2020 was a year like no other. As the Local Mental Health Authority and Intellectual and Developmental Disability Authority for Travis County, our services are part of the public health response to any disaster or crisis. Our staff swiftly rose to the challenge posed by COVID-19 with courage, know-how and perseverance. They mobilized to collaborate with agencies and organizations across the community. Integral Care is committed to the health and well-being of our community every day – in good times and bad. Despite the impact of the pandemic on their personal lives, our staff met the trials we faced to provide care to individuals living with mental illness, substance use disorder and intellectual and developmental disabilities. If this year has taught us one thing, it’s that we are stronger together.
Multidisciplinary Onsite Response
Agency-wide, we came together with collaborators from across the community to provide critical in-person care and support for people staying at protective lodging and isolation facilities. People staying at these facilities, set up by the City of Austin, were identified as high risk for contracting or spreading COVID-19. Many were people experiencing homelessness. Our multidisciplinary team was available seven days a week and included mental health professionals and peer support specialists from our Adult Behavioral Health, Housing and Homeless, Integrated Primary and Mental Health Care, Crisis, and Intellectual and Developmental Disabilities teams. They provided mental health care, access to basic needs like clothing and housing support services, and much more. A key goal for the team was ultimately moving people into permanent housing. Between March and August, we connected 31 people with housing.
“Guests at the Isolation Facilities had COVID-19, they often didn’t feel well and they were frightened. Sitting in isolation and imagining the worst takes a toll mentally and physically. Having Integral Care staff onsite, working alongside our medical team made all the difference. Our Integral Care colleagues talked with each guest daily and provided them the tools and mental health support needed to make it through each day. They were a valuable part of how we care for our community.” – James Shamard, IsoFac Taskforce Leader, City of Austin
Swift Shift to Telehealth
Our transition from face-to-face services to telehealth reduced the potential spread of COVID-19 and helped conserve the city’s limited supply of personal protective equipment. By April 7th we had transitioned 80% of our service delivery for mental health, substance use and intellectual and developmental disability services to telephone and telehealth. This allowed our staff to continue to deliver services that help clients weather life’s storms while keeping both staff and clients healthy.
“I honestly love receiving telehealth care. Keep up the good work y’all are doing.” – Integral Care client
Innovative Therapy for Children and Youth
As soon as school closed in March, our school-based therapists went virtual. They created new games and techniques to connect with children in a meaningful way despite not being together face to face. We kept the momentum going over the summer with 24 virtual summer groups for children and youth. All students received supplies to engage in activities together. The groups were a success and helped students weather this summer of social isolation. Our school-based therapists weren’t only assisting students – we provided 5 support groups for teachers as well.
“Luckily, kids are tech savvy. Schools provided Chrome Books to many kids who didn’t have access to a device at home. While we’d like to be in person, some kids have done better in telehealth, especially those who are really shy. That’s been a nice surprise.” – Stacy Spencer, Practice Manager of School-Based Systems of Care
Together with the City of Austin, Ending Community Homelessness Coalition and other collaborators, we provided groceries and meals for people experiencing homelessness during the pandemic. The Eating Apart Together (EAT) Initiative helped ensure Austin-Travis County did not go hungry. The EAT Initiative distributed 371,399 meals from the first week of April through the end of August. That included prepared meals and bags of shelf-stable groceries.
Integral Care’s homeless services staff didn’t stop supporting people experiencing homelessness in the community. They continued to go to camps where they provided basic needs like hygiene kits, education, and coordination of medical and mental health services. Grant funding allowed us to provide cell phones to clients, keeping them connected to services and care teams. We also secured employment and housing for a record number of people despite the challenges of COVID-19. During FY20’s pandemic months, 71 people were employed, and 45 people moved from the streets to a home.
Learn more about the EAT initiative’s impact in this heart-warming video.
A PATH team member and I were out 5 days a week. We have developed a meaningful relationship with clients experiencing homelessness. The importance of our relationship is taking the services Integral Care offers to the people where they are. The two of us routinely left food and water on average to 100 people daily, thereby helping the homeless population shelter in place. Numerous clients have been connected to the services needed by the work we have done. – Drew McAngus, Sr. Deputy Constable, Travis County Constable, Pct. 3
Our 24/7 Crisis Helpline expanded to support people feeling overwhelmed by the pandemic, connecting them to a mental health professional who could help them with anxiety, depression, stress, grief and worry. The Helpline provides free, immediate emotional support to anyone in the community in 15 languages. The expansion was made possible by a federal Crisis Counseling Program (CCP) grant. Watch our English and Spanish language PSAs here.
