reported overtime budgets<\/a> exceeding $1 million annually. The program would have largely been \u201crevenue-neutral\u201d for Garland, according to a statement from the city, with MD Health Pathways paying for associated administrative costs<\/p>\n\u201cI love this program,\u201d Mayor Pro Tempore Margaret Lucht said before voting to approve it. \u201cI think it\u2019s wonderful. I think you\u2019re doing something that will pave the way for larger cities to adopt a program like this and help people who don\u2019t have the means, the desire or the ability to have insurance.\u201d<\/p>\n
Telehealth was set to roll out in late spring or early summer of 2026, although billing software issues complicated the announcement of an official launch date. But by the beginning of February, it had become increasingly clear that the program\u2019s future in Garland had been thrown in doubt.<\/p>\n
Problems Arise<\/p>\n
Midway through the month, Lucht and other council members directed interim City Manager Mike Betz to terminate the contract, less than two weeks after essentially putting it up for a citywide May referendum at a Feb. 3 council meeting. Tap Telehealth was off the table after months of recall threats and backlash over the program.<\/p>\n
The problem? Low-cost healthcare, in this case, meant the $6 monthly fee was added to utility bills via an \u201copt-out\u201d structure, under which all of Garland\u2019s 81,000+ households tied to municipal customer accounts would have been automatically enrolled for the service. Opting out would have required a phone call or email, planned as a simple process for residents, but many felt even that was too much to ask. The \u2018tariff\u2019 would have increased to $9 in the program\u2019s seventh year.<\/p>\n
\u201cWhen I found out about this whole thing, I was shocked. I couldn\u2019t believe the city enrolled me in a program without my knowledge or consent, whether I wanted it or not. Additionally, there wasn\u2019t any competitive bidding,\u201d Garland resident Sharon Morgan said at the February council meeting. \u201cOpting out is like someone pulling a $10 bill from my backpack while I\u2019m trying to eat my lunch. No one\u2019s going to notice, but it should concern everyone.\u201d<\/p>\n
The public comments at the February meeting capped months of backlash from a growing, rapidly mobilized group of residents who were staunchly opposed to the program for a variety of reasons, including some who questioned the city\u2019s role in providing it in the first place. But above all, the $6 fee and lack of public knowledge before the vote fueled dissent.<\/p>\n
Council member Ed Moore, who voted against the contract\u2019s original August approval alongside Mayor Dylan Hedrick, said in an interview that he felt the level of public awareness was concerning and that the city should have looked more closely at MD Health Pathways and other potential options.<\/p>\n
\u201cI just felt that no, we need to do a lot more public engagement. I just did not feel that\u2019s a function of government,\u201d Moore said. \u201cIf you\u2019re going to do something like that, I really feel that you need to take that to the community, and you need to have vetted them. You need to find out a lot more information.\u201d<\/p>\n
Moore also said that while he thinks Tap Telehealth is a \u201cgood service\u201d and that council members voted with good intentions, he felt emotions fueled the process.<\/p>\n
\u201cI think that there was a lot of feeling and emotion involved in it. How do you take that out of the equation? You can\u2019t, especially when you have a guy like Dr. Dirk talking and giving you facts and figures from his perspective,\u201d said Moore.<\/p>\n
![\"MD](\"https:\/\/www.newsbeep.com\/us-tx\/wp-content\/uploads\/2026\/03\/Dirk-Perritt_Garland_Telehealth-7.jpg\")
MD Health Pathways CEO and Founder Dirk Perritt.<\/p>\n
Telehealth<\/p>\n
Dirk Perritt, the company\u2019s co-founder and CEO, is an emergency room physician at Texas Health Resources who completed his residency at Parkland Hospital and previously worked at BSW Garland. He said he launched the service with the city as a target client.\u00a0<\/p>\n
\u201cIt\u2019s one of the reasons I built the service to begin with, day to day, probably about 10 to 20% of the patients I see are from Garland,\u201d Perritt said in an interview. \u201cI work in Dallas, and I built this with them in mind that they were going to be the largest city that had implemented the program.\u201d<\/p>\n
MD Health Pathways provides similar services to 17 municipalities across three states. Based in North Texas, the company began providing services in Ferris, a town of 4,200 residents about 30 miles south of Garland, in 2022. All of its client municipalities and counties operate on an opt-out model, which Perritt said is necessary to keep costs down for users.<\/p>\n
