1. The 83 rd Texas Legislature: Everything You Need to Know TETAF EMS Leadership Lunch ‘n Learn Webinar Series January 30, 2013 Dinah S. Welsh

3.  Texas Legislature meets in odd years for 140 days  83 rd Texas Legislature began January 8, 2013  Legislature only constitutionally required to pass a balanced budget  Sine Die - May 27, 2013

4.  The Good – The Budget  The Bad  The Ugly

5.  Current Senate mix = 19R, 11D + 1open seat (that will be a D)  6 new members  Lt. Governor David Dewhurst leader of the Senate

6.  Senate Finance, chaired by Sen. Tommy Williams (R-The Woodlands)  Senate Health & Human Services, chaired by Sen. Jane Nelson (R-Flower Mound)  Senate State Affairs, chaired by Senator Robert Duncan (R-Lubbock)

7.  Republican majority currently in House = 95 R, 55 D (41 freshmen)  Speaker Joe Straus (R-San Antonio)

8.  House Appropriations Committee, chaired by Rep. Jim Pitts (R-Waxahachie)  House Public Health Committee, chaired by Rep. Lois Kolkhorst (R-Brenham)  House Calendars Committee, chaired by Rep. Todd Hunter (R-Corpus Christi)  House Human Services Committee, chaired by Rep. Richard Pena Raymond (D-Laredo)  House Homeland Security & Public Safety Committee, chair is vacant * House Committees not appointed as of 1/30/13 for 83 rd Legislature

9.  Longest serving Texas Governor  Very popular governor, but with decreased approval ratings  Appointments

10. 254 counties 113,243 House District Population 547,952 Senate District Population

11.  $101.4 billion available in general purpose spending  12.4% increase from 2012-2013  Additional funds available but dedicated (i.e. federal funds) = $208.2 billion all funds available for Texas budget

13.  Idea  Research and collection of data  Need for legislation to change status quo  Identify state legislator and convince to carry legislation  Writing and filing of bill  Referral of bill to committee  Hearing in committee, passage by one chamber of legislature  Referral to other chamber of legislature and referral to committee  Passage by second chamber of legislature  Signature by Governor, veto, or becomes law without signature  Law and implementation

14.  Supplemental appropriations bill - $6.2 billion to complete 2012-2013 spending ◦ Underfunding of Medicaid - $3.9 billion ◦ Deferred payments to public schools - $2.3 billion  Legislative Budget Board asks agencies to cut 10% from budgets for 2014-1015 spending  Public school reform  Health care reform with implementation of new federal health requirements

16.  The Good  The Bad/Ugly  The Unexpected

17. Try, try, try again o 2005 - legislation passed but was actually weaker than existing law o 2007 – legislation fails to pass o 2009 – Model Booster Seat Law Passed

19.  Repealed in 1997  Prior to 1997 all motorcyclists were required to wear helmets in Texas  Current law one has to show proof of $10,000 medical insurance coverage to ride without a helmet

20.  Prior to 1997 97% of motorcyclists wore helmets, after 1997 66% wear helmets  After 1997 – fatalities and injuries increase ◦ Operator fatalities increase by 31 percent ◦ Costs for brain injuries increase

21.  With all this data working against repeal of mandatory use of motorcycle helmets how was the law repealed?

23. Bill “Sputnik” Strain

24.  Trauma System created in 1989  State infrastructure created but no state funding  1997 – 22 RACs and 60 designated trauma facilities  First trauma and EMS monies appropriated by Texas Legislature ◦ Attempted fee on driver’s license renewal ◦ Ultimately $4 million used from the 911 fee fund

25.  2002 increased trauma diversions +  Looming medical malpractice crisis +  Significant changes to Texas transportation infrastructure +  And $10 billion budget deficit = TRAUMA FUNDING!!

