Tuesday, January 02, 2007

2007 bill tracking list now available

Happy new year!

Putting things together for the new year, getting organized, setting up calendars--it's like the first day of school with pencils all sharpened and a brand new notebook to fill. What a bummer it is then to find out that one of my proudest accomplishments for the last few weeks, the 2007 Bill Track List, may not have been publicly accessible as intended.

As it turns out, Google makes us go through two steps to grant public access to one of it Documents & Spreadsheets. Without boring you with the details, I'll just point out that I only recently discovered the second step. I have now taken the second step, and the Bill Track should be viewable at the link above. If not, would some kind soul let me know?

Thursday, December 21, 2006

Circumcize Texas (?)

Male circumcision has been discovered to prevent as much as 50 percent of infection for men. It is even protective for women, reducing their rates of infection substantially.

The discussion in Africa now is whether to promote male circumcision and even whether to make it mandatory. Tanzania, for example, is considering whether to implement "mass circumcision" for its male citizens.

This raises the question: should this policy be discussed in Texas?

More Blogger buzz(ing)

After some months of fiddling with a new version of Blogger, the Blogger folks say that it's out of beta and ready to use. They also say that it's time to shift all blogs to the new Blogger.


It's not happening here. Not that I don't want to shift to the new Blogger. After having panned it as inadequate for our needs, I am now eager to make the shift. For one thing, the new Blogger works better for email subscriptions. For another, it turns out that I like the categorization option. (I have secretly been playing with the new Blogger for, well, fun.)

So. I've backed up the template. I'm all ready to rework the sidebar. I'm eager to add some new subscribers. But it's not happening.

So. I'm linking to the article where the Blogger folks say it's gonna happen, so they can see (a) the link and (b) that I want to shift the blog! Sooner rather than later, guys.

Recall, recall!

Oh, dear! Yesterday's post regarding "AIDS in the Media" was an unfinished draft of an article that I am working on. I accidentally published it instead of saving it to drafts, and Feedburner/FeedBlits did their thing, sending it out to all our subscribers. Alas and alackaday! I hope you were not unduly confused by the thing just fizzling out before it reached any real conclusion. I've "unpublished" the article, properly saving it to drafts this time. This means you'll see it again someday. In the meantime, please delete the article from your email inbox or feed reader. It's not ready for prime time.

Tuesday, December 19, 2006

Sex, Drugs, & Money

I gave a policy briefing at the 15th Texas HIV/STD Conference along with Randall Ellis, Government Relations Director for Legacy Community Health Services. Called "Sex, Drugs, & Money," the briefing included discussion of the cultural context for HIV/AIDS policy in Texas, resources for local advocates, and an outline of issues that we will (or may) see in the 80th Texas Legislature. While only about 10 people had preregistered for the session, closer to 50 showed up. I was most pleased by the attendance; unfortunately, we did not have enough handouts for everyone who was present.

As promised, I have now published my presentation on the Texas AIDS Network website as a PDF file. I used my version of "beyond bullets" to create my presentation in PowerPoint, using graphics and very few words on my slides, but writing extensive commentary in the notes. While the "notes" are not a script of what I had to say in the briefing, they do give the flavor of what we talked about.

My thanks to all who attended the session. I look forward to working with you in the coming months.

Tuesday, December 12, 2006

STAR+PLUS delayed

The feds have not yet approved Texas' waiver application to extend STAR+PLUS coverage to the rest of the state, so plans to roll the program out in Travis, Bexar, Nueces service areas by January 1, 2007, have been put on hold. The Harris County STAR+PLUS program will continue uninterrupted, and eligible clients in other parts of the state will continue to be served by Medicaid.

More information from the Health and Human Services Commission is available here.

Tuesday, November 28, 2006

What DSHS says about HIV

On August 31, Commissioner Eduardo Sanchez presented the Texas Department of State Health Services Legislative Appropriations Request to the Legislative Budget Board. He used a PowerPoint presentation that included 44 slides. Slides 27 and 28 are reproduced below.

Regarding Slide 27 (above), his Notes page said:
DSHS also administers programs to prevent the spread of HIV. Treatment has improved dramatically. As it does, the number of Texans with HIV grows. People are living longer with HIV--but we must also remember that they are working, paying taxes, and leading healthier, more productive lives.

