As Texas Blows

State health officials, searching for solutions to Texas’ multibillion-dollar budget shortfall, have set their sights on these neonatal intensive care units, or NICUs, which they fear are being overbuilt and overused by hospitals eager to profit from the high-cost care — and by doctors too quick to offer pregnant mothers elective inductions and Caesarean sections before their babies are full term.

The Texas Health and Human Services Commission (HHSC), under the gun to find cost savings in the state’s huge Medicaid program, suggested last month it could save $36.5 million over the next biennium by better managing which babies end up in NICUs, curbing so-called convenience C-sections and refusing to finance elective inductions before the 39th week of pregnancy.

http://www.texastribune.org/texas-state-agencies/health-and-human-services-commission/maternity-wards-nicus-face-budget-scrutiny/

From PDiddie's blog:

"Hundreds of thousands of job cuts" in Texas
The only question is how Rick Perry will attempt to blame President Obama for it.


Deep reductions in a House committee's budget proposal would cost Texas hundreds of thousands of jobs through the next two years, according to an analysis released Thursday.

"I've been trying to say this for over a year. I've been trying to say how our economy was bad, and how our shortfall was going to be affecting Texas, and nobody seemed to believe me. But I think reality is probably setting in on that," said House Appropriations Committee Chairman Jim Pitts, R-Waxahachie. "I really didn't realize the extent of the total employment. It's pretty shocking."

"How about if we blame it on the Great Collapse of 2008?"


The Legislative Budget Board's "dynamic economic impact" analysis of the Appropriations-approved budget proposal predicts 271,746 fewer jobs in 2012, and 335,244 fewer in 2013, compared to what total employment would be if revenues and spending remained stable. That includes government and private-sector jobs.

The analysis cautions that the estimate "does not imply the state will lose that many jobs from our current employment level upon enactment" of House Bill 1, as approved by the Appropriations Committee this week.

Instead, it shows Texas would have fewer jobs compared to a scenario in which state spending remained constant relative to the current budget.
Bad economy blamed

"Since available revenue for the 2012-13 biennium is predicted to fall well below that amount, in large part due to the national economic recession, many of these job losses can be attributed to the steep downturn of the Texas economy during the past several years," the LBB analysis said.

"But I thought Rick Perry said Texas was doing great. Back during the campaign season. How about if we say it just won't be that bad, like Dewhurst has been saying?"


Senate Finance Committee Chairman Steve Ogden, R-Bryan, said the state needs to address the structural budget deficit caused by the 2006 school finance plan, but disputed the LBB's job loss estimates.

"We have a trillion-dollar economy in Texas. There's 9.5 million people employed in Texas. I don't think by any stretch of the imagination the budget that we pass is going to cost many - it may result in hundreds of job losses, but I would really doubt if it would be thousands," he said. "Most economic analysts would say that if you raise taxes to increase government spending, you'll cost jobs."

Travis Tullos, regional economist with Austin-based consulting firm TXP, described the LBB's prediction as a "worst-case scenario, generally speaking."

"If you were to increase taxes sufficient to cover that deficit - whatever that ends up being - that would be more deleterious to the economy than going ahead with a more conservative budget," Tullos said.

Vertigo-inducing spin. My question: how's that voting-a-straight-Republican-ticket-for-the-past-sixteen-years thing workin' out for ya?

Blog "Letters From Texas" rolls its collective eyes about the word games played by the Republicans in charge as they announce their Senate subcommittee to find "non-tax revenue." Earth to Republicans: if we used to own it, but now the government owns it, it's a tax

In case you are wondering, I am following your Texas posts and appreciate them.

Thanks. I know others are following. I have to chronicle this train wreck. It's like some stupid novel no one would believe.

AUSTIN — Texas lawmakers facing a projected shortfall in the next two-year budget have discussed plans to hire private medical vendors to care for state prisoners.

House Corrections Committee Chairman Jerry Madden of Richardson on Tuesday told the Austin American-Statesman that he’s discussed a draft plan. Madden says he’s spoken with a senior adviser to Gov. Rick Perry, Mike Morrissey.

Specifics have not been released.

