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Texas District Selling $205M of Certificates to Expand San Antonio Hospital

DALLAS — The Bexar County, Tex., Hospital District plans to price $205 million of certificates of obligation Wednesday backed by the Build America Bond subsidy to expand San Antonio’s University Health System.

Siebert Brandford Shank & Co. is senior manager on the negotiated deal with Stifel, Nicolaus & Co., along with a syndicate of five co-managers. First Southwest Co. is financial adviser. Fulbright & Jaworski and William T. Avila are co-bond counsel.

The tax-backed debt carries ratings of AAA from Fitch Ratings, AA-plus from Standard & Poor’s, and Aa1 from Moody’s Investors Service. All provide a stable outlook.

The $12 million of Series A and $193 million of Series B certificates will be the third and final installment of the district’s nearly $900 million financing for its current capital improvement program.

With the approval of the Bexar County Commissioners Court, the University Health System board of managers agreed to issue the debt for a trauma tower at University Hospital and a new urgent-care building downtown.

University Hospital, which serves as the public trauma and indigent health care center, was last expanded about 25 years ago. The hospital is too small to keep up with current demand for service, much less that coming from the San Antonio area’s rapidly growing population, officials say.

The hospital is the lead Level I trauma center for 22 counties in south and central Texas serving two million people. Other facilities include six outpatient primary-care clinics and three dialysis centers, as well as preventative health clinics providing prenatal and well-child services. University Hospital, part of University Health System, has been affiliated with the University of Texas Health Science Center at San Antonio since 1968.

With the new issue, the Hospital District’s parity debt will come to nearly $766 million.

UHS will contribute about $120 million towards the capital projects, with cash reserves and $8 million in interest earnings on invested bond proceeds, according to analysts.

“Following this issuance, the direct net-debt burden will remain low in our view, at less than $500 per capita and about 0.75% of market value,” wrote Standard & Poor’s analyst James ­Breeding. “Overlapping debt, including a number of cities and school districts, is what we see as significantly higher at $4,250 per capita and 6.9% of market value.”

Though San Antonio recently lost its AT&T headquarters to Dallas, the city and its suburbs include a mix of military, tourism, financial, health care, and biomedical industries.

Three of the top six employers are military installations with combined payrolls of 60,000. As a result of base realignments, San Antonio will gain 9,700 jobs over four years.

The Department of Defense Medical Education and Training Campus will be based in San Antonio, bringing in 12,500 new medical jobs at the largest inpatient facility in the U.S. military.

Lackland Air Force Base was also named the Cyber Command Center, a designation that is expected to generate additional jobs. Four Fortune 500 companies are headquartered in the county: Valero Energy Corp., Tesoro Corp., USAA, and Clear Channel. Toyota ranks as one of the region’s major manufacturers with its truck plant.

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