2014 Annual Report Texas Health Institute

He who has health, has hope; and he who has

hope, has everything. -Thomas Carlyle

Improving the health

of Texans and their

communities

An independent, nonpartisan, nonprofit think tank, Texas Health Institute (THI)

pursues solutions to accomplish quality, access, and cost effectiveness in population

health. Our mission is to improve the health of people and their communities.

Through participation and collaboration, THI works with communities on solutions.

Believing community engagement is essential to this process, the wisdom of com-

munity stakeholders provides THI with the varied and individual perspectives that

can result in successful and innovative interventions and improved outcomes. These

insights serve to guide our efforts in health education, awareness, prevention, and

policy development.

At Texas Health Institute, we “listen, tell, and guide.” Because the best possible

decisions are made when stakeholders: business, community leaders, government,

consumers, insurers, and suppliers/providers of health care, use fair and balanced

information. These decisions affect our health today and will shape the health of

generations to come.

Eliminating “silos”, collaborating to share resources,

and facilitating dialogue is essential for success in

addressing quality, access, and cost issues in health

care.

We live by the words of Margaret Mead, “Never

doubt that a small group of thoughtful, committed

people can change the world; indeed, it's the only

thing that ever has."

Improving the

health of Texans

and their

communities

3

2014-2015 TEXAS HEALTH INSTITUTE

Board of Trustees

Carol J. Paret, CIPP, Chair Chief Community Benefits Officer Memorial Hermann Healthcare System Tom Kohl, Chair Elect Senior Regional Account Manager Allergan USA, Inc. Kim D. Slocum, Immediate Past Chair President KDS Consulting Camille D. Miller, Secretary-Treasurer President/CEO Texas Health Institute Jennifer Coleman Senior Vice President Baylor Health Care System Paula S. Gomez Executive Director Brownsville Community Health Clinic George Hernandez President/CEO University Healthcare System Kim Jones Director, Testing and Research Jason’s Deli Corporate Headquarters Bert Marshall President Blue Cross Blue Shield of Texas Donna M. Meyer, PhD Community Health Strategies George Miller, Jr., MHSA CEO CommUnity Care Health Center Ben G. Raimer, M.D., FAAP Senior Vice President Health Policy & Legislative Affairs The University of Texas Medical Branch Clayton Ripley, CPA Managing Director Town Lake Capital Management George T. Roberts, Jr., FACHE Chief Executive Officer Northeast Texas Public Health District Dana Sellers President/CEO Encore Health Resources Emeritus Trustees:

Os Chrisman, P.C.

Ben M. McKibbens, FACHE

Charlotte Scott, Ph.D.

Don B. Wagner, FACHE

Texas Health Institute Values

Improving capacity at state and local levels to improve health and better manage and prevent chronic diseases facing Texas communities,

Fostering collaboration with national, statewide, and local stakeholders such as universities and employer groups,

Emphasizing evidence-based best and promising practices ap-proaches to health promotion and disease prevention,

Serving as a resource for Texas and the nation for implement-ing strategies in health promotion and disease prevention,

Evaluating and disseminating outcomes from THI projects through journal publications, presentations and toolkits, and

Using research to guide program development and implemen-tation.

In 2014, we traveled the roads of Texas and beyond.

Texas Health Institute (THI) worked with community leaders setting

their target on making a difference in their community’s health. We

traveled to College Station coordinating with Texas A&M University’s

School of Public Health and Texas Agri-Life and spent time in Austin

working with the University of Texas School of Public Health—Dell

Children's Medical Center of Central Texas to prevent childhood obesity

in Texas. THI headed up the highway for community health work in

both Bell and Williamson County. Planning and implementing our

newest project, Texas Health Solutions efforts sent THI staff to West

Texas, Amarillo, Central Texas and East Texas. We headed in every

direction—east, west, north, and south with outreach efforts in Houston,

Dallas, El Paso, and Amarillo, all to improve the health of Texans and

their communities.

THI worked with stakeholders to initiate a Community Behavioral

Health Assessment for Montgomery County and with Gateway to Care

to promote the Connecting Kids and Families project in Montgomery,

Liberty, Waller, and surrounding counties. We partnered with Texas

Medical Home Initiative to provide a successful Health Home Summit

for the second year in a row.

Lay Caregivers gathered together in San Antonio, Dallas, Houston, and

Austin to learn about advance planning with and for their loved ones, as

we conducted THI’s Lay Caregiver Initiative.

THI team members traveled across the country. Our health equity re-

search team presented at a variety of conference and seminars, including

events in California and Connecticut. President Camille Miller co-

chaired the Communities Joined in Action Annual Conference in De-

troit, Michigan.

THI takes lessons learned and solutions discovered, sharing the solu-

tions with communities throughout Texas and across the country.

Within the pages of this annual report, you will find THI working out-

side of Texas— with our 8th Annual 16-State Southern Obesity Sum-

mit and our 8-State collaborative work in genetics and genomics in the

Mountain states.

Throughout 2014, THI forged new partnerships and cemented treasured

ones across the state and across the nation that achieved tangible results,

improving the health of people and their communities.

2014-2015 TEXAS HEALTH INSTITUTE

Board of Trustees

Carol J. Paret, CIPP, Chair Chief Community Benefits Officer Memorial Hermann Healthcare System Tom Kohl, Chair Elect Senior Regional Account Manager Allergan USA, Inc. Kim D. Slocum, Immediate Past Chair President KDS Consulting Camille D. Miller, Secretary-Treasurer President/CEO Texas Health Institute Jennifer Coleman Senior Vice President Baylor Health Care System Paula S. Gomez Executive Director Brownsville Community Health Clinic George Hernandez President/CEO University Healthcare System Kim Jones Director, Testing and Research Jason’s Deli Corporate Headquarters Bert Marshall President Blue Cross Blue Shield of Texas Donna M. Meyer, PhD Community Health Strategies George Miller, Jr., MHSA CEO CommUnity Care Health Center Ben G. Raimer, MD, FAAP Senior Vice President Health Policy & Legislative Affairs The University of Texas Medical Branch Clayton Ripley, CPA Managing Director Town Lake Capital Management George T. Roberts, Jr., FACHE Chief Executive Officer Northeast Texas Public Health District Dana Sellers President/CEO Encore Health Resources Emeritus Trustees:

Os Chrisman, PC

Hardy Loe, PhD

Ben M. McKibbens, FACHE

Charlotte Scott, PhD

Don B. Wagner, FACHE

Texas Health Institute Team

Camille D. Miller, President/Chief Executive Officer

Sherry Wilkie, Chief Operating Officer

Kara Hamman, Chief Financial Officer

Dennis Andrulis, PhD, Senior Research Scientist

Marilyn Brown, MPH, Program Manager

Maria R. Cooper, MA, Policy Analyst

Lenora Doerfler, Development Coordinator

Patricia Ekpo, Accountant

Carol Gamble, Office/Event Coordinator

Rick Hernandez, Director of Lay Caregiving Initiative

Amy Minze, Executive Scheduler

John Oeffinger, Project Manager

Stephanie Ondrias, Director of Events & Education

Amenaghawon Oyegun, MD, Policy Analyst Intern

Swapna Reddy, JD, MPH, Health Policy Analyst

Anna Schellhase, Policy Analyst Intern

Nadia Siddiqui, MPH, Senior Health Policy Analyst

Michelle Smith, Obesity Program Coordinator

Eduardo Zurita, Public Health Intern

Our History:

Texas Health Institute began in 1964 as the Texas Hospital Education and Research

Foundation, a non-profit charitable 501(c)(3) organization. Recognizing that health care was

changing, that the number of uninsured persons in Texas was growing, and that managed

care organizations were expanding their market share, the Texas Hospital Association

(THA) authorized the transformation of the Foundation into the Texas Institute for Health

Policy Research (TIHPR) in 1996, with a primary focus on policy research to understand

and evaluate the new health world.

In late 2005, the TIHPR began merger discussions with the Texas Health Foundation, which

existed as a partnership between governmental public health agencies and a private non-

profit charitable [also a 501(c)(3)] foundation dedicated to supporting the programs of the

Texas Department of Health. An agreement between the organizations in 2007 resulted in

the emergence of a single entity, named Texas Health Institute.

The Texas Hospital Education and Research Foundation and the Public Health Foundation

have each been in existence over 50 years. These combined histories in public health and

health care have resulted in an organization which serves as a catalyst for change.

Our Vision:

To become a nationally recognized defining resource and catalyst for innovations that

improve the health of people and their communities.

Our Mission:

To improve the health of people and their communities.

5

Texas Health Institute

Programs & Projects

Obesity Prevention

Genetics/Genomics Collaborative Work

Awards for Excellence

Community Health and eLearning

Texas Primary Care and Health Home Summit

Fratis L. Duff MD Memorial Award

Health Equity and Disparity Research

Lay Caregiver Initiative

County Health Rankings

THRIVE: Tool for Health & Resilience in Vulnerable Environments

Texas Health Solutions

In October 2014, the 8th Annual Southern Obesity Summit took place in Louisville, Kentucky pre-

sented by THI and Shaping Kentucky's Future Collaborative. Attendees came

together to learn, collaborate and to help their individual states plan their obesity

prevention strategy. The Sunday Townhall featured: Larry Cohen, Executive

Director, The Prevention Institute; Stephanie K. Mayfield Gibson, Commis-

sioner of the Kentucky Department for Public Health; David Jones, Jr., Chair-

man, Chrysalis Ventures; General Allen Youngman (ret.), Mission: Readiness,

and was facilitated by William D. Hacker, MD, FAAP, Kentucky Commissioner

of Health 2004-2011.

The agenda also included: Jessica Lawrence, MS, Cairn Guidance, Inc.; Leon T.

Andrews, Jr., Program Director, National League of Cities' Youth, Education &

Families; Jasmine N. Hall Ratliff, Program Officer, The Robert Wood Johnson

Foundation; Richard Hamburg, Deputy Director, Trust for America's Health and Whitney Meagher,

Project Director, National Association of State Boards of Education. SOS included 60 breakout ses-

sions, poster presentations, pillar workgroup meetings, state team meetings and exhibits.

We owe a special thank you to our sponsors:

Blue Cross and Blue Shield of Texas, American

Heart Association, Blue Grass Community Foun-

dation & Lexington East End Equity Partnership,

The Greater Clark Foundation, Community Ven-

tures Corporation, Foundation for a Healthy Ken-

tucky, GE Appliances, Kentucky Department of

Public Health, KentuckyOne Health, Norton

Healthcare, The Community Foundation of Louis-

ville and UK HealthCare.

The SOS mascot in Louisville was

“Produce Girl” encouraging

attendees to enjoy the variety of

healthy snacks that were provided.

Larry Cohen, The Prevention Institute, Dr. Esteban Lopez, BCBSTX, Camille Miller, THI and Catherine Olivaris, also with BCBSTX at Southern Obesity Summit 2014

Thoughts Shared by 2014 SOS attendees…

“As a result of networking connections made at the obesity summit, we have partnered with Childcare Aware for

a NACCHO breastfeeding grant. I was also able to connect with Youth Empowered Solutions for youth advo-

cacy training. Finally, I was able to take back information from the presentations as well as from the vendors.”

“I have been fortunate to attend the last three Southern Obesity Summits. It seems every year there is a greater

impact on my career. This year, I attribute a wealth of knowledge, as well as key networking, directly to partici-

pating in the conference. First, the keynote speakers were unique, informative, and displayed a wealth of knowl-

edge across all facets of health…. I have since reached out to numerous people that I met during the conference

to ask questions based on their expertise. This not only benefits myself, but my organization as well. I look for-

ward to improving the health and wellness of Texas using skills/knowledge received from the Summit.”

“Information sharing has greatly impacted our efforts. I work in the early childhood realm, and I learned SO

much from the other states. I will now use this knowledge to inform our programming efforts. It really helps to

hear from colleagues that work in a similar climate (e.g., political, economic, geographic, etc.). Before SOS, I

was not sure how to reach out to early childhood programs, but the pillar workgroup gave me ideas on how to

pick sites and pilot programs.”

“We have hired a worksite wellness coordinator to initiate wellness for our business community. This was our

first year participating. For the SOS being in Louisville was a HUGE plus to our attendance.”

The Southern Obesity Summit (SOS) began with seed capital

from the Robert Wood Johnson Foundation as a spinoff project

of the Southern Rural Access Program, a seven-year initiative to

improve access to care. The Southern Rural Access Program’s

National Advisory Committee was led by Regina Benjamin,

M.D., MBA, the current United States Surgeon General.

