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HOUSTON – The Houston Chronicle reports that Houston mother Yolanda Ramirez choked back tears as she said her 20-year-old son, Kevin, was detained by ICE officers last week at his workplace, despite having a work permit and no criminal record. Ramirez, who is a visually impaired single mother, said one of her sons committed suicide in recent years, leaving Kevin to be the only one to care for her. Her son, who she said was “treated like a dog,” is able to apply for permanent residency after filing a Special Immigrant Juvenile petition more than four years ago. Houston residents detailed being detained by ICE and U.S Borders and Customs Protection, despite having documents showing legal residency or legal work status, at a news conference held by FIEL, Houston’s largest immigrant advocacy group. Immigration lawyer Susana Hart, who represents Ramirez’ son, Kevin Alexander Zaldana Ramirez, said she’s been asking ICE why Kevin was detained and getting no response.

ICE representatives told the Houston Chronicle the agency was looking into Kevin Ramirez’ case Thursday, but did not provide a statement as of Thursday evening. U.S. Customs and Border Protection in Houston had not responded to calls from the Chronicle as of Thursday evening. FIEL Executive Director Cesar Espinosa said the cases represent the first his organization knows of in Houston where residents in the country legally were still detained by ICE. The cases, which occurred on the heels of a mass immigration operation in Colony Ridge near Houston near the end of February and a workplace raid at a Spring business this week, represent a worrying trend toward rash detainment of documented immigrants and those without criminal records, immigrant lawyers and FIEL said at the news conference. “It’s very possible that because ICE operations are being sped up, the officers might not be aware of what protections a person might have,” Hart said.

FORT WORTH – The Fort Worth Star-Telegram reports that speaking Thursday evening at a Fort Worth private school, Texas Gov. Greg Abbott made the case for school vouchers — again: That parents, not the government, are best equipped to decide what type of education is best for their children. Although Abbott has struggled to get a voucher proposal through the Texas Legislature in years past, he sounded confident that a bill will reach his desk this year. Abbott was in Fort Worth Thursday to rally supporters of education savings accounts, a school voucher-like program that gives families public money to pay for private school tuition or homeschooling expenses. The governor spoke at a Parent Empowerment Night at Temple Christian School.

During the event, Abbott acknowledged that the proposal has passed the Texas Senate in “session after session after session,” only to fail when it reached the House. But the current session is likely to bring different results. Currently, 77 representatives are signed on as authors on the House’s education savings account bill — one more vote than the bill needs to get through the chamber. Abbott, however, encouraged families not to assume the bill is already across the finish line. Pointing to a row of Republican lawmakers in the audience, he encouraged parents to call their senators’ and representatives’ offices to voice their support for school vouchers. Abbott insisted that the proposal doesn’t represent an attack on public schools, saying that the state will have approved record per-student funding and teacher pay by the end of the legislative session. But he also accused public schools across the state of promoting a “woke, leftist agenda.”

AUSTIN – The Texas Tribune reports that Texas Railroad Commission Chair Christi Craddick and former GOP state Sen. Don Huffines announced Friday they are running for comptroller, minutes after the office’s current occupant, Glenn Hegar, was named chancellor of the Texas A&M University System.

Hegar’s impending departure from the comptroller’s seat creates a rare opening for one of Texas’ coveted statewide offices, most of which have remained occupied for the last decade.

Once Hegar leaves office, Gov. Greg Abbott will be tasked with appointing a replacement to serve out the remainder of his term, which runs through January 2027. The seat is up for reelection in 2026.

The comptroller serves as the state’s chief financial officer, accountant, revenue estimator and treasurer.

Abbott has not revealed his pick to succeed Hegar.

Huffines, a businessman and GOP donor who challenged Abbott unsuccessfully in the 2022 gubernatorial primary, pledged to spend at least $10 million on his comptroller bid. If elected, he said, “I will DOGE Texas by exposing waste, fraud, and abuse in government to increase efficiency and put every penny we save into property tax relief.”

