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Health & human services
September 16, 2008
Texas to provide food stamps to Ike victims
Texas will provide emergency food stamps to Hurricane Ike victims, the Health and Human Services Commission said today.
“We know that many Texans saw an unexpected loss of income this month because Hurricane Ike disrupted their jobs, their workplaces and their lives,” said Texas Health and Human Services Executive Commissioner Albert Hawkins. “Those Texans may now qualify for special hurricane assistance to provide food for their families while they get back on their feet.”
Residents of 29 counties are eligible if they meet certain requirements. For example, a family of four earning up to $2,915 this month may qualify. Call 211 for more information or visit any of the Commission’s benefits offices.
Texas received a federal waiver to make the food stamps available.
The eligible counties are: Angelina, Austin, Brazoria, Chambers, Cherokee, Fort Bend, Galveston, Grimes, Hardin, Harris, Houston, Jasper, Jefferson, Liberty, Madison, Matagorda, Montgomery, Nacogdoches, Newton, Orange, Polk, Sabine, San Augustine, San Jacinto, Trinity, Tyler, Walker, Waller and Washington.
Officials said more counties may be added later. Texans who live outside the eligible counties and lost food because of the hurricane should contact their local benefits office or call 211.
Texans who already receive food stamps will have a portion of their September benefits automatically replaced on their Lone Star cards, the card that food stamp recipients use to buy groceries.
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September 8, 2008
Cancer institute elects officers
The Cancer Prevention and Research Institute of Texas has elected officers. Texas voters last year approved Prop. 15, which created that entity and authorizes it to issue $3 billion in bonds over 10 years to pay for cancer research and prevention grants.
The officers are:
Chairman James Mansour of Austin, president of Telephone Management; vice chairman Malcolm Gillis of Houston, Rice University professor; secretary Dee Kelly of Fort Worth, lawyer.
For more on these three and the other members of the institute’s oversight committee, see this story
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July 17, 2008
The faces behind the numbers of uninsured
Less than a year after Linda Cannon was laid off from her job at Advanced Micro Devices, she gained 60 pounds in a period of six weeks and doctors told her that her health was in danger.
Cannon, a single mother who suffers from a thyroid condition, said that if it weren’t for the services of a local health clinic, she would not have been able to afford health insurance — and her condition may have spiraled out of control.
Cannon’s story is one of the many health insurance “horror stories” that a consumer advocacy group is trying to highlight in a national campaign aimed at raising awareness about the millions of Americans without health insurance. The campaign stopped in Austin today, where organizers pointed out particular problems plaguing Texas: rapidly rising insurance premiums and the highest percentage of uninsured residents (24%) of any state in the nation.
“The real tragedy is not that a few people are having horrible experiences,” campaign director Meg Bohne said. “It’s that so many people are dealing with trying to make really difficult life-changing decisions to get the health care they need.”
Organized by Consumers Union, the nonprofit publisher of Consumer Reports, the “Cover America Tour” — which started in New York in May and will make stops at both the Democratic and Republican National Conventions — has been documenting stories like Cannon’s through video footage, which you can watch on the group’s website here.
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July 8, 2008
Cancer group calls for taking hot dogs out of school cafeterias
From the everything-you-love-to-eat-may-eventually-kill-you department: A Washington, D.C.-based nonprofit is urging the U.S. Department of Agriculture to take processed meats such as hot dogs and bacon out of school lunchrooms.
The Cancer Project says its television commercial on the dangers of processed meat will run in Austin in advance of a hearing here on July 15 on federal nutrition programs such as the National School Lunch Program.
Worth noting: The Cancer Project is an affiliate of the Physicians Committee for Responsible Medicine, a research and advocacy group that promotes a plant-based diet and alternatives to animal research.
With ominous music playing, the TV spot features video of hot dogs and pizza and kids talking as if they’re adults with cancer.
“Cancer risk starts early,” warns the commercial, which is based on a recent report connecting processed meat to colorectal cancer. “Even small amounts of processed meats can lead to adult cancers.”
No hot dogs, sausage, pepperoni, deli meat or bacon at school? The Cancer Project likely has a tough battle ahead.
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June 27, 2008
Commissioner who oversees CPS to retire
Carey Cockerell, commissioner of the Department of Family and Protective Services, will retire Aug. 31, state officials announced today.
His agency oversees Child Protective Services, which was recently in the national spotlight for undertaking what state officials say is the largest child welfare operation in U.S. history. CPS removed more than 400 children from the Yearning for Zion Ranch, which is run by members of a polygamous sect, and the state Supreme Court later ordered a lower court to return the children to their parents.
Cockerell joined the agency in January 2005. Since then he has overseen major changes at CPS, including a $248 million reform effort lawmakers ordered in 2005 to add caseworkers and improve training.
“Carey took on one of the most difficult jobs in state government and achieved significant improvements in just a few short years,” Texas Health and Human Services Executive Commissioner Albert Hawkins said in a statement. “His thorough and thoughtful approach made real reform possible.”
Cockerell had been thinking about retirement since late last year, according to a statement distributed by the Health and Human Services Commission, which oversees the protective services agency.
“I’ll soon be a grandfather, and I’m looking forward to a lot of quality time with my family after four decades of working in state and local programs,” Cockerell said.
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June 23, 2008
The two Lance Armstrongs
The New York Times had an article yesterday questioning whether cycling champ Lance Armstrong’s high-profile personal life is threatening his reputation as a serious anticancer advocate.
The article describes the two Lances: the one pictured in tabloids alongside movie star Kate Hudson and the one who has testified before Congress and last year campaigned for Texas’ $3 billion cancer research initiative.
