Travis County Commissioners Court
Tuesday, July 19, 2011 (Agenda)
Item 4
Item number 4, receive and discuss the Travis County health care district dba central health draft for fiscal year 2012.
good morning.
is there another copy of this for the clerk?
>> yes.
>> thank you.
>> good morning, judge, Commissioners.
nice to be with you here today.
we're here to talk about our budget for fiscal year 2012.
and judge, how much time would you like to us spend?
I realize we're at 11:40 right now.
>> well, I'm sure that all that you have to say is so important we don't want to cut you short, but we normally recess for lunch at 12 noon.
>> just a couple minutes from me -- how about one minute from me before we start.
we wanted to bring to you discussion today about our draft budget.
we are in a slightly different point in our process this year than we normally have been in prior years in that our board is considering significant policy decisions around the setting of the tax rate, the use of reserves.
we're still tinkering with our expense line items so it's still very much a work in progress.
our board is meeting again tomorrow night and will meet again on August 3rd prior to bringing you on preliminary budget on August 17th.
so we're still on schedule, we're just a little bit -- still moving through some of the discussions at our board.
today we're going to take you through some information that really takes us back to the beginning so we have a full history over the last seven years and how that leads to the conversation for this fiscal year 2012.
john, I'll turn it over to you.
>> thank you.
let me start out by pointing out again what trish pointed out.
this is a draft budget, still a lot of work being done on it.
the numbers are changing certainly from week to week if not day the day.
remind you first of what our vision and mission is.
our vision, our shared vision is that central Texas is a model healthy community and our mission is to create access to health care for those who need it most.
this is a slide that we showed you last year.
we're still sort of in this journey but we're going to try to provide you some information today on where we've been and where we're going and how we're going to propose how to get there because we have been in existence, this is our seventh fiscal year.
we have been in existence for a while and we think that we have begun to fill the mandate that we've started out with but we've still got work to do out.
to give you a quick overview of the presentation, we're going to talk about service expansion history, about the efforts we have taken since our beginning to expand access.
talk about our financial and operational history.
talk to you some about the service expansions that are underway or planned or included in the five-year forecast, and then show you some highlights from that five-year forecast.
talk about policy considerations that are inherent in our budget as you guys have in your budget.
look at an overview of our 2012 draft budget, next steps and then q and a.
>> I'm larry wallace, chief service delivery officer for central health, and since the inception of the district, our primary goal has been to expand access to care.
and we will show you through some of the information that will be provided a little bit of history of our work and as trish has already said what we propose going forward.
key to us is who needs our services, what services should be provided, and where.
and so we've tried to answer those questions really as it undergirds our work for the last six years and continue going forward.
primary care continues to be the foundation really of our service delivery strategy.
there is much noted on the value of primary care.
and going forward with some of the proposed changes, we realize there will be more individuals seeking care.
and with the shortages that currently exist, we've really focused on trying to develop and maintain and expand a verbose primary care network.
community care serves as our primary partner for primary care, and our charts will show our expansion and growth over the last six years.
who we serve is the medical assistance program enrollees and we provide support up to people up to 200% eligible residents in Travis County.
and this chart shows the growth of the medical enrollment program.
starting back in '90 --
>> 2005.
>> -- 2005, a little more than 8400 individuals, and now we're projecting in excess of 20,000 enrollees.
keep in mind, we have people that come in and out of the program and over any 12 missouri period we can have as many as 36,000 individuals that participate in the medical assistance program.
the next chart shows our activity around primary care visits.
and again, this is a recap that shows really incremental increase over time.
we haven't had really a major increase from year to year, but as we have opened up new sites, expanded existing sites, increased our work with contract partners, communities care, again, is our primary source of primary care, however, over the years we've had the opportunity to develop contracts with our partners.
and really they show a significant growth since the inception of the numbers that they generate on our behalf.
so those relationships are very important to us and we seek to maintain them and expand them.
we always remain open to our partners who can create additional capacities.
we always want to sit down, talk about what that means and how they can create more access to our patients.
>> and larry, just for the record for those who are listening, give us more of an idea who those partners are, mhmr, seton, st.david's.
