Support Funding for Critical DSHS Services

Testimony by Philip Huang, MD, MPH, for TMA, Texas Pediatric Society, and Texas Academy of Family Physicians

House Appropriations Article II Committee
Feb. 18, 2015

Good afternoon, chair and members of the committee. I want to thank you for the opportunity to testify on behalf of the Texas Medical Association, the Texas Pediatric Society, and the Texas Academy of Family Physicians. I’m Dr. Phillip Huang, medical director and health authority for the Austin/Travis County Health and Human Services Department, and member of TMA’s Committee on Infectious Disease.

We understand the difficult decisions you face as you work to achieve a balanced budget in the coming months. From the perspective of the patients we care for, we know it is daunting to craft a budget that reflects concern for the physical and mental health of Texans who must rely on strong public health support. While we recognize the Department of State Health Services has many complex responsibilities, my comments today focus on three of the department’s exceptional items.

Exceptional Item 1: Maintain Fiscal Year 2015 Service Levels

We strongly encourage your support for continuing the funding of the state’s tobacco cessation and chronic disease prevention programs. Each Texas household already pays hundreds of dollars each year for the costs of smoking in our state. These funds will continue DSHS’ minimum tobacco cessation and prevention activities including Texas’ Quitline counseling, nicotine replacement therapy, media campaigns, and other programming targeted to young people.  

Exceptional Item 3: Preparedness for Infectious Diseases and Disaster Response   

We support Exceptional Item 3 to increase the agency’s and state’s capacity to investigate and respond to infectious disease outbreaks. Physicians are first in identifying and treating foodborne illnesses and infectious diseases. We believe with our mobile and diverse population, it is more important than ever that we have strong physician leadership and presence at DSHS, as well as strong surveillance and epidemiologic support for timely alerts and communications on infectious diseases and disasters. This is critical information physicians and public health authorities need to manage potential and emerging health threats. We believe this exceptional item request addresses some of the gaps identified in recent emergencies in Texas and also some of the priorities identified by the Task Force on Infectious Disease Preparedness and Response. Many physicians were on the front lines in these emergencies. Texas physicians were directly involved in the treatment, investigation, and monitoring of Texas residents exposed in the Ebola emergency in Dallas. Texas physicians were involved in West, at our Texas border, and in responding to multiple smaller outbreaks — such as the increased measles and pertussis cases that have been occurring in Texas now for several years.  

From our work and experience in public health emergency management and infectious diseases, Texas physicians can fully support the agency’s request to fund improvement in our state’s laboratory network capacity and enabling the state to maintain a stockpile of personal protective equipment. We urge you by rider to ensure practicing physician have input in planning and administering this stockpile. We also support the state’s proposal to make available:

  • continuing simulation training and education for health care professionals and first responders on infectious diseases, 
  • A trained rapid medical response team to support local infectious disease emergencies, and  
  • Grants to enable local communities to plan for hazardous chemical emergencies.    

Exceptional Item 9: Prevention of Chronic Disease

With one out of three Texas schoolchildren (10-17 years old) already obese, we know that in the next two decades chronic conditions associated with smoking, overweight, and obesity will crush our health system and cost Texas’ economy more than $30 billion in higher insurance costs, absenteeism, and other costly effects.[1] In addition, the growing number of older Texans during the coming decades will have dramatic consequences for our public health system, as well as for health care financing and delivery, informal caregiving, and pensions. Older adults and more patients with chronic disease will further strain resources in Texas cities and counties, where basic public health concerns (e.g., food safety and control of infectious diseases) may not be addressed adequately in every community.  

Texas physicians every day care for patients with disabling and costly chronic illnesses. It is essential that DSHS continue its chronic disease programs and that funding be supported to expand some of the department’s most effective community-based projects as well as new activities that we believe will help reduce the likelihood of exacerbating a chronic illness and its related costs.  

Exceptional Item 9 funding will enable communities to conduct evidence-based activities that promote physical activity and healthy eating. We believe these efforts have the greatest potential for slowing the proportion of overweight and obesity in Texas children and adults.  

Additionally, funding of this exceptional item will allow more communities to participate in projects for tobacco prevention and cessation, and diabetes prevention and control. We are pleased to see that the agency plans to address costly and potentially preventable hospitalizations with community pediatric management projects and by enabling more counties to participate in the department’s nationally acclaimed community-based preventable hospitalizations effort.

In closing: Physicians have long understood that we must continue to invest in our state’s public health infrastructure to address costly health concerns and to prevent paying an even higher price tag in the future. Texas’ exploding population in our large and mobile state means we need to ensure that we not only maintain our current public health system, but also continue to seek improvements and enhancements to address the problems raised as our state and population continue to grow. As you review the DSHS’ request for funding for 2016-17, we offer our assistance in your work and will continue to encourage you to support our public health system and workforce, and our capacity to respond to old and new public health threats and concerns. 



[1] Texas State Comptroller. The Hefty Price Tag of Obesity in Texas. 2014. Access online at

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