Monday, February 27, 2006

Integrated eligibility gets off the ground

So to speak. After several years of talking about integrated eligibility as a means to simplify the process of applying for safety net programs and saving the state money at the same time, Texas is finally getting its new system started. The program is not without its detractors. Its earliest days were marked by heavy concern about confidentiality and how various programs might be integrated. The Texas HIV Medication Program, for example, was one of the programs excluded from the system because of confidentiality concerns. Later challenges came because of the proposed reliance on technology for intake and the accompanying lay off of state employees (not part of the original intent of the legislation that got this ball rolling).

Early problems aside, the program is now underway, and it now must prove itself. As the program expands from Travis and Hays counties, consumers will be able to the the 2-1-1 call system as well as the Internet for initial eligibility screening and application for Medicaid, CHIP, food stamps, and other programs. To help gain acceptance for the program HHSC is scheduling a series of meetings around the state for stakeholders. In March, meetings will be held in Harlingen, Laredo, El Paso, and Lubbock. This appears to be the presentation that will be given at the meetings, if you want a preview.

House Public Health reviews Medicare Part D

During its February 15 meeting, the House Public Health Commitee heard testimony from James Randolph Ferris, MD (U.S. Dept. of Health and Human Services, Centers for Medicare and Medicaid Services, Dallas Region VI Office) and Albert Hawkins (Commissioner of Texas Health and Human Services Commission). Hawkins' testimony was accompanied by a set of slides, which are available online at the HHSC website. Committee members questioned when Texas could expect reimbursement for the state's costs in funding the glitches in transitioning clients from Medicaid to Medicare; additional workload placed on state agencies because of the system change--and problems; the clawback provision's sticker shock; cost impacts on pharmacies; costs to consumers; and other matters. You can listen to the entire hearing online (scroll down to the February 15, 2006, meeting).


  • Aside from all the numbers and dollars and "working hard" statements being tossed around, a major thread is the reliance on computers for data exchange. One can't help but wonder at both the complexity of the problem, which apparently wasn't anticipated, and the scale of the confidentiality issues that lurk in the background.
  • McReynolds and Truitt seemed to be the heavy hitters on questioning the programs, but DeLisi wins the (virtual) prize for questioning health outcomes.
  • At about 1:21 on the broadcast, Hawkins decided to toss in the information that there would be savings on HIV medications as a result of Medicare Part D. This tidbit came in an excess of zeal, I would say, to respond to Laubenberg's questions regarding the Kidney Health Program and projected savings (~$6 million for the biennium) as he tried to show additional savings thanks to Part D. Information from the Texas HIV Medication Program suggests otherwise, however.

Sign-On Letter: Oppose Cuts to Human Needs

This message comes to us from the Coalition on Human Needs. The sign-on letter is for organizations only, but a link is provided to help you write an individual letter. Note that the little envelope thingie at the bottom of the post will allow you to email this post to others on your mailing list.


Sign-On Letter Opposing Budget Cuts to Human Needs Programs

**Please forward to your networks and friends**

The Coalition on Human Needs invites state, local and national organizations around the country to sign the letter at the bottom of this email to tell Congress that our nation's priorities as expressed in the federal budget are profoundly misdirected. We hope this effort is even more successful than the budget sign-on letter we circulated last year, which attracted around 800 signatures from every state and received considerable attention on Capitol Hill and in the press.

Click here for a PDF version of the CHN Federal Budget Letter: [shortened link]
Click here if your organization would like to sign the letter: [shortened link]

Please note that the deadline for signing the letter is Monday, March 13.

This letter is only for organizations to sign. But you can still help even if you're not affiliated with an organization! Click here to send an easy-to-use email to Congress opposing budget cuts in human needs programs:


February 24, 2006

Dear (member of Congress):

The undersigned organizations are writing to let you know of our deep concern over misdirected priorities in the federal budget. Both the budget decisions for the current year (FY 2006) and the President’s proposal for FY 2007 consistently shortchange investments in education, child care and other work supports, training and community development that can help provide opportunities for shared prosperity. Cuts in health care, nutrition, services to prevent abuse and neglect, Social Security, and housing jeopardize basic health and economic security for millions. We urge your leadership to commit our resources towards protecting and enhancing opportunity and security for all Americans – the most responsible and effective strategy for a strong economy that works for all of us.

These cuts are neither necessary nor wise. They will simply pay part of the cost of unaffordable tax cuts that overwhelmingly benefit the top income groups. We seek your leadership in opposing budget choices that are wrong – for burdening states and localities with billions in cuts, for the harm they do to vulnerable people and to our capacity for economic growth shared by all.

Please oppose cuts in annually appropriated services. As the Budget Committee drafts its FY 2007 Budget Resolution, we urge you to call upon the Budget Committee and House/Senate leadership to include funding levels that at the very least will allow the current level of services in non-defense domestic programs. The President’s FY 2007 budget proposal cuts domestic discretionary programs by more than $16 billion, or 4.1 percent below the cost of today’s services, including cuts in funding to educate our children, provide food to low-income seniors and housing for people with disabilities. This is unacceptable.

We know that the Budget Resolution will simply include a total number for discretionary programs, with the details to be worked out later by appropriators. We also understand that totals similar to the President’s will inescapably result in cuts to services that meet human needs. These cuts will compound the harm caused by prior years of service reductions. The Budget Resolution must include totals high enough to prevent or reverse such cutbacks and to address areas of growing need. Further, we believe it is irresponsible to set binding caps on annually appropriated programs that do not allow for inflation or population growth. The President’s budget sets caps that shrink programs more each year, with a 4 percent cut in 2007 tripling to a 13 percent cut in 2011.

We recognize that if the Budget Resolution sets totals insufficient to meet need, services like Head Start, housing, nutrition assistance, juvenile justice, and job training will be cut. Please do all in your power to oppose domestic discretionary totals as low as the President’s.

Please oppose cuts in mandatory programs that reduce access to medical care, nutrition assistance, child care, and other vital social services. As you know, the FY 2006 budget cut nearly $39 billion in Medicaid, student loans, abuse and neglect services, child support enforcement and other essential help for low-income people. The President’s budget includes more cuts that will hurt low-income people, reducing Social Security benefits in some circumstances, denying Food Stamps to 300,000 people in low-income working families, making further cuts in Medicaid, and a $36 billion cut in Medicare that is so large it is hard to believe it could be made without threatening needed care. We call upon you to oppose reductions in services or increased costs for people in need.