>> well, peoples community clinic, el embassy buen, lone star care, which is a I don't remember partner of us, with us.
>> simms.
>> simms foundation is a contract that we entered into within the last year, I think.
and capital area dental foundation for dental services.
so those are the partners that we work with.
and continue to reach out to others who might want to partner with us.
this chart shows our impact on psychiatric care visits, and again, it's a significant increase from the start.
and shoals creek and Austin lakes are really the places where these services are provided.
and I think you are aware of our investment, our continued investments in these services to try to help meet the need as others withdraw their services or funding is eliminated.
>> do you want to add anything, trish?
>> I think as you can see from the chart, we started off funding central health began funding patients in psychiatric services in 2007 which was the result of the psychiatric services collaboration we created in the community, which is still ongoing.
this has been a very significant area of need as well as growth in the number of people served, but because the services were not available, we're really seeing the community now avail itself.
I think that, however, this is one very good indication of how we have a very significant unmet need in the community and even when we've made the kind of progress that we have, we're still facing a very, very -- very much a shortfall of appropriate mental health services.
>> is that any direct -- I guess can you describe and tell me some of the relationships that we have with the incarcerated persons under the
>> [indiscernible] that have psychiatric needs.
and, of course, needing medication, and not only that but needing the familyship relationship whereby they are able to be maybe more functional.
I guess does this reflect any of that relief factor from -- from these persons being incarcerated to whereby they can become more stable with the proper medication and also relative contact?
>> well, I guess the services that central health funds are for those who are not committed.
so it would be those who are not in the jail system.
>> so there's no relationship.
>> but it doesn't mean that once someone isn't released from the justice system and in need of psychiatric services there wouldn't be a connection.
>> but after incarceration is there any outreach to help facilitate their needs?
>> that really occurs through Austin-Travis County interval care and the health authority and the work it has connected with both the sheriff's office -- primarily, you know, the courts and the sheriff's office.
and that -- that -- that work is reflected in our stakeholder group.
all those parties were on at the table when we look at how we impact service delivery.
>> all right.
thanks.
>> this next chart just gives you a summary really of our work and where the services are provided.
from '08 to what we project for this year, our increase in primary care visits that is correct category, that includes dental and behavioral health, it increases by over 100%.
the totals for '08 were a little more than 200,000 and we're projecting for this fiscal year to end up a little bit more than 281,000.
you can see the benefit of our contract to providers over the last four years.
that area really shows the most significant increase if you will percentage wise, and those contracts tobacco of --contracts continue to be of very much value to our organization.
>> this next slide is a look at expenditures and revenues over our seven-year existence.
it's got a lot of data in it so let me the you through it.
take a moment to do that.
again, the first fiscal year of our existence was 2005.
we're in 2011 now.
and the maroon bar that you see there represents our expenditures, our actual expenditures in 2005 through 2010.
and then the budget for 2011, the blue bars, the dark blue bar is property tax and the light blue bar is all other revenue, which is primarily the rent revenue both base and additional rent that we receive from seton for the lease of brackenridge hospital.
you can see that in every year our expenditures exceeded our property tax, and we have budgeted for additional rent from seton in every year, but as you'll see when we talk about the five-year forecast, that rent has been sort of more variable.
our property taxes is more predictable than that.
but you'll see that we have done better relative to the way that we budgeted in almost every year.
you also see our tax rate, which started out at 7.79 cents per $100 of valuation, stayed that way in both f.y.
5 and '06 and is down in the current year to 7.19 cents.
and then below that you see the years in which we have gone above the effective tax rate, noting that in particular in the last two years, fiscal year 10 and the current year, bev stayed at the effective tax rate -- we have stayed at the effective tax rate.
so on average our increase over that seven-year period has been less than 3%.
it's 2.7%.
so we are in our seventh year of existence and a lot has happened since we were approved by the voters.
I think what this slide shows sue that we have had a gradual increase in both our expenditures and our revenues.
but really there's been a lot that's certainly changed since we were in existence.
when I was preparing the presentation, I reminded me self, for example, that in the first month of our fiscal year 2005, barack obama was running for office, not for president, but for the senate.
he was not yet elected to the senate.
and I also noticed that gas prices back then were $1.75 in October of 2004.
trending down to $1.50 in December of that year.
