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Senate Finance met to take up and consider SB 8 (Nelson) relating to making appropriations of certain federal coronavirus relief money. Since SB 2 in its entirety is in SB 8, Chair Nelson said the committee would only take up SB 8 during the hearing and dur to the number of witnesses all testimony would be capped at 2 minutes.

This report is intended to give you an overview and highlight of the discussions on the various topics taken up. It is not a verbatim transcript of the discussions 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.

 

Sen. Nelson Opening Remarks

  • Only intends to bring up SB 8 today since entirety of SB 2 is in SB 8
  • Testimony will only be 2 min because they want to wrap up before midnight

SB 8 (Nelson) Relating to making appropriations of certain federal coronavirus relief money.

  • Nelson reviewed many of the same points in the press release
  • Reviewed between 250-300 request of funding needs, quadrupled of funding they actually have to spend
  • Some of the requests did not qualify for ARPA funding
  • Until 5p today – any member of Finance who has additional recommendations for use of funds to turn them into Finance and go through a member of Finance
    • Will be doing this like a mini-version of a rider
    • Have $16.3 billion so will also need to know where you would take funding from when turning in a request
    • It will be a long night, will be going through this with staff
    • Make sure it is related to COVID and can be spent through ARPA
  • Lucio confirms nothing new will come up after it is submitted in writing
    • Intention to not take anything after 5p today, will strenuously resist any other requests
  • Perry asked order of hearing/process
  • Nelson – There are no invited witnesses, will go with the flow and will not hurry this; there are a lot of people wanting to testify today
  • Nelson – Biggest chunk of funding is the $7.2 billion UI

LBB Staff, Eduardo Rodriguez

  • Perry – Don’t have clarity on what item can ARPA be used for, what are the parameters or criteria for items to be on list for consideration?
    • At this time only have interim final rule and guidance, to combat effects of COVID 19
    • Final rule on guidance may not be issued until later this year
  • Perry – One-time expenses only?
    • Some may and some may not
  • Perry – Construction?
    • Sewer, water, and capital infrastructure ..air filtration and such
  • Perry – TDEM rack system relating to COVID?
    • Believe items included in SB 8 may be allowable under final rule but waiting for clarification
    • Important it is to respond to or mitigate COVID
  • Perry – How do we know if we are being duplicative?
    • Texas was allocated 2 sums of money – state and local money
    • $10.5 billion in local money and was distributed to entitlement areas and those allocations went directly to them and a smaller portion went to non-entitlement entities
    • Staff is responsible for tracking funds coming through state agency, do not know how every local entity applied their funds
  • Perry – Know $7.2 billion goes to pay off UI, but there is a possibility that a local jurisdiction has funding in the bank and they could risk the possibility of providing funding that is duplicative
    • Can get list to members of funds they know
  • Perry – Does not allow federal matching?
    • 90% correct, can be used as match only if grant program has FEMA funds to be pulled down
    • Could not use match if the federal funding does not allow for it
    • Specific to the federal program
  • LBB staff clarification – Funds cannot go beyond calendar year 2026

TDEM, Nim Kidd

  • Kolkhorst – $3 billion set aside for Section 2 of DSHS COVID services, looks like it is funding for surge staffing and therapeutic drugs and operation of regional centers.. is this in addition to funds provided in August?
    • There is a bit of uncertainty
    • Under the impression that FEMA will reimburse at 100% the cost associated with responding to COVID -19 which includes PPE, medications, delivering vaccines, etc
    • Extension is to give us a 100% but there will be a beginning and end of incident period
    • Believe will see 75/25 reimbursement come back if they do not extend the 100%
  • Kolkhorst – Does this set aside include nursing facilities
    • Nelson – requests can be made for reimbursements
  • Kolkhorst – Have FQHCs requested reimbursement, would like to look at a holistic approach

LBB Staff, Eduardo Rodriguez

  • Kolkhorst – Now hitting trench 4 ($25 billion) of money going to providers and nursing homes, it is going directly to them so do you keep a good track of that funding?
    • There is information available online they can pull down, very difficult to know when local entities apply for funding from other sources
    • Review information that is made available
  • Kolkhorst – Understands increase in Medicaid up to now 5 million, enhance FEMAP
  • Kolkhorst – would like estimate of when inflection point will hit, we were upside down and would like estimate of when inflection point will hit.. thinking January
    • Julie Lindsey, LBB– Last estimate was around November

