EDINBURG, RGV – Executives for five local hospitals have signed a document that supports giving clinics that provide services to the poor 20 percent of the tax dollars raised by a Hidalgo County Health Services District.
The executives to sign the document are: Dr. Carlos Cardenas, chief administrative officer for Doctors Hospital at Renaissance, Rene Lopez, CEO of Knapp Medical Center, Javier Iruegas, CEO of Mission Regional Medical Center, Cristina Rivera, CEO of Rio Grande Regional Hospital, and Doug Matney, CEO of South Texas Health System. (A copy of the document can be found at the end of this story.)
“We understand the importance of creating a strong safety-net of care in the community that starts by improving access to primary care services and helping needy patients to find a medical home,” the hospital executives wrote, in a June 29 letter to the Diocese of Brownsville and RGV Equal Voice Network. In the letter, the executives collectively call themselves Hidalgo County Clinical Services.
Now that the hospital executives have signed the document, pastors in up to 17 Catholic churches in Hidalgo County plan to hold workshops to educate parishioners about the concept of a health services district and how its formation would help the indigent poor that visit federally qualified and non-profit clinics.
This past spring, pastors at the 17 churches gathered over 7,000 signatures for a petition that said that if a health services district is established, the poor, indigent and expectant mothers are taken into account.
The commitment to help Nuestra Clinica del Valle, a federally qualified clinic that has nine facilities in Hidalgo County, El Milagro Clinic in McAllen, Hope Clinic in McAllen and Desarrollo Humano Clinic in Pueblo de Palmas also likely means that community groups such as RGV Equal Voice Network could encourage a “yes” vote on the health services district issue.
Creation of a Hidalgo County Health Services District is likely to be placed on the November ballot after an internal opinion poll commissioned by local hospitals found strong support for such an entity. “The poll is very encouraging,” said a healthcare consultant familiar with its findings.
Private negotiations between pastors, local clinics and community group leaders with hospital executives on the issue of a Hidalgo County Healthcare District have been going on for months. Among those participating in the negotiations were Lucy Ramirez Torres, executive director of Nuestra Clinica del Valle, the Rev. Jerry Frank, pastor of St. John the Baptist Catholic Church in San Juan, Ann Cass, executive director of Proyecto Azteca, and Michael Seifert, network weaver for RGV Equal Voice Network.
“We wanted to put a guarantee into this thing that the people who are really on the front lines for helping provide healthcare to the poor, the federal clinics and the non-profits, receive some of the funding generated by a healthcare district. Mission accomplished, we are ready to support it,” Frank told the Rio Grande Guardian on Thursday.
The document says that the 20 percent of the health services district’s annual tax dollars set aside for the local clinics should be allocated in a such a way as to reflect the number of patients each clinic has. Nuestra Clinica del Valle sees 27,000 patients at nine clinics. It would qualify for 72 percent of the funding. El Milagro, with 5,000 patients, would receive 13.3 percent. Hope Clinic, with 4,500 patients, would receive 12 percent. Desarrollo Humano, with 1,000 patients, would receive 2.7 percent.
“It is important to make this point: this is not for services rendered to the patients sent to the health clinics. This will be over and above that. This is a 20 percent grant, to be used for their needs, x-ray equipment, whatever it might be. This is a grant to be used by the clinics for indigent healthcare at their discretion,” Rev. Frank said.
The document signed by Hidalgo County Clinical Services also supports the creation of an advisory board for the Health Services District. The document says this is important to “ensure that any future changes in the District’s funding and operations take the needs of the poor into consideration.” The advisory board would consist of seven members appointed by the clinics. Nuestra Clinica would have four members, El Milagro, Hope and Desarrollo Humano would have one member each.
The document signed by Hidalgo County Clinical Services points out that, at the present time, the eligibility rate for indigent health care services is capped at 21 percent of the federal poverty level. “In future increases of the health district’s tax rate, an increase in the poverty level eligibility rate for indigent health care services will also be considered,” the document states.
Rev. Frank explained what this means. “If the health services district increases its basic tax rate from eight cents per $100 valuation, it would be obliged to increase the eligibility poverty level rate from the present 21 percent. The idea is more people would become eligible. If they raise it to 25 cents one day, that would happen.”
Hidalgo County Commissioners Court will have the biggest say on the composition of Hidalgo County Healthcare District’s board of directors. Rev. Frank said he and the other negotiators would have liked Hidalgo County Judge Ramon Garcia to sign the document signed by the hospital executives. However, Frank said, Garcia said that after taking legal advice he could not sign the document. Frank said the document is not weakened by the fact that it is signed by hospital executives rather than county commissioners. “The hospital executives’ commitment is a great victory in as much as they will coordinate all the indigent care operations of a future Health District,” Rev. Frank said.
