To clarify, I support the draft Committee resolution that Commissioner Gomez and I edited with staff support on late Thursday afternoon, finalized on Friday and posted here on the message Board Friday night. It appears from what I see posted today on the message board from Comm. Gomez’s office, she seems to be proposing a document prepared last week by staff by adding language Commissioner Gomez offered to my original resolution.
After listening to our discussion in Executive Session last Tuesday and working together with Comm. Gomez last Thursday, I no longer support my original resolution, but I do support the language posted Friday evening that our Committee worked on together. Here is why I support the Committee Resolution:
1. We strengthened the Whereas statements to include reference to the Health & Safety Code and county authority for ordering financial and performance audits of Central Health,
2. We kept Whereas statements giving context to the next Performance Audit and we streamlined statements connecting the Performance Audit to the current strategic plan
3. We reduced reference to the Central Health Board meeting that already occurred last week.
4. We focused most of our time together on the Scope –
Related to Scope of Work for the Performance Audit as our Committee draft compared with the early staff draft.
a. Both require the audit firm to be selected by Travis County (Purchasing Office) and to be free from substantial conflict of interest
b. Both require Central Health to pay for the Performance Audit
c. The Committee resolution also requires the Purchasing Office to consult with Central Health to make sure the Audit is useful in comparison to the last audit and in conjunction with other current work.
d. The Committee resolution emphasizes that the audit findings will be reported to the Commissioners Court and shared with the public
e. Both require information from Dell Medical School about the number of MAP and MAP eligible patients served and description of services
f. Both inquire about the status of developing an Integrated System of Care instead of also asking as in staff version about efficiency of indigent care.
g. Both ask about the whether the healthcare service records and performance metrics used by Central Health comply with industry standard or need improving
h. The Committee resolution requires new performance metrics for tracking improvement on any recommendations from the Performance Audit, progress on implementing the strategic and on closing gaps to meet the need in access to care.
i. The Committee resolution focuses on performance and avoids overly broad questions about accounting practices in years past noting that the County Auditor has reviewed publicly audited (and publicly funded) financial statements from Central Health annually and that Central Health has received budget awards from the Government Finance Officers Association for the last three years. The Committee agreed that if the Performance Audit reveals financial budgeting or audit concerns, the County Commissioners can amend the scope to include additional work in the finance arena. The Committee was mindful of duplicating work and public expenditures without ruling out additional auditing if warranted.
j. In the absence of any specific performance issue related to a specific law the Committee resolution omits the question about all federal, state and local laws.
k. The Committee resolution requires an analysis of Central Health’s outreach and marketing to their target population and to other groups
l. The Committee resolution requires improvements to the governance structure and a schedule for quarterly briefings with the Commissioners Court, Central Health executive staff and Central Health Board of Managers.
Looking forward to the discussion.
Commissioner Ann
P.S. I wrote this clarification all by myself!
