As county commissioners ponder raising taxes to pay for hospital and specialty care for the uninsured, some property owners and elected officials want assurances the University of Texas System is committed to building a surgical tower at the University of Texas Medical Branch.
The question is important.
First, taxpayers are being asked to help cover uninsured health care costs before the state releases $150 million to help pay for a tower that would restore hospital bed capacity at the medical branch to pre-Hurricane-Ike levels.
Second, foot-dragging on construction would prolong economic pain inflicted by the Sept. 13 storm, which resulted in mass layoffs and revenue losses at the medical branch, the county’s largest employer.
Steps to prevent future flooding and a project that will double the size of rooms make it impossible to restore capacity at John Sealy Hospital to 550 beds.
Some residents have long suspected UT wants to move the state’s oldest medical school to Austin. They want to know officials are committed to building the tower immediately.
Meanwhile, those UT System officials, who, among other things, hired a consultant who recommended moving most medical branch clinical operations to the mainland, have done little to cool the long-simmering distrust.
‘Planning Will Continue’
UT System officials, who chose to answer questions via a prepared statement, said they are committed to planning the tower but wouldn’t commit to a construction timeline.
Medical branch officials and state Rep. Craig Eiland, D-Galveston, said they expect construction to begin in 2011.
When pressed, Anthony de Bruyn, a UT System spokesman, said too many variables and conditions were at play to offer timetables.
UT officials want assurances of their own, including whether state lawmakers would adequately fund the medical branch if the tower were built.
“In the interim, the planning process for this new tower will continue,” system officials said in the prepared statement.
But county Judge Jim Yarbrough said he would like to hear UT firmly commit to construction, not just planning. County commissioners are keeping their promises, despite the unpopularity of higher taxes, Yarbrough said.
“We want a commitment for construction,” Yarbrough said. “We’re operating in good faith, and that’s what we’re asking them to do.”
Operating Funds
UT System officials have said they would kick in $200 million to help build the tower, expected to cost about $500 million.
The private Sealy & Smith Foundation has pledged $125 million.
UT’s commitment hinges on whether lawmakers intend to continue giving the medical branch a $96 million increase in general revenue money appropriated during the last session. That increase is vital for operating the added beds in the tower, officials said.
State support for the medical branch has come up short in the past several legislative sessions as the institution faced health care inflation and a growing population of uninsured Texans.
The regents have long been frustrated by the medical branch’s financial woes. Its tradition of treating the poor, along with medical inflation, led it to a $35 million deficit before the storm, officials have said.
UT Regents want to ensure the increased funding wasn’t a one-time pledge made out of post-disaster emotion.
Strings Attached
The state’s commitment also has strings. Lawmakers will release their $150 million only when the county devises a local funding mechanism to pay for uninsured health care.
Commissioners this week will consider increasing the tax rate to fund care for uninsured residents at 100 percent of the federal poverty level.
UT System officials in their prepared statement said they were encouraged by that plan.
Yarbrough said the UT System was going to have to make a decision with the information it has and start talking about construction timelines.
Lawmakers would not have approved the $150 million in tuition revenue bonds had they not planned to continue adequate funding for the medical branch, Yarbrough said.
“I understand their position,” he said. “When you look at the history of funding in the last 10 years, it hasn’t been warm and fuzzy between the Legislature and UTMB. Some funding faucets have been turned off. I’d like all the guarantees myself, but you just have to move forward, and that’s what we’re looking for.”
‘Confident They’re Committed’
All the UT System would say last week was it “remains committed to the restoration of UTMB and its research, education and clinical operations.”
Asked whether UT System immediately would commence construction if assurances and conditions were met, de Bruyn would say only that officials were committed to planning the tower.
Last week, UT System Chancellor Francisco Cigarroa and James R. Huffines, chairman of the system board of regents, which ultimately would have to approve construction of the tower, and other high-ranking officials met with Eiland seeking assurances lawmakers would appropriately fund the medical branch in legislative sessions to come.
Eiland said he had heard concerns among his constituents about UT System’s commitment to the tower. But he said he had no reason to doubt that commitment.
With hundreds of millions of dollars at stake, UT System officials are exercising fiduciary responsibility, he said.
One tricky point is an article in the Texas Constitution that forbids a legislature from binding future legislatures to spending. Despite that, Eiland said he was confident lawmakers would adequately fund the medical branch in years to come.
“I will continue to work to make sure there’s a level of comfort they need,” he said.
Crews would have to knock down old buildings before the surgical tower were built. Design, engineering and construction bidding also would have to be complete before 2011, Eiland said. The tower is expected to take three years to build.
“Whatever the timetable is, I expect it to be expedited in a responsible and thorough manner with no artificial hurdles or unreasonable demands,” Eiland said.
“I understand people’s concerns, but we have come too far and too many people have taken positive steps.”