In addition to expanding for COVID-related calls, we began covering calls for 45 other counties to connect Texans more quickly to crisis services and local care that supports their ongoing mental health. This was a result of the National Suicide Prevention Lifeline’s State Capacity Building Initiative. In total our Helpline answered over 72,363 calls, a 10% increase from 65,494 calls last year. Helpline staff placed 120,358 follow-up calls to help ensure individuals were safe and receiving ongoing support; this is an 8% increase from 110,769 calls last year. Outreach efforts in the community helped ensure people could find this crucial support tool. We also helped Texas Health and Human Services create a bilingual statewide marketing campaign to promote the COVID-19 Mental Health Support Line.
“Working at the call center during the pandemic has been quite challenging but also rewarding. What an opportunity and an honor to hold space for individuals who are truly suffering during this time. It has shown me that everyone has a limit, and everyone is suffering from the lack of connection and socialization, including myself.” – Meg Standley, Mental Health Professional, 24/7 Helpline
Help Where You Are
We provide support anywhere someone needs help: in the clinic, at home, in schools, on the phone, on the street, in jails. Though we transitioned 80% of our services to telephone and telehealth in response to the pandemic, we continued to meet some children and adults where they were.
“I am grateful to have had Mr. Mauricio come talk with me about my worries during the pandemic.” – teenage client
Mobile Crisis Care
In any disaster, Integral Care is at the ready to collaborate with other agencies and support our community. Our services are part of the public health response to any crisis. During the pandemic, our Mobile Crisis Outreach Team and Expanded Mobile Crisis Outreach Team continued face-to-face engagements anywhere a person needed help. We also expanded their service delivery model to include telephone and telehealth contact.
As always, our team members worked collaboratively with children and adults, providing person-centered, culturally-responsive and trauma-informed care to help resolve the crisis episode and bridge people to ongoing services.
“MCOT is a dedicated team that embraces a motto adapted from the USPS: ‘Neither snow nor rain nor heat nor gloom of night, nor COVID19, stays MCOT from responding to a person in need.’” – Patricia Shaw, LPHA Team Lead
“Despite an ever-changing pervasive crisis, MCOT remained steadfast on the frontline. With creativity, prudence, dexterity and a focus on those we served, we adapted to meet the challenges of the times and best support the community in any way tasked.” – Ryan Sullivan, MCOT LPHA
Clinic Care 2.0
Our East 2nd Street, Community First! Village and Psychiatric Emergency Services clinics continued to provide direct care for people who needed it most. Dedicated, courageous frontline counselors, nurses and prescribers ensured people with mental illness and substance use disorder could access care to advance their whole health during the pandemic.
Our IDD staff were another committed group despite the disruption of COVID-19. Their office paused in-person services for a time but re-opened to ensure that people received diagnostic testing and other crucial services during this uncertain time.
“We quickly had to balance our service delivery with safety-related innovations to protect the health of both our clients and our staff. This required the rapid implementation of strategies that preserved our approach to person-centered care, while ensuring our practices were grounded in the latest CDC guidance. We are proud that we were able to continue to provide face-to-face services to clients who needed it most. Throughout the pandemic, the E. 2nd Street Clinic didn’t close a single day.” – David West, Practice Manager – Psychiatric & Counseling Services, East 2nd Street Clinic
Nurse on the Go
Integral Care saw a barrier to equity and our clients’ access to testing and we worked with Austin Public Health (APH) to find a solution. In July, we secured APH testing kits for our nurses to test symptomatic or exposed clients residing in group homes or one of our residential facilities. In cases where one of our clients tested positive, APH went in to test all the staff and remaining residents, distribute PPE and provide mitigation education. We helped APH identify two early group home outbreaks as a result. We are grateful to APH for donating test kits and covering the cost of laboratory processing. This allowed Integral Care to provide free COVID-19 testing to approximately 100 clients during the last 2 months of FY20.