>> don't make me cry.
>> exactly.
>> [laughter] I felt bad when I saw that statistic.
so there's a lot that's changed both at the national level and at the local level.
>> before we go off the slide, can you remind us with regard to other major metropolitan counties that have health care districts, where do we -- where do we stand with regard to our tax rate in comparison to others?
>> I don't have the other districts with me, but we are well below certainly all of the major metropolitan hospital district areas, we are well below those.
in some case we're almost a third of what their rates are.
>> we are about half -- at the greatest level we're about half of the smallest district and we're about a third of the large.
anywhere from 23 to 26 cents per hundred dollars of value -- hundred dollars of valuation and we're at 7.
>> we have none that -- our tax rate is considerably lower than comparable metropolitan counties.
and we always knew that this day would come where our expenditures would exceed our revenue because our tax rate is exceedingly low in comparison to our comparable.
>> and we knew there was such significant unmet need which was part of the reason for thereconsideration of the districts and we have demonstrated that.
>> this first glance, this last bar, the fiscal 11 bar, if you had no history on the health care district, it might scare you.
but we knew this was going to come.
this is not at all surprising.
>> in fact, we've realized what we intended to do when we set out which was to expand access to care and provide is services that were not being provided.
I would consider that a victory.
>> this is in some ways very happy news that we have expanded our service delivery to such an extent that now it is time to take a meaningful and well informed look at the tax rate.
>> one other point to make about that, just as a comparison, is that our tax rate is lower than the tax rate of I think most of the emergency service districts here in this area.
their tax rate, of course, extends to a smaller area that they are responsible for, but we have a much larger area that we're responsible for, all of Travis County.
and so with that, let me -- let me move forward and talk to you a little about the five-year forecast that we did back in April.
we've been working with our board for some time now in preparation for the 2012 budget.
we started off with this five-year forecast back in April, and like all forecasts, the numbers that we put together are based on broad assumptions.
and they are conservative estimates for that forecast period beginning in 2012 and extending through 2016.
so the forecast is not intended to be a precise indicator of where we expect to be, it's really just a tool to help us identify our revenue and expense trends and what the related policy issues are going to be as we prepare the 2012 budget and look forward to those future years.
let me go back and recap.
this is what trish was talking about earlier.
when we went over the slide showing our seven-year history, if you looked at some of those early years, you saw that we did much better than we had expected, and looking at this slide you see this is year by year beginning in our first year of existence in 2005.
these numbers represent what we budgeted.
in other words, in 2005, we budgeted to receive, to end the year with 12.7 million.
that being the contribution that was made by Travis County and the city of Austin to the health care district in that first year to help us get started.
in fact, on an actual basis, we exceeded that.
we ended up with a surplus in that year of 31.3 million.
and then again moving forward, because of the uncertainty of some of the revenue that we get, the seton lease revenue, for example, we budgeted to actually spend down some of the money that we had received in 2005, 3.4 million.
instead, again we ended -- and we also increased the tax rate 3% in that year.
but we ended the year with an additional $25.7 million surplus.
so we have done much better relative to budget, again because of mostly because of seton lease revenue that we didn't expect to get.
so you see, for the first three years there what the story was, and then picking up in 2008, again in 2008 we budgeted to spend down some of our reserves, but we ended the year better.
same story in 2009.
then by the time we got to last year, 2010, we had built up a fund balance that was fairly large and although our expenditures had continued to increase since our inception.
we budgeted to come in flat, in other words, we budgeted to spend exactly what we expected to bring in, and instead we ended up with a $16.4 million surplus again mainly due to unanticipated revenue from the seton lease.
that brought us to the current year 2011 with our reserves bit you will more than they had built up more than 100 million, we felt like we couldn't ask, we should not ask for a tax increase in that year and we didn't.
instead we started out originally to spend down 10.8 million, then we came to the county back in may with a budget amendment that took that use of reserves to a budgeted 17.3 million.
so for us, 2011 really is kind of a watershed year.
we've been lucky.
sometimes it takes longer to get the contracts in place for the patience to the right place where we can see them.
we'll probably have some savings built from the revenue and expenditure side.
however, for the first time we will spend down some of our reservess for the first time in our existence.
and I'm going to turn it back to larry to talk about going forward in the future with our planned expansions.
