Annual Report 2017/2018

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FISCAL YEAR 2018

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TABLE OF CONTENTS Foreword by the Chief Executive Officer

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Legacy by the Numbers

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The Challenge

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Our Community Impact

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Expanding Access

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Donor Message

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Message from the Chief Medical Officer

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Original Artwork for Legacy Community Health

by Ivan Bocanegra

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MISSION

VISION

Driving healthy change in our communities.

Connecting our communities to health every day, in every way.

VA L U E S Health Care As a Right, Not a Privilege We believe that comprehensive health care is a human right. Legacy’s services and programs are open to all who need us, regardless of the ability to pay, without judgment or exception.

Devotion to Our Communities We continue to build our legacy on a solid foundation by learning from our communities, embracing the people in them, and serving their unique needs.

Especially when no one else will.

Leading The Charge We address issues others shy away from. Not because it’s easy or popular, but because it’s the right thing to do. The Legacy team possesses unwavering courage and serves as a visionary catalyst for sustainably healthy communities.

Active Stewardship of Resources We carefully manage our available resources, in order to deliver on our promise of driving healthy change. We remain grounded in responsible decision making for sustainable operations, putting every asset where it can do the most good for the community.

S TAT E O F T E X A S Legacy Community Health has been a health care provider in my district for as long as I have served in the Texas House. But even before I took office, I watched them grow into a true powerhouse in community health care, from working out of a one-story clinic in Montrose to an entire health system made up of over 30 clinics from Houston to Beaumont. They’ve kept their commitment to LGBTQ health as they expanded into full primary care services, making their mark in pediatrics, OB/GYN and behavioral health care. I thank Legacy for its commitment to affordable quality care to the most vulnerable, and I think that their work is just as valuable to the city today as it was when they were founded almost four decades ago.

Sincerely,

Gene Wu Texas House of Representatives, District 137

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KATY CALDWELL We continue to invest in the macro-shift to value-based care that emphasizes prevention of chronic diseases. Prevention is the key to better health and more efficient health care delivery.

Dear Friends, This year we officially became the largest Federally Qualified Health Center (FQHC) in Texas, serving nearly 170,000 community members at 34 clinics across southeast Texas.

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FOREWORD BY THE CHIEF EXECUTIVE OFFICER

Our growth will continue, and we are grateful to the many generous donors who helped us reach our $10 million goal for a new state-of-the-art campus in southwest Houston. It will be a place where pregnant moms can go for prenatal care, and then return to once their babies are born. We are committed to serving this diverse, multicultural community long into the future.

Legacy believes in investing in our community. We do so by ensuring that care is accessible to everyone, without judgment, while pursuing a business model that keeps costs down.

Looking forward, we continue to invest in the macro-shift to value-based care that emphasizes prevention of chronic diseases. Prevention is the key to better health and more efficient health care delivery.

More importantly, our values will remain the same: provide high quality, affordable care, regardless of income and without judgment.

Katy Caldwell CEO, Legacy Community Health

LEGACY COMMUNITY HEALTH BOARD OF DIRECTORS

LEGACY COMMUNITY HEALTH ENDOWMENT BOARD OF DIRECTORS

Amanda Goodie-Roberts, Chairperson

Tripp Carter, Chairperson

Melanie Gray, Board Member Emeritus

Brent Whiteley, Vice-Chairperson

Melissa Mithoff, Board Member Emeritus

Mike Holloman, Treasurer

James A. Reeder, Jr., Board Member Emeritus

Bryan Hlavinka, Secretary

Monsour Taghdisi, Board Member Emeritus

Michael S. Alexander Stephen Locke

Claire Cormier Thielke, Board Member Emeritus

Alex Jessett, Vice-Chairperson Naveen Pinglay, Treasurer Beryl Basham, Secretary Glenna Pierpont, At-Large

Tony Bravo Beth Bruce George Burch Abigail Caudle, M.D. Victor Cordova Richard Davidson Bryan Hlavinka Bethsheba Johnson Mariana Chavez Mac Gregor, M.D. Johnson Olatunji Marissa Taler

