[1. CALL TO ORDER] [00:00:06] >> IF I COULD GET EVERYONE TO RISE FOR THE INVOCATION AND THE PLEDGES. WE WILL GET THIS MEETING STARTED. >> GOD, WE THANK YOU FOR THE BLESSINGS OF HEALING. YOUR LOVE AND YOUR MYSTERY HAVE TAUGHT THAT HEALING HAS GONE THROUGH THE AGES. WE THANK YOU FOR BEING BLESSED TO HAVE A COMMUNITY WITH SUCH AN ABUNDANCE OF HEALERS OF PEOPLE WHO, THROUGH THEIR FAITH AND THEIR BLOOD AND THEIR D.N.A., THAT THEY HEAL US. AND THEY PROVIDE US COMFORT AND THEY PROVIDE US GUIDANCE TO HELP LIVE BETTER AND HEALTHIER LIVES. AND TO REPAIR US WHEN WE ARE BROKEN. THAT IS SOMETHING VALUABLE THAT CANNOT BE REPLACED. THAT IS SOMETHING THAT IS ESSENTIAL FOR ALL COMMUNITIES TO BE VIBRANT. WE THANK YOU TODAY F FOR THIS OPPORTUNITY TO BEGIN DISCUSSIONS ON A VERY IMPORTANT TOPIC. WE PRAY FOR DISCERNMENT TODAY. WE PRAY FOR THE ABILITY TO LISTEN TO ALL THE SIDES AND TO BE ABLE TO ADVOCATE FOR THOSE IN NEED. AND ESPECIALLY FOR OUR DOCTORS AND MEDICAL STAFF WHO ARE HERE, LIVING HERE IN NUECES COUNTY NOW. THANK YOU FOR YOUR BLESSINGS IN YOUR HOLY NAME. AMEN. >> AMEN. >> I PLEDGE ALLEGIANCE TO THE FLAG OF THE UNITED STATES OF AMERICA AND TO THE REPUBLIC FOR WHICH IT STANDS, ONE NATION UNDER GOD, INDIVISIBLE WITH LIBERTY AND JUSTICE FOR ALL. HONOR THE TEXAS FLAG. I PLEDGE ALLEGIANCE TO THEE, TEXAS, ONE STATE UNDER GOD, ONE AND INDIVISIBLE. >> THANK YOU. YOU MAY BE SEATED. IT IS 3 #:12. I'M CERTIFYING WE HAVE A QUORUM PRESENT. ALL MEMBERS ARE HERE. WE ARE AT 901 LEOPARD AT THE NUECES COUNTY COURTHOUSE. WE WILL MOVE RIGHT ON INTO OUR AGENDA FOR-- NEXT UP IS REALLY PUBLIC COMMENT. I'M GOING TO DO SOMETHING VERY DIFFERENT. I WOULD LIKE TO ASK IF THERE IS ANYONE HERE, SINCE WE DID POST THIS MEETING, THAT WISHES TO SPEAK ON ANYTHING OTHER THAN THE AGENDA ITEM LISTED. IF WE HAVE NONE, WE WILL COME BACK. DON'T WORRY. YOU WILL GET YOUR OPPORTUNITY TO SPEAK. WE ARE GOING TO DO THINGS A LITTLE BIT DIFFERENTLY. WE HAVE A COUPLE OF PRESENTERS, AND THENLY GO THROUGH-- I WILL GO THROUGH THE INDIVIDUALS WHO [1. Receive presentation, and discuss and consider the potential future elimination by Christus Spohn of the emergency residency program in this region; and all related matters. ] HAVE SIGNED UP TO COMMENT. WE ARE GOING TO START WITH SPOHN SINCE THEY INITIATED THIS. THANK YOU, DON, FOR BEING HERE. WE WILL GIVE YOU AS MUCH AS YOU NEED FOR YOUR TIME. THEN WE WILL HEAR THE OTHER SIDE AS WELL. OH. LET ME BE CLEAR, TOO. SORRY. THERE IS, LIKE, A TEN-MINUTE LIMIT FOR YOU. TEN-MINUTE FOR YOU. ALL OF US HAVE SOMEWHERE WE HAVE TO BE BY 5:30. SO THIS COURT IS GOING TO END. WE NEED TO GET THROUGH WITH THIS. THIS IS A WORK IN PROGRESS. WE ARE NOT MEANING TO CUT ANYONE OFF OR STOP ANYTHING, BUT WE WANT TO HEAR EVERYTHING. WE HAVE SOME IDEAS ALSO ABOUT SETTING UP A WORKING GROUP WITH SOME DIFFERENT SELECTED MEMBERS THAT I WOULD LIKE TO FORM A COMMITTEE TO MAYBE ADDRESS THIS AND TALK MORE ABOUT IT IN DEPTH AND STUFF. IF WE HAVE WILLING PARTICIPANTS. THAT IS MY PLAN FOR THIS MOVING FORWARD. SO THANK YOU ALL. I WILL GIVE YOU THE FLOORMENT. >> THANK YOU, JUDGE. THANK YOU-COMMISSIONERS. COMMISSIONER CHESNEY, COMMISSIONER HERNANDEZ, THANK YOU FOR THE FORUM. I SEE A LETTER, JUDGE, PER CONVERSATION. I WOULD LIKE TO READ IT. I'M WRITING TO YOU ABOUT THE RECENT DECISION TO PHASE OUT THE EMERGENCY MEDICINE RESIDENTIAL PROGRAM AT CHRISTUS HEALTH SYSTEM BY JUNE, 2026. THERE HAS BEEN SPECULATION, QUESTIONS, MISINFORMATION ABOUT THE DECISION TO END THE PROGRAM WHICH IS THE PARTNERSHIP IN CONJUNCTION WITH TEXAS A&M. I WANT TO ASSURE YOU THE RESIDENTS AND THE FACULTIES ARE ASSOCIATES. OUR COMMUNITY, THE DECISION WAS MADE WITH THOROUGH CONSIDERATION OF THE COMMUNITY'S NEEDS. AND THE RESOURCES NEEDED TO SERVE THOSE NEEDS. TO ENSURE THE QUALITY OF CARE OF OUR PATIENTS, WE ARE COMMITTED TO SEEING THE EMERGENCY DEPARTMENT STAFFING AND OTHER HEALTH SERVICES REMAIN STRONG AS WE WIND DOWN THE TEACHING PROGRAM. OUR FAMILY MEDICINE RESIDENCY AS WELL AS OUR FAMILY MEDICINE OBSTETRICS AND FELLOWSHIP PROGRAMS WILL CONTINUE UNCHANGED. WE HAVE ALSO INVESTED SEPARATELY IN A NURSE RESIDENCY PROGRAM TO SUPPORT NEW GRADUATE NURSES AS [00:05:02] THEY DEVELOP SKILLS TO PRACTICE INDEPENDENTLY IN COMPLEX AREAS. WE ALSO COMMITTED TO THE RESIDENTS CURRENTLY ENROLLED IN THE UNIVERSITY PROGRAM. THE PROGRAM'S DATE OF CLOSURE ISN'T UNTIL JUNE, 2026. FOR ANY IMPACTED ASSOCIATES, WE WILL DO ALL WE CAN TO PROVIDE SUPPORT, INCLUDING BUT LIMITED TO ASSISTING THEM AND FINDING ANOTHER OPEN POSITION WITHIN CHRISTUS. AS WE END THE PROGRAM, IT WILL NOT IMPACT PATIENT CARE AT ALL. OUR EMERGENCY DEPARTMENT WILL REMAIN INTACT AT CHRISTUS SPOHN HOSPITALS. THE EMERGENCY MEDICAL PROGRAM HAS BEEN AROUND SINCE 2007. IT WAS CREATED, WE WERE ONLY ONE OF THREE EMERGENCY RESIDENCIES IN THE STATE. NOW THERE ARE 18. THE PROGRAM HAS BEEN STAFFED FAR AND ABOVE THE GRADUATE MEDICAL EDUCATION GME CAP. IT IS PRIVATELY FUNDED BY CHRISTUS HEALTH FOR MANY YEARS AS A RESULT. WE ARE PROUD THAT MORE THAN 120 GRADUATES HAVE SUPPORTED AND ARE CURRENT RESIDENTS HERE SUPPORTING TODAY. THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS SPONSORED A WORKFORCE STUDY. THERE WILL BE A SURPLUS OF EMERGENCY PHYSICIANS BY 2030. FURTHERMORE, IN 2023, 555 EMERGENCY MEDICINE SLOTS ACROSS THE UNITED STATES WENT UNFILLED. THE NUMBER WAS UP FROM 2022. 219 WERE UNFULFILLED. AGAIN, THIS IS NOT AN EASY DECISION. ULTIMATELY, WE ARE SIMPLY UNABLE TO SUSTAIN THE PROGRAM FOR THE LONG-TERM FUTURE. THE MAJORITY OF THIS PROGRAM HAS BEEN PRIVATELY FUNDED THROUGHOUT THE YEARS BY CHRISTUS HEALTH. IAS A NONPROFIT, CHRISTUS SPOHN REMAINS DEDICATED TO QUALITY AND AFFORDABLE HEALTH CARE. WE SERVE AND WILL CONTINUE TO HAVE CONSUMER-FOCUSED CARE ACCESSIBLE. THANK YOU. >> THANK YOU. >> JUDGE, I WOULD LIKE TO ELABORATE A BIT. >> YES. >> WHATEVER FORM THAT YOU WISH. I'M FROM THIS COMMUNITY. BORN AND RAISED HERE. THIS IS WHERE MY PARENTS COME. MY PARENTS CAME TO THE HOSPITAL AT MEMORIAL. THAT IS WHERE MY NIECE PASSED AWAY. MY DAD RECEIVED GREAT CARE FROM THESE DOCTORS RIGHT HERE. RIGHT HERE. THIS IS THE TOUGHEST DECISION EVER MADE. SPOHN HAS A COMMITMENT TO THIS PART OF THE WORLD OF SOUTH TEXAS. THIS COMMITMENT IS FULL, FULLY TO THE COMMUNITY THAT WE SERVE. THAT INCLUDES E.R. THAT INCLUDES FAMILY MEDICINE. INTERNAL MEDICINE. CARDIOLOGY. SURGERY. SPINE, ORTHOPEDIC AND THE VERY DIFFICULT, NEUROLOGY, GASTROENTEROLOGY. THOSE ARE COMMITMENTS FROM SPOHN. THEY ARE SCARCE RESOURCES. THE DATA WE REVIEWED, IS WHAT I MENTIONED RIGHT THERE. THE DECISION TO WIND THIS DOWN WAS NOT EASY. BECAUSE WE SAID IN PRIVATE MEETINGS WITH BOTH THE FACULTY AND IT WAS BROUGHT UP AND THE RESIDENTS, THE FACULTY TOOK CARE OF MY PARENTS. AS YOU LOOK AT THE RELATIONSHIP WITH SPOHN, IT IS A RELATIONSHIP WITH THE HOSPITAL DISTRICT THAT IS SPECIAL. IT IS UNIQUE. WE CONSIDER IT A PARTNERSHIP. WE ARE PROUD OF IT. WE ATTEND TO IT. IT IS WHAT YOU DESERVE. THE COMMITMENTS TO THE WEST SIDE OF TOWN AND TO THOSE IN THE MARGINS, SPOHN'S MISSION HAS ALWAYS BEEN A PART OF. DATING BACK TO 1905 WHEN THE SISTERS CAME TO CORPUS CHRISTI. THAT IS EXPANDED. WE ARE BLESSED TO EMPLOY 3,000 ASSOCIATES IN OUR COMMUNITY. ACTUALLY, THERE IS 3,300 INDIVIDUALS THAT WORK AT SPOHN. 3,000 INDIVIDUALS FULL-TIME. A PAYROLL OF $285 MILLION EACH YEAR. THAT THE COMMUNITY DESERVES. FOR THE PAST SIX TO SEVEN YEARS, WITH DONORS AND SPOHN, CHRISTUS SPOHN, WE HAVE PROVIDED AN EXCESS APPROACHING HALF A BILLION DOLLARS IN INFRASTRUCTURE IN OUR COMMUNITY. THAT INCLUDES A RENOVATED REBUILT SPOHN SHORELINE. THAT INCLUDES A MASSIVE ADDITION TO SPOHN SOUTH. THE ADDITION OF THE CHRISTUS SEASON SURGICAL HOSPITAL. THAT INCLUDES GROWING, AND I WILL SPEAK TO THAT-- PRIMARY CARE IN OUR COMMUNITY. THERE IS SEVERAL WAYS, SEVERAL WAYS TO MOVE HEALTH CARE CLOSER TO PATIENTS. HEALTH CARE CLOSER TO YOUR COMMUNITY. NOT ONLY NUECES COUNTY. DUVAL COUNTY. WE CAN GO DOWN THE LIST. ONE WAY IS TO PUT UP FREESTANDING E.D.'S AND PLACE THEM IN THE COMMUNITY. STAFF THEM. FOR YOUR STAFF OR YOUR EMPLOYEES FOR THE COMMUNITIES TO ATTEND [00:10:03] TO. THEY GET GOOD CARE. REALLY GOOD CARE. OR ANOTHER WAY IS TO PUT PRIMARY CARE AND SPECIALTY CARE IN CLINICS CLOSER. WE HAVE CHOSEN THE SECOND. FOR AT LEAST A COUPLE OF REASONS. IT SETS UP A RESPONSIBILITY AND A CODE RESPONSIBILITY WITH PATIENT. LEARNING AND ASSUMING RESPONSIBILITY FOR OUR HEALTH CARE. IT SETS UP THOSE, AND WE ARE IN DIRE NEED OF THAT. WE SET UP 26 PRIMARY CARE PROVIDERS. NURSE PRACTITIONERS, INTERNAL MEDICINE, FAMILY PRACTICE. COMMISSIONERS, JUDGE, WE NEED ABOUT 1 $162 OF THOSE. IF YOU GO TO PORTLAND, FOR OUR CLINIC, IT MIGHT TAKE YOU 90 DAYS TO GET IN. OVER ON THE ISLAND, WHERE WE HAVE THE ONLY CLINIC THROUGH THE HEALTH SYSTEM, IT WILL TAKE YOU 30-40 DAYS. WE DON'T NEED THREE PROVIDERS ON THE ISLAND. WE NEED SIX. WE NEED SIX PROVIDERS AT LEAST ON THE ISLAND. WE NEED ANOTHER 10-15 ON THE SOUTH SIDE OF TOWN BY SPOHN SOUTH. WE NEED SIX PROVIDERS AT LEAST IN PORTLAND. WE NEED PROVIDERS IN ROCKPORT. MATHIS. WE NEED CARE WITH THE COLLABORATION OF THE HOSPITAL DISTRICT FOR THE UNDERSERVED AREAS. ALL WE UTILIZE IN TECHNOLOGY, ARE WE UTILIZING OUR BUS SYSTEM, OUR EXTENDERS TO MAKE SURE WE ARE CARING FOR THOSE. SPOHN IS BLESSED TO SERVE THE POOR. THAT HAS BEEN OUR MISSION SINCE THE FOUNDING OF THOSE BEFORE ME. SPOHN IS FULLY COMMITTED TO THIS PART OF THE COASTAL BEND. TO THE COASTAL BEND. TO THIS PART OF TEXAS. THE NEEDS OF THIS COMMUNITY ARE THERE. THEY ARE AROUND INTERNAL MEDICINE, FAMILY MEDICINE. THEY ARE AROUND NEUROLOGY. WE HAVE A REAL DEFICIT. THEY ARE AROUND GASTROENTEROLOGY. WE WILL HAVE A REAL DEFICIT. THEY ARE AROUND ELECTROPHYSIOLOGY WHEN IT COMES TO CARDIOLOGY. WITH DOCTORS COMING IN FROM OUT OF TOWN. WE WILL CONTINUE THOSE COMMITMENTS TO GROW THOSE. TO GET BACK TO OUR RELATIONSHIP WITH THE HOSPITAL DISTRICT, IT IS ONE THAT WE ARE PROUD OF. AND IT IS A PARTNERSHIP. THAT WILL CONTINUE, AND IT WILL GO. IT WILL GROW WITH THAT COLLABORATION OF THE TEAM. IT WILL GROW IN THE AREAS THAT THE COMMUNITY NEEDS. WE WILL UTILIZE TECHNOLOGY. THIS IS A VERY DIFFERENT ENVIRONMENT THAN IT WAS IN 1997. WHEN THIS AGREEMENT BEGAN. THAT IS MORE IMPORTANT, I BELIEVE, THAN EVER. GIVEN WHERE WE ARE IN HEALTH CARE. GIVEN THE COST. THE COST OF SEEING A PATIENT-- THE COST OF SEEING A DOCTOR IN A PRIMARY CARE CLINIC PALES IN COMPARISON TO THE COST TO THE RESIDENTS, TO EMPLOYERS, OF GOING TO AN E.R. WE HAVE MADE THE COMMITMENT IN THE E.R. SETTING. THE COMMITMENTS IN THE E.R. SETTING. FOR THE BEST CARE. THE BEST CARE AROUND. THERE ARE FOUR LARGE E.R.S IN TOWN. TWO BY SPOHN. TWO BY HCA. ONE HAS A RESIDENCY PROGRAM. WE WILL GO BACK TO A SETTING THAT HAS E.R. DOCTORS, BOARD E.R. DOCTORS, THE RIGHT COMPLEMENT OF THEM, THE RIGHT SETTING FOR THEM TO PROCEED. WE WILL FOCUS OUR TIME AND OUR RESOURCES ON WHAT WE SPOKE OF JUST NOW. I REALIZE, I REALIZE THE HARDEST-- THIS HAS BEEN THE HARDEST DECISION OF MY CAREER. IT IS. BAR NONE, THIS IS WHERE MY FAMILY RECEIVES CARE. I'M COMMITTED, JUDGE, COMMISSIONERS, YOU MENTIONED A GROUP COMING TOGETHER. I'M COMMITTED TO BEGIN THAT WITH THE MEETING. WE MET THIS MORNING. COMMISSIONER CHESNEY, THANK YOU. COMMISSIONER MAREZ, THANK YOU. IT WAS OPEN. IT WAS DELIBERATE. IT WAS PROFESSIONAL. SPOKE TO THE NEEDS OF THE COMMUNITY. I BELIEVE IT IS YOUR CALL, JU JUDGE. INCLUDE A MEMBER OF THE HOSPITAL DISTRICT. WHATEVER YOU MIGHT THINK. THERE HAS BEEN INFORMATION POSTED ON SOCIAL MEDIA THAT ATTACKS ME PERSONALLY. I THINK THAT COMES WITH THE JOB. NOT THAT IT HAS DO, BUT IT DOES. OKAY? THAT HAS NOT BEEN POSTED BY SPOHN. I REALIZED EARLIER A BIT AGO, THAT A PRIVATE CONVERSATION WITH THE FACULTY WAS RECORDED. NOW THE PRESS HAS IT. OKAY. THERE IS NOTHING IN THAT MEETING THAT I'M CONCERNED ABOUT. NOTHING. BUT I AM CONCERNED THAT THE NEXT MEETING I HAVE TO GO TO, WE HAVE TO OUT OUR PHONES BECAUSE WE DON'T TRUST EACH OTHER. THE MEETING TODAY WAS NOT RECORDED WITH COMMISSIONER CHESNEY, COMMISSIONER MAREZ. IT WAS A MEETING TO GET TO SOME SOLUTIONS AND PROBLEM-SOLVING. I WOULD HAVE TO SAY IT SHOULD INVOLVE OTHER SPECIALTIES THAT ARE SO DESPERATELY NEEDED. [00:15:02] AND ALL ENVIRONMENTS HAVE SECURE RESOURCES. THE STUDIES I JUST NOTED ARE FROM THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS. NOT FROM SPOHN. THE PROGRAM WAS NEEDED IN 2007. THERE WERE THREE RESIDENCY PROGRAMS. 