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87th Texas Legislative End-Of-Session Report

 
 
As we pull our minds out of Session Mode and review the last five months, we’re caught somewhere between astonishment and relief. At the close of the interim, Texas was staring down one of the most challenging social, economic, and political periods in modern American history. We watched COVID-19 rage around the globe and a controversial Presidential election play out, and anxiously waited to determine the capacity of the 87th Legislature. Our mid-2020 revenue update from Texas Comptroller of Public Accounts (CPA) Glenn Hegar was grim, projecting a fiscal 2021 ending shortfall of almost $5B and a severe reduction in General Revenue-Related (GR-R) funds. State agencies and higher education institutions were directed to identify savings within their budgets that would reduce total GR and GR-R appropriations by five percent, and budget writers were charged with leveraging every available dollar to help Texans facing a global pandemic, a recession, and mass unemployment.
 
Amidst all of this, the 87th Texas Legislature got to work. House District 21 Rep. Dade Phelan was sworn in as Speaker of the House with broad support, and his endorsement from Gov. Greg Abbott suggested some much-needed harmony among state leadership. January’s revenue estimates from the Comptroller were surprisingly optimistic, projecting a much smaller shortfall and a little more flexibility in GR-R. We were reminded to be cautious, but able to exhale and enjoy Texas’ economic resilience. The Governor announced his priorities for the session and the Senate lowered the threshold of votes required to bring bills to the floor in a way that (almost magically) extended precedence to Republican legislative priorities. House and Senate committee assignments mitigated possible discord between the chambers by establishing Republicans as Chairs of nearly every powerful committee. Really, the biggest uncertainty (COVID-19 aside) was when we would receive updated Census numbers. Redistricting committees scheduled hearings and sought stakeholder feedback with little more than a hypothetical to work with. It was uncomfortable and hectic, but “Better the devil you know…”.
 
February’s winter storm was the devil we hadn’t met. The grief visited upon Texas homes and the realization that our carefully designed system didn’t protect them inspired grief in everyone else. We all wanted accountability, but no one seemed to know who was in charge. Finger-pointing was executed so freely we thought someone would lose an eye. The Public Utility Commission (PUC) of Texas and the Electric Reliability Council of Texas (ERCOT) were both—voluntarily or otherwise—gutted of their leadership. A flurry of bills was drafted and debated, and we appeared on the verge of dramatically changing Texas’ energy market structure. From a strictly logistical perspective, we were already short on time—bills were still awaiting committee referrals when Winter Storm Uri swept through Texas. Legislators, many of whom experienced the consequences of the storm firsthand, became consumed with finding a fix. For about a month Uri was the lead in every story, and you were an energy expert whether or not you’d ever intended to be. Between the infrastructural damage, grid-wide debt incurred by the emergency pricing protocol, the funds lost due to load-shed, and more, the storm created so much financial devastation that a recovery seemed impossible. The crises of the day expanded and multiplied, delaying the legislative process and further taxing a budget process that was already filled with difficult decisions.
 
Though seemingly impossible, by the end of April—we had House and Senate versions of a two-year budget in hand. Both documents incorporated the five percent reduction to agency budgets, stayed within constitutional spending limits, and honored last session’s commitments to education and public health in addition to prioritizing public safety. The chambers’ symbiosis was enhanced by a May revenue estimate from the CPA projecting increased ending balances for this biennium and the next, as well as improved conditions for the Economic Stabilization Fund (ESF or “Rainy Day Fund”) for 2022-23. The Conference Committee’s work was accepted by both chambers in the final week of May, and but for the contention regarding distribution of federal funds, it was a conflict-free process. HB 2, the supplemental appropriations bill, was also passed without a hitch.
 
