lt;/p&gt; &lt;p class="western"&gt;&lt;span style="font-family: Cochin, serif;"&gt;&lt;span style="line-height: 1.35; font-family: Georgia, Times, serif;"&gt;Last year, Mayer and Smith&amp;nbsp;collected dust samples upwind&amp;nbsp;&lt;/span&gt;&lt;span style="line-height: 1.35; font-family: Georgia, Times, serif;"&gt;and downwind from 10 commercial cattle feed yards over&amp;nbsp;&lt;/span&gt;&lt;span style="line-height: 1.35; font-family: Georgia, Times, serif;"&gt;six months.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;span style="font-family: Cochin, serif;"&gt;&lt;span style="line-height: 1.35; font-family: Georgia, Times, serif;"&gt;They set up high-tech vacuums on the nearest county road, collected particulate matter onto mesh screens, and took the samples to a lab where sophisticated machinery helped them identify the gene sequences, which Mayer calls the "fingerprints" of antibiotic-resistant bacteria.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;"The 'aha' moment came when we saw how much more prevalent resistant sequences were downwind than upwind," said Mayer, a molecular biologist at Texas Tech. "It was not just higher in some of them &amp;ndash; it was&amp;nbsp;4,000&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;percent&amp;nbsp;more.&amp;nbsp;It made me not want to breathe."&lt;/p&gt; &lt;p&gt;&lt;span&gt;The study area is not only in one of the most windswept stretches of the country. It is also home to a high concentration of industrial cattle feedlots. In the Panhandle alone, 5 million beef cattle are sent to slaughter every year, according to the Texas Cattle Feeders Association.&amp;nbsp;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span&gt;&amp;ldquo;What we have demonstrated is that this mechanism of transport is completely viable,"&amp;nbsp;&lt;/span&gt;Smith said&amp;nbsp;of air travel by bacteria&lt;span&gt;&lt;span&gt;.&amp;nbsp;&amp;ldquo;We believe that this bacteria could remain active for a long period of time and, given the wind that we have around Lubbock, it could be traveling for long distances."&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt; &lt;p class="western"&gt;&lt;span lang="en-US"&gt;But he and Mayer a&lt;/span&gt;&lt;span lang="en-US"&gt;re the first to admit that&amp;nbsp;&lt;/span&gt;&lt;span lang="en-US"&gt;their findings raise a number of questions.&amp;nbsp;&lt;/span&gt;&lt;span lang="en-US"&gt;Among them: What happens when&amp;nbsp;&lt;/span&gt;&lt;span lang="en-US"&gt;the DNA of&amp;nbsp;&lt;/span&gt;&lt;span lang="en-US"&gt;antibiotic-resistant bacteria,&amp;nbsp;&lt;/span&gt;&lt;span lang="en-US"&gt;traveling on the wind,&lt;/span&gt;&lt;span lang="en-US"&gt;&amp;nbsp;reaches its destination?&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span lang="en-US"&gt;One of their main concerns is that bacteria harboring antibiotic resistance genes will transfer&amp;nbsp;antibiotic-resistant DNA&lt;/span&gt;&amp;nbsp;&lt;span lang="en-US"&gt;to bacteria in the community where they settle, spreading resistance.&lt;span style="text-decoration: line-through;"&gt;&lt;br /&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span lang="en-US"&gt;Difficult-to-treat super bacteria have been traced to hospitals &amp;ndash;&lt;/span&gt;&lt;span lang="en-US"&gt; such as in &lt;/span&gt;&lt;span lang="en-US"&gt;the case of the recent &lt;/span&gt;&lt;span lang="en-US"&gt;&lt;a href="http://www.latimes.com/business/la-fi-hospital-infections-20150218-story.html#page=1"&gt;endoscopy super bug&lt;/a&gt; &amp;ndash; and, increasingly, to livestock raised on industrial feedlots. The well-known &lt;a href="http://thechart.blogs.cnn.com/2012/02/21/how-a-mrsa-strain-came-to-flourish/"&gt;MRSA bacteria&lt;/a&gt;, which jumped from humans to cattle, where it grew resistant to antibiotics, now kills more than &lt;a href="http://www.cdc.gov/drugresistance/biggest_threats.html"&gt;11,200 people each year&lt;/a&gt;.&amp;nbsp;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span lang="en-US"&gt;But representatives of the cattle feeding industry,&lt;/span&gt;&amp;nbsp;which Texas A&amp;amp;M AgriLife &lt;a href="http://animalscience.tamu.edu/livestock-species/beef/"&gt;estimates&lt;/a&gt;&amp;nbsp;at 14 million beef cattle across the state, have rebuffed the Texas Tech&amp;nbsp;findings, deeming them partial and inconclusive.&amp;nbsp;Ives, a feedlot veterinarian who teaches at West Texas A&amp;amp;M University&lt;strong&gt;, &lt;/strong&gt;said the study mischaracterizes the&amp;nbsp;threat to humans of bacteria that have grown resistant to antibiotics&amp;nbsp;used on cattle.&amp;nbsp;Many of the antibiotics used on livestock are not used on humans, he explained.&lt;/p&gt; &lt;p&gt;"T&lt;span style="line-height: 1.35;"&gt;he judicious use of antibiotics as we are using them today has very little risk to human health,&amp;rdquo; Ives said. "My children work with me in the feedlot; my wife works with me. Am I concerned for their safety? No, I'm not."&lt;/span&gt;&lt;/p&gt; &lt;p class="western"&gt;A growing body of evidence has linked antibiotic resistance in livestock bacteria to human infection, and antibiotic resistance has become&amp;nbsp;an&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;issue of national concern in recent years.&amp;nbsp;&lt;span style="line-height: 1.35;"&gt;&lt;strong&gt;&lt;br /&gt;&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt; &lt;p class="western"&gt;&lt;span style="line-height: 1.35;"&gt;In 2013, the&amp;nbsp;Food and Drug Administration&amp;nbsp;issued&amp;nbsp;&lt;/span&gt;&lt;a style="line-height: 1.35;" href="http://www.fda.gov/downloads/AnimalVeterinary/GuidanceComplianceEnforcement/GuidanceforIndustry/UCM299624.pdf"&gt;guidelines&lt;/a&gt;&lt;span style="line-height: 1.35;"&gt;&amp;nbsp;for reducing antibiotic use for growth promotion in livestock, and earlier this year, the Obama administration&amp;nbsp;&lt;/span&gt;&lt;a style="line-height: 1.35;" href="https://www.whitehouse.gov/the-press-office/2015/01/27/fact-sheet-president-s-2016-budget-proposes-historic-investment-combat-a"&gt;announced&lt;/a&gt;&lt;span style="line-height: 1.35;"&gt;&amp;nbsp;that it would double funding aimed to fighting antibiotic resistance in its proposed 2016 budget.&lt;/span&gt;&lt;/p&gt; &lt;p class="western"&gt;&lt;span style="line-height: 1.35;"&gt;In his 10 years treating patients&amp;nbsp;at his Lubbock clinic, Dr. Randall Wolcott has seen bacteria grow increasingly resistant to antibiotics used to treat their infections. "We know that antibiotic-resistant genes are becoming more common," Wolcott said. "We use too many antibiotics for animal health, and it keeps food prices down. Is it a good tradeoff?&amp;nbsp;&lt;/span&gt;&lt;span style="line-height: 1.35;" lang="en-US"&gt;This research is a piece of the puzzle that will help decide that question.&amp;rdquo;&amp;nbsp;&lt;strong&gt;&lt;br /&gt;&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt; &lt;p class="western"&gt;&lt;span style="line-height: 1.35;" lang="en-US"&gt;In the community of Cotton Center, about 40 miles north of Lubbock,&amp;nbsp;Rocky Stone expressed mixed feelings about the study by Mayer and Smith. "The cattle industry employs a lot of people in this area," said Stone, superintendent of the Cotton Center school district. "Until someone shows me proof that there is a problem, I'm not going to worry about it."&lt;/span&gt;&lt;/p&gt; &lt;p class="western"&gt;&lt;span lang="en-US"&gt;&lt;span style="line-height: 1.35;"&gt;A mile down the road, Elba Saenz swept her front stoop. She has lived in&amp;nbsp;Cotton Center for nearly 40 years and has always noted the smell coming from the Hale Center Feed Yard, five miles north of her house. &amp;ldquo;If someone told me that there were resistant bacteria floating in the wind from the feed yard, I would believe them,&amp;rdquo; Saenz said.