Lessons Learned in the Creation of the Houston Area's First Environmental Health Clinical Service

More than a decade ago, members of the greater Houston community ranked the creation of an environmental health clinic as the region’s number one environmental health need. This clinic would be designed as a full-service specialty clinic, provide field environmental assessments and customized interventions to help reduce environmental exposures of particular concern, and serve as a platform for teaching medical students and other healthcare professionals about environmental health. This session will trace the development of BCM’s environmental health clinic (which opened in 2014) and its associated research, outreach, and professional education programs. It will also highlight the opportunities and pitfalls for others interested in creating–and sustaining—a similar effort. The administrative hurdles to setting up such a program have been substantial (obtaining buy-in at many levels; establishing billing and other procedures; developing and/or obtaining licenses for all exposure history, field assessment and outcome instruments; convincing key players of the economic argument in order to secure insurance reimbursement; ensuring compliance with patient confidentiality protections; and so on). Ultimately, this effort highlights (1) the value of strong leadership for building momentum and acquiring financial support; (2) the importance of data for building institutional support and evaluating progress in meeting goals, and (3) the need to recognize opportunities for cross-institutional and cross-sector collaboration, even with individuals, groups, and institutions with differing scopes and missions. Framing environmental health in a way that brings to light common needs, interests, and resources has been essential for achieving commitments and active participation of key partners, in particular the Harris Health System and Houston Department of Health and Human Services.