HHSC Staff, Trey Wood

  • Working on update to provide better estimate but believe inflection point in January of 2022
  • Will see increasing cost for those on Medicaid and it is around 5 million people, prior to pandemic just around 4 million
  • Now just over 23% higher people on Medicaid
  • Kolkhorst – Asked about clawback provisions
    • Current administration may be changing guidance on keeping prior funds
  • Nelson – FMAP is important issue to get arms around, there is going to be a tipping point in the future and it could have a serious impact to the state
  • Have normal FMAP in March of 2020 but during pandemic, federal bumped up FMAP share which contributed to not needing a supplemental funding
  • But along with receiving enhanced FMAP, you cannot disenroll people from Medicaid but people no longer eligible, etc are still receiving because they cannot disenroll them
  • Kolkhorst – UI is biggest amount of funding set aside and this is important and is a big deal
  • Kolkhorst – Other things in SB 8 is too plug large holes, fear large hole will be in inflection point
  • Kolkhorst – Do we have any idea how much funding went directly to the providers?
    • Rider 143 and SB 809 that requires agency to gather information, don’t anticipate having too much detail in the next few weeks
  • Kolkhorst – A lot of needed funds flowing through to providers and PPP was also needed which health care providers qualified
    • Balancing act is needed because also not sure how to calculate funding lost or what funding would have been
  • Lucio – Appreciates discussion of broadband, but need more in the Valley
    • Points out federal legislation moving that may also direct funds to this area
  • Lucio – Concerned about lack of housing and funding provided for housing
    • Nim Kidd, TDEM – will research and get details back to the committee
    • LBB Staff – Funds can be allocated for rent assistance, etc but points out this is the interim rules but subject to change
    • TDEM – Appears locals are moving to housing and unemployment, nothing requires locals to report to state on how money will be allocated but TDEM will stay watchful because they don’t want a duplication of resources
  • Nelson recognized Sen. Johnson who had joined the discussions
  • Taylor – Idea of finding out where money has gone, need to track money; What money could be used for, limited?
    • State funds are limited in capital projects, can be broadly used for sewer, water, broadband
    • Separate amount from Coronavirus Capital Projects fund which is $500.5 million primarily for broadband infrastructure and other broadband projects
  • Taylor – State and mental health hospital and higher education, will fit in interim, final rules?
    • Rodriguez – Allows for state to reimburse itself and can use those funds for other government services; treasury instituted broad guidelines
    • Amounts can be used for what would be allocated during normal state appropriations period
    • There are stipulations: Pay-go infrastructure; burden on state for proof that would be tied back to offsetting or mitigating ramifications from COVID-19
  • Nelson – Creighton who will be submitting will work to ensure stipulations are met; regarding state hospital work, definitely could argue its relation to COVID; hopeful that it qualifies
  • Taylor – How much lost revenue to the state due to COVID?
    • Rodriguez, LBB – Approximately $12 billion lost from COVID
    • Unemployment insurance a clearer and allowable use; public health and safety also in interim final rule; any items that state appropriates for allowable uses, if it changes, no clawback would be allowed, so state would not be held accountable
    • Grey area for items not clearly laid out as allowable are the questionable ones
  • Nelson calls up Comptroller’s office to verify
  • Philip Ashley, Comptroller’s Office – $12.6 billion lost revenue

 

