Featured: The DHR Health Medical Office Building at 1100 E. Dove Avenue in northeast McAllen is home to the DHR Health Imaging Center, Women’s Imaging Center, Transplant Institute, Surgery Institute, Vein Institute, Ear, Nose and Throat Institute and Plastic & Reconstructive Surgery Institute. The medical complex is one of the numerous major facilities located on the 130-acre site, which is headquartered in southwest Edinburg.
Photograph Courtesy R-MYNA EVANS
DHR Health’s efforts at Texas Capitol in 2019 result in key advances for medical education, health care, and disaster preparedness for Valley
By DAVID A. DÍAZ
With most new state laws and Texas’ two-year budget effective as of Sunday, September 1, 2019, several major provisions designed to improve medical education, health care, and public safety for deep South Texas, are the result of DHR Health, according to key state lawmakers.
“When you talk about DHR Health, they are one of the most effective medical teams, not only here on the ground for the community, but in addition to making sure that South Texas gets its fair share of health care dollars (from the Texas Legislature),” says Rep. Terry Canales, D-Edinburg. “There are other people and other hospitals that do a great job, but I can tell you that at the forefront of trying to secure money for the region and for the population that they represent and serve, DHR Health is number 1. I can tell you I am thoroughly impressed.”
Canales, who serves as Chair, House Committee on Transportation, and Sen. Juan “Chuy” Hinojosa, D-McAllen, who serves as Vice-Chair, Senate Committee on Finance, were among the many legislators who saw first-hand, during the Spring 2019 regular session of the Texas Legislature, how DHR Health leaders helped champion key measures that will benefit the Valley; now and in the future.
“Obviously, DHR Health is very much involved, a key player in providing health care here in South Texas, and their support of the (University of Texas Rio Grande Valley) medical school,” said Hinojosa “Lobbyists play an important role in that they also will provide a lot of information for all the legislators. It makes the whole difference. It is a multiplying of the information to educate the lawmakers to the needs of our areas we have here in the Rio Grande Valley.”
DHR Health is a physician-owned health system and the only locally owned and operated hospital left in Hidalgo and Cameron counties. Anchored in southwest Edinburg, with a growing presence in neighboring McAllen, DHR Health offers, on its 130-acre site, some of the most comprehensive medical care on the U.S. southern border, with more than 1,400 nurses and 650+ physicians providing care in 70+ specialties and sub-specialties.
Also, DHR Health is the flagship teaching hospital for the University of Texas Rio Grande Valley (UTRGV) School of Medicine, and encompasses a general acute hospital with the only dedicated women’s hospital south of San Antonio, a rehabilitation hospital, a behavioral hospital, more than 60 clinics Valley-wide, advanced cancer services, the only transplant program in the Rio Grande Valley – and the only functioning 24/7 Level 1 Trauma Center south of San Antonio.
In addition to helping secure $6 million to help the Rio Grande Valley improve trauma capabilities, DHR Health also rallied support for an additional $11 million for the Trauma Network in the State of Texas, supported Verónica Gonzáles and her team in securing $12 million in additional state money for the UTRGV School of Medicine, and helped shape legislation to increase the efficiency of the state Medicaid system.
Gonzáles is Vice President for Governmental and Community Relations for the University of Texas Rio Grande Valley.
DHR Health’s lobbying efforts utilize the vast expertise and experiences of their top leaders, especially physicians who make the time, here at home and in Austin, to inform state and federal lawmakers, and other powerful officials, of the specific needs of deep South Texas.
Roberto Haddad, Jesse Ozuna “the cornerstone of the work done there.”
DHR Health’s governmental relations team plays a vital role in shaping and implementing its leadership’s legislative strategies.
Robert D. Martínez, MD, Chief Medical Officer, Chief Physician Executive, DHR Health, is one of numerous DHR Health officials who travel to Austin to promote the legislative agenda for the hospital system, its patients, and the institutions served by, or which work with, DHR Health.
