Executive Summary

As part of their relationship in establishing the new Seton Medical Center Hays facility, the
Hays County Commissioners Court and the Seton Family of Hospitals commissioned this
assessment to better understand the health needs of the current population, where gaps in the
system of services exist, as well as anticipating the effects of population growth in the coming
years. The assessment is intended to be shared for public benefit in the community's
deliberations in creating a safe, effective, patient-centered, timely, efficient and equitable
system of healthcare for all residents of Hays County. Seton and Hays County mutually agreed
to retain the non-profit Central Texas Sustainability Indicators Project (CTSIP) to conduct the
Assessment because of the CTSIP’s history of integrating both quantitative and qualitative data
to discern key trends on local and regional issues.

The Assessment is intended to rely on both data on health care and health issues as well as
interviews of key people across Hays County about their perspectives on these data and the
climate around health care in the county. The Assessment is not a review of any one service
provider or type of service, nor is it an evaluation of the decision to build a new hospital in
Hays County.

In compiling the data for this Assessment, the CTSIP partnered with Morningside Research and
Consulting as well as pulled data from the hospital Public Data Set and the CTSIP’s own
Community Survey work. The key findings from the data are outlined in the Data Trends
section and provided in full in the Data Appendix. Significant demographic change is, and has
been, occurring in Hays County with particular cohorts driving the need for new thinking in
health care – notably the elderly, over 65 years of age, the un- and under-insured, and a growth
in minority families. The particular health issues arising from the data include pregnancy/birth
services, elderly services, and mental and behavioral health services.

The second major scope of work was to conduct a series of interviews. Interview groups were
designed to capture the perspectives of health professionals and community leaders from the
private, public and non-profit arenas. The conversations ranged across several topical areas,
including key data trends from their particular perspective, a sense of emerging and future
health needs of the population, how the expanding county health infrastructure would affect
these needs (focusing on both the new Seton Medical Center Hays facility as well as the new
Communicare Federally Qualified Health Center - FQHC), and what kind of political leadership
was needed to address health care county-wide. In addition to reinforcing what was suggested
by just the data trends, these qualitative interviews also identified new issues such as the need
for greater coordination of specific services such as EMS or for increases in primary care
providers, reimbursements for care to the un- and under-insured, whether from federal or local
sources, and the almost unanimous call for a new, broad and serious county wide conversation
on tackling health care. The historical challenge to such a conversation was perceived to be just
convening the diverging political identities of Hays County into one direction.

Several ongoing efforts in Hays County – all launched independent of this assessment – are the
critical next steps. The County is in the enviable position that a new group does not need to be
convened to followup on this assessment. Rather, the various parties already active in ongoing
efforts need to be encouraged to keep open seats at their tables and to invite the engagement of
a broader set of voices on healthcare – perhaps especially the physician community, state
leaders, and voices from each corner of Hays County.

The priorities and recommendations extracted from this assessment should not yet be seen as
actionable items by either Seton or Hays County. These priorities should be used to propel and
focus Seton and Hays County on exactly how they want to share the role of working with the
community and from that work to share the actions that need be taken.

The addition of a new hospital, and a new FQHC, in Hays County is a huge opportunity. But if
solely market forces are allowed to drive how health care is delivered to the residents of Hays
County, we fear that not only could critical health infrastructure be lost, but that some residents
will be no better served in the future than they are today. But if collaboration emerges, at a
scale more than Hays County has managed to date on this issue, to drive health care delivery –
and funding – we are hopeful that Hays County can be confident no one, regardless of ability to
pay, will be without good access and high quality health care.

 

Download the full PDF report here