Continued Questions from Members to Various Agencies

  • Schwertner – Figure out how $3 billion was calculated for hospital surge staffing with lack of visibility regarding what is actually needed?
    • Rodriguez, LBB – Not a number that LBB provided
  • Donna Shepard, DSHS – $3 billion based on total cost, doesn’t assume other types of funding; total cost of deployment and housing of nurses
  • Nelson – Original estimate $5 billion, coaxed down to $3 billion
    • Shepard – Correct
  • Schwertner – So total cost was only thing factored in? No adjustment was made for enhanced COVID-diagnosed patients or independent funding? Why not?
    • Shepard – Correct
    • State health doesn’t have visibility
  • Schwertner – Didn’t Rider 41 give you some visibility?
    • Shepard – Some recourse from other state health funds, but COVID release funds don’t give visibility as to where funds went;
  • Schwertner – No estimates?
    • Shepard – Knowledge that TX received X for counties, for cities, but no visibility beyond that
  • Schwertner – Need clarity
  • Kolkhorst – As SB 8 moves forward, in addition to $5 billion in surge already?
    • Shepard – Yes, $6 billion in surge previously
  • Kolkhorst – Have done $6 billion in surge staffing; have to get out of business of hiring nurses eventually; of the $6 billion provided to hospitals, don’t have to reimburse?
    • Shepard – Yes
  • Kolkhorst – Do you think that we will eventually get some transparency?
    • Shepard – Not sure
  • Kolkhorst – Want hospitals to be able to serve patients; certainly, had surge
    • Shepard – FEMA will reimburse $3 billion; need money upfront, then reimbursed, so money can be used for other services
    • Does not account for another surge
  • Nelson – Wants to make sure that hospitals are given everything they need
  • Campbell – FEMA will reimburse 100% of $3 billion?
    • Kidd – Yes, has to be COVID-related; will reimburse until end of calendar year, will be 75% if takes until next calendar year
  • Campbell – Dollars putting towards staff, extended past Sept. 30th; we spent $6 billion previously on staffing surge, now $3 billion; $9 billion just on nursing staffing and housing? Can you prove that up? Seems pretty high.
    • Shepard – Primarily, yes
    • Can show estimates of costs
  • Campbell – “Rural hospitals..will…you know….their already gonna get ripped off,” because of/with “CMS telling our HHSC/DSHS to do something to replace program for the DSRIP and the process you all put in is gonna rip off rural hospitals” on the amount they receive for Medicaid
  • Perry – On the FMAP enhancement, in addition to shortfall of Medicaid funding? What is cost of the million people?
    • Wood, HHSC – Estimated shortfall of $3.5 billion plus inflection point
  • Perry – Not safe to assume that the million people would be allowable ARPA cost, will be a clawback possibly; should not bank on ARPA dollar pot of money
    • Rodriguez, LBB – State is prohibited from paying liability that occurred prior to the pandemic; only interim final rule, possible this could happen
  • Perry – $3 billion is reimbursable; not creating $3 billion of potential GR for future
  • Perry – Regional infusion centers temporary? For counties that have hospital and are sitting on the money, some jurisdictions did other things with the money; money has already been spent?
    • Kidd – Yes
    • Regarding contract nurses, have been paid; in process for being reimbursed for expenses
    • $10.5 billion to counties and cities, all but 65 have received funds up front; less than a dozen who have take funding and put it towards healthcare of citizens
  • Perry – Knows of one hospital for certain and possibly two that cut wages of nurses, administration of some of the hospitals are sitting on lots of cash that didn’t benefit nurses that the money was intended to benefit
  • Perry – $300 million ask, we talked about regional warehousing is this that or what does this involve?
    • Kidd – $60 million for resources – Under contract with warehouse in San Antonio
    • $300 million for HQ/emergency center in Austin which would enhance statewide capability
  • Perry – Rural communities not being addressed, not putting regional hubs in rural areas
    • Kidd – Looking at areas outside of urban areas; money appropriated didn’t just go to urban areas
  • Perry – $7.2 billion in UI got us $50 billion or so in that range, that is bonded debt to state if don’t pay it back and new debt to state