Craddick, a Republican, has served on the oil-and-gas-regulating Texas Railroad Commission since 2012. She easily cruised to reelection last year, winning another six-year term through the end of 2030. She will not have to give up her seat on the commission to run for comptroller.

Craddick, an attorney from Midland, is the daughter of Rep. Tom Craddick, a former House speaker.

AUSTIN – The Texas Tribune reports that a bill that would give parents more power over which books their children can read in public school libraries will soon go before Texas senators for a full vote.

The measure was approved Tuesday by a 10-1 vote in the Senate Committee on Education K-16. Introduced last month by Sen. Angela Paxton, R-McKinney, Senate Bill 13 would represent an overhaul of how schools decide what books are placed in their libraries.

SB 13 would require that school boards, rather than librarians, have the final say over which new books or materials can be put in school libraries. The bill would also create a way for parents to challenge any library book and have it removed from shelves until the school board decides whether that material is allowed.

Under SB 13, each school district would also be required to have local advisory councils — with parents of students in the district making up a majority of voting members — that would recommend which books should be added and removed from school libraries. Additionally, the bill would not allow schools to have library materials that have “indecent content or profane content,” which can include books that use “grossly offensive” language.

During a committee hearing last month, Paxton characterized the bill as a way to address parents’ concerns about sexually explicit content in Texas’ public school libraries. She added the legislation “clarifies parental rights with respect to school libraries.” It comes as the Senate is also considering a proposal that would amend the state constitution to enshrine parents’ right to direct their child’s education.

“No child should pick up a book in their school library of all places and be exposed to inappropriate, harmful material within its pages,” Paxton said. “These young brains cannot unsee what they see.”

A similar proposal passed the Senate but didn’t get a vote on the House floor last session.

The bill would build on House Bill 900, a law passed in 2023 to keep sexually explicit content off of bookshelves. Last year, a federal appeals court blocked Texas from enforcing parts of the law that required book vendors to assign ratings to books based on the presence of or depictions of sex, saying it was unconstitutionally broad. Since then, Texas conservatives have increased their push for new legislation. This session, SB 13 is one of Lt. Gov. Dan Patrick’s legislative priorities.

But the proposal has also drawn harsh criticism from school librarians and anti-censorship advocates, who say it would make it easier for school districts to target and remove books about people of color and involving LGBTQ+ characters.

The measure comes as book bans have increased in Texas and nationwide in recent years. Texas banned around 540 books during the 2023-24 school year, according to PEN America, an organization tracking bans throughout the country. Of all the books banned during that time, 44% included characters or people of color and 39% included LGBTQ+ characters. Some of the book titles banned in Texas school districts in 2023 included “The Perks of Being a Wallflower,” “The Kite Runner,” “The Color Purple” and “The Handmaid’s Tale,” among other acclaimed books, according to PEN America data.

“Our communities are diverse and that’s the power and beauty of the communities to have so many different experiences available for our students to learn from,” Lucy Podmore, a public school librarian and former chair of the Texas Association of School Librarians, told The Texas Tribune last month. “It’s imperative that when we say ‘parents’ and ‘parental choice’ and ‘parents are the final say’ that we include all parents — that we’re not just giving voice to a select few.”

The library bill also raises some logistical concerns. In requiring school boards to approve each new library material, a responsibility traditionally overseen by school librarians, the bill’s proposed process would make it more difficult for libraries to obtain new books in a timely manner, librarians say. As a result, critics add, the bill could lead to school-aged children reading less, even as Texas students are still recovering academically from the COVID-19 pandemic.

Shirley Robinson, executive director of the Texas Library Association, said it’s “critically important” for libraries throughout the state to either maintain or increase the number of books available to students given the lagging reading scores. But the Senate proposal, she said, would create new obstacles toward achieving that — and potentially hamper spending on school library books in the long term.

