Should the Medical Director answer to the Board?

The CEO should answer to the board, and all senior positions, should report to the board.  This would be the current practice at MCHD.  But I am not sure that any particular senior position should "answer" to the board directly, since the CEO does that.  If the board has a problem with the performance of any senior position, the board should have the ability to take that up directly with the CEO.  I do not see the position of medical director as being any different in this regard than other senior positions.

Do you believe Board members should be allowed to ride along with EMS crews and spend time with Alarm and other departments?

Yes.  Obviously there needs to be a reasonability standard applied to this.  It is good for board members to be informed, but they should not become a hindrance to normal operations.  

Do you have any experience with EMS or medicine?

No, not beyond what I have learned as a board member of the MCHD.

Why are you running for this office and what 3 major goals do you want to be measured by if you are elected?

I am running because I believe in good government for Montgomery County.  My three top priorities are and always have been:  1) to continually lower the tax rate, 2) to have a budget which does not grow faster than our rate of population and inflation, and 3) increased excellence in the services offered by MCHD.

With regards to #1 in particular, we are considering some very interesting ideas on a going forward basis which could allow us to even more aggressively reduce the tax rate.  In principle, I would make it a dream goal to have MCHD have a tax rate of 0.  I do not know if that is achievable, but I sure like the idea and in my next 4 year term I would like to make realistic strides towards that goal.  

Do you support spousal benefits for same-sex partners of State & County employees? Please explain your reasons.

Absolutely not.

It is bad enough that we are forced by the US Supreme Court to treat "same sex marriages" as marriages.  Under no circumstances should we expand spousal benefits to non-spouses if we have the discretion to do or not do that.  But especially to same sex partners...especially now that "same sex marriage" is legal.  If we are compelled by law to do this, then so be it.  But if we have a choice in this matter, we should absolutely not extend spousal benefits in this manner.

Should Health Care Assistance Patients be required to have drug testing in order to receive assistance?

I would favor looking into that.  There might be legal or other difficulties that I am not aware of, but in principle, I think this is a good idea.

What is your opinion about Merit Pay versus COLA pay raises?

Generally speaking, salaries should follow productivity.  But we also recognize (just like every other employer, government and non-government) that MCHD competes for employment talent and many employers have COLA pay raises built into their compensation plans - as well as merit pay.  If MCHD endorsed a concept of merit pay only, and disregarded cost of living adjustments, it may put MCHD at a competitive disadvantage and the services that MCHD offers to the taxpayers and citizens of Montgomery County may suffer.  So in the abstract, of course merit pay is superior as an idea.  But implementing that has to be considered with the real world consequences.  

What is your opinion about salary caps?

I don't know of any business which could endorse the concept of either a salary cap, or a salary floor.  Salaries should follow productivity and serve the larger goals of the organization which can include employee recruitment/retention.  Obviously a governmental entity is not exactly a business, but even so, the same principles should apply.  To the extent allowed by applicable law, salaries should track productivity and serve the goals of the organization.  The "celing" on salaries at MCHD should come from the fact that we live in a taxpayer friendly county, and we believe in appropriate (and competitive) but not lavish salaries for government employees.  I am not sure any additional cap is necessary or serves the interest of the taxpayer/user of MCHD.

Should any first responder injured in the line of duty have their ambulance charges absorbed by the District?

I would need to study this.  I would need to fully understand the insurance program that the first responders are in currently, what those programs would typically pay for their ambulance charges and so on. I would also need to know how many calls like this MCHD typically handles, and how the economics play out for those calls.

Of course this is a nice idea, and we want to assist first responders.  Who in our great county does not favor that?

But if they have adequate employee benefits (which are purchased with an actuarially based insurance loss assumption) which are functioning adequately, I'm not sure it benefits Montgomery County taxpayers to step in and fix a problem which does not exist.  I need to obtain more data on this to answer beyond that.

Should salaried employees be paid overtime?

If they are working within their salaried position's job description, then, no.  That's sort of the point of being salaried rather than hourly.  

However, if a salaried position takes on duties outside of their normal job description, then they should be compensated according to the pay scale for that job.  Of course, such a practice in a large governmental organization could be abused, and it is my understanding that in police departments around the country, this is how they allow police to increase their total compensation.  So in principle this sort of overtime serves the interest/immediate needs of the organization, but if it becomes just a way to sneak additional compensation to employees, that would be an abuse and should be curtailed.

Is it the responsibility of the Board to monitor the spending of the District and verify expenses?

It is the responsibility of the board to approve  a budget, to monitor budget compliance, to hire an auditor and to review the annual audit.  Each of these functions seems to include the idea of "monitoring the spending".  If by verifying expenses that means obtaining/reviewing receipts, etc., that seems to be an accounting function which will be handled by the normal operations of the district, and verified by the auditors who will also recommend appropriate controls.  If by verifying expenses that means simply ratifying invoices on a monthly basis, then it should be noted that that is what we do at every monthly board meeting and that practice should continue.

