Friday, October 01, 2004

LBB hearing on DSHS HIV budget

Staff members from the Legislative Budget Board (LBB) held a hearing today regarding the Texas Department of State Health Services budget request for FY 2006-2007. Additional folks on the dais included representatives of the Speaker's Office, legislative staff, and Rep. John Davis, who serves on the House Appropriations and State Affairs Committees.

Commissioner Eduardo Sanchez laid out the department's budget request by talking about the state of health in Texas, emphasizing that it includes concern for both a sound mind and sound body. Two points of concern to the Texas HIV/AIDS community came in his discussion of exceptional items. The first was a request to restore the 5% reduction in general revenue. The second was a request for $5.7 million in new funding for the Texas HIV Medication Program (THMP).

In regard to the first, Dr. Sanchez was responding to the mandate that all state agencies have been instructed to follow in making their budget requests for the coming biennium: Make the budget request for 5 percent less that was appropriated for FY 2003 and make any additional funding requests as an exceptional item. Dr. Sanchez requested that the 5% funding cut be restored for the sake of the health of the people of Texas. He pointed out that, if the 5% was not restored, 400 people would have to be cut from the Texas HIV Medication Program's current client load.

In regard to the second, Dr. Sanchez discussed the exceptional item request for the Texas HIV Medication Program, pointing to a $5.7 million shortfall projected for FY 2007. He told the LBB that access to medications was important because the medications prolonged lives, reduced transmission, and allowed people to live productive lives.

Rep. Davis asked Dr. Sanchez whether there were any waiting lists for THMP. Dr. Sanchez pointed out that there were no waiting lists and that the Department had rules in place to move to cost containment procedures if the program ever began to run out of money. Waiting lists, he said, would be the last step in that process.

When it came time for public testimony, I spoke on behalf of Texas AIDS Network. I pointed out that a new actuarial report showed that THMP would experience an $8.3 million shortfall in FY 2007. The Network, therefore, supported both the restoration of the 5% funding cut and an increase in the exceptional item request from $5.7 million to $8.3 million. I emphasized the importance of THMP as our "safety net for the safety net."

Rep. Davis asked me about Fuzeon and its presence on the THMP formulary. I responded that Fuzeon was on the formulary but limited to 50 clients. An expensive drug, Fuzeon is partially responsible for the increased funding need for FY 2007. Rep. Davis asked about criteria for eligibility for the drug, and I agreed to provide additional information.

The next hearing on the budget will be on October 6 when the LBB hears the combined budget request for the Commission on Health and Human Services.

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