Nueces County Commissioners Court on Wednesday unanimously approved a resolution supporting draft state legislation that would allow the Nueces County Hospital District to use district funds to recruit and retain physicians and to expand graduate medical education positions, and separately approved an amended interlocal agreement under which the county will provide employee benefits for the hospital district.

The court’s action comes after a detailed briefing from hospital-district representatives about two draft bills — House Bill 4801 by Rep. Villalobos and Senate Bill 2666 by Sen. Hinojosa — that the district has asked legislators to file. The district asked the court to signal support so its legislative team can push the language through the 2025 session.

The resolution supports permissive language that would allow the hospital district to use any of its legally available funds to support recruitment, retention and expansion of residency positions, rather than imposing a mandatory spending obligation the district said could create an unfunded mandate. “The wording between the two bills is very similar,” a hospital-district representative told the court, “and we would prefer permissive language so the district may do this rather than being obligated forever.”

Commissioners and district leaders discussed how the program would be administered if the bills pass. The court and hospital-district speakers repeatedly emphasized the intent is to expand medical education and address documented physician shortages — for example in gastroenterology and other specialties — so more physicians train in the Coastal Bend and, the district hopes, stay to practice locally. The hospital district said the grants would be open to hospitals and training programs located in Nueces County, and that rules for any grant program would be developed by the hospital-district board if the law passes.

“It's a general bill that applies to all the hospitals,” the district representative said when asked whether the program would be limited to one system. Commissioners pressed for safeguards so the county’s support could not be used to give a single health system a long-term funding advantage. They instructed district staff to refine language and the proposed rule framework before the district files for legislative support with the court’s endorsement.

On a separate but related matter, the court unanimously approved an amended interlocal cooperative agreement between Nueces County and the Nueces County Hospital District governing the district’s participation in the county employee benefits program. The amended agreement clarifies how the hospital district will reimburse the county for benefits (health, dental, vision and life insurance) and confirms procedures for reconciliation and stop‑loss coverage. Under the agreement the district pays the county an administrative pass-through and adds an additional percentage that is reconciled periodically; the county confirmed the district will cover claims above the stop‑loss threshold.

Both votes were unanimous. Commissioners said the legislative support and the clarified benefits agreement are complementary steps: the resolution is intended to help broaden medical training and retention in the county, while the interlocal updates the administrative relationship between the county and district. The hospital-district board is scheduled to formally consider the draft bills and the district’s legislative strategy at its next meeting.

What’s next: the hospital district will finalize draft bill language with the offices of Sen. Hinojosa and Rep. Villalobos, develop proposed grant rules for the district board’s consideration, and return with the district’s preferred final language and any requested changes to this court before the district’s legislative filing is finalized. The county attorney and district counsel will coordinate the legal language of the interlocal and confirm the stop‑loss and billing mechanics handled in the amendment.