North Central Austin Edition | June 2024

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North Central Austin Edition VOLUME 17, ISSUE 3 JULY 3JULY 31, 2024

2024 Health Care Edition

Maternal care in hospitals expanding in Travis County

Births on the rise

BY BROOKE SJOBERG

In 2023, for the rst time in over a decade, Travis County’s population grew due to the number of people born within its bounds—not because of the people moving there. For that year, Travis County’s population increased by about 7,400 people. With a net migration of -2,411, this increase comes from an esti- mated 16,289 births countywide. Despite the modest increase of 270 births from 2022 to 2023, there is a growing demand for maternal care in the area. Statewide stang pressures point to a strain in Austin’s maternal resources, even as hospital groups work to expand space for care. “There are times when inductions are being held because there’s too many people coming in in labor,” said Dr. Margaret Whitney, an OBGYN with Women’s Health and UT Health. “There’s no bed, or there’s no nurse, so I think that’s probably the more palpable bottleneck across the board.”

Austinite Kellie Connolly gave birth to her daughter at St. David’s Medical Center in March 2023.

CONTINUED ON 32

COURTESY KELLIE CONNOLLY

Also in this issue Impacts: Alamo Drafthouse cinema chain sold (Page 7)

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Education: Austin ISD eyes tax increase to ease decit (Page 13)

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Austin is in STAGE 2 DROUGHT Water Restrictions

Watering one day per week

6 Automatic irrigation and hose-end sprinkler watering is restricted to one day per week. 6 Automatic irrigation watering times are before 5 a.m. or after 7 p.m. The runtime is reduced by 3 hours with cutoff at 5 a.m. instead of 8 a.m. 6 Hose-end sprinkler watering times are before 10 a.m. or after 7 p.m. 6 Hand watering or watering with a refillable receptacle such as a bucket is allowed on any day or time.

6 Water waste is prohibited. 6 Restaurants may serve water only upon request. 6 Charity car washes are prohibited, and home car washing is only allowed while using a bucket. 6 Patio misters at commercial properties, including restaurants and bars, may operate only between 4 p.m. and midnight. 6 Large ornamental fountains can no longer be operated. 6 New landscape variance required for watering outside of scheduled day

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Market leaders & metro team

Reporters Brittany Anderson Elle Bent Amanda Cutshall Kameryn Griesser Sarah Hernandez Parks Kugle Haley McLeod Hannah Norton Brooke Sjoberg Ben Thompson Amira Van Leeuwen Zacharia Washington Chloe Young Graphic Designers Rachal Elliott Alissa Foss Gloria Gonzalez Melissa Johnson Sabrina Musachia

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Impacts

BY ZARA FLORES, BEN THOMPSON & AMIRA VAN LEEUWEN

NORTH AUSTIN

5 Hui Lau Shan The Hong Kong-based dessert shop specializes in fresh mango desserts and drinks such as mango rice pudding, mango mochi and mango pancakes. • Opened May 21 • 7020 Easy Wind Drive, Ste. 150, Austin • www.huilaushan.us

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Now open

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Relocations

W. POWELL LN.

Spread & Co. Austin’s first grazing board company turned cheese- centric cafe, closed its Jefferson Square Shopping Center location on May 26 and will be relocating to a new space this summer, according to an Instagram post. Spread & Co. will continue working out of a commissary kitchen in the meantime, and the company’s Laguna Gloria location will serve as the new

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3 Toastique The micro cafe is owned by franchisee Carrie Carretta and her husband Rick Giambastini. Toastique will serve gourmet toast, granola bowls, smoothies, fresh cold-pressed juice, cocktails and espresso drinks. • Opening June 22 • 2620 Perseverance Drive, Retail B 2-2, Austin • www.toastique.com

pickup spot in the interim. • Opening summer 2024 • Location TBA • www.spreadandco.com

290

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In the news

PERSEVERANCE DR.

6 Innovative Water Solutions In April, the business celebrated its 20 year anniversary of providing sustainable water conservation systems to Central Texas, according to a news release. IWS specializes in rainwater harvesting, green infrastructure, drainage improvements and gray water reuse. • 501 W. Powell Lane, Ste. 206, Austin • www.watercache.com Alamo Drafthouse The Austin-based cinema franchise was acquired by Sony Pictures Entertainment, which plans to expand the chain’s operations. Founders Tim and Karrie League launched dozens of theaters throughout the state since founding Alamo in 1997. The acquisition follows Alamo’s North Texas franchisee filing for Chapter 7 bankruptcy, resulting in theatre closures, which would reopen in the future.