Please oppose further tax breaks that are not fully offset with other revenues. It is simply wrong to sacrifice our children’s education, health care and housing for the elderly and for people with disabilities, child care for working families, and many other commonsense services to help finance more than a trillion dollars in tax breaks. The budget should be an expression of our moral and practical priorities. Curtailing – not increasing – tax breaks heavily weighted towards the top one percent (those with annual incomes over $400,000) in order to invest in education, health care, or other services is the right thing to do. The President’s budget prevents such a responsible choice – allowing tax breaks to advance even though there is no money to pay for them, but requiring domestic spending increases to be offset by other spending cuts. It is time to call a halt to unaffordable tax cuts.

Just as we have come to understand the far-reaching consequences of federal budget choices on the lives of millions, Americans across our nation are watching and hoping that the public interest, not special interests, will be served in Congressional action on the budget for next year. We hope you will respond by taking the lead to oppose unnecessary and harmful budget and tax cuts.


Instructions to Texas Pharmacies re Medicare Part D

The Texas Health and Human Services Commission posted instructions for Texas pharmacies regarding Medicare Part D and how to handle issues with the transition from Medicaid to Medicare for prescription drug coverage on its web site a few weeks ago. Today's email carries the following reminder:

As you know, Texas is providing Medicaid prescription drug coverage for low-income Texans who are inappropriately denied medications under the new Medicare drug plans. While this coverage is available now, it is temporary and will not be available indefinitely. It’s important to prepare for the eventual transition back to the Medicare prescription drug program. [emphasis added]
That's an important reminder to consumers and case managers as well. The message continues with information about various places to get help with problems in the transition:

Don’t know what plan the beneficiary is enrolled in…

  • Pharmacists can call Medicare’s dedicated pharmacy assistance line at 1-866-835-7595. Pharmacists can get information on a beneficiary’s enrollment and on how to contact the plan.

If the plan does not recognize a low-income beneficiary as being eligible for reduced cost sharing…

  • The pharmacist must contact the prescription drug plan (PDP) to request approval for low-income cost sharing. Each PDP should have an expedited process for low-income, cost-sharing approvals.
  • If pharmacist cannot obtain approval for reduced cost-sharing from the PDP, and the situation is urgent, or other steps have not worked, contact the Medicare pharmacy assistance line at 1-866-835-7595.

What to do if the prescribed drug is not covered on your plan’s formulary…

  • If this is a refill of a prescription previously paid for by Medicaid, the plan should automatically fill the first time it is submitted. The pharmacist must contact the PDP for approval through their expedited process.
  • If the PDP does not approve the dispensing of the drug, the beneficiary may request an exception from the plan. If this is necessary, report these problems to Centers for Medicare and Medicaid Services (CMS) regional office at 1-214-767-6401.

Beneficiaries who need assistance in selecting a plan can contact 1-800-MEDICARE (1-800-633-4227) or a local Area Agency on Aging at 1-800-252-9240.

A few more changes

Not so many, I suppose. I've been working on accessibility for the site in several ways. As I mentioned before, I created tables of contents for past years and stashed them on Texas AIDS Net. I've now started posting tables of contents for 2006. The list for January is up, and February (which isn't quite over yet) will be posted in a few days. I do, of course, need to get some link or other up on the sidebar to show visitors where to find them. That will mean, I think, messing with the archive listing, which is why I've dawdled on this chore.

The ClustrMap has been running for nearly a month now and is starting to show some bubbles. Comparing the number of visitors and their locations to what I'm finding in Tracksy (our method for tracking web visitors), the two don't match. One shows more visitors; the other shows more places. Huh? Arizona, Maryland, and DC don't show up on the map, and the big fat bubble in the middle of Texas must be me. I've found another mapping system, which I will look at a bit more in the next few days. If it's easy to install, you may see a new map in the sidebar. This map is more interactive, so you'll have to do some of the work.

I've been doing a bit more to promote Texas AIDS Blog by making sure that it's linked in assorted blog directories. At some point, I began to lose count of these. The newest link is in Syndic8. We've also printed up some push cards to begin, well, pushing a bit to remind colleagues and friends to subscribe to the blog. Feel free to do a little pushing yourselves if you know someone who might be interested in joining us.

Speaking of joining us, we hope to have a happy announcement of a new team member soon. Stay tuned for that.

The Tag Cloud was a fun idea, but it didn't work out. As you may recall, the hope was to have key words from the articles posted listed by frequency in a "cloud" of "tags." The program worked for a couple of days and then stopped. I contacted about this and got a very prompt and courteous response. However, they've grown faster than their capacity to handle the load and, while they're hoping for new funding (aren't we all?), they have not yet been able to get service back up to speed. I will be deleting the tag cloud shortly.

Also the FeedBlitz service was out for a couple of days last week. Combining that with the holiday at the beginning of the week, I saved up a bunch of posts. Hope you took the week to catch your breath!

Friday, February 17, 2006

Tracking condoms?

This from CDC prevention news:

NEW YORK: "New York to Put Its Stamp on Condom Giveaway" Los Angeles Times (02.15.06):: Ellen Barry

The New York City Department of Health and Mental Hygiene announced recently that it is planning to develop memorable packaging for condoms to help its free condom program track distribution. Since June 2005, when Health Commissioner Thomas Frieden launched the Free Condom Initiative to help prevent HIV/STDs, the city has distributed 1 million condoms a month. However, the generically packaged condoms are hard for clinicians to track in order to gauge the program's efficacy. "We wanted to develop condom packaging that was noticeable and memorable so that we can later track the effectiveness of our distribution. We also aim to use the packaging to promote condom use and awareness," said department spokesperson Sandra Mullin.

Now you know I would be all for condom promotion if you've been paying attention to this blog, so you'll forgive me if I ask "exactly how is it they plan to track these condoms?" I grok packaging to "promote condom use and awareness." (I offer my favorite slogan for their use.) But, what? Barcodes? Electronic sensors? Camera trucks rolling around, calling out "Show us your condoms"? And what are they tracking? If it's not enough to count how many condoms are left in the bowl vs. how many you put in the bowl, are they tracking movement, routes of distribution, how many condoms per person?

Yeah, you can't tell much from such a sort squib, and I really need to go read the whole article, but time is short, and it's way more fun to cross my eyes and be a bit contrarian for a moment. One result, as it happens, is to consider the fact that condom distribution is very complicated these days, isn't it? There's the whole pushback against the use and distribution of condoms. There's the near absence of free condoms in bars. There are (perceptually) fewer condom dispensers in women's rooms--again. The condom lobby, unlike the pharmaceutical lobby, is pretty much non-existent. And then there's the whole range of issues about actual condom use. Just making them available doesn't mean that they will be used.


