Two local organizations that partner to offer health services to low-income residents continue to be locked in a leadership conflict. CommUnityCare’s response to recent comments from Central Health highlighted the ongoing disagreements between the partners — including essential questions about the nature of their relationship.
Central Health is Travis County’s taxpayer-funded public hospital district. The nonprofit CommUnityCare formed to take over operations of clinics previously run by Austin and Travis County. It is Central Health’s largest clinic partner, and receives substantial funding from Central Health, which owns many of the clinics CUC operates.
The two parties also share a human resources department due to a complex co-applicant agreement to receive federal public health center status. This status allows CommUnityCare to receive increased Medicaid and Medicare reimbursement rates, making it possible to offer care to low-income patients who can’t pay for services. In 2022, CUC reported serving around 129,000 unique patients.
In May, the organizations rolled out unified branding to communicate their “commitment to collaboration” as part of the “Central Health system.”
But tensions between the two organizations arose last month after Central Health CEO Pat Lee put CommUnityCare CEO Jaeson Fournier on leave for unspecified allegations of professional misconduct. CommUnityCare representatives and board members objected to Lee’s action, saying he did not have the authority to make employment decisions regarding Fournier without consulting the CUC board.
In comments during a September public meeting of the Central Health board of managers, Fournier said he learned about Lee’s effort to put him on leave after he pushed back on a Central Health presentation that “felt like an attempt to consolidate control over health center operations.”
On Oct. 10, Central Health posted a video featuring Lee on its website ostensibly aimed at clearing up questions about the relationship between the two entities. In the video, Lee contends that CommUnityCare is in fact part of Central Health’s organization.
“For several years, there's been a misunderstanding about CommUnityCare,” Lee said. “Many thought it was a private system separate from Central Health, like Lone Star Circle of Care or People's Community Clinic. When I started as CEO of Central Health nine months ago, I learned that CommUnityCare is actually part of Central Health, a public system that we have direct responsibility for.”
Lee said that Central Health and CommUnityCare have not been fully adhering to their formal operational agreement. He also said in a written statement on Central Health’s website that he has been working with acting CommUnityCare CEO Nicholas Yagoda “to realign with the agreement and make improvements.”
“Dr. Yagoda and I have discussed the nature of the public health center model, our relationship and the opportunity to improve transparency and accountability — as was always intended and indeed required by the public center model,” Lee said in the video.
But when reached for comment by KUT, Yagoda issued a statement saying that he did not approve Lee’s message, and had objected to the video’s release.
“The video erroneously suggests that I, as interim CEO, support Dr. Lee’s stance on what has unfortunately become a public dispute over the establishment and implementation of the public health center model and its requirements,” Yagoda said.
Yagoda said he took issue with Lee’s implication that CommUnityCare has not followed legal agreements between the two parties. He also said Lee should not have asserted that CommUnityCare is a part of Central Health while omitting the fact that CommUnityCare has an independent board of directors, which also serves as the governing board to secure federal public health center status.
“I disagree with these assertions and am disheartened that Dr. Lee would make such statements, and especially that he would do so publicly. Such actions undermine cooperation and collaboration around vital and complex issues,” Yagoda said.
“The last few weeks have been disorienting as Central Health has not only put the CEO on leave without the participation of the CommUnityCare board, but continues to sow confusion with videos, public statements and events suggesting agreement where agreement does not exist."
Ted Burton, Central Health's chief communications officer, responded to Yagoda's comments.
"Central Health remains committed to working with CommUnityCare, our primary care public health center partner, and its patient-led board to ensure we are cutting wait times and getting our patients into care as quickly as possible. Value-based patient care must always be our priority — no matter what," Burton said.
The original issue that highlighted the disagreement between the two organizations — Lee’s move to put Fournier on leave — remains unresolved. Lee told Travis County Judge Andy Brown at a September meeting that Central Health and CommUnityCare had each tapped independent investigators to address the conflict. A CommUnityCare board member also said during an Oct. 23 Central Health board meeting that there is a mediation session scheduled between the two parties next week.
Federally qualified community health centers are overseen by the Health Resources and Services Administration. An HRSA spokesperson acknowledged that the agency is aware of the conflict between Central Health and CommUnityCare.
"HRSA is committed to supporting access to affordable, high-quality care regardless of patients’ ability to pay in Austin and across the country," the spokesperson said in an emailed statement. "All organizations funded under the federal Health Center Program must comply with applicable requirements. HRSA will continue to monitor the situation in Travis County to ensure compliance with these requirements."