That Texas initiative passed, and the committee overseeing the new program meets for the first time today.
Last week, after Lt. Gov. David Dewhurst named the final members of the panel, the Lance Armstrong Foundation released a statement from Armstrong that said: “Today we are one step closer to winning the war against cancer. We look forward to beginning this journey with Governor Dewhurst and reaching new heights in Texas and beyond.”
Perhaps more media outlets would have published his statement if it had included information on his personal life — but probably not the kind of media outlets the foundation had in mind.
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June 19, 2008
Dewhurst makes appointments to cancer panel
Lt. Gov. David Dewhurst just announced his appointments to a panel overseeing the state’s new $3 billion cancer research and prevention program.
An Austinite is among them: Jimmy Mansour, president of Telephone Management. Dewhurst’s other picks are Lionel Sosa of San Antonio, a media consultant, and Charles Tate of Houston, chairman of Capital Royalty, LP.
“Each of these talented people is making a commitment to the citizens of Texas to work tirelessly to prevent cancer and find a cure for this awful disease that will save countless lives in our state, our nation and our world,” Dewhurst said in a statement.
The appointments come four days before the committee’s first meeting. Gov. Rick Perry and House Speaker Tom Craddick announced their appointments in March, and lawmakers and advocates have called on Dewhurst to make his choices.
The panel oversees the distribution of up to $300 million a year in grants for 10 years. Texas voters last year overwhelmingly approved a bond proposal for the program.
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June 17, 2008
Accenture apologizes for 'outrageous' redaction
Accenture spokesman Jim McAvoy apologized for the heavily redacted document the company’s lawyers sent me earlier this month.
“I am really sorry, deeply sorry that this happened, and it shouldn’t have happened,” McAvoy said. “It was outrageous.”
I wrote last week about how Accenture is trying to keep me from getting access to documents I requested from the Health and Human Services Commission regarding negotiations to unravel a major contract to enroll Texans in public assistance. The deal was originally worth $899 million, and the state has paid some $243 million.
The heavily blacked-out document I got from Accenture’s lawyers was a legal brief the company sent Attorney General Greg Abbott explaining that the documents contain trade secrets and should remain private.
Today I got a “revised redacted copy” of the legal brief from the Accenture lawyers. This time, instead of blacking out the information they view as trade secrets, the redacted words are just blank spaces. So the revised version is a little less jarring to look at. And more importantly, there are fewer words redacted.
For example, page 6 of the brief as originally redacted was almost entirely blacked out, but in the new version of the same page, I can read about how Accenture is concerned about releasing trade secrets involving a system called the Rapid Transition Suite.
So the fact that I can read more of this brief is good news. But the brief just explains why the documents I requested should remain private. Frankly, I’m not that interested in all of Accenture’s trade secrets.
What I really want is what I requested in the first place: the documents detailing Accenture’s negotiations with the state of Texas. A lot of taxpayer dollars are at stake.
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June 11, 2008
Adventures in pursuing government records
More than a month ago, I asked the Health and Human Services Commission for some information on its split with Accenture LLP, the company hired for what was originally an $899 million, five-year deal to enroll Texans in social services.
The company and the commission agreed more than a year ago to part ways, and I was working on a story about why the divorce still wasn’t final.
I was looking for correspondence between Accenture and the commission regarding the unraveling of the deal.
Accenture is fighting to keep those documents private. On June 6, Accenture lawyers sent Attorney General Greg Abbott a letter and a legal brief saying that the information I requested contains trade secrets and confidential information that is exempt from disclosure under the Texas Public Information Act.
“The particular types of exempt information so pervade the responsive documents that without them there is virtually nothing of substantive meaning left to the correspondence,” the brief says. “Accordingly, Accenture objects to the release of the correspondence in its entirety.”
The Accenture lawyers sent me a copy of the legal brief, but for some reason, my copy is a little hard to read. Here is a sample page of my redacted brief. I particularly like the paragraph that is entirely black except for three apparently inoffensive words: “It is a.”
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May 30, 2008
Austin advocate to head national cancer group
The National Coalition for Cancer Survivorship this week named Austinite Cathy Bonner its new president and CEO. Along with cyclist Lance Armstrong, Bonner was a leading force behind the $3 billion cancer research initiative that Texas voters approved in November. Bonner will move to Washington, D.C., to lobby Congress on behalf of cancer survivors, she said. “With a new administration and Congress, the war on cancer will be front and center and part of the debate in health care reform,” she said. She begins the gig on Aug. 1. Sen. Kay Bailey Hutchison, R-Texas, said in a statement that Bonner “is a visionary leader who dreams big and knows how to make things happen.”
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May 19, 2008
FLDS parents: Our children need us
SAN ANGELO — A judge today approved a Child Protective Services plan for what Sarah and James Jessop need to do to get back their five children, who are spread across the state in foster care.
Similar scenarios are playing out in five courtrooms in the Tom Green County Courthouse today as judges consider the future of more than 450 children removed from an Eldorado ranch run by a polygamous sect.
James Jessop’s lawyer, Jerri Lynn Ward, said she was pleased that the judge specifically said the children, who have been home schooled, did not have to go to public school.
“That’s about all I was happy with,” she said. What she really wanted was for the kids to be returned to their parents.
“They need us,” Sarah Jessop said.
“Any parent knows what a child needs,” James Jessop said. “They need a kind, loving mother and a kind, loving father.” He said the children have not been abused.
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May 16, 2008
Texas gets federal OK to expand use of TIERS
The federal agency that oversees food stamps this week agreed to let Texas expand a new computer enrollment system in a limited way.