18 NOW. THOSE RESOURCES ARE NEEDED IN OTHER AREAS. WE WILL CONTINUE TO RESOURCE EVERY DEPARTMENT. THE E.R., RADIOLOGY, ANESTHESIA, PATHOLOGY. SPECIALTIES THAT I MENTIONED, AND OTHERS. WE WILL CONTINUE TO PROVIDE CAPITAL THAT NO OTHER COMPANY WILL MATCH IN THIS AREA FOR HEALTH CARE. NONE. WE WILL CONTINUE TO RECRUIT INTO TOWN THOSE PHYSICIAN THAT IS ARE HERE FULL-TIME. I THANK YOU FOR THE TIME. I THANK YOU FOR THE TIME, COMMISSIONERS. >> THANK YOU. AND I APPRECIATE YOU YOUR WILLINGNESS TO SERVE ON THIS COMMITTEE AND LEAD THE COMMITTEE. I WOULD ASK ALL MEMBERS THAT WE ASK TO SERVE ON THIS IN THE FUTURE IN ORDER TO MOVE FORWARD WITH SOLUTIONS THAT THERE IS NO SECRET RECORDINGS. THIS IS A WORKING COMMITTEE. >> JUDGE, I'M WILLING TO MEET WITH COMMISSIONERS. IN I'M A HOSPITAL DISTRICT MEMBER. I'M NOT SAYING THAT CAN'T EVOLVE INTO SOMETHING ELSE RIGHT NOW. >> I WOULD ASK YOU TO RECONSIDER AND AT LEAST TO HAVE A COMMUNITY ADVOCATE. KAREN URBAN HAS OFFERED TO SERVE ON THIS. AND AT LEAST A DOCTOR FROM THEIR SIDE. WE CAN'T REALLY HEAR ISSUES OR FIND PROBLEMS OR SEE WHERE WE CAN MEET IN THE MIDDLE IF WE DON'T ALLOW BOTH SIDES IN. I WOULD ASK YOU TO SERIOUSLY RECONSIDER. I HOPE THAT YOU WOULD. I WOULD ASK ANYONE WHO STEPS UP TO DO THIS TO DO THIS IN GOOD FAITH. THIS IS FOR OUR COMMUNITY. THIS IS NOT ABOUT GETTING ON THE NEWS OR GETTING A GOTCHA MOMENT OR RECORDING SOMEONE WITHOUT THEIR KNOWLEDGE. OR FINDING SOMETHING TO MOVE FORWARD. THIS IS ABOUT FINDING SOLUTIONS FOR OUR COMMUNITY AND MOVING FORWARD IN THE BEST INTEREST OF OUR CITIZENS. >> I WAS NOT AWARE I WAS BEING RECORDED. I WILL REINFORCE THAT. I WILL RECONSIDER, AT YOUR REQUEST. I CAN'T GIVE YOU AN ANSWER RIGHT NOW. BUT I WILL, JUDGE. >> JUDGE, I WANT TO CLARIFY ON THAT. SINCE-- I'M NOT PUBLIC. I'M JUST RESPONDING. >> HE DID A PRESENTATION. THIS IS FINE. WE CAN TALK. THIS IS ALL ABOUT THIS. HE WAS SCHEDULED TO SPEAK. NO. NO. PUBLIC COMMENT IS NO TALKING. YES. HE DID A PRESENTATION. WE ARE GOING TO ALLOW ONE DOCTOR TO DO THE SAME. THEN WE WILL DO PUBLIC COMMENT. >> YEAH. I DEFINITELY WANT TO HEAR THE PRESENTATIONS. I AM DISAPPOINTED. WE HAD THIS CONVERSATION OUT OUTSIDE. ALL THE PROGRESS THAT WAS MADE THIS MORNING, YOU ARE KIND OF THROWING OUT THE WINDOW IF YOU DON'T RECONSIDER. YOU GAVE COMMISSIONER F MAREZ AND ME YOUR WORD THAT YOU WOULD DO THIS. I UNDERSTAND THAT SOMETHING HAPPENED BETWEEN WHEN WE MET, THAT YOU JUST DICTATED OR TALKED ABOUT, WHERE SOMEONE SENT SOME RECORDING OF SOME MEETING THAT I DON'T KNOW ANYTHING ABOUT AND QUITE HONESTLY, IT IS NOT MY BUSINESS. WHAT YOU ARE DOING, SO THAT WE ARE CLEAR, IF YOU DON'T WANT TO MEET IN THIS GROUP, THAT IS UP TO YOU. YOU ARE THEN GOING BACK ON YOUR WORD TO ME AND COMMISSIONER MAREZ THAT YOU WOULD HAVE THAT CONVERSATION BECAUSE I GET THAT YOU ARE UPTIGHT ABOUT THAT. AND YOU HAVE A LACK OF TRUST. IF YOU DON'T THINK ALL OF THESE PEOPLE IN THE ROOM HAVE A LACK OF TRUST WITH YOU, YOU ARE MISCALCULATING. THEY ARE STILL WILLING TO SIT IN A ROOM WITH YOU. THEY DON'T HAVE MUCH TRUST IN YOU RIGHT NOW. I WOULD ASK STRONGLY THAT YOU CONSIDER BASED ON THE FACT THAT YOU DID GIVE COMMISSIONER MAREZ AND MYSELF YOUR WORD, THAT YOU WOULD HAVE THAT MEETING. LET ME TELL YOU. FEELINGS ARE HURT. YOU AND I HAD A GREAT CONVERSATION TODAY. MY FEELINGS WERE HURT BIG-TIME BECAUSE I GOT BLINDSIDED BY THIS LIKE EVERYBODY ELSE DID. HOSPITAL DISTRICT BOARD MEMBERS THAT I TALKED TO GOT BLINDSIDED. SPOHN ADVISORY BOARD MEMBERS GOT BLINDSIDED. SO IF YOU DON'T THINK MY FEELINGS WERE HURT, AS YOU SAW IT THIS MORNING, BUT WE GOT THROUGH IT. WE WORKED THROUGH IT. WE CAME UP WHAT I THOUGHT WAS A REASONABLE PLAN. YOU DIDN'T COMMIT TO ANYTHING. I DIDN'T COMMIT TO ANYTHING. YOU COMMITTED TO YOUR POSITION. I COMMITTED TO MINE. I THINK YOUR DECISION IS WRONG. YOU THINK THAT I'M WRONG IN MY DECISION. WE COMMITTED TO SIT DOWN AND HAVE, AS I CALLED THEM, THE PEACE TALKS. >> YES, SIR. >> BEFORE WE GO TO WAR. AND NOW IF YOU ARE BACKING OUT OF THE PEACE TALKS, THAT PUTS ME IN A REALLY BAD SPOT. BECAUSE THERE IS NO POINT IN GOING AND HAVING A MEETING IF THEY ARE NOT INVOLVED AND INCLUDED IN THIS BECAUSE I CAN'T SPEAK FOR THEM. THE HOSPITAL DISTRICT CAN'T SPEAK FOR THEM. YOU CAN'T SPEAK FOR THEM. THE JUDGE-- IF THEY ARE NOT IN THE ROOM, THERE IS NO POINT IN EVEN HAVING THAT MEETING. WE MIGHT AS JUST-- WE MIGHT AS WELL JUST GO DOWN THE ROAD AND SEE HOW IT FALLS. I'M SUPER DISAPPOINTED. >> I WAS TOO, SIR. >> WHAT HAPPENED TO YOU DIDN'T HAPPEN TO YOU BECAUSE I DID IT. OR COMMISSIONER MAREZ DID IT. YOU GAVE YOUR WORD TO US. IF YOU NEED TO COOL DOWN ABOUT IT, I GET IT. [00:20:01] WE HAVE ALL BEEN UPTIGHT ABOUT. THIS I'M TRULY ASKING YOU TO RECONSIDER THIS AND COME INTO IT BECAUSE I REALLY FELT GOOD COMING OUT OF THAT MEETING. THAT WE WERE GOING TO GO IN WITH OPEN MINDS AND OPEN HEARTS AND REALLY TRY TO SEE. WE TALKED ABOUT HOW MAYBE THE COMMUNITY WOULD STEP UP. MAYBE THE HOSPITAL NEEDS TO DO MORE. YOU KNOW, WE TALKED ABOUT A LOT OF WHAT-IFS. IF WE CAN'T GET IN THE ROOM WITH THE PEOPLE THAT MAKE THE DIFFERENCE, THEN I DON'T KNOW WHAT TO DO. BECAUSE I DON'T HAVE THE EXPERTISE THAT THESE DOCTORS HAVE. TO BE ABLE TO TALK-- YOU KNOW, I GOT THEIR INFORMATION. I CAN'T TALK IT LIKE THEY. CAN I DON'T LIVE IT. I DON'T BREATHE IT. I'M TRYING TO ADVOCATE FOR THEM THE BEST WAY I KNOW HOW TO. SO PLEASE RECONSIDER THAT DECISION BECAUSE-- YOU KNOW, YEAH. I'M NOT SEEING SOMETHING HANDLED LIKE THIS IN A LONG TIME. I'M TRYING TO GET BACK ON TRACK. FORGET THE EGOS AND THE PERSONALITIES. FORGET ALL THE EMOTION. LET'S SEE IF WE CAN HELP THIS COMMUNITY. I'M ASKING YOU TO DO THE SAME THING YOU ASKED ME TO DO THIS MORNING. HEY, LET'S PUT IT ASIDE AND WORK THROUGH THIS. PLEASE DO THAT. THIS IS A SUPER EMOTIONAL ISSUE. IT IS A FACTUAL ISSUE. I MEAN, I MET WITH THE DOCTORS BEFORE I MET WITH YOU. I TOLD THEM, LOOK, I'M NOT SAYING DON'T BRING YOUR EMOTION. THAT IS IMPORTANT. BRING ME FACTS. I NEED FACTS. BECAUSE SPOHN SAYS THIS. AND I NEED REBUTTAL FOR FACTS. SO THAT WE CAN HAVE AN INTELLECTUAL DISCUSSION. NOT AN EMOTIONAL ONE. >> YES, SIR. >> IF YOU WON'T COME TO THE TABLE, IT IS GOING TO BE HARD TO HAVE A DISCUSSION. >> COMMISSIONER CHESNEY, YES, SIR. IT WAS A PLEASURE SEEING YOU TUESDAY EVENING. >> SAME SORRY. >> I HAD THE PLEASURE OF SEEFING YOU TUESDAY EVENING. I MENTIONED I MADE MYSELF AVAILABLE. YOU CALLED THIS MORNING AND I DROPPED EVERYTHING. IT IS NEEDED. >> THERE IS NO PATCH. NO BLUE STARS. >> I APPRECIATE IT. >> I APPRECIATE THE TIME. I VERY MUCH ENJOYED THE CONVERSATION THIS MORNING. COMMISSIONER MAREZ, COMMISSIONER CHESNEY. IT WAS HONEST, STRAIGHTFORWARD. I TOLD YOU THE STORY OF A DO DOCTOR. I WILL TELL YOU WHAT IS ON MY MIND AND WHAT I THINK AND WHAT I FEEL. THAT WAY I DON'T HAVE TO REMEMBER WHAT I SAID. THAT IS WHAT I DID. OKAY? I WILL RECONSIDER. RIGHT NOW, SIR, I CANNOT GIVE YOU THAT WORD. I WILL FOLLOW UP. THIS WILL NOT LANGUISH. RIGHT NOW, THERE IS DISAPPOINTMENT ON ALL SIDES. THE COMMITMENT SPOHN HAS IS IRONCLAD. YOU WANTED INFORMATION. THAT IS FROM THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS. THAT IS NOT FROM SPOHN. THAT IS THE NUMBER OF RESIDENCY PROGRAMS TODAY AND 2007. THOSE ARE THE TRUE NUMBERS. THE CAPITAL COMMITMENT TO REGION. THOSE ARE TRUE NUMBERS. THE NUMBER OF PEOPLE EMPLOYED BY SPOHN. AND THE $285 MILLION IN YEARLY SALARIES AND BENEFITS THAT GO TO THOSE, THAT CLEAN OUR HOSPITALS AND DO THE WORK. >> LET ME BE CLEAR, THOUGH, ALSO. THIS COMMITTEE IS GOING FORWARD. WE WOULD LOVE TO HAVE YOUR INPUT. I BELIEVE IT IS VITAL TO HAVE YOUR INPUT ON IT. BUT WE ARE GOING TO GO FORWARD WITH THIS COMMITTEE, AND YOU ARE NOT THERE, THEN SPOHN IS THE ONE LOSING OUT WITH THE INFORMATION THAT THEY CAN'T SHARE. >> JUDGE, THANK YOU. COMMISSIONERS, THANK YOU. >> I WOULD ASK WHO IS GOING TO BE PRESENTING FOR THE PHYSICIANS. YOU WILL GET TEN MINUTES OR JUST LIKE THE OTHER, AND THEN ALL THE OTHER DOCTORS WILL GET THE PUBLIC COMMENT. ANYONE THAT WISHES TO SPEAK IN THE TIME THAT WE HAVE LEFT, WE WILL GET YOU ALL UP THERE AS MANY AS WE CAN. I WILL STATE AGAIN, THAT WE ARE GOING TO FORM THIS COMMITTEE. I WOULD LIKE FOR IT TO BE TWO PEOPLE FROM SPOHN, TWO PEOPLE FROM THE HOSPITAL DISTRICT BOARD, TWO FROM OUR COMMISSIONER'S COURT, COMMISSIONER CHESNEY AND COMMISSIONER MAREZ HAVE ALREADY AGREED. I HAVE TALKED TO KAREN URBAN. SHE HAS AGREED TO SERVE AS WELL. I WOULD LIKE TO HAVE TWO PHYSICIANS THAT ARE WILLING TO OPENLY COME IN AND DISCUSS THIS THING. NO RECORDINGS FROM ANYONE. I WOULD LIKE ALL OF YOU TO COMMIT TO THAT. THAT WE WANT SOLUTIONS WITH THIS COMMITTEE. OR AT LEAST UNDERSTANDING. MOVING FORWARD. AND YOU HAVE TO HAVE THE RIGHT HEART IN COMING FORWARD AND WANTING THE BEST FOR THIS COMMUNITY. THANK YOU. I'M SORRY. IF YOU WILL STATE YOUR NAME. I HAVE A WHOLE LIST OF DOCTORS UP HERE. YES. >> MY NAME IS JOHN HERRICK. I'M ONE OF THE ASSOCIATE PROGRAM DIRECTORS FOR THE PROGRAM. WE DID ALL PLAN ON SPEAKING, BUT I CAN TRY AND SUMMARIZE AS MUCH AS WE CAN IN TEN MINUTES. SO WE CAN PROCEED. FIRST, AS I MENTIONED, MY NAME IS JOHN HERRICK. I FIRST CAME TO CORPUS IN 1997. FOR A ONE-MONTH MEDICAL STUDENT ROTATION. THAT ROTATION WAS ANOTHER HOSPITAL. I BECAME VERY INTRIGUED BY MEMORIAL MEDICAL CENTER. MY DREAM WAS TO WORK TEACHING RESIDENT AND TO WORK AT A COUNTY HOSPITAL WITH UNDERSERVED PATIENTS WHERE I FELT LIKE I COULD REALLY MAKE A DIFFERENCE. AT THAT TIME, THERE WAS NO EMERGENCY MEDICINE RESIDENCY HERE. I HAD TO GO TO NEW YORK TO GET THE TRAINING THAT I NEEDED. I KEPT THE NAMES OF CONTACTS IN CORPUS CHRISTI. [00:25:01] I CHECKED IN PERIODICALLY. I HEARD IN 2005 THAT SPOHN WAS WANTING TO START AN EMERGENCY MEDICINE RESIDENCY. THERE WERE GREAT JOBS ALL OVER THE COUNTRY. I FELT THAT MEMORIAL WAS A PERFECT FIT FOR ME. I MOVED HERE IN 2006. WE THEN GOT THE PROGRAM ACCREDITED AND TOOK OUR FIRST RESIDENTS IN 2007. I REMEMBER LEARNING ABOUT NCHD, NUECES AID, THE CLINIC CARD ON MY FIRST SHIFT IN 200 #. THIS WAS AN AMAZING PROGRAM. I HAD COME FROM NEW YORK CITY. I HAD BEEN IN OHIO. I NEVER HAD SEEN ANY PROGRAM THAT CAPTURED SO MANY VULNERABLE PATIENTS AND GAVE THEM CARE. THEY USUALLY FALL THROUGH THE CRACKS. WITH NUECES AID AND NCHD, THEY DID NOT. WE ARE THE FACE OF NCHD. WHEN A NUECES AID PATIENT HAS AN EMERGENCY, THEY COME SEE THESE DOCS. WHEN THEY HAVE A HEART ATTACK, A STROKE, A MAJOR TRAUMA, THESE ARE THE DOCS THAT TAKE CARE OF THEM. WE CONSIDER IT A GREAT PRIVILEGE TO TAKE CARE OF THE NCHD PATIENTS. WE MAKE SURE THAT THEY ARE TREATED WITH THE UTMOST DIGNITY AND RESPECT. WHEN WE ARE GONE, SHORELINE IS MOST LIKELY TO BE STAFFED BY REPLACEMENTS THAT WILL FLY IN AND OUT. THEY GENERALLY WORK A FEW SHIFTS AND THEN GO TO THEIR RESPECTIVE CITY OR WHEREVER THEY LIVE. THEY WON'T KNOW WHAT NCHD IS, LIKE WE DO. I JUST FEAR THAT WITH THE ENDING O'. >> THIS RESIDENCY, THE CARE OF THE NCHD PATIENTS WILL BE FOREVER ALTERED. I WILL TOUCH ON SOME OF THE ECONOMIC SUMMARY. SOME BACKGROUND. NUECES AID CONTRACT STIPULATES THAT TWO PROGRAMS MUST EXIST. ELIMINATING EM RESULTS IN ONLY ONE PROGRAM. A FELLOWSHIP WITH TWO FELLOWS IN JER RAT RICKS GERIATRICS OR OBSTETRICS IS NOT EQUIVALENT. AT THE TIME OF THE INITIAL CONTRACT, THERE WERE ONLY FM AND EM RESIDENCIES. THE DEFINITION OF A RESIDENT IS NOT EQUIVALENT TO A FELLOW. FELLOWS ARE GRADUATED RESIDENTS THAT ARE UNDERGOING ADDITIONAL SUB-SPECIALTY CERTIFICATION THAT IS COMPLETED AFTER BECOMING A FULLY TRAINED AND BOARD-ELIGIBLE OR BOORT-CERTIFIED PHYSICIAN. THERE IS ALSO GOING TO BE SIGNIFICANT DOWNSTREAM EFFECTS. NOT JUST IN THE E.R. MANY OF THE TRAUMA SURGEONS HAVE COME TO US. ONE THAT IS GOING TO SPEAK TO TODAY, AND THE SERVICE WOULD BE GREATLY DISRUPTED. THE SURGEONS COME AND TAKE JOBS HERE BECAUSE OF WORKING WITH THE RESIDENTS. THERE WOULD BE SUBSTANTIAL ATTRITION OF OUR TRAUMA SURGEONS. SOME OF WHOM HAVE ALREADY SAID THEY ARE GONE. AND THEY FEEL THAT THE LEVEL TWO TRAUMA DESIGNATION WOULD BE AT RISK. EXPENSE TO HIRE NURSE PRACTICERS, ADDITIONAL TRAUMA SURGEONS, FAR NEGATES ANY COST SAVINGS BY THE CHRISTUS SYSTEM. THE LAG TIME TO RECRUIT THE TEAM OF SURGEONS AND NURSE PRACTITIONERS OR PAS NEEDED WOULD NOT KEEP PACE