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Compromising Positions: Texas GOP and Tea Parties Find Their Fortunes Reversed in Ft. Worth

By Dale Huls

A funny thing happened at the 2014 Republican Party of Texas (RPT) convention last weekend. The grassroots tea parties and the Republican establishment were forced to compromise on an immigration plank in the Republican Party of Texas Platform. And the Republican elites are wailing and gnashing their teeth!

You see, “compromise” is what’s supposed to happen when the establishment wins and the tea party loses. Indeed, we are constantly being lectured about party unity. That was one of Texas Republican Party Chairman Steve Munisteri’s main opening messages to the convention – Party Unity. Sitting in the auditorium as a tea party member, I felt that this was the establishment laying down the terms of surrender. We are told that our enemies are too dangerous for the tea parties to not get in line after our intra-party struggles. When the Platform Committee Chairman, Tom Mechler introduced the RPT platform to the delegates, he stressed “compromise.” Mr. Mechler told us that everyone wouldn’t be able to get all they wanted in the platform, but for the sake of party unity, we should adopt the “perfected” document and move on. Indeed, messages of unity and compromise were the mantra of the day…for a Republican establishment that expected to win.

And why shouldn’t the Republican elites and corporate interests expect to win? They knew that the conservative tea party movement was coming to do battle over the “Texas Solution”. They saw tea party activists preparing for an ideological battle over principles and the rule of law. They monitored the social media posts, tweets and blogs. They understood that this convention would be less well attended than other recent conventions and activists were coming in numbers. With this understanding and foresight, the elitists Republican Party apparatchiks began a counter-campaign to protect the Texas Solution and keep it in the platform. Mailers went out with conservative sounding names claiming that the Texas Solution was necessary for outreach to Hispanic groups and avoid a demographic catastrophe in future elections with the promise of free jobs and legal residence in the United States (in other words – Amnesty). Newspaper articles were written, blogs posted, and surrogates were organized to counter the growing tea party threat. Agriculture Commissioner Todd Staples began contacting tea party groups and convention delegate trainings to push a rewritten Texas Solution plan that was actually more lenient than the original. Land Commissioner Jerry Patterson and amnesty lobbyist Norman Adams continued selling the Texas Solution’s guest worker program. A large Texas Solution pavilion in the convention center’s Exhibition Hall was purchased. And finally, the temporary platform committee was staffed with a majority of members sympathetic to a guest worker program and provided food and drinks by Norman Adams.

What could possibly go wrong? Well, the best laid plans of mice and Rinos often go astray when the full weight of the grassroots show up and work for a common goal. As soon as the temporary platform committee went into public session and testimony, it became obvious that the tea party was there to fight against any immigration plank that offered defacto amnesty via a guest worker program. Tea party operatives stayed day and night fighting to get rid of the guest worker language and report out the proceedings to the grassroots network at the convention. Extreme pressure was put on the committee to such an extent that Todd Staples’ rewritten Texas Solution never saw the light of day. By the end of the temporary platform committee’s stint, the immigration platform plank had been completely rewritten and the guest worker program language was changed to a “provisional visa” program (same song, different tune). That night in the Senate District caucuses, a few pro-amnesty temporary committee members were voted out by the grassroots and replaced for Friday’s Permanent Platform committee. With new committee members, a new plank was offered based on Senator Dan Patrick’s website on border security and immigration. In fact, when this amendment was offered, the committee vote was a 15 – 15 tie for which the Chairman Mechler declined to break. An amendment in a tie vote is NOT adopted. Consequently, seven committee members signed a “minority report” that took the amendment to the convention floor as substitution amendment and presented to all the convention delegates. Since this minority report still contained some objectionable language that needed removing and the remaining doubt that it would be accepted, the grassroots hurriedly prepared amendments to be filed before the 6pm Friday deadline (note: that only filed amendments may be considered on the convention floor under normal rules). These amendments dealt with fixing the minority report language or removing the provisional visa language and of the approximately 200 amendments filed about three-quarters addressed the immigration plank.