>> over the next five years, we have a very significant work that we will realize.
it's already began.
and this chart shows beginning in fiscal year 12 and moving through fiscal year 16, the anticipated additional patients that will be served.
now, that's over and before what we are serving now.
and the previous chart shows our primary care activity to be around 280,000 visits.
we find that most of our patients come see us two to three times a year, and so that is going to equate to about 92, 94,000 individuals.
so the numbers that we're showing you is really incremental increase of individuals over and above what we are currently serving.
and how we plan to get there, and it's important really for budget planning, we don't like to try to do things one year because going to be impact next year we have to sustain it been build it into our budgets.
>> [one moment, please, for change in captioners]
>> going, forward, the new north central health center, and that -- that facility has capacity to serve 15 to 20,000 individuals.
as we've talked to you about before, we will relocate the patients that live closer to this facility and it's a choice and the -- the 5,000 or so that we main closer to -- that remain closer to our existing location, we are in the process of developing a strategy where those services can continue.
>> one question in a came out with -- that came out with that, I want to maybe revisit it, that was the transportation, public transportation that may be made available to get to the new construction site.
has that basically been ironed out because that question did come up a few times.
to get from, you know, maybe a site that's no longer in service and then to get to this additional site, transportation concerns did come up.
public transportation.
so can you maybe talk about that just a little bit.
>> yeah, I think that it's -- if we think about who we're serving in this new site, our original analysis showed us that the majority of patients that were coming to northeast were actually in this north central area.
so those folks will actually have the ability to go someplace closer.
we're anticipating that there's a roughly 5,000 or so individuals that remain in this area where the current location is.
and so those folks would probably gravitate towards what we remains there, again, making it a closer not really requiring any additional transportation from that standpoint.
we don't -- there may be folks that live in this northeast area that would choose to go to the new facility, that's totally their choice.
but we found that the actual transportation routes to the north central are very good, because their main lines are both on lamar and on braker lane.
>> so that's been taken --
>> yeah, there's a bus stop right there at the facility.
>> okay.
because you know if you all recall, it did come up.
>> it did.
>> I just wanted to make sure that what the public is hearing is that there is -- there are opportunities.
>> yes.
>> we think this actually improved that transportation.
>> thank you.
>> well, we're excited about this new facility and what it's really going to bring to the community.
and we'll realize the impact beginning really next year.
so as you look at the bar chart and it shows the incremental increase in additional patients in fiscal year '13, it's a little bit more than 22,000.
but we believe most of that will be as a result of
>> [indiscernible] site and we're going to stage it over time, it's not going to happen day 1.
we believe it will really take probably 18, 24 months to bring it to the place where we want it to be.
in addition there's renovations occurring at the east clinic.
which are currently underway.
it's going to expand our capacity.
that's going to take a year to complete or thereabouts.
so when you look on the chart, again, we believe that our significant increase will -- will probably impact fiscal year '13 and going into '14.
same thing with the south clinic.
that renovation is complete.
william cannon, we are in the process of really doubling the capacity.
there's another -- there's another site that's right next to ours and we're in the process of -- of renovating and that will double the space to allow us to really expand the model of care that's provided in that community.
and we believe that will also factor into what our activities are for next year.
and then our last major project is our southeast hub and that's the purchase of the v.a.
clinic.
as you probably know, we don't expect to be able to occupy that facility for approximately two years while the v.a.
continues to build their new facility.
after which time we will -- our plan is to duplicate the scope of care that we have at the north central, which will be -- the whole range of primary specialty care, dental, pharmacy, because -- because the facility is already geared to do that.
and the v.a.
offers really -- they offer more services than we do and I'm kind of interested in maybe piggybacking on some of the things that they have in place.