BLUE CREEK RD.

MAP NOT TO SCALE

North Central

offers luxury dog boarding and daycare. The space features private suites for each dog, pools, shaded tents and more in the outdoor play area. • Opened March 18 • 8613 Burnet Road, Austin • www.bhvaustin.com 4 The Art Garage The studio is owned and operated by mother-daughter duo, Kelly and Kaiya Emmert, and offers paint-your- own pottery, glass fusion and mosaic creation. This is the second location of The Art Garage and also hosts birthday parties, workshops and more. • Opened June 1

Now open

1 Make at Rosie Cat Ashton and Clairissa Simmons aim to empower women and nonbinary creatives with this space, featuring equipment for crafts and projects like jewelry making, woodworking, embroidery and more. • Opened in April • 8711 Burnet Road, Ste. B30, Austin • www.makeatrosie.com 2 BHV Austin TOO Locally owned by Vanessa Calabria, BHV Austin TOO

• Locations throughout Austin • www.alamodrafthouse.com

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Impacts

BY ZARA FLORES, SARAH HERNANDEZ & AMIRA VAN LEEUWEN

Gloria’s Latin Cuisine space. The restaurant comes from Innovative Dining Group with chef James Flowers leading the kitchen. The menu features signature dishes like roasted wagyu bone marrow; cocktails; beer and more. • Opened June 3 • 300 W. Sixth St., Austin • www.boasteak.com

Now open

GUADALUPE ST. 9

In the news

6 The Headliners Club The private club will undergo $8 million of renovations starting Jan. 2025 without service interruption. The construction will include new dining options and an updated bar area. • 221 W. Sixth St., Ste. 2100, Austin • www.headlinersclub.com 7 Somaspace The studio is locally owned by Amanda Vernor and celebrated 15 years of business in June. Somaspace offers small group classes and specializes in private and

3 Mad Dogs Founded by Moustafa Eissa in Houston, the food truck-based business has opened in its first brick- and-mortar location—in the same building as dessert shop Midnight Cravingz. Mad Dogs offers halal hot dogs, which refers to the preparation of foods inn accordance with Islamic practices. The menu features an array of loaded hot dogs. • Opened April 26

semi-private classical Pilates instruction. • 1611 W. Fifth Street, Ste. 140, Austin • www.somaspacepilates.com

• 917 W. 12th St., Austin • Instagram: maddogstx

Closings

8 Hearth & Soul The shop—which was founded by Susie Busch and sold clothing, furniture and other goods— has closed. The Missouri and Florida locations will remain open. • Closed May 31 • 904 W. 12 St., Austin • www.hearthandsoul.com 9 Wheatsville Food Co-op General Manager Bill Bickford shared that the store’s sales have declined, and the effects of Austin Transit Partnership’s Austin Light Rail Phase 1 could hinder business, resulting in the closure. However, the team will search for another location in North Central Austin. • Closing Dec. 31, 2026 • 3101 Guadalupe St., Austin • www.wheatsville.coop

Downtown/West Campus

• Opened April 20 • 607 Congress Ave., Austin • www.sweetsensiwellness.com

Now open

4 Out of the Closet Thrift Stores The shop buys and sells second-hand clothes, home goods and more; Sexually transmitted disease testing is available weekdays, and HIV testing is available Saturdays. • Opened May 4

1 Retail Therapy The bar is owned by Eric Foster, Ryan Smith and Glenn Williams, and serves cocktails inspired by iconic fashion trends and designers. • Opened March 8

• 2927 Guadalupe St., Austin • www.outofthecloset.org

• 120 E. Seventh St., Austin • www.retailtherapyatx.com

2 Sweet Sensi Founded by Greg Autry, the business produces handmade CBD products like drinks, oils and more.

5 Boa Steakhouse The California-based steakhouse has opened in the former

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BY ZARA FLORES & AMIRA VAN LEEUWEN

First Street space offering wine by the glass and bottle; an array of cheese and fruit boards; and other small bites.

Now open

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• Relocating in late June • 1711 S. First St., Austin • www.housewineaustin.com

In the news

5 444 Tattoo The studio, formerly known as Companion Tattoo, underwent new ownership and a name change in June. 444 Tattoo is now owned by tattoo artist Annie Mess, who has more than 20 years of experience in the industry. The shop has several artists who specialize in different styles of tattoos, from traditional and color to black and gray.

