79R11540 CME-D


By:  Villarreal, Jackson                                          H.R. No. 257

Substitute the following for H.R. No. 257:                                    

By:  Truitt                                                   C.S.H.R. No. 257



R E S O L U T I O N
	WHEREAS, More than three million Texans reside in 121 
federally designated whole county health professional shortage 
areas, and 3.3 million Texans were living in an additional 47 
partial county and 47 special population health professional 
shortage areas as of June 2004, according to the Health Resources 
and Services Administration; the federal government has also 
identified 359 medically underserved areas and medically 
underserved populations in Texas; and
	WHEREAS, These designations indicate a statewide scarcity in 
health care resources and reveal the public health of Texans to be 
at risk; health professional shortage areas include geographic 
areas and population groups recognized as having an acute shortage 
of health care personnel, and medically underserved status is 
assigned according to four demand and resource indicators: 
percentage of elderly population, poverty rate, infant mortality 
rate, and ratio of primary care providers per 1,000 population; and
	WHEREAS, Moreover, the issue of access to health care is 
complicated by the fact that nearly 5.5 million Texans are living 
without health insurance and often must resort to seeking primary 
care in hospital emergency departments, further encumbering 
inadequate medical resources; and
	WHEREAS, Unfortunately, Texans are also faced with the 
increasing cost of health care, typified by the escalating price of 
prescription drugs; U.S. per capita spending on prescriptions has 
been projected to rise between 2000 and 2010 at an average annual 
rate of 11.2 percent based on U.S. Department of Health and Human 
Services data; with the average price of retail prescriptions 
filled in Texas increasing by nearly six percent between 2002 and 
2003 alone, the potential impact to individual Texans is alarming; 
and
	WHEREAS, The rising expense of health care and high rates of 
uninsured are equally consequential to the fiscal well-being of 
local, county, and state governments; in state fiscal year 2001, 
health care expenditures alone accounted for approximately 40 
percent of total net expenditures in Texas, and public hospital 
districts reported $1.2 billion in unreimbursed care; and
	WHEREAS, In an attempt to redress many of these issues and 
recognizing the shared interest of public health and the value of 
collaboration among all levels of government, the 76th Texas 
Legislature passed House Bill 1444 to administer a program of 
grants for counties, municipalities, public health districts, and 
other political subdivisions to provide essential public health 
services; however, in light of persistent obstacles to the 
successful delivery of critical health services, revisiting these 
efforts could prevent a crisis in public health for Texas; now, 
therefore, be it
	RESOLVED, That the House of Representatives of the 79th Texas 
Legislature hereby request the speaker to provide for an interim 
house study to make recommendations to the legislature relating to 
how public health and medical care services can be more effectively 
delivered through regional planning involving all relevant 
stakeholders in rural, border, and urban counties and the 
surrounding rural or suburban communities; specifically, the study 
should:  (1) identify incentives and resources necessary to promote 
personal responsibility and accountability, encourage preventive 
care, and expand use of available primary care services; (2) 
identify cost-effective technological innovations to improve 
health care access and coordination, such as telemedicine or 
automated medical records; (3) improve access and availability to 
primary care services; (4) improve access to secondary and tertiary 
care in rural communities; (5) identify how health care services 
can be improved through collaboration across funding streams, such 
as the Children's Health Insurance Program, Medicaid, and private 
insurance; (6) make recommendations to improve the capacity of 
public health entities in Texas to comply with the Centers for 
Disease Control National Public Health Performance Standards; (7) 
identify successful strategies and recommend incentives to develop 
multicounty public health entities authorized to collaborate to 
ensure that the essential public health services as authorized in 
Section 121.002, Health and Safety Code, are available to all 
Texans; (8) evaluate the role of existing regional public health 
entities and make recommendations to optimize their capacity to 
assume responsibility for the foregoing purposes or create 
additional regional entities as needed; and (9) recommend 
appropriate funding levels needed to implement the committee's 
recommendations; and, be it further
	RESOLVED, That the speaker assign the study to a select or 
standing committee at his discretion, exercising authority granted 
to the speaker by House Rule 1, Section 17, Interim Studies, and 
House Rule 4, Chapter F, Interim Study Committees.