Texas Hospital Association

Health Care Advocate: Aug. 25, 2022

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THA Calls for Legislative Investments to Bolster Struggling Workforce

THA continued stressing the top priority of every hospital today – workforce – during Tuesday’s hearing of the Texas Senate Committee on Health and Human Services.

Jennifer Banda, THA’s senior vice president of advocacy and public policy, testified on the COVID-19 pandemic’s impact on what was already a hospital workforce shortage. The committee was examining an interim charge directing it to study the pandemic’s impact on the health care workforce in both acute and long-term care, as well as identify ways to increase the state’s health care workforce pipeline.

While regulatory waivers, state-supplied workforce personnel, and hospitals’ own competitive moves to keep their in-house staff helped facilities during the worst surges of the virus, the pandemic “was and continues to be an enormous and costly impact to our health care system because a hospital’s workforce is its largest expense,” Banda said. And workforce costs in 2022 are up 33% since the pandemic began, she noted, with health care worker burnout a continuing concern.

Banda told the committee that to make a long-term difference, the Legislature can take steps to increase the pipeline of Texans “who want to take care of patients in all health care settings across the state,” including by increasing investments in:

  • The Nursing Shortage Reduction Fund to provide more funding for faculty enhancements and clinical training. Nearly 16,000 qualified applicants were turned away from Texas nursing schools in 2021, according to state figures. Banda said increasing the current allocation to the nursing shortage fund would help enroll those applicants in nursing school.
  • The Nursing Faculty Loan Repayment Program, as well as opening it to part-time faculty as well as full time; and
  • The Loan Repayment Program for Mental Health Professionals.

THA also advocated for Texas to continue its “strong investments” in graduate medical education and in the Physician Loan Repayment Program, which encourages doctors to practice in health professional shortage areas or to provide Medicaid and Children’s Health Insurance Program Services. Banda also asked the committee for a directed evaluation of the state’s allied health care workforce to figure out how to increase the supply of those professionals, including respiratory therapists, clinical lab specialists, and paramedics. (Jennifer Banda, J.D.)

Federal Judge Blocks HHS’ Abortion-Related EMTALA Guidance

On Tuesday, a federal judge in Lubbock issued an injunction agreeing with the state of Texas in a case challenging the Health and Human Services Department’s (HHS’) guidance purporting to remind providers of their existing obligations under the Emergency Medical Treatment and Active Labor Act (EMTALA) to provide abortions regardless of state law. The guidance was issued after the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade and ended federal constitutional protection of the right to an abortion. In response to Dobbs, HHS issued guidance directing hospitals and doctors, under EMTALA, to provide abortions under certain circumstances and indicated that they must follow federal, not state, law when doing so.

The guidance indicated that it merely restates existing guidance for hospital staff and physicians regarding their obligations under EMTALA, in light of new state laws prohibiting or restricting access to abortion. The state of Texas and two organizational plaintiffs filed suit against various HHS officials seeking to prohibit HHS from enforcing EMTALA in accordance with the guidance. The suit claims the guidance unlawfully requires abortions in situations where Texas outlaws them, thus infringing on Texas’s right to legislate and enforce its own abortion laws.

Finding HHS lacked the authority to issue the guidance, the judge issued an order prohibiting enforcement of that guidance – both as to when an abortion is required and EMTALA’s effect on state laws governing abortion – within the state or against the organizational plaintiffs. The order came on the day before Texas’ abortion “trigger law,” found at Chapter 170A of the Texas Health and Safety Code, took effect. Chapter 170A imposes criminal and civil penalties for most abortions performed in Texas at any stage of gestation, as well as the potential for loss of licensure for any physician performing an illegal abortion.

THA is analyzing the court’s opinion and its impact and will provide further information as warranted. (Steve Wohleb, J.D.)

Register for THA’s Quality & Behavioral Health Conference

Registration is open for THA’s 2022 Quality & Behavioral Health Conference on Oct. 13-14 at the Sheraton Austin Georgetown Hotel & Conference Center. This two-day conference offers two distinct tracks of education for both quality and behavioral health care professionals. Members can view the agenda, reserve a hotel room and register for the conference on THA’s website here. (Lindsay Thompson)

Continue Submitting Monthly Reports of COVID-19 Federal Funds, Expenditures to HHSC; Next Deadline Sept. 1

Hospitals should continue to submit monthly reports of federal money received during the COVID-19 public health emergency to the state as required by Senate Bill 809 and Rider 143, 87th Legislature. The monthly report form is available here. All hospitals are required to submit a monthly report regardless of whether they received provider relief funds that month. If no federal funds were received, enter $0 for all questions regarding the funding. More information is available at the HHSC Provider Finance Communications webpage under the Monthly SB 809 / Rider 143 COVID-19 Reporting subheading, including steps to take if you are delinquent in submitting any forms or if you believe your reporting submission status is listed in error. Deadlines recur on the first of every month. (Anna Stelter)

CDC Hosting Webinars on Changing COVID-19 Data Collection Process

With a transition coming up in mid-December for the way the federal government collects COVID-19 hospital data, the Centers for Disease Control and Prevention is hosting a series of trainings on its National Healthcare Safety Network (NHSN), which will replace TeleTracking. The CDC is breaking up its training webinars on NHSN into three topics, with multiple opportunities to attend:

  • NHSN transition preparation – Tuesday, Aug. 30, from noon-1 p.m. CT, and Wednesday, Aug. 31, from 2-3 p.m. CT;
  • Data submission: Overview of webform and CSV file upload – Tuesday, Sept. 13, and Tuesday, Sept. 20, both from noon-1 p.m. CT;
  • Data submission: Overview of bulk submission – Wednesday, Sept. 14, and Wednesday, Sept. 21, both from 2-3 p.m. CT.

