December 4, 2023

Health Insurance

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Evolving local health care needs important in 88th Texas Legislature | For Subscribers Only

With the 88th Texas legislative session set to begin in January, the evolving needs and issues of health care will be an important topic during the session.

Among the bills already filed during the prefiling period, a big focus involves mental health care, vaccination, direct-payer care and telehealth.

However, with legislators yet to arrive in Austin for the start of the session in January there are still committee assignments to be handed out and bills yet to be filed and local health care leaders have issues they hope are addressed this session.

During the summer, there was discussion among the various committees about providing extra funds for centers like the Gulf Bend Center to keep and retain staff, said center Executive Director Jeff Tunnell.

“Like all the organizations, other businesses and everything, costs are going up,” Tunnell said.

There are also talks of funding being allocated for an inpatient mental health facility within Citizens Medical Center, he said.

One bit of legislation looks like it will help Gulf Bend Center’s beta program with the Victoria Independent School District at Torres Elementary to put a case manager into the school to help with some of the development and mental health issues that have emerged in the wake of COVID-19.

HB 98 and its identical sister bill SB 113 would allow school districts to contract with local mental health authorities to provide on-campus mental health services and allow the district to enroll the provider in a medical assistance program that would enable them to be reimbursed under Medicaid.

The Gulf Bend Center and the district’s beta program starts Jan. 4, and they’re hopeful funding for the program will come out of the session, Tunnell said.

“COVID made an impact for students, and we’re seeing that impact now,” he said. “Kids missed those two years of growth.”

Hospitals are also facing rising costs, said Mike Olson, Citizens Medical Center CEO.

“Hospitals and physician office practices have experienced significant increases in the costs to provide services, including wages, pharmaceuticals and supply costs — even doubling or tripling in some cases. Despite rising costs, we have not seen any significant increases in payments from insurance plans or Medicare and Medicaid. I’m hopeful that legislation will be introduced to hold insurance companies accountable for fair contracting and payment policies. I would also support payer policies that reduce red tape and improve patient access to care, including limits on prior authorizations,” Olson said. “Insurance plans are increasingly looking for any reason to deny payment for services. Hospitals are having to spend an inordinate amount of time and staffing resources to try to fight the routine denials which are happening at alarming rates.”

Other issues Olson hopes are addressed in this legislative session are challenges with Medicaid 1115 waivers and helping the mental health care needs of the community.

“We need ongoing legislative support and funding to defray uncompensated care costs and funding of access to care projects established under the Medicaid 1115 Waiver,” he said. “We are seeing an increasing rise in behavioral health needs in our community, and funding to support mental health treatment options would be very beneficial.”

Over the course of the pandemic, challenges emerged with how hospitals operated, resulting in the reliance on different ways to address their needs.

“Continued support from the State and Federal government in the areas of telehealth, vaccination resources, and direct-payer support will be very beneficial to hospitals,” Olson said. “We received tremendous support during the COVID pandemic with state-funded resources, such as staffing, supplies, and logistical support. It’s unfortunate that the pandemic led to staffing shortages and wage pressures that have continued. It would have been extremely difficult to manage through the peak of the pandemic without this support.”

The Jersey College nursing program that is to be implemented at DeTar Healthcare System is also expected to be a topic of discussion during the session.

Local hospitals and nursing programs expressed concerns over the program taking spots away from the nursing programs in the Crossroads and limiting the ability of other health care facilities to meet nursing needs in September.

Olson maintains that the program will have a negative impact on the area with Citizens, other area hospitals and county officials filing letters of opposition to the program.

The Advocate reached out to DeTar Healthcare system for its perspective on the upcoming legislative session but did not receive a reply before Dec. 24.

Kyle Cotton was born and raised in San Antonio and graduated from San Antonio College and the University of Texas at Arlington. Cotton has covered economic development, health care, finance, government, technology, oil and gas and higher education.