Representatives from Travis County's health care district briefed county leaders about how a federal waiver will help them cover Medicaid costs and expand services. To use the waiver, the district needs to allocate matching funds.

Central Health officials emphasized the need for a medical school during the Travis County Commissioners Court's June 28 work session.

"We estimate that new tax dollars possibly would be used for health care service expansion and possibly debt service related to land acquisition for a new teaching hospital," Central Health chief financial officer John Stephens said. "Ownership of the land beneath the teaching hospital is a priority for Central Health."

Stephens said Central Health is talking with regional health partners about State. Sen. Kirk Watson's "10-in-10" initiative "to better understand the funding gap with regard to the medical school and larger health care infrastructure upgrades."

They said they also expect to keep the current tax rate in place for the next year fiscal year. No action was taken at the meeting.

Waiver

The federal government uses local tax dollars to partially reimburse hospitals for providing care to Medicaid patients.

In December, the Centers for Medicare and Medicaid Services approved the Texas Healthcare Transformation and Quality Improvement Program 1115 Waiver.

The five-year waiver supplements federal funds and expands what the money can be spent on toward the goal of improving how health care is delivered. The county is in the first year of the waiver.

"The 1115 Waiver provides an unprecedented opportunity for Central Health and its partners to create innovative health care solutions and make needed improvements to the safety net system in Travis County," said John Stephens, Central Health chief financial officer.

To use the waiver, local government entities must provide matching funds. The federal government contributes $1.40 for every local dollar involved.

Stephens said that last year, the district transferred $75 million to take part in the waiver. He said the district is able to transfer $78 million this year, but may be able to commit as much as $105 million.

Going forward, Central Health is calculating how much money it can allocate to the waiver project, how much money it may receive back and what are worthwhile projects.

Central Health will hear from key stakeholders and the public before taking any action, Stephens said.

Hospital

Central Health officials emphasized the need for a medical school during their presentation.

Stephens said 21 percent of Travis County citizens are uninsured, and more than 200,000 Central Texas families have limited or no health insurance.

Demand for services is expected to rise with the growing senior citizen population and projected doctor shortage. In four years, Central Texas will be short 770 doctors, Stephens said.

Central Health reported that it has increased primary care capacity and behavioral health services.

Rosie Mendoza, Central Health board of managers chairwoman, said the only way to meet future needs and fully utilize a teaching hospital is to have a steady, reliable stream of doctors and residents that a medical school provides.

Board Secretary Anthony Haley said a vote against creating a medical school is a vote in favor of the status quo for health care.