County OKs bonds to upgrade Ben Taub
Harris County commissioners Tuesday approved spending $70 million for upgrades intended to preserve the Level 1 status of Ben Taub Hospital’s trauma center, a vital component of the area’s scarce highlevel emergency care.
The public hospital, which serves mainly low-income patients, had one year to hash out a plan to maintain its accreditation after the American College of Surgeons found deficiencies during an inspection last year. The money approved Tuesday will pay for expanded operating room capacity and other improvements.
The college also recommended that the hospital increase the number of surgeons. Funding for three new positions was found elsewhere.
Commissioners Court voted unanimously in favor of construction bonds to cover the expansion at Ben Taub’s facility,
which includes seven operating rooms and supporting infrastructure to keep them running.
“It made sense for us to help them out,” said Bill Jackson, director of budget management for the county, noting that this was the first time the county has funded a Harris Health project in this way. “It was very important to get it done on a timely basis.”
County Judge Ed Emmett said the loss of Level 1 status at Ben Taub would have had major repercussions for patients and other area hospitals. The region has one other adult Level 1 facility, at Memorial Hermann Hospital.
Level 1 trauma centers have the expertise to care for the most critically injured patients. The Ben Taub and Memorial Hermann centers are among the busiest in the nation, routinely running at or above capacity. The accreditation group recommends that a community provide one such facility per 1 million residents. In Houston, each Level 1 facility serves 3 million.
Although Harris Health gets its own stream of funding from Harris County taxpayers, the building costs to expand Ben Taub’s operating room capacity will come out of bond debt the county can issue without taxpayer approval. The county has budgeted to repay it out of the general fund without a tax rate increase.
Harris Health began facing major budgetary constraints when several of the funding streams to pay for the care of uninsured and indigent residents dried up. In September, the Harris Health board of directors approved new limits on eligibility for subsidized care to reduce a projected $53 million deficit for fiscal year 2017.
The eligibility changes and an increase in property tax revenue have reduced the projected deficit to $20 million. Hospital officials plan to identify further cuts in the coming months, but that left no room for funding the $70 million trauma center improvements.
“The county stepped up, and we’re grateful,” said George Masi, Harris Health CEO.
The county could have had an additional $100 million at its disposal if Texas had accepted expanded Medicaid dollars available through the Affordable Care Act, Masi said.
“We have 70,000 patients who don’t have insurance who would have had insurance,” he said. “When you do the math it’s $70 million of support from the taxpayers of Harris County or $100 million in Medicaid dollars that Texas has refused to accept.”
Emmett echoed the sentiment that taxpayers were bearing the brunt of the opposition by state leaders to expanding Medicaid: “I really wish the state would step up and help with that funding, but they’ve chosen not to do so,” Emmett said.
Plans for expansion at Ben Taub gained momentum after a 2014 inspection found the hospital had too few operating rooms and not enough surgeons to adequately function as a Level 1 trauma center.
“We had 10 operating rooms. That is tremendously under-scoped in terms of capability and the demand that’s placed on the facility to do surgeries,” Masi said.
Gunshot victims or victims of industrial accidents were never diverted, he said, but essential, major surgeries that had to take place often got delayed.
The American College of Surgeons, which accredits trauma centers in the U.S., had planned to return before Nov. 6 to see whether Harris Health was on track to remedy the deficiencies.
The organization toured Ben Taub Nov. 3, and Masi said the representatives gave the facility’s leadership “very strong feedback that we had met all the criteria to achieve full accreditation.” He said he expects to receive a letter confirming the accreditation within the next two months.