Legacy Community Health - Year in Review - Fiscal Year 2020

YEAR IN REVIEW F ISCA L YEA R 2020

TABLE OF CONTENTS 4

Letter from Harris County Judge Lina Hidalgo

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Letter from the Chief Executive Officer

6

Legacy by the Numbers

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Feature, Resilience and Results: Powering Through a Pandemic

9

Expanding Access

12

The Challenge

13

Our Community Impact

15

Feature, Resilience and Results: Ending the HIV Epidemic During the COVID-19 Pandemic

18

Legacy in the News

19

Development and Donor Message

22

Letter from the Chief Medical Officer

LegacyCommunityHealth.org

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MISSION

Driving healthy change in our communities.

VISION

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

VALUES

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.

LE T TER FROM HARRIS COUNT Y JUDGE LINA HIDALGO With historic roots in the HIV/AIDS crisis, Legacy has now led the way through two pandemics. At the start of the COVID-19 pandemic, Legacy was among the first to open public testing sites in Houston and Beaumont, offering safe and affordable testing to residents in need, regardless of their ability to pay.

This year alone, Legacy opened six new clinics across Harris County, including the addition of school-based clinics in Galena Park Independent School District (GPISD), and a brand new flagship clinic in Southwest Houston. With these additions, Legacy now operates 41 clinics across Southeast Texas and has helped to expand access to care for over 200,000 community members.

I’m grateful to Legacy for always providing our community with hope and quality, affordable health care. I wish the agency and all its health care heroes continued success in the coming year. Thank you for your partnership in the County’s COVID-19 response efforts.

Sincerely, Lina Hidalgo Harris County Judge 4

2020 Year In Review

LET TER FROM THE CHIEF EXECUTIVE OFFICER

KATY CALDWELL This year, it’s hard to think of anything that happened before COVID-19. It seems like a lifetime ago, yet it was only last December that we opened our brand new building in Southwest Houston, that all our teams were physically working together in our offices, and that our frontline staff weren’t wearing masks and other personal protective equipment every day. That’s why this annual report is about 2019-2020 being a year of resilience and results: powering through a pandemic.

I am extremely proud of the challenges we’ve overcome and the accomplishments we’ve made while still maintaining the quality of care for our patients and improving service delivery to our communities. Many of our staff members took on different roles—some even went through different training—when the pandemic hit Southeast Texas. We were one of the first in Houston and the first in Beaumont to open outdoor tents to the public for COVID-19 testing. Our dental hygienists and school-based clinicians staffed the tents and trained to be screeners and test administrators. At the same time, our IT department moved at lightning speed to get our administrative staff equipped to work from home and our behavioral health providers moved to a virtual environment for patient care. We had to pivot during a worldwide pandemic as seamlessly as possible in the eyes of our patients. And we did just that.

Legacy Community Health continues to grow within communities that have a significant need for our services. Along with our new standalone clinic in Gulfton, Legacy Southwest, we have expanded our network of school-based clinics to include two schools in Galena Park Independent School District (GPISD). Thanks to the tireless advocacy by former Congressman Gene Green and current Congresswoman Sylvia Garcia, support from Legacy’s Board of Directors and GPISD Superintendent and Board of Trustees, this vision became a reality. We also opened four more clinics on YES Prep campuses. There is no better time to facilitate access to pediatric and adolescent care than now. We hope we can bring a sense of relief, security and safety to the parents and staff members of all the schools where our clinics are located.

In the coming months, we are continuing our expansion. This fall we opened Wellness Bar by Legacy in the Montrose area to provide HIV/PrEP and other sexual health services. In 2021, we are opening two more clinics: one in the Montrose Center’s Law Harrington Senior Living Housing Complex and the second in Avenue Community Development Corporation’s new building in the Near Northside.

We continue to serve our communities on the front lines by helping those who need care, without judgment, and regardless of their ability to pay. Our resilience brings results to the communities we serve, and we wouldn’t have it any other way.

Stay healthy, stay safe.

Katy Caldwell Chief Executive Officer Legacy Community Health Services 2020 Board of Directors

Legacy Community Health Endowment 2020 Board of Directors

Alex Jessett George Burch Chairperson Abigail Caudle, M.D. Taryn Hargrove Gore Naveen Pinglay Gary Hammett Vice-Chairperson Bryan Hlavinka Richard “Ricky” Davidson Mariana Chavez Mac Gregor, M.D. Treasurer Amanda Goodie-Roberts Johnson Olatunji Ryan Martin Neftali Partida Secretary Devin Vasquez Marissa Taler At-Large Member / Executive Committee

Tripp Carter Chairperson Brent Whiteley Vice-Chairperson Mike Holloman Treasurer Bryan Hlavinka Secretary

George Hawkins Mark McMasters, M.D. Emeritus Board Members Melanie Gray Melissa Mithoff James A. Reeder, Jr. Monsour Taghdisi Claire Cormier Thielke