OK, so I read the article. I'll stick with what I've written--it makes as much sense. (Well, they did get the pushback into the article, but the article was pretty much otherwise clueless about the issues--which leaves the reader clueless, no?)

Black Church Week of Prayer for the Healing of AIDS

The Black Church Week of Prayer for the Healing of AIDS, which takes place March 5-11, focuses on HIV/AIDS education and awareness highlighting the important role churches play in addressing the HIV/AIDS crisis. Each year, a growing number of Black congregations are supporting and caring for persons living with HIV/AIDS, developing AIDS prevention outreach programs, setting up HIV/AIDS ministries in the church and in the community, and establishing HIV testing facilities complete with staff and counselors knowledgeable about HIV/AIDS. This week of prayer calls upon Black faith communities worldwide to provide accessible services and resources for people who are infected with and affected by HIV/AIDS. The event is sponsored by the Balm in Gilead.

For more information go to:

[HAB news]

National Women and Girls HIV/AIDS Awareness Day

March 10, 2006 marks the first annual National Women and Girls HIV/AIDS Awareness Day. This day is set to raise awareness on the increasing impact of HIV/AIDS transmission on women and girls. In support of this event, the U.S. Department of Health and Human Services (DHHS) is hosting a National Women and Girls HIV/AIDS Awareness Day website that offers materials, including posters, flyers, and a fact sheet on women and girls and HIV, to assist in efforts to educate, motivate, and mobilize local communities in the fight against HIV/AIDS. The website also includes a list of events taking place across the country. Women and Girls HIV/AIDS Awareness Day is sponsored by the DHHS's Office on Women's Health.

For more information go to:

[HAB news]

Thursday, February 16, 2006

Facts about HIV and YMSM

HRSA has announced a new report from the RWCA SPNS (Special Projects of National Significance) program called: "Stigma and the SPNS YMSM of Color Initiative." The report discusses the role of stigma as a both a cause and a consequence of barriers to health care, especially for young men who have sex with men. Since the research study that is the basis for the report will continue until 2009, no final conclusions have been reached. However, the report does offer some useful insights into ways to overcome stigma in the health care setting.

In addition, the report provides some important "Facts About HIV and YMSM," which highlight the importance of this work:
  • In the United States, half of all new HIV infections are believed to occur in people under age 25; one-fourth occur in people under age 21.(1)
  • In 2002, 28 percent of all new diagnoses of HIV/AIDS were among 25- to 34-year-olds.(2)
  • Of the cumulative AIDS cases in 13- to 19-year-olds, 51 percent are among African-Americans and 20 percent are among Hispanics.(3)
  • Between 1998 and 2002, AIDS incidence increased by 16 percent among youth ages 13 to 24.(4) Given the time from seroconversion to progression to AIDS, which often spans 10 years or more, it is evident that a large portion of AIDS cases reported among people
    under age 30 resulted from HIV infection contracted in their teens.
  • Young people may be more vulnerable to HIV/AIDS than older people. Their social, emotional, and psychological development is not complete. Therefore, they have a tendency to experiment with risky behavior and alcohol and drug use.(5)
  • Several risk factors are associated with a higher risk for HIV among youth. For example, 1 in 7 adolescents in the United States live in poverty, 1 in 2 minority adolescents live in poverty, and nearly 5 million adolescents are uninsured.(6)


(1) Offi ce of National AIDS Policy. Youth and HIV/AIDS: 2000 A New American Agenda. Washington, DC; 2000.

(2) CDC. HIV/AIDS Surveillance Report. 2002;14:6.

(3) CDC. HIV/AIDS Surveillance in Adolescents. L265 slide series (through 2001). Slide 7. Available at:

(4) CDC. HIV/AIDS Surveillance Report. 2002;14:12. Table 3.

(5) Ellen JM. Adolescents and HIV. The Hopkins AIDS Report. 2002; May.

(6) Ryan C, et al. Adolescent health challenges: lesbian and gay youth care and counseling. Adolescent Medicine, State of the Art Review. 1997;8(2):208-10.

Wednesday, February 15, 2006

109th Congress, Second Session, schedules

I've updated the calendars over at Texas AIDS Net to show the schedule for the 109th Congress. The emphasis, of course, is on those times when Congress is not in session, when our congresscritters are (theoretically) available for visits in the home district.

During those periods, called "district work periods" by the House and just plain "not in session" by the Senate, the clever community advocate would make an effort to set up a meeting with the congresscritter in person. Another useful activity in these periods is to invite the congresscritter to visit a local facility so that they can put faces on the epidemic and see what's actually going on in the district. (Food, drink, and awards are sometimes helpful inducements for their attention, by the way.) These things sometimes take a while to set up, so it's not a bad idea to start checking the calendar and planning ahead.

There is some small difference between the Senate schedule and that of the House. I've taken to highlighting the Senate schedule in green on the Network calendars, the House in yellow. Also note that there are lots of one-week breaks early in the year, one long break in August, and an early adjournment "target" in October. The August break is traditionally considered to be an actual vacation time by folks who hang around Washington, DC, too much. (It gets hot and muggy there in August, so they think it's a vacation to come back to Texas in August???) The adjournment target is also just a "target." If they get their work done, they'll get out of school early. If not, that date could change.

Since, however, this is an election year, the House, at least, will be working pretty hard to hit that target. And speaking of election year, after the March primary, there should be some campaign activities around the state. These may also be opportunities to snag a quick visit with a member of Congress. If there are district forums, you can at least attend and ask a question.

Tuesday, February 14, 2006

2006 National Condom Week

It's here! My favorite awareness week of the year: National Condom Week. This is my favorite for two reasons:
  1. It's another opportunity to highlight the facts that HIV is preventable and that condoms are highly effective at preventing the spread of HIV, if used consistently and correctly.
  2. It gives me another chance to toss out my favorite slogan for condom promotion.

Why so, you may ask. In the first instance, the answer would be obvious were it not for the ongoing assault on condoms as an effective means of disease prevention. We all claim to want to prevent the further spread of HIV. It's just that some of us can't seem to stick with reality when we make that claim. To claim that one is trying to prevent infection at the same time one is disparaging one of the primary means of preventing that infection is hypocrisy of the highest order. Yet, we have many people who continue to do so loudly and in public. The result is that young people who are at risk for infection doubt the effectiveness of condoms and take their chances without them.

