The University of Texas Medical Branch
The 83rd Legislative Session and UTMB
Ben G. Raimer, MD, MA, FAAP
Senior Vice President
Health Policy and Legislative Affairs
December 9, 2013
Highlights
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Most encouraging legislative sessions in years
Speaker Straus’ leadership
Democrats operating in the minority
Strong freshman class
Breakout of largely adult behavior
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The Big Picture
• Budget
• Water Fund
• Transportation Fund
• South Texas Medical School
• Tuition Revenue Bonds
• GME
• Campus Carry
• Physician Education Loan Repayment
• CPRIT Reform
• Medicaid Reform
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Photo credit: Texas Tribune
Medicaid Expansion: The Discussion
No Medicaid Expansion in Texas
Medicaid costs too much-- uses up too much of the state
budget; inefficient and ineffective health care system
imposed on states by feds
VS
Not expanding Medicaid costs too much-- lost federal
funds, lost human capital, increased costs to local
governments and providers; inefficiencies and
ineffectiveness due more to state choices in Medicaid
policy, not federal
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SB 406 Scope of Practice
• Eliminates the requirement for onsite physician supervision and
allows doctors to delegate drug and durable medical device
prescribing authority to an advanced practice nurse or physician
assistant
• Increases from four to seven the number of advanced practice
registered nurses or physician assistants to whom a physician can
delegate prescriptive authority
• Improves coordination between the Texas Medical Board and the
Board of Nursing and Board of Physician Assistants
• Allows physicians to delegate prescribing authority to APRNs and
PAs for certain controlled substances in hospitals and hospice
settings
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UTMB’s Legislative Priorities - Outcomes
• Growth in formula funding to support: $24.5M
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Education of health workforce needed for Texas, now and in the future, including
undergraduate and graduate medicine, nursing, health professions, and
biomedical research
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Necessary infrastructure
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Research critical to solving the health problems of the state and nation
• Continuation of 2012-2013 levels of funding for the Health System
and existing special items with a new Hospital Formula: $10M
• New Exceptional Item funding for: NONE
o Vaccine development
o Regenerative medicine
o Emerging infectious disease research
• TRB funding for Inter-professional Education Building: NONE
• Release of TRB debt service for new Jennie Sealy Hospital: $11M
• Correctional Health Care funding: $48.1M
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UTMB Historic Funding
Biennium
Amount
FY08-09
$457.7 million
FY10-11
$566.6 million(1)
FY12-13
$474.2 million(2)
FY14-15
$506 million(3)
1. Base adjustment after Hurricane Ike; does not include $150 million TRB debt service or $150 million Ike Match
2. Reduction of 16.65% from prior biennium primarily in hospital General Revenue funds
3. Does not include $11.4 million increase in Higher Education Group Insurance (HEGI) for UTMB.
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UTMB’s Legislative Priorities - 84th Session
• Tuition Revenue Bond
• Formula Funding
• Hospital Formula
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Texas’ Future Leadership
• Governor
o Governor Rick Perry is not seeking reelection
o Attorney General Greg Abbott is the front runner to
replace him but only leads Senator Wendy Davis by
single digits in early polling
• Lieutenant Governor David Dewhurst
Announced Challengers in 2014
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Land Commissioner Jerry Patterson
Agriculture Commissioner Todd Staples
Senator Dan Patrick
Senator Leticia Van de Putte
• Speaker of the House Joe Straus
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Other Political Changes
• State Comptroller
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Susan Combs will not run again
Debra Medina
Sen. Glenn Hegar
Rep. Harvey Hilderbran
Raul Torres
• Land Commissioner
o George Prescott Bush
• Attorney General
o Rep. Dan Branch
o Railroad Commissioner Barry Smitherman
o Senator Ken Paxton
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Local Delegation Changes
• Senator Larry Taylor
• Representative Greg Bonnen
• Representative Craig Eiland (retiring after
20 years of service)
o Loss of 17th most senior person in House
o Loss of powerful member of insurance
committee
o Possible candidates:
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Judge Susan Criss (D)
Wayne Faircloth (R)
Bob Senter (R)
Growing list of others
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Advocacy
• What you can do to advocate for your patients, for your
profession and your school:
o Be involved with your professional society
o Visit your State Representative and Senator
o Know the issues and stay informed
• HPLA Web Site: www.utmb.edu/hpla
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Click on “Resources”
Look up your home geopolitical district
Review the Health Policy Briefs
Ben’s Blog
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Questions?
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