JPS Health Network has canceled its plans to build four, standalone health clinics as part of its bond program, county administrator G.K. Maenius said Tuesday.

Instead, the bond program will pay for just one clinic, known as a medical home, in the far southwest part of the county. Construction on that clinic, near the intersection of Granbury Road and Alta Mesa Drive, began last year.

The four medical homes were a small but significant part of the hospital’s plans for its bond program. As recently as last year, county and hospital officials discussed plans for four clinics throughout Tarrant County, with one in each precinct.

These clinics would join an existing network that offers a range of services outside of the hospital setting, and would help to meet the massive need for health care. In particular, new medical homes would have expanded access for the thousands of county residents who lack health insurance but who can qualify for free or low-cost care through JPS.

It’s unclear exactly when JPS changed its plans to build four medical homes. In a January 2022 update, hospital leaders said four homes were being considered for the hospital’s master plan.

The JPS bond program, which will likely total more than $1.5 billion when it is completed, is funded in part by $800 million in bonds approved by voters in 2018. In the years before the vote, county and hospital leaders drew attention to some of Tarrant County’s most pressing health needs, like more mental health services and updated buildings on JPS’s main hospital campus.

But medical homes, and a greater emphasis on primary care, were also highlighted before the vote. The groups tasked with evaluating the county’s health needs repeatedly found that JPS wasn’t able to serve all the patients who needed care, both at its main hospital campus and its existing medical homes.

A 2017 report from consultants said the hospital’s existing plans to build new medical homes were “not sufficiently scheduled and funded.”

The consultants found that patients at existing JPS health clinics were waiting days or weeks to book appointments because the need was so high.

A different report, from the consultant group Cumming, identified four sites that had the highest projected need for a clinic over the next decade. The report recommended sites in south Arlington, southeast Tarrant County, southwest Tarrant County and the west side of Fort Worth.

The medical homes were also listed on the November 2018 ballot. Voting in favor of Proposition A was a vote in support of $800 million in bonds for hospital facilities, “including, but not limited to, a new mental health and behavioral health hospital” as well as “four new regional health centers,” among other facilities listed.

The Star-Telegram asked for an interview on Thursday after a review of bond documents indicated just one medical home would be funded. But JPS leaders did not respond to the request or several followups, made on Friday, Monday and Tuesday morning.

On Tuesday evening, told that Maenius confirmed the change in plans, JPS said no one was available for comment but instead issued a statement from unnamed hospital executives.

The statement reads: “Both the County and the Hospital District always understood that the amount approved by the voters likely would not be enough to complete all of the projects that were contemplated by the report but were committed to a ‘no tax rate increase’ in connection with the projects.”

The statement said that hospital and county leaders worked to “prioritize the projects accordingly taking into account the amount we had to spend.” The current master facilities plan is designed to “address the most need utilizing the available dollars, including dollars that would be committed by the hospital district to fund the projects.”

Hospital executive also said that “These plans have been repeatedly communicated to the public and are updated on our YestoJPS.org website.”

A post on this website from Jan. 14, 2022, identifies Medical Home Southwest as “the first of four medical homes” to be built. Additional posts on the website reference the Medical Home Southwest, but they make no reference to the original plans to build four or that those plans had changed.

In 2018, JPS leaders estimated the total cost of the bond program would be $1.2 billion. But the cost of new health care building construction has increased 38.7% since then, according to the Bureau of Labor Statistics. The most recent estimate from hospital leaders is more than $1.5 billion.

The change in plans comes amid a “refresh” process of the county hospital’s bond program, said Darrick Walls, senior program manager with Broaddus & Associates, one of two firms hired to manage the bond program.

The initial analyses that informed the hospital’s master plan were completed in 2017, so hospital leaders are reevaluating the county’s health needs with more recent data, Walls said. During the latest planning process, Walls said, hospital leaders concluded the greatest need was to complete construction of the first health clinic and to build the new psychiatric emergency center, which is why those projects were among the first to break ground.

“In the future, there are still options to look at other opportunities for medical homes, but in the immediate, where we are with the budget, the main focus right now is on medical home number one,” Walls said.

Maenius said hospital leaders had reevaluted the need for four new medical homes after opening one in Euless in 2018 and after JPS agreed to partner with Cook Children’s Health Network to open a clinic in the Las Vegas Trail neighborhood.

The Euless clinic opened before the 2018 bond vote, and did not use any funding from the bond program. The clinic in Las Vegas Trail, which JPS announced in May, will be built on land donated to Cook Children’s and will be funded through fundraising from the children’s hospital’s health foundation. Maenius said he did not believe any bond dollars would pay for the Las Vegas Trail clinic.

“The hospital district is doing the right thing,” Maenius said. “They’re continually evaluating if we need with sites or not.”

Walls added that the bond program’s master plan was intended to be adjusted throughout the process, and that JPS’ decision to partner with Cook Children’s for the LVT clinic was reflective of the health network looking for new ways to meet the need in the county.

Walls said it was still possible for JPS to build additional medical homes in the future or to change its master plan again, but that additional medical homes were not budgeted into the bond program’s current cost estimates.

The JPS board of managers is preparing its proposed budget for 2024, after county commissioners forced the hospital to lower its tax rate.