Commissioners order Central Health performance audit

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Independent audit would determine what healthcare services needy Travis County patients got in return for $280 million in taxpayer money given to UT Dell Medical School

The Travis County Commissioners Court last evening voted 5-0 to unanimously approve Commissioner Margaret Gomez’s motion to order that Central Health undergo an independent performance audit and pay for it.

In effect, this will initiate a revolution in financial accountability for an organization that has collected $2 billion from Travis County taxpayers since it was created in 2004. Much of that money has been distributed to a variety of providers through a nonprofit subsidiary whose records are not accessible under the Texas Public Information Act.

The scope of the work that will be detailed in a Request For Proposals, which will be issued to solicit auditing firms do the work, will be devised by a subcommittee composed of Commissioners Gomez, Ann Howard, and Jeff Travillion, the latter acting as an alternate.

Margaret Gomez
Margaret Gomez

In an interview this morning, Commissioner Gomez said the scope of work that was detailed in a draft order is probably okay. “We will see when we talk to the county attorney’s office,” she said.

The draft order calls for an independent third-party performance audit of not only the Travis County Healthcare District, aka Central Health, but its affiliates including its nonprofit subsidiary Community Care Collaborative; CommUnityCare, which operates clinics; and the University of Texas Dell Medical School, which to date has received $280 million from Central Health.

Chief among the audit firm’s responsibility is to review and analyze the healthcare services Dell Medical School has delivered to eligible patients through Central Health’s Medical Assistance Program.

The Austin Bulldog‘s investigative report published June 30th showed that University documents published online plainly state that the Dell Medical School has no intention of providing healthcare services to low-income patients in return for the annual payments of $35 million.

Testimony for an against the audit

Fourteen people addressed the Commissioners Court in public comments taken before the vote. The five who opposed ordering the audit all referred to the review that Central Health conducted with an outside consultant in 2018 and the fact that another such review was scheduled for 2023. They viewed the proposed performance as unnecessary and disruptive to Central Health’s work.

However, that review conducted by Germane Solutions and completed in 2018 was under the direction of Central Health itself. Those speakers did not acknowledge that it was not a performance audit and did not address what, if anything, Central Health’s patients were getting in return for the $35 million a year given to UT Dell Medical School.

The nine people who spoke in favor of ordering the performance audit were much more focused on the perceived lack of services provided to indigent patients by Dell Medical School and on Central Health’s accountability in general.

Gonzalo Barrientos
Gonzalo Barrientos

Retired State Senator Gonzalo Barrientos (D-Austin) talked about the enabling legislation he proposed to create the Travis County Healthcare District, aka Central Health. That legislation “made it clear that providing healthcare for the poor and indigent was the mission for Central Health…The audit requires the participation of everyone involved in meeting Central Health’s mandate,” Barrientos said.

The Bulldog’s research shows that in the 2003 session of the Texas Legislature, Barrientos coauthored Senate Bill 1905 with Jeff Wentworth (R-San Antonio) to provide the statutory authority that would allow voters to authorize establishment of the healthcare district. However, that bill failed to pass. Instead, Wentworth’s amendment to House Bill 2292 was accepted and details of SB 1905 were made part of that larger bill, which passed. Then, in the election of May 15, 2004, 55 percent of voters casting ballots approved. In the election of November 6, 2012, the same percentage of voters approved raising Central Health’s property tax rate by an additional 5 cents per $100 valuation.

Among the others speaking in favor of the performance audit were former Travis County Auditor Susan Spataro; NAACP Austin President Nelson Linder; Frank Ortega of LULAC District VII, which has issued a report critical of Central Health; attorney Bill Bunch, executive director of the Save Our Springs Alliance; and longtime political consultant Peck Young, who had been actively lobbying the commissioners for this action.

Peck Young
Peck Young

Young, who addressed the commissioners in morning comments, said, “We are not charging either malfeasance or misfeasance. We simply want a full public review of how Central Health has fulfilled its legislative and Austin voter mandate. We do not understand why Central health and its supporters have struggled against this simple request.

“As you have heard, a meaningful audit requires the participation of Dell Medical School, Ascension Seton and all of Central Health’s other partners to be meaningful. We are not attacking these entities, We are simply requesting their participation to get all the information that will give us a meaningful audit…simply to verify how…taxpayer funded organizations are spending citizen’s money. Why would they not want this audit to demonstrate how well they have been stewards of those funds?”

Photo of Ken MartinTrust indicators: Ken Martin has been doing investigative reporting in the three-county Austin metro area since 1981. His aggressive reporting twice garnered first-place national awards for investigative reporting. Both of those projects resulted in successful criminal prosecutions. His 2011 investigation of the Austin City Council triggered a 20-month investigation by the Travis County attorney that resulted in the mayor and council members signing deferred prosecution agreements to avoid being charged, tried, and if convicted serving one to six months in jail and forfeiting their elective offices. He’s been investigating and reporting on Central Health since 2018. See more on Ken on the About page. Email [email protected]

Who funds this work? This report was made possible by contributions to The Austin Bulldog, which operates as a 501(c)(3) nonprofit for investigative reporting in the public interest. You can help support this independent coverage by making a tax-deductible contribution.

Related documents:

th management response to Germane Solutions performance review, February 12, 2018 (7 pages)

Draft order of Travis County Commissioners Court requiring an independent, third-party performance audit of the Travis County Healthcare District (4 pages)

Germane Solutions contract, June 22, 2017 (17 pages)

Related Bulldog coverage:

Central Health critics ramp up pressure ahead of vote on audit, July 25, 2022

Commissioners to order Central Health’s performance audit, July 14, 2022

Central Health’s $35 million payments to Dell Medical School an unlawful ‘gift of public funds’ that exceed statutory authority, June 30, 2022

New documentary takes aim at diversion of indigent healthcare funds, November 15, 2021

Central Health $76 million of bonds for new real estate, September 1, 2021

Central Health plans $63 million headquarters, July 6, 2021

Central Health settles Wallace lawsuit, April 27, 2021

Former Central Health exec sues for $1 million-plus, November 5, 2020

When the Me Too movement collides with Black Lives Matter something’s gotta give, October 30, 2020

Central Health manager’s ethics questioned, September 21, 2018

Central Health sponsorships top $200,000, May 2, 2018

Central Health’s checkup delivered, February 14, 2018

Lawsuit challenges Central Health spending, October 18, 2017

Central Health financial policies hotly debated, September 29, 2017

Dining and shining on taxpayer dollars, March 30, 2018

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