The Cheat Sheet Part I

Dear policy watchers,

As promised, we made a little easy to understand cheat sheet of four bills that we, The Texas Women Health Watch, feel are important to Texan women. The cheat sheet is in two parts. Here’s the first part and keep an eye out for the posting of the second part. Enjoy! <3 TK

:: The Cheat Sheet Part I::

H.B. No. 1133 – Maternal Mortality

Primary Author: Armando Walle. Walle is a member of the Democrat Party. He is a House of Representative for District 140, which includes Houston.

Summary: This bill would take effect September 1^st of 2011, and through Chapter 34 of the Health and Safety Code it would create a Maternal Mortality and Morbidity Review Board. Maternal morbidity is defined as a pregnancy-related health condition; it can happen during the pregnancy, labor, delivery, or within a year of giving birth. A severe maternal morbidity is defined as maternal morbidity that became life-threatening. The review board would be an advisory committee consisting of members from a variety of fields and backgrounds. The members of the board shall include:

• 4 obstetricians
• a midwife
• a registered nurse
• a family practice physician
• a mental health professional
• a pathologist
• either an epidemiologist, biostatistician, or researcher of pregnancy-related deaths
• a social worker or social service provider
• a community advocate
• a medical examiner or coroner
• a representative of the Department of State Health Services’ family and community health programs
• the state epidemiologist for the Department of State Health Services or the epidemiologist designee

In total, the review board shall consist of 15 members. The majority of the members shall be appointed by the Commissioner of State Health Services, and they will be chosen with an emphasis on racial, ethnic, and linguistic diversity. The review board will meet at least four times a year. The review board will have two main duties:

• to study and review maternal mortality and severe maternal morbidity
• to create recommendations for the prevention of maternal mortality and severe maternal morbidity

In order for the review board to fulfill their duties, they will develop standard procedures and criteria for their review and consult with other professionals, state professional associations, and institutions of higher education. During their identification and review of the maternal mortality and morbidity cases, the review board will obtain cases without the patient’s identifying information to ensure confidentiality. The review board and the Department of State Health services shall create a joint report over the review board’s findings. The joint report will also include the review board’s recommendations to help decrease the maternal mortality and severe maternal morbidity rate in Texas. The joint report will be submitted to the governor, lieutenant governor, speaker of the house, and appropriate legislative committees. In addition to the joint report, the review board may print research reports and statistical studies over maternal mortality and morbidity.

Potential Implications: Currently, there are some women who lack access to perinatal and intrapartum care services. The lack of resources may contribute to pregnancy-related deaths and severe maternal morbidity. Ideally, the review board’s recommendations in their joint report will highlight the need for more available perinatal and intrapartum care services. The review board could potentially help standardize and perinatal and intrapartum care around the state.

Current Status: Referred to the House Public Health Committee (as of February 28^th)

For more information, click here.

H.B. No. 1255 – Women’s Health, Family Planning, and Human Sexuality

Primary Author: Mark Strama. Strama is a member of the Democrat Party. He is a House of Representative for District 50, which Austin.

Summary: This bill would take effect September 1^st of 2011 and would be authorized under Section 32.0248 of the Human Resources Code. The act would create a 7 year demonstration project through the medical assistance program for women’s health care services. If a woman is eligible, she may be a part of the demonstration project and therefore have access to health and family planning services. The commission shall try to boost participation in the demonstration project through education, outreach, and other methods. The demonstration project is meant to help reduce federal and state spending, lower STD rates, and decrease unintended pregnancy rates.

In addition to the demonstration project, each school district’s Board of Trustees will consult with the local school health advisory council on human sexuality instruction, otherwise known as sex education. The Board of Trustees will choose an evidence-based human sexuality curriculum. The course materials will cover human sexuality, STDs, HIV, and AIDs. In adherence to state law, the materials will heavily emphasis abstinence and waiting for marriage as the preferred method to prevent pregnancy or the contraction of diseases. However, the curriculum must include instruction on contraceptives and how to properly use condoms. It is up to the Board of Trustees’ discretion whether the program shall be abstinence-only or a more comprehensive sex education curriculum. At the beginning of each year, school districts shall send a written notice to parents about the school’s sex education program and what it shall entail. Parents shall have the right to review the curriculum materials and to remove their child from any part of the class without academic penalty.