67,000 square feet and we are really excited about the opportunity there.
and you can see the impact shows really in -- in fiscal year '15 and 16, that's where you see the significant increase in numbers in new individuals that we will be able to serve.
>> let me turn now to the five-year forecast and show you the initial results.
as we continue to work through the 2012 bucket, we have gone back -- 2012 budget, we have gone back in a couple of cases to also update the forecast, especially for known decreases that we see in expense that are going to make those out years look better.
there's a lot of information on this slide.
but let me try to walk you through it.
the first year of the five year forecast again is the same as the budget year 2012, so you see information that starts in 2012 and then information about where it ends for the last year in the five year forecast, but, for example, our total operating reserves are the total of our allocated and unallocated reserves that we're just combining for simplicity's sake, we start out at the beginning of 2012, with 80.1 million on hand.
that's after we set aside the separate reserve that the board will establish for the hmo of 27.6 million.
so that reserve starts out at slightly north of 80 million.
and then you see our expenses, the expenses are constant in each one of the scenarios, each one of the three scenarios that we ran for the five-year forecast.
so the expenses remain constant.
they start out at -- at 115.6 in 2012 and they gradually increase over to 147 million in 2016, due to those expansions that larry just walked you through.
then the first scenario that we looked at was those expenses remain constant, the revenue is at the effective tax rate every year, the -- th rent that we receive from the seton lease remains the same, and that revenue at the effective tax rate, total revenue, is 99 million in 2012, doesn't go up much because we're staying at the effective tax rate, increases, though, to 103 and that's mainly just from the new property that comes on to the tax rolls.
then we show -- then we did a scenario where we went up to 4% above the effective rate in every year.
that bumped up our revenue initially in the first year, 2012 to 102.1.
it bumped it up more significantly by the time we get to 2016 because again the assumption is that we go every year 4% above the effective rate.
lastly, we did a scenario where we went up to 8% every year and that scenario bumps it up to 104.8 million in 2012 and 138.9 in 2016.
then lastly, our reserves started out at 80 million in 2012, you see where they ended up under those various scenarios, the first one should be at effective and that produces a deficit of 73.1.
again, this is not a prediction of where we're going to be because this is not a scenario that we can live with.
we'll have to do something in terms of a fix, either on the revenue side or on the expenditure side.
but that just shows us where we would end up just running the numbers that way.
at the 4% above effective scenario, we have a deficit at the end of 2016 projected at 28 and a half million.
and then at 8%, we have a positive reserve or fund balance of 27.3.
those again were the initial results.
we've gone back and we've made some changes to the forecast, just based on work that we have done with our partner community care and also some estimates from what would happen with health care reform in the expansion of medicaid in 2014.
so we made two changes to community care's expense budget.
the first change was we have worked through their original number that they asked for next year and we've reduced that by 7%.
so we're down now.
they started out at about 41.7.
we're down now 7% well below that.
what we've done is we've assumed that that 7% reduction would roll through to every year.
so when they presented their five-year numbers to us, we need this much in 2012, 2013 and so on.
we have rolled those numbers back by 7% a year and then we also assumed that with the expansion of the medicaid population, in 2014, they would begin to see more medicaid patients and that would mean 4 million in additional revenue to community care.
>> can you basically tell me, though, this is a hot button issue, even at the federal level, dealing with possible cuts in medicaid, medicare, social security, a whole bunch of things on the table right now, have you are these projections taking into consideration the possibility of medicaid cuts from the federal level?
if so, how will that impact us if we have to still -- if we still have to deal with the medicaid situation, of course we're dealing with indigents, a person -- but in the medicaid aspect of things, what -- what overall -- I guess everyone is kind of following this to see where it's going to ends up.
I really don't know.
none of us know at this point until they come up with something at the federal level to see how this trickle down effect will -- will impact local governments.
so my question to you is how -- the projections and all of these other things that we have on the table, does it take into consideration what type of impact you have to experience as far as medicaid?
