Naked City

Seton Gives Up on Children's?

The city's rocky relations with Seton Healthcare Network hit another bump last week when hospital officials acknowledged plans that may threaten the city-owned Children's Hospital of Austin, which Seton currently leases and operates along with neighboring Brackenridge Hospital. Seton wants to build and own a new $200 million facility because of overcrowded conditions at the existing hospital.

Seton's intentions had been whispered for months. Last week's confirmation not only clinched the rumors but raised serious concerns about the financial viability of Brackenridge; right now, Children's is one of the most profitable parts of Seton's operation. Were Seton to instead compete with it, or to back out of the lease deal it signed with the city in 1995, Austin taxpayers could suffer severe financial consequences.

It's unclear how Seton's plans will impact efforts to form a health-financing hospital district in which the city and county would share the costs of health care for the poor. Travis Co. Probate Judge Guy Herman serves on a steering committee studying the feasibility of such a district. He believes that city higher-ups had prior knowledge of Seton's plans but that neither the city nor Seton shared the information with the steering committee. "I am deeply disappointed for a number of reasons, one of which is what I perceive to be a lack of candor [from] Seton and the city while they have been participating in the hospital district creation efforts."

Those efforts will continue unabated, assured Mayor Gus Garcia. "We made a commitment to Judge Herman and we intend to keep that commitment." The committee's goal is to draft legislation for the next session and have voters decide the issue in November 2003. "Then," Garcia said, "the question is will the people of Travis County be willing to fund a hospital district?" Regarding Herman's dismay over city officials' prior knowledge of Seton's plans, Garcia said that Charles Barnett, until last year Seton's president and CEO, did indeed inform him of the hospital's intentions. (Barnett is now a senior VP of Ascension Health, which owns Seton.) "I asked him, what are you going to do with your Brackenridge contract, and he said, 'we intend to keep it.' I don't see Seton pulling out of Brack," the mayor added. "The reality is we need a bigger facility."

Mayor Pro Tem Jackie Goodman said she, like others, had been hearing the Seton buzz but had nothing substantive to go on until last week when two well-timed letters were sent to City Manager Toby Futrell. The letters -- one from leaders in the pediatrician community, followed by another from Seton interim President Pat Hayes -- cited the need for a new children's facility. Hayes called for a "single hospital ... at a new site with long-term growth potential." Said Goodman: "That's not a concept I agree with right off the bat. Why would you preclude having two hospitals?" Given the critical prospects of the city getting left in the lurch, Goodman said she'd like to round up a health care expert to advise her subcommittee on the economic impact of Seton's departure, and strategic options for the city.

Disagreements between the city and Seton have flared and simmered over the years, typically centering on the city's mission to provide reproductive and family-planning services to low-income women, a policy that directly conflicts with Seton's edicts handed down from the Catholic Church.

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