Fiscal Year 2018 Budget Update Central Health Board of Managers July 26, 2017 Jeff Knodel, CFO Lisa Owens, Interim Deputy CFO
How Central Health Leverages Public Funding (FY 2016 Actuals) Central Health Funding Community Health Care Impact Disproportionate Share $31,029,653 (DSH) Gross Hospital Costs $274,803,349 Uncompensated Care (UC) $42,934,389 Hospital Services Charity Care $4,251,733 Hospital DSRIP $53,242,473 DSRIP $22,825,048 Sendero Risk-based Capital $5,000,000 Health Sendero $85,974,331 Coverage ACA Subsidized Premiums $269,836 DSRIP $27,674,195 Ambulatory CCC $123,674,725 Care CCC Member Payment $24,632,814 Total $158,617,668 Total $537,694,878 Result: Central Health leverages public dollars to create 3.4 times their original value 2
Central Health FY 2018 Proposed Budget: Areas of Potential Risk Local • Adequate infrastructure to serve patient population • Aging population • Unanticipated delays to Central Health Brackenridge Campus redevelopment State • Property tax rate caps • Limitations to health services funding Federal • Repeal and/or replacement of Affordable Care Act • Possible changes to 1115 Medicaid Waiver 3
FY 2018 Proposed Tax Rate (4.5% over Effective Rate) FY18 FY17 (Proposed) Average Homestead $285,152 $305,173 Value Tax Rate 11.0541¢ 10.7385¢ Tax Bill $315.21 $327.71 Annual Increase = $12.50 (3.97%) 4
Central Health Property Tax Impact Statement: Fiscal Years 2017-2018 Actual Taxable 4.5% Over Percent Annual Appreciation Home Value Homestead Effective Tax Tax Bill Inc./(Dec.) Inc./(Dec.) Rate Value Rate - - - $200,000 $160,000 11.0541¢ $177 FY 2017 Baseline - - - $300,000 $240,000 11.0541¢ $265 - - - $400,000 $320,000 11.0541¢ $354 - - - $500,000 $400,000 11.0541¢ $442 9.00% $218,000 $174,400 10.7385¢ $187 $10 5.9% FY 2018 7.60% $322,800 $258,240 10.7385¢ $277 $12 4.5% 6.30% $425,200 $340,160 10.7385¢ $365 $12 3.3% 6.00% $530,000 $424,000 10.7385¢ $455 $13 3.0% 5
Central Health Tax Rate per $100 of Taxable Valuation 14.00 12.9 12.64 13.00 11.78 12.00 11.05 10.74 11.00 10.00 Cents 9.00 7.89 7.79 7.79 8.00 7.34 7.19 6.93 7.89 6.79 6.74 7.00 6.00 5.00 4.00 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Fiscal Year 6
FY 2018 Proposed Budget Property Tax Rate Update FY 2017 FY 2018 Approved Proposed Difference Budget Budget Update Tax Rate 11.0541¢ 10.7385¢ (0.3156¢) Property Taxes $169,806,722 $181,839,054 $12,032,332 7
Central Health FY 2018 Proposed Budget FY18 Proposed Budget FY18 Proposed Budget FY18 Proposed Budget Description FY17 Approved Budget (6/28/17) (7/26/17) Inc./(Dec.) Tax Rate 0.110541 0.107385 N/A Sources Property taxes 169,806,722 181,271,359 181,839,054 567,695 Seton lease revenue 31,544,675 10,303,467 10,303,467 - Interest 400,000 400,000 400,000 - Tobacco litigation settlement 1,800,000 1,800,000 1,800,000 - Subtotal revenue 203,551,397 193,774,826 194,342,521 567,695 Contingency Reserve 36,600,000 57,886,845 57,886,845 - Total Sources 240,151,397 252,229,365 252,229,365 567,695 Uses Health care delivery 229,738,205 240,293,811 241,433,090 1,139,279 Administration 8,926,601 9,715,099 9,143,516 (571,583) Tax collection 1,486,591 1,652,760 1,652,760 - Total Uses 240,151,397 251,661,670 252,229,365 567,695 Reserves (ending balance) Capital Reserve - - - - HMO Risk-based Capital Reserve - - - - Contingency Reserve - - - - Emergency Reserve 29,895,000 32,080,343 32,035,084 (45,259) Total Reserves 29,895,000 32,080,343 32,035,084 (45,259) 8
Central Health FY 2018 Proposed Budget Revisions from 6/28/17 presentation: Sources Increase property tax revenue: $568K • Certified tax roll received and estimated total taxable assessed value greater than initial budget Uses Increase Healthcare Delivery Operations: $1.1 million • Adjust payroll allocations • Increase in Contingency Appropriation for structural balance • Slight Decrease in Emergency Reserve Decrease administration: $572K • Review payroll allocations 9
Next Steps ü May 24 — Central Health Board of Managers (5-year forecast) ü May 30 — Travis County Commissioners Court ( FY 2017 update and FY 2018 budget guidelines ) ü June 21 — Central Health Budget and Finance Committee ( budget update ) ü June 28 — Central Health Board of Managers ( proposed budget ) ü July 19 — Central Health Budget and Finance Committee ( FY 2018 CCC proposed budget ) Central Health Board of Managers ( FY 2018 CCC proposed budget and Central Health July 26 — ü budget update ) • Aug. 9 — Central Health Budget and Finance Committee ( FY 2018 Central Health proposed budget and property tax rate ) Aug. 16 — Central Health Board of Managers ( FY 2018 Central Health proposed budget and • property tax rate ) • Aug. 22 — Travis County Commissioners Court ( Central Health proposed budget and property tax rate ) • Aug. 30 — First public hearing • Sept. 6 — Second public hearing • Sept. 13 — Central Health Board of Managers ( FY 2018 budget adopted ) • Sept. 19 — Travis County Commissioners Court ( FY 2018 Central Health proposed budget and property tax rate ) 10
(512) 978-8000 www.centralhealth.net @centralhealthtx
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