If you’re a homeowner in Austin, your annual property tax bill goes to a few places. There are the usual suspects you probably expect to see: the City of Austin, Travis County and Austin ISD. A smaller amount also goes to Austin Community College. And then there’s Central Health, Travis County’s public hospital district.
Maybe you’ve wondered, “What even is a public hospital district?”
In the simplest terms, a public hospital district collects taxes that fund medical care for low-income residents.
Voters approved Central Health in 2004. In the beginning, it was primarily tasked with funding care at a hospital that would serve low-income residents. Back then, that was University Medical Center Brackenridge. Now, it’s Dell Seton Medical Center. Central Health contracts with Ascension Texas to offer care for low-income individuals at that facility. That sets Central Health apart from the other five largest public hospital districts in Texas, all of which operate a hospital themselves.
But Central Health’s focus has expanded over the past two decades. It is now in the early stages of its new Healthcare Equity Plan, a seven-year vision to add clinics and services to close critical gaps in local health care availability. The plan is expected to cost around $682 million.
If you ask Central Health’s CEO, Patrick Lee — who recently completed his first 100 days at the helm of the organization — Central Health’s purpose comes down to an ambitious goal: to build out and provide a comprehensive safety net to catch folks falling through the cracks of the local health system.
“Central Health is empowered with the right to tax to provide the resources necessary to build this system and deliver the care and achieve the results of equitable health for all in Travis County,” Lee said in a May interview.
Some of these clinics will bring specialty and primary care services to Eastern Travis County, where access to medical services is sparse — like a clinic that opened late last year in the Hornsby Bend area.
Offering direct care like this is new for Central Health. Historically, it has partnered with other organizations to offer care, including Ascension and CommUnityCare, which operates many clinics that Central Health owns and receives some of its funding from Central Health.
Lee says this new focus will help Central Health to improve local health outcomes through primary and specialty care, ultimately freeing up more hospital resources.
“If we don't do this preventive work upstream, many of our patients end up in the hospitals, they end up in the jails, they end up homeless, and we end up paying a lot more for care that is less good,” he said.
That’s why one focus of the health equity plan is medical respite — programs where homeless individuals can recuperate after a stay at the hospital, which hopefully lessens the odds that they’ll need to be re-hospitalized. Other priorities include building up strategic specialty care services such as podiatry, which is often an important area of care for diabetes patients.
Who can access these services?
Central Health’s Medical Access Program, or MAP, is for folks who can’t afford traditional insurance and don’t qualify for Medicaid or Medicare. If your household makes 200% of the federal poverty level or less, you might qualify for MAP.
Central Health also has a nonprofit marketplace health insurance option called Sendero Health Plans. Many local artists and musicians get coverage from Sendero via a partnership with the Health Alliance for Austin Musicians.
If you don’t personally qualify for any of this, why should you care? Well, Central Health’s official mission is this: that "by caring for those who need it most, Central Health improves the health of [the] entire community." And, of course, your taxes pay for it.
What’s next for Central Health — and how you can weigh in
Lee says he hopes Central Health’s new direct-care clinics and services will build public trust in the organization over the coming years.
“I think five years from now, when we think of the care for our lowest income residents, we think of the safety net health system … the first institution that will come to the public's mind, and hopefully with a very positive impression, will be Central Health,” Lee said.
The coming months and years will also see some challenges to the organization play out. A lawsuit a group of taxpayers filed against Central Health accusing the organization of improperly giving funding to Dell Medical School has recently seen movement, while a separate lawsuit involving Central Health and its hospital partner Ascension is pending. An independent audit of Central Health’s financial practices ordered by Travis County is also underway.
Last year’s budget approval process for Central Health was contentious. The planning process for the next fiscal year budget is ongoing ahead of a vote scheduled for this fall — so the time is ripe if you want to get engaged and weigh in on Central Health’s priorities for next year.
You can do that by attending the hospital district’s public meetings which are usually held on the third Wednesday of every month.