In the second instance, it's a chance to remember that sex is, among other things, fun. We don't need to take the fun out of it when we remind folks to "Wrap that rascal!"

So here's a wrap-up of National Condom Week activities in Texas:

The Coastal Bend AIDS Foundation will conduct community outreach and condom distribution during National Condom Week. The agency will also be distributing condoms in the office for walk-ins. For more information, please contact Xavier Perez at

Special Health Resources of Texas (SHRT) will team up with Health Horizons of Nacogdoches to provide a health awareness event in observance of National Condom Week on Wednesday, February 15 from 1-5pm. The event will be held at the Sweet Union Apartments in Jacksonville. The agencies will provide HIV/AIDS information, condoms, outreach activities, OraQuick rapid HIV testing, and syphilis testing free of charge. The goal is to reach all high risk individuals with a focus on African American women of childbearing age and African American MSM. For more information, please contact Gloria Hawkins (SHRT) at 903-234-0936, 1-877-234-0936, or; or Beverly Anders (Health Horizons) at 936-569-8240 or

Health Horizons of East Texas will take part in a community health fair and offer HIV/STD testing, perinatal educational workshops and condom information. The event will take place at the Mt. Olive Baptist Church, 1942 North Main St., in Jasper. For more information, please contact Beverly Chatman at 926-569-8240, ext. 21.

In recognition of National Condom Week, San Antonio College peer educators along with Hope, Action, Care (HAC), BEAT AIDS, and the San Antonio Metro Health Department (SAMHD) will hold a health fair at San Antonio College (SAC), 1300 San Pedro, on Monday February 13 from 9am-3pm in the student mall area. For more information, please contact: Beth Morrison (SAC) at 210-733-2175, Charles Whitehead (BEAT AIDS) at 210-212-2266, Robert Herrera (HAC) at 210-212-4235, or George Perez (SAMHD) at 210-207-2437.

And here are some web sites with more information for this year's observance:

And then, of course, there are all those slogans for National Condom Week.

So enjoy the week and have fun--consistently and correctly, of course.

SatCast on use of social networks for CTR

FYI - from MMWR Weekly, February 10, 2006 / 55(05);130

Social Networks: A Recruitment Strategy for HIV Counseling, Testing, and Referral Services

CDC and the Public Health Training Network will present a satellite broadcast and Webcast entitled, "Social Networks: A Recruitment Strategy for HIV Counseling, Testing, and Referral Services," on Thursday, April 27, 2006, beginning at 1 p.m. EDT. The 2-hour forum will cover the rationale for the use of social networks as a recruitment strategy for HIV counseling, testing, and referral services; the components of the social networks strategy; how to assess organization readiness for using the strategy; and available training and technical assistance. A panel of experts will answer viewer questions, which may be sent via fax during the broadcast or by e-mail after the broadcast.

Organizations are responsible for setting up their own viewing locations and are encouraged to register their locations as soon as possible so that persons who wish to view the broadcast can access information online. Directions for establishing and registering a viewing location are available at The broadcast also can be viewed live or after broadcast on computers with Internet and RealPlayer(r) capability through Videotapes and video CD-ROMs of the broadcast may be ordered by telephone, 800-458-5231.

House Public Health Committee to meet

The committee will hold its next public hearing on Wednesday, February 15, 2006, beginning at 10 a.m. in Capitol Extension E2.036. The committee will meet to hear invited testimony on interim charge 2:

Consider the state's role and approach to Medicare Part D, and evaluate the impact to Texas Medicaid clients.

Three invited panels will speak to the committee. The first panel includes a representative from the Centers for Medicare & Medicaid Services as well as Commissioner Albert Hawkins, HHSC. The second panel will include representatives from various pharmacies, and the third will include representatives from health plans. No public testimony will be accepted.

If you cannot attend the meeting, you can hear it via Livestream. You will need an up-to-date version of RealPlayer to hear it. (For some reason, the version I have always makes the committee members look like Smurfs. [waving hello to the Real folks and noting: it's free and it works, or it's crap--I'm just saying])

15th HIV/STD Conference

The DSHS HIV/STD Program has announced initial plans for the 15th HIV/STD Conference, which will be held in Austin, December 11-15, 2006. Key conference dates include:

May 31: Call for Papers and scholarship application deadline.
June 15-16: Conference Planning Committee meeting.
July 31: Scholarship applicants notified of selection outcome.
September 26: Conference registration and co-sponsorship deadline.

Early registration costs $190. Late registration costs $250.

New HIV/STD Community Resources Directory

After having perfected* the HIV/STD Community Resources Directory in its last edition, the DSHS HIV/STD Program has now abandoned printing the directory in favor of an online edition in Adobe Acrobat (PDF) format. [sigh] With that not-so-minor gripe, the directory continues to be an invaluable resource, not only for information and referral services, but also to understanding how the way that the community provides resources for this epidemic is changing.

In that sense, HIV/AIDS is becoming mainstream in Texas. There are fewer stand-alone ASO's than there were 15 years ago; more and more services are being provided through health departments and clinics that provide broader health services. There are, of course, advantages and disadvantages in those changes. If HIV becomes more integrated into health care in general, they may be more resources to apply to services and care. The other side of that coin is the risk that the special needs of the HIV/AIDS affected population will get lost in a bigger system.

The Community Resources page for the HIV/STD program provides links to lists of planning councils and other resources across the state. The Community Resources Directory link on that page leads directly to the PDF file (in case you lose this one).

*It's just my quirk, I'm sure, but I liked the looseleaf format. I could make notes and add pages. Nothing stops me from printing this one out, of course, except a substantial investment in toner, but this is one more little sign of the cuts in funding for services.

Friday, February 10, 2006

Senate committees receive interim charges

Lt. Gov. Dewhurst has appointed some new interim committees and issued interim charges for the Senate's standing committees (finally). Of interest to the Texas HIV/AIDS community are the following charges:


4. Review health care funding, focusing on the Medicaid program, Medicare Part D, hospital reimbursements and trauma and indigent care.

Health and Human Services--

2. Monitor state and federal Medicaid reform proposals, including their impact on the Medicaid program in Texas, as well as cost-containment measures in other states, and make recommendations for legislative action, as appropriate.

9. Study the current use of the 2-1-1 network to provide access to information on federal, state, and local resources. Examine and make recommendations on strategies that improve the coordination of service information and expand the availability of information on services currently provided by community and faith-based organizations.

