The University of Texas Dell Medical School and Travis County’s health care district appear to have misspent local tax dollars that are supposed to be used for indigent care, activists charged Monday in a report that calls on county commissioners to order an independent audit.

The report, written by lawyer and activist Fred I. Lewis, questions the disposition of $105 million in county property taxes collected by Central Health and transferred to the Dell school. Travis County voters in 2012 agreed to raise property taxes, with $35 million a year going to the medical school.

The report contends that the funds are supposed to be restricted for health care of poor people but appear to have been improperly commingled with other medical school funds and spent on governmental affairs, communications, general administration, and faculty and staff salaries unrelated to such health care.

"Because UT Dell and CH (Central Health) appear to have breached these basic fiduciary and legal duties, Travis County, as the financial overseer of CH, has the responsibility to retain an independent, third-party auditor" to conduct a "comprehensive performance and forensic audit," the report said.

UT and Central Health officials have long defended the legality and benefits of their partnership, and they reiterated that stance Monday. Clay Johnston, dean of the Dell school, branded some of the criticisms as false.

"We do not commingle Central Health funds with any others," Johnston said. "We’re in full compliance with the affiliation agreement with Central Health. I’m not a lawyer, but I know all the lawyers here at UT-Austin, and UT System lawyers, have been quite confident the agreement is legal under state law."

Johnston also said the medical school has no governmental affairs function.

Patricia Young Brown, Central Health’s president and CEO, said the local tax dollars going to the medical school are "already improving and redesigning health care services delivered to patients in our network of providers around orthopedics, and obstetrical and women’s health services. The medical school is increasing the number of medical residents working in our community health clinics and is creating the next generation of doctors to care for our safety net population."

The health district announced last month that it would hire an independent firm to review its performance in the areas of planning and budgeting, financial transparency and reporting, and organization governance. A spokeswoman for Travis County Judge Sarah Eckhardt said the commissioners would consider whether to commission a separate, full-blown audit when they meet Tuesday.

A report released that month said more than $27 million had been spent on salaries and related expenses at the medical school, with the bulk of $105 million in taxpayer contributions yet to be spent. The report said $9 million went to faculty pay, $8.5 million to staff salaries, $3.5 million to benefits and $6.6 million to compensation and other payroll expenses for the rest of the year.

The activists say the goal of improving the health care system through the medical school is too farsighted and doesn’t directly benefit those in need. In addition, they say, Central Health and the Dell school have failed to keep state-required records detailing how the money has been allocated.

"These funds should go to our many needy families in Central Texas who lack health care," said Isabel Lopez-Aguilar, with a local group called HEALTH, for Help Ensure Accountable Leadership and Transparency in Health. "The community demands an independent, comprehensive audit of how these and other Central Health funds have been spent — which so far Central Health and UT have resisted."