AUSTIN (Nexstar) – In the past week, COVID-19 cases surged in Texas, with the state setting records for new cases nearly every day. Governor Greg Abbott started the week with a news conference to address the growing numbers.

“Surely the public can understand that if those spikes continue, additional measures are necessary,” Gov. Abbott said, pointing to the three charts behind him.

Gov. Abbott did not announce new restrictions on Monday, instead calling on Texans to voluntarily follow existing guidelines to slow the spread of the virus.

Some health experts warned that would not be enough.

“Our big metro areas seem to be rising very quickly and some of the models are on the verge of being apocalyptic,” said Dr. Peter Hotez, an infectious disease expert at the Baylor College of Medicine.

As the surge of COVID-19 cases put Houston hospitals closer to capacity, Texas Children’s Hospital started to take in adult patients. Dallas and Austin are also facing growing strain on hospital capacity.

Texas Democrats called for more action, including mandating masks. “I think where we’re at right now is we don’t necessarily need a full shutdown, but we do need to make more restrictions,” said Texas Democratic Party spokesman Abhi Rahman on Monday.

On Thursday, Gov. Abbott did add some restrictions. He directed hospitals in Bexar, Dallas, Harris, and Travis Counties to postpone elective surgeries to free up hospital beds. The governor also slowed down his phased plan to reopen Texas.

Friday brought more orders from the governor. He issued executive orders to close bars as well as rafting and tubing businesses. The orders also limited restaurants to 50-percent capacity statewide.

Election workers take steps to protect voters from COVID-19

Preparations for this year’s primary runoff elections in Texas have required more work than usual.

Elections officials are adding new procedures and sanitation measures to prevent COVID-19 transmissions.

While specifics vary by county, they all share one common goal: minimizing contact.

“If we’re going to vote inside, it must be absolutely as safe as humanly possible,” Travis County Clerk Dana Dana DeBeauvoir explained. “So we’re going to ask for masks. We want you to wear masks, we want you to sanitize your hands. When you get inside the polling place, voters will not have to touch any of the equipment and we’ll show you how we’ve worked around that.”

DeBeauvoir said each polling location will be receiving a toolkit full of PPE in Travis County, like the one pictured below.

A PPE kit that will be sent to polling locations in Travis County. (Maggie Glynn/Nexstar)

Many of the tools that will be issued to voters are single-use items, like finger cots, which cover your finger while using a tablet.

“So what you do is you sign your name, and then when you’re finished with it, you just take it off and throw it away,” DeBeauvoir explained.

At the booth, Travis County voters will use popsicle sticks.

“What you’re going to do is use the popsicle stick to touch the screen so that your hands never have to touch any of the equipment,” DeBeauvoir said.

She said the county has also made sure they have plenty of staff available, as about 80 staffers called out sick on election day in March.

“We have made an extra effort to recruit new newer people into the process. Which is always great to have younger folks, and perhaps we can offer some of our judges who are seniors the opportunity to work in a little less risky environment,” DeBeauvoir explained.

The League of Women Voters in Austin has also helped recruit new poll workers here.

In Lubbock County, instead of popsicle sticks, they’ll be handing out pencils.

“You’ll be given a pencil and you’ll use the eraser end to use for as a stylus,” Lubbock County Elections Administrator Dorothy Kennedy said.

Lubbock County will also be minimizing contact at check-in, and sanitizing the polling stations frequently.

In El Paso County, disposable marking utensils will also be given out, and curbside voting will be available to those who need it.

Potter County will also be offering curbside voting, but that isn’t something new.

“Curbside voting has been used for a while, but it’s not used en masse,” Potter County Elections Administrator Melynn Huntley said.

Early voting was expanded by Governor Greg Abbott back in the spring due to the coronavirus.

On Monday, the Governor said he still felt it was safe to vote in-person.

“I increased the length of time for early voting, so that more people would have a long period of time to gather for the purpose of voting. Meaning that they could go into voting sites with them being less crowded,” Gov. Abbott said.