“Budgets are based on what the spending was the prior year,” Robinson said. “So if we are essentially putting roadblocks and barriers up for those campus library budgets to be spent, they’re going to continue to be reduced further and further every single year.”

The local advisory councils created under the bill would recommend removing library materials that have “indecent content or profane content.” According to the bill, these councils would also make recommendations to ensure “that local community values are reflected” in public school libraries in their districts.

Education advocates say it’s unclear what the phrase “local community values” is supposed to mean. For Emily Witt, an author at the progressive-leaning Texas Freedom Network, it’s an open question about which community values are being upheld. The answer to that question, she said, may vary depending on the makeup of a given community and result in majority voices having an outsized opinion over what materials are available for all students to choose to read.

“Parents do have the right to control the education of their children, absolutely, but I think that creating laws like this and stoking fear in parents puts out the message that it’s not okay for their kids to learn about people who are different from them,” Witt said. “I think that does a disservice to parents as well.”

Texas isn’t alone in its efforts to further regulate school libraries statewide. More than 3,400 books have been banned in Iowa school libraries since 2023, a Des Moines Register survey found, after the state passed a law meant to ban books depicting sex acts from school.

And in 2023, Florida put in place a policy allowing parents to challenge books in school libraries or classrooms that they say depict sexual conduct. During the 2023-24 school year, Florida led the nation in book bans with more than 4,500, according to PEN America.

Deborah Caldwell-Stone, director of the American Library Association’s Office for Intellectual Freedom, said these efforts are being driven by advocacy groups that want many books on topics like race, history, sexual orientation and gender identity out of school libraries and out of reach for children. The result, she said, has been increased censorship in schools and public libraries nationwide.

“A library is really designed to be a place where you should be able to find a wide range of ideas that serve a variety of information needs that reflect the views and opinions of a wide range of people in the community,” Caldwell-Stone said. “Everyone should be able to find something on the shelf that reflects their experience, their identity and their beliefs — and we’re seeing that attacked as a concept.”

SB 13 is expected to swiftly pass the Senate. All 20 Republican senators sponsored the proposal. A date for the vote hasn’t been set yet.

AUSTIN (AP) – A new state law meant to ensure that more Texans recovering from substance abuse in residential facilities have uniform standards of care and living conditions may not have the effect lawmakers intended.

The 2023 law, which goes into effect in September, requires recovery homes to be accredited to receive state funding. That accreditation requires them to meet specific health standards, adhere to an established code of ethics and agree to inspections. But there aren’t enough people to inspect the nearly 600 recovery homes, the cost of becoming accredited can be cost prohibitive for some facilities and legislators haven’t earmarked enough money to subsidize the number of homes advocates say are needed.

“I don’t think there’s enough incentive for them to get accredited,” said Ralph Fabrizio, a certified recovery support peer specialist and owner of the accredited House of Extra Measures facilities in Houston. “There is just not a lot of money in recovery housing, and this is another expense some good providers can’t take on financially because they are already battling unlicensed recovery homes, setting the price point so low that it’s running them out of business.”

House Bill 299, which the Texas Legislature passed in 2023, prohibits a recovery house from receiving state money if it has not participated in the “voluntary” accreditation process.

“A lot of people come into recovery housing from other industries with not a full understanding of the rules in health care,” said Elizabeth Henry, director of policy for RecoveryPeople, a substance use recovery nonprofit based in Texas. “Things like referral fees and bonuses and things like that are not welcomed in health care, but we have people trying to get discounts on drug testing. One of the great things that happens when they go through accreditation is they learn these things.”

In addition to Oxford House, Texas Recovery Oriented Housing Network accredits recovery houses in Texas. To start the certification process, a recovery house must pay $500 per application and $10 per bed.

To help categorize recovery residences into more specific groups, NARR distinguishes these residences based on four levels of care.

The first level is peer-run recovery residences, where residents operate the facility. Level two is for monitored recovery residences, with an administrative director overseeing operations. A level three home is a supervised recovery residence, which has more intense oversight than monitored residences and includes 24/7 support for residents. The fourth and final level is for service provider recovery residences, which are typically operated by organizations or corporations that offer clinical and administrative supervision and credentialed staff.