At this point, the grassroots felt they had a fighting chance at replacing the Texas Solution immigration plank with a common sense immigration plank based on the rule of law. As the convention came to order on the last day, a grassroots network of Facebook, Twitter, text messaging and email spontaneously arose. Numerous activists were prepared to whip the votes by working the delegates and holding up yes/no signs indicating which way the vote should go. And then came the moment, everybody in the convention was waiting for. Mark Ramsey, a member of the Permanent Platform Committee, came out on the center stage to introduce the immigration minority report to the delegation. However, after introducing a motion to substitute the minority report for the proposed immigration plank reported out of committee, Mr. Ramsey started to discuss the committee’s proposed plank in detail. At this point, uneasiness settled on the anti-amnesty supporters. Why wasn’t he talking about the minority report? Why wasn’t he promoting the minority report was a much better stance on immigration? And then came the shocker, Ramsey offered a new amendment to the existing plank as a “trigger” for the provisional visa program and therefore a “fix” for the original plank. The grassroots immediately felt betrayed. It now looked like the minority report had been set up for failure. The problem was Mr. Ramsey’s amendment did make the plank better but it left intact the guest worker/ provisional visa program. Delegates wanted to know what happened and how they should vote. And then parliamentary confusion began, was debate cut off or was it not? Were we voting on the amendment or the minority report or both? Once the muddle was cleared up, the amendment to add a trigger was approved and the minority report failed.

Despair fell over the no amnesty delegates and activists. All of the filed amendments addressing the minority report were no longer relevant. And a last chance attempt was made to strip the provisional visa program from the proposed platform plank.  This too ultimately failed. It seems the establishment Republican supporters of the Texas Solution had won again. It looked like the provisional visa language would stay with the only “compromise” being the trigger amendment first offered by Ramsey. The grassroots had fought so hard. It seemed that money and manipulation had once again trumped conservative principles.

But wait all was not lost, from the floor microphones arose a single voice offering a motion to amend the immigration plank by offering the delegates another option. Peter Batura had written his own compromise amendment and had correctly filed it the previous day. In his amendment, he kept the textual language providing rationale from the proposed immigration plank and took the best specific bullet points offered in the minority report to craft a complete plank on his own. It would be an understatement to say that both sides of the issue were stunned at this development. Activists and establishment alike scrambled to read the amendment. Confusion reigned throughout the hall. As the reading went, the amendment read exactly like the proposed plank for the first three paragraphs. Each side asked “Was this a good thing or a bad thing?” Within minutes the leading activists decided that this was a strong alternative to the existing language and the word started going out via text messaging and emails imploring the body to vote yes on this amendment. The pro-guest worker/provisional worker crowd also began to whip their votes against. In fact, in Dan Patrick’s home Senate District (SD 7), Mark Ramsey, Valerie Swanson, and David Riddle managed to place their delegation solidly against the floor amendment (36 – 385). One member of the SD 7 delegation related that “a delegate in the section next to SD 7 asked me why SD 7 voted Democrat? I was so embarrassed…”

As the vote on the floor amendment took place, Chairman Munisteri called for a voice vote which was inconclusive according to the chair. In fact, Steve Munisteri did a remarkably fair job in understanding the will of the convention by calling numerous standing votes to visibly assess votes by the delegation. This vote was no different. However, if we thought the floor amendment was an unlooked for boon and a last minute reprieve from defeat, it was surely divine providence in what happened next. When Chairman Munisteri called for a “standing” vote, he sought confirmation of the vote from others on the stage. Consequently, both the convention Parliamentarian and Secretary answered that they had each seen a different outcome of the standing vote. With a disagreement on the stage Chairman Munisteri was unwilling to call the vote himself and determined that a “roll call” vote was in order. This was exactly what the grassroots wanted. Win or lose, a tallied vote of record was had been sought to document the vote and remove any doubt of vote unlike what occurred in the original Texas Solution vote in 2012.

Now, with each SD voting their full voting strength, the results of the roll call vote was 4763 for the motion and 3735 against. By over a 1000 votes, the tea party position had carried the day. By an approximate 60 to 40% split, the Texas Republican Party had elected to discard an unworkable “market-based” approach to immigration reform. Emphasis was refocused in the party platform to address border security and the rule of law. The new immigration plank was indeed a compromise position by taking the best of the committee’s proposed plank and the minority report and blending them together into a seamless document addressing immigration issues.

Unfortunately, the establishment and corporate interests seem to be not so interested in “party unity” after the platform was adopted and the convention closed. Norman Adams, the high dollar guest worker lobbyist, left insisting that the grassroots had set the Party back 10 years and this was the work of white supremacists. Please! It’s bad enough that the liberal press says these things about the GOP grassroots and tea party, but for other “Republicans” to say it is not advancing party unity after a hard fought intra-party disagreement.

Indeed, both sides knew the stakes were high in Texas regarding the immigration plank. It was suspected that the Texas Solution was intended to give cover to moderates such as Jeb Bush and Chris Christie regarding their own immigration stances. Additionally, it was suspected that Speaker Boehner would use the Texas Solution as a further justification for an amnesty vote this summer. Because if Texas, the reddest of red states, can support a guest worker/provisional visa program for all illegal aliens then it must be alright for the Republican-led House to do the same. However, after Saturday’s vote, moderate Republican 2016 candidates must stand on their own without the cover of Texas Republicans and John Boehner must reach for other justifications in his push for amnesty.

