Testimony Before The House Committee on Border and

Testimony Before The House Committee on Border and International Affairs August 12, 2004 José R. Rodríguez El Paso County Attorney County Courthouse 500 E. San Antonio Room 503 El Paso, Texas 79901 (915) 546 -2050 (915) 546 -2133 Fax

Border Health: Conditions ¡ More than 1/3 are uninsured.

Border Health: Conditions ¡ ¡ More than 1/3 are uninsured. 41 of 43 border counties are federally designated as medically underserved.

Border Health: Conditions ¡ ¡ ¡ More than 1/3 are uninsured. 41 of 43 border counties are federally designated as medically underserved. Critical shortage of health professionals.

Border Health: Conditions

Border Health: Conditions ¡ ¡ More than 1/3 are uninsured. 41 of 43 border counties are federally designated as medically underserved. Critical shortage of health professionals. Limited access to care.

Border Health: Conditions ¡ ¡ ¡ More than 1/3 are uninsured. 41 of 43 border counties are federally designated as medically underserved. Critical shortage of health professionals. Limited access to care. Chronic diseases.

Border Health: Conditions ¡ ¡ ¡ More than 1/3 are uninsured. 41 of 43 border counties are federally designated as medically underserved. Critical shortage of health professionals. Limited access to care. Chronic diseases. Lack of health research resources.

1. Increase capacity at border health educational institutions to increase the number of border health professionals. 2. Eliminate TEX-CARE reimbursement rate disparities. ¡ ¡ Medicaid CHIP

3. Increase capacity of the border public health surveillance system. 4. Establish and fund Hispanic Health Excellence Research Fund.

Priority Number One Increase capacity at border health educational institutions to increase the number of border health professionals. 1. l Fix reimbursement rate disparities to attract more physicians.

Priority Number One Increase capacity at border health educational institutions to increase the number of border health professionals. 1. l l Fix reimbursement rate disparities to attract more physicians. Increase # of guaranteed admissions to state supported med schools for applicants who live on the border.

Priority Number One Increase capacity at border health educational institutions to increase the number of border health professionals. 1. l l l Fix reimbursement rate disparities to attract more physicians. Increase # of guaranteed admissions to state supported med schools for applicants who live on the border. Fund school programs for health professions starting in the 6 th grade.

Priority Number One Increase capacity at border health educational institutions to increase the number of border health professionals. 1. l Create and fund magnet schools linked to med schools and health related businesses.

Priority Number One Increase capacity at border health educational institutions to increase the number of border health professionals. 1. l l Create and fund magnet schools linked to med schools or health related businesses. Create and fund a Border Health Service Corps program (6 years of grants and loans for 2 years of service in the border region.

Priority Number One Increase capacity at border health educational institutions to increase the number of border health professionals. 1. l l l Create and fund magnet schools linked to med schools or health related businesses. Create and fund a Border Health Service Corps program (6 years of grants and loans for 2 years of service in the border region. Fund two, 4 -year medical schools on the border.

Adjusted Weighted Medicaid and CHIP Capitation Rate Disparities* Bexar County Dallas County El Paso County Harris County Lubbock County Tarrant County Travis County TANF** children (over 1 year) $71. 00 $84. 00 $90. 00 $82. 00 $91. 00 $85. 00 $83. 00 TANF Adults 189. 00 198. 00 181. 00 177. 00 210. 00 185. 00 171. 00 Pregnant Women 335. 00 302. 00 272. 00 247. 00 230. 00 259. 00 342. 00 Newborns*** 408. 00 338. 00 369. 00 443. 00 385. 00 386. 00 350. 00 Expansion Children (Over 1 year) 73. 00 112. 00 77. 00 96. 00 84. 00 87. 00 82. 00 Federal Mandate Children 65. 00 64. 00 54. 00 69. 00 76. 00 73. 00 68. 00 CHIP**** Source: Health & Human Services Commission*FY 2004 HMO Rates by Service Delivery Area and Risk Groups, **TANF-Temp Aid to Needy Families, ***Includes TANF Child and Expansion Children 1 Year & Under, ****CHIP-Children's Health Insurance Program

Priority Number Two 2. Eliminate reimbursement rate disparities. l TBIC supports 16% increase in Medicaid rates, inpatient/outpatient services, professional services and CHIP rate. Also supports 10% bonus for locating in areas of need.

Priority Number Two 2. Eliminate reimbursement rate disparities. l l TBIC supports 16% increase in Medicaid rates, inpatient/outpatient services, professional services and CHIP rate. Also supports 10% bonus for locating in areas of need. Medicaid and CHIP reimbursement rates should be based on state average rates.

Priority Number Two 2. Eliminate reimbursement rate disparities. l l l TBIC supports 16% increase in Medicaid rates, inpatient/outpatient services, professional services and CHIP rate. Also supports 10% bonus for locating in areas of need. Medicaid and CHIP reimbursement rates should be based on state average rates. Implementation of S. B. 1053 to eliminate rate and spending disparities.

1. Priority Number Two 2. Eliminate reimbursement rate disparities. l l TBIC supports 16% increase in Medicaid rates, inpatient/outpatient services, professional services and CHIP rate. Also supports 10% bonus for locating in areas of need. Medicaid and CHIP reimbursement rates should be based on state average rates. Implementation of S. B. 1053 to eliminate rate and spending disparities. THHSC should develop accurate data regarding Medicaid and CHIP reimbursement rates, expenditures, and impact on healthcare providers.

Priority Number Three 3. Increase the capacity of the border public health surveillance system. l Fund disease control programs and other threats to public health like cancer and bioterrorism. Prevention programs should focus on sanitation and environmental health.

Priority Number Three 3. Increase the capacity of the border public health surveillance system. l l Fund disease control programs and other threats to public health like cancer and bioterrorism. Prevention programs should focus on sanitation and environmental health. Fund public health primary care services including non-emergency care for undocumented immigrants.

Priority Number Three 3. Increase the capacity of the border public health surveillance system. l l l Fund disease control programs and other threats to public health like cancer and bioterrorism. Prevention programs should focus on sanitation and environmental health. Fund public health primary care services including non-emergency care for undocumented immigrants. Fund an adequate public health surveillance system including collaborative binational initiatives and studies on bioterrorism.

Priority Number Three 3. l l l Increase the capacity of the border public health surveillance system. Fund disease control programs and other threats to public health like cancer and bioterrorism. Prevention programs should focus on sanitation and environmental health. Fund public health primary care services including non-emergency care for undocumented immigrants. Fund an adequate public health surveillance system and studies on bioterrorism. Adequately fund public health facilities. Fund public health community education initiatives, including binational programs.

Priority Number Four 4. Establish Hispanic Health Excellence Research Fund l Establish it -- and fund it! l Authorize funding to support research by Border Health Institute and Regional Academic Health Center, and other local and binational health research organizations.