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&amp;ldquo;But even if I am not happy about the feed yard, what am I supposed to do?" she added. "I live here.&amp;rdquo;&lt;/p&gt; &lt;p class="western"&gt;&lt;em&gt;Disclosure: The Texas A&amp;amp;M AgriLife Extension Service is a corporate sponsor of The Texas Tribune.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;em&gt;&lt;i&gt;&amp;nbsp;&lt;/i&gt;&lt;/em&gt;A complete list of Tribune donors and sponsors can be viewed&amp;nbsp;&lt;a href="http://www.texastribune.org/support-us/donors-and-members/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;here&lt;/a&gt;.&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Eva Hershaw</dc:creator><pubDate>Sun, 29 Mar 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/2015/03/29/scientists-find-antibiotic-resistance-blowing-nort/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>FBI at Health Commission Asking About 21CT Deal </title><link>http://www.texastribune.org/2015/03/27/fbi-interviewing-hhsc-employees-about-21ct/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/27/fbi-interviewing-hhsc-employees-about-21ct/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/Janek-Listens_jpg_312x1000_q100.jpg" alt="Executive Commissioner of the Texas Health and Human Services Commission Dr. Kyle Janek"&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;FBI agents have interviewed employees at the Texas Health and Human Services Commission about its problematic contract with Austin firm&lt;a href="http://www.21ct.com/"&gt; 21CT&lt;/a&gt;, Executive Commissioner&lt;a href="http://www.texastribune.org/directory/kyle-janek/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt; Kyle Janek&lt;/a&gt;&amp;nbsp;told The Texas Tribune, marking the first time an official with direct knowledge of the federal probe has confirmed it.&lt;/p&gt; &lt;p&gt;&amp;ldquo;I can tell you what I know. I&amp;rsquo;ve heard they were here talking to people. They have not talked to me," Janek said late Thursday.&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;How little-known 21CT landed a $20 million &lt;/span&gt;&lt;a style="line-height: 1.35;" href="http://www.21ct.com/products/torch/"&gt;Medicaid fraud tracking software&lt;/a&gt;&lt;span style="line-height: 1.35;"&gt; deal with HHSC, a whale of a state agency that spends billions each year on contracts, has become the&lt;a href="https://www.texastribune.org/2015/02/03/21ct-health-commission-recap/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;&amp;nbsp;center of three very public investigations &lt;/a&gt;launched since December.&amp;nbsp;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;The probes began after&amp;nbsp;&lt;a href="http://www.mystatesman.com/flist/news/complete-coverage-21ct/fmq/"&gt;news reports&lt;/a&gt;&amp;nbsp;detailed how the commission failed to seek competitive bids before awarding the contract to 21CT, and how the commission's then-deputy inspector general,&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/jack-stick/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Jack Stick&lt;/a&gt;,&amp;nbsp;was once a business partner of the company's lobbyist, James Frinzi.&lt;/p&gt; &lt;p&gt;HHSC had selected 21CT from a centralized list of approved state vendors,&amp;nbsp;the Texas Department of Information Resources Cooperative Contracts program. Nearly all the money used to pay 21CT came from the federal Centers for Medicare and Medicaid Services, which was told the contract was awarded through competitive bidding. &amp;nbsp;&lt;/p&gt; &lt;p&gt;The commission later confirmed&amp;nbsp;&lt;a href="http://www.texastribune.org/2015/02/10/did-hhsc-fudge-facts-get-18-million-feds/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;it was not&lt;/a&gt;. &amp;nbsp;&lt;/p&gt; &lt;p&gt;In December, a $90 million contract extension between the commission and 21CT was scuttled, and Stick, who had been promoted to chief counsel for the agency, was forced to resign, along with his former boss Inspector General Doug Wilson.&amp;nbsp;&lt;/p&gt; &lt;p&gt;Janek has said he&amp;nbsp;was &lt;a href="https://www.texastribune.org/2014/12/23/hhsc-chief-says-he-was-misled-21ct-deal/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;misled&lt;/a&gt; in staff briefings on the 21CT deal.&amp;nbsp;&lt;/p&gt; &lt;p&gt;In mid-January, the &lt;em&gt;Austin American Statesman&lt;/em&gt;, citing unidentified sources,&amp;nbsp;&lt;a href="http://www.mystatesman.com/flist/news/complete-coverage-21ct/fmq/"&gt;reported&lt;/a&gt; that an FBI investigation had been launched into the 21CT deal.&lt;/p&gt; &lt;p&gt;But it was not until Thursday, when Janek and his newly hired procurement director, &lt;a href="https://www.linkedin.com/in/ronpigott"&gt;Ron Pigott&lt;/a&gt;, discussed the FBI interviews with the Tribune, that any state official with first-hand knowledge of the federal probe confirmed it was active.&lt;/p&gt; &lt;p&gt;&lt;span&gt;"I had staff that had to go get interviewed by the FBI," Pigott said. "The FBI was at our offices, and they wanted to see files. It was all 21CT related.&amp;rdquo;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;The FBI declined to provide further details. &amp;nbsp;&lt;/p&gt; &lt;p&gt;"We can neither confirm nor deny the existence of an investigation at this time," said Michelle Lee, spokeswoman for the FBI in San Antonio.&amp;nbsp;&lt;/p&gt; &lt;p&gt;A 21CT official said the company knows nothing about the FBI's involvement.&lt;/p&gt; &lt;p&gt;"They haven't contacted us," said Mike Rosen, 21CT's spokesman.&amp;nbsp;&lt;/p&gt; &lt;p&gt;Pigott, who joined HHSC in February, said HHSC has improved its safeguards to prevent any other contract like the one crafted with 21CT from slipping through the system.&lt;/p&gt; &lt;p&gt;&lt;span&gt;The agency now competitively bids out any purchase it makes through DIR's Cooperative Contracts program. If such a protocol had been in place for the contract 21CT was granted, there might have been hundreds of possible contenders, and 21CT would not have won it, Pigott said.&lt;/span&gt;&lt;/p&gt; &lt;div dir="ltr"&gt;"We do have more checks and balances in place," he said.&lt;/div&gt; &lt;div dir="ltr"&gt;&lt;/div&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;&lt;span style="line-height: 1.35;"&gt;Two of the three state investigations launched since December are expected to yield reports next month. The Texas State Auditor's Office and a team handpicked by Gov. &lt;a href="http://www.texastribune.org/directory/greg-abbott/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Greg Abbott&lt;/a&gt; headed by an executive vice chancellor and chief financial officer of the Texas A&amp;amp;M University system are both looking into the commission's procurement practices.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;The state's public integrity unit, based out of the Travis County district attorney's office, is also conducting an investigation that is ongoing and could result in criminal charges.&lt;/p&gt; &lt;p&gt;Janek said he will be watching all the investigations closely.&lt;/p&gt; &lt;p&gt;&amp;ldquo;Whatever took place, the story will end up being probably cemented by state auditor&amp;rsquo;s report, Billy Hamilton&amp;rsquo;s task force, PIU if they say anything," Janek said. "Whatever the story is that people look back on in five years, it&amp;rsquo;ll be molded by what these outside groups have to say about it.