November 25, 2016
Thank you all for coming this morning.
It truly is a great day to be in Austin, Texas — because where else would today even be possible?
At the end of September, five years ago this week, when I laid out my challenge for the community to achieve 10 Goals in 10 Years, I knew we were starting something big as we set out to transform the health of our community and our economy.
How big? It turns out, even with all the research I did and the tons of people I talked to before laying out that vision, I didn’t know. I knew there was a lot of there there. But I didn’t know all of the there that was actually there. It turns out, there was some there there where I didn’t even know there was a there.
Even today, I’m excited by how much we’ve accomplished in five short years. Look at the hottest of the 10:
Goal 1: Build a medical school — Done
Goal 2: Build a 21st century teaching and safety net hospital — Coming this spring
Goal 3: Establish modern, uniquely Austin health clinics in our neighborhoods — check, check, check
Goal 10: Solve the funding puzzle — There were lots of pieces to this, but for the biggest piece we have the voters of Travis County to thank. They turned their thoughtfulness, optimism and empathy for their neighbors into an affirmative investment in a medical school and so much more.
A couple of years ago we announced plans for the LIVESTRONG Cancer Institutes of the Dell Medical School — part of Goal #6 for those of you keeping track. At that event, someone wisecracked that we might actually pull off the 10in10. They said, “we might do this — all except Goal #9, something about the morgue”. [It’s an election year and I’m a Democrat in Texas. Those folks might vote. I’m not forgetting them.]
Anyway, I’m pleased to tell you the Medical Examiner’s Office is coming along quite nicely, thank you very much. Travis County’s new facility is currently under construction and expected to be completed next summer.
And by the way, you might have heard last week that the LIVESTRONG Cancer Institutes landed the perfect person to lead the effort to make Austin a center for comprehensive cancer care, Dr. Gail Eckhardt – a nationally renowned cancer researcher who’s taken up the challenge to reinvent the way cancer patients and survivors are cared for and supported.
The LIVESTRONG Cancer Institutes at Dell Medical School also received a $6 million grant from CPRIT, which is the Cancer Prevention and Research Institute created by statute back in the 2007 legislative session and funded by a bond election that year. That’s something that couldn’t have happened just a few years ago. There was nothing there to get a grant. (We’ll see so much more of that. And so much more philanthropy in the next months and years.)
The difference the Institutes will make in the lives of Central Texans, including our safety net population, is fantastic.
Folks, our community really is getting this done.
But 10in10 was always more than a to-do list. We pursued multiple goals, not just one, because we wanted to ensure that the impact of the medical school didn’t end at its walls.
We wanted this vision to be a catalyst for our great institutions and great thinkers and great hearts to come together and create something bigger than they could ever do alone.
Together, we’ve set ourselves on a path to becoming a model healthy community with an economic engine that drives opportunity far and wide — to all Austinites. I believe this transformation, this seismic shift, will rival the damming of the river in the annals of Austin history.
And together, over these past five years, we’ve built the foundation for something we never would have dared to imagine back in 2011: replacing the decrepit Austin State Hospital with an “M.D. Anderson of the Brain.”
Stick around. We’ll get back to that in a bit.
A model healthy community
We’ve all watched with excitement as the Dell Medical School buildings – the result of a $436 million investment from the University of Texas Board of Regents — have seemingly sprouted up out of the old tennis courts. The first of the buildings opened in June, just in time to welcome the first class of students.
Right next door is the Dell Seton Medical Center at The University of Texas, a $305 million investment from Seton Healthcare Family and their supporters for a 21st century, modern teaching and safety net hospital.
Seton has been providing charity healthcare in Austin since 1902 and is building the new hospital at no taxpayer expense to replace the aging UMC-Brackenridge. It will continue to serve as our region’s lone adult Level 1 Trauma Center and will be part of a system of safety net hospitals while also providing a modern facility for students and residents to train.
They’re also investing in graduate medical education to the tune of $40 million a year. That is money spent training new doctors who are more likely to stay here and serve our community.