Texas Health Institute (THI) and Arkansas Center for

Health Improvement partnered to put on the inaugural SOS

in Little Rock in 2007. Since Little Rock, the SOS has been

held in Birmingham, AL (2008), Austin, TX (2009), Atlanta,

GA (2010), New Orleans, LA (2011), Charlotte, NC (2012),

Nashville, TN (2013) Louisville, KY (2014).

YOU ARE INVITED TO ATTEND SOS 2015

IN JACKSON, MISSISSIPPI NOVEMBER 15-17, 2015

Participants get moving during a quick activity stretch break between

presenters at SOS in Louisville. The Summit included several

opportunities for these exercise breaks throughout the day.

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The Mountain States Genetics Regional Collaborative (MSGRC) is one of seven regional collabora-

tives covering the nation. The MSGRC covers an 8 state region (Region 6) that includes Arizona, Colo-

rado, Montana, New Mexico, Nevada, Texas, Utah and Wyoming. MSGRC is federally funded

through the US Department of Health and Human Services, Health Resources and Services Administration

(HRSA), Genetic Services Branch. THI administers the MSGRC with Dr. Celia Kaye, Project Director and

Dr. Kathy Hassell as Deputy Project Director. MSGRC ensures that individuals with heritable disorders

and their families have access to quality care and appropriate genetic expertise and information in the con-

text of a medical home. It facilitates regional collaboration, encourages involvement of diverse popula-

tions, and supports innovative mini-projects that inform quality improvement and systems change in the

newborn screening and clinical genetics health care delivery systems. These collaborative efforts bring

together clinical providers, public health professionals, and affected individuals and families to fulfill the

MSGRC mission.

The eight states are geographically and so-

ciologically diverse. The region spans from

the border of Mexico to the border of Can-

ada and has a large concentration of both

Hispanic and Native American populations.

It includes a majority of the nation’s frontier

counties, making access to and delivery of

genetic services a challenge. This region

also has a large number of health profes-

sional shortage areas and medically under-

served areas and populations. With over

600,000 births annually, ensuring access to

coordinated and comprehensive genetic

services is a priority.

MSGRC develops, coordinates and sustains

collaborative projects in Region 6 to ensure

that individuals with heritable disorders and

their families have access to quality care

and appropriate genetic expertise and infor-

mation in the context of a medical home. It supports the work of six workgroups, including: Newborn

Screening, Consumer Advocacy, Telemedicine, Emergency Preparedness, Medical Home, and Health

Information Technology. MSGRC is also a key partner in the Newborn Screening Clearinghouse and

Congenital Conditions Program, led by the Genetic Alliance.

2014 Activities

In 2012, THI was awarded a 5 year MSGRC grant and the grant year 3

began on June 1, 2014.

Regional and national program evaluation was underway.

Supplemental funds were received to develop a strategic plan for imple-

mentation of electronic family history tools in the Region.

Working with other Regional Collaboratives (RC) to identify opportuni-

ties to work on activities related to the Affordable Care Act (ACA).

Funding was received for developing care plans and billing templates for

PKU and Sickle Cell Anemia under ACA.

MSGRC’s abstract “Provision of medical home services to individuals with genetic disorders and spe-

cial healthcare needs in rural and Native American communities” was accepted and the poster was pre-

sented at the University of Miami Health Disparities and Genomics conference.

Parent Partners project continued in 7 clinics in Wyoming and Montana. MSGRC worked with state

partners to develop surveys for families. The aim is to analyze data to show an evidence-based model

that can be followed.

The Hemoglobinopathies workgroup convened in Denver, CO, in November 2014 with

representatives from all 8 states in region.

MSGRC Priority Areas

1. Enhance collaboration within MSGRC, with National Partners, and with other Regional Collaboratives

2. Treat genetic disorders (and risk factors) in the context of a medical home

3. Contextually use the role of cultural competence and diversity to adopt innovative outreach projects

4. Build capacity in state public health departments to enhance and sustain the delivery of newborn and child screening and genetic follow-up and treatment services

5. Strengthen public-private partnerships, communication, and collaboration

6. Collaborate and partner with HRSA MCHB-funded programs that promote the scaling up of effective practices

7. Expand state and regional collaborative systems of cohorts of patients for long-term monitoring and analysis of follow-up and treatment

8. Continue to address Emergency Preparedness with state laboratories, clinical genetic centers, and families

Anticipated Outcomes

Enhanced delivery of genetic services and newborn screening

Expanded the infrastructure for genetic services

Improved care coordination for people with heritable disorders

Improved access to and delivery of genetic and newborn

screening services for people with heritable disorders

Improved emergency backup systems for newborn screening

services

Enhanced delivery of services related to newborn screening.

Texas Health Institute is proud to facilitate the Awards for Excellence in Texas School Health pro-gram. This program rec-ognizes, funds, and pro-motes effective school health programs and ini-tiatives that strive to continually improve the lifelong physical, mental and social well-being of students, staff and the greater school commu-nity. We are proud to an-nounce the 2014 winners on this page.

THE ROBERT M. BERNSTEIN, MD SPECIAL RECOGNITION AWARD

Dr. Robert Bernstein was a Texas Commissioner of Health, president of the Texas Health Foundation and

a board/executive committee member of the Texas Health Institute. One of Dr. Bernstein’s favorite pro-

jects was the Awards for Excellence in Texas School Health program. He started the award program in

1989 and presented awards to winners at every annual awards ceremony until his death in 2007.

A school or district is eligible to win the Robert M. Bernstein (RMB) Special Recognition Award once it

has won each of the other Awards of Excellence awards and its program continues to succeed.

DISCOVERY AWARDS

An award for a current health initiatives that have been in place for at least one

full school year that address the lifelong physical, mental and/or social well-

being of students, staff or the school community.

2014 Winners:

"FBISD's Chopped Cafeteria Manager Edition"

Ft. Bend ISD Sugar Land, Texas

Jenieffe Heaven, Assistant Director of Child Nutrition - Program Coordinator

"Stay and Play Recreational Area"

Little Cypress Intermediate School

Little Cypress-Mauriceville CISD Orange, Texas

Kelly Meadows, R.N., School Nurse - Program

Coordinator

"Moss Haven Farm"

Moss Haven Elementary School

Richardson ISD Dallas, Texas

Kim Aman, Teacher/Farmer - Program Coordinator

VANGUARD AWARD An award to a school / district that has won

a Discovery Award for Excellence and

continues to expand and improve their

program.