Register for any of these webinars on CDC’s Transition of COVID-19 Hospital Reporting website. More information on the transition is available in this recent American Hospital Association bulletin. (Jennifer Banda, J.D./Carrie Kroll/Karen Kendrick)

Nominate Texas’ Best for THA Distinguished Awards

It’s time to nominate outstanding hospital programs and people for THA’s annual distinguished awards program. Each year, THA honors those whose contributions elevate the quality of health care in the Lone Star State. Visit THA’s awards page for a summary of each honor. To nominate someone, select the appropriate award, then click the Nomination Information link from the sidebar on the right. Complete the online form and attach supporting materials. Entries for the awards are due by 5 p.m. Sept. 30. If you have any questions about the nomination process, contact Sharon Beasley by email or at 512/465-1030. (Sharon Beasley)

Last Call: Fill Out THA Member Survey by Aug. 31

To gauge members’ feedback on THA’s efforts, priorities and work, THA recently launched its 2022 Member Satisfaction Survey. This brief survey asks members to rate THA’s effectiveness in communications, advocacy and resource development, with an optional extended survey at the end.

The deadline to take the quick, 11-question survey has been extended to Aug. 31. All responses are anonymous and confidential. Members can access the survey here. (Amy Rios)

Register Now for Texas Health Law Conference

Registration is now open for the annual Texas Health Law Conference, held each year by the health law section of the State Bar of Texas. This year’s conference is set for Oct. 9-11 at the AT&T Executive Education and Conference Center in Austin.

The annual event will provide timely information on health law trends in light of the COVID-19 pandemic, as well as continuing legal education. It’s a popular draw for attorneys who either work in the health care sector or advise private-practice health care clients, as well as in-house counsel organizations.

Early-bird pricing is open until Aug. 31. Visit the conference website to register or to find out more. (Steve Wohleb, J.D./Cesar Lopez, J.D.)

Texas Register Highlights

The Texas Health and Human Services Commission (HHSC) published a final rule at Title 1, Texas Administrative Code, §353.8, concerning Certification of Managed Care Organizations Prior to Contract Awards. The rule was adopted without changes to the proposed text as published in the May 13 issue of the Texas Register (47 TexReg 2821). The rule implements Senate Bill 1244, passed in last year’s regular session of the Texas Legislature. It sets out the process HHSC will use to determine whether a managed care organization (MCO) satisfies the certification requirements under state law. The new rule sets forth that HHSC does not award a contract to an MCO that does not receive certification and outlines an appeal process for an MCO to appeal a denial of certification. The rule is effective on Aug. 28, 2022. (Aug. 19)

The Texas State Board of Pharmacy (TSBP) adopted amendments to Title 22, Texas Administrative Code §283.4, concerning Internship Requirements; and §291.33, concerning Operational Standards. The amendments are adopted without changes to the proposed text as published in the June 24, 2022, issue of the Texas Register (47 TexReg 3625 and 3628). The internship amendments clarify that a person graduating from a college/school of pharmacy will only be credited the number of hours obtained and reported by the program. The amendments are adopted under §§551.002 and 554.051 of the Texas Pharmacy Act (Chapters 551-569, Texas Occupations Code). The changes to operational requirements update a term, correct a citation reference, and remove the requirement for oral patient counseling on a new prescription to be provided in person, a requirement which had been temporarily suspended by the governor’s office. The amendments are effective on Aug. 24.

TSBP also finalized the repeal of Title 22, Texas Administrative Code §305.1, concerning Pharmacy Education Requirements. The repeal was adopted without changes to the proposed repeal as published in the June 24, 2022 Texas Register (47 TexReg 3652). The repeal of §305.1 removes professional practice degree program standards that are redundant with standards specified elsewhere in board rules. The repeal is effective Aug. 24, 2022. (Aug. 19) (Steve Wohleb, J.D.)

Federal Register Highlights

The Centers for Medicare and Medicaid Services (CMS) published a proposed rule establishing requirements for mandatory annual state reporting of the Core Set of Children’s Health Care Quality Measures for Medicaid and Children’s Health Insurance Program (CHIP), the behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid, and the Core Sets of Health Home Quality Measures for Medicaid. The proposed rule would also establish compliance requirements. According to CMS, despite the significant role that Medicaid and CHIP play in America’s health care system, this regulation would require states, the District of Columbia and territories to report on measures of the quality of health care provided to Medicaid and CHIP beneficiaries. Comments must be received no later than 5 p.m. on Oct. 21. (Aug. 22)

The Substance Abuse and Mental Health Services Administration (SAMHSA) Advisory Committee for Women’s Services (ACWS) published a Notice of Meeting to be held on Sept. 6, 2022. The meeting will include discussions on assessing SAMHSA’s current strategies, including the mental health and substance use needs of women and girls. Additionally, ACWS will be addressing priorities regarding the impact of COVID-19 on the behavioral health needs of women and children and directions around behavioral health services and access for those populations. The virtual meeting is open to the public. Those who are interested may present data, information or views, orally or in writing, on issues pending before the committee. Written submissions should be forwarded to the contact person by Sept. 1. Oral presentations from the public will be scheduled at the end of the meeting. Those interested in making oral presentations are encouraged to notify the contact person on or before Sept. 1. Up to five minutes will be allotted for each presentation. The meeting may be accessed via telephone or web meeting. To obtain the call-in number and access code, submit written or brief oral comments, or request special accommodations for persons with disabilities, you must register online here or communicate with SAMHSA’s Designated Federal Officer. (Aug. 24) (Steve Wohleb, J.D.)