November 6, 2013
Address to Real Estate Council of Austin
November 6, 2013
A little over two years ago, I stood before a lot of you in this room and made this simple, obvious observation: “It’s time for a medical school in Austin.”
Now, after 26 months of hard work by a lot of people, that observation has turned to action. This resource that our region has wanted and needed for so long is about to be a reality.
A year ago today, Travis County voters made a big commitment. They embraced a vision, invested in their collective future and voted to raise their property taxes.
A lot of you folks probably don’t find yourselves voting too often for higher taxes. And if taxes had been all that Proposition 1 was about last year, I guess I’d just thank you for doing your part to keep Austin weird and then let you get on with your lunch.
But, as we all know, we live in a unique place. Our community – our people – embraced Proposition 1 as our opportunity to invest in powerful new resources that will help keep our people and our economy healthy. We seized this chance to revolutionize healthcare in Central Texas by transforming the way some of our most powerful partners deliver it.
That transformation – one that will start at UT and stretch to every corner of Travis County – was the heart of the 10 Goals in 10 Years that I laid out in my speech two years ago. These 10 goals carry the promise of Proposition 1, and as I think you’ll see today, we’re making real progress toward achieving them. Our work isn’t finished – there’s still plenty to do. But our future is beginning to come into focus.
And it’s dazzling.
Our progress is testament to the people and institutions that have worked so hard and done so much to help people across this community. I’d be negligent if I didn’t take just a minute to thank some of them.
The UT System Board of Regents deserves our deepest thanks for their commitment to seeing this through. So do UT System Chancellor Francisco Cigarroa; Dr. Ken Shine, the former Executive Vice-Chancellor for Health Affairs who continues at the System as special advisor to the Chancellor on medial education; Dr. Sue Cox, who a year ago was UT Southwestern’s regional dean for Austin programs and is now also the Interim Associate Dean of the Dell Medical School; and Vice Chancellor Amy Shaw Thomas – all outstanding leaders and problem solvers.
At UT Austin, thanks to President Bill Powers, former Provost Steve Leslie, new Provost Greg Fenves, and Dr. Bob Messing, UT’s new vice provost for biomedical sciences, for moving fast and smart.
At Central Health, thanks to all of the board of directors – especially Board Chair Rosie Mendoza, former chairs Dr. Tom Coopwood, Clark Heidrich and incoming Chair Brenda Coleman-Beattie – and to President and CEO Trish Young Brown and her staff, including Larry Wallace, the vice president of service delivery, and Vice President of Planning and Communications Christie Garbe. They hit the ground running on this project two years ago and haven’t stopped. The Board, Trish and others have embraced a vision of serving this community. They believe in it. And they work hard.
At Seton, thanks to President and CEO Jesus Garza, Executive Board Chair Charles Barnett, and Greg Hartman, the president of academic medicine, research and external medicine: they’ve been creative, resourceful and energetic in fulfilling their mission to serve the community.
And thanks to my staff for all of the hard work they’ve done on this issue.
Believe me, that only scratches the surface of people who deserve thanks. This has been one of the biggest team efforts I’ve ever been a part of; I can’t begin to mention everyone who’s helped make this happen, but we might not be here today without any one of them.
So on behalf of all of us, let’s start by celebrating our community’s great, game-changing news:
My friends, it really is time for a medical school in Austin.
… It’s happening. And it’s happening fast.
About a mile north of here, in just four or five months, crews should start breaking ground on phase 1 of the medical complex, which will include the medical school building, a research building, a medical office building and other facilities.
The first class of students is expected to start in 2016.
2016 … Three years from now … Just five years removed from my 10 Goals in 10 Years speech that unofficially launched this effort.
Five years to create this seismic shift that’ll rearrange the landscape for UT and the talented students and faculty it wants to attract.
For the university and those students, that’s incredible progress. For our community, it means even more.
For every last one of us, Prop 1 and the med school represent the dawn on a new horizon, one that’s wider than we could have imagined.
Thinking about what Prop 1 and the 10-in-10 goals will mean for our future, let’s remember how far we’ve come and what brought us here.
Two years ago I spoke of the four transitions or periods I believe Austin has seen.
… The “settlement” period of the 1830s and 40s that put Austin on the map.
… The “stability” period of about a hundred years ago that provided infrastructure we needed to grow our region and our economy, and to energize our stable economy.
… The “smart” period in our lifetimes, in which Central Texas rode institutions like UT and projects like MCC and Sematech into an intellectual, global economy.
That brings us to now. This moment.
