Texas Border Business
By DAVID A. DÍAZ
Former longtime Rep. Roberto Gutiérrez, D-McAllen, 83, who passed away on Saturday, December 28, 2019, was the first lawmaker to file legislation that eventually resulted in the creation of the Regional Academic Health Center for deep South Texas – the key step needed to make possible the formation of the University of Texas Rio Grande Valley School of Medicine.
Gutiérrez, during his 14 years in the Texas Legislature, passed dozens of laws and policies that continue to benefit the state and South Texas, a decade-and-a-half after he finished his final two-year term on January 11, 2005.
One of his most notable endeavors was taking a pioneering role in championing the need for advanced medical education in the Valley, which at the time was the most populated regions of the state without a public medical school.
(In 1993, Gutiérrez also carried the legislation in the Texas House of Representatives that established South Texas Community College, now known as South Texas College, to serve Hidalgo and Starr counties.)
Sen. Juan “Chuy” Hinojosa, D-McAllen, in expressing his condolences to the late lawmaker’s immediate and extended families and friends, confirmed the importance of Gutiérrez’ impact on the creation of the Regional Academic Health Center (RAHC) and the UTRGV School of Medicine.
“As a state representative, Rep. Gutiérrez was involved and a key player in beginning the process for what is now the UTRGV School of Medicine,” Hinojosa said. “Representative Gutiérrez was a dedicated and committed public servant. He served our community in the Texas Legislature from 1991 to early 2005 and also served our country as a member of the Texas National Guard for ten years. His service and contributions to our district helped make the Rio Grande Valley a better place to live and raise our families.”
As the 1990s began, local legislative pressure was increasing on the University of Texas System leadership to establish a medical school in the Rio Grande Valley. But Valley lawmakers were told by some UT System leaders that a full-fledged, four-year medical school would be expensive – the projected cost at the time was more than $100 million (more than $200 million in today’s value) – and the political support in the Texas Legislature was not present.
However, during a fateful meeting on or about early 1994, Gutiérrez was told by Dr. Ramiro Casso, a family physician who had dedicated his life to healthcare and humanitarian efforts in the Rio Grande Valley, that there was another option that the UT System leadership knew about, but had not revealed.
It turned out that a medical school branch campus – generally, the term branch campus is “a location of an institution that is geographically apart and independent of the main campus of the institution – would cost much less than a four-year medical school, Casso informed Gutiérrez.
Best of all, Casso emphasized, there was already was a successful medical school branch campus in the state – the Regional Academic Health Center, which the Texas Tech University Health Science Center in Lubbock had been operating since 1969 in El Paso.
Armed with Casso’s revelation, Gutiérrez on Monday, November 14, 1994 – the first day legislation could be for action by the 74th Texas Legislature in 1995 – introduced House Bill 68, which authorized the UT System Board of Regents to “provide clinical, postgraduate, or other medical education programs in Brooks, Cameron, Hidalgo, Kenedy, Starr, or Willacy County.”
Almost three months later, on February 3, 1995, Sen. Eddie Lucio, Jr., D-Brownsville, filed Senate Bill 455, which authorized the creation of The Rio Grande Valley Regional Academic Health Center ((RAHC). This medical school branch campus would be part of the The University of Texas Health Science Center at San Antonio.
Lucio’s version was very similar in language and in its goal to Gutiérrez’ House Bill 68.
Lucio’s Senate Bill 455 called on the UT System “to provide undergraduate clinical education, graduate education including residency training programs, or other levels of medical education work in those counties. The primary purposed of the center is to provide education in primary medical care, but education in other health disciplines way also be provided.”
Neither measure was approved by the Texas Legislature in 1995.
But both bills let the UT System’s leadership and the Texas Legislature know that Valley lawmakers had come up a strategy for the foundation that would lead to a comprehensive medical school.
Gutiérrez’ HB 68, Lucio’s SB 455 in 1995 set the stage for creation of Regional Academic Health Center in 1997
Two years later – during the 75th Texas Legislature in 1997 – Gutiérrez was a joint author of House Bill 1557, which called for the creation of a Regional Academic Health Center in the Valley.
Hinojosa, then a state representative who was the primary author of House Bill 1557, along with Rep. Ismael “Kino” Flores, D-Palmview, Rep. Jim Solis, D-Harlingen, and Rep. Miguel Wise, D-Weslaco, joined Gutiérrez as joint authors of the measure.
House Bill 1557 was approved by the Legislature in the Spring of 1997 through its companion bill, Senate Bill 606, authored by Lucio and sponsored by Hinojosa.
Sen. Mike Moncrief, D-Ft. Worth, Sen. Carlos Truan, D-Corpus Christi, and Sen. Judith Zaffirini, D-Laredo, were coauthors of Senate Bill 606.
