Enlarge Bob Daemmrich

Governor Rick Perry offers words of advice to new and veteran House members during a speech on the opening of the 83rd Legislative Session on January 8, 2013

When Florida Gov. Rick Scott reversed his stance on Medicaid expansion this week, many Texas policymakers were left wondering: If Florida can reach a deal with the feds, could Texas?

The Florida compromise hinged on the federal government’s agreement to approve Scott’s initiative to privatize Florida’s Medicaid program statewide. Texas is one step ahead of Florida in that is has already received federal approval and privatized Medicaid statewide.

Although the Florida plan doesn't directly apply to Texas, Gov. Rick Perry — like Scott — won’t agree to expand Medicaid without a compelling political compromise from the federal government. And what Texas wants is flexibility, preferably in the form of a block grant, to contain Medicaid costs and improve access to care.

“What we can do and what we should do on the state level is push for statutory reform of the Medicaid program and use that to leverage Washington,” said John Davidson, a health policy analyst with the conservative Texas Public Policy Foundation. Rather than expand Medicaid, he said, Texas should approve measures to implement sliding scale co-pays and move to a defined contribution system for long-term care to minimize costs.

“It would be a lot more politically thorny for them to do that,” he said, but it would encourage the federal government to consider “the need for states to have flexibility to reform those programs in a way that works for the recipients and provides good value.”

In the 2011 session, Texas lawmakers anticipated saving $3.1 billion with a variety of Medicaid cost containment measures, many of which depended on federal approval. The state came up $1.2 billion short of that goal, partially because of an optimistic timeline for the implementation of managed care statewide, but primarily because the state stopped pursuing $700 million in anticipated savings because it was clear the measures they'd proposed — changing eligibility standards and implementing reasonable co-pays — would not receive congressional approval.

There's only a slim chance the federal government would approve a block grant waiver, said Kim Ross, a health policy consultant and former head lobbyist for the Texas Medical Association. But the structure of the Medicaid waiver the federal government approved — which allowed Texas to privatize Medicaid and set up standards for federal and local government entities to finance innovation in health care delivery models — indicates the federal government is willing to work with the state to reward health care innovations to control costs, he said.

“The big play is Medicaid expansion combined with Medicaid redesign to make sure you’re actually going to get better value out of that investment,” Ross said.

Despite Perry’s consistent reluctance to expand Medicaid, there is movement among a handful of Texas Republicans to accept its inevitability. By spending $15 billion, Texas could receive $100 billion in federal dollars over 10 years that could potentially finance additional innovation in health care delivery and reduce trips to high-cost hospital emergency rooms.

Health policy experts and politicians on both sides of the political aisle argue Texas could get a lot of bang for those bucks, while still taking actions that minimize the political damage and financial burden on the state.

Like Scott, for example, Texas could agreed to only expand Medicaid for three years, during which time the federal government would cover all of the new enrollees’ health care costs. Or the state could follow Arizona Gov. Jan Brewer’s example by including a severability clause that would end the Medicaid expansion if the federal government reduced its financial share of the program’s costs.

“The ACA's Medicaid expansion offers Texas a once-in-a-generation opportunity to design and test — at federal expense — new models for health care delivery that are cheaper, quicker, and more accessible,” Bill Sage, vice provost of health affairs in the law school at the University of Texas-Austin, said in an email. “If the state moves strategically in this direction, it may discover that the techniques and structures it develops for Medicaid beneficiaries are so efficient and effective that they are adopted by and for the general population.”

Enlarge Todd Wiseman

Jail officials across Texas are worried that state budget cuts to community-based mental health care services will mean more mentally ill inmates in their facilities.

Imagine you’re a cop. You show up to a scene where someone is clearly suffering some psychiatric crisis. They haven’t committed a crime, but they have a firearm.

“Nowhere in the code does it say a police officer has the right to take the gun,” said Lt. Michael Lee of the Houston Police Department. 

After hearing from stakeholders across Texas, mental health advocates, judges and law enforcement officials are urging state lawmakers to overhaul the nearly 30-year-old mental health code to address gaps like that one. 

