Monday, May 20, 2024

Hospital District board moves forward with hospital tax election; rate not yet set

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This November, Hood County residents will vote whether to move forward with a proposed tax for the local hospital district — although the rate of the tax remains to be set.

Since the beginning of 2023, the Hood County Hospital District board of directors has discussed the need to review, evaluate and determine the necessity of implementing a Hood County hospital tax for maintenance and operations.

Hood County residents have not paid a hospital district tax since 1996. At that time the tax rate was 15 cents per $100 of valuation according to the Hood County Appraisal District.

Residents have not had to pay this tax due to a lease agreement negotiated with Hospital Corporations of America in 1996. The agreement called for HCA to pay $15 million to the HCHD to lease the hospital from 1996-2026 with an option to renew the lease for an additional 10 years for $1,000. Community Health Systems, Inc. is now the owner of the lease agreement.

The HCHD is responsible for paying for indigent care as well as jail inmate care as required by Texas law. Indigent care is a program that helps low-income Texans who don’t qualify for other state or federal health care programs get free access to health care services. Some services include immunizations, medical screening services, annual physicals, inpatient and outpatient hospital visits, laboratory and radiology, and more.

“The HCHD is legally obligated to care for Hood County legal indigents; however, Texas state law does not require HCHD to cover health care and meds (including doctors and nurses) for Hood County inmates,” HCHD President Christy Massey said during a regular meeting April 26. “Hood County Commissioners Court placed the inmate medical care charges on HCHD in 1996. Unless the current commissioners court revokes the inmate coverage by HCHD and pays inmate coverage from the county funds, HCHD will run out of funding by mid-year 2025. It should be clear to the HCHD board that the only way to meet the state of Texas mandate for legal indigents and the commissioners court mandate on inmates is the implementation of an HCHD tax on Hood County citizens and business property.”

As a result of the current Hood County growth projections through 2025 and 2026 that forecast larger numbers of necessary legal indigent care, the HCHD board is currently reviewing needed legal steps to move forward on a “proposed tax increase” to be placed on the voter ballot for November 2024.

During the January meeting of the HCHD board, Massey told meeting attendees she had spoken with the Hood County Appraisal District and learned that the least impactful options on the proposed tax rate includes taxing a penny, a penny-and-a-half or two pennies — though the tax could end up being higher, if one is passed. One penny would result in residents paying $10 per $100,000 property valuation, a penny-and-a-half would result in $15 dollars per $100,000 and two pennies would equal $20 dollars per $100,000. A one-cent tax would bring $1 million into the hospital district while a two-cent tax would bring in $2 million.

"My suggestion is we continue to talk about it and make a vote so that we get all the information out to the county to let the people know what's going on,” Massey said, during the April 26 meeting. “To know that this is the hospital district, not the hospital, that this is the hospital district, not the county commissioners and let them make their own decision. If they're for a small tax, fine. If they're not for it, fine. We will figure out some other way to deal with all this.”

Massey said she wants as little tax as possible to take care of the indigent and agrees that a two-penny tax would take care of both the indigents and the two county ambulance services.

"I think one penny will take care of indigents at this point and one penny will take care of dividing money to the ambulance services to take care of this county,” she said. “What that will end up being is $20 per year if you have a $100,000 appraised place. Now if you have a $1 million appraised place, it will be more, but you're still taking care of the indigents, jail inmates and helping the ambulance services that take care of our county. If we do not end up proposing a tax that is reasonable and acceptable to the voters of this county, then we'll have to find another way of taking care of the situation.”

Texas EMS Director Ricky Reeves spoke up during the meeting and said that either way, there will be a tax increase on the county, whether it be through the hospital district or the Hood County Commissioners Court.

"I think it would be a lot easier to fund the hospital district for what it's actually designed for, than the commissioners court but either way, there will be a tax increase,” Reeves said. “I know you don't want a tax increase but if the hospital district fails, you still are going to be taxed to take care of these things.”

HCHD Vice President Monty Lewis said there are other options that would not include a tax increase; however, certain services within the county would suffer as a direct result.

"These monies have to be diverted from the same budget as it applies to the county, and there could be an impact across the county in ways that we haven't thought through,” he said. “Whether it be one cent, two cent, the idea should be that whatever tax rate is proposed for the voters to decide, we would not have to have the conversation for an extended period of time, so that whoever is going to operate the necessary mandates of the state — if commissioner's court decided that they wanted to handle the inmates again, which was passed on to us in 1996 — they can take that decision. But it's going to fall on the citizens of Hood County regardless.”

Reeves then explained that 17% of county residents are currently in indigent care. He added that although Hood County residents haven’t had to pay a hospital tax for almost 30 years, healthcare changes over time, along with growth.

"It's a retirement community,” he said. “So, for a lot of people, the payment does not meet the cost. But we're at the point now that to continue to be here, to continue to grow, to continue to service communities, you have to have some assistance from somewhere.”

Pecan Plantation Fire Chief Michael Barrett also explained that in Pecan, residents pay $20 a month for ambulance services — adding up to $240 a year.

"Today we're in the same boat as Ricky is," Barrett said. “Fire receives less than 3%. The majority goes to EMS, and they need additional money. Either this passes in November, it helps Ricky and helps our units at Pecan or it doesn't, and Pecan is going to have to — in March —ask for an increase, and that increase is probably another $20, so that's $40 total. The double taxation has to be explained to Pecan members.”

Secretary David Kuban explained that he is looking at the situation from a taxpayer’s standpoint and doesn’t care if the tax increase comes from the commissioners court or the HCHD — but he does care about how much it’s going to cost.

"To do it the way we've been doing seems to be the most efficient and most economic,” Kuban said. “But bottom line, I want us to look at what's best for the community. The whole issue about what Pecan does. Pecan’s part of the county so whether you want to live in Pecan or you want to live in DeCordova and pay for the amenities and do that, that's your free will to do from the standpoint of there's certain things you can do as communities to support it. You live in this community, you pay taxes here, you pay for it. We're trying to do it the least possible way to do it from a monetary standpoint, plus you got to serve your community. I don't care where you live in the community, whether you're in the city or Pecan or DeCordova, you still have a responsibility.”

“I'm a voter in this county. I get to make my choice,” Massey said. “I don't get paid for any of this. We're not going to make any decisions today about how much tax money to propose or how to get that information out to the county. We'll look into different ways of getting the information out. The people that are against it, they can put the information out against it also. How it comes out in November, if we get a tax, we do. If we don't, we’ll figure out how to deal with that.”

The next scheduled Hood County Hospital District meeting is set for noon Friday, May 31 at the Hood County Courthouse, second-floor courtroom.