FISCAL YEAR 2023 Budget & Tax Rate
Central Health staff plans to prepare the FY23 proposed budget at a property tax rate of 6% over the M&O (Maintenance and Operations) no new revenue rate to achieve priorities approved by the Board of Managers in the Central Health Strategic Workplan and recent Equity Focused Service Delivery Strategic Plan, also known as the Healthcare Equity Plan.
Proposed 2022 Meetings Calendar
|
May 11, 2022 |
Strategic Planning Committee – Budget Strategic Objectives (BSO) |
|
May 25, 2022 |
Executive Committee Meeting |
|
May 25, 2022 |
|
|
June 8, 2022 |
Strategic Planning Committee – Budget Strategic Objectives (BSO) |
|
June 15, 2022 |
Executive Committee Meeting |
|
June 15, 2022 |
|
|
July 27, 2022 |
Executive Committee Meeting |
|
July 27, 2022 |
Board of Managers Meeting – proposed budget |
|
July 27, 2022 |
Strategic Planning Committee – Budget Strategic Objectives (BSO) |
|
Aug. 10, 2022 |
|
|
Aug. 24, 2022 |
Executive Committee Meeting |
|
Aug. 24, 2022 |
|
|
Aug. 31, 2022 |
|
|
Sept. 7, 2022 |
Strategic Planning Committee – Budget Strategic Objectives (BSO) |
|
Sept. 7, 2022 |
Executive Committee Meeting |
|
Sept. 7, 2022 |
Board of Managers Meeting – budget & tax rate vote |
PROPOSED FY23 STRATEGIC PRIORITIES
Access and capacity
-
- Continue eastern Travis County site expansions in Hornsby Bend, Del Valle and Colony Park
- Development of multispecialty clinic at Rosewood-Zaragosa
Care coordination
-
- Implementation of Epic electronic health record
Member enrollment and engagement
-
- Implementation of MyChart patient portal
System of care infrastructure
-
- Development of financial and operational implementation plans
- Focus on affiliations with healthcare and community partners
- Continue development of direct clinical practices infrastructure
- Identify and support critical on-demand operational and administrative capacities
FY2023 Proposed Tax Rate 6.0% over M&O No New Revenue Rate
FY 2022 Approved |
FY 2023 Proposed |
|
|---|---|---|
Average Taxable Homestead Value |
$381,238 |
$427,918 |
Average Taxable Homestead Value Appreciation |
8.7% |
12.2% |
Tax Rate |
11.1814 |
9.8684 |
–M&O |
10.9204 |
9.6604 |
–Debt Service |
0.2610 |
0.2080 |
Tax Bill |
$426.28 |
$422.29 |
–M&O |
$416.33 |
$413.39 |
–Debt Service |
$9.95 |
$8.90 |
Central Health Property Tax Impact Statement: FY2022-2023
FY 2022 Approved Budget and FY 2023 Proposed Budget Sources and Uses Summary
DESCRIPTION |
FY 2022 APPROVED BUDGET |
FY 2023 PROPOSED BUDGET 08/24/2022 |
7/27 to 8/24 Variance |
|---|---|---|---|
TAX RATE |
0.111814 |
0.098684 |
(0.0000371) |
SOURCES |
|||
Property Taxes |
260,933,097 |
281,605,053 |
(105,845) |
Lease Revenue |
13,422,399 |
13,145,328 |
– |
Tobacco Litigation Settlement |
3,000,000 |
4,500,000 |
– |
Other |
3,000,000 |
1,500,000 |
– |
Total Sources |
280,355,496 |
300,750,381 |
(105,845) |
USES |
|||
Healthcare Delivery |
192,705,261 |
280,168,877 |
2,349,110 |
Administration & Tax Collection |
15,391,099 |
22,149,360 |
469,593 |
Total Uses |
208,096,360 |
302,318,237 |
2,818,703 |
RESERVES |
|||
Healthcare Delivery Contingency Reserve(1)(2) |
226,521,399 |
330,823,722 |
(2,924,548) |
Emergency Reserve |
38,719,836 |
38,719,836 |
– |
(1) previously reported as an appropriated use of funds in Healthcare Delivery
(2) Healthcare Delivery Contingency Reserves to be appropriated for FY2023
Uses Summary (Attachment B)
DESCRIPTION |
FY 2022 APPROVED BUDGET |
FY 2023 PROPOSED BUDGET 8/24/2022 |
|---|---|---|
HEALTHCARE DELIVERY |
||
Intergovernmental transfers: |
||
IGT – CCC DSRIP |
15,509,298 |
– |
Total Intergovernmental Transfers |
15,509,298 |
– |
Purchased Healthcare Services |
||
Primary Care: Medical, Dental, & Behavioral Health |
63,090,000 |
66,111,822 |
Specialty Care: including Specialty Dental |
17,175,000 |
24,388,000 |
Specialty Care: Behavioral Health |
1,383,856 |
12,000,000 |
Post Acute Care |
2,125,000 |
5,550,000 |
Pharmacy |
14,250,000 |
17,000,000 |
Community Health Care Initiatives Fund |
875,000 |
1,750,000 |
Purchased Healthcare Services |
98,898,856 |
126,799,822 |
Direct Healthcare Services |
||
Podiatry |
751,726 |
|
Cardiology |
837,410 |
|
Neurology |
362,511 |
|
Gastroenterology |
465,026 |
|
Nephrology |
196,081 |
|
Pulmonology |
228,359 |
|
Diagnostics and Clinical Expenses |
2,832,148 |
|
Direct Healthcare Services Total |
– |
5,673,261 |
MAP Eligibility – Increase in eligibility period |
2,000,000 |
2,000,000 |
Total Healthcare Services |
100,898,856 |
134,473,083 |
Healthcare Operations & Support |
||
ACA Healthcare Premium Assistance Programs |
13,319,929 |
14,648,261 |
ACA Education and Enrollment |
583,000 |
588,000 |
Real Estate and Campus Redevelopment |
5,303,564 |
3,693,750 |
UT land lease for teaching hospital |
981,231 |
1,027,277 |
Salary and Benefits |
18,866,066 |
25,545,451 |
Legal |
339,000 |
433,000 |
Consulting |
840,000 |
1,740,000 |
Other professional goods & services |
9,244,346 |
8,138,035 |
Outreach and Education |
942,274 |
1,428,000 |
