Off the Kuff Rotating Header Image

Texans Care for Children

Who cares about new mothers?

Not the Lege.

The new mothers contracted infections. They overdosed on drugs. Their hearts failed. They committed suicide.

The women died in different ways, but all perished within a year of giving birth. Rising rates of maternal mortality spurred Texas leaders in 2017 to reauthorize a special task force to study the deaths and figure out what to do.

But at the end of this year’s legislative session, public health advocates are frustrated that lawmakers left Austin without adopting the task force’s top recommendation: giving women access to health care for a full year after they give birth.

The Legislature agreed to spend $15 million over the next two years on postpartum depression and substance abuse treatment for some low-income women. But a far more sweeping and higher cost plan to expand Medicaid coverage for all eligible new mothers failed, despite having support from Republicans and Democrats.

“We’re disappointed state leaders basically ignored the needs of uninsured moms and uninsured low wage workers this session, by not taking action on bills to extend postpartum coverage,” said Adriana Kohler, a senior health policy associate for the Austin-based advocacy group Texans Care for Children.

[…]

The funding, however, will likely cover only some of the roughly 136,000 pregnant women on Medicaid in any given month. And pregnant women who relied on Medicaid for their diabetes medication or other prescription drugs could still lose those benefits in the transition, some public health advocates said.

Other bills filed by Republicans and Democrats to expand the state’s Medicaid coverage for new mothers from two to 12 months, post delivery failed. The change would have cost the state upwards of $75 million a year, according to a fiscal note. The legislation passed the House, but died after not receiving a public hearing in the Senate.

Rep. Garnet Coleman, D-Houston, chalked it up to politics. “Republicans don’t want to be viewed as expanding Medicaid,” he said.

Just as a reminder, Greg Abbott made a last-minute attempt to put an extra $100 million into the budget for “border security”. The budget as adopted is spending over $5 billion to buy down property taxes. The Lege passed a tax cut on yacht sales, which won’t actually cost that much money but is still a tax cut on yacht sales. My point here is that this was not a decision based on a lack of available funds. It was a failure to act because the Republican leadership had no interest in doing it, for the reason Rep. Coleman cites. It was a choice they made, one that reflected their values. Keep that in mind when you hear the usual blather about being “pro-life”.

By the way, CHIP is still running out

Just in case you were wondering.

Advocates say Texas will run out of funding for the Children’s Health Insurance Program sooner than they thought. The program, which Congress failed to reauthorize last month, covers nearly 400,000 children from working-class families in the state.

“It’s expected that Texas will run out of CHIP funding in January,” said Adriana Koehler, a policy associate with the advocacy group Texans Care for Children. “With the holidays coming up in the next few months, we really need Congress to get the job done now.”

Just a few months ago, advocates said it was unclear when the state would run out of CHIP funds. Some advocates expected the state had until next September; others said funds would run out in February.

Carrie Williams, a spokesperson with the Texas Health and Human Services Commission, said the funding could run out as early as January.

Williams said the agency pushed up the timeline because of reduced income from co-pays. After Hurricane Harvey hit, the federal government waived co-pays and enrollment fees for CHIP recipients. That meant less money was coming into the program than expected.

“So funds may be exhausted a bit sooner than February,” she said.

See here for the background. One might think that such a fanatically and performatively “pro-life” state like Texas would be full of leaders who would care deeply about 400,000 children losing access to health care, but one would have to be deeply naive to believe it. At this time, it looks like the best bet for action will be CHIP reauthorization as a part of a successful government shutdown hostage negotiation. There’s a sentence I hope I never have to type again. Remember when we had a government that was interested in actually, you know, governing? Those were the days, I tell you.

Decriminalizing truancy

This is important.

Sen. John Whitmire

Sen. John Whitmire

Senate Bill 106, filed by Sen. John Whitmire, D-Houston, would make major overhauls to current truancy law, including referring students to a civil court that hears truancy cases rather than a criminal court.

Under current law, children as young as 12 who miss 10 or more days or parts of days in a 6-month period and their parents must appear in court, where they face a Class C misdemeanor charge and a fine up to $500. School districts can file truancy charges when a student misses at least three full or partial days in a four-week period.

Advocates told the Senate Criminal Justice Committee that many truant students miss school because they are are pregnant, bullied or are the sole financial providers for their families. They said current law unfairly punishes them, labeling them a criminal at an early age.