Without their partnership over the past two decades, taxpayers would be spending far more than they are today to provide health care. Without their partnership, our safety net would be in tatters and we wouldn’t be here celebrating this milestone.
If you’re doing the math, all the medical school buildings being built by UT combined with the new teaching hospital adds up to about 3/4 of a billion dollars creating a medical district Austin never had. If you look at goal number 8, I’d say we’re moving on it. There’s something physically there. That number doesn’t include the tens of millions committed by the Regents to start the medical school and operate it, which was another piece of the funding puzzle.
If you haven’t visited a uniquely Austin health clinic, I’d highly recommend a trip to Central Health’s Southeast Health and Wellness Center, located in the former VA facility on Montopolis Drive.
A one-stop-shop to get and stay healthy. The center offers a variety of health services for Travis County residents who are uninsured or underinsured. They can find primary and specialty care, behavioral health and dental, as well as health and wellness programs, benefit assistance and cooking and exercise classes. It will also serve as the teaching and learning hub for faculty, residents and students of Dell Medical School.
Let me take a moment here…I want to thank the members of the Central Health Board, who had the courage in 2012 to put a property tax increase on the ballot. Together with president and CEO Trish Brown, they then tackled the dual challenges of redefining their relationship with Seton and establishing a formal relationship with UT. They never wavered in their mission to serve the needs of low-income and uninsured Travis County residents while protecting the interests of their taxpayers. I have the utmost respect for the work they did to ensure our community had the resources and partners needed to leap forward and create an integrated healthcare delivery system for those who need it most.
And to Trish and Katrina Daniel and the current Central Health board members who are helping us realize the vision approved by voters in 2012…You’re shaping the future of care for our neighbors who need healthcare – thank you for your leadership and commitment to that vision and a laser focus on improving health outcomes for Central Health clients and taxpayers alike.
I know that sometimes you feel frustrated by some who either forget we had an election or don’t care. The nitpicking and naysaying and efforts to revisit issues must get old. But if you stay true to the foundation that was laid in 2011 and 2012, which aligns with your mission, you’ll be part of an historical outcome.
And thank you to the University of Texas System and the University of Texas.
Deep in the DNA of Dell Med is its commitment to the community. Once the election occurred, I was, frankly, a little scared about who would end up being the leader of this new medical school. This was going to be the first medical school built on a Tier 1 Research university campus in about half a century. Who wouldn’t want that job? I thought, “Oh, man, we’re going to have every world class MD/PhD in the world applying.” That worried me. I was worried we’d end up with a world class MD/PhD, but it would be some pointy-head academic that just didn’t get what we wanted to see here.
Well, we got a world class MD/PhD. But this guy gets it. Dean Clay Johnston is simply something else. And he’s surrounding himself with more visionaries. It’s inspiring to see the quality of the faculty and staff being assembled.
They’ve developed a mantra and are living it. They’re “Rethinking Everything”. And they’re doing it by embedding themselves deeply in our community. Tying themselves to our people. All of our people. That’s a wonderful return we get for doing this differently.
No one can point me to another place where local money helps support a world-class medical institution. But what we get in return for that is a medical school that cares about us. If we hadn’t done it this way, we’d lose that amazing, unique focus. It would be just another medical school.
At Dell Medical School, nothing is sacred when it comes to making a difference in health care. As the Dean notes, it runs from those stupid hospital gowns that show your bottom to how to assure your community, and that includes your safety net community, stays healthy.
That’s revolutionary. (Not the showing your butt part. I do that every day.) It’s revolutionary to think—or rethink—our safety net. This isn’t and Prop 1 wasn’t an investment in only more injections for poor people or just additional doctor visits for those without insurance. That doesn’t get us there. The goal was something different, something more. It’s much bigger and we need to keep thinking much bigger.
It’s a reweaving of the safety net. An investment in transforming the safety net. Rethinking how the net should works. Redesigning it for Central Health to better meet its mission.
