Read more in our monthly newsletter, Transparencies.
May 21, 2019
I am pleased to announce that Integral Care’s Fiscal Year 2018 (FY18) Annual Report is now available. I invite you to learn about the work we did in 2018 to support adults and children living with mental illness, substance use disorder and intellectual and developmental disabilities (IDD).
As I reflect on last year, the word integration comes to mind. Integral Care believes in serving the whole person through integrated care. We believe that community systems and partners must collaborate at all levels, integrating their expertise, to advance the whole health of our community. In FY18, Integral Care partnered with the City of Austin, Travis County and Central Health, criminal justice, first responders, school districts, non-profit community-based organizations and healthcare providers to strengthen our local systems, improve access to care, and raise awareness around issues of mental health, substance use disorder and IDD.
Together, we are helping Travis County thrive and are moving closer to our vision of Healthy Living for Everyone.
Chief Executive Officer
May 6, 2019
Women are twice as likely as men to experience depression. Twice as likely to attempt suicide. The differences in how women experience mental health are real. Research identifies disparities between men and women in terms of risk, prevalence, presentation and treatment sought and received. For this month’s Transparencies, our Chief Strategy Officer, Ellen Richards and NAMI Austin’s Executive Director, Karen Ranus, talk about women’s mental health and how our community is addressing mental health issues.
Read more in our monthly newsletter, Transparencies.
April 19, 2019
The 86th Texas Legislative session is in full swing, with less than two months remaining. With over 7,500 bills filed, legislators are working hard to address a wide range of issue areas – from substance use disorder to mental health in schools. We’re following the progress at the Capitol and here’s the news worth noting.
Read more in our monthly newsletter, Transparencies.
March 27, 2019
Travis County’s robust economy has not come without its challenges. Our recent growth is greater than nearly any other large metro area in the country, and our human services infrastructure must innovate to keep pace. Of particular priority is increasing accessible and affordable treatment for substance use disorder in our community.
In general, funding for substance use treatment services is lacking. For the Travis County community, service availability has decreased in recent years due to funding issues. For those who cannot afford the high cost of private pay services and medication, this results in waitlists for services and limited access to medications. To complicate this further, individuals are often dealing with more than just a substance use disorder diagnosis.
“Home is where one starts from.”
Terrace at Oak Springs is Integral Care’s newest permanent supportive housing community. 50 individuals who are experiencing homelessness will have a safe place to call home, helping them on the road to recovery.
Many of the future residents have been living on the streets with nothing but what fits in a backpack. You can provide household essential items exclusively for Terrace at Oak Springs – kitchen tools, bathroom supplies, linens and more — to help make the apartments feel like homes.
We have partnered with COCObundle, a local social enterprise that has curated the registry of household goods. Once a bundle is purchased, COCObundle handles the rest—from stocking the products to creating welcome packages for each of the 50 residents to delivering the items to Terrace. When new residents arrive on move-in day, they already will have welcome packages in their unit.
To donate a bundle for a future resident, simply visit the Integral Care campaign on the COCObundle website and select your preferred bundle.
In lieu of a bundle, you can also make a donation to support the future residents of Terrace at Oak Springs.
Austin, Texas – Integral Care’s CEO David Evans will receive the National Council for Behavioral Health’s 2019 Visionary Leadership award. This award recognizes an individual who has demonstrated outstanding leadership in the behavioral healthcare field, improving the lives of individuals living with mental illness and addiction disorders and helping them live full lives in their communities. David Evans has over 40 years of experience as a leader in the fields of behavioral health and intellectual and developmental disabilities, serving as Integral Care’s CEO for 25 years.
Since 1993, David Evans has led Integral Care as the agency grew from 400 employees to more than 900 employees who serve our community at over 45 locations. Under his leadership, Integral Care has launched innovative healthcare policies and practices, including tobacco cessation, housing as a healthcare intervention and integrated health care.