Elections, abortion, bail reform, broadband, public safety, religious and second amendment freedoms, etc. have dominated the last few weeks of session. While a few of those priorities have crossed the finish line, we’re not going to be able to tie this session up with a bow and lay it to rest. Though we’ve received new census numbers (and with them, two new U.S. Congressional seats), there will still be a special session required to finalize redistricting. Sixteen billion dollars in federal COVID-19 relief funds are on their way, and the Governor and Legislature have been playing tug-of-war with federal monies since well before the session started. The Lieutenant Governor recently called for another special session after several of his priorities died on the House floor; and in the last 48 hours of session, Democratic House Members organized a walk-out to prevent a final vote on SB 7—this session’s highly controversial elections bill and one of Gov. Greg Abbott’s priorities. The Governor shortly thereafter responded by promising that the issue would be taken up during a special session (without specifying when that would take place) and expressing his intent to veto state budget appropriations for the legislative branch. “No pay for those who abandon their responsibilities. Stay tuned.” 
 
In recent days since Sine Die, the Governor spoke to the estimated timing of a special session or two, stating there will be two special sessions: one on redistricting and COVID relief funds in September or October, and the other occurring before the Fall 2nd called Special.  The 2nd called Special Session agenda will include SB 7, bail reform, and other issues yet to be determined.  In other words… we’ll see you soon for the 87th First and Second Called Special Sessions.

Membership Monday: Jeff Blankinship

The Texas Ambulatory Surgery Center Society has a new board member: Jeff Blankinship!

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VMG Health Associates Explain Fair Market Value and Referral Risks at Town Hall

Bartt Warner, director of compensation arrangements at VMG Health, and Dylan Alexander, manager for business valuation and transaction advisory at VMG Health, presented information to Texas Ambulatory Surgery Center Society members on May 27 about fair market value in the surgical center industry, as well as an Office of Inspector General opinion that speaks directly to ASC investment concerns.

VMG Health is a company that specializes in healthcare valuation, strategy and compliance. The company provides fair market value on all assets of the medical field, from equipment to physician salaries, and has developed experts to look at each component of the industry to satisfy customers’ total needs. It also helps with tailoring a compliance program specific to your organization that will ensure compliance with Center for Medicare and Medicaid Services, as well as other governmental regulations.

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The History & The Future Of Ambulatory Surgery Centers

The History & The Future Of Ambulatory Surgery Centers

According to Texas Health & Human Services, there are 560 ambulatory surgery centers (ASCs) — medical facilities specialized in elective, same-day and outpatient surgical procedures — in Texas. 

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AAAHC Officer Explains How to Prepare for Accreditation Surveys

On May 13, Dr. David Shapiro, an officer for the Accreditation Association for Ambulatory Health Care (AAAHC), spoke to Texas Ambulatory Surgery Center Society members about the survey process and steps ASCs can take in preparation for their surveys.

When it comes to AAAHC’s approach, Shapiro explained the surveyors work to be consultants with facility staff and collaborate with them to ensure they become accredited and are able to keep that status. “A lot of our standards are very open-ended,” he said. “We ask you to define things.” For example, pediatrics could mean something different for every center, and some centers might not even have pediatric departments, so it’s up to the facility to define what they have and what the cut-offs are for their departments.

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Texas Health and Human Services Commission Answers Questions About COVID-19 Updates

In April, the Texas Health and Human Services Commission answered some questions from the Texas Ambulatory Surgery Center Society about survey updates, rule changes and other helpful resources for ASCs.

As it pertains to surveys, HHSC is not authorized to do any virtual surveys at this time, and in-person visits are expected to meet the established expectations for infection control. All visits for surveys are addressed on a case-by-case basis. When it comes to the top survey citation since COVID, the staff expressed that surveyors have a special focus on infection control practices throughout all CMS-certified providers.

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TASCS Hosts Infection Control Week

April 26 to April 30, the Texas Ambulatory Surgery Center Society hosted Infection Control Week. This virtual conference brought together industry experts, discussing the initiatives, expectations and future of infection prevention in ambulatory surgery centers.