Lawmakers have taken a significant interest in mental health issues in the wake of mass shootings like the one in Newtown, Conn., in December that left 20 schoolchildren and six elementary school staff members dead. But lawmakers have said that a major overhaul of the mental health code is not likely to happen this legislative session — they haven’t held the appropriate interim hearings and studies for that massive an undertaking. Still, advocates say, there are a few critical changes lawmakers could make to the code that might prevent tragedies that can sometimes occur when people suffer from mental crises.

The Hogg Foundation for Mental Health issued a grant to Texas Appleseed, a nonprofit organization that advocates for social justice, which hired Dr. Susan Stone, a psychiatrist and lawyer, who traveled the state holding meetings to gather input on what is and isn't working in the Texas mental health code. The code was last substantively reviewed in 1985. 

“The mental health code really needs to be revised,” Stone said. “Clearly, the mental health system has changed drastically since then." 

In a report issued in September, a task force that reviewed the input from across the state recommended the current code be repealed and completely replaced.

“The current code is unwieldy and difficult to navigate,” they concluded. 

Their report contains dozens of recommendations to streamline and update the ways in which government deals with people who suffer from mental illness. HPD's Lee put particular emphasis on measures that give law enforcement officers authority to protect those who are ill and those who might be endangered by someone in crisis. As the population of mentally ill Texans increases, he said, police are often the primary government authority with whom they come into contact.

“There’s a lot of confusion around who's supposed to do what that’s not addressed by the code,” Lee said.

A key suggestion from the report, he said, is giving officers specific authority to confiscate weapons from people who might be a danger to themselves or others. It also recommends instituting a court process to oversee the return of the weapons to patients when and if they recover.

Lee said he and others in law enforcement are working with lawmakers to develop legislation that would address at least that  gap in the mental health code.

“That’s one issue out there that both sides can take a look at and say, ‘This makes sense,’” he said.

Enlarge

Economic issues continue to head the list of most important problems facing the country, according to our insiders in government and politics. They put federal spending/national debt in front with 29 percent, and the economy right behind that, at 16 percent. Immigration, which was a big issue just a few years ago, now is ranked at the top by only 2 percent of the insiders.

The state economy, on the other hand, is way down the list of most important problems facing Texas. Education is at the top of that list, with 29 percent saying it’s the biggest issue, followed by water supply, with 26 percent. Political corruption was third (it was seventh on the national list), with 11 percent.

The insiders think the country is on the wrong track, but nearly half said the state is going in the right direction.

We also asked some questions about politics, finding that 59 percent of the insiders don’t want to vote for Rick Perry for governor again in 2014. And the Tea Party is less popular with the Austin crowd — Republicans and not — than it has been with Texans in general. In a congressional race with three parties — Republican, Democrat and Tea — only 4 percent said they would vote for the Tea Party candidate. Two in five — 42 percent — chose the Republicans, and 33 percent chose the Democrats while 20 percent opted for Don’t Know. Does the Tea Party have too much, too little, or just the right amount of influence within the GOP? Too much, according to 70 percent of the insiders, while 17 percent said it was about right.

As always, we have attached the full collection of verbatim comments to this week’s question, and a sampling follows below.

Enlarge Todd Wiseman

.

What would you say is the most important problem facing this country today?

• "These are all important but there seems to be a failure of both parties to want to tackle problems in other than a partisan manner. This seems especially true at the national level."

• "Until policy makers act like grown ups, we cannot effectively address any of the substantive issues."

• "How about a confluence of taxes, social welfare programs, moral decline, and partisan gridlock? Too many taxes to pay for too much social welfare due to moral decline because too many people are immoral and not self-responsible, and our leaders lack the moral backbone to overcome their silly partisan differences to be responsible for the problem."

• "There will be a tipping point when it comes to spending. As a country, we can no longer be complacent of the status quo, however, this doesn't mean all the blame goes to the politicians. We as a society will have to decide what is important and how do we fund what is important."

• "I really mean cultural decline in that we don't broadly have the discipline, high standards, work ethic, hunger to excel we need to grow opportunity for future generations. Bad leadership and bad citizenship compound the problem."

• "The real answer is a combination of economic growth, education, and income inequality."

