Brazos County holds public hearing on proposed FY2025 mandatory provider payments for nonpublic hospitals

Brazos County Commissioners Court held a public hearing on June 24, 2025, at 9:30 a.m. at the Brazos County Administration Building to consider a proposed amendment setting the FY2025 rate for the county's Local Provider Participation Fund (LPPF), a mandatory provider participation payment the county would require of all nonpublic hospitals and how revenue from those payments would be spent.

The hearing matters because county officials and hospital representatives said the local payments would be paid from hospital operating dollars and can trigger federal matching funds to support care for uninsured and low‑income patients. Justin Flores, director of finance for Adelanto Healthcare Ventures, told the court that hospitals are seeking additional dollars for the fund because of federal program changes and high local uncompensated‑care costs.

Justin Flores, director of finance for Adelanto Healthcare Ventures, said the hospitals represented at the hearing include Baylor Scott & White and CHI St. Joseph and described uncompensated care in the region as large. "It's north of $50,000,000 that that occurs in in Brazos County alone," Flores said, and he later clarified the "true uninsured cost for for the for just Brazos County is probably, north of 40,000,000." Flores said the LPPF payments are not passed to patients. "These funds are not passed on to the patient in any way. It's statutorily, where Baylor Scott and White and and CHI Saint Joseph, they cannot pass this cost on along to the patients," he said. "These are from operational dollars that the hospitals are choosing to put into this fund."

Nina Payne, Brazos County budget officer, introduced Flores to give details and invited questions from the court. A representative who identified themselves as part of the Brazos County Council of Governments said the county's larger hospitals draw patients from surrounding smaller counties and described the LPPF as a pass‑through. "I might add also that it is a pass through. It doesn't come out of the coffers of the county. It is a pass through," that speaker said.

The court questioned how the funding flow works and who ultimately matches the local contributions. A county official cited a state match; Flores clarified the federal role, saying, "the federal government comes back and matches those," and described the arrangement as a flow that reduces demands on state general revenue.

No formal vote or final action on the proposed order was recorded during the public hearing. The court noted that the item will be placed on a future Commissioners Court agenda for review and possible action. "And there will be, hopefully, action on the agenda item during road commissioner's court to, review the order," a court speaker said during the hearing.

Speakers at the hearing described the LPPF as intended to support uncompensated care and Medicaid shortfalls, and hospital representatives said they support the proposal. The hearing record does not specify an exact county rate proposed in the public remarks or a final allocation plan for how the county would spend the revenue; the court indicated those specifics will be addressed when it considers the order on a later agenda.

The Commissioners Court did not take a vote during the hearing. The court recessed the hearing after comments and indicated a future meeting would include the formal agenda action to set the FY2025 LPPF rate.