Personal disasters
Fortunately, Texas is not facing a natural disaster of the sort Perry warned of, but the budget delivered by the Appropriations Committee to the House this week portends some personal disasters.

School budgets would be severely cut, costing the jobs of thousands of teachers and support staff. At least 8,000 state workers would lose their jobs.

Cuts in Medicaid and the Children's Health Insurance Program would mean that many elderly people would be turned out of nursing homes and many children of low-income families would lose access to pediatricians.

This is where the homey metaphor comes into play.

My family is fortunate enough to have a savings account for use as our own rainy day fund.

If I were to lose my job and therefore my health insurance and one of my children developed a disease, here is the response suggested by those who don't want to tap the state's rainy day fund:

"I'm sorry, darling. I need to hold on to my savings. Maybe I'll take you to the doctor next time you get sick."

(Some politicians have suggested we take our sick children to the emergency room. They are apparently unaware that emergency rooms treat emergencies, not diseases.)

For contributors, it's OK
Of course in the real world we would all use our savings to take our sick children to the doctor.

In the past, the Legislature and Gov. Perry were not so protective of the rainy day fund.

In 1990, they drained it of its entire $26.5 million for public schools. Two years later they took most of it for prisons.

Since then they have gone to the rainy day fund for another $1.6 billion for public schools and more than half a billion each for Medicaid and the Teacher Retirement System.

And while Perry is adamantly against using the fund for schools or medical care this year, in 2003 he persuaded the Legislature to allocate $295 million for his Texas Enterprise Fund and in 2005 another $100 million for his Emerging Technology Funds.

He has used both to subsidize business start-ups for major campaign contributors.

But sick kids who chose to be born to low-income parents? Let them suck it up.

rick [email protected]

How many guns in texas? $10.00 licence fee for each gun.

You don't fill Texas coffers off of gun owners and rich people. That's the oldest rule in the book.

The real role model is North Dakota, which is doing what Ellen Brown recommends in owning its own bank while simultaneously somehow not allowing envirowhacks and libtards to shut down oil operations.

This is all very personal to me. My mother in law is in a nursing home. She has, among other things, dementia and cannot walk at all. Medicaid just sent a notice that after careful review of her status, she will shortly be removed from the roll of recipients. Meaning, she will get ejected from the nursing home. None of her children are able to care for her at home. Sure, they will try. But, my wife has a bad back and both arms have had surgery, making her too weak to lift over five or ten pounds. Her sisters and brother are no better off.

We ain't talking North Dakota. We are talking Texas, where voters have voted straight ticket Republican for 16 years. Kinda hard to see how someone like even you can blame liberals for the current mess.

$10 per unit
17.4 firearms per adult here in Texas. ... (2003 statistic)
19 mill adult pop (14 and over)
323 mill guns

You do the math.

I have driven past gun shows. Since 2003, the number has likely doubled, based on the frantic "buy as many as possible before Obama takes them all away" frenzy.

When questioned by my sister in law, the nursing home said that the letter is part of the ritual and that we have no cause for concern. Screwy as it sounds, I am taking their word for now.

Her (The nurse) words are worth the paper they are written on.

Hopefully there is more information given to your sis inlaw that makes you feel hopefull.

Their bread and butter lies in keeping patients. They already are faced with possible budget cuts that could force them out of business.

AUSTIN — The Texas House voted 98-49 Sunday night to slash funding for public schools, nursing homes and college financial aid in a dramatic show by Republicans elected on a limited-government message in the face of a massive budget shortfall.

"This budget is the result of the worst recession that anybody in this room has ever experienced," said House Appropriations Committee Chairman Jim Pitts, R-Waxahachie. "I know this bill is not perfect. … This budget does fund the essential services of state government within our state revenue."

The $164.5 billion budget for the next two years - which would trim $23 billion from current state and federal spending - would have a disastrous effect on key services, said outnumbered Democrats, joined by some leading Republicans. Legislators voted along party lines, except for two Republicans who voted against it - David Simpson of Longview and Aaron Pena of Edinburg.

Republicans, whose House supermajority was built with a huge freshman class, contend that living within current revenues is fiscally prudent and what voters demanded last November. But some, including Pitts, also suggest that a search for non-tax revenue makes sense.