• "Dependency. We'll just vote for free stuff and dance away our days on sun-dappled hillsides. That 1971 Coca-Cola ad was a documentary, right?"

Enlarge Todd Wiseman

.

What would you say is the most important problem facing the state of Texas today?

• "Infrastructure to support a growing state must have transportation systems as well as water and education."

• "There really is NOT an adequate water supply system in Texas for our continued rate of growth. Next to air, running low on water is serious."

• "Businesses, communities, and people need water to thrive. If we don't get a handle on it, the Texas landscape will be dotted with ghost towns."

• "Our education system is broken and there will come a time when companies will leave Texas because they cannot find an educated workforce."

• "The economy of Texas withers without an infrastructure designed to keep up with mobility requirements"

• "Water is a necessity. Increasing population is creating visible strains on our water supply. If the water issue is not addressed, everything else will become unimportant very quickly."

• "Poor education, or better the waste of young minds, is the rot of al the other issues."

• "The focus on 'right or left' instead of 'right or wrong' in all of the areas listed above."

• "It's so cute that we regard Texas as significantly different from the rest of the United States but it ain't. Here too, first place is growing income inequality, which is strangling our economy. Second place goes to uncompetitive electoral districts, which are strangling our polity."

• "It is a hard choice between education and water. The current legislative mindset, however, is to let public education go the way of the dinosaurs and let charter schools (read culturally correct) take its place."

Enlarge Todd Wiseman

.

Thinking about the country, do you think that things are headed in the right direction, or do you think that things are headed off on the wrong track?

• "Too much spending and debt."

• "If Republicans don't gain control of the conversation, 'American Exceptionalism' will become a quaint, historical notion."

• "Hard to say wrong track with the stock markets at all-time highs, but can't shake that nagging little 16 trillion debt."

• "Sort of, gently, kind of in the right direction."

• "{Insert baseless, knee-jerk Obama attack here.}"

• "Inflated prices. Closed business. The economy is on the WRONG track."

• "We literally can't spend ourselves into prosperity, despite what the President thinks."

• "Wrong, wrong, wrong track. 'Sixteen tons, and what do you get? Another day older and deeper in debt...' Yes, we're all singing the same tune as Congress digs our way to eventual collapse."

Thinking about the state of Texas, do you think that things are headed in the right direction, or do you think that things are headed off on the wrong track?

• "Texas is much better than the feds, but an overwhelming part of our state budget and programs are dictated by the feds."

• "We are at the fork in the road where legislators and the citizens of Texas need to support the right policies. It's not too late, but we are quickly running out of time."

• "Will be interesting to see our job situation in 12 years after 12 years of failing to courageously and honestly invest in the health and education of Texas children."

• "Almost a polar opposite of the wrong track at the federal level."

• "If we can pay for education we will thrive as a state. People don't want to waste tax dollars, but most want a first class education system."

Enlarge Todd Wiseman

.

If Rick Perry were to run for governor again in 2014, would you vote for him, would you vote against him, or would you need to wait and see who is running against him?

• "Yes, he's been there a long time (and the media is fatigued) but hasn't the State been better for it?"

• "Give him credit-great politician. Does not translate into leadership for our state."

• "He's made the history books so let someone else come in and lead our great state."

• "I'd prefer fresh leadership, but I don't anyone who'd be better."

• "Never been a huge fan but it's difficult to fire someone whose state is outperforming the rest of the nation in job creation, property values and affordable living."

• "The only relevant question in politics is 'compared to what.'"

Enlarge Todd Wiseman

.

Suppose the Tea Party movement organized itself as a political party. When thinking about the next election for Congress, would you vote for the Republican candidate from your district, the Democratic candidate from your district, or the Tea Party candidate from your district?

• "An organized, standalone Tea Party would be a disaster for conservatives and must be stopped at all costs."

• "Honestly, as an independent voter I really would have to see what these individuals stand for, what they bring to the table and how they could help out our community.  I'm not voting for someone just because they have an 'R' or a 'D' after their name."

• "I vote for the best candidate regardless of party!"

• "Depends on the candidates"

• "Dixiecrats=Wallace=Perot =Tea Party"

• "Republicans must recruit and elect more like Senator Cruz."

• "You assume I vote."