Regarding Slide 28 (above), his Notes page said:

Clients of our HIV medications program are living longer as well. Again, the medications allow these Texans to live fuller, more productive lives and to contribute to the economy. Unfortunately, the cost of the medications used in this program has also grown--by 33% per client since 2000.

This is somewhat old news. However, the new news is that the whole question of an Exceptional Item for HIV in the Department's LAR is now somewhat up in the air. Discussion at the November 17 meeting of the HIV Medication Advisory Committee revealed that, while the estimates for potential funding needs for FY 2008-2009 continue to be based on a shifting foundation, the latest shift in the sands of this foundation suggest that the amount of funding needed will be substantially less that earlier proposed. Indeed, the amount may be sufficiently low that no Exceptional Item request will be made for HIV medications at all--with any amount needed being taken from other programs or resources at DSHS.


The questions that next come to mind are: If that happens, what will happen to the funds that were targeted for prevention, services, and surveillance? Will they just disappear also? If they continue to be included in the LAR, do they stand a chance of approval without the added "muscle" of a request for medication funds?

To begin looking for answers to those questions I returned to the Commissioner's presentation to see what he was saying before these questions arose. Oh dear! It looks like HIV prevention, services, and surveillance weren't even part of his spiel. He made nice "Republican" arguments about "productive lives," but he didn't make the connection between the need to increase prevention so that the upward curve of people living with HIV could be straightened out, if not reversed. It looks like we'll have to make the connection for him.

Comprehensive sex ed: Who cares?

As it turns out, most US adults do--and they support the inclusion of comprehensive sex ed in public school curriculum. Isn't it interesting, then, that Rep. Warren Chisum hasn't gotten the message? If he had, he certainly wouldn't have filed HB 311, Relating to parental approval of a student's participation in human sexuality instruction in public schools.

Chisum's bill reverses the current opt-out provision for sexuality education in Texas' public schools to make it opt-in. Whereas parents currently have the option of removing their children from sexuality education if that is their desire, now all parents must specifically sign their children up for this education.

Here are some tidbits from the Annenberg National Health Communication Survey, published in the November issue of the Journal of Pediatrics & Adolescent Medicine (and included in a report on Medscape):
  • The survey was conducted by the Annenberg National Health Communication Survey, a nationally representative measurement of people older than the age of 18 years in the United States. Surveys were conducted by landline telephones between 2005 and 2006.
  • Researchers inquired about respondents feelings about 3 different school-based sex education programs: abstinence only, abstinence plus information regarding contraception and prevention of STIs (comprehensive sex education), and comprehensive sex education plus instruction on the use of condoms. Subjects' responses were placed in reference to their self-described political ideology and rates of attendance of religious services.
  • 1096 respondents provided study data. The mean age of participants was 46.8 years, and 78.7% of subjects were white. Rates of self-identification as conservative, moderate, or liberal were 35.5%, 39.5%, and 25%, respectively. There was a fairly even distribution across different frequencies of attendance at religious services, with 20.4% reporting no attendance and 21.4% reporting attendance once a week.
  • Overall rates of support for comprehensive sex education, comprehensive sex education plus teaching condom use, and abstinence-only education were 82%, 68%, and 36%, respectively. Half of respondents opposed abstinence-only education, making it the most opposed educational option.
  • Only 39% of respondents felt that abstinence was an effective means to prevent unplanned pregnancies. However, 80.4% of subjects felt that comprehensive sex education could reduce unintended pregnancies. Most participants disagreed that teaching teenagers to use condoms would encourage them to have sex. Women tended to have higher rates of opposition to abstinence-only programs compared with men.
  • More liberal political ideology was associated with greater preference for comprehensive sex education. Rates of support for such programs were 70.0%, 86.4%, and 91.6% among participants with conservative, moderate, and liberal political philosophies, respectively.
  • Comprehensive sex education and condom instruction received strong support from respondents who attended religious services a few times a year or less frequently. While abstinence-only programs received more support among subjects who attended church more often, there was equal support for abstinence-only and comprehensive sex education programs among the subgroup of participants who attended services more than once per week.
While I could quibble about how these research results are framed for reporting, the final conclusion is still that US adults support comprehensive sex ed in the schools even when presented with abstinence-only education as an alternative. Even in Texas, there is strong support for comprehensive sex ed in the schools (according to a 2004 Scripps Howard Texas Poll--no link available).