  • Perry – Collectively have dropped ball as state and are $100 million short on high cost provider network that is meant to help rural providers and that needs to be fixed and is the first need to get that fund whole; doesn’t think amount for broadband in SB 8 covers this need; infrastructure deal putting money into broadband in state; key term must be last mile, must be from source to house
  • Kolkhorst – On interim rule, says any expenses incurred before COVID?
    • Rodriguez -specifically to conversation about costs incurred before pandemic, meant to benefit during specific timeframe
    • CSFR (Coronavirus state fiscal recovery funds) allowed to retroactively cover costs beginning on March 3, 2021 through 2026
  • Kolkhorst – Good article (WSJ and Kaiser) about how insurers waived out of pocket charges for COVID 19 treatments, now patients having to deal with charges; hospitals have worked hard and done a fabulous job and ponders if hospitals were profiting or were bottom-lines enhanced? $7.1billion hole in unemployment insurance fund; must understand that everyone who had a COVID code, hospitals were paid for; private insurers are the ones who must pay more eventually
  • Buckingham – For the hospitals being reimbursed, which costs are being reimbursed?
    • Rodriguez – That information is not collected, amounts that come solely from state agencies
  • Johnson – Reads from bill language section 5; state not getting any more money at all, so budgets won’t increase?
    • Rodriguez – Interim final guidance expands upon eligible uses of funding; salaries for health and safety workers allowed expense, paid for upfront, freed up GR given back to treasury
    • No, not adding to budgets; will pay back money spent, and free up money for other services
  • Nelson – Could have put more funding towards this issue; fiscally responsible to free up GR in this manner
  • Johnson – Just wants transparency; freeing up GR, not raising salaries; pressures to free up GR
  • Johnson – $3 billion for staffing surges, bill says it’s meant for future nursing surge expenses?
    • Rodriguez – Yes, for future expenses up until end of calendar year
    • If any portion of funds are reimbursed by FEMA, will return reimbursements to treasury for credit in GR
    • Obligation of funds for legislature, if not used for this, can re-obligate funds; funds cannot be co-mingled with other reserve accounts
  • Johnson – Should leftover funds be segregated into other funds instead of going into GR?
    • Rodriguez – Even if put back in GR, would have to be treated differently as CSFR; have to remain with original intent of money
  • Johnson – Federal reimbursements received for federal programs shall be credited, same concept?
    • Rodriguez – Yes
  • Taylor – Can we make it a requirement that if you get state funds, you have to be transparent?
    • Rodriguez – Could do that; problem is that there are billions of dollars given to locals, not aware of any statute that require municipality to report to state
  • Taylor – Need transparency, need to know what hospitals are doing with this money to make sure it’s not being misappropriated
  • Kolkhorst – $286 million in section 6 of bill to make sure that premiums for TRS and TRS Active Care insurance plans do not increase as result of COVID claims incurred; would like to hear from TRS
  • Ryan Guthrie, TRS – Looked at all the claims that have been filed attributable to COVID costs, came up with number that is in bill
    • Nelson – 5% increase if didn’t do this?
    • Yes, based on COVID-claims
  • Kolkhorst – Anything in ERS related to this?
    • Nelson – No, not addressed
  • Nelson – Chose things that affected the greatest number of Texans for bill
  • Perry – Section 2 would be logical place for additions; have had numerous home health providers reach out, did not get PPE money reimbursement; important to remember them, taken for granted
  • Perry – Going back to section 5, if money is paying salaries, how does it qualify as a one-time expense?
    • Rodriguez – Forward-looking costs; not cost-reimbursement, estimated cost of what we know we’re going to pay; specifically for salaries for individuals that qualify
  • Perry – Need to make sure folks know this is a bonus, not a higher salary
    • Rodriguez – Money from CSFR funds and not GR
  • Kolkhorst – Through SB 809 in combo with SB 133, first report on money received by feds due on October 1; can get better transparency through this
    • Rodriguez – Will get it by October 31, for hospitals

