Travis County Commissioners Court
November 14, 2006
Item 30
Let's go immediately into health care.
>> I have a son that has one.
>> appreciate your patience.
>> thank you so much, judge. Trish young president of the Travis County health care district. Here to speak to you today about item no. 30, dr. Donald patrick of chair of our hospital and specialty care committee who has joined us. You have received materials in advance of today's meeting regarding the lease amendments that have been approved by the Travis County health care district board of managers on October 26th. And -- and I am -- I would be happy to run through very briefly the summation of the changes, if that would be helpful.
>> it may help just so the public will be informed.
>> yes.
>> you -- you were able to visit with most if not all of us in advance of today, so we understand what's happening. But -- for our watching public, it may be good just to kind of quickly summarize it.
>> be happy to. We have two categories of -- of amendments to this lease. And -- by way of background, this amendment has been prepared essentially as a result of the creation of the district two years ago. This lease original was held between the city of Austin and seton for the lease of brackenridge and children's hospital and upon creation of the district there were certain things that have changed that need to be reflected in this lease. We have two categories of amendments, one we are referring to as technical amendments, which do very basic things such as change city to district, remove certain provisions that are no longer valid bypassage of time and -- and deleted certain articles that address the actual closing that occurred back in 1995. Those -- those changes are reflected in the lease and have been approved by the board. In addition, there were a couple of substantive amendments that have to do with the payment to seton for operation brackenridge children's hospital in the area of charity care. The original lease did -- provides three categories of payments to seton for operation of the hospital. One is a charity care payment, which is to support the provision of services that are provided at brackenridge. A second is physician services, a third category payment relates to the medical assistance program, which is an actual payment for services rendered to medical assistance program enrollees. That document or that agreement, although it is provided for in the lease, the fact that there is -- that such an agreement exists, that agreement is outside of this lease and is -- is held in a separate document. We actually renewed that -- that map and provider services agreement in February of this year. I think that you may recall that at that time. But we are focusing -- what we are focusing on here today is the amendment to the charity care provision of this lease, which accounts for two changes. One the original lease as held by the city of Austin provided for charity care payments to seton only for those individuals that resided within the city limits of Austin. We have made an adjustment to the lease at $345,000 to the annual payment to seton, which reflects the remainder of the Travis County population outside of the city of Austin limits. Additionally, prior to the creation of the district, there were two medical assistance programs. One we referred to as the urban program, which was provided for and financed by the city of Austin. The rural program which was provided for and financed by the county. After one year of existence, the district combined those programs into a single consolidated medical assistance program that has a common eligibility criteria. Due to changes to that common eligibility criteria, there were certain individuals that under the prior arrangements or prior to the district would have been enrollees of the medical assistance program and there be we would have made payments to seton for the services that seton provides to them. Once the eligibility criteria was standardized those individuals, approximately 1400 or so, would no longer be eligible for enrollment in the medical assistance program. However, we still continue to treat those patients. They still continue to receive services at brackenridge and thus they have essentially moved from a -- a map enrollee with a payment source attached to it with the category of charity care. Likewise we made an adjustment to increase the chairt care payment to -- chair tee care payment to seton for those no longer comp salessed through map. That amount was 1.5 million per year. There were -- there is a -- assuming that you all approve this amendment today, there will be an -- a partial payment made for fiscal year 2006 to reflect a ramp up, so to speak, of that 1.5 million. Then 1.5 million will be paid on an annual basis going forward. Additionally the original lease did not provide for a -- for an expense inflater related to that charity care payment. Thus since 1995 the charity care payments to seton have been the same amount each year. Seton did ask for and we agreed to providing a cpiu inflater applying beginning in 2007. We think that is a reasonable and fair adjustment to make. The net effect of these changes essentially the -- the increase to seton for charity care payments is 345,000. There it is a change from a map payment from one program to the next of the 1.5 million. And so essentially the total -- the total charity care payments that we are making in addition to what we made before is -- is 1,845,000 on top of what we had been paying before. But again we are no longer making payments to seton under the map enrollee, under the map provider agreement for certain enrollees.
>> but having to pick up the county residents outside the city of Austin, seton picked up an additional approximately how many residents?
>> oh --
>> pretty big number.
>> it's about -- the city I'm sorry I don't have the number off the top of my head. The historical city of Austin spent about 85% of the total Travis County population, which is now around 800,000. So --
>> okay. Previously the -- the seton city of Austin contract did not include residents outside of the city of Austin. These changes will incorporate them and seton really I guess have been serving them since we --
>> that's exactly right, sir. We have been serving them prior to that as well.
>> right. Questions? It's something that we need done and --
>> uh-huh.
>> need to pay for it.
>> yes, sir.
>> move approval of the recommended changes. Discussion of the motion? We didn't give you a chance to say anything other than good morning.
>> good morning.
>> I'm awfully happy to be here and say hello. I know that the county is in good hands, I have worked with all of you, appreciate the work that you do.
>> we appreciate the outstanding work of the board. We know you all get paid for all you do
>> [laughter] all in favor? Show Commissioners --
>> Commissioner Davis is --
>> Commissioner Sonleitner, Gomez, Daugherty, yours truly voting in favor.
>> yes, judge, I have abstained. I have submitted a disclosure statement for this particular vote to abstain on this particular item, the clerk has the disclosure statement.
>> for the public just because your spouse --
>> right. Works for the daughters of charity, employed by the daughters of charity.
>> that does it, right?
>> yes.
>> thank you very much.
>> thank you very much. Again appreciate your patience.
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Last Modified:
Tuesday, November 14, 2006 6:30 PM