&amp;rdquo;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Terri Langford and Aman Batheja</dc:creator><pubDate>Fri, 27 Mar 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/2015/03/27/fbi-interviewing-hhsc-employees-about-21ct/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Video: Video: A Conversation With Clay Johnston </title><link>http://www.texastribune.org/2015/03/26/livestream-dell-medical-school-dean-clay-johnston/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div class="video"&gt; &lt;div class="livestream"&gt; &lt;iframe src="http://new.livestream.com/accounts/4773527/events/3876094/player?autoPlay=false&amp;height=357&amp;mute=false&amp;width=635" width="635" height="357" frameborder="0" scrolling="no"&gt;&lt;/iframe&gt; &lt;/div&gt; &lt;/div&gt; &lt;p&gt;&lt;span&gt;Full video of my 3/26 conversation with&amp;nbsp;Clay Johnston&lt;/span&gt;&lt;span&gt;, dean of the University of Texas at Austin's Dell Medical School.&lt;/span&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Evan Smith</dc:creator><pubDate>Thu, 26 Mar 2015 12:04:15 -0500</pubDate><guid>http://www.texastribune.org/2015/03/26/livestream-dell-medical-school-dean-clay-johnston/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Terrell State Hospital Privatization Deal Scuttled After Audit </title><link>http://www.texastribune.org/2015/03/25/hhsc-ditches-plan-privatize-terrell-state-hospital/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/25/hhsc-ditches-plan-privatize-terrell-state-hospital/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2015/03/25/Terrel_State_Hospital_TTcrop_jpg_312x1000_q100.jpg" alt="Terrell State Hospital is one of 10 state psychiatric hospitals."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;&lt;!--&lt;!--StartFragment--&gt;--&gt;&lt;/p&gt; &lt;p&gt;&lt;sup&gt;*Editor's note: This story has been updated throughout.&amp;nbsp;&lt;/sup&gt;&lt;/p&gt; &lt;p&gt;A plan to privatize Terrell State Hospital is dead following a scathing audit that raps the state health commission for bypassing its own contracting procedures.&lt;/p&gt; &lt;p&gt;The Texas Health and Human Services Commission canceled the deal &amp;mdash; which was still being negotiated &amp;mdash; immediately following the Wednesday release of a report by Texas State Auditor John Keel, commission spokeswoman Stephanie Goodman said.&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;The review&lt;/span&gt;&lt;a style="line-height: 1.35;" href="http://www.sao.state.tx.us/reports/main/15-017.pdf"&gt;&amp;nbsp;of the deal&lt;/a&gt;&lt;span style="line-height: 1.35;"&gt;&amp;nbsp;is the latest setback for Texas Health and Human Services Executive Commissioner Kyle Janek. The commission is already being investigated for the way it awarded a $20 million anti-Medicaid fraud software deal to a single bidder in 2012. And late last year, a state audit dinged the agency for a messy telecommunications contract with AT&amp;amp;T that ballooned from $48 million to $80 million.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;In this latest report, the state auditor took issue with the commission's October decision to tentatively select Geo Care LLC to run the hospital, one of the state's 10 psychiatric facilities. The audit found&amp;nbsp;that the commission undervalued the contract and skipped having the deal blessed by the Texas attorney general's office, as required.&lt;/p&gt; &lt;p&gt;The commission "did not ensure that its decision to tentatively award a contract to GEO Care, LLC to manage selected operations at Terrell State Hospital provided the best value to the State," the audit said. The findings of the audit were first reported by &lt;em&gt;The Dallas Morning News&lt;/em&gt;.&lt;/p&gt; &lt;p&gt;The auditor's report put the privatization deal at $30 million, an early estimate the commission had reported to the Texas Comptroller's Office. That figure was wrong and should not have been provided, Goodman said.&lt;/p&gt; &lt;p&gt;No final price tag for the privatization plan was reached before the project was put on hold after state Sen. Robert Nichols, R-Jacksonville, started raising questions about the deal.&amp;nbsp;The commission's own operating budget for the facility is about $55 million a year.&amp;nbsp;&lt;/p&gt; &lt;p&gt;GEO Care, which eventually became the company known as Correct Care LLC, issued a statement expressing regret over the state's decision not to proceed.&amp;nbsp;&lt;/p&gt; &lt;p&gt;&lt;!--&lt;!--StartFragment--&gt;--&gt;"Correct Care is disappointed in the audit's findings. We believe our proposal to build a new Terrell State Hospital on the existing campus would have benefitted patients, the Terrell community and the state of Texas," said Jeremy Barr, a spokesman for Correct Care LLC.&amp;nbsp;&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;Late last year,&lt;/span&gt;&lt;span style="line-height: 1.35;"&gt;&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/robert-nichols/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Nichols&lt;/a&gt;&amp;nbsp;raised concerns about the project and asked Keel's office to review it. And at a February legislative hearing, Nichols grilled Janek about why the agency moved forward with a plan to privatize Terrell State Hospital, a 288-bed facility with 980 staffers, without vetting it with lawmakers.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;Nichols has said he is concerned about efforts to privatize state hospitals because his district includes Rusk State Hospital.&amp;nbsp;&lt;/span&gt;&lt;span style="line-height: 1.35;"&gt;In 2012, the state dropped plans to privatize Kerrville State Hospital because the commission found it would not save money or improve patient care.&amp;nbsp;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;&amp;nbsp;&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;!--&lt;!--EndFragment--&gt;--&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Terri Langford</dc:creator><pubDate>Wed, 25 Mar 2015 14:39:40 -0500</pubDate><guid>http://www.texastribune.org/2015/03/25/hhsc-ditches-plan-privatize-terrell-state-hospital/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Abbott to Foster Care Agency: Get Your Act Together </title><link>http://www.texastribune.org/2015/03/25/abbott-foster-care-agency-get-your-act-together/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/25/abbott-foster-care-agency-get-your-act-together/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2015/02/17/BDS_4051CMS_jpg_312x1000_q100.jpg" alt="Gov. Greg Abbott annouces several emergency legislative items in his first State of the State speech on Feb. 17, 2015."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;&lt;sub&gt;&lt;span&gt;*Editor's note: This story has been updated with comment from the&amp;nbsp;Department of Family and Protective Services.&lt;/span&gt;&lt;/sub&gt;&lt;/p&gt; &lt;p&gt;In the wake of three child deaths under the state&amp;rsquo;s ward so far this year, Gov. &lt;a href="http://www.texastribune.org/directory/greg-abbott/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Greg Abbott&lt;/a&gt; on Wednesday told the Department of Family and Protective Services to straighten up and fly right.&lt;/p&gt; &lt;p&gt;In a letter to DFPS Commissioner John Specia, Abbott asked the agency to step up enforcement, develop a tool for screening potential foster parents and educate caregivers about gun safety, among other changes.&amp;nbsp;&lt;/p&gt; &lt;p&gt;&amp;ldquo;Abuse or neglect of our most vulnerable Texans &amp;ndash; our children &amp;ndash; is intolerable and it is especially unacceptable when it happens to a child under the care umbrella of the state of Texas,&amp;rdquo; Abbott wrote in the &lt;a href="http://gov.texas.gov/files/press-office/DFPS_Letter_03252015.pdf"&gt;letter&lt;/a&gt;.&lt;/p&gt; &lt;p&gt;The governor, who in February proposed a $40 million increase to DFPS funding, asked the agency to implement the reforms and report back in three weeks.&lt;/p&gt; &lt;p&gt;In late January, a 2-month-old baby girl in Dallas, Justice Hull, was intentionally drowned by a 14-year-old teen.