An exchange of letters between business leader Woody Hunt and state Sen. Eliot Shapleigh sheds light on some
of the issues involved in building a medical center in El Paso, and that medical center's relationship with UTEP.
The exchange began with a letter from Shapleigh to Hunt on Aug. 31, expressing a concern that the community
did not benefit as much as it should have from a decision to place a new school of nursing on the UTEP campus.
Shapleigh contended that the proper place for a nursing school was on the Medical Center of the Americas
campus, and that such a move was contemplated in discussions and memorandums over the years, and further,
charged that the decision to move the nursing school was made behind closed doors by Hunt, other
businessmen, and UT System officials.
Hunt replied in a letter dated Oct. 9, and Shapleigh responded to that Oct. 12.
In his Oct. 12 letter, Shapleigh wrote in the second paragraph: "I appreciate the dialogue that we are having on
the Medical School—it makes us better as a community."
NPT presents a background article on the issues, links to the three letters, and excerpts from the two most recent
letters.
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Background, Sept. 14, 2007: The Medical Center of the Americas
For the second time since UTEP signed on as a partner in the proposed medical center, the UT System has
decided to place a major health-related asset on the UTEP campus instead of the Medical Center of the
Americas, a site anchored by Thomason and Texas Tech in Central El Paso.
Unlike the last time, however, when the placement of a biosciences research building seven years ago caused a
blowup between state Sen. Eliot Shapleigh and UTEP President Diana Natalicio, with many community leaders
taking sides or getting caught in the middle, the collective response seems far more measured, and the outlook
for El Paso and the MCA positive.
No doubt many -- with Shapleigh in the lead -- consider it a missed opportunity to quickly develop "critical
mass" at the Medical Center of the Americas. In a letter to businessman and former UT Regent Woody Hunt,
Shapleigh outlined the history of the MCA and UTEP's involvement, criticizing the lack of public discussion in
the decision to place a new $50 million Allied Health center on the UTEP campus. Hunt was among other
businessmen to meet with UT Regent board Chairman James Huffines and UTEP President Diana Natalicio in El
Paso several weeks ago to discuss the decision; no public officials were involved, and although Hunt is a
member of the MCA Foundation, that body was not involved in the discussion either, leading to Shapleigh's
critique of the process.
However, Shapleigh's letter ends with a series of action items, noting, as have other community leaders,
including Hunt, that UTEP no longer has to be considered a major partner for the MCA to work. There are
significant developments on the horizon, spurred by funding last session for the Texas Tech Medical School,
which will accept its first four-year medical students in 2009. [letter with attachments]
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Oct. 9, 2007: Hunt to Shapleigh
Hunt replied in a letter dated Oct. 9, 2007: "I want to answer your statements in the most direct and complete
way possible to ensure that your personal advocacy is not confused with the actual events and facts. We have
an obligation to avoid such distinctions in our discussions."
Hunt describes the origin of the medical center concept in the 1998 economic summit, and notes that from the
beginning there was discussion about "what a border health center might be or could be." The issue of whether
to model after existing medical centers or create a new model formed a backdrop for the discussion, Hunt wrote.
In 1999, the Paso Del Norte Health Foundation hired the Lewin Group to explore the issues, and in 2000 the
Lewin Group issued its report. While the report reflected a "central planning and coordination role for key
institutions," Hunt wrote, it also suggested "a structural model different from existing medical center
complexes."
Hunt wrote that Shapleigh's "personal view" is that UTEP and others involved had a commitment to move the
nursing school to the central campus, but that is not the case. Hunt quoted a May 2006 letter to Shapleigh in
which Hunt wrote "to clearly detail to you that your view of what was to be done in this regard and my view as
it concerned the Nursing School were not in alignment."
"This started as and remains a dynamic process. The idea of a "centralized (medical) campus" and a border
health institute is a vision that must be based on best practices, good planning and effective strategy, not on
political expediency or individual preferences. Efforts at collaboration at this level, therefore, were and remain
significant in both scope and breadth," Hunt wrote.
Hunt wrote that an MOU is not a firm commitment, but rather a commitment to work toward a common end:
"The reason they exist is because there are both structural and governance obligations that must be met along
with the expression of commitment to the vision."
