Central Health

Health care for all.

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The Central Health Budget

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If you live in Travis County, your tax dollars fund health care for more than 1 in 8 residents, giving everyone a fair chance at better health. Central Health dedicates 96% of its budget to health care delivery including clinical and hospital services, and health care coverage. The remaining 4% covers administration expenses.

board defined objectives

Proposed FY 2021 and Beyond Strategic Priority Categories

  • Improving access to care
  • Consideration of ongoing COVID-19 events
  • Enhancing clinical programming and supporting transformational operational initiatives
  • Implementing the hospital funding model
  • Redeveloping the Downtown Campus

Major Texas Hospital Districts: FY2020 Tax Burden Comparison

Major Texas Hospital Districts:FY2020 Tax Burden Comparison

Taxable Values by Tax Year (in billions)

Taxable Values by Tax Year (in billions)

7-Year Forecast: 6.9% over No New Revenue Rate

Updated August 2020

7-Year Forecast: 6.9% over No New Revenue Rate Updated August 2020

Central Health Property Tax Impact Statement: FY2020-2021

Central Health Property Tax Impact Statement: FY2020-2021

FY2021 Approved Tax Rate

6.9% over No New Revenue rate

FY2021 Proposed Tax Rate 6.9% over No New Revenue rate

FY 2020 Approved Budget and FY 2021 Approved Budget

Sources and Uses Summary

DESCRIPTION

FY 2020 APPROVED BUDGET

FY 2021 APPROVED BUDGET

TAX RATE

0.105573

0.110306

SOURCES

Property Taxes$214,906,371$234,057,519
Lease Revenue$13,749,848$12,909,866
Interest$2,150,000$1,720,000
Tobacco Litigation Settlement$3,500,000$2,800,000
Subtotal Revenue$234,306,218$251,487,385
Contingency Reserve Carryforward$56,499,497$115,856,728

Total Sources

$290,805,715$367,344,113

USES

Healthcare Delivery$278,017,579$353,858,895
Administration$10,899,878$11,399,403
Tax Collection$1,888,258$2,085,816

Total Uses

$290,805,715$367,344,113

RESERVE

Emergency Reserve$38,719,836$38,719,836

DESCRIPTION

FY 2020 APPROVED BUDGET

FY 2021 APPROVED BUDGET

HEALTH CARE DELIVERY

Intergovernmental transfers:
IGT - Disproportionate Share

$36,120,000

$0

IGT - CCC DSRIP

$25,574,651

$23,528,575

Total Intergovernmental Transfers

$61,694,651

$23,528,575

Healthcare Services
Primary Care: Medical, Dental, & Behavioral Health

$50,270,000

$56,935,000

Specialty Care: including Specialty Dental

$8,940,000

$12,565,000

Specialty Care: Behavioral Health

$883,856

$1,883,856

Post Acute Care

$5,400,000

$5,400,000

Pharmacy

$11,600,000

$13,250,000

Hospital & Specialty Services

$50,225,000

$57,000,000

Hospital Performance Incentive

$2,700,000

$2,700,000

Reproductive and Sexual Health

$1,950,000

$1,150,000

Healthcare Services - PSH/PFS Payment

$600,000

$600,000

Integrated Care Collaboration (ICC)

