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The Senate Committee on Finance met on February 25 to hear invited testimony from health care agencies. This report focuses on testimony from the Health and Human Services Commission and the Department of State Health Services.

This report is intended to give you an overview and highlight of the discussions on the various topics the committee took up. It is not a verbatim transcript of the hearing but is based upon what was audible or understandable to the observer and the desire to get details out as quickly as possible with few errors or omissions.

Opening Comments

  • Chair Jane Nelson – Intends to break for around an hour at noon

Health and Human Services Commission

Julie Lindsey, LBB

  • Summary of Budget Recommendations
  • $83.8 billion in AF, decrease of 2.7% from last session, reductions are generally offset by increases in GR; this was originally due to less favorable expected FMAP
  • Decreases in budget due in part to 5% reduction request and expiry of one-time construction funds
  • $69.4 billion for Medicaid client services, $1.8 billion in CHIP client services
  • Decrease of $198.5 million due to delay in Medicaid intensive behavioral services
  • $229 million for Healthy Texas Women, increase of $8.1 million overall, but decrease of >$60 million GR due to approval of federal waiver
  • In total $1.4 billion for community mental health, $496 million for substance abuse
  • $1.4 billion for SSLCs, continue adjusted FY2020 spending levels into 2022-23, with reductions for census and one-time costs; expected FMAP meant increased GR
  • $894.6 million for state mental health hospitals, recommendations do not include funding for finishing construction for Austin and San Antonio, nor staffing for Harris County
  • No funding for foster care lawsuit, included in exceptional item 2
  • Rider highlights: changes to 42 riders primarily to streamline language or alter reporting reqs
  • 12 riders added to HHSC mainly due to these riders not applying to other Art II agencies
  • 90 riders deleted
  • $4.1 billion in agency requests not include in the base budget, modifications coming that will be included in future working docs
  • Nelson – SB 1 funds Medicaid caseloads for the next biennium, but HHSC expects decline because clients will begin to roll off
    • Yes, increased FMAP is contingent on keeping these individuals enrolled, expects this through 2022
  • Kolkhorst – Asks on extent of increased FMAP
    • Federal guidance basically ensures it through December of 2021, but tied to duration of public health emergency
  • Kolkhorst – Some of the services to pregnant women kept on Medicaid would lead to cost savings, correct?
    • Technically yes
  • Kolkhorst – Medicaid is mainly MCOs, very little FFS; we saw a downturn in services used during lockdown, do we have any numbers on amount of money the MCOs saved and how this played into state share of savings?
    • Yes, increased FMAP and other COVID impacts were not assumed when 2022-23 bill was constructed & not in introduced bill; will be working with agency to look at conference committee forecast to see if it changes funding
  • Kolkhorst – $11.5 billion 1115 waiver expenditures annually, not reflected in SB 1?
    • Correct, can get the numbers to you
  • West – If the state decided to expand Medicaid, are there different strategies in Art. II where we could swap the GR for federal funds?
    • Yes, HHSC has provided an updated estimate for what Medicaid expansion would look like; would need additional conversations with agency
  • West passes out materials related to Medicaid expansion and potential GR savings
  • West – Laying predicate, wanted to make sure legislators and agencies had info
  • Kolkhorst – Regarding waiver spots, do we have a number on how many don’t qualify?
    • Can follow up

Cecile Young, HHSC

  • HHSC Presentation
  • Provides overview of HHSC mission, org structure, agency operations

