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Pact just start for children's hospital; Location, construction funds are next issues
December 18, 2010



Bexar County Judge Nelson Wolff (from left), University Health System head George Hernandez, Commissioner Paul Elizondo, Mayor Julian Castro and Christus Santa Rosa chief Pat Carrier at the signing.




By Don Finley

The city's two large nonprofit health care systems formally agreed Friday to build a new state-of-the-art children's hospital.

The next step: figuring out how to pay for it and where to put it.

Surrounded by a small army of elected officials and others at the Bexar County Courthouse, the leaders of the Christus Santa Rosa Health System and the tax-supported University Health System signed a letter of intent to create a "network of children's services" throughout the city, including a new children's hospital.

"It's not been an easy road," County Judge Nelson Wolff said. "But over the past year, Santa Rosa and University Health System, the only two nonprofit health systems in our community, came together and decided not just to do better, but to be the best - a world-class children's hospital. And I think our children deserve nothing less than the best."

Officials floated an estimated cost of $450 million or more for a top-level children's hospital, or between $1.2 million and $1.5 million per bed.

And although both hospital systems will provide some of the money, the rest will have to come from the community, they said.

"Building a new hospital is an expensive undertaking, and we know we must rely on philanthropic and community support to make it a reality," said Patrick Carrier, president of the Christus Santa Rosa system.

Many observers had been skeptical that an agreement ever would come, given the fierce competition between local hospital systems and a contentious battle in the early 1990s over a similar plan that ended with disagreement over where it should be built.

Some of those who fought to keep it out of the South Texas Medical Center almost two decades ago said location would be less of an issue today.

"I think the center of the city has moved," said state Sen. Leticia Van de Putte, D-San Antonio, who added that the University System had invested in clinics throughout San Antonio since then. "Our newest and most heavy demand for CHIP and Medicaid applications doesn't come from inside Loop 410 any more. They're on the Loop 410 perimeter. They're the communities of John Jay, Holmes, Marshall, Robert E. Lee, MacArthur and Roosevelt" high schools.

Under the agreement - which allows for other hospital systems to join later - the two organizations would contribute their existing pediatric assets to a new, nonprofit corporation.

The value of those, plus whatever construction costs they invest, will determine the percentage of board members they can appoint. The new hospital's managers will likely come from the ranks of the two institutions.

"If Christus Santa Rosa puts in three-quarters of the money and we put up one-quarter, then they should have three-quarters of the governance," said George B. Hernández Jr., president of the University System. "Over the next couple of months, we'll drill down to the details and what we can each do."

One stumbling block may be impending budget cuts at the state and federal levels that could affect programs such as Medicaid - a major factor, since 80 percent of patients at Christus Santa Rosa Children's Hospital traditionally are covered by Medicaid, one of the highest percentages in the state.

However, Hernández said that even if cuts occurred, it made sense for the two organizations to leverage their operations to survive.

Graham Reeve, president of the Baptist Health System, praised the agreement in an e-mail: "We have and will continue to be advocates for this important initiative. Today's announcement is certainly indicative of progress, and we look forward to hearing more details as they unfold."

The Methodist Healthcare System e-mailed an unsigned statement that reserved comment, saying it had no details of the agreement.

"We would be happy to continue being part of the discussion," the statement said. "Naturally, we care deeply about the future of children's health services in San Antonio."

Dr. Fernando Guerra, a pediatrician and director of the Metropolitan Health District, who also opposed a Northwest Side hospital years ago, said the new agreement was a welcome event.

"I think it's just unfortunate that our community, when all of this started a number of years ago, didn't come together around it," Guerra said. "I personally feel a children's hospital can be a wonderful way to build a community across all sectors."


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