The U.S. Department of Agriculture Food and Nutrition Service had warned the state Health and Human Services Commission that it had concerns about the computer system known as TIERS, in part because the state has struggled to process food stamp cases as quickly as required. Processing time for cases in TIERS has lagged significantly behind cases processed in the state’s older computer system.
This week, William Ludwig of the Food and Nutrition Service told Hawkins in a letter that Texas may expand use of TIERS, but only to 22 percent of food stamp cases. About 13 percent are in TIERS now, according to commission spokeswoman Stephanie Goodman.
Ludwig wrote that although the state has made efforts to improve customer service, “far too many approvals remain untimely and call center performance needs to be more constant.”
The state has long planned to expand use of TIERS (Texas Integrated Eligibility Redesign System) statewide to enroll people in food stamps, Medicaid and other programs. That has been controversial.
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May 1, 2008
Commissioner offers more info about sect children's impact on foster system
State Sen. Jane Nelson, R-Lewisville, said yesterday she wasn’t satisfied with testimony about the Fundamentalist Church of Jesus Christ of Latter Day Saints provided by Commissioner Carey Cockerell of the Department of Family and Protective Services.
Specifically, she wanted him to more thoroughly explain the impact of putting hundreds of the sect children into the foster care system and what policy changes may be needed.
Per her request, Cockerell last night gave her this written response.
The highlights:
• “Even with the addition of the FLDS children to our foster care system, there are thousands fewer children in foster care than there were 18 months ago,” Cockerell wrote. “The addition of 463 children represents an increase of less than three percent in the number of children in Texas foster care.”
• Though many of the staff members who were sent to San Angelo have returned to their normal duties, others will be needed to handle the needs of the sect children, including 42 caseworkers who will track their progress in foster care.
• Cockerell does not yet have any suggestions on policy changes or legislation needed.
Is Nelson satisfied with Cockerell’s written response? An aide said this morning she’s still reviewing it.
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April 30, 2008
Senator not satisfied with commissioner's answers on Eldorado
State Sen. Jane Nelson, R-Lewisville, chairwoman of the Senate Committee on Health and Human Services, said that she’s not satisfied with what Commissioner Carey Cockerell of the Department of Family and Protective Services told the panel today about the operation in Eldorado.
She asked senators not to ask Cockerell any follow-up questions publicly so as not to jeopardize the ongoing investigation.
“I agreed to this format with the understanding that the agency would cover the topics we discussed,” Nelson said in a statement, referring to her request that Cockerell discuss the impact of the Eldorado case on the foster care system. “That didn’t happen at the hearing, which concerns me because, as policy makers, we have a responsibility to ensure that the agency is fulfilling its mission. We have asked for a written response by the end of the day to the questions we put to the agency and are now awaiting that response.”
Nelson did not mention these concerns about Cockerell’s testimony during the hearing, which is still in progress. Senators are discussing ongoing trouble with the foster care system (high staff turnover, for example).
UPDATE: Later in the hearing, Nelson told Cockerell she thought he did not provide complete information on the four Eldorado topics she requested he discuss (update on investigation/welfare of kids, challenges from policy/resources standpoint, impact on system as a whole, any needed legislation the agency has identified for next session). Cockerell said it wasn’t his intention not to fully answer her questions. A spokeswoman for the agency said it’s too early to address some of the topics, such as what legislation might be needed. The spokeswoman, Jennifer Sims, said the agency will provide the written answers Nelson requested but won’t yet be able to offer much detail.
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41 sect children have had broken or fractured bones, commissioner says
State child welfare workers want to know why 41 of the children removed from the polygamous ranch near Eldorado have a history of broken or fractured bones.
That is according to Commissioner Carey Cockerell of the Department of Family and Protective Services, who revealed new details about the West Texas operation during a hearing today of the Senate Health and Human Services Committee. More than 400 children are now in foster care around the state as officials investigate suspected abuse.
During the meeting at the Capitol, Cockerell also told senators that when the children were in shelters in San Angelo with their mothers, state officials tried using three different ID bracelets but that the families tampered with all of them. It was also difficult to identify the children and women because women switched children, clothes and the children’s clothes, he said. The women are accustomed to “sharing motherly duties, including breastfeeding,” he said.
Cockerell said every decision he and others in the agency made was based on ensuring the children’s safety and dignity.
Citing the ongoing investigation, Senator Jane Nelson, R-Lewisville, chairwoman of the committee, asked that senators not publicly ask Cockerell follow-up questions.
“All of us are concerned for the welfare of these children,” Nelson said.
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April 29, 2008
Senate hearing to touch on Eldorado
At a hearing on foster care tomorrow at the Capitol, members of the Senate Health and Human Services Committee will get an update on the children from the polygamous ranch in Eldorado, who are now in foster care around the state.
The meeting in the Senate Chamber at 9 a.m. will likely focus on foster care issues not related to Eldorado. But Commissioner Carey Cockerell of the Department of Family and Protective Services is expected tell senators the latest from West Texas and discuss the impact of adding 463 children into an already-crowded system.
Senators are not supposed to ask Cockerell follow-up questions about Eldorado during the public hearing so as not to jeopardize the ongoing investigation, according to an aide to state Sen. Jane Nelson, R-Lewisville, chairwoman of the committee. They are being asked to have follow-up conversations on their own, the aide said.
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April 28, 2008
Governor's office temporarily stalled buses with sect children
Last Thursday, three buses loaded with children from the Yearning for Zion Ranch prepared to leave San Angelo shelters for foster care in another part of the state when the Texas Third Court of Appeals set a hearing for today in Austin.
