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A dentist closing clinics waits for money from the feds as private practices suffer losses

Swish Dental has closed all but one of its eight locations, including at the Mueller development, as a result of the coronavirus pandemic. (Emma Freer)
The economic injury disaster loan, for which Dr. Desai applied, initially promised up to $2 million in assistance but now has an apparent cap of $15,000, which she said would barely cover Swish Dental's rent.
"We're not exactly sure we're going to receive it, how much we're going to receive. And it just seems like [the Small Business Administration has] tons of applications," she said.
Across Austin, private practices have seen a sharp drop in business because of a state-mandated moratorium on non-essential procedures and surgeries. According to the healthcare data firm Infinedi Analytics, patient visits are down 68% in Travis County, compared to 47% nationally.
"The problem … is a lot of the routine care and elective surgeries are pretty much on hold right now as we gear up and get ready for whenever this surge of patients is going to happen," said Dr. Jack Myers, a Temple-based physician and board member of the Texas chapter of the American College of Physicians.
The American Academy of Family Physicians, which represents 134,600 members, lobbied Congress to account for private practices in its $2 trillion stimulus package.
"If there is a private practice out there in the United States of America that is still seeing their full complement of patients, they're in violation of the federal and state mandates," AAFP President Gary LeRoy said. "So I don't know anyone who's not been touched by this."
On March 26, President Donald Trump signed into law the Cares Act, bipartisan emergency legislation that included $377 billion for small businesses. Last Friday, applications opened for a relief program included in the act—the Paycheck Protection Program—which allows small businesses like Swish Dental to apply for up to $10 million in forgivable loans so long as they don't lay off any employees or they rehire those who had been already.
Local private practices are waiting for this money to be disbursed, and some have questioned if the stimulus will be enough to prevent these businesses from going under.
Consulting firm Gist Healthcare reported April 1 that 61% of primary care clinicians are uncertain about their ability to remain open in four weeks and 19% are unsure if they will be forced to close permanently.
Some practices are already reducing costs.
"We are hearing about nurse practitioners who are losing jobs or being furloughed across the state," Texas Nurse Practitioners Board President Christy Blanco said.
Last week, dozens of professional organizations and state medical societies—including the American College of Physicians, the American Medical Association and the Texas Medical Association—wrote a letter to Health and Human Services Secretary Alex Azar requesting additional relief for private practices, beyond what was included in the Cares Act.
Specifically, the signatories asked the U.S. Department of Health and Human Services to provide one month of revenue to physicians, nurse practitioners and physician assistants caring for patients covered by Medicare or Medicaid "to account for financial losses and non-reimbursable expenses."
Some physicians are incurring expenses—such as staying in hotel rooms or renting apartments to avoid exposing their families to the coronavirus—that do not qualify for federal assistance under the Cares Act, per the letter.
"Who's going to recoup those expenses?" Dr. Myers asked.
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(Paxton Smith/Instagram)
Paxton Smith’s 2021 valedictory speech at Lake Highlands High School in Dallas wasn’t the same speech she had previously shared with school administrators. She dropped the approved speech and made a case for women’s reproductive rights after lawmakers passed the Texas "Heartbeat Bill.”
Her advocacy made news on NPR, YouTubeTV and in The Guardian. Just over a year later, the “war on (women’s) rights” she forewarned has come to a head as the U.S. Supreme Court voted Friday morning to overturn Roe v. Wade, ending constitutional protection for abortion access.
“It is up to the people to show up and show the courts and the politicians that we won’t sit back and let this happen,” Smith told Austonia Friday morning. “We will show up, we will fight back. Before, we were scared of them, now they should be scared of us.”
Now a University of Texas sophomore and abortion rights activist, 19-year-old Smith said she wanted to give the same speech in the “the most public way possible” to reach “as many people as possible who don't agree that I deserve this right.”
However, she says the response was “actually overwhelmingly positive” and supportive of her cause. According to a recent UT poll, 78% of Texas voters support abortion access in most cases.
The speech opened up further opportunities for activism: she advocated for reproductive rights at the International Forum on Human Rights in Geneva, interviewed with Variety magazine and spoke to tens of thousands at Austin’s Bans Off Our Bodies protest at the Texas Capitol in May.
Smith also serves on the board of directors for the Women’s Reproductive Rights Assistance Project, a national nonprofit organization that helps fund abortions or medication abortion—like Plan C pills—in all 50 states. Most recently, Smith has been attending protests in Washington, D.C. leading up to the ruling.
“This is land of the free. This is where you get to choose how you live your life,” Smith said. “Overturning Roe v. Wade violates everything that we have come to believe about what it means to live in this country. I think a lot of people aren't willing to accept that this is a human right that is most likely just going to be gone for over half of the country within the next couple of weeks.”
Bracing for the next steps, Smith gave some tips for supporters:
- Find a protest to attend.
- “I would say invite somebody to go to those protests with you, invite a couple of friends, invite people into the movement,” Smith said.
- Talk about the issue on social media—use the platform you have.
- “Have these kinds of conversations where people can just talk about their fears and then find ways to go and advocate for yourself,” Smith said.
- Volunteer at a nonprofit near you.
“I feel like a lot of the reason things have gotten as bad as they have within the abortion rights world is that people are not making a scene, not protesting, not putting the effort into ensuring that the government doesn't take away this right,” Smith said. “I want to emphasize that if you're not doing anything, don't expect the best scenario, expect the worst because that's the direction that we're going in.”
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(Council Member Chito Vela/Twitter)
The U.S. Supreme Court overturned Roe v. Wade, the landmark ruling that guaranteed a constitutional right to an abortion, Friday morning. Moments later, Austin City Council set a special meeting for next month to pass a resolution aimed at decriminalizing abortion.
The GRACE Act, which stands for guarding the right to abortion care for everyone, is a twofold plan submitted by council member Jose “Chito” Vela. It recommends that city funds shouldn’t be used to surveil, catalog, report or investigate abortions. It also recommends that police make investigating abortion their lowest priority.
Council Member Vanessa Fuentes, who co-sponsored the resolution along with council members Paige Ellis, Kathie Tovo and Mayor Steve Adler, said the importance of the GRACE Act cannot be overstated.
“By introducing this resolution during a special session, City Council is doubling down on fighting back for reproductive health,” Fuentes said. “Items like the GRACE Act will promote essential healthcare while enabling individuals to exercise their bodily freedom.”
The act takes an approach similar to when former council member Greg Casar moved to decriminalize the possession of small amounts of marijuana. Ultimately, state law doesn't allow city officials to order police chiefs to adopt specific enforcement policies so the resolution would be a request to Police Chief Joe Chacon. In May, Politico reported that Vela is having "ongoing conversations" with Chacon about the proposal.
Austonia contacted Attorney General Ken Paxton for comment on the GRACE Act but did not hear back by time of publication. On Friday, Paxton celebrated the overturning of Roe and announced an annual office holiday on June 24 in recognition of the high court's decision.
In a press release, Vela said the Texas state government has a history of overturning municipal protections of human rights. Thirty days after the Supreme Court’s ruling, Texas will ban all abortions, with exceptions only to save the life of a pregnant patient or prevent “substantial impairment of major bodily function.”
Still, Vela expressed hope for the GRACE Act’s longevity. Council’s special meeting on it is set for the week of July 18.
“We know this resolution is legally sound, and Austin is not alone in this fight,” Vela said. “We are working with several other cities who are equally horrified by the prospect of an abortion ban and want to do everything they can to protect their residents.”
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