WITH THE RATE OF THE EM RESIDENTS LEAVING OR GRADUATING AND PUT THE LEVEL TWO TRAUMA ACCREDITATION AT RISK. THE AMERICAN COLLEGE OF SURGEONS JUST PERFORMED A SURVEY WITH US. THEY CITED THE RELATIONSHIP BETWEEN THE TRAUMA SERVICE AND THE ED, MAINLY THE EM RESIDENTS AS A MAJOR STRENGTH OF OUR TRAUMA PROGRAM. WE HAVE A LOT MORE THAN TEN MINUTES HERE. I'M GOING TO START SUMMARIZING. FREELANCE. ONE OF THE OTHER THINGS THAT JUST CAME UP IS THA THE RESIDENTS WILL NOT-- NO ONE WILL HAVE TO LEAVE. THEY WILL GO THROUGH 2026. AND TO BE ACCREDITED, THERE ARE SIGNIFICANT HURDLES TO THAT. YOU HAVE TO HAVE AT LEAST 18 RESIDENTS AT ALL TIME TO BE AN ACCREDITED PROGRAM AND MAINTAIN. THAT THEY ARE PROPOSING TO PHASE OUT 12 PER YEAR. EVEN BY DEFINITION, IN THE THIRD YEAR, YOU WOULD NOT HAVE 18 RESIDENTS. WE DON'T KNOW IF SPOHN WENT TO THE ACDME AND GOT SPECIAL PERMISSION TO DO A PHASE-OUT OR IF THEY DIDN'T KNOW ABOUT THE REGULATIONS. WE DON'T KNOW. WHAT THE PHASE-OUT IS BASED ON. THAT IS NOT BEEN SHARED WITH US. >> SOUNDS LIKE A GOOD QUESTION FOR THE GROUP. YES. >> COMMUNITY IMPACTS. WE HAVE A TRACK RECORD OF STRONG COMMITMENT TO OUR COMMUNITY. GO BACK TO THE COVID DAYS. THE HOSPITAL WAS FAR OVERWHELMED WITH THE NUMBER OF DOCTORS NEEDED, AND USUALLY, THE SYSTEMS DON'T CROSS. THERE IS I.C.U. DOCTORS, THERE IS E.R. DOCTORS. IN JULY, WHEN COVID HIT, THERE WAS AN I.C.U. NORMALLY TAKING [00:30:03] CARE OF 40-50. THEIR SERVICE SWELLED TO 150. SPECIAL SHIFTS WERE CREATED. I WORKED THE FIRST DAY. WE ALL WORKED EXTRA SHIFTS. NOT IN THE E.R. UPSTAIRS, TAKING CARE OF COVID PATIENTS, MANAGING THE VENTS, RUNNING THE CODES. AND WITH THE LOSS OF A RESIDENCY, YOU ARE LOSING 36 BODIES F FOR THE NEXT PANDEMIC. CORPUS WOULD BE DIFFERENTLY STAFFED. (INAUDIBLE). >> VENTILATORS. EMERGENCY MEDICINE PHYSICIANS ARE SKILLED IN CRITICAL CARE, ABLE TO TAKE CARE OF VENTILATORS. AND INTUBATE PATIENTS, PLACE CENTRAL LINES, ADVANCED. >> THANK YOU. >> ALONG THAT SAME LINES IS HURRICANES. WERE PRONE-- WE ARE PRONE TO HURRICANES. WHEN THE LAST MAJOR HURRICANE, WE DIVIDE UP INTO TEAMS. WE STAY. WE DON'T LEAVE. IF YOU HAVE OUT-STAFFED PHYSICIANS FLYING FROM OUT OF TOWN THAT ARE NOT EVEN HERE, THEY ARE NOT EVEN GOING TO BE ABLE TO GET HERE TO WORK THEIR SHIFTS. WE LIVE HERE. WE STAY HERE. WE TAKE CARE OF THE PATIENTS. HOW MANY HOURS DID PEOPLE STAY? 72 HOURS IN THE HOSPITAL. SLEEPING IN THE HOSPITAL. >> WE WILL HAVE TO ASK YOU TO WAIT UNTIL YOUR PUBLIC-SPEAKING, PLEASE, BEFORE THIS GETS OUT OF HAND. >> THE COMMUNITY WOULD BE MUCH LESS PREPARED FOR A FUTURE NATURAL DISASTER. JUST SOME OF THE PERSONAL AND BUSINESS IMPACTS. 50 FAMILIES MOVED HERE WITH THE RESIDENTS WE HAVE. 36 RESIDENTS AND 16 FACULTIES. THERE HAS BEEN MENTION THAT THEY WOULD FIND OTHER ROLES IN SPOHN. WE ARE ALL EMERGENCY MEDICINE TEACHERS. SO THERE IS NO OTHER EMERGENCY MEDICINE ROLE SIMILAR. THERE IS NO OTHER JOB FOR US IN THE SPOHN SYSTEM. THE NEXT CLOSEST EMERGENCY MEDICINE RESIDENCIES ARE SAN ANTONIO, AUSTIN, AND HOUSTON. THERE ARE NO EQUIVALENT ROLES IN THE SYSTEM. FOR US. WE HAVE TALKED ABOUT THE TRAUMA SERVICE. TALK A LITTLE BIT ABOUT THE FINANCES OR THE UNAFFORDABILITY OF THE RESIDENCY. WE STAFF THE EMERGENCY DEPARTMENT WITH SIX DOCTORS. TWO ATTENDINGS. I'M AN AEND THE ATTENDING. AND FOUR RESIDENTS AT ALL TIMES. THEY ARE ALSO PHYSICIANS. THERE ARE SIX PHYSICIANS IN SPOHN E.R. AT ANY TIME. IF FOUR ARE GONE, MAYBE THEY COULD GET BY WITH-- IF FOUR RESIDENTS ARE GONE. AND THERE ARE TWO ATTENDINGS. JUST TO PAY FOR TWO MORE OF US IS APPROXIMATELY $5 MILLION IS WHICH IS THE WHOLE COST OF THE RESIDENCY RIGHT THERE. THAT IS NOT INCLUDING ON THE TRAUMA SERVICE AND THE NICU. THEY WORK HARD. THEY WORK 80 HOURS A WEEK WHEN THEY ARE ON THE MICU. TO REPLACE WITH A NURSE PRACTITIONER THAT WORKED 40 HOURS A WEEK, THE TRAUMA TEAM, THE TRAUMA DIRECTOR ESTIMATES THAT HE WOULD NEED FOUR TO SIX NURSE PRACTITIONERS TO REPLACE ON HIS SERVICE AT THREE TO FOUR TIMES THE COST. THE FINANCIAL-- OTHER PEOPLE HAVE CALLED. WHEN I TALK TO OTHER C.E.O.'S. THEY DON'T GET IT. AS FAR AS THE COST FOR THAT, OTHER CITIES ARE CLAMORING TO START EMERGENCY MEDICINE PROGRAMS. SOMETIMES FOR THE WRONG REASONS. SOMETIMES BECAUSE THEY ARE SO PROFITABLE. THEY PROVIDE SO MUCH LABOR FOR THE HOSPITAL. WE HAVEN'T BEEN-- WE DON'T KNOW WHAT SPOHN IS DOING DIFFERENTLY THAT EVERYONE ELSE IS WANTING TO START. WE ARE THE ONLY ONE IN THE COUNTRY BEING CLOSED. >> WE ARE ABOUT AT THAT TIME DUE. ANY OF THE COMMISSIONERS HAVE ANYTHING YOU WANT TO SAY BEFORE WE MOVE INTO PUBLIC COMMENT? I WOULD LIKE TO ASK IF, YOU KNOW, IF YOU COULD GET BACK TO ME WITH TWO NAMES OF PHYSICIANS THAT ARE WILLING TO PARTICIPATE IN THIS WITH THE REQUIREMENTS THAT I ASKED. AND IF YOU COULD GET BACK TO ME ANY TIME SOON, WE WOULD LIKE TO GET THIS STARTED AS SOON AS POSSIBLE. YES. I KNOW WE HAVE SOME HOSPITAL DISTRICT BOARD MEMBERS. I WOULD ASK ART GRAS THAT DOE IF HE WOULD SERVE AS WELL. I SEE DR. READY IN THE BACK. IF THE TWO OF YOU WOULD AGREE [00:35:02] RIGHT NOW, THEN I HAVE MY COMMISSIONERS, THE HOSPITAL DISTRICT, AND HOPEFULLY, ANOTHER ONE FROM SPOHN. AND THEN THE TWO DOCTORS. I KNOW KAREN URBAN HAS ALREADY AGREED. THE SOONER WE GET THIS MOVING, THE BETTER DISCUSSIONS CAN BE MADE. I'M NOT SURE WHAT KIND OF SOLUTIONS WE CAN FIND. WE ALL WANT TO DO WHAT'S BEST FOR THIS COMMUNITY. >> I APPRECIATE THAT. THANK YOU, JUDGE SCOTT. THANK YOU, COMMISSIONER. >> YES, PLEASE. >> DR. HERRICK, WE GOT SOME INFORMATION PROVIDED TO US. IT WASN'T SIGNED BY ANYBODY IN PARTICULAR. I DON'T KNOW WHO SUBMITTED IT. >> WE AS A GROUP WORKED ON THAT. THAT DOCUMENT. >> OKAY. THAT WAS SUBMITTED BY YOU AS A GROUP OF DOCTORS? >> YES, YES. >> NEXT TIME, JUST PUT A SIGNATURE ON IT. (LAUGHTER). >> THIS IS MY FIRST TIME BEING IN A FORMAT. I'M A LITTLE NERVOUS. NEXT TIME I WILL BE BETTER. >> IT IS OKAY. WE WANT TO MAKE SURE IT IS FROM YOU. (LAUGHTER). >> SO THE QUESTION THAT I HAVE HEARD A LOT ABOUT IS ON THE RETENTION. WE DON'T RETAIN LOT OF DOCTORS OUT OF THE PROGRAM. CAN YOU KIND OF TALK TO THAT SPECIFICALLY A LITTLE BIT, TOO? >> DEFINITELY. >> THERE IS SO MUCH GOING AROUND. I DON'T KNOW WHAT. >> SO I CAN LOOK AT THESE THREE GENTLEMEN RIGHT HERE. THESE ARE ALL GRADUATES OF THE PROGRAM THAT DR. BRODEUR, WE KEPT STRAIGHT OUT OF RESIDENCY. DR. PETER SON HAD A FOUR-YEAR MILITARY COMMITMENT AND SERVED. AND CAME RIGHT BACK. DR. CAMBRON WENT SOMEWHERE ELSE FOR A YEAR BUT JUST GOT BACK HERE AS SOON AS HE CAN. YOU KNOW, OUTSIDE OF THAT, WE HAVE ABOUT A 50% RETENTION RATE HERE, AND IT IS NOT JUST, IT IS NOT JUST SPOHN. THERE ARE OTHER COMPETITORS IN TOWN. THTHERE IS PHYSICIAN'S PREMIER. THEY HAVE FIVE LOCATIONS IN TOWN. THOSE ARE MOSTLY STAFFED BY OUR GRADUATES. A HUGE PERCENT OF THEM. IN FACT, THREE OF THE MEDICAL DIRECTORS OF THE DIFFERENT PREMIERS ARE ALL OUR GRADUATES. MOST OF THEM AT EMERGENCY MEDICINE AND A HUGE PERCENTAGE OF THE DOCTORS IN TOWN ARE FROM OUR PROGRAM. THAT EXTENDS TO KINGSVILLE. YOU WANTED FACTS. OUT OF THE GRADUATING CLASS, OUT OF THE THIRD-YEARS, THEY ARE ALREADY LOOKING FOR JOBS NEXT YEAR. WE HAVE FOUR THAT WANT TO STAY IN THE COMMUNITY, OUT OF THE CURRENT GRADUATING CLASS. SINCE T THIS HAS HAPPENED, THEY ARE LOOKING ELSEWHERE. THAT IS JUST ANOTHER LOSS AND ANOTHER EXAMPLE. THAT IS AN AVERAGE PERCENTAGE. THAT IS HIGHER THAN I WOULD SAY THE NATIONAL AVERAGE OF RETENTION. WE HAVE-- PEOPLE LOVE CORPUS, AND A LOT OF-- WE'VE GOT PEOPLE THAT HAVE STAYED FROM VERMONT. IT SEEMS LIKE THE FURTHER AWAY, THEY COME AND THEY WANT TO STAY. WE HAVE HAD PEOPLE FROM ALL OVER THE COUNTRY. BECOME CORPUS CHRISTI RESIDENTS. >> YES. OVERALL, I KNOW MOST OF THE STATS. WE HAD 109 OF THE GRADUATES WORK OR PROVIDE SOME DEGREE OF SERVICE. SOME OF THAT WOULD BE MOONLIGHTING OR DURING THEIR THIRD YEAR, AND FILL THE SHIFTS. THAT IS ANOTHER FACTOR. THEY RELY HEAVILY ON OUR RESIDENTS TO STAFF THAT. THOSE ARE ALL GOING TO BE COST-SHIFTED. THERE IS SIGNIFICANT BONUSES AND THINGS LIKE THAT THAT HAVE TO BE PAID. THERE IS A HUGE PIPELINE OF NEEDED FECISIONS-- PHYSICIANS THAT WILL BE LOST. >> AND TO ME, THAT IS VERY ENCOURAGING. HONESTLY, IF YOU DIDN'T RETAIN ANY OF THEM, I WOULD STILL SAY THIS WAS A GREAT PROGRAM. WE GET ALL THESE PEOPLE, WHILE THEY ARE HERE. YOU GET 36 PEOPLE WORKING IN THE COMMUNITY. PLUS THE FACULTY. WHAT ARE YOU-- WHETHER YOU RETAINED THEM OR NOT, IT IS IMPORTANT, BUT IT IS NOT THAT COMPELLING FOR ME. IT IS MORE COMPELLING THAT SIX OUT OF 12 STAYED LAST YEAR. THAT WAS SOME MISINFORMATION THAT WAS AROUND. THAT PEOPLE WEREN'T STAYING HERE. UNFORTUNATELY, THAT IS WHY WE ARE DOING THIS. TO GET THE TRUTH OUT. >> THAT WOULD BE THE NORM. SO LET'S SAY THE MARKETS ARE TIGHTER IN AUSTIN AND PLACES LIKE THAT. SO PEOPLE MAY JUST GO FOR TRAINING AND NOT RETAIN BECAUSE IN THE SAN DIEGOS AND PLACES WITH GREAT WEATHER, PEOPLE ARE JUST ALLOWED TO COME AND TRAIN. THEN THEY HAVE TO LEAVE BECAUSE THERE IS NO SPOTS. THE FACT THAT WE RETAIN ANY PHYSICIAN SOAS THAT THERE IS A NEED HERE FOR THE PHYSICIANS. THE FACT THAT WE HAVE BEEN ABLE TO-- WE HAVE POSITIONS FOR FOUR WAITING SHOWS THAT THERE IS [00:40:05] GREAT NEED FOR. THAT I CAN SPEAK TO, YOU KNOW, THE STUDY THAT WAS JUST QUOTED. THAT IS THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS. OUR SPECIALTY WAS HURT. THEY PREDICTED THERE MIGHT BE AN OVERSURPLUS. THAT CAME OUT IN 2019. I BELIEVE. WHEN THAT STUDY CAME OUT. THEY SAID THERE MIGHT BE A SURPLUS OF EMERGENCY MEDICINE PHYSICIANS. THEY HAVE ALREADY TAKEN THAT BACK. THEY DIDN'T ACCOUNT FOR THE HIGH RATE OF ATTRITION OF PHYSICIANS IN COVID. PEOPLE GOT BURNED-OUT. MANY DIED. WERE PERMANENTLY INJURED. THEY HAVE REVERSED THEIR POSITION ON THAT STUDY. EVEN IN OUR OWN CLASS, WE DID SEE A REDUCTION LAST YEAR IN THE SLIGHT NUMBER OF APPLICANTS. THIS YEAR THAT HAD ALREADY REVERSED. WE HAVE BEEN ASKED, WE HAD TO SHUT DOWN OUR RECRUITING. ON THE FIRST DAY THAT WE OPENED UP OUR RECRUITING, IT IS CALLED THE NEW HAMPSHIRE NATIONAL MATCH PROGRAM. WE HAD 600 APPLICATIONS FOR PEOPLE THAT WANTED TO APPLY FOR OUR PROGRAM. 600 PEOPLE ARE WILLING TO COME TO CORPUS CHRISTI. WE HAVE TO WHITTLE THAT DOWN TO 12. THE FACT THAT THEY SAY THERE IS AN OVERSURPLUS, NOT HERE. YOU KNOW, MAYBE THERE ARE IN THE SAN DIEGOS AND OTHER PLACES THAT PEOPLE REALLY WANT TO GO, BUT I LOVE CORPUS. IT IS A TRADITIONALLY HARD PLACE TO RECRUIT FOR PHYSICIANS. >> I HAVE ALWAYS FELT IF YOU CAN GET PEOPLE HERE, THOUGH, THEY WILL STAY. IT IS HARD TO RECRUIT THEM TO COME HERE UNTIL THEY GET HERE AND REALIZE WHAT A WONDERFUL PLACE IT IS. I MEAN, I HAVE HEARD THAT FROM BUSINESSMEN ALL OVER SOUTH TEXAS. IT IS REALLY HARD TO RECRUIT THEM HERE. THE FACT THAT YOU HAVE THEM HERE AND HAVE THEM CAPTIVE, IF YOU WILL. THEY CAN GET INVOLVED IN THE COMMUNITY. >> WE TRY TO GET THEM HERE TO ROTATE. EVEN AS A MONTH MEDICAL STUDENT. IF WE CAN GET THEM HERE FOR A MONTH, WE KNOW THEY WILL RATE US HIGH. WE CAN GET THEM. YOU KNOW, PEOPLE COME HERE. THEY SEE AMAZING STUFF. CORPUS HAS A LOT OF PATHOLOGY AND A LOT OF SICK PATIENTS. THEY GET TO DO A LOT IN THE RESIDENCY. AND THEY WANT TO COME BACK. THAT IS EXACTLY RIGHT. IF WE GET THEM HERE, WE CAN KEEP A LOT OF THEM. >> WELL, I WILL LET OTHER PEOPLE TALK. ONE THING MR. DOMINGUEZ AND I DID AGREE ON, THE REPUTATION OF YOUR PROGRAM IS SPECTACULAR. IT IS ONE OF THE BEST IN THE COUNTRY. AND SPOHN SHOULD BE PROUD OF. THAT YOU SHOULD BE PROUD OF. THAT AND ALL THE DOCTORS FROM THE ROOM SHOULD BE PROUD OF. THAT THAT IS EVEN MORE BEFUDDLING TO ME THAT WE WANT TO SHUT ONE OF THE BEST PROGRAMS IN THE COUNTRY DOWN. AND WE WANT TO TAKE 52 PEOPLE THAT DO EMERGENCY MEDICINE OUT OF OUR COMMUNITY. THAT DOESN'T MAKE SENSE TO ME. HOPEFULLY, AS WE MOVE FORWARD, WE WILL BE ABLE TO HAVE SOME OF THOSE CONVERSATIONS GOING FORWARD. AGAIN, I WANT TO LET OTHER PEOPLE TALK. I WANT TO CONGRATULATE YOU AND YOUR PROGRAM BECAUSE IT IS-- NOBODY QUESTIONS-- YOU ARE GETTING THE TOP OF THE TOP FROM THE RECRUITS. YOUR TOP THREE MATCHES. YOU ARE GETTING EVERYTHING YOU WANT. AND IT IS BECAUSE YOU ARE SO GOOD. AND BELIEVE ME, NOBODY-- I DON'T THINK ANYBODY IS ARGUING THAT POINT DURING THIS DISCUSSION. CONGRATULATIONS ON THAT. THANK YOU FOR BEING HERE. >> THANK YOU. >> COMMISSIONER MAREZ WOULD LIKE TO SPEAK. >> YES. SURE. >> JUDGE, I THANK