State of Texas: Working to help communities hit hardest by COVID-19

Texas Politics

AUSTIN (Nexstar) – It’s a rare, quiet moment in the middle of a jam-packed November morning of seeing patients. Dr. Guadalupe “Pete” Zamora took off his face shield and mask and escaped to his office at his medical practice in east Austin – an area of the city that’s been a COVID-19 hot spot.

Still dressed in blue scrubs and a Dallas Cowboys bandana tied around his head, Zamora sat down at his desk and jumped on a Zoom call to walk us through what he’s seen the last few months, weeks and days.

“I guarantee you of the three [patients] I tested today, all will be positive,” Zamora said. “It’s coming back, and we’ll be in stage four soon.”

Zamora treats mostly Black and Hispanic patients, and has had about 220 people test positive for COVID-19 since the pandemic first flared up in mid-March.

“We’ve lost two. They were both older folks,” Zamora said with sadness in his voice but also a hint of relief that he hasn’t had more deadly cases.

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Dr. “Pete” Guadalupe Zamora with a member of his medical staff (Courtesy Dr. Zamora)

The virus is hitting the populations he serves the hardest. In Travis County, hospitalization rates have been higher among Hispanics than any other race, according to the Austin Public Health COVID-19 dashboard.

Nationally, cases are more than twice as high for Hispanics and Black people when compared to white people, and deaths among Black people are twice as high as deaths among white people, according to the U.S. Centers for Disease Control.

Zamora said the state’s cases highlight the need for a state office — like the now-shuttered Office of Health Statistics and Engagement — that focuses on racial disparities in health care. Early in the pandemic, that office could’ve helped cities like Austin pinpoint areas where people were more likely to get sick and create a plan to address it.

“You could make the case by going into those communities and seeing, like, what is it that’s driving the spread? What is it that’s driving deaths?” said Lauren Lluveras, a former employee of the minority health statistics office.

The Office of Minority Health Statistics and Engagement was created in 2010 and was originally called the Center for Elimination of Disproportionality and Disparities. Its first big project and discovery: Child Protective Services was more likely to remove children from Black parents than from white parents.

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Lauren Lluveras, former employee of the Office of Minority Health Statistics and Engagement (KXAN Photo/Erin Cargile)

The office’s name was later changed to the Office of Minority Health Statistics and Engagement, and the work expanded to looking into disparities across the state’s health agencies.

The office received about $2 million a year from the state, and Lluveras was one of about two dozen employees.

“I had never before then knew that you could predict health outcomes by somebody’s zip code, predict somebody’s likelihood that their child was going to be removed based on their race and ethnicity,” Lluveras said. “It was really eye-opening, and I just really fell in love with the work they were doing there.”

She was a regional specialist assigned to about 30 counties in Central Texas. Lluveras recalls visiting the small town of Marlin, near Temple, after a section of town with more people of color had its water shut off. She talked to members of the community and shop owners and tried to convince them to speak at a City Council meeting.

Lluveras also recalled a trip to Waco where she met families with low-weight, pre-term newborns, and connected them back to the McLennan County Health District.

During the 2017 legislative session, lawmakers defunded the minority health statistics office due to what State Rep. Garnet Coleman, D-Houston, said was political infighting among lawmakers during the state budget process.

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State Rep. Garnet Coleman, D-Houston (Courtesy Texas Tribune)

Coleman said he believes the move was a way to “go after” former State Rep. Dawnna Dukes, D-Austin, who was highly supportive of the state office. She was a member of the House Appropriations Committee at the time, and faced multiple felony indictments related to abuse of public office. All the charges against Dukes were later dropped, and she lost a bid for reelection in 2018.

Lluveras, who had to find another job, said she went to the Capitol to fight for the office, but the Senate Finance Committee ultimately zeroed out the office’s budget.

The Senate Finance Committee’s chairwoman, Jane Nelson, R-Flower Mound, did not respond to KXAN’s requests for comment about the situation. Her staff said they were under the impression the Texas Health and Human Services Commission would continue to collect and analyze racial data, and the agency was directed to team up with a university to continue the work.

The Legislative Budget Board said that never happened, and the office shut down in September 2018.

“None of its functions transferred anywhere, and we just left all of these people hanging,” Lluveras said.

Coleman, who serves a predominantly Black district in Houston, said the people who ultimately suffered the most were Texas minorities. He believes if the office were still intact, the state would’ve responded to COVID-19 racial disparities faster.