2 Date Nite Gallery The gallery is locally owned by artist Landry McMeans. Date Nite Gallery showcases a variety of local artists in a range of mediums, including paintings, jewelry, ceramics, clothing and fiber art. • Opened June 1

• 4390 S. First St., Austin • Instagram: 444_tattooatx

Closings

• 3908 Menchaca Road, Austin • www.landrymcmeans.com

6 1417 French Bistro The Bouldin Creek neighborhood restaurant shuttered its doors at the end of May, which was announced via social media. Allison Welsh owned the restaurant, offering a variety of French specialty dishes. A note on the door states the building will be redeveloped to make way for a new project called Bouldin Creek Lofts. • Closed May 30 • 1417 S. First St., Austin 7 Sunroom The women’s clothing and accessory shop, founded by Lucy Jolis in 2013, has closed its Austin location within the South Congress Hotel. The Malibu, California, location of Sunroom will relocate and remain open. The online shop will also remain open. • Closed June 1 • 1603 S. Congress Ave., Austin • www.shopsunroom.com

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South Central

3 Kido International The global preschool and infant care brand will open a new location in the Bouldin Creek neighborhood this year. Kido International will offer daily Spanish immersion and outdoor play as part of its curriculum for children 6 weeks to 5 years old. • Opening in 2024

Coming soon

1 Tacodeli The Austin-founded chain will be taking over the space where Masa y Más taqueria sat on South Lamar Boulevard. This will be the first standalone location of Tacodeli which will feature an expanded cocktail menu with a new signature drink, the Doña Rita, a spicy cocktail featuring the restaurant's Salsa Doña. • Opening July 14 • 1817 S. Lamar Blvd., Austin • www.tacodeli.com

• 1924 S. First St., Austin • www.kidoschools.com

Relocations

4 House Wine After 16 years, the locally owned bar helmed by Kerry White has relocated from 408 Josephine St., Austin. The business will continue operations in its new South

NORTH CENTRAL AUSTIN EDITION

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EAST AUSTIN

Impacts

BY COMMUNITY IMPACT STAFF

fresh juices and sandwiches. The location features some artwork from owner Mike Affaneh. • Opened June 1 • 1623 E. Seventh St., Austin • www.pranacafe.love

Coming soon

PHILOMENA ST.

ROBERT BROWNING ST.

Coming soon

6 Hopdoddy Burger Bar Construction is slated for a new location of the Austin- founded chain offering burgers, fries, shakes and more. Hopdoddy was founded in 2010 by friends Larry Foles, Guy Villavaso, Larry Perdido and Chuck Smith.

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• Opening in spring 2025 • 2005 Aldrich St., Austin • www.hopdoddy.com

3 Mam Mam The East Asian food counter is now open inside Springdale General. Mam Mam is locally owned by Kris Hoang, and offers East Asian-inspired dishes like papaya salad and Hat Yai fried chicken. • Opened March 7 • 1023 Springdale Road, Bldg. 1, Austin • www.mam-atx.com

973 7 Radius Butcher & Grocery The new shop, led by founder Kevin Fishner and head butcher Joe Saenz, will replace Salt & Time Butcher Shop and Restaurant which will close July 6. Radius officials will source food from some of the same farms Salt & Time does. • Opening in 2024 • 1912 E. Seventh St., Austin • www.eatradius.com 8 OKO After eight years, neighborhood bar Ah Sing Den closed June 9, to be replaced by OKO from Trinity Concepts and FAM Hospitality group. The restaurant will offer dishes inspired by Filipino, Thai and Japanese culinary traditions. • Opening this fall • 1100 E. Sixth St., Austin 130 TOLL

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East Austin

spring. The cocktail menu, developed by Zachary Bobo, is agave-based with many Latin American ingredients. • Opened April 26 • 2808 Manor Road, Austin • www.thelonggoodbyeatx.com 4 Sunshine Vinyl The LGBTQ-owned record store, helmed by Luca Kisielius, offers new and used vinyl. It also hosts acoustic sets, DJ sets and charity events. • Opened June 15 • 1601 E. Fifth St., Ste. 108, Austin • Instagram: sunshinevinylatx 5 Prana Café The neighborhood cafe offers smoothies, coffee, tea,

Now open

1 La Seareinita A new restaurant from Gabriela’s Group has opened in what used to be a Whataburger, with a focus on seafood

