CommuniCare and the Multi-Assistance Center (MAC) at Morgan’s WonderlandWorking Together to Improve the Lives of People with Disabilities in Bexar County and Beyond

By Robert P. Sanders, MD, MHA, FAAP, CPE

s of 2019, there were more than 297,000 people living with disabilities in Bexar County, representing 15% of the population, and more than 369,000 when the seven contiguous counties are included.1 People with disabilities encounter social and economic disparities which affect their ability to work, obtain insurance and get access to care. Vital medical, therapy, and social services are often unavailable, and where they do exist, the complex nature of our healthcare system means their delivery is often delayed, uncoordinated, and scattered throughout multiple sites and healthcare organizations. As a result, people with disabilities suffer poorer health outcomes than the general population, with higher rates of medical complications, lower quality of life, and ultimately reduced life expectancy.

San Antonio is now home to the Multi-Assistance Center at Morgan’s Wonderland (The MAC TM), the first facility of its kind in the world, designed to improve the lives and health outcomes of people of all ages with disabilities by creating a one-stop shop for medical, ther- apeutic and social service needs. San Antonio real estate developer Gordon Hartman was inspired by his daughter Morgan, who lives with autism and other disabilities, to create a place where people with any level of ability can come to have fun, and in 2010 opened Morgan’s Wonderland, the first and only ultra-accessible theme park in the world. Since then, his team has gone on to create an ultra-accessible water park, sports program, and summer camp, which are now under the umbrella of Morgan’s Inclusion Initiative. The MAC is the next phase of that evolution, and was created through a combination of private donations and state and local government funding, in partnership with a diverse group of community-based organizations such as medical, dental and therapy providers.

The MAC is a new state of the art 165,000 square foot building located across the street from Morgan’s Wonderland in northeast San Antonio, and officially opened October 2, 2022. While the building is remarkable, the critical innovation at The MAC is The MAC Care

Model,2 which places the patient (known as a MAC Member) and their caregivers at the center of the model, and works to address all the Member’s social determinants of health (SDOH), as well as their medical and therapy needs. The core of the MAC Model of Care is The MAC Navigation System, where each MAC Member is served by a dedicated MAC Navigator, who does an extensive intake and then coordinates referrals to an array of partner organizations addressing SDOH and medical needs. This process is made possible through use of The MAC Nav, a novel software platform designed in partnership with the Dedalus corporation, a division of Microsoft, that connects the Navigator and MAC Member with all The MAC’s partner organizations. Over 30 community organizations are represented on-site to support the full range of SDOH needs, including access to food, transportation, case management and legal services. Therapies on-site at The MAC include physical, speech/feeding and occupational therapy provided by TEAMability, Our Lady of the Lake University and the Children’s Hospital of San Antonio and applied behavioral analysis (ABA), provided by BlueSprig.

Essential medical services at The MAC are provided by CommuniCare Health Centers. CommuniCare is a Federally Qualified Health Center system that has cared for the underserved of San Antonio for over 50 years. CommuniCare was founded in 1972 as a two-room pediatric clinic in the back of a church on San Antonio’s West side by Sister Dolores Girault, D.C., a retired nurse and pharmacist, in response to an outbreak of diphtheria.3 Since then, CommuniCare has grown to include 23 sites providing primary and specialty medical, dental, and behavioral health care in Bexar, Kendall and Hays Counties.

CommuniCare at The MAC is a 21,000 square foot clinic providing primary care and behavioral health counseling to individuals with special needs from birth to 60 years of age; once enrolled, patients will never age out. The clinic also includes pulmonology and women’s health services, with plans to add a range of other specialty services as the facility grows. As part of The MAC Medical Home, CommuniCare works closely with other partner organizations, including a Center for Health Care Services behavioral medicine clinic, a Children’s Hospital of San Antonio clinic providing autism diagnosis, therapy, and pediatric specialty services, the Happy Ohana Smiles special needs dental clinic, the Sponsel Eye Experts ophthalmology and optometry clinic, and an audiology clinic run by Our Lady of the Lake University. Construction is now starting on Phase II of The MAC, which will include a full ambulatory surgery center, a Baptist M&S imaging center, an employment center, a drop-in daycare center and a special needs spa and salon. Working closely with public health and data science researchers from the University of Texas at San Antonio (UTSA), The MAC, along with CommuniCare and its other partner organizations, will conduct ongoing outcomes research to ensure that this extraordinary collaborative effort improves all aspects of life and health for individuals with disabilities. The goal of The MAC is to serve as a model for special needs care to be emulated throughout the San Antonio region and ultimately the rest of Texas and beyond.

References

1. People with Disabilities: A Texas Profile. Texas Investment Council. March, 2019. https://gov.texas.gov/uploads/files/organization /twic/Disabilities-Summary.pdf

2. The MAC Multi-Assistance Center at Morgan’s Wonderland. White Paper. Updated June 15, 2022. Available at morganswonderlandmac.org

3. https://communicaresa.org/about-communicare/

Robert P. Sanders, MD, MHA, FAAP, CPE is the Director of Complex Care at CommuniCare Health Centers. In this role he serves as the Medical Director of the CommuniCare at The MAC clinic. He is also the Chair of The MAC Medical Home Committee, which coordinates medical services at the MAC. He is a board-certified pediatrician, pediatric hematologist/oncologist and a certified physician executive.