$719,990

$719,990

Proposed: Community Health Care Initiatives Fund

$0

$875,000

Primary & Specialty Care Reserves

$2,000,000

$2,000,000

Total Healthcare Services

$135,288,846

$155,078,846

Healthcare Operations & Support
ACA Healthcare Premium Assistance Programs

$9,251,800

$11,559,354

ACA Education and Enrollment

$604,319

$601,320

Healthcare Facilities and Campus Redevelopment

$10,074,543

$5,156,629

UT land lease for teaching hospital

$921,627

$940,843

Salary and Benefits

$15,367,494

$15,021,176

Legal

$184,500

$332,000

Consulting

$1,073,000

$1,085,500

Other professional services

$4,493,819

$7,065,656

Marketing, Community Relations & Engagement

$796,166

$839,990

Leases, security & maintenance

$803,220

$1,774,296

Phones, computer equipment & utilities

$2,532,760

$2,449,460

Printing, copying, postage & signage

$300,633

$334,522

Travel, training and professional development

$237,140

$276,607

Other operating expenses

$255,995

$293,822

Health Care Capital Line of Credit

$0

$1,091,773

Total Healthcare Operations

$46,897,017

$48,822,947

Reserves, appropriated uses & transfers:
Transfer to capital reserve

$2,950,000

$34,100,000

Transfer to emergency reserve

$6,406,290

$0

Sendero risk-based capital

$0

$0

Contingency reserve appropriation

$23,407,493

$87,064,169

Proposed: Hospital Services Reserve

$0

$4,000,000

Total Reserves, appropriated uses & transfers

$32,763,783

$125,164,169

Debt service:
Debt service - principal retirement

$1,065,000

$1,180,000

Debt service - interest

$308,283

$84,357

Total Debt Service

$1,373,283

$1,264,357

Total Healthcare Delivery

$278,017,579

$353,858,895


ADMINISTRATION

Salary and Benefits

$5,903,601

$5,561,651

Legal

$1,390,820

$1,497,136

Consulting

$1,187,720

$1,259,570

Investment Services (Travis County)

$115,500

$115,500

Benefits & Payroll administrative services

$174,550

$185,337

Other professional services

$482,950

$1,257,450

Marketing, Community Relations & Engagement

$212,700

$182,350

Leases, security & maintenance

$335,200

$244,940

Insurance & Risk Management

$150,030

$150,000

Phones, computer equipment & utilities

$135,900

$135,449

Printing, copying, postage & signage

$103,775

$85,245

Travel, training and professional development

$211,960

$222,282

Other operating expenses

$495,172

$502,494

Total Administration

$10,899,878

$11,399,403


TAX COLLECTION

Appraisal District Svcs

$1,069,646

$1,123,128

Tax Collection Expense

$818,612

$962,688

Total Tax Collection

$1,888,258

$2,085,816

TOTAL USES

$290,805,715

$367,344,113

Budget Calendar

DateMeetingSubject
May 13Central Health Strategic Planning Committee(FY 2021 Central Health Strategic Priorities)
May 18Community Conversation(COVID-19 Budget Impact)
May 27Central Health Board of Managers Meeting(FY 2021 Central Health Forecast)
June 17Central Health Budget and Finance Committee(FY 2021 Budget Priorities CCC proposed budget and Capital Projects Planning)
July 15Central Health Budget and Finance Committee(FY2021 Central Health Proposed Budget)
July 31Central Health Board of Managers(FY2021 Central Health and CCC Proposed Budgets)
August 19Central Health Budget and Finance Committee(FY2021 Central Health Proposed Budget and tax rate)
August 19Central Health Board of Managers Meeting(FY2021 Central Health Proposed Budget and tax rate)
August 25Travis County Commissioners Court (FY2021 Central Health Proposed Budget)
August 26Central Health Board of Mangers Meeting(FY2021 Central Health Proposed Budget and tax rate)
August 31*Community Conversation (FY2021 Proposed Budget)
September 2*Central Health Public Input Session(FY2021 Central Health Proposed Budget and tax rate)
September 9*Central Health Public Hearing(FY2021 Central Health Proposed Budget and tax rate)
September 16*Central Health Board of Managers Meeting(FY2021 Central Health Budget and Tax Rate Adopted; CCC Budget Approval)
September 29*Travis County Commissioners Court(FY2021 Central Health Budget and Tax Rate Adopted)

*Dates are subject to change

Central Health FY2021 Budget  Frequently Asked Questions 

Q1: What does Central Health do and how are Travis County tax dollars used to support health care and health coverage?

Central Health is the local health care district that ensures Travis County residents with low income get quality health care. We do this by:

  • Offering a health coverage programthe Medical Access Program (MAP and MAP BASIC), to Travis County residents with low income and no insurance. 
  • Partnering with clinics, hospitals, and health organizations, helping us offer 175 health care locations to our Medical Access Program (MAP and MAP BASIC) members 
  • Supporting Central Health-affiliated CommUnityCare Health Centers — a Federally Qualified Health Center (FQHC) system that offers primary care, dental care, behavioral health care, and some specialty services to low-income, uninsured, and underinsured Travis County residents. 
  • Supporting Central Health-affiliated Sendero Health Plans  an Austin-based nonprofit corporation that serves as Central Texas’ community health maintenance organization (HMO). Central Health created Sendero in 2011 to improve access to care for those covered by publicly funded health insurance programs. 

Q2: Central Health's funds also support its Enterprise affiliates CommUnityCare and Sendero Health Plans. Where can those budgets be found?

