A healthy service deserving support

A recent article reporting that county officials were considering a bond issue to fund about $100 million of improvements raised some eyebrows.

Readers were especially interested in the suggestion that the county could buy the old Wal-Mart property in Texas City. The idea was to consolidate the Galveston County Health District, the Texas City tax office, possibly the Central Appraisal District and other offices under one roof.

Discussions about the bond issue — which includes a lot of roadwork — are tentative. But the proposal to consolidate some of the health district’s offices deserves your attention.

This agency has tried to improve its productivity and, through hard work and sound management, it has succeeded. Its leaders have further pointed out places where additional investment could lead to further efficiencies.

The proposal to buy the Wal-Mart building is the largest single expenditure under discussion. No one has dropped an estimate yet, but it appears the project would require $30 million.

The health district would get most of the space in the 120,000-square-foot building.

Excluding ambulance stations, the animal shelter and some smaller offices, the health district now operates in three large buildings. The administration building in La Marque dates from the 1950s and hasn’t aged well. The list of structural problems (foundation, roof, air-conditioning and asbestos) is long. Everyone agrees the building ought to be demolished.

The environmental-health building next door is in better shape, but its spaces are cramped. While most people associate the health district with its mission to provide care to the county’s uninsured or underinsured residents, it also provides services such as air- and water-quality monitoring and restaurant inspections that benefit all residents. As the county has grown, the demand for these services has increased. The district needs more room.

In addition, the district leases space for its 4C’s clinic in Texas City. The clinic provides health care to county residents who aren’t covered by insurance.

The district is paying almost $30,000 a month in rent — money the district could use in providing care.

The larger issue is that the building’s space just doesn’t lend itself to an efficient clinic. Architects have suggested it would take $2.5 million to $3 million to renovate the space, a questionable expenditure for a building the county doesn’t own.

The health district, under the direction of Dr. Mark Guidry, should be commended for finding ways to increase productivity.

The district’s physicians, physician assistants, nurse practitioners and mental-health counselor see more than 40,000 people a year. From 2006 to 2007, the average number of patients seen by each medical team increased from 5,905 to 6,542. The state average for public health districts is 4,604. The national average is 4,338.

In an age of a rapidly growing number of people with no medical insurance and with steep medical inflation, the cost per patient visit dropped from $81 to $71. That’s well below the state average of $109 and the national average of $115.

A building with more space for exam rooms — and with space to make the layout more efficient — would make a productive operation that much better.

In addition, federal regulations will require electronic record-keeping by 2010. That will require extensive electrical work, which would be part of the proposal for new space at the old Wal-Mart building.

The requirement will have a bonus in that collection rates tend to be higher when patients can be told how much they owe when they leave a clinic. That’s not possible now; the health district has to bill patients. Too often, a collective cynicism prevails about the ability of people in this country to pool money together to do something worthwhile.

Here’s an example of an agency faced with a rapidly growing population of people who need care and services and which has worked hard to meet the needs while controlling costs. It’s an agency that has a measurable record for improving its own productivity. It now has a thoughtful plan for using public funds to provide better, more efficient service.