The author is the legislator who files a bill and guides it through the legislative process (also called the primary author). The Senate allows multiple primary authors for each bill or resolution. The House of Representatives allows only one primary author, the House member whose signature appears on the original measure and on the copies filed with the chief clerk. Both chambers also have coauthors, and the House of Representatives has joint authors.
In the House of Representatives, the joint author is a member authorized by the primary author of a bill or resolution to join in the authorship of the measure and have his or her name shown following the primary author’s name on official printings of the measure, on calendars, and in the journal. The primary author may authorize up to four joint authors.
A coauthor is the legislator authorized by the primary author of a bill or resolution to join in the authorship of the measure. Both the Senate and the House of Representatives allow an unlimited number of coauthors on a bill or resolution. A coauthor must be a member of the chamber in which the bill was filed.
The sponsor is the legislator who guides a bill through the legislative process after the bill has passed the originating chamber. The sponsor is a member of the opposite chamber of the one in which the bill was filed.
A companion bill is a bill filed in one chamber that is identical or very similar to a bill filed in the opposite chamber. Companion bills are used to expedite passage, as they provide a means for committee consideration of a measure to occur in both chambers simultaneously. A companion bill that has passed one chamber can then be substituted for the companion bill in the opposite chamber.
On Sunday, May 27, 1997, Senate Bill 606 was approved by the Texas Legislature and signed into law by Gov. George W. Bush on Saturday, June 16, 1997.
Senate Bill 606 allowed The University of Texas Health Science Center at San Antonio (UTHSCSA) — now known as UT Health San Antonio — to open a Regional Academic Health Center (RAHC) to train physicians who would practice medicine in the Valley.
UTHSCSA opened its RAHC Medical Education Division in 2002 in Harlingen and its RAHC Medical Research Division in 2006 in Edinburg.
In 2013, the Texas Legislature approved for The University of Texas System Board of Regents to create a medical school, using the resources from the Regional Academic Health Center, for the Valley.
The UTRGV School of Medicine now has more than 200 medical students and over 200 medical residents and fellows serving in nine hospital-based training programs throughout the Valley, with more training programs on the horizon.
Legislative history, key highlights of RAHC law in 1997
The House Research Organization, which is the nonpartisan research arm of the Texas House of Representatives, in its bill analyses provided the highlights of House Bill 1557 by Hinojosa/Gutiérrez/Flores/Solis/Wise.
The analysis follows:
House Bill 1557 by Hinojosa/Gutiérrez/Flores/Solis/Wise would authorize the Board of Regents of the University of Texas System to establish a Regional Academic Health Center (RAHC) serving Cameron, Hidalgo, Starr, and Willacy counties as the Lower Rio Grande Valley Academic Health Center.
The Regional Academic Health Center could consist of facilities located throughout the region used to provide undergraduate clinical education, graduate education, including residency training programs, or other medical education in connection with any UT system component.
The board could execute and carry out affiliation and coordination agreements with other entities or institutions in the region. The board could delegate management of the Regional Academic Health Center to any component institution or institutions of the University of Texas System. The Regional Academic Health Center’s operating costs would be paid from the operating funds of the component institution, which could be supplemented by funds from any other public or private entity. The board of regents could accept and disburse any gifts and grants for the use and benefit of the Regional Academic Health Center.
A teaching hospital or any physical facilities of the Regional Academic Health Center used in teaching and research programs, including libraries, auditoriums, research facilities, and medical education buildings, could be provided by a public or private entity.
The Regional Academic Health Center would be subject to the supervision and rules of the Higher Education Coordinating Board.
House Bill 1557 would take effect September 1, 1997.
House Bill 1557 by Hinojosa/Gutiérrez/Flores/Solis/Wise would address the serious shortage of primary care physicians in South Texas. In the Lower Rio Grande Valley, the average number of doctors per 100,000 residents is less than half the statewide average.
The bill would not only address this deficiency but provide needed economic development for the region, enhancing both the quality of health care and professional opportunities for residents of the Valley.
The Valley is beset by serious public health problems, lacking adequate preventative and indigent health care programs necessary to care for its growing population. The total population of Hidalgo, Cameron, Starr and Willacy counties is nearing 900,000, making the Valley the most populous area in the state without an academic medical facility. The closest such facility is in San Antonio, hundreds of miles away from the border communities most in need of assistance.
These communities cannot rely on increasing the number of medical residents to supplement their pool of health care providers. The hospital- based residency programs in the area are operating at close to full capacity. Additional infrastructure and resources are necessary to successfully increase the number of medical residents in the area.
The Regional Academic Health Center would not aim to increase the number of doctors throughout the state, but rather shift students from other medical schools in the UT system. Students could transfer from other medical schools in Texas to complete their medical education. The bill would also provide an incentive for local high school and undergraduate students to pursue careers in medicine.