So this is what “compromise” feels like when your positions, by and large, carry the day. As demonstrated by the comments, posts, tweets, and blogs in social media, it appears the grassroots can get comfortable with this kind of compromise. However, it is up to the political elite and corporate interests in the Republican Party to see if they can practice what they preach. Will they get in line and defend the party platform? Will they join forces because our enemies are too dangerous for us to be divided? Will they follow the advice of Tom Mechler who called for the sake of party unity to adopt the “perfected” document and move on? After all, he is the one who said everyone would not be able to get all they wanted in the platform. Will Republicans across America support what Texas has done to reject a backdoor amnesty program and support a more common sense and rule of law approach? I wonder.

Saddle up Texas!

Dale Huls is an executive board member of the Clear Lake Tea Party.
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http://watchdogwire.com/texas/2014/06/02/frisco-residents-call-for-removal-of-long-standing-companies/

Frisco residents call for removal of long-standing companies

What does it say about a community in which new-to-the-party residents seek to run long-standing businesses out of town – or at least out of their neighborhood? That’s the case as a group of Frisco residents are calling on their city council to relocate an asphalt and two concrete mixing plants around which real estate developers along with the Frisco ISD chose to build and homeowners voluntarily bought homes.

Proponents of the move cite potential health hazards (breathing problems, headaches, reduced appetite, throat and eye irritation, cough,and increased risk of cancers) as well as risks of fire and explosion a la the 2013 West, Texas fertilizer plant incident, as reasons to move the plants. Younger children are noted as “uniquely at risk” in light that they “eat, drink and breathe more in proportion to their body size than adults.”

An online petition additionally notes “environmental contaminants may affect children disproportionately because their immune, respiratory and other systems are not fully developed, and their growing organs are more easily harmed. This means they are more at risk for exposure to harmful chemicals found outside where they play and in the environment where they spend most of their time – school and home.”

Good neighbor or neighborhood bully?

Per The Dallas Morning News, the APAC-Texas asphalt plant opened in 1982. Those with a history in this area likely remember the plants as fixtures along State Highway 121 long before Denton and Collin Counties hit their current growth trends.

The Morning News reports:

The first homes were built about a block north of the plants beginning in 2003. Complaints began soon after. But the neighborhood continued to grow. Frisco ISD’s Isbell Elementary opened about 2,000 feet north of the plants in 2004 and Vandeventer Middle School along Independence Parkway in 2012. Several businesses, including a pediatrician, a veterinarian and a hotel, have also joined the neighborhood.

Residents complain of strong asphalt odors and dust that they say trigger headaches, burning eyes, itchy throats and nausea. Asthma and allergy symptoms get aggravated, they say. Children don’t want to play outside.

Were these odors never in evidence as development occurred? Or when homeowners were purchasing their homes? If so noticeable and potential threats blatantly in evidence, might more prudent buyers have elected to buy elsewhere?

“Throughout this change in our community, the company has worked to keep our neighbors informed about our operations, and we have been responsive to their concerns, making significant improvements to our operations along the way,” Stephen Koonce, president of APAC-Texas, told the paper in an email that referenced Frisco’s dramatic changes.

Complaints lodged

Complaints have been lodged, but other than the asphault operations’ residual odor classified as unpleasant, the plants are not considered to be sources of harmful health effects.

The Frisco ISD as well as the city and state regulators monitor the situation. Under a 2007 Frisco Clean Air Ordinance, 249 odor complaints related to the plants have been filed, 79 since January. None, however, have resulted in a code violation.

With regard to the Texas Commission on Environmental Quality (TCEQ), the Morning News says:

In the past year, the TCEQ has received 46 complaints about the asphalt plant. Most of them fall under the state’s nuisance law, which bans anyone from discharging an odor that interferes with the normal use and enjoyment of someone else’s property.

Proving a violation under this law is no easy task. Odors have to be judged objectively on their frequency, intensity, duration and offensiveness to determine whether a nuisance exists. Residents are urged to use the state’s odor logs to track the problem.

None of the complaints investigated in the last five years has resulted in a violation, according to the TCEQ. But on May 16, TCEQ issued a notice of violation for odors to APAC-Texas based on a compliance investigation done over four days in March and April.

APAC has until June 15 to respond with actions taken and documents that show the plant is in compliance.