YOU FOR CALLING UPON THAT COMMITTEE. I AGREE. YOU KNOW, WE WANT WILLING PARTNERS TO BE PART OF THAT GROUP. WE HOPE THAT EVERY PARTY IS REPRESENTED BECAUSE THAT IS THE ONLY WAY IT IS GOING TO SUCCEED. I WILL SAY THIS PUBLICLY SO WE DON'T FORGET. THERE ARE FUNDING SOURCES THAT WE HAVE LOCALLY, OBVIOUSLY THROUGH THE NUECES COUNTY HEALTH DISTRICT. WE APPRECIATE THEIR PARTNERSHIP THAT HAVE HELPED US THROUGHOUT THE YEARS. WITH THE COUNTY BUDGET. BUT ALSO IS THERE A WAY THAT WE CAN LOOK AT INCENTIVE VISING RECRUITMENT? THE PROGRAM ITSELF MAYBE? RIGHT? WE DON'T KNOW ALL THE DETAILS YET. WE KNOW SOME OF SIT PRO PRY AIR THE. IT IS A STRANGE MIX OF HAVING A NOT FOR PROFIT HOSPITAL WORKING AND DOING THE CARE. THAT IS OUR PART, THAT IS OUR COMMITMENT TO THE COMMUNITY. I THINK OF MY TIME. ANY TIME I'M WITH MY DOCTOR, I ALWAYS FEEL LIKE, YOU KNOW, LIKE WITH A PRIEST. LET ME JUST SPILL ALL MY GUILT. OUT. (LAUGHTER). >> AND SHARE MY ACCOUNTN'T FOR-- ACCOUNTABILITY FOR MYSELF. BUT NOT AS AN EXCUSE. AS AN ELECTED OFFICIAL, IT IS TOUGH. I'M SURE MEDICINE HAS TO BE WORSE. YOU OVEREAT, YOU DON'T EXERCISE. YOU DON'T DO A LOT OF THINGS THAT SNEAK UP ON YOU. I HAVE BEEN IN THOSE BEDS. AT SPOHN QUP SHORELINE. MY FAMILY MEMBERS HAVE BEEN THERE. LOST FAMILY MEMBERS THERE. THE QUALITY OF CARE THAT Y'ALL PROVIDE IS REMARKABLE. [00:45:04] I CAN IMAGINE HOW YOU ALL SURVIVED DURING COVID. I ALWAYS THOUGHT THAT WOULD BE THE TOUGHEST TEST THAT WE FOUND. AND IT IS UFLT UNFORTUNATE THAT THIS DECISION HAS BEEN MADE. I ALWAYS TRY TO BE OPTIMISTIC. IN THAT WE HAVE THIS DISCUSSION TODAY, TO BE ABLE TO MOVE FORWARD. I THANK THE JUDGE FOR CALLING UPON THE COMMITTEE TO COME TOGETHER. I THINK OF MY DAUGHTER. SHE IS A STUDENT RIGHT NOW. ONE OF THEIR CALLS AND ONE OF HER CLASSES-- I DON'T KNOW WHAT KIND OF BIOLOGY OR CHEMISTRY CLASS SHE IS TAKING. SHE IS SO BRILLIANT. THTHEY ARE TALKING ABOUT FINDING THE NEW SET OF-- WHAT IS IT? ANTIBIOTIC-RESISTANT DRUGS OR WHATEVER. RIGHT? SOMETHING LIKE THAT. SHE TOLD ME. IT WENT RIGHT OVER MY HEAD. I WANT HER TO COME BACK ONE DAY. IF SHE GOES INTO MEDICINE, THIS WOULD BE A GREAT PLACE TO START. HOPEFULLY, TO BE CLOSE TO FAMILY. >> YES. >> BUT YOU KNOW, IN LOOKING AT THIS, I FEEL THAT WE ARE TAKING THE RIGHT STEPS. RIGHT? WE CANNOT BE THE ONLY PART OF THE SOLUTION. WE CAN BE A GREAT PART OF IT. RIGHT? SO I HOPE THAT TODAY WITH THIS CALL TO ACTION THAT WE HAVE HAD, FROM THE JUDGE, FROM THE MAJORITY OF THE COURT, FROM OUR PARTNERS HERE, THAT WE ARE GOING TO MAKE IT HAPPEN. THIS ISSUE IS NOT GOING TO GO AWAY. WE ARE GOING TO CONTINUE TO DISCUSS IT. HOPE IS A GREAT THING. AND YOU KNOW, I HOPE THAT THIS WILL HELP WITH OUR RECRUITMENT. OUR RETENTION. THAT WE DON'T LOSE ANYONE. I AGREE. WE HAVE A BEAUTIFUL COMMUNITY. IF YOU HAVE ANY VISITING PHYSICIANS, ONLY BRING THEM BETWEEN RIGHT NOW AND APRIL. RIGHT? WE KNOW THAT. THEY WILL DREAD THE SUMMER. THAT IS SOMETHING TOTALLY DIFFERENT. RIGHT. THANK YOU ALL FOR YOUR WORK. YOU HAVE MY COMMITMENT TO BE ON THIS COMMITTEE. THANK YOU, JUDGE, TO PUT ALL THE EFFORT IN. TO TRY TO FIND A SOLUTION. >> WELL, I ASSUME-- I HOPE THE TALKS DO HAPPEN. A REASONABLE GROUP, WE ARE WILLING TO NEGOTIATE AND COMPROMISE WHERE NEEDED. AND DO ALL OF THAT IN GOOD FAITH. I CAN ASSURE YOU THAT. >> THANK YOU. THANK YOU ALL FOR BEING HERE. >> CAN I SAY SOMETHING? >> OH, YES. I'M SORRY. >> I MEAN, IT IS IRONIC THAT WE TALK ABOUT COMMUNICATION IN BIG GROUPS. WE HAVE THE SAME PROBLEM HERE. THERE IS ONLY FIVE OF US. I DIDN'T KNOW WE HAD A COMMITTEE. >> WE JUST FORMED IT. JUST NOW. (LAUGHTER). >> BUT ANYWAY, I WANT TO LET YOU KNOW, THAT COMUN COMMUNICATION IS BOTH WAYS. RIGHT? I REALLY CARE FOR RESIDENCY. I SUPPORT IT. I LOOK AT BOTH SIDES, TOO. IT IS NOT JUST THE ONE-SIEFDED THING. WE CAN BLAME WHOEVER WE WANT TO BLAME. IT IS A TWO-SIDES TO EVERYTHING. IT HAS A STORY. I WISH I HAD ALL YOU GUYS SUPPORT HECTOR GARCIA. THAT IS WHAT WE NEEDED. TO SUPPORT THE HECTOR GARCIA. >> I WAS THERE. I WAS AT THE RIBBON-CUTTING. >> VERY FEW OF YOU WERE THERE. THAT IS THE INDIGENT CARE. TO ME, MY PASSION IS THE INDIGENT CARE. WITH THE HOSPITAL DISTRICT. YOU KNOW? I DON'T KNOW HOW MANY DOCTORS ARE GOING TO GO WORK FOR INDIGENT CARE WHEN THEY LEAVE. THE DOCTOR YOU MENTIONED A WHILE AGO, HOW MANY OF YOU ACTUALLY WORK FOR SPOHN? THE ONES WHO GRADUATED? >> WHAT? >> HE WAS TALKING ABOUT THREE DOCTORS. >> ALL OF YOU. >> ALL OF YOU WORK FOR SPOHN? OH, GOOD. CONGRATULATIONS. THAT IS REALLY WHAT I LOOK AT. WHO IS GOING TO STAY AND WORK AT SPOHN? YOU KNOW? BECAUSE IF YOU TRAIN THEM AND YOU CAN GO ANYWHERE YOU WANT TO GO, THEN WE ARE SPENDING MONEY THAT WE SHOULDN'T BE SPENDING. TO ME. RIGHT? I MEAN, I THINK SPOHN PROBABLY SHOULD HAVE A TWO-YEAR CONTRACT ONCE YOU GRADUATE. YOU HAVE TO STAY AT SPOHN. BECAUSE EVERYBODY WANTS YOU WHEN YOU GRADUATE. NOBODY WANTS TO PAY FOR YOU WHEN YOU GRADUATE. IF EVERYBODY WOULD GET TOGETHER. THE E.R.S, THE HOSPITALS, AND THEY SAID COME TO THE TABLE, OKAY. WE ARE GOING TO HELP PAY FOR THOSE $280 MILLION THAT HAVE BEEN SPENT BY SPOHN. YOU KNOW, AND THEN YOU CAN HAVE WHATEVER YOU WANT WHEN YOU GRADUATE. I'M LOOKING AT BOTH SIDES HERE. WHEN THEY GRADUATE, THEY SHOULD HAVE AN OPTION. I ALWAYS SAY WE SHOULD HAVE A CONTRACT. WHEN THEY GRADUATE. TO STAY THERE AT LEAST TWO YEARS. YOU KNOW? WE LOSE POLICE OFFICERS LIKE THAT. WE LOSE SHERIFF'S OFFICERS LIKE THAT. BECAUSE WE TRAIN THEM AND WE LOSE THEM. YOU KNOW? AND YOU KNOW, WHEN I SAW THEM TALK ABOUT THOSE SIX, I SAID HOW MANY OF THOSE SIX WORK FOR SPOHN? >> WE HAVE A GREAT RETENTION RATE. >> THE RETENTION IS HERE LOCALLY. I DON'T KNOW IF IT IS FOR SPOHN. THAT IS WHAT I'M SAYING. MAYBE WE ALL NEED TO COME TO THE TABLE. YOU KNOW, TAKE A LITTLE SKIN IN THE GAME. [00:50:01] PUT A LITTLE BIT OF MONEY AND SAY HERE IS THE MONEY TO TRAIN THE PEOPLE. WHERE DO THEY GO WHEN THEY GRADUATE. THAT IS GOOD. MY CONCERN IS ALSO THE E.R. MY CONCERN IS ALSO THE FACT THAT THE WAITING TIME THE-- I HATE TO WAIT IN THE E.R. >> ABSOLUTELY. >> I KNOW IT MAKES IT EASIER WITH THE RESIDENCY. I WOULD LIKE TO HEAR THAT, TOO. SEE WHAT THEIR COMMITMENT IS. I KNOW THE RESIDENCIES HELP. I LIKE TO HEAR WHAT IS THE COMMITMENT FROM SPOHN. ARE THEY WILLING TO MAKE AN OPEN COMMITMENT TO SAY, HEY, YOU KNOW WHAT? WE ARE GOING TO HIRE MORE DOCTORS IN THE NEXT TWO YEARS. THEY NEED TO COME TO THE TABLE, TOO, AND SAY WHAT THEY ARE GOING TO DO. THERE IS ONLY TWO RESIDENCY PROGRAMS HERE. THAT THEY ARE REQUIRED TO HAVE. TWO. IT JUST SAYS TWO. THE ONLY ONES MANDATORY IS THE FAMILY MEDICINE RESIDENCY. THAT ONE WE HAVE TO HAVE. THE OTHER ONE WAS CREATED BY SPOHN. THAT GOES, THEY HAVE TO REPLACE THAT WITH SOMETHING ELSE THAT IS GOING TO BENEFIT THE COMMUNITY, I THINK. SO I UNDERSTAND. I MIGHT BE WRONG. AGAIN, SO I THINK THAT RESIDENCY, THERE MIGHT BE SOMETHING ELSE OUT THERE THAT IS GOING TO BE GOOD. WE DON'T KNOW. WE CAN'T JUST SHUT THE DOORS TO EVERYTHING ELSE EITHER. AND NOT GIVE SOMETHING ELSE A CHANCE. TO GROW LIKE THE RESIDENCY GREW. IF YOU WANT TO KEEP THE RESIDENCY, MAYBE WE NEED TO GET TOGETHER AND SAY HEY, HOW MUCH ARE WE ALL PUT ON THE TABLE? MAKE IT WORK AND KEEP SOME OF THE RESIDENCY. WE ARE ALL PITCHING IN. WE STILL HAVE ANOTHER RESIDENCY THIS BOND IS GOING TO BRING IN. NOTHING WRONG WITH HAVING THREE. FOUR: I MEAN, I DON'T CARE. WE WILL PAY FOR THEM, RIGHT? YOU KNOW, WE ALL WANT SOMEBODY WHO IS TRAINED AND READY TO GO. NOBODY WANTS TO -- >> I CAN SPEAK A LITTLE BIT TO SOME OF THE FRUSTRATIONS WITH WAITING TIMES AND THINGS LIKE THAT. I WAS HERE GETTING THE PROGRAM ACCREDITED. I WORKED A SHIFT AT SHORELINE. I WILL NEVER FORGET THE FIRST DAY I WORKED THERE WITH NO RESIDENTS. THERE WAS 17 CHARTS IN THE RACK. THAT MEANS 17 PATIENTS HAD BEEN WAITING ALL NIGHT TO BE SEEN. AND THE FIRST FIVE OR SIX I SAW WERE DEBTLY ILL. DEATHLY ILL. LOW BLOOD PRESSURE. HEART RATES OF 150. THERE IS NO WAY THEY SHOULD HAVE BEEN WAITING WITH THOSE WAIT TIMES. WITH THE RESIDENTS, WE HAVE SOLVED THAT. WE SOLVED THAT THE DAY THE RESIDENT SEE MOVED FROM MEMORIAL TO SHORELINE. THE METRICS DECREASED GREATLY. NOW ALL WAITING TIMES ARE BASED ON NURSE STAFFING. THERE IS NOT ENOUGH NURSES TO STAFF THE BEDS. UPSTAIRS. THEY HOLD PATIENTS IN THE EMERGENCY DEPARTMENT. WE WILL GO TO THE WAITING ROOM AND SEE PEOPLE. WE WORK IN TRIAGE TO DECREASE WAITING ROOM TIMES TO GET TESTS ORDERED. IF THEY NEED AN X-RAY, WE MEET THEM UP-FRONT. WE START THE WORKUP. DRAW THE BLOOD AND GET IT. THE WAITING TIME IS DECREASED SIGNIFICANTLY WITH THE RESIDENTS. NO MATTER WHAT STAFFING MODEL THEY GO BACK TO, THEY WILL NOT HAVE SIX. THAT IS ASTRONOMICALLY-- TO GO TO SIX WOULD BE PAYING THE HOURLY RATE THAT WE DID-- THAT WOULD BE $10 MILLION A YEAR TO STAFF IT WITH SIX DOCTORS. WE WORK FOR MUCH LESS. ABOUT $20 AN HOUR LESS THAN THE AVERAGE TEXAS E.R. DOC. WE LIKE WHAT WE DO. WE HAVE NEVER TAKE AN SHIFT BONUS TO WORK AT SHORELINE. WE MAKE OUR OWN SCHEDULE. SO STARTING JULY 1, THE COSTS ARE GOING-- AND WAITING TIMES ARE GOING TO GO BACK TO WHAT IT WAS ON THOSE FIRST SHIFTS. THAT IS PROBABLY ANOTHER THING THAT IS IMPORTANT TO UNDERSTAND HERE. THIS DOESN'T START IN 2026. SO IF THERE IS NO NEW CLASS, ALL THE HOSPITAL STAFFING IS BASED ON 36, HAVING 36 RESIDENTS. THERE ARE GAPS STARTING JULY 1 THAT WILL AFFECT WAITING TIMES, TRAUMA CARE, ACCREDITATION AND KIND OF THE SNOWBALL EFFECT. >> THEY ARE RESIDENTS UNTIL 2026. RIGHT? >> THEY ARE PROPOSING WE NOT TAKE A NEW CLASS. STARTING JULY 1, THERE WOULD BE 24. THERE IS 12 RESIDENTS. FIRST-YEAR RESIDENTS. 12 SECOND-YEAR. 12 THIRD-YEAR. THEY ARE PROPOSING THAT WE DO NOT TAKE A NEW CLASS. SO JULY 1, WE WOULD NOT HAVE A NEW GROUP OF 12 RESIDENTS. WE WOULD STILL HAVE 12 SECOND-YEARS AND 12 THIRD-YEARS. WE GO TO 24 RESIDENTS STARTING JULY 1. IF NONE OF THEM LEFT. THESE GUYS ARE SUPERSTARS. THIS IS OUT NATIONALLY. THEY HAVE IVY LEAGUE PLACES [00:55:03] WANTING THEM. THEY ARE GOING TO HAVE TO DECIDE IF THEY WANT TO STAY HERE OR NOT. >> WELL, I THINK ALL DOCTORS LIKE THE START. THEY TAKE CARE OF YOU. ESPECIALLY THE ONES IN TRAUMA. I ADMIRE THOSE A LOT. TRAUMA DOCTORS ARE MY FAVORITE. RIGHT? THE THING IS, LET ME TELL YOU. WHAT BOTHERS ME, WE ASK FOR MORE DOCTORS. WHEN WE SEE OUR DOCTOR, YOU KNOW, I SEE A PA. THREE TIMES IN A ROW. I WANT TO SEE MY DOCTOR. I SEE A PA. >> SO WHEN THESE DOCTORS ARE GONE, THEY REASON REPLACED. THEY WILL BE REPLACED. >> I GET CHARGED THE SAME AMOUNT OF MONEY. ARE WE SHORT ON DOCTORS? OR DOCTORS DON'T WANT TO -- >> YES. NATIONALLY. >> THE PAS DO A GREAT JOB. DON'T GET ME WRONG. MAYBE WE NEED TO HAVE A RESIDENCY FOR PAS. I DON'T KNOW. MAYBE IT IS A GOOD THING TO HAVE. EVERYBODY IS USING THOSE PAS NOW. >> WE WORK WITH NURSE PRACTITIONERS. OR PAS AND PPAS. THAT IS WHAT-- WHO THESE DOCS WILL BE REPLACED WITH. THE FINANCIAL REALITY. YOU CAN'T AFFORD TO REPLACE A RESIDENT DOCTOR. >> NOTHING WITH A PA. NOTHING WRONG WITH A PA. I'M SORRY. JUDGE, THANK YOU VERY MUCH. I APPRECIATE IT. >> THANK YOU, COMMISSIONER. >> YOU KNOW, I DON'T THINK WE HAVE ANY-- I DON'T KNOW WHY WE WOULD HAVE A COMMITTEE-- WE CAN'T TELL SPOHN WHAT TO DO. WE CAN'T TELL THE DOCTORS WHAT TO DO. WE DON'T HAVE A CONTRACT WITH THEM. WE DON'T HAVE A CONTRACT WITH ANYONE. THE HOSPITAL DISTRICT HAS AN AGREEMENT. RIGHT? THEY HAVE AN AGREEMENT. THEY KEPT THE AGREEMENT. YOU KNOW, THEY HAVE THE RESIDENCIES. THEY GET RID OF ONE. THEY HAVE TO PUT ANOTHER ONE. I DON'T KNOW HERE. YOU KNOW, I DON'T EVEN KNOW EITHER ONE OF YOU WENT TO THE HOSPITAL DISTRICT OR NOT. IF THE DOCTORS DIDN'T GO AND SPOHN DIDN'T GO TO THE HOSPITAL DISTRICT, SHAME ON YOU. YOU SHOULD HAVE GONE FIRST TO THE HOSPITAL DISTRICT. OKAY? THANK YOU. >> THANK YOU. COMMISSIONER HERNANDEZ WOULD LIKE TO SPEAK FIRST. THEN WE ARE GOING TO GET EVERYBODY STARTED ON THE PUBLIC SPEAKING. THREE MINUTES EACH. >> YES, JUNK. FYES, JUDGE. I LIKE THE IDEA OF FORMING THIS COMMITTEE. THANK YOU TO THE GENTLEMEN VOLUNTEERING TO PARTICIPATE. THE FASTER WE GET THIS COMMITTEE GOING, THE BETTER IT WILL BE FOR THE COMMUNITY SO WE CAN GET THINGS DONE RIGHT. THANK YOU. >> THANK YOU. [E. PUBLIC COMMENT: This section provides the public the opportunity to address the Commissioners Court on any issues within its jurisdiction. The Commissioners Court may not take formal action on any