Galveston County Daily News, Sept. 3, 2008 UTMB's Karen Sexton is quoted in this article in which she says that UTMB is taking measures to reduce costs and become more financially efficient. "Layoffs are difficult and used as a last resort but are very necessary for business," she said. Despite the changes, Sexton said the medical branch, the county's largest employer, was doing well and was focused on the future.