Hospital shortage, appraisal district and more discussed during hospital district meeting

MARFA — New staff, Presidio’s hospital shortage and the push for inclusion on the Presidio Council Appraisal District’s board of members were among the topics the Big Bend Regional Hospital District discussed during Thursday’s regular meeting. Here’s a rundown of what was discussed.

New case manager

The board passed a motion to hire a patient liaison on a contract basis in order to implement cost-savings measures and case management for clients. According to BBRHD Executive Director J.D. Newsom, this person would “manage hospital systems and give clients a higher level of support.”

Although he wanted to keep the identity of the candidate confidential, Newsom said the individual had worked at Humana for 13 years, doing utilization review for the health insurance company. Currently, she works at the hospital as an RN case manager. During the discussion, District 1 Director Andrea Perez said her office “would really benefit” from a consultant who could deal with the kinds of technical questions they’ve been getting about hospital bills for medication.

Appraisal District board membership

The Presidio County Appraisal District took up much of Thursday afternoon’s discussion after Newsom said he’d met with Chief Appraiser Cynthia Ramirez earlier in the week to discuss the possibility of a BBRHD representative being appointed to the appraisal district board. According to Newsom, Ramirez cited a tax code confirming that PCAD isn’t required to offer them a seat, to which Newsom said the hospital district’s pursuit to become part of the board “may take some political arm-pulling.”

PCAD’s bylaws state that the district is governed by a board of seven directors which are selected by the voting taxing units of Presidio County. The tax code does not include hospital districts among tax units, which is why their inclusion is not mandatory. Still, Newsom said it’s “fairly common” for hospital districts to serve on appraisal district boards as local taxing entities.

“We’ve got a vested interest in being able to provide input into what appraisal districts are doing because we collect property taxes,” Newsom said. “That would be our interest in serving on that board — just being able to have that input into what’s going on with the appraisals.”

According to Teresa Nunez who represents Marfa ISD on PCAD, the possibility of BBRHD getting a representative was raised during a board meeting earlier that week. Nunez works as an employee for the Brewster County Appraisal District, which does grant its hospital district a seat among board members.

“They’ve always been on our [BCAD] board because it is their right,” she told The Big Bend Sentinel. “If they are an entity, they should be able to.”

Because PCAD votes on new board members in the fall of odd number years, Newsom suggested taking the appropriate measures to push for a seat sooner rather than later. Alpine Operations Manager Buddy Cavness suggested contacting Chairman John Ferguson about their intentions to gain representation on the board.

Staff and hospital shortages

Following concerns from a well-documented lack of emergency healthcare access in the county, Newsom addressed possible solutions.

During the executive director’s report session, Newsom told the BBRHD board that he’d opened a conversation with Rick Flores, executive officer at Big Bend Regional Medical Center, and Rod Ponton, Presidio County attorney, about expanding healthcare in Presidio to include urgent or express care.

He also said Ponton was working on forming a Texas government corporation to provide urgent care in the county. This would include a partnership with Texas Tech that would send residential doctors to Presidio and provide telemedicine from 7 p.m. to 11 p.m. during the week, as well as 24-hour service over the weekends.

“The city of Presidio has intermittently been working on this process for about four years, but it’s very preliminary regarding the participants and the level of participation,” Ponton told The Big Bend Sentinel. “We think in the near future we’ll have some more details to present to our respective boards or city councils as the case may be for their review and comment.”

According to Newsom, a new hospital assessment shows that visits to ER from Presidio are about 800 a year, leading some of the board members to speculate out loud whether a large fraction of those visits come from across the border.

“The reality in Presidio is this: the clinics that are there are family-practiced, so they are run by appointments. Walk-ins are almost impossible,” Perez said during the meeting. “Same way people from across the border come this way, people from Presidio go across the border to get faster and cheaper attention.”

Staff shortages at clinics in the region were also alluded to during public comment when Marfa resident David Marwitz expressed concerns about Sul Ross’ nursing program, which was recently restarted during a time of financial hardship for the university.

While addressing the board, Marwitz worried the university had unrealistic expectations about the nursing program being self-sufficient because it’s expensive and encouraged the BBRHD to “do everything you can to help the nursing program there.”

“I think he’s right; If we can develop local talent and educate local folks to be nurses then they will stay and support their communities,” Newsom told The Big Bend Sentinel. “Hopefully we won’t have these problems of shortages anymore.”

CORRECTION: This article initially stated that the Presidio County Appraisal District board voted against allowing the Big Bend Regional Hospital District to have a representative on the board. Instead, the board of directors has never voted on BBRHD representation because the tax code doesn’t require that they do. The Big Bend Sentinel regrets the error.