The ‘bottom line’

A 1990s proposal to move the plants failed, but Koonce says it’s still an option.

“It has been our intent to relocate prior to the expiration of the current permit,” he told the Morning News declining to give specifics. The company’s air quality permit runs through 2019.

As a neighborhood north of the plants has reportedly experienced turnover, other residents are termed reluctant to move. Per the Morning News, “they bought their homes after real estate agents or builders told them the plants would be gone within a few years” and cite “close-knit neighbors, strong schools and great parks and trails” as reasons to stay.

Real estate agents, builders said the plants would be gone. That’s hardly a surprise.

And all those factors that help run up property values after these companies are run out of the area? Let’s term them about ensuring childrens’ health, not salvaging bad judgement that makes buying property in a less-than-desirable locale a more-than-risky proposition.

It is, after all, for the children

Frisco residents just approved a $775 million (slightly more than $1 billion with interest) for a bond package that includes 14 new schools. On top of an existing $2.6 billion debt load ($1.4 billion principal/$1.2 billion interest), this leaves taxpayers total debt approaching $4 billion.

Many questionable actions are sold and perpetrated using today’s “for the children” hype, an organized strategy of short-term gain and gratification to benefit one generation at the expense of those to come. And with government entities, increased property taxes generally follow.

That said, companies operating in non-hostile environments are what keep people employed. Employment funds other life pursuits including funding mortgage payments and property taxes.

Neighborhood bullies banding together to impede the legal operations of businesses that provide other neighborhoods’ livelihoods is short-sighted as well as dangerous in setting precedent that only the “right” businesses are desirable.

Never mind that the roads which lead to these subdivisions are paved with materials out of APAC or similar asphault plants. Forget that the slabs on which Frisco’s many homes and other businesses sit exist thanks to the system of concrete mixing plants that populate areas across the Dallas-Fort Worth metroplex.

Evidently the output of those plants is welcomed, but the operations are met with an after-the-fact “not in my neighborhood” mentality.

Close proximity to an airport has appeal as a great convenience, but squawking begins when someone invariably ends up in a flight path. Nuclear power as an energy source has its fans as well, but few want such plants in their own backyards. That’s certainly a fair position, but don’t then choose to move in next to either one.

That Frisco residents would rather not live by these plants is well within their rights, but to move into such an area and then start complaining is bad judgment and bad manners.

For now, it sadly seems some residents’ approach is about being bullies over good neighbors when it comes to working with long-standing neighborhood businesses to broker an equitable solution with which all can live.

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The Texas Two-Step Regarding the Texas Solution in 2014

By Dale Huls
Bio block:  Dale Huls is an executive board member of the Clear Lake Tea Party

Last Thursday, the Clear Lake Tea Party (CLTP) and a few other invited activists sat down to a teleconference call initiated by Commissioner Todd Staples. It was his intention to reach out to tea party activists about the upcoming fight over the “Texas Solution” immigration plank prior to next week’s RPT convention. It made sense that Commissioner Staples would reach out to the CLTP since their Executive Board had endorsed him during the Lt. Governor’s Primary campaign.

Commissioner Staples expressed to the grassroots on the call, dissatisfaction with the “Texas Solution” plank in the 2012 Republican Party of Texas Platform and proposed a new “Border Security and Legal Workforce Reform” plank. Staples wanted to coalesce grassroots support behind the newly proposed immigration plank and manage the platform fight. He claimed that the proposed plank addressed all the earlier issues with the “Texas Solution” and would be the basis for resolving the flood of illegal aliens crossing our southern borders. It was his assumption that if the conservative grassroots and most establishment Republicans could get behind this new plank then a messy, contentious platform fight could be avoided.

Unfortunately, that was not a correct assumption and the tea party activists were having none of this. The shock on the faces of those on the CLTP end of the conversation was profound. Here was a former candidate for Texas Lt. Governor who had made border security one of his high-profile campaign issues championing an immigration policy that made no sense to those involved in border security issues. In reviewing the proposed plank, it became immediately apparent, as one activist put it, “This is nothing more than an erudite re-writing of the Texas Solution.” As with the Texas Solution, this new plank is a “market-based” approach to illegal immigration. Again, what is being proposed is a “guest worker” solution that would end illegal immigration if we can just give enough guest worker visas to all who sought them. It is incomprehensible to those who care about their State and their country to see the grand Republican solutions to the human tragedy and national security of illegal immigration centered on “cheap labor.” With approximately 40% of Americans dropping out of the job market, we are being asked to support more jobs for non-Americans. Although the proposed 2014 immigration plank intends to provide protection for American workers through a reformed visa system for which hiring foreign workers would cost more in visa fees than hiring Americans, there was no answer to the question of why would businesses pay more for a foreign worker visa when they can hire cheaply under the table just as they do today.

