Harris County voters to decide on $2.5B bond for hospital, clinic expansions

In November, Harris County voters will have to decide whether or not to fund a $2.5 billion expansion of the Harris Health System over the next 10 years in a move that could expand health care access for more than 1 million uninsured residents.

The bond is part of HHS’s 2021-25 Strategic Facilities Plan. If approved by voters, the bond is estimated to raise monthly property taxes by less than $6 after 10 years for the owner of a home valued at $300,000, according to Harris County budget office projections. Additional investments are also expected to come from grants, philanthropy and operational cost savings.

The details

If approved, the bond funding would allow HHS to:

• Replace and renovate Lyndon B. Johnson Hospital in northeast Houston with a new hospital adjacent to the existing hospital, including 390 acute care beds, for a total capacity of at least 600 beds at both hospitals
• Extend the lifespan and capacity of Ben Taub Hospital in the Texas Medical Center by at least 10 years
• Create a new community clinic in precincts 2, 3 and 4

The projected tax rate impact is $0.02 or less, which won’t be fully realized until the entire $2.5 billion has been accessed, which is not expected to occur for a decade, according to HHS information.

HHS President and CEO Dr. Esmaeil Porsa said the need is urgent and the effects are long term because the hospitals have failing infrastructure and the county population is rapidly growing.

“Having people in hospital beds in the hallways of the hospital, that should not be happening in this day and age, in the city of Houston, home to the largest conglomeration of hospitals and hospital systems,” Porsa said. “It’s not only not fair to our patients and to our communities, it’s really unfair to our employees who have to render those services in those conditions.”

Countywide Harris Health health care operations include:

• Two full-service hospitals: Lyndon B. Johnson Hospital, which has 215 acute care beds and is a Level III trauma center, and Ben Taub Hospital, which has 402 acute care beds and is a Level I trauma center
• 17 community health centers
• Eight homeless shelter clinics
• Four multispeciality clinics
• Three same-day clinics
• Dental center
• Mobile health units

In one year, HHS serviced:

• 854,313 clinic visits
• 147,496 emergency room visits
• 193,727 telehealth clinic visits

Digging deeper

Texas has the highest rate of uninsured people in the country with 18% of the state lacking health insurance, compared to an 8.8% national average, according to the 2021 American Community Survey. For Harris County, the data also shows 21.8% are uninsured, and nearly 1 in 4 people in Houston is without health insurance.

Harris County's population also continues to grow, according to the U.S. Census Bureau. HHS officials called the county health system insufficient to meet current needs and future demands. Both hospitals are operating at over 90%-100% daily occupancy.

For low-income families in Harris County, accessing health care is challenging, particularly for those without health insurance, according to HHS data. Research by public health experts has found that low-income families face consequences when they are unable to access health care, including:

• Uninsured patients coming in for late-stage diseases, including cancer
• Poor diabetes control
• Higher mortality rates
• Avoidable hospitalization

When it comes to need, the county’s poverty rate is higher than the national average at 16.4% for all age groups, compared to 12.8% nationwide, according to the U.S. Census Bureau.

In Harris County, Black and Hispanic residents are overrepresented in the poverty populations. Census data shows those living below the federal poverty level are 23% Black as well as Hispanic or Latino at 19.6%, compared to white residents at 8%.

Patricia Cabrera serves on the board of the Spring Branch Community Health Center. Cabrera said while she is familiar with the health inequities that affect working Latino families, she wants to clear a misconception when it comes to this demographic.

“This affects the working poor, working families," Cabrera said. "The prosperity of this city really does depend on the same population. It’s a fairness, equity issue.”

She said working Latino families often don’t receive health care benefits from their employers, but they are the main people at job sites working to complete building projects or construction throughout the county.

“People are contributing, and we’re all benefiting from the prosperity of their work. Because of their work, we should also find ways to make their life livable,” Cabrera said. “Health care is our No. 1 concern after food and shelter. Food and shelter depends on having good health and being able to go to work. It’s all connected.”

What’s next

One thing Porsa emphasized at the Aug. 18 Harris County Commissioners Court meeting was if the bond gets approved, each project has various phases that are expected to be carried out over several years.

“A couple years ago, LBJ Hospital was facing such serious infrastructure failures that we actually considered closing down the hospital,” Porsa said. “So at that point, my board instructed me to actually start planning the LBJ replacement knowing that at some point we were going to come to this day.”

• HHS is preparing to break ground at the new LBJ Hospital in April or May 2024.
• LBJ Hospital campus construction is planned for 2024-35.
• Ben Taub Hospital campus construction is planned for 2024-30.
• Clinic and health center construction is planned for 2025-33.

Baylor College of Medicine President Paul Klotman said at the Aug. 18 meeting that the need for these facilities is urgent.

"The facilities are inadequate, whether we’re talking about bed numbers, operating rooms, recovery space, Level I trauma capacity,” Klotman said. “We’re behind. This bond election is an investment in the future for Harris County and the city of Houston.”