Travis County commissioners unanimously voted to hire a firm to conduct an independent performance audit on Central Health—the county’s hospital district for low-income residents—at an April 4 meeting.

The audit will cost $845,200, according to county documents. The chosen firm, Mazars USA, proposed to kick off the audit in May, compile a draft report by November and present the final report in January.

The audit will assess Central Health’s:
  • Effectiveness meeting the needs of the county’s poor population;
  • Financial accountability;
  • Public transparency;
  • Record keeping; and
  • Compliance with city, state and federal laws.
Central Health CEO Mike Geeslin voiced concern regarding the $845,200 price tag at the April 4 meeting and said the district only budgeted $300,000-$350,000 for the audit. It is unclear if the audit will affect property owners within the Central Health taxing district as the 2024 budget and tax rate will not be approved until September, said Ted Burton, Central Health vice president of communications.

Why an audit?

The Central Health audit was spurred when local activists; attorneys; and community groups including Austin Taxpayers Union, the NAACP and the League of United Latin American Citizens alleged Central Health lacked financial transparency.


In a report released in March 2022, the human rights groups outlined concerns with Central Health’s growing contingency reserves—money set aside for potential financial deficits. The report also cited Central Health gave more than $280 million to Dell Medical School with no public record of how those funds were used to provide health care to low-income residents.

Central Health undergoes a financial audit annually, and it has come out clean every year since 2005, Burton said.

Quote of note: “A financial audit, which is what they do regularly, only looks to see whether their accounting lines up,” attorney Fred Lewis said during public comment. “It does not tell us whether or not the entity is performing well or even if the money being spent is in compliance with the law or being spent efficiently.”

Dig deeper


More information on the Central Health performance audit is available starting on Page 934 in the Travis County Commissioners Court agenda packet.