Closings

including ceviche. • Opened May 25 • 2305 Burleson Road, Austin • Instagram: laseareinita

9 Cuvée Coffee The coffee shop and roaster closed its doors in East Austin but will continue operations in downtown at 48 East Ave. The shop is helmed by Mike McKim and shut down after a decade due to a rent increase. • Closed May 29

2 The Long Goodbye The bar and patio, owned by Katrina and Charles Ferraro, began serving drinks off Manor Road this

• 2000 E. Sixth St., Austin • www.cuveecoffee.com

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NORTH CENTRAL AUSTIN EDITION

Government

BY BEN THOMPSON

Homestead tax exemptions boosted Austin’s senior and disabled homestead tax exemption was raised in May. The details In Texas, some of the value of residents’ primary homes can be reduced for taxing purposes under the homestead exemption. The city’s update reduces the taxable value of eligible Austinites’ primary residence by $30,000, for a $154,000 total exemption. The move follows other increases approved in recent years and adds onto Austin’s blanket 20% exemption for all homesteads. The change could cost others about $100 on their next bills. Eligible Austin homeowners can apply for the exemption or check their status through the central appraisal districts in Travis, Williamson and Hays counties.

Historical (1979-2020)

Near term (2021-2040)

Mid-century (2041-2070)

End-century (2071-2100)

Temperatures rising The number of hot days in Austin is expected to increase through the 2000s, especially with high greenhouse gas emissions.

105

Min. temp. > 80°F 0 2 15

0 1 3

Number of days seasonally Max. temp. > 100°F

Max. temp. > 110°F

NOTE: MEDIAN PROJECTIONS ARE BASED ON A HIGH GREENHOUSE GAS EMISSION SCENARIO.

SOURCES: CITY OF AUSTIN, THE UNIVERSITY OF TEXAS AT AUSTIN CITY CLIMATE COLAB/COMMUNITY IMPACT

Austin prepares for summer heat to worsen With dangerous heat levels likely to continue this summer, local officials are advising residents to stay safe and prepared through the season. The gist Officials said to expect energy and water conser- vation, and for residents to watch out for friends,

family and neighbors as heat-related illnesses rise. What else? New projections from The University of Texas and city researchers suggest Austin can expect to see more hot days and intense weather swings as the climate changes and local population grows. Austin’s count of summer heatwaves and hot spells—respectively defined as three or more straight days of “excessive” heat and two or more straight days with highs over 102.5 days—are expected to at least double.

$1B wastewater plant project moves forward Austin officials approved spending more than $1 billion to upgrade one of two main wastewater treatment plants serving much of Austin Water, partially supported by upcoming utility rate hikes. What happened Multiple contracts for updates to the Walnut

Walnut Creek Wastewater Treatment Plant

by City Council on May 30. The plant’s capacity will be increased by 33%. What’s next Austin Water’s projected rate adjustment will help cover the cost of wastewater plant projects. AW anticipates its rates could rise about 30% over the next four years. New rates will be set during the summer budget process.

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Education

BY ELLE BENT

Austin ISD ocials approved a scal year 2024-25 operating budget of $953.99 million and took on a decit of $41.25 million June 20—as long as the board votes to place a tax rate increase on the November ballot. Without an increase in the tax rate to $0.9287 per $100 of property value and other savings, the decit reaches about $78.2 million—the largest ever for AISD. Before recapture—when the state takes property tax dollars from a district—the general fund totals $1.78 billion. The operating budget is left at $953.99 million after paying $821.06 million in recapture. Austin ISD eyes tax increase to ease decit

How we got here

"AISD did not put the [district] here; the state not supporting public education by way of funding has really exacerbated this problem that we have. My hope is that our legislators are paying

In mid-April, AISD sta discovered property value growth and average daily attendance rates were lower than they expected, bringing the pre- dicted $60 million shortfall to $89 million before cuts, resulting in less revenue for the district. Ocials made about $29 million in cuts to central oce positions and other costs this spring for FY 2024-25 to oset the decit. AISD ocials are pointing to multiple issues with public education funding that impact the budget, including: • House Bill 3, passed during the 88th legislature session, mandating an armed security guard at every campus, incurring more costs to the AISD Police Department • A loss of $7.8 million promised in Medicaid reimbursements for special education students due to the ndings of a federal audit

attention to the pain that school districts are going through right now." MATIAS SEGURA, AUSTIN ISD SUPERINTENDENT