Hidalgo County Clinical Services letter
Here is the letter signed by Hidalgo County Clinical Services:
June 29, 2016
To Diocese of Brownsville and Equal Voice Network:
Hidalgo County Clinical Services (HCCS) is committed to supporting the priorities outlined in the attached document because we believe that their implementation will strengthen access to care, delivery of car, and critically needed funding for healthcare services in our community.
As you know, membership of HCCS includes all of the county’s general acute care hospitals. While HCCS members are dedicated to fulfilling our hospital’s mission of taking care of the growing needs of patients in Hidalgo County, we understand the importance of creating a strong safety-net of care in the community that starts by improving access to primary care services and helping needy patients to find a medical home.
Again, we appreciate the opportunity to support these shared priorities because community health clinics provide critically needed prevention and wellness services to many of the same patients we see day in and day out at our hospitals.
Dr. Carlos Cardenas
Chief Administrative Officer
Doctors Hospital at Renaissance,
Chief Executive Officer
Knapp Medical Center
Chief Executive Officer
Mission Regional Medical Center
Chief Executive Officer
Rio Grande Regional Hospital
Chief Executive Officer
South Texas Health System
Commitment by Hidalgo County Clinical Services
The “attached documents” referenced by the hospital chiefs is titled, “Commitment by Hidalgo County Clinical Services to Diocese of Brownsville and RGV Equal Voice Network.” Here is the document:
Commitment by Hidalgo County Clinical Services to Diocese of Brownsville and RGV Equal Voice Network
1) Hidalgo County Clinical Services is committed to implementing a grant program that is equal to 20 percent of total annual tax revenues by the Health Service District to be allocated to Nuestra Clinica (nine clinics), El Milagro Clinic, Hope Clinic, and Desarrollo Humano Clinic.
Allocation of tax revenues will be based on the clinics’ respective number of unduplicated patients, which is the criterion used by government and private foundations in awarding grants: Nuestra Clinica, with 27,000 unduplicated patients in nine different clinics in Hidalgo County, would qualify for 72 percent of these particular funds; El Milagro with 5,000 patients, 13.3 percent; Hope Clinic with 4,500 patients, 12 percent; and Desarrollo Humano with 1,000 patients, 2.7 percent.
2) HCCS supports the formation of an advisory board for the Health Services District whose primary purpose is to ensure that any future changes in the district’s funding and operations take the needs of the poor into consideration. It will consist of seven members appointed by the aforementioned clinics. Nuestra Clinica del Valle will appoint four members and El Milagro, Hope and Desarollo Humano Clinics, one member each.
The Health District Consumers’ Advisory Board will operate under the following terms and directives:
(a) Members shall serve three year terms.
(b) Members shall have a four-term limit.
(c) Members do not need to possess an extensive knowledge of health care.
(d) Employees of Hidalgo County are not eligible for appointment to the Advisory Board.
(e) Employees of a city or municipality within the Health District are not eligible for appointment to the Advisory Board.
(f) Any vacancy on the Advisory Board will be replaced by the respective appointing body.
(g) The Health District’s budget, budget revisions and estimated tax rules shall be made available to the Advisory Board for their input.
3) At the present time, the eligibility rate for indigent health care services is capped at 21 percent of the federal poverty level. In future increases of the health district’s tax rate, an increase in the poverty level. In future increases of the health district’s tax rate, an increase in the poverty level eligibility rate for indigent health care services will also be considered.
Letter to Pastors
The 17 parishes where 17,000 signatures were raised for a petition on the healthcare district issue are:
St. John the Baptist in San Juan, San Martin de Porres in Mission, St. Jude’s in Pharr, Sacred Heart in Elsa, Our Lady of Mercy in Mercedes, St. Anne in Pharr, St. Joan of Arc in Weslaco, Mother Cabrini in Las Milpas, Sacred Heart in Hidalgo, St. Joseph in Donna, St. Theresa of Infant Jesus in Edcouch, Holy Family in Edinburg, Our Lady Queen of Angels in La Joya, St. Paul’s in Mission, Juan Diego in McAllen, Our Lady of Sorrows in McAllen, and Sacred Heart in McAllen.
The pastors of these 17 churches recently received this letter from Rev. Frank:
July 26, 2016
Dear Father XXXXX,
Thanks and congratulations for leading your parish to gather petitions regarding a potential Health District in Hidalgo County. Seventeen parishes in the county collected over 7,000 signed petitions in anticipation of the November election.
In his (attached) letter of April 28, 2015, Bishop Flores made it very clear that he is not recommending a vote either for or against the proposition to create a Health District. Rather, his concern is that, should the Health District be created, it truly give priority to the health needs of the poor.