&amp;nbsp;&lt;/p&gt; &lt;p&gt;Justice came into CPS custody after her mother was jailed shortly after the girl&amp;rsquo;s birth. CPS workers then placed Justice in the care of a family friend. Police say the family friend's daughter intentionally drowned baby Justice.&lt;/p&gt; &lt;p&gt;Last year, nine children died while under DFPS supervision, according to Abbott&amp;rsquo;s letter.&lt;/p&gt; &lt;p&gt;"We appreciate the support of Governor Abbott on this very important issue, and look forward to working with him and with legislators to strengthen protections and ensure safety for children in families who are involved with Child Protective Services," Specia said in a written statement.&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Edgar Walters and Terri Langford</dc:creator><pubDate>Wed, 25 Mar 2015 10:52:18 -0500</pubDate><guid>http://www.texastribune.org/2015/03/25/abbott-foster-care-agency-get-your-act-together/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Obamacare Cash Helps Pay State's Medicaid Bill </title><link>http://www.texastribune.org/2015/03/25/medicaid-shortfall-benefiting-aca-funds/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/25/medicaid-shortfall-benefiting-aca-funds/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/Turnerfrown2CMS_jpg_312x1000_q100.jpg" alt="State Rep. Sylvester Turner, May 26, 2011."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;Texas Republicans have long considered the Affordable Care Act a favorite political punching bag. But that hasn&amp;rsquo;t stopped state budget writers from spending extra money flowing out of Washington under the law sometimes known as &amp;ldquo;Obamacare.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Facing a $338 million unpaid bill for Medicaid, the state&amp;rsquo;s health insurance program for the poor and disabled, lawmakers on the House Appropriations Committee voted Tuesday to help pay for it with a $102 million cash infusion that came&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;from the feds &lt;span&gt;under President Obama's signature health law&lt;/span&gt;. But that&amp;rsquo;s not how lawmakers say the information was presented to them.&lt;/p&gt; &lt;p&gt;&amp;ldquo;No one indicated that it had anything to do with the ACA,&amp;rdquo; said state Rep. &lt;a href="http://www.texastribune.org/directory/sylvester-turner/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Sylvester Turner&lt;/a&gt;, D-Houston, the committee&amp;rsquo;s vice chairman. &amp;ldquo;Many individuals are running away from the ACA, but then we&amp;rsquo;re taking the benefits, and we&amp;rsquo;re using the benefits, at least at this point, to pay down on the unfunded Medicaid bill.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Each legislative session, lawmakers usually must pass a &lt;a href="http://www.texastribune.org/2015/03/19/supplemental-budget-will-cost-433-million-house-me/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;supplemental budget&lt;/a&gt; bill to pay for unexpected costs and IOUs, so it was a pleasant surprise for budget writers to hear there was a $102 million surplus in Medicaid&amp;rsquo;s &amp;ldquo;Integrated Eligibility and Enrollment&amp;rdquo; program.&amp;nbsp;That&amp;rsquo;s agency jargon meaning&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;the federal government started paying&amp;nbsp;a greater share of Texas&amp;rsquo; administrative costs to run Medicaid.&lt;/p&gt; &lt;p&gt;&amp;ldquo;That was under the ACA,&amp;rdquo; said Stephanie Goodman, a spokeswoman for the Health and Human Services Commission, the state&amp;rsquo;s largest health agency. &amp;ldquo;We were not sure we were going to get it.&amp;rdquo;&lt;/p&gt; &lt;p&gt;It had previously been unclear, Goodman said, whether Texas would qualify for the &lt;a href="http://www.medicaid.gov/State-Resource-Center/FAQ-Medicaid-and-CHIP-Affordable-Care-Act-Implementation/Downloads/FAQs-by-Topic-75-25-Eligibility-Systems.pdf"&gt;more generous federal reimbursement&lt;/a&gt;, which was designed with the assumption that the state would expand its Medicaid program to cover low-income adults. Texas&amp;rsquo; Republican leadership has consistently opposed Medicaid expansion, a central tenet of the health law, criticizing the public insurance program as inefficient.&amp;nbsp;&lt;/p&gt; &lt;p&gt;The $102 million was apparently the single largest Easter egg state officials found in the health budget. In total, the five health and human services agencies reported $278 million in unspent funding for various programs.&lt;/p&gt; &lt;p&gt;That included money intended for&amp;nbsp;services for low-income Texans, like the Children&amp;rsquo;s Health Insurance Program, which had $15.3 million left over, and the Texas Women&amp;rsquo;s Health Program, with $4.5 million unspent. Both programs saw lower-than-expected enrollment, which the health commission attributed in part to the Affordable Care Act.&lt;/p&gt; &lt;p&gt;The women&amp;rsquo;s health program in particular saw lower-than-expected enrollment, according to the agency, because more women were purchasing subsidized Obamacare plans on the federal exchange. Federal data show roughly 1.2 million Texans signed up for coverage.&lt;strong&gt;&lt;br /&gt;&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;But the leftover money from CHIP and the women&amp;rsquo;s health program, plus surplus funding earmarked for mental health services, will not go toward paying down the state&amp;rsquo;s Medicaid deficit, state Rep. &lt;a href="http://www.texastribune.org/directory/john-otto/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;John Otto&lt;/a&gt;, R-Dayton, told the appropriations committee, which he chairs.&lt;/p&gt; &lt;p&gt;Last week, Democrats wondered why budget writers would leave health funding on the table in a state that has the highest rate of people without insurance.&lt;/p&gt; &lt;p&gt;&amp;ldquo;No one can argue there are tremendous unmet needs dealing with health and human services, often more needs than we have money to appropriate,&amp;rdquo; Turner said in an interview. Otto did not return a phone call seeking comment.&lt;/p&gt; &lt;p&gt;&lt;i&gt;This story was produced in partnership with&amp;nbsp;&lt;a href="http://www.kaiserhealthnews.org/"&gt;Kaiser Health News&lt;/a&gt;, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.&lt;/i&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Edgar Walters</dc:creator><pubDate>Wed, 25 Mar 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/2015/03/25/medicaid-shortfall-benefiting-aca-funds/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>House Committee Considers Banning E-Cigarette Use by Minors </title><link>http://www.texastribune.org/2015/03/24/house-committee-considers-e-cigarette-ban-minors/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/24/house-committee-considers-e-cigarette-ban-minors/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2014/07/17/E-Cig_jpg_312x1000_q100.jpg" alt="E-cigarettes vaporize a liquid solution for inhalation. They have grown steadily in popularity since they were introduced in 2005."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;A week after the Texas Senate passed a bill to prevent minors from buying electronic cigarettes, House lawmakers on Tuesday considered similar legislation they say would protect young Texans from addictive nicotine products.&lt;/p&gt; &lt;p&gt;The House Public Health Committee took up five bills that would extend current restrictions on tobacco products to vapor products like e-cigarettes. Texas retailers are banned from selling cigarettes and other tobacco products to customers younger than 18, but sales of e-cigarettes to minors are allowed.&lt;/p&gt; &lt;p&gt;Texas is one of nine states that allow minors to buy e-cigarettes, which are considered less toxic than conventional cigarettes but contain the addictive substance nicotine.