Should the District be involved in the transfer of patients, where ALS(Advanced Life Support) is not required?

I think the district should consider this, with appropriate guidelines, including the protection of private industry.  I believe an opportunity exists here locally for the district to do more in this regard, and it might be a way to significantly reduce the tax rate.  I want to personally study what they did in Tarrant County in this regard to see if something similar is doable in Montgomery County.  Worth considering.  Not ready to say yes.  But it is absolutely worth carefully considering.

 Is it better to build stand alone EMS facilities, co-locate with fire departments, or purchase existing facilities and modify them?

It is best to pursue the cheapest alternative available which still provides an adequate location for EMS in our growing county.  Of those alternatives listed, often purchasing and modifying existing facilities is the cheapest.  And often building a stand alone facility is the most expensive.  MCHD has from time to time co-located with fire departments and that has sometimes worked well.  However, each expansion is different, and all options should be considered, including others not listed above.  All things being equal from an operational, safety, and demographic perspective, then the cheapest alternative should be used. 

Do you support or oppose increasing and broadening the Sales Tax to reduce property taxes? Why?

I do not support increasing or broadening any tax, at any time, ever.  End of story.

The idea that government is going to increase one tax to give us a break on another is one of the oldest farces in the book.  It's always easy to bring in the new tax, but then, when it comes time to get rid of the old one....Voila! New dire needs are discovered!  So the old one remains in place, also.  This is insidious and the taxpayer should never fall for this sort of chicanery.  

I strongly opposed (and still oppose) the gross margins tax that Rick Perry put in a few years ago.  I think that should be repealed.

But as for property taxes, local governmental officials and board members, together with active citizens, should go to work to make sure that each local governmental entity is stingy with taxpayer dollars, and that they have as a GOAL to REDUCE the tax rate.  This should be the goal of every local governmental entity, and the taxpayers should DEMAND that elected board members unequivocally support that goal.

That has been my philosophy at MCHD.  Under no circumstances will I ever support an increase in the actual tax rate.  Yes, we have been blessed in Montgomery County to live in an area that is growing and prospering, and liberal critics can say that we can simply afford to be conservative.  I reject that.  We have worked hard at MCHD to create a culture of thrift and a culture which truly values the taxpayer and the taxpayer's dollars.  And we have worked hard to implement a budget and policies which reflect these important values.

Finally, we have to work/hope/pray that the work of hospital districts remain throughout Texas remain as they are.  If the courts were ever to take over the financing of distrits like they did with public school finance, then our ability to control our own fate locally will almost disappear.  We have many good people who have served in our local school districts.  But the fact is that their funding/taxation/spending is controlled by the State of Texas and even the United States in many respects.

Should Board members have open lines of communications with all employees of the District?

Board members should monitor policies for the district which ensure sound fiscal management, increasingly excellent operations and an ever-decreasing tax rate.  MCHD is a large, complex organization and board members are part-time volunteers exercising an important oversight responsibility.  Accordingly, their primary line of communication should be with the CEO (and with/through the CEO, senior management).  I think there are too many employees with competing interests and perspectives for board members to have "open lines of communications" with all of them.  Taken literally, that could allow all employees to call board members, any time they have something to say.  In a dysfunctional organization with a high level of dissatisfaction, that would lead to chaos, rumor mills, private political agendas and serioiusly erode morale.  Moreover, individual board members are not really empowered to speak for the board, and there are good reasons why most board communications should be in the light of day, not hidden from the public.Employees have grievance procedures and HR policies to deal with their issues as employees.  I'm not sure it benefits the taxpayers of Montgomery County to openly invite employees to circumvent these existing policies and go straight to board members.

That said, of course we recognize that as a country, we still have a First Amendment...in spite of what is happening on college campuses.  Most MCHD employees are also citizens of Montgomery County, and taxpayers, and therefore, we should not clamp down on employee communications in a way which violates the letter or spirit of the First Amendment.  We recognize that the First Amendment has always allowed regulation of the time, manner and place of free speech, and those are the precise categories of the issues in play here.  Perhaps various pathways to communicate with board members could be considered such as a "whistleblower" phone line and system, like publicly traded companies.

Should Hospital District personnel be allowed to carry while at work?

If this is within our discretion (ie, allowed by state law), I would be in favor of this.

If state law currently does not allow this, I would be in favor of pushing the legislature to carefully consider allowing hospital district personnel to carry.

Naturally, we would want the board to help craft policies to safely and successfully implement this important right, and I would be eager to work on formulating and articulating such a policy.