Trey Wood, HHSC

  • Provides overview of agency funding structure; 96.6% of funding goes to client services, 4.4% supports agency
  • Will not have Medicaid shortfall this biennium, projecting surplus of $170 million; primarily due to enhanced COVID FMAP, must maintain Medicaid clients to continue to receive this
  • Caseloads are expected to decrease in 2022-23
  • $83.8 billion in AF for 22-23, incl. $31.4 million in exceptional item funding for HHSC
  • Primarily funded by federal dollars at $51.5 billion
  • Highlights slide 11, $127.2 million in reductions, asking for facility support back at $6.1 million
  • Understand budget challenges, HHSC has minimized exceptional items request, focused on maintain essential services, request items to prevent agency functions from breaking, and pare requests to minimum
  • Highlights two exceptional items: exceptional item 11 partially funds beds at San Antonio hospital, 15 partially funds CAPPS
  • Exceptional items detailed on Slide 15, roughly $2.4 billion in GR
  • Kolkhorst – You’ve filled all top management? Appreciative of that
    • Young, HHSC – Yes
  • Kolkhorst – What do you see the whole HHS funding picture looking like?
    • Have seen a reduction in caseloads in CHIP due to retaining Medicaid enrollment
    • Doesn’t look like Medicaid would normally look
  • Kolkhorst – What cost savings items were thought of but not implemented?
    • Can get this information to you
  • Kolkhorst – On the waitlist, it looks like there’s 166k? If we tried to attack that at 10%, what type of numbers are we looking at?
    • Wood, HHSC – Using population growth model, around $76 million in GR and $190 million in AF; can get 10% numbers to you
  • Kolkhorst – Regarding 1115 waiver, what is the importance of extension to 2030?
    • Young, HHSC – Wanted to ensure funding for DSRIP was able to continue forward
    • Essentially a UC for behavioral health and public health, directed payment programs, etc.
  • Kolkhorst – Ambulance has new coverage at $150 million/year, TIPPS at $600 million annually; seems like this is moving more towards hospital-based practices, do have concerns that you could clear that up with CMS to consider community and independent physicians in TIPPS
  • Kolkhorst – UC program is almost $3.9 billion/year, what does this go to? Not in budget?
    • About 19% of supplemental payments are off-budget, references slide 6
    • These are payments to hospitals for charity care
  • Kolkhorst – How many uncovered lives do we have?
    • Wood – We get estimate from the federal government, believe it is 2 million; can get accurate numbers to you
  • Kolkhorst – Important to look at how many would and would not be covered by expansion, what that would do to the $8 billion UC pool
  • Kolkhorst – This is not the largest chunk of the waiver, Comprehensive Hospital Increased Reimbursement Program is
    • New CHIRP program, part of this is URIP and Average Commercial Rate Increase
    • We’re submitting all programs to CMS on March 1 to go through process of getting them approved, went through programs during negotiations
  • Kolkhorst – So much of Medicaid is not FFS, saw lack of utilization during COVID; where are we on the monthly per capita payment to MCOs, did we meet the 3%?
    • Young – Gotten some experience rebate back, roughly $400 million
  • Kolkhorst – Asks after implementation of projects with DSHS
    • Have exceptional items on things that need to continue
  • Kolkhorst – Asks after state hospitals with partial funding, some buildings are just shells
    • Legislature has made significant funding investments for state hospitals, do need to be able to continue the work
  • Kolkhorst – This has been echoed in mental health hearings; finally made investments, there is a lot of pressure on mental health delivery services that we need
  • Perry – There are concerns relating to rural Texas and the ball got dropped over the interim; SB 170 on rural health care cost reimbursement, do you understand the legislative intent of this? One of the issues is it is not retrospective
  • Perry – Got the impression that HHSC staff thought there was wiggle room before
  • Perry – Does new waiver give flexibility to move in and outpatient revenue?
    • Can get this to you
  • Perry – Delivery add-on has been added to rural health, had issues before where amounts were overrepresented, need to keep Labor Delivery Add-on separate from inpatient
  • Perry – Have you seen vape products creep into Medicaid & CHIP population?
    • Haven’t seen anything on this
  • Perry – 3,512 slots for the waitlist, wants break down of population groups
    • Wood – Have 77k individuals on waitlist in CLASS, 933 for DBMD, 107k for HCS, 7k for MDCP, 19k for STAR+PLUS HCBS, 91k for Texas Home Living
  • Perry – If you got funding, how do you prorate among those groups?
    • We use a growth model to determine how we ask for it
    • 224 for CLASS, 13 for DBMD, 2,057 HCS, 220 MDCP, 812 HCBS, 102 for THL
  • Perry – Spent originally $300 million for 3 session to build Austin, Houston, and San Antonio hospitals; heard that cost is at $1.7 billion total
