Small UTMB concern

GALVESTON — State health care leaders said a plan to downsize the University of Texas Medical Branch poses vexing questions about the future of Galveston County’s poorest and most traumatically injured patients.

The medical branch might be the first major hospital in recent Texas history to scale back its services to the extent University of Texas regents have approved, said Anne Dunkelberg, associate director for the Center for Public Policy Priorities — a nonprofit research agency.

“There’s really no parallel to it,” she said.

Now health care leaders predict other hospitals in the region will see an influx of uninsured patients. Those with chronic conditions, such as diabetes, cancer and liver disease, might not have access to specialty care, causing them to get sicker and even die, they said.

And the shutdown of one of the state’s elite trauma centers could put more pressure on the two other Level 1 trauma centers in a region serving 4 million people.

The medical branch plans to cut its services as a result of the Sept. 13 hurricane that swamped the island and caused $710 million worth of expenses at the medical branch. It will layoff about 3,800 of 8,000 employees and remove at least 350 of its 550 hospital beds.

David Lopez, CEO of the Harris County Hospital District, said the plan will cause a ripple effect across the Texas health care system, a patchwork of overburdened providers that treat the 30 percent of Texans without insurance.

The system for Texas’ uninsured is on “very thin ice and it can come crashing down in a heartbeat,” Lopez said. “But we manage to keep it going. It’s a struggle year in and year out. But as long as everyone is sharing in that, it sort of keeps it going. If one part of the system goes down, it further exacerbates the problem for everyone else.”

Though the medical branch had scaled back its charity care in recent years, it still provided $120 million in uncompensated care per year.

Lopez said the medical branch’s patients, specifically those without insurance, will turn to other local hospitals, where patients already suffer long wait times at emergency rooms.

It’s not clear whether or how those hospitals will be compensated for providing more charity care, Lopez said.

He said the Harris County Health District could ask the state for a piece of the indigent care funding once doled out to the medical branch.

Dan Stultz, CEO of the Texas Hospital Association, said the downsizing could be reversed once the island’s population returns and can support a 550-bed hospital. But there’s no guarantee people will return.

Charity Hospital in New Orleans — which treated a large indigent population — shut its doors in 2005 after Hurricane Katrina ravaged the city and flooded the hospital. Three years later, it has not reopened.

“The hospital closed to see if New Orleans would come back and it hasn’t to the magnitude (for the hospital) to rebuild,” Stultz said. “I don’t know what’s in the tea leaves, but for UTMB to prosper, Galveston needs to prosper.”

Hospitals along the Gulf Freeway corridor and in Houston are already seeing an increase in patient volume since the medical branch shut down two months ago.

Mainland Medical Center in Texas City and Clear Lake Regional Medical Center in Webster have reported large increases in hospital admissions and emergency visits.

Galveston County Health District — where 90 percent of the patients are uninsured — once referred patients to the medical branch for specialty services. Now, those patients are turning up at the 4Cs Clinic in La Marque, needing specialty care that the clinic’s doctors can’t provide, said Dr. Mark Guidry, CEO of Galveston County Health District.

With a downsized medical branch, the county’s uninsured will have limited access to treatment for special conditions such as kidney disease, diabetic complications and cancer, Guidry said.