Car ing

in Many Faces and Many Places

an n ua l Re P o R t 2013

Mission Driving healthy change in our communities.

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

ValuesHealth Care As a Right, Not A Privilege: We believe that comprehensive healthcare 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 solidfoundation by learning from our communities, embracing the people in them, andserving 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 groundedin responsible decision making for sustainable operations, putting every assetwhere it can do the most good for the community.

The Principles that Guide Our Pursuits

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Kathy Hinze, Senior Director of Legacy Southwest’s maternity services, sees patients who face too many barriers to care. “I recently treated ‘Monica,’ an OB/GYN patient whose hardships stayed with me long after she left the exam room,” says Hinze. “Monica missed a few prenatal appointments because she simply couldn’t get to the clinic, and she wasn’t gaining any weight despite being several months into her pregnancy.”

Determined to help, Hinze talked to Monica about her concerns. “She didn’t own a car and had few transportation options available,” says Hinze. “Monica couldn’t afford to buy much food, so she simply

wasn’t eating.” Hinze worked with Legacy’s social service department to ensure that Monica was connected with a food pantry and had transportation for her future appointments. “Monica left that day knowing where her next meal would come from, and knowing that we had a plan to keep her baby healthy before it was born.”

Five Legacy locations offer full OB/GYN services to help the women who traditionally would have gone without comprehensive care. “We

want to take care of the whole patient,” says Hinze, “and that means setting them up for success after they leave the clinic.” Our goal is to ensure healthy pregnancies that lead to healthy, happy, bouncing babies.

Women ’s H ea l th : Helping Families Secure

Their Own Legacy.

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New Faces in New Places

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The face of Legacy Community Health Services continues to change, both in the patients and communities

we serve. Thanks to the efforts of everyone on our staff, Legacy has made strides – both great and small – to

keep the faces across our many places happier and healthier than ever. Every new location, every new program,

and every decision we make hinges upon one thought: Driving healthy change in our communities.

Our reach now extends from just southwest of Houston all the way to Beaumont. We’ve added services on

KIPP school campuses, in Baytown and in southwest Houston, all to keep up with the need for the personable,

compassionate, and affordable health care that we provide.

Expanding to Beaumont has helped us stay true to our roots, as two of our

three clinics there specialize in HIV treatment, education, and prevention.

We’ve been serving HIV positive Texans for more than 30 years, and that

commitment will continue as long as there is a Legacy.

Our staff remains as responsive as ever to the growing needs of the diverse

communities we serve, and we are all proud of the work we’re doing across

southeast Texas. This means helping expectant moms get the support they

need to stay healthy throughout their pregnancies. It means bringing brighter,

healthier smiles to the Fifth Ward thanks to our expanded dental practice.

And it means helping people from all over Baytown deal with the behavioral health issues that too many suffer

from in silence.

Everyone at Legacy, from the Board of Directors to front line staff answering phones, is committed to building

healthy communities one person, one family, at a time. While Legacy continues to change and grow, we all

look forward to continuing to serve our many patients’ smiling faces for years to come.

Katy Caldwell Executive Director

Legacy Community Health Services

Faces in the Community Help Us Reach New Places

Legacy has enjoyed tremendous growth since I joined the organization. From our humble beginnings as the

Montrose Clinic more 30 years ago, we have evolved to become a dynamic, responsive, and respected community

organization. We have seen our ability to treat patients increase dramatically and have strived to maintain the

same high standard of care our patients are accustomed to during this time. We cannot do it alone, however.

Our community partners are a big reason why Legacy has been successful at reaching so many new faces in

so many new places, and have helped us become the largest FQHC in Southeast Texas. Without CHRISTUS

Healthcare, for example, Legacy might not have such a strong presence in Southwest Houston. Without Henry

Schein Cares, we might not have such robust dental services at our Lyons Campus.

Our strong partnerships support Legacy’s efforts to meet our patients’ diverse

needs, and we wouldn’t be able to truly live up to the “community” that’s so

prevalent in our name without them. We partner with schools, churches, and

all manner of community and grassroots organizations to deliver the tailored,

compassionate health, wellness, education, and social support our patients

have come to rely on. Legacy strives to be an integral part of the communities

we live and work in, and we can’t do this alone.

At Legacy, we’re committed to connecting our communities to health every day,

in every way. This means being open to new opportunities, like our recent expansions outside Houston’s city

limits, and being a collaborator others can rely on. We want everyone associated with Legacy – from donors

and partners to patients and staff – to be proud that they’re a part of our family, and to know that we are

dedicated to taking care of their needs in new and exciting ways and places.

