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April 11, 2000     (512) 463-0300

San Antonio Welcomes Health Services Public Hearing

SAN ANTONIO - The Senate Committee on Health Services held a public hearing Monday, April 10, 2000 in the San Antonio City Council Chamber. The committee is holding hearings throughout the state to study interim charges issued by Lt. Governor Rick Perry. Members of the committee include Senators Jane Nelson of Flower Mound, serving as chair, Mike Moncrief of Fort Worth, Jon Lindsay of Houston, Frank Madla of San Antonio, and Drew Nixon of Carthage.

First on the agenda for Monday's hearing was Charge two. This says the committee shall inventory and analyze the amount and type of research related to pharmaceuticals, biotechnology and genetics currently occurring in Texas to maximize the benefits to Texans in these fields. The Committee is also examining the ethical implications associated with pharmaceuticals, genetic and biotechnology research.

A presentation was given by a panel of experts: Dennis Perrotta, PhD, Texas Department of Health; Fernando Guerra, MD, Bexar County Medical Society/Texas Medical Association; and Max Burke, Vector Research Inc. The presentation related to chemical and biological terrorism, that is, the use of chemicals, living pathogenic microbes, or toxins produced by microbes or plants as agents of force for terrorism objectives. Chemical-biologic agents are attractive because they are cheap and generally easy to synthesize or grow.

Historically, this type of terrorism dates back to 600 B.C. when the Athenians contaminated a river with skunk cabbage to give defenders violent diarrhea. In Medieval times cadavers were catapulted over castle walls to spread disease. More recently, the World Trade Center Bomb was laced with cyanide, but the cyanide dissipated when the bomb went off. Types of chemical agents include: nerve gas, vesicants, phosgene and cyanide. Types of bioagents are: viruses, bacteria, fungi and parasites. Types of biological toxins include: botulinum, ricin, SEB and T-2 Mycotoxins. The use of airborne agents is the most likely and the most effective. Food borne agents are less likely, while waterborne is the least likely because they are not effective in large areas. Some of the recommendations given to the committee are: improve disease surveillance, establish practice response plans, increase training on diagnoses and improve the preparation of resources like hospitals, antidotes and the disposition of the dead.

John Nemunaitis M.D. and Charles Cunningham, M.D., are with the Mary Crowley Medical Research Center at Baylor University Medical Center in Dallas. John Howe, M.D. is with University of Texas (U.T.) Health Science Center at San Antonio, and Ben Rodriguez, is with Management and Business Advisors. Tom Kowalski, from the Texas Healthcare and Bioscience Institute gave testimony on the advances in genetics.

Next on the agenda was Charge one. This calls for the committee to evaluate the changes in the Medicaid system since the beginning of Medicaid reform. The committee is to assess reform efforts in light of the original goals for implementation of Medicaid managed care, as well as the impact of Medicaid managed care on patient outcomes, cost implications to the state. The committee is also to specifically evaluate the ability of Medicaid managed care organizations and the state to manage chronic illnesses and develop specific strategies for disease management for certain populations.

Invited testimony was given by Commissioner Don Gilbert of the Texas Health and Human Services Commission; Josie Williams, M.D., Texas Health Quality Alliance and Beverly Koops, M.D., Texas Department of Health. One of the main points repeated in both invited and public testimony was that doctors, patients, state agencies and hospital administrators must be involved together in decisions about managed care.

The committee then received testimony on Charge three, in which it will review the type, amount, and use of patient-specific medical information, including prescription data and current statutory and regulatory provisions governing its availability. The report shall explore whether statutory and regulatory provisions are consistent and adequately enforced.

Charge four was next on the agenda. The committee is studying the impact of the degree of choice granted physicians to administer immunizations to children under the Vaccinations For Children (V.F.C.) program. The committee shall focus on the health and fiscal implications to the public and private sectors of granting choices to physicians where more than one manufacturer produces the same vaccine at an equivalent price.

Invited testimony was taken from Sharilyn Stanley, M.D., Associate Commissioner, Texas Department of Health; Fernando Guerra, M.D., representing the Bexar County Medical Society and Texas Medical Association; and Seguin physician Karen Perryman, M.D.

Testimony relating to Charge five was next. The committee is to assess the preparedness of the Texas health care workforce to meet the health care needs of Texans beyond the year 2000, including how to retain Texas-trained medical personnel. The committee is evaluating the availability of health care providers in rural and urban areas.

Nancy Ackley representing the Texas Nurses Foundation, and Dr. Antonio Furino from the Center for Health Economics and policy at U.T. Health Science Center at San Antonio; and Dianna Prachyl representing the Texas Dental Hygienists' Association

Charge six was the last charge covered in the hearing. The committee is monitoring the implementation of Senate Bill 445, 76th Legislature, Regular Session relating to the Children's Health Insurance Program.

Invited testimony was given by Vicki Perkins representing Christus Santa Rosa Hospital.

The committee recessed subject to call of the chair. The next meeting is tentatively scheduled for a date to be announced in May.

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