It always seems as though Texas Health Institute has a million things we want to tell you about in our monthly newsletter and rarely do we find the space to work it all in. I thought you might find it interesting to note that Texas Health Institute staff are working to improve the health of Texans with projects and presentations in Arlington, Atlanta(GA), Birmingham (AL), College Station, Corpus Christie, Dallas, Georgetown, Nacogdoches, San Angelo, San Antonio, the Woodlands, Waco, Waxahachie, Bexar County, Coastal Bend regions, Tarrant County, the Llano Estacado, Williamson Counties, Arizona, Colorado, Montana, Nevada, New Mexico, Texas, Utah, Wyoming, and as well as our efforts here in the State's capital.

We are working with Texas A&M University, University of Texas, Methodist Healthcare Ministries, Communities Joined in Action, the Catholic Health Association, Rockwell Foundation, Baptist Christian Life Commission, Catholic Health Association, the Michael and Susan Dell Foundation, The Commonwealth Fund, the Centers for Disease Control and Prevention (CDC), the Department of State Health Services (DSHS),Substance Abuse and Mental Health Services Administration (SAMHSA), Health Resources and Services Administration (HRSA), Women, Infants and Children (WIC) of USDA, Texas Department of Transportation, Texas State Demographer, Texas State Data Center, State Epidemiologist, Trull Foundation as well as community leaders, consumers, policy makers and so many more.

Our priorities are on the uninsured, mental health transformation, genetics and newborn screening, obesity, healthcare workforce, long term care, chronic disease, emergency preparedness and community collaboration.

This glimpse into THI's activities barely scratches the surface of our work. Together we are making a difference. Thank you!

"Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has."
~ Margaret Mead

Sincerely,

Camille D. Miller

President/CEO

Texas Health Institute

Cover the Uninsured Week April 27-May 3

In 2007, THI released the Vision for Change report that outlined twelve solutions to reduce the number of the uninsured in Texas. Four-and-a-half solutions were adopted by the Legislature and it is estimated that these solutions will provide coverage for more than 300,000 Texans when finally implemented.

But why is insurance and the effort to cover the uninsured such an issue?

Health insurance contributes significantly to an individual's ability to access acute, chronic and preventative health services in Texas. An uninsured child usually does not have a regular doctor and is therefore far likelier to have an unmet medical, dental or prescription drug need.

Or, take for example a statistic from the American Cancer Society: Uninsured people diagnosed with cancer are 60% more likely to die within five years than newly diagnosed people who have private health insurance.The inability of any individual to access primary care in their community can lead to costly hospital treatment for preventable health problems.

And unrecovered hospital costs drive up medical costs for everyone.

Decreasing the uninsured rate in Texas will significantly improve access to care for all Texans. When combined with a comprehensive approach that addresses cultural, socio-economic, systemic and educational barriers, being insured becomes fundamental to improving health.

So how big is this uninsured issue for Texans?

5.59 million Texans are uninsured.
Three-out-of- four uninsured Texas children are eligible for Medicaid or CHIP but are not enrolled.
Texas has the highest uninsured rate in the nation.
Health insurance is expensive. The Texas Department of State Health Services tells us that while more than half of privately insured Texans are provided coverage by their employers, employer-sponsored health insurance premiums are outpacing worker's wage rates.

What can be done to cover the uninsured?

Texas Health Institute and many community health advocates across the state are engaging individuals, businesses, civic and community leaders as well as state decision makers in a dialogue regarding next steps. While the 2007 actions of the 80^th Texas Legislature were important steps toward raising the healthcare bar, additional action must be taken to ensure EVERY Texan has access to quality, affordable healthcare.

During Cover the Uninsured Week, April 27-May 3, Texas Health Institute is participating in a number of events (see below) to raise the profile of the uninsured issue. In the months ahead, you will hear more about efforts to educate and inform uninsured stakeholders on the mounting impact of being uninsured and its effects on the future of our health and healthcare systems in Texas.

Texas Health Institute Announces State Projections of Uninsured Rates

Link to Press Release Data

Texas Health Institute's 12 Uninsured Health Care Solutions

Texas Health Institute researched best practices and trends in Texas and other states to develop 12 practical policy solutions for increasing health coverage in the state. Each proposal targets a specific subset of Texas' uninsured populations. When combined, these policy solutions could reduce the number of Texans without health coverage by almost half - extending coverage to 2.7 million Texans at an annual cost to the state of $1.6 billion with a federal match of 1.7 billion and creating 90,000 new jobs.