requests made during the Public Comment period which are not on the Agenda, but can refer such requests to County staff for review if appropriate.] I'M JUST GOING TO START DOWN THE LIST. YOU WILL HAVE THREE MINUTES WHEN YOU GET UP TO THE PODIUM, PLEASE STATE YOUR NAME AND ADDRESS. I HAVE THIS LIST THAT WAS E-MAILED TO ME. I ASSUME THIS LIST WISHES TO SPEAK PUBLICLY AS WELL. I DON'T KNOW WHERE PAYTON IS. WHERE I GOT IT. I ASSUME. WE WILL START WITH DR. SANDRA WILLIAMS. >> CAN YOU PULL THAT MIC UP, PLEASE? THANK YOU. >> I'M A LITTLE BIT TALL HERE. >> STATE YOUR NAME AND ADDRESS AS WELL. >> GOOD AFTERNOON. MY NAME IS SANDRA WILLIAMS. I'M NOT A NEW CEASE COUNTY RESIDENT. I LIVE IN HOUSTON, TEXAS. I PRACTICE IN ANGLETON, TEXAS. I'M CURRENTLY THE PRESIDENT OF THE TEXAS COLLEGE OF EMERGENCY PHYSICIANS. WE ARE THE PROFESSIONAL ORGANIZATION THAT REPRESENTS OVER 2,100 EMERGENCY MEDICAL PHYSICIANS IN THE STATE. AS WELL AS ALL OF THE EMERGENCY MEDICINE PROGRAMS IN THE STATE. THE FIRST THING I WANT TO TALK TO YOU GUYS ABOUT IS WHAT EXACTLY MAKES AN EMERGENCY MEDICINE RESIDENCY TRAINED PHYSICIAN. WE GO THROUGH A LOT OF TRAINING AND A LOT OF SCHOOLING THAT MAKES US VERY DIFFERENT FROM THOSE THAT ARE A PHYSICIAN'S ASSISTANT OR A NURSE PRACTITIONER. WE GO TO UNDERGRAD AND GET A DEGREE IN SOMETHING. AFTER THAT, THINGS CHANGE. WE GO TO MEDICAL SCHOOL. IT IS FOUR YEARS. FOUR GRUELING YEARS OF DIDAK TICKS AND HOSPITAL AND CLINIC ROTATIONS. WE LEARN LITTLE TINY BITS ABOUT THE VARIETY OF TYPES OF MEDICINES OUT THERE SUCH AS CARDIOLOGY, NEUROLOGY, AND PEDIATRICS. WE THEN CHOOSE TO SPECIALIZE IN EMERGENCY MEDICINE AND DO THIS PROGRAM. THE RESIDENCY PROGRAM IS THREE TO FOUR YEARS WHERE WE LEARN AND HONE A VERY UNIQUE SKILL SET THAT MAKES US THE BEST QUALIFIED PROVIDERS OF EMERGENCY CARE. WE DO THIS BEDSIDE CARE EVERY DAY IN THE EMERGENCY DEPARTMENT, WITH OUR ALREADY RESIDENCY-TRAINED EMERGENCY MEDICINE PHYSICIANS. WE ARE THERE 24 HOURS A DAY, 7 DAYS A WEEK. 365 DAYS A YEAR. PROVIDING THIS EXEMPLARY [01:00:03] HIGH-QUALITY CARE -- >> I'M GETTING A MESSAGE THEY CAN'T HEAR YOU IN THE BACK. I'M SO SORRY. I KNOLL YOU ARE TALL. IT IS NOT GOING TO-- YOU MAY HAVE TO PICK IT UP AND HOLD IT. >> I'M SORRY. I FEEL LIKE A SINGER DOING THIS. >> I'M SO SORRY. THANK YOU. >> THIS ALLOWS US TO PROVIDE VERY HIGH QUALITY UNSCHEDULED EMERGENT CARE TO A WIDE VARIETY OF PATIENTS. WE LEARN HOW TO VERY EFFECTIVELY AND EFFICIENTLY TAKE CARE OF A VERY SIMPLE PEDIATRIC FEVER, A PATIENT WITH ABDOMINAL PAIN THAT WINDS UP HAVING APPENDICITIS, WHILE A PATIENT IS HAVING A HEART ATTACK AND ANOTHER ONE IS HAVING A MOTOR VEHICLE CRASH. WE DO ALL OF THAT EFFORT LESLI. EFFORT LESLI. OTHER PRACTITIONERS DO NOT HAVE ANYWHERE NEAR THE TRAINING THAT WE DO. THEY FINISH UNDERGRAD AND GET A TWO-YEAR DEGREE. THAT IS IT. THERE IS NO COMPARISON. YOU SHOULD WANT THE BEST CARE FOR YOURSELF, FOR YOUR FAMILY, AND FOR THE OTHER MEMBERS OF THIS COMMUNITY. >> VERY GOOD. >> THANK YOU, MA'AM. >> THANK YOU. >> DR. BRIAN DUNN. >> HE IS TALL, TOO. (LAUGHTER). >> YOU HAVE TO HOLD IT. >> WE WILL PASS THE BATON. >> HONORABLE MEMBERS OF THE COURT, THANK YOU FOR THE OPPORTUNITY TO ADDRESS THIS MOST IMPORTANT SUBJECT. MY NAME IS BRIAN DUNN. I'M CURRENTLY THE MEDICAL DIRECTOR OF THE EMERGENCY DEPARTMENT AT CONLEY MEMORIAL AND CHIEF OF STAFF OF THE HOSPITAL. I'M SECRETARY OF THE TEXAS COLLEGE OF EMERGENCY PHYSICIANS I. I HAVE BEEN IN PRACTICE FOR OVER 0 YEARS. $30 YEARS. I GREW UP NOT F FROM HERE. MY DAD WAS ON THE BORDER PATROL. MY PARENTS STILL LIVE IN KINGSVILLE. MY FATHER AND BROTHER WERE BOTH BORN AT SHORELINE HOSPITAL. FOR MANY YEARS, I WOULD GO TO THE EMERGENCY DEPARTMENT AT CHRISTUS SPOHN HOSPITAL AND WORK SEVERAL SHIFTS A MONTH THE IN AN EFFORT TO GIVE BACK TO MY HOMETOWN AND HELP BRING STATE-OF-THE-ART EMERGENCY MEDICINE THERE. I WAS THE FIRST AND FOR MANY YEARS THE ONLY REZ CONDITION SI-TRAINED MYCISION-- RESI RESIDENCY-TRAINED PHYSICIAN TO WORK THERE. LARGE NATIONAL CONTRACTING GROUPS FREQUENTLY HAVE TO PLACE PHYSICIANS, PS A WHO ARE NOT TRAINED MANY EMERGENCY MEDICINE IN RURAL FACILE DIS. THEY DON'T HAVE THE SPECIFIC TRAINING NEEDED TO DEAL WITH LITERALLY EVERYTHING THAT COMES THROUGH THE DOOR. THE SPOHN RESIDENCY HAS BEEN A TREMENDOUS SOURCE IN SOUTH TEXAS. THE SENIOR RESIDENTS AS WELL AS FACULTY WORK IN MULTIPLE HOSPITALS IN THE AREA SERVING A TREMENDOUSLY UNDERSERVED POPULATION. IN GENERAL, THEY EITHER GO BACK HOME OR STAY WHERE THEY TRAINED. MANY CHOOSE TO STAY HERE IN THIS AREA. MANY OF THEM COME TO LOVE THE CLIMATE, THE CULTURE AND THE PEOPLE OF SOUTH TEXAS. AS IS THE CASE WITH MANY ISSUES, THERE ARE NATIONAL CONCERNS AND LOCAL CONCERNS. AS THE SAYING GOES, ALL POLITICS ARE LOCAL. NATIONALLY, AS WELL AS IN TEXAS, WE HAVE MANY EMERGENCY MEDICINE RESIDENCIES. WHEN I TRAINED, THERE WERE NO EM PROGRAMS IN TEXAS. AS IT STANDS NOW, THERE IS ONE EM RESIDENCY PROGRAM IN SOUTH TEXAS. ONLY ONE CHANCE FOR SOUTH TEXAS TO TRAIN THE BEST AND THE BRIGHTEST. AND HAVE A LARGE PERCENTAGE OF THEM STAY HERE WITH THEIR FAMILIES AND CONTRIBUTE TO THE ECONOMY AND OVER THE YEARS, AS MY PARENTS GOT OLDER, WHEN THEY CONTACTED ME WITH A MEDICAL QUESTION AND I KNEW THEY NEEDED TO SEE SOMEONE RIGHT AWAY, I DIRECTED THEM AWAY FROM SPOHN AND HAD THEM COME TO CORPUS. KNOWING THAT THE LIKELIHOOD OF THEM SEEING A PHYSICIAN INKINGS. MY DAD IS NOW 90. I'M NOW PERFECTLY COMFORTABLE WITH HIM GOING TO KINGSVILLE. KNOWING THAT A TRAINED PHYSICIAN WILL SEE HIM AND WILL DO WHAT I WOULD DO. I'M SURE YOU WANT THE SAME FOR YOUR COMMUNITY AND YOUR FRIENDS AND FAMILIES. IF THIS PROGRAM IS DUE TO ECONOMIC JEOPARDY, PLEASE INVESTIGATE WHAT ALTERNATIVES MAY EXIST TO KEEP THIS PRICELESS RESOURCE HERE IN SOUTH TEXAS. ONCE IT IS GONE, THE PROSPECTS OF GETTING ONE BACK WILL BE VERY GRIM. THANK YOU. >> THANK YOU. >> MARILYN BREW DEWAR. MARILYN BRODEUR. THANK YOU. >> I'M MARILYN BRODEUR. 600 ELIZABETH STREET. MY NAME IS DR. MARILYN BRODEUR. MY HUSBAND OF 16 YEARS IS-- I'M MAR MARILYN BRODEUR. MY HUSBAND IS DR. MICHAEL BRODEUR, A CORE-TEACHING FAC FACULTY. [01:05:02] I'M A DENTIST. AT 20 YEARS OLD, I WAS THE YOUNGEST STUDENT IN MY CLASS AT THE UNIVERSITY OF MARYLAND, BALTIMORE. I THEN TRAINED AT JOHNS HOPKINS DENTAL RESIDENCY. I CARED FOR THE DENTAL NEEDS OF MEDICALLY COMPLEX PATIENTS. MANY TIMES TREATING IN THE OPERATING ROOM. I'M NOW A STAY AT HOME MOM TO FOUR CHILDREN. BUT I CAN SPEAK MEDICINE. I WOULD LIKE TO URGE THIS BODY THAT IF A DECISION IS NOT MADE SOON, THIS RESIDENCY PROGRAM IS IN THE MIDST OF AN INTERVIEW SEASON. THAT WAS TERMINATED. THE INTERVIEW SEASON ENDS IN JANUARY. EVERY SINGLE WEEK, THERE ARE MULTIPLE STUDENTS FROM ALL OVER THE COUNTRY WHO ARE COMING TO CORPUS. THE TRUST HAS BEEN SHATTERED. THE REPUTATION OF THIS PROGRAM HAS BEEN SHATTERED. AND UNLESS SOMETHING IS DONE IN A TIMELY FASHION, THIS PROGRAM WILL BE SEVERELY, SEVERELY LIMITED. THE QUALITY OF APPLICANTS WILL DECREASE. AND WE WILL NOT HAVE THE AMAZING CARE THAT HAPPENED AT SPOHN SHORELINE. THE MEDICAL DIRECTOR TOLD ME THAT BEFORE THE RESIDENCY WAS AT SPOHN SHORELINE, THE WAIT TIMES WERE 80 MINUTES. ONCE THE RESIDENCY MOVED THERE, THE AVERAGE WAIT TIME IS 23 MINUTES AS OF RIGHT NOW. THE ADMIT RATE AT SPOHN SHORELINE IS 60%. THAT MEANS THOSE PATIENTS ARE SO SICK THEY CAN'T GO HOME. THEY HAVE TO STAY IN THE HOSPITAL. 60%. THE AVERAGE ACROSS THE UNITED STATES IS 15% TO 20%. THESE PHYSICIANS ARE SO NEEDED IN THIS COMMUNITY, AND FRANKLY, IT IS TERRIFYING THAT SPOHN WOULD MAKE THIS, IN MY OPINION, EXTREMELY RECKLESS DECISION TO COMPLETELY KILL THIS PROGRAM. THESE RESIDENTS WILL LEAVE UNLESS A DECISION IS MADE SOON. IF THIS PROGRAM IS NOT RESTORED IN A TIMELY FASHION, IT WILL DIE. THESE RESIDENTS MAKE UNDER $15 AN HOUR. WHEN THEY ARE WORKING IN THE I.C.U. WHY ARE THESE 36 SALARIES SUCH AN ONEROUS BURDEN TO BEAR WHEN CHRISTUS SPOHN EMPLOYS OVER 3,000 PEOPLE? WE HEARD THAT DIRECTLY FROM THE C.E.O. WHAT ABOUT THESE 36 SALARIES? IS TOO MUCH FOR CHRISTUS SPOHN? WHY WERE BONUSES ANNOUNCED ON MONDAY? AND DID ANY SPOHN EXECUTIVES ALSO RECEIVE THESE BONUSES? IT SEEMS LIKE THERE IS A MISREPRESENTATION TO ME OF THE MONEY. THANK YOU FOR LISTENING TO MY COMMENTS. (APPLAUSE). >> I'M GOING TO ASK YOU TO PLEASE DON'T DO THAT. PLEASE NO CLAPPING OR COMMENTING OUT LOUD. AVERY TOMINIK. >> 3610 LAKE CHAMPAGNE. MEL LOW. I'M IN 7TH GRADE. I ATTEND SCHOOL AT RIVER HILLS CHRISCHRISTIAN ACADEMY. I'M THE DAUGHTER OF DR. TOMINIK, THE PROGRAM DIRECTOR AND AN AGGIE DOCTOR FOR THE TEXAS A&M RESIDENCY PROGRAM. I ASKED TO SPEAK HERE TODAY MYSELF. I WROTE THIS SPEECH MYSELF. I KNOW HOW IMPORTANT THIS RESIDENCY PROGRAM IS TO A LOT OF PEOPLE. AND IT IS ALSO VERY IMPORTANT TO ME. RESIDENTS AND ATTENDINGS MOVE HERE FROM ALL OVER THE COUNTRY TO STUDY AND TEACH AT THIS PROGRAM. A LOT OF PEOPLE-- SORRY. A LOT OF THE GRADUATES STAY IN CORPUS CHRISTI WORKING IN THE AREA AND CARE FOR PEOPLE LIKE MY GRANDPARENTS, MY GREAT GRANDPARENTS, BOTH IN CORPUS AND ALICE. THE RESIDENCY PROGRAM IS SPECIAL TO ME. I HAVE MADE SUCH GOOD FRIENDS WITH ALL THE RESIDENTS AND ATTENDINGS. MY MOM WOULD TAKE ME TO THE HOSPITAL I. I COULD SEE ALL THE RESIDENTS TRAINING IN ACTION. IT WAS SO SPECIAL, AND I KNOW A LOT OF KIDS DON'T EXPERIENCE THAT. HERE IN MY HAND, I HOLD OVER 3,000 SIGNATURES THAT SIGNED OUR PETITION TO SAVE THE RESIDENCY PROGRAM. THIS IS WHY THE EMERGENCY MEDICINE RESIDENCY PROGRAM NEEDS TO BE SAVED. YOU NEED THEM. CORPUS NEEDS THEM. WE ALL NEED THEM. THANK YOU FOR YOUR TIME. >> THANK YOU. GRACE LEASEON. >> HELLO, JUDGE SCOTT. [01:10:01] PHYSICIANS, FAMILY, AND FRIENDS. THANK YOU FOR ALLOWING ME TO SPEAK TODAY. MY NAME IS GRACE LEESON. CORPUS CHRISTI, TEXAS. I AM THE DAUGHTER OF TWO EMERGENCY MEDICINE PHYSICIANS. MY PARENTS, BROTHER AND I MOVED TO CORPUS CHRISTI IN 2008. MY PARENTS FOUND THEIR DREAM JOB. MY EARLIEST MEMORIES IN THE CITY ARE RELATED TO MY PARENTS AND THEIR JOB AS DOCTOR TEACHERS. I BEGAN ELEMENTARY SCHOOL. I REMEMBER MY PARENTS PRESENTING TALKS TO MY CLASSMATES ON CAREER DAY. I DON'T REMEMBER EXACTLY WHAT THEY TOLD MY PEERS. I DO REMEMBER THE INCREDIBLE SENSE OF PRIDE THAT I FELT AS MY PARENTS STOOD DRESSED IN WHITE COATS AND BLUE SCRUBS. TO THIS DAY, I'M OVERWHELMINGLY PROUD OF MY PARENTS. AS I GREW, MY INTERACTIONS WITH THE RESIDENCY PROGRAM INCREASED. MY FAMILY FREQUENTLY BROUGHT MY BROTHER DRAKE AND I TO THE HOSPITAL FOR WHAT MY FAMILY CALLED THE TRADEOFF. WE WOULD SIT IN THE DOCTOR'S LOUNGE AND WATCH CARTOONS ON CHANNEL 44 WHILE OUR PARENTS RELIEVED EACH OTHER FROM SHIFTS. MY BROTHER AND I VOLUNTEERED TO SERVE AS ULTRASOUND MODELS FOR THE PRACTICING RESIDENTS. WHY DID WE LET DOCTORS POKE OUR TUMMIES AND LOOK AT OUR GUTS? BECAUSE THESE DOCTORS ARE SUPERHEROES. THEY SAVE LIVES. THEY CARE ABOUT US. WE WANT TO BE CLOSE TO THEM AND HELP THEM IN ANY WAY WE CAN. I SHADOW PHYSICIANS AT CHRISTUS SPOHN THROUGHOUT MIDDLE AND HIGH SCHOOL. LAST SUMMER, I WAS A RESEARCH ASSOCIATE WHERE I ASSISTED RESIDENTS IN COMPLETING RESEARCH DESIGNED TO IMPROVE HEALTH CARE IN OUR COMMUNITY. INSPIRED BY THE MISSION OF CHRISTUS SPOHN RESIDENCY PROGRAM, I AM PURSUING A CAREER IN MEDICINE. I'M A SOPHOMORE AT THE UNIVERSITY OF NOTRE DAME IN INDIANA. I'M DOUBLE-MAJORING IN ENGLISH AND PRE-MEDICINE WITH A MINOR IN COMPASSIONATE CARE IN MEDICINE. I STUDY ENGLISH AMIDST MEDICINE BECAUSE I VALUE EFFECTIVE COMMUNICATION IN HEALTH CARE: I'M MINOR IN COMPASSIONATE CARE IN MEDICINE BECAUSE I VALUE JUSTICE FOR ALL PATIENTS. THE CLOSURE OF THE RESIDENCY PROGRAM WILL BE A GRAVE MISTAKE. THE PHYSICIANS INVOLVED IN THIS PROGRAM CARE ABOUT THIS COMMUNITY. THEY ARE INCREDIBLY SUCCESSFUL, INTELLIGENT, RELIABLE, AND SELFLESS. THEY HAVE PROVIDED CARE TO CORPUS CHRISTI AMIDST HURRICANE HARVEY, THE COVID-19 PANDEMIC AND THE FREEZE OF 2021. THESE PEOPLE WANT TO CONTINUE TO SERVE US THROUGH HEALTH CARE. LET THEM CONTINUE TO TAKE CARE OF US. THE EMERGENCY MEDICINE RESIDENCY PROGRAM IS A FAMILY. THEY CARE FOR THE COMMUNITY, AND THEY CARE FOR EACH OTHER. PLEASE DO NOT TEAR THIS FAMILY APART. PLEASE DO NOT TEAR MY FAMILY APART. PLEASE DO WHAT IS RIGHT FOR IN COMMUNITY. THANK YOU FOR YOUR TIME. >> THANK YOU. DR. CRAIG PETERSON. I THINK IT IS PETERSON. YES. SORRY. YES. >> I SUSPECT I'LL NEED TO PULL OUT THE -- >> YES. >> THANK YOU FOR ALLOWING ME TO ADDRESS YOU TODAY. MY NAME IS CRAIG PETERSON. 