As the discussion turned to border security, we were further distressed to see that border security is addressed only in the vague and indeterminate language found in the original 2012 Texas Solutions plank. We made it clear to Commissioner Staples that the issues of border security and immigration reform must be addressed as two separate issues. While Staples initially agreed with this premise, it soon became apparent as we drilled down into the issues that he really did not agree on this point. He indicated that there could be no movement on border security without immigration reform (otherwise known as comprehensive immigration reform).

We challenged the Commissioner that his proposed border security and immigration plank only addressed the issue from an economic perspective in that all border violators were economic immigrants looking to provide for their families rather than the true scope which includes drug cartel members, multi-national gang members, criminals, drug smuggling mules (willing and forced), human traffickers and their victims. How can the Republican Party gain respect in the Hispanic and Asian communities if all that is talked about is “cheap labor” and not the sickness that plague their communities. Consequently, we were told by Commissioner Staples that it was impossible to “close” the border. He said the 2000 mile border (really 1200 miles in Texas) was unenforceable and that a “market-based” answer was the only feasible solution to minimizing illegal border crossings. Really, the ancient Chinese built the Great Wall of China to keep out the barbarian hordes, the Roman’s built Hadrian’s Wall to defend against the Picts, and the Israelis’ have built their security walls against Islamic terrorists. Even the USSR built an “iron-curtain” to keep people in. To say that America does not have the ability to close a border is ridiculous.

We pointed out “Operation Strong Safety” which reduced illegal border by 80 – 90% showed that DPS could manage the border. Staples disparaged the DPS operation and claimed it wouldn’t work on a larger scale. Wow! We brought up the border fence and he said that ranchers on the border prevent a contiguous fence from being built because of individual property rights issues. He even said that he was against any Federal or State intrusion onto his property to police the border and protect our national security. At this point, one of our members stated that if a private individual would prevent our borders from being secure they could be considered “un-American.” At this point, we got a real rise out of the Commissioner who took offense at the implication. If you can take an individual’s property to put in a shopping mall, eminent domain should surely cover the land needed to put up a fence!

Finally, we noted that this new proposal goes even further than the 2012 version by adding language to provide so-called “dreamers” a path to citizenship and modernize legal points of entry rather than addressing all the illegal entry points. Although we did not directly address these issues with Commissioner Staples, this is clearly a direct call for amnesty for some illegals. Ostensibly, this language in the Republican Party plank directly codifies the Obama Administration’s stance regarding the children of illegal aliens. It is this very attitude that is causing the tsunami of children crossing the border illegally causing the Federal government to jump through hoops in order to feed and house these minors. The fact that policies such as this encourage illegal immigration – not discourage it.

Ultimately, while we are sure this conversation did not go the way Commissioner Staples intended it to go, it was extremely enlightening to the grassroots participants. We believe that this is an attempt to “manage” the upcoming Texas Solution plank debate with the Party leadership orchestrating a false dichotomy between two choices that are, in essence, the same. The question to tea parties, conservative grassroots, indeed, the Republican Party at large is what you believe in with respect to the questions of border security and immigration reform. Do you think that the Republican panacea to the immigration issue and subsequent electoral success resides in a “guest worker” solution? Do you think that border security and legal immigration reform are inseparable? Do you think that America cannot “close” its southern border? If you do, then support the Party leadership and business interests and back either version of the Texas Solution.

However, if you believe that the 2014 immigration plank is a continuation of moderate Republican policies that seek to appease progressives and big business, then you must join in the effort to rebuke this approach and provide a real Texas solution. If you believe that Texas border security must be the first step in solving the overall illegal immigration issue, then it is up to you to see that this is the lynchpin of any RPT Platform plank addressing this issue. Rather than offering platitudes regarding border security we should be offering real solutions for securing our border. These could include:

  • Offering Federal block grants to States to protect the border
  • Call for increased funding to allow the Texas DPS to expand the pilot program Operation Strong Safety to a permanent surge
  • Close legal ports of entry until Mexico begins to police its side of the border
  • Stop the promise of amnesty
  • Ask the Federal Government for an accounting of all illegal aliens captured on Texas soil.