LegacyCommunityHealth.org

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BY THE NUMBERS

LEGACY BY THE NUMBERS WHOM WE SERVE

41

locations across Baytown, Beaumont, Deer Park and Houston

1,240

LATINX

BY RACE / ETHNICITY

61%

AFRICAN AMERICAN CAUCASIAN

22%

ASIAN

OTHER

2%

3%

12%

employees

614,470 completed appointments

>189,617

50

28

BY AGE 0

of our patients live at or below the federal poverty level

16%

15%

12 & Under

community members served annually

51%

38%

%

BY GENDER IDENTITY

13 – 19

20 – 44

61%

45 – 64

38%

3% 65 & Over

1%

OUR FINANCIALS Total Revenue

$225,387,606 Total Expenses

$220,850,795 Total Uncompensated Care

$20,026,007 6

2020 Year In Review

Fee-for-Service Breakdown 4%

15% 48% 33%

Medicaid

Self-Pay/Sliding Scale/Grants

Private

Medicare

PATIENT PROFILE

CHAZ CORDER

SAME-DAY PrEP PATIENT

Chaz Corder is an opera singer, vocal coach, drag queen, teacher and church employee. To say that Corder’s life is on the move would be an understatement. In order to care for his sexual health, he searched for a clinic that could offer competent care for LGBTQ+ individuals in an environment that is stigma-free and empowering. He found Legacy Community Health.

On any given day, Corder’s schedule is packed to the brim with activities. From work, to play, to volunteering, Corder keeps busy. This is no secret to his vocal coaching students, his church peers, or the fans of his drag queen alter ego, Sutton-Leigh Seymour.

For someone with such a busy schedule, it was imperative to Corder that he find a health care provider that could see him in and out the door quickly. As a member of the LGBTQ+ community, he was also concerned with finding a provider who could provide competent care, and also understand and cater to a person’s culture and health.

This was doubly important for Corder while he searched for a provider to prescribe him PrEP, or pre-exposure prophylaxis, a oncedaily pill for the prevention of HIV. A Google search landed Corder on the steps of Legacy Community Health in Montrose, where he could access same-day PrEP—a service that checked all the boxes—quick, competent and judgment-free.

“I’m a very public person,” Corder says. “I advocate for things that matter, such as getting PrEP into the hands of vulnerable populations.

Same-day PrEP can do that. I actually set aside more time than I needed for the appointment. I thought I would be there for an afternoon, but I was in and out—walking out the door with PrEP inhand—in just about two hours.”

“Taking charge of your sexual health is important,” Corder continued, “Stigma be damned. This is your health and you should own it.”

LegacyCommunityHealth.org

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RESILIENCE AND RESULTS

RESILIENCE AND RESULTS:

POWERING THROUGH A PANDEMIC Legacy has always faced issues head-on and the COVID-19 pandemic has been no different. While the communities Legacy serves are no strangers to weathering storms, the COVID-19 pandemic hit as hard as a hurricane and continued to surge. Its impact was felt across the communities Legacy serves. As the world changed around them, Legacy team members came together quickly to help provide continued access to the affordable quality health care their patients have come to rely on.

Safety Measures

From the pandemic’s onset, Legacy teams worked swiftly to implement measures to protect the health of staff and patients while continuing to provide access to care. Symptom screening and triage were set up at all locations, increased sanitization practices were enacted, patient-facing staff were supplied with personal protective equipment, visitors and staff were required to wear face coverings and protective measures like social distancing and hand hygiene were implemented. Further efforts included the rapid conversion of certain in-person visits to telemedicine and telehealth (video visits), the demarcation of clinic areas for well and sick patients and the setup of drivethrough visits and laboratory testing.

Increased Access to Care

Throughout the pandemic, Legacy’s Operational and Clinical teams led efforts to maintain access to care while reducing the risk of COVID-19 exposure for staff and patients. Legacy was among the first to open COVID-19 testing tents to the public, opening locations in Houston’s Fifth Ward, Montrose and Southwest areas on March 16, 2020, and in Beaumont two days later. The Government Relations team engaged with state officials to help implement the utilization of telemedicine and telehealth, allowing patients to access care from the safety of their homes.

Training and Redeployment

Legacy’s efforts would have been impossible without the extraordinary willingness of team members to put aside concerns about the virus and step into new roles to support continued delivery of care. Within days of the first reported cases of COVID-19 in the community, staff were cross-trained and redeployed. Dentists worked at COVID-19 testing tents.

School-Based Health Care providers started seeing patients through telehealth and telemedicine platforms. Non-patient-facing staff worked around the clock from home to put procedures in place to “I have no idea when we will ensure uninterrupted access to care, such as converting behavioral be allowed to return to normal health services from 100% in-person care to 90% virtual care in just activities. But rest assured, I am a few weeks. Even with the increased distance from one another, grateful for Legacy’s presence in staff implemented new technologies, protocols and procedures at our community and the services remarkable speed.

that are provided.”