Since the hearing related to a request by lawyers for 48 mothers that children not be moved, Attorney General Greg Abbott’s office had legal questions “about precisely why the kids would be moved,” said Krista Piferrer, a spokeswoman for Gov. Rick Perry.
So Perry’s office ordered Child Protective Services to keep the buses from moving, she said. There were about 49 children and adults on the buses, she said.
“When the state’s chief lawyer calls with some legal questions or concerns, our office thought it was best practice to stall the buses,” she said.
She said the children stayed on the air-conditioned buses for about 20 minutes until “the attorney general’s office was satisfied with the information they received” from the governor’s office and CPS. Then, the governor’s office gave the go-ahead to continue moving the children to foster care shelters and group homes around Texas.
A spokesman for Abbott declined to comment.
“It was more of a better safe than sorry” situation, Piferrer said. “It went by in a snap.”
The appeals court denied the request to keep the children in San Angelo and canceled the hearing.
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Was there welfare fraud in Eldorado?
Readers have been asking whether residents of the polygamous ranch in Eldorado run by the Fundamentalist Church of Jesus Christ of Latter Day Saints have relied heavily on public assistance.
They ask because FLDS communities in other states have been accused of welfare fraud. For example, the Los Angeles Times reported in 2001 that as many as half the residents of the FLDS center of Hildale, Utah, were on public assistance. The fraud comes in when plural wives claim not to know where their husbands are, the article says.
But it doesn’t appear that the residents of the YFZ Ranch in West Texas relied heavily on public assistance. Though statistics aren’t available for individual families or addresses for privacy reasons, Stephanie Goodman, a spokeswoman for the Texas Health and Human Services Commission, gave me these numbers for Schleicher County, which includes Eldorado. Keep in mind these numbers are for the entire 2,800-resident county and that easily more than 500 people lived at the ranch before the state pulled out the children during the recent raid.
Schleicher County TANF cases (cash assistance program): There are no current cases.
Food stamps: 122 recipients in September 2005; 203 recipients in April 2008
Children’s Health Insurance Program: 111 children in January 2003; 63 children in April 2008
Medicaid: 262 people (including 160 children) in September 2006; 283 people (including 182 children) in April 2008
These numbers leave a lot of questions and certainly don’t give us a definitive explanation of how common it was at the ranch to be on public assistance. But clearly, everyone there wasn’t enrolled in Medicaid.
Mary Batchelor, director of Principle Voices, a Utah-based group that advocates for fundamentalist Mormons, said welfare fraud is one of many stereotypes unfairly linked to polygamy.
“The fact that polygamy itself is associated with abuse, underage marriage, welfare fraud is just not true,” she said. “It may well be true of some members who practice polygamy — just like any part of our society. But it’s not true of everyone. It’s not true of the majority.”
For more on the raid — and what people are saying about the state’s decision to remove all the children from the ranch — see our Sunday story
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April 10, 2008
State to tap emergency funds for Eldorado operation
The child welfare operation in Eldorado will likely be costly for state agencies and local governments.
So today, Gov. Rick Perry, Lt. Gov. David Dewhurst and House Speaker Tom Craddick asked Comptroller Susan Combs in a letter to allow the Health and Human Services Commission to cover costs for state and local government entities.
“It is our intent that allowable emergency costs will be reimbursed to the appropriate agencies either through budget execution, an emergency appropriation next session, or another appropriate measure,” said a letter from Perry, Dewhurst and Craddick.
Expenses associated with the operation in Tom Green and Schleicher counties include everything from additional Child Protective Services cases to the cost of court representation for people who cannot afford a lawyer. That cost normally falls to the county, but the letter said: “we recognize that unrecovered costs would likely cause severe hardship for the involved counties.”
“Ensuring the safety and welfare of Texas children is our top priority,” they wrote.
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April 4, 2008
Lance Armstrong: Cancer is colorblind, treatment should be too
Lance Armstrong has been in Washington over the last couple days, meeting with senators and doing the other things he does to raise awareness of issues surrounding cancer.
Friday he spoke to the Intercultural Cancer Council, a group that seeks policies and other solutions to decrease cancer rates in minority communities.
He noted that Friday was the 40th anniversary of the assassination of the Rev. Martin Luther King Jr., and he reminded the audience that in 1958 King talked about the disparity in health care as one of the great injustices in society. Armstrong questioned how much things have changed in the 50 years since.
“Things have to change,” Armstrong said.
He also recalled a doctor who told him that the disparity between what society knows how to do, and what it actually does, to fight the disease is a moral and ethical failure.
“As somebody that, I suppose, perhaps was given the best care, we take those things for granted and we shouldn’t,” Armstrong said. “As long as that divide exists, we’re all going to lose.”
He told the hundreds of people in the audience that one thing they could do was elect a candidate who understands that cancer “doesn’t care if you’re a Republican or a Democrat, if you’re black or you’re white, if you’re rich or you’re poor.”
Here are some video excerpts from the rest of his speech:
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March 31, 2008
Cohen vows to continue fighting for strip club fee
State Rep. Ellen Cohen today said she was “disappointed but not dispirited” by a state district judge’s decision on Friday to strike down a $5-per-customer strip club fee.
Cohen, a Houston Democrat, was the author of 2007 legislation that mandated the fee to pay for sexual assault prevention programs and health insurance for low-income Texans.
Cohen said that, if necessary, she’ll work during the 2009 session to refine the fee.
“If we have to make some adjustments, we’ll make them,” she said, adding that the fee had overwhelming support from the Legislature.
Texas Attorney General Greg Abbott plans to appeal the ruling, a spokesman said.