Enlarge Todd Wiseman

.

Do you think the Tea Party movement has too much influence, too little influence, or the right amount of influence in the Republican Party?

• "Their litmus tests tend to drag candidates too far away from right-center voters. Dangerous when running statewide or nationally."

• "It's a small part of a small part of the overall population that determines who represents us in office.  Until the Ds reorganize as a viable electoral force, it's going to be tough to dislodge the Tea Partiers as a force."

• "Like all other 'movements' whether it be the Prohibitionists, the Suffragists, the Anti-Masonic or the Bull Moose, once their issue is spent or fails, they'll fizzle out. For a new party to make it, you've got to be for some things, it so hard to keep up the pace, being against everything."

• "Being conservative and obstinate don't have to go together"

• "They make their voices heard -- that is the goal of every organized group that descends on the Capitol every day.  The Tea Party's only crime is that they are effective.  Do you think teachers or trial lawyers have too much influence on the Democratic Party?"

• "Too much.  Not in regard to fiscal conservatism, which is needed, but because of all the other crackpot baggage they seem to carry--nullification, birther-ism, xenophobia, etc."

Our thanks to this week's participants: Gene Acuna, Cathie Adams, Brandon Aghamalian, Jenny Aghamalian, Jennifer Ahrens, Victor Alcorta, Clyde Alexander, George Allen, David Anthony, Jay Arnold, Charles Bailey, Tom Banning, Dave Beckwith, Andrew Biar, Allen Blakemore, Tom Blanton, Hugh Brady, Chris Britton, Andy Brown, David Cabrales, Thure Cannon, Snapper Carr, Elizabeth Christian, Elna Christopher, James Clark, Harold Cook, Kevin Cooper, Beth Cubriel, Randy Cubriel, Curtis Culwell, Denise Davis, Hector De Leon, June Deadrick, Tom Duffy, Richard Dyer, Jeff Eller, Jack Erskine, Wil Galloway, Neftali Garcia, Norman Garza, Dominic Giarratani, Bruce Gibson, Stephanie Gibson, Eric Glenn, Kinnan Golemon, Daniel Gonzalez, Jack Gullahorn, Wayne Hamilton, Bill Hammond, Adam Haynes, Susan Hays, John Heasley, Laura Huffman, Deborah Ingersoll, Richie Jackson, Cal Jillson, Jason Johnson, Karen Johnson, Bill Jones, Mark Jones, Robert Jones, Walt Jordan, Lisa Kaufman, Robert Kepple, Richard Khouri, Tom Kleinworth, Sandy Kress, Pete Laney, Dick Lavine, James LeBas, Luke Legate, Leslie Lemon, Ruben Longoria, Matt Mackowiak, Luke Marchant, Dan McClung, Parker McCollough, Robert Miller, Bee Moorhead, Mike Moses, Keats Norfleet, Pat Nugent, Nef Partida, Gardner Pate, Wayne Pierce, Richard Pineda, Allen Place, Kraege Polan, Jerry Polinard, Gary Polland, Jay Pritchard, Jay Propes, Ted Melina Raab, Bill Ratliff, Tim Reeves, Patrick Reinhart, Kim Ross, Andy Sansom, Jim Sartwelle, Stan Schlueter, Bruce Scott, Robert Scott, Ben Sebree, Jason Skaggs, Ed Small, Martha Smiley, Todd Smith, Larry Soward, Dennis Speight, Jason Stanford, Bill Stevens, Keith Strama, Colin Strother, Michael Quinn Sullivan, Sherry Sylvester, Jay Thompson, Russ Tidwell, Gerard Torres, Trey Trainor, Ken Whalen, Darren Whitehurst, Seth Winick, Peck Young, Angelo Zottarelli.

Enlarge

In this edition of the Newsreel: The Texas budget battle is finally under way (quietly), Medicaid expansion may be taking shape and Lt. Gov. David Dewhurst tells the regents of the University of Texas System to lay off the administration at UT-Austin.