15630 GYPSY STREET. THE VIEWS I'M ABOUT TO EXPRESS ARE MY OWN. I'M AN EMERGENCY PHYSICIAN AND ATTENDING AND CORE FACULTY WITHIN THE EMERGENCY MEDICINE PROGRAM AT CHRISTUS SPOHN SHORELINE. I'M HERE TO TELL YOU THAT THE ABRUPT AND IN MY OPINION, UNWARRANTED CLOSURE OF THE EMERGENCY MEDICINE RESIDENCY PROGRAM IS A SPECTACULAR TRAGEDY FOR THE FUTURE OF EMERGENCY CARE IN CORPUS CHRISTI AND THE COASTAL BEND. IN 2011, MY WIFE AND I TOOK A CHANCE AND MOVED TO CAR PUS CHRISTIE FROM FORT WORTH FOR THE LAST TWO YEARS OF MEDICAL SCHOOL. THIS PROGRAM EASILY BECAME MY TOP CHOICE. I RECEIVED AN AMAZING EDUCATION HERE. I WAS HONORED TO SERVE IN THE ROLE AS CHIEF RESIDENT. AFTER RESIDENCY, I WENT ON ACTIVE DUTY WITH THE AWARE FORCE. MY WIFE AND I AND OUR BRAND NEW BABY MOVED TO SAN ANTONIO. I DESCRIBED THIS PROGRAM TO THEM. I WOULD REGULARLY HEAR TERMS LIKE YUAN CON ORB UNICORN OR HIDDEN GEM. I NEVER DISAGREED. I WAS NAMED FACULTY OF THE YEAR TWICE AT AMC. I RETURNED TO THIS RESIDENCY AS SOON AS I CAN. FOR ME AND MY FAMILY, THE CHOICE WAS EASY. THIS PROGRAM IS CLEECIAL SPECIAL. CLEARLY SPECIAL. WE MOVED TO CORPUS IN MAY OF 2020. JUST BEFORE THE HEIGHT OF COVID. THE EMERGENCY RESIDENTS HERE PLACED THEMSELVES IN HARM'S WAY ROUTINELY. THE RESIDENTS WERE THE ONES IN THE ICUS AND EDS, INTUBATING, AND HELPING TO PROVIDE OXYGEN TO PATIENTS. THEY WERE HOLDING IPHONES SO YOU COULD TALK TO LOVED ONES WHEN YOU COULDN'T VISIT. SADLY, THEY WERE HEADING THE HANDS OF THOSE WHO PASSED SO THEY WOULDN'T BE ALONE. WE WERE STRETCHED TO THE BRINK. WITHOUT THE EMERGENCY MEDICINE RESIDENCY, THE SITUATION WOULD HAVE BEEN MORE CATASTROPHIC. TODAY EMERGENCY MEDICINE RESIDENTS MEET TRAUMA PATIENTS IN THE RESUSCITATION BAY, THEY DELIVER BABIES WHOSE MOTHERS HAVE HAD NO ACCESS TO PRENATAL [01:15:04] CARE. THEY WATCH OVER THE SICK AND INJURED IN THE ICU. THEY HELP STAFF IN RURAL REGIONS TO SERVE IS UNDER-- TO CARE FOR THE UNDERSERVED. I HELPED MY PARENTS MOVE HERE AT THE HEIGHT OF COVID. AND MY IN. >> LAWS A SHORT WHILE LATER. WE HAVE INVEFSED IN IN COMMUNITY. I VOLUNTEER ON THE CCPD. I TRAIN MEDICS TO SAVE LIVES. EVERY YEAR AT CHRISTMAS, THIS PROGRAM DONATES MONEY TO MISSION OF MERCY FREE CLINIC. MY FAMILY IS ACTIVE IN OUR CHURCH. MY WIFE TEACHES AT MY SON'S SCHOOL. OUR RESIDENT SPOUSES ARE NURSES, TEACHERS, PARAMEDICS, AND FAMILY PHYSICIANS. I WASN'T BORN HERE, BUT CORPUS IS MY HOME. YOU ARE ALL MY NEIGHBORS. THIS RESIDENCY IS MY FAMILY. THANK YOU. >> THANK YOU. >> DR. MICHAEL HALL PERTH. HALL PERT. >> JUDGE SCOTT, COMMISSIONERS. I APPRECIATE THE OPPORTUNITY TO SPEAK WITH YOU TODAY. MY NAME IS MICHAEL HALPERT. I LIVE IN CORPUS. I'M A RESIDENT OF NUECES YOUNT AND A RECENT RETIRED PHYSICIAN AND SURGEON. I'M NOT A POLITICIAN. IN THE 40 YEARS SINCE I GRADUATED FROM MEDICAL SCHOOL IN SAN ANTONIO, I HAVE SPENT NINE YEARS AS A MILITARY PHYSICIAN, NEARLY TWO DECADES IN PRIVATE PRACTICE, SEVERAL YEARS AS MEDICAL SCHOOL FACULTY ANT TEXAS TECH SCHOOL OF MEDICINE, AND THE LAST FIVE YEARS OF MY CAREER BEFORE I RETIRED EARLIER THIS YEAR AS A TRAUMA SURGEON AT SHORELINE HOSPITAL. I KNOW HOW VALUABLE GOOD MEDICAL CARE IS TO A COMMUNITY. I KNOW WHAT IT TAKES TO RUN A SUCCESSFUL PHYSICIAN TRAINING PROGRAM. I SIMPLY CANNOT BELIEVE THAT WE ARE GOING TO LOSE THIS PROGRAM. I HAVE SEEN A LOT OF PLACES, AND LET ME TELL YOU, AS OTHERS HAVE SAID, THIS PLACE IS A GEM. IT IS A MAJOR LEAGUE QUALITY PROGRAM THAT IS NOT EXPECTED TO BE FOUND IN A PLACE AS SMALL AS NUECES COUNTY OR CORPUS. IT ATTRACTS THE TOP YOUNG PHYSICIANS FROM AROUND THE COUNTRY AND HAS A REPUTATION THAT OTHER PROGRAMS ENVY. I WORKED WITH THESE RESIDENTS EVERY DAY DURING MY FIVE YEARS AT SHORELINE. I COULD NOT HAVE PROVIDED THE QUALITY OF CARE WITHOUT THEM. NUECES YOUNT AND SOUTH TEXAS ARE SHORT OF PHYSICIANS. THE BEST DETERMINANT OF WHERE A YOUNG PHYSICIAN GOES INTO PRACTICE IS WHERE HE OR SHE TRAINED. MOST CITIES WOULD BE DELIGHTED AND PROUD TO HAVE A PROGRAM LIKE THE ONE THAT SHORELINE IS CLOSING. I JUST CAN'T BELIEVE WE ARE CLOSING THIS. IT IS INCREDIBLE. AS I NOTED, I WAS A TRAUMA SURGEON BEFORE I RETIRED. THE TRAUMA SERVICE WAS SURVEYED BY THE AMERICAN COLLEGE OF SURGEONS THIS PAST JANUARY. AS DR. HERRICK NOTED, THE SURVEYORS WHO ARE VERY HARD TO IMPRESS, COMMENTED ON THE HIGH DEGREE OF COOPERATION AND TEAMWORK BETWEEN THE EMERGENCY MEDICAL STAFF AND THE TRAUMA SURGEONS. THIS TEAM WORKED TO SAVE LIVES. WITHOUT THE RESIDENTS, THE QUALITY OF TRAUMA CARE WILL SUFFER. THE RESIDENTS ARE ALSO THE BACKBONE OF THE MEDICAL INTENSIVE CARE PROGRAM AND OF COURSE, THROUGH THE MAJORITY OF CARE AND THE SHORELINE E.R. MR. DOMINGUEZ STATED THAT THIS CLOSURE WILL ABSOLUTELY NOT IMPACT THE QUALITY OF CARE THAT PATIENTS RECEIVE. HE SIMPLY CANNOT BELIEVE THIS. HOW CAN THE CLOSURE OF A PROGRAM THAT ATTRACTS THE BEST AND BRIGHTEST YOUNG PHYSICIAN TRAINEES TO OUR COUNTY, MANY OF WHOM REMAIN HERE TO PRACTICE, NOT IMPACT THE QUALITY OF CARE? JUDGE SCOTT, THE COMMISSIONERS, YOU HAVE SIGNIFICANT INFLUENCE IN THE OPERATIONAL-- OPERATION OF SHORELINE HOSPITAL. PLEASE DO WHAT YOU CAN TO REVERSE THIS SHORT-SIDED SHORTSIGHTED DECISION. THANK YOU FOR THE OPPORTUNITY TO SPEAK. >> THANK YOU. >> DR. BROOKE DAMBOYSE. I'M KIND OF HOPPING AROUND. SORRY, EVERYONE. I KNOW WE WILL HAVE TO STOP BEFORE THIS. I'M TRYING TO PICK RANDOM NAMES. >> JUDGE, MY NAME IS DR. BROOK DAMBOYSE. A MILITARY VETERAN, A GRADUATE OF THE CORPUS CHRISTI EMERGENCY MEDICINE RESIDENT PROGRAM AND A FACULTY MEMBER FOR THE PROGRAM. I WORK IN KINGSVILLE-AL LITTLE, SHORELINE. MOST OF THE COMMENTS I HAVE BEGINS TO TO MAKE HAVE BEEN CONSIDERED. I'M GOING TO EXPLAIN WHO THESE RESIDENTS ARE. THEY ARE FULLY TRAINED PHYSICIANS HERE EXPANDING THEIR EMERGENCY MEDICAL TRAINING. I STARTED THIS PROGRAM IN JULY OF 2020 IN THE HEIGHT OF COVID. WE STAFF NOT ONLY YOUR EMERGENCY DEPARTMENTS BUT ALSO YOUR TRAUMA I.C.U. AND YOUR MEDICAL I. KRUVMENT U. TWO MONTHS INTO MY TRAINING, IN [01:20:03] COVID, I WAS COVERING TEN I.C.U. PATIENTS ALONE AS A RESIDENT. MEANING I WAS RESPONSIBLE FOR EVEVERY ASPECT OF CARE FROM HOW THEY WERE VENTILATED, FROM HOW THEIR HEART KEPT BEATING WITH MEDICATIONS TO HOW THEIR URINE OUTPUT WENT. I WILL TELL YOU ONE PATIENT'S STORY. A 40-YEAR-OLD MAN CAME IN, AND HE HAD TWO CHILDREN. HE ALSO HAD A WIFE. WITHIN ONE DAY OF HIS STAY AT THE I.C.U., HE WAS INTUBATED. HIS CHILDREN STOOD BY AND WATCHED WHILE THAT HAPPENED. 36 HOURS LATER, HIS WIFE HAD DECIDED THAT HE WOULD NOT UNDERGO CARDIOPULMONARY RESUSCITATION. NOTHING COULD BE DONE TO SAVE HIM. I STOOD IN THAT ROOM WITH ANOTHER RESIDENT. 36 HOURS LATER, AND TOOK THE TUBE OUT WHILE HIS CHILDREN STOOD OUTSIDE OF THE DOOR CRYING. THERE WAS NOTHING WE COULD DO. THERE WAS NO ONE ELSE THERE TO PROVIDE CARE FOR HIM. THAT IS WHO YOUR RESIDENTS ARE. THEY ARE NOT JUST STAFFING YOUR EMERGENCY DEPARTMENTS. THEY ARE STAFFING YOUR I.C.U. THEY ARE NOT EQUIVALENT T TO AN ADVANCED PRACTICE PROVIDER. THEY ARE NOT YOUR MP. THEY ARE NOT YOUR PA. THEY ARE HERE TO PROTECT AND SUPPORT YOUR COMMUNITY WITH EVERYTHING THAT THEY HAVE. 24 HOURS AFTER THAT, A CODE WAS CALLED ON THE FLOOR. YOUR RESIDENTS RESPOND TO THOSE CODES ON THE FLOOR WHILE THEY COVER YOUR I.C.U. I WENT TO THAT CODE, AND IT WAS HIS CHILDREN'S MOTHER. IT WAS COVID. SHE HAD A BREATHING MASK ON. WE DID EVERYTHING WE COULD. I HAD TO TURN HER ON AND TELL THOSE CHILDREN THAT THEIR MOTHER DID NOT MAKE IT AS WELL. I WAS TRAINED AS A CASUALTY NOTIFICATION OFFICER IN THE MILITARY. I NEVER THOUGHT I WOULD HAVE TO USE THOSE SKILLS DURING MY RESIDENTSY. I CAME TO THIS PROGRAM BECAUSE IT IS A GEM. IT OFFERS SOMETHING THAT NOTHING ELSE IN THE COASTAL BEND WILL OFFER. IT IS UNIQUE TO NUECES. YOU SHOULD DO EVERYTHING YOU CAN TO RETAIN THIS PROGRAM OR THE PHYSICIANS WITHIN IT. THANK YOU. >> THANK YOU. >> CRYSTAL TRESTOR. >> I JUST WANTED TO SAY -- >> STATE YOUR NAME AND ADDRESS. >> I'M SORRY. I'M DISTRACTED. MY NAME IS CRYSTAL TRESTOR. CORPUS CHRISTI. I JUST CAN'T SAY HOW MUCH IT MEANS TO ME PERSONALLY THAT YOU WOULD CONVEY THIS SESSION TODAY. I DON'T REALLY FEEL LIKE I NEED TO SPEAK FOR OUR RESIDENCY PROGRAM. THEY HAVE COVERED THAT. WHAT I WANT TO SPEAK TO YOU FROM IS FROM MY PERSPECTIVE. THIS IS MY INDEPENDENT OPINION REGARDLESS OF WHO KEEPS THE BILLS PAID IN MY HOME. I STARTED IN 1992. AS A PARAMEDIC. I WAS HERE WELL BEFORE THE RESIDENCY PROGRAM STARTED. I HAD TO SIT AND THINK, THERE WAS A TIME THAT WHEN MEMORIAL HOSPITAL WAS HERE, REGARDLESS OF WHAT WAS GOING ON, BECAUSE OF THIS-- THE MORAL COMPASS OF THOSE FOLKS THAT MANNED THOSE EMERGENCY ROOMS, OF HOW THEY BEHAVED. WHEN THE RESIDENCY PROGRAM CAME, AND THE WAY THAT THAT BLOSSOMED INTO BEING ABLE TO PROVIDE THAT DEPTH OF CARE THAT IS ALREADY MENTIONED, I HAVE DONE CRITICAL CARE TRANSPORTS. IN THE CITY SINCE-- TO HAVE THOSE EMERGENCY MEDICINE TRAINED FOLKS MANNING OUR RURALS, THINK ABOUT HOW LONG IT TAKES ANYONE TO DRIVE FROM KINGSVILLE TO A LEVEL TWO TRAUMA CENTER. I'M GOING TO TELL YOU. IT MATTERS. THERE IS A DIVIDED FOCUS. WE NEED MORE PRIMARY CARE AND WE NEED MORE THINGS LIKE THAT AND URGENT CARE CENTERS. I'M GOING TO TELL YOU, NOT A SINGLE PERSON IN THE E.M.S. COMMUNITY IS GOING TO TAKE SOMEONE THERE. THEY ARE GOING TO TAKE THEM TO THAT LEVEL TWO TRAUMA CENTER. AND HAVING THE DEPTH OF COVERAGE THAT HAVING THE RESIDENTS THERE AND NOT ONLY THAT, RIGHT NOW, TODAY ON CAPITOL HILL, THERE IS NURSES SPEAKING OUT FOR THE PATIENT SAFETY AND STAFFING ISSUES. THAT IS ACROSS THE COUNTRY. THAT IS A KNOWN. BECAUSE OF COVID. OUR NURSES HERE THAT WORK ALONGSIDE THESE DOCTORS ARE LEARNING WITH THEM. THEY ARE BECOMING EXPERTS WITH THEM. THEY TRAIN WITH THEM. MYSELF, THEY HAVE COME IN AND ON THEIR OWN TIME HAVE LEARNED FROM THEM. NOT BECAUSE THEY WERE PAID TO BE HERE. BECAUSE THEY HAD THE MORAL COMPASSION. AND THE ETHICS TO KNOW THAT WHEAS WHAT NEEDS TO BE DONE. I'M TERRIFIED WHAT HAPPENS IF THIS PROGRAM GOES AWAY. I JUST WITHIN THE LAST MONTH, HAD A LOVED ONE IN A RURAL CENTER HAVING THE WORST DAY OF HIS LIFE. I CALLED OUT NOT BECAUSE I WAS DOING ANY FAVORS. I NEVER WOULD ASK THAT. I'M, LIKE, WHAT DO I DO? AND THOSE-- THIS HOSPITAL AN THOSE GUYS IN THAT E.R. SAID "WE ARE WAITING FOR HIM. GET HIM HERE." THANK YOU FOR YOUR TIME. I REALLY APPRECIATE YOUR EAR. >> THANK YOU. [01:25:07] >> DR. CHRIS SOUTHERLY. I GOT A LIST TURNED IN. SO THANK YOU. OH, NOT ON THE BOTTOM PART. OKAY. THANK YOU. DR. J.D.CAMBRON. NOT SPEAKING EITHER? >> KARL. >> THIS IS J.D. NO THE? >> HOW ABOUT KARL? >> OKAY. IF KARL IS HERE AND KARL WANTS TO SPEAK, THAT IS GOOD. (LAUGHTER) I HAVE J.D. WHOEVER THAT IS. >> JUDGE, THANK YOU VERY MUCH. (LAUGHTER). LET ME INTRODUCE MYSELF. MY NAME IS DR. KARL SIRAD. I LIVE IN CORPUS CHRISTI. JUDGE, COMMISSIONERS, THANK YOU FOR ALLOWING ME TO SPEAK TODAY IN SUPPORT OF US MAINTAINING THE EMERGENCY MEDICINE RESIDENCY PROGRAM. I'M NOT HERE TO REPRESENT THE RESIDENTS, PER SE, OR NECESSARILY SPOHN. I'M HERE TO REPRESENT THE COMMUNITY. I AM A PEDIATRIC I.C.U. PHYSICIAN. I WORK AT THE HOSPITAL. I TRAINED HERE. I LIVED HERE FOR 30 YEARS. I'M INVESTED IN THE THIS COMMUNITY. I HAVE SEEN THE IMPACT THAT RESIDENCY MADE WHEN IT FIRST CAME INTO BEING IN 2007. I HAVE SEEN THE IMPACT ON THE CHILDREN IN THIS COMMUNITY. PRIOR TO THAT, IT WAS NOT UNCOMMON FOR ME TO TAKE CARE OF CHILDREN WHO WERE NOT ADEQUATELY STABILIZED, DID NOT RECEIVE TIMELY CARE, AND VERY OFTEN HAD SERIOUS IMPACTS DOWN THE ROAD. TODAY, JUST RECENTLY, I GOT A CALL FROM ONE OF OUR E.D. PHYSICIANS WHO WAS TRAINING AT SPOHN. I HELPED TRAIN THEM. AND IT WAS A YOUNG GIRL WITH A DIABETIC EMERGENCY. AND HE DID ALL OF THE THINGS RIGHT. I DIDN'T HAVE TO SAY A WORD. WHEN SHE GOT TO US, SHE WAS STABILIZED AND WAS HOME THE NEXT DAY. THAT DID NOT HAPPEN 16 YEARS AGO. I WILL TELL YOU THE MINUTE THAT THE RESIDENCY PROGRAM CLOSES, OR EVEN BEFORE THAT, THE IMPACTS WILL BE FELT BY THE MOST VULNERABLE IN OUR COMMUNITY. THAT WILL BE THE CHILDREN. THE INDIGENT. THE UNDERINSURED. THE PREGNANT WOMEN. AND THOSE WITH MENTAL HEALTH DISORDERS. THEY WILL BE THE FIRST ONES TO FEEL THE IMPACT. IT WILL NOT BE ADMINISTRATORS OR PHYSICIANS. IT WILL BE THEM. I WILL ALSO TELL YOU THAT LOSING THIS PROGRAM WILL AFFECT