&lt;/p&gt; &lt;p&gt;State Rep.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/nicole-collier/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Nicole Collier&lt;/a&gt;, D-Fort Worth, author of a bills that would &lt;a href="http://txlege.texastribune.org/84/bills/HB646/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;ban e-cigarette sales to minors&lt;/a&gt;, said her 14-year-old daughter could walk down the street from her school, enter a shop and legally purchase an electronic cigarette.&amp;nbsp;&lt;/p&gt; &lt;p&gt;&amp;ldquo;As a parent, I&amp;rsquo;m not comfortable with this situation,&amp;rdquo; Collier said. Right now, she said, it&amp;rsquo;s left to individual business owners to choose not to sell vapor products to minors.&amp;nbsp;&lt;/p&gt; &lt;p&gt;Bills filed by Collier and fellow Reps.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/jason-a-isaac/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Jason Isaac&lt;/a&gt;, R-Dripping Springs; &lt;a href="http://www.texastribune.org/directory/ryan-guillen/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Ryan Guillen&lt;/a&gt;, D-Rio Grande City; &lt;a href="http://www.texastribune.org/directory/oscar-longoria/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Oscar Longoria&lt;/a&gt;, D-Mission; and&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/chris-paddie/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Chris Paddie&lt;/a&gt;, R-Marshall, would all restrict the sale of e-cigarettes to people younger than 18 years old. The bills differ mainly by referring to the products they seek to ban as either &amp;ldquo;vapor products,&amp;rdquo; &amp;ldquo;nicotine products&amp;rdquo; or &amp;ldquo;e-cigarettes.&amp;rdquo; The committee did not vote on any of the bills Tuesday.&lt;/p&gt; &lt;p&gt;Electronic cigarettes have grown steadily in popularity since they were introduced in 2005 and now represent a $3 billion industry worldwide, according to the World Health Organization. They are often marketed as a method for smokers to quit tobacco cigarettes.&lt;/p&gt; &lt;p&gt;But there&amp;rsquo;s concern that e-cigarettes can also act as a gateway to more harmful tobacco products.&lt;/p&gt; &lt;p&gt;Last week on the Senate floor, state Sen.&amp;nbsp;&lt;a href="http://www.texastribune.org/directory/juan-chuy-hinojosa/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Juan&amp;nbsp;&amp;ldquo;Chuy&amp;rdquo;&amp;nbsp;Hinojosa&lt;/a&gt;, D-McAllen, called e-cigarettes &amp;ldquo;training devices&amp;rdquo; that young people use before moving on to products like tobacco cigarettes. The Senate passed Hinojosa&amp;rsquo;s&amp;nbsp;&lt;a href="http://txlege.texastribune.org/84/bills/SB97/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Senate Bill 97&lt;/a&gt;&amp;nbsp;to make it illegal to sell e-cigarettes to minors.&amp;nbsp;&lt;/p&gt; &lt;p&gt;The World Health Organization has also&amp;nbsp;&lt;a href="http://www.who.int/nmh/events/2014/backgrounder-e-cigarettes/en/"&gt;warned&lt;/a&gt;&amp;nbsp;that with fruit and candy-like flavors, e-cigarettes can seem even more attractive to youths.&lt;/p&gt; &lt;p&gt;On Tuesday, several high school students from Central Texas testified in favor of restricting e-cigarette sales.&lt;/p&gt; &lt;p&gt;&amp;ldquo;Texas has the opportunity with this bill to create environments that are safer, cleaner and healthier for children now and in the future,&amp;rdquo; said James Collins, a Hays High School senior and vice chairman of the Kyle Area Youth Advisory Council. The group started advocating against electronic cigarette use by minors after several students noticed classmates "vaping" on campus.&lt;/p&gt; &lt;p&gt;&amp;ldquo;The e-cigarette is the device, and the vapor is the component that can actually cause harm to health,&amp;rdquo; Collins said. &amp;ldquo;In addition to nicotine being in the vapor, minors can also use the device as a way to deliver hash oil and even methamphetamine. The exploitation of the device, specifically vaporization, goes a lot deeper.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Andy Garza, a junior at Lehman High School in Kyle, told the story of a friend who felt addicted to e-cigarettes.&lt;/p&gt; &lt;p&gt;&amp;ldquo;She didn&amp;rsquo;t know that it was addictive, because many people are misinformed,&amp;rdquo; Garza said. &amp;ldquo;They think it&amp;rsquo;s healthy. They think there&amp;rsquo;s nothing wrong with it. They think it&amp;rsquo;s fun.&amp;rdquo;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Ryan McCrimmon</dc:creator><pubDate>Tue, 24 Mar 2015 16:42:02 -0500</pubDate><guid>http://www.texastribune.org/2015/03/24/house-committee-considers-e-cigarette-ban-minors/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>A Look at the Priority Bills for Straus and Patrick </title><link>http://www.texastribune.org/2015/03/23/patrick-and-straus-top-20-priority-bills/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/23/patrick-and-straus-top-20-priority-bills/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2015/03/20/StrausPatrick_jpg_312x1000_q100.jpg" alt="House Speaker Joe Straus (left) and Lt. Gov. Dan Patrick."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;Along with their bully pulpits and control over the legislative process, Lt. Gov. &lt;a href="http://www.texastribune.org/directory/dan-patrick/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Dan Patrick&lt;/a&gt; and House Speaker &lt;a href="http://www.texastribune.org/directory/joe-straus/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Joe Straus&lt;/a&gt; have another valuable weapon in their efforts to influence the legislative session: low bill numbers.&lt;/p&gt; &lt;p&gt;While most bill numbers are assigned sequentially based on when they are filed, the speaker and the lieutenant governor traditionally award the lowest bill numbers to measures they view as priorities.&lt;/p&gt; &lt;p&gt;With the first half of the legislative session in the rearview mirror, here&amp;rsquo;s a look at Senate Bills 1-20 and House Bills 1-20. This legislation provides a window into where Patrick and Straus are placing their political capital and where the two chambers could find themselves at odds as the session's end draws closer. Three of the House bills have yet to be filed.&lt;/p&gt; &lt;p&gt;Scroll down to see the various categories, the related bills and links to descriptions of related issues in our &lt;a href="http://txlege.texastribune.org/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections" target="_blank"&gt;Texas Legislative Guide&lt;/a&gt;.&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Aman Batheja, Morgan Smith and Becca Aaronson</dc:creator><pubDate>Mon, 23 Mar 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/2015/03/23/patrick-and-straus-top-20-priority-bills/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Rural Hospitals Struggle to Keep Their Doors Open </title><link>http://www.texastribune.org/2015/03/20/rural-hospitals-struggle-keep-their-doors-open/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/20/rural-hospitals-struggle-keep-their-doors-open/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2015/03/19/EmptyHospitalRoom_jpg_312x1000_q100.jpg" alt=""&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;&lt;sub&gt;*Correction appended&lt;/sub&gt;&lt;/p&gt; &lt;p&gt;It could have happened anywhere, but it was on the high plains of Guthrie, Texas &amp;mdash; 90 miles east of Lubbock &amp;mdash; where Dannie Tiffin suddenly collapsed of a heart attack last spring.&lt;/p&gt; &lt;p&gt;No one knows for certain, but doctors and hospital staff in this rural area say they&amp;rsquo;re pretty sure the 62-year-old electrician could have made it, had he gotten care in time.