Chantini Thomas

School Nurse, Bellaire High School

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2020 Year In Review

RESILIENCE AND RESULTS / EXPANDING ACCESS

Communication and Education

During this time of isolation, Legacy’s Leadership, Marketing and Public Affairs teams kept staff, patients and communities informed and connected. For staff, regular—and often daily—updates were provided via text, email, intranet (staff website), virtual town halls and team check-ins. For the community, a COVID-19 page was created and staff made frequent updates to the page and all Legacy social media channels. As quickly as the Centers for Disease Control and Prevention and other governing bodies provided updates, information was shared. Legacy’s team became a trusted source of reliable COVID-19 information for the media and community organizations.

“Thank you for all you and the Legacy team are doing. I hope you are taking care of yourselves as well as you are taking care of others.”

Laila Khalili

Legacy did much more than simply respond to the pandemic.

The organization as a whole remained committed to connecting communities to health every day, in every way. While the future of the pandemic is uncertain, patients know they can continue to count on Legacy to show unwavering courage and commitment to providing access to affordable quality health care for all who need it.

Community Initiatives Project Manager Avenue Community Development Corporation

EXPANDING ACCESS

THE NEW LEGACY SOUTHWEST CLINIC & LEGACY PHARMACY – SHARPSTOWN

Thanks to the generosity of foundations, corporations, private donors and Legacy employees, the new Legacy Southwest clinic was opened in December 2019 in Gulfton, one of Houston’s most diverse and underserved neighborhoods.

The 33,000 square foot state-of-the-art facility replaces the original Legacy Southwest clinic, which could no longer meet the growing health care needs of the neighborhood.

The new Legacy Southwest offers Adult Medicine, Obstetrics, Pediatrics, Public Health services, and Eligibility and Social Services. Walk-in Clinic services are also available for Obstetrics and Pediatrics. This innovative campus provides health care to approximately 400 patients a day. In June 2020, Legacy opened an adjoining pharmacy to support the growing pharmacy needs of Legacy and non-Legacy patients including filling and refilling prescriptions, free medication delivery, one-on-one medication counseling, health coaching, and vaccinations and immunizations. With the opening of the clinic and pharmacy, Legacy has built a one-stop shop of high-quality health care services available to Gulfton community members regardless of the ability to pay and without judgment.

LegacyCommunityHealth.org

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PATIENT PROFILE

EVELYN & OLIVER BOECKMANN

LEGACY SOUTHWEST WALK-IN CLINIC PATIENT

During the COVID-19 pandemic, Evelyn Boeckmann became concerned when her son Oliver developed a cough. With COVID-19 very much on her mind, she attended an appointment at Legacy Community Health’s Pediatric Southwest Walk-In Clinic. Dr. Yong Han saw Oliver and helped him get the treatment he needed.

“Everyone was very nice and we didn’t have to wait long to see Dr. Han,” said Boeckmann. “Any worries I had about the virus quickly disappeared. The staff wore masks and disinfected after each patient.”

The Legacy Southwest Pediatric Walk-In Clinic opened in 2019 to offer comprehensive services to patients and their families through flexible hours, minimal wait times and convenience of care. Located in Houston’s diverse Gulfton neighborhood, the clinic is staffed seven days a week and patients between the ages of newborn to 18 years old get care for a multitude of illnesses and conditions.

Boeckmann’s children get much of their health care through Legacy’s school-based clinics at KIPP Connect. However, during the COVID-19 pandemic, the Legacy Southwest Pediatric Walk-In Clinic proved to be the right option at the right time.

“The care my son got was amazing. I had no doubt that Legacy made his health and well-being a priority during this stressful time,” said Boeckmann.

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2020 Year In Review

PATIENT PROFILE

LIA WILSON

LEGACY SOCIAL DETERMINANTS OF HEALTH PROGRAM Putting food on the table has long been a struggle for Lia Wilson. She is legally blind and disability benefits only go so far. However, a visit to her Legacy provider last year helped change that. “I remember my doctor asking me several questions about my living conditions. That appointment eventually led me to the Legacy Health Advocates program,” said Wilson.

At a routine visit with her Legacy provider, Wilson met Legacy Health Advocate Interns Christine Townsend and Tiara Flowers. They located several food pantries around Houston to help her get the food assistance she needed.

Legacy’s Health Advocate program was created in 2018 to screen patients for social determinants of health—the conditions in which people are born into, grow and live every day—that affect their overall health and well-being.

At Legacy, patients are screened specifically for food, housing, transportation and financial insecurities, which refers to rental and utility assistance. Legacy Health Advocates work with patients to locate community resources to address their needs.

Since Wilson is visually impaired, she must take the bus to visit food pantries each month. The COVID-19 pandemic has meant longer waits for her rides. However, that has not dampened her spirits.