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LEGACY BY THE NUMBERS

34 locations across Baytown, Beaumont, Deer Park and Houston

WHOM DO WE SERVE? HISPANIC

AFRICAN AMERICAN

CAUCASIAN

ASIAN

OTHER

59%

23%

14%

2%

2%

Number of employees

1,019

AGE 40

>169,906

34%

34%

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community members served annually

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16%

13% 10

Number of appointments booked

520,445

0

3% Under 12

13-19

20-44

45-64

Over 65

GENDER

60%

of our patients live at or below 100% of the federal poverty level

56%

43%

<1%

OUR FINANCIALS (FY18) Total revenue

$147,805,018

$144,444,606

Funding sources 2%

Total uncompensated care

Total expenses

$9,347,480

Fee for service breakdown

1% 1%

4%

Fee for Service

13% 32%

Pharmacy

51%

Govâ&#x20AC;&#x2122;t Grants Foundations Fundraising

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Other

Medicaid

15% 26%

55%

Self Pay/Sliding Scale/Other Private Insurance Medicare

BEN ELDER GENDER HEALTH & WELLNESS PROGRAM PATIENT When Benjamin, Ann Elder’s son, began showing signs that he did not identify as his biological gender at a very young age, she took him to see a child psychologist who confirmed that Ben, who was assigned female at birth, was in fact transgender. Ann saw Ben fully transition by age seven, but as puberty approached, she began looking for better transgender care for her son.

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PAT I E N T P R O F I L E

When Ann Elder was given estimates on the cost of puberty blockers for her son, she was shocked.

The questions surrounding her son’s well-being were overwhelming. She wondered if she would be able to provide him with what he needed to live a fulfilling life.

Ann reached out to Legacy about our transgender health care program and was put in touch with Dr. Jennifer Feldmann, who would see Ben as his new pediatrician and gender care provider. Dr. Feldmann, Ann explains, is everything they were looking for in a physician. “She’s kind, thorough and treats him with respect,” Elder says, “I’m not her patient. My husband isn’t her patient. She’s there for Ben and really empowers him.”

Due to Legacy’s status as a community health center, the costs of puberty blockers and hormone replacement therapy are much more affordable, lifting an incredible weight from the Elders’ shoulders. Ben, now 13, couldn’t be happier with his treatment, and as for Ann, the relief that her son will be okay is enough. “We have gone from being frightened to death about my son’s future to feeling extremely hopeful about his care and his support—it was a life changer,” she says.

Legacy offers not only medical care, but emotional support for Ben. Despite the grim suicide statistics among transgender teens, Ann rests easy with Legacy’s care, saying, “With Legacy, Ben feels emboldened. I don’t feel like I have to worry about his mental state. [Legacy] has made my child feel not only okay, but like he’s special. He walks out of there feeling like a rock star.”

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THE CHALLENGE

CONDITIONS AFFECTING OUR COMMUNITIES AND THE NATION MENTAL HEALTH

HIV

1 in 5 youth in the U.S. between the ages of 13 to 18, struggle with mental health issues, and up to 76% of those youth are left with insufficient or no treatment.

Untreated mental illnesses during the formative years of life can lead to reduced performance in school, substance abuse, delinquent behaviors and lasting difficulties socializing.

Houston is ranked 10 in the nation for identified cases of HIV, with about 1 in 200 people living with the virus.

Health education and access to free or low-cost testing, prevention (PrEP) and treatment are vital to stopping the spread of the virus and ending the epidemic.

1 in 3 families in Harris County identify as food-insecure.

The lack of nutritious food has been shown to have detrimental effects on physical and mental health, and impedes chronic disease management.

(City of Houston Health Department)

MATERNAL MORTALITY

(National Alliance on Mental Illness)

DIABETES More than 30 million Americans are living with diabetes. Of those, nearly 1 in 4 (7.2 million) are unaware of their condition.

Health education and routine care are important for early detection and management of diabetes. Early detection can help patients make lifestyle changes to prevent disease progression and reduce subsequent complications.

