What began as a 4-3 vote on Sept. 12 by the board of managers for Travis County’s health care district, Central Health, to end its nonprofit health plan, resulted in a subsequent community-led press conference, a postponed vote by the Travis County Commissioners, and ultimately a reversal in all 4 opposing votes at a specially called Central Health board of managers meeting Saturday, Sept. 22.

The managers voted unanimously Saturday to overturn their approval of Central Health’s fiscal year 2018-19 budget and to allocate $26 million in funds for its nonprofit health care plan, Sendero Health Plans.

About 50 advocates and local residents attended the specially called Central Health board of managers meeting, many wearing red stickers and T-shirts with the name of a newly formed group, “Save Sendero.”

“This is a human issue, this is not solely a financial decision,”said Joey Gidseg, a member of Democrats with Disabilities, during public comment session.

After over three hours of both public comment and public discussion by the board of managers, managers voted unanimously on a new motion to allocate $26 million to Sendero Health Plans in the FY 2018-19 budget and keep it in operation under a specific set of standards set forth by board members Shannon Jones and Sherri Greenberg.

This represents a $2 million increase from the previously proposed $24 million that was allocated to Sendero under the condition that the health plan would wind down operations by 2020.

The conditions of the motion outline a plan over the next year to hold Sendero Health Plans accountable to a set of standards that will be continuously reported back to the board of managers. The specifics of the standards are not yet outlined.

The motion also outlines that by June 2019, the board must receive a new third party actuarial opinion, at which point, if Sendero has not met the standards that the board outlines, it will begin a new wind-down process.

Some board members, including Sherri Greenberg, said they had reservations about Sendero’s financial viability, and that it could be diverting funds from other efforts made by Central Health to improve health outcomes for Travis County residents with low income.

“I don't think this is a question of $2 million [additional] dollars or not." Greenberg said. "I think that this is a question of people who we need to talk about and a commitment to them. Just like [Central Health CEO] Mike Geeslin said, can we be all in forever now? Or if not, we need to look at other ways to provide healthcare to people and for people to transition [to a new plan].”

Board members in favor of the plan, including Cynthia Valdez and Julie Oliver, said independent actuarial reports presented publicly for the first time at Saturday's meeting proved that a plan could be formulated to help secure more funding from the federal government. That plan would encourage sick patients to transition to Sendero Health Plans from a limited health plan operated separately by Central Health, called the Medical Access Plan, or MAP.

The final vote to keep Sendero in operation meant that Sendero’s 24,000 members will not have to join a new health plan during the open enrollment period from Nov. 1 to Dec. 15.

Alex Berek, a Sendero member who spoke at the meeting has a rare disease known as reflexive sympathetic dystrophy that causes severe pain and limits movement. He said he believes this decision saved his life and likely the lives of many other Sendero members.

“I am disabled. I am on disability and I can't work anymore and I wish I could,” Berek said. “I wish I was healthy enough to work, because believe me, I would. But the only way for me to choose a plan is to know, do they pay for my medicine and is it affordable?”