Hinojosa: Let’s look at a Hidalgo-Starr Counties Healthcare District

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EDINBURG, RGV – Former Congressman Rubén Hinojosa has suggested a workshop of state legislators and stakeholders be convened to see if drafting in Starr County could help secure a “yes” vote for a healthcare district in Hidalgo County.

Under such a plan, which would likely need legislative support, Starr County’s healthcare district would be merged with a new one in Hidalgo County. The idea was discussed at the Rio Grande Guardian’s first [email protected]’s luncheon at Bob’s Steak & Chop House in Edinburg. Dr. Carlos Cardenas, chairman of the board at Doctors Hospital at Renaissance, was the special guest.

Hinojosa represented much of Hidalgo County in Congress for 20 years before retiring in 2017. He was in the audience at the [email protected]’s luncheon and spoke about the possibility of resurrecting a healthcare district plan for Hidalgo County after Rio Grande Guardian Editor Steve Taylor had asked if Starr County could be brought into the mix.

Taylor pointed out that South Texas College (STC) would not have secured a $159 million bond issue had it not been for the voters of Starr County. Hidalgo County residents voted “no” on the measure. Taylor wondered whether uniting Starr and Hidalgo counties could have a similar impact for a healthcare district. Hidalgo County voters have twice voted down a healthcare district referendum.

“Let me make a suggestion,” Hinojosa said. “Invite the state representatives and state senators to have a little workshop and see if it is feasible to do what Steve suggested, and that is to dissolve the Starr County Medical District and create one that is Starr and Hidalgo County combined.”

Hinojosa said there will likely be a special legislation session this summer as well as the regular legislative session that starts in Austin in January. Thus, the time is right for the Rio Grande Valley’s state legislative delegation to get together and hold a workshop. He said he would like to be invited.

Hinojosa then spoke about his experience in setting up STC back in the mid-1980s. Involving Starr County was crucial, he said.

“Then (McAllen) Mayor Othal Brand and (businessman) Glen Roney and (attorney) Morris Atlas met with me and said, we have tried three times (to set up a community college) and all three elections over 25 years have failed by at least five to ten, if not 15 percent. We would like to invite you to lead us, using whatever strategy you want and we will follow you,” Hinojosa recounted.

Hinojosa said he was chosen to bring 39 community leaders together with the intention of securing a “yes” vote for a community college taxing district.

“I said I would consider it under one condition: that if we could not get unanimous support to bring Starr County in with Hidalgo County to create a community college district, that they would allow me as a chairman to dismiss those that voted against bringing Starr County. I gave them five reasons why we had a better chance of proceeding where they had failed three times,” Hinojosa said.

“Bottom line is, I dismissed 13 people from that group of 39 and the rest of us worked and we got it done. Starr County voted 78 percent ‘yes’ for the community college. Hidalgo County voted 47 percent ‘yes’ for a community college and combined we won with 58 percent and started our community college.”

Hinojosa said South Texas College has twice been able to pass bond issues only because of the support education receives from Starr County voters. “Starr County said, ‘yes’ with 85 percent and we said ‘no,’ (with only) 45 percent (support) in Hidalgo County,” Hinojosa said.

Fast-forwarding to today and the push to create a healthcare district, Hinojosa said: “I think if Chuy and Bobby Guerra can find a way to make this happen, a combined Starr and Hidalgo County (healthcare district), I think we can bring together a team that could organize a campaign strategy and win it because that certainly would bring millions of dollars to this region of Hidalgo-Starr.”

Chuy is state Sen. Juan ‘Chuy’ Hinojosa, D-McAllen. State Rep. R.D. ‘Bobby’ Guerra was at the [email protected]’s luncheon.

Ruben Hinojosa said the idea of a healthcare district is hardly new. “Let’s leverage public and private monies because it works in San Antonio, it works in Houston, it works in Fort Worth, it works in El Paso. Why wouldn’t it work here? Sometimes you have to make a change, even though you are going to get opposition from those that do not want any taxes. But, the time is right, the time is ripe to do this. If, Dr. Cardenas, you could call a meeting and hopefully I would be invited, we could find a way to do it.”