“If it wasn’t for the resources Legacy helped me find, I wouldn’t be able to eat,” said Wilson. “So, it means a lot to me that there are places like Legacy that really care about their patients.”

LegacyCommunityHealth.org

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THE CHALLENGE

CONDITIONS AFFECTING OUR COMMUNITIES & THE NATION CHRONIC CONDITIONS

MENTAL HEALTH

One common chronic condition, diabetes, has increased by 40% in Texas over the last ten years.

The COVID-19 pandemic has been stressful for many community members. Over the past year, calls to the National Alliance on Mental Illness of Greater Houston have increased by approximately 1,500% per week. Mental health and substance use resource pages on the Texas Health and Human Services Commission website have seen a 500% jump in visitor traffic.

CHRON� IC CON� DI� TIONS Research shows that people who receive diabetes education and support are more likely to adhere to medications; better control their blood glucose, blood pressure and cholesterol levels; have lower health care costs; and better health outcomes.

(Association of Diabetes Care & Education Specialists and Texas Diabetes Council)

INFANT MORTALITY In 2018, Texas reported 18.5 deaths per 100,000 live births, higher than the national average of 17.4 deaths per 100,000 live births. Houston’s preterm birth rate of 11.2% is higher than the national average of 10.02%.

Routine prenatal care can improve the health of expectant moms and their newborns. Infants whose mothers did not get prenatal care were three times more likely to have a low birth weight and five times more likely to die than infants whose mothers received routine prenatal care.

INFANT MOR� TALITY

(National Center for Health Statistics and March of Dimes)

MENTAL HEALTH

As the COVID-19 pandemic continues, the need for mental health services will almost certainly increase while there is already a shortage of mental health professionals. The federal government and many states have expanded the coverage of telemedicine to address the increased need for mental health services.

(Kaiser Family Foundation, Houston Chronicle and Texas Tribune)

HEALTH DISPARITIES Nearly one in four children in Harris County faces uncertainty in whether adequate and nutritious food will be available in their homes. Research showed that access to nutritious food and other social determinants of health like housing and neighborhood safety make up 80% of what dictates a person’s health and life expectancy.

There needs to be more focus on addressing the underlying causes of poor health, and specifically the long-standing barriers of specific groups of people to achieving the highest possible health outcomes—those achieved by segments of the population not facing the same barriers.

HEALTH DISPARITIES

(Episcopal Health Foundation, Houston State of Health and Houston Health Department)

HIV EPIDEMIC IN THE SOUTH HIV is still on the rise in the South. States within this part of the country make up just over one-third of the U.S. population, yet account for 52% of new HIV diagnoses and about 45% of all people living with HIV. According to data gathered by the Houston Area Ryan White Council, at the end 2018, there were 29,078 diagnosed people living with HIV in the Houston Eligible Metropolitan Area (EMA), which includes Chambers, Fort Bend, Harris, Liberty, Montgomery and Waller counties.

(CDC and Ryan White Council)

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2020 Year In Review

HIV EPIDEMIC

Prevention and treatment can help end the spread of HIV, and it starts with knowing your HIV status. Testing is the only way to know for sure if a person has HIV.

THE SOLUTION

OUR COMMUNITY IMPACT MANAGING CHRONIC CONDITIONS Since opening in 2017, Legacy Pharmacies have provided free walk-in blood pressure and diabetes screenings and health coaching.

In 2019, Legacy’s Adult Medicine, Pharmacy, and Public Health teams worked together to launch a new program to help hypertensive diabetic patients better care for themselves. Through the program, Patient Educators teach patients how to manage their conditions and provide them with a blood pressure cuff to self-monitor their blood pressure and Pharmacists work with patients to adjust medications.

CHRON� IC CON� DI� TIONS PRENATAL & POSTPARTUM SUPPORT In 2020, Legacy’s Public Health team made its popular prenatal education program, Becoming a Mom, virtual so expectant parents could learn how to have healthy pregnancies and deliveries and better care for newborns from the safety of their homes. The team also successfully piloted its Postpartum Navigation Program (PNP) to provide high-risk expectant moms with intensive support in making and keeping appointments beginning in the third trimester, continuing through delivery and postpartum. The program is in place at Legacy’s East End, Fifth Ward and Montrose clinics with more locations planned.

INFANT MOR� TALITY

ACCESS TO MENTAL HEALTH CARE Legacy has worked tirelessly to make sure behavioral health resources are available to patients whose mental health has been affected during the COVID-19 pandemic. Within weeks of the onset of the pandemic in the area, telepsychiatry, telepsychology and teletherapy services were launched and have continued to be available to established and new patients. In fiscal year 2020, over 38,322 adult and pediatric mental health appointments were completed via telemedicine.

Legacy therapy groups also continue meeting through Zoom video calls, reducing any transportation barriers and decreasing the risk of exposure to the disease while ensuring access to mental health services for those in need.