“Our collaboration with Austin Public Health and the City of Austin was, in many ways, the ideal response of local organizations and health officials to a public health emergency. Integral Care’s rigorous client screening assisted APH with identifying potential clusters or outbreaks in high-risk settings and helped them target critical resources including staff and PPE.” – Jacqueline Mosley, Director, Medical Analytics & Nursing/Infection Prevention & Control Officer
We assisted 47 people living with intellectual and developmental disabilities as well as complex medical or behavioral health needs to remain in their home. Often this population must live in a nursing home or a state supported living center. By identifying needs and submitting a request to Health and Human Services, we linked them to the Home and Community Based Waiver program. These 47 people can live successfully in the community because they now receive the comprehensive support they need.
“People with IDD deserve access to needed supports not just for their health and safety, but so that they also have the opportunity to live in the community like everyone else instead of an institution. I am confident that I can speak on behalf of the dedicated team involved, it is truly an honor to help make community living a reality for each person we serve.” – Jesus Gutierrez, II, PASRR IDD Program Manager
EMOCT on 911 Floor
Last December, the City of Austin took an important step of reducing law enforcement engagement in mental health situations. Integral Care staff on our Emergency Mobile Crisis Outreach Team (EMCOT) began answering mental health calls at the 911 Call Center. Experienced in co-responding with EMS and law enforcement on 911 crisis calls, these team members were a natural fit for this new initiative. Embedding Integral Care clinicians at the call center means quicker assessment, triage and connection to appropriate care for people in crisis.
This innovative approach to handling 911 calls reduces law enforcement and EMS time and transport and diverts people from emergency department admission, placement in a psychiatric hospitals and jails.
“Just one example of our impact – 911 received a panicked call from an out-of-state mother. She hadn’t been able to reach her adult child, who had texted her expressing thoughts of suicide. In many situations, this call would result in law enforcement deployed to handle the potential crisis situation. In this case, a mental health counselor arrived on scene and the person was connected to medical providers to start medications.” – Marisa Aguilar, Practice Manager, Expanded Mobile Crisis Outreach Team
Fewer Hospital Stays
Those who work in crisis residential care know the value to the community. We see people transform right in front of our eyes. Integral Care’s 16-bed crisis residential program, The Inn, provides short-term psychiatric crisis care in a safe environment for adults recovering from a mental health crisis (including adults with a co-occurring intellectual and/or developmental disability). We know through select data points and anecdotal evidence that The Inn’s services are of value to our larger community and system of care. This year, Integral Care collaborated with The University of Texas at Austin Dell Medical School and LBJ School of Public Affairs on a return-on-investment study. The analysis of 3 years (FY2017 – FY2019) concluded that The Inn provides an annual cost savings between $1.3 million to $2.9 million to the healthcare system by limiting costly acute psychiatric hospitalizations.
“The versatility in how The Inn cares for individuals provides a unique and individualized experience for each person who walks through the door; not to mention the ability to offer the right treatment at the right time at the right level of care by affording diversion opportunities from emergency departments, inpatient psychiatric hospitals, and even jail.” – Tracy Abzug, Practice Administrator of Crisis Residential Services
IDD & Mental Health
Health and Human Services (HHSC) tapped Integral Care and four other Local Intellectual and Developmental Disability Authorities (LIDDAs) in the state to be part of a Learning Collaborative to help reimagine crisis services and supports for people living with IDD (Intellectual and Developmental Disabilities). The state’s new IDD Outpatient Mental Health Pilot will provide a more robust model of care, with a focus on collaborative and person-centered care. In FY20 we advised HHSC on the latest best practice models and associated outcome measures that demonstrate success in providing specialized outpatient mental health services for people with IDD. This coming year we will pilot the new services.
“Integral Care is honored to be one of the five LIDDAs piloting an expansion of specialized mental health services for people with IDD. We are confident we will cost-effectively narrow the gaps in services for people with IDD and decrease the need for long-term institutionalization, incarceration, or unnecessary hospitalization.” – Ken Winston, Director, Practice Management IDD Services
Housing Saves Money
A home is the basic foundation for health and well-being. In late 2019, we opened Terrace at Oak Springs (TAOS), a unique apartment community providing single occupancy apartments with onsite support services to adults experiencing homelessness in Travis County. Data collected in March showed that TAOS is a significant return on investment for our community. Six months prior to moving in, the 50 residents formerly living on the street cost the local community nearly $500,000 in utilization of emergency health and justice services. Six months after move-in, cost had dropped to $150,000 due to reduced utilization.
Residents have made tremendous progress since making the transition from the streets to a home. You also can hear one resident’s journey from homeless to a home on our podcast, Looking Back on the Early Months of Terrace at Oak Springs.
