Senator Carona's Email Update
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EMAIL UPDATE

June 6, 2008

What's New . . .

Lt. Governor David Dewhurst appointed Senators Kip Averitt, Craig Estes, Tommy Williams, and Juan "Chuy" Hinojosa to the Joint Committee on Use of Sales Tax on Sporting Goods. It is important to note that the tax is not in addition to the 6 1/4 percent state sales tax rate, but is a dedicated portion of that tax. When the Legislature first dedicated a portion of the revenue generated by the sales tax collected on certain sporting goods, it was intended to fund state parks. In recent years, however, the revenue has been diverted to other areas of the state budget. The Committee is charged with examining how much of the tax revenue should be appropriated for its original purpose, which items are eligible for the tax, and what, in addition to state parks, should be funded with that revenue. Senator Averitt will serve as co-chair of the panel along with Representative Harvey Hilderbran.

The Texas Commission on Environmental Quality approved rules relating to the recycling of used computers. The recycling program was created by HB 2714, which the Legislature passed in 2007; the bill requires computer manufacturers to provide a convenient means for consumers to recycle their old computers. Although I appreciate TCEQ's work in developing the rules, I am disappointed the TCEQ Commissioners did not adequately address recyclers who export used computers to other countries by requiring those recyclers to abide by the laws of the recipient country, since this may prove to be a loop-hole around the spirit of the law.

With the 2009 Legislative Session approaching, the number of interim hearings is increasing, as committees of the House and Senate work to address their interim charges. On June 16th, two Senate committees are holding hearings in the Dallas area: the Senate Jurisprudence Committee, 10:00 a.m. in the Fort Worth City Council Chamber, 1000 Throckmorton; and the Select Committee on Public School Accountability, 12:00 Noon in Room 102, UNT Dallas Campus, 7300 Houston School Road. For a complete list of upcoming hearings, you may visit the House or Senate websites.

The Transportation and Homeland Security Committee held a hearing in McAllen, Texas, on May 20th to hear testimony on a range of issues. At the hearing, the Committee heard testimony on recent border security efforts from Steve McCraw, Director of the Governor's Office of Homeland Security. The Committee also received an update on driver license security from the Department of Public Safety, as well as a report on repairs to more than 500 structurally deficient bridges in Texas. Additionally, the Committee addressed media expenditures by the Texas Department of Transportation to promote highway projects. The Committee's next hearing in this area will be on Tuesday, August 12th, in Irving.

Prior to each legislative session, state agencies submit a Legislative Appropriations Request (LAR), which is an outline of that agency's requested budget for the upcoming biennium. This month, Governor Rick Perry and the Legislative Budget Board have directed each state agency to limit their LARs for the 2010-2011 biennium to current spending levels plus an amount equal to the two percent pay raise state employees will receive in 2009. Additionally, each agency was also directed to submit detailed information on how they would reduce spending by an additional 10 percent.

Focus . . .

This month I would like to take a closer look at Parkland Health and Hospital System, the largest health care provider in Dallas County. Originally founded in 1894, Parkland has grown into one of the largest hospital systems in the nation with over one million patient visits a year. On an average day, Parkland will care for 650 inpatients, perform 40 surgeries, treat 400 people in the emergency department, fill 15,000 prescriptions, deliver 45 babies and perform over 22,000 laboratory tests.

Chapter 281, of the Texas Health and Safety Code requires Dallas County to provide for the establishment of a hospital or hospital system to furnish medical aid and hospital care to the indigent and needy persons residing in Dallas County. To meet this state mandate, Dallas County created the Dallas County Hospital District, which operates as Parkland Health and Hospital System. Parkland is governed by a seven-member Board of Managers who are appointed by the Dallas County Commissioners Court. Each member is appointed for a two-year term and may serve no more than three terms or until they are replaced.

Parkland's operating budget for fiscal year 2008 is $1.026 billion. As a public hospital, the greatest component of this budget is local property taxes which comprise just under 40 percent of Parkland's revenue. Payment for patient care, including reimbursement from Medicaid, Medicare and commercial insurance, accounts for 35 percent. Government reimbursement under various state and federal programs comprises nearly 14 percent; and the remaining revenue comes from various other sources and interest on the hospital's investments. Parkland is debt free and is one of the most financially stable public hospitals in the country. The system also is actively supported by the Dallas philanthropic community, and it recently received a $10 million donation from the Harold Simmons Foundation, which funded the construction of the Simmons Ambulatory Surgical Center.