  • Perry – We’re short beds in West Texas, see consistent issues; for a fraction of the cost of the hospitals you could add 100 beds and alleviate this need
  • Lucio – Empty facilities could be retrofitted and deliver care in rural areas
  • Lucio – On slide 13, exceptional item 11; 40 additional beds in San Antonio, does this address the need? Where did this number come from?
    • Mike Maples, HHSC – Back in 2014 we did a study that looked at needs of the system, 2 big recommendations were to replace 5 facilities and expand capacity
    • 3-biennium plan brings us >300 beds
    • COVID had an impact on some facilities, had to reduce capacity and waiting list grew; never stopped serving people
  • Lucio – What is HHSC doing to prep to address the increase of need?
    • One of our exceptional items is some of those projects as part of the 3-biennium plan
    • When we fund the expansion, at some point we will also ask for funds to operate
    • Number of projects ongoing to relieve pressure, working to get patients out of the hospitals, alternative bed usage, new flow through models, etc.
    • Before COVID we were on track to reduce waiting list, anticipate this to continue after COVID
  • Lucio – Many have to travel long distances to get services, would love for you to talk to our hospitals in the RGV
  • Lucio – Have recent developments at the federal level changed assumptions in the recommendations?
    • Enhanced FMAP is expected until the end of the calendar year
    • Will see an inflection at some point where continuous enrollment begins to cost the state money, expecting this in November
  • Lucio – Asks after women’s health funding and support
    • Wood – For Health Texas Women we looked at funding for 2021 and then averaged it out over 22-23
  • Lucio – So same level as 2021?
    • Didn’t fully start up the program immediately in 2021
  • Lucio – Would like funding to track need
    • Part of this is based on services designed in the program, HHSC tried to structure program based on available funding
  • Lucio – Cost growth for Medicaid services are not in budget, will this be funded in the future?
    • Yes, typically forms basis for supplemental
  • Lucio – How have 5% cuts affected eligibility and admissions?
    • Do not anticipate not meeting federal requirements for eligibility determination
  • Lucio – Asks after Foster Care Lawsuit
    • Exceptional item exists to pay for requirements
  • Lucio – Are we using the most up to date data to fund teaching hospitals?
    • Can get this info to you
  • West – Indicated Medicaid caseload are projected to decrease in 2022-23
    • Wood – Yes, based on when the public health emergency will end and caseload returning to historic norms
  • West – Texas is leading the nation in number of uninsured
    • 9 million uninsured in Texas, 900k eligible under Medicaid expansion
  • West – Can HHSC develop a model on what GR could be replaced by federal funds under Medicaid expansion?
    • Challenging question, we do have a model of what Medicaid expansion would look like and cost; do not have this model today
  • West – That’s what I’m asking for, we’re looking for GR savings; can you put together a hypothetical model?
    • Young – Happy to look at anything we need to
  • West – Trying to figure out if there is a GR swap available
    • Can look at GR in budget, but which programs you would not want to fund with GR is a policy question
  • West – Getting different reports on DSRIP, can you clear this up?
    • Feds have told us for a couple of years that DSRIP is going away, one of the reasons we wanted the extension was to lock in DSRIP dollar amounts
    • Not sure why they don’t like DSRIP, but they don’t
  • West – Which services under DSRIP are going to go away?
    • Programs directly under DSRIP now will go away, but trying to fund same types of services; incl. things like certain chronic care at hospitals
  • West – Can they still provide these services if money is made available?
    • Yes, but not through DSRIP
  • West – Is the 3% Medicaid population increase an HHSC or LBB projection? Does LBB have the same projection
    • Wood – This is an HHSC projection, LBB uses the agency projections
    • Lindsey, LBB – We did use agency projections this time around so assumptions line up
  • Buckingham – On EVV, are you taking provider need to purchase new items into account?
    • Stephanie Stephens, HHSC – Exceptional item on EVV is to comply with federal law
    • Working closely with providers to streamline and ensure members are served
  • Buckingham – Have you looked at cost savings from waivers and telehealth, etc. happening during COVID?
    • Have leveraged telehealth throughout pandemic, saw a dramatic increase of utilization at the start of the pandemic
  • Buckingham – Did overall utilization change?
    • Utilization decreased overall due to the pandemic, but we have seen a spike in telehealth
  • Buckingham – I have a bill trying to keep waivers in place
