SAN ANTONIO, Texas -- Shriners say they will keep a presence in all 22 cities where they now provide care for children, including Galveston, but some of the facilities may be downgraded to outpatient surgical centers.

Shriners Hospitals for Children will also begin accepting insurance for patients who have it.

Traditionally, the Shriners have provided care free of charge and without billing insurance companies, but the new hospital CEO Douglas Maxwell said Thursday that the nonprofit needs to change the way it does business.

The rising cost of medicine and its shrinking endowment forced the Shriners this week to look at revamping its 22-hospital system to remain solvent.

"We will always take care of the child to the best that we can," Maxwell said.

He said no child will be turned away.

Shriners Hospital in Galveston, located at 815 Market St., has been closed since Hurricane Ike slammed ashore in September.

Thursday's news means the hospital will reopen, but it could take up to four weeks to renovate and hire new staff.

Shriners Galveston is a 30-bed facility that offered treatment, rehabilitation and orthopedic care for burn patients 18 and younger from all over the world.

Since closing, many of the doctors have focused on helping the patients at UTMB in Galveston, which is across the street.

The UTMB burn unit used to only accept adult patients, but in April, opened up to burn patients of all ages to fill the need.