“We would’ve known where people have diabetes, who had heart disease and hypertension because we would’ve been keeping those statistics and then we could act before people were infected with COVID-19,” Coleman said. “And tell them specifically in those areas that you have to be more vigilant — that came very late in this pandemic.”

In April, about a month into the pandemic, KXAN reported on groups calling for a closer look statewide at how the disease was affecting people of color.

At that time, Texas Department of State Health Services was tracking race and ethnicity data for COVID-19 cases, but it was incomplete. Nearly a fifth of the cases were listed as “unknown,” and DSHS said it had only received case report forms for about 2,000 of the 10,230 cases reported by local jurisdictions.

After requests from lawmakers, HHSC said it launched a study in the last month to better understand how and why COVID-19 is having a greater impact on vulnerable populations. It hopes to release that information next month.

HHSC also said even without state funding for the minority health office, they’ve tackled a project addressing obesity among minorities in Beaumont, Laredo and Port Arthur, have worked to increase breastfeeding rates among Black women, and improved pregnancy-related outcomes in Hidalgo and Smith counties.

Travis County Associate Judge Aurora Martinez Jones had just launched a big project with the minority health office when it shut down.

“I’m so glad to hear this coming up,” Martinez Jones said. “It has been a thorn in my side ever since they did away with it.”

She had seen the legislative report put out by the Texas Department of Family and Protective Services showing Black children in Travis County were nearly eight times more likely to be removed from their families than white children.

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Assoc. Travis County Judge Aurora Martinez Jones on Adoption Day (Courtesy Judge Martinez Jones)

As a Black woman who handles child welfare cases, Martinez Jones embarked on a mission to find out why the discrepancy existed, and to come up with a solution to change it. Jones formed the Child Welfare Race Equity Collaborative, which was made up of several organizations. The minority health statistics office was one of most powerful players at the table when they held their first meeting in May 2018.

Little did Martinez Jones know, it would be the first and last meeting with the state office.

“I think that a vast majority of Texans didn’t realize this was happening,” Martinez Jones said. “It was devastating for us to move the work forward.”

With the minority health statistics office gone, Jones had to regroup. She called on county agencies to help. The latest data that came out last month shows the rate of removals for Black children has been cut in half, which means they’re still about four times as likely to be removed from their home by child protective services than white children.

“Quite honestly, that’s still not good enough,” Martinez Jones said. “And, we’ve got a lot more work to do.”

In a Tweet last month, State Rep. Donna Howard, D-Austin, said she will be working to reinstate the minority health statistics office.

Coleman, who is a diabetic, said he plans to file a bill in the upcoming 2021 legislative session to bring it back, and restore its full funding.

“I think it’s imperative as long as we have issues that kill people, health issues that take people’s lives in a disproportionate way to others,” Coleman said. “It has to be done and I think that those of us of color, we know that this is very important.”

Texas Democratic Sen. Borris Miles filed a bill earlier this month that would bring back the office of minority statistics and engagement in a smaller capacity. Senate Bill 75 proposes putting the office within the Department of Family and Protective Services to address the disparities of minority children in the child welfare system. The bill, which does not mention racial inequities in health care in its scope of work, calls for the use of existing resources and directs DFPS to consult with a university to assist them.

Sen. Miles said he wants the office to have even more power than before and would support a full restoration of the office, but he drafted the bill “pragmatically” given the tighter budget facing the state next year due to COVID.

“I didn’t want to let money stand in the way,” said Miles, who went on to say in an emailed response:

“Had this office been open we would have been able to immediately recognize the disproportionality in which black and brown folks were being affected by COVID. Many of the questions and answers we needed could have been gathered during this pandemic. There was no need to ever defund the Office of Minority Health and Engagement except to hide the harsh truths that the offices revealed.  It was only $2 million in a $107 billion dollar budget.  But COVID has revealed the many disparities in our society, including in health and human services.  This bill is the first step in restoring an office that could identify and provide solutions to those problems.”

Lawmakers push for STAAR exam waiver

Teachers and education advocacy groups across Texas are asking the state to reconsider administering the STAAR test next spring.

“When we’re going through something that has never in our lifetime occurred in the disruptions in our students’ academic careers… It’s just no time for a test,” Texas State Teachers Association President Ovidia Molina explained.

That’s why State Rep. Gina Hinojosa, (D-Austin), filed a petition against the standardized testing.

“Our governor should join other governors across the country, and requests of Betsy DeVos, that we get a waiver from having to take the STAAR test this academic year,” Rep. Hinojosa explained.

