Saturday, Feb. 14, is the last day for voters to get out and vote for or against the creation of the Somervell County Hospital District.

For months, county residents have heard about tax rates, board elections, reasons for a district and reasons against. As of Monday morning, 240 voters had already made their way to the poll to cast their votes and approximately 24 ballots had been mailed out.

Despite the push for information, county residents continue to have questions about the potential new district and what the creation, or lack of, would mean for Somervell.

Nearly three years ago, Glen Rose Medical Center (GRMC) began moving forward with plans to expand the clinic.

Gary Marks, CEO of GRMC, and County Commissioner Mike Ford said original plans called for funding via a rural grant program through the United States Department of Agriculture (USDA). But when federal spending was cut under new congressional leadership, the USDA lost the money.

In addition, Congressman Chet Edwards was not able to secure $700,000 in earmarked money for the expansion project.

“From my perspective, I don’t think any of us (on the Commissioner’s Court) thought we cannot do this project,” Ford said, noting that he cannot speak for the court as a whole.

One of the biggest issues facing GRMC was an overcrowded emergency room.

“The overcrowding of the ER was the main drive of the design,” Ford said. “It was so far beyond - we knew something had to be done.”

Marks and Ford have both said construction costs on the hospital expansion project were increasing daily, finally reaching critical mass in April 2008.

On April 14, all four commissioners voted to approve a $14,380,000 certificate of obligation (CO) out of county tax and revenue money.

Ford said the court decided to go with the CO because a bond election would take more time with costs continuing to increase.

“It was a timing issue more than anything else,” Ford said.

Commissioner Lloyd Wirt sits on the hospital board as a non-voting member.

“The USDA loan was the one pursued exclusively. It was the first choice for the board and the court but it fell through,” Wirt said. “There was lots of time spent and lots of work trying to get the best financing. As the possibilities were narrowed down, that (CO) was the best alternative.”

Dr. Michael Davis, Chief of Staff at GRMC, said if the clinic shut its doors, physicians would be forced to leave.

“If the hospital were to financially crash, we would all have to leave and none of us want to do that,” Davis said. “We’re not particularly vested in any process, but the hospital district is an option.”

He added that scaling down services offered at GRMC wasn’t a viable option.

“The current environment in health care doesn’t allow a physician to do strictly out-patient care,” Davis said.

Questions have also been raised over future taxpayer dollars. As property owners face an estimated 7-cent tax increase per $100 in value under the hospital district, many have asked if they could expect to see a corresponding 3.5-cent drop under the county.

Ford said he would reasonably expect the county’s tax rate to drop, but could not commit such a change.

Wirt agreed.

“That 3.5 cents is in our budget this year for the first payment to the CO. But we don’t know what the needs of the county will be, so I can’t say positively the tax rate will drop,” Wirt said. “Definitely, we will not have to put that 3.5 cents toward the hospital but that’s not to say we wouldn’t need to put it somewhere else.”

For example, if the county suffered storm or fire damage, the money would be needed for repairs.

Addressing concerns over a possible conflict of interest, Ford said he hopes his work with the foundation doesn’t turn out to be what voters base their decision on.

“A hospital district is the best and least expensive way to provide quality health care to our residents,” Ford said.

If voters pass the petition and approve the creation of a district, five Foundation Board Members will be named to a temporary board. Permanent board members would be elected during the May general election.

Ford said many of the questions residents have cannot really be answered until the permanent board members are elected.

Under the Texas State Health and Safety Code, district board members are responsible for hiring a superintendent to serve as the chief administrator.

The board is also allowed to enter into contracts on behalf of the district and to maintain or acquire property, facilities and equipment for the district.

Board members must report annually on the condition of the district before the Commissioner’s Court. The district would also be subjected to annual audits.