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March 27, 2008
Federal official seeks Austin application for Medicare test project
Kerry Weems, acting administrator of the federal Centers for Medicare & Medicaid Services, was in Austin today to encourage the local health care community to apply to be one of a dozen sites around the country for a Medicare test project on electronic health records.
The five-year project would give doctors incentive payments to use electronic health records in their practices.
“This is a way of improving physicians’ practices and speeding adoption” of electronic health records, Weems said.
If a doctor adopts electronic health records, all patients — not just Medicare patients — would benefit, Weems said. Using them has been shown to reduce the cost of — and improve the quality of — health care, he said. Electronic health records help reduce duplicative tests, cut down on doctors’ administrative burden, improve management of chronic diseases and reduce hospitalization, he said.
Individual doctors could earn up to $58,000 in incentive payments — and group practices up to $290,000 — during the five-year demonstration project. The money would come from what Medicare expects to save through the use of the electronic records.
“This is real money,” Weems said.
Weems said he expects about 30 communities to apply for the competition by the May deadline.
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March 26, 2008
Minnesotans talk funny, stay healthy
Congressional Quarterly today released a ranking of all the states in terms of their health care. Texas ranks 39 — an improvement from 43 last year and 46 two years ago.
The top five:
- Minnesota
- New Hampshire
- Vermont
- Maine
- Massachusetts
The bottom five:
- Florida
- Nevada
- New Mexico
- Louisiana
- Mississippi
CQ looked at 21 factors, including hospital beds per capita, infant mortality rate, teenage birth rate, percentage of population and children covered by health insurance, obesity rate and the rate of sexually transmitted diseases.
Here’s a link to more information about the report, although it appears you’ll have to pay if you want a copy.
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March 13, 2008
First three appointments named to cancer institute panel
An Austinite is among the three appointees Gov. Rick Perry named today to the oversight committee of the new Cancer Prevention and Research Institute of Texas.
Texas voters in November approved Proposition 15, a $3 billion bond proposal for cancer research and prevention championed by Lance Armstrong. The proposition establishes the institute to distribute up to $300 million a year in grants for 10 years.
Perry’s appointments are:
Scott Sanders of Austin, owner and CEO of RiverCity Sportswear.
Malcolm Gillis of Houston, a Rice University professor and former president of the university.
Jeanne Phillips of Dallas, senior vice president of Hunt Consolidated, Inc.
The oversight committee will also include appointments by Lt. Gov. David Dewhurst and House Speaker Tom Craddick. Comptroller Susan Combs and Attorney General Greg Abbott will be ex officio members of the committee.
There will also be a separate committee of medical experts to make recommendations on which entities receive the grants. Public and private institutions in Texas may apply.
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February 27, 2008
Lawmaker questions state's compliance with Frew Medicaid settlement
When Texas last year agreed to pay doctors 25 percent more to treat children on Medicaid, the goal was to improve access for patients on the federal-state health insurance program for low-income people.
The increase was part of a settlement in Frew v. Hawkins, what was then a 14-year-old dispute over whether the state did enough to ensure that Medicaid services reach patients.
But one state lawmaker is questioning whether the state is in compliance with the settlement.
State Rep. Abel Herrero, D-Robstown, wrote in a letter this week to Health and Human Services Executive Commissioner Albert Hawkins that an ophthalmologist in Corpus Christi found 143 procedures for which doctors receive more to treat adults than children.
That discourages doctors from treating Medicaid patients under 21, Herrero, wrote — “the very problem the Frew settlement was designed to solve.”
Stephanie Goodman, a spokeswoman for the commission, said that the state studied which procedures doctors performed on Medicaid patients in 2006 to determine which procedures would get rate increases. None of the 143 was performed in 2006, so they were not increased, she said.
But after the Corpus Christi ophthalmologist, Dr. John Bishop, brought up the issue, the agency decided to include those procedures, she said.
“We’re going back and increasing the 143 rates,” she said. Those procedures “couldn’t be very common if no one billed for them.”
But Bishop said that every week he sees a condition he’s never seen before.
“There’s a saying in medicine that there are so many rare things that rare things happen commonly,” he said.
For example, Bishop said, one of the 143 procedures is a glaucoma operation for infants. That’s rare because glaucoma is uncommon in infants, he said. He did not perform this operation in 2006 on Medicaid patients. But he did perform it on other patients in 2006 and said he expects to perform it in the future on Medicaid patients.
Bishop also disagrees with the agency’s conclusion that the 143 procedures were not performed on Medicaid patients in 2006. He said he performed one of those procedures — an eye operation — 57 times on Medicaid patients in 2006.
“The state doesn’t like to admit that they’re wrong,” he said.
Now that the state has agreed to increase the 143 ophthalmology rates, he said he’s pleased.
But Helen Kent Davis, governmental affairs director for the Texas Medical Association, said the issue has also arisen in other specialties, including pathology and radiology.
Goodman said the agency is checking to see “if there are other rates that no one billed for in 2006 that still could potentially be used in the future. Nothing’s come up yet.”
Davis said the medical association has identified a payment issue with ultrasounds for pregnant women under 21. If a radiologist performs the service, the rate increase applies, but if an obstetrician/gynecologist performs it, the increase does not apply, she said. Davis said the association is working with the state agency to resolve that and other errors.
Herrero urged Hawkins to ensure that the state complies with the settlement.
“Apart from the legal issues,” Herrero’s letter said, “there is a moral imperative for the state to make good on the promises it makes to its citizens — especially in matters as crucial as health care.”