(◊ Legislative Action taken)

◊ Provide Technical Assistance and Seed Funding for 3-Share/Multi-Share Programs

◊ Expand Use of Medicaid Health Insurance Premium Program (HIPP)

Enact Employer Tax Credits

Replace State's Existing Reinsurance Program

◊ Expand Eligibility for Texas' Insurance Health Risk Pool (TIHRP)

Increase Access to Pre-Paid Medical Plans

Require All Texas Higher Education Students to Have Health Coverage

Allow CHIP Buy-In at Full Premium Cost

◊ Fully Restore the Children's Health Insurance Program (CHIP)

Align Medicaid and CHIP Renewal Policies

Expand Access to Medicaid for Poor Parents

Encourage Expansion of Federally Qualified Health Centers

Cover the Uninsured Activities:

April 23 - Raising The Bar On Health Solutions; A Capitol Idea

THI invited all Texas Legislators and 2008 Legislative candidates to participate in a "fireside chat" at the Capitol with health leaders Lynda Frost, JD, PhD, Associate Director, Hogg Foundation for Mental Health; Roland A. Goertz, MD, MBA, President, McLennan County Medical Education and Research Foundation; Randall F. Jones, MPA, DHA, FACHE, FACMPE, President & CEO, University of North Texas Health Science Center; and Darren Rodgers, MA, MBA, President, Blue Cross Shield of Texas, moderated by THI's President and CEO, Camille D. Miller. The question-and-answer discussion was based on the release of the new Texas Health Institute brochure, Raising The Bar On Health Solutions, funded by Methodist Healthcare Ministries. Raising The Bar focuses on four health issues impacting Texans today; Uninsured, Obesity & Diabetes, Mental Health and Healthcare Workforce. To receive your copy of Raising The Bar and discuss how to bring these health issues to light in your community, please contact THI V.P. of Development, Lenora Doerfler at 512-279-3915.

April 29 - Camille D. Miller, THI President / CEO presented Raising The Bar On Health Solutions information at the 2008 NORTH TEXAS HEALTHCARE FORUM - Transforming Healthcare: A Regional Discussion held in Arlington, Texas. Miller provided a state and regional perspective to the event which also featured national perspectives, discussion and breakout sessions. Leadership from the community that participated and made this possible include: Wes Jurey, Arlington Chamber Foundation; Nancy Williams, Health Industry Council of the Dallas-Fort Worth Region; Dan Petty, North Texas Commission; and Doug Hawthorne, Texas Health Resources. Former THI intern Marcus Mitias was a member of the planning team. THI Board member, David Tesmer led the THR (Texas Health Resources) team that planned and executed this community meeting.

In his closing remarks, Doug Hawthorne summarized 15 characteristics he

heard that are essential to next steps:

action brave

choice innovative

consensus consistent

confidence evidence-based

discipline transparent

systemness standards

sacrifice confident

responsible

Special thanks to Doug and David for reprinting copies of our Raising The Bar

brochure for these 400 participants.

April 29 - Community Media Relations Training, San Angelo, Texas. Liza Creel, THI Program Manager, Amanda Conway, THI Events Manager and Mitchell Gibbs, THI V.P. of Marketing and Communications traveled to San Angelo to present a community workshop on media relations sponsored by Methodist Healthcare Ministries. The event addressed the uninsured issue in detail, including new data projections for the Concho Valley on uninsured rates through the year 2040. A panel of local public relations experts in the health field, Lyndy Stone, Director of Marketing for Shannon Medical Center, Rebecka Zemlock, Public Relations /Marketing Director for San Angelo Community Medical Center and Mike Campbell, Medical Director of La Esperanza Health and Dental Centers, shared tips with participants and a local media panel of Kathy Munoz, News Director for KLST and KSAN television, Jayna Boyle of The San Angelo Standard Times newspaper, provided the "inside scoop" on developing successful media events.

TXCapitol_ Raising the Bar Panelists (l-r) Roland A. Goertz, Randall F. Jones, Darren Rodgers, (front) Lynda Frost and Camille D. Miller.

Uninsured, Obesity, Mental Health and Healthcare Workforce topics garnered interest.

Some 70 participants participated in the "fireside chat" on health and healthcare issues.

