Endorsement watch: For the hospital bond

Good call.

It’s unacceptable for a public hospital whose mission is to save lives to instead endanger them due to aging infrastructure that’s been neglected for too long.

The pipe break was the second of three in 2020. Just weeks before, hallways in the second-floor obstetric triage and ultrasound unit turned into streams 2-3 inches deep. Stairwells became waterfalls. Without enough isolation valves to stop the water flow in sections where the pipes had burst, the entire hospital’s water lines came to a standstill. The series of internal disasters left behind yawning ceilings, ruined equipment and peeling walls.

It took nearly two years and $13 million for the hospital to fully recover, even as it juggled routine staffing and capacity shortages that became particularly acute during the pandemic. Even now, on the screens at a command center in LBJ, the stats for LBJ and its sister hospital, Ben Taub, are stark: on a relatively calm Friday afternoon, the needle on the occupancy gauge for both was already all the way to the right — at 98 and 97%.

Plans for an expansion have been in the works for years and in the upcoming election, voters will be asked to fund them.

We think the ask is not only fair but overdue.

LBJ operates “virtually at the seams,” Dr. Kimberly Monday, associate professor of neurology at UTHealth Houston’s McGovern Medical School and former chair of the Harris Health board, said in a public comment recently. “And Ben Taub is not much better.”

Harris Health System runs more than 30 clinics and ambulatory care centers as well as LBJ and Ben Taub. In a city where nearly 1 in 4 people are uninsured, the two safety-net hospitals are critical. Each year, the system provides more than $2 billion worth of health care to nearly 300,000 unique patients, and it has earned national recognition for its treatment of stroke and trauma, as well as for its preventive care “food farmacies.”

Harris Health has long planned to expand services to accommodate the county’s growing population, which has doubled in size since LBJ and Ben Taub opened in their current locations three decades ago. However, the system’s budget is limited by its reliance on property taxes and Medicaid reimbursements.

Last year, after a bitterly partisan budget impasse in Commissioners Court led the county to default to a no new revenue rate, Harris Health was forced to scrap plans for an expansion and make drastic cuts just to maintain its operation, with a projected $43 million deficit. Though the system has so far gotten by without running a deficit, Harris Health CEO and President Esmaeil Porsa told the Chronicle he’s not optimistic it will stay that way.

$2.5 billion bond on your ballot this November would help Harris Health make much-needed improvements. The majority of the money — $1.6 billion — would go toward building a new LBJ hospital with a Level I trauma center, which provides the most comprehensive care for injuries, near the existing LBJ north of Kashmere Gardens. That would make it the county’s third Level I adult trauma center and the first outside of the Texas Medical Center.

According to Porsa, the need for trauma care in that northeast corridor is high, as the existing LBJ hospital is currently the busiest Level III trauma center in the state, with over 80,000 annual patient visits.

The new building would expand the number of inpatient beds in that area from 215 to 390, with room to add another 60, and allow for the beds to be used for interchangeable needs. It would also add capacity for patients under observation, and include a helicopter landing pad. That extra capacity will help accommodate patients from the existing LBJ so the hospital can undergo $433 million in renovations and expand inpatient and outpatient care, including psychiatric services, which it currently isn’t able to provide. That’s despite mental health care being the primary need of many repeat patients who show up for emergency care.

See here for some background, and take a minute to once again shake your fist at the one current and one former Republican Commissioner that forced all these problems to linger for their personal political goals. I don’t have anything to add to this but I will have an interview for you next week to discuss this issue in more depth.

On another matter, the Chron counsels a No vote on State Proposition 1.

The Legislature stepped in this year with some new laws to make it harder for local jurisdictions to infringe on certain agricultural practices or for property owners to mount nuisance complaints against producers.

Many agricultural groups supported the changes, including the cattle association and the Texas Farm Bureau. Others were concerned the bills went too far.

Here in Houston, Plant It Forward Farms shows that it’s possible for agriculture and urban living to coexist: “We have not experienced any sort of issues with the city of Houston,” said Liz Vallette, president of the urban farming group that works with independent growers and helps refugees establish their own farming businesses. Occasionally, she said, a management district might complain about the piles of compost material stashed in trash bags, but that’s a quick fix.

Houston is notoriously low regulation in many areas, of course, and other cities might not be as accommodating.

“There is a need to rein in cities, there is no question about that,” Judith McGeary said during a Senate committee hearing. But, the attorney and farmer with the Farm and Ranch Freedom Alliance pointed out, “It’s important to recognize how strong the Right to Farm law already is.”

How strong? Consider Ehler v. LVDVD, filed in 2003. The Ehlers of El Paso County sued their next-door neighbors, a dairy farm that, during heavy rain, flooded their property with manure. But because the dairy operation had existed for at least one year, the court sided with the farm.

The recent statutory changes helped firm up that legal precedent, as well as upping the burden of proof for cases not covered by the Right to Farm statute first passed in 1981.

The rub, though, is that laws can easily be undone. So, voters will be asked in November to give the Right to Farm laws extra protection by enshrining them in the Texas Constitution. The new language would protect a broad array of operations, including timber, horticulture and wildlife management as well as ranching and farming. The amendment still ensures the state can protect animals and crops from danger. But while the amendment doesn’t preclude regulation, it does specify that those regulations have to meet a relatively high legal threshold: “clear and convincing evidence” that they protect the public from “imminent danger.”

We think that’s a step too far. Balancing the needs of a state as big as Texas is a complicated endeavor. We agree that agriculture is essential to our state, not just economically but because we all eat.

But what’s best for cities and farmers today might not be best in 50 years. What’s the point in tying future leaders’ hands with a constitutional amendment that can be changed only by a vote of at least two-thirds of each chamber and voter approval of a subsequent ballot measure.

I seem to recall making a similar argument about the Double Secret Illegal anti-same sex marriage amendment of 2005. That one eventually got undone by other means, which I doubt would be an issue for the right to farm. Anyway, see here for more on the state propositions, and make note of this one.

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One Response to Endorsement watch: For the hospital bond

  1. Pingback: Interview with Lesley Briones about the Harris Health System bond referendum | Off the Kuff

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