10. Monitor the implementation of H.B. 2292, 78th Legislature, Regular Session, relating to health and human services. Focus on implementation of service coordination and consolidation efforts to assess the impact on service quality, while reducing costs.

H&HS Joint Charge with State Affairs Committee--

1. Examine and make recommendations, if necessary, regarding the state's role in regulating pharmacy benefit managers in the interest of consumer protection. Examine alternative methods of dispensing maintenance drugs, including mail service and retail pharmacies, and provide an analysis of the state’s role in protecting consumers.

2. Study how to reduce dependence on Medicaid for the provision of long term care by increasing use of long-term care insurance and health savings accounts. Include a study of options for increasing the use of advance planning tools, such as health care power of attorney and living wills, to ensure more effective decision-making regarding critical end-of-life and other health care decisions. Finally, study the feasibility of implementing innovative models of nursing facility services that encourage autonomy, choice and dignity of residents.

Reports are due by December 1. Hearings and meetings should start popping up on calendars soon.

CDC gets shrill

Remember that weather service report* that was issued prior to Hurricane Katrina where the normally bland National Weather Service guys, instead of citing wind directions and speeds and such, added two or three paragraphs about the level of devastation that could come from a Cat 5 hurricane? People who read it at the time thought that this was clearly evidence of a federal employee doing all he (or she) could to get someone's attention without actually grabbing shoulders and shaking.

I think the CDC just did that.

In today's Morbidity and Mortality Weekly Report, the CDC cites recent statistics from the 33 states that have had named HIV reporting for at least 4 years.
Of the estimated 157,252 diagnoses of HIV infection, the number of cases and diagnosis rates among blacks were higher than those for all other racial/ethnic populations combined. Among males, blacks had the largest or second-largest percentage of cases in every transmission category; among females, blacks had the largest percentage of cases in all transmission categories. Moreover, among both males and females, blacks represented the largest percentage of HIV/AIDS diagnoses in every age group.

On three separate occasions in the article, the CDC calls for a coordinated and comprehensive response to the racial/ethnic disparities shown by the statistics. By the third time, they're spelling it out:
A comprehensive national program is required to address the substantial racial disparities in HIV/AIDS diagnoses in the United States described in this report. To reduce disparities, partnerships must be enhanced among a broad range of persons and groups, including governmental agencies, community organizations, faith-based institutions, educational institutions, community opinion leaders, and the public.
Perhaps it's time for the rest of us to get a bit shrill and start talking about the policy changes that are needed to make a comprehensive response to this devastatation possible and the funding cuts that hamper the use of what tools we already have. When funding for proven prevention methods are cut and funding for wishful thinking is expanded, it's no surprise that we see such devastation. Katrina didn't give us a pass because funding for FEMA was cut. HIV in not going to decline just because we don't want to pay for effective prevention any more.

*I can't find the original announcement on the NWS site, but Think Progress quotes from it in their Katrina Timeline. Scroll down to August 28, 4 PM CDT to read the hair-raising (and accurate) prediction of the devastation that would follow Katrina.

Wednesday, February 08, 2006

More on SMART and not-so-smart

The Washington Post (sub. req.) has a story about the SMART clinical trial and treatment interruption. I started a post here that was intended to be a screed about not citing original sources in news stories, but the more I looked at David Brown's story, the more I liked it. So I bagged my first post and now look a bit more closely at what Mr. Brown has to say, which includes:
  • outline of the study's structure and results;
  • a taste of the controversy surrounding the study's outcome; and
  • a better taste of the human concerns that prompted the study and follow in its wake.

In a nutshell: HIV treatment is a burden. There are too many pills. There are too many side effects. If the HIV doesn't kill ya, some of those side effects might. What if you interrupt treatment when CD4 counts are up and viral load is low? Oopsie. Not such a good idea. "Well, maybe it still is," some argue. "I don't care," says one happy fellow on drug holiday. "Why not be smart about SMART (get it?) and at least continue following those who were in the trial to see what happens long term 'cuz there might be, you know, some useful information there," says the advocacy community.

Brown says it better, of course, so do read his article.

That still doesn't meet my need for original sources, so I went on a hunt. Here's the NIH's latest press release on SMART. Here's NIH's Q&A about SMART. Here are minutes (scroll down or search the page for "SMART") from the AIDS Research Advisory Committee (ARAC) meeting on May 24, 2004, which suggest that there may have been trouble in the study early on. Webcasts/podcasts from the 13th annual CROI about SMART (scroll down to "Oral Abstracts: Antiretroviral Therapy II: New Insights and Treatment StrategiesFeb 7, 2006 10:00 AM "). That ought to keep us busy for a while.

Panexa, for what ails ya

Yesterday was a busy day spent mostly out of the office and in meetings or scurrying around on assorted errands. It was, in the end, also a tad stressful. So maybe a second cup of coffee and this bit of a laugh will get me jumpstarted today.

I found the parody on the Houston Chronicle's MedBlog, by Leigh Hopper. If you're interested in an eclectic mix of health and medical information, check out her blog. If you're going cross-eyed from reading the package inserts for too many meds, read about Panexa for a nice change of pace:

PANEXA is a prescription drug that should only be taken by patients experiencing one of the following disorders: metabolism, binocular vision, digestion (solid and liquid), circulation, menstruation, cognition, osculation, extremes of emotion. For patients with coronary heart condition (CHC) or two separate feet (2SF), the dosage of PANEXA should be doubled to ensure that twice the number of pills are being consumed. PANEXA can also be utilized to decrease the risk of death caused by not taking PANEXA, being beaten to death by oscelots, or death relating from complications arising from seeing too much of the color lavender. Epileptic patients should take care to ensure tight, careful grips on containers of PANEXA, in order to secure their contents in the event of a seizure, caused by PANEXA or otherwise.

Monday, February 06, 2006

2006 National Black HIV/AIDS Awareness Day Events in Texas

From the DSHS HIV/STD Program:

The following is a list of 2006 National Black HIV/AIDS Awareness and Information Day (NBHAAD) events taking place around Texas on or around Tuesday, February 7, 2006. This awareness initiative is designed to mobilize African Americans around the country to get tested, get educated, and get involved with HIV/AIDS in their communities.

The HIV/STD Program wishes to thank all of the organizations that sent event information to the E-Update. Please note that this list is presented for informational purposes only; the Texas Department of State Health Services does not necessarily sponsor or endorse any of the events and/or activities listed.

