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Government JPS Bond Proposal: Commissioners Court to decide in two weeks if and...

JPS Bond Proposal: Commissioners Court to decide in two weeks if and for how much

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Paul Harral
Paul is a lifelong journalist with experience in wire service, newspaper, magazine, local and network television and digital media. He was vice president and editor of the editorial page of the Fort Worth Star-Telegram and editor of Fort Worth, Texas magazine before joining the Business Press. What he likes best is writing about people in detail and introducing them to others in the community. Specific areas of passion are homelessness, human trafficking, health care and aerospace.

The Citizens Blue Ribbon Committee Final Report can be found here: bit.ly/2018JPSBond

JPS Health Network

The JPS Health Network (JPS) has served Tarrant County as its public hospital since 1939. In addition to its main campus, the system has more than 40 locations throughout Tarrant County.

About JPS:

— 14 community health centers and 20 school-based health centers, serving 13 school districts;

— The main hospital with Tarrant County’s only Level 1 Trauma Center;

— A behavioral health facility with the only psychiatric emergency center in Tarrant County;

— More than 1 million patient encounters per year (including 20,000 patients with behavioral health diagnoses);

— 140,000 Emergency Department visits per year;

— 4,400 babies delivered annually;

— 60,000 inmate correctional health encounters per year;

— 6,500 employees in JPS Health Network, making it the 8th largest employer in the county;

— Sponsorship of 18 residency and fellowship programs for 200 graduate students, including the nation’s largest hospital-based family medicine residency program;

— Undergraduate programs composed of affiliation agreements with more than 50 institutions for more than 1,000 health profession students.

Source: Citizens Blue Ribbon Committee Report

Citizens Blue Ribbon Committee Key Recommendations

— Four new community health centers should be built in the next five to 10 years with a plan for continued health center development over the next 20 years.

— A new Ambulatory Surgery Center is needed on campus to alleviate capacity constraints and move lower-acuity surgical cases to a more appropriate, lower-cost setting. In addition, the

committee recognizes that the JPS Center for Cancer Care would be more ideally located in a patient-friendly, dedicated new facility on or near campus. (Relocation of the cancer care facility is underway in a leased building.)

— A new JPS main hospital tower with supporting ancillary departments should be constructed. This recommendation is based on a facilities consultant evaluation that indicates the existing JPS main hospital facilities are not recommended for inpatient acute medical services because they do not meet industry standards. The health system consultant report focusing on population growth projections and need indicated the extent to which the bed count of the hospital tower falls short of the current and 20-year predicted need. A majority vote targeted about 676 beds for the hospital.

— A new JPS behavioral health facility should be built. The facilities consultant’s evaluation concluded that the existing JPS facilities are not recommended for inpatient behavioral health care services because the total psychiatric inpatient bed count falls far short of both the current and 20-year predicted need. This inpatient capacity is critical because JPS is best positioned to serve the most complex behavioral health patients in the community. A majority vote targeted about 298 beds for the behavioral health facility.

— JPS should take a leadership role in a countywide planning effort to build and retain a future health care workforce to address the growing needs, as well as build particular service lines at JPS where we anticipate dramatic increases in demand such as geriatrics.

— A strong integrated health care delivery system should be created for low-income uninsured and underinsured patients to reduce preventable, duplicative and costly health care utilization and improve quality of life.

— To approach the county’s overall health in a holistic manner, and to decrease the overall costs of health care, a series of cross-sector, countywide strategies should be developed, focused on disease prevention and the social determinants of health.

Although many decisions related to these recommendations must still be made, particular needs are great enough that the committee was able to come to unanimous agreement on the report. Tarrant County is in the enviable position of planning for growth and rapid change. We have the opportunity now to make Tarrant County a healthier place for the next generation to live and a place where we can take even greater pride in our collective ability to meet the needs of our population.

Source: Citizens Blue Ribbon Committee Report

The final report of the committee can be found here: bit.ly/2018JPSBond

Tarrant County commissioners will decide Aug. 14 whether to submit an $800 million bond proposal to the voters Nov. 6 to fund new construction, renovations and other needs for the JPS Health Network (JPS).

The commissioners informally agreed in a July 31 meeting on the $800 million number.

The money would be spent in phases to implement the suggestions of a Citizens Blue Ribbon Committee that commissioners appointed in December 2016 to evaluate the county’s current and future health care needs, the current delivery system and the role of the JPS Health Network.

Among the key recommendations in the committee’s February 2018 report were:

— Build four new community health centers in the next five to 10 years with a plan to continue developing health centers over the next 20 years.

— Add a new Ambulatory Surgery Center on the JPS main campus to “alleviate capacity constraints and move lower-acuity surgical cases to a more appropriate, lower-cost setting.”

— Relocate the JPS Center for Cancer Care to be “more ideally located in a patient-friendly, dedicated new facility on or near campus.” (Relocation of the cancer care facility is underway in a leased building.)

— Construct a new JPS main hospital tower with supporting ancillary departments with about 676 beds.

— Construct a new JPS behavioral health facility because the current total psychiatric inpatient bed count falls far short of both the current and 20-year predicted need. The report suggested targeting about 298 beds for the behavioral health facility.

“We are grateful for dedication and hard work done by the members of the Citizens Blue Ribbon Committee,” said Robert Earley, president and CEO of JPS Health Network. “Their efforts validated what we long have known at JPS: our facilities aren’t keeping pace with the tremendous population growth throughout Tarrant County.”

If authorized by the commissioners and approved by the voters, the $800 million package would fund most of the committee’s recommendations.

In response to a question from County Judge Glen Whitley at the July 31 meeting, Tarrant County Administrator G.K. Maenius said the committee did not put a dollar figure on its recommendations, but a consulting group hired by the county said the total price was about $1.2 billion.

“That’s a fairly large number,” Maenius said. “We believe that through efficiencies and looking at alternate ways to deliver the same level of service that we can lower that particular amount.”

The hospital district would bring about $300 million into the funding from a Futures Fund set up several years ago in anticipation of looming capital expenses, Maenius told the Fort Worth Business Press.

An example, he said, is the proposed new construction and relocation of the JPS cancer center, estimated to cost $30 million. Instead, the JPS system has contracted with the Moncrief Cancer Institute to lease and renovate a building the institute was not planning to use, saving about $25 million.

The JPS system gets about 39 percent of its funding from ad valorem taxes and the rest comes from other sources such as Medicare, Medicaid, insurance and various federal and state sources, Maenius said.

Since only the tax stream is consistent and the other sources of funding may change, JPS Network maintains 200 days of operating funds in reserve. Money above that can be used elsewhere and some of that goes into the Future Fund.

There is about $182 million in that fund now, and county and hospital officials are confident that $120 million more will be available over the next 10 years, Maenius said.

Maenius said county and hospital officials also are exploring public-private partnerships where possible to reduce the funding needed for hospital expansion.

Whitley also referred to the cancer center, saying he thinks other opportunities for public-private partnerships include a proposed parking garage and other opportunities that may arise.

But he also said he believes it is necessary that the system build suggested medical home sites to promote preventive health care, which he sees as critical to the county.

He also thinks that there will be other efficiencies offered in new or renovated buildings.

“For the last 34 years, since the last time we did a bond issue, we kind of shoehorned things in wherever it would fit, and that’s not doing the most efficient when it comes to putting things together,” Whitley said.


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