4 March 19 - 25, 2026 dallasobserver.com DALLAS OBSERVER Classified | MusiC | dish | Culture | unfair Park | Contents “I think that there was a lot of feeling and emotion involved in it. How do you take that out of the equation? You can’t, especially when you have a guy like Dr. Dirk talking and giving you facts and figures from his perspective,” said Moore. Telehealth D irk Perritt, the company’s co-founder and CEO, is an emergency room phy- sician at Texas Health Resources who completed his residency at Parkland Hospi- tal and previously worked at BSW Garland. He said he launched the service with the city as a target client. “It’s 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 Gar- land,” Perritt said in an interview. “I 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.” 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 Gar- land, 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. 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–out structure tied to municipal bills, which al- lows up to 10 residents of the billed address to access the service. The company contracts with doctors and physician assistants to provide care in its cli- ent 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. “It’s someone you can text, call or video; they’re not asking for a credit card or insur- ance,” Perritt said. “It’s already paid for through this utility billing mechanism, and that allows you to communicate really quickly and easily.” In total, Perritt estimates he invested roughly $1 million in the ill-fated endeavor in Garland. He also said that a statement he made at a council work session that his business model would have failed if Garland had de- clined the contract was misinterpreted by those opposed to the program. “If something fails in Garland, it’s hard to go sell your program elsewhere,” Perritt said. “And so yes, I was fully invested, and that’s 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’s why I meant about it, and it’s in my backyard.” Perritt said the company decided to offer free access to up to 10,000 households as a gesture of “goodwill.” The 10,000 figure be- came a rallying point for community mem- bers opposed to the project, who cited company statements indicating that at most, fewer than 3,000 users received care. That’s opposed to the nearly 6,000 households that preemptively opted out of the program fol- lowing the contract’s approval. “The 6,000 people that opted out of a 250,000-participant program is a small number. I mean, it’s less than 6% of the pro- gram. And then you compare it to our trial program, only 10,000 individuals and 3,000 utilizations,” Perritt said. “That’s a 30% uti- lization. So if you apply that to the popula- tion of Garland of 250,000 people, a 30% utilization is going to be 80,000 people. So, a highly successful program.” In hindsight, he said he would not have offered the pilot. “Should we have done this for the right thing to do for the patient? Absolutely, so I did,” he said. “I think it harmed the deal, be- cause it became a litmus test, a KPI that was never in the contract.” Community Pushback F ormer three-time council member and mayoral candidate Deborah Morris posted that number a few times on Facebook. 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. “I saw that and then checked into it and read all the documentation and said, ‘What the heck?’ This has not been announced to the public, other than the people who read agendas, which I’m probably one of 10,” Morris said. In the months following the contract’s approval, at least 100 Garland residents spoke against the added utility bill tariff, with social media frenzy intensifying with every update on the program’s rollout. Beating the proverbial drum, Morris posted hundreds of times in Facebook groups and in numerous comment threads arguing against the project. “If this had been a voluntary, transparent opt-in, we wouldn’t be having this conversa- tion, because at that point it’s buyer be- ware,” Morris said. “And it’s 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.” 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. “They 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,” Morris said. “I can’t even say how inappropriate that is.” Her efforts helped galvanize growing resistance to the plan, with one group, dub- bing itself the “Civic Justice League,” among the most tenacious in its online at- tacks and public comments at council meetings. They advertised themselves with monikers such as “Sergeant Tenacious” and “Steadfast Shirley” in an unmistakably AI- generated poster shared to Facebook groups. At the Feb. 3 council meeting, Danny Starnes, a.k.a. “Captain Contract,” said the program’s lack of awareness months after the contract was signed raised questions. “We’re talking 81,771 households with a population of 250,000 people,” Starnes said. “And they still don’t know. You heard people come up here today that never heard about this program. It’s been months. MD Health Pathways’ entire business model depends on people not knowing.” Another speaker said the decision felt “pretty rushed through, with little citizen input.” Council members then unanimously voted to call a special May election, putting the $6 tariff to a referendum. Timeline • March 2025: MD Health Pathways pres- ents information to council members at a Community Services Committee Meet- ing. • Summer 2025: City staff research the company and work on a contract. Council members receive updates at meetings on May 5, June 16 and Aug. 4. • Aug. 19: Council approves a contract with MD Health Pathways by a 7-2 vote. • October - January: Public opposition grows, problems with community engage- ment and software issues hamper rollout. • Feb. 3: Council unanimously places a referendum on adding the telehealth fee to utility bills on May ballots. Mor- ris and others continued to lobby for the contract’s cancellation. • Feb. 17: Garland’s interim city manager cancels the contract after council mem- bers push for an end to the agreement. Perritt’s 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 pro- ceed with the contract after the call for a May 2 special election and planned to spend hundreds of thousands on a political campaign. When the city manager canceled the con- tract a few weeks later, the election — antici- pated to cost the city approximately Unfair Park from p3 >> p6 Mike Brooks MD Health Pathways CEO and founder Dirk Perritt.
