Aransas County commissioners, at their regular meeting Monday, March 22, unanimously approved authorizing the issuance of a RFP for a Medical Facility Operator/Manager. The authorization was delayed because a updated copy of the RFP was not presented to commissioners at their March 15 meeting.

Long Term Recovery Team (LTRT) members William Whitson and Kim Foutz outlined changes made to the RFP since last week’s meeting.

“(The changes are) all in line with what you discussed in your last meeting,” said Whitson.

Foutz said the new timeline calls for the RFP to “be on the street” for five weeks.

Potential uses for a new facility now include a Federally Qualified Health Center and an Urgent Care Center.

Enhanced threshold requirements in proposals include:

• Must possess, or previously possessed, valid license, accreditations, certifications needed to operate proposed facility and to secure payor sources.

• Proposers must be Medicare/Medicaid eligible.

• If proposal is for a hospital facility, proposer must be willing and able to secure transfer agreement with all large acute care hospitals, as well as with all freestanding ERs.

• Willing to contract with all major health plans and policies which subcontract with CMS (Medicare) and Texas Medicaid program, including CHIP.

Some items in the RFP are now required in round one scoring, including:

• Start-up budget and reserves.

• Medical equipment and technology budget.

• Two-year forecast for revenue and expenses, including indigent care reimbursable expenses.

• Two-year forecast of payor mix and patient mix data.

• Estimate of the total subsidies required to achieve breakeven in years 1-5, and amounts expected from each potential subsidy source.

• If a hospital, specify the revenue dollars per inpatient bed day required to achieve breakeven in year 1-5, along with the number of recommended inpatient beds.

“The Evaluating Committee thinks this information is very important in evaluating RFPs,” said Foutz.

Commissioner Wendy Laubach asked for examples of hospitals that aren’t considered acute care.

“That could be a micro-hospital, a mental hospital, etc.” said Foutz.

Evaluation Committee member Jennifer Racette, a former hospital administrator, addressed some of the more technical issues surrounding the RFP, and what might be expected by proposers.

She noted in Texas a hospital license is standard across the board, requiring certain things, such as an ER.

“The current ER (you have in Aransas County) is connected to a hospital. There has to be an ER on site of the main campus,” said Racette.

Corpus Christi Medical Center, which operates ER 24/7 Rockport, has an ER at its main campus.

Racette said if there is a proposal received for an acute care hospital, then there could conceivably be two ERs (in Aransas County).

“I don’t know if Aransas County can support that,” she said.

She talked about the importance of the payor mix/patient mix in determining the viability of a proposal, noting it will tell the committee if the proposer can actually “make it” with what they propose.

“It will be interesting to see if a proposal can make it with county funds, from indigent health care,” said Racette. “If not, it points toward a taxing district.”

Commissioner Pat Rousseau jumped in immediately, and said, “(We have stated very specifically) we’re not interested in a taxing district.”

It was noted the proposals expected will probably be for other levels of care, not an acute care hospital.

Evaluation Committee member Matt Brewington, who works in the healthcare field, said the goal is to make the RFP as broad as possible “and hopefully get proposals we haven’t event thought of.”

Commissioners than unanimously approved authorizing the issuance of a RFP for a Medical Facility Operator/Manager.

(Note: The Evaluation Committee includes residents with knowledge, expertise, and understanding of the healthcare field. They will review the RFPs and make a recommendation to the court. Their names were published in the March 17 edition of this newspaper.)

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