“I am honored to receive an Award of Excellence from the National Council. I also accept this award on behalf of Integral Care, our Board of Trustees, and our dedicated staff who work every day to improve the lives of adults and children living with mental illness, substance use disorder and intellectual and developments disabilities. Together, we’re implementing best practices and building innovative partnerships across schools, medical research, public safety and criminal justice – all of which improve outcomes for people in our community and move us toward our vision of Healthy Living for Everyone.”
– David Evans, CEO of Integral Care
David Evans is an unwavering champion of creating opportunities for people experiencing mental illness, substance use disorder and intellectual and developmental disabilities to live in the community – not institutions. His entire career, across multiple states, has been dedicated to this singular goal. Mr. Evans has been recognized by NAMI Austin for his work promoting dignity and inclusion of people living with mental illness and called a Healthcare Hero by the Austin Business Journal. He also holds the prestigious ACMHA Feldman Award for Lifetime Achievement for mental health leadership and health policy.
The award will be presented on March 26, 2019, in Nashville, TN, during the Awards of Excellence Celebration in conjunction with the National Council Conference – NatCon19. Hailed as the nation’s premier behavioral health conference, NatCon19 will convene more than 5,000 behavioral health professionals to discuss solutions and outcomes that transform health care.
February 6, 2019
Mental health issues and substance use disorders (SUDs) rarely occur independently. Why then, are they so often addressed separately, without a more coordinated system of care? Treating the whole person is always the most effective strategy.
Read more in our monthly newsletter, Transparencies.
January 7, 2019
As the Texas Legislature heads back into session, a major focus will be funding for the new Austin State Hospital (ASH). The reimagined state hospital isn’t just a new building, it’s a redesign of the mental health delivery system. An effective redesign would mean that our mental health system would have the right services that prevent people from being hospitalized and could also help them return to the community with the appropriate supports following a hospitalization.
Read more in our monthly newsletter Transparencies.
December 10, 2018
The 86th Texas Legislature is right around the corner – set to begin January 8th. In gearing up for this session, we’d like to take a look at some of the valuable legislation that came out of the 85th session, progress made during the year and a half interim, and the anticipated issue areas coming up in January.
Find out more in our monthly newsletter Transparencies.
November 29, 2018
A report from the Children’s Mental Health Crisis Task Force recommends that to improve care for children the community needs to remove the stigma associated with mental illness, offer more crisis intervention options and better coordinate care.
Read the report here.
A home means recovery from homelessness, mental illness and substance use disorder. When people have a safe place to live, appropriate support services and the tools they need to achieve well-being, recovery begins and they can reach their full potential and contribute to their community.
May 22, 2019
Texas Health and Human Services Commission has committed $1.9 million to support homeless services, including expanding shelter services and shelter redesign, increasing access to mental health and substance use services for families experiencing homelessness, and supporting clinic operations and the expansion of housing services at Terrace at Oak Springs. Set to open in summer 2019, this new permanent supportive housing community includes 50 fully furnished, single occupancy efficiency apartments and an onsite integrated health care clinic – 3000 Oak Springs Clinic. Features include onsite staffing 24 hours a day, onsite laundry facility, outdoor green space, community room with library, computers, and internal and external security cameras. Terrace at Oak Springs is modeled after other successful programs across the country and the first of its kind in Central Texas.
The 3000 Oak Springs location provides integrated primary health care and mental health care to residents of the apartment community. Services include counseling and case management, drug and alcohol treatment, exercise and nutrition programs, medication management and support, employment services, and assistance accessing benefits. Clinic services are also available to adults in the community who are eligible for Integral Care services. The clinic will be open 8 AM to 5 PM Monday through Friday, and will offer scheduled appointments and a limited number of walk-in appointments. Community members will be able to access clinic services through the same intake and assessment process that Integral Care uses for all of its services.