“Second, as we are talking about today. It is important for people to wear masks, when they go out especially in congregated in areas like the individual voting location,” Abbott explained. “And so, we believe that if people take the time to vote early, and when they do some wear a mask, it really shouldn’t pose, much of a problem with regard to being exposed to COVID-19.”

Keith Ingram, the state’s Director of Elections, said the governor’s decision to push the runoff from May to July gave officials time to develop ways to improve procedures at polling places.

“We worked with Department of State Health Services to come up with recommended health protocols for both election workers as well as voters,” Ingram said.

Ingram pointed to plans in several counties to limit person to person contact when voting.

“The contact between poll workers and voters is going to be minimal,” Ingram said. “And we strongly recommend that voters wear a mask when they come to vote.”

Early voting begins June 29, and runs through July 10. The deadline to request a mail-in ballot is July 2. Election day itself is July 14.

For information about finding a voting location in your area, click here.

Hearing highlights nursing home frustrations

Frustrations boiled over in a special subcommittee hearing on nursing homes, as U.S. lawmakers discussed the spread of COVID-19 among these vulnerable elderly populations — and how to stop it.

Lawmakers on the House Ways and Means Health Subcommittee pointed fingers at the Trump administration, New York Governor Andrew Cuomo, the nursing homes themselves, and, more often than not, the federal agency that regulates them.

“Give us what you’ve done about these report cards, or else every one of you should be fired, from the top to the bottom!” yelled Representative Bill Pascrell of New Jersey. “I’ve had relatives who have died in these homes, and I’m not going to leave this alone.”

He was referring to Centers for Medicare and Medicaid Services infection control inspection reports, as well as federal coronavirus data now required to be reported by the homes each week.

Ahead of the hearing Thursday morning, Rep. Lloyd Doggett (D-Texas) told KXAN Investigators their reporting on the crisis in long-term care facilities prompted him to call for more meaningful change.

KXAN’s complete coverage of COVID-19 in nursing homes 

“I think we have a real nursing home crisis,” Doggett emphasized.

Rep. Doggett chaired the subcommittee hearing and pointed out that more than 800 homes still have not reported the required data to CMS. He said many of those homes are in Texas.

KXAN Investigators found 117 Texas homes with no data reflected, out of the 831 total homes that had not reported — more than any other state.

“We don’t have the information we need to make good policy or to protect families,” he said, emphasizing the importance of hearing from experts in Thursday’s hearing.

Harvard Professor and witness Dr. David Grabowski testified that the lack of transparency in the federal data was not only concerning, but hindered the ability to adequately respond to the crisis.

“The other problem with not having early data was not being able to learn… about which facilities have cases, and which don’t. What’s working in terms of best practices?” Dr. Grabowski said. “This really prevented us from any type of learning.”

Austin resident Delia Satterwhite testified about the frustration she felt when trying to get answers about her brother in a nursing home, days before he died.

“It felt like they were keeping a secret. No one wanted me to know what was happening,” she said. “My brother should still be alive.” 

A lack of transparent reporting was not the only deficiency discussed at Thursday’s meeting.

“We have seen, for 30 years now the standard of sufficient nurse staffing, and it’s not enough,” Senior Policy Attorney for the Center for Medicare Advocacy Toby Edelman said. “What we see a lot is that nurse aids have not just 15 people, but 20 to 25 residents they are responsible for.”

MORE: Trend: Staff shortages increasing in Texas nursing homes

A Connecticut nursing home employee testified to working twelve hour days regularly during the outbreak.

“There were many days I came home crying,” Melinda Haschak said. “Today, we are still understaffed, over worked and still do not have enough PPE. While I appreciate the donations of food and the occasional pizza party — we do not need a pizza party, we need PPE.”

Edelman emphasized a need for more “sufficient” staffing requirements and more oversight on infection prevention in the homes.

“People are dying in nursing homes because people are not washing their hands,” she said, noting that employees will “cut corners” when they are short-staffed.