2014 Winner:

“Healthy Start: Food, Fitness, Fun”

Northside ISD San Antonio, Texas

Linda Seewald, Director of Health and

Physical Education - Program Coordinator

REACHING FOR EXCELLENCE GRANTS

A grant for any school or district desiring to begin a

new health program or initiative to improve the life-

long physical, mental and/or social wellbeing of stu-

dents, staff or the greater school community.

2014 Winners:

“Healthy Families Fit Kit” Dallas ISD Dallas, Texas

Karen Burnell, M.Ed., Coordinated School Health Specialist

– Program Coordinator

"Hereford ISD SHAC Summer Youth Program" Hereford ISD Hereford, Texas D'Ann Blair, Di-

rector of Special Education Services - Program Coordinator

"Sow Healthy in Schools and Community" Seguin ISD Seguin, Texas Peter Silvius, Coordinator

of Outdoor Education and Physical Education - Program Coordinator

"Digging in for Healthy Minds and Bodies - A School Garden Project"

Silver Creek Elementary School Azle ISD Azle, Texas

Kelly Whitehead, R.N., Registered Nurse Coordinator - Program Coordinator

2014

Reaching for Excellence grant recipient Dallas ISD ’s

Karen Burness and Barbara Johnson for the Healthy

Families fit Kit with Commissioner David Lakey and THI

President, Camille D. Miller

Dr. David Lakey, and Camille D. Miller

congratulate Stephanie Kellum of Fort Bend

ISD on winning a Discovery Award.

9

eLearning:

THI launched an eLearning program in the last quarter of

2014. THI received two major grants to kick off this

work.

In September, Health Resources and Services Administra-

tion (HRSA) awarded the Region 6 South Central Public

Health Training Center to Tulane School of Public Health

and Tropical Medicine (Tulane SPHTM). Tulane organized the four organization consortium to de-

velop public health training for Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. THI serves

as the Local Service Provider (LPS) for Texas and is the only public health institute among the 39

LPS sites. We join the University of New Mexico and University of Oklahoma in this four year grant

to deliver high quality, leading edge content to public health professionals. Dr. LuAnn White, senior

associate dean for academic affairs and admissions and Professor, Director of the Tulane Center for

Applied Environmental Public Health is the principal investigator. Camille Miller is the Chair of the

Practice Advisory Board. John Oeffinger is co-principal investigator responsible for the Texas LPS.

In October, THI and Tulane SPHTM were awarded another major grant by NNPHI funded by Centers

for Disease Control (CDC). “Integrated Pest Management eLearning Training” will convert CDC’s

“Biology and Control of Vectors and Public Health Pests” 3-day, in-person course to an online cur-

riculum. It is expected that the course curriculum will be hosted on Tulane SPHTM’s eLearning man-

agement system. Dr. LuAnn White is co-principal investigator and Tulane will handle the learning

outcomes evaluation.

This is a collaborative course development program designed for the environmental health profes-

sional. An important innovation is the MyPlan and MyCQI components for each course. MyPlan is

designed for the environmental health professional to write an action plan in how they will implement

their new knowledge. MyCQI is cross-walked with Public Health Accreditation Board’s domains so

the learner can generate documentation for their organization’s PHAB accreditation application.

THI Community Based Services

Community Health Needs Assessments

Community Coalition Building & Facilitation

Technical Assistance for Program Evaluation, Identification of Community Priorities

Policy Development & Analysis

Community Engagement for Wide-Ranging Collaborative Efforts

Coalition-Based Policy Development

eLearning Course Development and Deployment

The Institute of Medicine

reported that “it now takes

an average of 17 years for

new knowledge generated

by randomized clinical

trials to be incorporated

into practice, and even

then, application is highly

uneven.” This statement

can also be said about the

application of new knowl-

edge among public health

practitioners. One means

to reduce the length of

time it takes to learn new

practitioner-based knowl-

edge is to deliver eLearn-

ing courses, extending the

reach of in-person courses

to a larger audience.

eLearning, or web-based

education and training

course development and

deployment, positions THI

as an innovative leader in

providing online education

courses to local health

departments, the public

health community, and

other stakeholders.

THI Community Health Programs and Training Research shows that health outcomes for any community are impacted by social and environ-

mental factors known as “social determinants of health.” Our health is impacted by our ethnicity,

income, education, literacy, housing status, ZIP Code, mental health, air quality, access to nutrition

and physical activity among many other factors. In Texas, research conducted by the University

of Texas Health Science Center-Tyler has recently shown that local policy decisions – passing

comprehensive smoke-free ordinances, for example – have a direct and measurable impact on im-

proved mortality. Strong collaborative efforts at a local level are necessary to successfully impact

local policy. At Texas Health Institute we view all health issues through the lens of commu-

nity. (see more of our community work on pages 14 & 15 of this report.)

The second Texas Primary Care and Health Home Summit presented by Texas Health Institute and the

Texas Medical Home Initiative was held May 8-9, 2014 in Austin at the Westin hotel. The 2014 Summit

was designed to introduce the concept of the health/medical home to first-time attendees and to build on

last year’s Summit for those that attended the inaugural Summit.

More than 200 people from all parts of Texas attended the

Summit. Attendees had the option to participate in one of four

in-depth pre-Summit sessions on topics including Health

Home 101 (anatomy and physiology of the health home);

Health Home 201 (lessons learned from practices who have

transformed to health homes); integrating behavioral health into

primary care and the role of information technology in the health

home.

The conference officially began with a plenary luncheon and an

address by Amy Gibson, Chief Operating Officer of the Patient-

Centered Primary Care Collaborative. Ms. Gibson gave an over-

view of the history and current state of the health/medical home in

the US. The afternoon was devoted to five concurrent workshops

that were repeated.

Topics included health homes for young adults with special health-

care needs; maternal-fetal health homes; presentation of a success-

ful health home model from the physician and payer perspective;

overview of the medical neighborhood and a case study in physician aggregation.

Friday morning featured an address by Drs. Christine and Tom Sinsky, internists from Dubuque, Iowa who

presented their research on innovations in primary care practice. Concurrent workshops took place both days

and topics included creating a health home in a resident clinic; an adolescent health home project; improved

transitions in care; patient engagement; overview of the Medicaid 1115 waiver projects and use of health

care workers in medical home projects; integration of behavioral health into primary care.

The meeting closed with a panel discussion moderated by Dr. Ken Shine on moving forward with the health

home model of care in Texas.