MENTAL HEALTH

SOCIAL DETERMINANTS OF HEALTH PROGRAMS Since its creation in 2018, Legacy’s Social Determinates of Health (SDOH) program has screened for and addressed the environmental and societal issues that affect patients’ health outcomes. This is a holistic, proven approach that provides everyone the opportunity to attain the highest level of health. At the center of the program are the Health Advocates. Health Advocates are community members who are recruited and trained to screen patients to determine medical and social wellness needs including access to food, stable housing, transportation and financial resources. This year, 90 Advocates screened close to 10,000 patients and managed a caseload of 1,662 patients to connect to services located in their communities.

Thirty-two percent of patients reported the need for assistance and 58% have enrolled in case management to get help addressing their needs.

SDOH

HIV TESTING, PREVENTION & TREATMENT SERVICES In 2019, Legacy expanded the number of locations that offer free HIV testing from four to nine, added Patient Educators at each site to provide education and support, and began offering same-day PrEP, the once-daily pill to prevent HIV. These combined efforts made it more convenient for community members to access HIV testing, prevention and treatment in a supportive environment.

At the onset of the COVID-19 pandemic, Legacy’s Public Health team noticed a trend in people living with HIV who were falling out of care. The team implemented an intensive and ongoing outreach initiative that re-linked more than 700 HIV patients back into care between March and July 2020.

HIV

PATIENT-CENTERED MEDICAL HOME Legacy maintained its Patient-Centered Medical Home (PCMH) recognition from the National Committee for Quality Assurance. PCMH is a primary care model with the triple aim of better patient health, better care and lower costs.

PCMH

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PATIENT PROFILE

LAKIN SCHNEIDER

GENDER CARE PATIENT

Lakin Schneider needed another professional opinion—his doctor simply wasn’t providing the care he needed. He knew he had to change providers for the sake of his own health. It was then that a friend turned Schneider on to Legacy Community Health, where they knew Schneider could find competent gender care. Five years later, he couldn’t be happier.

Schneider had spent two years with a provider in Houston working on his hormones. For the two years he saw this provider, he never had his blood drawn. “He refused to order blood work,” Schneider said. “That felt wrong.”

On the hunt for a new provider, the East Texas resident was directed to Legacy Community Health’s Central Beaumont clinic by a friend, where he met Dr. Pamela St. Amand, revered in her field for her care of transgender patients.

It didn’t hurt that the Beaumont location was a much closer drive than his former provider in Houston.

“Dr. St. Amand really cares,” Schneider said. “She’s not ushering you in and out of her office. She cares about your life, not just the issue you’re there to talk about. She’s personable, and I’ve seen her at community events for the LGBTQ+ community outside of her capacity at Legacy, too. You know she cares.”

Schneider knows the value of being recognized as more than a number on a medical file; so much so that he transferred all of his health care to Legacy, not just his hormone therapy. He credits not only Dr. St. Amand, but the frontline staff, too.

Accessing health care as a member of the LGBTQ+ community, especially as a transgender person, can be an uphill battle if the clinic staff is not respectful of your name, your pronouns and your life. “This is a nonissue at Legacy,” Schneider said. Since transferring his care to Legacy Central Beaumont, he has never experienced dead-naming (the use of the birth or other former name of a transgender or non-binary person without their consent), improper pronouns, or the disrespect occasionally reported by LGBTQ+ individuals in health care settings.

“You’ll be comfortable here,” Schneider said. “Anyone involved with Dr. St. Amand is great, all the way down to the individuals scheduling your appointments. You’re in good hands.”

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2020 Year In Review

RESILIENCE AND RESULTS

RESILIENCE AND RESULTS:

ENDING THE HIV EPIDEMIC DURING THE COVID-19 PANDEMIC Legacy has been at the forefront of fighting the HIV epidemic since its very beginning. In recent years, the South has become the epicenter of the epidemic, accounting for an estimated 52% of new HIV diagnoses annually while accounting for 38% of the U.S. population. The South is behind in providing essential services for HIV prevention and treatment compared to the rest of the country. For example, 27% of PrEP users in the U.S. in 2016 lived in the South, although more than half of new HIV diagnoses occurred here. In the past year, COVID-19 magnified many of the systemic factors contributing to the epidemic, compelling Legacy to reevaluate its approach in helping to end the HIV epidemic.

In 2019, Legacy expanded the number of locations at which it offers free walk-in HIV testing from four to nine, making it easier for community members to find testing nearby. Patient Educators were added to the expanded locations to provide support and linkage to care and financial resources.

One important breakthrough in Legacy’s fight against HIV last year was the implementation of same-day PrEP. In the past, it could take patients several visits to a health care provider and several more days or even weeks to get started on PrEP. Legacy launched same-day PrEP so that patients can start the regimen within hours of their testing visit, providing patients with HIV protection the same day they are tested.

This has been critical in empowering patients to take control of their health and immediately reduce their HIV risk.

