In this section:

Funding Sources

As a tax-exempt organization, Texas Health allocates at least 5% of its net patient revenue to the community as charity care and community benefit. A portion of this funding is used to deliver care to people in underserved and vulnerable communities and to implement Community Health Improvement programs, grants and sponsorships.

Additionally, we receive community health investments through the Texas Health Resources Foundation and community, state and federal grants and sponsorships to help address our region’s most critical needs.

Access, Health Literacy and Navigation Programs

Enabling community members to quickly find and access the support they need and make informed decisions about their well-being is critical to improving public health and advancing equity in healthcare. Texas Health currently implements the following programs to drive progress:

Health to Home

Individuals experiencing homelessness often face recurring and costly medical treatments, leading to frequent hospitalizations for acute medical and behavioral health needs. To break this cycle, Texas Health Presbyterian Hospital Dallas and Austin Street Center, a prominent homeless shelter in Dallas, joined forces in 2020 to provide a comprehensive solution to rebuilding lives.

The collaborative program, Health to Home, offers a secure environment for homeless individuals to recover and develop a path toward improved well-being and housing. At Austin Street Center, participants receive medical and behavioral health support and essential resources such as food, clothing, transportation, job assistance and career training. Texas Health Dallas provides health services and, when feasible, employment opportunities, uniforms and transportation to the hospital.

Recognizing the extensive need in Dallas, program leaders have engaged other hospitals and medical centers to refer qualified patients to Health to Home. The Texas Health Resources Foundation, the American Rescue Plan Act and community sponsors secured the initial funding to operate the program. However, sustained support from additional donors is crucial to maintaining it. It has already demonstrated a significant reduction in hospital visits and healthcare costs while preserving participants' independence and dignity.

Efforts are underway to replicate this success in Tarrant County. Texas Health is assessing provider availability, services and existing gaps to develop a similar program in this community.

2023 Highlights

Health to Home:

• Enrolled 72 people and housed 24, meeting 96% of the program target for the year. Of these participants, all received case management services, 32 were navigated to transportation services and eight received behavioral health services.
• Saved approximately $4.73 healthcare dollars for every $1 spent to implement the program.
• Received a $1.26 million grant and nearly $359,000 in gifts through the Texas Health Resources Foundation to support program operations through 2024.

Please see Health to Home’s annual report for a deeper look at the program’s impact during the year.

Sexual Assault Nurse Examiner (SANE) Program

Texas Health's SANE (Sexual Assault Nurse Examiner) program is dedicated to supporting survivors of sexual assault as they embark on the path to healing. Its certified nurses meticulously and compassionately collect forensic evidence, a crucial step in prosecuting perpetrators. A Department of Justice report found a 95% increase in successful prosecutions of cases where a SANE-certified nurse collected evidence.

Additionally, SANE staff educate professionals, first responders, child advocacy organizations and educational institutions on the nuances of appropriate response techniques. They also guide leaders across seven counties on how to establish Sexual Assault Response Teams (SART) and provide wrap-around support services for victims. Finally, staff members leverage social media and publicity to build consumer awareness on how to recognize, treat and prevent sexual assault and domestic violence.

2023 Highlights

SANE:

• Cared for and treated 880 sexual assault victims, of whom 44 were prepubescent children and 100 were adolescents. The highest number of victims was in Tarrant County.
• Delivered 40 sexual violence prevention training programs to 823 community stakeholders.
• Engaged child advocacy agencies and the district attorney in the rural areas of Kaufman and Denton Counties, which lack a children’s hospital to accommodate child victims. Texas Health is assessing how to provide support in these areas best.
• Certified three new pediatric SANE examiners and hopes to certify additional pediatric examiners to serve Erath County in 2024.

Please see SANE’s annual report for a deeper look at the program’s impact during the year.

Community Health Ministry

Community Health Ministry (CHM) is a strategic initiative that connects North Texas faith communities with resources and tools to help them address health disparities within their congregations. By fostering collaboration between faith leaders and Texas Health’s Community Health Improvement programs, CHM expedites health improvement efforts through the exchange of ideas and the synergistic use of resources.

2023 Highlights

CHM:

• Established a framework for bringing together multiple congregations to organize activities and programs and identify resources and services to address their members’ needs.
• Launched the Community Health Ministry webpage to provide seamless access to information and available resources. The webpage includes a digital platform from which health promoters, faith community nurses and faith leaders can engage with other faith communities, access valuable resources for their congregations, participate in virtual health-related webinars and continue to build a bridge between faith and wellness. The website also contains a community calendar for faith stakeholders to promote activities and events.
• Developed and presented a webinar about social determinants of health to faith leaders, faith community nurses and health promoters. Content aligned with the Healthy People 2030 Framework.
• Created an evaluation tool to help congregations report on convening activities that bring together multiple congregations to meet a community need.

