Check back for updates as this story develops.

Updated Oct. 25 at 8:19 a.m. CST

In a new statement, Central Health said St. David's HealthCare's recent objections to Proposition 1 are based on misunderstandings, citing a comment from St. David's CEO David Huffstutler that there are not opportunities to participate in the 1115 Medicaid Waiver under similar conditions as Seton. Central Health claims it has tried for months to bring St. David's into the conversation of developing the integrated delivery system, Community Care Collaborative and the Medicaid Waiver.

"It is the wish and intent of Central Health to encourage St. David's to rejoin the discussion in order to fulfill our vision to plan and deliver more cost-effective and comprehensive health care for those most in need in our community," according to the statement.

Central Health said CCC partners must contribute to its development. The statement said St. David's maintains its indigent care services meet that requirement. Central Health said while that participation is needed, "True partnership is not possible without commitment, and this includes bringing financial resources to the table."

Updated 12:25 p.m. CST

Don Zimmerman of the Travis County Taxpayers Union PAC called the announcement an affirmation of what the group has been alleging for a month and a half.

"We're happy to see one of the inside players is now telling the truth about Proposition 1," he said.

He said that St. David's helped create the Travis County Healthcare District, "So they're not opposed to using property taxes to fund indigent health care."

"Their objection lies in cost shifting," he said. "Central Health advertises that they provide indigent health care, but they are leaving St. David's and other hospitals with millions of dollars in indigent care costs."

Updated 12:10 p.m. CST

Central Health President/CEO Patricia Young Brown said she was very disappointed by the announcement from St. David's.

"We feel it is a fairly abrupt end to a community collaboration we think holds great promise," she said. "We view St. David's as a large provider who certainly needs to be at the table about how we are going to make all of this work."

She added that she was confused about the opposition of St. David's to Proposition 1, because without passage of the tax rate increase, Central Health is unable to avail itself of all of the available federal funds through the 1115 Medicaid Transformational Waiver.

Central Health calculated the amount of the tax increase in order to maximize the federal funds associated with the waiver, said Christie Garbe, Central Health chief communications and planning officer.

Young Brown said that Seton Healthcare Family planned to spend a minimum of $250 million to build a new hospital to replace University Medical Center Brackenridge and already supports graduate medical school functions.

"I think there have been multiple misunderstandings. St. David's should be part of the community collaboration given the role that they have in the community," she said.

Lynda Rife, campaign consultant for the Keep Austin Healthy political action committee, said the announcement was disappointing, but not surprising.

In response, KAH will continue reaching out to the community, Rife said.

"We're going to step up our game; we're releasing a new TV commercial today airing on broadcast and cable."

She adds Proposition 1 has already been endorsed by more than 40 organizations including The Austin-American Statesman and The Austin Chronicle.

Updated 11:25 a.m. CST

St. David's HealthCare announced Oct. 24 that it does not support Proposition 1 on the November ballot.

Proposition 1 would raise Central Health's tax rate by 5 cents to 12.9 cents per $100 of property valuation. According to the ballot language, the money would fund support of a new medical school and a site for a new teaching hospital, among other uses.

St. David's President/CEO David Huffstutler told Community Impact Newspaper that Proposition 1 is not the appropriate way to fund a medical school in Austin.

Huffstutler said that typically, medical school funding comes through the state, the legislature and a university, but that other methods such as corporate or private philanthropy have been discussed as well.

"This is not an anti-tax or an anti-medical school issue," he said in a statement. "This is an issue about ensuring a taxing authority is doing what it was created to do."

Huffstutler said that the medical school project takes Central Health away from its main priorities.

Central Health works with health care providers to serve uninsured and under-insured residents who earn less than 200 percent of the federal poverty line.

In the statement released Oct. 24, Huffstutler said that taxpayers are carrying the burden for indigent care; hospitals provide care to uninsured patients through emergency rooms and then pass on costs to insured patients.

He went on to say that St. David's would endorse Proposition 1 if the tax increase was going to directly fund indigent patient care, which is part of Central Health's stated purpose.

"But Proposition 1 asks voters to authorize paying much higher taxes with almost no additional incremental indigent care provided as a result. Before spending millions of tax dollars on a medical school, we want Central Health to meet their primary obligation of providing indigent care in Central Texas and to relieve us of some of the burden we already carry in the district," he said.

Huffstutler told Community Impact that St. David's provides $165 million a year worth of care to Medicaid and uninsured patients. About 78 percent of those funds are reimbursed, leaving St. David's with a $35 million deficit.