Capitol Update: Senate budget draft cuts spending by $28.8 billion

posted 01.26.11

Senate Finance Chair Steve Ogden, R-Bryan, released the Senate version of the state budget Monday, Jan. 24, and those hoping for less painful reductions will be sorely disappointed. The Senate would spend $158.7 billion in total spending, a reduction of $28.8 billion from current spending. That’s just $2.3 billion more than the stark House version released last week.

Like the House, the Senate assumes no new revenue, no population growth for any programs, no caseload growth for Medicaid and CHIP, and doesn’t touch the state’s $9.4 billion Rainy Day Fund, money generated by taxing oil and natural gas revenue. (For an explanation of the Rainy Day Fund, check out Texas Tribune’s Texplainer.)

The Senate budget closely tracks the House version in articles II and III, (health and human services, and education, respectively) including a 10 percent cut to Medicaid and CHIP provider fees, and massive reductions in education spending at all levels. Both budget drafts include significant savings from implementing bundled payments in Medicaid, rolling out Medicaid managed care in the Valley, reducing ER utilization in Medicaid and CHIP, and cuts to mental health programs and a host of other programs administered by the Texas Department of Health and Human Services.

Several programs designed to improve the state’s primary care physician workforce that had been eliminated in the House budget were granted a small reprieve by the Senate. Included among them are the funding initiatives administered by the Texas Higher Education Coordinating Board for family medicine residency programs and other primary care residency programs, the Statewide Primary Care Preceptorship Programs, and the state’s newly enhanced Physician Education Loan Repayment Program. The coordinating board would receive 29 percent less funding for family medicine residencies; the preceptorship program and the loan repayment program would both be cut by 25 percent.

Graduate medical education formula funding also fares a little better in the Senate budget. It was cut by 32 percent in the House version, but only by 28 percent by the Senate. Total GME spending under the House budget would fall 44 percent; in the Senate, 26 percent.

As we reported last week, these budgets represent a starting point for weeks of committee work. TAFP will advocate for increased investment in primary care, providing testimony, data, issue briefs, policy documents, and by engaging TAFP’s Key Contacts who will reach out to their representatives and help make the case. You can join the Key Contact program by going to the Key Contacts page of www.tafp.org.

Also, you can stay informed on what’s happening under the dome by watching your e-mail inbox for each edition of QuickInfo. During the session, each edition will lead with the TAFP Capitol Update. We’ll be shooting our first webcast news show, Capitol Report, in coming weeks, and each issue of Texas Family Physician magazine will feature legislative news and features.

For talking points and information on TAFP’s top legislative priorities, visit TAFP’s Advocacy pages on www.tafp.org. There you’ll find issue briefs on scope of practice, and on the value of the state’s preceptorship program. More will come soon, so stay tuned.

Hancock files session’s first nurse practitioner scope bill

Under House Bill 708, advanced practice registered nurses would be granted complete prescriptive authority and be allowed to diagnose and treat patients without any physician supervision, all under the regulation of the Texas Board of Nursing.

The bill, filed by Rep. Kelly Hancock, R-North Richland Hills, would allow nurse practitioners, nurse anesthetists, and clinical nurse specialists to “diagnose, prescribe, and institute therapy or referrals of patients to health care agencies, health care providers, and community resources; and plan and initiate a therapeutic regimen that includes ordering and prescribing medical devices and equipment, nutrition, and diagnostic and supportive services, including home health care, hospice, physical therapy, and occupational therapy.”

Join TAFP for Legislative Action Day on March 10

Hone your advocacy skills at the TAFP Legislative Action Day on Thursday, March 10. If you are coming to Austin for Interim Session or the C. Frank Webber Lectureship, plan to arrive a day early. Free to attend, physicians will receive advocacy training, resources, and talking points during a lunch seminar with TAFP’s lobby team, then head over to the Capitol to meet with their legislators that afternoon.

The 82nd Texas Legislative Session is underway, and with a massive budget shortfall and a looming scope of practice fight, family physicians must stand together and advocate for the policies that protect your practice and your patients. We encourage you to contact your legislators ahead of time and schedule an appointment. Or for assistance, contact the TAFP staff at (512) 329-8666 or tafp@tafp.org.

Registration is now open; go to www.tafp.org.

Thanks to the Physicians of the Day; volunteers still needed

Thanks to all of the physicians who have volunteered for the Physician of the Day program so far this session: Melissa Gerdes, M.D., of Whitehouse; David Watson, M.D., of Yoakum; David Greer, M.D., of Henrietta; Stephen Spann, M.D., of Houston; John Frederick, M.D., of Austin; Ron McMurry, M.D., of Jasper; John and Judith Egerton, M.D., of Austin; Rosanne Popp, M.D., of Houston; and Joane Baumer, M.D., of Fort Worth.

The Physician of the Day program brings a family physician to the Capitol each day of the legislative session to provide health care to members of the Capitol community. TAFP still needs volunteers during the 82nd Legislature. View more information about the program, including the online calendar of available dates, on the Physician of the Day page of the TAFP website.