TRAVIS COUNTY, Texas (KXAN) — Travis County commissioners voted Tuesday to order an independent performance audit of Central Health after members of NAACP-Austin and Texas LULAC District VII expressed concerns about where millions of taxpayer dollars are going.

Central Health is the public hospital district in Travis County created to provide healthcare services for people who are low-income, lack easy access to care and are uninsured. Central Health told KXAN in fiscal year 2022, more than 97% of the entity’s $506 million budget is dedicated to healthcare delivery for low-income residents.

The audit was initially requested by groups who previously laid out eight areas of concern in what they called a “Red Flags Report.” Notably, they want more documentation on Central Health’s programming with its partners, including Dell Medical School and Ascension Seton.

A spokesperson for Central Health said Travis County commissioners already have vast oversight of the health entity, including appointing four people to its board of managers and being involved in its budget process. He also said Central Health is already independently audited annually and does an independent, third-party performance review every five years.

“We are concerned that calling for an additional performance audit now would divert valuable time and resources away from our primary mission – providing healthcare to 1 in 9 Travis County residents,” said Phillip Ramati, a spokesperson for Central Health.

After listening to public comment and going into executive session to talk about legal options, the commissioners decided unanimously to amend their 2017 financial order for Central Health to include an independent performance audit and to create a subcommittee that would oversee the scope of the work. Commissioners will sit on that subcommittee.

During public comment, some speakers, including two representatives from the Texas Anti-Poverty Project, also expressed concern that the audit would simply distract from services provided by Central Health and that it would be “redundant” because the entity has a five-year audit scheduled for early 2023, which Central Health confirmed to KXAN it’s preparing for now.

“Central Health has been an asset to our people in poverty,” a member of the Texas Anti-Poverty Project said. “We cannot afford to put our patient care on hold.”

Meanwhile, the “Red Flags Report” explained the audit requested is “distinct” from the audits Central Health goes through regularly and would allow commissioners a look into who funding benefits after it goes to Central Health’s partners.

“They will simply verify how the taxpayer-funded organization is spending the taxpayers’ money,” a speaker in favor of the audit said.