You can view the video at: https://trib.it/WVsMA4

Enlarge Todd Wiseman

Monday, Feb. 25

• House Appropriations Committee hearing (8:30 a.m.)
• Senate State Affairs Committee hearing (9 a.m.)
• Senate Finance Committee hearing (9:30 a.m.)
• House International Trade and Intergovernmental Affairs Committee hearing (10 a.m.)
• House Pensions Committee hearing (10 a.m.)
• Senate Nominations Committee hearing (11 a.m.)
• Senate Open Government Committee hearing (1 p.m.)
• House Elections Committee hearing (2 p.m.)
• House Investments and Financial Services Committee hearing (2 p.m.)
• House Judiciary and Civil Jurisprudence Committee hearing (2 p.m.)
• House Technology Committee hearing (2 p.m.)
• House Ways and Means Committee hearing (2 p.m.)
• Senate Agriculture, Rural Affairs and Homeland Security Committee hearing (2 p.m.)
• Senate Finance Committee hearing (2:30 p.m.)
• House Government Efficiency and Reform Committee hearing (4 p.m.)

Tuesday Feb. 26

• House Appropriations Committee hearing (7:30 a.m.)
• House Human Services Committee hearing (8 a.m.)
• House Transportation Committee hearing (8 a.m.)
• House Insurance Committee hearing (8:30 a.m.)
• Senate Health and Human Services Committee hearing (9 a.m.)
• House Business and Industry Committee hearing (10:30 a.m.)
• House Criminal Jurisprudence Committee hearing (10:30 a.m.)
• House Environmental Regulation Committee hearing (10:30 a.m.)
• House Economic and Small Business Development Subcommittee on Manufacturing hearing (11 a.m.)
• Senate Jurisprudence Committee hearing (1:30 p.m.)
• House Public Education Committee hearing (2 p.m.)

Wednesday, Feb. 27

• Senate Intergovernmental Relations Committee hearing (1:30 p.m.)
• House Corrections Committee hearing (2 p.m.)

Thursday, Feb. 28

• House Defense and Veterans' Affairs Committee hearing (8 a.m.)

Enlarge

As a physician and as president of the Texas Medical Association, I hear daily complaints from Texas patients and doctors about our state’s Medicaid program, which cares for low-income citizens and Texans with disabilities.

Texas physicians have a clear message for our federal and state policymakers on the issue of Medicaid expansion: “Reform first, then expand only with a state-specific plan that targets the unique health care needs of our state’s population and that Texas taxpayers can afford.”

Before we move forward on that expansion, we need to make sure that Texas Medicaid patients have access to physicians. Because Medicaid patient-care rates are often below the actual cost of care, Texas physicians are forced to severely limit the number of Medicaid patients they can see. This forces many Texas Medicaid patients to forgo normal medical care in a doctor’s office and to overuse expensive emergency department care.

To improve Medicaid patient access and dramatically reduce the high cost of emergency room care, Medicaid payment rates should increase to the same levels as Medicare rates before any expansion of Medicaid in Texas.

Texas physicians are also discouraged from accepting new Medicaid patients because of the program’s 1,802-page rulebook and exasperating, irreconcilable red tape. We need to return to treating the patient, not the administering bureaucrat.

Additionally, Texas physicians are increasingly frustrated by the lack of transparency or fair review process by so-called Medicaid fraud investigators. Make no mistake — we should have zero tolerance for any form of intentional and malicious Medicaid fraud. However, Medicaid auditors need to focus on financial fraud instead of second guessing real-life medical treatment decisions.

Texas must enact these critical reforms before developing a state-specific Medicaid expansion plan for Texas. We must look beyond the federal government’s expansion solution to design one especially for Texas and for Texans.

The physicians of the Texas Medical Association are confident that state leaders and lawmakers — with input from patients, health care providers, employers, taxpayers, and others — can design a comprehensive solution that is healthy for patients and taxpayers.

Texas physicians support Medicaid reform and a Texas-specific Medicaid expansion that:

• Allows the state to develop a benefit package that makes sense for its patient population,
• Provides Medicaid payments for patient care equal to those of Medicare,
• Has patient responsibilities like co-pays and deductibles, and
• Allows the state to revise or eliminate the program if conditions change.

Implementing these reforms will improve Texas Medicaid and allow Texas patients to receive the care that they need.

Michael E. Speer is a Houston neonatologist and president of the Texas Medical Association.

