The Austin Chronicle

Naked City

Hey, You! Wanna Run a Hospital District?

By Amy Smith, June 18, 2004, News

It took two years to get a proposed Travis Co. hospital district on the ballot; now it's time to get the new operation up and running, with its own budget and tax rate, by Oct. 1. That's the cutoff date under state law after which the city of Austin and Travis Co. can no longer spend tax money on public health services in their own budgets.

With that in mind, city and county officials are fast-tracking the selection process for hospital district board members; the Travis Co. Commissioners Court hopes to have selected its four candidates by mid-July, with the Austin City Council making its four picks by July's end. The city and county will jointly select a ninth member; one likely choice for that appointment might be Clarke Heidrick, an attorney who chaired the steering committee that shepherded the proposed district through to victory at the ballot box May 15.

But does Heidrick want what will largely be a thankless job? "I'm still thinking about it," he said. "I am interested in the sense that I'd like to be able to see and complete what many of us started, but this is always going to be a work in progress."

The city and county's present challenges include collecting a large enough pool of qualified applicants to create a nine-member board with a good demographic balance. Both entities are essentially looking for the same qualifications, with financial expertise topping a list that also calls for experience in legal affairs, government, health or social service management, or health care. The city and county will also limit the number of appointees who draw income from the health care industry. And finally, the district board will need members willing and able to commit time – lots of time – to the hospital district, particularly during its first two years.

Thick skin would also be a favorable attribute, Heidrick noted. "Certainly in the early phase, the district is not going to satisfy everybody," he said. "And the reality is that it will never have enough money to satisfy all the demands." Still, Heidrick believes that the district, while it won't solve all of the county's health care ills, will put a pretty good dent in a system currently hobbled by overcrowded emergency rooms and clinics, and a large share of uninsured people – as much as 28% of the area population, according to some hospital estimates.

For that reason, Heidrick would like to take the hospital district idea on the road to neighboring counties that rely on the regional trauma center and other services at city-owned Brackenridge Hospital, but which don't contribute to the health care financial pie. "How do you turn this into a regional district? That's a challenge that really interests me," Heidrick said. "It will take a lot of missionary work and diplomacy to try and sell the idea to other counties, but I think it can be done."

But first things first. County commissioners early this week were finalizing criteria for board candidates; the city has posted applicant info on its Web site,

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