Faith Community Nursing and Health Promotion

Under the umbrella of Community Health Ministry, Texas Health's Faith Community Nursing and Health Promotion team trains and empowers faith community nurses (FCNs) and health promoters (HPs) to lead health ministries in their respective faith communities.

FCNs apply their active nursing license and at least two years of experience to integrate clinical and spiritual strategies that support holistic health – body, mind and spirit. HPs are nonclinical professionals who help develop and implement health programs. Together, they provide essential care to their congregations and communities, offering screenings, vaccinations, and educational events on mental health, diabetes, Alzheimer's and more.

2023 Highlights

FCNs and HPs:

• Engaged and supported members of 117 North Texas faith communities, serving 111,620 people. Of those reached, individuals gained access to services to prevent chronic disease, manage behavioral health, and advance health literacy and navigation that address health disparities. This effort improved health outcomes and avoided nearly $4.1 million in healthcare costs.
• Shared education and resources at 387 events, providing 25,725 people with information and support for behavioral health, health literacy and navigation, health screenings, vaccinations, chronic disease management, social determinants of health and more.
• Conducted health screenings and delivered flu vaccines to nearly 9,600 people at 521 events. Screenings ranged from skin cancer to hearing and vision to mammograms.
• Facilitated 527 support groups, helping 6,611 people navigate divorce, addiction, grief and more.
• Held 15 workshops to manage chronic diseases, educating 117 people.
• Connected nearly 65,000 people to resources to address non-medical factors influencing their health, such as transportation, housing and food assistance at 1,169 events.

Please see Faith Community Nursing’s annual report for a deeper look at the program’s impact during the year.

Continuum of Care

Many people in North Texas have chronic diseases or are at high risk of being hospitalized because they lack a primary care provider who can help manage issues before they escalate. They also face non-medical barriers to care, such as being uninsured or having limited access to transportation or healthy food.

Texas Health's Continuum of Care (CofC) program is designed to remove these barriers. A community health worker-led model, CofC engages with individuals to link them with primary care providers, organizations and resources, facilitate prescription assistance, navigate health insurance, secure stable housing, provide access to nutritious food, and offer additional support services. Meetings are free and can happen in person, virtually or by phone to make participation easy.

Funded through Texas Health Resources Foundation gifts and grants, Texas Health hires community health workers from local communities as they understand the cultural and socioeconomic hurdles these patients face. This localized approach reinforces trust and support, fostering a more effective and personalized healthcare experience.

2023 Highlights

Continuum of Care:

• Managed 1,022 referrals and supported 432 participants who agreed to participate. More than 60% of these individuals were uninsured and 45.4% lived in high-need ZIP codes.
• Facilitated 184 referrals to medical homes, and of those, 101 individuals attended appointments with providers to help manage their health issues before they worsened.
• Connected hundreds of people to resources that could address non-medical needs.

Snapshot: Directing People to a Better, Healthier Life Through Texas Health's Continuum of Care program, community health workers (CHWs) collaborate with various healthcare professionals and community organizations to remove barriers that hinder individuals' well-being. Baylie Turney, a certified CHW at Texas Health Harris Methodist Hospital Stephenville, meets monthly with faith and social service organizations to discuss identified needs and assess collective resources that may help. She leveraged her relationship with First Baptist Grace Place, a faith-based ministry serving Erath County, to help one woman pay for a new hot water tank, essential for cooking and bathing. Grateful for the support, the woman became a volunteer interpreter for the ministry, paying the support forward. A veteran who struggled with depression and social isolation visited the Emergency Department eight times in less than two months. Turney coordinated free in-home counseling through the federal Program to Encourage Active, Rewarding Lives (PEARLS). This prompted the man to accept other help with his utility bills and meals delivered through Meals on Wheels. These interventions improved his well-being and reduced his reliance on emergency care. Similarly, Leonor Buckner-Gallegos, a CHW at Texas Health Harris Methodist Hurst-Euless-Bedford, made a significant impact on a man with diabetes who cannot read or write. He gained access to vital resources such as food stamps and proper medical treatment after Leonor assisted him with financial aid applications. Now engaged in activities like Zumba and dance classes, he's enjoying improved social and physical health. Buckner-Gallegos plans to further empower him by teaching him how to use his car navigation system. This will enable him to confidently travel beyond his familiar surroundings and easily access additional support or care.

