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Inside baseball with the hospital district

I’m not really sure what I’m supposed to learn from this article about the political relationship between the Harris County Hospital District and Commissioners Court.

New name for HCHD

You have to wonder if David Lopez ever feels like he’s in the circus.

When Lopez, the CEO of Harris Health System, Harris County’s public hospital district, visits Commissioners Court to present a proposal, purchase, or budget, he tends to play the role of target in a precision knife-throwing act, facing a flurry of sharp questions.

So it was last week, when Lopez sought to buy a mothballed outpatient surgery center on the Southwest Freeway for $7.8 million. Frowning court members said it was the first they had heard of the item, and nearly rejected the matter outright before sending it to the county infrastructure director for further study.

It was the latest example of disconnect between the hospital district and the county’s leaders. The district operates separately from the county, but its board is appointed by Commissioners Court and the court approves its annual budget, tax rate and long-term real estate leases and purchases. Aides to the court members attend the board’s meetings to monitor operations and, presumably, report back to their bosses.

Yet, Lopez and HHS cannot seem to get buy-in from the court on a consistent basis.

“The district is adrift in a sea of uncertainty, and they can’t really figure out what they need to do or should do. It’s a moving target,” said Commissioner Steve Radack, the health system’s most vocal critic on the court. “They say one day they need a hospital in this area, then they go to another area, then they come back to the first area. They really don’t know what they want.”

Things that I did learn from this story: Harris Health System, formerly known as the Harris County Hospital District, and Commissioners Court sometimes don’t see eye to eye on what HHS wants to do. Better communication between them might or might not help.

Things that I did not learn from this story: First and foremost, whether an outside observer would be inclined to agree with the HHS’s vision for primary care and prevention or if such an observer would agree with the Court that the HHS isn’t focused enough on primary care and prevention. Or perhaps that observer would tell us that it’s not so much a matter of vision as it is one of execution on HHS’s part or expectations on the county’s. It would also be nice to know what an outside observer thinks the county’s needs are and what the priorities should be, and how those compare to what HHS and the county say HHS is doing. Unfortunately, the whole story was basically a he said/she said, and that left me unable to properly evaluate either side’s position. It’s good to know that HHS and the Court disagree on things, but it would be even better to know, or at least suspect, that one or both of them is talking out of something other than their mouths. I don’t have any way of drawing that kind of conclusion or inference from this story, and that’s a shame.

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