Episcopal Health Foundation has awarded Integral Care $1.5 million to expand our clinical services and implement a new financing and collaborative infrastructure. As our interdisciplinary care teams research new interventions in our clinics, we can demonstrate improved health outcomes and reduced costs of care to managed care organizations and develop a case for a value-based payment structure. Partnering with Episcopal Health Foundation will help us create the infrastructure for this new payment system while providing us flexibility to continue our clinical work by bridging funding streams.
Our new Integrated Practice Unit at Dove Springs, an expansion of services offered by Dell Medical School and Integral Care at the Bipolar Disorder Center at UT Health Austin, will serve as the pilot site for this initiative. Later this year, Integral Care will bring this collaborative approach to yet another clinic – our 3000 Oak Springs Clinic, which is part of the forthcoming Terrace at Oak Springs permanent supportive housing community.
Integral Care’s integrative, team-based approach provides a strong foundation for implementing a value-based payment structure, which relies on collaboration and coordination throughout the cycle of care. By showing the improved health outcomes and reduced care costs of this care delivery model, we can collaborate with managed care organizations to create a value-based payment system that focuses on improving quality of care, rather than increasing quantity of services.
AUSTIN, Texas — Of the more than 7,000 people who experience homelessness in Travis County each year, many have complex health problems as diverse as heart disease and asthma. To help address these persistent challenges, Dell Medical School at The University of Texas at Austin, CommUnityCare Health Centers and Integral Care, Travis County’s mental health authority, are joining forces to launch an innovative, federally-funded mobile care team that serves homeless individuals where they are.
The collaboration, which is funded by a five-year, $2.3 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), will support homeless men and women who have a chronic medical condition along with serious mental illness and/or substance use disorder. The mobile, multidisciplinary team will be staffed by qualified health care providers who integrate comprehensive primary care, mental health care, substance use treatment, intensive case management, and wraparound services such as housing assistance and social programs enrollment into a continuum of care with one single team.
“Homeless Austinites living with multiple complex medical problems are among the most vulnerable and difficult to reach members of our community, but we believe that our innovative approach can work,” said Dell Med’s Tim Mercer, M.D., MPH, assistant professor in the departments of Population Health and Internal Medicine, who is the project director for this grant. Efforts to effectively treat this population require careful coordination among advocates and organizations working in Austin’s health ecosystem, he said.
“Our goal is to fill gaps in care by leveraging the existing strengths and infrastructure of the three collaborating organizations in a whole new way,” Mercer said. It’s also essential to coordinate efforts with other local organizations, such as the Ending Community Homelessness Coalition (ECHO), he added.
A 2017 Point-in-Time Count performed by ECHO found that 2,036 Austin residents experience homelessness on any given night, of whom 553 are chronically homeless, 345 have a substance use disorder and 519 experience serious mental illness. It also found that 61 percent of people experiencing homelessness access health care through an emergency room or not at all.
Meeting People Where They Are
One key design feature of the mobile model is that it allows the team to bring care to patients where they live, unlike the traditional model of requiring patients to seek services in clinics or hospitals to address their health needs.
“Normally the burden is entirely on the patient — they have to make appointments, figure out how to get a ride, go to the pharmacy, get their labs processed — they are constantly forced to jump through hoops,” said Audrey Kuang, M.D., clinical director of the homeless health care program at CommUnityCare and assistant professor in the departments of Internal Medicine and Population Health at Dell Med. “It’s tough enough for the average person, but for someone struggling with mental illness or chronically sick or worrying about their next meal, those hoops can be insurmountable obstacles,” she says.
Equipped with mobile medical supplies, laptops to access medical records on site, and well-honed “street medicine” engagement tactics, the team remains unfettered by the need for a building or an exam room to care for patients.
“We can meet with clients on the street, a park bench, under a bridge — wherever we need to be to serve them best,” says Kuang.
When more complex care is needed, the mobile team can also see patients in one of CommUnityCare’s 24 clinics or Integral Care’s four integrated mental and primary care clinics in Travis County.
