Aransas County commissioners, at their special meeting Monday, March 15, tabled authorizing the issuance of a RFP for a Medical Facility Operator/Manager. The reason for delaying authorization is the final updated copy of the RFP was not presented to commissioners.

The court is scheduled to take action regarding the RFP issuance at its meeting at 9 a.m. Monday, March 22.

Long Term Recovery Team (LTRT) members William Whitson and Kim Foutz presented a Power Point overview regarding the RFP at the court’s March 15 meeting.

Aransas County Medical Services, Inc. (ACMSI) and the county are working together in issuing the RFP, using a process outlined by federal regulations since federal funds will be used to build any future medical services facility. It is being finalized with feedback from the Evaluation Committee, County commissioners, and the Texas General Land Office (GLO).

The Evaluation Committee includes residents with knowledge, expertise, and understanding of the healthcare field.

If the court approves authorizing the issuance of a RFP, and after the RFPs are returned, the committee will rank them and present a select number to the court and ACMSI for consideration, along with the committee’s recommendation.

Commissioners will then consider the recommendation from the committee, and award the contract. The county and ACMSI will then work with the successful respondent to negotiate an operations contract, and associated improvements.

That operations contract would then be considered for approval by the court.

Different means of marketing the RFP, to reach the largest number of qualified operators, was also outlined.

The timeline calls for a Medical Facility Operator/Manager proposal to be selected by May 24, or about one month from now.

General highlights of the RFP are:

• Facility will be located on the ACMSI site adjacent to 400 Enterprise Blvd.

• The operator can be non-profit of for profit

• The RFP is designed to let the private sector medical market respond to the needs of the community.

The RFP draft has been submitted to the GLO for review. Preliminary feedback has been received.

The list of potential uses was broadened to include more than just a micro-hospital.

“Micro-hospital was the term originally used by Texas A&M (when the lack of local medical facilities became very apparent after Hurricane Harvey),” said Foutz. “The committee said it wanted to widen, not narrow the language (or definition of what might end up in that space).”

Other uses of the property, and whatever is constructed, could include anything from an acute care hospital to a rural health clinic.

The final design of any facility will be mutually determined by the parties involved during the design process, based on best practices, the operator’s proposals, and the available budget.

Any additional facility improvements above the grant budget will be at the sole expense of the provider.

The operator has to demonstrate financial stability, possess or have previously possessed valid licensing/certifications, and be Medicare/Medicaid eligible, among other requirements.

(Note: not being Medicare/Medicaid eligible was the ultimate downfall of two previous ER centers in Aransas County.)

Commissioner Wendy Laubach said what she is hearing from constituents is a need for a “way after hours” (even possibly 24/7) urgent care, and not just an ER.

“We need to say this is something we would want to see,” she said.

Commissioner Jack Chaney, noting the lack of payment options in previous ER and Urgent Care facilities, said, “We need some place that can serve everyone … I’m not looking for a place someone can stay for three-plus days.”

Commissioner Bubba Casterline said he only wants an operator that can survive through the years.

“I’m looking for the long-term improvement of medical care in the county,” said Casterline.

Commissioner Pat Rousseau noted a provider will have to accept Medicare, Medicaid and private insurances in order to survive.

Laubach said the public will want to know what the proposals are, and asked when the public will be able to see them.

Whitson said all proposals will be open to the public (except for those parts that include proprietary information).

Chaney asked that the LTRT present to the court a matrix outlining all proposals received.

Laubach asked if she can see the proposals once they are opened.

Whitson said the court will see all the proposals after the committee ranks them.

“That’s part of the federal process (we have to follow),” he said.

Foutz then reviewed a draft of evaluation criteria to be used in the selection process. It provides scoring for everything from quality of the proposal to an operator’s history, and financial strength to payment mix and indigent health care experience. Management approach and ability to provide acute care will also be used to determine the finalist.

“Be patient (with the process),” said Whitson. “This goes from macro to micro. We will come up with the right one.”

Chaney reiterated his desire to get away from using the term micro-hospital.

Laubach responded, “Yet we have a bond we can’t use unless (it’s a) micro-hospital.”

Discussion then centered on the four-week timeframe outlined for receiving and choosing the best proposal.

“This is a complicated RFP. Is four weeks enough time?” asked Chaney.

Whitson said it typically takes about 45 days to turn around an RFP.

“How will that affect the overall schedule?” asked Laubach.

Whitson responded, “I’d rather take a little more time to make the right decision.”

Foutz noted a lot of work occurs after the operator of the medical facility is selected.

She said the environmental process will take a long time, as well, depending on the facility.

Whitson said the architectural plan and environmental plan will be developed simultaneously.

Chaney said the county needs to be in control of the architectural design.

The operating agreement, as outlined by the GLO, states the county nor the ACMSI can generate a profit from the facility, but both can be paid for expenses incurred.

Foutz said the ACMSI has a record of operating in this field, and the county will be involved via providing indigent health care (as it currently does).

The operator will have to sign an agreement for a minimum of 20 years.

Laubach asked what happens if the operator fails.

Whitson replied, “We have an asset to sell and the money goes back to the state.”

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