The Children’s Hospital Association of Texas (CHAT) Urges You to Become an Advocate for Our Children's Hospitals!
This is the first edition of the Children’s Hospital Association of Texas (CHAT) e-newsletter in advance of the opening day of the 83rd Texas Legislature on January 8, 2013. You have received this newsletter because you are affiliated with one of CHAT’s member hospitals or you have indicated that you would like to receive information about children’s healthcare in Texas.
The mission of the Children’s Hospital Association of Texas is to support the development of an effective, comprehensive, high-quality and appropriately funded children’s healthcare delivery system in Texas. Our member hospitals include Children’s Medical Center of Dallas, Children’s Hospital of San Antonio, Cook Children’s Health Care System (Fort Worth), Covenant Children’s Hospital (Lubbock), Dell Children’s Medical Center of Central Texas (Austin), Driscoll Children’s Hospital (Corpus Christi), El Paso Children’s Hospital and Texas Children’s Hospital (Houston).
The purpose of our newsletter is to provide information and encourage your active support for children’s healthcare issues in the state, particularly related to proposed legislation and funding. With our member hospitals, CHAT will be working with state legislators to improve funding for children’s health care and to support legislation that improves the health of Texas children.
Photos courtesy of Seton Healthcare Family.
Texas is Growing
The Texas economy and population are outpacing the rest of the nation in growth, and this is especially true for children. According to the 2010 U.S. Census, one out of every 11 U.S. children lives in Texas (6.9 million) and more than one out of every four persons in Texas is under 18 years of age (27.3%). Between 2000 and 2010, the number of children in the U.S. increased by 1.9 million; over one-half (53%) of this increase was due to the increase in the number of children in Texas.
2013 Legislative Session Must Address Funding Deficits in Children’s Programs
Texas legislators must write a balanced budget every two years. The budget written in 2011 was “balanced” in that budgeted expenditures did not exceed the anticipated revenues collected by the state for 2012 and 2013. However, to write a balanced budget the Texas Legislature made significant reductions in many programs and pushed some expenses for 2013 forward for the next legislature to address.
In 2011, the Legislature did not fully fund Medicaid services for the current state fiscal year, 2013, which runs from September 1, 2012 through August of 2013; therefore, one of the first items of business will be to appropriate $4.7 billion to pay for Medicaid and other health and human services programs for the rest of this fiscal year.
In 2011, the Legislature made significant cuts to funding for children’s hospitals, including reducing Medicaid hospital payments for both inpatient and outpatient services. The Legislature directed the Health and Human Services Commission (HHSC) to implement a new prospective Medicaid payment system for inpatient services at children’s hospitals, and the 2013 Legislature must decide whether to fully fund this new reimbursement system. Finally, as a result of the new Medicaid 1115 waiver, less local funding will be available for the Medicaid Disproportionate Share (DSH) program, which helps to reduce Medicaid payment losses. New state funding may be required to avoid significant losses for children’s hospitals.
Medicaid Matters to Children’s Hospitals and to All Children Who Rely on Children’s Hospitals
Medicaid is a federal funding resource that requires state or local public funds to operate health care programs targeted at various populations and needs, including medical services for children with disabilities, children who have suffered abuse or neglect and children in lower income families.
Medicaid funding is of particular concern to children’s hospitals because we serve many of the most vulnerable and needy children. Over half of the children admitted to children’s hospitals are covered by Medicaid. If cuts are made, or if Medicaid funding does not keep up with the costs necessary to serve a growing child population, children’s hospitals will face major difficulties in providing the range of comprehensive services that children in Texas need and deserve.
In addition to funding for Medicaid and CHIP, we will be focusing on the following areas during the session:
Keep Kids Healthy
Investments in sound public health initiatives are the first line of defense against preventable injury, disease and disability and the resulting medical care costs. Many of the medical care problems of children can be avoided if we:
Maintain strong immunization efforts,
Reduce the exposure of pregnant women and children to tobacco smoke,
Ensure that children eat healthy foods and get regular exercise,
Reduce rates of child abuse and neglect,
Keep children in automobile safety seats when travelling by car.
The federal Affordable Care Act (ACA) made some important advances in private health coverage for children, including a prohibition on pre-existing condition exclusions; a requirement that private plans provide dependent coverage until a child turns 26; prohibitions on lifetime limits on the dollar value of coverage and annual limits on coverage; and required coverage of a range of preventive services without cost-sharing.
Texas faces the choice of whether to expand Medicaid coverage to low-income adults, including the parents of many children now covered by Medicaid. Covering families (not just the children) in Medicaid is likely to bring more children into the Medicaid program as families seek coverage. The challenge is whether the state is willing to adequately fund this expansion and to provide the necessary state general revenues for its current Medicaid program obligations for children, individuals with disabilities and low-income elderly individuals.
Build a High-Quality Pediatric Healthcare System
To meet the needs of the growing child population, it is critical to have a sufficient number of healthcare providers that are trained and experienced in healthcare needs of children. Funding for graduate medical education, loan forgiveness programs, preceptorships and other training programs must be improved. The Legislature will need to act on recommendations to improve the quality of Neonatal Intensive Care Unit (NICU) services. Funding for specialized programs like MEDCARES, which supports medical child abuse programs at children’s hospitals, need to be continued.
You Can Help!
There is strength in numbers! Please click on the link below and become involved. We will keep you informed about these important issues before and during the legislative session. You may be asked to contact your legislators before key votes.
You can also help spread the word to your co-workers, colleagues and other business and personal contacts. Educate them about children’s healthcare issues and encourage them to get involved. You CAN make a difference!
Click here to become an advocate for Texas children’s hospitals.
Children’s Healthcare Issues in the News
Click on the following links to learn more about some of the issues impacting children’s healthcare in Texas.
"Serious injuries from child abuse on rise, especially in infants," CBS News, Monday, Oct. 1, 2012
"Treat the children before treating their disease," The Atlantic, Monday, Sept. 24, 2012
"State agency doesn't have enough worker to protect abused kids," Austin American-Statesman, Sunday, Sept. 23, 2012
"Census Bureau: Texas still tops uninsured ranks," Texas Tribune, Thursday, Sept. 20, 2012