&lt;/p&gt; &lt;p&gt;&amp;ldquo;The &amp;lsquo;what-ifs&amp;rsquo; &amp;mdash;&amp;nbsp;that has haunted me and our children day and night,&amp;rdquo; said Keitha Tiffin, Dannie&amp;rsquo;s wife, who works at a hospital in Childress. &amp;ldquo;The thought that if he had been here, would he still be with us today?&amp;rdquo;&amp;nbsp;&lt;/p&gt; &lt;p&gt;Since the hospital closed in Paducah, a town 30 miles to the north, patients in Guthrie have 60 long miles to travel to Childress for care. It&amp;rsquo;s a feeling of isolation that has crept up on other rural corners of the state following&amp;nbsp;a spate of 10 hospital closures in the past two years. And financial data collected by the state and federal government shows revenue is falling&amp;nbsp;for other rural hospitals, suggesting more may be on the brink.&lt;/p&gt; &lt;p&gt;Policymakers, operating on tight budgets, must decide whether they are willing to spend more money on small hospitals serving a limited number of patients, hospitals that in most cases could not keep their doors open without government assistance. But without them, people, inevitably, will die.&lt;/p&gt; &lt;p&gt;&amp;ldquo;We&amp;rsquo;ve all seen the crash that&amp;rsquo;s coming in the next five years,&amp;rdquo; said Lynn Butler, an Austin-based lawyer who has worked on hospital bankruptcy cases. &amp;ldquo;The Legislature&amp;rsquo;s more interested in cutting revenue and cutting services than providing the basic services for these rural communities. This is a perfect storm of events that&amp;rsquo;s going to hit the state, hard.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Texas' rural hospitals have long struggled to stay afloat, but new threats to their survival have mounted in recent years. Undelivered promises of federal health reform, payment cuts by both government programs and private insurers, falling patient volumes and a declining rural population overall have been tough on business &amp;mdash; a phenomenon one health care executive called "death by a thousand paper cuts." Add to that Texas&amp;rsquo; distinction as the state with the highest percentage of people without health insurance and you get a financially hostile landscape for rural hospital operators.&lt;/p&gt; &lt;p&gt;&amp;ldquo;Hospital operating margins, and this is probably true of the big guys and the small guys, too, are very small, if not negative,&amp;rdquo; said John Henderson, chief executive of the Childress Regional Medical Center. &amp;ldquo;In a way, Texas rural hospitals are kind of in a worst-case scenario situation, because we lead the nation in uninsured, and we took Medicare cuts hoping that we could cover more people.&amp;rdquo;&amp;nbsp;&lt;/p&gt; &lt;p&gt;That was part of an agreement negotiated by the American Hospital Association when Congress passed the Affordable Care Act, President Obama&amp;rsquo;s signature health care law. The idea was that hospitals would take cuts to their Medicare payments, but in return they would have to spend less on &amp;ldquo;charity care&amp;rdquo; because most patients would have health insurance.&lt;/p&gt; &lt;p&gt;But because Texas' Republican leadership has vehemently opposed expanding Medicaid to low-income adults, hospitals say they are paying the price for cost savings they didn't receive.&lt;/p&gt; &lt;p&gt;Federal health reform mandated penalties for hospitals, rural and urban, that have too many patients re-admitted for follow-up care. Another program cracks the whip on hospitals where too many patients get sick during their stay. Federal sequestration, meanwhile, has meant a 2 percent across-the-board cut to Medicare payments.&lt;/p&gt; &lt;p&gt;Rural hospitals took a further hit from the federal health law&amp;rsquo;s reductions in &amp;ldquo;disproportionate share hospital&amp;rdquo; payments to hospitals with large numbers of indigent and uninsured patients. And then there was the Texas Legislature&amp;rsquo;s 10 percent cut for Medicaid outpatient care in 2011.&amp;nbsp;&lt;/p&gt; &lt;p&gt;The sum of all these changes has people like Don McBeath, who lobbies for rural hospitals, warning of a repeat of the widespread hospital closures Texas experienced three decades ago. In 1983, the federal government restructured the way Medicare made payments to hospitals, meant to reward efficient care. Those changes proved untenable for small hospitals with low patient volume, heralding decades of closures that claimed more than 200 small Texas hospitals as casualties, McBeath said.&lt;/p&gt; &lt;p&gt;Some counties can afford to raise taxes to keep their hospitals open; others cannot, or find that raising taxes is politically impossible.&lt;/p&gt; &lt;p&gt;And when a small county hospital closes, often the hospital in the next county over must shoulder a bigger burden of uninsured patients. Even patients with insurance face higher deductibles and often can&amp;rsquo;t pay their bills.&amp;nbsp;&lt;/p&gt; &lt;p&gt;&amp;ldquo;When it closes, you&amp;rsquo;re forced to make other decisions, other plans,&amp;rdquo; said Becky Wilbanks, a judge in East Texas&amp;rsquo; Cass County, which saw a hospital closure last year. &amp;ldquo;That&amp;rsquo;s an economic hit that we took.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Rural hospitals are often one of the biggest and highest-paying employers in a community, Wilbanks said.&lt;/p&gt; &lt;p&gt;And when they close, it can have a domino effect on other local businesses, said Hall County Judge Ray Powell. When his county&amp;rsquo;s hospital closed in 2002, it prompted the local farm equipment dealership to close its doors and move to Childress.&lt;/p&gt; &lt;p&gt;&amp;ldquo;It was a big loss,&amp;rdquo; he said. &amp;ldquo;It was devastating.&amp;rdquo;&lt;/p&gt; &lt;p&gt;Across Texas, rural counties are seeing their populations dwindle. King County, home to Guthrie, is one of Texas&amp;rsquo; 46 rural counties that are projected to lose population over the next four decades &amp;mdash; at a time when the rest of the state&amp;rsquo;s population is expected to double.&lt;/p&gt; &lt;p&gt;It&amp;rsquo;s a trend of urbanization that is only hastened when a small hospital shuts down, Henderson said, because the hospital&amp;rsquo;s closure can be the death knell for an entire community.&lt;/p&gt; &lt;p&gt;&amp;ldquo;Who would choose to live in or retire to a community that doesn&amp;rsquo;t have a local hospital or local ER?&amp;rdquo; said Henderson. &amp;ldquo;How can a rural community hope to be there if you can&amp;rsquo;t provide health care?&amp;rdquo;&lt;/p&gt; &lt;p&gt;King County is one of 24 counties that lacked &lt;a href="http://osd.state.tx.us/Resources/Presentations/OSD/2013/2013_03_19_Texas_Farm_Bureau_AgLead_XI_FarmLead_IV.pdf"&gt;even a single physician&lt;/a&gt;, according to a 2010 analysis by the state demographer.&lt;/p&gt; &lt;p&gt;That spelled tragedy for Keitha Tiffin when her husband needed immediate medical attention. The people who rode with him in the ambulance from Guthrie to Childress had no medical training, she said, besides basic CPR.&lt;/p&gt; &lt;p&gt;&amp;ldquo;I now think to myself, how many lives have been lost because these rural areas haven&amp;rsquo;t any medical expertise, not even a medic?&amp;rdquo; she said. &amp;ldquo;It&amp;rsquo;s too late for my husband, but dear God, this should not happen to anyone else.&amp;rdquo;&lt;/p&gt; &lt;p&gt;&lt;i&gt;This story was produced in partnership with&amp;nbsp;&lt;a href="http://www.kaiserhealthnews.org/"&gt;Kaiser Health News&lt;/a&gt;, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.&lt;/i&gt;&lt;/p&gt; &lt;p&gt;&lt;sub&gt;*Correction:&amp;nbsp;An earlier version of this story misidentified a lawyer who worked on hospital bankruptcy cases. His name is Lynn Butler.