The University of Texas Medical Branch The 83 rd Legislative Session and UTMB Ben G. Raimer, MD, MA, FAAP Senior Vice President Health Policy and Legislative

The University of Texas Medical Branch

The 83rd Legislative Session and UTMB

Ben G. Raimer, MD, MA, FAAPSenior Vice President

Health Policy and Legislative AffairsDecember 9, 2013

Working Together to Work Wonders

Highlights• 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


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

Medicaid Expansion: The Discussion

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• 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

SB 406 Scope of Practice

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UTMB’s Legislative Priorities - Outcomes• Growth in formula funding to support: $24.5M

o Education of health workforce needed for Texas, now and in the future, including undergraduate and graduate medicine, nursing, health professions, and biomedical research

o Necessary infrastructure

o 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: NONEo Vaccine developmento 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

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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 Match2. 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.


• Tuition Revenue Bond

• Formula Funding

• Hospital Formula

UTMB’s Legislative Priorities - 84th Session

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Working Together to Work Wonders 9

Texas’ Future Leadership

• Governoro Governor Rick Perry is not seeking reelectiono 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 DewhurstAnnounced Challengers in 2014o Land Commissioner Jerry Pattersono Agriculture Commissioner Todd Stapleso Senator Dan Patricko Senator Leticia Van de Putte

• Speaker of the House Joe Straus


• State Comptrollero Susan Combs will not run againo Debra Medinao Sen. Glenn Hegaro Rep. Harvey Hilderbrano Raul Torres

• Land Commissionero George Prescott Bush

• Attorney Generalo Rep. Dan Brancho Railroad Commissioner Barry Smithermano Senator Ken Paxton

Other Political Changes

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• Senator Larry Taylor• Representative Greg Bonnen• Representative Craig Eiland (retiring after

20 years of service)o Loss of 17th most senior person in Houseo Loss of powerful member of insurance

committeeo Possible candidates:

- Judge Susan Criss (D)- Wayne Faircloth (R)- Bob Senter (R)- Growing list of others

Local Delegation Changes

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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 societyo Visit your State Representative and Senatoro Know the issues and stay informed

• HPLA Web Site: www.utmb.edu/hplao Click on “Resources”o Look up your home geopolitical districto Review the Health Policy Briefso Ben’s Blog

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Questions?

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Documents

The University of Texas Medical Branch The 83 rd Legislative Session and UTMB Ben G. Raimer, MD, MA, FAAP Senior Vice President Health Policy and Legislative