ON "60 MINUTES": FRAGILE RURAL HEALTH CARE SYSTEMS IN TEXAS WEAKENED BY COVID-19 PANDEMIC PREPAREDNESS AT RISK OF BEING OVERWHELMED OR CLOSED

State-Controlled Re-Opening Comes as Small-Town Clinics and Hospitals Are Vulnerable to Outbreak

Texas, like other states, will begin a slow, gradual re-opening of business tomorrow. But health care providers in rural areas of Texas tell Sharyn Alfonsi that if COVID-19 outbreaks get worse in rural areas, their financially fragile care systems could become overwhelmed. Some are already on the brink of closing. Alfonsi's report will be broadcast on 60 MINUTES Sunday, May 3 (7:00-8:00 PM, ET/PT) on the CBS Television Network.

Sid Miller, who as agriculture commissioner also oversees the state's rural health care system, says 60 of the 163 rural facilities he's struggling to keep open in Texas have less than 30 days of cash on hand. Hospitals already teetering on the brink of financial collapse lost precious revenue from nonessential surgeries and procedures like colonoscopies the state cancelled to prepare for the pandemic. Says Miller, "It pushed them over the edge... I'm afraid, this pandemic... we're going to continue to lose healthcare providers in rural Texas and across the nation," he tells Alfonsi. "We had one filing for bankruptcy this week."

Some argue the virus is less inclined to thrive in low-population areas. But Miller points to a rural town in South Dakota where an outbreak started at a meat plant. "It just doesn't hold true."

The situation is particularly acute in Texas, says Dr. Leighann Falcon, who runs a clinic and works at Memorial Medical Center in Calhoun County. "We lead the nation in a lot of things and including uninsured," says Falcon. "Our little hospital down the street on any given year can provide up to $6 million in uncompensated care... It's hard to run a business when you're giving away $6 million a year." She's skipping her own salary to pay staff and dealing with extra costs of treating every patient as a potential COVID-19 case. Personal protective equipment is at a premium. To a struggling hospital, paying more than a dollar for a mask that used to cost six cents is daunting. "Without assistance, they won't survive," says Falcon. "If our hospital were to close, it would devastate our community. We're already short physicians. We're short for healthcare. If you have an emergency, and the nearest emergency room is over 35 miles away, that's not a good thing. "

Nurse practitioner Elizabeth Ellis owns the only clinic in the town of Bedias, Texas, where many of the 443 residents are elderly, uninsured or on Medicaid. In addition to seeing patients in her clinic, she must make house calls to remote areas of East Texas to those who cannot travel. Grimes County, where Bedias is located, is seeing an increasing number of COVID-19 cases. It was a balancing act to stay open before the pandemic; now Ellis fears the worst as people go back to work. "A lot of our community members have to leave the county for jobs. That puts them at risk," she tells Alfonsi. "So it was inevitable that at some point in time it was going to hit the county." If the virus presents itself in greater numbers, "I'm going to be overwhelmed. And what frightens me is that all of America's critical access hospitals, especially here in Texas, are at risk of closing."

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