A sweeping agreement, with an initial term of 25 years, will establish a new health care delivery system for the needy in Travis County and deepen ties between Central Health, the public hospital district, and the private, nonprofit Seton Healthcare Family.
That master agreement, with options to renew every five years, gives Seton new powers to make decisions about managing the care of patients who Central Health serves through its affiliated CommUnityCare clinics.
Those powers will come through a nonprofit — the Community Care Collaborative — that Seton and Central Health are creating to serve 50,000 low-income Travis County residents. Seton must contribute $20 million a year for five years to help finance that system and increase services in primary, specialty and behavioral health care.
Seton also is planning to finance, build and own a $250 million teaching hospital to replace University Medical Center Brackenridge, the state’s oldest public safety-net hospital, now owned by Central Health. Seton has been operating it since 1995 under a 50-year lease.
Central Health officials provided an overview of the master agreement to its board Wednesday night and plans to post it, along with three related agreements, at its website, www.centralhealth.net, on May 24. The Central Health board will discuss the related agreements May 22 and is expected to approve all four on May 29, giving the public just five days to read documents described as dense, long and complex.
“This is the only public hospital we own,” said Isabel Rios, one of four residents who spoke to the board Wednesday night. “We need more time to review” the documents, she said.
Similar comments came from others, along with concerns about the future of women’s health care under Seton, which cannot provide birth control services as a Catholic-owned health system.
When the new teaching hospital opens in 2017, UMC Brackenridge will close and Seton will operate the new hospital under its ownership. Central Health will sub-lease to Seton the land it sits on.
The University of Texas owns the land now and will lease it to Central Health under a long-term agreement. That will give Central Health the control it needs to protect taxpayers, Central Health officials said.
As owner of the new hospital, Seton must take “reasonable actions,” officials said, to maintain the highest level trauma center to serve the region, as UMC Brackenridge does now. The new hospital also must function as “part of the safety net” for the community and be the teaching hospital for a new UT-Austin medical school.
And Seton must continue the same level of services it provides now for the same price.
If a religious issue arises, Central Health and Seton will work together to transition the services to Central Health or other health care providers. Right now, the non-Catholic St. David’s Medical Center performs sterilizations to patients who are delivering a baby and request the service. That arrangement is expected to continue.
In addition, CommUnityCare provides sterilizations to patients seeking them.
The agreement between Seton and Central Health can be terminated if either party breaches the contract or becomes financially insolvent. Depending on the circumstances, Central Health can buy the hospital and operate it or sue Seton.
Seton is awaiting final approval, expected in June, from its parent, Ascension Health, to build the hospital.
The agreements are the result of Central Health’s participation in the state’s Medicaid overhaul, which is aimed at reducing indigent patients’ health costs. Central Health and Seton anticipate a windfall of federal dollars to help support the collaborative and a medical school in Austin.
To maximize the federal match, Central Health received voter approval in November for a 5-cent property tax rate increase that will bring in an additional $54 million a year and up to $76 million in federal matching dollars.
Central Health will control three of the five board member seats on the collaborative, with two appointees chosen by Seton. It will be overseen by the boards of Seton and Central Health, which will approve the annual budget, set purchasing policies and approve contracts worth more than $100,000.
Texas law doesn’t require the collaborative to meet publicly, but its records are open. Officials expect six meetings a year to be open to the public.
The public can comment on the agreements at meetings at 5:30 p.m. May 22 and May 29 at 1111 E. Cesar Chavez St.