SmartHealth Clinic

Baptist SmartHealth Clinic

The Baptist SmartHealth Clinic accepts patients by referral/consultation, who have a previously diagnosed chronic illness (Heart Failure, Chronic Obstructive Pulmonary Disease, Diabetes Mellitus, Myocardial infarction, End Stage Renal Disease, Pneumonia, Sepsis, Uncontrolled Hypertension, HIV/AIDS and Hepatitis C). These patients are seen in a traditional face-to-face office visit and medically managed by an Advanced Practice Registered Nurse (APRN) and/or a clinical pharmacist (PharmD), under the direction of the clinic Medical Director. The APRN and PharmD utilize evidence–based practice guidelines from various professional groups as well as consultation with the Medical Director to optimize chronic disease management.

The Baptist SmartHealth clinic also provides tele-management services to qualified patients. These services include follow-up phone calls by Patient Navigators (LMSW and/or RN) to ensure the patient has adequate follow-up, to assess their symptoms for signs of disease exacerbation and to provide the patient with disease process and self-care behavior education. These services are provided to patients who have one of the previously mentioned chronic disease and have been deemed high risk for readmission. The patient navigation program screens and identifies patients who are high risk for hospital readmission. They work closely with hospital case management and outside community agencies to connect patients to any necessary resources. They also provide follow-up telephone calls to patients and provide them with disease process information and information concerning available community resources.

The Baptist SmartHealth Clinic serves adult patients, who have a diagnosed chronic disease (as indicated above). These programs interact with patients in both inpatient and outpatient settings; utilizing tele-management visits, group visits, and traditional face-to-face office visits to provide care to patients. The program focuses on patients who have no health-insurance or have Medicaid, as these patients tend to have less access to care on an outpatient basis, but patients are admitted to the program regardless of their funding status. HIV eligibility and care are delivered according to HRSA and Ryan White B/C guidelines.

“AIDS/HIV can destroy a family if you let it, but luckily for my sister and me, mom taught us to keep going. Do not give up, be proud of who you are, and never feel sorry for yourself.” ~Ryan White

The Ryan White HIV/AIDS Program (RWHAP) and Housing Opportunity for Persons with AIDS (HOPWA) program at Baptist’s SmartHealth Integrated Care Clinic (SHICC) is committed to excellence in the delivery of medical, educational and a variety of support for adults living with HIV / AIDS. The Southeast Texas (SETX) counties served include Jefferson, Orange and Hardin.

Here at SHICC, we provide patients and clients with the following:

  • Medical Care
  • Case Management
  • Medication Assistance
  • Navigation for Community Resources
  • Housing assistance and case management services through our HOPWA program which includes: tenant-based rental assistance (TBRA), short-term rent, mortgage, and utility assistance (STRMU), Permanent Housing Placement (PHP), and Supportive Services.
    • Short-Term (STRMU) – provides short-term rent, mortgage, and utility payments for households experiencing a financial crisis or a change in their economic circumstances. STRMU provides 21 weeks of services within a 52-week period.
    • Long-term (TBRA) – assist households who are housed or homeless. To receive TBRA services, households must present evidence of current or imminent tenancy in the private unassisted housing market. TBRA alleviates the rent burden of low-income households. TBRA provides an ongoing and portable rental subsidy that helps households obtain or maintain permanent housing,
    • Permanent Housing Placement (PHP) – helps households access, secure, and establish a permanent residence, maintained either on their own or with the help of ongoing rental assistance.

Additionally, we provide medical care and support services to patients who are privately insured, as well as to those with a demonstrated inability to pay in accordance with Baptist Hospital’s and Ryan White funding policies.

The Ryan White and HOPWA programs do not and shall not discriminate on the basis of race, religion, gender, gender expression, age, national origin, undocumented status, disability, marital status, and/or sexual orientation in any of its activities or operations.

Contact: Byron Young, APRN, FNP-BC, Clinical Director
(409) 212-6391

The Baptist SmartHealth Clinic integrates care and services with the overall organization by participating in hospital wide, multi-disciplinary Quality Assurance/Performance Improvement initiatives, committees and work groups, participation in multi-disciplinary and interdisciplinary care planning process and adherence to organization-wide policy and procedure.

Hours of Operation

Monday – Thursday 8:00 am to 5:00 pm
Friday – 8:00 am to 3:00pm

Staff on call 24 hours weekends, holidays, and after-hours for patient emergencies.