Monthly Update
January 2014
CCC Board of Directors Meeting Dates:

 All Board meetings will be held at 2:00pm at 1111 E. Cesar Chavez St., Austin, TX 78702 and are subject to change as needed.

  • February 11, 2014 
  • March 11, 2014 
  • April 8, 2014 
  • May 13, 2014 
  • June 10, 2014 
  • July 8, 2014 
  • August 12, 2014 
  • September 9, 2014 
  • October 14, 2014  
All meetings of the Board of Managers of Central Health and the Board of the CCC are open to the public. 


One of two monthly meetings of the BOM of Central Health is streamed live. Audio of Central Health Board meetings is available on 


  * The BOM of Central Health must approve budgets of the CCC in an open meeting.

:: 512-978-8464

Contact: Laura Miles
A Note from the CMO 
Mark Hernandez, MD 
Chief Medical Officer


Happy New Year! I hope each of you comes back from the holiday season with energy and readiness for the work ahead in 2014. This newsletter is devoted to a look at behavioral health care delivery in the CCC.


Mental health disorders affect us all, as providers, as family members, and as patients. This fact was brought home to me in a  recent article in the New England Journal of Medicine  which noted  that "At least 10% of the world's population is affected by one of a wide range of mental disorders" and "The global economic costs of mental disorders were estimated at $2.5 trillion (yes with a T) in 2010".


The authors provide a list of recommended policy actions to improve treatment and care of people with mental disorders. I have listed these below:

  • Empower people with mental disorders and their families
  • Build a diverse mental health workforce
  • Develop a collaborative and multidisciplinary team-based approach to mental health care
  • Use technology to improve access to mental health care
  • Identify and treat mental disorders early
  • Reduce the rate of premature death (in individuals with behavioral illness)

It is with some pride that I see evidence of many of these suggested policies already in play throughout the CCC and its service providers. The telepsychiatry Delivery System Reform Incentive Payment (DSRIP) projects speak directly to using technology to improve access to behavioral healthcare services. Integral Care's Emerge program with CommUnityCare strives to reduce medical morbidity while dealing with behavioral health issues concurrently in the primary care setting. Additional DSRIP projects are being implemented with local school districts to assist in early diagnosis and treatment.  We are on the cutting edge of healthcare delivery transformation here in Travis County, and behavioral health is leading the way.


- Mark

Transforming Care - DSRIP Project Highlights from Integral Care



Overview.  Austin Travis County Integral Care (Integral Care) has served as the local mental health authority for Travis County since 1966.  In this capacity, it provides community-based behavioral health and developmental disabilities services at a variety of locations including Integral Care's 46 facilities, on the streets, in consumer's homes, and schools.


In 2012, Integral Care served more than 32,000 individuals and families, in one or more of the following areas: behavioral health; intellectual and developmental disabilities; prevention and wellness; psychiatric crisis and jail diversion services. Individuals who receive services have either a single or a combined diagnosis of developmental disabilities, persistent mental illnesses and/or substance use.


Based on individual needs, services may include psychiatric evaluations, 24-hour crisis interventions, medication treatment, inpatient treatment, employment and vocational services, service coordination, family support and respite care, housing, information and referral, supported living and residential services.


In addition to providing services for the CCC population, Integral Care is an affiliate partner to the Community Care Collaboration (CCC).


DSRIP Role and Projects.  As a behavioral health community center, Integral Care qualifies as a Performing Provider for the 1115 Medicaid Transformation Waiver.  In this capacity, Integral Care receives federal funding based on successfully completing performance outcomes of approved waiver projects.  The following is a listing of approved DSRIP projects currently being implemented by Integral Care:


  • Community Behavior Support (CBS) Team:  The CBS Team offers an array of services for consumers diagnosed with both a developmental disability and serious mental illness by a care team trained to treat this complex population.  The project goal is to decrease inappropriate use of emergency departments by individuals with this dual diagnosis.
  • Expanded Prescriber Capacity for Specialty Behavioral Healthcare Needs:   This project facilitates timely access to needed care and medications by increasing prescriber staff at multiple service locations, including the Austin Resource Center for the Homeless (ARCH).  The project goal is to increase the volume of visits for patients seeking services at specialty care clinics.
  • Expanded Behavioral Health Telemedicine Services:  This project adds telemedicine services to two outpatient clinics as well as the Psychiatric Emergency Services center to facilitate timely access to needed care. The project goals are to increase telemedicine visits for psychiatry and to increase the number/percentage of patients reporting timely access to care.
  • Expanded Integrated Health Peer Support Services:  An increased number of individuals are being trained as Peer Support Specialists to serve as role models for individuals struggling with psychiatric issues because they have been through similar experiences.  The project goal is to improve patients' reported overall health/functional status.
  • Chronic Disease Prevention:  Disease prevention and management services are being implemented for individuals diagnosed with mental illness to help them manage their own care more effectively. The project goal is to improve patient's reported overall health/functional status.
  • Expanded Mobile Crisis Outreach Team (MCOT) Services:  This project ensures 24/7 MCOT availability for people in psychiatric crisis in the community. The focus of this project is on hospital and jail diversion, including co-responding with EMS, Austin Police Department, and Travis County Sheriff Crisis Intervention Teams. The project goal is to decrease behavioral health (including substance use) 30-day readmission rates.
  • Hospital and Jail Alternative Project (Crisis Residential):  This project expands Integral Care's crisis residential service capacity by 150 percent, focusing on treatment for consumers with co-occurring substance use and behavioral health disorders.  The project goal is to decrease preventable hospital and jail admission/readmission rates.
  • Expanded Integrated Primary and Behavioral Health Care Services (South Clinic in Dove Springs):  This project expands access to both integrated primary and behavioral health care in a new facility (see article below). The project goals are to increase the number of adults and children in southeast Austin who access services and decrease the time between discharge and follow-up.  