Peers Helping Peers
This fall, Integral Care and East Austin College Prep (EACP) launched the teen Mental Health First Aid pilot. Over 5 weeks, the entire sophomore and junior class at EACP (120 students) learned essential tools to recognize a developing mental health or substance use issue and how to help their peers. We were 1 of 35 teams chosen for the pilot from hundreds of applicants across the country. The program was sponsored by the National Council for Mental Wellbeing and Lady Gaga’s Born This Way Foundation.
“I feel like this program has opened my eyes a lot on mental health. I am ready to use everything I have learned in real-life situations.” – Brittany, a junior at EACP
Travis County Residents Served
Staff in Austin/Travis County
of Proud Service to Our Community
In FY20, Integral Care was awarded $7,707,063 in grant funding – including multiyear contracts, one-year awards, and subcontracts with collaborators in the community – to expand existing programs and launch 9 new programs. Programs include community-based mental health care, substance use treatment, and suicide prevention. $755,000 of our grant funding was awarded to support our COVID-19 response efforts.
|Alice Kleberg Reyonlds Foundation||“$10,000”||Provide essential services to IDD and homeless team due to COVID-19|
|All Together ATX||“$20,000”||Provide essential services to Adult Behavioral Health and IDD clients due to COVID-19|
|All Together ATX/United Way||“$20,000”||Provide continued data plans for 250 flip phones distributed to individuals experiencing homelessness. (1 year)|
|Austin ISD Alternative Learning Center||“$52,681”||Provide mental health and substance use support at Alternative Learning Center. (1 year)|
|Cancer Prevention and Research Institute of Texas (CRPRIT)||“$125,831”||Taking Texas Tobacco Free through a Sustainable Education/Training Program Designed for Personnel Addressing Tobacco Control in Behavioral Health Settings|
|Cancer Prevention and Research Institute of Texas (CRPRIT)||“$60,535”||Taking Texas Tobacco Free. (1 year)|
|CARES ACT||“$29,391”||Based on prior Medicare billings|
|Casey Family Foundation||“$16,041”||Safe Landing Program to provide mental health services to youth in the foster care system. (1 year)|
|Del Valle ISD||“$1,000,000”||“Provide direct mental health services to students, families and staff identified as a victim of crime in DVISD. 1 year.”|
|Episcopal Health Foundation||“$30,000”||Funds for telehealth equipment needed to comply with and operate in the pandemic environment. (1 year)|
|Meadows Foundation||“$143,500”||Healthy Transitions Integrated Healthcare Team for Youth with Mood Disorders with Dell Medical Schoo. (1 year)|
|Montandon Charitable Trust||“$25,000”||Child and Family Services integrated care provider’s office (Riverside) (1 year)|
|National Suicide Prevention Lifeline||“$291,513”||“National Suicide Prevention Lifeline’s State Capacity Building Initiative. Collaboration with HHSC. Contract in March 2020. (2 years; Total $626,753.)”|
|Office of the Governor||“$20,464”||Odessa Coordinated Response (1 year)|
|Religious Coalition to Assist the Homeless||“$10,000”||Wraparound Services for residents at Terrace at Oak Springs. (1 year)|
|St. David’s Foundation||“$162,871”||“Mental Health First Aid Renewal (2 years; Total $523,413)”|
|St. David’s Foundation||“$42,432”||Subcontractor on application to St. David’s Foundation for SAFE Health program; Collaboration with SAFE Alliance and Planned Parenthood. (1 year)|
|St. David’s Foundation||“$6,000”||Mini-grant for wraparound housing. (1 year)|
|Substance Abuse and Mental Health Services Administration||“$1,000,000”||“Provide Assisted Outpatient Treatment (AOT) in community. Collaboration with Dell Medical School Travis County Probate Court, and Travis County Clerk’s Office. (4 years; total $4,000,000)”|
|Substance Abuse and Mental Health Services Administration||“$400,000”||“Community for Outreach Intervention w/Youth and Young Adults at clinical risk for psychosis (RA1SE). Continuation. (4 years; total $1,600,000)”|
|Substance Abuse and Mental Health Services Administration||“$125,000”||“Mental Health Awareness Training Grants. Continuation. (3 years; total $375,000).”|
|Texas Council for Developmental Disabilities||“$13,955”||Central Texas African American Family Support Conference: for key notes speakers and registration fees (1 year)|
|Texas Health and Human Services – House Bill 13||“$856,972”||“School-Based Youth Mental Health Crisis Continuum System of Care will deliver coordinated mental health crisis hotline, crisis triage, ISD staff training, rural on-campus student assessment and treatment, and County-wide community-based crisis stabilization (FY 21 & FY 22). FY22 Budget not yet confirmed. “|
|Texas Health and Human Services Commission||“$2,645,805”||Substance Use Treatment Services (5 years)|
|Texas Health and Human Services Commission (CCP)||“$275,046”||Crisis Counseling Program Service (CCP) Immediate Services Program due to COVID-19|
|Travis County’s Community Development Block Grant – COVID (CDBG-CV)||“$324,026”||Response to COVID-19. Funding for Integrated Response Team at Travis County Protective Facilities. (1 year)|
Recognizing that behavioral health and physical health go hand in hand, Integral Care works to address our clients’ whole health.