The Regional Academic Health Center could be modeled on other successful regional health centers in Texas, such as the regional academic health centers affiliated with Texas Tech University Health Sciences Center. The Tech centers have provided valuable service to rural and other under-served areas, and the South Texas RACH could learn from their successes.
The Regional Academic Health Center could further draw on existing expertise by forging an affiliation with a Texas medical school, such as the University of Texas Health Science Center in San Antonio or University of Texas Medical Branch in Galveston. This would allow the Regional Academic Health Center to start from a solid base of information and resources and create the best environment for the new institution’s success.
The communities the Regional Academic Health Center would serve are committed to financially supporting the project. The medical and business communities, as well as municipal governments, have expressed their willingness to help the Regional Academic Health Center succeed.
House Bill 1557 by Hinojosa/Gutiérrez/Flores/Solis/Wise would be an important first step of a long-range plan to improve health care in South Texas. Establishing the Regional Academic Health Center is an essential next step in developing health care education in Texas, a modest alternative to creating a full scale medical school. The Regional Academic Health Center would enhance the quality of preventative and indigent health in the Valley, saving the state substantial sums in future health care costs.
House Bill 1557 would not address the Valley’s needs in the most cost efficient manner. Although South Texas is deserving of economic development, such an ambitious project as a Regional Academic Health Center should not be viewed as a development tool. Instead, it should only be created if it would best meet the needs of the community in question.
South Texas’ health care needs could be addressed without a regional medical center. The best predictor of where doctors will practice is the location of their residency programs, not of their previous medical training. The region should focus on expanded residency programs, which would more quickly provide an infusion of doctors into the area, instead of on constructing a new center, with expensive facilities and long-term overhead obligations.
House Bill 1557 does not adequately describe how the Regional Academic Health Center would be funded. Although the bill would prohibit the use of state funds for the center’s construction, maintenance and operation, adding a new medical component to the UT system would inevitably bring increased costs for the state. Texas should not undertake a financial burden of undetermined magnitude during this time of economic uncertainty. Higher education institutions are already under severe financial pressure, and if their resources are stretched even thinner among a larger number of institutions, the quality of higher education could be diminished for all Texas’ students.
Texas already has a high quality, extensive medical education system. Adding another institution could help create a glut of doctors, especially as potential Medicaid and Medicare cuts threaten the growth of demand.
BIOGRAPHICAL HIGHLIGHTS FOR ROBERTO GUTIÉRREZ
The following biographical highlights are provided by his family:
McALLEN – Roberto Gutiérrez, 83, passed away on December 28, 2019, peacefully in his home. He was a loving husband to his wife Cecilia prior to her death and remained committed to sustaining the beautiful union they had by caring their values forward. Roberto was a great father, grandfather, uncle, brother, and an accomplished leader. He will long be remembered for his strong work ethic and his commitment to the community. Roberto was a distinguished gentleman, easily recognizable by his silver hair. His strength and can-do attitude will remain in our hearts forever. He taught us that everything and anything is possible with hard work, dedication and passion. Roberto ended many of his learning moments with the phrase “Dale Gas” (Step on the gas).
Roberto was born on June 11, 1936 and came from humble beginnings. He was a Sergeant in the United States Army – 49th Armored Division; in addition served ten years in the Texas National Guard. His focus and drive for success is evidenced in his educational accomplishments such as his Masters in Education. As a teacher, we will fondly remember him for his commitment to help students with his teachings to assist them in vocational careers. He later used those skills to become a successful businessman but never forgot his humble background by serving his community in various civic clubs. This commitment to helping others led him to pursue city and state-wide positions so he could make a difference for everyone everywhere.
Roberto served 14 years as State Representative of District 41. He was the embodiment of the saying, “Together, we do more.” He concentrated his efforts to expanding education in the Rio Grande Valley, promote public safety for children and improve access to health services. State Representative Roberto Gutiérrez authored and passed the House Bill that created South Texas Community College, his position on the State Appropriations Committee allowed him to increase the funding for the University of Texas Pan American (now the University of Texas Rio Grande Valley). He pioneered the idea of a medical school in South Texas with the implementation of a Regional Academic Health Center and a UT Biomedical Research Facility. Additionally, Roberto championed an early diabetes detection program for Texas school-age children, passed a bill for bicycle safety, and created laws such as Joey’s Law to protect our youth.
He was an incredible role model and inspiration to all. The words of wisdom he gave everyone he met will run deep within the community, and especially with his family. Roberto’s legacy will live on through his children and grandchildren: His son Roberto (Kelly) Gutiérrez, Jr. and their children Roberto Daniel, A. Cecilia, Iris Isabelle; his daughter Gilda (Joel) Romero and their child Joel Roberto; and his daughter Sara (Mark) Gonzáles and their children Sarita Cecilia, Gabriela Marie, Andrea Renee. He is also survived by his brother Henry Gutiérrez.