TMATestimony by Thomas J. Kim, MD, MPH
House Appropriations Subcommittee on Article II
Department of State Health Services
Feb. 12, 2019
Chair Davis and Committee Members, thank you for the opportunity to testify on behalf of the Texas Medical Association and the Texas Public Health Coalition. My name is Thomas Kim, MD; I’m an internist and psychiatrist here in Austin and a member of TMA’s Council on Legislation.
Today, I’m testifying in support of fully funding the Department of State Health Services in order to ensure that the critical public health needs of all Texans are met.
We particularly appreciate the proposed $8 million towards immunizing both children and adults, as we experience the consequence of Texas’ low vaccination rates on our collective well-being. Right now, DSHS is investigating a number of measles cases, with Texas being one of 10 states reporting cases in the last month alone.[1]These outbreaks highlight the agency’s key role in protecting Texans’ health as well as importance of funding its exceptional budget items.
This notion of public health reminds me of the recent privilege I had to hear our current Surgeon General speak on the matter. Framed as a call to action, the Surgeon General spoke of public health as the people’s health recognizing that a healthy people is a good in of itself, but also ensures and advances our economic prosperity and national security.[2]
Please permit me to highlight the following exceptional items.
Exceptional Item 1. Safeguard the State Public Health Laboratory
Responding to highly contagious agents, like measles, requires testing that is accurate, reliable, and rapid. But beyond measles, the state’s laboratory also tests for Zika, influenza, HIV, rabies, foodborne pathogens, environmental contaminants and more, and is often the only testing source in the state.
Another critical service of the state laboratory is to screen for genetic disorders. Early recognition can often prevent significant intellectual and physical disabilities if not save the life outright. We ask for full support of the Texas Newborn Screening program serving over 400,000 of our newest Texans born each year. We further ask that the committee consider correcting budget rider language that diverts funding support and instead establish a screening preservation account to ensure that this life altering and saving program remains.
Exceptional Item 3: Combat Maternal Mortality and Morbidity
TMA applauds this committee and the Texas Legislature in making maternal mortality and morbidity a statewide priority during last session. We ask this committee to continue supporting DSHS in these efforts, so that it may sustain its momentum in TexasAIM, public awareness, and preventive measures to save mothers’ and babies’ lives.
Exceptional Items 4 and 7: Improve Texas Vital Records and State Public Health Data
Our state’s vital records provide critical data needed by the state, local jurisdictions, and families. We depend on public health data to identify actionable trends with chronic diseases, behavioral health issues, injuries, and environmental risks. Without this data, we are incapable of navigating a path towards realizing better health and wellness.
Exceptional Items 6 and 8: Control Tuberculosis Infectious Diseases
Tuberculosis (TB) rates in Texas remain higher than the national average, and we must continue to prioritize the control of this highly contagious disease. TMA supports DSHS’ TB control strategies to bolster surveillance, investigation, and response efforts as well as make direly needed updates to the Texas Center for Infectious Disease. This will require a fully functional electronic state surveillance system, i.e. NEDSS, adequate staffing, and testing capabilities at both the state and local levels. We all also rely on DSHS’ Infectious Disease Response Unit to provide medical support in the event of high-risk, high-consequence infections like Ebola or influenza.
Ensure Base Budget Funding for DSHS
Finally, TMA supports the agency request to maintain existing services required to implement key public health activities critical to the peoples’ health. This includes fully funding the base budget for prevention services to address Texas’ biggest killers such as heart disease, cancer, and stroke.[3] Tobacco use is the No. 1 preventable cause of these chronic diseases and premature deaths in Texas. We appreciate this committee in eliminating the DSHS rider that limited media advertising for tobacco prevention. Ultimately, more needs to be done to safeguard against early exposure to nicotine, which has been complicated by the rise of e-cigarette and vaping products, particularly among our children.[4]
In conclusion, investing in our people’s health through the DSHS now will avoid higher costs in the future. TMA recognizes the importance of a strong public health infrastructure and is ready to work with this committee towards continuing to improve the health of all Texans.
Thank you for your attention and I am happy to answer any questions at this time.
[1] https://www.cdc.gov/measles/cases-outbreaks.html
[2] https://www.surgeongeneral.gov/priorities/index.html
[3] DSHS Vital Statistics, 2015
[4] Texas Department of State Health Services (DSHS), YRBS Data Brief: Tobacco Products, November 2018, https://www.dshs.texas.gov/chs/yrbs/attachments/November-2018-Data-Brief.pdf
86th Texas Legislature Letters and Testimonies
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