• The basic student allotment—the amount school districts receive from the state based on student enrollment and attendance—not increasing since 2019 despite ination • Slow property value growth due to Senate Bill 2, a property tax relief plan passed during the 88th legislative session

Budget spending

Going forward

General fund: $1.78B Debt service fund: $241.25M Food service fund: $47.42M

would receive a one-time incentive payment of $500, as opposed to a pay increase. “Our community has the ability to make a decision on taxes, their dollars can support our schools,” Education Austin president Ken Zaris said. “Every stone needs to be turned before cuts are made at schools.” District ocials will discuss possible revenue streams and vote on placing a VATRE on the ballot at a future board meeting.

District ocials will likely ask the community to vote on a tax rate increase in a Voter Approved Tax Ratication Election, or VATRE, in November. If approved, ocials predict a VATRE would generate about $42 million in additional revenue. This would be about an increase of $35 a month to homeowners. Members of Education Austin, the district labor union, expressed support of a VATRE at a June 6 board meeting. Without it, full-time employees

Total: $2.06B

The district will pay $821.06 million, or 48% from the general fund to recapture. This leaves an operating budget of $953.99 million.

SOURCE: AUSTIN ISDCOMMUNITY IMPACT

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Transportation

BY HALEY MCLEOD

Update: The last phase of work began in June. • Timeline: summer-fall • Cost: $300,000 • Funding source: Austin Mobility Bonds

Ongoing projects

W. KOENIG LANE

1 Airport Boulevard C1A Project: The project will bring new pedestrian and bike shared-use paths, intersection safety upgrades, enhanced sidewalk connectivity and a new pedestrian signal at Airport Boulevard and Middle Fiskville Road. Update: Construction began in June. • Timeline: June-December • Cost: $482 million for total Corridor Mobility Program • Funding source: 2016 Mobility Bond 2 Airport Boulevard IA Project: This segment of the project includes the installation of new pedestrian hybrid lights at Gunter Street, Harvey Street, 40th street, Bolm Road and Manor Road intersections. Update: The beacons at Gunter Street and Harvey Street are operational. • Timeline: construction to be completed this fall • Cost: $482 million for total Corridor Mobility Program • Funding source: 2016 Mobility Bond 3 Bluebonnet Lane and Melridge Place Project: Mobility improvements will span from Del Curto Road to Rabb Road to increase access to Little Zilker Park, businesses and nearby neighborhoods.

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Completed projects

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E. 55TH ST.

4 Airport Boulevard C1 Project: The Airport Boulevard C1 project will include improvements to pedestrian walkways, new dedicated bike lanes and upgraded intersections from 55th Street to North Lamar Boulevard. Update: Roadwork and improvements are complete, and the route is now open to the public. • Timeline: project completed May 31 • Cost: $482 million for total Corridor Mobility Program • Funding source: 2016 Mobility Bond 5 Barton Springs Road pilot safety program Project: The program recongures single-vehicle lanes in both directions to reduce accidents. Update: The speeding and safety analysis indicates a 64.2% reduction in speeding. • Timeline: The pilot period will run from August 2023-August 2024. • Cost: $524,000 • Funding source: 2020 Safety and Active Transportation Bond

BARTON SPRINGS RD.

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AZIE MORTON RD.

BLUEBONNET LN.

DEL CURTO RD.

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Real estate

Two-thirds of the ZIP codes in Central Austin sold more homes year over year in May. Residential market data

Number of homes sold in each ZIP code

May 2023

May 2024

+6.3%

+77.78%

-23.88%

-35.48%

+57.14%

78705 78751 78752 78756

78757

78731

78701

78702

78703

78704

78705

78722

290

360

78723

78703

-16.67%

+44.44%

+200%

+745.45%

+64.29%

+15.22%

78701

78722

78702

78704

290

183

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MARKET DATA PROVIDED BY AUSTIN BOARD OF REALTORS AND UNLOCK MLS 5124547636 WWW.ABOR.COM

78723

78731

78751

78752

78756

78757

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a d e c e

A Caring Community Built on 4 Core Values

COMMUNITYIMPACT.COM

Central Austin

Median home sales price

May

2023

2024

May

2023

2024

566 674

$895,000 $720,000 $2,092,800 $975,000 $315,000 $793,000 $599,750 $1,000,000 $635,000 $485,000

$711,500 $755,000 $1,190,500 $950,000 $335,000 $650,000 $633,234 $1,125,000 $644,500 $465,000 $947,000 $655,000

New listings

78701

321

311

78702

Closed sales

78703

Homes under contract

318 292

78704

Homes sold by price point

78705

May 2024

78722

128

$900,000+

78723

78731

$700,000-$899,999

78751

$500,000-$699,999

78752

$300,000-$499,999

$675,000 $710,000

78756

<$299,999

78757

NORTH CENTRAL AUSTIN EDITION

Providing care to generations for over 70 years.

