Travis County Commissioners Court delayed passing Central Health’s fiscal year 2023-24 budget and tax rate another week on Sept. 19 after commissioners expressed continued concern over what the district proposed.

Central Health officials are asking for a property tax rate of $0.100692 per $100 valuation and a $744 million budget, an effective 18.4% year-over-year budget increase. The new tax rate would cost the owner of an average-value home an extra $56 per year.

Central Health provides health care services to people earning at or below 200% of the federal poverty level, which is around a $60,000 annual income for a family of four.

What they’re saying

Travis County commissioners have expressed hesitance about approving Central Health’s budget proposal as the district already has about $379 million in contingency reserves, and county leaders said they haven’t heard straight answers on how the proposed budget will help the hospital district provide care to more people.

Travis County Commissioner Brigid Shea said she was “disturbed” to see Central Health had spent less than 40% of its budget on health care services in 2021 and 2022.

Travis County Judge Andy Brown added Central Health should take on the cost of health care for people in jail and the county’s upcoming mental health diversion center.

Quote of note

“I can’t help but compare your budget to our budget,” Commissioner Margaret Gomez said. “We still take care of indigents. If people need a lawyer and they can’t afford one, we provide it. We pay for that, and we don’t make excuses for that. We have it in the budget. We don’t have it in the reserves somewhere. I think that's real commitment to taking care of indigents in this county.”

The other side

Central Health CEO Mike Geeslin said the district plans on waning its contingency reserves for its seven-year Healthcare Equity Plan. The plan includes over 150 projects aimed at adding and improving health care services for the county’s poor population.

“The issue of the level of reserves is an important perspective,” Central Health Board Manager Ann Kitchen said. “I’m excited about the opportunity to start spending down those reserves. That’s what this Healthcare Equity Plan is about—spending down those reserves in a responsible way."

Several current and previous Central Health patients appeared at the meeting encouraging commissioners to approve the budget.

“I feel we are on a threshold of transformation of care in Travis County,” said Nora Comstock, Founder of Las Comadres para Las America, during public comment.

What’s next

Commissioners Court will vote on Central Health’s budget and tax rate Sept. 26. If the court decides not to approve the budget, Central Health’s existing tax rate or the no-new revenue tax rate—whichever is lower—will be applied.