Women’s Preventive Healthcare

1. TEXAS WOMEN’S HEALTHCARE COALITION Women’s Preventive Healthcare February 2019

2. Our Staff Leah Gonzalez, MSSW Policy & Advocacy Associate, TWHC LGonzalez@TexasWHC.org Evelyn Delgado Chair, TWHC President, Healthy Futures of Texas EDelgado@TexasWHC.org Erika Ramirez, MPA Director of Policy & Advocacy, TWHC ERamirez@TexasWHC.org Perdita Henry Communications Specialist, TWHC PHenry@TexasWHC.org

3. Texas Women’s Healthcare Coalition Who We Are: 83 healthcare, advocacy, faith organizations What We Do: Strive towards access to preventive healthcare, including contraception, for ALL Texas women www.TexasWHC.org

4. Background

5. Women’s Preventive Healthcare Services • Well-woman exams • Screenings • Contraceptive services • counseling, methods, and supplies • Additional services Not Abortion

6. Healthy Texas Women (HTW) • Covered Services • Well woman visit • Contraceptive services • Breast and Cervical Cancer • Screenings & Diagnostic Services, Cervical dysplasia treatment • Screening, limited treatment for • Hypertension, diabetes, cholesterol, postpartum depression • STD screening and treatment • Sterilizations • Immunizations • Other preventive services • Client Eligibility • Women ages 15-44 • 15-17 w/ parental consent • 200% Federal Poverty Level • Citizen/Eligible Immigrant • Not pregnant • Eligibility Determinations • Client eligibility is determined by HHSC • Apply online or paper application • Fee-For-Service (with a few contracts)

7. Family Planning Program (FPP) • Eligibility: • Women and Men • Age 64 or younger • 250% of the Federal Poverty • Level (FPL) • Texas residents • Not be eligible for any similar • program, including HTW • Eligibility is determined at the point • of service by family planning • contractors • Covered Services: • Well woman visit • Contraceptive services • Breast and cervical cancer screening & • diagnostic services • Screening for • Hypertension, diabetes, cholesterol • STD screening and treatment • Sterilizations • Immunizations • Prenatal Services

8. Women’s Health Program Budget & Clients Served

9. Maternal Mortality The Texas maternal mortality rate saw a sharp increase in 2012. New data analysis show the increase was not as sharp as originally reported, but is still worse than other states. Significant disparities still exist, as Black women are at the highest risk for maternal death.

10. Selected Recommendations from the TX Maternal Mortality and Morbidity Task Force 1. Increase access to health services during the year after pregnancy & throughout the inter-conception period Enhance screening and appropriate referral for maternal risk conditions. Improve postpartum care management and discharge education for patients and families Increase maternal health programming to target high-risk populations, especially Black women. 2. 3. 4.

11. Benefits of Family Planning Reduces unintended pregnancies & allows healthy birth spacing Reduces maternal & infant complication risks Results in better maternal & infant health outcomes • Provides a critical entry point into healthcare services: • Helps prevent, detect, and manage chronic conditions before pregnancy • Increases access to postpartum and inter-conception health care • Improves continuity of care

12. Women’s Preventive Healthcare and the 86th Legislature

13. TWHC Policy Priorities 1. 3. Ensure women have access to the full range of FDA-approved contraceptives of their choice, including LARC. Increase continuity of care for women by eliminating barriers to preventive healthcare access. Maximize the ability of the women’s healthcare safety net to reach more women and save Texas taxpayer dollars. Ensure funding for women’s preventive healthcare, including contraception. Identify areas with a shortage of qualified family planning providers, develop strategies to increase provider participation in the state’s women’s health programs. 4. 2. 5.