Potential Implications: Ideally, this bill could help expand women’s access to preventive health and family planning services through the demonstration project. However, it is not clear what the eligibility requirements are for women to participate. Also, the method of outreach is unclear. While the demonstration project sounds beneficial to women with all of the available preventive health and family planning services, it needs effective marketing for the targeted population to even be aware of the project. Hopefully, the Public Health Committee adds clarifications to the bill to strengthen it and give it a real chance at the hearing.

Currently it is state law that sex education programs give a preference to abstinence as a contraceptive method. Therefore, the sex education component of the bill may simply perpetuate the use abstinence-only education, which has been indicated to be ineffective at reducing pregnancy rates. The goal of the bill is to reduce costs and unwanted pregnancies, but because of the state law that goal may be hard to reach. Hopefully, this bill may generate discussion on the state’s current sex education programs and whether it’s effective or not.

Current Status: Referred to the House Public Health Committee (as of March 1^st)

For more information, click here.

Introducing the Bills

Dear policy watchers,

Now that we have a better idea about health care in our state, we want to focus on the bills pertaining to women and preventative health care. We’re going to be following four bills. The bills are:

• Senate Bill No. 834 – Supplemental Breast Cancer Screening
• Senate Bill No. 1138 – Women’s Health Program
• House Bill No. 1133 – Maternal Mortality
• House Bill No. 1255 – Women’s Health, Family Planning, and Human Sexuality

We chose these bills, because the health of Texas women is something that we identify as a social policy issue. The health and well-being of the mothers, caregivers, providers, and nurturers is vital to the survival of families, and the human race in general (I mean, without women, there wouldn’t be babies, and without babies, there wouldn’t be people; sounds like a social issue to us). On a more serious note, women are often marginalized in our society and in our policies, and therefore should be protected by our policies. Some women don’t even know that these bills are being presented, so we feel, that as women and as social work students, we need to educate women about the things that impact each other the most.

Time for class! See y’all later! Stay tuned! <3 TK

P.S.

Watch out for our little "cheat sheet" that will explain all of the bills:)

Cover Texas Now Advocacy Day

Dear policy watchers,

In order to get a feel for the state of affairs of health care reform in Texas, we decided to attend the Cover Texas Now Advocacy Day at the Texas State Capital on March 30th, 2011. The advocacy day focused on funding for Medicaid, CHIP, and the creation of a state-run insurance exchange. (TexasImpact.org)

Check out the KXAN news coverage on the event posted on YouTube:


Kudos to the reader who can spot us in the crowd!

Here are the highlights of the event:
• We were asked to be a part of a news segment, and
• We also joined in chants led by the School of Social Work’s very own (and former union organizer) Courtney Weaver. We chanted “3.2 just won’t do,” “kids not cuts,” and “what do we want? Health care! When do we want it? Now!”
• We got to meet some really cool RNs and other health care professionals from San Antonio, Austin, Houston, etc. We even got to eat with the ethics director of a major San Antonio hospital. They gave us great insight into the issues at hand.
• We met with the legislative aide of Senator Kirk Watson (who coincidentally got her BSW at UT Austin ) and educated her on what the people want.
• We went to the gift shop.
• We took an impromptu tour (which was spurred on by our difficulty in finding an exit)

Interested in our thoughts on the event? Keep on reading!

Thy: It was my first time attending a Lobby Day, and I did not know what to expect. When I first reached the steps of the Capitol, I immediately noticed the homemade signs and umbrellas. (Check out the pictures of the signs below!) We were encouraged to wear green to represent our unity in our concern about healthcare and to bring umbrellas to represent the need to tap the rainy day fund. I honestly did not think many people would wear green or bring umbrellas, but to my surprise many concerned advocates did. I was also impressed with the turn out, there were over a 100 people there and from all walks of live. I did an impromptu survey and asked the fellow advocates where they were from, and they were from all over Texas, such as Third Ward Houston, Brazos County, and San Antonio.

Kristen: It was my first time at a Lobby Day as well, and I was also surprised at the wide range of people attending the event. Prior to attending the lobby day, I had spoken to a state trooper who works mostly at the capital right now, and he was saying that there is a much different air to the events at the capital this year. He said there was more tension than in the past. I went to the lobby day not sure what to expect, and I did sense a certain amount of tension, but it wasn’t necessarily hostile. Everyone was there for different reasons. Some people had personal experiences that drew them to the event, and others were professionals in health care and social work that saw the value in the funding of Medicaid and Medicare.