>> that's a very good question.
and the answer is no.
we have not -- we have assumed that the medicaid expansion will occur in 2014.
and that there will be no significant reduction to the federal share paid for medicaid revenue.
now, that's something that we pointed out.
our board asked us to run these scenarios and -- and certainly some of our board members understood that there are changes out there to the health care system predicted in 2014 and so what we did was -- we went -- this is a fairly aggressive assumption, I think.
but when we presented it to our board, we presented it as such.
and we also talked about other risks that are there at the federal level for the revenue that we get from seton, the additional rent that we get from seton and so on.
so you are absolutely right.
it is -- it is trying to gaze into a crystal ball at this point.
but we've tried to present both, you know, sort of a worst case and a best case to our board.
this may not be the absolute best case scenario.
it is a somewhat optimistic scenario.
>> I guess it puts a lot of local governments in a wait and see posture, because really even from this Commissioners court you have to -- as far as what we're dealing with, you know, the trickle down effect on what happened at the federal level, we will have to kind of wait and see.
so -- so that puts I guess all local governmental entities in that type of setting.
so -- so again, I -- I understand your aggressiveness in what you are trying to do and to come up with some type of -- of finalized projections.
but it's -- I'm going to have to put a question mark through it in my mind until we exactly see what type of impact that will have on all local governments that receive trickle down moneys from the federal government programs per se.
>> I think that's right.
I mean this is a picture of what could happen, it's not necessarily what will happen.
>> right.
>> on page 21, you give us an overview of the 2012 budget.
>> yes, sir.
>> let's turn to it before we run out of time.
>> you bet.
>> we are -- this draft budget that we're presenting to you today does have a presumed 8% increase above the effective o and m tax rate this year and it also includes 1.3 million for debt service in the next item on your agenda has to do with that, with the notice of intent to issue co's.
so the 75.5 million that's in our 2012 draft budget includes both the 8% increase to our o and m rate at this point and also a date service rate that's going to be somewhere on the order of about .15 cents per $100 of assessed valuation.
we have in our revenue projections, we have taken our seton lease revenue down from 29.5 this year to 28.5 and we did that when we synced up our numbers with seton, what they were expecting to get for next year.
we have also reduced our interest revenue and our tobacco settlement revenue, which the county participates in and which is based on interest rates on how the money in the permanent trust fund earns interest revenue.
so with the current interest rate environment, we're simply trying to be as realistic as we can.
so we have taken that projection down, also.
then we are expecting to use less in reserves in 2012 than we are in 2011, 6.3 million less.
that 11 million we are projecting for the 2012 budget would be 6 million for operation and 5 million for the hmo reserve that we are going to set aside.
so it will come from that reserve.
our health care delivery, it looks like it's actually going down, but it's not.
I'll walk you through a slide that -- that explains the difference.
hour health care delivery base budget is actually increasing from 2011 to 2012.
our administrative costs are going up by about 500,000.
this is mainly due to centralizing some costs in -- in administration.
for example, our facilities management folks are now budgeted out in the health care programs, and the health care cost centers, but we're pulling all of those back in house so we can keep better track of them in our administrative program.
and then we have the sindero paid in capital, the paid in capital amount or distribution that the district will make to our hmo.
hmo that will increase by 3.5 million, will increase 25 million.
so you see told sources and uses of funds at 117.1 million.
sendero.
again going back to the 2011 health care delivery budget, which was 108 million in total without the administration included, and there were two items in that 2011 budget that are one-time items, one is a reduction in the regional upl program.
this is another amendment that the county did for us to allow us to access funds that we have set aside in prior years.
they were funds that the board had appropriated in prior years and we were allowed to pull those into our operating budget in 2012, but that is a one-time cost.
then we have changed the way that we're budgeting for depreciation.
we used to budget for fully, that is including the depreciation expense in our budget.
but we no longer do that.
what we have done instead is to show what the depreciation amount will be, then we have an add-back in exactly the same amount that gets us down to zero because depreciation doesn't require an outlay of funds for that.
it's simply an accounting number.
so in order to not have to appropriate additional money, we simply reduced that depreciation down to zero, still disclosing what it was going to be.
then we have some unused service expansion funds this year.
we have -- we do have, as I said earlier, a $3.1 million increase in community care.
started out at about 41 -- or started out higher than that, excuse me.