The Central Health financial statements are reported monthly to the Central Health Board of Managers. The financial statements are reported at a very detailed level including expenditures, providers and service lines. The financial statements are also on the Central Health website located at: Centralhealth.net/finance

The Central Health September 2019 financial statements can be found at:  Centralhealth.net/wp-content/uploads/2020/01/CH-Financials-Sep-2019.pdf 

The Community Care Collaborative financial statements for September 2019 can be found at: Centralhealth.net/wp-content/uploads/2020/01/CCC-Preliminary-Sep-2019-Financials.pdf 

CommUnityCare staff will present a detailed breakdown of expected FY2021 health care delivery expenses during the Board of Managers meeting on September 9. 

Central Health staff will present a detailed breakdown of expected FY2021 health care delivery expenses during the Board of Managers meeting on September 16. 

Q3: Central Health is set to increase the tax rate for FY2021. What is the reason for this tax rate increase and does this require voter approval?

The demand for health care services for people with low income is increasing, especially because of the COVID-19 pandemic. Central Health is committed to ensuring all Travis County residents with low income have access to the best possible health care. 

The Central Health Board of Managers on Aug. 26 approved a proposed property tax rate of 11.0306 cents per $100 of taxable property value for the upcoming 2021 fiscal year. The 6.9% over No New Property Tax Rate is a consistent rate of increase as FY2020. The proposed tax rate will result in an annual increase of $24.97* for the average taxable homestead value of $355,379 – a little more than $2 a month.  

*Increases in taxes are a result of two components – the property assessed value and the tax rate. 

Approximately 96% of Central Health’s FY2021 budget funds the delivery of health care. Four percent is for administration.  

The FY 2021 tax rate will support a $20 million increase in the budget to fund health care services during 2021. This funding will support: 

  • A $5.2M increase for primary care (I.e. medical, dental and behavioral care).  
  • A $3.6M increase for specialty care, including specialty dental care.  
  • A $1M increase for behavioral care. 
  • A $1.2M increase for care people may need after being hospitalized.  
  • A $6.8M increase for hospital and specialty services.  
  • A $1.7M increase for Affordable Care Act Healthcare Premium Assistance Program.   

NOTE: Although new clinics in Eastern Travis County may not open in FY 2021, construction is expected to start in FY 2021. Central Health’s long term capital planning includes $28M to fund potentially three new clinics in Eastern Travis County, with funding planned throughout FY2021 and FY2022 based on individual project timelines 

Central Health has the lowest tax rate of any major urban Texas hospital districts. 

Central Health’s estimated tax bill is approximately 4 percent of the overall property taxes for taxpayers of Travis County. 

This tax rate increase does not require voter approval as it is less than the Voter Approval Rate. 

Q4: Are there additional public input opportunities before the Central Health budget is approved?

There is a public hearing scheduled for September 9 at 5:30 p.m. The public is invited to and can sign up to speak either in person, by phone or virtually: 

  • If you wish to speak virtually or by phone, sign up to speak at Centralhealth.net/meeting-sign-up or by calling 512-978-9190 – 90 minutes prior to the start of the meeting (4 p.m.)  
  • If you wish to speak in person, join us at 1111 East Cesar Chavez Road by 5:30 p.m. Please note: COVID-19 protection guidelines will be followed. All attendees will be required to wear masks while inside the building. 

All normal citizens communication guidelines will be followed for the public hearing. 

Q5: Can you provide a status update on permanent health centers in Eastern Travis County?

Hornsby Bend Health Center

  • Central Health purchased 10.63 acres last year in the Hornsby Bend/Austin’s Colony community just south of Dailey Middle School.  
  • We have conducted a preliminary utility review to determine location/access to the water, wastewater, and electrical for site. This will help to determine cost to route water, wastewater and electrical to site.  
  • Currently, Central Health is evaluating data as part of our service delivery planning process and has asked CommUnityCare to do the same. Preliminary findings are expected to be reported in October 2020. 
  • In March 2020, Central Health opened the Hornsby Bend Health Center on 14312 Hunters Bend RoadWe are focused on increasing utilization at this health center, which is not operating near capacity. 
     

Del Valle Health Center

  • Central Health is buying land in Southeast Travis County to build a new health and wellness center. 
  • The 2.5 acres at 7050 Elroy Road, just east of the Texas State Highway 130/Texas State Highway 45 toll roads, will be the home of a new clinic operated by Central Health-affiliated CommUnityCare to serve the rapidly growing population in the Del Valle area in Eastern Travis County.  
  • Central Health will pay $801,000 for the land, with the final sale expected to occur within 30 days. Funding for the purchase is part of Central Health’s Fiscal Year 2020 budget. 

Prior to determining a date for start of construction or the opening of any new clinic, Central Health will continue to engage with residents during the planning process. 