Thy: The press conference soon started, and there were a total of six speakers. The speakers included Terry Little, Senator Rodney Ellis, Representative Sylvester Turner, businessman Lan Bentsen, small business owner Beth, and Dr. Dan Stolts. All of the speakers represented the different people that would be affected by the healthcare budget cuts: politicians, big corporations, small businesses, medical personnel, and families. Each speaker brought their own viewpoint, and I appreciated learning from their different perspectives. For example, Lan Bentsen is an international investor from Houston. He spoke from a business standpoint, and he kept remarking how the budget cuts are simply “bad economics”. He brought up the point that budget cuts would cost Texas more because of the matching federal funds. The budget cuts could cost Texas $20 billion dollars! Another speaker, Dr. Dan Stolts reminded the audience that 67 counties currently do not have hospital facilities, and the budget cuts could significantly increase that number.

All of the speakers presented valid points. Some speakers were more popular than others, and I definitely noticed who received more applause. All of the speakers wanted essentially the same thing. They all asked for the Texas legislature to take a balanced approach to the budget, get rid of loopholes like tax breaks, and to tap into the Rainy Day Fund.

Among the six speakers, there was one that really stood out to me. She was introduced as Terry Little and her family. Terry Little, short for Teresa Hall Little, was a grandmother from Houston. She told her sad story of how she became the guardian of her two grandchildren because the mother died from a drug overdose. She then told the audience about how one of the grandchildren, Lana, was diagnosed with ataxia-telangiectasia (AT), which is a rare, progressive, genetic, recessive, and fatal degenerative disease. I could hear the audience gasp and sympathetically murmur as Terry Little described the disease with all of its horrid adjectives. I then felt a collective indignation grow among the audience as Terry Little talked about the struggles her family had to endure in her fight to keep both of the grandchildren on Medicaid. She had originally wanted to adopt the grandchildren, but the grandchildren would lose their Medicaid. She had to settle for being a legal guardian so the children could keep their Medicaid. Her husband is turning 65 this year, and he will be retiring soon. Terry Little was worried about the future and how the health care reform bill would affect her family. She ended her wretched story with the powerful statement that her grandchildren are just 2 of the 3 million children on Medicaid. To me, her story gave a personal face to the problem. It reminded me that Medicaid serves more than the elderly, it also helps children.

Kristen: Next up was someone many of us know and love…Courtney Weaver! Courtney is a first-year student in both the MSSW and MPAff programs. Prior to coming to UT, Courtney spent time as a union organizer, so who better than her to lead us in chants? She led us in chants, such as “3.2 Just Won’t Do” and “What do you want? Health Care! When do you want it? Now!”

Thy: After the interactive pep rally, I followed the green mass of advocates into the Capitol for lunchtime. Kristen and I met a couple from the Christus Center Rosa Hospital. They were kind people who talked to us about their thoughts on the health care reform bill. Kristen and I had a little trouble finding the room for lunch. The Capitol really is a confusing maze of doors and stairs! Luckily, we found the room and grabbed our lunch. I was really excited that lunch was provided for us, and after a morning of advocating, Schlotzsky’s Deli sure does hit the spot. Kristen and I ended up sitting at a table of health care professionals and we had a lively discussion. Before we knew it, it was time for our legislative visit.

Kristen: Talking to the health care professionals at lunch was enlightening and enjoyable. Most of them were nurses and administrators, but there was even the chair of the ethics committee at one of the bigger hospitals in San Antonio. All of them had been encouraged to go to the lobby day on work time, because their supervisors saw the value in Medicaid and Medicare and in the power of the legislative process. I am quite sure that all of them were very busy people, but they felt strongly enough about the issue to take time out of their week to participate in this event. Of course health insurance coverage has influenced all of them in different ways, but what intrigued me were the personal stories that they shared with us. For example, the chair of the ethics committee was expressing his frustration with who could be on his own insurance plan. He was saying that even though his daughter could still technically be on his insurance, because she has a dependent of her own, she is no longer eligible to be on his plan. Others had similar stories about those they loved and cared about not being covered by any sort of health insurance, and the concern and fear that caused.