FOOD INSECURITY th

LGBTQ+ STATISTICS In greater Houston, over 100,000 self-identifying LGBTQ+ individuals are uninsured.

Being uninsured often reduces access to routine health care, preventive medicine such as PrEP, treatment for chronic illnesses and delays detection of disease. It often means having to choose between health and basic needs.

The U.S. has a maternal mortality rate of 26 deaths per 100,000 live births, the highest of any developed nation. In Texas, 1 in 5 births occurred in women that received inadequate or no prenatal care.

Women need access to routine, prenatal care to help detect and treat any potential risks to healthy, full-term pregnancies.

(March of Dimes, NPR, Obstetrics & Gynecology Journal)

(Lesbian Health Initiative of Houston)

CANCER

(Centers for Disease Control)

ORAL HEALTH By 2030, 1 in 5 people in the U.S. will be aged 65 or older.

Access to routine health care will be vital to keeping this portion of the population healthy, but does bring up a potential shortage of geriatric health care providers.

1 in 2 adults living below the Federal Poverty Level (FPL), have untreated tooth decay.

Limited access to routine dental care, due to low income and/or the lack of health insurance, has led to a greater prevalence of oral diseases among people with lower socioeconomic statuses.

Cancer is the 2nd most common cause of death in adults and children in Texas.

Communities with lower socioeconomic statuses face structural and financial barriers to health care, resulting in limited access to preventive care. Access to care allows for early detection of cancer with higher chances of survival.

(Administration for Community Living)

(Centers for Disease Control)

(Texas Dept. of State Health Services)

AGING POPULATION

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(Feeding America)

BELOW BASIC HEALTH LITERACY

ACCESS TO CARE AND PREVENTION

1 in 7 adults in the U.S. have below basic health literacy, a vital skill needed to manage their health.

Low literacy has been linked to a higher occurrence of poor health outcomes, including less frequent use of preventive services and higher rates of hospitalization. These outcomes are also associated with higher health care costs.

In the U.S., 1 in 5 adults aged 18 to 36 say they cannot afford routine health care expenses.

Among millennials, 70% consider cost to be a crucial factor when looking for health care. Often, they will skip, delay or stop receiving care because of high costs and other financial obligations, including education, housing, transportation and food.

(US Department of Health and Human Services)

(The Harris Poll, Harris Insights & Analytics)

BEVERLY CALDWELL BEAUMONT CLINIC PRIMARY CARE PATIENT Beverly Caldwell has been wrestling with health care as a diabetic woman for years. The high costs of medications and doctor visits had forced her to move in with her parents.

That was until she discovered Legacy.

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PAT I E N T P R O F I L E

For years, 58-year-old Beverly Caldwell had been battling the costs of her diabetes, with little to no help. “Other health care providers would say, ‘Oh, you have to go to a specialist,’ or they would tell me, ‘Oh, you have to do that on your own,’” she says. Unable to afford insurance or up-front health care costs, she was left with few options.

At a community health fair one afternoon, Beverly spotted a booth for Legacy’s Central Beaumont location. She informed the Legacy staff member about her situation, afraid she’d have to go without insulin. Within days, she had an appointment at Legacy Central Beaumont to get her diabetes under control.

She was able to visit with an endocrinologist to lower her A1C levels and establish routine care to better manage her health.

“I went to Legacy without enough money and they said, “that’s okay.” They care, and I just love Dr. King, she’s my doctor and she is awesome. When she comes in to see you she will sit there, talk to you, and say, ‘How you doing Mrs. Caldwell?’”

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PAT I E N T P R O F I L E

JESSICA RAMIREZ BEHAVIORAL HEALTH PATIENT Mental health care isn’t something Jessica’s family ever gave much thought to. For Jessica, the notion of having a therapist was something reserved for “crazy people” — that is until she decided to seek help for herself and discovered the stigma around mental health.

Jessica Ramirez has struggled with depression much of her life, but outside of school counselors, she never had the opportunity to seek professional treatment. “My older family members don’t believe in this stuff, so it kind of makes you not believe in it,” she says. For her family, imbalances and uncertainty should be addressed with the church.