Enlarge

The Texas Medicaid program is an indispensable part of the health care safety net for our state’s neediest, most vulnerable residents. State lawmakers have a responsibility to ensure that it delivers quality coverage and adequate access to care for those who rely on it, and also that the taxpayer-funded program is efficient and sustainable over the long term.

That is precisely why they should not expand it.

Put bluntly, Medicaid provides the worst health care outcomes in the country at the worst value to taxpayers. Providers in Texas have been abandoning the program for years, citing low reimbursement rates and burdensome federal red tape. Today, seventy percent of Texas physicians refuse to accept new Medicaid patients, and beneficiaries find it increasingly difficult to find a doctor who will see them. Instead, they seek out primary care in hospital emergency rooms, driving up the cost of uncompensated charity care, which now totals about $5 billion a year in Texas.

Proponents of expansion often cite uncompensated care as a reason to expand Medicaid, arguing that more people on Medicaid will mean fewer unreimbursed costs for hospitals. But the problem is more complicated than that. The cost of unreimbursed care comes not only from treating the uninsured, but also from treating Medicaid patients, for whom hospitals are typically paid about 50 cents on the dollar compared to private insurance. To make up the difference, hospitals receive local and federal tax dollars, but they also recoup costs by charging more to private insurance, which in turn increases insurance premiums for everyone.

By adding an estimated 1.5 million people to the program, it is likely that expansion will increase, not decrease, uncompensated care costs in Texas, as an influx of Medicaid enrollees discover that the only place they can reliably get health care is in a hospital emergency room.

The federal Affordable Care Act (aka ObamaCare) attempts to expand Medicaid to cover everyone who earns less than 138 percent of the federal poverty level, about $31,800 for a family of four. But for states that refuse expansion, anyone earning at least 100 percent of the federal poverty level (about $23,000 for a family of four) will qualify for subsidized private health insurance through the federal exchanges established by ObamaCare. In short, the law advocates a system in which those with very low incomes are forced to get sub-standard coverage on Medicaid, and those with higher incomes get a subsidy for higher-quality private coverage.

This is not only unfair to the working poor; it is also unfair to Texas taxpayers. Texas’ Medicaid program is broken and failing, and fundamental reform would be imperative even if ObamaCare did not exist to exacerbate the problem. State Medicaid spending is on an unsustainable trajectory. Currently, the program consumes 25 percent of the state budget, but an expanded Medicaid program would account for 33 percent of the budget by 2040, forcing spending cuts in other areas, tax hikes, or both. Recently, the Congressional Budget Office confirmed the findings of a 2010 study by the Texas Public Policy Foundation: without reform, Medicaid spending by the states and the feds will double every decade.

Pushing for a short-term influx of federal cash is short-sighted and irresponsible. State lawmakers must instead undertake a complete overhaul of the system and push the federal government to cooperate in this effort. For too long, a straightjacket of federal rules and regulations has prevented Texas and other states from enacting fundamental, market-based reforms that could control cost growth, increase physician participation, and improve health outcomes for Medicaid enrollees.

Toward this reform goal, the Texas Public Policy Foundation is developing a new model called Save Texas Medicaid that not only empowers Medicaid beneficiaries to become cost-conscious participants in their own care, but also gives them access to the same private coverage plans that other Texans now enjoy. Instead of intermingling federal and state funds, so that neither the state nor the feds are politically accountable for outcomes, Save Texas Medicaid calls for a defined contribution of federal funds to the state.

Expanding the state’s Medicaid program without fundamental reform is financially reckless and morally unconscionable. The good news is that there is another way to provide for our poorest residents over the long term. Given the flexibility, Texas could design a sustainable system that delivers better, more affordable care.

That is something state lawmakers owe to current Medicaid recipients and Texas taxpayers alike. 

Arlene Wohlgemuth is the Director of the Center for Health Care Policy at the Texas Public Policy Foundation.

With no opposition, the Texas House passed its first supplemental appropriations bill (they expect one or two more) and sent it along to the Senate. It would spend $4.8 billion in general revenue (state funds) and pull down another $6.6 billion in federal funds. What might have become a debate over 2011's budget cuts was instead a yes-fest, with representatives pulling down all of their proposed amendments and then suspending the constitutional rules to send the legislation forward. This bill covers the cost of the current Medicaid system for the rest of the current budget cycle. To come: Another supplemental for wildfires, prison health care, and probably, a number of amendments that weren't added to this first bill. 

