1. Bexar County Healthcare Summit

2. Public Health Bexar County Healthcare Summit

3. Public Health 1. ISSUE: Third trimester syphilis screening for all pregnant women across Texas, with emphasis on Bexar County. – RECOMMENDATIONS: Amend existing Texas law (Chapter 81.090 of the Texas Health and Safety Code) to require that practitioners add a syphilis test during the third trimester (28-32 weeks) of pregnancy. Bexar County Healthcare Summit

4. Other Considerations Strong support for the recommendation. Important to understand why congenital syphilis cases happened. Identify physician champions to support implementation of this clinical guideline now. Concern that prevention is not covered in the recommendation. Bexar County Healthcare Summit

5. Public Health 2. ISSUE: Reduce barriers to inclusion in the state immunization registry by moving to an “opt-out” as opposed to “opt-in” registry system. – RECOMMENDATIONS: Support legislation that improves the state’s ability to collect and monitor statewide immunization data; amend Texas Health and Safety Code Chapter 161 by moving to an “opt out” versus the current “opt in” consent. Bexar County Healthcare Summit

6. Other Considerations Strong support for the recommendation. Data is of high value to schools. Need to also target immunizations for older populations. Would be helpful to also include birth defects registry. HASA could help make data accessible. Bexar County Healthcare Summit

7. Public Health 3. ISSUE: The rise in obesity in the United States tracks in parallel with our increased consumption of sugar: almost 80 pounds of added sugar to our diet per year. Almost half of our added consumption of sugar is in liquid form: soda, sugar- sweetened juices, and sports drinks. – RECOMMENDATIONS: Support appropriations to the Department of State Health Services (DSHS) to support local communities that desire to educate their members on the connection between obesity and excess sugary beverage consumption and to promote drinking water instead. Bexar County Healthcare Summit

8. Other Considerations Strong support for the recommendation. Include all sugar sweetened beverages as well as 100% juice as 100% juice has a lot of sugar and is available in large serving sizes. Consider changing language from “excess consumption” to “daily consumption.” Bexar County Healthcare Summit

9. Public Health 4. ISSUE: Research has demonstrated a clear link between consumption of sugar-sweetened beverages and increased risk of poor diet quality, higher rates of obesity, and obesity-related health problems. – RECOMMENDATION: Support legislation that seeks to restrict the types of beverages that may be sold to students on public school campuses with emphasis on sugar-sweetened beverages. Bexar County Healthcare Summit

10. Other Considerations Strong support for the recommendation. Recommend that soda should not be available to adults in schools as well Need to provide clear assessment on the economic impact to schools. Bexar County Healthcare Summit

11. Higher Education and Healthcare Workforce Bexar County Healthcare Summit

12. Higher Education and Healthcare Workforce 1. ISSUE: Changing demographics and the capacity to meet the healthcare needs of the population. – RECOMMENDATION: Support legislation directed at focusing on the growing majority Hispanic population in the healthcare workforce and the creation of pathways to healthcare support occupations; health technologists and technicians; and ultimately to health diagnosis and treating. Support legislation directed at continuing the efforts by Texas Workforce Commission in administering College Credit for Heroes programs. Bexar County Healthcare Summit

13. Other Considerations Creating a support system for students – Cultural workforce grants – Holistic admissions process – Wrap-around services/sustainability – Creating and advocating a national model for success Community Outreach – “Promotores” Health Prevention Advocates (as community health workers) Bexar County Healthcare Summit

14. Higher Education and Healthcare Workforce 2. ISSUE: Although the education of nurses has expanded significantly, there are still major shortages of baccalaureate-prepared nurses, advanced practice registered nurses and nursing faculty. – RECOMMENDATIONS: Support Texas Higher Education Coordinating Board Nursing Shortage Reduction Funds increases; create Texas Nurse Loan Repayment program for nurses who chose to complete a doctoral degree in nursing and enter a faculty role; support higher education funding request (Formula Funding and Tuition Revenue Bonds); remove barriers for nurse practitioner practice authority; health professionals should be granted full practice authority to practice to the fullest extent of their education and demonstrated competencies. Bexar County Healthcare Summit

15. Other Considerations Removing barriers to APRN and PA education programs Additional funding for PA, APRN, RN and Allied Health professional education Further recruitment and additional funding support for expanded faculty resources Increase partnership with higher education institutions through MOU, clinical practice, and other community outreach efforts Bexar County Healthcare Summit

16. Higher Education and Healthcare Workforce 3. ISSUE: The lack of Graduate Medical Education (residency) positions in Texas continues to create a bottleneck impacting Texas’ ability to meet current and growing patient needs for healthcare. – RECOMMENDATION: Support appropriations to maintain the advances made to increase the number of medical residents through the targeted GME Expansion Grant programs. The Texas Higher Education Coordinating Board has requested the following appropriations that should be supported: Planning Grants $900,000, Unfilled Position Grants $6.5 million, New and Expanded Program Grants $12.5 million, Grants for Additional Residency Years $2.925 million, Resident Physician Expansion Grant $5 million, Primary Care Innovation Grant $2.1 million. Need stable education platforms! Bexar County Healthcare Summit

17. Healthcare Coverage Bexar County Healthcare Summit

18. Healthcare Coverage ISSUE: Find a uniquely Texas Way Program to provide access to healthcare coverage to the millions of working Texans who are not covered by an employer. – RECOMMENDATION: Support a uniquely Texan, private market-based coverage program that will provide affordable healthcare coverage to low- wage working Texans and strengthen the state’s economy. Bexar County Healthcare Summit

19. Other Considerations Strong need to have local and statewide business leadership support of this initiative. Agreement that focuses on shared patient responsibility is important in promoting the Texas Way Program. Must seek to realize efficiencies to control cost while continuing to provide value-based care. Focus on Impact to Human Lives Bexar County Healthcare Summit

20. Behavioral Health and Criminal Justice Bexar County Healthcare Summit

21. Behavioral Health and Criminal Justice 1. ISSUE: State funding disparities in mental health services across Texas severely restrict access to much needed care and cost-effective treatment. – RECOMMENDATION: Support legislation to increase Bexar County Mental Health Authority funding to current statewide average of $15.37 per person. Bexar County Healthcare Summit

22. Behavioral Health and Criminal Justice 2. ISSUE: Drug courts guide offenders identified as drug-addicted into treatment under intensive judicial supervision that will reduce drug dependence, reduce recidivism, and improve the quality of life for them and their families. – RECOMMENDATION: Seek state appropriations to fund drug courts in Bexar County at a sustainable level or at 100% operational costs. Bexar County Healthcare Summit

23. Other Considerations Collaborative model in Bexar County should continue to be showcased while advocating for funding for both LMHA & felony drug court Request new funds at the state level rather than a redistribution of existing funds – Provide equity at the per capita funding level for urban areas – Outline the ROI clearly for an upfront investment in mental health – Request community funding and funding for state hospital expansion Identify and carve out funding specifically for children Identify funding and strategies to address workforce shortage issues for behavioral health Bexar County Healthcare Summit

24. Closing Remarks Judge Nelson Wolff Bexar County Healthcare Summit

25. Bexar County Healthcare Summit