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Commissioners approve $95 million Healthcare District budget

Wednesday, September 17, 2008 by Kimberly Reeves

County Commissioners passed the Travis County Healthcare District’s $95.2 million budget on Tuesday morning over the wishes of four North Austin neighborhoods that oppose the construction of a clinic near the North Burnet/Gateway area.


The healthcare district’s budget is fairly lean on increases. Of the $5.5 million in additional spending in the budget, $4.2 million will go to additional services. The district also is pushing forward with a capital campaign, opening a clinic on William Cannon in South Austin; adding children’s wellness services in Del Valle; and leasing space to provide an urgent care alternative to Brackenridge’s emergency room services.


The crown jewel of the healthcare district’s expanded services, however, will be the replacement of the antiquated Northeast Clinic with a new district-owned $18 million facility on land near the intersection of Braker Lane and North Lamar. That has drawn fire from neighbors in four local neighborhood associations, who say the location makes no sense to serve clientele and would be better placed near the intersection of US 183 and Lamar Boulevard, in proximity to East Austin and public housing projects.


North Park Estates Association President Walt Esquivel – who pointed out that he was Hispanic — made a passionate defense of putting the clinic in Central North Austin, noting a lack of input from the community, no public oversight and a facility that would be better placed closer to the people who used it. Esquivel and Françoise Luca questioned claims by the district that the clinic was well placed for current clinic patients.


Clarke Heidrick, speaking on behalf of the board, told the commissioners it would be irresponsible to stop and restart the siting process on the Northeast clinic. The opportunities for input were ample, Heidrick said. The needs to serve more people, and quicker, are apparent and immediate. Even moving at this pace, the clinic would not be open until, possibly, late 2010 or possibly 2011.


“And I think what you’re hearing from these people – and I respect their view – is that it really is not about East Austin,” Heidrick said. “It’s about the fact that they do not want this project at that particular location, and I think it has to do with the mission that we have, and that they do not want people that come to the clinic to be in their neighborhood. It’s not about East Austin.”


Esquivel had presented Commissioner Sarah Eckhardt’s office last week with census data that he said indicated the need for the health care district’s services were in East Austin and not anywhere near his neighborhood. Nor were health care opportunities considered a problem, according to federal data he pulled up on health care providers.


Travis County Healthcare District CEO Trish Young, however, disputed that claim, saying that the district had carefully surveyed its existing information and found that 60 percent of the clients served by the Northeast Clinic would be within 4 miles of the new clinic location. The surrounding neighborhoods also were aging, meaning that the number of people in the area accessing Medicare was increasing. 


Neighbors had suggested delaying the clinic and passing the budget, but the County Attorney’s office said the decision would have to be an up or down vote on the full budget and the tax rate. The tax rate for the coming year would be 6.79 cents per hundred-dollar valuation, a slight increase for the owner of the average home in Travis County but less than the tax rate that initiated the district.


County Judge Sam Biscoe said the county had to move forward with the budget, with the understanding that commissioners had no right to a line-item veto.


Commissioner Ron Davis abstained from the vote because of family employment but did not hesitate to note that concerns in the area were limited to four neighborhoods. Eckhardt drew a firm line in the sand on the issue, saying that everyone she had talked to – opponent or supporter – agreed that access to health care options needed to grow. Travis County has a large uninsured population and an aging population, she noted.


“Some people will not be happy with where we’re leading,” Eckhardt said. “But I have reviewed the process, and I have reviewed the data, and I’ve reviewed the outside data provided to me, to satisfy myself that there was no gross negligence on the part of our board members that this body appointed, and I found no gross negligence.”


Reasonable minds can differ on the data, but the base census data provided by Esquivel only corroborated the health care district’s assessment of need.


“I have also reviewed the external process, and I agree with the neighbors that it was not as transparent as it could have been, and that the external process of engaging the neighbors was late,” Eckhardt said. “It has been robust since it was initiated, but it was late. However, we cannot allow the perfect to be the enemy of the good here. This is a good process and it is a good proposed location. I do wish that it had been more transparent and the neighborhood conversation had been more robust earlier, but the process and what has come out of the process is good, and does serve what we all recognize as our goal.”


The final vote on the budget and tax rate was 4-0-1, with Davis abstaining.

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