CONVENIENT LOCATIONS ACROSS THE GREATER AUSTIN AREA.

CLINIC LOCATIONS Cedar Bend Cedar Park Circle C Georgetown Leander North Austin Steiner Ranch Westlake

NEPHROLOGY LOCATIONS Bastrop Cedar Park Circle C Georgetown Kyle Lockhart

Marble Falls North Austin San Marcos Westlake

Visit www.adclinic.com or call 512-901-1111 to schedule your appointment.

COMMUNITYIMPACT.COM

Health care

BY SARAH HERNANDEZ

Health Care Edition

2024

Community Impact 's annual Health Care Edition features news on the timeliest topics in the industry. I delivered my first child eight years ago and I remember being surprised when hospital staff suggested I book a room on my due date like I would a hotel. As it turns out, I wasn’t the only one scheduled to have a baby then, and today, there are perhaps even more women who need a delivery room. In our cover story, we explore the latest U.S. Census numbers revealing an increase in the number of births in Travis County and how hospitals are responding. This story is part of our Health Care Edition which we deliver every June in all editions of Community Impact . Much like a baby, every edition is unique.

Premium sponsor:

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Austin Diagnostic Clinic adclinic.com 512-901-1111

Providing comprehensive primary and specialty care with over 20 locations.

What's inside

Over 1M Texas children cut from Medicaid (Page 20)

Psychiatric care expands at rebuilt Austin hospital (Page 25)

Austin Public Health ends COVID-19 reporting (Page 29)

Vaccine exemption rates are on the rise in Texas schools

Percent of students in K-12 with a conscientious exemption Exemption rates

Vaccination rates in school-age children were high for the 2022-23 school year, but increasing conscien- tious exemption rates and lingering pandemic dis- ruptions prevent them from being higher, according to the National Conference of Legislatures. The context In the 2022-23 school year, rates for consci- entious exemptions increased by 0.5% for most vaccines in Texas public schools, bringing the exemption rate to 3%, according to the Texas Department of State Health Services. State law allows for conscientious exemptions from vaccinations for a variety of reasons, including religious belief, according to DSHS. Chris Crookham, the immunizations unit program manager at Austin Public Health, said the pandemic may have affected the rise in exemption requests. “Because of the fear and concern around the rapid development of the COVID-19 vaccine, ... I think there was probably a large demand or a large request in exemptions for COVID-19 vaccines,” Crookham said. “That might have probably had some effect on exemptions for other vaccines as well.” Rebecca Hardy, a speech-language pathologist

and president of Texans for Vaccine Choice—an organization that aims to protect and advance vaccine choice through education and public policy—shares the same sentiment. The COVID-19 vaccine brought attention to other childhood vac- cinations that do not have “the safety or efficacy testing that you would have expected,” she said. Texas has three conditions for students’ vaccine exemptions: • If a health care provider determines a certain vaccine unsafe for the student • If the student is in the U.S. military • If they have a personal or religious belief against getting immunized “Certainly, some exemptions are legitimate, and that’s why they exist… but, of course, the more exemptions you have, the lower vaccine update you have,” Crookham said. “With a lower vaccine uptake, then there’s going to be less immunity throughout the population.” The DSHS has different immunization require- ments for different grade levels at public and private schools, and students entering kindergar- ten and seventh grade require new vaccinations. Students in those grades in Travis and Hays counties had an immunization rate of over 90%

Williamson

0.68-1.57% 1.58%-2.99% >3.00%

Travis

Bastrop

Hays

Caldwell

Comal

Guadalupe

Bexar

SOURCE: TEXAS DEPARTMENT OF STATE HEALTH SERVICES/COMMUNITY IMPACT

for every required vaccine. Going forward

Crookham said APH has several programs to increase vaccine accessibility, such as the Shots for Tots clinics; the Mobile Vaccine Program; and Vaccines for Children.

