Woman with a Plan

Legacy Community Health Services’ executive director Katy Caldwell

Meet Katy Caldwell, Legacy Community Health Services’ executive director
by Alan Davidson  •  Photo by Dalton DeHart

See also An Amazing 30 Year Evolution: A new era begins for Legacy Community Health Services

Katy Caldwell is a big-boned gal with an easy laugh and crackling energy. She strides into our meeting wearing a smart pantsuit and a festive blouse. It’s clear this woman has presence.

We meet at a local sushi bar for our interview—a trendy restaurant on the corner of Richmond Avenue and Kirby Drive. I savor the irony of meeting Caldwell, the executive director of Legacy Community Health Services, at a site full of AIDS-related memories for gay men “of a certain age.” The sushi bar sits on the historic site of The Copa, a pivotal hot-spot for drag queens and gay life when I moved to Houston in 1980. That world is long-gone-with-the-wind. Of all the bartenders, managers, owners, and entertainers I knew from The Copa, all are dead now—save for Hot Chocolate.

During her 15 years as spokeswoman and chief visionary for one of America’s largest and most successful HIV care centers, Katy Caldwell has transformed our old neighborhood clinic. When she first stepped in, Montrose Clinic was in constant crisis mode. AIDS was still gutting the gay, lesbian, bisexual, and transgender communities, and an HIV diagnosis still felt like a death sentence. The clinic had 35 employees, saw 2,000 patients, and gave about 6,000 HIV and STD tests annually—all on an annual budget of 2.5 million dollars that was stretched painfully thin trying to serve the fractured needs of a decimated community.

Caldwell’s decisiveness, along with her talent for risk-taking, has propelled Legacy through massive growth. Now a Federally Qualified Health Center, the clinic boasts 300 employees, 50,000 patients, and an annual budget of 35 million dollars.

Taking the Heat for Hard Decisions

Caldwell quotes these wise words from her Grandpa Summerill: “If you die and everybody loves you, you’ve done nothing! Every time you make a decision, someone is not going to like it. The only way to get anything done in this world is to make a decision.”

And make decisions she can. As Legacy’s executive director, Caldwell has made many a decision—big and small, micro and macro, painful and easy. She also displays the courage to stand by her decisions, taking both the accolades and the blowback. ?

Changing the clinic’s name, from the beloved Montrose Clinic to Legacy, was just such a decision. Some critics thought the new name meant they were abandoning their namesake, their mission, and the memory of those who created the original Montrose Clinic. But as Legacy grew, their mission expanded. Instead of serving the LGBT community exclusively, they now serve all Houstonians. They still excel in HIV care, but they also reach out to the homeless, the indigent, the uninsured, and just about anyone else who needs health care. With 26 percent of Texas residents lacking health insurance, such clinics play a vital role in our healthcare system.

Legacy now reaches deep into the
city with four locations: the brand-spanking-new clinic in Montrose, the Legacy
Lyons Clinic in the Fifth Ward, the Legacy Southwest Houston Clinic, and
the Legacy Baker-Ripley Clinic near Hobby Airport.

Caldwell thrives on taking strategic risks. She first ran for elected office in 1988 as a liberal Democrat in the highly Republican Bellaire neighborhood. She lost that race, but won in 1991 when she ran for Harris County Treasurer. She served for four years before suffering
a stinging loss during the Republicans’ infamous “Contract with America” election sweep.

Strategic risk-taking is the norm at Legacy under Caldwell’s leadership: new or reorganized services, new board members, and new ideas are all part-and-parcel of the attitude that filters through the ranks of Legacy’s leadership team.

Network Nurturer

Wherever she goes, and whatever she does, Caldwell has a knack for making friends—lots of them. She recalls being a sixth-grader at St. Thomas Episcopal School. A friend of hers from public school invited her on a Rainbow Girls trip. Caldwell’s mother  reminded her that she only knew one person going on the trip. Her reply: “I’ll know them all by the time I get back!

“I’m happy to walk into a room of strangers. It’s a personal challenge,” Caldwell says. That willingness to meet new people and grow friendships has served her and Legacy well. Indeed, the many friendships honed during her stints as a teacher, financial analyst, Harris County treasurer, Austin lobbyist, political volunteer, Masonic Lodge member—and even her personal friendship with ?
Mayor Annise Parker—have all come together to ensure her success at Legacy.

A Passion for Care

Caldwell served as her mother’s primary caregiver during a tragic ordeal with cancer in 1985. She was there for the many trips to M.D. Anderson for surgeries, chemo treatments, and radiation therapy, ending with a final, sad goodbye. “Since Mother was a teacher, there was never any question about insurance, or treatment, or coverage.” Then in 1987, Caldwell’s friend Jim Reaban was sick and dying with AIDS. He had no insurance, no care, and no safety net. After seeing her friend in deep despair and dire straits, Caldwell became a Montrose Clinic volunteer to help others who needed the same love and support she gave to Reaban.

By the mid-’90s, the wave of AIDS deaths had created a glaring leadership vacuum in Houston’s LGBT community. Many gay men had become exhausted after a decade of caring for dying friends, so in 1996 Caldwell stepped up and accepted the job as executive director of Montrose Clinic. Houston had only six care centers that were addressing the AIDS crisis: Montrose Clinic, Bering Dental Clinic, AIDS Foundation Houston, Montrose Counseling Center, The Assistance Fund, and Omega House. Caldwell would be the fourth woman to lead one of those care centers, and she became the community’s ambassador promoting “quality healthcare for everyone.”

Just as Caldwell joined the clinic, there was an AIDS medication breakthrough. After years of triage care and scrambling to meet the needs of an exiled community, AIDS clinics across America gave birth to a practical system of holistic HIV care. Caldwell capitalized on that new vision as Montrose Clinic morphed into Legacy Community Health Services. Specializing in “the big hug,” as one of Legacy’s patients describes it, the clinic has become a place where “the whole person” is treated—physical and mental health, social services, dental and eye care, and medication management.

Last month saw the opening of the clinic’s gleaming new “Taj Mahal of Montrose” facility in the heart of the neighborhood. To the critics of her leadership and vision, Caldwell says, “By expanding our mission and our reach across Houston, we actually now provide better and more care for the LGBT community. If they had stayed small and solely focused on the LGBT community, they would never survive the coming changes demanded by the Affordable Care Act and the health insurance reforms. If we hadn’t changed and grown, the ‘Montrose Clinic’ would have been out of business by 2014.”

Most notably, the clinic chose to build its flagship facility in Montrose, even though they could have saved over two million dollars by moving elsewhere. “But we chose to honor our roots and our name—Legacy. We are true to the legacy of all the people who shaped and created who we are today,” she says.

Legacy Community Health Services is building on the hard lessons learned in the early days of AIDS care—back when many agencies met the demands of a community in exile even though they didn’t have two nickels to rub together. Those veterans from the front lines of the epidemic have struggled to create a model of holistic care that is transforming America’s healthcare system. It’s a fabulous legacy indeed—one that Katy Caldwell has the vision, courage, and strength to nurture well into the future.

Alan Davidson, the author of Body Brilliance: Mastering Your Five Vital Intelligences, is the winner of two national Book of the Year Awards.


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