Chronic Disease Prevention and Management & Behavioral Health Programs

To reduce the burden and costs of chronic diseases, Texas Health identifies root causes, designs interventions and helps fund and execute initiatives that improve wellness for North Texans. These include:

Community Impact

Texas Health Community Impact uses cross-sector collaborative grants to address local community needs in resourceful and innovative ways. This data-driven, outcomes-focused approach pinpoints North Texas ZIP codes most in need of help and drives how Texas Health engages with leaders, influencers and existing resources within those underserved areas. Together, we’re responding to health disparities, eliminating the root causes of chronic disease, and providing tools that instill lifelong health and well-being.

Five regional leadership councils assess and award annual grants, $18.2 million since 2019, strategically tailored to uplift under-resourced populations. Projects are evidence-based, rooted in community expertise and tailored to the local context and regional priorities.

2023 Highlights

Texas Health Community Impact:

• Awarded $8 million in grants for 15 programs that support high-need communities across nine North Texas counties.
• Expanded the Together Harnessing Resources to Give Individuals Voice and Empowerment (THRIVE) program to four additional schools. This program improves students' mental health and involves them in reducing food insecurity. The Texas Health Resources Foundation is fundraising $2.6 million to expand THRIVE into 10 North Texas schools by the end of 2024. Program originators received the George Washington Freedom Medals for creating “schools where community service learning is exemplary and whose students regularly demonstrate community involvement in action.”
• Awarded a capacity-building and collaboration development grant to enhance the foundational capabilities of community-based organizations within Erath, Johnson and Kaufman Counties. Community leaders are identifying ways to enhance efficiency and effectiveness to optimize the impact of future Community Impact grants.
• Awarded a $150,000 grant to the University of North Texas at Dallas to study healthcare innovations developed during the COVID-19 pandemic. These insights will help Texas Health enhance efforts to reduce disparities and deliver culturally sensitive and unbiased quality care.

Please see the 2023-2024 Grants Awarded by Texas Health Community Impact for a deeper look at the programs’ progress and value during the year.

Snapshot: Scaling Mental Health Support in North Texas School Districts One in five children in the U.S. show mental health disorders each year, according to the Centers for Disease Control and Prevention. Yet access to behavioral healthcare for children and youth is often riddled with barriers, and even mental health professionals struggle to stem the tide. With schools overwhelmed by the challenges of mental health issues, exacerbated by the COVID-19 pandemic, Texas Health joined forces with Meadows Mental Health Policy Institute (MMHPI) to tackle these problems in innovative ways. The MMHPI, through generous support from Texas Health Community Impact and other funders, developed The North Texas School Mental Health Executive Learning Community, a bold, new approach to supporting Texas students with mental health needs in schools. Nineteen school districts – representing nearly half a million students, almost 57,000 educators, and 647 schools across North Texas – have joined the Learning Community, which brings senior district officials together for monthly training sessions, in-depth discussions and important collaborations. The purpose is to help districts execute school mental health programming effectively and improve student outcomes, well-being and academic achievement. “This is a first-of-its-kind program that promises to dramatically improve the emotional well-being of children and their families in North Texas,” said Andy Keller, PhD, President and CEO of The Meadows Institute. “District leaders will be equipped to develop successful programs and increase access to mental health care for students, helping them work with parents and families to identify and treat student mental health conditions early, particularly before depression and anxiety develop into crises.” D CEO magazine recognized the program’s impact, honoring the two organizations with its Outstanding Mental Health Collaboration award.

Snapshot: Providing Access to Nutritious Food The City of Bridgeport is located within the U.S. Department of Agriculture’s (USDA) Food Access Research Atlas census tract, is considered low-income and has limited access to affordable and nutritious food. To help address this need, city leaders allocated land, water and electricity to build a community garden. They aim to bolster local fresh food production and distribution, provide vital nutrition and food systems education, and facilitate hands-on training in cutting-edge agricultural techniques. Texas Health Community Impact funds the project through a USDA grant. Beyond addressing immediate nutritional needs, project leaders use the garden to teach community members about agriculture, nutrition and environmental sustainability. Moreover, they involve Bridgeport High School students in learning activities centered around food production, education and consumption. During its inaugural harvest, volunteers spent more than 125 hours cultivating and distributing more than 200 pounds of fresh produce to families in need. Texas Health is establishing a dedicated task force to seamlessly transfer full garden ownership to the city in three years, making the garden a sustainable community asset.

