First progress and then postponement as Central Health returns to Commissioners Court

The Travis County Commissioners Court on Tuesday signed off on Central Health’s proposed $238 million budget for Fiscal Year 2017-18, but came up short on reaching an accord between the hospital district and activists who demand more transparency from it.

State law requires the court to approve the budget created by staff at Central Health, an otherwise autonomous jurisdiction with its own board of directors and taxing authority.

That board approved the proposed budget at a meeting on Sept. 13. The new tax rate of 10.74 cents per $100 of taxable land value represents a nominal decrease from last year’s rate of 11.05 cents. However, rising property values mean it’s effectively a 4.5 percent increase and the owner of an average home worth $305,000 will pay an extra $12.50 on their tax bill next year.

By comparison, the county’s own proposed budget features only a 3.42 percent increase over the effective tax rate. Commissioner Gerald Daugherty expressed dismay over the difference between the two and also called for the district to find some resolution with attorneys Fred Lewis and Bob Ozer who have been doggedly critical of Central Health’s partnership with Seton Healthcare Family and the University of Texas’ Dell Medical School.

Both men have made frequent appearances at Commissioners Court in the past year as they have lobbied to reform the financial policies Central Health abides by.

“Quite frankly, I think that this has been a little preoccupying to y’all,” Daugherty told Central Health CEO and President Mike Geeslin. “That doesn’t help you.”

Both Lewis and Ozer attended Tuesday’s meeting and urged the court to delay approval of the budget, or at the very least approve it only for a matter of months rather than the full fiscal year. Lewis once again took aim at the $35 million annual payment Central Health makes to the medical school, which he suggests has not been spent on the district’s existential mission of providing health care to the county’s indigent residents.

“Considering the fact there’s been a lot of questions about how the money has been spent in the past, I think the financial controls need to be in place before you approve the budget,” Lewis said.

Central Health and UT officials have long maintained that the annual payments are helping to create a brand-new system of health care in the county and that the effort is already showing fruit in the implementation of new clinics and initiatives.

Commissioner Margaret Gómez, meanwhile, criticized the district for moving too slowly to expand service into low-income neighborhoods east of I-35. She said residents there are losing patience.

“I know where that frustration and that anger comes from because you pay for something and if you’re not getting the service, you’re going to be pretty upset,” said Gómez.

The court ultimately approved the budget and tax rate on a 4-0-1 vote, with Gómez abstaining.

After attending to other business and breaking for lunch, County Judge Sarah Eckhardt resumed the voting session in the afternoon and laid out an item that would have revised Central Health’s financial policy. Although she initially indicated hope that the court could approve the changes right then and there, the discussion bogged down once again over confusion about the proposed amendments – many of which were suggested by Lewis – and by Geeslin’s request to bring them before his board of directors on Wednesday night.

One hour after taking up the item, Eckhardt postponed the action to the court’s Oct. 3 meeting.

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