Q6: What is Central Health's response to COVID-19 and what is the plan to reach communities of color that are disproportionately impacted by the virus?

In February 2020, Central Health and CommUnityCare began working together to ensure people could still get health care during the worsening Coronavirus pandemic. Central Health prioritized how it pays for contractors who deliver health care, conduct coronavirus testing, and transition to telemedicine.  

More specifically, Central Health has: 

  • Supported CommUnityCare in its COVID-19 response and maintained communications with the local Emergency Operation Center. 
  • Made it easy for people to apply for and renew their MAP benefits over the phone or online. 
  • Helped MAP patients transition out of the hospital and still receive appropriate care. 
  • Central Health and CommUnityCare worked with community members to develop culturally appropriate public health messages about wearing masks in public, practicing social distancing, washing hands regularly, and other ways residents can protect themselves and their families and help stop the spread of the virus. 
  • Central Health has been working to ensure members of Travis County’s African American and Hispanic communities have access to critical, clear, culturally appropriate, up to date COVID-19 prevention, screening, testing, and treatment information. We’re doing this through both paid media targeting minority communities, and a grassroots outreach initiative distributing COVID prevention information, masks and hand sanitizers to small businesses that employ, serve or are owned by African Americans and/or Latinos – focusing on the 11 Travis County ZIP codes with the highest concentration of families living in poverty.

CommUnityCare has: 

  • Launched telehealth – doctor visits by telephone. Approximately 70% of appointments moved to telehealth appointments during the pandemic.  
  • Began offering mail order and curbside pharmacy services. 
  • Worked with residents to select locations for five COVID-19 testing sites in Eastern Travis County,
  • Participated in the City of Austin’s Emergency Operations Center and related task forces regarding the pandemic response.  

Continued Outreach Efforts: Getting Ahead of the Next Curve 

  • Central Health, CommUnityCare, and Austin Public Health recently kicked off a joint media, community outreach, and personal protective equipment (PPEdistribution effort with the goal of measurably reducing the community’s positivity rate. We are planning a press conference this week to launch the 6-week initiative. 
  • While PPE distribution is ongoing, the upcoming efforts are more coordinated, larger in scale, and targeted at reducing spread as we head into the next curve of the pandemic.  
  • Paid and earned media will remind people of ongoing importance of masking, distancing, and hand washing during the next several weeks.  
  • These efforts will focus on high-risk ZIP codes and vulnerable populations. Bilingual and culturally appropriate media coordination and PPE logistics are being finalized, and additional information on launch dates will be provided next week. 

Q7: How does Central Health ensure that the most vulnerable communities, specifically communities of color, get a proportional amount of the budget allocated to meet their needs?

Central Health is the local health care district that ensures Travis County residents with low income get quality health care. We do this by:

  • Offering a health coverage program, the Medical Access Program (MAP and MAP BASIC), to Travis County residents with low income and no insurance. 
  • Partnering with clinics, hospitals, and health organizations, helping us offer 175 health care locations to our Medical Access Program (MAP and MAP BASIC) members. 
  • Supporting Central Health-affiliated CommUnityCare Health Centers — a Federally Qualified Health Center (FQHC) system that offers primary care, dental care, behavioral health care, and some specialty services to low-income, uninsured, and underinsured Travis County residents. 
  • Supporting Central Health-affiliated Sendero Health Plans — an Austin-based nonprofit corporation that serves as Central Texas’ community health maintenance organization (HMO). Central Health created Sendero in 2011 to improve access to care for those covered by publicly funded health insurance programs. 

As demographics shift and the number of families with low income increases in certain areas of the county, Central Health uses systems-based planning approach for the service delivery, design, development, and construction of health and wellness centers across Travis County. This planning approach: 

  • Ensures tax dollars are invested in areas with the most urgent health care needs.  
  • Supports equity by improving quality across the entire continuum of care and using a health equity lens to increase access to care by building a comprehensive and coordinated health care system designed to care for people with low income.  
  • Reflects timely access to care, evidence-based protocols, improved clinical outcomes, and sustainable and efficient use of taxpayer resources. 

Q8: Are there opportunities for providers post bids for services in Travis County?

Health care providers can visit us at Centralhealth.net to learn about ways, we can partner with them to broaden our network of providers for Medical Access Program (MAP and MAP BASIC) members. 

Q9: Can we access the Community Conversation presentations and budget handouts?

A9Yes. All previously recorded Community Conversations, presentations, and budget handouts can be found at Centralhealth.net/fy21-budget/engagement. More information about Central Health’s budget development process and timeline can be found at Centralhealth.net/fy21-budget.