The community-based mobile care team will consist of at least six health professionals, including:
- A primary care physician or nurse practitioner
- A mental health care psychiatrist or nurse practitioner
- A licensed chemical dependency counselor
- A nurse case manager
- A qualified mental health professional case manager
- A peer navigator
An important part of this community-based program is that it relies on the complementary strengths of the organizations involved. Integral Care has been providing outreach and recovery services to people experiencing co-occurring homelessness, mental illness and substance use disorder for over 20 years. Integral Care also partners with the Austin Police Department and Austin-Travis County EMS to connect individuals living on the street to housing, mental and primary health care and alcohol and drug treatment as part of the Homelessness Outreach Street Team. CommUnityCare, part of Central Health’s enterprise, provides primary care and standard case management services to the homeless as well. Dell Med’s population health experts will augment these existing resources through direct care, coordination among the partners, and research and evaluation efforts.
“We are excited to expand our partnership with Dell Med and CommUnityCare to further support our city’s homeless community,” said Darilynn Cardona-Beiler, director of adult behavioral health systems at Integral Care. “This grant allows us to bring our expertise together and innovate in a unique and effective way. Together, we’re meeting people where they are in the community — providing integrated primary care, mental health care and much needed substance use treatment on the streets of Austin.”
In addition to serving as orchestrator of the project, researchers from Dell Med’s Department of Population Health will work to measure the success of the effort. Its data integration division will coordinate information from Integral Care’s and CommUnityCare’s electronic health systems and directly from patients to evaluate effectiveness and identify opportunities for improving and expanding this care model.
“By incorporating research into this project, we will be able to understand if this approach to caring for our city’s homeless works and can pay for itself, by reducing hospital and ER visits, for example, and if it can be scaled and replicated to improve the health of communities across the nation,” said William Tierney, M.D., professor and chair of Dell Med’s Department of Population Health.
November 14, 2018
The HOST team is a partnership between Integral Care, the Austin Police Department, Emergency Medical Services, Downtown Austin Community Court and the Downtown Austin Alliance. An approved increase of funding will cover the cost of a certified peer specialist/peer recovery coach and allow more funding to address immediate needs, like obtaining official ID documents and bus passes.
Find out more in this report from KXAN.
“Mental health services in Austin ISD is an essential part of educating the whole child,” said Tracy Spinner, district director of health services. “We are thankful for dedicated partners like Integral Care who have stepped up to continue services for our students at 16 campus mental health centers. While we are one step closer to supporting our students, the need for additional funds is still present and we are continuing to meet with potential partners to fully fund these services.”
The Austin school board Monday night approved an agreement with Integral Care to keep 16 campus mental health centers open this school year. Read more in the Statesman.
U.S. News and World Report shined a spotlight on Integral Care’s integrated care services. The article features an Integral Care client who lives with bipolar and obsessive-compulsive disorders and benefits from integrated mental and physical health care as well as wellness services. Our client says, “It has really built me up to be a better woman.” The story also features our partners Dell Medical School and CommUnityCare.
February 20, 2018
Integral Care’s Systems Chief Medical Officer James Baker wrote an article for this month’s TexasMedicine about the ways our state can focus on prevention and early detection of mental illness.
By James G. Baker, MD, MBA
It is far too common in psychiatry for diagnosis to first come in a crisis visit to the emergency department, the equivalent of diabetes being first diagnosed as ketoacidosis. That is why I am very persuaded by the argument that we should focus on early detection and treatment in mental health, just as in other medical specialties.
What if our medical association and our local medical societies took the lead in the development and implementation of strategic population mental health initiatives across the state focused on early detection and intervention of mental illnesses? Our shared vision could be a statewide population mental health initiative with four parts:
Routine screening for depression, anxiety, and post-traumatic stress as a part of every outpatient clinic visit in Texas. Mental health screening could ― and should! ― be just as routine as temperature, pulse, and blood pressure screens for every adult in Texas, whether care is provided in the public or private sector. As an example, The University of Texas Southwestern’s Madhukar Trivedi, MD, has an iPad software program, VitalSIgn6, that screens for depression and can be modified to screen for other common mental health challenges.