Taylor speculated that Starr County leaders could be interested in a partnership with Hidalgo County, if they received a lot more clinics and healthcare infrastructure and healthcare dollars.

Asked by Hinojosa to comment on his suggestion of a workshop, Cardenas said:

“Bringing a group of all stakeholders together to study options and get solutions, I think is certainly worth looking at. To help convene a work group, the stakeholders coming together to convene that work group, we would be willing to be a part of that, to look at potential solutions.”

Cardenas said if stakeholders and state lawmakers do not think about the future of the healthcare in the Valley it is “tantamount to sticking our head in the sand.” 

Cardenas said: “We have to be willing to look at it. There would be opposition to a variety of things but sometimes we can find solutions in the face of adversity. I think it is important to look at it as an area with all stakeholders. Part of the issue has been the way funding happens in our state. It puts a lot of strain on communities, particularly communities at risk, communities with fewer resources. All of that needs to be looked at and I think a workshop may be the way to look at it, to come up with what might be a potential solution or what might be a variety of solutions that could be explored.”

The question of whether Hidalgo County should have a healthcare district was raised by a member of the audience, Sonia Falcon. 

“Are there any plans to bring back the medical district, the hospital district?” asked Falcon, a banker from McAllen.

“There are no plans at the present time,” Cardenas replied.

Falcon then asked how the last referendum failed. “Everybody wants the medical school but nobody wants to pay for it,” she said, referring to the fact that the UT-Rio Grande Valley School of Medicine would have enjoyed a much more solid financial base had a healthcare taxing district been formed. 

“We need to take a different approach. With the legislature being so short on cash, we have to have a way to sustain it. It cannot be perceived as helping “rich” hospitals,” Falcon said. 

Cardenas responded: “There are certainly a variety of ways to look at trying to solve the difficult issue and problem of funding. For most folks in this audience and others who listen, you probably recognize that (UT) Permanent University Fund monies are available for building bricks and mortar but they don’t provide for the operational side of the equation. While there are a lot of dollars in the Permanent University Fund, providing the human capital and personnel that you need to actually deliver the product, medical education and the other parts of it, is not that easy.”

Cardenas described federal Medicaid waiver programs as a “patchwork” solution to a community’s healthcare funding needs. “We can look at a variety of funding mechanisms, we can turn to the legislature to help us and commit to that. But I think these are issues being borne by every major community in the state. How do we do our funding? There are a lot of things as a community we need to fund, education, healthcare, our roads and services.”

The devil, Cardenas said, is in the details. 

“That is why it is important to remain involved and to try to work through the legislature to fix these issues and problems. So, maybe we need to look at other solutions and/or rethink how we come up with funding. It is way beyond the scope of my knowledge and talk here but I think what seems to work when it comes to solving problems is being engaged. That means community engagement at every level. It means being politically active and, you know, the old saying, and it is trite but true, is if you are not at the table you will certainly be on the menu.”

So, Cardenas said, the Valley needs to stand up and be counted.

“I think Sonia brought up some good points, and so I think our community needs to decide as we move forward what we want and what we want for our area. It is going to happen by osmosis or you just bring it and it occurs. The (medical) school has to have its ability to remain sustainable. We have to continue to build the infrastructure necessary to teach the next generation of physicians and to do what we need to do.”

Cardenas said it is “very clear” that public-private partnerships in the healthcare arena make “really good sense” when they are well done and well executed. 

“We have got examples of that happening. That is happening right now with DHR as the flagship teaching facility for the university’s (UTRGV) School of Medicine. It is a public-private partnership. It is working together towards the same goal, within the confines of the funding structures available to us. It is up to us as a community, and I am talking about the greater community as a state, to come up with the mechanisms that we need to look at as a state, moving forward, to find creative solutions to these issues and problems that are apparent in every community in our state.”