Bryan Hlavinka Chair

Legacy Health Services Board of Directors

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“I can honestly say that KIPP Care has saved at least one student’s life,” says Auboni Cordoloni, Clinic Coordinator for KIPP’s North Campus. “Sally,” a second grader, was living with uncontrolled asthma and had been to the school nurse more than 40 times. “I had to call 911 twice because of her asthma attacks, and even these trips to the hospital couldn’t clear her airways.”

Students like Sally are the reason Legacy opened school-based clinics across Houston at KIPP schools in August 2013, providing convenient, high-quality health care to students who are often underinsured or uninsured.

Sally was referred to Legacy’s KIPP Care clinic where Candice Roman, Pediatric Nurse Practitioner, kept a close eye on Sally’s health. “She would do well during the week, but would come back to school on

Monday wheezing,” says Roman. “We reached out to her family, and found out that she wasn’t taking some of the medications we thought she was on. In addition, her at-home nebulizer was broken, and the family didn’t have insurance.”

The KIPP Care team helped Sally and her family connect with Legacy’s Patient Assistance Program, which provided them with a new nebulizer and the medications Sally needed. Cordoloni and Roman met with Sally’s mom and went over every detail of her daughter’s treatment plan. “Sally’s mom was in tears by the end of the meeting,” says Cordoloni. “She just couldn’t believe how much KIPP Care had been able to do for her daughter.”

P ed ia t r i c s :

Legacy’s Many Places Expands to KIPP

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Today, Sally is a new person. She’s no longer a regular at the clinic, and her asthma is officially under control. Her family acquired medical insurance shortly after the in-home meeting, and Legacy was able to help provide the medications she needed until then. “Before KIPP Care came to campus, there was little I could do to make an impact on the lives of students like Sally,” says Cordoloni. “I’m thankful every day that our students have access to all Legacy has to offer.”

Montrose Campus

Patients continue to rave about our Montrose

location, and we took steps in 2013 to keep them

happy and coming back for more. We nearly

doubled the space in the waiting room on the third

floor, home to pediatrics and adult medicine, to give

patients a more relaxed space. This remodel added

eligibility offices, and we’ve hired more staff, to make

the new patient intake process smoother and more

efficient. Legacy continues to add medical providers

to keep up with demand for our services. Finally,

we opened a new gravel parking lot with plans on

turning it into paved spaces in 2014.

Southwest Campus

The Legacy Southwest Clinic endured even more

change in 2013 – this time in the form of new

renovations – that added more exam rooms and a

cleaner, brighter waiting room. “We’re still bursting

at the seams at this location, which has been offering

after hours care seven days a week for almost a year,”

says Richard Beech, M.D., Legacy’s Chief Medical

Officer. We’ve added more behavioral health providers

at our Baker-Ripley location, one of the few clinics

in this diverse area to offer mental health services.

Legacy Mapleridge Clinic moved offices completely

(though it stayed in the same building) and is now

housed in a much larger, more patient-friendly,

space. Legacy remains committed to keeping this

location a vibrant part of our health care umbrella.

Legacy Bissonnet Clinic opened its doors in 2013,

extending our reach further into Houston’s Alief

neighborhood. Families in need of pediatric care or

behavioral health services can access our clinic six

days a week.

Angels of Hope, Legacy’s autism support

group, helps patients and their families

navigate a life-changing diagnosis.

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Clinic Updates

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Lyons Campus

Legacy is proud and excited to begin offering our

premium, comprehensive dental services at our Lyons

Campus. The Fifth Ward has long needed access

to affordable, high-quality dentistry, and Legacy is

pleased to fill this need. The Lyons Campus continues

to remove barriers to care for the area’s underinsured

and uninsured, and has added staff to offer more

appointments for primary care, pediatrics, OB/GYN

and maternity services, and behavioral health.

San Jacinto Campus

Legacy opened our San Jacinto Clinic in 2013,

reaffirming our commitment to meeting the health care

needs of Baytown’s underserved. This new location

adds more than 10,000 patients to our existing

panel, a number that could more than double as

there is great demand for the services Legacy provides.

South Park Campus

When Legacy South Park opened in October of

2012, there were only five employees on staff to

handle a robust pediatric practice. In less than a year

Legacy has quadrupled the number of employees at

this clinic, and now treats men, women, and children

for all their primary health needs. We also offer OB/

GYN and Maternity services, and our Behavioral

Health staff is on hand to assess, diagnose, and treat

a wide range of mental conditions.

