Commissioners approve Central Health performance audit

At long last the Travis County Hospital District, better known as Central Health, is being brought under a microscope that will give the Travis County Commissioners Court a much tighter grip on how the agency is managed.

Commissioners voted unanimously Tuesday to approve a contract with Mazars USA LLP to conduct an independent performance audit of Central Health. The audit will cost $854,200, initially paid for by Travis County but to be reimbursed by Central Health.

This item was sponsored by Commissioner Jeff Travillion, who noted that performance audits were initially required for state agencies through the efforts of John Sharp, who served as State Comptroller from January 1991 through December 1998. Travillion said these audits had brought about billions of dollars in savings.

Travillion said the audit will answer questions about whether Central Health is on the right path and doing what it is supposed to be doing. He said he wanted to know if delivery models are in place to be sure people are being served.

“We want to see not just what we’re spending but what are we getting for what we are spending,” he said.

Commissioner Brigid Shea, who was working from home and not on the dais, noted that the scope of what Mazars will do is not like the annual financial audits and will be done by an independent third party.

“We need a thorough audit to identify what needs to change and what can be improved,” she said. “We have to have an independent deep dive to answer questions raised by the public over the years.”

Commissioner Ann Howard said, “I want to make sure we’re going to read this audit, study it and talk about it. I don’t want it going to waste…It’s important to take it seriously and be committed to doing the work with Central Health on whatever comes back” in the audit.

Central Health honcho comments

Mike Geeslin, president and CEO of Central Health, said he was looking forward to speaking with the Mazars USA auditors about a number of issues, which he did not list.

“We think the review is essential to how we operate,” he said, and should provide a “great baseline” for the agency’s work going forward.

He said Central Health continues to work on a plan to directly provide healthcare services, based on a community needs assessment that was presented in 2022.

That would constitute a radical change from the way the agency has conducted business since being formed in 2004, acting as payor for services provided by healthcare partners. Geeslin added that Central Health will continue to work with partners as well.

Although Geeslin did not mention it in his statements to the Commissioners Court, Central Health is currently involved in lawsuits with Ascension Seton with a goal of taking over the teaching hospital.

Public support for the audit

Those speaking in favor of the contract before the commissioners voted included attorney Fred Lewis, who said regular audits don’t address whether Central Health’s money is being spent well.

As the Bulldog reported, he said that depositions taken in a lawsuit against Central Health prove that UT Dell Medical School has no records to show how much healthcare services have been delivered to indigent patients in return for the $315 million received from Central Health.

“In 40 years of practicing law I’ve never seen such a lack of accountability,” Lewis said

Peck Young addressed the commissioners on behalf of NAACP Austin and LULAC. He said the scope of work in the contract will provide comprehensive answers to questions raised over spending.

“The question is are we going to have sufficient transparency? This proposal will give you the answers needed to do the necessary reforms to take care of the sick and injured.”

Retired State Senator Gonzalo Barrientos once again reminded commissioners that he had a hand in 2003 legislation that enabled the public vote to establish the hospital district.

Regarding the performance audit, he said, “The sooner we do this the more people we can help get out of pain and anguish.”

Authorized property purchase

After a lengthy closed-door executive session, the Commissioners Court voted 3-1 (Commissioner Margaret Gomez opposed, Shea absent) to approve Central Health’s purchase of property “not to exceed fair market value.” Also approved in that motion was an order to authorize publishing notice of intention to issue approximately $100 million in certificates of obligation to purchase and renovate a Precinct 1 property and to renovate the Rosewood-Zaragosa property.

The location of the property is not yet public information, and will be announced when the deal is finalized, said Ted Burton, chief communications officer for Central Health. He provided a press release indicating the property is existing office space located in northeast Austin. The agency plans to convert the space into a new medical complex serving low-income and homeless people.

Certificates of obligation of about $90.5 million will pay for that property, and another $9 million in certificates will fund the renovation of the Rosewood-Zaragosa clinic.

The press release states the northeast Austin site will be opened in 2025, to include 50 “respite care beds for people experiencing homelessness, where they can heal and recover while receiving medical attention….”

Other Central Health news

As the Bulldog reported April 4^th:

The agency could be radically transformed if Senate Bill 2332, authored by Senator Lois Kolkhorst (R-Brenham), should that legislation be enacted.
The longstanding lawsuit, Birch et al v. Travis County Healthcare District et al (Cause No. D-1-GN-17-005824), which seeks to halt Central Health payments of $35 million a year to fund UT Dell Medical School, may be concluded this summer.

Trust indicators: Ken Martin has been doing investigative reporting in the three-county Austin metro area since 1981. See more on Ken on the About page. Email [email protected].