At the same time, Legacy’s Public Health and Marketing teams implemented an awareness and engagement campaign to reduce stigma associated with HIV and remove barriers to HIV testing, prevention and treatment. These efforts sought to educate a broad audience about HIV to normalize it, address misconceptions about risk and empower community members to seek testing and care while “owning their health.”

While there is still work to be done in the fight to end HIV, Legacy’s innovation and outreach achieved substantial results.

In 2019, Legacy provided 3,314 rapid HIV tests and completed 10,287 PrEP prescriptions. Legacy’s roots run deep in local, regional and national efforts to end the HIV epidemic and that commitment continues. While COVID-19 made it more challenging to connect with community members, Legacy opened new channels for people in Southeast Texas to find safe, non-judgmental spaces to engage with their health.

LegacyCommunityHealth.org

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PATIENT PROFILE

YESSENIA ALVARADO

LEGACY SPANISH AUTISM PARENT SUPPORT GROUP The first time Yessenia Alvarado heard the word “autism” was the day her son Elieser was diagnosed with the condition. As a toddler, she noticed he would not talk, he did not hear, and that he often clenched his teeth. “He wasn’t doing the same things my oldest child did at his age,” said Alvarado. “I kept asking the doctors what was wrong.”

Initially, Alvarado had a hard time accepting her son’s diagnosis.

She would not let him attend family parties for fear he would be ridiculed for his behavior. After an exhaustive search for help, she discovered the Spanish Autism Parent Support Group at Legacy Community Health.

“It was a blessing to find the group. At first, I would go by myself and would often cry. I have learned a lot from talking to other families of children with autism. I have gotten a ton of support that has helped me to better understand my son’s diagnosis and how to better manage it,” said Alvarado.

In 2012, clinic social workers at Legacy created the Spanish Parent Autism Support Group after discovering a gap in services for Spanish-speaking parents of children living with autism. While families can register to join the group, the majority of parents come to the group through referrals from their clinical social workers.

Since the COVID-19 pandemic, the group has been meeting virtually.

“Any Spanish-speaking parent, legal guardian, or caregiver of a child or children with autism can benefit from being a part of the group,” said Priscila Leal, Licensed Clinical Social Worker at Legacy. “Attending the group has allowed parents to become more empowered in the overall care of their children with autism.”

Elieser is now 21 years old and attends college. Alvarado encourages other families to attend Legacy’s Spanish Parent Autism Support Group. She says the information and resources provided by the group will help families find the support they need to live with autism.

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2020 Year In Review

PATIENT PROFILE

SAMANTHA DURAND

LEGACY TELEMEDICINE AND DRIVE-THROUGH LAB TESTING When Samantha Durand woke up one morning with a painful and itchy blister on her left arm, her family knew she needed immediate medical attention. They called Legacy Community Health and Durand was able to get a telemedicine appointment with her regular provider, Dr. Tamisha Jones.

“Dr. Jones told my mom and me that she was concerned by what she saw on my telemedicine appointment, so she told us to visit the drivethrough tent where a doctor could take a look at it in person,” said Durand.

Within an hour of the telemedicine visit, Durand and her mom were at Legacy’s drive-through lab tent located outside the Fifth Ward clinic. Within minutes, her blister was lanced, a sample was collected for lab testing and she was provided with a prescription for a topical antibiotic. For even more convenience, Durand’s mom was able to pick up the medicine at Legacy Fifth Ward’s onsite pharmacy.

Getting quick and safe care during the COVID-19 pandemic was especially reassuring for Durand and her parents. Her story highlights the importance of patients having a medical home for routine and more urgent care needs.

“It’s incredibly reassuring to know that not only do you have an exceptional pediatrician, but the whole team was there for us despite the global pandemic,” said Jess Ferdinand, Samantha’s mother. “Everyone was professional and kind and made it so easy to navigate this potentially scary situation.”

“The approach to comprehensive primary care at Legacy creates partnerships between patients, clinicians, medical staff, and families while improving health outcomes, whether it is during a pandemic or not,” said Dr. Tamisha Jones, Pediatric Medical Director. “Samantha is proof that it works. I checked in with her the next day, and she was feeling much better and tackling her next challenge, online school!”