On the road with thi

MARCH 1 - Dallas County Jail Reentry / CDC Demonstration Ex-Offender Meeting

This meeting was hosted by Omar Jahwar at Vision Regeneration and facilitated by James Reed with Dallas Leadership Foundation. Project staff, Hardy Loe, Hardy Loe & Associates; Sharon Phillips, Parkland Hospital; Danielle Levin-Louckes, The Williams Institute; Meredith McKinney, The Williams Institute; and Camille Miller, Klaus Madsen and Marcus Mitias representing Texas Health Institute were joined by Erin Walker, Lolita Robinson, Patricia Jones, Bill Johnson, Shannon Jones, Damon Brown, Jarrod Johnson, Joseph Adams, Chris Combs, Bob Silmon, Randall Bailey, Alfonso Holmes, Darrell Feldman, John Carol, Roman Jefferson, Samuel Henderson, and Terry Altman.

The purpose of this neighborhood focus group was to further understand the barriers that returning jail inmates consider the most important issues and topics concerning reentry into the community. Discussion and concerns from this initial focus group will be used to assist the ongoing THI/CDC Demonstration Project in developing meaningful, sustainable, and implementable interventions to address jail recidivism and enhance successful community re-integration in the Dallas area communities. The three needs deemed essential were: a job, housing and healthcare.

March 5-6 - Association for Community Health Improvement Annual Conference, Atlanta, Georgia

Klaus Madsen participated in an Intensive Session "Beyond Community Primary Care: Integrating Levels of Care and Public Health" led by Dr. Ron Anderson, Parkland Health and Hospital System. Dr. Anderson's presentation was built off recommendations from National Steering Committee on Hospitals and the Public's Health that he and Klaus Madsen served on. Liza Creel and Klaus worked closely with staff from the American Hospital Association's Health Research and Educational Trust to prepare the report: http://www.hret.org/hret/programs/nschph.html Throughout the 1 � day session, the 20 participants shared practical examples from their healthcare organizations and their communities with session leaders: Ron Anderson, George Rust, MD, Interim Director, National Center for Primary Care , Morehouse School of Medicine, David Satcher, MD, Director, Center of Excellence on Health Disparities, Morehouse School of Medicine and Raymond J. Baxter, PhD, Senior Vice President, National Community Benefit, Kaiser Permanente.

Klaus particularly enjoyed the 2 hour intimate session with former Surgeon General David Satcher who talked about mental health integration with physical health, the emerging global movement around social determinants of health and his years as Surgeon General.

March 12 - CDC Health Transformation Meeting, Georgia Health Policy Center, Atlanta, Georgia.

Klaus Madsen participated in the second meeting of an effort by our sister Institute in Georgia, Georgia Health Policy Center to infuse public health into the health reform debate. The meeting included more than fifty participants who are facilitating conversations around health system improvement in their states.

At the meeting, Klaus presented a paper that Camille Miller had developed with participants at the January meeting of this group.

March 12-13 - Communities Joined in Action Board Retreat, Atlanta, Georgia

Camille Miller was recently appointed to the board of Communties Joined in Action, a membership organization of community organizations, individuals and corporations who care passionately about improving the lives of the uninsured and underinsured in the face of today's health care crisis. Klaus represented Camille at the board strategic planning retreat.

March 19- Leadership Austin 2008 Essential Class.

THI President / CEO Camille D. Miller presented the Healthcare and Social Equity class information on the major issues facing health care in Texas and what should be done in the best interest of all Texans. The discussion included workforce needs, the nursing shortage and a need for a workforce development strategy. Miller's remarks concluded with an emphasis on efforts to engage Texans to make changes in Texas policy. Also presenting to the class were Charles Barnett, CEO of Seton Hospitals; Eduardo Sanchez, Director, Institute for Health Policy, University of Texas Health Science Center at Houston, School of Public Health; and a panel discussion by Ann Kitchen, ED Indigent Care Collaboration; Ellen Balthazar, ED Any Baby Can, Chair Basic Needs Coalition of Central Texas; Tom Spencer, ED Austin Area Interreligious Ministries who spoke on social equity collaborations. (Leadership Austin website )

March 26- NNPHI/CDC Jail Health Meeting

Project partners convened the meeting at the Dallas County Dept. of Health and Human Services facility with a welcome and introduction by Camille D. Miller, Texas Health Institute President/CEO and Sharon Phillips, Vice President, R.N. MBA Senior Vice President Community Medicine, Parkland Health & Hospital System.

Project leaders provided an overall review of activities including an update on the March 1^st ex-offender and family meeting. Discussion centered on revisiting taskforces concepts, prioritization of needs and activities and the need to develop further solutions for future activities and efforts.