Thy: Kristen and I met up with four other advocates, and we had a little pep talk before we entered Senator Kirk Watson’s office. We entered the office, and his legislative assistance Victoria Lippman greeted us. We followed her to the Capitol cafeteria so we could sit down at a round table and have a chat. Immediately, some of the advocates started to share their views and ideas on the healthcare reform bill. I was a bit nervous to speak up, but after a few minutes I felt confident enough to share my thoughts on the importance of medical insurance. I think what made me feel more comfortable was that everyone at the table was very respectful to each other. There were a few suggestions made that I found interesting. Someone suggested an increased tax on cigarettes; someone else talked about creating a tax on sodas. I felt that the legislative visit was informative, and I sincerely hoped Victoria Lippman would be able to accurately relay the information to Senator Kirk Watson.

Kristen: While I enjoyed the legislative visit, I was a bit disappointed that we were not able to meet with Kirk Watson himself, or someone who had more power in the decision making process. From what I understood, Victoria was an MPAff intern in Kirk Watson’s office. She was great, but I didn’t get the feeling that she knew a lot about the issue or his feelings on it. That being said, everyone who met with Victoria had really interesting ideas. I didn’t necessarily think that all of them were relevant to what we are actually lobbying about, but everyone in the group was very informed and had unique perspectives and ideas to share.

Thy: Kristen and I had to leave early because we both had work and class to get back to. Right before we left, we stopped by the gift shop and browsed the merchandise. I ended up buying an adorable rubber ducky. We took one last picture, and left the Capitol to go back to UT.

Kristen: In the gift shop there was a book called “The Beer Guide”…only in Texas would we sell beer handbooks in our state capital!

Thy: Overall, we really enjoyed the experience of advocating and attending a Lobby Day. If you ever get a chance, you should look into the available Lobby Days and sign up for one. Come on readers, let’s get political!!

And we took LOTS of pictures!













In the spirit of chanting, we made up our own! Join us as we sign out…

Give me a T!

Give me a K!

Team TK!

Welcome to Texas Women Health Watch

Dear policy watchers,

Health care is an increasingly prominent issue for debate with the advent of the Patient Protection and Affordable Care Act. Locally, this has manifested itself in debates regarding the current Texas legislative session. Specifically, preventative care for women is a vital issue for the health of our city, state, and nation.

Here are some key points regarding health care in our state:
• As of January 2011, there is an estimated budget shortfall of $27 billion (Center for Public Policy Priorities, 2011)
• Medicaid alone was short at least $7.6 billion, but if you include the loss of federal matching funds, it’s at least $18 billion (CPPP, 2011)
• Minority women have a life expectancy that is five years shorter than their white counterparts according to a recent study by the Agency for Healthcare Research and Quality, or AHRQ (2010).
• Black and Hispanic women are much more likely than their white counterparts to have an abortion, because they have higher rates of unplanned pregnancies due to a lack of access to family planning resources (Cohen, 2008).
• Similarly, in 2007, 22.7% of pregnant minority women received either late or no prenatal care, compared to 11.1% of white women (Kaiser Family Foundation, 2009).

We created this blog as a response to these statistics. Our goal is to better understand health care in our state, and to educate others about this important issue. In this blog, we plan to examine legislation pertaining to preventative care for women, and evaluate the strengths and weaknesses of health care in our state. We’ll try to keep the legislative jargon to a minimum and try to make this understandable for our readers.

Who are we? Good question.

Thy and Kristen (otherwise known as Team TK) are MSSW students at the University of Texas at Austin. We are currently enrolled in a social policy class taught by the infamous Miguel Ferguson (you might spot him around UT campus on his French scooter thingy-mabob).

Team TK OUT!

References:

Agency for Healthcare Research and Quality [AHRQ]. (2010). Health care for minority women: Recent findings. Agency for Healthcare Research and Quality. Rockville, MD. AHRQ Pub. No. 11-P005. Retrieved February 5, 2011 from http://www.ahrq.gov/research/minority.htm.

Cohen, S.A. (2008). Abortion and women of color: The bigger picture. Guttmacher Policy Review, 11(3), 2-12.

The Henry J. Kaiser Family Foundation. (2009). Putting women’s health care disparities on the map: Examining racial and ethnic disparities at the state level. Retrieved February 5, 2011 from http://www.kff.org/minorityhealth/upload/7886.pdf.