Will community telehealth services be worth the cost for Garland residents?

A 7 -2 council vote indicates there are still questions

By Rita Cook

GARLAND – The Garland City Council agenda item was to consider an agreement with MD Health Pathways to deliver Community Telehealth Services aimed at expanding access to care for uninsured and underinsured residents.

The item passed 7 – 2 with Garland Mayor Dylan Hedrick and Distrct 3 Councilmember Ed Moore voting against.

The MD Health Pathways program was introduced as a proposed community health initiative in May with staff notes indicating the topic had been previously discussed at a Community Services Committee in March.

Over the summer the item was continually discussed and on August 19 the MD Health Pathways item passed.

However, that was not until after the contract was updated to include a 3% annual escalator applied to ongoing fees, including a $25,000 utility assistance fund contribution and a $50,000 annual escrow payment for future program costs.

Staff also indicated the agreement “Requires MD Pathways to provide monthly updates to City Council during the program’s first six months and annual updates thereafter.”

What the Telehealth Access Model scheme will do is offer citywide access to basic healthcare services through a monthly fee added to residents’ utility bills.

Some residents were against the monthly fee.

Some do not want to be forced to pay the monthly fee because they do not need the service.

Other residents questioned how residents would know they could opt out and how to opt out.

Similar cities were pointed out as having worked with MD Health Pathways to expand access to care, reduce non-emergency ER visits, and support preventative health efforts. Models that were mentioned included Henderson, Ferris, and Crandall. However, not all cities charge residents a monthly fee.

In the case of Garland, the agreement is a seven-year contract, starting at $6 per household per month and increasing to $9 by year seven.

Moore said in response to the MD Health Pathways Program “I want to begin by making clear my fundamental objection to the MD Health Pathways proposal. My concern is not with the value of telehealth services themselves, but with the way this program has been structured and introduced.”

He mentioned the fact the program is an opt-out and not an opt-in program.

“That means 240,000 Garland residents (roughly 80,000 homes) will be automatically enrolled and billed for a service that they did not request, and for which they were not given the chance to voice their opinions in a meaningful public forum before we committed the City’s resources. In my view, which is not how government should operate.”

He stated the financial implications include:

• $50,000 annually will be contributed by MD Health Pathways into an escrow account for future program costs.

• $25,000 annually will also be contributed by MD Health Pathways into a low-income assistance fund.

• $80,000 in IT and software support costs and $8,000 for billing inserts will also be covered by MD Health Pathways, not by the City.

• Meanwhile, Garland households will be charged $6 per month, gradually increasing to $9 per month by year seven.

• Return on Investment: 240,000 people, approximately 80,000 homes with a 15% opt-out equals 68,000 homes at $6 per household equals $408,000 monthly or $4.9 million annually.

“Yes, this telephone-based healthcare service may answer routine health questions, may reduce unnecessary ER visits, and may improve community health in the long run. Those are worthy goals. But they must be balanced against two critical principles: resident choice and fiscal responsibility,” Moore explained. “I do not believe this program was constituent-driven. It was not built out of grassroots participation. It is being imposed from the top down, with residents given no real say until after the framework was already decided. That is my critical objection. That said, I respect the process, and I respect the vote of this Council.”

B. J. Williams, Councilmember District 4 said he voted for the item because “This agreement includes a commitment from the provider to deliver approximately six months of community education and engagement before any implementation of services.”

He added “It’s important to note that this is not the final approval of the program itself. The contract includes a termination clause, ensuring that the City maintains flexibility while community feedback is gathered.”

Meanwhile for Garland residents who want to opt out you MUST email optout@garlandtx.gov. The email must include your name (utility account holder), address, phone number, and confirmation that you want to opt out of the program. 

You may call Mr. Phillip Urrita, Assistant City Manager, City of Garland at (972) 205-2435, for more information about this program.