But what can the grassroots do with the convention so close? First of all, immediately begin contacting your Senate District 2014 Temporary Platform Committee members and find out if they support the Texas Solution or not. If they do, begin organizing your convention delegates to vote in a different Permanent Platform Committee member who is against the plank. At the convention, elect SREC Committeemen and Committee women who stand against this approach. Encourage all to change the language from economic migrants to the true bane of illegal immigration that is manifest in drugs, crime, and human slavery. And finally, confront our politicians and candidates regarding their support or non-support for the Texas Solution. These are men and women of standing within the Republican Party and should not shy away from making a stand that so divides us today. Many of them have made promises to get elected or gather in the Party nomination. They can influence the outcome regarding what is in the 2014 Republican Party of Texas Platform. Ultimately, this is on you, the Texas activist, to decide what message you want to send to the rest of America.

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http://watchdogwire.com/texas/2014/05/23/nurse-practitioners-can-aid-texas-health-care-challenges/

Nurse practitioners can aid Texas health care challenges

Restrictive laws limit participation

May 23, 2014

As health care costs rise and access to care becomes more challenging, is Texas missing an opportunity by maintaining highly restrictive laws that exclude advanced practice registered nurses (APRNs) like nurse practitioners from having a prominent role in our health care system? Reform for a Healthy Future: Expanding Scope of Practice for Nurse Practitioners in Texas, a new report from the Texas Public Policy Foundation, explores the advantages APRNs offer and how those in Texas are being lured away by states with relaxed scope of practice regulations.

APRNs’ current status

Advanced practice registered nurses generally fall into one of these areas of specialization: nurse practitioners, clinical nurse specialists, nurse anesthetists or nurse midwives.

Texas is one of a dozen states with restrictive scope of practice regulations. While Texas requires nurse practitioners (NPs) and other APRNs to practice with some form of supervision, delegation, or physician team-management, per the report, sixteen other states and Washington D.C., allow these professionals to evaluate patients, diagnose, initiate and manage treatments, and prescribe medications — all under authority of the state board of nursing.

Last session’s ‘reform’ still left unhelpful limits

In 2013, the 83rd Texas Legislature’s passage of SB 406 expanded APRNs’ and physician assistants’ (PAs) scope of practice, but restrictions remain.

The bill loosened APRNs/PAs independent prescribing of legend and other controlled drugs, devices and supplies, but the changes are far short of actions producing positive outcomes in other states.

SB 406 also did nothing to change current regulations that keep NPs from receiving Medicaid managed care organizations (MCOs) reimbursements unless the supervising physicians accepts Medicaid or has a contract with a patient’s MCO. This provision results in Texas NPs seeing fewer patients.

Physician shortages to impact health care access

With the Patient Protection and Affordable Care Act (ACA) subsidizing coverage for low-income Texans thereby bringing increased primary care demands, new physician shortages are a given. Without expanding Medicaid, the U.S. Department of Health and Human Services (HHS) estimates up to 2.8 million Texans might gain coverage through the ACA exchange. With a Medicaid expansion, 4.2 million new enrollees are expected.

Physician shortages are nothing new in Texas. HHS has designated 126 of Texas’ 254 counties as Health Professional Shortage Areas (HPSA), areas lacking primary care physicians based on a doctor-patient ratio of about one per 3,000 residents. Texas additionally has 295 Medically Underserved Areas (MUA), more than any other state in the country.

Though two new medical schools – one in Austin and the other in the Rio Grande Valley – will help, the report cautions that “simply graduating more primary care physicians will not necessarily mean increased access to primary care in Texas” as “graduating medical students can always move elsewhere.”

The use of alternative providers like APRNs can help accommodate this new care access demand.

Nurse-led clinics offer alternative

Allowing patients the flexibility to rely on nurse-led clinics for primary care services can help offset physician shortages. The TPPF report cites data showing not only that increasing nurse-led clinic numbers helps reduce demand for primary care physicians, but that Medicare patients accessing primary care through NPs rose fifteen-fold between 1998 and 2010.

Additionally, data does not support concerns that NP primary care is inferior or producing sub-standard outcomes (over primary care physician services). Per the report:

A survey of 37 articles published between 1990 and 2009 on the quality, safety, and effectiveness of primary care provided by NPs compared to physicians found that outcomes were comparable across all categories, including health status, satisfaction with care, ER visits, hospitalizations, blood pressure, and others.

Economic benefits realized

Eliminating scope of practice restrictions could offer cost savings as basic NP-provided health care services performed in retail clinics generally have lower per visit costs.

Aside from addressing Texas’ provider shortages, a relaxation of APRN scope of practice laws has economic benefit. One 2012 study found “the effect of increasing the efficient use of APRNs in Texas would be $16.1 billion in total expenditures and $8 billion in gross product annually, as well as the creation of more than 97,000 jobs.”