KIPP Care

Legacy’s partnership with the KIPP family of schools

strengthened in 2014 by offering on-site medical

services on seven campuses. More than a school

nurse, Legacy’s campus-based medical service providers

can diagnose and treat many common illnesses and

can prescribe medications for families to pick up at

their local pharmacies. With proper consent, KIPP

students can be seen without a parent present,

providing families a convenient, less obtrusive method

for accessing pediatric and behavioral health care.

Like most parents with a teenager in the house, Guadalupe Barrerra has had her share of struggles. “It was often hard to communicate with my son,” she says. “He was quiet and distant, and so a lot of the people I know rejected him.” Guadalupe desperately wanted to understand what he was going through. Her search for answers led her to Legacy.

“A friend of mine has been a Legacy patient for years, and she and her son have been attending the Angels of Hope Autism Support Group for a while. I saw the improvement in their relationship, and wanted that

for my family,” says Guadalupe. Her son is on the low end of the autism spectrum, and therefore falls just short of being diagnosed with the disorder, but the group welcomed Guadalupe with open arms.

Jeannette Valdivieso, M.D. and Legacy’s Director of Behavioral Health, says that “Most children are diagnosed before they turn five. We’re seeing autistic children in their teens at our Southwest Campus who were never diagnosed. We’re often the first behavioral health specialist these children have seen, and so they’ve never gotten the support they need.”

Through the autism support group, Guadalupe has learned to be a better advocate for her son. She’s in constant communication with his school to make sure he gets the assistance he needs, and pays closer attention to all aspects of his schooling. Guadalupe says, “It was so hard listening to him say things like ‘I’m not smart,’ or ‘I know I’m different than everyone else.’ The support group has taught us both how to handle these moments, and how to boost his self-esteem back to where it should be.”

B eha v i o ra l H ea l th : Supporting Health Beyond the Exam Room

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Pa t i en t ’sRac eWhite* 38,244 56% African-American 13,732 20% Asian 438 1% Native-American 269 0% Multi Racial 587 1% Other/Refused to Report 15,030 22% 68,300

*Most Hispanic patients identify race as white

FY 2012-2013 Visits and Patients

Pa t i en t s by S i t e Site Patients Visits

KIPP 311 1,031LBR Baker-Ripley 7,859 28,272LBT Baytown 945 4,753LLC Lyons 8,434 19,761LMC Montrose 24,832 78,038LMR Maple Ridge 1,759 5,347LSP South Park 2,682 6,574LSW Southwest 20,533 63,085Mobile Dental 945 1,527

TOTAL 68,300 208,388

WhiteAfrican- American

visits patients

20122013

44,6

87 68,3

00

208,

388

145,

041

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A g e0-12 21,941 32% 13-19 5,889 9% 20-24 4,795 7% 25-29 6,139 9% 30-34 6,242 9% 35-39 5,466 8% 40-44 4,662 7% 45-49 4,129 6% 50-54 3,508 5% 55-59 2,616 4% 60-64 1,619 2% 65+ 1,294 2% 68,300

E thn i c i t yHispanic 34,119 50% All others 34,181 50%

68,300

G ende rMales 32,432 47% Females 35,713 52% Transgender 155 0% 68,300

Males

Hispanic

Females

All Others

0-12

13-1920-24

25-2

930-34

35-39

40-44

45-49

50-5455-59

60-6465+

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“I was seeing primarily HIV positive patients at my private practice in 1995, but no one was taking care of the vision needs of uninsured HIV positive Houstonians,” Scott Sawyer, M.D., says. “Monte Frost and I were friends with Montrose Clinic’s Executive Director at the time, and we all decided to do something about it. Monte bought the equipment, I recruited a few other doctors to volunteer with me, and we opened our doors to HIV patients in need of eye care.”

“We were seeing 30 people a day two days each month, but we could only do so much,” says Sawyer. “I’d sit down with a patient, dilate their pupils, check to see if the eye was healthy, and send them on their way. We’d have to send serious patients to a hospital, and we weren’t able to really check their vision.”

“Demand was way beyond our capacity,” according to Sawyer, so he started working two days a week to try and keep up. “I finally became a full-time employee in 2007.”

After nearly 20 years with Legacy, Dr. Sawyer’s favorite part of coming to work is still interacting with his patients. “I love our patients,” he says. “Many of them have never had their eyes checked, or haven’t seen an eye doctor in years. I make sure that they’re comfortable before I start my exam by answering any questions or patting them on the back if they need it. It’s an honor to be their first eye doctor, and a responsibility I take seriously.”

V i s i on Car e : The Familiar Face of the Frost Eye Clinic

Dr. Sawyer knows how far Legacy has come, but still wishes we could do more. “I hope one day we are able to offer vision care services at all Legacy clinics. There will never be a shortage of people who need eye care, and we’re doing all we can to help people see and feel better.”

