Collin County Commissioners oppose Parkland Hospital merger bill

by Bill Baumbach of The Collin County Observer

Late Monday evening, the Texas House County Affairs Committee held a hearing on HB515.

HB515 was introduced by Reps. Allen Vaught and Carol Kent, both Dallas Democrats. The bill would allow citizens to file a petition forcing an election to merge the Dallas County Hospital District (Parkland) with a contiguous county. Elections would have to be held in both the petitioning county and in Dallas County, and voters in both would have to approve it for the merger to take place.

The Collin County Commissioners Court vehemently opposes the bill. Merging with Parkland is one of their worst fears.

Dallas County Judge Jim Foster and Parkland President Dr. Ron Anderson both testified that the merger was to the benefit of all counties, and might be needed so that Parkland could remain a level 1 Trauma center. If Parkland were to give up their level one status, the closest level one center would be in Houston. It was pointed out that when a traffic accident in Collin or Rockwall Counties results in a horrific trauma, the patient is almost always airlifted to Parkland - whether or not the victim is insured. Loss of access to Parkland would inevitably cost the lives of some suburban residents.

Dr. Anderson and members of the committee pointed out that Parkland not only served the poor and indigent, but also insured Dallas and suburban residents with the region's premier trauma center, burn unit and 24 hour psychiatric center.

Parkland's indigent care covers uninsured citizens who earn up to 200% of the federal poverty level (FPL). Judge Foster testified that last year, Parkland absorbed over $20 million in unpaid bills from suburban residents. Collin county covers up to 100$ of FPL, but also subjects applicants to an asset test that disqualifies more poor folks than the income level does. Other counties have more stringent income qualifications.

At one point during his testimony, Dr. Anderson quoted the Ellis County Judge as telling him, "Why buy the cow, if I can get the milk for free."

While County Judge Keith Self attended the hearing, he wisely (after the drubbing he got the last time he appeared before the County Affairs committee) did not testify. Commissioner Kathy Ward and the County's Health director, Candy Blair, spoke on behalf of the commissioners court.

Commissioner Ward was closely questioned by several members of the committee, especially Chairman Garnet Coleman and Rep. Valinda Bolton. The Chair, in particular was inclined to lecturing on the history of health care benefits and legislation in Texas. Commissioner Ward, however remained poised and gracious, and the committee reciprocated. Her reception was in stark contrast to the last two legislative appearances by our county officials.

Ward testified that the county was willing to explore new ideas in indigent care, but that they were opposed to HB515 because the election would be too expensive and because it wasn't clear how much of Parkland's debt Collin County residents would have to assume.

Ward also stated that Collin County paid its bills. She noted that last year, the county paid Parkland on 143 invoices for 'qualified' Collin County indigents. What she did not list was the number of bills that went unpaid, because the county would not grant benefits because of income or asset tests.

Ward noted that an election would cost the county over $400,000. She rightly stated that HB515 would allow only 50 voters to file a petition to force an election. Ward pointed out that Collin County had any number of political activists who could go to any 7-11 and get 50 signatures before lunch.

Ward's $400,000 figure would be correct if the referendum was the only item on a county-wide ballot. However, HB515 does not mandate a special election. Nothing in the bill would prevent the commissioners from scheduling the election at the next regular election date. Combining the referendum with normally scheduled elections would drastically reduce the cost.

Ward also objected to a provision in the bill which would grant Dallas county commissioners the right to appoint the Hospital district's representatives from the annexed county. She rightly stated that there was no way Collin County Commissioners would agree to that.

As to the debt issue, it is addressed in the bill, "If the district has outstanding debts or taxes, the voters in the election to approve the annexation must also determine if the annexed territory will assume its proportion of the debts or taxes if added to the district."

Candy Blair told the committee that according to Parkland's own statements during its last bond election, 90% of patients from suburban counties were insured and their bills were paid at a much higher percentage than patients from Dallas County.

With both HB515 and the Local Option Transportation Bill (SB855) asking local voters to take control over their own destinies by using the ballot box to decide if they want to support mass transit or improved health care, the 81st legislature is blazing a new trail in proposing innovative approaches to some of the most difficult political problems we face in suburban Collin County.

The legislature is not dictating new taxes, instead it asks the voters, "is a mass transit system worth paying higher taxes?" and "Is improving health care access worth paying a hospital district tax?"

The county would do well to negotiate with the legislature to remove the more objectionable provisions of these bills - and then let the voters decide.

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