Local health care advocates who have called for an independent audit of Central Health's finances said Monday that Travis County Commissioners Court should order a review of the $105 million the health district has given to The University of Texas Dell Medical School, suggesting the school has misspent money and not kept proper records.

A report written by Austin lawyer Fred Lewis, who has previously criticized Central Health as lacking transparency, alleges that Dell Medical School "appears to have failed to comply with state-required financial accounting and to have misspent health care funds intended for the poor."

Dr. Clay Johnston, the dean of the medical school, said the allegations were false, particularly a claim in Lewis' report that Dell Medical School had "commingled" money meant for indigent health care with unrelated school expenses.

"These allegations aren't real," Johnston said. "We can easily show we don't commingle funds."

Since 2014, Central Health has sent Dell Medical School $105 million in $35 million annual increments.

The financial relationship between the health district and the school began after Travis County voters approved a ballot measure in 2012 to improve local health care delivery and support the school's creation, among other objectives. By approving it, voters agreed to raise Central Health's tax rate by 5 cents to 12.9 cents per $100 of assessed property value.

Noting that most of the money Dell Medical School has received from the arrangement remains unspent, Johnston said when the school has used money, it has done so in accord with an affiliation agreement with Central Health. He said the school and its partners are confident the arrangement follows state law.

Central Health CEO Patricia Young Brown defended the medical school's use of taxpayer money and said the public investment in the school has benefited local health care services.

“We’re confident the money is being spent the way voters intended when they passed a ballot referendum to transform health care in our community and create and fund a new medical school at UT," Young Brown said in a statement.

Lewis spoke to reporters Monday outside the Travis County Administration Building in Central Austin. He was joined by a group of advocates for low-income health care access, including Jill Ramirez, CEO of the Latino Healthcare Forum; Dr. Bruce Malone, an Austin-based orthopedic surgeon; and Isabel Lopez-Aguilar, a spokesperson for the recently created advocacy group HEALTH (Help Ensure Accountable Leadership and Transparency in Health) for Travis County.

Lopez-Aguilar said the group's urging of an independent audit of Central Health's contributions to Dell Medical School was meant as a call for clarity and not an attack on the school.

"Central Health's lack of transparency continues to be a concern in our community," she said.

Central Health announced last month it plans to hire an independent firm to review its financial and organizational performance, following a Commissioners Court direction for the district to develop regular financial reviews.

Lewis and Lopez-Aguilar have demanded an audit be overseen by Travis County and not Central Health.

Young Brown has said Central Health is the appropriate agency to oversee an audit and is abiding by its guiding statutes by doing so.