Each level has standards that must be met before being certified by NARR, including requirements for administrative operations, recovery support, physical environment, and even how to be a good neighbor. It also includes a rule that makes paid work agreements completely voluntary so residents don’t suffer consequences for declining work, a costly concept for recovery home providers.

Texas Recovery Oriented Housing Network is the only accreditation agency in the state that can certify all levels, as Oxford House Incorporated deals mainly with level 1 homes.

While these standards are meant to improve residents’ recovery, they saddle housing providers with additional costs. Providers make most of their money from residents’ rent.

Henry said House Bill 299 was initially meant to include funding, but lawmakers removed this portion during committee hearings. “We don’t know why,” she said.

Residents’ private or public health insurance usually does not cover housing costs for recovery residences, leading to recovery homes closing or switching to more profitable care facilities.

“Currently, the conundrum that we face is that the higher the severity of illness, the lower the resources the person has available. This is because the higher the severity, the higher the care they need, which is more expensive, and insurance doesn’t pay for it,” Henry said.

The exact number of recovery homes in Texas is unknown because accreditation is voluntary. Still, advocates believe 600 to 700 recovery homes are operating in a given year. The Texas Health and Human Services Commission reports that 407 are accredited or chartered homes, with 326 of those being low-intensity resident-run homes.

Henry estimates around 300 homes lack accreditation and risk being cut off from all state funding.

The Texas Health and Human Services Commission could not provide an exact number of recovery homes that lack accreditation because no agency gathers information on every recovery home that exists.

To meet the current demand from Texans seeking to recover from substance abuse, the state needs at least 300 more dwellings and 200 more high-intensity managed care homes to be accredited, said Jason Pullin, the director of the Texas Recovery Oriented Housing Network.

According to the National Study of Treatment and Addiction Recovery Residences, the state currently ranks 33rd in the nation for recovery homes per capita. Most Texas counties — 218 — have no identified recovery housing, and 86% have fewer than five.

The Texas Recovery Oriented Housing Network has accredited 81 recovery homes, with 23 residences becoming newly certified through the voluntary process in fiscal year 2024. Even if the demand for accreditation increases, the Texas affiliate of the national accreditation organization will likely not meet it due to a lack of staff.

“We currently have one paid employee, myself, but we operate from El Paso to Beaumont, Amarillo to South Texas. These homes must be physically walked through as part of the accreditation process. We just don’t have the bandwidth,” said Pullin, the organization’s director.

Texas Health and Human Services Commission identified the single issue concerning accreditation is providers don’t find it financially feasible or worthwhile.

The exact amount of money a recovery home receives from the state can vary depending on the level of substance use it is meant to address, as higher-intensity programs might need medicine programs and clinical support.

State funds usually cover rent for specific residents in a recovery home, ranging from $300 to $2,000 monthly. However, this is not a reliable source of funding for most providers.

“The vast majority of recovery homes in Texas do not receive state funding,” Henry said. “Currently, approximately 15 homes under PROJECT HOMES and those supported by BeWell Texas receive state funds, and both programs require NARR accreditation. However, BeWell Texas only covers costs of residents who meet specific criteria, making the funding highly limited and inconsistent.”

In fiscal year 2024, the Texas Health and Human Services Commission spent $10 million on substance-use housing, with $4 million going to the Texas Targeted Opioid Response recovery housing program.

The majority of state funding for recovery housing goes to Oxford House, which has had a decade-long contract with the Texas health agency, with the current one being $1.6 million annually. Oxford House has accredited 326 homes, with 20 residences newly chartered in 2024.

“While this funding has provided stable support for Oxford Houses, it has also contributed to a significant gap in recovery housing options, as other recovery homes remain largely unfunded,” Henry said.