It’s no coincidence that after decades of talk about building a medical school in Austin, we voted last year to invest in one and we’re now just three years from opening it up.
I think Travis County voters took the extraordinary step of passing Prop 1 because they sense – we all sense – the beginning of a new period in Austin’s history. I call it a “synthesis” period.
Look at what’s happening around the world. In prosperous regions from Houston to Hong Kong, medical innovations are connecting with the engineering and technological advances that our region is already renowned for. People aren’t just prospering financially; they have access in those places to cutting-edge medical and health treatments and innovations.
Make no mistake: we didn’t invest in this medical school because UT needed some big new thing. Yes, this will be the first medical school built on the campus of a tier one research university in decades – some say as many as 50 years. But we’re not doing this just so our university can keep up with other universities and have whatever cool toys they have.
We passed Prop 1 in large part because it will synthesize what’s good for our economy with what’s good for our people.
We passed it to push Central Texas into a 21st Century economy that runs more and more on biotech and healthcare advances … AND to grab the real, tangible improvements it will make in people’s lives.
Prop 1 was a declaration that Central Texans deserve the chance to live better and longer lives, even as we fulfill the vast promise of our intellectual strength. It synthesized our health – the health of generations of Central Texans – with the health of our economy.
That realization brings responsibility. If we just create a new economic boom that enriches Arboretum entrepreneurs but leaves our Dove Springs neighbors behind, we will have failed to make the most of this opportunity.
But we’re not going to fail.
From the very beginning, as we started this effort two years ago, we’ve worked to harness the powers of this new resource to transform the way we care for our families, friends and neighbors across Travis County.
We’ve pursued 10 goals, not just one, to make sure the medical school’s impact doesn’t end at its walls. We’ve leveraged our resources to create a sum that’s greater than its component parts. And we gave ourselves 10 years to make sure there was time to do things right, structuring investments so our kids and grandkids would reap the rewards.
The good news is that we’re on track to achieve all of our goals.
The better news? In most of these cases, we’re ahead of schedule.
The first goal was and is the med school.
UT officials and working groups have been doing a construction crane’s-worth of heavy lifting to make it happen fast. They’ve received preliminary state approval to offer a doctorate of medicine. They’re beginning the accreditation process with the national accrediting entities, and they’ve gone as far as they can in that process in this really short period of time.
They’re also designing the school’s administrative and academic components, including the outlines for each year’s curricula. They’ve sifted through more than 100 applications from prospective deans and are now interviewing finalists, aiming to have someone on board – in Austin – shortly after the end of the year.
And, perhaps most importantly to most of us, they’re mapping out how the med school will interact with the community. They’re plotting how their students, residents and faculty will provide patient-based care through a network of community services.
In the next few months, the most visual fruits of that work will start to appear between 15th Street, MLK, Trinity and I-35. The UT System has already voted to fund the academic, research, and medical office buildings, along with a parking garage and chilling station. UT Regents will probably approve the final design for the first buildings in February, and then construction can begin.
You can’t say it enough:
… It’s time for a medical school in Austin.
Believe it; it’s happening.
The second of the 10 Goals is to build a new 21st Century teaching hospital that will replace the aging UMC-Brackenridge, provide a modern place for students and residents to train, and help shore up the safety net for our poor and uninsured neighbors.
Building a new hospital – that will continue as our region’s lone Level 1 Trauma Center and the safety net hospital – is a tough, tough job. If Travis County taxpayers were responsible for it – as taxpayers are in many other urban counties – then the benefits of the Prop 1 would be eaten up pretty quickly in construction costs and bond payments.
It’s our good fortune that our community has a longstanding arrangement with the Seton Healthcare Family to provide charity care here.
As part of that partnership, Seton’s parent organization, Ascension, responded to the passage of Prop 1 by formally committing to build the new hospital with about $245 million of its own money, plus about $50 million they plan to raise through philanthropy.
Look for that construction crane around the med school site in the next year or so. Everything is on track so that the new hospital is projected to open in time for new medical students by 2017.
The third of the 10-in-10 goals was to create “modern, uniquely Austin health clinics” in our neighborhoods.
Put another way, it’s to provide better, earlier healthcare in communities so that people are healthier and, when they do get sick, have access to medical care that will help them stay out of the E.R.
This is a major structural change in how to deliver care to our safety net population. It’s new. It’s exciting.
And if you’re talking about keeping our community healthy, there’s nothing more important.
In June, after months of work, Central Health and Seton updated and enhanced a nearly 20-year partnership that Seton had with first the City of Austin, which was inherited by Central Health, to provide healthcare to the poor and underserved.
