February 4, 2025
AUSTIN — Winter has arrived in earnest in Central Texas, and thousands of unhoused Travis County residents need more than just warm shelter. They also need medical care for both acute and chronic conditions that are made worse by the cold.
Their overall poor health is one of the factors that contributes to homelessness, so providing them with timely care can make a big difference in their ability to get and keep stable housing.
Central Health, Travis County’s hospital district, is closing this critical gap in care with its appropriately named Bridge program and clinic, a collection of services designed to connect the dots between different care and environments and to meet the needs of residents with low income who lack stable housing.
Health coverage
Many of Travis County’s unhoused residents are covered by, or eligible for, Central Health’s Medical Access Program (MAP) and MAP Basic, which covers the cost of their essential medical care, or by other payors such as the Veteran’s Administration or Texas Medicaid.
But that’s only one part of what it takes to build a Bridge. Over time, MAP can cover unhoused patients as they establish a medical home for primary care, such as at the Central Health system’s CommUnityCare health centers. They can then get referrals for specialty care as needed, including more than a dozen lines of service launched by Central Health just in the last year, at clinics including the Capital Plaza Specialty Clinic (5339 N Interstate 35) and Rosewood-Zaragosa Specialty Clinic (2802 Webberville Road).


“But if these patients are facing medical needs now – even ones that are fairly routine, like having a flare-up of their allergies, a severe migraine, or flu-like symptoms — their default option has been to go to an emergency room,” said Dr. Pat Lee, President and CEO of Central Health. “This is not the best, most efficient, or most cost-effective way to deliver this care. In practice it’s more likely that they don’t seek care at all until their condition has grown more serious. We can and must do better to care for this vulnerable population of our patients.”
The Bridge program provides comprehensive and immediate acute, chronic, and preventative care for people who are unhoused. Since June 2024, a twice-weekly Bridge clinic at the Capital Plaza clinic has seen enrollees and recent graduates of Central Health’s medical respite program, which provides patients who lack stable housing with safe spaces for recovery from injury, illness and surgery.
In September, the Bridge program launched an innovative partnership with Austin-Travis County Emergency Medical Services. Patients who are enrolled in or eligible for MAP can be brought by first responders directly to the Bridge clinic, and not to the emergency room (or the county jail), to receive comprehensive care that’s appropriate for their needs.
“This is absolutely something that we’ve needed as an option for a long time,” says EMS Division Chief Angela Carr. “It’s a great resource for EMS and the citizens of Travis County. Having the ability to navigate people to that clinic has opened up a lot of opportunities to help those patients – additional care, wraparound services, things that simply don’t happen in an emergency room. We can bring people who are starting from zero and get them the services they need.”
The third component of the program is Bridge Mobile, which launched in January 2025. Based at Central Health’s Downtown Campus (formerly the Brackenridge/Children’s Hospital complex and Clinical Education Center), the mobile team and its well-stocked van can reach current and prospective Central Health patients in shelters, in housing, or directly on the streets.
On January 8, the Bridge Mobile team established visits to the City of Austin’s Eighth Street Shelter for Women (the former Salvation Army downtown shelter, now operated by Urban Alchemy on behalf of the city). The services provided for the seven female patients seen that day included blood draws, a pap smear, follow-ups to previous hospitalizations, scheduling future primary care visits, renewing MAP coverage and printing new MAP cards, vision vouchers, prescription refills and over-the-counter medications, and health education for tobacco use, flu shots, cancer screenings, and hypertension.

“The Bridge mobile team is here to fill in the gaps for people that are unable to access care or have had traumatizing experiences with the current system of healthcare,” said Dr. Feba Thomas, clinical lead for Bridge and the primary provider working with patients at Eighth Street. “Since our initial mobile clinic on January 8, we have had many people come back to say how appreciative they are for us being there. We’ve heard repeatedly that our patients would not have accessed care if we were not there. We have had the privilege of caring for medical needs in a trauma-informed way with wraparound services and also address non-medical drivers of health when we are able to do so.”
Future destinations for the Bridge Mobile team include the Integral Care Therapeutic Diversion Center, recently established with Central Health’s support to provide an alternative to jail for people with medical or behavioral health needs or substance use disorders. The Mobile team will visit patients transitioning into supportive housing at the Hungry Hill Foundation in East Austin and Foundation Communities’ Waterloo Terrace property near The Domain, as well as working with the Texas Harm Reduction Alliance.

The Bridge program is staffed by complete medical teams that rotate between the Capital Plaza clinic and the mobile sites. Each team brings together physicians and advanced practice providers, nurses, medical assistants, community health workers, and psychiatry and social support as needed.
“It’s difficult enough for people living without shelter to connect with the services and support they need, even when they’re healthy,” said Dr. Audrey Kuang, Central Health’s co-director of high-risk populations and founder of both the Bridge Program and the medical respite program. “Our goal with the Bridge Program is to deliver the care patients need to stay on track, delivered consistently and comprehensively by providers who can stay engaged with those patients as they heal, establish medical homes, and prepare to exit homelessness.”
Carr notes that she and her EMS colleagues “are so thankful for the opportunity for collaboration” with Central Health. “These are our most vulnerable populations, and [Bridge service] absolutely leads to better outcomes. The possibilities are endless when we work together.”