And parts of the revolutionary change–the new, re-woven, re-fashioned safety net–are already starting to show, with so much more to come. It’s giving a larger life to Central Health’s mission.
For example, they’ve redesigned the system of perinatal care for low-income and uninsured women in Travis County, an effort that was led by Dr. Amy Young, Dell Med Chair of Women’s Health.
These changes are ensuring access to safe, effective care where expectant women are first seen by obstetricians and then referred to the most appropriate medical home in their neighborhood, or regional center with more specific care if necessary.
What this means for Travis County women and children is fewer babies in the NICU and healthier mothers.
Orthopedic Wait Lists
They also teamed up with community physicians to tackle the lengthy waits for specialty care that have been an ongoing challenge for those accessing care through the safety net.
Until recently, the waiting list for orthopedic care sometimes exceeded a year. The team designed and began implementing a new model that provides better access to appropriate care. In just a few months of the pilot program, the wait to see a specialist is now generally 30 days or less generally for those with the most serious conditions.
In addition to accessing the right care, patients are treated by a multidisciplinary team that also educates the patient on how to optimize health, reduce pain, and improve function and quality-of-life.
Without the Central Health investment, we wouldn’t have the leadership of Dr. Kevin Bosic. He’s the inaugural chair of the Department of Surgery and Perioperative Care and professor of orthopaedic surgery at Dell Medical School. He’s worked to create partnerships with community physicians, St. David’s Healthcare and others. Thank you to all the partners.
Sandra Joy Anderson Community Health and Wellness Center
The recently opened Huston-Tillotson University Sandra Joy Anderson Community Health and Wellness Center is a partnership with HT, CommUnityCare, Austin Travis County Integral Care, and the Dell Medical School at The University of Texas at Austin.
It’s dedicated to helping underserved residents of Austin gain access to health care and will offer both medical and behavioral health care services in a primary care setting. The new leaders is a nationally known physician named Dr. William Lawson, the former chair of psychiatry at Howard University.
Pause and think about this clinic a second. We sought “uniquely Austin clinics”. A clinic on the campus at HT, one of our most uniquely Austin institutions is very cool. A partnership that ties UT to HT, East to West, and that serves an underserved population. Well, again, not only does that fulfill the promise to our voters and further Central Health’s mission, but it’s something that never could have been there happened this way without the medical school.
Underpinning all of these successes is Dell Med’s fundamental commitment to Population Health.
Population Health refers to work that maintains and improves the health of a defined population. It’s a relatively new field – only a handful of medical schools even have departments of population health. It’s significant that Dell Med is one of them. And it’s a sign of things to come. It’s rethinking how we do things. Again, it’s revolutionizing the process. A unique investment in the infrastructure of care.
In Austin, under the leadership of the new Chair, Dr. William Tierney, the Dell Medical School is taking responsibility for the health of the people of Travis County — all of the people of Travis County. They’re looking at new technologies and new ways of using data to help people get healthy when they’re sick – and new strategies and partnerships to help them stay healthy when they’re well.
As I said, it’s part of Dell Med’s DNA. It’s rethinking and reweaving our safety net in ways that would have been totally lost to our community without this unique school.
And it’s going to help make Austin a model healthy city and Central Texas a model healthy community.
Part 2: A model healthy economy
We’ve really only started on the economic development goals, in large part because we needed the medical school — the catalyst — up and running. Even so, we’re making neat progress on goals 4 and 5.
I’m proud that, last year, ACC became the first community college in Texas to establish a web lab incubator that will facilitate first-class research and help take discoveries from bench to bedside. In late 2014 and early 2015, I worked closely with ACC and the Governor’s office so that ACC would receive $4.9 million from the state’s Emerging Technology Fund. This was one of the last grants from this fund. They’re moving.
I said it over and over during the campaign that a medical school is more than a building with the words “medical school” on its side. We do, in fact, have a building called the “Health Learning Center” that houses what we think of classrooms and some of the administrative offices.