Public Testimony

Kelly de Schaun, Galveston Island Port Board of Trustees

  • Opportunity to support travel and tourism; $169 billion for TX from tourism
  • One of best investments to make in tourism; rider for bill, $800 million for travel and tourism; investments in businesses that have faced troubles during pandemic, support of destination management organizations
  • Net positive industry; a dollar invested in tourism is $4 gained in state taxes
  • Campbell – If can’t get full amount, some amount for tourism

 

Meera Riner, COO for Nexion Health

  • Look at nursing facilities for appropriations; pandemic of staffing, need to ensure that there is a sustainable measure to take care of residents

 

Tanya Lavelle, Disability Rights Texas

  • Broadband money a huge plus for people with disabilities
  • Disappointed that there were no dollars assigned to affordable housing for people with disabilities; impacted by pandemic, have had to decide between income and health
  • Opportunities for state to invest small amount to see huge gains; lots of ROI

 

David Wheaton, TX Houser’s Advocacy Group

  • ARP funds supposed to go to those impacted most by pandemic; lack of money for housing does not meet needs
  • People at risk of eviction, can’t pay rent or mortgages; need funding for affordable housing
  • Invest in building affordable housing, eviction protection, funding for alleviating homelessness

 

Winter Prosapio, Natural Bridge Caverns

  • Help tourism recover from COVID; consider the many Texans working in tourism, $800 million tourism plan

 

Cyrus Reed, Lonestar Chapter of Sierra Club – Against

  • Missing opportunity to invest in water infrastructure and parks
  • Need money for weatherization, could target money to directly help people who have been impacted by COVID
  • Consider small amounts of money for targeted needs, flood planning
  • If not possible, future money could be used towards this

 

Irene Alejandro, Community Justice Action Fund

  • Asks for $20 million for community violence prevention funds

 

Bob Kafka, Adapt Texas

  • Ask for allocation of dollars for attendants for those with disabilities; Medicaid a fixed amount, not variable or a free market; providers can’t raise rates
  • Follow recommendations in Rider 157, will save money in long run

 

Mitch Fuller, Department of Texas VFW

  • Veteran mental health and suicide; $1.7 million to study ketamine to treat battlefield injuries
  • Wanting to get veterans off of pharmaceutical pills; ketamine is another method to address this moving forward

 

Chip Van Steenberg, TX 911 Alliance

  • Asking for $148 million for Next Generation 911 costs
  • Moving to new system in a deregulated world; addressing COVID-19 needs

 

Butch Oberhoff, TX EMS Alliance

  • Tremendous workforce shortage; asking to work towards workforce development program that will create more EMS professionals, especially in rural areas; would boost EMS industry
  • Perry – What is average age of EMS professionals?
    • 57 years old; some 80 year old paramedics

 

Cynthia Zolnierek, TX Nurse’s Association

  • Need to ensure adequate nursing workforce; nurses retiring early or leaving due to pandemic
  • Need adequate funding for programs so they can produce more nurses for workforce
  • Kolkhorst – This program can restore reduction of program, pays for nurses produced above amount from year before
  • Campbell – One problem contributing to nursing shortages is that nurses go directly in NP programs, what can you say to this?
    • Program needs to incentivize pre-licensure graduates
    • Need to improve work environment for nurses

 

Matthew Lovitt, National Alliance on Mental Illness – For

  • Appreciative of investment in state hospitals for those with mental illness; should also invest in order areas of mental health care: transitional housing and crisis response system

 

Gyl Switzer, TX Gunsense

  • $20 million for community violence intervention programs; federal government has said money can be used for these programs
  • Violence accelerated by COVID

 

John Hawkins, TX Hospital Association – For

  • Appreciate resources being included in bill
  • Funds go directly to Department of Health Services to pay for staffing; support transparency for all federal funds
  • Reports due Oct. 31, can request grace period for report extensions; once you have reports, will have data you need to put it all together
  • Request that you redirect FEMA reimbursement towards long-term costs for hospitals

 

Eddie Parades, Nursing Home Operator

  • Federal support has run out
  • $12 million deficit for nursing homes in TX
  • Adjust for $480 million for nursing homes; $20 per patient, per day in future past pandemic to focus on staffing and tremendous hole in delivering care
  • Kolkhorst – $19.63 in place right now, what is request for?
    • Request for 4 quarters after PHE ends; rounded up from $19.63, would be happy with this amount
  • Kolkhorst – Able to float $12 million? How is census? Part of QUIP program?
    • Have losses for rents; doing creative refinancing, short-term loans, consolidating homes
    • 17 nursing homes in TX, based in Dallas; down 15%
    • Yes; QUIP 5 identical to QUIP 4, have tougher quality measures to achieve
    • Have to prove that losses were greater than federal funds received; distribution will occur in Dec of this year

 