On Monday, Lisa McKown, the manager of research and development for Beyond Clean, spoke about public health initiatives to reduce healthcare-associated infections and offered helpful ways the community can get involved to prevent HAIs.

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STERIS Associates Discuss Outsourcing Sterilization Process to Prevent Infection

STERIS Associates Discuss Outsourcing Sterilization Process to Prevent Infection
By Tara Phipps

On Thursday, April 22, two STERIS associates discussed offsite reprocessing centers and issues ambulatory surgery centers face with vendor trays at the bi-weekly Texas Ambulatory Surgery Center Society town hall event.

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TASCS’s Capitol Day during the 87th Texas Legislative Session

Last week, the Texas Ambulatory Surgery Center Society (TASCS) held its bi-annual Capitol Day virtually. The event was a success that included meetings with a focus group of ambulatory surgery center (ASC) members and various legislative offices, including a welcome kick-off from Senator Dawn Buckingham, MD herself. 

Texas Senator Dawn Buckingham welcomes TASCS Capitol Day to discuss 87th Legislative Session initiatives concerning the healthcare industry.

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3 Ways Outsourcing the Sterile Processing Department Will Keep Your Total Joints Program Ahead of ASC Trends

3 Ways Outsourcing the Sterile Processing Department Will Keep Your Total Joints Program Ahead of ASC Trends

 

At one time it might have been surprising to find out that an Ambulatory Surgery Center (ASC) functioned without an in-house Sterile Processing Department (SPD). Today, it's common to see centers survive and even thrive without them.

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This World Health Day, What Are You Doing To Build A Fairer, Healthier World?

This World Health Day, What Are You Doing To Build A Fairer, Healthier World?
By TASCS Board Member James McClung, Chief Development Officer of Reliant Medical Services

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Incident Reporting: Best Practices For ASCs

On March 4, Texas Ambulatory Surgery Center Society members attended a virtual town hall, in order to learn best practices on proper incident reporting to Texas Health and Human Services.  

Laura Schneider  RN, Sr. Director of Clinical Services for Amsurg, began by reviewing the requirements of ASC Incident Reporting:

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5 Tips For Patient Safety Awareness Week

5 Tips For Patient Safety Awareness Week 

Patient Safety Awareness Week encourages people to learn more about healthcare safety, and this year, it takes place March 14–20, 2021. This topic can include the reporting, prevention and reduction of issues that harm patients and others in medical settings.

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ASC Accreditation During The COVID-19 Pandemic

ASC Accreditation During The COVID-19 Pandemic

The Texas Ambulatory Surgery Center Society provides members with information and education through bi-weekly virtual town halls. On February 11, members learned what to expect in regards to surveys for accreditation programs during the COVID-19 pandemic.

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POSTPONED- Capitol Day

Capitol Day has been postponed to allow centers to recover from the impacts of the Winter Storm Uri. Because each center has been impacted in some way, we appreciate your input on when a new advocacy day would be convenient for your participation.

TAKE THE SURVEY

POSTPONED-Infection Control Week!

NEW DATE TO BE ANNOUNCED SOON!

 We apologize for any inconvenience but we are rescheduling next week's event due to the inclement weather and power shortages that our ASCs have experienced this week.

A future date is TBD and will be announced when available. 

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Controlled Medication Logs in Ambulatory Surgery Centers

In order to provide members with information and education, even in the midst of a pandemic, the Texas Ambulatory Surgery Center Society (TASCS) has been holding virtual town halls. The latest one took place on Jan. 28 and was about controlled medication logs in ambulatory surgery centers.

It was a focused, brief, yet very informative symposium from two of Texas’ top experts on the topic, Diane Buffington of Surgical Care Affiliates and Chris Dembny of Dembny Pharmacy Consultants LLC.

