JPS getting less bang for more buck in bond program. Poor people will pay the price | Opinion

If you ever wonder why people are cynical about government spending and planning, consider the JPS Health Network.

Tarrant County’s public health operation asked voters for approval to issue $800 million in bonds, part of an estimated $1.2 billion package that envisioned new hospital buildings, a new mental-health facility and four innovative clinics that would help people without insurance seek care and, with any luck, reduce costs.

Now — five years later — the price tag of the entire package is approaching $1.5 billion. Nothing is built. And that ambitious plan for four “medical homes” is pared back to just one.

Hospital district and county officials do not deserve blame for sustained inflation; every project, public and private, is seeing spiraling price tags. But they compounded the problem with a lack of urgency and creativity, and they’ve invited more public skepticism and disappointment with a failure to act transparently the entire way.

But then, responsiveness to the public apparently isn’t a priority. The hospital system’s board of managers seem clueless to the prevailing attitude about property tax rates. They tried to enact a large effective tax increase by failing to reduce the tax rate even as higher property appraisals would mean a revenue windfall.

County commissioners overturned them, 5-0. That’s Republicans and Democrats alike. The public has had enough of local governments enjoying huge revenue increases on the backs of ballooning property values, and thank goodness the elected commissioners recognize it, because the appointed managers don’t.

And, as usual, JPS was slow to make itself accountable to the public. It steadfastly refused to answer Star-Telegram reporter Ciara McCarthy’s questions about the medical homes. That was after demanding that McCarthy file a formal records request — with its built-in delays — for budget information that any member of the public should be able to access with the click of a mouse.

Board member Trent Petty finally acknowledged the medical-home change at a meeting Thursday, explaining that priorities changed amid the COVID pandemic and lasting inflation. He said board members had to choose among priorities with the available resources.

The medical homes promise an improved model for preventive care for those without the resources to regularly acquire it. They offer one-stop shopping for those who might struggle to find (or afford) a primary care physician.

If the bond program’s ambitions must be trimmed, perhaps JPS officials are right to prioritize an expansion of the main hospital and the creation of more mental health facilities. It’s just a shame it’s come to that. The cost of managing chronic diseases such as diabetes and treating their consequences will be a frightening challenge for health systems everywhere in the years ahead.

County officials expressed confidence as recently as April 2022 that all four clinics could still be built. Inflation was a known factor by then, and yet no one seemed to think it might be a good idea to put on a little speed. Now, we’ll have just one medical home, too far out to do much good for most of the county, including Arlington and the northeast suburbs.

The health care equation is growing only more complicated. Costs continue to rise, and Texas continues to decline expanding Medicaid. That puts a burden on the public-health system, and if we wait for health concerns to show up in the emergency room, that’s the most expensive and least efficient way to deal with them.

JPS managers know this. They face a difficult landscape, to be sure. But Tarrant County needs a robust public health system, along with an efficient one. Right now, it’s getting neither.