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February 19, 2008
Texans waiting longer for food stamps
To Texans applying for food stamps, it may not seem to matter whether their application goes through the state’s old computer enrollment system or the newer one.
But new state data show that fewer than half of Texas food stamp applications processed using the updated computer system, known as TIERS, are completed within the 30 days required by the federal government. TIERS average of 48 percent of applications within 30 days is significantly lower than the 90 percent under the old system, SAVERR.
That 48 percent — which is from December, the last month available — represents a steady decline from last summer. The federal standard is 95 percent. See page 26 of this report. Timeliness is also an issue for Medicaid applications.
“If we are that abysmally low on meeting federal timeliness requirements,” State Rep. Patrick Rose, D-Dripping Springs, told state health officials during a Capitol hearing today, “it makes sense to figure out what those kinks are before we begin to expand (TIERS) further.”
But TIERS expansion is already under way. About 350,000 cases for programs such as food stamps and Medicaid are in TIERS, compared to about 150,000 a year ago, Rose said.
High staff turnover is one of the main reasons for the backlogged applications, state officials said. Attrition of employees who enroll Texans in food stamps and Medicaid has tripled since 2003, state officials said.
The Health and Human Services Commission today announced a plan to hire more state workers and to give existing employees raises.
“We recognize that we have got to make a serious infusion and fast” in the number of state workers who can handle TIERS cases, said deputy executive commissioner Anne Heiligenstein.
TIERS, which is now in use in Travis, Hays and Williamson counties and elsewhere for certain programs, was first mandated by the Legislature in 1999 to replace the outdated SAVERR system — which stands for System of Application, Verification, Eligibility, Referral and Reporting.
State auditor John Keel reported last year that because of chronic problems, TIERS is not ready to be used statewide.
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February 5, 2008
No ruling expected today on strip club fee
State district judge Margaret Cooper is now hearing attorneys for a group of strip clubs argue that a new $5-per-patron fee is unconstitutional.
Attorneys for the state say that the issue should be considered in a trial, which is set for March 3.
Cooper said she does not plan to rule today.
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Judge hearing strip club case recuses herself
Attorneys representing a group of Texas strip clubs were prepared to ask state District Judge Lora Livingston this afternoon to declare a new $5-per-customer fee unconstitutional.
But soon after a hearing began in a downtown Austin courtroom, Livingston said she might have a conflict of interest. Once she realized the hearing was on the so-called “pole tax,” she left the courtroom and said she would try to get the case assigned to another judge.
The fee was created by the Legislature last year to pay for sexual assault prevention programs and health insurance for low-income Texans. It went into effect Jan. 1 and a group of strip clubs has been fighting it, saying it is an arbitrary tax because it does not apply to other sexually oriented businesses.
Livingston said she has served on the Texas Equal Access to Justice Foundation, an organization that pays for legal services for low-income Texans. The strip club legislation says that fees collected may be transferred to that foundation.
“I can’t really hear this case,” Livingston said. “I did not directly lobby anybody on this bill but I may have been in the room with legislators or others when this legislation was discussed.”
Another judge may preside over the hearing this afternoon.
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January 29, 2008
State schools on Lt. Gov.'s list of priorities for Senate
Evaluating the state’s process for preventing and investigating abuse and neglect in state institutions for people with mental retardation is among the topics Lt. Gov. David Dewhurst has asked the Senate Committee on Health and Human Services to consider before the Legislature reconvenes in 2009.
Dewhurst’s interim charges to the panel also include:
• monitoring a plan to reduce caseloads for Child Protective Services workers.
• examining Texas’ strategies for preventing child abuse.
• developing a pilot program that pays for health care for Medicaid recipients based on outcomes rather than procedures performed.
• studying the effectiveness of nursing homes and home-based care in Texas.
• Studying the state’s needs for doctors, dentists nurses and other health care professionals.
“These issues are critically important because they affect the physical health of our citizens and the fiscal health of our economy,” said state Sen. Jane Nelson, R-Lewisville, chairwoman of the panel. “We will have the opportunity to put our health and human services under a microscope to ensure that they are being delivered efficiently and, most important, safely.”
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January 24, 2008
Commissioner: Fewer foster children sleeping in state offices
Fewer Texas foster children are sleeping in state offices, hotels and emergency shelters, Commissioner Carey Cockerell of the Department of Family and Protective Services told a House panel today.
That practice occurs when state workers cannot find an appropriate placement in a foster home or residential treatment center. State officials started tracking the practice in January 2007. That month, 32 children spent at least one night in an office or hotel; by May, the number had increased to 160 and the state was also relying on emergency shelters. In each location, the children were supervised by Child Protective Services workers.
It appears to be happening less often. In December, 10 children slept in an office, hotel or — more often — an emergency shelter. In January so far, 11 have.
“I think we’ve made great progress,” Cockerell said.
But he said the “unfortunate reality” is that there will always be some situations in which it will be difficult to immediately place children in foster care, such as when a child is removed from his or her family in the middle of the night.
“We’re just always going to have some emergency situations that arise,” he said.
Most of the children who have not been immediately placed in foster care have been difficult to place because they have serious emotional or physical needs, state officials have said.
State Rep. Patrick Rose, D-Dripping Springs is chairman of the House Committee on Human Services, which met today.
“No child sleeping in an office is an acceptable situation,” Rose said.
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Lt. Governor appoints members of panel to oversee public assistance enrollment
Lt. Gov. David Dewhurst has named state Sen. Jane Nelson, R-Lewisville, as Senate chairwoman of a joint Senate-House committee to oversee the state’s troubled system of enrolling Texans in public assistance. This is according to an aide to Nelson. The other Senate members are Sen. Judith Zaffirini, D-Laredo, and Sen. Bob Deuell, R-Greenville, the aide said.