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“People who struggle to access health care often overlook their teeth,” says Debbie Costello, Legacy’s Dental Practice Manager. “They’re busy working, caring for their families, and making sure everyone around them is happy and healthy, so that toothache or regular teeth cleaning gets put on the back burner.”

To address our patients’ need for affordable oral care, dentistry became one of the many faces of Legacy’s comprehensive health care model in 2010. We were able to expand our dental practice to the Legacy Lyons Campus in 2013, a move made possible thanks in large part to a generous grant from the Global Product Donation Program at Henry Schein Cares. This charitable arm of Henry Schein Incorporated, awarded Legacy a

two-year grant which will furnish us with a wealth of Schein’s high- quality dental products at no cost to the organization.

Legacy was able to completely outfit our Lyons Avenue Campus’s dental lanes in record time, thanks to timely deliveries from Henry Schein Cares. “Opening each pallet of supplies is like Christmas morning,” says Costello. “I never know what’s inside the boxes, but I know whatever I find will be put to immediate use.”

Costello says, “We’ve received equipment and supplies beyond our expectations. Without Henry Schein Cares, the dental practice at our Lyons Campus would still be in its infancy. Every dollar we haven’t

had to spend on supplies like sterile gloves, sponges, or x-ray shields has been re-invested in the patient experience.”

Establishing relationships with community partners like Henry Schein Cares is one more way for Legacy to maximize our efforts at building healthy communities across Southeast Texas.

D en ta l Car e : Healthy Smiles , Happy Faces

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Legacy Community Health Services Unaudited Financial Statement for FY 2014

Total Revenue $75,378,593 Total Expenses $70,026,557 Total Re-invested in Patient Care $5,352,036 Total Funds Raised $2,695,956 Expenses by Category Salaries and Benefits $42,033,355 Medication Services $8,383,440 Labs, Insurance, and Co-pays $6,959,072 Administrative Expenses $12,604,780

Financials

Salaries and Benefits

Medication Services

Labs, Insurance, and Co-pays

Administrative Expenses

Board o f D i r e c t o r s

Bryan Hlavinka, ChairpersonBeth Bruce, Vice-Chairperson

Jani C. Lopez, SecretaryGlenn Bauguss, Treasurer

Ian Rosenberg, At-Large/Executive Committee

Legacy Community Health Endowment

Board o f D i r e c t o r sClaire Thielke, Chairperson

Mark Grierson, Vice-ChairpersonJames A. Reeder, Jr., Secretary

David Fox. J.D., Ph.D. Treasurer

Legacy Community Health Services

Sehba AliBeryl BashamGeorge Burch

Dr. Abigail CaudleVictor Cordova

David L. Fox, J.D., Ph.D.Cyndy Garza Roberts

Michael AlexanderTripp Carter

Joshua L. EspinedoMelanie Gray

Amanda GoodieAlton LaDay

Glenna PierpontJay Sears

Lauren SolizJohn C. Sheptor

Mike HollomanMelissa Mithoff

James A. Reeder, Jr.Monsour Taghdisi

As of August 2014

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In 2006, Donnell Walker was one of the 25% of HIV positive Americans who didn’t know they had the disease. “I was in what I thought was a monogamous relationship for 13 years,” Donnell says. “I had no reason to think I was HIV positive, but decided to get tested when someone from Legacy approached me at a night club.”

The positive results sent Donnell into a tailspin. His partner had been HIV positive for over a year without disclosing this fact. Their relationship ended, and Donnell fell into a deep depression that led to extreme weight gain and three suicide attempts. Donnell says he’s “intimately familiar with what the phrase ‘rock bottom’ means. It felt as though my life was over and that I’d lost everything, including my will to live.”

One of the lone bright spots was the treatment he received at Legacy, which began three short days after his initial diagnosis. Donnell was able to get not only the treatment and medications he needed to regulate his disease through Legacy, but also the support services necessary to get his life back under control. He connected to Legacy’s Body Positive program, which provided him with a nutrition and exercise regimen, and Behavioral Health providers, who helped him cope with the stresses brought on by his diagnosis.

LGBT H ea l th : The Face of a Patient

“I’m proud to say that I’ve lost nearly 120 pounds thanks to Body Positive’s experts,” Donnell tells us. “Everyone at Legacy has done their best to help me work through the initial shock of learning my status, the depression that followed it, and my rebirth as a fit, healthy person living with HIV. Thanks to the staff at Legacy, I’m determined not to let my HIV status define my life.”

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