City of

Federal Legislative Agenda 2017

Protect and Fund Women's Health Services

Situation Assessment

Enhanced services are needed for maternal and child health, dental/primary care, family planning, women’s preventive health care and cancer screening for the US/Mexico Border where we up to 40% of the population is uninsured or underinsured and is medically underserved.  The need to enact legislation to protect and fund current and expanded services is important for all, but especially for Laredo and other US/Mexico border communities and most especially 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. Over 45% of the population is school age, making it one of the youngest communities. Being young and having a high birth rate only augments the need for quality and adequate maternal and child health care.  In the last three (3) years we have seen an increase in prematurity (12 deaths per year), gestational diabetes, pre-eclampsia, and a rise in congenital syphilis syndrome. In large part this is due to late or no prenatal care, interruption in the continuum of care for wellness and preventive health care and a large uninsured population. With new and emerging disease such as Zika and cancer early detection and the continuum of care and learning to navigate the health care system is critically important.


Both infrastructure and human resources are needed as many border communities, and especially Laredo, remain designated as a Health Professions Shortage Areas (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 years and almost 20% over the last three years and/or level funding, especially for Title V, Title X, Block Grant and Primary Care services, is a challenge. 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. But the rising need of services and the lack of adequate provider’s preventive health services have greatly affected the City’s ability to adequately address health care concerns especially for women and children. The Texas Department of State Health Services (TDSHS) and Texas Health and Human Services has assisted with its own women’s health services (Healthy Texas Women) and the Medicaid Transformation waiver, these have assisted but we need to protect and expand funding at the federal level as well. Until there are more clinics and health care providers, indigent and uninsured health services need Title V, X and the block grant resources for local public health providers. Funding to support these efforts must be safeguarded and enhanced.


Potential Solution

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, and not 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 for women’s health services. In the short term the protection of the health services block grant, Medicaid Transformation waiver extension and expansion of Title X and V are crucial. We cannot have women with no, care go to the emergency rooms for high risk deliveries and care.



Discussion with local providers on a hospital district and medical school training has been initiated as well a Mayors Task Force is being developed.


Target Agencies

• Assistant Secretary of Health Womens Health Services

• HHS Womens Health Services

• HHS Title X and Title V Services

• Centers for Medicaid and Medicare Services (CMS)

• Health Resources and Services Administration (HRSA) – Bureau of Primary Health Care

• HRSA - Health Careers Opportunity Program



Dr. Hector F. Gonzalez

Health Department Director

2600 Cedar Avenue

Laredo, TX78040

Phone: (956) 795-4900

Fax: (956) 726-2632