The P.A.L.M. (Project AIDS/Land Manor) Center is setting up a table in the parking lot of Lucky Seven grocery store at 4005 Magnolia St. in Beaumont on Tuesday, February 7 in observance of NBHAAD. They will be providing condoms, free HIV testing, information, and literature. For more information, call Carla Baker at 409-832-0710.

The Coastal Bend AIDS Foundation prevention staff will be at Corpus Christi's North Side Manor doing HIV outreach on Monday, February 6 and testing on Tuesday, February 7 and Wednesday, February 8 in observance of National Black HIV/AIDS Awareness Day. North Side Manor is a predominantly African American community. For more information, please contact Xavier Perez at

The La Sima Foundation, Inc., Paul Quinn College, the Dallas County Health and Human Services' STD Division/Medical Mobile Clinic, and other community based organizations will be hosting a community forum in observance of National Black HIV/AIDS Awareness Day, on Tuesday February 7 from 2-4pm in the Grand Lounge at Paul Quinn College. The theme of this year's community forum is "Life After an HIV diagnosis..." The forum will highlight different aspects of living with an HIV diagnosis; from diagnosis, to work, to illness and eventually death. The Dallas County Medical Mobile Clinic will be providing free HIV and syphilis screening from 10am-5pm. During the community forum, a panel of people living with HIV/AIDS will discuss different aspects of living with HIV. Panelists include a person in recovery who went to treatment and graduated from a Texas university; a family with the mother and father living with HIV and a child born to an HIV positive mother; a young lady living with HIV, and a young man living with HIV. The panel will give valuable insight to life after an HIV/AIDS diagnosis. For more information about this event, please contact Cheryl Matatall (La Sima Foundation) at 214-941-1132 or Glenda Davis (Paul Quinn) at 214-302-3526. For more information about HIV or other STD screening, please call Monica Tunstle Garrett (DCHHS) at 214-819-2155 or 1-866-4EZCURE (439-2873).

In observance of NBHAAD, the Tarrant County Public Health (TCPH) Department's Adult Health Services unit will co-sponsor a health/job fair (1-5pm) and a candlelight vigil (7-9pm) on Tuesday, February 7 at the East Saint Paul Baptist Church, 5300 Oak Grove Road West, in Fort Worth. Roy C. Brooks, County Commissioner Precinct 1, will present a proclamation at the evening program. In addition, two community radio forums will air on Friday, February 3 at 12:30pm on KNON 89.3 FM, and Monday, February 6 at 12:30pm on KHVN 970 AM. Free HIV testing will be offered at the East Saint Paul event and at TCPH Adult Health Services, 1100 S. Main St., Ste. 1500, in Fort Worth. Collaborating agencies include: Wellness 4Life, Help Education Learning Project (HELP), AIDS Outreach Center (AOC), MHMR of Tarrant County Street Outreach Team (MHMR SOR), MHMR of Tarrant County Project Help First Plus (PHFP), North Central Texas HIV Planning Council, and City of Fort Worth Public Health Outreach. For more information contact Elaine Allen (TCPH) at 817-321-4800, John Reed (HELP) at 817-733-9993, Tracy Edwards (AOC) at 817-535-1113, or Eli Hernandez (MHMR SOR) at 817-569-5760.

The University of Texas Medical Branch (UTMB) will host a presentation on HIV/AIDS among young African American females ages 14-24 on Tuesday, February 7 from 11:30am to 1:30pm in the Levin Hall Dining Room (2nd Floor), located at 10th and Market Sts. in Galveston. Patrice Yarbough, Ph.D. will be the keynote speaker. This presentation is free and open to the public. For more information, call 409-747-0202.

Planned Parenthood of Houston and Southeast Texas is conducting free HIV testing on Tuesday, February 7th from 10am to 6pm at the Stafford Clinic, 3727 Greenbriar, Ste. 118 and at its Greenspoint Clinic, 11834 Airline Dr. For more information, call 281-494-5757 (Stafford) or 281-820-5305 (Greenspoint).

The YWCA Houston is planning a day of events to commemorate National Black HIV/AIDS Testing Day. On the morning of Tuesday, February 7, there will be free HIV testing, and a city proclamation that will lead into a community walk with the collaboration of the Houston African American State of Emergency Task Force and its partnering agencies from 9-11am. After the walk, the YWCA will continue testing at its center from 1-5pm. That evening, the youth of Motherland Inc. will put on a theatrical production. The day will conclude with a presentation for parents entitled "HIV 101." Gift certificates to Fiesta grocery mart will be offered to the first 40 participants that test on Tuesday. The YWCA Houston center is located at 3621 Willia St. For more information, call 713-868-9922.

Montrose Counseling Center's Risk Reduction Department will join with Houston's African American State of Emergency Task Force by attending the National Black HIV/AIDS Awareness Day media conference held at the YWCA (see above) on Tuesday, February 7 from 9-11am. The center's risk reduction specialists will then go to the Acres Home area (W. Little York and W. Montgomery) to provide HIV/AIDS education and testing from 12-2pm and at the Bonita Street House of Hope from 3:30-5:30pm. Contact Sally A. Huffer at 713-529-0037, ext. 324 for more information.

Special Health Resources of Texas (SHRT) will set up an HIV/AIDS information booth at Longview Mall, 3500 McCann Rd., on Tuesday, February 7. For more information, please contact Tyronda Jones at 903-234-8808 or

Health Horizons of East Texas will provide HIV testing and information on Tuesday, February 7 at the Lufkin Hope Center, 1204 Cain St. For more information, please contact Beverly Chatman at 926-569-8240, ext. 21.

Special Health Resources of Texas (SHRT) will observe NBHAAD by offering HIV/AIDS information and free OraQuick rapid HIV testing on Tuesday, February 7 from 1-6pm at the East Texas Border Health Clinic at 401 N. Grove, Ste. A, in Marshall. The target audience for this event includes youth, African American MSM, African American women, and Hispanics engaged in high risk behaviors. For more information, please contact Gloria Hawkins at 903-234-0936, 1-877-234-0936, or

BEAT AIDS will be offering HIV testing at the ACI (local bathhouse) on Tuesday, February 7 from 2-5pm and 7pm-12am. They will also offer testing at Skinny's from 1-4pm. Please contact Charles Whitehead at 210-227-4689 or for more information.

Ryan White CARE Act reauthorization

We've tried to stay out of the middle of the reauthorization wars. The targets move, the fog of war risks casualties from friendly fire, and any other military analogy you want to toss into this.