Democrats speak out
Democrats lined up Sunday night to speak against House Bill 1, acknowledging their inability to prevail in a chamber where Republicans hold a 101-49 supermajority.

"This is a choice," said Rep. Joaquin Castro, D-San Antonio. "Eighty thousand kids are not going to get their scholarships and grant money because of this bill. Forty-three thousand people are going to get kicked out of nursing homes or denied nursing home entrance because of this bill; 335,000 Texas jobs are going to go away because of this bill."

Rep. Harold Dutton, D-Houston, likened the situation to entering a burning house and finding schoolchildren in one room and elderly people in another.

"I finally figured out that I couldn't save anybody in this fire," Dutton said, asking why lawmakers chose not to put out the fire by addressing the state's underlying fiscal problems.

Rep. Sylvester Turner, D-Houston, who voted "present," said, "This budget is not worthy of the Texas House of Representatives."

Rep. Patricia Harless, R-Spring, said her vote reflects a simple message to her constituents: "We balanced the budget with the revenue we had, and we didn't raise any new taxes or fees."

Still, she shared the concerns of her Democratic colleagues who savaged the budget because of its severe cuts to education, health care and human services.

"I have those exact same concerns, too," Harless said. "I'm sad that we're having to cut teachers. I am sad that the nursing homes are going to be closed and that seniors will be harmed in some way. But it's a tough economic time, and we have to spend the money we have, and if we don't have the money, we can't spend it."

Proposed spending is expected to grow in the Senate, which will now take up the measure. Senate budget-writers are working on a proposal that appears likely to contain $10 billion more in state-related revenue to soften the cuts. Differences between the chambers would be worked out in negotiations.

The state faces a shortfall estimated at $27 billion through the next two years when taking into account money needed to continue current services to a growing population. The House has voted to bridge about $4 billion of that gap with cuts this fiscal year and a $3.1 billion dip into the rainy day fund, which is all Gov. Rick Perry said he is willing to spend.

Castro cast blame on Perry, saying, "I don't think that we should be trapped by the ideology of one person with political ambition, trapped by the political ambition of one governor."

In an interview, Rep. Charlie Geren, R-Fort Worth, said, "Some of the cuts, especially in public education, are going to be devastating. … The governor has said he's not going to sign a budget that reaches into the rainy day fund any further. So at first glance, this is the type of budget that's going to have to come out of the House.

"I think that as soon as it does, we're all going to be just overcome with the phone calls that we're going to get from people in our districts to encourage us to take a closer look," he said.

Pitts promised his colleagues that he would work to improve key areas.

'False choices'
Democrats have said repeatedly that they've been forced to make "false choices" because of GOP revenue restrictions. They, along with some Republicans, say the cuts should be tempered with more spending from the rainy day fund, which is expected to contain about $9.4 billion, and moves such as eliminating some tax exemptions.

"We aren't really accomplishing anything except re-shuffling chairs on the Titanic," said Rep. Jessica Farrar of Houston, leader of the House Democratic Caucus.

She added that the burden would be shifted to local governments, which would be forced to turn to local taxes without the benefit of federal matching funds that the state gets when it spends money.

House Bill 1 would short public schools by nearly $8 billion of money they'd otherwise get under current funding formulas. An education staffer said it would be the first cut in the Foundation School Program since its 1949 enactment.

The proposal falls more than $4 billion short of covering Medicaid caseload growth. It would cut Medicaid reimbursement rates to nursing homes and other health care providers, raising the prospect of nursing home closures.

Geren predicted the final product will fall in between House and Senate proposals.

"It's easy to run the first time saying I'm not going to increase any fees or any taxes or whatever, until you've seen this first budget and see what it does to your local districts," Geren said. "And I think that they're all, new members and old members alike, having to really consider, is this what's best for Texas?"

Austin bureau reporter Gary Scharrer contributed to this report.

So far, only the poor and public education face the harsher cuts.

What a surprise. I'm afraid Texas of where Texas will be in 20 years when the results of decisions made today are bearing fruit. The sad thing is that Texas is so gifted with natural resources that they could have a lot with just an average tax rate.