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County and Central Health eye reforms

Thursday, October 13, 2016 by Caleb Pritchard

The Travis County Commissioners Court could soon expand its oversight of Central Health in what would be the first significant revisions to the governing financial policy since 2008.

According to a draft the court approved on Tuesday, the hospital district’s nonprofit spinoffs would have to conduct annual audits and provide the results to county officials.

The draft identifies four separate entities: Sendero, which provides health insurance plans; CommUnityCare, which operates clinics across the county; the Community Care Collaborative, Central Health’s partnership with Seton Healthcare Family; and Capital City Innovation, the nonprofit established “to foster the development of an Innovation Zone” downtown.

In addition to the audits, most of the nonprofits would be required to submit monthly financial statements. CommUnityCare would submit its statements every quarter.

The promise of expanded oversight comes in the wake of criticism of Central Health raised by the League of United Latin American Citizens and other activists, including attorney Fred Lewis.

The informal coalition asked the court to use its ability to reject Central Health’s proposed budget for Fiscal Year 2016-2017 unless the district agreed to certain reforms aimed at increasing transparency over its operations.

Key among Lewis’ complaints is the lack of detailed accounting for the $35 million in property tax revenue and federal grants that Central Health distributes each year to the University of Texas Dell Medical School via its partnership with UT and Seton. The district began those disbursements three years ago.

On Tuesday, Lewis told the court, “To spend $105 million that’s supposed to go to indigent health care with no documentation is, frankly, an abdication of their supervisory authority and, frankly, means that we have no idea as we sit here today what the $105 million was spent on.”

The district has maintained that the medical school will increase the quality of local health care for the entire community, including indigent residents. However, in a nod to increased transparency, Central Health CEO Patricia Young Brown told the court in a memo sent on Monday that the district is preparing to hire a third-party firm to take a closer look at its operations.

The review will focus on Central Health’s planning and budgeting, financial transparency and reporting, and its organizational governance, Young Brown wrote.

She added that the district has initiated talks with the medical school “to develop a method of review” for the yearly $35 million paid to the school. According to Young Brown, “As these conversations conclude, we expect to implement a process that ensures accountability to the community.”

Young Brown’s memo indicates that the district will release a request for proposals in the coming weeks for interested firms to respond to. She explained that she recommended to Central Health’s board of directors that it “expedite” the process in light of her recent announcement that she will retire at the end of the year.

Central Health critics, including Lewis, have demanded that any third-party firm handling a review of the district’s operations be commissioned by the Commissioners Court or another independent body.

On Wednesday, district spokesman Ted Burton told the Austin Monitor, “The board of managers is the most familiar with the business needs of the organization, and is in the best position to identify the best, most appropriate firm to review Central Health’s performance. Of course the firm and its performance review will be shared with the public.”

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