Amid transparency anxieties, Travis County approves Central Health’s budget

After nearly four hours of start-and-stop discussion on Tuesday, the Travis County Commissioners Court gave its blessing to Central Health’s proposed tax rate and budget for Fiscal Year 2016-2017.

The 4-0-1 vote capped off one of the longest discussions before the court in recent memory and also allayed any concerns that the court would reject the $240 million budget in the face of reservations about the hospital district’s approach to transparency.

However, after the vote, County Judge Sarah Eckhardt pledged to amend the county order that created Central Health to give the court more robust oversight of the district.

“And I do imagine that we will revisit this document regularly,” Eckhardt said. “It’s not something that you do and walk away from. Unfortunately, we did it in 2008 and didn’t come back to look at it until 2016. I don’t want that ever to happen again.”

The bulk of Tuesday’s discussion was taken up by the 27 residents, activists and officials who gave public testimony, often talking for far longer than their allotted time. Approximately 20 of the speakers urged the court to adopt the budget, and of those, many represented Central Health, the University of Texas Dell Medical School, Seton Healthcare Family or the various nonprofits that receive grants from Central Health, including the Health Alliance for Austin Musicians and CommUnityCare.

CommUnityCare Board Member David Hart urged the members of the court to consider the importance of Central Health’s basic mission of providing health care for underinsured and uninsured residents. He explained that he was homeless for four years after a health crisis cost him his engineering job in 2008. He regained his health during that time, he said, thanks to CommUnityCare.

“I was outside the safety net, and I fell into it. Anybody in Travis County can fall into the safety net. We catch them,” Hart said.

Less ebullient about the quality of care provided by Central Health and its partners was Isabel Lopez-Aguilar of the League of United Latin American Citizens District VII chapter. She explained to the court why patients who have experienced diminished levels of service were not at Tuesday’s meeting.

“You won’t hear the stories because a lot of the community members are now working or taking care of their kids, and they have a language barrier so they’re not going to complain,” said Lopez-Aguilar.

She also alluded to the $35 million in property tax revenue and federal grants that Central Health distributes to Dell Medical School via its partnership with UT and Seton. That transaction has been questioned by activists who worry that without detailed accounting, it’s uncertain whether the money is advancing the district’s fundamental mission of providing indigent care.

“So when we’re just giving money to a medical school, that’s fine, but we want to know what’s going on. I don’t think we’re asking for the world,” said Lopez-Aguilar. “It is very simple: We want to make sure that the tax dollars are being spent the way that they were earmarked.”

Central Health Chair Katrina Daniel explained that the district is open to addressing community concerns over its accounting. However, she noted that there could be some obstacles by way of state and federal law.

“Beyond that, we commit to continuing to work with you and your staff to reach some agreed-upon language in the financial policy that I think will reach some of that transparency you’ve heard about today and asked for,” Daniel told the court.

That commitment mollified all the commissioners except Commissioner Ron Davis, who abstained from voting.

Attorney Fred Lewis, who on Monday issued an eight-page report calling on the court to withhold approval of the budget until a new system of accountability was installed at Central Health, greeted Tuesday’s outcome with cautious optimism.

“We’re making progress, but we’ll have to see what sort of accounting and audit procedures they’re going to come up with in the coming weeks,” Lewis told the Austin Monitor.

Beyond the transparency concerns, Central Health’s budget was largely uncontroversial. The balanced $240,151,397 spending and revenue package lowers the tax rate to 11.0541 cents per $100 of property valuation. That amounts to an annual tax bill of about $315 for the average homestead, which is valued at $285,152.

Photo by Larry D. Moore [CC BY-SA 4.0], via Wikimedia Commons

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