Supported by the 7,000 petitions you signed and another 5,000 from other community groups, we have been able to leverage a signed commitment (also attached) from all the hospital executives in Hidalgo County. They promise their full endorsement and support of the Bishop’s and our position.
Of course, only the duly appointed Health District’s board of directors, if the proposition succeeds, will decide the district’s business. Nonetheless, the hospital executives’ commitment is a great victory in as much as they will coordinate all the indigent care operations of a future Health District.
Our next step is to inform our parishioners regarding the pros and cons of a Health District so that thy can vote wisely in the November election. Consequently, I ask you to consider hosting a meeting of your interested parishioners so that we might respond to their questions and concerns. Bulletin announcements will be made available for you to use in promoting the meeting.
For your information, I have again attached a fact sheet. Since time is so crucial in our efforts to arrange these meetings before the November election, I will call you soon to once again solicit your support. Working with Bishop Flores, we can have a huge impact on the delivery of health care to our poorer families.
Please do not hesitate to call me at 956-874-3835.
Fraternally yours in Christ,
Cc: Bishop Daniel Flores
Petition signed by 7,000 parishioners
This is wording of the petition signed by 7,000 parishioners:
We the undersigned respectfully request that Senator Juan “Chuy” Hinojosa and Hidalgo County Commissioners incorporate the following items into any revised proposition purporting to create a hospital or health services district in the county:
1. Dedicate 20 percent of total annual tax receipts for the Health Services District to those local non-profit health-care clinics that can demonstrably show that they primarily serve the indigent poor in Hidalgo County. An estimated 40,000 persons access these clinics yearly.
2. That these funds be specifically directed both to attend to the most severe life-threatening and chronic ailments that affect our community, including diabetes, and high-blood pressure, and also to support much needed pre-natal care for expectant mothers and child health-care services in these clinics.
3. Since eligibility for indigent health care is now restricted to those earning 21 percent or below of the federal poverty level, we ask to increase eligibility up five percent for every one cent increase in the tax rate. And to cap eligibility at 100 percent of poverty level. This is to insure that any future changes in the district’s funding takes the needs of the poor into consideration.
4. A consumers’ advisory board of ten members be set up which would include members from the non-profit clinics. This helps to insure a broad perspective of community need is represented in the Hospital District.
Letter from Bishop Flores
Bishop Flores wrote about the possibility of healthcare district in a letter dated April 28, 2015. Addressed to pastors, it said:
This past November, Hidalgo County held an election which included a proposition to create a hospital district. That proposition failed. Newspapers report that political and medical leaders plan to revise the proposition in order to improve the likelihood of its passage.
The issue is one that touches on the public good, and I would not presume to tell parishioners whether to vote for or against a proposed Hospital District in Hidalgo County. Conscientious Catholics can disagree as to whether it is in the public interest. I do believe, though, that the Church has a responsibility to remind all concerned of the need to give priority to the needs of the poor if and when a new proposition is crafted.
With this in mind, I have decided to permit the circulation of a petition that has been developed through consultation with leaders supportive or sympathetic to the Church’s teaching on Social Justice. I am grateful to Father Alfonso Guevara and Father Jerry Frank for their work on this issue.
The petition does not enter into specific ways of configuring the tax rates or tax ceilings. I think those matters are better handled in open discussion during the political process. However, the petition does put forward a realistic framework that insures that the poor indigent and expectant mothers are taken into account in any new proposal.
Some of these points have been widely discussed already. The first point would provide sustained funding for local non-profit clinics which are on the front lines of service to the poorest of our people. With diabetes, high blood-pressure, and other preventable or manageable illnesses running rampant among the poor in our community, it is important that those places that attend to the uninsured, the undocumented and the homeless have access to funding that makes their work possible.
Point Two asks that any such funding be specifically directed to help the poor and uninsured confronting the most serious health threats. It also asks that special attention be given to expectant mothers and young children.
I encourage you to make copies of the attached petition and to offer it to your parishioners to sign them after all Masses on the week-ends of February 14/15 and 21/ 22. Each sheet can contain up to ten signatures per side. Once you finish, please have them delivered to your respective deans from whom I will arrange to have them picked up.
I repeat that parishioners are not being asked to take a stand for or against a proposition, but rather to make known our concerns that any new proposition, should it be presented to the voters, truly take into account the health and well¬ being of the poor.
For further clarification and/ or explanation, please call Fathers Alfonso Guevara and Jerry Frank or myself.
Yours in Christ Jesus,
Most Rev. Daniel E. Flores, S.T.D.
Bishop of Brownsville
Editor’s Note: The main image accompanying this story shows Lucy Ramirez Torres, executive director of Nuestra Clinica del Valle, being interviewed by reporters. (Photo: RGG/Steve Taylor)