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Harris Health will receive an infusion of one-time federal funds from the USA Rescue Act, which has a $45 million shortfall due to a budget battle among top Harris County officials last year.
“(I feel) relieved, more relieved than anything else,” says Dr. Esmaeil Porsa, CEO of the Safety Net Hospital District, which serves low-income and uninsured residents in Harris County.
In September, Dr. Porsa testifies at Commissioners Court about the impact a no-new revenue rate would have on the Harris Health system.
“We are not wizards, which is what it means to cut services,” Porsa said at the meeting.
He worried that a multi-million dollar shortfall would slow their plans to expand cancer screenings or services they outsource to health care providers, such as behavioral health, dialysis and hospice care.
Harris County was poised to approve a proposed tax rate with a Democratic majority in the court. However, Republican commissioners Jack Cagle and Tom Ramsey boycotted the meeting, saying the rate was too high for taxpayers. Without a quorum, the much lower no-new revenue rate was accepted.
In the weeks that followed, Harris County Commissioners found a solution to fill the financial gap the hospital district was facing. Federal money from the USA Rescue Act has provided a cushion, allowing Harris Health to move money around and ensure services won’t be cut this year.
Construction of the Quentin Mease Outpatient Clinic is underway – an effort to cut a backlog of 3,000 patients needing colonoscopies starting in September 2022. The facility was at risk of a delayed opening, according to documents from Harris County’s Office of Budget and Management. But now federal funds allow Harris Health to afford to staff the clinic.
“I know for a fact that once our endoscopy suite comes online this summer, we can start doing colonoscopies,” Porsa said. “It’s really, really important.”
The immediate fire has been extinguished, but the system’s long-term future is also at stake. Harris Health is preparing to approach voters with a bond question this year to fund a solution to ongoing infrastructure problems at Lyndon B. Johnson Hospital: building a brand new replacement hospital.
Dr. Porsa, which plans to present a proposal to the hospital board in March, said the breach keeps the system’s credit rating intact. Ending the fiscal year with debt could lower the system’s score and require it to borrow at a higher rate — a tougher sell to voters at the polls.
Talks about a replacement hospital began after a series of plumbing problems were discovered at LBJ Hospital. The most notable occurred on the morning of August 22, 2022, when water began leaking from the ceilings into patient care areas, according to Aown Syed, the hospital’s vice president of operations.
“It was almost like we were being flooded,” Syed said. “All our teams jumped in. It wasn’t a matter of what position you were in. Everyone knew all the hands on the ground.”
A connector, or the material that joins pipes together, has deteriorated. A leak in the heating hot water line started on the fourth floor. Water then seeped down to the second and third floors, soaking sheet rock and ceiling tiles.
“Staff were all soaked – whatever they were wearing,” Syed said. “There was debris left everywhere.”
About 45 beds went offline. Patients were transferred to Ben Taub and other partner facilities.
“Our whole hospital was at a standstill,” Syed said. “In the sense of saying we have people in the emergency room and they have yet to come upstairs to be admitted and we have patients on these floors that need to be transported right now.”
For the next 18 months, LBJ Hospital underwent a partial overhaul of its plumbing infrastructure that fixed all the corroded connections in patient care areas, Syed said.
However, the infrastructure of sanitary water lines that carry sewage still requires renovation.
The building housing LBJ Hospital first opened in 1989 as a replacement for Jefferson Davis Hospital, which closed the same year.
Apart from the plumbing issues, Syed believes the physical size of the hospital is too small compared to the demand. Patients are now connected two to a room. In addition, limited space in the emergency room, operating rooms and clinics is causing a backlog, he said.
“We’re the only facility out here on the northeast side of Houston,” Syed said. “If we weren’t here, the reality is unfortunately that this is a desert.”
The replacement hospital was not the only long-term financial concern after the adoption of a relatively low property tax rate.
Harris Health is expected to face a $150 million deficit next year if the no-new revenue rate continues, Chief Operating Officer Louis Smith confirmed in a Nov. 15 meeting.
“This $45 million is a band-aid to plug a hole for this fiscal year,” said Daniel Ramos, Executive Director of Harris County’s Office of Budget and Management.
Harris Health will need to work with the budget office to fill that shortfall, especially if the system’s revenue isn’t growing, but the costs of inflation and staffing shortages remain high.
“This funding is only for one year, we don’t have infinite ARPA dollars,” said County Judge Lina Hidalgo after commissioners voted to approve the award of ARPA dollars to Harris Health. “Next year we will still have to figure out what to do to plug this hole.”