TMA: Continue to Invest in Texas' Public Health Infrastructure

TMA Testimony

House Human Services
House Bill 2510 by Rep. Four Price 

Monday, March 23, 2015

Good morning, Chair Raymond and members of the committee. I want to thank you for the opportunity to testify on behalf of the Texas Medical Association. My comments today are limited to Article 4 of House Bill 2510, which relates to the state’s core public health system. We thank Rep. Price for his leadership and for these recommended changes regarding our public health system. 

Inventory of Public Health Duties
We endorse the activities specified in HB 2510 to complete an inventory of the roles, responsibilities, and capacity of our state, regional, and local services and programs. We have a fragmented public health system that is supported and managed by diverse local health departments, districts, and local health authorities. We believe most communities are uninformed about their public health services nor do they know if these are effective in supporting their community. This inventory will help inform local officials so they can better plan and address gaps and barriers to protecting their residents. We support the collaboration with the Public Health Funding and Policy Committee created by Senator Nelson; however, we ask that you recognize that the composition of this body is currently limited. We would like to see this inventory process also include other stakeholders at both the community and the statewide levels. This would ensure a more public and transparent process.  

Public Health Action Plan
The development of state priorities for our public health services delivery system is an important first step in planning for improvements to protect our residents. The intention to set goals and identify priorities for each region of the state recognizes the diversity and differences in our state. This will help ensure these regional plans represent approaches appropriate to the local population and will make it more feasible to measure and assess improvements. The requirement to update the state action plan every two years will ensure this is a public document that will continue to change as our population needs expand.

Physician Leadership in Public Health
We previously have expressed our great concerns about the need for strong physician presence and leadership at the Department of State Health Service (DSHS). The commissioner of the Texas state health agency is also a national leader and policymaker. We ask you to ensure statutorily that Texas can continue to provide this level of leadership in our state and country, as did Dr. David Lakey. Over the last decade, we have seen a significant decline in the number of physicians working in public health at DSHS. This is also occurring in many local health departments. It concerns us particularly because disease transmission and disease preparedness are increasingly global concerns, as we saw with the Ebola scenario in Dallas. It is now more important than ever that community physicians be able to work with trained public health physicians who understand the intersection between medicine and population health. We urge you to ensure the commissioner over infectious diseases is indeed a physician. 

We want to express our appreciation to Rep. Price, and members and staff of the Sunset Advisory Commission, who have worked to understand the complex responsibilities of the Department of State Health Services. The core functions of a state health agency are to monitor and assess the population’s health and work to plan, implement, and manage barriers and threats to health. 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. Thank you for the opportunity comment, and I am happy to answer any questions.  

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Last Updated On

June 20, 2016