Commentary: Travis County commissioners can protect taxpayers and poor

Travis County taxpayers generously voted in 2012 to raise Central Health Hospital District’s tax rate to fund additional medical care for our poor residents. This additional care included a medical school consistent with Central Health’s only mission by law to provide health care for the poor.

During the 2012 election, Central Health and Austin’s political leaders assured voters that Central Health would put $35 million a year toward the medical school to cover expanded indigent care. Central Health promised voters that $35 million would be permanently earmarked for services to needy patients by the medical school’s faculty and residents.

They have not honored their word.

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Central Health has given the University of Texas-Dell Medical School $105 million to date and is scheduled to give Dell $35 million more this month and every year thereafter. Based on UT-Dell payroll records, analysis shows that 83.6 percent of the school’s salaries has been paid for with Central Health funds. Of the 50 administrative personnel in the dean’s office, 41 are paid for completely with Central Health funds. The funds are paying for fundraising, communications, admissions, administration and business operations, which have nothing to do with care for the poor.

Based on repeated Public Information Act requests, UT-Dell has produced documents that show only $2.9 million in Central Health funds have been spent on health care. There are likely more health care expenditures, but Dell has produced no financial records as to its Women’s Health Pilot Project. This, however, probably amounts to only several million more dollars.

Because of this lack of accountability and transparency, the county auditor recently stated to the Travis County commissioners court that she needs the itemized expenditures by UT-Dell and other third parties with Central Health funds. She first asked for the documentation over a year ago; she has yet to receive itemized health care service records.

Going forward, UT-Dell intends to spend with no increased accountability over the next two years $32.6 million of Central Health funds on undefined “community health infrastructure development” and $61.6 million on “start-up costs to launch clinical services.” The specifics are unknown because there is no detailed agreement. We do know these expenditures are intended to serve the entire community — and UT-Dell — and not just the poor, as promised and as required by law.

As part of this $94.2 million, UT-Dell is projected to spend $15.2 million for faculty “transformative” health care modeling and redesign projects for the entire community. UT-Dell also intends to commercialize and profit off selling these models, and not share any profits with Central Health, although Central Health paid for the models. A nice gift for Dell and a bad deal for taxpayers. And to top it off, UT-Dell intends to charge Central Health’s patients for their care.

The commissioners court can end this abuse of taxpayers and the poor today. Based on the court’s financial oversight authority over Central Health, it can impose financial and accounting procedures and controls over its expenditures. Our citizen’s group, HEALTH, has asked the court to impose these basic, good government transparency and accountability requirements:

• Central Health’s funds are spent in compliance with state law — and particularly the Texas Indigent Health Care and Treatment Act.

• Central Health and its providers maintain appropriate service and performance-based records.

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• Central Health funds are allocated properly to ensure Central Health pays for only the poor’s health care and not for other patients or unrelated services.

• Central Health and all its third-party vendors, including Dell Medical, have a complete performance audit of all its transactions.

It is beyond time the court did its job and stop Central Health, UT-Dell and others from abusing Travis County’s poor and taxpayers.

Lewis is a longtime Austin attorney and public interest advocate.

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