Dewhurst’s appointments come more than three months after the committee was required by state law to begin meeting, state Rep. Patrick Rose pointed out today during a meeting of the House Human Services Committee. Rose is chairman of that committee and the author of the legislation that mandated the oversight panel.
“We’ve waited and waited and waited,” Rose said.
House members of the committee are Rose, Rep. Tan Parker, R-Flower Mound, and Rep. Bryan Hughes, R-Mineola, House Speaker Tom Craddick announced last September.
Hughes is the joint presiding officer, along with Nelson. He said today the panel would begin meeting by next month.
One of the key issues for the committee will be the Texas Integrated Eligibility Redesign System, the computer backbone of the state’s system to enroll Texans in programs such as food stamps and Medicaid. The system, known as TIERS, was the subject of two critical state reports last year. In one of them, state auditor John Keel said the software is poorly designed and doesn’t have the capacity for use beyond a Central Texas pilot area.
The state received permission from the federal government in November to expand TIERS to other Central Texas counties not in the pilot, but several lawmakers at the House Human Services Committee meeting today questioned whether it is ready.
“Why do we insist on rolling out a program that is still to date not functioning as it should?” state Rep. Abel Herrero, D-Robstown, asked during the hearing.
About 3.7 million Texas are enrolled in the programs TIERS was designed to handle.
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CHIP enrollment continues to increase
Enrollment in the Children’s Health Insurance Program has increased by 52,629 since September, Texas officials told state lawmakers today at a hearing at the Capitol.
There are now 352,891 children in the program, and officials said they expect the program to continue to grow. That’s because of changes the Legislature made to the program last year.
For example, starting Sept. 1, 2007, a 90-day waiting period for the program was eliminated. That change has led to a significant decrease in complaints from families in the program, Elisa Garza, the state’s CHIP director, told members of the House Committee on Human Services.
There were more than 500,000 children enrolled in CHIP in 2003, the year lawmakers enacted enrollment restrictions during a budget crunch. The 2007 legislation reverses some of those restrictions.
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January 17, 2008
House panel considers government's role in wellness
A House panel today is considering what state government’s role should be in promoting healthy lifestyles for state employees and recipients of government programs.
The key question, said Dianne White Delisi, R-Temple, who leads the House Committee on Public Health, is “how far government can go, should go, for the best results.”
The state is working on a number of wellness programs that aim to save lives and health care costs by focusing on disease prevention. The Legislature last year created a pilot program that would provide incentives for Medicaid recipients to improve their health by, for example, quitting smoking.
And another new law created a state employee wellness program. Delisi said state health officials should look to the comptroller’s office as a model for the statewide program. Comptroller Susan Combs started a voluntary wellness program that has included giving employees time off to exercise and making chair massage available to relieve stress.
“People get to kind of chill out,” Combs said of the massage. “Instead of thinking about your money, they get to kind of relax.”
This year, Combs plans to offer yoga and tai chi at work, she said.
Delisi said peer encouragement can work to make the comptroller’s program successful. But she said of Medicaid recipients, “I think it’s going to be a harder population to change behaviors.”
Health and Human Services Executive Commissioner Albert Hawkins said he agreed. That’s why incentives are key for the Medicaid program, he said.
Some 30 states are working on wellness programs for Medicaid recipients, Hawkins said. Most of them have some kind of incentives, though none offer cash. Usually the incentives are credits to purchase items such as health or beauty aids, he said. Hawkins said Texas should also consider having grocery stores provide discounts on fresh fruits and vegetables to Medicaid recipients who participate in the wellness program.
There are about 2.9 million Medicaid recipients in Texas in a given month.
With the right mix of incentives, Hawkins said, “We think we’ll be able to move a lot of the behavior in the right direction.”
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Craddick creates committee on state schools
House Speaker Tom Craddick this week created a nine-member panel to evaluate state institutions for people with mental retardation.
“The Legislature recognized there were immediate needs in institutional care for Texans with disabilities,” Craddick, R-Midland, said in a statement. “Though funding and supervisory changes have occurred, further attention is warranted for the issue of institutional care and for the range of these services. I trust that this committee will do its best to ensure that the level of care our citizens with disabilities receive is not only safe, but fair and right.”
Texas’ 13 state schools and centers for people with mental retardation have been under scrutiny since a December 2006 federal report described unsafe, unclean and unhealthy conditions at the Lubbock State School, where 17 residents died from June 2005 to November 2006. News reports last year revealed severe cases of abuse at other state schools in recent years.
Almost 5,000 Texans live in the institutions, including more than 400 in Austin.
The panel, which be chaired by Sherman Republican Rep. Larry Phillips, includes representatives John Zerwas, R-Richmond; Myra Crownover, R-Denton; Susan King, R-Abiline; Armando Martinez, D-Weslaco; Dora Olivo, D-Rosenberg; Joe Pickett, D-El Paso; Patrick Rose, D-Dripping Springs and Vicki Truitt, R-Keller.
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January 16, 2008
Lance Armstrong to host Mayor Bloomberg
Lance Armstrong will host New York City Mayor Michael Bloomberg and former U.S. Surgeon General Richard Carmona in Austin on Friday, said Katherine McLane, a spokeswoman for the Lance Armstrong Foundation.
McLane said the trio plans to make a midday announcement that will “center on this nation’s approach to the war against cancer.”
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January 14, 2008
Center: Consider paying foster families more
In the past year, more than 500 abused and neglected children in Texas have slept at least one night in a state office or a hotel room because state workers can’t find foster homes or shelters for them.