In the midst of ongoing turbulence between the University of Texas System regents and the leadership of its flagship institution, the Texas Senate and House honored University of Texas at Austin President Bill Powers this week with resolutions acknowledging his accomplishments and his years of service. The resolutions passed in both chambers, an honor coming at a time of strain between the university and the board of regents whose members have all been appointed by Gov. Rick Perry. Lt. Gov. David Dewhurst became emotional when he addressed the Senate and Powers, criticizing the regents for undermining Powers and “cases allegedly of character assassination.”

Houston’s Senate runoff is underway, with early voting running through next Tuesday and the actual runoff election set for Saturday, March 6. Two Democrats — Rep. Carol Alvarado and former Harris County Commissioner Sylvia Garcia — are competing to replace the late Mario Gallegos, also a Democrat, in SD-6. An Alvarado win would trigger another special election to fill her House seat.

More than 100 witnesses signed up to testify before the House Public Education Committee this week in a hearing on student testing and graduation requirements that lasted into the evening and proved the unpopularity of those tests in the Texas Legislature. Students, parents and educators overwhelmingly spoke in support of state Rep. Jimmie Don Aycock's House Bill 5, arguing that the current system forces teachers to teach to the test and stifles flexibility to provide career-orientated courses.

Just four months after winning re-election, state Rep. Mark Strama, D-Austin, announced he won't seek another term in 2014. He's considering a run for mayor and said he wants to clear the way for other candidates who have shown interest in his spot. The early announcement gives them room, but makes him a lame duck with most of the session still in front of him.

Vistasp M. Karbhari, the provost at the University of Alabama, remains the sole candidate for the presidency of the University of Texas at Arlington following a meeting of the UT System Board of Regents that was hastily called to revisit his prospective employment.

Karen Johnson is going part-time at United Way of Texas and picking up another job at Power Across Texas, and will stay with the first one through the session and the year while United Way looks for a new CEO. She’s been with them for 13 years. 

Matt Hirsch moved to the building next door, leaving the Capitol media offices of Lt. Gov. David Dewhurst for the nearby media offices of Attorney General Greg Abbott. Before the government gig, he worked in Dewhurst’s campaign office.

Matthew Ladner is joining the Texas Public Policy Foundation for the legislative session to help them with school choice issues. He worked on education issues in Florida for then-Gov. Jeb Bush.

Gov. Rick Perry appointed:

• Jeff Hildebrand of Houston, Ernest Aliseda of McAllen and Paul Foster of El Paso to the University of Texas System Board of Regents. Hildebrand is chairman and CEO of Hilcorp Energy Company, Aliseda is the managing attorney of Loya Insurance group and a municipal judge for the city of McAllen, and Foster, a reappointee, is the executive chairman of Western Refining Company.
• Three regents to the Texas State University System, including two reappointments in Charlie Amato of San Antonio and Bill Scott of Nederland. The new regent is Vernon Reaser III of Bellaire, president of the Texas Teachers Alternative Certification and Texas Educators Association. Amato is chairman of SWBC. Scott is chairman and CEO of Trans-Global Solutions.
• Andres Alcantar to another term on the Texas Workforce Commission. He current chairs that panel; before joining TWC, he worked on the governor’s policy staff. 
• William “Barry” James, and orthodontist from Palestine, to the Upper Neches River Municipal Water Authority’s board. That’s a reappointment.
• Douglas Wilson to another term as inspector general of the state’s Health and Human Services Commission.
• Charles Bacarisse of Houston and Cynthia Villa of El Paso to the Texas Department of Information Resources. Bacarisse is a veep at Houston Baptist University and a former Harris County Clerk. Villa, a CPA, is a veep at UT-El Paso.
• Chris Crouch Graham, owner of Hondo’s in Fredericksburg, to the State Preservation Board.
• Joe Ward, a rancher and retired businessman from Telephone, to another term on the Soil and Water Conservation Board.