So what's the problem, Warren? Could this be a solution in search of a problem?

Monday, November 20, 2006

Texas AIDS Network 2007 bill track

The Network will be (as much as time and staff resources permit) posting its tracking list for the 80th Texas Legislature on line. The bill track--so far--has three levels of tracking.
  • HIV/STD: Bills on this list specifically address HIV/AIDS or other sexually transmitted diseases. The Network may take a position for or against these bills, may actively support or oppose them through testimony or other means, and may request the Texas HIV/AIDS community to do the same. The Network will also write bill analyses that relate them to the Network's policy principles.
  • Related: Bills on this list have the potential to affect HIV/AIDS prevention, treatment, or care even though they do not specifically reference HIV/AIDS or sexually transmitted disease. The Network may take a position for or against these bills, may support or oppose them in hearings, but may not invest significant resources in doing so. The Network will track the progress of these bills and look for changes that may have an effect, either positive or negative, on prevention, treatment, or care.
  • Of Interest: Bills on this list have the potential to affect the context, such as the social or overall health care environment, in which HIV/AIDS prevention, treatment, or care occur. The Network will review these bills for negative or positive impact and take action as resources are available. In most cases, the Network will simply monitor their progress through the legislative process.

Bills may be moved from one list to another depending upon Network resources and the degree to which they may be expected to have an effect on HIV/AIDS prevention, treatment, and care.

80th Texas Legislature, Pre-filed bills

The 8th Texas Legislature won't begin until January 9, but legislators are already pre-filing bills. Doing so gives their legislation an official number and a stronger possibility (they hope) of getting their bill passed during the actual session. Once committees are formed in the new session, bills with be formally "read" in the House and Senate and referred to committee where they will be recommended for passage--or die.

You can find a list of the prefiled bills at the Capitol website. Click the link for reports. Make sure that the box for Legislature says "80R - 2007." There are a number of ways to search for bills, including author, subject, and filing date. If you choose filing date, start with November 13 to see bills pre-filed from the beginning--and select every week day thereafter to see all of the bills.

If you want to follow any bills during the session, you can create a "My TLO" account and set up your own tracking lists. I am setting up online tracking lists for Texas AIDS Network using Google Docs & Spreadsheets. You can, if you want to, follow what I'm following by checking the Texas AIDS Network 2007 Bill Track.

Friday, November 10, 2006

Progressing on legislative contact list

At some point, I suppose that my struggles with the legislative contact lists could get boring if all you're interested in is getting your hands on the lists and then using them. It's that latter part that is, of course, my goal in all of this activity. Once the contact lists are completed, you will be able to use them to find contact information for your elected representatives and then start sending letters and faxes, making calls and visits--to tell them about the need for increased funding for HIV and to support good policy for HIV prevention.

Until then, however, I'm busily working away on those lists. A couple of points related to the lists arise.

  • For Texas House and Senate members, I will eventually list the room number for their offices at the capitol. This room number is not needed for sending mail to them but rather will matter only if you plan to come to Austin for a legislative visit. I have started adding this room number for re-elected incumbents (new legislators won't have an office until later on), but it should not be "trusted" come January and the new legislative session. After every general election, Texas legislators play a sort of "fruit basket turn over" game with offices at the capitol. As "good" offices are vacated by retiring (or defeated) members, others scramble to take over their office space. This means that a lot of legislators will be moving around in the next few weeks--and, of course, that room number will change. Phone numbers will mostly stay the same, but some fax numbers will also change. I will make these "corrections" as the information becomes available.
  • Email addresses should be pretty standard for most state legislators. The pattern is (firstname).(lastname)@house(or senate).state.tx.us. The problem is with that first name, since many legislators have nicknames. Sometimes they use the nickname for their email, sometimes not. Robby Cook, for example, uses his nickname for most purposes, but his email is robert.cook. As my good friend, Gollum, would say: "Tricksy!" If you want to send email to your representative before the list is completed, there are two possibilities. One, take a chance on your legislator following the pattern for creating an email address without any variation. Two, go to the legislator's official web site to send a message via the online email form. To do the latter, start at www.house.state.tx.us or www.senate.state.tx.us to find those official web pages.

Find the lists at Texas Congressional Delegation: 2007-2008 and Texas State Government: 2007-2008. Fee; free to volunteer to help complete these lists. :)