Budget Buzz

 The Texas 83rd Legislative Session is well past its midpoint, and Senate and House financial leadership have crafted a straightforward, no-nonsense budget to take to their colleagues in the House and the Senate. The Senate voted out its budget this past week, and after several tweaks on the House side, their budget will be ready for consideration by the whole House on Thursday, April 4. We will witness House members engage in a lengthy floor discussion and vote for passage with a generous number of amendments, then a conference  committee made up of members from both houses will iron out the differences between the two chambers and reach consensus for the approval of both houses.

So where are we at UTMB in all this? We are glad to see the emphasis placed by both houses on restoration of funding in the formula to support the operations of our educational programs and to support the operation of our hospital. Although we would like for our hospital appropriation to be placed into a mission-specific formula, it appears that formula changes will be reviewed  in a more in-depth fashion during this next interim period between legislative sessions. Timing is everything!

What about the university exceptional item requests? These continue to reside in Article XI of the Senate Budget, which means they can be brought back up for discussion and/or funding if sufficient funds are available in the final days of the session. But, in reality, the mood among members of the Legislature has been to place additional funding into the overall educational support funding rather than in special projects for each university. UTMB has found a strong advocate and friend in alumnus and former faculty member Dr. Greg Bonnen. Dr. (State Representative) Bonnen from Friendswood has filed an amendment to the House version of the budget that would place an additional $1.5 million of funds into UTMB’s operation of the Galveston National Laboratory to offset federal cuts anticipated through the sequester. 

Representative Eiland will also offer up an amendment to restore funding from the unclaimed lottery proceeds to UTMB’s Indigent Care Fund to $10 million per year (rather than the reduction to less than $5 million per year in the current budget).

Correctional Managed Care’s budget requests have found some favor, especially in the Senate with the past two years’ shortfalls added to the base budget, plus an overall base budget increase in anticipation of the increased costs associated with medical inflation. In addition, the Senate has added funding to support salary adjustments for employees (who have had no increase in more than four years), funds for capital improvements (especially digital radiology equipment) and funds for restoration of staffing at selected units.

The issue of provider representation on the Correctional Managed Health Care Committee came up this week in the Senate during a vote on recommendations to restructure the committee. The proposed legislation would have eliminated representation from Texas Tech Health Sciences Center and from UTMB on the committee. Interventions by Senator Robert Duncan and Senator Tommy Williams thwarted that effort, and the Senate adopted language that reconfigures the CMHCC membership to include both Tech and UTMB. as well as two members from other medical schools and two members from the mental health profession.

There is much going on beyond the financial issues that have plagued the state for the past several sessions. The House voted unanimously this past week in support of creating a new mega-university in the Valley under the auspices of the UT System. That university would consolidate UT Brownsville and UT Pan American into a single entity and add a medical school. The university would be eligible for Permanent University Fund (PUF) funding and would immediately undertake the development of a medical school/health sciences center. Support for the new university would come from PUF, local contributions and the UT System. No name has been selected for the university; that will be left to the discretion of the UT System Board of Regents. The addition of a medical school serving South Texas is hailed as a way to address the health care provider shortages that have plagued that region for decades.

Senator Nelson’s Scope of Practice bill (SB 406) has left the Senate and is headed for the House. That bill expands the ability for physician assistants and advanced practice nurses to expand their scope in prescription authority but continues to call for them to report to a physician team leader. Leadership from the Texas Nursing Association, the Texas Academy of Physician Assistants, Texas Pediatric Society and Texas Medical Association have all weighed in to support the bill. In addition, there is another bill that proposes the expansion of the physician assistant education programs in Texas by the addition of a “fast track” for individuals with prior health care experience, such as certified military medics and international medical graduates.

The topic of guns on campus is back for another round of discussions at the Capitol. The right to carry a concealed weapon (with permit) onto a university and/or  hospital campus has resulted in considerable discussion. UT System Chancellor Cigarrora weighed in on the discussion with the following statement, in a Feb. 24, 2011 letter to Governor Rick Perry:

 “I have great respect and value the authority of the Legislature to make this important public policy decision, and I recognize the variety of opinions surrounding it. …Yet parents, students, faculty, and administrators, and the institutional law enforcement have all expressed to me their concerns that the presence of concealed handguns on campus would contribute to a less-safe environment, not a safer one.”

At the Capitol, most of you might already know that a concealed weapon permit gains you access to the building’s interior without going through the usual metal detector and/or security screening process. Some writers have speculated that the Capitol itself probably has more people carrying concealed firearms than any other building in the state! Texans feel strongly about their right to carry, so expect a healthy discussion on this issue. Remember that during the last session the Legislature approved the shooting of feral hogs with automatic weapons from helicopters! Anything is possible. The UTMB Faculty Senate has gone on record as being opposed to concealed carrying of weapons on campus.

Public education continues to be a topic of healthy dialogue in both chambers, with proponents of school vouchers, increases in funding for schools, changes in graduation requirements, changes in testing requirements, and reviews of core curriculum standards all getting generous discussion and action. The House passed out a hefty school package last week and added $1 billion in funding as they voted out their budget recommendations from House Appropriations.

This week’s activities should set the stage for the House to vote their revised version of the Senate budget, and then for a Conference Committee made up of House and Senate members to review and take action on that budget. As always, stay tuned for more.

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