As Central Health, our countywide public health care district for the poor, recently celebrated the groundbreaking of two replacement clinics in eastern Travis County, Austinites might want to hold back their applause. Health Equity First, the collaboration of local LULAC and the NAACP, has released a troubling new report detailing eight major Central Health red flags that suggest serious financial and operational mismanagement. The report (which can be found at healthequityfirst.com/red-flag-report) questions whether Central Health is serving the poor or the taxpayers well.
This issue will come to a head in the coming weeks as we call on county commissioners to order an independent and comprehensive performance audit of Central Health. County commissioners have financial oversight authority over Central Health and the community needs independent and comprehensive answers to these serious issues.
Central Health’s budgets are misleading to the point of appearing fake. For example, he recently stated that “ninety-seven percent ($491 million) of Central Health’s $506 million fiscal year 2022 budget is dedicated to providing health care to people. low income”. In reality, only 20% of Central Health’s budget is actual health care services. His alleged $491 million in “health care benefits” includes items such as travel, printing and copying, telephones, utilities, insurance, marketing, community relations, legal fees and other administrative expenses that are not generally considered health care.
His budget also shows that $298 million of his alleged $491 million in “health care benefits” is actually just sitting in a reserve account for unexplained future contingencies. These reserves have grown from $36 million to $298 million over the past five years and now represent 59% of its budget. Unused provident funds in a bank account and miscellaneous administrative expenses should not be presented to the public as health care for the poor.
Along with its dodgy budgets, a performance audit is essential to restoring community trust in Central Health. When voters approved a tax increase for Central Health in 2012, its leaders repeatedly promised that “…a specific amount of the estimated $54 million per year in new tax revenue – $35 million – would be permanently assigned to services provided to needy patients by the faculty and residents of the medical school, who are physicians-in-training,” as reported by the Austin American Statesman on October 14, 2012. Similar promises were made in other articles in the Statesman, The Austin Chronicleand KUT.
Central Health broke its word. To date, county taxpayers have paid the medical school $280 million, but there are no records showing that health care was provided to the poor for those funds. The community has asked repeatedly for years about the number of patients seen and the care provided. No.
Central Health is quick to claim that there is no need for a performance audit because it is audited financially every year, but that is misleading. Financial audits do not check whether Central Health misclassifies budget items or spends taxpayers’ money inefficiently, inefficiently, or outside of its mission. As for the audit scheduled for 2023, Central Health Claims will assess its performance, it should be noted that Central Health undermined the integrity of the last performance audit conducted in 2017 by insisting on audit control. This effectively prevented the public from receiving independent and trustworthy analysis. The main question the community wanted answered in 2017 was shrewdly dodged by its manipulated audit: how much of its then $105 million in medical school funds went to health care for the poor. ?
Frankly, Central Health cannot be trusted to self-audit. Our County Commissioners should order a full, independent performance audit now. We deserve reliable answers to two basic questions: How much health care did the poor get from medical school for $280 million? Is Central Health spending taxpayer dollars efficiently, equitably, and consistent with its mission to the poor? That shouldn’t be too much to ask.
Nelson Linder is president of NAACP Austin and Frank Ortega is director of Texas LULAC District VII. Their organizations recently jointly created the Health Equity First project. The project aims to raise awareness of the need for increased transparency and accountability in public hospital districts in Texas, such as Central Health, so that they better meet the health care needs of the poor.