NORTH CENTRAL AUSTIN EDITION

Health care

BY HANNAH NORTON

BY ELLE BENT

Over 1M Texas kids cut from Medicaid

Dell Children’s Medical Center gears up for stem cell program

Navigating Medicaid cuts Texas accounts for nearly one quarter of the children removed from Medicaid since the "unwinding" process began in April 2023.

Over 2 million Texans have lost health care coverage since the state began reviewing Medicaid eligibility in April 2023—including 1.3 million children. The state- and federally funded program provides health insurance for certain low-income Texans, including children, pregnant and postpar- tum women, people with disabilities, and seniors. The big picture Nearly 74% of the children removed from Texas Medicaid through March 11 were cut for procedural reasons—meaning the state did not have enough information to confirm the child’s eligibility—the Texas Health and Human Services Commission reported. Joan Alker, the executive director of the Georgetown University Center for Children and Families, said that means the renewal process has broken down in some way and either the renewal letter was lost in the mail or families had trouble completing the paperwork.

Texans are notified at least 10 days before their coverage ends, a HHSC spokesperson said. Texas has removed more children from Medicaid than any other state during the Medicaid “unwind- ing” process, according to a new Georgetown University report. Nationwide, 4.16 million children lost Medicaid coverage from April-December 2023. What they’re saying Dr. Kimberly Avila Edwards, an Austin pediatri- cian, said the impacts of Medicaid unwinding are “painfully visible” to pediatricians every day. “Families are foregoing vital care for their chil- dren and teens for fear of financial devastation. Par- ents are checking in for their child’s appointments, only to learn that child is no longer covered,” said Edwards, who is also a professor at Dell Medical School at The University of Texas. Patients who experience gaps in health coverage are more likely to experience delayed medical care, unmet medical and mental health needs, and

Dell Children’s Medical Center of Central Texas, located in Mueller, is almost ready to offer a stem cell transplant program to patients, a feat that’s been years in the making. Dr. Amir Mian joined Dell Children’s last summer as division chief of pediatric hematology and oncology to help build the program. The details The program will treat children and adolescents with different cancers and blood disorders. Mian’s team is looking to start offering autologous bone marrow transplants by the end of this year. This refers to harvesting a patient’s healthy stem cells—located in the bone marrow—and returning them to the same patient who may have lost these

Additionally, Mian and his team are in the process of seeking accreditation through the Foundation for the Accreditation of Cellular Therapy, or FACT. This takes between 12-18 months, and provides specific guidelines and quality measures to hospitals. As part of the accreditation process, Mian’s team has begun working on standardized operating procedures, or SOPs, which include steps as simple as how to identify patients, how to store cells and how to transport patients. Ideally, the team will begin collecting cells for transplants by the end 2024, Mian said. Once accredited, the program can provide stem cell therapies and allogeneic transplants. What’s next The team at Dell Children’s will continue working through regulatory processes to earn accreditation and begin treating patients by the end of this year or potentially early next year.

How does a stem cell transplant work? An autologous transplant is a long process that places a patient into an immunocompromised state. Step 1: A patient is determined as eligible for a transplant

Texas: 24% Florida: 14% Georgia: 7% California: 5% All other states: 50%

4.16M children

Step 2: Patient is admitted, placed in private room with air filters to reduce risk of infection Step 3: A patient’s stem cells are collected through the chest or the arm then stored in a blood bank Step 4: Patient is treated with a high dose of chemotherapy or radiation therapy to prepare for the transplant

SOURCES: GEORGETOWN UNIVERSITY CENTER FOR CHILDREN & FAMILIES, TEXAS HEALTH AND HUMAN SERVICES COMMISSION, U.S. CENTERS FOR MEDICARE & MEDICAID SERVICES/COMMUNITY IMPACT

unfilled prescriptions, Edwards said. To appeal a decision about Medicaid coverage, Texans can visit a local eligibility office; call 211 and select option 2; or mail a letter to the Texas health and Human Services Commission, P.O. Box 149027, Austin, TX 78714-9027.

to chemotherapy. The action taken

Step 5: Patients receive stem cells back into their bloodstream

Step 6: Patient is monitored throughout recovery process

After Mian joined the hospital in 2023, recruiting for the team that will work in the program began.

