The Bexar County Hospital District’s budget for fiscal year 2020 includes more operating expenditures than revenue as the hospital system prepares for facility upgrades and a major overhaul of its electronic medical records system.

The $2.02 billion in operating expenses for 2020 is up from $1.9 billion in 2019, University Health System President and CEO George Hernández told Commissioners Court on Tuesday.

“The reason why there are more expenses than operating revenue this year is mainly due to the implementation of EPIC,” the new electronic medical records system that will cost the hospital system $170 million, Hernández said. “This kind of system upgrade is once in a lifetime, and we will see a return on that investment by 2021.”

Hernández said that in addition to the EPIC system, other projects for 2020 contributing to the increase in expenses are renovations to the Texas Diabetes Institute and the Southeast and Southwest Family Health Centers, which are more than 20 years old. The hospital system also recently acquired a clinic from the City of San Antonio that needs a major roof repair, he said.

The budget also includes $100,000 in increased funding for the CentroMed location that operates out of Haven for Hope and an additional $1.5 million for outpatient addiction treatment programs through Crosspoint Inc., said Commissioner Justin Rodriguez (Pct. 2), who said the commissioners have been working with UHS to secure additional funding for mental health treatment programs for adults and children.

“We have been working together to get funding to Clarity Child Guidance Center, to increase the number of crisis beds for pediatric patients, and additional funding to provide clinical support for children with special needs,” Rodriguez said, noting that the recent closure of all Nix medical and behavioral health facilities left a “major gap in urgent-care options throughout the city.”

There also will be $5.6 million allocated in the budget for additional mental health services as the commissioners work with the Bexar County Hospital District and local organizations  to determine funding needs, Rodriguez said.

Portions of the funding will go toward training people, including child and health care providers, and local organizations such as schools to recognize signs of childhood trauma and understand the potential for long-term negative health impacts when attempting to understand and redirect their behavior. 

Hernández said that while the hospital system will be spending more, it will receive $33.7 million more in funding from Medicaid for uncompensated care, and from continued growth of the Pharmacy Meds-to-beds program, which helps patients obtain  medications before being discharged from the hospital, and retail pharmacy services offered through UHS.

“Overall these upgrades and additional programs we anticipate will all result in financial improvement,” including a gain from operations of $67.1 million, and a bottom line gain of $17.1 million, Hernández said. “We are getting to the point where we will be a major player, and will be in the same league with every other teaching hospital in the U.S.”

Roseanna Garza reports on health and bioscience for the San Antonio Report.