Texas may be able to combat its foster care capacity shortage by paying foster families more money, Tiffany Roper of the Center for Public Policy Priorities suggested today in a policy paper.
Roper writes that people often argue that foster parents shouldn’t be in it for the money.
“Texans need to reexamine this attitude,” she writes. “Defining fostering as a profession doesn’t mean employing foster parents who are ‘in it for the money.’ Rather, like teachers, foster parents should be called to work in a helping profession, but with adequate compensation.”
The Legislature did increase reimbursement rates in 2007 (now $21.44, to $85.76 per day for a foster family, depending on a child’s needs; more for treatment centers). But Roper said it’s not clear whether those rates are adequate and recommends further study.
Her other recommendations include:
• Stop allowing foster homes or residential treatment centers to reject a particular child. “Children residing in offices and hotels have not been a random group of children,” Roper writes. Rather, they’ve been children with mental health problems or a history of running away.
• Consider whether foster home rules that went into effect last year are reasonable. Some foster parents have decided to stop fostering rather than comply with new rules, Roper writes, such as one that increases the number of adults required in certain homes. Roper writes that it’s not clear whether the state is striking the right balance between protecting children and encouraging Texans to be foster parents.
• Consider increasing the availability of foster/adoptive parent training.
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January 11, 2008
Abbott defends health care plan
Texas Attorney General Greg Abbott, responding to criticism of his proposed health care program for children in the child support system, said this afternoon that the plan would be sustainable.
He is proposing that the state contract with a private insurance company to cover about 200,000 uninsured children in the system. A court could order a parent whose children aren’t insured through job-based insurance or a government program to buy the private insurance.
State Rep. Garnet Coleman, D-Houston, argued today that the plan wouldn’t work because ordering a parent to pay for a child’s medical care doesn’t mean they can afford to do so.
But Abbott said the 200,000 children don’t include those whose parents don’t pay child support.
“The kids we’re talking about are the kids of parents who pay their child support,” he said. “Therefore, they have the resources to also pay medical support.”
Noncustodial parents are already required by state and federal laws to provide for their children’s medical care. Last year, Abbott’s office collected $58 million in cash medical support, he said. That’s money that a court orders a noncustodial parent to pay the custodial parent to pay for a child’s health care or insurance.
That $58 million would be enough to sustain a new insurance pool, Abbott said.
The problem with the current model, he said, is that there is no guarantee that the money goes toward medical care. And when it does, parents may be using it for costly emergency room visits rather than preventive doctor visits, he said.
By putting the children in a single insurance pool, the state would be able to provide cheaper insurance than would otherwise be available, he said.
Abbott also nixed a suggestion by health policy expert Anne Dunkelberg of the Center for Public Policy Priorities that the new program be tacked on to the Children’s Health Insurance Program.
“The private sector solution is going to turn out to be more economical,” Abbott said.
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Abbott's health care plan draws criticism
State Rep. Garnet Coleman, D-Houston, today questioned Texas Attorney General Greg Abbott’s proposed health care program for children in the state’s child support system.
Coleman compared the proposal — which Abbott says is designed to provide private coverage to the 200,000 uninsured children in the system — to the Texas Healthy Kids Corporation, a public-private program mandated by the Legislature in 1997. That program dissolved not long after the start of the Children’s Health Insurance Program in 2000.
Texas Healthy Kids was not just for families in the child support system. But Coleman said the program relied financially on the participation of noncustodial parents who received court orders to pay for their children’s health care coverage.
The program didn’t work because many of the noncustodial parents couldn’t afford to pay for the health insurance, Coleman said, adding that Abbott’s proposal, which would require parents to buy insurance, is also unlikely to work.
Under Abbott’s plan, a private insurance company would contract with the state, and a court could order parents to buy the private insurance based on their ability to pay.
“It sounds very good and I applaud the attorney general for thinking about it,” Coleman said. “However, our experience was that, unfortunately, it did not work.”
Abbott’s proposal would require legislative action. The attorney general said Wednesday that the idea “addresses a pressing need for children in Texas in a way that keeps a watchful eye on taxpayer dollars.”
But Tom Banning, CEO of the Texas Academy of Family Physicians, called the plan “a good political soundbite lacking substance.”
“With premiums rising faster than the rate of inflation, parents don’t have the money to purchase health insurance, and a court order isn’t going to change that,” he said.
Coleman put it this way: “You can’t get blood from a turnip.”
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January 10, 2008
Families can now pay CHIP enrollment fees online
Texas families can now pay online by credit card to enroll in the Children’s Health Insurance Program, state officials said.
The payments can be made at texasonline.com, a Web site where Texans can also renew driver licenses, order birth records and more.
“The ability to pay through Texas Online gives busy families more options for taking care of the the enrollment fee,” Texas Health and Human Services Executive Commissioner Albert Hawkins said.
CHIP provides health care coverage for children in families that earn up to $41,300 a year for a family of four. Enrollment fees are $50 or less per year, depending on income.
It costs an additional $2 to use the online payment system. The system accepts Visa, MasterCard, American Express and Discover as well as major debit cards. The state still accepts check or money order payments by mail.
For more information about CHIP or children’s Medicaid or to apply, see this site.
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January 9, 2008
Attorney General proposes health insurance program for children in child support system
Texas Attorney General Greg Abbott today proposed a health insurance program to cover uninsured children in the state’s child support system.
He said the program, which would provide private insurance, is designed for the 200,000 children in the system who don’t have coverage from their parents’ jobs or from government programs.
“This idea addresses a pressing need for children in Texas