The county's hospital payment fund (DRAFT – not published)

In short

• Paid in by local hospitals, year ending Sept. 30, 2025: about $85.0 million.¹
• Paid out from the fund the same year: about $86.3 million, for health care.¹
• Share of the county’s “other taxes”: about 97 cents of each dollar (our math).²

Numbers marked “our math” are our estimates, not official figures. The notes show the inputs and the steps.

How it works

• What it is. Texas lets a county set up a special fund that local hospitals must pay into. The county sets the payment rate each year.³
• Where the money goes. The law lets the fund pay for certain health-care transfers and for care for people who cannot pay.³ In 2025 the fund spent about $86.3 million on this.¹
• Why it matters for you. The payments come from hospitals, not from your home’s tax bill. But the county’s reports count them as “other taxes.” So the county’s tax total looks bigger than what homeowners pay.²

What the numbers show

In the county’s audit, “other taxes” were about $88.1 million in 2025. Of that, $85.0 million came into the hospital fund. The other $3.0 million was in the main fund.²

Year	”Other taxes,” county-wide
2016	$1.3 million
2018	$31.8 million
2020	$11.3 million
2022	$21.8 million
2024	$26.3 million
2025	$88.1 million

Source: the county’s ten-year table of changes in net position.⁴

The audit’s summary says spending on community services rose mostly because of “an addition of $56.8 million” in this program.⁵

The other side

• Money in, money out. The fund took in about $85.7 million in all and spent about $86.3 million.¹ It is not a pile of savings.
• It can change a lot each year. The table above jumps up and down. The ten-year table does not say how much of each year was hospital payments. So we can’t say how much of the 2025 jump came from this fund alone.⁴
• What the report does not say. It shows money in and out of the fund. It does not say whether the fund brought more health-care money to the area. It does make the county’s spending and tax totals look larger.¹²

Changes to this page

• Nov. 2, 2026: Rewrote the questions to ask so each is open, neutral and addressed to the public body.
• Nov. 2, 2026: We checked every figure against its source. We reworded the other-side points so they stick to what the sources show.

Questions to ask

• How does the county pick the payment rate each year?
• Where does the county report how the fund’s money was spent, by program?¹

What we still don’t know

• The fund’s 2024 payments, from the same kind of table.
• How much health-care money came back to local hospitals because of the fund.

See also Where the county’s money comes from.

Footnotes

1. Williamson County, Annual Comprehensive Financial Report, year ended Sept. 30, 2025, combining statement for smaller special funds, Local Provider Participation fund: taxes $85,039,566; total revenues $85,697,215; community services spending $86,315,842. Public copy: https://emma.msrb.org/P11938140.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

2. Same report: Statement of Activities, other taxes $88,055,497; main fund budget-to-actual, other taxes $3,015,931. Our math: $85,039,566 + $3,015,931 = $88,055,497; $85,039,566 ÷ $88,055,497 = 96.6%. ↩ ↩² ↩³ ↩⁴

3. Same report, fund descriptions: “Section 292B of the Texas Health & Safety Code allows Williamson County to create a Local Provider Participation Fund. The county annually sets the rate associated with mandatory provider participation payments from local hospitals.” ↩ ↩²

4. Same report, statistical section, changes in net position, governmental activities, “Other taxes,” 2016–2025: $1,328,610 (2016), $31,775,438 (2018), $11,304,726 (2020), $21,774,138 (2022), $26,304,520 (2024), $88,055,497 (2025). ↩ ↩²

5. Same report, management’s discussion and analysis. ↩