Routine substance-use screening as part of physical exams for every teenager and adult in Texas. The NIDA Modified Assist (for adults) and the CRAFFT (for adolescents) are examples of quick, easy-to-use screening tools. Significant reductions in alcohol and substance use can result when screening is followed by a nurse or social worker offering brief, evidence-based intervention at the same doctor visit.
Easy access to evidence-based, first-episode psychosis treatment and research protocol for every newly diagnosed patients in Texas. Early and aggressive treatment in programs like RA1SE have been shown to improve markedly the outcome of patients with schizophrenia and other psychiatric disorders that include psychotic symptoms. Its availability currently is limited, but detection and early treatment are just as important with schizophrenia as they are with cancer.
Easy access to mental health first-aid training for everyone in Texas. Mental Health First Aid is a training course started in Australia 15 years ago that is now available statewide for anyone in the community, including first responders. The training reduces stigma, and, just like CPR, Mental Health First Aid has the potential to save lives. Our goal could be to train 750,000 people statewide.
Perhaps our medical association and local medical societies could partner with medical school departments of psychiatry, with local mental health authorities, and with local and statewide philanthropic organizations to demonstrate quick and quantifiable success in our four-part, population mental health initiative. Armed with that data, we could approach policymakers with strategies to improve access and quality of mental-health and substance-use services to everyone in our state, especially to the poor.
The potential impact on our patients and our communities ― and on each one of us ― is huge. As a mother, father, son, or daughter, you are just as likely to have family affected by mental health as by cancer ― up to one in three Texans has a mental health and/or substance use disorder. As a taxpayer, you help fund at least $1.4 billion in emergency department costs from mental illnesses presenting in crisis.
Each of us now knows that mental illness is medical illness, just like diabetes, cancer, or cardiovascular illness. And each of us knows that contemporary mental health care is rooted in science. Next, we must insist upon prevention, early intervention, and aggressive treatment for people who endure these potentially devastating disorders. When all that is required for early detection is a couple of questions asked while taking a pulse, then collectively we must insist that those questions get asked.
James G. Baker, MD, MBA, is a member of the Texas Medical Association Council on Science and Public Health. He also serves as associate chair of clinical integration and services in the Department of Psychiatry at The University of Texas at Austin Dell Medical School and as systems chief medical officer for integral care, the community mental health center for Austin and Travis County. Dr. Baker is a Distinguished Life Fellow of the American Psychiatric Association and a recipient of the National Alliance for the Mentally Ill Exemplary Psychiatrist Award as well as the Mental Health America of Greater Dallas Pamela Blumenthal Memorial Award.
The commentary article was originally published on the Texas Medical Association’s website here as part of TMA Publication TexasMedicine February 2018.
December 14, 2017
The Austin Chronicle highlighted how Integral Care works closely with community partners to support the mental health needs of Travis County, particularly those experiencing a mental health crisis. “Anyone can experience a mental health crisis,” said Laura Wilson-Slocum, Integral Care Practice Administrator. This article explores the variety of crisis services Integral Care provides our community – the Judge Guy Herman Center for Mental Health Crisis Care provides short term crisis care in an overnight setting, our Mobile Crisis Outreach Team co-responds with the Austin Police Department and EMS to provide community-bases crisis care, and our Psychiatric Emergency Services provides mental health urgent care seven days a week. Read the article here.
November 15, 2018
October 15, 2018
Join us this year as we honor Dr. Clay Johnston and highlight the partnership between Dell Medical School and Integral Care.
Funds raised this year will go to provide the latest evidence-based best practices that are the critical tools for building recovery for persons with intellectual and/or developmental disabilities who are experiencing a mental health crisis.
New Milestones Foundation raises funds to support Integral Care in meeting the needs of adults, families, and children in our community with mental illness, substance abuse disorders and intellectual and developmental disabilities. We accomplish this by bridging the gaps between what government funds and what enhances Integral Care programs and services and between what we have today in practice and what might be promising practices for the future.