But, we also have a building that’s soon to be completed called the Discoveries Building. The Discoveries Building is Dell Med-speak for a research building. It’s 264,428 square feet. There will be 86 thousand square feet of wet lab space and about 40 k of dry lab space. The difference between wet and dry space is fluid and might change depending on the type of research the school pursues. That’s a big different than five years.
Central Health, Seton and UT have formed and are the founding members of Capital City Innovation, Inc., the non-profit that will help established businesses and enterprising start-ups become part of the emerging health ecosystem in an innovative downtown. Just this month they officially started the search for the first executive director for Capital City Innovation.
The 14-acre Central Health property, at the heart of our Innovation Zone and across 15th Street from the medical school buildings and teaching hospital, also represents an enormous opportunity to redevelop a large swath of downtown to benefit the healthcare mission of Central Health and, fulfilling the promise of Goal #8, create a special place for all of us. The RFP is out on that.
I’m incredibly confident in the entrepreneurial spirit and innovative spark of Austinites to take full advantage of this unique economic opportunity.
But let me challenge you to remember the community-focused vision that has gotten us here. We can only claim success if the economic benefits of this opportunity spread to every corner of this community.
So, after five of the 10 years, I think you’ll agree that’s big progress on goals 1, 2, 3, 6, 8, 9 and 10. The beginning of real results on 4 and 5 with foundations now laid. And we have five years to go even further.
Part 3: Behavioral Health
You might note I skipped over number 7. I want to give it some special attention.
Again, the past few years have been strong. A lot to be proud of. And, importantly, I think we have an extraordinary chance to go much further than was originally anticipated.
Let’s start with this fundamental scientific principle: Psychiatric issues are illnesses or diseases of the brain. Brain health, in concept, is no different than heart health. Yet we deal with it entirely different.
We don’t have a brain-health system in the same way we have health-care system for the rest of the body. For most of us, what we have is a public system that only helps people in crisis, either in emergency rooms or jails — the most expensive and ineffective places to provide care. What we’re missing is the care necessary to keep folks out of crisis.
Before we go any further, we all need to understand that mental illness is common. Often hidden but common:
When we put together the 10in10, I asked the local Psychiatric Stakeholders Working Group for ideas to meet Goal 7 – Providing needed psychiatric care and facilities. Man, did they provide ideas.
Our region had been woefully behind in providing for the behavioral health needs of our community, including for those who had insurance or could privately pay. In fact, that was one of the driving factors in the creation of Central Health in 2004 when our local crisis system for mental health was itself in crisis.
The group presented some great ideas, real solutions, not just Band-Aids. They were pricey options, but they were the ones that would make a big difference in people’s lives and ultimately save all of us costs over the long term.
It was a pretty daunting vision, but folks were smart — and we were a little lucky — and were able to take advantage of the 1115 Medicaid Transformation Waiver secured by the state. That 1115 money has been instrumental to a huge number of 10in10-related programs and projects, including in the area of brain health.
Thanks to the voters of Travis County, Central Health had the money available to fund a significant number of the behavioral health ideas. It gave us the chance to test them out and see which bright ideas continued to shine.
Austin Travis County Integral Care was also able to leverage state funds to help build a more robust mental health system — one that’s not crisis focused but has an array of community-based care where people receive care as quickly as possible and connect to care within their communities — the BEST place for someone to receive care:
We’ve accomplished so much more to improve the behavioral health system than we ever expected back in 2011. That experience — plus a few other key ingredients — have put us in a position to take advantage of a unique opportunity.
Part 4: MD Anderson of the Brain
In 2013, two sessions ago, the Legislature directed the Department of State Health Services to come up with a plan to address the aging infrastructure of our state psychiatric hospitals. In 2015, the consultant recommended that 5 of the 10 hospitals be completely rebuilt. It’s known as the Cannon Report.
The Austin State Hospital was one of those identified for replacement. It’s probably one of the two or three worst. Worst!
Being the consummate optimist, I call that an opportunity.
Remember how I mentioned an MD Anderson of the Brain? Well, why not?
