Wednesday, February 09, 2005

Texas budget hearings

The House Appropriations Subcommittee on Health and Human Services held its hearing on the Department of State Health Services legislative appropriations request yesterday. (The Senate Finance Committee hearing is today.) For most of the hearing, Commissioner Eduardo Sanchez held the hot seat, while he was grilled by committee members about various aspects of the budget.

The major good news related to HIV appropriations is that the 5 percent reduction originally mandated as an across-the-board cut for all state agencies has been eliminated for HIV. The Legislative Budget Board recommended restoring $4.1 million to HIV, keeping funding at 2005 levels.

However, new actuarial studies of the projected needs of the Texas HIV Medication Program show that the shortfall for FY 2006-2007 is higher than previously projected. The actual need is a little over $15 million (up from $11.7 million). Again, there is good news in that the Department of State Health Services has amended its legislative appropriations request to seek this higher amount of funding. (Historically, getting the Department to do that has been almost impossible.)

During the hearing, the subcommittee members asked several questions about HIV and STDs. All of them showed concern about the direction of the epidemic and the effectiveness of prevention.
  • Rep. Isett (R-Lubbock) expressed concern about the apparent disparity between the low amount of funds being spent on abstinence education and the high amount of funds being spent on the treatment of HIV and STDs. He asked for more information about what other prevention programs were being provided. He also requested more information about funds being spent on HIV in other programs.
  • Rep. Dukes (D-Austin) and others entered into a dialogue about the Texas A & M study of abstinence education in Texas.
  • Rep. Luna (D-Corpus Christi), Vice-Chair of the Appropriations Committee, sat in on most of the hearing. She asked whether there was unmet need for HIV services. Are people who are not getting services from the Department going elsewhere for care, and does this involve cost-shifting to local communities?
  • Rep. Davis (R-Houston), Chair of the Subcommittee, asked about the epidemiological trends for HIV and STDs and reasons for recent increases in new cases.

The Department will be providing additional information to committee members in response to their questions.

Thanks to Rep. Dukes, the hearing also included a lively discussion of Hepatitis C programming in the state. It appears that rumors that most Hep C programming would be abandoned are now not true. (We'll see.)

Texas AIDS Network testified in support of the the exceptional item request for $15 million for HIV medications, thanked the Legislative Budget Board for restoring the 5 percent reduction, and requested that Rider 29 (relating to abstinence education) not be amended.

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