  • Buckingham – What are you basing your mental health numbers on? Seeing different numbers from different sources
    • We are refining mental health assumptions, will be looking at available data, estimate will look different
  • Buckingham – I think it needs some refining
  • Taylor – ABA is very important for children with autism, why was it delayed?
    • Young – Believes HHSC had to try and determine rate setting; preliminary things had to come into place before next steps
    • Have a hearing in March on the rates, have heard that rates may not be adequate
    • Will look at input and implementation will come after
  • Taylor – We are we just now having a rate hearing in 2021 that should’ve been done 2019
  • Taylor – Suggested rate is at $28/hour, but market is $50/hour, no point to a benefit no one will provide; how did we get these numbers?
    • Can get info to you
  • Taylor – This budget says we should be starting at the end of 2021, you are talking about implementing in 2022? What is this delay due to?
    • Once we get comments from the rate hearing, there is work to be done with CMS
  • Nelson – Wanted to give HHSC enough time to work with stakeholders, but totally agree
  • Kolkhorst – Can you explain the All Texas Access project?
    • Sonja Gaines, HHSC – This is SB 633, asked to focus on rural services and look for opportunities for efficiencies; did quite a bit of planning across the region with LMHAs and state hospitals, received significant survey feedback
    • Some of the approach was what was doable without money in communication and coordination
    • Some areas have good resources already, saw some best practices
  • Kolkhorst – Need to meet the needs of rural areas, will really push on this this session, imperative as we go post-COVID to support youth mental health
  • Kolkhorst – Those without insurance was 2.9 million, Medicaid expansion would roll in 900k
    • Wood – Yes, based on federal poverty level
  • Kolkhorst – What is cost estimate for Medicaid expansion?
    • 5 years out, FY2026 we’re looking at annual AF cost of $7.1 billion, annual GR of $720 million
    • This assumes 90/10 match, but no guarantee this will continue
  • Kolkhorst – DSRIP was originally intended to drive innovation, important to get a good understanding of conversion of some of the DSRIP programs, some were intended to be self-funding; also need an understanding of supplemental payments
    • Can get this to you
  • Nelson – We know bills have been filed and discussions will take place in Senate HHS; very important that we deal with accurate data, needs to come from HHSC and LBB
  • Nelson – Overdose deaths have risen alarmingly over the pandemic
  • Nelson – Received over $200 million in federal grants to combat opioid use, how are we using these and how are we coordinating with other agencies?
    • Gaines, HHSC – Great response work has been going on, roughly $270 million for this since 2017
    • Opioid deaths have risen over the course of the pandemic
    • A lot of collaboration across the state between LMHAs, other agencies, etc.; focus areas are MAT, incl. counseling and therapy, distributing naloxone through EMS
  • Lucio – Should focus on substance abuse issues, ensure individuals get the help they need; asks for info on how serious the problem is
    • Sometimes people are not going to reach out, trying to reach people in unconventional places, working with school systems, regional service centers, etc.
  • Nelson – Passed a series of bills as Chair of Senate HHS, incl. cost reduction bills; these required HHSC to establish cost & quality benchmarks in Medicaid to be used during procurement, HHSC has canceled last 4 procurements for managed care and these practices have not been implemented
    • Young – Cancellation of procurements has more to do with failures at the agency rather than legislative initiatives; major changes with RFPs underway
  • Nelson – Rider in the budget will help you, instructs HHSC to implement these directives
  • Nelson – One of four goals with budget is to strengthen public safety & health, responsible for efficiently delivering quality health care; what are your priorities?
    • Hope to be a stabilizing force, intending to hold commissioner position for a long time if confirmed; have been involved in these issues for a long time
    • Wants to make HHSC an example agency for others
  • Kolkhorst – When we moved to MCOs away from FFS, HHSC became a contracting agency and we haven’t had the movement yet for HHSC to be really good at contracting yet
  • Kolkhorst – Would also encourage you to look at Alternatives to Abortion, funding didn’t flow until the back half of the biennium
    • Do need to be able to move quicker, certain things can lag due to need for federal approval
    • As I recall, HHSC did a new RFP due to so much additional money coming into the Alternatives to Abortion programs
  • Huffman – Regarding ongoing lawsuits, have a bill to put money associated into dedicated account, looking for joint authors
  • Nelson – Put me down on that bill

