As the number of days on the session calendar grows shorter, the Conference Committee members from the House and Senate finally came together to present their recommendations for all Articles in the state budget, with the exception of Article III (education).
Of special interest to UTMB was the presentation of the budget related to correctional health care services. In Conference Committee, the amount appropriated for offender health care was $858 million (a compromise between the House and Senate’s proposals). The compromise budget specifically calls for a greater reduction in hospital funding, maintaining pharmacy funding at $51 million per year, and reducing $7 million in unit-based and mental health services for the biennium. The Texas Department of Criminal Justice (TDCJ) will ultimately be responsible for allocating inmate health care resources in a manner that will ensure constitutional compliance (federal) of services.
The Conference Committee also restructured TDCJ’s contracting process with UTMB and Texas Tech. The future role of the Correctional Health Care Committee and its staff will be determined by TDCJ. UTMB will negotiate a contract directly with TDCJ for operation of the community-based units around the state, hospital and clinical services, and certain other core services such as pharmacy, telemedicine and electronic medical records.
It was late in the week before the House of Representatives was able to finalize SB 23 (administration of and efficiency, cost-savings, fraud prevention and funding measures for Medicaid and CHIP). This bill substantially restructures Medicaid, expands managed Medicaid, and provides for a variety of direct cuts and spending reductions amounting to $1.65 billion. A large number of amendments were attached to SB 23, which precipitated much discussion and debate. Funding for the Medicaid/CHIP program remains an estimated $4.8 billion short of the amount necessary for the biennium.
Finally, fiscal matters bills SB 1811 (state agency appropriations and state funding mechanisms) and SB 1581(fiscal matters related to public and higher education) reached the House floor for consideration. The impasse between the House and Senate regarding revenue sources reached a resolution that seemed acceptable to executive leadership in both houses. The compromise funding agreement for higher education came to $830 million. No agreement was reached on the funding for public education.
The “guns on campus” legislation was attached to SB 1581 as a rider. A point of order related to the germaneness of the rider on SB 1581was raised immediately and sustained. SB 1581 was sent back to the Senate for reconsideration. This additional delay has resulted in the House deferring once again the business on Article III budgets.
The failure of SB 1581 leaves the state without a comprehensive plan for public education unless an amendment can be placed on a Senate bill immediately. Key leadership is in heavy deliberation regarding potential ways to resurrect legislation regarding public school finance.
The Conference Committee has agreed on SB1811 and approved Article III (education), with the following items relevant to UTMB:
- 10% reduction to formula-funded items (relevant to student and resident education)
- 15% reduction to the hospital and clinics’ base budget
- 25% reduction to all other special items in all health-related institutions’ budgets.
These reductions are fair when compared to the reductions at other health-related institutions.
The next step in the process is for the Conference Committee to vote out the entire state budget as soon as the printed version is available, which should be before the Memorial Day weekend. Both the House and Senate need to approve HB 1 in a formal vote before anything is official. In short, this means in theory (and politics) that some things still could change.
Currently on the horizon is the consideration of HB 4, the Supplemental Appropriations Bill. UTMB interests include the Supplemental Appropriations Request (SAR) for correctional care funding and the debt service for the Tuition Revenue Bond needed to construct the proposed Jennie Sealy Replacement Hospital and restore bed capacity to pre-Ike levels. UTMB has also requested an extension of time for the expenditure of revenue in HB 4586 (FEMA match funds) from the previous session.
It is NOT over until it is over! “Sine die” is at midnight on Memorial Day, May 30, 2011. Anything can (and will) happen up until the moment the clock strikes midnight (and in some sessions they have unplugged the clock).
If you want to get a real flavor for what is happening, go to: www.house.state.tx.us or www.senate.state.tx.us during the time the House or Senate are in session and click on the live video stream. You will be able to follow the process and appreciate the pace and dynamics of the session.