A more open approach to APRNs is occurring in other states – and occurring with positive results. Texas’ health care challenges will only increase as our population grows as well as ages. The APRN model offers the means to ensure the delivery of quality, cost-effective care to all Texans.

Failure to incorporate this approach is truly a missed opportunity.

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http://watchdogwire.com/texas/2014/05/20/u-s-supreme-court-orders-review-2008-robbie-tolan-shooting/

U.S. Supreme Court orders review of 2008 Robbie Tolan shooting

Was evidence ‘properly credited’?

May 20, 2014

The U.S. Supreme Court has ordered the 5th U.S. Circuit Court of Appeals to reconsider the case involving the shooting of Robert (Robbie) Tolan, son of former major league baseball player Bobby Tolan, by a Bellaire police officer.

The shooting

On New Year’s Eve 2008, Tolan, then 23, was unarmed when shot outside his parents’ Houston-area home as police mistakenly believed he was in possession of a stolen car. It was later determined an officer had typed in the wrong license plate when checking the ownership of Tolan’s vehicle.

Sgt. Jeffrey Cotton fired three times, but only hit Tolan once. At the trial, Tolan testified that, at the time of his shooting, he was on one knee protesting Cotton pushing his mother. Tolan was shot in the presence of his parents as they tried to attest to the family’s ownership of the car.

The bullet remains lodged in Tolan’s liver after surgeons were unable to remove it.

Recourse unsuccessful

A 2010 trial ended with a jury acquitting Cotton of criminal charges while the lodged bullet ended Tolan’s once-promising prospects of his own professional baseball career.

The Tolan family also filed a civil lawsuit against Cotton and and city officials claiming the use excessive force with Tolan’s shooting. Racial profiling, false arrests and racial harassment was also alleged. The Tolan family is black, Cotton is white.

A Houston federal district court judge sided with Cotton and the city’s arguments that government officials are immune from civil lawsuits unless their conduct is found in violation of constitutional rights. The 5th U.S. Circuit Court of Appeals later affirmed that decision, but has now been instructed to re-open the case.

The new ruling

Per the Supreme Court,  the 5th Circuit “failed properly to acknowledge key evidence offered by the (Tolans).” The ruling went on to say the 5th Circuit’s  judgment was vacated “so that the court can determine whether, when Tolan’s evidence is properly credited and factual inferences are reasonably drawn in his favor, Cotton’s actions violated clearly established law.”

“We’re pleased the Supreme Court agreed that the case should go forward,” said attorney Martin Siegel, who represented Tolan in his appeal to the high court, according to TheBoxHouston.com. “A jury should decide whether Robbie’s civil rights were violated. Robbie continues to suffer from the after-effects of the shooting, and we hope this decision will bring him closer to having his day in court.”

Meanwhile, William Helfand, attorney for the Cotton and the city, reportedly noted how the high court isn’t refuting the district judge’s ruling that no constitutional violation occurred, it’s just “instead focused on a procedural concern regarding the 5th Circuit’s analysis of the case.”

“I imagine that on review, I don’t expect any change in the (summary judgment) decision,” he told KTRK-TV.

Benjamin Crump, the attorney who represented the family of Trayvon Martin, has also now been hired to represent Tolan.

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http://watchdogwire.com/texas/2014/05/19/guilty-plea-in-south-texas-vote-buying-operation/

Guilty plea in South Texas vote-buying operation
Votes bought with cash, food, beer, cigarettes

May 19, 2014

A former south Texas politiquera, Diana Balderas Castañeda, earlier this month pleaded guilty in federal court to one count of vote-buying in conjunction with campaign activities supporting the election of four Donna ISD school board candidates.

In the criminal complaint, FBI Special Agent Brandon Cook defines a politiquera as “a person who works for a candidate to encourage people to vote, to bring voters to the polls, to ensure that voters select the appropriate candidate and to pay voters for their votes.”

Castañeda admitted during a 2013 interview with FBI agents that she was in fact paid by a candidate to provide food, beer or cigarettes as well as cash ($10 to $20) in exchange for specific candidate votes during the 2012 primary and general elections. Castañeda additionally said she would sometimes take voters to buy drugs after they voted.

Castañeda was one of three politiqueras arrested in late 2013. While currently free on bond, Castañeda faces up to five years in federal prison. Sentencing is scheduled for July 25. Another politiquera, Rebecca Gonzalez, is expected to be sentenced in September. She pleaded guilty to the same charge in February.

More fallout ahead?

KGBT in Harlingen reports how authorities have not released the names of candidates and/or campaign managers involved in the vote-buying operation, but notes incumbents Ernesto Lugo, Alfredo Lugo, Mike Flores and Nick Castillo retained their seats in the 2012 school board election.

