Adequately fund Title V Programs for maternal and child health services, including dental, primary care and family planning, especially for areas that are designated as health professions shortage areas and that continue to be severely uninsured. The need to enact legislation is necessary to safeguard current funding and assure that adequate future funding for preventive primary health care is provided for underserved and indigent communities, especially for Laredo and other Texas-Mexico border communities, where local Health Departments serve as primary care providers.

The demand for maternal child health services has multiplied because of Laredo’s under and uninsured population, which is estimated at over 50%. To meet both the infrastructure and human resources needs, border communities, especially Laredo, have addressed the shortage through local means. Laredo remains designated as a Health Professions Shortage Area (HPSA) and Medically Underserved Areas (MUA) for primary care physicians, nurses, dentists and mental health providers. The disparity between need and resources is enormous and critical. Unfortunately, a constant reduction over the last five years and almost 20% over the last three years – and/or level funding, especially for Title V and Primary Care services, is a challenge. As mentioned, given the opportunity, Laredo has excelled and met this need through innovative operational changes, multidisciplinary staff responsibilities and through local and regional partnerships with local hospitals and providers. The approach is a community wide effort. The rising need for services and the lack of adequate providers and Title V funding cuts have greatly affected the City’s ability to adequately address health care concerns. In addition, the Texas Department of State Health Services (TDSHS) has transferred its funding for primary care and chronic disease detection to the Bureau of Federally Qualified Health Centers (FQHCs). However, for local medically underserved and indigent communities such as the Texas-Mexico border, FQHCs are not sufficient; certainly in Laredo, one FQHC cannot meet the current need, forcing City Public Health Services to become responsible. Until there are more clinics and health care providers, indigent care and Title V services will remain critical for local public health providers. Funding to support these efforts must be safeguarded and enhanced. Instead, funds continue to be reduced and local health departments do not qualify for the benefits of FQHCs.

To support this effort, direct funding to the border as its own region, would pose a more equitable formula to support the current and continued disparities. For Laredo/Webb County, provide adequate funding based on the local need of border communities, rather than based on formulas. A potential solution is the creation of both a state and federal designated United States-Mexico Border Region that has dedicated funding based on local needs of the border, instead of having funds directed to the current regional office structure (Federal Region VI and State Region 11 for Laredo). Finally, provide a waiver to allow for a “Federally Qualified” status to assist with benefits and reimbursement. This will allow us to serve more patients in need.

None has been made thus burdening our local communities. In Laredo we absorb over $300,000 in indigent Maternal and Child Health (MCH) services through public health. The cost for high-risk pregnancy and emergency room maternity and neonatal care is overwhelming. Therefore the need for continued early screening and care is critical, as well as additional support for indigent care services is warranted; if not, we will put more through emergency care.

• Health Resources and Services Administration (HRSA) – Bureau of Primary Health Care
• HRSA - Health Careers Opportunity Program
• Department of State Health Services