Although society is taking steps to end the stigma associated with mental health, we still have a ways to go. For patients like Jessica, the effects of mental health stigma were farreaching. As she grew older, her depression remained.

Rather than battle it on her own, she reached out to Legacy Community Health to help her take control. After a year of treatment with Legacy, she says she has no plans to stop anytime soon.

“I’ve talked to other mental health care providers and it’s just different. Dr. Young is just the best and is open to anything I have to say. I feel like she cares more than anything. I feel safe.”

Looking back on her struggle with crippling depression over the years, Jessica couldn’t be happier with her current state and her outlook on the future. “I’m just really happy. I love it. I have never even thought about stopping,” she says.

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P U B L I C A F FA I R S A N D A D V O C A C Y

OUR COMMUNITY IMPACT MENTAL HEALTH IN SCHOOLS Following the Santa Fe school shooting outside of Houston, Legacy joined discussions with statewide elected officials to increase mental health providers in schools as one way to reduce campus violence. Legacy’s Dr. Teandra Gordon, Director, Therapy, School Based Health Care, testified before the Senate Education Committee on the benefits of clinics based in Houston schools.

GRASSROOTS ADVOCACY Legacy kicked off a new advocacy program, Grassroots Guide to Health Care, that hosted State Senator Sylvia Garcia, Council Member Jerry Davis and Council Member Robert Gallegos. The program works with the community to begin building support for our health policy agenda ahead of the 2019 Texas Legislative Session.

NON-DISCRIMINATION Legacy Chief Executive Officer Katy Caldwell testified before the House Select Committee on Economic Competitiveness, a special committee formed by Speaker Joe Strauss in the wake of the “Texas Bathroom Bill” in an effort to speak to Texas’ business-centric attitude, noting that discrimination would hinder the state’s growth.

AFFORDABLE CARE ACT Legacy has become the most visible FQHC in Texas protecting the ACA and encouraging consumers to enroll. As Politico reported, “Legacy Community Health launched for the first time a $25,000 radio and social media campaign in English and Spanish to combat confusion among potential enrollees about the status of the health law.”

COMMUNITY HEALTH CENTER FUNDING This past year we faced an unusual resistance in Congress to help fund community health centers, a normally routine and bipartisan endeavor. Community health centers received funding, but only after some lobbying and public pressure. Chief Executive Officer Katy Caldwell took to the press urging lawmakers to appropriate the annual funds for community health centers, stating, “Further delays will impact our bottom line and service to our communities. Let’s not break what’s working in health care today.” (Texas Tribune)

HIV Legacy’s Public Affairs team led the first Houston Advocacy Week in partnership with the END HIV Houston Coalition. The goal of the partnership is to bring a sense of urgency to the HIV epidemic in Houston and to keep HIV on the radar of local elected officials.

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THE SOLUTION

OUR COMMUNITY IMPACT YOUTH REENTRY CASE MANAGEMENT In 2016, Legacy collaborated with Houston Methodist to launch the Youth Reentry Case Management Program – a program linking young people released from juvenile detention centers to medical and behavioral health services. In 2018, over 200 juveniles were linked to Legacy’s behavioral health services and continue to receive support today.

SCHOOL BASED HEALTH CARE Legacy’s School Based Health Care program saw continued growth across its 18 KIPP, YES Prep and Cristo Rey Jesuit campuses in the 2017-2018 school year. Just over 24,500 appointments were completed, providing students with access to trusted, high-quality health care services, conveniently located in their own schools.

The services provided included: behavioral health care, sick-child visits, vaccinations and preventive care such as well-child visits, asthma and obesity management and adolescent health care (e.g., contraception, puberty, STI prevention). The clinics were able to complete nearly 1,300 well-child visits and over 2,600 vaccinations, which were increases over the previous year of 136% and 177%, respectively.

AUTISM SUPPORT Legacy’s Autism Support Group (ASG) is a program dedicated to primarily Spanish-speaking families. The only service of its kind throughout the greater Houston area, the ASG has provided education, resources and support to help over 100 families better advocate and care for their children with autism.