&lt;/sub&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Edgar Walters</dc:creator><pubDate>Fri, 20 Mar 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/2015/03/20/rural-hospitals-struggle-keep-their-doors-open/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Supplemental Budget Would Cost $433 Million, House Members Learn </title><link>http://www.texastribune.org/2015/03/19/supplemental-budget-will-cost-433-million-house-me/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/19/supplemental-budget-will-cost-433-million-house-me/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2015/02/04/_KCA8357_jpg_312x1000_q100.jpg" alt="State Rep. John Otto, R-Dayton, in the Texas House of Representatives, Feb. 8, 2011."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;House budget writers intend to add $433 million to the current two-year budget with a supplemental bill laid out Thursday, though a plan to repurpose millions in leftover funds from various health care programs drew sharp questions from Democrats.&lt;/p&gt; &lt;p&gt;Since the Texas Legislature meets every two years, lawmakers usually have to pass a supplemental budget bill to pay for unexpected costs and IOUs for the current budget.&amp;nbsp;The Legislature is now crafting the 2016-17 budget, and the supplemental budget bill would augment the 2014-15 budget lawmakers approved two years ago.&lt;strong&gt;&lt;br /&gt;&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;At Thursday's House Appropriations Committee hearing, Chairman &lt;a href="http://www.texastribune.org/directory/john-otto/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;John Otto&lt;/a&gt;, R-Dayton, and members of the Legislative Budget Board explained details of&amp;nbsp;&lt;a href="http://www.legis.state.tx.us/BillLookup/History.aspx?LegSess=84R&amp;amp;Bill=HB2"&gt;House Bill 2&lt;/a&gt;&amp;nbsp;for the first time.&amp;nbsp;The supplemental budget bill includes&amp;nbsp;$254.7&amp;nbsp;million&amp;nbsp;in general revenue, the portion of the budget lawmakers have the most control over, and $177 million in federal funds.&amp;nbsp;Otto is the bill's author.&lt;/p&gt; &lt;p&gt;Budget board officials explained to House members that the bill will cover more than $1 billion in state needs, with much of the costs covered by transferring leftover money from other parts of the budget. For instance, the bill adds $768 million into TRS-Care, the health insurance program for retired teachers that &lt;a href="http://www.texastribune.org/2015/02/25/otto-promises-fund-health-care-retired-teachers/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;faces insolvency&lt;/a&gt;, largely by taking advantage of savings in public school funding &amp;ldquo;due to higher than anticipated property value growth and lower-than-anticipated student enrollment,&amp;rdquo; explained Marva Scallion with the budget board. The board analyzes fiscal issues&amp;nbsp;for the Legislature.&lt;/p&gt; &lt;p&gt;HB 2 also includes $20.6 million for the Texas Facilities Commission to address part of&amp;nbsp;&lt;a href="http://www.texastribune.org/2015/02/28/rats-bats-and-bureaucratic-woe-state-government/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;a long list of pressing maintenance issues in state buildings&lt;/a&gt;. The money will include $10.9 million for the Texas School for the Deaf,&amp;nbsp;where some buildings don't have working fire alarms and others have had rodent infestations.&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;Several members of the House Appropriations Committee expressed concerns about how House Bill 2 plans to cover a $338.4 million &lt;/span&gt;&lt;span style="line-height: 1.35;"&gt;shortfall in Medicaid, largely by transferring $278.2 million from other &lt;/span&gt;h&lt;span style="line-height: 1.35;"&gt;ealth and &lt;/span&gt;h&lt;span style="line-height: 1.35;"&gt;uman &lt;/span&gt;s&lt;span style="line-height: 1.35;"&gt;ervices programs, including money originally allocated for mental health and women&amp;rsquo;s health services.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&amp;ldquo;It&amp;rsquo;s one thing if the needs are met, that&amp;rsquo;s fine," said state Rep. &lt;a href="http://www.texastribune.org/directory/sylvester-turner/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Sylvester Turner&lt;/a&gt;, D-Houston. "But I know there are still needs in mental health."&lt;/p&gt; &lt;p&gt;State Rep. &lt;a href="http://www.texastribune.org/directory/helen-giddings/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Helen Giddings&lt;/a&gt;, D-DeSoto, said she was especially troubled that there were funds unspent in the Children's Health Insurance Program.&lt;/p&gt; &lt;p&gt;&amp;ldquo;It&amp;rsquo;s extremely hard for me to go back to district 109 and try to justify why children have health problems that are not being met,&amp;rdquo; Giddings said.&lt;/p&gt; &lt;p&gt;Officials with the Legislative Budget Board told the committee that the leftover funds are due to programs that couldn&amp;rsquo;t spend all of their funding in time. In some cases, it&amp;rsquo;s because the state received&amp;nbsp;more&amp;nbsp;federal funding than expected. In other cases, the timing of certain programs made it impossible for certain agencies to spend all the money they were budgeted in the current two-year budget cycle, which ends in August.&lt;/p&gt; &lt;p&gt;Lawmakers asked the budget board&amp;nbsp;to provide more specifics about the leftover funds in the different health programs. Otto said committee members would have all of the information they need before the bill is voted out of the committee.&lt;/p&gt; &lt;p&gt;State Rep. &lt;a href="http://www.texastribune.org/directory/greg-bonnen/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Greg Bonnen&lt;/a&gt;, R-Angleton, warned lawmakers to be careful that their concerns don't create a &amp;ldquo;perverse incentive&amp;rdquo; where agency officials will fear facing criticism if they do not spend every dollar they&amp;rsquo;re appropriated.&lt;/p&gt; &lt;p&gt;&amp;ldquo;While we definitely want the services to be provided and the needs to be met, that needs to be done efficiently and wisely,&amp;rdquo; Bonnen said.&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;This year&amp;rsquo;s supplemental bill is starting out far smaller than the one approved in 2013. That bill cost&amp;nbsp;$875 million when the House approved it,&amp;nbsp;but it&amp;nbsp;grew more than six times larger in the Senate to $5.4 billion.&amp;nbsp;Senators&amp;nbsp;added several items to it, including $2 billion for the state water plan, as part of a broader budget deal.&lt;/span&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Aman Batheja</dc:creator><pubDate>Thu, 19 Mar 2015 11:58:12 -0500</pubDate><guid>http://www.texastribune.org/2015/03/19/supplemental-budget-will-cost-433-million-house-me/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Post-Scandal, Lawmakers Changing Gears on Health Agency </title><link>http://www.texastribune.org/2015/03/18/after-scandal-lawmakers-change-gears-health-agency/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;div style="float: left; margin-right: 10px; margin-bottom: 10px;"&gt; &lt;a href="/2015/03/18/after-scandal-lawmakers-change-gears-health-agency/"&gt; &lt;img src="//s3.amazonaws.com/static.texastribune.org/media/images/2015/01/14/Sunset027Nelson_jpg_312x1000_q100.jpg" alt="Sen. Jane Nelson, R-Flower Mound, wraps up the Sunset Advisory Commission hearing on Jan. 14, 2015."&gt; &lt;/a&gt; &lt;/div&gt; &lt;p&gt;As the state&amp;rsquo;s largest health agency reels from a scandal over how it awarded contracts to private vendors, lawmakers on Wednesday said they are slowing down on their ambitious &amp;mdash; and controversial &amp;mdash;&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;plan to restructure it.