LegacyCommunityHealth.org

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PUBLIC AFFAIRS

LEGACY IN THE NEWS

MEDIA RELATIONS, APPOINTMENTS AND AWARDS

Total News Mentions:

Potential Readers Reached:

Total Ad Spend Equivalency:

650+ Articles

671M

$1,350,989

Houston Chronicle’s Top Workplaces of 2019

Appointed to Houston Mayor Sylvester Turner’s Hispanic Advisory Council

Houstonia Magazine’s Top Doctors of 2019 Dr. Pedro Bustamante IV Dr. Chad Lemaire Texas Monthly’s Super Doctors: Rising Stars of 2019 Dr. Shetal Amin

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2020 Year In Review

Legacy Community Health

Tim Martinez

Utilization Review Accreditation Commission’s (URAC) Specialty Pharmacy Accreditation

Adolescent Health Initiative (AHI)’s Gold Certification as an Adolescent-Centered Environment

Legacy Pharmacy – Montrose

Legacy Montrose

DONOR MESSAGE

THE BROWN FOUNDATION The COVID-19 pandemic hurt all of the obvious businesses, such as sports, entertainment, restaurants, and retail. No section of society emerged unscathed, and that includes organizations like Legacy Community Health. From dealing with patient appointments being down 50%, to the increased IT needs that enabled the transition to telemedicine, everyone at Legacy had to scramble to adjust to the new normal that was forced upon them. Thankfully, Houston’s philanthropic leaders answered the call when Legacy’s Development Department reached out to ask for support. Among those donors is The Brown Foundation, whose Board of Directors and staff quickly approved a $500,000 donation to Legacy.

“The Brown Foundation stepped up in a big way to help their community during this crisis,” said CEO Katy Caldwell. “Their decisive action during such a trying time exemplifies their mission of striving to make Houston a stronger, more vibrant community.”

“I’ve been with Legacy since 1996,” said Caldwell, “and The Brown Foundation has donated millions of dollars to our cause over the years. Each donation, whether it has helped us build a new clinic or sustain a vital program, has made a significant impact on the lives of our patients.”

“People turn to those they trust in times of crisis,” said Chree Boydstun, Legacy’s Chief Development Officer. “The Brown Foundation knew that this meant more people than ever would be relying on Legacy Community Health for testing, education, and treatment. Everyone at Legacy is grateful for the Brown Foundation’s continued support, and for the trust they place in us to continue serving the Greater Houston area.”

The Brown Foundation has been supporting Legacy since 1993, when the organization was one small building in the heart of Montrose. “They’ve donated to every one of our capital campaigns,” said Boydstun, “so it’s no exaggeration to say they’ve been instrumental in helping us grow into the largest FQHC in the southern United States.”

In addition to approaching The Brown Foundation, Legacy’s Development Department did all it could to react to unexpected deficits caused by the sudden downturn in patient encounters, and that meant exploring every avenue of funding available. Team members talked to new donors, like the Alice Kleburg Reynolds Foundation who generously sent a first-time donation of $20,000 to Legacy’s COVID-19 response. The team also worked with philanthropic corporations like Texas Mutual, who supplied a $50,000 grant to help Legacy react to the pandemic.

Thanks to The Brown Foundation and other charitable organizations, Legacy was able to react quickly to the current crisis and plan ahead for an uncertain future, knowing that Houston’s philanthropic community will be there every step of the way.

LegacyCommunityHealth.org

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DEVELOPMENT

LEGACY MAKES A DIFFERENCE

BY SET TING A #TASK4MASKS The COVID-19 pandemic forced everyone to make drastic changes to their everyday lives. Gone were the informal dinners with friends, quick runs to the grocery store to pick up one or two things and daily trips to the office to work and collaborate with colleagues. One of the biggest adjustments people have had to make hasn’t been where they go or what they do, but in what they must wear.

Early on during the health crisis, the CDC recommended that people wear cloth face coverings in public to reduce the spread of COVID-19.

Masks became the latest fashion trend, with many showing off their personality through masks with bright colors and fun patterns.

Unfortunately, many Legacy patients were arriving at clinics without masks. At first they were unable to find masks due to nationwide shortages, but since 51% of Legacy patients live below the federal poverty line, the majority of them simply couldn’t afford to buy one.

This became a serious issue as the pandemic wore on and Harris County issued a mandate stating that everyone must cover their face while in public. Schools, businesses and outdoor venues hosting 10 or more people began requiring that masks be worn at all times.

In accordance with the County, Legacy complied with this order to ensure the safety of patients and staff. In order to better serve patients, Legacy launched the #Task4Masks campaign, a donation drive aimed at providing a reusable cloth mask for every Legacy patient who came through the doors.

The Development team asked donors to donate masks, provide cloth mask-making supplies, sew masks themselves, or make a financial contribution. Thanks to their generosity, more than 8,700 masks have been distributed to patients, with more coming in all the time.

Once again, Legacy’s donors rallied around a cause to ensure the health and safety of their friends and neighbors. Legacy has always known it has some of the best supporters in Houston, but it’s in times of crisis when donors really shine and remind everyone just how special they are. Thanks to its supporters, Legacy has been able to weather literal and metaphorical storms throughout the years. It’s thanks to them that patients know Legacy will be there for them for years to come.

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2020 Year In Review

DEVELOPMENT

RESILIENCE IN PHILANTHROPY Houston is known as a city that never gives up and a community that rallies around great causes to ensure everyone gets the support they need. Thanks to two major rain events in three years, Legacy Community Health’s Development Department has firsthand knowledge of just how generous and inspiring Houston’s philanthropic leaders can be.