MENTAL HEALTH & SUBSTANCE ABUSE SERVICES Legacy’s newest social service program, Access Increase Mental Health and Substance Abuse Services (AIMS), allows Legacy to provide support services to patients struggling with substance abuse. In only nine months, the Addiction Service Case Managers have helped over 300 patients gain access to support services and care.

CANCER PREVENTION Legacy collaborated with the University of Texas School of Public Health to create the “Salud en mis Manos” program – a partnership that allows Legacy to provide mammograms for medically underserved Latino women.

In 2018, Legacy achieved a 95% screening rate for women participating in the program.

HIV PREVENTION Legacy continued to provide leadership in ending the HIV epidemic in greater Houston through its partnership with the Houston Health Department and the END HIV Houston Campaign, and the development of a multipronged approach focused on expanding access to care and building awareness of testing, prevention and treatment options.

Legacy’s Medical, Public Health, Marketing and Communications teams came together to create the multipronged approach, which included expanding access to care through increased hours for testing and appointments to better meet community members’ needs, and a multimedia awareness campaign with popular radio personalities, striking print and digital advertising and billboards. All elements of the campaign focused on the triple message of “Get Tested. Get Prevention. Get Treatment.” Legacy helped over 700 patients gain access to preventive care, and the campaign continues into Fiscal Year 2019.

In 2018, Legacy also began a pilot program with UberHealth in Beaumont, providing Ryan White patients with a convenient transportation service to ensure they are able to get to their medical appointments. More than 60 rides were provided in the first 30 days of the program.

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OUR COMMUNITY IMPACT EDUCATION In partnership with Comcast, ExxonMobil and H-E-B, Legacy sponsored nine back-to-school events preparing over 1,500 students with new backpacks filled with school supplies for the upcoming school year. Legacy also sponsored and participated in the Houston Mayorâ&#x20AC;&#x2122;s Back to School Festival, which provided school supplies and resources to economically-disadvantaged children and their families.

PATIENT CENTERED MEDICAL HOME Legacy received the well-respected Patient Centered Medical Home (PCMH) recognition through the National Committee for Quality Assurance (NCQA).

PCMH is a primary care model with a triple aim of better patient health, better patient care and lower costs.

DIABETES MANAGEMENT Legacy launched a new initiative to help patients manage their diabetes. The program utilizes an educational curriculum, sessions with registered dieticians and pharmacists and a fitness program, all aimed at enhancing glucose control and preventing complications for our diabetic patients. In 2018, 333 patients participated in the program.

SOCIAL DETERMINANTS OF HEALTH PROGRAM In 2017, Legacy launched its Social Determinants of Health program to help reduce food insecurity as a barrier to health and well-being for our patients.

In its first year, over 7,000 patients were screened for food insecurity and linked to community resources to increase access to nutritious food. A supplemental program was launched in 2018 to help address other barriers patients face to health and wellness, such as financial hardship and inadequate housing and transportation. The pilot, which was modeled on Health Leads, an organization that connects patients to the community-based resources they need to be healthy, has now become a permanent Legacy program.

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THE SOLUTION

LEGAL ADVICE PROGRAM Financial, social and literacy barriers often impede marginalized communities from accessing supportive services such as legal advice. In 2015, Legacy launched a new program in partnership with Thurgood Marshall School of Law, providing legal consultations to eligible Legacy patients. To date, over 600 patients were referred to and supported by Legacyâ&#x20AC;&#x2122;s Legal Advice program at no cost, providing families who may not have previously been able to hire a lawyer with expert legal advice.

MATERNAL & NEWBORN HEALTH In June 2018, Legacy piloted the OB2Pedi program, an educational initiative that guides women through their journeys, helping to ensure healthier pregnancies and seamless entries for their newborns into pediatric care. In its first 60 days, over 2,000 pregnant patients enrolled in the program and received educational materials to help them along their pregnancy.

The OB2Pedi program complements the Becoming A Mom classes, which are provided to expectant moms through an ongoing partnership with the March of Dimes. The classes are taught in a group setting, allowing women to connect with and support one another, while gaining practical information and tips on caring for themselves during and after their pregnancies, and their newborns. Just over 625 moms graduated from the program over the year.