Panelists included: Dr. David Lakey, Commissioner of Health; Kay Ghahremani, Associate Commissioner for

Medicaid and CHIP; Jamie Dudensing, Policy Director for Lt. Governor Dewhurst, and Dr. Robert Morrow,

Medical Director for Blue Cross and Blue Shield of Texas.

Opening Address: Amy Gibson, Chief Operating Officer

of Patient-Centered Primary Care Collaborative

“Moving Forward with the Health Home Model of Care in Texas” panel discussion

Panelists from left to right: Dr. Ken Shine, Jamie Dudensing, Kay Ghahremani, Dr. David Lakey, and Dr. Robert Morrow

Texas Academy of Family Physicians

Texas Chapter of the American College of Physicians

Texas Medical Association

Texas Pediatric Society

TMF Health Quality Institute

PathAdvantage Associated

Pfizer

United Healthcare Services

University of Texas Systems

From left to right: Dr. Robert Jackson,

President of Texas Medical Home Initiative,

Dr. Sue Bornstein, and Camille D. Miller,

THI President/CEO

3rd Annual Texas Primary Care and Health

Home Summit will take place June 18-19, 2015

in San Antonio, Texas

Special thanks to our major conference sponsors:

11

On a beautiful Saturday in March, for THI's Spring Music Series and Fundraiser, we gather in Henly, Texas at the West Henly Country

Club. We honored Dr. Kenneth Shine with

the Fratis L. Duff Award, the highest honor given

in Texas for contributions in Public Health.

We wore our boots, jeans, and a few wore cowboy

hats. We enjoyed the musical artistry of Texas

greats: Marcia Ball, Stan Smith, Willie Alva-

rado, Patricia Vonne, and the poetry shared by

2013 Poet Laureate of Texas, Rosemary Cata-

calos. Chef Wes Ondrias delighted the crowd with

delicious barbecue and all the fixings, and cold

beverages hit the spot in the sunny hill country

day. It was a pleasure to spend the day with such

great company — friends and family — and have

the privilege of honoring a significant contributor

to the public health of Texas, Dr. Kenneth Shine.

The Fratis L. Duff Memorial

Award is given in memory

and recognition of Dr.

Duff’s years of service to the

Texas Department of

Health. The award was es-

tablished in 1990 to recog-

nize outstanding contribu-

tions to public health in

Texas and is the most re-

spected award in the state

for public health.

FRATIS L. DUFF MD MEMORIAL

AWARD

THI President, Camille D. Miller presents Dr. Shine

with a Texas plaque commemorating the event.

Texas Health Institute Board of

Trustees Chair, Carol Paret offering

opening remarks to kick off the THI

Spring Music Series and Fundraiser

The Honorable Donna Howard, State

Representative, sharing a proclamation

for Dr. Ken Shine

Poet Laureate of Texas, Rosemary Catacalos and 2014 Fratis L Duff Award winner,

Dr. Kenneth Shine

THI has been involved in health equity research and programs since 1999, and with the leadership of Senior

Research Scientist, Dennis Andrulis, PhD, MPH, who has over 20 years of national, state and local experi-

ence in health disparities and cultural competence research, programs and policies, THI has significantly

expanded its capacity and skills in this programmatic priority.

With ongoing support from the W.K. Kellogg Foundation (2011-2015)

THI has been monitoring and reporting on the implementation progress

of over 60 provisions in the ACA with significant opportunity and

implications for addressing longstanding health disparities in the U.S.

As part of this work, THI has released half a dozen reports, and pre-

sented this work nationally to raise awareness, inform advocacy and

policy, and share best practices. Building on this initiative, THI has

also been monitoring the opportunities and challenges of the new law

for safety-net hospitals systems, with research published in Health

Affairs, and a recent report documenting payment and delivery re-

forms, Medicaid 1115 Waiver activities, and other innovations.

With support from W.K. Kellogg Foundation, The California Endow-

ment and the Connecticut Health Foundation in 2014, THI is develop-

ing a set of novel health equity report cards for health insurance mar-

ketplaces in two leading reform states—California and Connecticut.

These report cards are intended to highlight progress, successes and gaps in reaching and enrolling racially

and ethnically diverse populations, who comprise a large majority of those eligible for marketplace cover-

age yet are often hard to reach and enroll. Findings from these leading states are intended to inform other

states as they work to improve programs and policies for reaching diverse populations.

THI also continues to address other major topics from a health equity perspective, including emergency

preparedness, climate change, community resilience, and regionalization of care. With support from the

Joint Center for Political and Economic Studies and the Kresge Foundation THI completed two reports—

one providing a multi-state baseline inventory of climate change data, research, programs and policies, and

a second documenting opportunities for building community resilience to climate change. The former

gained considerable attention, including a local NPR radio and online article featuring Nadia Siddiqui,

THI’s Senior Health Policy Analyst.

Health Equity Presentations Across the Country in 2014

THI Health Equity Program Staff continue to present their work at major scientific and community

venues across the country, including those sponsored by the National Institutes of Health, Institute of Medi-

cine, American Public Health Association, Kaiser Family Foundation, Congressional Black Caucus, Vet-

eran’s Health Administration, Families USA, among many others. These presentations are intended to in-

form research, advocacy, policy, program development, and public health practice to advance a health care

system that is equitable for all populations.

Following are examples of presentations:

Dr. Andrulis was the keynote at a conference on building an equitable health care delivery system con-

vened by the National Academy for State Health Policy for federal and state decision makers. Highlight-

ing current work on the transformation of the health care safety net, a project supported by the Blue

Shield of California Foundation, he highlighted adaptation strategies around collaboration, cost-

containment, and managing transformation. He also discussed challenges moving forward especially to

balance traditional fee for service revenues with the

move toward population health.

Dr. Andrulis was featured in the Harvard Political

Review on November 26, 2014, sharing his senti-

ments on the heightening accounts of xenophobia

following the emergence of Ebola.

Ms. Siddiqui was invited to present a seminar on the

ACA and health equity at the Translational Health

Disparities two-week Course sponsored by NIH’s

National Institute for Minority Health and Health

Disparities.

Tracking Implementation

and Implications of the

Affordable Care Act for

Diverse Communities

Advancing Emergency

Preparedness and

Response for Culturally

Diverse Communities

Climate Change and

Diverse Communities:

Assessing Legacies of the Past,

Building Opportunities for the

Future.

