Anticipating a winter surge of COVID-19, Bexar County’s public hospital system will hire more nurses and provide more services for victims of family violence, which officials say has increased significantly during the pandemic.

At a meeting Tuesday night, the University Health board of managers approved spending $5 million to cover the cost of adding up to 40 temporary nurses per month in hospital’s coronavirus units.

“We do need these nurses in response to surges and other situations that are out of our control,” said Tommye Austin, senior VP and chief nursing officer at University Health.

University Hospital officials say projections show the coming increase in cases may not be as bad as it was during the summer, but that depends largely on how San Antonio residents act during the holiday season.

University Health President George Hernandez warns that the surge of cases could be worse if people continue to host large family gatherings or aren’t diligent about wearing face masks.

At its peak in July, when the city had more than 1,000 patients with COVID-19 in its hospitals for weeks on end, the Bexar County public hospital system was treating around 250 infected patients.

Austin said that even with 300 employees already on the hospital’s supplemental staffing team, there likely will be a shortage of ICU nurses as well as nurses to cover areas when workers get sick with the virus and need time off to quarantine.

Also Tuesday, the board approved a $650,000 funding request to improve services at the Women and Children’s Shelter in San Antonio.

The 13-month agreement with Family Violence Prevention Services will fund at least five employees who will provide counseling services, serve as a liaison with Child Protective Services, run an intervention program for perpetrators of violence and coordinate services for child residents.

Dr. Sally Taylor, senior VP and chief of behavioral medicine for University Health, said the shelter has an unmet need for specialized psychiatric services for an estimated 200 adult and 200 child clients. The funding will provide treatment via telemedicine.

The nonprofit also plans to hire an on-call forensic nurse who can provide on-site initial assessments for an estimated 250 women who have suffered injuries, including strangulation.

Studies show that strangulation attempts increase the risk of domestic violence homicide by 700 percent. Victims who survive a strangulation attempt are unlikely to survive another violent encounter, the figures show.

Taylor presented a statistic that stunned some board members: Bexar County has the highest rate of women killed by male intimate partners of any major city in Texas, with 4.8 deaths per 100,000 in 2017.

“This has been an ugly secret in Bexar County for some time,” said Dr. Margaret Kelley, an OB-GYN and hospital board member appointed to the board this year.

Family Violence Prevention Services was established in 1977 and provides the 24-hour emergency shelter and crisis intervention facility for both adult and child victims of violence.

The health system’s financial support which begins on Dec. 1 will also help pay for food, transportation and pet kennels needed by family violence survivors.

Vice Chairman Ira Smith said he was glad that the hospital system is working with the nonprofit.

“Folks don’t seem to understand the complexity of these situations,” he said.

In another coronavirus-related development, Chief Financial Officer Reed Hurley told the board there’s been an unexpected upside to the pandemic: It’s resulted in the savings of millions of dollars in an upgraded technology system.

The implementation of the Epic electronic health record system, which is used for everything from billing to ordering lab tests, had been planned for three years and its cost had been estimated at $170.8 million.

But travel restrictions during the surge meant the team of consultants from the company’s Wisconsin headquarters couldn’t train employees in person throughout the system. This shaved off about $30 million from the total.

“We just didn’t spend that money,” Hurley said.