Site Profile: Bexar County Health Collaborative

Long-Standing Collaborative Tackles Drivers of Community’s Health
Collaborative isn’t just a namesake, but it is at the heart of the mission of this San Antonio-based organization. The Bexar County Health Collaborative has both a long-range vision and a long history of pulling together a broad range of partners to achieve improved health status for the local community.

This commitment to collaboration and exploration of innovative mechanisms to achieve better population health account for the Bexar County Health Collaborative’s selection as an initial site for the Robert Wood Johnson Foundation-supported program Bridging for Health: Improving Community Health Through Innovations in Financing.

Current Standing: Bexar County ranks 74 of 237 counties in Texas.

Leader of the Initiative: Non-profit Health Organization

Collaborative: The non-profit serves as a convener and backbone support organization for collaborative partners including: the San Antonio Metropolitan Health District, hospitals, community organizations, government entities, and businesses

Potential Financing Mechanism Being Explored: Prevention/Wellness Trust

Community Goals: Community health improvement and health equity

“The Health Collaborative has become a powerful network of citizens, community organizations and businesses,” says Elizabeth Lutz, the collaborative’s executive director. “The result is a more robust, less duplicative, more synergistic approach to solving critical community health needs, while efficiently utilizing resources and empowering the community to take ownership of their own health

A History of Collaboration

The collaborative began informally in 1997 when the city’s major health care organizations agreed to conduct a joint comprehensive health needs assessment. The collaborative evolved into an incorporated entity in 2000 in response to the founding members’ long-term interest in banding together to improve community health. The result of the nearly two-decade effort is a powerful network – with 65 members including health care providers, government entities, community organizations, and businesses—that are empowering the community to take ownership of its health.

The collaborative’s leadership role can be seen in their efforts to facilitate collective impact among community health initiatives. The collaborative plays a key role convening and engaging stakeholders and building consensus for action. This is seen most visibly through the collaborative’s signature project—the community health assessment.

Broad Focus on Determinants of Health, Health Equity

Since its inception the collaborative has routinely conducted community health assessments and more recently began developing community health improvement plans (CHIP) with its partner, the City of San Antonio Metropolitan Health District. The data-driven CHIP guides policy and programmatic decision-making within the county to make the vision of health improvement and disease prevention a reality. The collaborative is now in the process of completing its 2016 community health assessment, which may expand upon previously identified needs or identify new priority areas.

The 2014 Bexar County CHIP, Building Healthy Communities and Healthy Systems One Piece at a Time, reflects the collaborative’s commitment to addressing upstream social determinants of health and the ultimate goal of health equity for all of the community’s residents. The data-driven strategic plan identifies focus areas of interest to the community with related goals. These focus areas are:

  • Healthy Eating and Active Living – fostering systemic and social change to support equity in healthy eating, active living, and wellness
  • Safe Communities – developing community-defined safe neighborhoods by identifying and implementing best practices of community empowerment
  • Healthy Child and Family Development – bettering access to and utilization of preventive health care to improve healthy child and family development
  • Behavioral and Mental Well-Being – improving and expanding a comprehensive, integrated behavioral health system to provide holistic services with access for all
  • Sexual Health – ensuring all Bexar County community members of any sexual orientation or gender identification have access to culturally appropriate education and resources to promote sexual health


The Bexar County Health Collaborative is advancing its mission through exploration of innovative alliances outside the scope of the traditional health care delivery system, as well as exploring novel methods for financing programs targeting community focus areas.

The collaborative remains committed to aligning partner activities towards achievement of a shared vision and has created five work groups, focusing on metrics, partnership development, health care systems/guided care, built environment, and school systems, to achieve greater engagement.

The Health Collaborative of Bexar County is also exploring the viability of sustainably financing a “Pennies for Prevention” program by creating a prevention/wellness trust in partnership with hospitals, members of the finance community, and other relevant community organizations. Additionally, the collaborative is working with the San Antonio Metropolitan Health District to support community health initiatives funded by the 1115 Medicaid Waiver Delivery System Reform Incentive Payment (DSRIP) Program.

“The Bexar County Health Collaborative has a solid foundation,” says Tanisa Adimu, a senior research associate at the Georgia Health Policy Center and technical assistance provider to the collaborative. “The strong and long-lasting relationship among partners has and will continue to serve them well as they work to implement programs that are shared by numerous community partners and leaders.  This can result in extraordinary outcomes for the communities they serve.”