Additionally, some recovery homes occasionally receive housing vouchers from local mental health authorities, but these payments can take months to process, making them impractical options for many homes and residents.

The federal Substance Use Prevention, Treatment, and Recovery Block Grant covers 70% of all substance use services in Texas, something advocates say needs to be switched to state funds soon as federal funding can be unreliable, and the accreditation process is already a financial burden for recovery housing providers.

Pullin said the costs a recovery home can incur annually vary widely depending on whether the provider rents or owns the homes, whether transportation is provided, what programming is offered, and more.

“In my estimate as a former operator, the average budget for a recovery home would range from $50,000 on the low end to over $100,000 on the upper end,” he said. “Every provider has a unique program. There is no way to get an accurate average with a multitude of differences among providers.”

The current situation in Texas has led many recovery homes to look for other funding sources, either by leaving the industry altogether or switching to programs that have more consistent federal and state funding.

This is why recovery housing advocates and managers have asked lawmakers to send $4.3 million to level two or three accredited homes during the next two-year state budget cycle. Most level one homes already receive consistent funding, and a clinic or hospital usually supports level-four dwellings, so they don’t need additional funding, Henry said.

The recovery home industry warned lawmakers in a hearing that without rental assistance, facilities with expensive programs will continue to close or move to more profitable outpatient programs, and more dangerous, unregulated facilities will replace them.

“We are hopeful that this funding proposal will successfully move through the appropriations process and become part of the state budget, expanding access to quality recovery housing for more Texans in need,” Henry said.

What is a recovery home?
Lyndsi Taylor, a 35-year-old Pearland resident, began a downward spiral into drug abuse seven years ago when her youngest daughter died. She’s bounced around from couches to rehab programs to the streets, but this year, she is ready for a change.

“It’s a full-time job just worrying about how you’re going to get pills. And it’s so exhausting, and I’m just so tired of that; I’m so tired of that same old worrying about something that doesn’t even do anything for me and causes nothing but trouble in my life,” Taylor said.

For people like Taylor, a recovery home is a community of like-minded individuals who are there to pick you up at your lowest moments.

“The girls are great. There’s a sisterhood and a bond because we’re all going through the same thing,” Taylor, who is currently staying in a recovery home in Houston, said. “We hold each other accountable. But we’re there for each other when you need it, too. You need that community because you can’t do it alone.”

For many Texans, leaving rehab is just the start of the recovery journey, not the end.

“You are pretty much going from the street to 30 days in treatment and then right back home,” said Sarah Saidock, who was a resident of a recovery home in 2021. “Those addictive behaviors are still going to be engraved in you.”

Saidock said her time at a recovery home allowed her to regulate her emotions again after years of numbing them with drugs.

“If I hadn’t been sent to that recovery home, I wouldn’t have had that time to heal and grow and be a responsible parent for my daughter that I still am today; that made a world of difference for me,” said Saidock, who has worked at House of Extra Measures, a recovery housing program in Houston since her treatment.

Recovery housing benefits individuals by reinforcing a substance-free lifestyle and providing direct connections via support groups, participating in house meetings, peer support, job training, and more.

“You must learn many little things, like keeping the house clean and pushing in your chair. At first, I thought that was stupid, and then I started to like taking care of the house, taking care of myself, and being respectful,” said Kimberly Ham, who has been a Hoskins House for Women resident in Houston for the past three months.

However, for many who are searching for help with their addiction, finding a quality recovery home can be a challenging task.

“I’ve been to awful places. I mean roach infestations, people still doing drugs all the time and stealing,” said Taylor. “There are a lot of places like that, but this place is completely different.”

Why is accreditation important?
Studies show that recovery homes with enforced standards are a key step in recovery and preventing relapses. Still, the quality can vary from place to place since the accreditation process is voluntary in Texas.

“Anybody can open up a recovery home, put some beds in it, put utilities on it, market it, and put some bodies in there,” said Fabrizio.

This has led to a problem where tracking what recovery home is open or closed can be challenging.

