GREATER COLUMBUS CHAMBER OF COMMERCE The Dell School of Medicine at The University of Texas at Austin and Other Healthcare Issues September 25, 2014 Clarke Heidrick

History of Brackenridge Hospital The regional trauma center and safety net hospital for our region originally built at current location in 1884 - oldest public hospital in Texas and operated by the City of Austin beginning in 1904 named for Dr. Robert Brackenridge in 1929 current hospital built in 1970s Children’s hospital built adjacent in early 1990s in mid 90s, substantial losses resulted in the City's lease of Brackenridge and Children’s to Seton Seton has made substantial investments in Brackendridge/Level 1 Regional Trauma Center. Agreement with City in 2002 enabled development of Dell Children’s Hospital by Seton

Austin Should Have Had a Medical School when The University of Texas at Austin was First Built Politics resulted in an election 1881 between Galveston and Austin - Galveston won - UTMB established 1891 - then hurricane of 1900 Austin got the rest of The University of Texas Since UTMB was established, 5 other health institutions have been developed by UT System: UT Southwestern Medical School UT Health Science Center at Houston UT Health Science Center at San Antonio MD Anderson Cancer Center UT Health Science Center at Tyler New South Texas Medical School currently being developed Texas A&M facility in Round Rock – 134,000 sq. ft. facility for 3rd and 4th year students – December 2009 Existing Southwestern Medical School residency program in Austin since 2009 – 13 programs/more than 225 residents now – will soon convert to UT Austin residency program

Central Health formed by election in 2004 under name of Travis County Healthcare District - 7.8¢ (6.4¢ City/1.4¢ County) initial tax rate - consolidated most of City and County healthcare functions tripled number of MAP participants to 23,000+ opened additional primary care clinics (14 when we started/21 now) supported hospital based care at Brack operated by Seton under lease added specialty care capability lead community collaboration on mental health/added capability at Shoal Creek and elsewhere broad based community planning effort lead by Senator Watson in 2010/11 identified gaps/laid the foundation for the November 2012 election 2012 election raised tax rate from 7.9¢ to 12.9¢ - $35 million a year for new medical school

Current Property Tax Rates Around the State *1 year old estimate   Current Rate Current Per Capita* Central Health 12.9¢ (was 7.89¢) $115 San Antonio 27.62¢ $162 Dallas 27.10¢ $172 Houston 17.9¢ $122

Community Health Needs outpatient specialty care for uninsured mental health resources disease management and more efficient and effective care for poorest and sickest and broader need for systematic change Brackenridge needs to be replaced - trauma and emergency care hospital for region more doctors will be needed for growing and aging population in Central Texas cancer care women’s health

Senator Watson’s 10x10 Vision and Leadership First Announced at RECA in September 2011 (lots of work before that) UT Med School new teaching, trauma and emergency care hospital (Seton intends to fund up to $250 million for this with philanthropy covering the approximately $50 million balance) added capability in mental health added capability in outpatient primary and specialty care added capability in cancer care research facilities

Key Milestones Senator Watson’s speech in September of 2011 April 2012 Letter of Intent between Seton and Central Health. UT Regents Action in May of 2012 - committing two funding streams to an Austin medical school totaling $30 million per year - and identifying a need for a local match of $35 million per year. November 2012 Central Health Proposition No. 1 - increase current tax rate of 7.9¢ by 5¢ to 12.9¢ yields $55 million of additional funds annually. Additional funds available in late 2013 and early 2014. Michael and Susan Dell Foundation commitment of $50 million in January of 2013. Announcement of configuration of UT Austin Medical District (Fall 2013) Seton and Central Health enter into a Master Agreement by which Seton will construct new teaching hospital and Central Health, Seton and Integral Health form a working partnership to more effectively manage the care of over 20,000 of our poorest and sickest residents (June 2013) Appointment of New Dean – Dr. Clay Johnston (January 2014) Seton kicks off its $50,000,000 own capital campaign for new hospital and announces that new hospital will be named “Seton Medical Center at University of Texas” (April 2014) Groundbreaking for medical school (April 21, 2014) Central Health plans for the reuse of its 14 acres of land now occupied by Brackenridge (2014) Medical school to open (August 2016) New teaching hospital to open (January 2017)