Mark Lashley, CEO of TX Providers for IDD community – Against

  • Provide caregivers to those in IDD community; up to 30% vacancy rates, need funding to make company competitive

 

Scott Kerwood, Fire Chief – On

  • Increase funding for EMS and Fire Districts; first responders for COVID related incidents
  • Building more fire stations to address increase in growth and emergency incidents

 

Rodney Rueter, Lutheran Ministries and Leading Age Texas

  • Federal funding helped reduce losses, but not enough; federal funding now stopped
  • Employee shortages; have 24 open positions, use agencies to fill spots but much more expensive

 

Ann Graham, TX Chapter of Americans for the Arts

  • Restore funding to arts caused by COVID; $35 million will be vital step to restoring industry
  • Tourism expressly allowed for ARP funding

 

Christina Green, Children Advocacy Center of TX

  • $160 million for VOCA funding in bill, very appreciated; anticipate sustainability issues, need to continue to work for VOCA
  • Kolkhorst – Legislature didn’t cut VOCA funding, a federal issue

 

Recess for senate floor, will resume for public testimony for as long as it takes

 

John Henderson, TORCH – on

  • Understand needs far exceed federal funds, agree out of pockets should be first priority, appreciate funding for staffing of nurses
  • Few rural hospitals have yet benefitted and yet to receive a single state nurse
  • No funding specific for rural hospitals
  • Notes Campbell’s earlier remarks on transition to 1115 waiver resulting in loss of dollars
  • $240 million set aside requested

Danielle Goshen, Galveston Bay Foundation – on

  • Support investment in resilient drinking water and wastewater infrastructure
  • Example of need can be seen in Winter Storm Uri
  • Supports TPPW request on conservation in parks, mitigate flooding, etc

Kristen Robinson, Angel of Care Pediatric Home Health – on

  • Most did not qualify for PPP funds, no rate enhancement, etc
  • No assistance with PPE
  • Provides statistics of those waiting for support since they have no staffing
  • Request also to look at authorized hours vs billed hours

Rachel Hammon, Texas Assoc for Homecare and Hospice – on

  • Request funding directed to home and community-based services
  • Industry in dire need of funding
  • Perry – asked if she knew how much of PPE they did not get
    • No, but believes their needs fit into criteria
  • Perry – cannot fix delta in wage so it is huge; in billions… but PPE may be beneficial to know amount in next few days

Carmen Tilton, Texas Assisted Living Association – on

  • On front lines, their residents are most at risk and staff most at risk exposure
  • Deprioritized for PPE and support previously
  • Asks recognition to support long term care in Texas

Jeff Humber, Texas Home Health – on

  • Ability to provide care is in a state of crisis
  • Increase labor and IT cost, increase need in PPE, new requirements from state and federal mandates have all increased cost of case
  • Unprecedented labor shortage also causing issues
  • Bill does not address home health care services
  • Fast food and convince stores may be luring workers away, want to offer higher and retention bonuses as well as other recruitment strategies

Drue Farmer, Judge from Lubbock County – on

  • Here to speak on mental health care issues
  • Premium pay for direct care workers concern; need incentive money to keep people in homes and with relationships with clients they have started
  • Support sec 12 of bill for state hospital
  • Advocates for expansion of Sunrise Canyon

Thomas Bates, father – on

  • Daughter needs continued support of home health
  • Have started losing nurses
  • Need help

John Carlton, Texas State Assoc of Fire and Emergency Districts – on

  • ESDs created by petition and have cap on revenues and employee about 5k firefighters and additional volunteers
  • No direct allocation from previous COVID funds
  • 90% of ESDs have said counties do not have funding for them
  • Request $434 million cost incurred as result of pandemic

Tyler Sheldon, Texas State Employees Union – on

  • Reviewed state employees roles they fulfilled during COVID
  • Pay has been stagnant in last 10+ years
  • Can use hero pay ($6200 bonus as back pay for those who worked on front lines)

Lyndsey Lanagan, Legacy Community Health Centers – on

  • 73 FQHCs in the state
  • Appreciates incubator grant that Nelson created years ago
  • Ask for investment in incubator program which has not seen investment since 2011
  • Request need of about $200 million
  • Perry – $210 million for incubator? Will federal funds come in then?
    • $200 million for incubator and yes can pull federal funds