“First and foremost, I’m a mother, and I have a child of two children in AISD, and one in third grade, who will be taking the STAAR test for the first time. We have dealt as a family with the just normal anxiety and stress of prep preparation for the STAAR test,” Rep. Hinojosa added. “But as we all know, our families are under really unprecedented pressures right now because of the pandemic.”

The Texas Education Agency said it values the benefits STAAR can provide, which includes a glimpse of how students are doing. That’s especially important now, in order to gauge where the students are coming out of the pandemic.

The TEA said it’s also not tone-deaf to the perils of the pandemic. That’s why it removed the usual grade promotion component, meaning students will still be able to move on to the next grade regardless of how they score on the 2021 STAAR test.

Rep. Hinojosa, however, said there are better ways to understand how the kids are faring.

“There are other tools, other types of assessments not like a standardized test that teachers use to assess, that teachers have those expertise. It’s not real-time information that teachers use to fill the gaps for their students,” Rep. Hinojosa said.

The Association of Texas Professional Educators also agreed, adding any data gathered from this spring’s testing will be useless.

“The accountability system has serious sanctions attached to it. So we could be basing really important decisions such as whether or not to apply sanctions to a school district or appoint a board of managers based on tests with results that we can’t trust,” ATPE Lobbyist Mark Wiggins explained.

The hybrid online, in-person learning structures at schools across the state have also highlighted the digital divide, which could further impact STAAR testing scores.

Abbott touts COVID treatments, says no to shutdowns

Texas Gov. Greg Abbott said Thursday a newly-approved treatment for COVID-19 has made it to Texas.

Abbott said the drug bamlanivimab, an antibody therapy developed by Eli Lilly and Company that is the first immediate use medical treatment authorized by the U.S. Food and Drug Administration for COVID-19 patients, is ready to be distributed around the state.

The drug is given through an intravenous drip, and he said the Lubbock area has received its first allocation of the drug. More places around Texas will get it on a weekly basis, he said.

“The goal is to give it to people at such an early date during their infection that it keeps them out of the hospital,” Abbott said.

The company said it’s sending 80,000 doses all over the country, including parts of Texas, at no cost to the states. The company said it should have a million doses by the end of the year.

The drug is for patients “at high risk of progressing to severe COVID-19,” including those aged 65 years or older and have certain preexisting medical conditions.

“It’s best use is for the early stage of COVID cases and patients who were in the early iterations of COVID-19,” Abbott explained.

Michelle Herrera and her husband both signed up for the treatment when it was still in its trial phase in August. They both received the drip IV from Baylor Scott & White just days after testing positive for COVID-19.

“Two to three days afterwards, I felt great, much, much better. The symptoms were already improving,” Herrera explained.

But her husband’s symptoms worsened over the coming weeks, leading them to believe she received the actual treatment while he was given the placebo.

She said it was a no-brainer agreeing to take part in the trial, since both of them tested positive and so did their 11-month-old and 3-year-old.

“One of us needed to get better, or if not both of us so that we could be there to take care of them,” she said.

“No family’s coming to help you, and you have COVID—no friends are coming to help you. They’ll bring food to your door, but no one wants to come in,” she said.

But, as Abbott explained, not everyone will have easy access to the treatment due to limited supplies. In the meantime, the state’s top doctors urge Texans to continue wearing masks and social distancing.

“We’ve got this monoclonal antibody. We have vaccines coming on the way. But this is a marathon, and we’re not at the finish line yet,” Dr. John Hellerstedt, commissioner of the Department of State Health Services said.

“Our vaccine, in the meantime, is this mask. And the more we wear this mask, the more we protect ourselves and the more we protect others,” Dr. John Zerwas with the University of Texas System added.

Governor Abbott also called on Texans to keep taking steps to control the virus. But he said he will not order another state lockdown, even as cases rise across Texas.

Abbott defended his decision, saying he does not believe that shutdowns work.

“One thing that we’ve learned over the course of COVID is one of the most common ways that COVID has spread is not by someone going to work but by people gathering together in home setting or in casual settings after bars closed or something like that,” Abbott said, responding to a reporter’s question during Thursday’s news conference.

The Governor said he now believes that orders to shut down businesses hurt more than they help.

“If you lock people down and try to prevent any movement whatsoever, there are now known severe medical consequences of that, emotional, mental consequences as well as the devastating financial consequences,” Abbott said.

Difficult holiday decisions for families with elderly relatives

With Thanksgiving coming up, Texas nursing home and assisted living residents face a difficult decision: can—or should—they go home for the holidays to see family?

The state of Florida recently lifted visitation restrictions at long-term care facilities and noted residents have the right to leave their facility, as well. Meanwhile, top health officials in New Jersey discouraged families from bringing nursing home residents to any family gatherings.