SOURCE: AMERICAN CANCER SOCIETY, DELL CHILDREN’S MEDICAL CENTER/COMMUNITY IMPACT

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Health care

BY HANNAH NORTON

Texas nurse practitioners call for end of ‘pay-to-play’ rules

Texas faces an ongoing primary care provider shortage as the state’s population grows—and nurse practitioners say cutting a major regulation would help solve the problem. The federal government classies communities with fewer than one primary care provider for every 3,500 residents as health professional shortage areas. Of Texas’ 254 counties, just 30—most of which are in metropolitan areas—do not have provider shortages, according to the Rural Health Informa- tion Hub. The details Texas nurse practitioners must sign an annual contract and pay a fee to a supervising physician, who oversees patient care through in-person or virtual meetings at least once a month. Ten other states have similar laws, according to the American Association of Nurse Practitioners. Erin Pérez, president of the professional organi- zation Texas Nurse Practitioners, said some nurse practitioners who graduate from Texas universities choose to work in telemedicine or move to other states to avoid the “regulatory burden,” contributing to the health care workforce shortage. Over 72% of nurse practitioners in Texas are licensed in primary care, according to a 2022 report from TNP. “[This regulation] takes from patients’ nances because somebody’s having to pay for it. So even if they’re in the hospital, or they’re in a nursing home, or they’re in a rehab, ... somebody is paying that physician signature fee that does not improve their care,” Pérez said. Nurse practitioners must receive a master’s or doctoral degree, undergo clinical training and get a national board certication before they can begin

Erin Pérez, president of Texas Nurse Practitioners, speaks at the professional organization’s annual conference on Sept. 30.

COURTESY TEXAS NURSE PRACTITIONERS

caring for patients. However, they do not have to complete a multiyear residency program, which is required for physicians. TNP has advocated for independent practice legislation for several legislative sessions, with bipartisan support from lawmakers. On the other side, the Texas Medical Association has defended the existing regulations, arguing physician-led teams are essential to protect patients. “I never want to stop a nurse practitioner from graduating and performing at the highest level of their license,” TMA President Dr. Ray Callas said. Zooming in Texas has 8.8% of the U.S. population and 7.3% of

active U.S. physicians, the TMA reported in 2022. Shortages are particularly dire in rural areas, where hospitals sometimes close due to a lack of employees. According to the TMA report, 32 Texas counties had no primary care physicians in 2022. Callas said decreasing the amount of time physi- cians spend in school and recruiting doctors from other countries could help reduce the strain. “We want to make sure that we have internet ... throughout the state of Texas,” Callas said. “That would help tremendously—if people have broadband access to the internet, we might be able to make access easier from the telemedicine standpoint.”

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NORTH CENTRAL AUSTIN EDITION

Health care

BY AMIRA VAN LEEUWEN

More veterans to soon have access to in vitro fertilization

The Department of Veterans Affairs will soon expand its in vitro fertilization, or IVF, care to eligible unmarried veterans and veterans in same- sex marriages, according to a news release. The context The expansion of care is part of the VA’s efforts to support veterans who are seeking to grow their families. According to a Demographic Study completed by the Texas Workforce Investment Council in 2021, veterans make up 6.7% of the Texas population. Under existing law, all veterans who receive IVF from the VA must be unable to procreate without the use of fertility treatment due to a health condition caused by their military service. The VA was previously only allowed to provide IVF services to veterans who were legally married and—within that relationship—able to produce their own eggs and sperm, according to a news release. Veterans enrolled in VA health care are eligible

for a range of reproductive health care services, including: • Maternity care • Gynecology care • Cervical cancer screenings • Menopause care Under this expansion, the VA will be able to pro- vide IVF to veterans using donated sperm or eggs. What they’re saying VA Secretary Denis McDonough said she is proud the VA will soon help more veterans raise families. “This expansion of care has long been a priority for us, and we are working urgently to make sure that eligible unmarried veterans, veterans in same-sex marriages and veterans who need donors will have access to IVF in every part of the country as soon as possible,” McDonough said in a news release.

The Department of Veterans Affairs offers a range of infertility services such as:

Infertility assessments, counseling Laboratory tests, including genetic counseling and testing

Ultrasounds, X-rays Hormone therapies Surgical corrections Fertility medications Artificial insemination Tubal ligation reversal Vasectomy reversal Oocyte cryopreservation (egg freezing) and sperm cryopreservation Sperm retrieval techniques (including sperm washing for intrauterine insemination)

SOURCE: U.S. DEPARTMENT OF VETERAN AFFAIRS/COMMUNITY IMPACT

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