Oklahoma Children’s Heart Center asks legislature for $250 million bond to build dedicated heart hospital

The University Hospitals Authority asked the Senate Appropriations Committee on Oct. 27 to approve $250 million in capital support toward a proposed pediatric heart center attached to Oklahoma Children’s Hospital, saying the center would consolidate cardiac surgeries, intensive care and outpatient services in a single facility.

Randy Dowell, chief executive officer of the University Hospitals Authority and University Hospitals Trust, told committee members the preliminary construction estimate for the project is $294,000,000, of which the Authority is seeking $250,000,000. Dowell said OU Health, which manages the hospital, and philanthropy would cover the remainder.

The request would be financed either by a bond issue, Legacy Capital Fund repayment, or a combination, Dowell said. The Senate subcommittee recommendation is a $250 million bond with an additional $20 million in annual appropriations for debt service. Dowell said the bond-service estimate on a 20-year sale would be about $20.5 million per year under current assumptions; Legacy Capital Fund repayment would equal roughly $12.5 million per year without interest if chosen instead.

The ask followed a clinical presentation by Dr. Harold Burkhart, chief of the division of cardiac, thoracic and vascular surgery at the University of Oklahoma. Burkhart described a decade of program growth since 2014, when the pediatric cardiac program did fewer than 100 procedures annually and many families left Oklahoma for care. He said the program now performs about 500 cases a year and has reopened a pediatric heart transplant service, listing three children currently waiting and noting the program performed its first successful recent transplant in October.

"This is the only place in Oklahoma to have heart surgery. No other place in Oklahoma does heart surgery," Burkhart said, describing why a centralized, high-volume center improves outcomes and access for families across the state.

Burkhart cited outcomes data submitted to the Society of Thoracic Surgeons and said adjusted mortality after congenital heart surgery at his center was about 1.42 percent in recent reporting, below an indicated national average of 2.66 percent. He said US News & World Report has ranked the program among the top 50 cardiac programs, and that clinical volume supports research, education and complex care such as transplantation.

Dowell described project elements and cost breakdowns in more detail: roughly $160.4 million for construction of about 200,000 square feet, $30 million for furniture and equipment (FF&E), $48 million in soft costs (design and preconstruction), $19.3 million for four-year cost escalation and a 15 percent contingency. He said the Authority is in predesign and OU Health has funded initial design work of about $1.5 million; the Authority estimates $10 million of design fees in FY 2026 would be included within the $250 million request if funded.

Committee members asked about the project’s operating model and financial risk. Dowell and Burkhart said recruitment of surgeons, cardiologists and nurses is already underway and that the center’s payer mix is heavily weighted toward Medicaid: about 77 percent of pediatric patients are covered by Medicaid, frequently through managed care. Dowell told the committee OU Health has a governmental affairs team monitoring potential federal Medicaid changes and is preparing contingency plans.

Senators pressed for clarity about timing and early-use dollars. Dowell said if approved in July the Authority would issue an RFP for architecture and might reduce the bond size after design work; he said the subcommittee’s recommended $20 million appropriation for debt service would allow the project to proceed into the design phase.

No formal vote occurred during the hearing. Committee discussion continued with a separate presentation from Oklahoma State University on the veterinary teaching hospital.