Leased Facilities, Security and Maintenance |
1,947,000 |
2,348,500 |
Insurance and Risk Management |
142,000 |
250,000 |
Phones, Computer Equipment and Utilities |
3,293,473 |
6,762,525 |
Printing, Copying, Postage and Signage |
384,056 |
620,305 |
Travel, training and professional development |
280,966 |
801,502 |
Other operating expenses |
39,741 |
174,445 |
Health Care Capital Line of Credit |
1,091,773 |
500,000 |
Debt service – principal retirement |
4,060,000 |
4,345,000 |
Debt service – interest |
2,092,676 |
1,651,744 |
Transfer to capital reserve |
12,546,013 |
49,000,000 |
Total Healthcare Operations |
76,297,107 |
123,695,794 |
UT Affiliation Agreement |
– |
22,000,000 |
Total Healthcare Delivery |
192,705,261 |
280,168,877 |
ADMINISTRATION |
||
Salary and Benefits |
7,134,758 |
9,131,752 |
Legal |
1,456,636 |
2,756,636 |
Consulting |
1,341,120 |
1,626,520 |
Investment Services (Travis County) |
115,000 |
115,000 |
Benefits and Payroll Administration Services |
168,243 |
356,266 |
Other professional goods & services |
819,787 |
1,156,850 |
Marketing and Communications |
209,958 |
184,098 |
Leases, Security and Maintenance |
274,250 |
929,200 |
Insurance and Risk Management |
375,000 |
455,000 |
Phones, Computer Equipment and Utilities |
401,716 |
629,573 |
Printing, Copying, Postage and Signage |
60,745 |
54,725 |
Travel, training and professional development |
370,789 |
449,605 |
Other operating expenses |
492,244 |
156,485 |
Appraisal District Svcs |
1,179,284 |
1,155,350 |
Tax Collection Expense |
991,569 |
992,300 |
Cash held for self insured employee health benefits |
– |
2,000,000 |
Total Administration & Tax Collection |
15,391,099 |
22,149,360 |
TOTAL USES |
208,096,360 |
302,318,237 |
Increased Investments in Healthcare Services
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Purchased Healthcare Services
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Direct Healthcare Services
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Healthcare Operations & Support
FY2023 Capital Funds Planning
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FINANCIAL FORECAST
Significant Uses of Funds
- Completion of all planned facilities
- Completion of two additional clinical facilities and one Respite Care site
- All cash funding with exception of previously issued debt
- Implementation of Epic Electronic Medical Record system
- Significant increases to clinical staff providing direct Specialty Care and ancillary services
- Increased access to Primary Care services
- Transition to more direct payments for hospital services
Risk Areas
- Economic
- Economic downturn or recession
- Workforce competition
- Inflation
- Regulatory
- Uncertainty of future supplemental program funding
- Local Provider Participation Fund (LPPF) status
- Degradation of 340B pharmacy program
- Financial
- Significant changes to hospital reimbursement programs
- Insurance risk-based capital requirements
- Changes to FQHC PPS payment levels
Assumptions
- Property Tax Revenue
- Future new construction estimates anticipated to be less than current year ($6.145 Billion estimated)
- Taxable Assessed Values anticipated to grow at a slower rate than current year
- Steady, straight-line tax revenue to reduce revenue volatility
- Other Revenue
- Continued receipt of Tobacco Litigation payments
- Continued ground lease and Parking Garage lease payments
- CEC lease payments discontinued after 2024
- No additional Downtown Campus lease payments assumed
- Third-party clinical revenue not assumed
- Healthcare Services
- Estimate 8-10% increase for medical inflation
- Increases in healthcare service delivery levels and additional facility capacity as well as new services provided directly by Central Health
- Increase infrastructure support for new clinical services
- Anticipate transition to a more direct hospital funding model
- Transition of Community Care Collaborative (CCC) costs beginning in FY23
- Continued enrollment and funding for CHAP and ACA High Risk Premium program
- Salary and benefits
- Accounted for salary increases and health insurance growth
- Accounted for rapidly changing market demands for staff
- Significant (>100) new staff to support direct Specialty Care services at future facilities
EXEMPTIONS
MAJOR TAXING JURISDICTIONS –FY 2022 EXEMPTIONS
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*Recent legislation increases Homestead for School Districts to $40,000
Proposed Changes to Exemptions for FY2023
- Established a methodology for incrementally increasing Over 65 and Disabled Exemptions based on a look back at the three year average increase in Average Taxable Homestead Value to create minimum incremental increases each year.
- For FY2023 the increase in the three year Average Taxable Homestead Value is 7%.
- Staff requests the Central Health Board approve recommendation to the Travis County Commissioners Court to increase Over 65 and Disabled Exemptions to $110,000 and maintain Homestead Exemption at maximum allowable of 20%.
