October 24, 2012
Central Health Executives and Board of Managers were surprised and disappointed yesterday to receive a letter from St. David’s HealthCare President & CEO David Huffstutler declaring an end to a discussion about their involvement in the development of a new healthcare delivery system to serve the uninsured in Travis County. The letter and the position stated by St. David’s HealthCare are based on a misunderstanding of the complex and far-reaching efforts to improve the health of Travis County.
To fulfill its mission of creating access to care for those who need it most, Central Health is asking Travis County voters to raise additional tax revenues that are essential to expand healthcare services and improve the long-term health of Travis County residents.
“We thank St. David’s for bringing attention to the fact that the issue is about more than just a new medical school and a new teaching hospital,” Central Health President & CEO Patricia A. Young Brown said. “We urge everyone to consider that our local support for the services a medical school can provide is only one component, albeit highly visible, of a full range of projects and programs aimed at improving the health of those who do not have access to care, and ultimately of our entire community. Our plans address the expansion of healthcare services to low-income uninsured residents.”
The letter includes many statements with which Central Health disagrees. Central Health perceives that there has been a significant misunderstanding on the part of St. David’s. For example, St. David’s CEO says there are no opportunities available to participate in the 1115 Medicaid Waiver under the same or similar conditions as Seton. That is not true. Central Health and other partners have attempted to work with St. David’s for many months to bring them into the discussion regarding the development of the integrated delivery system, Community Care Collaborative (CCC), and the Medicaid Waiver. St. David’s participation in this unprecedented community effort is needed. However, true partnership is not possible without commitment, and this includes bringing financial resources to the table.
Because Central Health is investing significant public tax dollars, the agency must maintain a majority interest in the CCC in order to protect the interests of the taxpayers. A basic premise established at the beginning of the discussions regarding development of the CCC was that all participating partners contribute resources to its development. St. David’s maintains that their indigent care services meet this requirement, thus entitling them to additional funding from this effort. However, Central Health and Seton are both contributing significant resources: tax dollars from Central Health and $250 million from Seton to build a new teaching hospital to replace the current University Medical Center Brackenridge, as well as funding of graduate medical education. Seton provides valued indigent care services and is adding to that commitment with funding of new assets for the benefit of the community.
“The expectation of true partners is full commitment to the program and the change it will bring,” Brown said.
These initiatives under development are all reliant upon funds derived from what’s known as the Section 1115 Medicaid Transformation Waiver. In brief, under the 1115 Waiver the federal government will match $1.46 for every $1 raised locally, which will fund approved projects after they meet measurable objectives to transform the healthcare delivery system. The passage of Proposition 1 will allow our community to bring the maximum amount of federal funds available back to our own community.
St. David’s opposition is difficult to understand, because without the passage of an increase in Central Health’s tax rate, there are little to no local funds available to participate in the 1115 waiver. The additional tax revenue is necessary to draw down the significant federal funds available for our community. Otherwise, money is left on the table.
The 15 Travis County projects submitted in the first round 1115 Waiver funding include healthcare service delivery expansion and improvements in primary care, specialty care, and behavioral health services—all for low-income un- and underinsured residents of Travis County. These are not projects that will fund either graduate medical education or the medical school. Descriptions of these projects are available to the public atwww.texasregion7rhp.net.
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.
Copies of Central Health’s letter to St. David’s HealthCare as well as St. David’s response follow.