Less than two weeks after the politiqueras’ arrest, Donna school board President Alfredo Lugo hanged himself. The FBI as well as Lugo’s fellow board members and family have declined comment on if Lugo was also being investigated

With investigations ongoing, the prospect of more arrests seems likely.

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http://watchdogwire.com/texas/2014/05/16/bond-elections-reality-absent-from-entitlement-epidemic/

Bond elections: Reality absent from entitlement epidemic

Future generations to inherit major debt

May 16, 2014

Texas voters approving much of the $6.5 billion ($9 billion with interest) sought by local governments in May bond elections prompts two interesting observations. First, an entitlement epidemic breeding a self-indulgent culture and mindset that living beyond one’s means will override basic economic principles is thriving. Second, the reality ahead will be fascinating when economic principles kick in (as they always do) and future generations realize today’s “for the children” hype was an organized strategy of short-term gain and gratification to benefit one industry within one generation at the expense of generations to come.

Texas: An all-star debtor state

Never mind the silly talk of Texas as a bastion of conservatism – at least when it comes to fiscal responsibility. We’ve already got $322 billion in local debt. Texas prides itself on being competitive? You bet! We’re competing with California and New York as the nation’s biggest financial deadbeats.

Local government debt – that of school districts, cities, counties, community colleges, health/hospital districts, water districts and authorities along with other special purpose districts – is growing faster than the increase in population and inflation. School districts are the largest growth sector for this debt. Spending from 1999 through 2009 saw Texas public education funding rise five times faster than student enrollment growth. And as new “wants” are never-ending, many taxpayers – i.e., voters – remain comfortably mired in unquestioning lockstep with the education industry’s demands.

No reading, writing or doing the math wanted

The education industry has become an entitlement industry. The folks who once promoted reading as fundamental changed their tune when legislators considered offering voters the fundamental opportunity to read current debt levels (penalty and interest) on bond election ballots when school districts and other government entities seek new debt. Educators seemed to feel entitled to holding back that information.

And math. Credible math problems once involved calculating principle and interest. Not only was this a good exercise in understanding math principles, but it was also functional knowledge as most of us at one point or another make long-term purchases like a home or car in which interest significantly adds to the base purchase price.

Funny though, the education industry seems to feel entitled to disregard the interest when it comes to promoting school bonds. Students once learned an expenditure can’t be accurately evaluated unless interest is part of the equation. Yet in 2013, school districts, joined their other local government counterparts in fighting any entitlement of which voters might be deserving with regard to such transparency in bond elections.

And thankfully, teaching character doesn’t appear so great a priority any more. After all, an industry that feels to entitled to obscure the true financial picture of a taxpayer-funded entity is hardly qualified to instruct others on matters of honesty or right and wrong!

And as lip service is continually paid to the theory of critical thinking, those utilizing such a skill quickly fall out of favor. Independent thought is rarely appreciated as it, on the subject of school finance, too often prompts discussion of economic realities and costs/benefits of dollars spent. Educators’ and their groupies’ best cases are based on promises for the future, not honest looks at outcomes of the past.

Bullying works!

The mechanics of getting bond elections passed are identifiable, trackable. Many elections are called at targeted times when turnout will be predictably small, but key voter participation can be optimized. With schools, early voting sessions rotated between school campuses and timed with school events (back-to-school or end-of-school) aids the casting of “friendly” votes.

Peer pressure extends into community presentations and other materials that discourage dissent from the prevailing, “popular” point of view promoted by business leaders and prominent social figures. Campaigns – often well-funded by prospective contractors – also pointedly remind that with school tax freezes, voters age 65 and older will be protected from additional taxes any proposed measure brings.

While demands for increased spending legitimately exist in some quarters, the education industry and its followers have created a culture that feeds on the appearance of endless prosperity and superficial success. Future generations will take a double-barrel hit with being short-changed in their academic preparedness as well as saddled with massive debt.

In Lady Madonna, Paul McCartney sings “Who finds the money? When you pay the rent? Did you think that money was Heaven sent?”

That mindset would seem to prevail today.

LuAnnheadshot
Lou Ann Anderson is an information activist and the editor of Watchdog Wire-Texas. As a contributor at RagingElephantsRadio.com and a policy analyst with Americans for Prosperity-Texas, she writes and speaks on a variety of public policy topics. Lou Ann is the creator and online producer at Estate of Denial ®, a website that addresses probate abuse via wills, trusts, guardianships and powers of attorney along with other taxpayer advocacy issues.

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