The largest community it contracts with is a county in South Carolina with just under 45,000 people, company representatives said. Most communities use an opt\u2013out structure tied to municipal bills, which allows up to 10 residents of the billed address to access the service.<\/p>\n
The company contracts with doctors and physician assistants to provide care in its client communities. At least 10 physicians would have been hired to serve Garland, Perritt said, and most residents in other communities are seen within 2 minutes of texting the service.<\/p>\n
\u201cIt\u2019s someone you can text, call or video; they\u2019re not asking for a credit card or insurance,\u201d Perritt said. \u201cIt\u2019s already paid for through this utility billing mechanism, and that allows you to communicate really quickly and easily.\u201d<\/p>\n
In total, Perritt estimates he invested roughly $1 million in the ill-fated endeavor in Garland.<\/p>\n
He also said that a statement he made at a council work session that his business model would have failed if Garland had declined the contract was misinterpreted by those opposed to the program.<\/p>\n
\u201cIf something fails in Garland, it\u2019s hard to go sell your program elsewhere,\u201d Perritt said. \u201cAnd so yes, I was fully invested, and that\u2019s why I invested a million dollars ahead of its launch, because this was going to be the biggest city without a hospital that needed it the most, and that\u2019s why I meant about it, and it\u2019s in my backyard.\u201d<\/p>\n
Perritt said the company decided to offer free access to up to 10,000 households as a gesture of \u201cgoodwill.\u201d The 10,000 figure became a rallying point for community members opposed to the project, who cited company statements indicating that at most, fewer than 3,000 users received care. That\u2019s opposed to the nearly 6,000 households that preemptively opted out of the program following the contract\u2019s approval.<\/p>\n
\u201cThe 6,000 people that opted out of a 250,000-participant program is a small number. I mean, it\u2019s less than 6% of the program. And then you compare it to our trial program, only 10,000 individuals and 3,000 utilizations,\u201d Perritt said. \u201cThat\u2019s a 30% utilization. So if you apply that to the population of Garland of 250,000 people, a 30% utilization is going to be 80,000 people. So, a highly successful program.\u201d\u00a0<\/p>\n
In hindsight, he said he would not have offered the pilot.<\/p>\n
\u201cShould we have done this for the right thing to do for the patient? Absolutely, so I did,\u201d he said. \u201cI think it harmed the deal, because it became a litmus test, a KPI that was never in the contract.\u201d<\/p>\n
![\"Deborah](\"https:\/\/www.newsbeep.com\/us-tx\/wp-content\/uploads\/2026\/03\/Deborah-Morris-Garland-City-Council-9.jpg\")
Former three-time council member and mayoral candidate Deborah Morris opposed the MD Health Pathways contract.<\/p>\n
Former three-time council member and mayoral candidate Deborah Morris posted that number a few times on Facebook.<\/p>\n
Among the strongest opponents of the contract, she said she found out about it the weekend before the August vote and began stirring up residents, most of whom were unaware at the time, a problem that seemed to persist through the coming months.<\/p>\n
\u201cI saw that and then checked into it and read all the documentation and said, \u2018What the heck?\u2019 This has not been announced to the public, other than the people who read agendas, which I\u2019m probably one of 10,\u201d Morris said.<\/p>\n
In the months following the contract\u2019s approval, at least 100 Garland residents spoke against the added utility bill tariff, with social media frenzy intensifying with every update on the program\u2019s rollout.\u00a0<\/p>\n
Beating the proverbial drum, Morris posted hundreds of times in Facebook groups and in numerous comment threads arguing against the project.\u00a0<\/p>\n
\u201cIf this had been a voluntary, transparent opt-in, we wouldn\u2019t be having this conversation, because at that point it\u2019s buyer beware,\u201d Morris said. \u201cAnd it\u2019s at that point anybody who gets charged would know about it. There would be nobody paying a bill not realizing that they were being charged a quote, unquote, non-mandatory fee they could opt out of.\u201d<\/p>\n
MD Health Pathways representatives had previously told council members that an opt-in model was not feasible, as it would have raised the Tap Telehealth monthly fee to roughly $60 and threatened accessibility.<\/p>\n