The issues are, however, perennial:
  • On the one hand, you've got some big cities with some fairly high numbers of people living with HIV. High concentrations of people with HIV place high demands on services. The solution is generally to create specialized facilities that can provide the quality of services needed and address the quantity issues. This requires a steady and dependable stream of funding.
  • On the other hand, you've got the dispersed rural areas and smaller urban areas that do not have the high concentration of cases, but also don't have the quality or quantity of available services. And the epidemic is growing rapidly in some of these areas.

These same issues were hashed over the last two times that the Act was reauthorized: How do you continue to provide services to the many folks in the urban areas who need them without slighting the growing number of folks in the less densely populated areas who also need them?

What's different now is that we no longer see the increases in HIV funding that we could count on in the past. Indeed, over the past five years, funding for both services and prevention have been cut. Funding for medications continues to increase, but at such a slow rate that there are serious waiting lists in many states.

Texas, of course, has it all. There are five "Title I cities": Houston, Dallas, Austin, San Antonio, and Fort Worth. These cities absorb most of the HIV funding that comes to Texas, either through their Title I grants or their access to medications through THMP. The rural areas and smaller cities have fewer cases, to be sure, but they receive much less in terms of funding for services and use a smaller proportion of the funds spent through THMP. Nonetheless, these Texans who do not live in the Title I cities also deserve quality care that is easily accessible.

Depending upon the proposal for how to reauthorize the Ryan White CARE Act, some part of Texas will benefit, some part will not. Whether there is a middle way remains to be seen.

Whatever it is, that middle way needs to be found soon. The President called for reauthorization in his State of the Union Address. Now the HIV/AIDS community's disagreement is cropping up in the media. It's time for one of those Unity Conferences to bring some unity.

DSHS reviewing mental health crisis response

The Texas Department of State Health Services, through a committee appointed by Commissioner Eduardo Sanchez, is holding a series of hearings around the state to gain public input regarding response during a mental health crisis. DSHS announced the hearings on February 3, and the first hearing is tomorrow. Talk about your fast turnaround!

Here's the schedule:

Feb. 7, 2006- San Antonio
Texas Diabetes Institute Auditorium, 701 S. Zarzamora, San Antonio, Texas 78207-5209
3:30 p.m. to 5:00 p.m. – Invited Testimony by Stakeholder Representatives
6:00 p.m. to 8:30 p.m. – Public Testimony
Persons requiring ADA assistance, may contact Lupe Morin, (210) 436-8018 or Lupe Torres, (210) 731-1300, ext. 352.

Feb. 15, 2006 - Austin
909 W. 45th Street, Bldg. 2, Public Hearing Auditorium, Room 164, Austin, Texas 78751-2803.
3:30 p.m. to 5:00 p.m. – Invited Testimony by Stakeholder Representatives
6:00 p.m. to 8:30 p.m. – Public Testimony
Persons requiring ADA assistance, please contact Gloria Ratley (512) 206-5816 or T.D.D. (512) 206-5330 at least four business days prior to the meeting.

Feb. 23, 2006 - Big Spring
Big Spring State Hospital Allred Bldg. #538, Auditorium/Room # 101, 1901 N. Hwy. 87 Big Spring, Texas 79720
3:00 p.m. to 5:30 p.m. – Invited Testimony by Stakeholder Representatives
6:30 p.m. to 8:30 p.m. – Public Testimony

Feb. 27, 2006 - Harlingen
Valley Baptist Medical Center – Woodward Conference Center 2101 Pease Harlingen, Texas
Contact for ADA assistance: Coni Diedrich Aguirre (956) 289-7130
3:00 p.m. to 5:30 p.m. – Invited Testimony by Stakeholder Representatives
6:30 p.m. to 8:30 p.m. – Public Testimony

New Federal Poverty Guidelines

The U. S. Health and Human Services Department has published new federal poverty guidelines (FPG) for 2006. These guidelines are used to determine eligibility and benefits for several programs, including Medicare Part D, Medicaid, and the Texas HIV Medication Program. The following list shows the FPG various family units. A "family of one" would be considered to be at 100% of the 2006 FPG if its income were $9,800 and so on.

Persons in family unit Poverty guideline
1 ............................................ $9,800
2 ............................................ 13,200
3 ............................................ 16,600
4 ............................................ 20,000
5 ............................................ 23,400
6 ............................................ 26,800
7 ............................................ 30,200
8 ............................................ 33,600
For family units with more than 8 persons, add $3,400 for each additional person.

The FPG for families in Alaska and Hawaii is higher.

FPG is not the same as FPL (federal poverty level), the latter being a unit used by the Census Bureau. In practice, FPG lags behind FPL.

As required by law, this update is accomplished by increasing the latest published Census Bureau poverty thresholds by the relevant percentage change in the Consumer Price Index for All Urban Consumers (CPI–U). The guidelines in this 2006 notice reflect the 3.4 percent price increase between calendar years 2004 and 2005. After this inflation adjustment, the guidelines are rounded and adjusted to standardize the differences between family sizes. The same calculation procedure was used this year as in previous years. (Note that these 2006 guidelines are roughly equal to the poverty thresholds for calendar year 2005 which the Census Bureau expects to publish in final form in August 2006.)

The Texas HIV Medication Program allows eligibility for services to clients whose income is at 200% of FPG. For a "family of one" in 2006 that amount will be $19,600.

Friday, February 03, 2006

Mapping our visitors

What a surprise! I've tinkered with the template again, this time adding a ClustrMap to show where visitors to Texas AIDS Blog are coming from. It's over in the sidebar. Although the actual mapping won't start until tomorrow, I expect that we will all need to be patient for a few days to give the little circles a chance to accumulate.

Here at the Network started doing some more serious tracking of visits and page views three months ago, generating all sorts of tables and statistics to see how we were doing. Our "target audience" is, of course, the Texas HIV/AIDS community. I was quite pleased to see that a plurality of our visitors did indeed come from Texas and that most of our visitors were interested in what we had to say about HIV/AIDS. There were, however, some interesting "outliers," if you will. Visitors have come from as far away as China; we've had several visitors from the Middle East. Salaam alaikum, ya'll. There was an astonishing number of searches for a particular Medicare prescription drug plan from Humana, which we happened to mention in one post.