THI Policy Analysts: Nadia Siddiqui

and Maria Cooper

13

COMMUNITY ENGAGEMENT Regional Stakeholder meetings, Lay and Professional Caregivers, Statewide Advisory groups,

Focus groups, Local Advisory groups, Business, Veterans, Faith-based groups, Develop

statewide Lay Caregiver Network, Speaking engagements

EDUCATION & TRAINING Workshops and seminars, Material resources, Tool kits, Comprehensive web-based resources,

E-learning opportunities, Caregiver Summit

PUBLIC POLICY DEVELOPMENT Identify strategic policy priorities of Texas, Local, state and federal government, Business,

Nonprofit sector

CAREGIVING LEARNING OPPORTUNITIES

Camille Miller has developed and piloted a workshop enti-tled, Seasons of our Your Life, which is based on the work of Parker Palmer. Ms. Miller has recognized that we are all destined to be caregivers or care receivers. This interactive workshop leads participants through a personal exercise that pro-vides a picture of the “Hidden Wholeness” each of us possess to cope with life’s challenges.

Amy Praskac was engaged to provide a second workshop entitled On the Road: Ad-vance Planning. This work-shop provides training on advance planning, record keeping and organization. This important workshop teaches attendees how to address frequently neglected aspects of end-of-life plan-ning and receive tips on how to fill the gaps in their record keeping.

A key component of the program will be an extensive website that serves as a Resource of Resources for the lay and professional caregiver and which pro-vides sponsorship opportuni-ties for entities that provide services and good to the caregiver. Ease of navigation and comprehensive informa-tion will be the underlying goal for the site’s develop-ment. There exist many re-sources on the web for care-givers most of which are restricted to membership, geographic area, specific population or particular condition.

In 2014, THI in collaboration with the Texas Team launched the Lay Caregiver Initia-

tive. Together we act as neutral conveners, facilitating balanced dialogue and creating a

vision of improved care giving for all Texans. The critical role that family and friend care-

givers play in our state's healthcare system, the financial impact of caregiving on our econ-

omy and the importance of the 3,720,000 hours that Texas caregivers have provided at an

estimated economic worth of $34 billion per year is

important to sustain. Together THI and Texas Team

listen to caregivers health care solutions, provide

important educational resources, and through the

process of discovery provide policy solutions. The

past 10 years have given us a new generation of

caregivers with complex challenges that require

comprehensive initiatives that can offer the best

chance at an acceptable quality of life.

Funded by BCBSTX, Houston Oil Production Enterprises, Inc. & private donations, THI

began conducting classes and engaging communities to start the gears turning to bring the

topic of caregiving to the forefront.

Lay Caregiver Initiative

In March 2014, Rick Hernandez was hired to serve as program director for the Lay Care-

giver Initiative. THI staff is collaborating with the Texas Team, a regional action coali-

tion (http://www.texasnurses.org), composed of a diverse array of stakeholders, charged

with transforming the health of Texans through nursing.

The County Health Rankings & Roadmaps (CHR&R) provide an easy-to-use snapshot comparing the over-

all health of nearly every county in the nation. The rankings illustrate that where someone lives influences

how well and how long someone will live. Good health includes many factors beyond medical care.

CHR&R is produced by the University of Wisconsin Population Institute with major funding by the Robert

Wood Johnson Foundation.

CHR&R program helps communities identify and implement solutions that make it easier for people to be

health in their schools, workplaces, and neighborhoods. THI was awarded funds to promote the release of

the 2014 County Health Rankings in Texas Report. THI worked with closely with the Texas Department of

Health Services to distribute the report. THI has been the lead Texas partner since the state program was

created in 2009. Our 2014 effort ensured each of the 254 Texas county judges received the printed report.

This was an important step since county judges significantly influence funding for county efforts to address

local health issues.

THI also coordinated the state communications program with numerous state and local media about County

Health Rankings and their importance. THI staff made a presentation to Texas Medical Association’s Com-

mittee on Rural Health describing THI’s five year effort with CHR&R and explaining the data sets and

ranking methodology. THI completed the 2014 project with a webinar featuring THI Board member,

George Roberts, FACHE, who described the Northeast Texas Public Health District’s use of the County Health

Rankings in the creation and operation of FitCity Tyler. FitCity Tyler has had resounding local community support

with citizens taking advantage of the program to reduce their weight.

Summary Health Outcomes & Health Factors

Rankings

Counties received two ranks:

Health Outcomes

Health Factors

Each of these ranks represented a weighted summary of

a number of measures. Health outcomes represent how

healthy a county is while health factors represent what

influences the health of the county. To the right is the

ranking of the top ten counties in Texas in each cate-

gory.

THRIVE, developed by the Prevention Institute (PI) and distributed in partnership through the National Network of

Public Health Institutes (NNPHI), is a community approach to address health disparities. PI updated its Community

Approach to Addressing Disparities in Health with the revision of THRIVE in 2014.

A centerpiece of THRIVE is a set of community level factors that are linked to Healthy People 2010 Leading Health

Indicators. It now features a simplified list of thirteen factors to facilitate use of the tool at the local level. THI at-

tended a NNPHI sponsored training workshop in January, 2014 and a second one in December 2014. THI staff met

with Chip Riggins, MD, MPH, then Executive Director, Williamson County and Cities Health District (WCCHD)

and members of his staff to determine their interest in piloting THRIVE in a Williamson County community. THI

completed a THRIVE “Train the Trainer” session with Melissa Cammack, MS, CHES (Director of Healthy Commu-

nities) and Kristen Eastman, MPH (Community Coordinator) in October in Taylor, Texas. Together, WCCHD and

THI identified four types of communities to use the THRIVE tool in:

Low income with limited access neighborhood in Taylor

farming areas outside of Taylor

a neighborhood in Georgetown that organizes a yearly health fair

a school working to integrate initiatives with parents and students to increase grades and reduce absences.

WCCHD initiated a meeting with the Georgetown Health Foundation to explore opportunities to help fund one or

more of the community initiatives as a follow-up to the training. THI staff will incorporate THRIVE in our Texas

Health Solutions Toolbox, even though funding was not secured to purse the Williamson County work.

