New documentary takes aim at diversion of indigent health care funds

Why is Central Health financing the Dell Medical School?

A new short documentary by Austin filmmaker Steve Mims questions why a big portion of taxpayer funds collected for the care of the poor in Travis County are instead being used to fund the operations of Dell Medical School.

Through Central Health, the county hospital district, Travis County taxpayers fork over $35 million per year to Dell Medical School in perpetuity. This arrangement dates to 2012, when voters approved an increased Central Health property tax, “including support for a new medical school.”

The problem with the arrangement is twofold, according to the film, which the Bulldog viewed at a pre-screening November 12. First, it’s illegal. Neither the state constitution nor state law authorize a county hospital district to fund medical training.

Second, it’s bad policy. It diverts resources earmarked for indigent healthcare to an elite university, while saddling Travis County taxpayers with a burden that the state as a whole should share, or which the University of Texas System could pay for. The film points out that the latter has the second-largest endowment in the country at an estimated $31 billion.

The film, Inquest: An Examination of Central Health, points to the role of powerful interests in orchestrating this arrangement in 2011-2014, including the chamber of commerce, which viewed a medical school as important in a push to diversify the Austin economy by bolstering the city’s credentials as a center for biomedical research. After backers failed to secure state funding for the new medical school, they turned to local sources of funding, despite the lack of express statutory authority for such a setup.

The film features interviews with a variety of stakeholders with knowledge of these events, including former State Senator Gonzalo Barrientos, NAACP Austin President Nelson Linder, former Central Health board member Frank Rodriguez, and lawyers Fred Lewis and Robert Ozer.

Through archival footage, former State Senator Kirk Watson also features prominently in the film as a powerbroker and champion of the new medical school. His role is particularly worthy of scrutiny in light of recent reports that he’s seriously considering another run for Austin mayor, a position he held from 1997 to 2001.

Inquest isn’t the first time that critics have aired questions about Central Health’s finances. For years, in fact, they’ve raised objections to the Dell Medical deal, including both in the press and in court, where a long-running lawsuit is still pending. But Inquest offers the most accessible, hard-hitting treatment of the matter to-date.

The filmmaker told the Bulldog in an interview, “I think that it’s possible to make a film about policy that’s not tiresome, that’s really watchable and that normal people can sit down and watch and not be bored with, and come away understanding something.”

Mims added, “I’m not a journalist but this is a weird form of journalism of some sort…I think there’s a lot of room for people to take this kind of thing on. The way we’re rolling this out is we’ll have one public screening and then it will be on YouTube after that. That was impossible let’s say 15 years ago. The idea that you can now make essentially an investigative piece independently and put it up and allow people to see it is one little part of the solution to the problem that we have of underfunded journalism. Because this is a serious thing and it’s hard to get people to pay attention to it.”

Mims has a background making music documentaries and commercials, as well as a 2011 film about a death penalty case. He forayed into local policy with a 2019 short film, Zoned Out: The Legacy of CodeNEXT, and into state politics with an hour-long 2018 film, Run Like the Devil, which documented the senate race between Ted Cruz and Beto O’Rourke. Mims lectures on film at the University of Texas at Austin.

For its part, Central Health denies the illegality of its funding to Dell Medical School. Attorneys for the hospital district wrote in a court filing that the funding is “part of Central Health’s efforts to provide an integrated and innovative health care delivery system today and for the future health care needs of the growing community.”

The funding supports “the recruitment of faculty, residents, and medical students who will provide the highest quality medical services in Travis County.” As to the statutory basis for the setup, Central Health’s attorneys pointed to a provision of law that gives hospital districts contracting authority “to provide or assist in the provision of services.”

Lewis, who is an attorney for plaintiffs in that case as well as a co-producer of Inquest, retorted, “You can’t contract to do something illegal. You cannot contract to spend state funds contrary to statutory authority. Hospital districts are very limited in what they can do. And it’s limited to medical care.”

In a factsheet on its website, Central Health says that Dell Medical allocates the majority of Central Health funding for “academic medicine departments and other initiatives, including faculty salary support; the infrastructure for clinical, education and research programs; and community health initiatives.”

The lawsuit, Birch et al v Travis County Healthcare District, remains in the pre-trial discovery phase. Plaintiffs are seeking a court order enjoining Central Health from spending funds on items not authorized by statute. However, the case was filed in October 2017 and has been delayed by a variety of factors, including the pandemic and the death of one of the plaintiff attorneys. “We’re ramping back up,” Lewis says. “I’m hoping that by the end of the spring it can be heard on motions.” After that, an appeal could drag it out for years longer.

In the meantime, critics have taken their case to the court of public opinion. Inquest will premiere November 17 at the Austin Film Society at 6259 Middle Fiskville Road. Tickets for the event are free and may be obtained by registering here.

View the documentary: