Commissioners pass health district tax increase but plan increased scrutiny

On their second attempt, the Travis County Commissioners Court voted 4-1 to approve a tax increase and 3-1 to approve the 2024 budget for the county health care district.

The votes increase the tax rate to 10.07 cents per $100 valuation. With rising home values, this will add about $56 to an average home’s yearly tax bill. Property tax revenue will increase from $281.6 million in 2023 to $312.4 million. The budget will jump from $628.5 million to $744.2 million.

Commissioners postponed a vote on the tax rate and budget last week amid questions about the district’s progress and priorities. Several speakers opposed to the tax increase noted that the district, known as Central Health, accumulated a $379 million contingency fund while low-income residents wait for clinics and services. 

The contingency fund grew rapidly in recent years as Central Health cut payments to Ascension Seton, claiming Ascension serves fewer low-income patients at Dell Seton Medical Center than its contract requires. After months of mediation, Central Health sued Ascension in January for breach of contract. Ascension countersued soon after and accused Central Health of planning to use the contingency fund to buy Dell Seton Medical Center.

Central Health board members and supporters deny this. They say the district will spend the contingency fund and tax increase on the district’s seven-year, $680 million Healthcare Equity Implementation Plan to repair and expand the county’s safety net. They point out that there is no plan in the budget to acquire a hospital.

”We have new clinics coming online, we have our specialty clinic coming online before the end of the year. We are actually performing a lot of the services our patients are asking for, but they need time to come to fruition,” Central Health Board Vice Chair Dr. Cynthia Brinson said.

Those testifying in favor of Central Health included representatives from People’s Community Clinic, Integral Care, the Black Men’s Health Clinic, Central Presbyterian Church and the Health Alliance for Austin Musicians, or HAAM. 

“I appreciate the strategic effort Central Health has put into serving lower-income individuals and families, including musicians,” said HAAM CEO Paul Scott. HAAM members received subsidized health insurance through Central Health subsidiary Sendero Health Plans.

Opponents included retired state Sen. Gonzalo Barrientos (D-Austin), who proposed countywide health care districts in 2003. A bill Barrientos co-authored failed but became part of a larger health care bill signed by the governor.

“My request to you, that I ask because of those who have been in touch with me for years since we passed this legislation: No more property tax increases at this point,” Barrientos said.

After hours of testimony for and against the tax increase, Precinct 4 Commissioner Margaret Gómez – who has argued that Central Health’s progress is much too slow – made a motion to table it. Her motion was not seconded, and commissioners instead moved to discuss the matter in executive session. 

When they came back in session later Tuesday afternoon, Gómez was the sole vote against the tax increase and budget. Precinct 2 Commissioner Brigid Shea abstained from voting on the budget after criticizing the district’s budget priorities. 

Shea said she would like to see the results of an audit now underway before she can offer her support. She requested quarterly meetings to monitor Central Health’s spending on health care services. County Judge Andy Brown agreed and brought a motion for quarterly meetings up for a vote and it passed unanimously. 

Photo by Larry D. Moore, CC BY-SA 4.0, via Wikimedia Commons.

The Austin Monitor’s work is made possible by donations from the community. Though our reporting covers donors from time to time, we are careful to keep business and editorial efforts separate while maintaining transparency. A complete list of donors is available here, and our code of ethics is explained here.