\u201cThey voted to automatically enroll 81,000 Garland households without notice or consent to have this bill start showing up on their water bill in the spring or early summer,\u201d Morris said. \u201cI can\u2019t even say how inappropriate that is.\u201d<\/p>\n
Her efforts helped galvanize growing resistance to the plan, with one group, dubbing itself the \u201cCivic Justice League,\u201d among the most tenacious in its online attacks and public comments at council meetings. They advertised themselves with monikers such as \u201cSergeant Tenacious\u201d and \u201cSteadfast Shirley\u201d in an unmistakably AI-generated poster shared to Facebook groups.\u00a0<\/p>\n
At the Feb. 3 council meeting, Danny Starnes, a.k.a. \u201cCaptain Contract,\u201d said the program\u2019s lack of awareness months after the contract was signed raised questions.<\/p>\n
\u201cWe\u2019re talking 81,771 households with a population of 250,000 people,\u201d Starnes said. \u201cAnd they still don\u2019t know. You heard people come up here today that never heard about this program. It\u2019s been months. MD Health Pathways\u2019 entire business model depends on people not knowing.\u201d<\/p>\n
Another speaker said the decision felt \u201cpretty rushed through, with little citizen input.\u201d Council members then unanimously voted to call a special May election, putting the $6 tariff to a referendum.<\/p>\n
Timeline<\/p>\n
March 2025:\u00a0 MD Health Pathways presents information to council members at a Community Services Committee Meeting.
\nSummer 2025:\u00a0 City staff research the company and work on a contract. Council members receive updates at meetings on May 5, June 16 and Aug. 4.
\nAugust 19: Council approves a contract with MD Health Pathways by a 7-2 vote.
\nOctober \u2013 January: Public opposition grows, problems with community engagement and software issues hamper rollout.
\nFeb. 3: Council unanimously places a referendum on an adding a telehealth fee to utility bills on May ballots. Morris and others continued to lobby for the contract\u2019s cancellation.
\nFeb. 17: Garland\u2019s interim city manager cancels the contract after council members push for an end to the agreement.<\/p>\n
Perritt\u2019s claims that the company would also cancel the contract if the tariff were put to a vote also compounded community backlash. He said he had decided to proceed with the contract after the call for a May 2 special election and planned to spend hundreds of thousands on a political campaign.<\/p>\n
When the city manager canceled the contract a few weeks later, the election \u2014 anticipated to cost the city approximately $300,000, officials said in a statement \u2014 became moot and was subsequently canceled.<\/p>\n
\u201cThey did not want this to go to the citizens,\u201d Morris said. \u201cAnd after it did, all of a sudden, they flipped, and were ready to bulk up and fight with a lot more money than any of us have. So was I comfortable with that thought and having this become just more drama? This was wrong to start with. It just needed to be killed.\u201d<\/p>\n
Mary Ehlenfeldt works as an accounts receivable manager from her west Garland home most of the time. The 65-year-old has insurance through her employer, which includes a telehealth program. But that costs $40 per visit in out-of-pocket fees.<\/p>\n
She\u2019s also had cancer twice: ovarian cancer 24 years ago and breast cancer 15 years ago. Ehlenfeldt survived both, but the toll on her body left her \u201cseverely\u201d immunocompromised and she has semi-regular bouts of respiratory issues, she said.<\/p>\n
After attending a council meeting where MD Health Pathways representatives were signing people up for the free access period, she said she signed up and used the program three times.<\/p>\n
\u201cIt saved me an amazing amount of co-pays. I\u2019ve used it a few times,\u201d Ehlenfeldt said. \u201cAnd my granddaughter, who lives with me, she\u2019s an adult, but she lives in my home. She was able to use the service because she lives in my home. And you know, otherwise, she would have had to go pay an exorbitant amount of money to see a doctor because she doesn\u2019t have insurance,\u201d<\/p>\n
She said she was \u201cangry\u201d when the referendum was canceled after the contract was terminated, and that, in her mind, control of the narrative had been lost to a vocal minority.\u00a0<\/p>\n
\u201cPeople need to know that this was taken away from us without a vote,\u201d Ehlenfeldt said. \u201cThey were complaining that we didn\u2019t vote for it, so when they said we\u2019re going to put it to a vote, then they said, \u2018No, we\u2019re not going to vote. You don\u2019t get the vote on it. We\u2019re taking it away.\u2019 So yeah, you all took away our vote too. Thanks.\u201d<\/p>\n
\u201cNot Going To Go Away\u201d<\/p>\n
