FAQ - Hospital District

Question: Why do some Texas counties have hospital districts while others don’t?

Answer: Chapter 61 of the Texas Health and Safety Code Charter requires counties to provide health care to eligible residents who are considered indigent. The Tarrant County Commissioners Court created the Tarrant County Hospital District (dba JPS Health Network) in 1959 to give sound financial footing to the City-County Hospital constructed in 1938 on land donated by John Peter Smith. Other Texas counties fulfill the statutory requirement through creation of a public hospital or a county indigent health care program.

Question: Does JPS provide care for only poor people?

Answer: No. While JPS Health Network is proud to provide quality health care in an efficient and cost-effective way to our community’s most vulnerable residents, it accepts commercial payors.  JPS also provides the county’s only Level 1 Trauma and psychiatric emergency care. Our responsibility is to serve Tarrant County’s population health needs, regardless of payer source. 

Question: What’s the benefit of a county health care system vs. just a public hospital or paying private hospitals to care for the poor?

Answer: Providing services that allow patients to access care in the appropriate setting is a more cost-effective way of delivering health care. JPS offers inpatient acute care, primary and specialty outpatient clinics, school-based health centers, and medical and psychiatric emergency care. Other hospitals might treat someone who arrives in the emergency room episodically; JPS is equipped to provide integrated services across the continuum of care.

Question: Who makes the policy decisions for the Hospital District and how are those people selected to serve?

Answer: Members of the Tarrant County Hospital District Board of Managers are selected by the four elected county commissioners and the county judge.

Question: What planning has JPS completed to date? How did JPS Health Network identify what Tarrant County’s future health care needs are?

Answer: JPS has already invested almost seven years in the planning process. The original study seeking assistance in developing a strategic facilities plan began in 2009. The resulting plan comprehensively addressed the current and future needs of a dynamic, diverse and growing community in light of aging buildings, a rapidly changing health care environment, technology advancements and increasing academic demands. JPS conducted empirical, objective analysis of community health needs in 2010 and 2013 that included demographic assessment, health status needs indicators, health services used, clinic capacity and wait times.

All work previously completed was necessary to prepare for the long-range planning process currently underway, to address future need, capacity and delivery of care for Tarrant County residents.

Question: Where do we find copies of the needs assessment?

Answer:  The 2010 and 2013 needs assessments, as well as the 2011 Strategic Facility Utilization Plan and the 2013 Community Health Implementation Strategy, and other planning documents are available at: www.jpshealthnet.org/about_jps/planning_for_the_future

Question: In previous presentation, JPS stated that the current method of delivering services is inefficient. How did the JPS facility become so inefficient? Who’s to blame?

Answer: Incremental additions to a building whose core was constructed in the late 1930s has resulted in a situation in which continual patchwork improvements are costly and ineffective. Since that time, the Tarrant County population has experienced aggressive growth, and necessary expansions have led to challenging and inefficient adjacencies that no longer perform, -- given the changes in health care.

Evolving health care needs and technology changes, increased demand triggered by population growth and the need to enhance efficiency and patient satisfaction in order to maximize reimbursements requires a master plan for major facility and service improvements.

Question: What has JPS done thus far to improve efficiencies?

Answer: For the past several years, JPS Health Network has been building a culture of continual process improvement through the use of lean/Six Sigma performance projects. Efficiencies include, but are not limited to, the development of the JPS Medical Home Southeast Tarrant, which consolidated five outpatient clinics into one centrally located facility; a split flow entrance to the Emergency Department, where patients are quickly triaged and those determined to need urgent care are redirected to the appropriate location; and relocating invasive labs to the east side of South Main Street, close to the Emergency Department, Operating Rooms and Intensive Care Unit.

Question: JPS stated that it want to reduce the average length of stay (LOS) What impacts average LOS?

Answer: Numerous issues impact average LOS, including acuity, co-morbidity, quality of care and the ability for discharged patients to be placed in appropriate care outside of the hospital setting in a timely manner. Our goal, just like all other acute care hospitals, is to provide the appropriate level of care while reducing average LOS.  It is difficult to find private health care facilities willing to take patients, particularly when we are seeking long-term care and skilled nursing facilities for patients who may not  come with financial reimbursement.

Question: Has the County looked at contracting with private hospitals to care for indigent patients?

Answer: The JPS Health Network has and will continue to collaborate with community partners to provide the best health care possible for Tarrant County residents in the most cost-effective manner. Through behavioral health initiatives, homelessness issues and leadership in the 1115 Texas Medicaid Waiver, JPS has demonstrated its willingness and ability to partner and collaborate with health care colleagues.

When JPS can’t meet the needs of the underserved, it puts a burden on other public and private institutions and agencies, such as law enforcement, emergency medical technicians and fire personnel.  JPS is uniquely equipped to handle the acuity and co-morbidities of the county’s diverse and expanding population.

JPS outsources several operations – certain physician and medical services, the gift shop, outpatient pharmacy, environmental services and legal services. Additionally, JPS outsources inpatient behavioral health patients when JPS is at capacity. Unfortunately, it is at a cost higher than what it would cost to provide services at JPS. Private health care providers, which have to meet certain profitability margins, are often unable to care for JPS patients at a cost lower than what JPS is able to do.

Question:  Where does the revenue that supports JPS come from?  Is it true that JPS is fully funded by Tarrant County tax dollars?

Answer: No. JPS only receives about 40 percent of our funding from Tarrant County taxpayers. However, JPS revenues also come from two other sources in approximately the following proportions: commercial insurance and other payers -- including Medicare and Medicaid (40 percent) and other federal performance-based supplemental reimbursements (20 percent).

Question: Where can I find the JPS Health Clinic closest to me?

Answer: JPS Health Clinics can be found on this list:  JPS Clinic Locations Map 2017.pdf