Garland is joining a growing list of Texas cities offering telehealth as a public utility—and it’s the biggest city so far to adopt the Tap Telehealth program from Dallas-based MD Health Pathways.

Last week, the Garland City Council voted 7–2 to bring the company’s service to residents of the suburb, located northeast of Dallas, enabling access to text-, phone-, or video-based medical care bundled into monthly utility bills. The move followed months of public discussion.

MD Health Pathways called the approval “a landmark moment.” The company says Garland is the largest U.S. city without a hospital, a gap that has existed since Baylor Scott & White Medical Center-Garland closed in 2018,

While Garland has emergency rooms, behavioral health providers, and specialty clinics, including the Garland VA Medical Center, it hasn’t had a full-service community hospital in over six years. Nearly 26% of residents are uninsured, according to a report on Citizan Portal, further complicating access to care.

The city said the concept for Tap Telehealth was shaped by MD Health Pathways Founder and CEO Dirk Perritt’s experience as an emergency medicine physician at a Garland hospital, “where he saw firsthand the challenges patients face in accessing timely care.”

Perritt’s local insight later evolved into a “nationally scaled solution” and has now come full circle with Tap’s implementation in Garland.

“With this approval, [Garland] is setting a powerful example for how communities can leverage innovation to deliver more accessible and responsive healthcare,” Perritt said in a statement. “We’re proud to partner with Garland in leading the way.”

MD Health Pathways will work closely with city leaders and community partners to engage residents, the city said, ensuring they benefit from expanded access to telehealth services ahead of the program’s official launch in 2026. 

Telehealth on utility bills as an ‘opt out’ service

The telehealth program will appear on Garland residents’ utility bills as an opt-out service, Citizen Portal noted, and aims to reduce unnecessary emergency room visits by providing “accessible healthcare options.”

The Tap program enables residents to access care without upfront costs beyond the flat monthly fee.

The Tap Telehealth program is already available for residents of Ferris, 20 miles south of Dallas. Ferris residents who don’t opt out of the city’s Tap Telehealth program pay a flat monthly fee of $9 per family, according to MD Health Pathways’ website.

Other Texas cities offering Tap Telehealth include Henderson, Crandall, Mabank, Troup, and Paradise. 

How Tap Telehealth works

For a flat monthly fee bundled into a resident’s utility bill, Tap Telehealth will connect residents to medical advice and prescriptions through text, phone, or video, providing care without leaving home or incurring insurance costs, MD Health Pathways says.

Patients will begin the process by texting or calling to explain their symptoms. A doctor will then diagnose their condition, prescribe medications to a local pharmacy, or provide a referral as needed. A personalized medical profile will be created, and follow-up care will be included to monitor the patient’s recovery.

Quincy Preston contributed to this report.

The report was updated on Aug. 27, 2025, 10:10 a.m., with additional information on the Baylor Scott & White Medical Center-Garland closure in 2018.

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