Plans for JPS Health Network’s renovation and expansion projects, which are estimated to cost at least $1.5 billion, are unclear almost five years after Tarrant County voters first approved $800 million in bonds to rebuild the county’s aging safety net hospital.
Officials with JPS, its board of managers, and current and former Tarrant County government officials have presented conflicting narratives about the total cost of the bond program and what projects would be included.
Voters approved $800 million in bonds for the program in 2018, and the hospital was expected to add up to $400 million more for the program from its reserves, for a total cost of $1.2 billion. The bond package presented to voters included “a new mental health and behavioral health hospital, a new main hospital tower,” as well as “a new cancer center, four new regional health centers, and a new ambulatory surgery center.
In August, the Star-Telegram reported that the program — with a total cost that had risen to $1.5 billion — would only fund the construction of one new neighborhood clinic instead of the anticipated four clinics. After that article was published, JPS CEO Dr. Karen Duncan said at a public meeting that hospital leaders priced out all of the bond projects in 2021. At the time, the total cost of the various new and expanded buildings was more than $2 billion, she said, about $800 million more than voters had expected when they went to polling places in 2018.
“And so as we sat down, we said there was no way this was going to be a $1.2 billion (project). In fact, I think we priced it out at about $2 billion or $2.2 billion,” Duncan said.
In a follow-up interview with the Star-Telegram, Duncan said she met with hospital leaders, county commissioners, and the hospital board of managers starting in 2021 to re-evaluate the health network’s master plan, after everything from staffing to the cost of building supplies had been upended by the first year of the COVID-19 pandemic.
When asked when JPS leaders decided to build one neighborhood clinic — called a regional health center or medical home in the bond program — instead of the four originally planned, Duncan said, “the plan has not necessarily changed.” She added that she joined members of the commissioners court and the JPS board in 2021 to “look at the original recommendations.
“We all sat together and decided: What were the priorities and what could we build for that $1.5 (billion)?” Duncan told the Star-Telegram.
Duncan told the Star-Telegram that this budget reckoning happened in 2021, in collaboration with members of the commissioners court.
But former County Judge Glen Whitley said this was not his understanding of the bond program when he left office in December 2022. Whitley, County Administrator G.K. Maenius, and Commissioner Roy Brooks were all part of a committee that met with JPS leaders monthly to discuss progress on the bond, Whitley and Duncan said.
Whitley said he had expected the county hospital to move forward with the $2.2 billion price tag, which would include four medical homes.
“We never discussed not having the need for four medical homes,” Whitley said. “Nowhere was it ever mentioned, at least in the meetings that I attended in 2022.”
Maenius, who is retiring this month after more than 35 years as the county’s first administrator, told the Star-Telegram that JPS would build just one new medical home within the bond program. He noted that additional clinics could open through future partnerships with other entities, like a clinic that will open in the Las Vegas Trail neighborhood of Fort Worth. That clinic, which JPS announced in May, will have doctors from both JPS and Cook Children’s Health Network on site. The building will be built on land donated to Cook Children’s and will be funded through fundraising from the children’s hospital’s health foundation.
Brooks, who represents precinct 1, said this week that he still expects all four medical homes to be built as planned.
“There has not been a decision made not to build four medical homes,” Brooks said. “In fact, the hospital district will probably build more than four medical homes.”
When the Star-Telegram asked Brooks whether those medical homes would fall within the $1.5 billion bond program, he said there could be additional sources of funding available.
“One would make a mistake to consider that $1.5 billion is the totality of the funding available to build out these programs,” Brooks said.
JPS officials have not explained what their current plans are for the behavioral health inpatient hospital, which was part of the original bond program. The new behavioral health hospital was one of the top priorities identified by the Blue Ribbon Committee, a group of Tarrant County community members who prioritized the health needs of the county. The committee recommended a new behavioral health facility with about 298 beds, because the existing “bed count falls far short of both the current and 20-year predicted need,” according to the committee’s report.
Construction has already started on the first part of the psychiatric emergency center, which will function like an emergency room for patients with mental health or substance use crises. But it’s unclear what JPS’ plans are for behavioral health beds separate from the emergency center.
During a presentation to Tarrant County commissioners on Aug. 15, Darrick Walls, the senior project manager from Broaddus & Associates, one of two firms hired to manage the bond program, presented a master facility plan that did not include a separate behavioral health facility. It listed the psychiatric emergency center and the new hospital, estimated to cost $79.5 million and $875.8 million, respectively.
JPS did not clarify the situation when the Star-Telegram reached out with questions. A JPS spokesperson initially provided a link to a Dec. 12, 2022, commissioners court meeting. During that meeting, Duncan referenced the committee that Whitley and Brooks were both a part of, which she said had decided to prioritize the psychiatric emergency center and a medical home in Southwest Fort Worth, near the intersection of Granbury Road and Altamesa Boulevard.
When the Star-Telegram asked for answers to questions about the behavioral health beds specifically, the spokesperson said: “As previously communicated, JPS made a presentation to the Tarrant County Commissioners Court on December 13, 2022, providing an update on the prioritization for the bond program.”
That presentation made no mention of the behavioral health beds beyond the psychiatric emergency center.
The spokesperson also said: “We have continuously shared prioritization of projects publicly, including through Board meetings, Commissioners Court briefings, and on our YestoJPS.org website.”
After the Star-Telegram asked again whether JPS had changed its plans for behavioral health beds, the spokesperson said in an email that “JPS does not intend to lower the number of available behavioral health beds. We have no further plans to offer at this time.”
It is not clear whether the information provided was in reference the current number of behavioral health beds at JPS or the amount of beds planned in the new behavioral health inpatient hospital that was part of the original bond proposal.
On Thursday, Roger Fisher, the vice chair of the JPS board, noted that the board had taken no formal vote or action to change any of the bond projects to date.
“Our goal is to build all of it,” Fisher said. “We were trying to shoot for a 10-year window, and maybe that’s a 15-year window to fulfill the obligation that voters approved.”
The bond program’s plans have changed before. Leaders had initially expected to build a center for cancer treatment. Instead, they decided that renting and updating a space on Eighth Avenue would be a better use of money and allow the center to open sooner. The decision to rent, and not build, the cancer center as part of the bond program dramatically reduced the anticipated costs for the center, former JPS CEO Robert Earley said in 2021.
The JPS bond program is the result of more than a decade of campaigning by hospital and county leaders, who spent years hiring consultants, organizing committees and communicating to the public about the hospital’s desperate need for new buildings to accommodate the growing population.