Steve Aleman, Disability Rights Texas – on

  • Students with disabilities in public education, in third year of being effected by pandemic
  • Many still at home, schools having tremendous staffing needs for students with disabilities
  • Ask these issues to be considered for the funding

Christina Hoppe, Children’s Hospital Assoc of Texas – on

  • On frontline to respond to severe pediatric cases of COVID 19
  • CHAT appreciates funds to address mental health crisis and ensure funding for staffing is transparent
  • Symptoms of anxiety, depression and suicide ideation are growing
  • Increase mental health care workforce

Margie Costello, Disability Services of the Southwest – on

  • Provide personal care and feel forgotten
  • How many do you know will wipe a butt for $8 an hour when flipping a burger makes $15
  • When a client does not have an attendant they do not get out of bed or toilet and go into nursing care
  • Industry is at a critical stage
  • West – how many employees?
    • 15k employees, requesting what Texas Assoc of Homecare is asking
  • Whitmire – would like more details on children that need assistance?
    • Multiple programs that are long term support and services
    • Some of intellectual or physical disabilities but all are unable to care for themselves
    • Most programs start around 3-4 years old and go up to adult services
    • Located across Texas

Laurie Sprouse, Live Events Coalition and member of NFIB – on

  • Represent events and hospitality
  • Request $800 million to help businesses rehire and rebuild
  • 80% of clients come from outside of Texas and sell Texas to the world
  • Furloughed 2/3 of staff and cancellations over the last 15 months

Kelsey Streufert, Texas Restaurant Association – on

  • Restaurants and those in hospitality were required to close for almost last year
  • Also facing supply chain issues
  • Recovery is going into reverse for them as last 3 months of returns are worse than before

Vance Ginn, TPPF – on

  • Federal government has over $28 trillion in national debt, keep in mind the taxpayer
  • $7.2 billion in UI but he notes he calculates $7.9 billion
  • Also mentions border wall and property tax relief with a shoutout to Bettencourt bill
  • Don’t want fiscal cliff like happened during ARRA
  • Transparency for dollars is also requested, maybe put up a website on how funds are spend

John Hryhorchuk, Texas 2036  – for

  • State could make meaningful investment one time for our future
  • Speaks on broadband need
  • Dedicate a portion to data and mapping efforts
  • $30 million of Cap fund to make anchor hubs at state parks
  • Cybersecurity is important as it IT modernization
  • State Hospital is example to save money and address immediate needs
  • Must ensure fiscal sustainability and coordinate with local governments to leverage their funds
  • Kolkhorst – ARRA funds in 2011 created fiscal cliffs, so suggestion is one time funding?
    • Yes

Dennis Borel, Texas Coalition of Disabilities

  • Gatekeepers community care workforce, community care and attendants got nothing so far

Ann Bishop, Texas Public Employees Association

  • Consider state employees and retirees

Carol Smith, Private Providers of Texas – on

  • Does not include funds to provide one time recruitment and retention bonuses for front line workers
  • $200 million requested or consider $55 million for community based ICF

John Sapanski, Apex Primary Care

  • Support $400 million toward home care and hospice industry, not everyone received funds last round
  • See need for funds for recruitment and retention for nurses and home health/hospice workers

Eva DeLuna Castro, Every Texan – on

  • Access to behavioral health care funding is important
  • Concern with missed opportunity to be more transformational
  • Modernize systems and programs but not possible with current allocation because of how much is going to UI funds, would be largest amount going to UI compared to all states 44% for Texas
  • $3.7 billion for TDCJ concern could create a fiscal cliff

Priscilla Anderson, Mother to Ian and works at Caleb – on

  • Funds requested for community attendant workforce
  • Struggling to meet staffing demands

Sarah Kirkle, Texas Water Conservation Association – on

  • Worked with several to identify pressing needs for water infrastructure
  • $5 billion in funding requests for water infrastructure

Traci Berry, Excel Center for Adults – on

  • Thanks members for support of adult high school education and Taylor to sponsor request of $12 million for funds

