STATE of TEXAS HOUSE of REPRESENTATIVES SARAH DAVI 5 DISTRICT 134 HARRIS COUNTY April 10, 2018 Alex Azar, Secretary Valerie Huber, Deputy Assistant Secretary for Population Affairs US. Department of Health and Human Services 200 Independence Ave, S.W. Washington, DC. 20201 RE: Title Grant Administration in Texas Secretary Azar and Deputy Huber: As a Republican member of the Texas House of Representatives, representing the world?s largest medical complex, the Chairman of the Appropriations Subcommittee on Health and Human Services, and as the Secretary of the Women's Health Caucus, I write to express my concern with Attorney General Ken Paxton's March 22, 2018 correspondence, regarding "Discrimination Against Texas Regarding Title Grants." The Attorney General's correspondence contains various inaccuracies, which I can only assume are from being incorrectly advised, and I respectfully request you DENY the State of Texas' Application for Title Grants, allowing the monies to continue to ?ow through the Women's Health and Family Planning Association of Texas The Attorney General?s letter incorrectly states that "your predecessor removed Texas from the list of eligible Title grant recipients when it came to Texans? overwhelming support for laws that respect the sanctity of life among the unborn." This is simply not true. Texas competed for the grant and lost. In 2013, HHS determined that a coalition of providers, better met the objectives of Title than the State of Texas. The Attorney General's letter also incorrectly states that "Title funding was discontinued to Texas in 2013." But as previously explained, Title ?mds kept ?owing to Texas, just not to the state government of Texas to administer. The funds went directly to the to administer. Capitol: Committees: PO. Box 2910 Chair, General Investigating Ethics District: Austin, Texas 78768?2910 Chair, Article II Subcommittee, Appropriations 4148 Bellaire Blvd. (512) 463-0389 Calendars Corrections Houston, Texas 77025 Fax: (512) 463-1374 Email: Sarah.Davis@house.texas.gov (713) 664?7095 Secretary Azar Letter April 10, 2018 Page 2 of 3 The most glaring inaccuracy in the Attorney General's letter is the assertion that state general revenue (GR), was used to fund its own "Texas Family Planning Program. I believe that the Attorney General may have been incorrectly advised regarding the difference between Title family planning funds and the "Texas Women's Health Program." The "Texas Women's Health Program" was created when the State of Texas lost its waiver funds for the "Women?s Health Program." It was the loss of those federal funds that required the use of GR and creation of the new "Texas Women's Health Program" and the creation of the "Extended Primary Health Program", not for Title funding loss (because again, no Title money was lost, it was just directed to for administration.) It should also be noted that the Texas Health and Human Services Commission (HHSC) has been plagued with contracting scandals. As recently as yesterday, it was revealed that HHSC used incorrect scoring methods in determining CHIP contract awards, resulting in the cancellation of ?ve CHIP contracts and the termination of an associate commissioner for procurement Operations and two of his staff members. As the rule of law currently states, no state or federal funds may be used to cover the cost of abortion. However common political rhetoric continues to capitalize on the public?s unfamiliarity with current and past protocols that regulate the abortion industry. As such, in?ammatory letters under the guise of protecting Texas' belief to protect human life, risk future administration of the Title grant funding, currently administered at impeccable - and legal? rates in Texas. The Women?s Health and Family Planning Association of Texas is responsible for Spreading a $14 million across 28 providers and 100 clinics statewide. I have grave concerns that allowing the State of Texas to once again administer these grant funds will put the Texas network of community health centers, hospital-based clinics, public health departments and free-standing providers at grave risk of shuttering their facility doors. Texas has a history peppered with examples of limiting access to women?s health care either by exclusion of providers, limitations on funding, or arbitrary policy measures that ultimately result in decreased access to care. Policy measures and provider restrictions have often been enacted under the false pretense of protecting women's health, when in reality we see that low income individuals are ultimately forced to go without the health services they so ardently need. The current structure allows funding to ?ow to the areas of need based on clinic size and scope of service, and the Women?s Health and Family Planning Association of Texas have served the women of our state well by providing access that has already been limited through other women's health programs. I implore you to retain the status quo for Texas, and withhold eligibility for the State of Texas to administer the grant funding. The current system does not need a change, and I recognize through recent past occurrences, if the system does change, it will likely harm the very people we are meant to serve. Secretary Azar Letter April 10, 2018 Page 3 of 3 The current distribution, use, and general administration of the grant is serving the purpose it is meant to serve since its inception during the Nixon years. In consideration of abundant caution, I do not see the need to ?x something that is not only not broken, but functioning exactly as it was envisioned to do so. Thank you for your time and consideration, and I look forward to any questions or concerns you may have. Sincerely, Representative Sarah Davis House District 134