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E X PA N D I N G A C C E S S

LEGACY PHARMACY “Legacy was the first pharmacy that I would consider I have a relationship with . . . it’s more personal than most pharmacies that I’ve been to and [staff] are generally very, very helpful.”

MICHAEL C. Legacy Pharmacy - Montrose Patient

In October 2017, Legacy successfully launched two flagship pharmacies in Houston’s Montrose and Fifth Ward neighborhoods, housed inside of our very own clinics.

By developing and opening our own pharmacies, Legacy has embedded specially-trained pharmacists into our team-based care model. Pharmacists are able to address patients’ medication needs, help coordinate care, provide one-on-one health and wellness counseling and improve access to health care between visits, which together help us deliver more personalized care and improve the health outcomes of our patients.

In 2018, Legacy Pharmacy – Montrose had over 7,000 patients come through its doors and filled over 80,000 prescriptions, and Legacy Pharmacy – Lyons had nearly 2,000 patients use its services and filled over 15,000 prescriptions. Both locations have been pivotal in expanding the care we provide to the communities we serve.

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PAT I E N T P R O F I L E

HAROLD RAY BISHOP MONTROSE CLINIC AND PHARMACY PATIENT In 1983, Harold found out that he was living with HIV. In a time when an HIV diagnosis could have easily been a death sentence, all he wanted was compassionate, dignified care. For the last 15 years, he has relied on Legacy and never looked back.

At the onset of the AIDS crisis, much uncertainty flooded the medical field. There was (and still is) no cure, but in 1983, there was barely a treatment. For many patients, all that could be provided was palliative care as they rested in hospice. The stigma surrounding AIDS patients was at its highest, as many providers would refuse to treat those afflicted with this new, and what they considered frightening, disease.

Those who did receive treatment often faced discrimination.

Harold found Legacy Montrose a little over 15 years ago. “The care is unparalleled,” he says. “The health care providers are very compassionate, professional and they take care of all the needs of individual patients. The care is specialized, quality and efficient.”

Ocular complications are common for many who are living with HIV, and optometry becomes an important component of treatment. Harold found that Legacy’s on-site vision center makes treatment simple and streamlined by having all his services in one place with physicians who are familiar with his medical history.

With his health in mind, Harold switched to Legacy’s pharmacy as soon as it opened. Not having to coordinate doctor-to-pharmacy has given him increased confidence and convenience. He also adds that without Legacy’s pharmacy, he is not sure how he could afford the cost of care. “It would be a great challenge,” he says. “I don’t know if I could afford medication. Legacy, with its pharmacy, has provided all the medications I have ever needed. It’s extremely convenient and more personalized. I used to use Walgreens, but I think it’s a wonderful opportunity that Legacy now has their own specialized pharmacy operating on site.”

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LEGACY NORTHLINE â&#x20AC;&#x153;Our goal is to help bring greater health equity to this underserved area, and to do so in a way that reflects the diversity of the community. We believe everyone deserves access to quality health care, whether they have insurance or not.â&#x20AC;?

K AT Y C A L D W E L L Legacy Chief Executive Officer

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E X PA N D I N G A C C E S S

This past year, Legacy continued its quest of expanding access to health care with our newest clinic, Legacy Northline. This was a significant milestone for Legacy, marking our very first expansion into north Houston where, in many neighborhoods, more than 50% of the population lives below 200% of the federal poverty level.

Legacy Northline serves the neighborhoods of Acres Homes, Independence Heights, Northline and Northside, offering Behavioral Health, Family Medicine, Geriatrics, Obstetrics & Gynecology and Pediatrics. Legacy Northline is another step in our mission of driving healthy change in our communities.

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DONOR MESSAGE

THE FAMILY THAT GIVES TOGETHER THE HARPERS

Lisa Foronda Harper’s relationship with Legacy stretches back 15 years, all the way to 2003 when she first emceed the Legacy Luncheon. “I come from a medical family,” Lisa says, “and know the importance of healthy living. Not everyone has a doctor in the family like I did, so Legacy’s dedication to helping anyone in need of health care really spoke to me.”