26.  Diverse coalition of interested parties  Data to prove problem  Legislative study  Legislative leadership  Timing

27.  Designated Trauma Facility and EMS Account created (HB 3588)  96% of funds to designated trauma facilities  2% EMS agencies  1% RACs  1% DSHS  Grand total distributed to eligible hospitals since the inception of this funding source is approximately $382 million

28.  In addition, SB 1131 was passed imposing fees on certain traffic violations $539,766 distributed to date  Currently 264 designated trauma facilities compared to 60 in 1997

29.  Grassroots data gathering  Engaged advocates  Legislative visits, relationships  Personal stories – victim impacts  PERSISTENCE!

30.  Data, data and more data!  Bringing to legislator’s level - local data makes a world of difference  Lawmakers need data at multiple levels: ◦ Local data ◦ Compare communities across the State ◦ Compare the State across the Nation  Data needs to be accurate and current  Data gathering does not stop after legislation is passed

31.  Who is my legislator? ◦ www.fyi.legis.state.tx.us/Home.aspx www.fyi.legis.state.tx.us/Home.aspx  Great websites ◦ www.capitol.state.tx.us www.capitol.state.tx.us ◦ www.senate.state.tx.us www.senate.state.tx.us ◦ www.house.state.tx.us www.house.state.tx.us  Great Apps ◦ TexLege – FREE ◦ Texas Capitol Watch - $.99 ◦ Texas Legislature Online (TLO) www.txlegis.com - FREEwww.txlegis.com ◦ Texas Tribune - FREE

32.  EMS & Trauma Day at the Capitol – February 26, 2013, Austin  Begin with continental breakfast and briefing at the Texas Hospital Association, briefing will begin at 9 a.m.  Walk to Capitol for House and Senate recognitions  Press conference to emphasize importance of the Texas EMS & Trauma Systems  Time to Visit with YOUR legislator  CONTACT YOUR LEGISLATOR NOW to let them know you’ll be in town 2/26/13 and request for time to meet with them

33.  Development of coordinated EMS, trauma and acute care advocacy initiatives  Initiated Coalition to Protect Trauma Care in 2010, will re-activated for 2013 Texas Legislative Session  Use strengths of existing organizations  TETAF Legislative Watch

34.  HB 10 – Pitts – emergency supplemental state appropriations  SB 53 – Zaffirini – life support services provided by certain EMS personnel  SB 159 - Carona/HB 567 – Smith – definition of an authorized emergency vehicle  SB 223 – Watson – designation of certain vehicles of the Texas Division of Emergency Mgmt as authorized emergency vehicles  HB 104 – Gonzales, Larry – repeal of the Driver Responsibility Program

35.  HB 365 – Martinez, “Mando” – certain diseases or illnesses suffered by firefighters and EMTs  HB 409 – King, Phil – state EMS medical director  HB 705 – Howard – enhanced penalties for assault of ER personnel  HB 521 – Kuempel – direct payment by an automobile insurer to EMS providers  HB 746 – Ashby – allowing health care providers to provide services across state lines in catastrophic circumstances  SB 166 – Deuell – use by certain health care providers of electronically readable information from a driver’s license or personal identification certificate

36.  HB 434 – Riddle/HB 435 – Turner, Sylvester/HB 516 - Pitts - several different bills dealing with blood specimen collection  Several bills dealing with use of wireless devices in cars  Several bills dealing with reducing intoxicated drivers and increasing penalties

37.  HB 778 – Guillen – requiring an annual football game between The University of Texas at Austin and Texas A&M University

38.  Led by Ed Racht, M.D.  Division exists to further develop and coalesce the EMS system in Texas  Get involved!

39.  “EMS Exposure Management & Immunization Practices”  February 20, 2013 beginning at noon CST  Bill Coll, B.A., M Pub Affs. LP, REHS, Program Manager, Infection Preventionist, Office of the Medical Director, Austin/Travis County EMS System  CE credits will be offered at a small fee to cover costs

40. Dinah S. Welsh Chief Executive Officer Texas EMS, Trauma & Acute Care Foundation 3400 Enfield Road Austin, Texas 78703 dwelsh@tetaf.org 512/524-2892 www.tetaf.org