Monthly Update
 November 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 can be changed or added as needed.

  • TBA 
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. 


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

:: 512-978-8164

Contact: Mark Hernandez
A Note from the CMO  



Ted Held, MD
Assistant Chief Medical Officer

In my younger and more vulnerable years my father gave me some advice that I've been turning over in my mind ever since. "Whenever you feel like criticizing any one," he told me, "just remember that all the people in this world haven't had the advantages that you've had."

-F. Scott Fitzgerald, The Great Gatsby, 1925


The holiday season is upon us, the traditional time to slow down, take a break with friends and family; to reflect and give thanks for the good things in our lives.  It is also the time to reflect on the lot of those less fortunate than us.  When I reflect on the patients we serve, I am reminded that, although written almost a hundred years ago, Fitzgerald's quote is as true today as it was in the roaring 20's.  Many of the health problems our patients face are due to disadvantages that often begin at birth, and are beyond individual control.


 A newborn can't pick her parents; she can't control whether her mother reads to her; she can't choose the neighborhood she grows up in, the distance she lives from a grocery store, how she is taught to handle stress; nor can she choose the color of her skin, the quality of her schools, or the wealth of her parents.  But these factors are incredibly important predictors of adult health, and must be acknowledged if we are to improve health outcomes.


 What do growing up in poverty, poor parental attachment, and growing up as a minority have in common? They cause stress - and too much stress can be very bad for you.  Female war veterans with PTSD, for example, are more likely to have a preterm birth than female veterans without PTSD.  When polled about the degree of racism they have experienced, African Americans who experience much more racism have many more preterm births compared to African Americans who report less racism in their past.


While we as a health care providers cannot change racism, or prevent war, we can decrease the stress associated with them, by providing support and teaching resiliency.  Group care programs are one useful tool we can use to create a built-in support system for patients sharing a common experience. The discussion and time spent with peers seems to matter greatly, as we know from group psychotherapy.  


CenteringPregnancy (group prenatal care) and CenteringParenting (group newborn care) are two promising tools that are changing Maternal-Child health.  Both programs have been shown to improve health outcomes such as preterm birth, rates of breastfeeding and bonding, and parental attachment, parenting skills acquisition, and many other outcomes.


I hope you can keep your stress to a minimum this holiday season, and find time to remember and enjoy all of the good things in your life.


-- Ted

1115 Waiver and DSRIP Projects 


The 1115 Medicaid Waiver allows for funding of Delivery System Reform Incentive Payment (DSRIP) projects that increase access to health care services, increase the quality and cost-effectiveness of care, increase patient satisfaction and enhance the health of the patients and families served.  The Community Care Collaborative (CCC) has 15 approved DSRIP projects.


Project Description: CenteringPregnancy is an evidence-based model for group prenatal care that was designed to improve birth outcomes, including reducing preterm births and low birth-weight babies. The DSRIP project expands CommUnityCare's capacity to offer this model to more women at its North Central and East Austin locations.


The target population for this DSRIP project is pregnant women with incomes under 200% of the federal poverty level, with a focus on African-American women. The group model fosters a supportive peer-to-peer learning environment for the participants, which empowers them to choose and sustain health-promoting behaviors. In this model, eight to twelve women with similar gestational ages meet together, learn care skills, participate in a facilitated discussion, and develop a support network with group members.  


Specific topics covered in the group sessions include: the importance of breast-feeding; finding social supports; birth spacing and pregnancy planning options. Within these group sessions, the OB/GYN practitioner completes one-on-one standard physical health assessments. Each group meets for ten sessions throughout pregnancy and the early postpartum period. Women enroll in the program at the beginning of their second trimester.


CommUnityCare has also adapted the model to fit the needs of the target population in two ways: 


1. Allowing the attendance of children in CenteringPregnancy sessions. The CenteringPregnancy evidence-based curriculum discourages the presence of children in the same room as the mothers during the group visit, but experience has taught program staff that this practice dissuades many mothers from participating in the curriculum; thereby reducing their access to prenatal care. CommUnityCare has set up a separate play area for children adjacent to the group seating so that mothers could bring their children to each session, as needed.


2. Allowing enrollment beyond the recommended gestational age. Women of low socioeconomic status tend to access prenatal care later than other women. While the CenteringPregnancy guidelines require that the curriculum start between a woman's first and second trimester, the CommUnityCare staff will regularly expedite scheduling for cohorts where the women are further along in their pregnancy.


In addition, CommUnityCare adopted clinical practice standards for successful completion of the CenteringPregnancy curriculum where none existed. 

Leader Spotlights



Andrea Guerra, MPH, is Project Manager for the Women's Health DSRIP projects at the Community Care Collaborative (CCC). Her other projects include expansion of STI testing and treatment and expanding the use of long-acting reversible contraception among young women in Travis County. Andrea has a degree in History and French from the University of Texas at Austin and a Masters in Public Health degree from the Mailman School of Public Health at Columbia University in New York City. Prior to her work at the CCC, she spent seven years at the Austin/Travis County Health and Human Services Department as a program planner and evaluator, epidemiologist and grant writer in the Chronic Disease Prevention and Control Program, and in the Epidemiology and Disease Surveillance Unit. 



Sonal Patel is the Practice Leader at the East Austin and Women's Health clinics.  Sonal previously worked at Seton in the Graduate Education offices.


Sonal is originally from Victoria, Texas and moved to Austin in 2000 to attend college. Sonal has her MBA and has been in the health care field for 12 years. She started out as a medical assistant and fell in love with helping our patient population.

In her free time she loves to travel and spend time with her friends and family. 

Southeast Health & Wellness Center 


Hundreds of enthusiastic area residents braved the downpour to come out for the Grand Opening of the Southeast Health & Wellness Center this past Saturday, Nov. 18.


Phase One of this new health center, which officially started seeing patients on October 1, opens the doors to patients for primary care, behavioral health care, specialty care, radiology, and dental appointments, as well as for pharmacy services. A community meeting room is also included in this first phase, as well as eligibility and enrollment services for health coverage programs. Phase Two of the project, expected to open in 2015, will include other services to promote wellness and prevention. More information on these services will be released as they are finalized.




More photos will be posted to Facebook in the coming days. Follow Central Health on Twitter or Facebook for the announcement!


United States Representative Lloyd Doggett and Texas State Senator Kirk Watson joined community stakeholders, Central Health's Board of Managers, the CommUnityCare Board of Directors, and members of the local community all celebrated the opening with a ceremonial flag presentation by local veterans, ribbon cutting, and tour of the new center.


Speakers who addressed how this new health and wellness center will improve access to health care in the Austin area included CommUnityCare Chief Medical Officer Deborah Morris-Harris, Ph.D, M.D and Dell Medical School Vice Dean of Strategy and Partnerships Maninder Kahlon, Ph.D.


Among those recognized for their leadership in the community engagement process were leaders from the Dove Springs and Montopolis neighborhoods and organizations including Austin Interfaith, Alliance of African American Health in Central Texas, Latino Health Care Forum, Wat Buddhananacht of Austin, and the Southeast Austin League of United Latin American Citizens (LULAC).


In 2012 Southeast Travis County, designated as a Health Professional Shortage Area (HPSAs) by the U.S. Department of Health and Human Services, was home to 460,000 residents; mostly young, Hispanic and medically underserved individuals and families. By 2017, the area is expected to grow by 13% to 520,000. Annual medical office visits at health centers contracted by Central Health in South and Southeast Travis County increased 60% from 2005 to 2010 and continues to grow.