It wasn’t long until her then-boyfriend, nowhusband, Greg Harper was getting involved.

“We support each other in everything we do,” says Greg, “and I saw how passionate Lisa was about Legacy. I was in the room when she fielded calls from friends of ours looking for affordable mental health care or caring OB/GYN services, and I listened to her recommend Legacy to everyone. Her passion, coupled with everything I’ve learned about the work Legacy does, made the decision to become donors extremely easy.”

Lisa eventually moved from volunteer to employee, where her appreciation of Legacy’s health care team only deepened. “I know doctors who will spend hours on the phone with insurance companies so their patients can get the medicine they need,” says Lisa. “That commitment to the community is inspiring, and lets Greg and me know our donations are being used to develop communities and help families grow.”

When the 2018 Frank Billingsley Golf Classic needed a presenting sponsor, the Harpers (along with the Ebel Family Foundation) answered the call. Greg says, “I could rally my friends and business contacts around an event

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The Harpers recognized the need for Legacy’s brand of compassionate, premium health care services goes far beyond our existing clinics, and because of this they made a significant contribution to the Building Healthy Families capital campaign for a new clinic in southwest Houston. “We saw the doors that were opened for patients when new clinics opened in Baytown and Beaumont,” says Greg, “and the way communities flocked to clinics in the Fifth Ward and Montrose, and we knew we had to be a part of driving that type of change in southwest Houston.”

Having been on the front lines, Lisa knows full well how important donors are to Legacy’s future. “We need locations that people can access easily and feel comfortable in once they arrive,” she says. “Initiatives like Legacy’s Little Readers and the [Building Healthy Families] capital campaign aren’t covered by patient copays, but they’re an essential part of building healthy communities.”

“We know our donations keep Legacy nimble and responsive to community needs,” says Greg. “We want to be a part of supporting them as they rise to meet those unseen health care challenges on the horizon.”

“Houston is a city of opportunity, and those opportunities shouldn’t dry up when someone needs to see a doctor because they don’t have insurance,” says Lisa. “Thanks to Legacy, we can play a role in helping people across southeast Texas seize the opportunity to stay healthy.”

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like the golf tournament. It’s an impeccably-managed day that raises money and awareness, and all of my guests said they couldn’t wait for the 2019 version.”

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DEVELOPMENT PROGRAM

LEGACY’S LITTLE READERS ENJOYS LANDMARK YEAR

Legacy’s Little Readers started with a simple idea: to help improve the literacy skills of children who often don’t have access to books at home. From that humble beginning a new movement was born, one that has given away more than 67,000 books to pediatric patients since the program began in 2015. Little Readers provides books to children—from newborns to 12-year-olds—at well-child visits and educates parents on the importance of reading out loud. “We owe it all to our community of donors,” says Maria Cantu-Ondarza, Legacy’s Director of Community Giving. “Without them, this program wouldn’t exist.”

“The Houston community has responded to Legacy’s Little Readers in a big way,” says Legacy Chief Development Officer Chree Boydstun. “Our biggest supporter has been H-E-B and Scott McClelland, the President of their Houston Division. Their long-term underwriting of Little Readers has given us the type of stability we needed to ensure its long-term success.”

“The Houston community has responded to Legacy’s Little Readers in a big way.”

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CHREE BOYDSTUN Legacy Chief Development Officer

Legacy’s Little Readers has enjoyed tremendous financial support beyond H-E-B’s generosity. The 2017 Cocktail Party raised more than $70,000 for a Little Readers Corner in our Southwest Clinic. Vivian Wise, a longtime Legacy supporter, was so inspired by the event that she pledged $25,000 on the spot during the evening’s call-to-action.

“The stats are undeniable.

Children who are read to at least three times a week are twice as likely to score in the top 25% on reading tests and are better able to dunderstand the complexities of language.”

