NUECES COUNTY, Texas — A bill designed to address Nueces County’s ongoing physician shortage is drawing both support and concern from local leaders, as proposed changes from a major hospital system raise questions about fairness and funding access.
House Bill 4801, filed by State Rep. Denise Villalobos, aims to create a grant program that would allow the Nueces County Hospital District to recruit and retain physicians while increasing residency opportunities. The funding would also support hospitals providing indigent care to underserved residents at little or no cost.
Supporters said the bill is vital for a region facing a growing gap in access to primary and specialized medical care.
“We have to serve our indigent community, but we also have to get doctors for this community in general,” Precinct 4 County Commissioner, Brent Chesney, said. “The byproduct of this bill is even though this is geared towards the indigent, if you bring in more doctors, this is going to help the community as a whole.”
The bill advanced out of committee on April 30 after being reported favorably with a committee substitute, meaning changes were made to the original version. However, KRIS 6 News was unable to obtain a revised version. Among the revisions proposed by CHRISTUS Spohn Health System, one of the largest healthcare providers in the region, is language that would restrict eligibility for grant funding to hospitals that account for at least 33% of the county’s combined charity-care costs.
To elaborate more, the stated purpose of the Nueces County Hospital District on its website is, “Providing access to high-quality, affordable, and accessible health care services to the indigent and needy residents of Nueces County.” According to the revisions in the proposed bill, annual participation in a grant program should be limited to hospitals that have provided at least one-third of the indigent care in Nueces County in the previous year; since there are three hospitals in the county that provide indigent care.
"This bill is crucial and I think Spohn is a major player in this community," Chesney mentioned. "They put forth these last minute amendments that is slowing things down because they're worried that they may not get all the funding. That can't be what this is all about. Big kuddos to Representative Villalobos in her freshman term and kuddos to Senator [Juan] "Chuy" Hinojosa for carrying it in the Senate, but now we've got to get it to the finish line. We have to use some of these funds that the Hospital District collects to go and retain doctors. That's the big picture here."
Another proposed change would distribute funding proportionally based on the amount of indigent care each hospital provided in the previous year. Furthermore, CHRISTUS Spohn proposed a hospital that qualifies for annual participation in a grant program should not receive more in grants than the proportional amount of indigent care it provided in the previous year. That's among hospitals that qualify for the grant program in that year.
Chesney said the changes could shut out other local hospitals and centralize funding towards one particular hospital system, which he believes is not in the spirit of public service.
“That’s not what they want their legacy to be. That’s not who they serve,” Chesney added. “They serve the people of the community. Unless your only opposition is selfishness, that’s not right.”
Nueces County Hospital District Administrator and Chief Executive Officer, Johnny Hipp, also acknowledged that the revisions could present challenges.
“That hospital system [CHRISTUS Spohn] doesn’t operate the only residency programs in the community, and they’re not the only ones who have needs,” Hipp said. "The whole grant program is one that has to go through the hospitals. The hospitals would have to come through the Hospital District and request grant funds in establishing grant programs."
Following a recent Physician Needs Assessment conducted by the Nueces County Hospital District, data showed a significant shortage in both primary care and specialty physicians across the region. In particular, Hipp said the data showed a need to recruit and retain more Family Care and Internal Medicine physicians. Hipp believes HB-4801 could help close that gap, but only if funding is distributed broadly.
“If the Hospital District Board or Commissioners Court limited the funds used there, we would limit our ability to address all of the needs we have in the community,” Hipp said.
KRIS 6 News reached out to CHRISTUS Spohn for an interview. A spokesperson from their team provided the following statement instead:
"CHRISTUS Spohn Health System values its working relationship with Rep. Denise Villalobos and her staff. We appreciate her work and have shared our support for a grant program that could provide funding to hospitals in a manner proportional to the amount of indigent care we provide to the residents of Nueces County. CHRISTUS Spohn is blessed to serve the Coastal Bend community and will continue to prioritize healing while providing compassionate and dignified health care to those in need."
As of April 30, HB-4801 has been reported favorably out of committee with a substitute version, meaning it cleared a key step in the legislative process and is now eligible to be scheduled for debate on the Texas House floor. The bill received a 10-1 vote in favor from the House Committee on Intergovernmental Affairs. If it passes the bill would go into effect September 1. Follow the progress of the bill here.
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