Photo by Patricia Lim/KUT News.Central Health's new budget proposal continues the rollout of a plan to fund more direct services and clinics.
Monday, August 26, 2024, Olivia Aldridge, KUT
Central Health leaders on Wednesday tentatively approved an $884 million budget for the 2024-25 fiscal year, which will go before the Travis County Commission in September for a final vote.
Central Health, Travis County's public hospital district, which is primarily responsible for covering health care costs for low-income and poor residents through tax revenue, voted at its Wednesday meeting for a new tax rate of 10.7969 cents per $100 of assessed value, which will increase the average local homeowner's taxes by $66.
What is included in your budget?
Central Health expects to spend more than $353 million on health services this year, including a record $60 million for services Central Health provides directly at its clinics and other facilities.
Until recently, Central Health only partnered with other organizations to provide health care services, including Ascension Texas, which operates Dell Seton Medical Center, a local hospital that serves poor and low-income residents. But as part of Central Health's Healthcare Equity Plan, the hospital district will gradually invest in building more clinics and providing more direct health care services over the next few years.
Central Health projects the Health Care Equity Plan will cost about $700 million over seven years. Most of the funding will come from the district's substantial reserve fund, which Central Health will gradually draw down. This year, Central Health plans to draw down $98.3 million, leaving about $396 million in the fund.
The health department has budgeted to hire about 386 more full-time staff next year and plans to fund new specialist services such as rheumatology and endocrinology, as well as increase investment in medical respite care, which provides space for people experiencing homelessness to recover after hospitalization.
“I'm very proud of many aspects of this proposed budget, particularly the medical respite program, which I've always thought was very important to me,” said Ann Kitchen, chair of Central Health's board of directors. “The approach that Central Health is taking to really address an issue that's very challenging for our community, particularly for people of color, is incredibly forward-thinking.”
In early August, Central Health voted to renovate the former Austin Children's Hospital and build a medical respite facility downtown, and the proposed budget includes $11 million for the project.
Issues
The board voted to bring forward the overall budget, but some board members expressed concerns about a budget line item that goes toward paying the University of Texas.
In addition to contracts for certain medical services provided by the university, Central Health pays Dell Medical School $35 million annually under a ballot proposition approved by voters in 2012 that allowed Central Health to increase property taxes to support the development of a new medical school “consistent with the mission of Central Health.”
The annual payments to Dell Medical School are the subject of a lawsuit by a group of taxpayers who argue the funds are being properly used for research and administrative costs, rather than for medical expenses for poor residents.
Board member Cynthia Valadez echoed those concerns, voting against specific areas of the budget that committed funding to the University of Texas at Austin and the University of Texas System. Manager Shannon Jones abstained from those votes, and Manager Eliza May abstained from the vote regarding the University of Texas System.
“I want the University of Texas to understand that we need to come after them and hold them accountable for the tax dollars that they take from us because we believe they are targeting the poor and we just need to make sure that they are,” Valadez said.
During a meeting in early August, Valadez criticized the University of Texas' decision to fire employees connected to diversity, equity and inclusion efforts in order to comply with Texas law.
“We want to have a discussion as a board about why we continue to contract and pay people who are not philosophically aligned with our mission,” she said.
Next
Because Central Health's board is appointed, not elected, its budget and tax rates also must be approved by county commissioners — a process that became controversial last year when Travis County leaders pressed Central Health about its budgeting practices.
Central Health is scheduled to present a proposed budget to the commission on Sept. 12, ahead of a final vote on Sept. 17. In the meantime, the county will also hold a public hearing to review a long-awaited independent audit of Central Health's finances. That hearing is scheduled for Tuesday, Aug. 27.
This story was produced as part of a reporting partnership between The Austin Monitor and KUT.
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