It was time for an upgrade, honestly, given everything that’s changed over the last 20 years about healthcare in general and our community in particular.
And thanks to Prop 1 and the medical school, this more-powerful partnership will enable transformations that were scarcely imaginable 20 years ago.
Central Health and Seton created what we’re calling the Community Care Collaborative. Through the Collaborative, those two and other partners – including Austin Travis County Integral Care (what we used to call MHMR) – will invest in efforts to improve the health of people, not just pay pricey bills from places like emergency rooms.
Revenue that Prop 1 raises will be used to obtain a $1.40 federal match for every dollar we raise locally through what’s known as the 1115 Medicaid transformation waiver. That money will then flow through the Collaborative.
This will create a roughly $120 million-a-year pool of money – most of it from the feds – to address the root causes of health problems. We’ll be able to do a far better job of providing integrated care that’s more efficient and more effective.
Some of that Collaborative funding will flow to the medical school, which will supply students, residents and faculty to help keep Austin healthy. The curriculum is being designed from the ground up to make sure students are learning, in part, by being out in the community caring for our friends and neighbors.
In addition, some money will be used to strengthen neighborhood clinics that Central Health already funds. Some will be used to fund new clinics.
And some will be used to fund truly innovative programs that keep people healthy, in doing so, and save taxpayers money.
It’s hard to imagine – in fact, I can’t imagine – Central Health doing any of these things, in more than incremental ways, without Prop 1.
The fourth goal today concerns the need for more behavioral health and psychiatric care in our county.
Two years ago, I pointed out that the average wait time for the uninsured to get basic, state-funded psychiatric help in Travis County was five months. For intensive treatment, it was four months.
There’s been some progress, but the numbers are still bad. They sound bad – in the vague way regrettable statistics sound.
So let’s talk about the people …
… The homeless person you drive past every day who should be getting help.
… The bright kid in school who’s constantly – and inexplicably – disrupting teachers.
… The acquaintance who takes his own life …
These are the faces of a crisis. It would be immoral not to address that crisis.
And Prop 1 helps address it.
At least 10 percent of the money raised by the Community Care Collaborative will fund projects focused exclusively on psychiatric care. And more will go toward programs that will help address this crisis. One potential project would offer telepsychiatry services to low-income patients at community clinics. Another would work with patients, who are diagnosed with both diabetes and depression, on lifestyle changes to help them stay healthy.
Besides that, the new teaching hospital will include around 14 medical-psychiatric beds for hospital patients needing psychological care. Right now, we have none. This will get people out of the emergency rooms and inpatient beds and into beds that are better staffed to meet their needs.
Don’t underestimate what we’re accomplishing here.
… By contributing to a new medical school and stronger clinics, Travis County voters were smart in passing Prop 1.
… In committing to better clinics and community care, they were far-sighted.
… And by providing the means so we can start to confront mental health issues … they’re heroes. We’ll all be working to ensure those heroic efforts continue.
The fifth goal called for the development of a research institute and laboratories for public and private research.
On this one, get ready to hear a lot of folks bragging.
The Seton-UT Southwestern Clinical Research Institute is up and running at UMC-Brackenridge.
The planned Dell Medical School research building is expected to cover more than 200,000 square feet.
And the corner of downtown that the med school will anchor is already being discussed as an “innovation cluster” – what starts there really will change the world.
Just this morning, Mayor Leffingwell formally launched a stakeholder process to make sure we take advantage of this opportunity. Right in this room, some folks from Boston who helped create a very successful innovation district there shared their lessons about how we can replicate that in Austin.
I’m very excited about how UT officials responded to this goal and the passage of Prop 1:
They comprehensively surveyed the campus to track health and medical research that’s already going on here – work that could be coordinated with and flow into the endeavors of new, first-rate med school faculty and students’ degree programs.
Make no mistake: there was plenty of good research work being done in Austin before Prop 1 passed. But the vote and the medical school will supercharge that work and work is being done to assure that.
Next up is our goal to launch a commercialization incubator. This has always been a critical goal, since the greatest discoveries in the world won’t make much difference if they don’t find their way into people’s hands.
In light of the research I just mentioned, commercialization has only become more important.
Over the last couple of years, there have been preliminary discussions about locating a commercialization incubator near the Dell Pediatric Research Institute. I’m hopeful that work will bear fruit.
One way or another, during the first half of next year – around the time we’re breaking ground on the med school – we should have a report with recommendations for financing a commercialization incubator. And of course this will be a critical part of the innovation cluster I mentioned before.
This is going to happen, if only because it has to.
If you know me at all, you know what beating cancer and what cancer care have meant to me.
It’s just as important to anyone else who faces the disease, either as a patient, caretaker, family member or friend of someone fighting that beast. They want to know they can receive – and are receiving – exceptional care.
This year, on the heels of Prop 1’s passage, a report funded by the LiveSTRONG Foundation, the Shivers Cancer Foundation and Central Health found that significant, high-quality cancer treatment is most certainly available here.
But not everyone can access this life-saving care – especially the poor. And too many feel they have to leave the region for the care they need.
So our next step will be to identify ways to fill gaps that the report identified. That process is being evaluated, and you should look for more on that in the coming weeks.
The eighth of the 10 goals was to improve basic infrastructure and create a “sense of place.”
Part of that’s obvious: the streets and water lines need to be ready for what’s about to happen here.
And part of it is kind of touchy-feely, too. How do we take advantage of this change to make the most of this part of downtown?
There’s been good progress on both fronts.
As I noted, just today, the mayor announced the formation of a downtown stakeholders group that will look, in part, at how to address the challenges and opportunities of this downtown growth. This potential innovation cluster wouldn’t be happening without Prop 1. And its potential is fantastic. Creating a sense of place that is a place of creativity and economic vitality.
Plus, the redevelopment of Waller Creek into a jewel of our downtown is also an important part of this process. Just last month, the University announced that Waller Creek will be a “defining feature in the creation of a high-quality and welcoming environment” around the medical school.
We’re creating a sense of place that is a place of healing.
Let’s not take this goal lightly. We only get one chance at re-creating this part of downtown. If we build all of the buildings we need but fail to create a place that people want to go, it will be a terrible missed opportunity.
The ninth of the 10 goals called for us to strengthen the Travis County Medical Examiner’s Office, which has been stretched beyond its resources. The idea was that, if everything worked out just right, a new coroner’s office could go in next to the medical school.
Well, I hope you all are sitting down, because …
It doesn’t look like there’ll be enough room around the med school to accommodate the medical examiner.
You might mistake my update on this one as being a little … well, funereal. You might be thinking of ways to tell your kids that Number 9 of the 10-in-10 died, or it didn’t make it, or it went to Kirk Watson Big Idea Heaven.
You might even joke that, in the end, it’s always the morgue that gets you.
But don’t bring me down. We’ll get this done, if for no other reason than to make sure I don’t lose any of my 10-in-10.
When I wrapped up this list two years ago, the last goal appeared to be the toughest: solve the funding puzzle. How do we pay for all of this? For a while, it felt like that was all anyone could or wanted to talk about.
But we refused to jump to the endgame and play typical Austin politics. We were disciplined in our approach and how we attacked this issue – and it paid off. We said we would need a new playbook, and we wrote one.
Two years later, this last goal demonstrates the triumph of Prop 1. But it also illuminates the challenge we share going forward.
On one hand the funding puzzle’s solved. Two years ago, there wasn’t enough money to get a medical school. Simple as that.
Now, there is. The new approach led us to a point where some of it’s coming from the regents, some from UT’s own budget, some from philanthropy.
That last point is a big one. Our community depends on, and is grateful for, generous giving like that of Michael and Susan Dell. That’s why I made sure philanthropists were represented on the initial Organizing Committee that got this ball rolling two years ago.
The rest – the $35 million-a-year puzzle piece – will come from Travis County taxpayers through Prop 1.
For this, we should give the voters the credit they deserve – every chance we get.
Visionary, thoughtful, optimistic voters solved the med school part of the puzzle. And Seton solved the teaching hospital piece. And federal matching funds, available through the Medicaid waiver, solved a big problem of how we will provide the care that our community needs. But all of these things come together. They each make all of it work.
But our work isn’t over. This effort, this transformation, has brought us two ongoing tasks: to keep our people healthy, and to keep our economy healthy.
I don’t know that we’ll ever do anything like Proposition 1 again. That was a generational, transformational referendum – I’ve never seen anything like it, here or anywhere else, and I don’t expect to ever again.
But there will be new opportunities to help our friends and neighbors live longer, healthier, fuller lives. There will be new challenges for our economy and our competitiveness. We’ll need to be vigilant. We’ll need to be creative. And we’ll need to come together, setting petty issues aside for the good and the future of this community.
I’ll say it again, because it feels so good to say it:
“It’s time for a medical school in Austin.”
But that does beg the question …
Thank you all. God bless you and all you do – and all you’re going to do – for this community.