“Since undergoing accreditation is a voluntary process, HHSC cannot confirm the total number of operating recovery homes in Texas,” said James Rivera, spokesperson for the state health agency.

States cannot simply close down unlicensed houses because doing so would violate the Federal Fair Housing Act and Americans with Disabilities Act.

“Other recovery homes will say they will give you grace but want their money immediately. They want their money, and it’s almost impossible to focus on recovery when stressed about finding a job just to get a bed,” said Stephanie Paris, who had been abusing opioids and heroin since the age of 11.

Paris, 46, decided she was ready for a change after being released from rehab in early 2024. However, she knew the grim options that awaited someone with her financial means.

“It’s virtually impossible, especially in today’s economy, to start from scratch all over again without some kind of support and assistance,” she said. “You are pretty much homeless once you leave a rehab program.”

When Paris thought she had no other options and would have to continue her court mandated probation on her own, she learned about the House of Extra Measures. This accredited recovery housing organization offered services to people with little to no income.

“It was a game changer. It allowed me to make my recovery the most important thing in my life, and that set a routine and foundation for me. All of this can be hard to do when you have to worry about paying rent or end up back on the street,” she said.

What is the solution?
Recovery housing advocates say more money from the state will save taxpayer dollars.

“We are currently spending a bunch of money on people with some pieces of addiction. We’re spending on the justice system. We are spending it on child removals and spending it on human trafficking prevention. It touches every area that we taxpayers pay for,” said Cynthia Humphrey, executive director of the Texas Association of Substance Abuse Programs.

Advocates want $2 million of the $4.3 million requested from the state to be used on implementing and administering accreditation programs.

“Additional funds would allow us to increase staff and our ability to develop more training materials for providers who want to get into operating a recovery home,” Pullin said. “There is not a lack of interest in this purpose. It’s a lack of resources.”

Advocates also propose using some of these funds to create rental assistance programs for accredited providers, easing some of the financial burden created by trying to provide quality service.

“My husband is one of the do-gooders who started a recovery home in the early 2000s, and it lasted about two years after pouring so much money into the home,” Humphrey said. “We need to do something for our providers and those seeking help.”

AUSTIN, Texas (AP) — Jonah Paul, a California state employee, says he’s lucky if he gets home by 7 p.m. when he takes the train two days a week to his Sacramento office — a lengthy commute that’s about to become more frequent.

He is among thousands of state employees across the U.S. being pushed back to the office this year — a trend in states led by Democrats as well as Republicans. It’s happening in both California and Texas, which together have more than 350,000 public-sector workers.

The roll-back of remote work mirrors the Trump administration’s mandate for federal workers and moves by some of the nation’s largest corporations including Amazon, JP MorganChase and AT&T.

Democratic California Gov. Gavin Newsom’s order this week cites concerns about productivity and collaboration. Starting July 1, state workers must be in the office at least four days a week, with exceptions on a case-by-case basis.

“The governor’s executive order kind of blindsided everybody,” said Paul, who is also president of the downtown Sacramento chapter of SEIU Local 1000, the state’s largest public sector union. “People have been really upset.”

Indiana Republican Gov. Mike Braun issued his return-to-work mandate one week before President Trump’s executive order for the federal workforce.

In Texas, some state employees got emails this week telling them to return to the office full-time as soon as possible after Republican Gov. Greg Abbott instructed state agencies to end remote work.

“Any remote work policies must ensure taxpayer dollars are being utilized efficiently,” explained Andrew Mahaleris, a spokesperson for Abbott. “With remote federal workers returning to the office where possible, it’s important that state agencies ensure they do the same.”

Other states vary. New York, which also has one of the country’s largest state workforces, allows each agency to set its own rules. And some legislatures, like Wisconsin, have introduced bills to require in-person work by law — an idea shot down by Democratic Gov. Tony Evers.

These return-to-office orders shouldn’t lead to massive quitting, but they usually result in top performers leaving first, and recruitment and retention suffer, according to economist Nicholas Bloom at Stanford University.

