The 88th Texas Legislature began as the three-year anniversary of the global COVID-19
pandemic loomed. The session ended just as the federal public health emergency declaration
expired. Bookended by these two significant dates, the legislative session mirrored the impact
COVID-19 had on our health care institutions, our health care workforce, and our communities.
The pandemic cast a long shadow on the Texas Capitol, and lawmakers’ health care priorities
and proposals – both positive and negative – reflected their understanding of how hospitals
weathered the pandemic.

In October 2021, THOT interviewed nursing leaders with three of our member institutions to better understand the operational shifts and investments taken to manage the nurse staffing shortage.

Building on work conducted in 2021 and 2022 on nursing workforce challenges, the Teaching Hospitals of Texas convened nurse executive leaders from member health systems in the summer of 2022 to review the data and research on the nurse workforce shortages and recommend strategies to increase the number of nurses, expedite timeframes for transition to independent practice, and support and retain existing nurses.

Formed in 1986, Teaching Hospitals of Texas (THOT) is a 501(c)(6) non-profit association of state, public and non-profit hospitals and health systems committed to providing access to quality health care for all Texans and to training the next generation of physicians, nurses and allied health personnel.

Based on a review of the published literature and real-world experience, the executive nurse leaders of the member hospitals that comprise the Teaching Hospitals of Texas developed specific recommendations and identified possible funding vehicles to target and address challenges driving the state’s nurse workforce shortage.

Our key priority for the 2023 legislative session is to ensure the recovery and long-term stability of Texas’ teaching hospital and health systems’ services, patient care, and community investments. Our goals for this session include stabilizing and strengthening care delivery and innovation, enhancing access to health care, safeguarding local health care systems and public health response, maintaining access to community provider-based health plans, safeguarding trauma funding and emergency preparedness, investing in Texas’ health care workforce, and supporting access to behavioral health services.

Texas has an insufficient number of inpatient psychiatric beds. The state’s nine mental hospitals are often full, and the private psychiatric beds that are available are inaccessible to many because of cost. The result is that those needing inpatient psychiatric treatment are held in hospital emergency departments or county jails until a bed becomes available or forego essential treatment altogether.

The lack of inpatient psychiatric treatment capacity and associated increased wait times for treatment contribute to:

• Worse patient outcomes.
• Increased costs to the criminal justice system.
• Reduced access to timely care for all Texans needing hospital-level care.

To help address the immediate needs for earlier diagnosis and intervention for children and adolescents, THOT member, the University of Texas Health Science Center at Tyler participates in two initiatives of the Texas Children’s Mental Health Consortium: the Child Psychiatry Access Network and the Texas Child Health Access Through Telemedicine.