Hospital district board votes against operating a Presidio County hospital

TRICOUNTY — The Big Bend Regional Hospital District (BBRHD) board voted that operating a hospital in Presidio County was neither feasible nor desirable at a meeting last Thursday at the Presidio County Courthouse.

At previous meetings, City of Presidio City Administrator Joe Portillo and City Attorney Rod Ponton had asked board members to discuss the possibility, referencing legislation that requires the board to “periodically review the feasibility” of operating a hospital in the county.

Texas’ special district local laws code has a special section just for “medical services for Presidio County” that requires the board to consider the “feasibility and desirability of operating a hospital in Presidio County,” and says they “shall operate a facility that provides medical services in Presidio County. At a minimum, the facility must provide outpatient medical services to the district’s residents.”

But the final subsection says the board may contract or otherwise cooperate with another entity to provide the services required. That’s what BBRHD does, says Jacqueline McCracken, the district’s executive director. “We have clinics through PCHS in Presidio and Marfa. We also have a contract with Marfa Country Clinic,” she explained.

Though the law is satisfied, McCracken’s recommendation to the board is that they should consider the option of a hospital in Presidio County every year, to assess needs and viability. At the meeting, the board asked Big Bend Regional Medical Center CEO Rick Flores to weigh in: what does it cost to operate a hospital in the area?

It’s $25 million a year, according to Flores. The board withdrew into a closed executive session to discuss the potential of a Presidio County hospital, allowed because the board would be discussing provision of services. When they returned, with little public discussion, they unanimously voted that operating a hospital there was not “feasible or desirable.”

McCracken wants it returned to periodically. “People don’t just build hospitals on a whim,” she explains. It takes time, discussion and roughly $25 million a year. “That’s a lot of money, a lot more than we have.” Because of the legislation requiring periodic discussions of a Presidio hospital, McCracken says, “We have to answer this question, it has to be done at a meeting formally and if it generates more of a conversation, that’s great.”

When McCracken arrived at the role, she says the board was focused on the viability of the hospital in Alpine. Now that it’s stable, she says, they’re able to think about other opportunities.

At the Thursday meeting, the board welcomed new member Alejandro Armendariz, whose appointment to represent Presidio’s District 1 on the board was approved in December.

The board also cancelled an upcoming election due to no new applicants to contest incumbents. Esther Howard, the board chairman, plans to depart from District 5, but will be “held over” until a candidate applies and is approved by the board in lieu of an election. At the meeting, it was noted that every member of the current board has been appointed rather than elected, owing to the low interest in joining the board. After the May 2 election date, interested applicants are invited to apply for the soon-to-be-vacant District 5 seat.

The board also voted to approve new legal counsel from Alan Bojorquez, an attorney out of Austin with an office in El Paso.

Hospital CEO Flores updated the board on Coronavirus Disease 2019 (COVID-19), saying that risk was low in West Texas, but the hospital was attempting to prepare. “We’re just waiting. Our crew is ready for the worst. Can we accommodate? I don’t know,” he said. He recommended the board and the public monitor the illness’ spread through Johns Hopkins’ tracking:

The next meeting of the Big Bend Regional Hospital District will take place March 19 at 5:30 p.m. at the BBRHD office in Alpine.