First there was Hurricane Harvey in 2017, which caused devastation in every corner of the city. The Wortham Theater Center was one of many downtown buildings to sustain major damage which meant the venue, which every year hosts Legacy’s Luncheon, would be unavailable for months. Rather than throw in the towel, Luncheon Co-Chairs Elizabeth Petersen, Melissa Mithoff and Katherine Murphy helped Legacy adapt and respond to adversity by moving the event back a month and changing the Luncheon to a Cocktail Party. A formal downtown event became a fabulous River Oaks soirée. Usual programming gave way to short speeches and the Astros American League Championship Series game playing on big screens around the party. As a result of everyone’s “never say die” attitude, the Cocktail Party raised $400,000 for Legacy’s Little Readers and Pharmacy programs.

That can-do spirit was evident once again in 2019, when Tropical Storm Imelda swept through Houston on Thursday, September 19. While many held out hope until the last minute that the Cocktail Party would go on as usual, including honoree Fady Armanious who kept his guests updated in real time on social media, widespread flooding made it necessary to cancel the event. Once again however, the event CoChairs—Shannon Hall, Marcus Sloan, Richard Flowers, Angel Rios, Hallie Vanderhider, Sheridan Williams, Elizabeth Petersen, Melissa Mithoff and Paige Fertitta—wouldn’t take the cancellation lying down, and re-tooled the party on the fly. The event was moved to mid-December, and hosts Paige and Tillman Fertitta welcomed guests into a home decorated to resemble a true holiday wonderland. Thanks to the hard work and determination of all involved, the event raised $300,000 for Legacy’s Little Readers.

Thanks to its generous donors, Legacy has been able to maintain the high level of service, both in and outside the exam room that patients have come to expect. Because of its donors, Legacy has given away more than 140,000 books through Little Readers and its Pharmacy has been able to grow each year, helping more patients than ever access the medications they need to stay healthy. The Houston philanthropic community has always been known for its steadfast resolve and resilient spirit, and team members at Legacy are fortunate to count themselves among those who have experienced this firsthand.

LegacyCommunityHealth.org

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LET TER FROM THE CHIEF MEDICAL OFFICER

VIAN NGUYEN, M.D. As Legacy’s Chief Medical Officer and an OB/GYN physician, I consistently search for new ways to advocate for my patients, and the community as a whole, to improve their health. This year that approach was magnified to an extreme as we face the COVID-19 global pandemic.

From the onset of the pandemic, Legacy teams from across the organization came together to not only address a public health threat, but also protect the more than 200,000 patients we see throughout the year. I’m proud to be part of the leadership team that coordinated efforts such as: • Setting up four standalone satellite clinics to provide COVID-19 testing to the public weeks before most other organizations.

• Changing the physical structure of our clinics to provide more safety measures for our staff and patients.

• Creating a virtual pediatric clinic that implemented telemedicine appointments to ensure medical care for parents who had sick children.

• Providing adult primary care virtually when possible.

• Having a drive-up option for labs and other in-person services.

We have learned a lot about the resilience of our organization, patients and community from facing COVID-19. In the coming year, we look forward to implementing new programs to help some of our most vulnerable patients, specifically: • Rigorously protecting patients with comorbidities as well as those who are immunocompromised against any and all infectious diseases, such as COVID-19.

• Empowering adolescents and young adults to become more involved in their health through the launch of a new online resource and educational initiatives designed to expand our capacity to engage this hard-to-reach group “on their turf.”

• Opening new clinic spaces to focus on community needs and expanding access to care. These spaces include Wellness Bar by Legacy, a walk-in clinic in Montrose that will offer health screenings, free, rapid HIV testing and same-day PrEP for the prevention of HIV, and more.

• Exploring and implementing innovative ways to help patients with their health needs, such as remote blood pressure monitors and more ways to incorporate telehealth across our service lines.

I look forward to meeting the goals we’ve set out to accomplish, including meeting the public health and community health care needs of our patients where they reside. As we continue to navigate through the COVID-19 pandemic, I believe that Legacy’s focus on preventative medicine, education and outreach in ways that are more convenient to our current and future patients—whether it be done virtually or other ways—will not only help our community heal, but become healthier.

Vian Nguyen, M.D. Chief Medical Officer

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2020 Year In Review

SERVICES OFFERED

BY LEGACY

With Legacy’s vision of health care for all, we’re committed to providing a wide range of services: Adolescent Care Adult Medicine Behavioral Health Dental Eligibility & Enrollment Endocrinology Family Medicine Gender Health & Wellness Geriatrics Health Promotion & Education HIV/STI Screening, Prevention & Treatment

LGBTQ+ Services Obstetrics & Gynecology Patient Navigation & Linkage to Care Pediatrics Pharmacy School-Based Health Care Social Services Sports Medicine Transgender Specialty Care Vaccinations & Immunizations Vision

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