OUR WORKFORCE, OUR ABILITY TO HAVE ACCESS TO CARE AND QUALITY OF CARE. I HAVE A FEW MORE SECONDS. I WILL TELL YOU THIS. PEOPLE ARE TRAINED HERE, S THEY STAY HERE. THIS IS AN UNDERSERVED AREA. NOBODY WANTS TO COME HERE. TRYING TO ATTRACT TALENT IS DIFFICULT. LOSING THIS PROGRAM, YOU WILL SEE AN EXODUS OF TALENT. IT WON'T BE THAT WE WON'T ATTRACT THEM. YOU WILL ACTUALLY SEE A NET EXODUS OF TALENT. I THANK YOU FOR DOING WHAT WE CAN TO TRY TO FIND SOLUTIONS TO KEEP THIS PROGRAM HERE. BECAUSE IT IS A RESOURCE THAT A SMALL COMMUNITY LIKE THIS CAN ILL AFFORD TO LOSE AND I WILL TELL YOU, WE WILL PROBABLY NEVER EVER REPLACE IT IF WE DO. THANK YOU. >> THANK >> DR. GARCIA? ED GARCIA. >> THANK YOU, JUDGE. THANK YOU TO OUR COMMISSIONERS. FIRST OF ALL, I'M SO-- TIME IS SHORT. I'M GOING TO BE BRIEF. I'M SO HAPPY TO HEAR THAT A COMMITTEE IS BEING FORMED TO LOOK INTO THIS PROBLEM. I'M NOT HOLDING ANYONE AT FAULT. I'M NOT GOING TO BLAME CHRISTUS THIS OR CHRISTUS THAT OR PEOPLE RECORDING STUFF OR-- OBVIOUSLY, I EVEN GOT HIGHLY A LITTLE BIT-- THIS AFFECTS ME EMOTIONALLY ALSO. I'M HERE TO GIVE YOU, JUDGE AND COMMISSIONERS, I'M HERE TO GIVE YOU ANOTHER PERSPECTIVE. MY NAME IS DR. ED GARCIA. I LIVE AT 1009 DELTA DRIVE. I'M SO PROUD TO SAY THAT I LEFT A THRIVING INTERNAL MEDICINE PRACTICE IN AUSTIN, TEXAS TO COME HERE, AND I'M ONE OF THE OLD-TIMERS. I USED TO WORK AT THE OLD MEMORIAL TRAUMA CENTER. THE OLD MEMORIAL HOSPITAL YEARS BEFORE ANYONE HAD HEARD OF A TRAUMA CENTER OR-- EXCUSE ME. YEARS BEFORE ANYONE HAD HEARD OF AN ELITE EMERGENCY ROOM PROGRAM, [01:30:05] AND THOSE WERE THE BATTLE DAYS. OUR CHARTS-- THE RACKS WOULD FILL UP ALL THE WAY. AND PATIENT WAITS FOR FOUR, FIVE, SIX HOURS. I DID SOME WORK AT THE OLD EMERGENCY ROOM AT CHRISTUS SHORELINE. AND THE WAITS WERE JUST AS HUGE BACK THEN. I DON'T KNOW WHERE ANYONE GOT THIS IDEA OF A 90-MINUTE WAIT. WAITS OF THREE, FOUR HOURS WERE NOT AT ALL UNUSUAL. SLOWLY, I MOVED MY PRACTICE INTO OCCUPATIONAL MEDICINE, AND I AM THE HEAD OF INDUSTRIAL MEDICAL SOLUTIONS. I'VE GOT ONE OF THE NICEST AND MOST INTERESTING JOBS ON THE MEDICAL PLANET. I TAKE CARE OF CHEMICAL WORKERS, REFINERY WORKERS. I TAKE CARE OF HEAVY CONSTRUCTION WORKERS. MECHANICS. WE HELP, WE HELP REFINERY ROW COORDINATE THE MEDICAL CARE OF THE REFINERY AND CHEMICAL AND CONSTRUCTION WORKERS, AND WE HELP GUIDE THEM THROUGH OCCUPATIONAL BUREAUCRATICTHAT IS SPECIAL OSHA. OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION. WE GUIDE THEM THROUGH MEDICAL ISSUES. THIS EMERGENCY ROOM AND ITS HIGH-CLASS PHYSICIANS ARE INSTRUMENTAL. BUT ENOUGH F OF ME OR ENOUGH OF THEM. I'M HERE TO REPRESENT THE WORKERS OF WHERE I WORK AND OTHER PLACES. KOS INGLESIDE. DUPONT. VALERO, CITGO, FLINT HILLS. THESE PEOPLE NEED NOT A LITTLE OLD E.R. AGAIN, I'M READING FROM MY NOTES. NOT A LITTLE OLD E.R. THAT WE HAD BEFORE. THEY NEED A STATE-OF-THE-ART SPHIS SKATED, CUTTING-EDGE, SPIRITED LEARNING ENVIRONMENT WHERE THEY CAN GET THE BEST MEDICAL CARE. REFINERY ROW DESERVES NOTHING LESS THAN THAT. THANK YOU. . >> THANK YOU. I WOULD JUST LIKE TO POINT OUT WE HAVE HAD A FEW ELECTED OFFICIALS COME THROUGH. I KNOW COUNCILMAN MIKE WAS HERE. WE JUST HAD JUDGE KLINE WALK IN THERE BACK IN THE BACK. JUST TO LET YOU KNOW HOW IMPORTANT THIS IS TO OUR COMMUNITY AND HOW INVOLVED THESE OTHER INDIVIDUALS ARE AND WANT TO BE HERE AND HEAR YOUR CONCERNS AS WELL. SO THANK YOU, JUDGE, FOR JOINING US AS WELL. NEXT UP, LET'S HAVE DR. SIMMONS. MICHAEL SIMMONS. >> I'M NOT A RECENT GRADUATE O OF -- >> (LAUGHTER). >> OF THIS RESIDENCY PROGRAM. MY NAME IS MICHAEL SIMMONS. I'M AN E.M.S. DIRECTOR FOR THE RESIDENCY AND THE CITY. I WANTED TO DIRECT COMMISSIONER GONZALEZ. I HAVE BEEN HERE FOR 24 YEARS NOW. I HAD A WONDERFUL CAREER WITH SPOHN. BETWEEN DR. HERRICK AND I, FROM THE OLD MEMORIAL DAYS, I HAVE SEEN THOUSANDS OF NCAHD PATIENTS AND KNO KNOW SEVERAL OF THEM BY THEIR FIRST NAMES. REALLY WHAT I WANT TO DO IS TELL A SHORT STORY THAT SHOWS YOU HOW MUCH THINGS HAVE CHANGED. IN 2006, THE VICE PRESIDENT OF THE UNITED STATES SHOT SOMEBODY IN THE FACE. THEY WERE TRANSPORTED TO MEMORIAL HOSPITAL. AT THAT TIME, I HAVE NEVER SPOKEN OF THIS PUBLICLY. AT THAT TIME, THERE WAS ONE DOCTOR AND TWO NURSES TO TAKE CARE OF THAT TRAUMA. THE TRAUMA SURGEON WAS ALREADY IN THE OPERATING ROOM WITH ANOTHER TRAUMA PATIENT. SO THIS FELLOW-- THIS FELL ON ONE DOCK AND TWO NURSES. THAT WAS FOR SOMEBODY THAT WAS VERY IMPORTANT AND VERY WELL-RESPECTED. IF THAT HAPPENED TO THE LOWEST OF US THAT LIVED IN NUECES COUNTY NOW, THERE WOULD BE AT LEAST FOUR DOCTORS, TWO TECHS, NURSES AND RESPIRATORY THERAPISTS THAT WOULD BE ON THERE. THAT IS FOR SOMEBODY THAT A LOT OF PEOPLE DON'T THINK MATTER. THAT IS HOW MUCH WE HAVE CHANGED WITH THE RESIDENCY PROGRAM. THANK YOU. >> THANK YOU. >> DR. KIM LISTON. >> I THINK YOU HAVE THE LIST OF DRP WE WERE OFFERED TO PRESENT. >> OKAY. WELL, I WILL GO, THEN, JUST TO THIS OTHER LIST. THANK YOU. CARL KAVELLA. >> GOOD AFTERNOON. MY NAME IS CARL KAVELLA. [01:35:03] THIS IS ONE OF MY DAUGHTERS. I LIVE AT 1 CAMDEN PLACE. I'M THE CAPTAIN OF THE SOUTHERN RESPONDER, A 210-FOOT OIL SPILL RESPONSE VESSEL. STATIONED HERE IN CORPUS CHRISTI BAY. A MONTH AGO, ON WEDNESDAY, SEPTEMBER 13, I DIED UNDER WAY AT THE HELM OF MY VESSEL. FOLLOWING 18 MINUTES OF CPR AND BEING SHOCKED BY OUR AED, I REGAINED PULTS, BREATH, AND CONSCIOUSNESS. I WAS TRANSPORTED FIRST BY POLICE BOAT AND THEN BY E.M.S. FROM INGLESIDE. I INSIFERSED OVER AND OVER TO EVERYBODY THAT I BE TAKEN TO SPOHN SHORELINE EMERGENCY ROOM. I DID THIS BECAUSE MY WIFE, AN EMERGENCY ROOM NURSE FOR 16 YEARS, WHO WORKED AT MEMORIAL AND THEN SHORELINE FOR A TOTAL OF TEN YEARS, KNOWS THAT THE BEST DOCTORS IN THE CITY ARE THE ONES TRAINED IN SPOHN'S EMERGENCY MEDICINE RESIDENCY PROGRAM AND THE FACULTY TRAINING THEM. SURE ENOUGH, I WAS TREATED AT SHORELINE'S EMERGENCY ROOM BY FACULTY ATTENDING KIM LEESON. AND EMERGENCY MEDICINE PHYSICIANS. THEY IDENTIFIED THE WIDOW-MAKER HEART ATTACK I WAS HAVING AND SENT ME TO THE LAB IN MINUTES. FOUR HOURS AFTER COLLAPSING AT THE HELM, I WAS RECOVERING IN THE I.C.U. AND CRACKING JOKES WITH MY FAMILY BECAUSE I RECEIVED THE VERY BEST EMERGENCY CARE AVAILABLE IN CORPUS CHRISTI. BECAUSE OF THEM, MY WIFE IS NOT A WIDOW. MY CHILDREN HAVE THEIR FATHER. AND I CAN CONTINUE TO RAISE MY CHILDREN AND RESPOND TO SPILLS AND OTHER EMERGENCIES IN CORPUS CHRISTI BAY AND BEYOND. BUT NOW SPOHN HAS DECIDED TO PRIORITIZE MONEY OVER PROVIDING EXCELLENT EMERGENCY SERVICES. ABOVE PROVIDING A STEADY STREAM OF EXCELLENT EMERGENCY ROOM PHYSICIANS WHO CHOOSE TO REMAIN IN CORPUS CHRISTI AND SERVE OUR COMMUNITY. AND ABOVE CONTINUING TO ATTRACT AND RETAIN THE BEST FACULTY POSSIBLE TO NOT ONLY TRAIN THOSE E.R. DOCS BUT ALSO TO PROVIDE WORLD-CLASS MEDICAL CARE AROUND THE CLOCK. THIS MEANS THEY WANT TO GET RID OF DR. KIM LEESON, DR. MEGAN COOK AND DR. VAL NEWTSON IN HOPES THAT THEY CAN SAVE BUCK. MAKE MORE MONEY IN OTHER WAYS? SO I ASK YOU TO APPLY PRESSURE TO SPOHN EXECUTIVES TO RECONSIDER WHAT WILL UNDOUBTEDLY BE A DISASTER ROWSE DECISION FOR OUR CITY. I BEG YOU THE TAKE A STRONG STAND FOR HEALTH, SAFETY, AND WELL-BEING OF EVERY CAR PUS CHRIS-- CORPUS CHRISTIAN. THANK YOU FOR YOUR TIME AND ATTENTION. THANK YOU TO ALL THE DOCTORS AND NURSES, TECHS, AND OTHERS WHO HAD A HAND IN ME BEING ALIVE TODAY TO ADDRESS YOU. THANK YOU. >> THANK YOU. THAT IS THE END OF THIS LIST. AND IF I'M NOT SUPPOSED TO GO TO THE OTHER PAGE, IS THERE ANYONE HERE WHO WISHES TO SPEAK THAT DIDN'T HAVE THE OPPORTUNITY TO SIGN UP ON PUBLIC SPEAKING? YES, MA'AM. YOU CAN COME AND STATE YOUR NAME AND ADDRESS FOR US, PLEASE. >> GOOD AFTERNOON. MY NAME IS CHRISTIE SNOD GRAZ. , SNOD GRASS. I HAVE BEEN A NURSE FOR TEN YEARS. MOST OF THOSE YEARS WERE SPENT WORKING AS A BEDSIDE NURSE AND A CASE MANAGER AT SPOHN. THE DOCTORS AND STAFF AT CHRISTUS WERE PHENOMENAL AND EXHIBITED A LEVELLE OF EXPERTISE THAT RIVALED MUCH LARGER SYSTEMS IN MUCH LARGER CITIES TO. SAY THESE HEALTH CARE WORKERS PROVIDE IMMENSE VALUE TO OUR COMMUNITY IS AN UNDERSTATEMENT. HOWEVER, WHILE WORKING AS A NURSE AT CHRISTUS, I BEGAN TO REALIZE THERE WAS A PRETTY LARGE DISCONNECT BETWEEN THOSE MAKING THE DECISION FOR THE HOSPITAL AND THOSE WHO ACTUALLY HAD TO IMPLEMENT THOSE DECISIONS AND PROVIDE PATIENT CARE. THERE WERE CONSTANT CONCERNS ABOUT STAFFING, PATIENT SAFETY, AND UNMANAGEABLE WORKLOADS. WHEN THOSE CONCERNS WERE BROUGHT TO ADMINISTRATION, THEY WERE OFTEN DISMISSED OR PROMISES WOULD BE MADE BUT NEVER DELIVERED ON. THAT IS WHY IT IS UNFATHOMABLE TO ME THAT THEY WOULD ELIMINATE A PROGRAM THAT WOULD MAKE THOSE ISSUES WORSE. BECAUSE OF THESE ISSUES, TWO YEARS AGO, I MADE THE HEARTBREAKING DECISION TO LEAVE NURSING. A CAREER THAT I LOVED SO DEEPLY, BUT COULD NO LONGER DO BECAUSE OF THE LACK OF SUPPORT AND THE [01:40:01] RISK TO MY PATIENTS AND TO MY LICENSE. NOW I WORK FULL-TIME IN THE WORLD OF HEALTH CARE REFORM. I ADVOCATE FOR THE RIGHTS OF HEALTH CARE WORKERS AND FOR PATIENTS. I WAS ABOUT TO BOARD A FLIGHT TO WASHINGTON, D.C. WHEN I HEARD THE NEWS THAT SPOHN WAS CLOSING ITS RESIDENTTY PROGRAM. I KNEW THIS COULD HAVE DEVASTATING ON SEQUENCES ON OUR COMMUNITY. I IMMEDIATELY REACHED OUT TO SOME SPOHN STAFF MEMBERS WHO STATED THEY COULD NOT SPEAK TO ME ABOUT THEIR CONCERNS BECAUSE THEY FEARED SPOHN WOULD RETALIATE AGAINST THEM. WELL, SPOHN MAY HAVE BEEN EFFECTIVE IN SILENCING THE VOICES OF THEIR STAFF. IN DOING SO, THEY AMPLIFIED THEIR STAFF'S CONCERNS. BECAUSE IF THE RESIDENTS CANNOT USE THEIR VOICE, THEN I WILL USE MINE. THIS WEEK I TRAVELED WITH A TEAM OF HEALTH CARE WORKERS TO MEET WITH OVER 50 CONGRESS MEMBERS. WE ALSO MET WITH THE ASSISTANT TO THE PRESIDENT FOR PUBLIC HEALTH AND DISTAR BYES AT THE WHITE HOUSE AND THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. WE BROUGHT THE VOICES OF THESE PHYSICIANS AND THEIR CONCERNS TO THE INDIVIDUALS IN CHARGE OF MAKING DECISIONS FOR THIS COUNTRY. I ASKED THEM TO DO THE EXACT SAME THING THAT I'M GOING TO ASK ALL OF YOU TO DO TODAY. LISTEN TO YOUR HEALTH CARE WORKERS. THEY ARE THE CONTENT EXPERTS ON WHAT IT TAKES TO CHEMOOUR COMMUNITY SAFE F AND CARED FOR. THEY NEED TO BE INCLUDED IN ALL DECISION THAT IS AFFECT PATIENT CARE AND THEIR CONCERNS NEED TO BE ADDRESSED WITH UTMOST IMPORTANCE. YOU HAVE HEARD FROM THESE DOCTORS HOW THIS WILL IMPACT OUR COMMUNITY. I'M NOT GOING TO REITERATE THOSE CONCERNS THAT YOU HAVE ALREADY HEARD. INSTEAD I'M SIMPLY ASKING THAT YOU GIVE CAREFUL CONSIDERATION OTTO ALL THE CONCERNS THAT HAVE BEEN BROUGHT TO YOU TODAY. THE DECISION SPOHN MAKES GOING FORWARD WILL BE A REFLECTION OF HOW MUCH THEY VALUE THE VOICES IN THE ROOM TODAY. PLEASE MAKE SURE THAT THE DECISION YOU MAKE IS TRULY WHAT IS BEST FOR OUR COMMUNITY. THANK YOU. >> THANK YOU. IT LOOKS LIKE I MISSED ONE. RACHEL SOUTHERLILY. ST ARE YOU STILL HERE? SORRY. >> MY NAME IS RACHEL SOUTHERLY. I LIVE AT 312 PEERMAN PLACE. I'M THE WIFE OF DR. CHRISTOPHER, SOUTHERLY, THE MEDICAL DIRECTOR AT SPOHN SHORELINE HOSPITAL. AGAIN, I THOUGHT I HAD SOMETHING PREPARED. A LOT OF PEOPLE HAVE TALKED ABOUT IT ALREADY. I WANT TO REITERATE HE WAS NOT INVOLVED IN ANY OF THESE DECISIONS. IT BLINDSIDED HIM, IT BLINDSIDED HE. ME. WE ARE NOT FROM TEXAS. I NEVER WOULD HAVE CHOSEN TO LIVE IN TEXAS. IT IS REALLY HOT. S IF (LAUGHTER) WE LOVE IT HERE. WHENEVER MY FAMILY ASKS, MY FRIENDS ASK, WHY CORPUS CHRISTI? AND WE SAY, WE LOVE OUR JOBS. WE WERE AT DINNER WHEN WE GOT THE OWN THE CALL. WE HAD TOLD FRIENDS HOW MUCH WE LOVE OUR JOBS. AND IN THE BLINK OF AN EYE, IT IS GETTING-- THE RUG IS GETTING PULLED OUT FROM UNDERNEATH US. I'M GOING TO BRAG FOR A MOMENT. MY HUSBAND HAS WORKED INCREDIBLY HARD WITH HIS CORE FACULTY, WITH THE EMERGENCY MEDICINE RESIDENTS TO DECREASE WAIT TIMES EVEN MORE. DOOR-TO-DOCTOR TIMES, RELATIONSHIPS BETWEEN THE EMERGENCY DEPARTMENT AND THE REST OF THE SPECIALTIES IN THE HOSPITAL. HE STAYS ON TOP OF SCHEDULING TO ENSURE STAFF IS UTILIZED REALLY WELL. HE IS AN EXCELLENT MENTOR TO THE RESIDENT PHYSICIANS. HE WAS EVEN RECOGNIZED NATIONALLY BY HIS CONTRACT GROUP AS MELD CALL DIRECTOR OF THE YEAR. HE IS DOING AN EXCELLENT JOB. I MIGHT BE A LITTLE BIT BIASED. BUT I'M PRETTY SURE YOU COULD ASK MOST OF THE PEOPLE HERE. THEY WOULD SUPPORT THAT FACT. AND THAT IS WHY