then some -- some miscellaneous changes to get you down to what our health care delivery budget is.
looking again a little further at 2012 draft budget, the tax rate that we are proposing in this draft budget is 7.97 cents.
our capital budget for next year is expected to be 2.3.
the capital budget for 2011 includes the amount that the court approved as an additional appropriation for us to buy the v.a.
facility and that's why there's that large difference between capital budgets from 2011 to 2012.
we do expect at the end of 2012 that our capital reserve will be down to 2 million which is the money that we are getting in certificates of obligation to renovate that v.a.
facility.
our allocated reserve will be 15.7 million.
our risk based capital reserve will be 22.6 million.
for future years.
and our unallocated reserve will be 56.9.
we are working with our board to look at what we think the -- the true number for our unallocated or emergency reserve should be.
and so we may make some changes to that policy that we'll share with you as we go forward in that process.
>> can I ask you on the reserves.
are you wondering the same -- the same -- are you under the same rules that the county would be in -- at least 11% of our moneys and reserves, that cuts down the rate of interest that we -- when you want to borrow money.
do we come under the same --
>> we are not under those.
we are actually under a much more aggressive policy.
that's part of the reason that we're looking at that.
we have this reserve level shown here at least for 2011 is 150 days, which is about 45 percent as opposed to the county's 11%.
>> annual.
>> right.
so it's more of a health care standard than it is a governmental standard and the discussion that we're having with our board now is that we want to make it, we may want to make it a mix of the two.
part health care, part government.
somewhere in the middle perhaps of 30%.
still, leaving us plenty of money on hand to deal with emergencies as they come up.
but not as aggressive as it is now.
>> so the --
>> because our largest source of revenue is property tax.
>> right.
so the co's that -- that you are anticipating borrowing, do you know what the interest rate on that would be?
>> we have some estimates.
right now, we think -- about 4.5% and that's for a taxable rate.
so we're expecting to get, we may not get quite as good of a raise as the county does on the stuff that you guys issue, but we're hoping to get a good rate since our tax base is essentially the same as the county's.
>> I'll hold on that.
debt service
>> [laughter] anyway credit card type of stuff.
>> I would mention one thing.
going back to slide 20, I think it is.
we still have unused service expansion dollars for this year.
the year is not over.
it's possible our board may tell us to keep -- going ahead and take some actions that we could possibly do this year to spend those funds as well.
so it's possible our total expenses may actually look larger next year by the time we come back to you with our next draft of the budget.
or our preliminary budget, I should say.
>> so where is the capital expense for the new clinic in north Austin?
>> it was already in our prior capital budget.
some of that was -- going back, some of it went back to 2008 I believe.
>> and you were kind enough to provide a proposed schedule for us.
next steps.
>> yes.
>> next steps are for our board to approve a preliminary budget, we'll go from draft to preliminary, with a recommendation on the tax rate.
we will bring that preliminary budget to the court on August the 23rd and on that same day we'll bring to you hopefully the sale of our certificates of obligation, the 16 million and our certificates of obligation for you to approve that sale.
we're going to hold public hearings on September the 1st and the 7th.
and then our board will have a special called meeting on September the 14th to adopt the budget that we will then bring to the Commissioners court, hopefully on September the 27th or on the 20th, rather, with the 27th as a fall back date if we need that.
>> okay.
>> I just have one other question.
just out of curiosity, how much money do you all have to give up when you do the homestead exemption?
>> have we kept up with that?
>> 65 and over?
>> I don't know.
I'm sorry, I haven't calculated that number.
but I can find that and I'll get it to you.
>> oh, thanks.
>> so residents who want to see a copy of this
>> can go to our website.
>> should be directed to the health care website.
and that's on the last page.
>> on the last page, yes.
>> okay.
fascinating information.
while we're still hot.
The Closed Caption log for this Commissioners Court agenda item is provided by Travis County Internet Services. Since this file is derived from the Closed Captions created during live cablecasts, there are occasional spelling and grammatical errors. This Closed Caption log is not an official record the Commissioners Court Meeting and cannot be relied on for official purposes. For official records please contact the County Clerk at (512) 854-4722.
