Travis County Commissioners Court

 Critic: Proposed Financial Policies ‘Pointless’

Commissioners Court will vote tomorrow
on Central Health financial policies for FY 18

by Ken Martin
© The Austin Bulldog 2017
Part 3 in a Series
Posted October 9, 2017 1:14pm

The Travis County Commissioners Court is scheduled to vote tomorrow on financial policies that Central Health must follow in FY 2018, which began October 1.

County Judge Sarah Eckhardt had been adamant at the September 19 meeting that she wanted a vote October 3, saying, “A perpetual conversation is not healthy.” At the October 3 meeting, however, she said, “Although last time I said I would take a vote today, I’m going back on that because we’re received so much new information and we’re drafting.”

The new information to which she referred were two new drafts prepared by Assistant County Attorney John Hille. He handed the drafts to the commissioners just as they took up the matter of Central Health’s financial policies at 1:45pm—nearly four hours after the scheduled time of 10am.

Another piece of new information was an October 2 letter to the judge and others from Patricia C. “Patti” Ohlendorf, vice president of legal affairs for the University of Texas at Austin.

Ohlendorf, who attended the October 3 meeting of the Commissioners Court, seeks to preserve the $35 million a year the university gets for Dell Medical School through the Affiliation Agreement it has with Central Health and the Community Care Collaborative.

The university received $105 million through FY 2017. The Affiliation Agreement calls for additional $35 million per year in perpetuity but contains no requirement for accountability for providing healthcare services for indigent, uninsured or underinsured patients. The medical school’s own reports indicates most money has been spent on salaries.

University resisting accountability

 Central Health Financial Policies Hotly Debated

$185 million given to Dell Medical School and
Seton, with little to show for indigent healthcare,
and $55 million more is on the way in FY 2018

by Ken Martin
© The Austin Bulldog 2017
Part 2 in a Series
Posted Friday September 29, 2017 2:12am
Correction posted September 29, 2017 8:43am (see footnote)

The challenge for Central Health is how to improve accountability for mega-millions of dollars it doles out to other agencies.

The chief beneficiaries of this funding are the University of Texas at Austin Dell Medical School and the Seton Healthcare Family.

Together they will have received $240 million through the FY 2018 from taxes levied by Central Health. State law dictates those funds may only be used to provide indigent healthcare services.

Yet Central Health, the agency created by voters in 2004 to provide healthcare services for the uninsured poor people of Travis County, has little proof of how much of that $240 million was actually used to provide indigent healthcare—services that by law is Central Health’s sole responsibility.

A showdown over proposed new financial policies that could increase accountability and help to repair this institutionalized breach of fiduciary responsibility is scheduled for the Commissioners Court meeting of October 3.

Central Health’s chief obstacle in implementing changes in financial policies and accountability is that the agreements the agency struck with these two major partner organizations—in 2013 with Seton, in 2014 with the University—do not require an accounting of how much indigent healthcare services they provide.

If the Commissioners Court orders Central Health to adhere to the proposed tougher financial policies, that may require renegotiation of those longstanding agreements and a major realignment of how Dell Medical School and Seton are allowed to use the largesse received from taxpayers.

The budget approved by the Travis County Commissioners Court September 19 provides $237.8 million for Central Health’s operations during FY 2018. The agency will levy a tax rate of 10.7385 cents per $100 property valuation. This will result in a tax bill of $327.71 for the average homestead valued at $305,173.

Out of those funds Dell Medical School will receive $35 million and Seton will receive $20 million. That $55 million equates to more than 23 percent of the entire Central Health budget.

Persistent advocates for accountability