I would place the Second Amendment near the top of my personal constitutional priorities.  In Montgomery County, I contaced the NRA Foundation and set up the first local chapter of Friends of the NRA.  I was chairman (or co-chairman) of that fine organization for many years and when I was involved we raised well over $100,000 for the NRA Foundation which gives grants protect our firearms heritage and to promote freedom and the Second Amendment for subsequent generations.

Should District employees have open lines of communications with Board members, without fear of reprisal?  Why or why not?

As stated above, I think we could consider something like a "whistleblower" hotline which facilitates communications with a board member designated by the board to be the recipient of these communications.  (It would be important for any board member who receives these communications to have the trust and confidence of the board).  Again, this is common practice for public companies, and there might be some wisdom in this appraoch for the district. Such a program would of course include non-retaliation for communications made in good faith.

Do you believe the Board should have access to all MCHD reports and records, excluding patient records?  Why or why not?

Subject to the board member articulating what policy he or she is looking at to verify, and of course, subject to the normal operational requirements of the district, then obviously the starting point for this would have to be "yes".

However, it is also easy to see how continual requests for access to "all reports and records" is rather sweeping, and could therefore become abusive and expensive, could have no rational relationship to successfully implementing a board policy, and could distract the district from its operations.

Accordingly, a better approach would be this.  The board should discuss with the administration what types of reports and records exist which relate to the verification of successful implementation of board policies, and those reports and records should be regularly delivered to the board. When approprite, they should be delivered to the board in the board packet prior to monthly, public board meetings.

This way, the public ALSO has access to important information, and the district can set up a procedure where this information is produced/formatted regularly and delivered to ALL of the board in the ordinary course of business.  This avoids the administraion having to change its day to day procedures to deal with ad hoc requests.  Rather, it can fold the production of reports and records into its normal business (and hire people to assist in this regard, if it turns out to be necessary...which in turn allows the board to know what it costs to generate such information).

Should Board members have complete access to all areas of the District?  Why or why not?

Again, assuming that a board member is seeking to understand the implementation of a particular policy set by the board, and assuming that the board member has given a reasonable notice to the district such that the district can safely and efficiently respond to the request for access without disrupting the district's operations, then the starting point for the answer to this question has to be "yes".

However, it is also easy to see how uninvited and unexpected guests at the district (and especially at its stations around the county) could seriously disrupt operations.

A better approach would be this.  If a board member seeks to understand the implementation of a particular policy and believes that some sort of site visit will facilitate that, then that board member should communicate that to the chairman of the board, and to the CEO.  Then CEO will then, with appropriate consultation with the requesting board member and the chairman, either make appropriate arrangements or discuss alternatives for the board member to verify some aspect of implementation of a board policy.

The Board is to set Policy, should it have any say in procedures?  Explain your rationale.

It is correct to say that the board should set policy.  It is also correct to say that the board should monitor compliance with policy.  However, sometimes the line between policy and procedures is not always completely clear.  Therefore, it is not correct to say that absolutely "the board should have no say in procedures".  

The implementation of policies set by the board is primarily the responsibility of those employed on a day to day basis by the district. However, ultimately, the successful implementation of board policies is the responsibility of the board, as a policy which is not implemented is not a policy.  Sometimes, in the context of the successful implementation of policy, a conversation between the board and the administration must include a discussion of procedures.  This is unavoidable in the real world.  But of course for the most part, the board is responsibile for setting policy and hiring a CEO directly accountable to them to make sure their policy is implemented.  If all policies are in fact being implemented successfully, then the board will have no reason to get involved in procedures.

The Board is not supposed to micro-manage, but should they trust and verify?

That's not a bad summary.

But even more important than trusting is simply looking at objective, quantifiable criteria to determine if the board priorities are being met.  These include budget numbers, the tax rate, the audit, outside accrediting bodies, and whether or not illegal aliens are in the indigent care program.  If the tax rate which the district sets goes down, year after year, then the policy with regards to the tax rate is being successfully implemented.  I'm not sure what the element of "trust" is here.  It's really almost a case of just verification.

List Civic, Political or union organization or individuals to whom you have contributed time or money (five years).

Civic/Religious: Church, Excelsior Dance, CYT Houston, the Houston Area Pastor's Council, various edudational organizations

Political: Ted Cruz, Steve Toth, Ted Seago; former Montgomery County GOP precinct chair.

Should Disrtict employees take home District vehicles and if so for what purpose?

If that practice is consistent with the employee's employment arrangement, if a determination has been made that this practice is beneficial to district operations, and if that practice is consistent with other well-run hospital districts in Texas, then I think that practice could be acceptable. The important thing is that the district has a policy with regards to vehicle use which has been thought through from the perspective of employment/HR, operations, budget, and compliance with state law.

Should District employees living out of the county take home emergency vehicles?

I would need to hear a good rationale for this practice before I could endorse it.