He complimented the effectiveness of the Rio Grande Valley’s state legislative delegation: Hinojosa; Canales; Sen. Eddie Lucio, Jr., D-Brownsville; Sen. Judith Zaffirini, D-Laredo/Starr County; Rep. Armando “Mando” Martínez, D-Weslaco; Rep. Sergio Muñoz, D-Mission; Rep. Ryan Guillén, D-Rio Grande City; Rep. Eddie Lucio, III, D-Brownsville; Rep. R.D. “Bobby” Guerra, D-McAllen; Rep. Óscar Longoria, D-La Joya; and Rep. Alex Domínguez, D-Brownsville.
But he also had special praise for DHR Health’s government affairs team for their work before the Texas Legislature: Roberto Haddad, Vice President and Counsel for Government Affairs and Policy at DHR Health, and Jesse Ozuna, Government Affairs Officer at DHR Health.
“Those two gentlemen were the cornerstone of DHR’s advocacy efforts. Two very bright individuals with a real good sense what the community needs,” Martínez said. “Both from here, both very intimately involved with the health care system. They not only identified a lot of issues for us, but helped us navigate where we should best try to take issues, or not worry about somethings, really helped us understand the big picture, not only in the Texas Legislature but federally, because sometimes federal issues are tied into the state.
“They (Haddad and Ozuna) did a tremendous job. We wouldn’t have been able to do any of this without them. They were really my keeper when I would go to Austin for meetings. They prepare you, they give you the information, tell you where the pitfalls are,” Martínez continued. “It is really vital to have folks who have a desire, a grasp of the issues at hand, in the service area, because they grew up here. They obviously want the best for their community, and that showed. They were a tremendous strength for us. We wouldn’t have been able to do it without them.”
Level I Trauma Center funding secured for Valley
One of the more prominent examples of DHR Health’s state legislative efforts involved successfully securing millions of dollars in state funds for area hospitals to upgrade their trauma care services.
“We need a Level I Trauma Center here in the Rio Grande Valley, and DHR Health took the lead and played a key role in pushing and lobbying for an increase in state money targeting the Rio Grande Valley, for us to be able to have Level I trauma resources for our public,” Hinojosa recalled. “They were successful in that we ended up having $6 million set aside specifically for a hospital here in the Valley to be able to increase their services to Level I.”
Canales emphasized how important – and difficult – it is to divide state money among hundreds of competing interest groups.
“When I say that the most important feature or aspect that we are tasked in the Legislature is passing a budget, all the other laws and all the other bills that we file, I would call them either a nuisance to some or a cherry on top,” Canales said. “But when you are talking about passing a budget, there is only so much money that Texas can spend, so everyone wants a slice of the pie.”
The 86th Texas Legislature in May passed a $250.7 billion, two-year state budget, a spending plan that covers the period from Sunday, September 1, 2019, through Tuesday, August 31, 2021.
“Everybody is up there fighting for it (state funding), and the people who fight the most effective are the ones who actually come home and bring more to their areas, to their districts,” Canales said. “I can tell you that DHR Health is an extremely effective advocate for health care in South Texas. You can see everything they do, from the expansion of Trauma I to the expansion of medical research.”
DHR Health leaders invested their resources on behalf of improving trauma center capabilities, and other legislative gains for the Valley, because they see it as their duty as citizens, Martínez said.
“We believe because DHR Health is the biggest, busiest medical center, with sub-specialists, we have been building to this (Level I Trauma Center status),” Martínez continued.
Trauma center levels across the United States are identified in two fashions – a designation process and a verification process, according to the American Trauma Society. The different levels (ie. Level I, II, III, IV ) refer to the kinds of resources available in a trauma center and the number of patients admitted yearly. These are categories that define national standards for trauma care in hospitals. Categorization is unique to both Adult and Pediatric facilities.
A Level I Trauma Center is a comprehensive regional resource that is a tertiary care facility central to the trauma system. A Level I Trauma Center is capable of providing total care for every aspect of injury – from prevention through rehabilitation.
As of Wednesday, May 1, 2019, DHR Health began functioning as a Level I Trauma Center.
