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How the Texas Legislature can fulfill “our promise to patients” this session

By Rhonda Sandel

CEO of Texas Emergency Care Center and board president of the Texas Association of Freestanding Emergency Centers (TAFEC)

Expand access to care through Texas’ freestanding emergency centers

By Rhonda Sandel, April 23, 2019 | Op-ed for TribTalk

You may not know it, but your access to life-saving care is declining day by day. In their National Report Card the American College of Emergency Physicians’ ranked Texas 47th among the states for access to emergency care, giving us an ‘F.’ For a state with much to be proud of, these are not numbers anyone can brag about, and they reflect a dangerous situation.

In our big cities, emergency rooms are overcrowded and inefficient. Patients commonly wait hours to receive care, suffering needlessly, with their conditions possibly turning worse before they finally get the medical attention they need. And in our smaller communities, we have the highest rate of rural hospital closures of anywhere in the nation. Today, many rural Texans have to drive for hours to be seen by a doctor, and this problem is growing.

What is causing the overcrowding in our large hospital ERs? A booming population, combined with fewer and fewer hospitals and a severe shortage of primary care physicians. Numerous underinsured and uninsured patients don’t have access to the medical care they need. And because ERs are required to treat patients regardless of their ability to pay for their care, they become the go-to treatment option for conditions both major and minor.

Because hospital ERs are so often used as a catchall for other conditions—and there are fewer and fewer of them—the wait times grow longer and longer. How many lives have been needlessly lost as a result? The health of numerous Texans has been irrevocably damaged as they’ve been forced to wait in hospital ER waiting rooms for hours at a time. Texas must tackle this problem head-on, with policy solutions that expand access to the life-saving medical care patients deserve and that reduce the overcrowding in our hospital ERs.

The 81st Texas Legislature moved in the right direction by formally approving a structure and laws that govern the operation of freestanding emergency centers. FECs, as they are commonly known, have been a mainstay in Texas for 10 years, saving countless lives, diminishing hospital ER wait times and when disaster strikes — as it did during Hurricane Harvey — also serving as the only source for medical care within dozens of miles. In some parts of the state, like Rockport or La Vernia, FECs provide the only access to emergency care in the area.

FECs are an essential part of the state’s medical infrastructure. And we need lawmakers’ help to expand access to care.

House Bill 1278 by Rep. James White, R-Hillister, would allow non-hospital-based and/or hospital-affiliated emergency rooms to provide more acute care services to Texans who have serious medical needs but may not require ER care.

Because FECs are equipped, staffed and licensed to provide imaging, radiology, laboratory, pharmacy and other services, they are well suited to provide both emergency services and outpatient services. And with a full ER model requiring that they remain open 24 hours a day, the round-the-clock hours, locations, and capabilities, make FECs particularly well suited to provide care to the people in the communities where they live.

FECs could be a vital resource for Texans who have very few options for outpatient care, especially in rural parts of the state. HB 1278 will provide the fix to current law essential for FECs to begin providing more care to more patients. This additional access to care would improve the health of many Texans, allowing some medical conditions to be treated before they become life threatening, thus helping to save more lives.

Disclosure: The Texas Association of Freestanding Emergency Centers has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

Rhonda Sandel

Rhonda Sandel is CEO of Texas Emergency Care Center and board president of the Texas Association of Freestanding Emergency Centers (TAFEC).

Commentary as seen originally on TribTalk.org.

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