“Legacy has always taken care of our patients outside the exam room,” says ANN BARNES, M.D. Boydstun, “and Little Readers extends that Legacy Chief Medical Officer care to our littlest patients. Studies have shown that reading aloud to young children is the best way to stimulate their language and cognitive skills.” Children whose parents work professional jobs hear about 215,000 words each week, while children growing up in underprivileged homes hear only about 62,000 words each week. “Little Readers is part of our plan to combat this disparity,” says Boydstun.

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Our corporate partners at Apache, CenterPoint, Comcast, the Evangelical Lutheran Church in America and the OKRA Charity Saloon, donated nearly 10,000 books that we were able to distribute. Many of these books were bilingual, which is significant because 43% of Legacy patients are best served in a language other than English. In calendar year 2017, Legacy gave away 22,534 books to children, which covered 75% of the year’s well-child visits.

Ann Barnes, M.D., Chief Medical Officer, agrees. “The stats are undeniable,” she says. “Children who are read to at least three times a week are twice as likely to score in the top 25% on reading tests and are better able to understand the complexities of language.” The ratio of book to child in middle-income neighborhoods is 13-to-1, or 13 books for every one child. In the neighborhoods Legacy serves, that ratio is one book for every 300 children. Dr. Barnes says, “This program fills a need that most people don’t know exists, and gives us another avenue to build healthy families.”

Legacy’s Little Readers is just one more way we drive healthy change in our communities.

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MESSAGE FROM THE CHIEF MEDICAL OFFICER

DR. ANN BARNES I cannot help but think about the strength our organization demonstrated this past year when Hurricane Harvey shut down our city and our clinics. Our Legacy team members worked seamlessly as a unit to ensure our patients had a safe space to return to for their mental and health care needs.

As an organization, we knew opening our clinics not only served our mission of providing health care services to our patients, but also signaled a sense of fortitude and recuperation within our communities. Through sheer determination and dedication from our teams, we were able to welcome our patients across all of our clinics in less than a week after Hurricane Harvey hit.

This achievement, and the many we have noted throughout the year, demonstrates the patient-centered approach we embrace in our daily work, and gives me so much hope for the plans we have for the year ahead. As we focus on continuous quality improvement, our teams are working hard to ensure that our patients are not just coming to a medical clinic, but to a quality facility they can consider their medical home.

In order to achieve this, our plans for the year ahead include: •

Expanding services – Legacy will increase its scope of services to include addiction psychiatry, endocrinology and sports medicine, giving our patients the ability to access specialty care which they may not currently have.

•

Accommodating growth – Legacy is on the brink of breaking ground on a new clinic to replace the current facility that serves our growing population of southwest Houston. The state-of-the-art facility will offer preventive health care, community and educational spaces, outdoor respite zones and ample parking, while increasing the existing space to serve our patients. Our School Based Health Care added four new clinics this school year to increase the number of students receiving affordable health care services at selected schools.

•

Engaging patients – In a patient-centered environment, quality can only be improved with the active participation of those who receive care. Legacy is implementing a new patient satisfaction survey that allows patients to evaluate our work based on their visits. Utilizing this survey will help us evaluate the way we provide care and deliver a valuable and comfortable health care experience our patients will want to keep coming back to.

•

Addressing social determinants of health – Unstable housing, transportation and food insecurity often serve as barriers to positive health outcomes. With the success of a recently-piloted Legacy program, all clinics will integrate social determinant screening procedures into current medical workflows. The program will help to link positively screened patients to community resources in order to improve their quality of life and bring them one step closer to better health.

This year, I am also excited to partner with our new Associate Chief Medical Officer, Dr. Charlene Flash, a nationally-recognized infectious disease specialist. Together, Dr. Flash and I will work with our teams to determine the most effective ways of incorporating disease prevention into Legacy’s integrated care model. By doing so, our organization can guide our patients toward reaching their full health potential and do our part in improving health equity amongst our marginalized communities.

I’m honored to work with all of my colleagues as we enter a new level of quality care for our patient population, and am immensely grateful for the continued support our partners, board members and donors have provided in helping us get to that level. I thank you for the continued support you’ve provided to Legacy and I look forward to our journey in 2019.

Sincerely,

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Ann Barnes, M.D., M.P.H. Chief Medical Officer

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