Dr. David Grabowski suggested offering increased pay to workers and better benefits.

Lawmakers argued that federal agencies should have been better prepared to handle the crisis in nursing homes after the outbreak at a facility in Kirkland, Washington.

“It took FEMA some 61 days, two months, to get out its directive concerning personal protective equipment for nursing homes. When the equipment finally came from FEMA, much of it was junk,” Doggett said. “Frequently was unusable — glorified trash bags for gowns and cloth masks instead of N95 masks.”

He argued it took even longer to get adequate testing to these homes, and that some homes still haven’t completed any testing.

Several lawmakers argued that rules in some states allowing coronavirus patients back into these homes exacerbated the spread.

“If we are to ensure our nation’s parents and grandparents are protected moving forward, we need to fully understand why Governor Cuomo and the four other governors ordered COVID-19 positive seniors to be forced into nursing homes, exposing the entire nursing home population and staff to death,” said Rep. Tom Reed (R-NY).

Dr. Grabowski agreed this policy was a “mistake,” but after some tense moments with Rep. Reed, he also stated that the policy was “consistent” with federal guidance.

  • Watch the full meeting or read the witness testimony here.

Rep. Doggett told KXAN they requested testimony from Seema Verma, the Administrator for the Centers for Medicare and Medicaid Services, to answer some of these questions. He said they offered multiple dates and times, but the agency declined to offer any witness for the hearing.

Avoiding high costs for COVID-19 testing

So you need or want to get a COVID-19 test: where do you go?

The decision can be overwhelming, and even more confusing is how much it’s going to cost you — despite the fact that major insurance companies say they’re covering it.

But what if you don’t have insurance? What will you be charged?

KXAN posed the question to viewers and its own employees:

What have you paid for a COVID-19 test and where did you go?

Dozens of people responded via email or social media, and the answers were all over the map. Some in central Texas paid nothing while others paid as much as $249 out-of-pocket without insurance.

And then, there were unusual cases like Pam LeBlanc who said her insurance was billed more than $6,000 after she had a swab test done at one of Austin Emergency Center’s drive thru clinics. Another viewer saw the story and reached out saying his insurance was also billed that much, and in the end he was still charged for more than $2,000 of it.

KXAN learned Thursday that these patients were billed for lab work that was never done, and the problem is being corrected.

If you’re looking for a free test, here’s what you need to know: Every single person — with or without insurance — who went to a CommunityCare clinic, CVS Pharmacy or an Austin Public Health testing site said they did not have to pay a dime. Testing was completely free at these locations, because the programs are all government funded.

KXAN had an at-length conversation with Austin Emergency Center because three viewers reached out about receiving exorbitant insurance bills after visiting their drive thru COVID-19 clinics.

In at least two cases, patients told KXAN their insurance was billed over $6,000 for their trip to get a swab test at the AEC clinic in the Mueller neighborhood on East 51st Street.

Viewers who did not use insurance and paid out-of-pocket said they were charged $249 at the same drive-thru.

AEC, which has four locations in Austin, said it operates just like an emergency room attached to a hospital. The only difference is its free standing.

When the pandemic hit, AEC doctors and leaders developed a process to evaluate a patient outside in their cars. Unlike the mobile clinics that are government funded and offering free testing, AEC said it is still assessing patients in the drive thru like they would if that patient were to come into the building.

AEC said it felt like the assessment portion was important for patients so they can have their concerns addressed, and be brought into the building if they appeared to be ill and needed treatment.

With the assessment, comes two separate fees:

  • Professional fee — covers assessment, patient evaluation, treatment plan discussion
  • Facility fee — covers basic costs needed to stay open 24 hours a day (ex: water and electricity)

AEC bills the insurance company for the two fees, and said insurance companies typically pay 40% to 80% of the two fees. However, the major insurance companies have said during the current crisis, they’re paying for all COVID testing and all COVID-related costs — which is supposed to include emergency room expenses.