Sylvia Hernandez Kauffman, Inspector General

  • Provides overview of the office’s mission & operations
  • In FY2020, OIG recovered >$500 million, more than any other year; OIG was able to maintain or exceed pre-pandemic metrics
  • Exceptional items @$2.2 million in GR; asking for restoration of clinical staff funding reduced by recent federal funding loss, and funding for access to Equifax TWN database
  • Buckingham – Previously had Sunset recommendation to remove OIG ability to keep fees to prevent conflicts, but LBB recommends allowing OIG to keep a certain amount
    • Penalties are seldom used currently, to meet the number in the budget it would require 80 penalties/year which is the wrong incentive
    • Lindsey, LBB – Can get this info to the committee
  • Nelson – Regarding clinical staff lost funds, what changed?
    • Federal partners did an audit that determined OIG could not receive this funding unless it could prove all staff were directly clinical; cannot use this funding if staff are administrative

Marsha McLane, TCCO

  • Provides overview of TCCO and agency operations, as well as agency reforms in 2009; responsible for sexually violent offenders, 512 civilly committed individuals
  • Asking for money this cycle due to expansion of clients under TCCO

Stanley Muli, TCCO

  • $35 million in baseline funding, 5% reduction incorporated
  • 5 exceptional items at roughly $4 million; incl. caseload growth, case management career ladder, private audit firm contractor, and 2 FTEs for workload growth since 2015
  • Huffman – Can you account for why caseload numbers are nearly doubling?
    • Change goes back to county level decisions
  • Huffman – There is an evaluation before they’re sent back
    • Yes, DPS, HHSC, TDCJ, and TCCO evaluate cases
  • Huffman – There’s a very serious reason these people are in TCCO, trying to get you the funding you need; very few people are released form the program, though treatment, etc. is done to try and release those that can
    • Correct, many different factors in releases

The Committee recessed in the morning and returned in the afternoon; audio was not broadcast for the first minute after the committee reconvened

Department of State Health Services

Julie Lindsey, LBB

  • $9 million in one-time funding provided to the agency in the previous biennium
  • $32.9 million related to the required five percent reductions
  • Includes method of finance swaps to replace general revenue
  • A decrease in permanent tobacco funds due to the spending of the corpus of the accounts
  • A reclassification of the insurance maintenance tax and fee accounts
  • 2021 base account funding for Covid-19: $1.8 billion, will increase with federal funding available for 2022-2023
  • The epidemiology federal award only is receiving approximately $126.8 million
  • Reduction in $23.9 million in general revenue and $29 million in the ESF
  • No reductions were included in the agency’s 2021 base
  • Item 12 – EMS and Trauma Care Systems: $246.9 million general revenue-related funds, a reduction of $22.4 million in all funds from the 2021 biennium
  • The driver responsibility program was ended in the 86th legislature
  • Revenue in 2020 saw a reduction, but specifically how much was due to Covid-19 is unknown, revenue is expected to rebound, but not to its previous level for 2021
  • The writer highlights section: Modifications made to 10 agency riders
  • Minor edits made to an additional 8 riders
  • 12 riders were deleted
  • 3 exceptional items totaling $55.5 million in GR
  • Nelson – The goal in repealing the driver responsibility program was to ensure funding for trauma care would remain stable, but there was a reduction in $22.3 million to this sector, was this due to Covid-19?
    • It is unclear, but it does seem that other fee and fine revenue was reduced due to less traffic, etc.
  • Nelson – It appears that one of the proposed reductions is to the shingles vaccine program was $4 million, exactly how many people would this impact?
    • It would impact approximately 14,500 adults
  • Nelson – Is there another program that this population could utilize due to this reduction in funds?
    • I believe that other non-agency programs provide similar services, but there isn’t direct federal funding provided for the shingles vaccines
  • Nelson – That is something we will have to look into