Council member Carissa Dutton was initially one of the program\u2019s most outspoken advocates. Her district is home to a large number of uninsured and underinsured people, she said.<\/p>\n
She\u2019s seen neighbors struggle with healthcare needs and felt the program would have provided needed access to vulnerable residents.<\/p>\n
\u201cIt was being able to have access for residents at an extremely low cost,\u201d Dutton said. \u201cBecause otherwise they wouldn\u2019t have, you know, it kind of bridges that gap of, \u2018Do I buy groceries or do I go to urgent care?\u2019\u201d<\/p>\n
Dutton said that while she still supports the program, her issue was with the implementation.\u00a0<\/p>\n
She said MD Health Pathways could have been more transparent at times, but also thought council members could have been better informed, which hampered the rollout.<\/p>\n
Dutton works two jobs outside of council and felt the plan was rushed through committee before council members had been properly briefed. Former City Manager Judson Rex, whose contract was not renewed in December, played a part in the rollout\u2019s issues, she said.<\/p>\n
\u201cWe rely on our staff to have things prepared and ready, and all of the due diligence part really done before it gets brought to council, and because of our former city manager, that didn\u2019t happen the way that I would have liked it to today,\u201d Dutton said.<\/p>\n
She also said that she would have liked to start community engagement earlier, but was advised against doing so by city staff. When contacted, Rex declined to comment for this story.<\/p>\n
When asked if the turnover in the city manager\u2019s office contributed to the program\u2019s failure, Mayor Hedrick said, \u201cAbsolutely not.\u201d\u00a0<\/p>\n
While acknowledging that \u201cthe need is not going to go away\u201d in Garland and that she still thinks Tap Telehealth is a valuable program, Dutton said the discourse had reached a breaking point, making supporting it untenable.<\/p>\n
\u201cThings had just gotten so far out of hand and out of control that I did not feel like we were going to be able to recover from it,\u201d Dutton said. \u201cThe hate messages that we were getting were just insane. Threats of recall, just insane messages coming in, nonstop, 24\/7, we\u2019re getting blamed for the ice storm.\u201d<\/p>\n
Why Didn\u2019t People Know?<\/p>\n
Perritt had a tense exchange with the interim city manager and Hedrick at the Feb. 3 community meeting, in which he said the city had refused to send text notifications about the program to all Garland residents. The city manager said the texts in question would have required the city\u2019s emergency notification system and would have diminished its effectiveness, while Hedrick said the mailers would have required city funding not covered by the contract.\u00a0<\/p>\n
\u201cWe were fulfilling our contractual obligations as part of the city, going out in the mailers in the utility bill system, and posts on social media,\u201d Hedrick said in an interview. \u201cSo they\u2019re always welcome to go above and beyond that if they wanted to market it further.<\/p>\n
Both he and Perritt agreed that too few knew about the $6 tariff. Neither could agree who was ultimately responsible.<\/p>\n
When asked whether the city had failed to hold up its end of the partnership, Perritt said, \u201cWe do. Absolutely.\u201d<\/p>\n
He said the city\u2019s inability or unwillingness to set a launch date was affecting the program\u2019s rollout and community engagement. In a statement, City Manager Mike Betz said that the \u201cCity began upgrading its utility billing software to enable the addition of the program fee on the utility bill. An official program launch date was expected to be set once the upgrade was complete.\u201d The city had originally planned to complete upgrades in the spring, but technical issues with its billing vendor delayed the project until early summer, staff told council members at a January work session.<\/p>\n
Perritt also pointed to the portion of the master agreement outlining the city\u2019s minimum community engagement initiatives. The issues with community engagement, he said, ultimately torpedoed the program.<\/p>\n
According to the agreement, the city was responsible for \u201csending periodic informational mailers or bill inserts about the program, posting about the program on the City\u2019s official social media accounts several times per year, including program information in materials provided to new residents, and collaborating with PPTX (Physicians Pathways PLLC) to present the program at community events or health fairs.\u201d<\/p>\n
