University Hospital System Trauma Expansion

Editorial: Hospital expansion an urgent necessity
San Antonio Express-News

Editorial: Hospital expansion an urgent necessity (PDF Document)

The planned expansion and renovation of the University Health System is essential.

The Bexar County Commissioners Court may have been playing with political fire this week when it served notice of intent to issue certificates of obligation to begin what will be an $899 million project.

But the commissioners’ bold move, which precludes taking the issue before voters, begins necessary action to provide health care and preserve a viable trauma care system in Bexar County.

Along with the $279.4 million in certificates of obligation for the first phase of the project comes an 8 percent property tax increase that totals $19 per $100,000 valuation.

Two more debt issues would be required and another three-fourths of a cent tax increase would follow in 2011, adding another $7 per $100,000 valuation tax increase.

The University Hospital emergency room already handles 65 percent of the trauma cases in Bexar County. The ER was designed to handle 35,000 patients annually, but today it treats 70,000 each year.

Already, 75 percent of medical emergencies are being diverted, officials said.

The county’s population is expected to grow 10 percent by 2015, health system officials noted.

Additionally, the Air Force is planning to close the Wilford Hall Medical Center trauma facility, and Brooke Army Medical Center will not be capable of handling the overflow as it transitions into a multiservice military medical operation, health system officials said.

University Health System is the destination of trauma cases and other medical treatment involving the uninsured, and state officials say almost 25 percent of Bexar County residents lack health insurance.

Additionally, University Hospital receives patients from 22 surrounding counties that don’t have trauma centers.

The aging hospital also lacks enough beds to serve the population, and many rooms built 40 years ago do not meet modern standards.

Overcrowding is forcing paying patients to other facilities.

The situation is urgent.

Officials, who began planning the expansion in 2005, say inflation is increasing the cost of the project by $100,000 a day.

The plan calls for a new trauma tower and renovation of the existing 1968 tower for other functions. The project will increase the number of beds and enlarge diagnostic and treatment capabilities.

Additionally, downtown care and services will be expanded and the Robert B. Green Hospital building will be renovated under the plan.

The University Health System has been a conservative steward of its resources, avoiding a tax increase for 16 years, albeit with help from rising property values.

Positive economic conditions could eliminate the need for the second tax increase in 2011.

And the district will use $120 million in reserves and other funds for the project, reducing the amount that must be financed by debt to $766 million.

Critics want the plan to be put on the ballot for a vote, and Commissioner Lyle Larson, the only Commissioners Court member to oppose moving forward, agrees.

But as County Judge Nelson Wolff noted, the court members were elected to make tough decisions.

Their decision is appropriate and within their legal purview, even if it is politically unpopular.

Wolff and Commissioners Sergio "Chico" Rodriguez, Paul Elizondo and Tommy Adkisson, who approved the move, will answer to voters when they seek re-election.

But they took comfort in history as they made their decision, noting the story of the late Blair Reeves.

As detailed in the Express-News, Reeves cast the deciding vote on a tax increase that had been rejected earlier by voters to allow the hospital district to build a teaching hospital for the University of Texas System. He also lobbied the Legislature to pass the law allowing the court to overrule voters.

The result is the University of Texas Health Science Center at San Antonio, one of the city’s most important institutions and a key economic generator.

Reeves ran unopposed at the end of that term and was hailed as a hero in later years.

Wolff and his colleagues must face the heat and make a final decision on issuing the certificates of obligation in August, and voters have the option of petitioning for an election.

The Commissioners Court decision should stand. The expansion is unquestionably needed.

And no matter what happens, these leaders deserve credit for showing courage in their efforts to move the county in the right direction.

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