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DEA Compliance Update

SUMMARY: The Drug Enforcement Administration (DEA) is amending its regulations to implement a new single-sheet format for DEA Form 222, used by DEA registrants to order schedules I and II controlled substances. The rule provides for a two-year transition period, during which the existing triplicate version of the forms may continue to be used. The rule also includes a number of minor procedural changes.

https://www.deadiversion.usdoj.gov/fed_regs/rules/2019/fr0930.htm

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Virtual Town Hall this Thursday!

 

Join us this Thursday for our next topic in our Town Hall series

Controlled Medication Logs in the ASC 

Collaborate with these two speakers to discuss this important topic on the 28th.  

 

This is a members-only benefit and you must register to get access. 

To sign up for a membership, please fill out our application. 

Legislative Recap WE 1/22/21

From our TASCS Lobbyist


The highlight of this week was the House and Senate releasing their base budgets for the 2022-2023 biennium. Both chambers proposed General Revenue expenditures of $119.7 billion, staying under the Legislative Budget Board’s 7.06 percent spending limit. Senate Finance Committee Chair Jane Nelson referenced the “many tools available to balance this budget, which will require us to re-establish our priorities, stretch every dollar and find more efficient ways to deliver services.” The budgets are notably similar, prioritizing teacher’s retirement funding and the investments in public education that were made last session, providing funding for Medicaid caseload growth, and increasing funding for mental health initiatives. Budget hearings are predicted to begin in February. 
 
Both chambers will convene on January 26th, and the House will convene again on the 27th, before adjourning until the following Tuesday, February 2nd.  Remember also that the race to replace former Rep. Drew Springer in House District 68 will be Saturday, January 23rd. We will send out a report as soon as the results are in.
 
On Thursday, President Joe Biden’s Chief Medical Adviser Dr. Anthony Fauci discussed new COVID-19 variants found in South Africa and Brazil. Early evidence suggests that the new variants show greater resistance to the body’s immune response than the dominant strain, and could potentially slightly decrease the effectiveness of the vaccine.  He underscored the importance of widespread mask-wearing and immunization.
 
President Biden also released the new administration’s National Strategy for The COVID-19 Response and Pandemic Preparedness. The document outlines a strategy to mitigate the spread of the virus through expanded mask-wearing, testing, and public health guidance; utilize the Defense Production Act to increase production of vaccination and testing supplies; advance health equity for racial and ethnic groups disproportionately affected by the virus; and increase protections for workers while reopening schools and businesses. This strategy was accompanied by multiple COVID-19-specific executive orders.
 
This week, the Department of State Health Services (DSHS) received 333,650 first doses of COVID-19. DSHS requested that those doses be shipped to 260 providers across the state, including 77 large hub providers.
Texas Headlines
Toxic substance or water supply? Lawmakers to weigh whether wastewater from oil fields could replenish the state's aquifers
 

Success in scramble to succeed Sen. Springer in the Texas House could rely on shifting population
 

Lt. Gov. Dan Patrick Statement on the Texas Senate Budget
 

TribCast: What the new Biden administration means for Texas
 

Texas employers applaud bills to prevent surprise taxes on PPP loans
 

Health officials issue dire warning as Texas sees its worst COVID-19 outbreak
 

Watch: New Texas senators discuss plans to address COVID-19’s impact on health, businesses
 

Reversing Donald Trump policy, Joe Biden will include undocumented immigrants in critical census count
 

Pandemic drives worst annual job losses on record for Texas
 

Texas has a problem with its COVID-19 vaccination data, and the stakes are high. Now the state is scrambling to solve it.
 

Dan Patrick asks Texas to revise coronavirus vaccine distribution plan as eligible people experience frustration trying to locate a dose
What to Expect Next Week
View this document for scheduled legislative meetings. 
Priority Bill Tracking Report
Please click HERE to review bills tracked through January 22, 2021.
Relevant State & Federal COVID-19 Updates from the Week
Please click HERE to read the COVID-19 Updates from the week.