Clinics as Community Hubs for Health

St. David’s Foundation believes that when Central Texans get sick or need medical attention, all people should be able to easily access the care they need. Community Health Clinics (CHCs) provide medical care to those experiencing poverty and uninsured Central Texans and are a key partner in ensuring community members have access to healthcare.

With an estimated 80% of a person’s health being shaped by factors outside of the medical setting, the Foundation has increasingly prioritized funding for social determinants of health (SDoH) across our grantmaking efforts. In addition to serving the preventive and urgent healthcare needs of community members experiencing poverty, clinics are well positioned to address the non-clinical factors that impact the health of individuals such as transportation, housing and food insecurity. As community clinics accommodate this expanded scope, our long-standing partnerships have evolved to help strengthen their ability to screen for social needs and develop workflows to connect patients to vital social services.

Many clinics have already begun to implement the changes necessary to adopt this focus on population health. The Foundation seeks to learn with our clinical partners how best to transition from a fee-for-service model to a community hub for health – a model that incentivizes keeping communities healthy rather than one that promotes increased procedures for sick patients. We recognize the transition across the healthcare system to payment models that are tied to health outcomes is challenging and our funding supports the necessary changes to new care models that incentivize keeping communities healthy.

Our work with Clinics differs from the other areas of our work (Childhood Resiliency, Healthy Women and Girls, Older Adults Age in Place and Thriving Rural Communities) in two important ways:

  • Clinics are a platform for health. The communities that are a focus for our other areas of work utilize and rely on clinics as an important tool to get and stay healthy.
  • Clinics include not only the Foundation’s community grant partners, but also our own St. David’s Dental Program. Learn more about the Dental Program and the intersection between our external support (grantmaking) and internal work (direct programs).

Our Approach

Texas has the highest uninsured rate in the country with an estimated 270,000 (12.6%) Central Texans without health insurance. Without Medicaid expansion, this number will only increase. And while some individuals that are currently uninsured may qualify for private or government sponsored insurance, many will not pursue these options due to concerns about citizenship status, or complicated application and eligibility requirements.

Even for those who have the benefit of health insurance, navigating the health system can be complicated and an overall negative experience if care is not well coordinated by the primary care provider, which is often at the CHC.


Continue to support safety net clinics by facilitating the growth of infrastructure and capacity as Central Texas clinics transition to serve as community hubs for health, so that:

  • The uninsured and underinsured have access to high quality care;
  • Clinics are prepared to incorporate necessary changes to their care models to be able to succeed in new payment approaches that reward value over volume;
  • Clinics deliver comprehensive primary care and interact effectively with those operating outside of the clinic to strengthen community linkages and ultimately improve the health and well-being of patients and of the population overall.


As we continue to support and work alongside our safety net clinic partners, our approaches will include:

  • Providing access to primary care and behavioral health services for the uninsured focusing on funding access to key medical services for uninsured at partner clinic locations
  • Expanding capacity of clinics to provide activities, processes, and strategies to improve care delivery models.
  • Encouraging and supporting efforts to develop and strengthen community linkages outside of clinic settings to improve community health and well-being.

Senior Program Officer

Amy Einhorn, MPP
Learn more about Amy here.

Medicaid Expansion Report

Millions of our state’s most vulnerable populations do not have health insurance – more than double the national average. Texas could alleviate a substantial portion of the state’s uninsured problem by expanding health insurance coverage using available federal funds and benefit from notable economic gains. While the primary reason to expand health insurance is human health and wellness, providing adequate resources for health insurance also makes economic sense.

Read more in a recent report from The Perryman Group which estimates the potential economic benefits of increasing health insurance coverage in Texas.

It Just Makes Sense: Economic and Fiscal Benefits to Texas of Accessing Additional Federal Funds for Health Insurance Expansion

By The Numbers

According to the Austin Area Sustainability Indicators, approximately 22% of
black, 18% of Hispanic, and 11% of white residents report some kind of barrier to health care. Rural residents report limited access to specialty medical care because of cost, availability, or accessibility.

Additionally, nearly 53% of Austin Area residents making less than $55,000 a year do not receive paid sick leave benefits.