John Hellerstedt, DSHS

  • Provides an overview of DSHS operations; proud of staff efforts during COVID & continue to support state response to pandemic
  • 4.7 million vaccine doses administered, will continue response efforts until COVID does not affect daily lives
  • Have been awarded $6.5 billion in federal COVID relief dollars, have spent >$4 billion
  • Appreciates adding spinal muscular dystrophy to the screening panel
  • Reduced exceptional items requests in light of COVID pandemic
  • Nelson – Thank you for your efforts. Do we expect federal funds will continue to fund all the costs associated with distributing the vaccine?
    • We expect federal funds to continue but we don’t know when they will run out or change their mind, defers to Donna
    • Donna Sheppard, DSHS – Currently we have $6.7 billion in federal rewards and the last reward runs out in calendar year 2024; we have just received $1.5 billion for lab capacity and testing. We do feel like the funds are sufficient to combat Covid-19
  • Nelson – Do we anticipate spending the remaining funds?
    • We do.
  • Kolkhorst – Would you say our vaccination efforts have been effective?
    • Hellerstedt, HHSC – I would say so; remarkable to be able to function as a society during the pandemic, success is due to hygiene and being a leader in testing
  • Kolkhorst – I like your optimism. With the approval of Senate Finance, we funded most of your exceptional items. The $73 million in new funds for public preparedness, where are we on all of that?
    • We have implemented the new NED system and have made a significant upgrade. I would have to ask my subject matter experts and technical folks if they think we are set.
  • Kolkhorst – On the federal funds, I see that we have removed $1.7 billion. I would like to know more about the four-year contracts and how we will account for that.
    • Sheppard, DSHS – The numbers from SB 1 have already changed to $4.5 billion. We will still see a gap in our federal funds, but hopefully, that gap will close the next biennium.
  • Kolkhorst – Give us an example of the four-year contracts.
    • The federal grant awards last for four years. We have just received a vaccine grant for $200 million. We would identify the needs for each year.
  • Kolkhorst – Describe the federal funds for lab upgrades.
    • Epidemiology and lab capacity was addressed, particularly items concerning testing. We also sent out money to other facilities throughout the state.
  • Kolkhorst – We have seen a lot of conventional testing. How do the public and private sectors interact?
    • Hellerstedt – The majority of the testing is done through the private sector, also have public health labs that are organized by the CDC
    • COVID tests require reporting positives and negatives, unlike other diseases; positivity data has informed pandemic trend modeling
  • Kolkhorst – We are seeing positivity rates plunge in a positive way. What do you say to that?
    • We are getting better at responding to COVID, but should be wary of variants
    • Need more complete vaccination effort to reduce spread to less than 1
    • Seeing remarkable decreases in cases and hospitalizations
    • Big reason for success is willingness of individuals to take preventative measures seriously
  • Kolkhorst – Is the federal government reimbursing us for all costs associated with vaccines?
    • The vaccine is at no charge and supplies come with it to use when you vaccinate
    • There is some funding for the administration of the vaccine; don’t think all costs are covered besides that.
  • Kolkhorst – We now have a pharmacy program that has helped our efforts in rural communities. What have you seen the change in the effectiveness of riders related to maternal issues?
    • I think they have been extremely effective, very wide participation
    • We covered close to 99 percent of all deliveries in hospitals associated with the AIM effort
  • Kolkhorst – Tell me about your coordination of urban and suburban centers that operate under DSHS; are there improvements we need to make?
    • I think we are doing well; local level implementation is the best practice for efficiency
  • Kolkhorst – Where are we on contract tracing and do we need it anymore?
    • It is an effective tool even on the downside of the pandemic
  • Kolkhorst – I think there is a time when we phase out of it for privacy reasons; I want to have a robust discussion on this matter even though it is voluntary
  • Nelson – How can you assure there are no data breaches by the third party entity and what happens to the data once it is no longer needed?
    • Data has been reviewed by IT experts and they think it exceeds standards in privacy
  • Nelson – I have lost a lot of confidence in IT experts and want to be assured that the data is disposed of properly if you could follow up on that
  • Nelson – Would the five percent reduction eliminate the MEDCARES program? Would the funding go to hospitals and clinics, why was this offered as one of your proposed reductions, and what exactly is the MEDCARES program?
    • The MEDCARES program created consultants that were experts in child abuse and neglect and they would have a core medical function in evaluating suspected child abuse and neglect
    • Sheppard – The five percent reduction is in state funds; we are left with a small amount to restructure this division and fund maternal mortality
    • MEDCARES is more of a direct service and our federal partners want the award to be about population health
  • Lucio – There are issues with finding open hospital beds, what steps have you taken to ensure there are beds preemptively available?
    • Hellerstedt – When the pandemic reached its peak it was difficult to transfer patients to a higher level of care
    • Typically, there is consent involved with the hospital and the referral. Trauma RACs are the basis, consist of multi-county areas with feeder hospitals with a central hospital acting as the receiving hospital
    • We definitely got to the point where we were at capacity; transferring physicians had to make some tough calls
    • Ability to transfer is improving along with COVID trends
  • West – Gives thanks. As it relates to the Texas Center for Infectious Disease tuberculosis prevention and care program, how are you going to be able to fund this expiring program?
  • Sheppard – In SB1, we had some money we already received and it was added into the base budget for 2022-2023. We will still receive revenue in other ways as well
  • West – Will you elaborate on MEDCARES?
    • Funds go to major hospitals and it funds investigation of child abuse and prevention related to child abuse for 11 hospitals
  • West – Does it go out in terms of a grant?
    • It is a contract with 11 hospitals