“We have to find a way to encourage students and we’re finding that if you come through with a punitive manner it just doesn’t work,” said Yvonne Williams, a Travis County judge who deals with dozens of truancy cases a week.

Sen. Whitmire is acting on the tireless advocacy of Texas Appleseed, which has been banging the drum over the school-to-prison pipeline for several years. Decriminalizing truancy is at the top of their legislative agenda for this session. It’s great to see this move forward, especially (as Grits reported from the hearing) in the face of some heated but misleading opposition. Kudos to all for this, but let’s make sure it crosses the finish line.

Meanwhile, Sen. Whitmire has some other reforms on the burner as well.

Legislation that would take the biggest step in eight years to reform Texas’ juvenile-justice system by keeping more teen-aged offenders in community and regional treatment centers, rather than in a remote state lockup, was approved late Tuesday by a state Senate committee.

Under Senate Bill 1630, up to 80 percent of juvenile offenders who are now sent to state lockups could instead be held in local treatment programs – a move that could significantly downsize the state’s long-troubled youth corrections system and save taxpayers perhaps as much as $40 million.

“This is the next huge step to keep the youth closer to their communities in programs that work, instead of state programs that have not,” said state Sen. John Whitmire, D-Houston, the author of the measure. “We’ll not only have better results, but this will save money.”

Officials and justice experts testified during a public hearing the plan, if approved, would mark the most significant change in Texas’ juvenile justice system in years – a change recommended seven years ago, when the number of youths in state lockups was cut by more than half in favor of local treatment and rehabilitation programs.

Under the bill, youths serving time for so-called indeterminate sentences – most held for less-serious crimes and who remain in the program until they successfully complete it – would be sent to regional facilities, many of them operated by counties, instead of the state’s five high-security lockups that more resemble prisons than rehabilitation centers.

Tom Brooks, chief juvenile probation officer of Harris County, and his counterpart in Bexar County, Lynne Wilkerson, were among a long list of witnesses voicing support for the legislation, which has also been endorsed by officials of the Texas Juvenile Justice Department.

[…]

Whitmire said Senate budget writers refocused the agency’s two-year budget to fund more local rehabilitation and treatment programs and to hire more parole officers.

“It currently costs about $140,000 a year to house a youth in a state facility, and it costs just $60,000 in a local or regional program – with much better outcomes,” Whitmire said.

I don’t see how anyone can argue with that. Again, I’m glad to see this moving, and I hope to see it go the distance.

There is one reform that won’t happen at this time, however.

Armed with research on the dangers 17-year-olds face in adult jails and prisons, children’s groups and criminal justice advocates have made the cause a top priority this session. Texans Care for Children convened a summit on the issue last fall, and a January report from a House committee has recommended changing the law.

Texas’ law, the committee notes, is out of step with both federal law and all but eight other states. The report notes research that says adolescent brains are still developing, which calls into question whether they should be held as culpable as adults, and suggests they might have a better chance at rehabilitation.

Sheriffs and jailers have supported the idea as well, in part because federal law already requires them to keep 17-year-olds out of “sight and sound” from older inmates, which is an expensive proposition. In practice, especially in smaller county facilities, 17-year-olds are confined alone instead. Juvenile court judges in Bexar and Harris counties have also signed on, editorial boards at the Houston Chronicle, San Antonio Express-News, Austin American-Statesman have all called for change this year.

With such a drumbeat of support, moving 17-year-olds into the juvenile justice system seems like just the sort of research-based, bipartisan idea that a reform-minded Legislature would embrace. On Wednesday afternoon, a House committee will hear a handful of bills to do so.

But for now at least, the proposal is likely headed nowhere in the Senate, where the most visible opposition has come from an unlikely source: Whitmire.

“I personally, philosophically, believe that if a 17-year-old commits a violent act, I see no reason to change that they wouldn’t be [treated] as an adult. I just think that a 17-year-old knows right from wrong,” Whitmire told the Observer. “I just am not of the opinion that it’s a broken system, and I’m not prepared to change the law to assist the sheriffs in the management of their jails.”

Well, we’ll have to disagree on that. I think the wind is blowing in the direction of less incarceration, and we should take advantage of any opportunity we can to pursue that. Maybe next session for this part of it.