As a functioning Level I Trauma Center, DHR Health has 24/7 in-house coverage by general/trauma surgeons, and on-site specialists in areas such as orthopedic surgery, neurosurgery, radiology, emergency medicine, internal medicine, and critical care.
DHR Health offers a specialized, comprehensive team to care for patients who suffer traumatic injuries from causes such as motor vehicle crashes, gunshot wounds, crush injuries, and falls. The emergency department at DHR Health is the primary entry point for most patients, they are evaluated and stabilized in its designated trauma area before getting transferred to a different area of the hospital to receive additional medical care.
DHR Health and their trauma team will also serve as a healthcare leader in Prevention and public education to surrounding communities.
DHR Health helped improve the efficiency of Medicaid in Texas
Another major legislative development dealt with DHR Health helping improve on the efficiency of the Medicaid program. Medicaid is the state and federal cooperative venture that provides medical coverage to eligible needy persons. The purpose of Medicaid in Texas is to improve the health of people in Texas who might otherwise go without medical care for themselves and their children, according to benefits.gov, the official benefits website of the US government.
Medicaid in Texas is administered by the Texas Health and Human Services Commission (HHSC), which contracts with private firms known as managed care organizations (MCOs). MCOs are licensed by the Texas Department of Insurance. HHSC pays each MCO a monthly amount to coordinate health services for Medicaid clients enrolled in those MCOs’ respective health plan.
This arrangement is known as the Medicaid Managed Care System in Texas.
Prior to the five-month regular session of the 86th Texas Legislature and in order to help South Texans bring their concerns and ideas directly to state lawmakers, DHR hosted a public hearing of the House Committee on Human Services on Wednesday, August 28, 2018. The hearing drew legislative, medical, health care, business, and community stakeholders and concerned citizens.
Carlos Cárdenas, MD, Chairman, Board of Managers, DHR Health, as well as Past President of the Texas Medical Association (TMA), testified before that legislative panel last year, during the committee hearing held at the Edinburg Conference Center at Renaissance.
“Texas’ Medicaid managed care system faces grave but surmountable challenges that must be addressed with all due haste, beginning with enhanced security not only of the health plans but also of the state’s own actions, including deep funding cuts and insufficient agency staff, jeopardize Medicaid’s ability to care for the neediest among us,” Cárdenas said at the time.
Cárdenas, who spoke on behalf of TMA, said his testimony was intended to focus on “significant deficiencies in the Texas Medicaid managed care program and how Texas can expeditiously correct them.”
During the regular session of the 86th Texas Legislature (January through May 2019) DHR Health advocated for a variety of legislation to improve the overall Medicaid program.
DHR Health, working with stakeholders across the state, secured some victories, featuring the passage of several pieces of legislation will improve the Texas Medicaid system and ensure that patient care is the focus of the program, not bureaucracy.
Success included legislation to:
• Improve patient care coordination between managed care companies and healthcare providers;
• Shorten the time period for managed care plans to approve patient discharge plans so that patients can get out of the hospital faster;
• Increase accountability and oversight of managed care companies;
• Simplify and streamline the appeals and complains process; Secure an adequate state health care budget;
• Improve care coordination of a patient between an MCO and a healthcare provider; and
• Improve accountability of MCOs with more HHSC oversight to ensure patient care is at the center of every case.
“Having the state make adequate appropriations in the Medicaid program ensures that our most vulnerable population will continue to receive the proper healthcare they need,” Martínez said. “When an individual who is struggling financially to make ends meet, the last thing they need to be worrying about is whether they or their children, will have sufficient healthcare coverage in the event they get sick and have to go see a physician or end up admitted in a hospital.”
R-Myna Evans and Reannon C. Ramos contributed to this article. For more information, please contact Roberto Haddad, Vice President and Counsel for Government Affairs and Policy at DHR Health, or Jesse Ozuna, Government Affairs Officer at DHR Health, at 956/362-7165. For more on this and other Texas legislative news stories which affect the Rio Grande Valley metropolitan region, please log on to Titans of the Texas Legislature (TitansoftheTexasLegislature.com).