HARLINGEN, RGV – Valley Baptist Health System CEO Manny Vela says Cameron County can learn valuable lessons from neighboring Hidalgo County on how to secure public support for a hospital/healthcare district.
In Hidalgo County, voters narrowly rejected setting up a hospital district in a referendum last November. Supporters of the initiative, led by officials in the healthcare industry, will try again – possibly in November 2016 – only next time around it will be called a healthcare district.
Vela spoke in depth about the merits of a healthcare district in a Q&A with this reporter at a Rio Grande Valley Leadership class at Texas State Technical College in Harlingen.
“A healthcare district will not access anywhere near the dollars we currently access through our LPPF (a local provider funding district) funding district. It almost pales in comparison. However, it is extremely beneficial with regard to supporting the (UT-RGV) medical school,” Vela said.
“Part of the problem for Hidalgo County and one of the reasons, I am told, it did not pass, this last go round with the referendum, is I do not think it was clearly articulated as how those funds would be spent in regards to how it supports a medical school. That was one of the reasons. There were obviously a few more.”
As reported first in the Rio Grande Guardian, Cameron County leaders are looking at setting up a healthcare district, for the same reason Hidalgo County is – because it will allow the county to draw down more federal dollars for healthcare and provide a more stable funding source for the UT-RGV School of Medicine.
Vela pointed out that state Sen. Eddie Lucio, D-Brownsville, and state Rep. Eddie Lucio, D-San Benito, have filed legislation to set up a healthcare district in Cameron County.
“We have looked at that in Cameron County and that is what I keep pressing internally. Yes, it is a great concept, I think it is a good thing to have the ability to create a healthcare district so let us take advantage of this legislative session, let’s get the bill passed, let’s get the bill signed, let’s keep the bill in our back pocket,” Vela said.
“But, before we go to our community in regards to supporting this kind of initiative, let’s go to UT and make sure they supply a budget to us, so we know exactly how the funds will be spent. So, when we go out to our business owners, our property owners, because they are the ones who are going to be taxed, we can legitimately and in good faith and confidence say, listen, this benefits us all in this manner and this is how these dollars are going to be spent. I am not seeing anybody in either county do that right now.”
Vela said it is imperative that strong community outreach be implemented before voters are asked to determine whether a healthcare district should be formed.
“I think that is imperative for both counties. You have to build up support. Personally, I am not willing to go out there and lay my credibility on the line unless I know how those dollars are going to be spent. That is not fair to the property owners. And then the County needs to be involved because right now the County raises taxes and a percentage of their general revenue funds go to indigent care. When you create a healthcare district, that entity takes over the responsibility for taking care of the indigent population. So, the County would no longer need to use up to eight percent of their general revenue funds to take care of that population,” Vela said.
“So, I think those are some of the issues that have to be addressed at the County level. The County needs to step forward and say what their intentions are. Will they reduce their property taxes commensurate with the increase on the healthcare district side or not? It is going to be one of the components of the discussion. I think unless you address those issues in a very transparent way… you have got to be upfront with the community.”
One of the reasons the Hidalgo County hospital district issue was defeated, analysts say, is because the language on the ballot said the tax rate would be no more than 70 cents per $100 property valuation. This legislative session, state Rep. R.D. ‘Bobby’ Guerra, D-McAllen, is trying to pass legislation that would set the cap at 25 cents.
“It was not enough for them (Hidalgo County) to be out there supporting it with a general statement, trust us, we are not going to tax you to the level listed in the language. It was a lesson well learned. If Cameron County does not take note and take heed, shame on us here in Cameron County for not taking advantage of the lessons learned in Hidalgo County,” Vela said.
Asked what percentage of the tax dollars raised by a healthcare district would go towards the medical school and what percentage would go towards providing care for the indigent population, Vela answered: “Steve, that is what I am telling you. I don’t think anybody has done that. It gets very complicated because when you talk about supporting medical schools, you are literally talking about support residency programs because they are the ones that will be in the hospitals providing care to the unfunded patient. Then you start talking about the mechanism by which they will be able to bill, what is the organization they will bill and who will pay them? It is a very complicated funding mechanism situation.
“Honestly, because it is a pretty unique situation down here, because we don’t have a county hospital, because we don’t have a healthcare district right now, I do not know if anybody is aware of any model that currently exists we could draw from. So, I have reached out to UT previously and I will do so again and ask for their help. I think they are in the best position, probably more so than anybody else to help us develop what the budget might look like. So that when it is time for us to try to sell this to the community, we do so legitimately. People deserve to know exactly what you are talking about. People want to know, how are you going to sell my tax dollars? They deserve to know.”
Vela said he has heard people ask whether UT would pull out of the medical school project if voters do not approve the formation of a healthcare district. “People say, what is UT going to do, pull out? Is the Legislature going to just stop funding the new medical school? These are legitimate questions. That is where UT and the Legislature have to say, yeah or nay. If it is nay it becomes a little bit harder to see the prospect of a hospital district. But, I think the starting point is looking at a budget that is as realistic as you can get and see if you can sell it to the community. If you cannot, in good faith, I do not have any desire to go out and get my butt whipped.”
Vela was also asked about the likely impact of the new UT-RGV School of Medicine on the Valley.
“I am incredibly excited about the medical school because we do have a physician shortage in the Rio Grande Valley. I am probably 100 times more excited about all of the other allied health professions that are going to be made available through UT-RGV, through Anabell’s school, through other institutions that are down here. If we have a physician shortage, multiply that by ten and you get the allied health profession shortage. That is why I am so excited about UT-RGV, even probably more so than the medical school, but don’t get me wrong, I am incredibly excited about the medical school as well,” Vela said.
The “Anabell” Vela referenced was Anabell C. Cardona, president and CEO of VGI, or the Valley Grande Institute for Academic Studies. Cardona is in the RGV Leadership Class of 2015.
Editor’s Note: This is the second in a three-part series on Manny Vela’s analysis of the state of healthcare in the Rio Grande Valley. Click here for the first part, which focused on access to healthcare. The third part, looking at the 1115 Waiver and the RGV’s Local Provider Funding District, will be posted later this week.