We as Texans have a huge amount of pride in what MD Anderson does for cancer care for Houston and beyond, as well as the new treatments they develop through research and clinical trials. It’s a destination for care for people from around the world. It offers hope.
I believe we can offer the same hope here for folks with illnesses and injuries of the brain — PTSD, Alzheimer’s, bipolar disorder, depression, concussions and more.
I believe we can provide world-class care to meet the brain health needs of Central Texans while also facilitating research and educational programming that pushes the edge of science and care to improve brain-health outcomes for all people regardless of their socio-economic status.
I believe we can help end the stigma that surrounds mental illness and make it a statement of hope for people to say “I have a mental illness or brain condition and I’m getting treatment in Austin.”
And I believe that because we have a couple of catalysts in place today that haven’t been there in the past.
Catalyst Number One…the Dell Medical School. The chair of psychiatry, Dr. Steve Strakowski, is a rock star with a vision for rethinking the obsolete system currently in place. Not just the state system, but the whole continuum.
Catalyst Number Two…the state MUST to do something about the Austin State Hospital. It has to do something. And we’ve been working with the state’s Health and Human Services Commission, which according to its Legislative Appropriations Request sees a unique opportunity with Dell Med “to move past the obsolete system currently in place to provide the highest-value care, stressing quality for patients and cost-effectiveness for taxpayers.”
I keep thinking about the old commercial? Our brand new medical school with its new psych department is the chocolate. The imminent need and the mandate to replace ASH is the peanut butter. Put ‘em together and we got one sweet deal. (In my mind, peanut butter cups have always been essential to a model health community.)
Seriously, let’s go make some peanut butter cups and change the world.
There are more questions than we have answers at this point. That will be a familiar statement to those of you who were around 5 years ago when I gave the first 10in10 speech.
But we have a need, we have an interested and highly motivated group of stakeholders and we have the highlights of a vision. And that’s a foundation from which great achievements can launch.
Included in this is the vision of the UT System chancellor, Admiral McRaven. In this State of the System speech, he called for a Quantum Leap — an effort akin to the Manhattan Project — to understand, prevent, treat and cure the diseases of the brain.
Another key person is Dr. David Lakey. He’s the former commissioner of the Texas Department of State Health Services and now the associate vice chancellor at UT System. I’ve known him a long time and he’s taking up how to combine what our universities provide with the needs identified in the Cannon Report. I expect he’s headed right after this to go testify at the House Select Committee on Mental Health.
We have an opportunity, working with HHSC, local government, non-profit and private sector providers and supporters of mental health to make Austin the place where we model 21st century mental healthcare. Where we focus on the person, not just where they receive care or how it’s paid for.
I’ve spoken a lot about collaboration, coordination and community partnerships making the 10in10 possible. The same is true to accomplish an MD Anderson of the Brain.
We’re starting from a great place. Austin Travis County Integral Care and Central Health are committed to building out the continuum of care. The St. David’s Foundation continues to make significant investments to improve access to care. Travis County and the City of Austin are working towards a Sobriety Center. And private and non-profit entities are plugging in to the system at various points in the continuum, such as Seton Shoal Creek hospital, Austin Oaks Hospital among others.
And advocates such as Judge Guy Herman and Andy Brown are keeping the pressure on the system to address the needs of those in, or potentially in, our judicial system.
I and others in Austin have met with the Meadows Mental Health Policy Institute, one of our state’s best resources for objective, high quality research and planning to improve mental health. This vision has them intrigued. I think it will garner national attention too.
We can get this done.
I’m out of time. There you have it. Five years ago we said we could do it. We could achieve 10 Goals in 10 Years that positively changed our home forever. We’re doing it. You have made it happen. The voters of Travis County are a special people willing to invest in their futures and the futures of their neighbors who may have less than they do. We’re re-weaving the safety net and giving greater life to Central Health’s mission. We’re making Austin a model healthy city. We’re creating new economic opportunity.
And I believe we can build the MD Anderson of the Brain.
In case you can’t tell, I love being your state senator. Thank you.