Carrie Williams, DSHS press officer, says those interested in participating in the Expanded Primary Health Care Program submitted applications, which DSHS was reviewing at press time. Ms. Williams says most contracts took effect Nov. 1. To accelerate patient access, the hospital districts in Houston, Dallas, Fort Worth, and San Antonio, and The University of Texas Medical Branch in Galveston started providing services under the expanded program in September. Contractors receive payments through a voucher system, and DSHS is developing a fee-for-service system, which Ms. Williams says should be available in 2015. “DSHS will allow a hybrid contract with both voucher-based and fee-for-service reimbursements if the contractor chooses this option,” she said.
DSHS conducted nine public regional meetings for inter- ested parties across Texas in April and May. Attendees includ- ed current and potential physicians and providers, TMA, the Texas Association of Community Health Centers, the Texas Association of Local Health Officials, other professional and community organizations, and women’s health advocates. The department used its input to make program decisions, such as opting to keep the Primary Health Care Services Program and the new Expanded Primary Health Care Program separate.
Ms. Williams says many participants in the Primary Health
Care Services Program voiced concerns about the expanded program. For example, some rural organizations worried they didn’t have a large enough demand to justify fully dedicating 60 percent of funds to family planning services. “Ultimately, DSHS wanted to give local communities op- tions in how to provide primary health care services. Keeping the two programs separate allowed those communities that wanted to participate in the new expanded program to take on the new funds. Smaller communities could choose to remain in the traditional Primary Health Care Services Program,” Ms. Williams said. More information on the Expanded Primary Health Care Program is on the DSHS website (
http://bit.ly/17DOE8g).
All articles in Texas Medicine that mention Texas Medical Association’s stance on state legislation are defined as “legislative advertising,” according to Texas Govt. Code Ann. §305.027. That law requires disclosure of the name and address of the person who contracts with the printer to publish the legislative advertising in Texas Medicine: Louis J. Goodman, PhD, Executive Vice President, TMA, 401 W. 15th St., Austin, TX 78701.
Texas enacts strict abortion measure I
n July, Gov. Rick Perry signed a law that bans abor- tions at or after 20 weeks postfertilization and subjects physicians to stiff penalties for violating the law. The legislature passed the measure despite concerns from the Texas Medical Association and heated debates that dragged the issue out into two special sessions. House Bill 2 includes 20-week postfertilization
abortions in the Texas Medical Board’s list of prohibited prac- tices by physicians or license applicants and assesses admin- istrative penalties for physicians distributing or prescribing abortion-inducing drugs in certain situations. The law restricts use of RU-486, an abortion-inducing drug approved by the U.S. Food and Drug Administration for use by women who seek an abortion; requires abortion providers to have hospital privileges; and requires abortion facilities to meet ambulatory surgical center standards. Governor Perry said at the HB 2 bill-signing ceremony that the law “ensures that anyone performing abortions in Texas is doing so in a facility that is safe, clean, and prepared to deal with any emergencies that might occur — a reasonable, common-sense expectation for those caring for the health and safety of Texans.” TMA didn’t take a position in the debate but was concerned with the legislative intrusion into the patient-physician rela- tionship and the practice of medicine and with a legislatively created standard of care. “This bill includes determinations
26 TEXAS MEDICINE November 2013
that should be made by the medical community and science, not by the legislature,” TMA President Stephen L. Brotherton, MD, wrote the House State Affairs Committee. TMA warned the bill could have a chilling effect on physi- cians’ ability to use their best judgment in treating pregnant patients, resulting in access-to-care issues and potential risks for both the mother and the fetus. TMA also worries the law is overly broad in that it requires physicians or other health care personnel to be available 24 hours a day, possibly indefinitely, to assist patients with pregnancy complications and provide potentially unprecedented access to medical records. Planned Parenthood, women’s health organizations, and abortion rights groups filed a lawsuit Sept. 27 that seeks to block two provisions of HB 2 that were scheduled to take effect Oct. 29. At issue in the suit are the law’s restrictions on the use of abortion-inducing drugs and the requirement that abortion providers have hospital privileges. Plaintiffs also argue that the inevitable closure of abortion clinics will limit women’s access to the procedure. The lawsuit doesn’t challenge the ban on 20-week postfer- tilization abortions or the requirement that abortion facilities meet ambulatory surgical center standards. n
Crystal Zuzek is an associate editor of Texas Medicine. You can reach her at (800) 880-1300, ext. 1385, or (512) 370-1385; by fax at (512) 370-1629; or by email at
crystal.zuzek@texmed.org.
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