\u201cIt was the city\u2019s obligation to promote the program through utility billings, notifying the community of the opt-out mechanism. \u2026 They were obligated to do that through their city channels, through their Facebook, through mailers, some of which had been done,\u201d Perritt said. \u201cMost of it, because the city wasn\u2019t doing it, we kind of felt the onus on ourselves.\u201d<\/p>\n
However, the city mailed at least two utility bill inserts with opt-out information, posted to social media accounts multiple times and hosted an MD Health Pathways tent at Garland\u2019s annual Christmas on the Square event, in addition to town halls and other community events, as stipulated by the contract.<\/p>\n
Still, Hedrick said the council could have slowed the process down originally to gather more residents\u2019 opinions.<\/p>\n
\u201cWe frequently make decisions where they\u2019re not rushed, but we meet all of the notification requirements,\u201d he said. \u201cAnd I know it\u2019s difficult with everyone\u2019s busy lives to follow everything that\u2019s being done on the City Council all the time, but it could have certainly done a better job of getting a sense of input from the beginning.\u201d<\/p>\n
In the end, he couldn\u2019t have supported any opt-out program, he said, especially knowing some residents might not read utility bills line by line or be aware of the fee. And by February, a large number still weren\u2019t.<\/p>\n
\u201cI\u2019ve had community meetings with various neighborhood groups and concerned citizens, and some of them didn\u2019t even know about the program at all,\u201d Hedrick said. \u201cEven with the best efforts of MD Health to try to reach our citizens, there\u2019s still always someone who isn\u2019t aware, and they simply didn\u2019t know about the program.\u201d<\/p>\n
Looking Forward<\/p>\n
Garland still doesn\u2019t have a hospital, and ambulances are still running residents to out-of-town hospitals, sending them to ER doctors like Perritt, who said Garland \u201cis not the end\u201d for his company.<\/p>\n
\u201cAnytime you\u2019re offering a service that disrupts the current process of billing $1,500 for strep throat in an ER and offering it for $9 unlimited to do in your home, you\u2019re going to see some friction, but we\u2019re offering a new health care infrastructure,\u201d Perritt said.<\/p>\n
Hedrick said he is not opposed to telehealth and that the city will continue trying to lure another hospital to Garland, nearly a decade after Baylor Scott and White closed its doors.\u00a0<\/p>\n
\u201cThe hospitals also have a profit incentive, and if they can\u2019t make their numbers work with the number of uninsured patients that they had, It\u2019s very difficult to get a hospital to come back,\u201d Hedrick said. \u201cBut we\u2019re certainly working on addressing those kind of issues.\u201d<\/p>\n
Almost immediately after the city canceled its contract, council members unanimously approved an agreement with RightSite. The service will connect non-emergency EMS patients with virtual care on-scene and, hopefully, stave off long ambulance trips to surrounding cities for overloaded emergency personnel. The city is also in talks with Parkland Health to offer telehealth services at city buildings or non-profit locations.<\/p>\n
\u201cI appreciate everyone being so engaged on this proposal. The proposition of healthcare is continuing to be important in the city of Garland,\u201d Hedrick said. \u201cAnd again, we\u2019re working to truly try to get a hospital back or other means, with RightSite or health pods, to do something for our citizens, to address the health care needs we have.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Dave Novara doesn\u2019t go in for doctor\u2019s visits often. Not uncommon for a 43-year-old, Novara has had some…\n","protected":false},"author":2,"featured_media":209848,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[160,162,161,2220,3621],"class_list":["post-209847","post","type-post","status-publish","format-standard","has-post-thumbnail","category-plano","tag-plano","tag-plano-headlines","tag-plano-news","tag-science","tag-technology"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/209847","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/comments?post=209847"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/209847\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media\/209848"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media?parent=209847"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/categories?post=209847"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/tags?post=209847"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
![\"Mechanic](\"https:\/\/www.newsbeep.com\/us-tx\/wp-content\/uploads\/2026\/03\/Dave-Novara_Garland-1.jpg\")
Dave Novara, a mechanic in Garland, is frustrated with healthcare costs.<\/p>\n