Wellness for Life Mobile Health Program

Texas Health's Wellness for Life mobile health units have delivered high-quality preventive and chronic disease management services to medically underserved communities for nearly three decades.

Family nurse practitioners and mammography technologists provide essential services ranging from mammograms to well exams to blood tests for diabetes and cholesterol at churches, schools, grocery stores, community centers and public parks. By establishing a presence at these local gathering spots, the program ensures that crucial healthcare interventions are accessible right in the backyards of those who need them most.

A culturally diverse healthcare team creates a welcoming environment that fosters trusting relationships with community members. This approach is pivotal in facilitating long-term lifestyle changes and overcoming cultural barriers that often hinder effective healthcare delivery.

The program, funded by grants, donations and corporate sponsorships through the Texas Health Resources Foundation, has achieved significant milestones since its inception. Staff has completed 114,340 mammograms and 18,957 wellness exams, detected 156 cases of breast cancer and identified 171 individuals with pre-diabetes.

2023 Highlights

Wellness for Life:

• Improved access to care by delivering healthcare services to 3,296 community members, increasing screenings to pre-pandemic levels. Of those served, 90% reported a high satisfaction score.
• Conducted 3,023 screening mammograms, reaching 96% of eligible females. Of the 179 with abnormal results, 72% visited a Texas Health facility for diagnostic follow-up. Additionally, clinicians completed 607 cervical exams, reaching 91.8% of eligible females.
• Distributed 248 colon cancer screening kits, with a 57% return rate.
• Completed blood analysis on 146 individuals and detected 43 with pre-diabetes.
• Affiliated with Our Daily Bread to bring mobile health services to the Denton Community Shelter for unhoused individuals. Program leaders also collaborated with Arlington Life Shelter and the Salvation Army’s Fort Worth shelter.

Please see Wellness for Life’s annual report for a deeper look at the program’s impact during the year.

Reduce Social Isolation and Lift Outcomes for Seniors (Reduce SILOS)

Despite technological and social media connectivity, older adults are facing a loneliness epidemic in Texas Health’s service area. Many have limited resources, transportation issues, chronic illnesses and other factors that keep them isolated, impacting their emotional and physical well-being. Baseline measures found that 51% of people assessed reported high social disconnectedness and 41% reported severe depression.

In light of these findings, Texas Health secured Community Impact funding and a three-year AARP Foundation grant in 2020 to create Reduce SILOS. This free program strengthens connections for low-income, socially isolated hospital patients ages 50 and older.

For 12 months, participants worked with a community health worker (CHW) who connected them to resources, programs and events based on their interests. To manage late-life depression, members also enrolled in the free federal Program to Encourage Active, Rewarding Lives (PEARLS). To monitor progress, they were re-screened at three, six and 12 months.

The AARP Foundation grant expired at year-end 2023. Over the past three years, Reduce SILOS significantly reduced participants’ feelings of social disconnectedness while increasing their perceptions about receiving social support. More than 4,426 adults ages 50 and over completed a screening survey, exceeding the program goal of 1,000 individuals. Of those screened, 25% asked Texas Health to contact them about social engagement services that can improve their emotional well-being. CHWs completed more in-depth assessments and enrolled 199 individuals.

Improvements were highest in the first three months of participation, as members received interventions that lowered their isolation and depression. Key outcomes include:

• Improved participants’ social connectedness by 14.2% and perceived social support by 12.3%, exceeding the 10% goal.
• Reduced depression by one stage of severity for 70% of PEARLS members who reported having moderate or severe depression, meeting the goal.
• Reduced members’ healthcare charges six months before and after program enrollment by 22.4%, exceeding the 5% goal. Program activities avoided more than $1.35 million in treatment.
• Enabled 56.3% of participants to improve their social connectedness and 50.9% to increase their perceived social support by at least 10%. However, this fell short of the goal of 72% of participants achieving at least a 10% improvement.

2023 Highlights

Reduce SILOS:

• Increased the program’s reach from an average of 150 older adults per month in 2022 to 219 per month. The team also expanded the program to qualified Texas Health Physicians Group patients. Providers referred 73 older adults and five enrolled.
• Secured additional funding to operate the program for two years in concert with Texas Health’s Continuum of Care initiative. Staff will cross-train all Community Health Improvement CHWs to support both programs and expand them to additional ZIP codes. It will be available to adults of all ages experiencing social isolation and loneliness.
• Engaged social work graduate students from Texas Christian University to learn about the program and support participants.

Please see Reduce SILOS annual report for a deeper look at the program’s impact.