Jesús Garza, who remade himself as a health care leader after eight years as Austin’s city manager, will take over July 1 as chief of the Seton Healthcare Family, the largest hospital system in Central Texas.
Garza, 60, officially takes charge — he has been interim president and CEO — as the health care world is swirling with change under the Affordable Care Act and uncertainty about how Texas will accommodate its vast uninsured population. He pledged that the Catholic Church-affiliated Seton would stick to its mission. “We are here to serve the poor and vulnerable.”
While overseeing an annual budget of $1.7 billion and 12,950 employees, Garza will collaborate with Central Health to better coordinate care for Travis County’s sickest and poorest residents. He also will help establish a medical school and a $250 million teaching hospital in Austin.
Garza, who came to Seton in 2002, was paid $1.3 million as chief operating officer in 2010, the most recent year for salary data. His predecessor as CEO, Charles Barnett, was making nearly $2 million.
Garza discussed the looming challenges Seton faces last week. An edited transcript follows:
What’s up with the teaching hospital?
We have one more approval (pending) from our parent, Ascension Health, and we anticipate that will happen either late, late spring or early summer. We’re on track.
This hospital will replace University Medical Center Brackenridge, the oldest public hospital in Texas. (Seton runs it on behalf of Central Health, the hospital district.) But Seton will own the new hospital, eliminating public ownership. Does the public get a say?
The way Central Health has approached this is, we will be on public land with some lease arrangement. Through a master agreement (with Central Health), we would make commitments. We intend for it to continue to be a Level I trauma center. Obviously, it will be a teaching hospital, which will be an immense public service. And it will be the primary safety net for people who don’t have insurance. … As that public discussion takes place, I am sure Central Health is going to take public input. The public, in essence, will have a new facility, and they will own the land.
Will the safety net remain as is or will Seton reduce its role?
The Community Care Collaborative we are creating (with Central Health) will make it a joint responsibility.
Seton bears most of the cost of providing charity care at Brackenridge. Will taxpayers pay more?
The fairer question is: Will the public bear a greater responsibility for the things that belong in the public square? Does that mean they (Central Health) will pay a little more? In some instances, yes. Will it mean sometimes we pay more? In some instances, I can see where the answer to that is yes. If we manage this well, we can avoid that.
Avoid having taxpayers contribute a larger share?
That’s the intent, but having said that, if the state decided to do something drastically different with Medicaid or cause there to be more uninsured people, then all of us are going to pay more for that. There is no way of avoiding the cost when circumstances beyond everyone’s control happens. But in the sharing of risk through managing this population, it’s intended that we both be at risk.
What happens to Brackenridge when the new hospital opens? Could it become a medical school building?
I don’t know whether it would be a medical school building. Once all of the agreements are done, the re-purposing of Brack will be considered … with Central Health. We intend to keep the clinical education campus, the old Children’s Hospital of Austin building (on the Brackenridge campus). We train a lot of nurses there.
What is this medical district we’re hearing about?
That’s going to happen. It will be from 15th to MLK, west to Trinity and east to IH-35. You’re going to need research facilities; you’ll need teaching facilities; you’ll need lab space. UT will do an evaluation and determine what they have now and what they need. But you ought not think when the medical school opens (in fall 2016), they’ll have all that done.
Will a time come when going to the hospital won’t cost so much?
There may be a time when what we spend for hospital services won’t be as big a percentage as what people pay now. There will be other ways to deliver care — not in the institution. We really do have to be disciples of a new way of helping people understanding their own health care needs.