THI Community Health

THRIVE: Community Tool for Health & Resilience In Vulnerable Environments

County Health Rankings & Roadmaps - 2014

15

Texas Health Solutions Program Planning and Development Work in 2014

THI and TPPF began the development and planning of Texas Health Solutions (THS) in February, 2014. THS staff

initially started meeting with individuals and organizations in South Texas, then expanded its efforts to other parts of the

state including the Panhandle, West Texas and along the U.S./Mexico Border, East Texas and Central Texas. These

“listen, tell, guide” engagements took place in small focus groups, with key community leaders using key informant

interviews, and with members of the press. Community meetings included engagements discussing rural, urban, and

suburban health care delivery; health insurance or the lack of it in selected areas; the impact of Medicaid and Medicare

on specific populations; Veterans and active duty military personnel and their family’s care; and, the ability or inability

for Texans to gain access to affordable and quality care in their community.

The result is a better understanding and appreciation of “sick” or episodic-driven health care as we know it in 2014 and

the beginning of the move toward whole population or public health care with new payment and/or delivery models.

Each of the state’s regions offers a different dynamic based in large part on the local community’s leadership and cul-

ture, general public attitudes towards health care, the health care providers involved in delivering care and how they

view their organization’s future.

Texas Public Policy Foundation (TPPF) and Texas Health Institute (THI) are partnering to facilitate the implementation of

Texas Health Solutions. The end result of Texas Health Solutions (THS) will be the development of unique ac-

countable healthy communities that improve the overall health of the community and lower costs for the whole com-

munity’s population. Meadows Mental Health Policy Institute (MMHPI) will provide behavioral health expertise.

Created and operated by local community leaders, in collaboration with TPPF, THI and MMHPI, the community

driven programs will maximize flexibility to design and implement health care demonstration projects starting with

behavioral health and focusing on veterans and their families; children; and people in the criminal justice system,

thus impacting the entire community. The results will demonstrate how Texans can transform health care by creat-

ing healthy communities. Healthy communities will result in increasing quality and access while lowering cost of

health care.

THS will use a Collective Impact framework in four Texas communities. This framework is based on the StriveTo-

gether Partnership experience which addressed cradle to career education in a community. It is important to note that this is

not a “model” as there is no single method for implementing the framework in a community. Instead, this framework acts

as a guide for those willing to commit over the long-term to develop the right infrastructure that meets the unique needs of

their community.

This project will build on THI’s successful Shared Vision for Health Care in Texas Project to RAISE Health Care in

Texas. In 2005, leaders in Texas developed the following principles to RAISE the health of Texans:

Regional solutions for regional differences—but within a statewide strategic framework.

Access for all - a rational system for access to care other than through the emergency room.

Incentives for personal responsibility - engaging all stakeholders in realigning incentives

to produce outcomes the community desires.

Sound use of resources - ensuring that all current resources are contributing to the outcomes

the community desires.

Education about consequences - identifying both the intended and unintended conse-

quences of making changes before making a change.

Four health transformation communities are taking part in the project. They are geographically located in Central Texas,

East Texas, the Panhandle, and West Texas/Border. Each community will identify metrics to define the financial and health

challenges individuals and families face in today’s health care system; develop and implement strategies to improve the

metrics; and monitor and evaluate the results. Data collection, sharing, monitoring, and public display through a community

dashboard are important tasks. Results will be evaluated both quantitatively and qualitatively through outcome measures

and community narratives. THS communities will meet as a Learning Community to share best practices, and lessons

learned. The findings of this project will be disseminated among health care policy decision-makers, and will form the cor-

nerstone for transformation of America’s fragmented health care system, based on a community designed and community

driven framework.

TPPF is the project lead on policy development, THI is the lead on community capacity building and technical assistance,

and MMHPI will provide behavioral health expertise.

Doing together what none of us can do alone; we will transform health care by creating healthy communities.

RAISE

Regional solutions

Access for all

Incentives for personal responsibility

Sound use of resources

Education about intended and unintended

consequences of solutions.

STATEMENTS OF FINANCIAL POSITION

DECEMBER 31, 2014 AND 2013

2014 2013

ASSETS

CURRENT ASSETS:

Cash and cash equivalents $ 200,831 $ 543,967

Accounts receivable 138,277 105,537

Pledges receivable 75,000 59,000

Grants receivable 71,142 240,976

Prepaid expenses and other assets 17,521 16,552

Total current assets 502,771 966,032

INVESTMENTS 864,180 1,021,866

TOTAL ASSETS $ 1,366,951 $ 1,987,898

LIABILITIES AND NET ASSETS

CURRENT LIABILITIES:

Accounts payable $ 72,488 $ 323,524

Trust funds payable 26,002 37,958

Accrued expenses 58,582 144,397

Deferred revenue

6,556 5,000

Line of credit - 200,000

Total current liabilities 163,628 710,879

NET ASSETS:

Unrestricted

(246,874)

Temporarily restricted 1,396,917 1,523,893

Total net assets 1,203,323 1,277,019

TOTAL LIABILITIES AND NET ASSETS $ 1,366,951 $ 1,987,898

In Maxwell Locke & Ritter LLP’s opinion, the following financial statements present fairly,

in all material respects, the financial position of THI as of December 31, 2014 and 2013 and

the changes in its net assets and its cash flows for the years then ended in accordance with

accounting principles generally accepted in the United States of America.

THI complied, in all material respects, with the types of compliance requirements referred to

above that could have a direct and material effect on its major federal program for the year

ended December 31, 2014.

17

TEXAS HEALTH INSTITUTE

STATEMENT OF ACTIVITIES

YEAR ENDED DECEMBER 31, 2014

Unrestricted

Temporarily Re-

stricted

Total

REVENUES:

Federal grants $ 641,191 - 641,191

Other grants 301,822 331,475 633,297

Contributions 256,045 46,845 302,890

Sponsorships 128,647 45,000 173,647

Seminars 159,269 - 159,269

Investment earnings - 26,823 26,823

Other 9,882 - 9,882

Net assets released from restric-

tions 577,119 (577,119) -

Total revenues and

net assets released

from restrictions 2,073,975 (126,976) 1,946,999

EXPENSES:

Mountain States Genetics

Regional Collaborative Center

Grant

641,191 - 641,191

Other programs 991,438 - # 991,438

Development 93,331 - # 93,331

General and administrative 294,735 - # 294,735

Total expenses 2,020,695 - 2,020,695

CHANGE IN NET ASSETS 53,280 (126,976) (73,696)

