Nathan Bernier/KUT

A waiver program that provides billions of dollars for Texas hospitals expires next year, and a panel of House lawmakers is asking state health officials if they have a Plan B. 

The 1115 Medicaid transformation waiver, among other things, gives billions in federal dollars to Texas hospitals that provide care for patients who don't have health insurance.  

In 2013, Texas spent almost $4 billion in what's called "uncompensated care" for low-income Texans.

A new report finds serious breakdowns in procedures and safeguards by state-run hospitals across Texas.

The year-long investigation was by Disability Rights Texas—an organization designated by federal law to protect people with disabilities.

The report is titled “Turning a Blind Eye" and is focused on systemic failures within the state agencies that Disability Rights Texas says dismissed patient safety.

The Texas Department of State and Health Services (DSHS) has failed to comply with a directive from the state legislature – but not without good reason.

Last session, the legislature asked DSHS to review proposals from companies interested in privatizing a state hospital, with the provision it be run at ten percent savings for four years. The agency was told to bring an approved proposal to the Legislative Budget Board and the Governor’s Office of Budget, Planning and Policy by Sept. 1. Instead, yesterday DSHS submitted a letter to those two agencies explaining why they were empty handed.

There was only one proposal submitted, by GEO Care for the Kerrville State Hospital. DSHS graded the proposal a 64 out of 100.

“Savings in the proposal were achieved primarily through reductions in staffing and benefits,” DSHS Commissioner David Lakely wrote, “to a degree that would put both our patients and the State of Texas at risk.”