March 29-April 5 MSGRCC Workshops in Austin

As the 2007 grant recipient of the Mountain States Genetics Regional Collaborative Center (MSGRCC), Texas Health Institute hosted MSGRCC workshop meetings in Austin. The MSGRCC is one of seven regional collaborative centers in the nation and provides infrastructure for state genetics programs, capacity building for regional genetic and newborn screening collaboratives and works to improve early identification of infant illness. MSGRCC is federally funded by the US. Department of Health and Human Services, Health Resources and Services Administration (HRSA) Genetic Services Branch and includes the states of Arizona, Colorado, Montana, New Mexico, Nevada, Texas, Utah and Wyoming.

The workgroups that met were:

March 1-2 - MSGRCC Partnership for Quality

March 29 - MSGRCC Public Health Workgroup

March 30 - MSGRCC Consumer Advocacy Workgroup

April 5 - MSGRCC Newborn Screening Workgroup

For more information about the Mountain States Genetics Regional Collaborative Center, please visit (MSGRCC website ). New information is being added regularly to the new website at www.msgrcc.org. If you have news information related to a MSGRCC program focus to add to the recently created "NEWS" section of the website, please send it with source and date information to mgibbs@texashealthinstitute.org for review. We hope this news section gives regional visitors an opportunity to keep us informed of related activities and news from your area.

April 10-11 - Christian Life Commission 2008 Board of Consultants Meeting

The Board of Consultants representing 30 statewide Baptist congregational and community leaders met April 10 & 11 at Lakeview Conference Center in Waxahachie, Texas. Texas Health Institute President, Camille D. Miller, presented information to the group regarding health priorities in Texas. The Christian Life Commission is making health and healthcare a priority topic of their public policy and congregational education work for the next two years. The Board of Consultants will engage in further discussion and refine their policy priority recommendations for the Christian Life Commission Board's action.

April 10-11 - The National Governor's Association Center for Best Practices' Healthy Kids, Healthy America grantee meeting in Nashville, Tennessee

The meeting convened more than 25 state officials from 15 states who participated in a project funded by The Robert Wood Johnson and the Centers for Disease Control and Prevention to prevent childhood obesity through policy and environmental change. Klaus Madsen served on a panel on

Legislative & Policy Options to Prevent Childhood Obesity with Amy Winterfeld, Program Principal, National Conference of State Legislatures and Katie Tharp, Senior Officer, Department of Public Health, State of California. Klaus' presentation focused on recent legislation in Texas and highlighted the work of the THI-facilitated coalition on obesity policy "Partnership for the Healhty Texas: Conquering Obesity". Several states represented in the Nashville meeting attended last years Southern Obesity Summit in Little Rock. Klaus visited with them about recruiting participants from their states and making presentations at this years Southern Obesity Summit: September 7-9, 2008 in Birmingham, Alabama.

Communications Update

Texas Health Institute continues progress with our website reorganization and redesign. During the past few months, we have been conducting interviews with THI stakeholders, including legislative staffers, community organizations, program partners, staff and board, soliciting on what will make a stronger and more vital web communication tool for THI. We thank them all for their input and would like to issue this invitation to any THI supporter to add to our website wish list. Your thoughts and comments on how we might build a tool that would best meet your public policy health needs are welcome.

You may also have noticed a "thematic" approach with this newsletter. We plan to include in future monthly newsletter issues a short section providing greater detail on an issue or program THI is addressing. We hope this section will give you more background on issues and our methods of addressing them. Of course, we'll continue to provide in each newsletter information on a wide range of health policy topics in addition to our feature information. We would appreciate your feedback on this format and suggestions for improving our newsletter and all THI communications.

About the Texas Health Institute

Our mission is to provide leadership to improve the health of Texans and their communities through education, research, and health policy development.

Senior Editor: Camille D Miller

Editors: Mitchell Gibbs / Havovi Katki

The Texas Health Institute (THI) is a nonpartisan, nonprofit organization focused on the development of health policy solutions to improve the lives of Texans and their communities. From acting as an honest broker and hosting unbiased health policy forums that facilitate dialogue among policymakers and other healthcare stakeholders, to creating a vision of an improved future healthcare system, THI is a think tank - providing evidence-based policy options and solutions as well as innovative, "outside the box" collaborative options to improve the health of Texans and their communities.

The THI newsletter is a monthly publication of the Texas Health Institute written to update THI board of trustee members and Friends of the Institute.

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* Funding for this was made possible (in part) by 5 U79 SM57485-02 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderator do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices or organizations imply endorsement by the US Government.