NET ASSETS, beginning of year (246,874) 1,523,893 1,277,019

NET ASSETS, end of year $ (193,594) 1,396,917 1,203,323

TEXAS HEALTH INSTITUTE

STATEMENTS OF CASH FLOWS

YEARS ENDED DECEMBER 31, 2014 AND 2013

2014 2013

CASH FLOWS FROM OPERATING ACTIVITIES:

Change in net assets $ (73,696) $ (115,425)

Adjustments to reconcile change in net assets to

net cash used in operating activities:

Net unrealized gain on investments (26,797) (166,359)

Changes in current assets and liabilities:

Accounts receivable (32,740) (11,887)

Pledges receivable (16,000) 64,600

Grants receivable 169,834 94,024

Prepaid expenses and other assets (969) 15,494

Accounts payable (251,036) 205,901

Trust funds payable (11,956) (1,313)

Accrued expenses (85,815) (37,697)

Deferred revenue 1,556 (111,257)

Net cash used in operat-

(327,619)

(63,919)

CASH FLOWS FROM INVESTING ACTIVITIES-

Net sales of investments 184,483 315,853

CASH FLOWS FROM FINANCING ACTIVITIES-

Net (payments) proceeds from line of credit (200,000) 150,000

NET CHANGE IN CASH AND CASH EQUIVALENTS (343,136) 401,934

CASH AND CASH EQUIVALENTS, beginning of year 543,967 142,033

CASH AND CASH EQUIVALENTS, end of year $ 200,831 $ 543,967

SUPPLEMENTAL DISCLOSURE

OF CASH FLOW INFORMATION-

Interest paid on line of credit $ 1,119 $ 5,041

19

SOLUTIONS

thru

Pol icy Development,

Prevention, and

and Education

POLICY DEVELOPMENT

As a public health

institute, THI plays a

critical role in convening

stakeholders on public

health issues, identifying

opportunities for

influencing change, and

facilitating the develop-

ment of strategies to

Impact local, state, and

national policy.

EDUCATION In 2014, THI

posi t ioned i tsel f as a

Texas leader in provid ing

innovat ive onl ine educa-

t ion courses to local

health departments , the

publ ic health commu-

nity , and other impor-

tant THI stakeholders .

PREVENTION From the World

Health Organization, “many factors

combine together to affect the

health of individuals and

communities. Whether people are

healthy or not, is determined by

their circumstances and environ-

ment.” THI invites discussion,

develops opportunities for study,

and working with communities,

encourages solutions for disease

prevention and population health.

Ron J. Anderson, MD

Ron J. Anderson, MD died on

September 11, 2014.

A kind and brilliant servant

leader, Dr. Anderson served on

the Board of Trustees for Texas

Health Institute for 17 years.

In 2014, THI established the:

Ron J. Anderson Memorial

Fund. THI President, Camille

Miller said, "We have all lost a

dear friend and the epitome of

a Servant Leader. My friend,

our board member, an incredi-

ble family man and a man of

God will be missed terribly.

We will honor him at Texas

Health Institute by establishing

the Ron J. Anderson Memorial

Fund .”

THI established the Memorial

Fund to continue the work that

Dr. Anderson started in Dal-

las—his dream to establish a

"Dallas Community Health

Institute."

While serving on THI’s Board,

Dr. Anderson presented the

concept of a Dallas Community

Health Institute to the board in

May of 2013. The board ap-

proved it unanimously.

“We have been working with

him on this and talked last

about it the day before

he received his diagnosis.

We look forward to being

a part of making one of his

dreams come true.” shared

Camille Miller.

Texas Health Institute is

raising money to launch

the Ron J. Anderson

Community Health

Institute in

Dallas, Texas.

Dr. Ron J. Anderson, M.D., RPh., a native Oklahoman, came to Dallas to do an Internal Medicine Resi-

dency after graduating from Medical School at OUHSC in Oklahoma City in 1973. He finished his post-

graduate medical training at UTSW affiliated hospitals (Parkland and the Dallas VA) including a Chief

Residency in 1976. Dr. Anderson served as President and CEO of Park-

land from January, 1982 through December, 2011.

Nationally, Dr. Anderson served as:

Chairman of the National Association of Public Hospitals

Chairman of the National Public Health and Hospital Institute

Member of the Association of Academic Health Centers

Commissioner of Kaiser Commission on Medicaid and the Uninsured

Board member of the American Hospital Association, and

Elected member of the Institute of Medicine.

At the State level, Dr. Anderson served as

Chairman of Texas Hospital Association

Chairman of Teaching Hospitals of Texas

Chairman of Dallas Hospital Council

Member of DFWHC's Foundation for Education and Research, and

Chair of Texas Health Institute Board of Trustees.

Dr. Anderson was an avid supporter of THI and served with integrity and compassion. The values and

professionalism that he exhibited throughout his 30 year tenure at Parkland, he brought to the THI Board

table as a servant leader.

From Camille D. Miller, President/Chief Executive Officer:

Each year at Texas Health Institute, we work hard to improve the

health of Texans and their communities. We believe that all

health is local and throughout 2014, we worked in communities

across the state to learn, to teach, and to accomplish our mission.

2014 also marked the passing of our dear friend and longtime

THI advocate, Dr. Ron J. Anderson. Dr. Anderson served as a trustee on the THI

Board for many years and was my colleague and friend for the past 20 years. His

energy and vision will be sorely missed and his inspiring leadership will be the

fuel that takes us to greater levels in the coming years. Our efforts in 2015 and

beyond will be focused on fulfilling his legacy of improving health and health

care for all of the people of Texas. We are excited to begin the implementation of

the Ron J. Anderson Community Health Institute in the Dallas area. Its mission

will be to focus on community engagement, health policy, strategic planning,

and research and training in health.

Upon Dr. Anderson’s death, Steve Love, president of the Dallas-Fort Worth Hospital

Council was quoted in the Dallas Morning News, “Anderson was a giant of North

Texas health care...he championed the plight of the most vulnerable in our soci-

ety, and many lives have been saved in North Texas because of his clinical caring

compassion for others.”

He was a servant leader and a wise and dear friend. Both in his life and now in

his death, Dr. Anderson serves as the motivation to work even harder at achiev-

ing our mission. People matter and it is up to each of us to do what we can to

improve the quality of life available to all people. In the coming year, we are

committed to doing our part. We invite you to be a stakeholder in this effort.

Together, we will make a difference.

8501 North MoPac Expressway, Suite 170 Austin, Texas

78759

512.279.3910

www.texashealthinstitute.org

Remembering a Servant Leader

Dr. Ron J. Anderson