IT IS SO MIND-BOGGLING WHEN IT SAYS ON THE CHRISTUS HEALTH WEBSITE THAT ONE OF THEIR CORE VALUES IS EXCELLENCE. THAT THEY DIDN'T HAVE HIM IN THE ROOM, ASKING HIM, HEY, HOW CAN WE MAKE THIS BETTER? I'M PROUD TO KNOW ALL THESE PEOPLE. I HOPE THAT THIS DOESN'T TAKE A DRAMATIC TURN IN A VERY SAD DIRECTION. BECAUSE THE EMERGENCY DEPARTMENT IS RIGHT NOW THE DEFINITION OF EXCELLENCE. I FEAR THAT THESE DECISIONS THAT WERE MADE SEEMINGLY IN HASTE, WITHOUT CONSULTING SOME OF THE EXCELLENT TEAM MEMBERS THEY HAD AT THEIR DISPOSAL, IT WOULD BE GOING IN THE WRONG DIRECTION. THANK YOU FOR YOUR TIME. >> THANK YOU. >> THAT IS THE END OF MY LIST. I'M NOT SURE IF ANY OF THE OTHER COMMISSIONERS WANT TO SPEAK AGAIN. I WOULD JUST LIKE TO-- WERE YOU WANTING TO SPEAK? PLEASE. >> HELLO. I'M A PHYSICIAN HERE. I I'M HERE ON A PERSONAL LEVEL. [01:45:03] DOMENIC DOMINGUEZ DESCRIBED HIS TIES TO THE COMMUNITY. I'M ALSO LOCAL. I WAS BORN AND RAISED HERE. WENT TO HIGH SCHOOL HERE. WENT TO UNIVERSITY IN CORPUS COS CHRISTI. WENT TO A&M, COLLEGE STATION. I ENDED UP RETURNING HERE. I DID NOT INTEND TO STAY HERE. I FOUND SOMETHING SPECIAL ABOUT THIS PROGRAM. I ENDED UP RETURNING TO TRAIN HERE. I HAVE STAYED HERE. SO IT IS TRUE. PHYSICIAN THAT IS DO TRAIN HERE TEND TO STAY HERE. I HAVE WORKED SIDE BY SIDE WITH THE RESIDENTS. AS A RESIDENT MYSELF, I'M FP-TRAINED. I WILL TELL YOU WORKING SIDE BY SIDE WITH THEM, THEY ARE PHENOMENAL. I'M HERE SO SPEAK ON BEHALF OF THE NUECES COUNTY MEDICAL SOCIETY. I WAS PRIVILEGED TO BE CHOSEN AS THE PRESIDENT OF THE SOCIETY THIS PAST YEAR. IN THAT CAPACITY, WE DID CALL AN EMERGENCY MEETING LAST NIGHT. WE DID HAVE BOTH SIDES OF THE TABLE-- AT THE TABLE TO EXPLAIN THINGS TO US. IT WAS PRETTY CLEAR TO US THAT SPOHN DOES HAVE THEIR-- YOU KNOW, THEIR INTENT AND REASONING BEHIND THINGS. OUR STANCE ON THE MATTER IS THAT WE HAVE A CRITICAL SHORTAGE OF HEALTH CARE IN THE AREA. WE APPRECIATE THEIR VISION OF BOLSTERING PRIMARY CARE IN THE COMMUNITY WHICH IS AN ABSOLUTE NECESSITY. THAT IS GOING TO TAKE TIME. AND FOR NOW, THE INDIGENT POPULATION IN THIS COMMUNITY IS DEEPLY DEPENDENT ON THE E.R. AND THEIR RESOURCES. THESE GUYS ARE ROCK STARS. AND THEY DEAL WITH THESE PATIENTS DAY IN AND DAY OUT. AND IT IS OUR POSITION THAT WE ARE GOING TO BE LOSING A VALUABLE RESOURCE. A RESIDENCY IN A COMMUNITY LIKE OURS IS A PRIVILEGE AND A GIFT. IT IS A GIFT THAT WE ARE GOING TO BE THROWING AWAY. SO THEY HAVE THE FULL BACKING OF THE MEDICAL SOCIETY. WE ARE 743 PHYSICIAN MEMBERS STRONG. 445 OF THOSE MEMBERS ARE ACTIVE PRACTICING PHYSICIANS IN IN COMMUNITY. IN NUECES COUNTY. THAT IS ALL I HAVE TO SAY. THANK YOU. >> THANK YOU VERY MUCH. RACHEL, I'M SORRY. I THOUGHT YOU LEFT. SO YES. >> I'M NOT A DOCTOR. RACHEL CABIERO. I'M A COMMUNITY ADVOCATE. FULL DISCLOSURE. I'VE BEEN A COMMUNITY ADVOCATE FOR THREE YEARS. I GOT INVOLVED IN POLITICS WHENEVER WE HAD A TYRANNICAL JUDGE IN OFFICE, AND MEASURES WERE ISSUED OUT TO THE PUBLIC BY THIS COURT. I'M HERE BECAUSE I HEARD THE TESTIMONIES O'. >> THESE DOCTORS ON TUESDAY AT CITY COUNCIL. AND BECAUSE I WANT TO CONTINUE MY EFFORTS TO ADVOCATE FOR MY COMMUNITY. WHAT I CAN'T SEEM TO WRAP MY HEAD AROUND IS THAT WE HAVE BEEN NATIONALLY KNOWN FOR A VERY LONG TIME THAT WE HAVE THE MOST OBESE AND UNHEALTHY COMMUNITY IN THE COUNTRY. AND I BELIEVE THAT CHRISTUS SPOHN, IF THEY ARE DOING THEIR RESEARCH, SHOULD KNOW THAT. THEY SHOULD KNOW THAT IT TAKES 18 DOCTORS TO FULFILL THEIR, YOU KNOW, THEIR RESIDENCY INSTEAD OF 12 WHICH THEIR TIME WOULD NOT COUNT. ANYWAY, I HAD TO STAY HEALTHY BECAUSE ON THE-- I'M THE SOLE EMPLOYEE OF MY FAMILY BUSINESS. MY FAMILY RELIES ON DOCTORS. I BELIEVE MOST OF YOU GUYS HAVE SAID, YOU KNOW, MR. CHESNEY, YOU ARE RUBBING YOUR BACK. YOU NEED THESE GUYS, TOO. (LAUGHTER) I JUST DON'T UNDERSTAND THE DECISIONS THAT ARE BEING MADE IN THIS PROGRAM. SO A COUPLE OF ISSUES. ONE, I DON'T UNDERSTAND WHY CHRISTUS SPOHN WOULD PUT A GAG ORDER ON THESE DOCTORS. IT IS OUR CONSTITUTIONAL RIGHT TO SPEAK WHAT WE NEED TO SPEAK TO DEFEND OURSELVES. I DON'T UNDERSTAND WHY THEY WOULD DEFUND A PROGRAM IN ONE OF THE MOST UNHEALTHY AND OBESE PLACES IN THE COUNTRY. I HAVE BEEN INVOLVED IN POLITICS K, LIKE I SAID, DOING RESEARCH FOR THE LAST THREE YEARS. I KNOW THE DIFFERENT POLITICIANS THAT ARE INVOLVED ON THE BOARDS. THEY MAY SEEM AS FRIENDS BECAUSE THEY ARE ON THE BOARDS. THEY ARE ALSO POLITICIANS. I'M A TRUE COMMUNITY ADVOCATE, AND SO I WOULD LIKE TO BE ABLE TO OFFER MYSELF TO THE COMMITTEE TO PROVIDE MY RESEARCH AND REGARDING THE POLITICS IN THE AREA. SO THANK YOU FOR YOUR TIME. DOCTORS, THANK YOU. I'M SORRY YOU ARE BEING TREATED POORLY. THIS IS POLITICS, AND HOPEFULLY, THE COMMUNITY WILL WAKE UP AND GO TO BAT FOR YOU GUYS. >> THANK YOU. WE HAVE CARLOS VARGAS ON-LINE. IF YOU CAN UNMUTE. YOU ARE ON. THANK YOU. >> CARLOS VARGAS HERE. I'M AT THE UNIVERSITY OF IOWA UNDERGOING ELECTROPHYSIOLOGY TRAINING. DR. KIM AND BEN LEESON, WHEN I WAS A AT TEXAS A&M IN CORPUS [01:50:06] CHRISTI. THE PROGRAM WAS INSTRUMENTAL IN ME, YOU KNOW, WANTING TO GO INTO MEDICINE. AND HAVING THE RESIDENTS THERE AND TALKING WITH THEM, REALLY ENCOURAGED MANY ETO PURSUE MY TRAINING. I WANT TO GO BACK TO CORPUS CHRISTI. I HAVE A HOUSE THERE. 5917 O'TOOLE. ONE OF THE MAIN REASONS I WOULD WANT TO GO BACK IS BECAUSE OF THE TEACHING THAT GOES ON THERE AND THE TRAINING. AT MY LEVEL OF TRAINING, THERE IS NOT A SINGLE FULL-TIME ELECTROPHYSIOLOGIST IN CORPUS CHRISTI RIGHT NOW. EVERYONE FLIES IN. FOR ME TO HEAR THAT A PROGRAM IS GOING TO GET DEFUNDED WAS HEARTBREAKING TO ME. I LOVE TEACHING. THAT ENCOURAGED ME TO GO BACK. BEFORE THIS, YOU KNOW, GETS OFFICIAL, I THINK, YOU KNOW, THEY SHOULD LOOK AT WHAT THE SALARIES ARE FOR THE C.E.O. AND ALL THESE OTHER ADMINISTRATORS BEFORE THEY CUT FUNDING TO A REALLY VALUABLE PROGRAM FOR THE AREA. >> THANK YOU. I THINK WE HAVE MADE IT CLEAR THAT WE WANT TO PROVIDE A WORKING GROUP TO DISCUSS THIS AND SEE WHAT WE CAN DO IN THE FUTURE WITH THIS. WE HAVE-- WHAT, EIGHT MEMBERS, TWO, FOUR, SIX, EIGHT, NINE THAT I HAVE TALKED TO AND SELECTED. I APPRECIATE YOUR INPUT IN THIS. LET ME ALSO BE CLEAR. I'M NOT GOING TO GIVE ANYONE ANY FALSE HOPE. I'M NOT SURE WHAT KIND OF AUTHORITY WE WOULD HAVE OVER THIS. WE WANT TO LISTEN TO YOU, AND WE WANT TO HEAR YOUR CONCERNS. WE APPRECIATE EACH AND EVERY ONE OF YOU. THIS IS OUR COMMUNITY AS WELL. WE GO TO THE HOSPITALS. WE WANT TO BE CARED FOR. WE HEAR BOTH SIDES. WE ARE GREAT PARTNERS WITH SPOHN ALSO. AND THE WORK THAT THEY HAVE DONE IN THE PAST WITH OUR INDIGENT CARE AND EVERYTHING ELSE, WE WANT TO KEEP THOSE COMMUNITIES. WE WANT TO KEEP THOSE PARTNERSHIPS ALIVE. WE WANT THIS TO BE A WORKING GROUP AND NOT AN ATTACK GROUP. IF THE PHYSICIANS WILL GET WITH ME AND GIVE ME THE LIST OF THE TWO NAMES THAT THEY WOULD LIKE TO BE ON THERE, I BELIEVE WE CAN GET IN CONTACT WITH YOU AND GET THIS WORKING GROUP STARTED. JUST AS SOON AS POSSIBLE. I KNOW MR. DOMINGUEZ LEFT. I FEEL CERTAIN THAT THEY ARE GOING TO BE ONBOARD WITH THIS AS WELL. IT HAS JUST BEEN A ROUGH DAY FOR EVERYBODY. ONCE THINGS CALM DOWN, WE HAVE THE SAME COMMON GOAL. WE WANT THE BEST FOR THIS COMMUNITY. WE CAN BE UNANIMOUS IN THAT MOVING FORWARD WITH THIS GROUP. COMMISSIONER CHESNEY? >> REAL QUICK, JUDGE. I JUST WANT TO KIND OF END AND IF ANYBODY ELSE WANTS TO JUMP IN, TOO, OBVIOUSLY, TO ME THIS IS-- I REALLY APPRECIATE YOU TAKING THE TIME BEING HERE. I'M A LITTLE CONCERNED THAT YOU ARE ALL HERE AND WE ARE NOT-- WE HAVE ALL THESE PEOPLE IN THE EMERGENCY ROOM. I WANT TO GET YOU OUT OF HERE REALLY QUICK. I DO BELIEVE THIS IS A BAD DECISION. I THINK IT HURTS INDIGENT PEOPLE THE MOST. QUITE HONESTLY. THE PEOPLE IN OUR COMMUNITY THAT NEED YOU THE MOST ARE THE PEOPLE THAT HAVE THE LEAST. AND PEOPLE THAT-- A LOT OF PEOPLE I REPRESENT HAVE THE M MOST. AND SO THEY CAN FIGURE THIS OUT. THEY CAN FIND IT. THEY CAN GO FIND IT. THE PEOPLE THAT NEED THIS THE MOST ARE THE ONES WITH THE LEAST. WE HAVE TO REMEMBER THAT. IT DOESN'T MAKE SENSE TO ME. BUT IT DOES HURT EVERYONE. IT IS NOT JUST THOSE WITH THE LEAST. IT HURTS THE AGING COMMUNITY THAT WE HAVE AS WELL. TO NOT HAVE THE EMERGENCY CARE. I HAVE HEARD PEOPLE SAY SOMEWHERE, THIS ISN'T MY FIGHT. THIS ISN'T OUR FIGHT. IT IS EVERYBODY'S FIGHT. THIS IS EVERY ELECTED OFFICIAL'S FIGHT. THIS IS EVERY COMMUNITY LEADER'S FIGHT. THIS IS EVERYBODY'S FIGHT BECAUSE IF WE DON'T STAND UP FOR THIS, THEN WE ARE GOING TO LOSE THIS, AND IT WILL NEVER BE REPLACED. I'M SORRY. I DO NOT BELIEVE ONE WORD THAT PEOPLE SAY "WE ARE GOING TO BRING BETTER. WE ARE GOING TO BRING MORE." UNTIL THERE IS A WRITTEN AGREEMENT OR PLAN, THAT IS NOT BELIEVABLE TO ME. THIS IS REAL. PEOPLE CAN TOUCH THIS, SEE THIS AND FEEL THIS. AND BELIEVE ME. I DO AND I THINK THE MAJORITY OF THIS COURT DOES. WE ARE GOING TO PUT THIS TOGETHER VERY QUICKLY. I HEAR YOU ON THIS TIME CRUNCH WE ARE UNDER. SO WE ARE GOING TO MEET EARLY NEXT WEEK. WE ARE GOING TO GET THIS GOING. THE JUDGE SAID IT RIGHT. YOU KNOW, WE HAVE A BULLY PULPIT. WE HAVE A RELATIONSHIP WITH THE HOSPITAL DISTRICT THAT HAS BEEN VERY IMPORTANT. WE HAVE A LOT OF INPUT THERE BECAUSE WE APPOINT THOSE BOARD MEMBERS. THEY ARE AN INDEPENDENT BOARD. THEY DO WHAT THEY WANT TO DO. AND WE HAVE SOME PARTNERSHIP WITH SPOHN THROUGH THE HOSPITAL DISTRICT. IT IS OUR FIGHT. IT IS ABSOLUTELY OUR FIGHT MORE THAN ANY OTHER ELECTED BODY IN THIS COUNTY. IT IS EVERYBODY'S FIGHT. SO PLEASE DON'T JUST WEIGH IN WITH US. WEIGH IN WITH EVERY ELECTED OFFICIALS AND TELL THEM TO WEIGH IN. WEIGH IN AND GO BACK. I'M GOING TO DO IT. GO BACK AND FIND ALL THE BIG DONORS TO SPOHN. MONEY TALKS. EVERYTHING TALKS. WE HAVE TO DO THIS. WE HAVE TO DO IT QUICKLY. WE KNOW IT. [01:55:01] AND I FEEL VERY GOOD ABOUT-- IF WE GET SPOHN TO THE TABLE. THAT MAYBE WE CAN COME UP WITH SOMETHING. BUT AGAIN, DON'T LEAVE HERE WITH FALSE HOPE. LEAVE HERE WITH A LITTLE BIT. DON'T LEAVE WITH FALSE HOPE. I SUPPORT THIS 100%. I KNOW OTHERS ON THIS COURT DO, TOO. WE APPRECIATE GREATLY YOUR TIME AND BEING HERE. THANK YOU FOR PRESENTING THIS. WE WANTED TO GIVE YOU ALL AN OPPORTUNITY TO HAVE SOME DIALOGUE. IT WAS FRUSTRATING WITH THE COUNCIL. BECAUSE IT WAS PUBLIC COMMENT AND THEY CAN'T TALK BACK TO YOU DURING PUBLIC COMMENT. WE WANT TO SET THIS TODAY SO WE COULD ENGAGE WITH YOU. THANK YOU ALL VERY MUCH. IF YOU SEE ME COME THROUGH, PLEASE GET ME IN QUICKER. I WOULD APPRECIATE. NO. I'M KIDDING. (LAUGHTER) . >> THERE WILL BE SOMETHING TO IT. >> ANY OTHER COMMISSIONER WANT -- >> I WANT TO ECHO THAT. ESPECIALLY, YOU KNOW, THE EMERGENCY ROOM. YOU ALL DEAL WITH SECONDS, MINUTES, AND HOURS. I THOUGHT UNTIL MANY OF YOU SPOKE, WE HAD DAYS, WEEKS, AND MONTHS. TIME IS OF THE ESSENCE. I MEAN, WE HAVE TO GET THIS RESOLVED QUICKLY. WE HAVE TO START TALKING. HOW CAN THE COMMUNITY HELP SUPPORT THIS? WE ARE ALL IN THIS TOGETHER. WE HAVE TO COME TO A DECISION PRETTY QUICK. WHAT OUR STRATEGY IS. WHO THOSE PARTNERS ARE THAT CAN HELP WITH FUNDING. AND COME TO A SOLUTION AND SAY HERE. I DON'T KNOW WHAT WE CAN COMMIT TO OR HOW MUCH. THIS IS WHAT OUR COMMUNITY CAN INVEST IN. CAN YOU MEET US HALFWAY? RIGHT? I'M NOT SAYING THAT TO OUR PHYSICIANS. I'M SAYING THAT TO THE ADMINISTRATION. CAN YOU MEET US HALFWAY? THAT IS MY COMMITMENT TO YOU. WE NEED TO PUT OUR MONEY WHERE OUR MOUTH IS NOW. WE CANNOT MISOUT ON ANY MORE POTENTIAL RESIDENTS BLACK-LISTING US BECAUSE OF THE PROBLEMS THAT WE ARE GOING THROUGH RIGHT NOW. WE WILL GET THIS RESOLVED. AND-- IN MINUTES AND DAYS RATHER THAN WEEKS AND MONTHS. I GUARANTEE YOU THAT. THANK YOU. >> THANK YOU ALL FOR BEING HERE. WE HAVE ANOTHER JUDGE THAT WALKED IN IF YOU ALL DIDN'T SEE HIM. THE OTHER JUDGE KLEIN CAME. IN I WANTED TO GIVE HIM A SHOUT-OUT. YOUR ELECTED OFFICIALS ARE VERY CONCERNED AND WILLING TO STEP OUT OF THEIR COURTS AND COME DOWN HERE AS WELL. SO PLEASE TAKE NOTE OF THAT AS WELL. DO WE HAVE ANY ADJOURNMENTS IN MEMORY TODAY OR ANYTHING? NO. I WILL ACCEPT A MOTION TO ADJOURN. >> I THINK HE HAD ONE, JUDGE. >> YOU DO? I'M SORRY. I THOUGHT YOU SAID NO. >> I MISHEARD. MY BAD. >> I WILL ACCEPT A MOTION TO ADJOURN. >> SO MOVED. >> SECOND. >> WE HAVE A MOTION AND A SECOND. ALL THOSE IN FAVOR, SAY AYE. >> AYE. >> AYE. AND IT IS 5:0 #. WE ARE * This transcript was compiled from uncorrected Closed Captioning.