&lt;/p&gt; &lt;p&gt;A panel of lawmakers and citizens last year recommended that the state&amp;rsquo;s five health and human services agencies, including the massive Health and Human Services Commission (HHSC),&amp;nbsp;be combined into one &amp;ldquo;mega-agency&amp;rdquo; that was supposed to be more efficient. But now that lawmakers are scrutinizing HHSC's awarding of a $110-million contract outside of the competitive bidding process,&amp;nbsp;state leaders say the massive structural changes recommended by the so-called Sunset Commission&amp;nbsp;should take more time than originally planned.&lt;/p&gt; &lt;p&gt;&amp;ldquo;In light of recent events I propose that we implement these reforms over an extended timeline,&amp;rdquo; state Sen. &lt;a href="http://www.texastribune.org/directory/jane-nelson/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Jane Nelson&lt;/a&gt;, who chairs the Sunset Commission, said in a statement. &amp;ldquo;This allows us more time to monitor the reorganization over the next two sessions," the Flower Mound Republican added.&amp;nbsp;&amp;nbsp;&lt;/p&gt; &lt;p&gt;Nelson and her Sunset Commission co-chair, state Rep. &lt;a href="http://www.texastribune.org/directory/walter-t-four-price/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;Four Price&lt;/a&gt;, R-Amarillo, said in the&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;Wednesday statement that&amp;nbsp;they were developing substitute legislation to reflect the changes.&lt;/p&gt; &lt;p&gt;If passed, the new bills would direct the health and human services agencies to immediately streamline their &amp;ldquo;administrative&amp;rdquo; functions &amp;mdash; including contracting and legal services &amp;mdash; and create a new Medical and Social Services Division to house the state&amp;rsquo;s Medicaid program for the poor and disabled.&lt;/p&gt; &lt;p&gt;But the five-agency consolidation would move forward on a slower timeline, the lawmakers said. Their bills would combine three agencies &amp;mdash; &lt;span&gt;&amp;nbsp;HHSC,&amp;nbsp;&lt;/span&gt;the Department of Aging and Disability Services, and the Department of Assistive and Rehabilitative Services&lt;strong&gt;&amp;nbsp;&amp;mdash;&amp;nbsp;&lt;/strong&gt;into one beginning next year. Texas'&amp;nbsp;Department of State Health Services, which oversees public health, and the Department of Family and Protective Services, which manages child welfare, would be looped in&lt;strong&gt;&amp;nbsp;&lt;/strong&gt;starting in 2019.&lt;/p&gt; &lt;p&gt;The bills would also create a &amp;ldquo;think tank&amp;rdquo; called the Policy and Performance Office at HHSC&amp;nbsp;to promote coordination within the system.&lt;/p&gt; &lt;p&gt;Advocacy groups for children and people with disabilities have pushed back against the consolidation plan, saying the state&amp;rsquo;s neediest populations would be neglected under the new structure.&lt;/p&gt; &lt;div id=":3ik.co" class="JL"&gt; &lt;div id=":3io.ma" class="Mu SP"&gt; &lt;p&gt;Price said while he stands by the consolidation plan, "u&lt;span style="line-height: 1.35;"&gt;tilizing a graduated approach for the development of these recommendations is wise so that more time can be devoted to proper implementation."&lt;/span&gt;&lt;/p&gt; &lt;p&gt;&lt;span style="line-height: 1.35;"&gt;&lt;i&gt;This story was produced in partnership with&amp;nbsp;&lt;a href="http://www.kaiserhealthnews.org/"&gt;Kaiser Health News&lt;/a&gt;, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.&lt;/i&gt;&lt;/span&gt;&lt;/p&gt; &lt;/div&gt; &lt;/div&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Edgar Walters</dc:creator><pubDate>Wed, 18 Mar 2015 17:31:29 -0500</pubDate><guid>http://www.texastribune.org/2015/03/18/after-scandal-lawmakers-change-gears-health-agency/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item><item><title>Map: Breast and Cervical Cancer Program Providers </title><link>http://www.texastribune.org/2015/03/18/breast-and-cervical-cancer-services-map/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</link><description> &lt;p&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;T&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;span id="docs-internal-guid-e02c6f3a-239d-b591-7901-206eb5248e15"&gt;he Texas Senate has proposed changing how funding is distributed from the joint federal-state Breast and Cervical Cancer Services program to &lt;a href="http://www.texastribune.org/2015/01/28/senate-renews-effort-keep-funds-planned-parenthood/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;gut funding&lt;/a&gt; for Planned Parenthood. Opponents say the changes&amp;nbsp;could disproportionately affect low-income women in rural areas and West Texas.&lt;/span&gt;&lt;/p&gt; &lt;p&gt;Under the Senate&amp;rsquo;s version of the state budget, dollars for clinics that offer breast and cervical cancer screenings for poor women would be prioritized for public entities like state, county and community health clinics. Private clinics that provide cancer screenings as part of &amp;ldquo;comprehensive&amp;rdquo; primary and preventive care would come in second place. Private specialty clinics, like Planned Parenthood, would only get cancer-screening funding if there&amp;rsquo;s money left over.&lt;/p&gt; &lt;p&gt;&lt;em&gt;Use this map to see the locations of public and private providers that participate in the Breast and Cervical Cancer Services program. Click the legend to see how the map could change, and zoom in to take a closer look at how different areas of the state could be affected by the proposed changes.&amp;nbsp;&lt;/em&gt;&lt;/p&gt; &lt;div id="pym-graphic"&gt;&amp;nbsp;&lt;/div&gt; &lt;p&gt;The funding mechanism, which&amp;nbsp;&lt;span&gt;has&amp;nbsp;&lt;/span&gt;&lt;a href="http://www.texastribune.org/2015/03/06/funding-fight-cancer-clinics-could-be-collateral-d/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;sparked concerns&lt;/a&gt;&lt;span&gt;&amp;nbsp;among providers and&amp;nbsp;&lt;/span&gt;&lt;a href="http://www.texastribune.org/2015/03/10/house-budget-writers-modify-womens-health-proposal/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;some lawmakers&lt;/a&gt;,&amp;nbsp;is meant to target the 17 Planned Parenthood clinics that participate in the program. (Under state law, these clinics are already prohibited from performing abortions if they accept taxpayer dollars.)&amp;nbsp;But under the proposed funding revisions, at least 34 providers not affiliated with Planned Parenthood &amp;mdash; nearly one-fifth of those currently using program dollars &amp;mdash; could see their funding reduced or cut entirely.&lt;/p&gt; &lt;p&gt;Program providers in rural areas of of the state and in West Texas say they will be most affected by the Senate's proposal. For example, all seven cancer-screening providers in the Panhandle would likely fall to second or third priority for funding. In the El Paso area, only one provider is likely to qualify for first-priority funding.&lt;/p&gt; &lt;p&gt;&lt;em&gt;Disclosure: Planned Parenthood was a corporate sponsor of The Texas Tribune in 2011.&amp;nbsp;A complete list of Tribune donors and sponsors can be viewed&amp;nbsp;&lt;a href="http://www.texastribune.org/support-us/donors-and-members/?utm_source=texastribune.org&amp;amp;utm_medium=rss&amp;amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections"&gt;here&lt;/a&gt;.&lt;/em&gt;&lt;/p&gt; </description><dc:creator xmlns:dc="http://purl.org/dc/elements/1.1/">Alexa Ura and Becca Aaronson</dc:creator><pubDate>Wed, 18 Mar 2015 06:00:00 -0500</pubDate><guid>http://www.texastribune.org/2015/03/18/breast-and-cervical-cancer-services-map/?utm_source=texastribune.org&amp;utm_medium=rss&amp;utm_campaign=Tribune%20Feed:%20The%20Texas%20Tribune%20Sections</guid></item></channel></rss>