Amanda Fredriksen, AARP

  • Handout provided of 4 priorities
  • Appreciate funding for broadband
  • Would like to see support for home and community based services (people want to age in place at home)
  • Nursing home and assisted living population and safety during disaster

Beth Lawson, Lubbock Mental Health Care & Commissioner on Judicial Mental Health

  • Requesting increase to beds (add more)

Sydney Carter, Mental Health Policy Fellow

  • Need mental health and substance treatment providers

Jennifer Owen, Trinity Care Center in Round Rock

  • Include long term care staffing funding support
  • Never experienced staffing shortage like they are facing now
  • Kolkhorst thanks witness and congratulates her

Kevin Warren, Texas Healthcare Assoc  

  • Thanks them for their support for Medicaid add-on
  • Need funding to support and strengthen long term care workforce
  • Lucio – how many seniors in nursing home, death
    • Number has come down, 15% drop as a result of COVID
    • Over 9k residents and over 100 staff in caring for others
  • West – have received information from LBB on local recovery funds, are any seeking funds from local metropolitan funds or PRF?
    • No on metropolitan funds
    • Most recent traunch is for providers of all types and specific of those expenses from March of this year, no way to mitigate cost beyond that
    • But yes they did submit an application

Hannah Mehta, Protect Fragile Kids

  • Home health care is critical to keep children home where they belong

Crystal David, Parent – on

  • $4 million for Project Baby Dillo, genome sequencing and educational accommodations

Terry Charicher, Parent – on

  • Daughter qualifies for home services, but shortages impact health care
  • Have personal care and respite care, but SB 8 does not allocate funding to home services

Rose Debon, Parent

  • Request funding for home health care of $411 million

Dr. Dominque – Texas Prisons

  • Leading nation on incarcerated deaths
  • Air purification system called IWave in conjunction with air conditioning system
  • Down 6,700 officers, may work if they feel protected and have AC

Damian Cook, Canines for Warriors

  • Service dogs waiting list has expanded to 2025 and over 1k applications and seeing more requests for wrap around services
  • $1 million over next two years which will allow service for additional 50 veterans

Candy Burton, PACS Tx

  • Recruitment and retention bonuses for home care workers
  • Providers are saying they have never seen a workforce crisis as they have experience now
  • Group homes require consistent staff, lack of consistency can trigger behaviors and issues
  • Several group homes getting ready to close
  • Lucio – how many people don’t want to come back to work?
    • Don’t know where everyone is going but at $8 an hour no one wants to fil the shifts
  • Bettencourt – did you do polling and data on people not showing up to work
    • Providers do conduct exits surveys

John Shepherd, Texas Foundation for Conservation and Texas Outdoor Partners

  • Consider role played by outdoor industry

Ray Hymel, Officer

  • Asking to consider state employees in context

Mary Naranjo, Piney Woods Home Services – on

  • But support amendment for home health care
  • Kolkhorst – $411 million, what happens after that?
    • Paid hazard pay

Sonja Burns, self – on

  • Thanks Kolkhorst for rider on step down
  • 1/3 of hospital population is considered long term
  • Need direct care, peer support and psychiatric peer support
  • Long term population is being discharged and need to do real data on outcomes

Nelson closes public testimony

Lucio – patients need to get infusion sites, and many are not getting there, need to consider funding those who transport to center and provide therapy at home

Nelson – thanks everyone who participated, almost had a 12 hour hearing (30 mins shy)

Nelson – have had a lot of additional amendments turned in and 250-300 contacts that came in before bill was filed

Nelson – have $16.2 billion to distribute, unusual process and bill lays out the way she suggests they distribute funding but now with request suggests the following:

  • Will ask 5 workgroups during session to sit down and take both recommendations prior to bill write up and those today and separate into subject matter by article and ask workgroup to sit down with recommendations and give back to committee to consider asking the following questions:
    • Consider one time or ongoing expense?
    • Does it qualify for ARPA?
    • Will it be in DC infrastructure bill?
    • Where within bill filed would you get the money?
  • Each workgroup should make and compile recommendations by Thursday
  • Perry – broadband has big soundbite but federal dollars going to this already