The outrageous insurance bills can be traced back to Genesis Lab, according to AEC.

The center decided to start using the lab after an extensive search because Genesis was able to provide a large quantity of test kits, and fast results in two days. One difference with Genesis, according to AEC, is that the lab bills the patient’s insurance directly, where in most cases the lab bills the provider and the provider bills the insurance company.

When AEC learned on June 2 Genesis was charging patients fees in the thousands, and in some cases thousands of dollars in fees for lab work that was never even done (like in Pam LeBlanc’s case), they put a stop to it.

AEC said from that point forward Genesis stopped billing insurance directly, and AEC started going to bat for patients dealing with high bills so that they will not be on the hook for those charges.

KXAN was also told some patients not using insurance paid AEC $249 for one COVID-19 test they received in the drive thru, while others paid $199.

AEC said it adjusted the price from $199 to $249 due to the rising cost of supplies. The $249 fee is the cash price AEC came up with that covers the testing, but waives the professional and facility fee.

When it comes to patients on Medicare and Medicaid, AEC said free standing ERs do not get reimbursed for either, therefore they become cash pay patients.

In a statement on Thursday, AEC said, in part:

AEC is an emergency room operation that offers COVID-19 symptom assessment and testing. All patients have their history and vitals taken, and are evaluated by a nurse and emergency room provider. If they are critically ill, they are brought inside the emergency room for further evaluation.

Our company is not affiliated with Genesis Labs. When we learned of the exorbitant fees they were charging for their lab test, we immediately sought out a new lab to partner with. For those patients who were charged these outrageous prices for their testing, AEC will work on their behalf to do everything we can to make sure they don’t have a patient responsibility balance due.

Those with billing concerns should call the AEC Patient Advocate Line at (512) 736-7097.

New travel rules require Texans to quarantine

Texans traveling to New York, Connecticut and New Jersey will be required to quarantine for 14 days upon arrival due to rising coronavirus infection rates, according to a joint statement from the three states’ governors on Wednesday.

Texas was included in the requirement along with eight other states — Alabama, Arkansas, Arizona, Florida, North Carolina, South Carolina, Washington and Utah.

“I probably wouldn’t put myself in that position,” Deena Turner of Austin said before boarding a flight at Austin-Bergstrom International Airport.

“We now have to make sure the rates continue to drop,” New York Gov. Andrew Cuomo said Wednesday at a video briefing with Govs. Phil Murphy of New Jersey and Ned Lamont of Connecticut, both fellow Democrats. “We also have to make sure the virus doesn’t come on a plane again.”

Visitors from states over a set infection rate will have to quarantine, Cuomo said.

What was presented as a “travel advisory” affects three adjacent Northeastern states that after time were able to check the spread of the virus this spring as New York City became a hot spot for the pandemic.

Those governors are now warily eying other states with rising caseloads, trying to keep history from repeating itself.

“This is a smart thing to do,” Murphy said. “We have taken our people, the three of us … to hell and back. The last thing we need to do right now is subject our folks to another round.”

On May 21, Gov. Greg Abbott lifted travel restrictions to Texas from areas with high COVID-19 infections, and they included New York, New Jersey and Connecticut. Those restrictions had been in place starting April 27.

The states’ health departments will provide details of how the rule will work, Murphy said. Visitors to New York from affected states will be informed that they need to quarantine and that violators could face a mandatory quarantine and a fine, Cuomo said.

The quarantine is voluntary but “urgent guidance,” Lamont said at a briefing in Hartford, noting it will be enforced differently in each state. Connecticut is considering putting up signs at entry points and getting the word out via social media.

Some in Austin believe the orders go too far.

“When I talk to business associates in New York, they’re not happy about it either,” Mike Lawrence said before boarding a flight to Arizona. “They would prefer that I come in, do business, and leave.”

The announcement comes as summer travel to the states’ beaches, parks and other attractions — not to mention New York City — would normally swing into high gear.