Because of its statutory mandate, Parkland is Dallas County's "safety net" provider. As such, Parkland provides care to the uninsured, individuals covered by Medicaid, and indigent patients. In fact, only nine percent of Parkland's patients have private insurance; 45 percent have no insurance; and 45 percent have Medicare or Medicaid, each of which has a lower reimbursement rate than commercial insurance.

One of the greatest challenges facing Parkland is the amount of uncompensated care provided by the hospital system. Uncompensated care refers to patients who are self-pay or qualify for charity care, and the shortfall after payments from Medicaid. Parkland provides services to uninsured Dallas County patients who qualify for tax-supported care under a charity program called Parkland HEALTHPlus. The cost of uncompensated care in excess of payments received during fiscal year 2007 was approximately $512 million and $478 million in fiscal year 2006. Although some view Parkland as an attractor for people who have come to this country illegally, it was designed to meet the medical needs of Dallas County residents. It is Parkland's policy to pursue all available funding sources to pay for medical services provided to unfunded patients so that the cost of care is not borne solely by Dallas County taxpayers.

Although Parkland is only mandated to be the safety net provider, the hospital has gone beyond that charge to become one of the premier health care providers in the nation. Parkland Hospital is a Level I Trauma Center, which treats approximately 50 percent of all trauma cases in Dallas County. Additionally, Parkland houses the region's only American Burn Association Certified Burn Center, which offers comprehensive services from emergency treatment to intensive care to rehabilitation and outpatient follow-up to more than 500 patients each year.

As Dallas County has grown, demand for Parkland's services has grown as well. From 1980 to 2007, the annual number of births and outpatient visits have more than doubled with most other services increasing by at least 50 percent. During this time frame, the only decline was in emergency room visits, which is because of Parkland's focus on preventive and primary care.

In 1987, Parkland developed the Community Oriented Primary Care Program (COPC). This program operates 11 community-based clinics throughout Dallas County, as well as a number of school-based clinics, women's clinics and a homeless outreach medical service. The program focuses on community health, preventive care and wellness and has demonstrated reductions in emergency room visits and hospitalizations. By providing medical homes to residents of the community, Parkland can reduce the burden of illness, while preventing patients from needing more costly emergency or inpatient medical care. These efforts result in a healthier community and reduce the cost of care.

Parkland also serves as the primary teaching hospital for the University of Texas Southwestern Medical Center, one of the top medical schools in the country. All physicians at Parkland are faculty members or residents from UT Southwestern which allows patients to receive cutting-edge medical care. As a result of this relationship, more than half of the doctors in the Dallas area have trained at Parkland.

Because of Parkland Hospital's status as a Level I Trauma Center, a premiere burn treatment center and a teaching hospital, it has achieved excellence beyond its requirements and provides Dallas County taxpayers who are treated there with the highest level of care in the country.

Did You Know . . . ?

If you are interested in learning about more vacation opportunities within Texas, visit www.traveltex.com. At the site, you will find information on activities and events throughout the state, an online trip planner, and a guide to hotels and other lodging, as well as a complete listing of Texas parks and campgrounds. Texas is among the top three most visited states in the United States, and tourism generates an estimated $54 billion and 521,000 jobs for our state annually.

In Closing . . .

I will always appreciate hearing from you. If I or my staff can be of assistance to you, please do not hesitate to contact us.


Sincerely,

John Carona
State Senator - District 16
http://www.carona.senate.state.tx.us/

Capitol Office District Offices
P.O. Box 12068
Austin, TX 78711
512-463-0116
800-662-0334
512-463-3135 (fax)
john.carona@senate.state.tx.us
8080 N. Central Expy.
Suite 1440, LB 44
Dallas, TX 75206
214-378-5751
214-378-5739 (fax)
5401 N. Central Expy.
Suite 300
Dallas, TX 75205
214-521-3884
214-953-1886 (fax)

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