Nueces County Hospital District to consider new terms to save ER residency program

The Nueces County Hospital District is considering a new agreement with Christus Spohn Health System, potentially spending about $21 million to buy time in the hopes of saving the hospital's emergency medicine residency program.

The hospital district Board of Managers will meet 12:15 p.m. Friday to approve proposed deal points to serve as a framework for an agreement with Christus Spohn. If approved, attorneys for the hospital district and health system would then hammer out the terms of a final agreement.

Currently on the table is a six-year agreement starting in July 2024. The hospital district could potentially spend about $1.4 million for the 2024-25 academic year, about $2.8 million for 2025-26, and $4.25 million annually for 2026-27 through 2029-30 to ensure the emergency residency program is not lost without a fight.

Earlier this fall, Christus Spohn shocked the community and the residents and faculty of the emergency medicine residency program by announcing plans to terminate the program by June 26.

The three-year program trains resident doctors recruited from across the country to practice in an emergency care environment. The program's 36 residents and about 17 faculty man the Christus Spohn Hospital Shoreline emergency department, and many graduates remain in Corpus Christi or South Texas upon completion of the program.

It is the only emergency medicine residency program in the Coastal Bend.

Christus Spohn said the decision was made with "incredible consideration to our ministry's available resources" and a "limited" ability to continue to sustain the program. CEO Dom Dominguez also indicated to the Nueces County Commissioners Court that Christus Spohn is shifting focus to increasing primary care and specialty clinics in the community.

In the days after plans to end the program were announced in October, doctors involved with the program and others in the Corpus Christi medical community immediately mobilized to save the program, touting it as a pipeline for quality physicians. Supporters created a petition and began regularly attending Corpus Christi City Council, Nueces County Commissioners Court and Nueces County Hospital District meetings.

Droves of doctors in white coats attended meetings. Faculty in the residency program and other local medical professionals spoke during public comment sessions, while residents themselves often formed a wall of silent support in the audience, refraining from speaking publicly out of fear of retaliation.

Nueces County Judge Connie Scott quickly proposed a working group with members of the commissioners court, doctors and Christus Spohn, but Christus Spohn representatives declined to attend meetings.

But Christus Spohn did begin negotiations with the Nueces County Hospital District.

The hospital district had some sway because it contracts with Christus Spohn to provide medical care to the county's indigent, or low-income, population.

As part of this agreement, the hospital district has maintained that Christus Spohn is responsible for hosting at least two residency programs. With the planned phase out of the emergency residency program, Christus Spohn did not indicate whether it planned on introducing any new residency program in replacement.

In mid-November, the hospital district board of managers considered terms for a five-year $18 million agreement. The board declined to move forward with those terms after hearing from residency program faculty that the plan was not a long-term solution and only realistically bought the program a year, as the program would struggle to recruit when it could not guarantee potential residents that they could complete their residencies in a fully-functioning program.

The six-year plan currently under consideration adds just one more year, bumping the price tag of the agreement, and is not envisioned as a long-term solution. Instead, the agreement would buy the community time to find a more permanent solution, Nueces County Hospital District administrator Jonny Hipp said Wednesday.

Hipp attended a Nueces County Commissioners Court meeting Wednesday morning to provide county leadership with an update on the potential agreement.

"It's really a question of two things," Hipp said. "It's one, having long-term funding set aside for it; and two, making sure we have a facility in Corpus, a teaching facility hospital that will accommodate the hospital."

The terms under consideration by the hospital district would also require that an agreement include a clause that would prevent Christus Spohn from terminating the residency program unilaterally without the consent of the hospital district.

"That is to make sure that we have enough notice that it was going to happen and that we can make sure that there are plans that the program is accommodated in the community," Hipp said.

The hospital district funds would cover the direct costs of maintaining the program. The $21,250,000 would come from the hospital district's reserves.

Any additional funding Christus Spohn might be able to secure for the program from other sources would offset the hospital district's contribution.

Commissioner Joe A. Gonzalez expressed concerns about the price tag and whether it was the hospital district and county's role to become involved in the issue.

Commissioners Brent Chesney and John Marez, the two county leaders most involved in discussions of the residency program's future, spoke in support of the hospital district agreement, acknowledging it is not a perfect deal.

"Let's spend some money to keep 50 doctors," Chesney said. "That's what people forget. We all always talk about what we can do to bring great things to our community. Sometimes you have to invest in what's here."

Hipp said that a transition of the program could be reached before the full six years, lessening the financial impact on the hospital district.

"Nueces County has made this a priority," Marez said. "And it's not perfect... it's about saving this program right now in the amount of time that we were given. It will still give these doctors to interview and recruit and retain some well-qualified residents — we have to do it now."

Chesney also commended the efforts of the doctors who have been clear about their desire to stay in Corpus Christi.

"These people want to be here," Chesney said. "They have fought to be here. They have unified like no group I've ever seen."

Nueces County Hospital District seeks alternate solution to save residency program

Doctors surprised as Christus Spohn plans to end emergency medicine teaching program

Nueces County weighs in on loss of Christus Spohn emergency medicine residency

This article originally appeared on Corpus Christi Caller Times: Compromise in the works to buy time for emergency medicine residents