Health Care Summit Reveals Bexar County Challenges

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A young boy curiously admires the Mission Reach during its grand opening ceremony on Oct. 5, 2013. Photo by Iris Dimmick.

A young boy curiously admires the Mission Reach during its grand opening ceremony on Oct. 5, 2013. Photo by Iris Dimmick.

Over the summer months I convened several meetings and working groups from the healthcare industry to put together position papers on challenges we face in Bexar County. Their work culminated in the Bexar County Healthcare Summit, which I hosted Sept. 20 with Mayor Ivy Taylor. We had fruitful discussions with more than 300 healthcare leaders and practitioners, but our work is just beginning. From this summit we have crafted an aggressive legislative agenda that we are now asking our local delegation and the healthcare community to champion when the Legislature convenes in Austin in January.

Some of the issues we addressed this week are the very same challenges we faced in 2001 when then-Mayor Ed Garza and I held the first healthcare summit: reducing access to sugary sodas by school-age children, parity in mental health services, addressing the needs of our uninsured and underinsured, and sustaining our local healthcare workforce.

But that’s not to say we haven’t made progress over the past 13 years. From the 2001 summit we formed the Fit City initiative, which is still going strong today and helping families address their fitness and health challenges. We are seeing great success with community wide fitness events like Síclovía, which more than 65,000 people are anticipated to take part in this Sunday.

A girl rides a Razor scooter down the center of Broadway Street during Síclovía 2013. Photo by Iris Dimmick.

A girl rides a Razor scooter down the center of Broadway Street during Síclovía 2013. Photo by Iris Dimmick.

We’ve made headway with addressing the mental health needs of our community, particularly with those who come into contact with the criminal justice system through our jail diversion programs and specialty treatment courts.

And even though Texas did not participate in the expansion of Medicaid, the “Enroll SA, Get Bexar Covered” coalition — a community effort that has become a national model — successfully enrolled 76,000 residents in affordable health insurance plans during the first open enrollment period for the Health Insurance Marketplace.

BCHS-Texas Healthcare Financing enrollment surge

So looking ahead we know there is still a lot of work to do. We broke our recommendations from this most recent summit into four distinct areas: public health, higher education and the healthcare workforce, healthcare coverage, and behavioral health and criminal justice.

The public health discussion spearheaded by Dr. Thomas Schlenker, director of public health for the San Antonio Metropolitan Health District, focused on:

• Requiring practitioners to administer syphilis tests during the third trimester of pregnancy to reduce the problem of mothers passing along the infection to their newborns.

• Supporting legislation that would improve the state’s ability to collect and monitor immunization data, and move to an “opt-out” instead of the current “opt-in” consent for taking part in the registry. Such monitoring would allow health professionals to better identify vaccination needs and reduce the risk of disease outbreaks.

• Supporting appropriations to educate communities about the link between sweetened drinks and obesity, and reducing access to sugary beverages in schools.

The higher education and healthcare workforce track addressed:

• Legislation to encourage and support Hispanics and military veterans to enter healthcare professions.

• Increasing funding to alleviate the shortage of baccalaureate-prepared nurses, advanced practice registered nurses and nursing faculty.

• Supporting the Texas Higher Education Coordinating Board’s request for some $30 million in additional funds for programs to increase the number of medical residents and reduce physician shortages in Texas.

Bexar County’s Felony Drug Court Magistrate Ernie Glenn and Center for Health Care Services Director Leon Evans led the discussion on behavioral health and criminal justice with these initiatives:

• Seek legislation to equalize funding for local mental health authorities to the statewide average of $15.37 per capita. The Center for Health Care Services, Bexar County’s local mental health authority, receives $13.71.

• Support additional state appropriations to fund Bexar County drug courts, which divert drug and alcohol abusers from jail into treatment under judicial supervision. This reduces long-term costs and recidivism among this population.

The largest mountain we have to tackle, though, is expanding coverage for our uninsured and underinsured in a Republican-led state. The healthcare coverage working group came out in support of the so-called Texas Way Program, “a uniquely Texan, private market-based coverage program” to extend coverage to low-wage working Texans. An $8.2 million state investment would leverage $6 billion in federal funds over the first three years. It is my hope that rather than looking at this as a hand-out for the working poor, our Republican leaders in the legislature will instead see it as a program of great economic importance.

We know that we cannot legislate this community into better health, but by coming together as healthcare professionals, elected officials and community leaders we can create the types of programs that will help our residents have access to the care they need and help them get better control of their health. When we have healthier bodies and lifestyles, we not only feel better, we eliminate public health epidemics like diabetes and childhood obesity and become an even stronger community.

*Featured/top image: A young boy curiously admires the Mission Reach, one of the city’s many burgeoning recreational  options, during its grand opening ceremony on Oct. 5, 2013. Photo by Iris Dimmick.

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