14. TWHC Policy Priorities 1. • Ensure funding for women’s preventive healthcare, including contraception. • Nearly 1.8 million Texas women are in need of publicly funded preventive services • At a minimum, maintain the 2018-2019 funding levels for the state’s women health programs, with the goal of increasing funding to meet the need for services statewide.  • House and Senate versions of the Budget 

15. TWHC Policy Priorities 2. • Identify areas with a shortage of qualified family planning providers, develop strategies to increase provider participation in the state’s women’s health programs. • Identify areas of greatest need by collecting and analyzing data that provides an accurate picture of unduplicated provider capacity and fund distributions to contractors in the state.  • Increase provider outreach and eliminate barriers to provider participation.  • Require HHSC to provide complete date in the Women’s Health Programs Savings and Performance Annual Report • HB 992 (Calanni)

16. TWHC Policy Priorities 3. • Ensure women have access to the full range of FDA-approved contraceptives of their choice, including LARC. • Increase access to long-acting reversible contraceptives (implants and IUDs).  • Enable women to receive a 12-month supply of birth control at a single pharmacy visit, if prescribed.  • Ensure adequate provider training that aligns with Quality Family Planning (QFP) best practices recommended by the Centers for Disease Control and Prevention.  • HB 30 (Hinojosa), HB 937 (Davis)

17. TWHC Policy Priorities 4. • Increase continuity of care for women by eliminating barriers to preventive healthcare access. • Address policy and system limitations preventing eligible CHIP clients from receiving services through Healthy Texas Women.  • Ensure women receive effective referral services into women’s healthcare programs and other treatment as needed.  • Automatically enroll eligible 19-year-olds into Healthy Texas Women when their CHIP or Children’s Medicaid certification period ends.  • SB 189 (Miles)/HB 606 (Thierry) • HB 60 (Ortega)/SB 256 (Rodriguez)

18. TWHC Policy Priorities 5. • Maximize the ability of the women’s healthcare safety net to reach more women and save Texas taxpayer dollars. • Develop a workable solution for the coverage gap that will maximize federal funding and substantially increase the number of women able to access a medical home where they can receive critical preventive care and family planning services.  • Extending Medicaid coverage for women up to a year postpartum.  • Improve maternal and child health by creating a tailored coverage option for women to access care before, during, and after pregnancy.  • HB 241 (Farrar)/HB 411 (Thierry)/HB 610 (Walle)/HB 744 (Rose)/SB 147 (Rodriguez) • HB 1110 (Davis) • SB 308 (Watson)

19. Texas Women’s Healthcare Coalition Get Involved! Sign up for our newsletter – www.TexasWHC.org Call in or attend a meeting in Austin Reach out to TWHC with recommendations and concerns Provide your expertise through legislative visits and testimony

20. Thank You! Leah Gonzalez, MSSW Policy & Advocacy Associate, TWHC LGonzalez@TexasWHC.org Evelyn Delgado Chair, TWHC President, Healthy Futures of Texas EDelgado@TexasWHC.org Erika Ramirez, MPA Director of Policy & Advocacy, TWHC ERamirez@TexasWHC.org Perdita Henry Communications Specialist, TWHC PHenry@TexasWHC.org

21. TWHC Bills of Interest HB 992 (Calanni) - Relating to the capacity of certain minors to consent to maternal health care. HB 30 (Hinojosa) - Relating to the transfer of unused long-acting reversible contraceptive products under Medicaid and the Healthy Texas Women program. HB 937 (Davis) - Relating to health benefit plan coverage of prescription contraceptive drugs SB 189 (Miles)/HB 606 (Thierry) - Relating to the automatic enrollment of certain women in the Healthy Texas Women program.

22. TWHC Bills of Interest HB 60 (Ortega)/SB 256 (Rodriguez) - Relating to a requirement that public institutions of higher education provide certain information regarding certain women's health programs to students. All following bills have the same caption: Relating to the Medicaid eligibility of certain women after a pregnancy. HB 241 (Farrar)/HB 411 (Thierry)/HB 610 (Walle)/HB 744 (Rose)/SB 147 (Rodriguez) HB 1110 (Davis) SB 308 (Watson)