Texas Health and Human Services officials told families in a webinar that residents have “the right to make an informed decision to leave the facility for a holiday activity.”

HHSC officials recommended families still avoid large holiday gatherings and encouraged outdoor gatherings as opposed to indoor events. They also urged families to follow other CDC guidance, such as observing proper hand hygiene and wearing masks.

Texas HHSC recommended certain guidelines for long-term care facility residents to follow if they leave their facility for holiday gatherings. (Slides provided by: Mary Nichols of Texas Caregivers for Compromise, taken from Texas HHSC webinar)

In a Facebook Live event, the Texas Long-Term Care Ombudsman Patty Ducayet reminded families the CDC is encouraging people at risk of a severe case of COVID-19 to avoid in-person gatherings.

“I think we can all interpret that most nursing facility residents and many assisted living facility residents would meet that category, so there is a great deal of discouragement about bringing someone home for a visit,” she said. “We know that visit can bring an incredible amount of joy.”

Ducayet urged families and long-term care residents to take the appropriate safety precautions, whatever they decided.

“I really, really want you to think about how important it is to protect yourself and that vulnerable person living in a long-term care facility by wearing a mask unless you are eating,” she said.

Ducayet has told KXAN in the past, long-term care residents always retain the right to leave their facility for any reason, but many facilities are encouraging their residents to only leave for necessary medical appointments.

HHSC guidelines note that a resident will be required to quarantine in their room or unit for 14 days when they return if:

  • They have been gone overnight
  • They are exposed to someone with COVID-19
  • They are exposed to someone exhibiting COVID-19 symptoms while awaiting test results

Ducayet told families if they plan to see a long-term care resident, either in the facility under the new visitation rules or outside at a family gathering, they should also plan to quarantine for 14 days leading up to the visit.

Lisa Morris serves as an essential caregiver to her mother in her assisted living home in Forney, TX. (Photo provided by: Lisa Morris)

Lisa Morris lives across the street from her mother’s assisted living facility in Forney outside of Dallas. She plans to pick her mother up for the day on Thanksgiving.

“They’ve had to put up with so much this year. So, I think it’s time to… they need to get out,” Morris said through tears. “I know that the virus is there, and they need to be safe and all, but it’s also important to get to get them with their families during the holidays.”

Her mother was willing to quarantine for 14 days upon returning to the facility, and they plan to wear masks while she’s over at their house.

“I don’t want her to take the chance of being out and getting the virus and taking it in, by any means,” Morris said.

Morris and her mother are still waiting to hear from her facility what other requirements and guidelines could be required.

Cissy Sanders lives in Austin near her mother’s skilled nursing facility. She thinks HHSC should require more broad quarantine requirements for residents who leave the facility.

“I am so nervous that a resident is going to leave the facility on Thanksgiving, contract the virus from a family member or friend and bring it back,” she said.

She also wishes the state would require testing and contact tracing for all residents upon their return.

“Especially that Austin/Travis County is seeing an increase in cases in the community, the risk of exposure is a real thing,” she said.

Other Central Texas families are still in the process of making these difficult decisions about the holidays.

“Honestly, today, I haven’t made up my mind,” Nellie Pennington told KXAN a week before Thanksgiving.

Her mother lives in a nursing facility in Belton. She obviously wants to see her mom, but said her mom’s safety is “top priority.”

“We don’t have a huge family,” Pennington explained. “I feel I can keep my mom safe at our house just for a day-visit.”

Still, she’s hesitant. Her mother has just come out of a nearly month-long quarantine process after getting a positive COVID-19 test, but Pennington also worries about the toll isolation and quarantine have taken on her mom’s health in other ways, too.

“She thinks she is confined to her room. All of her world is just… it’s like being in prison, she says,” Pennington said. “It makes her very depressed.”

Nellie Pennington worries about how nine months of isolation has affected her mother’s appearance and physical health. (Photo provided by: Nellie Pennington)

HHSC laid out more details in an email to another Texas family member, which was shared with KXAN and in a group called Texas Caregivers for Compromise.

An HHSC official said they encouraged facilities to ask residents questions to help determine if the resident was exposed to someone with COVID-19. According to the email, those questions could include:

  • Were you in any crowded spaces?
  • Were you in any situation where you were unable to maintain a physical distance of at least 6 feet from someone who was not wearing a facemask?
  • Did you knowingly encounter anyone who tested positive for COVID-19 within the last 14 days?
  • Did you encounter anyone who was exhibiting any symptoms related to COVID-19?

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