As for Texas, we've had visitors from:

Abilene ~ Addison ~ Alvin ~ Arlington ~ Athens ~ Austin
College Station ~ Dallas ~ Denton ~ Floresville ~ Fort Worth
Greenville ~ Houston ~ Irving ~ Kingwood ~ Lubbock
Mission ~ Pampa ~ Plano ~ San Angelo ~ San Antonio
Sherman ~ Tampa ~Temple ~ The Woodlands ~ Tyler ~ Waco

See what I mean about local communities? Maybe the ClustrMap will give us a different perspective on "community."

Community Shares of Texas

Texas AIDS Network joined together with a small group of statewide non-profit organizations in 1991 and 1992 to form a workplace giving federation called "Another Way." In time, Another Way affiliated with Community Shares USA to expand its capacity and credibility, changing its name to Another Way Texas Shares.

Today AWTS changed its name yet again, becoming Community Shares of Texas. I supported the change, but I'm still a bit sad to see "Another Way" disappear.

Way back in the old days, a mere 15 years ago, there was no workplace giving federation for statewide organizations. The philosophy of charitable giving was--and largely still is--that local funds should support local organizations. Statewide organizations--like Texas AIDS Network, for a very fine example--do, however, provide services in local communities across the state. Indeed, they often provide their services in areas where no local organization exists for the community that they serve. And, of course, some issues are simply larger than a local community and must be considered in a statewide context. It made sense to try to create an organization that would allow statewide charities to seek support from individuals who wanted to donate to their work despite the fact that the charity itself might not have an office right down the block.

Way back in those old days there was another reason for wanting a new workplace giving federation, and that, indeed, was part of the origins of "Another Way" as both name and concept. There was, to be sure, already an existing and very large workplace giving federation that operated in most Texas communities both then and now. Yet, as we polled our member organizations in 1991 and 1992, we repeatedly heard the same story: AIDS service and prevention organizations were simply not accepted by that federation for funding. It became urgent to create a mechanism for those organizations to participate in workplace giving campaigns through a new federation.

Times change, and then, again, they don't. While the name of Another Way Texas Shares has changed, it still serves an important purpose for Texas AIDS Network and the Texas HIV/AIDS community. As a statewide charity, Texas AIDS Network is both proud to participate in an organization that shares its hopes and dreams for a better Texas and grateful for the support which Another Way Texas Shares has provided through the years by opening doors for us to many public and private workplace giving campaigns. Local AIDS organizations, such as Beat AIDS in San Antonio and the PWA Coalition in Houston, also benefit from the welcome mat that AWTS has so willingly placed out for us.

I have every confidence in the future of Community Shares of Texas and look forward to many more years of productively working together.

Thursday, February 02, 2006


The President's State of the Union Address on Tuesday included several references to HIV/AIDS. The practice of pundits and, these days, bloggers is to look for the code within the message to find out what is really being said. Here's what President Bush said:

To overcome dangers in our world, we must also take the offensive by encouraging
economic progress, and fighting disease, and spreading hope in hopeless lands. Isolationism would not only tie our hands in fighting enemies, it would keep us from helping our friends in desperate need. We show compassion abroad because Americans believe in the God-given dignity and worth of a villager with HIV/AIDS, or an infant with malaria, or a refugee fleeing genocide, or a young girl sold into slavery. We also show compassion abroad because regions overwhelmed by poverty, corruption, and despair are sources of terrorism, and organized crime, and human trafficking, and the drug trade.

In recent years, you and I have taken unprecedented action to fight AIDS and malaria, expand the education of girls, and reward developing nations that are moving forward with economic and political reform. For people everywhere, the United States is a partner for a better life. Short-changing these efforts would increase the suffering and chaos of our world, undercut our long-term security, and dull the conscience of our country. I urge members of Congress to serve the interests of America by showing the compassion of America.

. . .

A hopeful society acts boldly to fight diseases like HIV/AIDS, which can be prevented, and treated, and defeated. More than a million Americans live with HIV, and half of all AIDS cases occur among African Americans. I ask Congress to reform and reauthorize the Ryan White Act, and provide new funding to states, so we end the waiting lists for AIDS medicines in America. (Applause.) We will also lead a nationwide effort, working closely with African American churches and faith-based groups, to deliver rapid HIV tests to millions, end the stigma of AIDS, and come closer to the day when there are no new infections in America. (Applause.)

The early passages seem more self-congratulation (and defense) than policy proposal, but the last paragraphs contains some red meat for the HIV/AIDS community. It is backed up with a whole fact sheet from the White House that outlines what these words mean to the President and his administration. The initiatives include:

  • Taking action against HIV/AIDS at home
  • A plan to meet key domestic HIV/AIDS challenges
  • Taking action against HIV/AIDS abroad

That the President addressed HIV/AIDS in the U.S. is significant, since all of his attention has been focused, it seems, on Africa and other parts of the world. While that has gone on, we've fallen behind in funding for services, prevention, and medications. We've also lost ground on policy in several areas. Now that we have his attention (so to speak), let's hope that we don't regret it.

[Hat tip to Reader C for the fact sheet.]

Support Medicare reform

Consumers Union is running a campaign to get HR 752 out of committee and moving through the legislative process in congress. The bill would create a simplified alternative to the current mess of programs being offered through Medicare Part D by creating a Medicare-run pharmacy benefit program. Their campaign is being conducted in the name of "seniors," but, of course, it will help people living with HIV/AIDS, too. Here's the message that CU wants you to have:

Right now, a bill that would help simplify Medicare for seniors and save taxpayers money is bottled up in a House committee. We need your help to bring it to a vote! 218 members of Congress must sign a petition about 80 have signed so far.

Tell your representatives to give seniors a break and bring the Medicare bill to a vote!

The Medicare drug benefit is extremely confusing for seniors, due to the scores of private plans from which they must choose. HR 752 will help make the Medicare drug benefit much simpler by offering an alternative a Medicare-operated drug plan that will have predictable premiums, co-pays and a dependable list of covered drugs.

HR 752 also will save taxpayers significant amounts of money by allowing Medicare to negotiate the best possible drug prices for seniors.

Support HR 752 today! Visit:

The link takes you to a page that provides more information about the campaign and a handy email form to send a message to your congressperson. For more information about the bill itself, click here.

Texas Representatives who have already signed on:

Lloyd Doggett
Al Green
Gene Green
Eddie Bernice Johnson
Sheila Jackson-Lee
Solomon P. Ortiz
Silvestre Reyes

You can drop them a "thank you" through their web sites. If your congressman is not on this list, do go send them a message through the CU website.