As Metrocare faces significant financial concerns, the organization’s board of managers is accepting help from Parkland Health.
On Wednesday, Metrocare’s board voted unanimously to enter an agreement that Parkland Health laid out earlier this week for a loan of up to $18 million in emergency assistance.
Metrocare, Dallas County’s safety net behavioral and mental health provider, is working to address a potential $15 million budget shortfall highlighted in a Dallas County commissioners court meeting last month.
“The last thing I would want to have happen is for people to be afraid that they come to the clinic and the doors would be locked,” Tate Ringer, Metrocare’s interim CEO, told KERA. “We’re not in that type of place. We are responding in the way we are in order to ensure that not only has care continued, care will continue.”
Ringer said her organization and Parkland have been exploring ways to work more effectively together for about five years – but the financial concerns sped up the need for a formal partnership.
Metrocare’s mission also plays into why community leaders are invested in keeping the organization running.
Dallas County and Parkland’s community needs assessment, released in April, found mental and behavioral health outcomes are worsening in the county, and community members shared an “urgent need” to address it.
“Mental health is the number one concern for Parkland’s community health needs assessment,” Ringer said. “So it serves us. We both have the same mission to serve the health and public of Dallas County.”
In January, an audit highlighted a problem in Metrocare’s budget – there was a gap between the estimates leadership used to develop the budget and how much the organization needed to spend.
“We also didn’t have the visibility to be able to respond when funding changes happened, when costs got higher than expected, like the [employee] benefits,” Ringer said. “So, we didn’t respond fast enough.”
Since the audit, Ringer said Metrocare has taken on a commitment to “absolute transparency and openness” and developing better financial reporting and budget forecasting practices.
The organization's leadership also experienced significant changes in the past year. Its long-term CEO retired in April, and the previous CFO resigned within the last year. In June, Dallas County commissioners approved a recommendation for an interim CFO.
Dr. John Burruss, Metrocare’s previous CEO, told KERA in February the “business aspects” of the organization were going to require a lot of attention from the next set of leaders. He said leadership was going to face the ongoing challenge present in mental health care: how to provide necessary care while remaining solvent.
As the board realized the extent of the concern, members decided not to conduct a CEO search to ensure continuity of care, according to Ringer. She said she was brought in to strengthen financial controls and reporting, so the organization can change and adapt more quickly.
With the partnership approved by both Parkland and Metrocare, Ringer said the next steps are already in motion.
She said teams from both organizations are starting to look at what can easily be changed to save money. In addition, the Dallas County commissioners also voted last month to pay a health care solutions firm $600,000 to take over Metrocare’s 11-week transitional restructuring – and Ringer said the firm is already making progress.
The Metrocare board of managers is currently working on the 2027 fiscal year budget, which it hopes to approve next month.
“The amount of work that's happened in two weeks is really miraculous,” she said. “But it also speaks to what we're going to be doing over the coming next several months along with the budget to ensure stability for long term.”
The emergency financial support from Parkland will help Metrocare as it creates and implements a longer-term plan. Metrocare has to fill an $18 million gap to break even for the fiscal year that’s about to start, according to the firm hired by the county.
In the meantime, Ringer said she wants community members to be cautious about claims that Parkland Health is taking over Metrocare, that both organizations are merging or that Metrocare is “going under.”
“Those things aren't legally possible because we're both two different governmental entities,” she said. “It’s really an opportunity in the midst of the crisis that Dallas County now has a potential for collaboration that makes mental health and disability care more sustainable…I think we’ll look back and say, ‘Okay, we made lemonade out of lemons. It was difficult, but the system and the health care of the county [are] better because of it.'”
Abigail Ruhman is KERA’s health reporter. Got a tip? Email Abigail at aruhman@kera.org.
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