The Brady City Council held a workshop meeting with Hospital officials yesterday (June 24, 2014). A few citizens attended, mostly those directly affected by the EMS issue being discussed. The meeting was low-key, business-like and non-confrontational. The net result was that everyone assured everyone else that they only wanted what was best for the people of McCulloch County without ever specifying exactly what that might be or how it might be accomplished.

All City Council members were present except Linda Lott, a Hospital employee. Representing "the Hospital" were Clay Jones, Tim Jones and Michelle Derrick. Fire/EMS Chief Lyle Daniel was invited to sit at the Council table to answer technical question.

The quotes around "the Hospital" are deliberate because it is not clear exactly who "the Hospital" actually is. That is the first question raised by the workshop. It is a complicated one because at least three and maybe four separate business entities operate under the generic term "Brady Hospital".

Most citizens think the McCulloch County Hospital District runs the hospital because they are the ones who collect property taxes. They did - up until last year when the 83rd Texas Legislature passed HB 1920¹ allowing the McCulloch County Hospital District to lease the facility "... to any person". It appears that the Hospital District leased the facility to "Heart of Texas Healthcare System"^2,3, a Tax-Exempt corporation set up specifically for that purpose.

The terms of the lease are unknown to us at this time. Depending on the terms of the lease agreement, it may be that the McCulloch County Hospital District serves as a landlord and tax collector, but has no control over the day-to-day operation of "the Hospital". That is another question raised by the workshop.

Oddly, neither the McCulloch County Hospital District nor HOT Healthcare System are party to the current Interlocal Cooperation Agreement that governs Ambulance and Emergency Medical Services in McCulloch County. Apparently neither of them is "the Hospital" in the context of this workshop.

The agreement, signed in 2009, is between the City of Brady and "Service Organization of the Big Country" (SOBC), a Tax-Exempt corporation headquartered in Lubbock. SOBC is apparently "the Hospital" as far as EMS and Ambulance Service is concerned in McCulloch County.

Some claim there is another Tax-Exempt corporation called "Service Organization of Concho Valley" (SOCV) involved. SOCV was listed by the Texas Secretary of State as "Inactive" as recently as June 1, 2014 and no one has produced documents showing they are party to any agreement with the City of Brady.

Looking carefully at the the Form 990⁴ filed by SOBC with the IRS, Tim Jones is the only person at the workshop with an official connection to SOBC. In Part VII, he is listed as a trustee or director. One other item of interest is that Discovery Healthcare Consulting Group is listed as the "... person who possesses the books and records" of SOBC.

The most interesting item in SOBC's Form 990 comes in Schedule O (page 21) where "The Organization Delegated Its Control Over Management Duties to Discovery Healthcare Consulting Group, 2950 50th Street, Lubbock, Texas 79413".

Discovery Healthcare Consulting Group (DHCG) is a Limited Liability Corporation (not a Tax-Exempt nonprofit). After tracking it through the various agreements and business entities, it seems to me that DHCG is ultimately "the Hospital" as far as EMS/Ambulance management.

Several thoughts (opinions) come to mind as a result of all this research. The first and firmest is that McCulloch County is not big or prosperous enough to support two Ambulance/EMS services. There simply aren't enough people here. The choice is between one good one or two poor ones struggling for business. I come down squarely in favor of one good one, which we already have.

On the other "hospital" questions that came up as a result of looking into the EMS issue, my thoughts (opinions) are tentative. The first is that McCulloch County is not big enough to support a full service hospital capable of competing with other hospitals within driving distance. The issue then becomes deciding what level of service we can afford and how to access what we can't afford locally. Continuing to overbuild and over-promise will lead to no hospital at all in Brady.

The complicated, convoluted business structure of "the Hospital" is destructive for the community. It must either be explained so every citizen can understand it or it must be simplified. Otherwise, it will destroy not only "the Hospital" but community purpose as well.

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