Central Health concerns continue to stymie Commissioners Court

On Tuesday the Travis County Commissioners Court once again failed to reach a compromise that could satisfy all parties involved in the seemingly interminable controversy over transparency at Central Health.

Before the court was a review of the new financial policies it imposed on the health care district to guide its operations in the current fiscal year.

That policy was created after Central Health came under fire – primarily from attorneys Fred Lewis and Bob Ozer – over its agreement to contribute $35 million each year to the University of Texas’ Dell Medical School.

Among the various stipulations of the policy, Central Health committed to creating new internal controls over its financial activities, providing the County Auditor with monthly financial statements and undergoing an annual financial audit conducted by a third-party firm.

On Tuesday, CEO and President Mike Geeslin requested three amendments to the policy, including one that would remove Central Health’s obligation to provide financial statements for Capital City Innovation, a partnership between the district, medical school and Seton Healthcare Family that, according to a UT press release, is “part of a vision by the community to develop a health innovation nexus that improves the lives of Central Texans.”

In a letter sent to the court before the meeting, Geeslin wrote, “Central Health requests this change be made because, although Central Health is a founding member of the CCI, it is not the controlling member and does not have the ability to unilaterally direct the nonprofit organization to provide the County Auditor with an annual audit in accordance with the requirements outlined in the financial policies.”

Geeslin also asked to remove a portion of the policy that referred to a memorandum his predecessor, Patricia Young Brown, and Central Health Chair Katrina Daniel had created that indicated the district’s intent to undergo a thorough performance review. Geeslin explained that its inclusion in the policy is redundant since the district is already undergoing that review.

Cynthia Valadez, a member of the district’s board of managers, complained that Geeslin never ran the letter by her or her colleagues.

“We got a copy of this letter yesterday and we had a meeting last Wednesday,” she told the court.

County Auditor Nicki Riley also aired her grievances.

“What’s been the problem all along, because of the way Central Health was created, it’s a holding company, if you will, and makes large payments to other companies which we have no access to and the financial policies do not extend to them,” Riley said, referring to its agreements with Seton and UT and the various spinoff nonprofits created by the partnership, including Capital City Innovation, Sendero Health Plans and CommUnityCare Health Centers. “I want to know what they’re spending the money on. I think that’s a fair request and that’s the problem all along.”

Supporters of Central Health have argued that it is working with Dell Medical School and Seton to transform health delivery within the community and that the process is currently in its nascent phase. The $151 million the district has transferred to the school so far has been partially used for administrative salaries to help get the program off the ground.

“That was what I think that (state Sen.) Kirk Watson had in mind,” Commissioner Gerald Daugherty said. “I think that’s what the people that supported the creation of the med school in conjunction with Central Health, I think that that’s what they thought they were going to do.”

For his part, Lewis, the outspoken critic of Central Health’s operations, offered five amendments to the financial policy. Lewis’ plan would require the district to explicitly pledge to comply with state statute, maintain an exhaustive array of records for a minimum of five years, allow the County Auditor access to those records, ensure that any money spent on collaborative projects be spent in pursuance of the district’s mission to provide health care for the indigent and undergo a full third-party performance audit along with both its spinoffs as well as Dell Medical School and Seton.

An hour after the discussion on the item had started, consensus on the dais appeared out of reach and County Judge Sarah Eckhardt decreed that the court would bring the policy back for consideration no sooner than the Sept. 12 meeting. She also said that she would take Lewis’ suggestions “under advisement.”

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