Published April 25, 2023
Karen and David Terrell have been seeing the same primary care doctors for 16 years. The couple trusts their care team intrinsically after a doctor caught David’s cancer during routine blood work.
“If it hadn’t been for them,” Karen says, “we wouldn’t have caught the leukemia in time.” She doesn’t want to start over with new doctors after working with a team that saved her husband’s life.
But she’s going to have to. And the Terrells aren’t alone.
David and Karen are both retired Galveston County employees. They, along with about 1,000 other Galveston County retirees, employees and their families, learned in an email last month that the county-run primary care clinics and pharmacies they’ve relied on for the better part of two decades will close this week.
The speedy closure, approved during a March 20 commissioners court meeting, left many wondering how and where they will obtain the health care they’ve been promised. Patients I’ve spoken with have plenty of concerns: the potential added cost of paying for prescriptions that were once covered; the short notice; the lack of communication; and having to build relationships with new doctors, to name a few.
Breaking promises to hardworking people, then keeping them in the dark, is no way to govern.
I don’t know the Terrells personally, but I can understand what they’re going through. My dad’s a retired county employee – different county, different state – and I remember the careful number crunching that went into planning his post-65 future. Every penny and promise made to him mattered. To think someone could send his finances and mental well-being into disarray with one email is infuriating. That’s not how people should be treated.
A beloved benefit
The county launched a program offering copay-free health clinics in 2007 with one location in downtown Galveston. Over the years, the program has expanded to three clinics; county officials added a pharmacy offering free generic prescriptions in 2009. The service, which is separate from the county’s insurance plan, costs patients $25 per month.
The goal was to provide easy-to-access preventive care and lower the number of employees with major health concerns, reducing the county’s cost burden. It worked. When the program celebrated its 10th anniversary in 2017, the Galveston Daily News reported that the county’s increase in health care costs had slowed from 15 percent to 5 percent per year in the decade since the clinics opened.
And along the way, the 1,000 or so employees and retirees who used the clinics learned to rely on the services.
Until last month, when the commissioners court voted to end the program, citing financial reasons. The move came two weeks after county officials first briefed the court on a post-pandemic dip in clinic utilization. The clinics cost the county about $1.3 million per year, or roughly $900 per user, according to the March 6 presentation. That money could be better spent on a different program, commissioners agreed.
“Several factors were considered while making the decision to close the Health Clinics and Pharmacy,” Rebecca Gilliam, benefits manager in the county’s human resources department, wrote in an email to employees hours later. “Decline in utilization, diminished level of care, and a significant increase in future operating cost were the leading factors in this decision.”
The email then noted that the county is now in discussion with the University of Texas Medical Branch to provide care for employees, retirees and dependents.
Then all was silent. Until Friday, when the commissioners court approved that new partnership with UTMB in a unanimous vote. Through this new program, plan participants will have access to four UTMB locations for primary care, at a cost of $10 per visit. Commissioners also mentioned potential plans for a new pharmacy program, though details about what it will entail and when it will come to fruition are not yet clear.
“From everything I can see,” County Judge Mark Henry said during Friday’s meeting, this new iteration of the program “will appear to be better.”
The Terrells – and others – disagree.
Secrecy is standard
For this column, I’ve talked to county employees, their family members and retirees. I have only spoken with one county official: Stephen Holmes, the lone dissenting commissioner from the March 20 vote, who agreed to talk to me after Friday’s meeting.
The dearth of information from the county is not for lack of trying. I’ve regularly reached out via phone and email over the past few weeks, leaving more than a dozen messages, none of which were returned.
That was no surprise to the employees, who did not want to be named due to fear of retribution. Secrecy, they say, is standard operating procedure for the county.
I’m inclined to believe them, especially after Friday’s public meeting at which a Galveston County employee who’d answered commissioners’ questions for several minutes declined to identify himself when I asked his name as he left his microphone.
“Who are you with?” he asked.
“The Houston Landing,” I replied. Not a lot of people know our name yet, but I figured he might recognize it from the Texas Public Information Act request I filed last month.
He laughed. “Yeah, no,” and blew past me, rushing out the door.
I later learned he is Tyler Drummond, Judge Henry’s chief of staff, and as such should know his behavior was needlessly obstructionist at best.
I obviously don’t like when people treat journalists that way. But I get that it happens. What I don’t get is when people apply that same lack of basic decency to people like the Terrells.
The Terrells learned about the clinic closures through an email. “I don’t even do email,” says David. Luckily, Karen saw the note in her inbox a few days after it was sent. But David wonders how many other retirees in their 70s or older, like him, may have missed the message.
“It would have been different if they gave us six months or a year of notice,” says David.
“Or,” Karen adds, “if they said, ‘Starting next year, we’re going to have to make some changes.’ But this is not enough time.”
I spoke with one man who didn’t even know the prescription program would be ending when he stopped to pick up an order last Tuesday. The pharmacy typically dispenses 90 days’ worth of prescriptions at a time, so he hadn’t visited since February, before discussions to disband the service were initiated at commissioners court.
“There was no plan in place,” Commissioner Holmes said Friday after the vote. “The biggest misstep of the commissioners court was pulling the rug out from under the employees without a safety net. There’s not a plan in place, so they start panicking.”
Drummond on Friday noted during his time at the microphone that the county is in discussions to launch a new pharmacy program. He hopes to have a proposal prepared to be voted on by the commission within the next few weeks.
But in the meantime, the pharmacy many have come to rely on will close on Wednesday.
“Our next meeting will be May 1, which means we’d have to pull the trigger on May 1,” said Holmes. “And I’m hoping to have that on the agenda at the May 1 meeting, but we’ll see how it goes.”
Holmes has a lot of questions. Can the county waive copays for patients at least a few times a year? Will the new programs actually generate the promised cost savings? Who will fall through the cracks, deciding they’d rather not start over with new doctors?
The Terrells don’t think they’ll use the UTMB clinics. They moved to Tyler a couple of years ago, when they decided their limited mobility could put them in jeopardy if a hurricane forced evacuation.
They don’t know what they’ll do next.
“You can’t even find a doctor in the amount of time they gave us,” says David.
“That’s why I get really upset about it,” says Karen. “How are we ever going to find that type of care again?”
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