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