- John Rosato, Southwest Strategies
- In memory of Eleanor Gaston
- Austin Regional Clinic
- Barbara & David Weden
- Hal Katz
- Jacqueline Fox & Frank Hoffman
- Mary Garwood Yancy PhD
- Nickie & Eric Froiland
- Susan & Scott Hector
|Alexander Kinneer||Mary & Rick Aldrich|
|Barbara E. Morris-Blake||NAMI of Central Texas|
|Carol & Rick Roberson||Paul D. Leeke|
|Christopher Cotton||Sarah Churchill Llamas|
|Debra & David Evans||Stacy & Stephen Strakowski MD|
|Donald Anderson||Tejas Behavioral Health Management Association|
|Gary Daniel||Will Gaynor|
- Alexander Carlson
- Elizabeth Bull
- Frost Bank Insurance, Inc.
- Hon. Elliott Naishtat
- Hon. Sarah Eckhardt
- Karen Ranus
- Mel Barrentine
- Rev. Susan Hawkins Sager
- Robert E. Feinstein MD
- Russell Douglass
- Wanda & Emmitt Hayes
|ABC Longhorn Moving||Frost Bank Insurance, Inc.||Luanne Southern||Rosalind Hunt|
|Alexander Carlson||Gilbert Davila||Mary Gatlin Hearon||Rossie Manning|
|Anne Chamberlain||Gregory & Cindy Abell||Maura Brady||Russell Douglass|
|Brad Stodden||Harvey Simon||Mel Barrentine||Sakiko & John Willis|
|Carol Jean Faget MD||Hon. Elliott Naishtat||Michael Schoenfelder||Sandy Wattles|
|Coby Chase||Hon. Sarah Eckhardt||Rachel Gunner & Morrie Schulman||Sarah Williamson|
|Daniel Fishman||Jennifer Baum||Red Horn Coffee House and Brewing Co.||Susan & Thomas Ardis|
|Darlene Sullivan||Jessica Loerch||Rev. H. Ed Calahan||Suzanne Whatley|
|David W. Springer PhD||Judith S. Yudof||Rev. Susan Hawkins Sager||Timothy Malpass|
|Don Green||Karen Ranus||Robert Dillard||Toni Inglis|
|Dowe Gullatt||Katherine & Mark Voges||Robert E. Feinstein MD||Wanda & Emmitt Hayes|
|Elizabeth Bull||Louise Lynch||Rohini & Prayag Sreenivasan||Yasmin Merchant|
|Aimee Chaelani||Christine Albert||Hadley Hempel||Paul Moomaw|
|Amanda Thomas||Darlene Lanham||Ilene Gray||Rachel Brooks|
|Angella Emmett||David G. Halpern||Kerry Porter||Rebecca Maag|
|Angie Risher||David Olivenbaum||Kristen M. Reynolds||Rebecca Mauldin|
|Anne Nagelkirk||Deborah Marcus||Kyle McCall||Russell Herman|
|Autumn Righino||Diane T. Land||Louise McDermott||Sandra Roth|
|Barbara Weisberg||Ellen Richards||Mark Filley||Sarah Arvey|
|Bill Wheatle||Emily Russell||Megan Strawn||Sarah Peterson|
|Carrie Hernandez||Flannery Bope||Melanie Pearce||Shirley & Roy Redden|
|Caryn Carlson||Frances Patch||Michele Guzman||Stephanie Rubin|
|Cheryl Scott-Ryan||Friends of Cirrus Logic||Naila Ismail||Timothy Sanderson|