"Contrary to your suggestion, this decision does not open the door to the creation of two competing medical
centers. Instead, it reflects a reasoned approach to the "integration" of medical and allied health systems and the
underlying "analytics" associated with those systems, just as the Lewin Group report indicated it should be
done," Hunt wrote.
"Your personal disappointment with the decision does not make the decision wrong and does not make the
decision-making process a violation of the public trust," Hunt wrote. Hunt questioned Shapleigh's conclusion
that "a public decision was made in private."
Hunt also pointed to collaboration between the Tech and UT systems. He writes that UTEP has appointed
research physician Dr. Malcolm Mitchell as a liaison to Texas Tech, working to create an MOU to define
adjunct and joint faculty appointments; three UTEP faculty already have adjunct positions at Texas Tech and
"form the nucleus of a UTEP presence on the Texas Tech campus; and that there are activities under way to
include the physical location of adjunct professors and programs being coordinated at the medical campus.
He ended the letter by quoting from the Lewin report: "Over time, the Border Health Institute's success should
not be assessed strictly for its independent success as an institution, but on its ability to contribute to the success
of its partners and its ability to generate a flow of benefits over time to the communities in the El Paso region."
Hunt stated that placing the nursing school on the UTEP campus affirms that ideal, and "it is my sincerest hope
that when you reaffirm where things actually sit today you will choose to work, as a very important part of the
leadership of our community, through the collaboration that has worked for us so well, thus far. In this fashion,
we can be assured to achieve the dreams of success and value that people of good-will aspire and share."
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Oct. 12, 2007: Shapleigh to Hunt
Shapleigh opened his response by recognizing Hunt's work: "At the outset, let me first thank you for your
generosity of time, resources and courage. Without you, the Medical School, the MCA Foundation, the tactical
Cimarron Grant regarding our own President simply would not be. Our community owes you a debt of
gratitude—and I hope someday that we will give you the recognition that you are due for your leadership.
"I appreciate the dialogue that we are having on the Medical School—it makes us better as a community. Here
is my response to your letter."
Shapleigh wrote that after eight years, the UT system has not done enough to support a "unified campus in El
Paso. … Naming a professor is not a commitment. Take a look at Laredo if you want to see what a real
commitment looks like."
As for whether the decision to place the nursing school on the UTEP campus reflected a community-driven
process, Shapleigh wrote, "When public officials are deliberately cut out of the process by private interests and
non-elected officials, the people are excluded as well."
Shapleigh also wrote that Hunt's reference to the Lewin Report provided incomplete context for understanding
the Medical Center of the Americas: "The Lewin Report is one of dozens on our medical campus; it relates to
research, not health education. To my knowledge, the Lewin Report has never been cited, quoted or used at a
single Senate hearing. To selectively rely on it, and not the whole record, as you do in your letter denies the
reality of a decade of collaborative work."
Shapleigh re-enforced the idea that the Medical Center of the Americas is a physical location, and referred to
discussion of a virtual campus several years ago.
"We dismissed the notion of the “virtual” online medical center envisioned by Natalicio and Pickett in 1999
long ago when we moved forward on the community vision for a physical medical school and “unified” medical
center," Shapleigh wrote.
He referred to the fact that "Houston, San Antonio, Lubbock, Albuquerque, Phoenix and other major health
campuses all have nursing facilities. Texas Women’s University moved the entire nursing program to Houston
way back in the 1980’s because Houston had the teaching hospitals," and wrote that Thomason CEO Jim
Valenti and dismissed Texas Tech School of Medicine Dean Robert Suskind had told UTEP President Diana
Natalicio that the nursing school should be on the MCA.
"Let’s face it—the decision to move nursing in a deal with Tenet was a mistake that we will live with for years,"
wrote Shapleigh.
He ended the letter: "As always, I look forward to working together to move El Paso forward—but to do that,
UT and others will have to be more honest with their intentions and communications. Given the broad
collaboration we have achieved at our MCA, I’m sorry that UTEP decided to go alone. Keep the faith—our
community is worth the fight."