Erath County commissioners on Aug. 11 approved a new county indigent health-care handbook and related procedures after an outside audit and an internal review found weaknesses in how the county’s indigent fund was administered.

The court voted to adopt the handbook and implement a multi-step verification and payment process intended to reduce errors and increase oversight.

The handbook summarizes relevant state law, incorporates state notifications and forms, and sets local procedures the county will follow. It also formalizes who will perform each step: initial application intake and document collection, a supervisory verification step, auditor review of bills, and a judge-level appeal process. The court approved the handbook after staff said the changes respond to problems identified in the audit.

Carla Trussell, a member of the public who spoke during public comments, said the problems were serious and demanded transparency. “This is our money, not yours,” Trussell said, urging the court to explain what happened with the funds and who supervised the employee handling them.

County leadership told the court the audit — and subsequent access to the provider system — revealed a mix of problems, including missing eligibility documentation, at least one case where a recipient was not eligible, and instances where payments exceeded permitted amounts. The county said it had contacted appropriate authorities and engaged an outside audit firm; the audit report has been redacted for personal information and made available to the public.

Assistant County Attorney Brandy Clements and indigent program staff presented the handbook and attachments, which include state-promulgated notices (in English and Spanish), forms, eligibility checklists and a clear division of duties so multiple people review applications and bills. Under the handbook, the county will follow the services required by state law and will not automatically pay for optional services except on a case-by-case basis approved by the commissioners.

The handbook also addresses medical care for people incarcerated in the county jail. The draft makes the county’s practice explicit: inmates will generally be treated under the indigent program during incarceration, a practice the presenters said other counties commonly follow, but the court reserved the ability to review that approach as staff seek other funding options.

County staff described a three-stage verification and payment flow: an initial intake and verification by a designated staff member; a supervisory verification step in the treasurer’s office; and final review by the auditor’s office before payment. Judge-level appeals and requests for payments above the program’s statutory cap would come to the commissioners.

Commissioners emphasized the changes represented stronger oversight, not a reversal of state requirements. “We can add controls on top of [state law],” Judge Huckaby said, “so that going forward we are doing things in an appropriate way and that they’re done rightly.”

The court approved the handbook after a motion and second; commissioners voted in favor.

Ending: The county said the audit and the new handbook aim to prevent future errors and to restore public confidence by documenting procedures, required forms and a multi-person oversight process. The county has redacted the audit report for personal data and said the redacted report is available to the public.