The U.S.-Mexico Border Health Commission has been a failure, state Sen. Eliot Shapleigh said in a letter sent to the U.S. Department of Health and Human Services.

The letter was sent to Health and Human Services Secretary Michael O. Leavitt, Special Assistant to the Secretary for International Affairs William R. Steiger, and Office of the Americas/Office of Global Health Affairs Director Rosaly Correa de Araujo. Members of the Border Health Commission (BHC) in the U.S. and Mexico also received the letter.

Shapleigh, D-El Paso, says the BHC has failed to provide results from its border health initiatives and requests HHS reply with solutions to the problem. The senator said the commission has been a “disappointment” because its budget is not large enough to make a significant impact on the health of border residents, it has not maintained data on its initiatives and thus there is no way to measure the commission's effectiveness.

“Our federal government must take a strong stand for the 5 million people who call the border home. I wrote Secretary (Michael) Leavitt, and copied every single border federal lawmaker to ask why Leavitt permits such disparities to continue,” said Shapleigh.

In the letter, Shapleigh points out that over the past years, the BHC has had a budget of $4 million and compares this to other domestic commissions. These include the Appalachian Regional Commission, which received $65 million in Fiscal Year 2007, and Alaska's Denali Commission with a Fiscal Year 2007 budget of $53 million. Both are federal-state partnerships that foster economic development in their respective regions.

Reports by the Office of Management Budget indicate that the program funding level for the BHC for Fiscal Year 2009 is $7 million.

“The goal should be to maximize health outcomes like inoculations, access to quality care and prenatal care and to at least reach the level of funding that other domestic commissions have attained,” said Shapleigh.

The BHC was created in 2000 as a binational health commission under the auspices of HHS, designed to work in conjunction with Mexico's health authorities. Its mission is to “provide international leadership to optimize health and quality of life along the U.S.-Mexico border.” The BHC oversees four states in the United States, six in Mexico and has appointed commissioners in each state, including four in Texas.  

Shapleigh argues that in the eight years since BHC's inception, the health situation in the border has not improved, and describes current health care statistics in the region as “grim.” The letter provides specific statistics on the Texas-Mexico border, including percentages of the population that do not have health insurance, that suffer ailments such as diabetes and tuberculosis, and dentist-to-population ratio statistics.

The statistics provided in Shapleigh's letter outline the serious health and health care disparities along the Texas-Mexico border. Statistics on the BHC's Web site indicate that if made the 51st state in the nation, the entire border region would rank last in access to health care, second in death rates due to hepatitis and third in deaths related to diabetes.

“To date, the BHC cannot demonstrate how its activities during the past eight years have made any significant improvements in the health or quality of life of border residents,” says Shapleigh, adding that the commission faces several problems including the need for role clarification, credibility and a creation of a method of a sustainable resource allocation.

The senator said he has not heard from either the HHS officials or the BHC commissioners who received the letter.

“Specifically, Leavitt has created a facade which provides an appearance of progress when, in fact, Secretary Leavitt has sponsored and permitted a failure. For 12 months, the commission did not even meet. We want an answer as to why border citizens are treated as second-class citizens,” said Shapleigh.

An assessment conducted in 2005 by the OMB's federal program Expect More gave the BHC “zero percent” for four out of five criteria in the program results and accountability section. Four questions evaluated the program's progress in long-term and short-term performance goals and one addressed the program's effectiveness and results.

The evaluation comments state that the BHC was in the process of “developing an efficiency measure to evaluate the effectiveness” of the commission's initiatives.

Overall results indicate that the BHC scored a 7 percent on program results and accountability; 100 percent on program purpose and design; 75 percent on strategic planning; and 86 percent on program management. The 2005 assessment was the latest study available at the OMB Web site.

The BHC did hold a public meeting in McAllen last week but chose the date of the Texas primary, thereby guaranteeing almost no media coverage.

The Guardian made numerous attempts to contact the recipients of Shapleigh's letter over a three-day period, including U.S.-Mexico Border Health Commission commissioners David L. Lakey, Ronald J. Dutton, Antonio Falcon and J. Manuel de la Rosa for comment on Shapleigh's letter. Lakey and Dutton's office in the Texas Department of State Health Services said they were not available for comment and Falcon, a Rio Grande City physician, did not return several phone calls.

De la Rosa, the dean of Texas Tech’s Health Science Center School of Medicine in El Paso, was the only commissioner to return phone calls to the Guardian. He said he had not yet read Shapleigh's letter. The press office at the Department of Health and Human Services in Washington D.C. referred the Guardian to a public health analyst in the Office of Rural Health Policy, Health Resources and Services Administration.

The Guardian also attempted to contact BHC general manager Dan Reyna, and the commission's press information officer Kelsey Wells. Wells initially said the BHC was about to release a press release concerning Shapleigh's letter. The press release was never sent. Later, Wells told the Guardian that a “general manager” at BHC would return our calls. Wells did not give the name of the “general manager” and Reyna did not call back.