“States are going to have to increase salaries or fatten up the benefits package in other ways if they’re asking people to forgo this flexibility,” said Chris Tilly, a UCLA professor of urban planning who studies labor markets.

While many are anxious, others are already accustomed to the change. More than half of California’s 224,000 full-time employees, such as janitors and highway patrol officers, already report for duty in-person each workday.

Texas pivoted despite a legislative committee’s findings in February that remote work has had a positive impact, said Myko Gedutis, organizing coordinator of Texas State Employees Union CWA Local 6186. The survey found 80 out of 96 agencies reported improved recruitment and 46 saw improved productivity, while 40 agencies reported no improvement.

Texas state employee Rolf Straubhaar said many are concerned that people with medical needs won’t get exceptions.

“This can push out employees who, for medical reasons, need to work from home,” Straubhaar said.

Paul wakes up around 5 a.m. for the two-hour train ride from his home in Oakland to his employment development job in the state capital. His agency already staggers in-office days due to limited office space, and now his colleagues face more logistical challenges.

“There’s a physical space constraint that makes this order even more absurd,” Paul said. “It’s not really realistic to force everyone to come back.”

WEST TEXAS (AP) – A historic measles outbreak in West Texas is just short of 200 cases, Texas state health officials said Friday, while the number of cases in neighboring New Mexico tripled in a day to 30.

Most of the cases across both states are in people younger than 18 and people who are unvaccinated or have an unknown vaccination status.

Texas health officials identified 39 new infections of the highly contagious disease, bringing the total count in the West Texas outbreak to 198 people since it began in late January. Twenty-three people have been hospitalized so far.

Last week, a school-age child died of measles in Texas, the nation’s first measles death in a decade. The U.S. Centers for Disease Control and Prevention announced this week that they were sending a team to Texas to help local public health officials respond to the outbreak.

Across the state border from the epicenter of the outbreak, Lea County, New Mexico, had 10 cases Thursday after health officials confirmed an unvaccinated adult who died without seeking medical care had the virus, though as of Friday, measles has not been confirmed as the cause.

But in an update on the state health department’s website, the number of cases in Lea County shot up Friday to 30. The department has said it hasn’t been able to prove a clear connection to the Texas outbreak; on Feb. 14, it said a link is “suspected.”

The CDC said Friday it has also confirmed measles cases in Alaska, California, Florida, Georgia, Kentucky, New Jersey, New York City, Pennsylvania, Rhode Island and Washington.

But the Texas and New Mexico outbreaks make up for most of the nation’s case count.

The rise in measles cases has been a major test for U.S. Health and Human Services Secretary Robert F. Kennedy Jr., an anti-vaccine activist who has questioned the safety of childhood vaccines. Recently, he has stopped short of recommending people get the vaccine, and has promoted unproven treatments for the virus, like cod liver oil.

Kennedy dismissed the Texas outbreak as “not unusual,” though most local doctors in the West Texas region told The Associated Press that they have never seen a case of measles in their careers until this outbreak.

The measles, mumps and rubella vaccine is safe and highly effective at preventing infection and severe cases. The first shot is recommended for children ages 12 to 15 months, and the second for ages 4 to 6 years.

Childhood vaccination rates across the country have declined as an increasing number of parents seek exemptions from public school requirements for personal or religious reasons. In Gaines County, Texas, which has the majority of cases, the kindergarten measles vaccination rate is 82% – far below the 95% needed to prevent outbreaks.

Many of Gaines County’s cases are in the county’s “close-knit, undervaccinated” Mennonite community, a diverse group that has historically had lower vaccination rates and whose members can be distrusting of government mandates and intervention.

Measles is a respiratory virus that can survive in the air for up to two hours. Up to 9 out of 10 people who are susceptible will get the virus if exposed, according to the CDC. Owing to the success of the vaccine, the U.S. considered measles eliminated in 2000.