The New Teaching Hospital: Maintaining Commitments; Building for the Future New facility will continue as the primary safety net hospital and Level I Trauma facility for the region Unlike UMCB, the new hospital will have more education and research space For the first time, dedicated in-patient psychiatric services Size of the new facility is being developed with an assumption of transformational change to the delivery system

The New Medical School – opportunity to change healthcare locally and nationally Scheduled to enroll its first class of 50 students in summer of 2016 Research intensive institution with strong community based education experiences Strong emphasis on inter-disciplinary training to breakdown historical silos in medicine By 2016, Central Texas will need 770 more doctors, with greatest need in some of the most complex sub-specialties Medical school and health science center campus will create 15,000 new jobs and more than $2 billion in annual economic activity 80% of doctors educated and trained in Texas stay and most locate within 50 miles of where they trained

Existing Campus 11

Existing 12

Phase 1 Phase 1 GSF: 1,415,100 13 P NURSING P Dell Medical RESEARCH School RESEARCH URBAN RAIL STATION MOB (1) HOSPITAL PARKING STRUCTURE P 13

Phase 2 Phase 2 GSF: 603,000 14 NURSING Dell Medical School URBAN RAIL STATION 14

Phase 3 Phase 3 GSF: 2,298,675 15 P P NURSING Dell Medical RESEARCH School RESEARCH MOB (2) URBAN RAIL STATION MOB (1) HOSPITAL PSYCH HOSPITAL CANCER CENTER PARKING STRUCTURE P 15

Proposed: Toward the City Capital 16

New Medical School Dean Dr. Clay Johnston, MD, PHD BA Physics Amherst College 1987 MD Harvard Medical School 1992 Internship-Mass General 1992-1993 Residency (neurology) U Cal SF 1993-1996 Masters & PHD in Public Health 1998 (U Cal Berkley) Professor U Cal SF (Neurology/ 1998-Present Epidemiology/Bio Statistics) Associate Chancellor for Research 2009-Present Married to Physician; 2 kids ages 9 & 11 Well balanced leader in research (primarily with respect to strokes) as well as leader in clinical outreach and healthcare policy

Research and Economic Development Existing Dell Pediatric Research Institute at Mueller across from Dell Children’s. UT Austin institute in 150,000 sq. ft. building on 8.5 acre tract that is a part of 15 acre tract owned by UT system. Other half of the tract is available for expansion. Seton/UTSW Research Institute. Dr. Steven Warrach (formerly with NIH) will coordinate translational research and bring in world class researchers. Located in Clinical Education Center next to UMCB. Austin Tech Incubator - part of IC2 at UTA. Cindy Walker Peach is ED. Develops companies. Already have 120 small biotech companies in Austin. More to come. Contemplates development of new building 150,000 sq. ft. with at least 60,000 sq. ft. of wet lab (wet lab costs $400-800 a sq. ft.). Either at Mueller or on a new campus. $80 to 90 million - PPP. Long term - innovation district in area just South of medical school complex.

ECONOMIC DEVELOPMENT TARGETS The study by Jon Hockenyos (TXP, Inc.) indicates that UT Medical School, New Teaching Hospital and Research Facilities could produce: $340 million in direct new annual activity from the complex 2,100 new permanent jobs in the complex $1 billion in direct annual spending by life science sector 6,900 direct jobs in life science sector $2 billion including indirect (ripple) economic activity 15,400 jobs including indirect (ripple) activity

Conclusion 20 years from now: world class medical school, trauma and emergency facilities adequate capacity in a reengineered health system that emphasizes health/wellness, primary care and deemphasizes hospital admissions and lengthy stays and maximizes efficiency and realigns incentives. great research and robust biotech economy centered in NE quadrant of downtown.