In addition, Integral Care has submitted proposals for the three-year DSRIP projects listed below for consideration by the Center for Medicaid Services:

  • Provision of bilingual integrated care services in three independent school districts - Del Valle, Manor, and Pflugerville - for students who experience serious behavioral health issues and who may have a co-morbid medical condition;
  • The development of cultural competency curriculum for employees and network providers to encourage inclusion, increase patient engagement, improve access to services and promote healthcare equity;
  • Implement the First Steps program targeting specialty care for infants and toddlers who exhibit mild to moderate developmental delays but who do not qualify for services through existing federal and state programs. 
Leader Spotlight   

Dawn Handley, LPC, is Integral Care's Chief Program Operations Officer. Handley joined Integral Care in 2008 and is responsible for directing adult and children's behavioral health, disease management, crisis services and integrated care. She is a member of the National Advisory Board for the Integrated Behavioral Health Program at The University of Texas at Austin. Handley is a member of the Crisis Services Implementation and Psychiatric Services Stakeholder Committees and has a critical role in the implementation of Integral Care's DSRIP projects.


Ms. Handley has more than 20 years of experience in the behavioral healthcare field. She graduated from Stephen F. Austin State University with a Bachelor of Arts in Psychology and a Master of Education in Counseling. Prior to joining Integral Care, she served as the Chief Operating Officer for Connections Individual and Family Services and interim Executive Director and Board Chair for Waterloo Counseling Services.  Ms. Handley has held other leadership positions in other healthcare organizations and has received awards for her outstanding contributions from the Texas Network of Youth Services.


New ATCIC Integrated Health Center




In December 2013, Integral Care opened its first integrated healthcare facility in the south Austin neighborhood of Dove Springs at 5013 South IH 35. This newly renovated 24,000 square feet facility is the first of its kind available for people in south and southeast Austin. Integral Care estimates that approximately 1,800-2,000 children and adults will receive services in its first year of operation. Behavioral healthcare providers are co-located with CommUnityCare medical professionals and support personnel, including Peer Support Specialists and promotoras, to provide behavioral health services, primary care, and wellness services to assist with health promotion and chronic disease management. 


The Dove Springs facility offers a wide-range of amenities including: convenient access to bus routes and major highways, separate waiting and check-in areas for adults and families with children, state-of-the-art technology to provide quality innovative care including telemedicine, community rooms available for neighbors and community groups, and an on-site dispensary with financial screening for medication assistance.


This facility will address an identified need for these services in a historically underserved area.  CEO David Evans says, "We feel privileged to provide these critical services and improving healthcare outcomes in a community that has been traditionally underserved."


Introducing Integral Care's Associate Medical Director



Kathryn J. Kotrla, M.D.,

joined Integral Care in January 2014, to facilitate its ongoing efforts to achieve excellence in care delivery. Among her many responsibilities, Dr. Kotrla will work with the CCC to develop evidence-based care protocols for individuals with physical and behavioral health service needs. She will also interact with leaders of The University of Texas at Austin medical school to explore creative models of undergraduate and graduate medical training within a community behavioral health setting. 


In addition, Dr. Kotrla is on the faculty of the Texas A&M University College of Medicine in the Department of Psychiatry and Behavioral Sciences.  Throughout her career, Dr. Kotrla has served in multiple leadership roles in behavioral health, health policy, and medical education at LoneStar Circle of Care, Texas A&M University College of Medicine (College Station and Round Rock campuses), Veterans Administration, and Ben Taub General Hospital.


Southeast Health and Wellness Center


Central Health will open a new state of the art health and wellness center in the fall of 2014 at the location of the former VA clinic on Montopolis Drive in the 78741 ZIP code. 


The new Southeast Health and Wellness Center is a model for providing high quality, cost effective, person centered care in the integrated delivery system. This site exemplifies the CCC's vision for the future of care delivery in Central Texas. 


The Southeast Health & Wellness Center is being designed and developed through an intensive community engagement process.  The next community event is anticipated to be held at the site on January 4, 2014, to review the schematics of the planned facility renovations.


The goal of the center is to provide a facility where residents can obtain a full spectrum of health related services, including medical care, behavioral health services, nutrition and wellness assistance, and more.