October 15, 2017
Integral Care is now offering weekly Mental Health First Aid (MHFA) classes in Austin and Georgetown. MHFA is a one-day training that teaches people how to help someone who may be experiencing a mental health crisis or showing signs of mental illness or substance use disorder. Thanks to a grant from the St. David’s Foundation, no one will be turned away. However, a donation of $10 is welcome.
MHFA can save a life, just like CPR can save someone who can’t breathe or is having a heart attack. Register today.
If you missed our Community Forum: A Home is More Than Four Walls, check out the recap on our podcast This Is Integral. Darilynn Cardona-Beiler, our Director of Adult Behavioral Health Services, Chris Laguna, our Practice Administrator for Housing and Homeless Services, and Anne Nagelkirk, our Director of Communications and Engagement share some of their favorite moments from the forum and talk about Integral Care’s work in homelessness and housing.
A home means access and connection to community, quality health care, and recovery – all of which help build health and well-being. Organizations across Travis County work to prevent homelessness as well as engage individuals experiencing homelessness, connecting them to housing so they can regain their health and independence. When people have a safe place to call home and access to support services in the community, they can thrive and meet their full potential.
Big thanks to our panelists Lisa Garcia, Vice President of Assisted Housing at the Housing Authority of the City of Austin Department of Assisted Housing, Alan Graham, Founder & Chief Executive Officer at Mobile Loaves & Fishes, Julian Huerta, Deputy Executive Director at Foundation Communities, and Darilynn Cardona-Beiler, Director of Adult Behavioral Health Systems at Integral Care.
November 13, 2018
Last week, Integral Care hosted a Community Forum on Rebuilding Health and Well-Being After Trauma. It was an impactful event featuring Dr. Elisa Borah of UT’s Steve Hicks School of Social Work, Seanna Crosbie of Austin Child Guidance Center and Dr. Valerie Rosen of UT’s Dell Medical School. The panel also included someone with lived experience who courageously shared her story. Our experts shared information about direct and indirect trauma and resources that support recovery.
To build upon the information shared at the forum, we recapped the event in our new podcast – This is Integral, which explores topics that are integral to the health and well-being of our community. Please join Integral Care’s Dr. Kathleen Casey, Director of Clinical Innovation and Development, and David West, LCSW, LCDC, Integrated Care Clinic Practice Manager, as they discuss key takeaways from the forum. They’ll share favorite moments from the panel and talk about Integral Care’s approach to supporting individuals impacted by trauma.
Please find resources from our panelists below.
We look forward to seeing you at our next Community Forum in the spring.
July 17, 2017
On July 17th, over 100 people attended the Ribbon Cutting Ceremony for the Judge Guy Herman Center for Mental Health Crisis Care. Senators, Representatives, City Council members, law enforcement, our partners St. David’s Foundation and Central Health as well as members of the community were all present to mark this historic occasion.
The Herman Center will provide short term, emergency psychiatric crisis care for adults in Travis County. It will support our community by providing an alternative to incarceration and in-patient care, and will offer the opportunity to ensure that individuals whose primary issue is mental health have an appropriate and safe place to be stabilized, assessed and treated. The goal is to quickly resolve the immediate crisis so the individual can return home or transfer to another Integral Care residential program for ongoing support and recovery. The Herman Center offers the right level of care at the right time while reducing the cost of care and improving health outcomes for patients. Primary referrals to the Herman Center will come through law enforcement and health care providers like emergency rooms. The Herman Center is not suitable for walk-ins or self referrals. To learn more about the services of the Center, click here.
Thank you to all of our community partners, especially St. David’s Foundation and Central Health, for making this much needed service available in the community. St. David’s Foundation funded the project with a grant totaling almost $9M and Central Health made the land available via a low cost (virtually free) long-term lease, valued at $1.2M.