Harris Health says 10,000 patients could lose services if proposed budget is not adopted

Harris Health System, one of the largest indigent health care systems in the country, will be operating at a $45 million deficit if the county cannot pass a property tax rate and proposed budget, potentially endangering services to 10,000 patients, county and health system leaders said Thursday.

Harris Health had proposed a budget of $2.38 billion for fiscal year 2023 — a roughly 2 percent increase from the current budget. The increase was needed to account for inflation, Harris Health officials say, especially with rising labor costs. Other services need to be expanded to address unmet needs among its current patients, officials say.

“It is not a sustainable path for us right now,” said Louis Smith, Jr., chief operating officer of Harris Health. “As we look at year two and year three moving out to 2023 and 2024, we will have to be pulling back more services. We don’t want to be in that situation.”

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Harris County commissioners have not been able to pass the proposed budget, because the two Republicans — Precinct 3 Commissioner Tom Ramsey and Precinct 4 Commissioner Jack Cagle — skipped Tuesday’s meeting to urge the court to adopt a lower overall property tax rate. State law requires four members of the court be present to set the tax rate.

The county was forced to adopt what is known as the no new revenue rate, a levy that brings in the same amount of property tax revenue as last year. The court’s three Democrats will take up the proposed tax rate again at the next Commissioners Court meeting on Sept. 27.

Harris Health System includes Ben Taub and Lyndon B. Johnson hospitals, both of which treat a large share of uninsured, low-income residents and people of color. The system also operates more than 30 clinics throughout Harris County.

Dr. Esmaeil Porsa, Harris Health CEO and president, says the system has been chronically underfunded. Building maintenance has suffered, he said, pointing to the recent outbreak of Legionella bacteria at Ben Taub and a 2019 water pipe break that triggered an internal disaster at the same hospital.

He said 3,000 people are on the wait list for colonoscopies at Harris Health, and the agency was preparing to pay other providers to ease the backlog. Those services are in limbo without additional funds, he said.

Porsa emphasized that the agency will prioritize cuts to contract work and other planned building projects. But if they still cannot address the shortfall, they may have to cut back on other important outpatient services, such as dialysis treatments.

In statements, the Republican commissioners cast doubt on health system leaders’ portrayal of the financial hit. Cagle said even if the proposed budget and tax rate is not adopted, new property growth would still give the hospital system additional revenue.

Ramsay argued that many of Porsa’s funding requests were capital investment not included in the budget. “That, however, doesn’t make for good headlines and so we are led to believe that catastrophe will strike,” he said, adding that more funding for law enforcement — the central issue on the court — would “alleviate the situation.”

Porsa, however, says the deficit accounts only for necessary operating expenses.

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“There are no pet projects at Harris Health,” he said. “All of our projects are focused on saving lives and improving health… there is nothing I can cut.”

Other Houston health leaders say the funding shortfall would create a ripple effect throughout the county. Any interruptions to Harris Health operations could lead to swamped ERs in other Texas Medical Center hospitals, exacerbating wait times and reducing the level of care, said Dr. Paul Klotman, president and CEO of Baylor College of Medicine.

Klotman called the decision to skip Tuesday’s meeting a “ridiculous political strategy” that puts the health of the community at risk. Health care, he said, is a “zero-sum game.”

“It will be chaotic for everybody,” he said.

Staff writer Jen Rice contributed to this report.