Mental Health and Developmental Disabilities Centers in the Hill Country look to Tod Citron as their chief executive officer. He says he serves a 19-county catchment area stretching from the I-35 corridor, Hays and Comal Counties, west for 23,000 square miles to Val Verde and Del Rio, providing services for people with mental health issues and disabilities. There are 39 similar agencies in Texas, and the Hill Country is the second largest. He says “I stay on the road a lot. But when I came here, I wanted a more rural environment, and I find that driving through the Hill Country is like travelling in a photograph.”
He says, “Scattered across the catchment we have 12 outpatient clinics. We also have eight day-habilitation centers for those who are intellectually or developmentally disabled, as well as 24-hour group homes. We serve about 10,000 patients per year, a majority of them with mental illnesses.”
Citron says a typical patient may be an adult with depression. Many of them are “working poor,” someone supporting a family of three on $25,000 per year or less, who can’t afford the medications and therapy they need to function. Some of their patients are unemployed. The clinics offer both counseling, or talk therapy, and medication assistance. Each clinic has a pharmacy specializing in psychotropic medications.
“Medical compliance is important,” he says. “We run medication workshops teaching how to maintain medication, and we offer follow-up visits. Our pharmacies are run through Genoa Healthcare, which manages pharmacies throughout the U.S., specializing in matching mental health formularies with patients. Someone with depression might need an anti-depressant matched with an anti-psychotic. We have prescription assistance programs which often let our clinics provide medications at no cost to the patient.”
He says, “We are a ‘safety net’ program, working with people who are uninsured or underinsured. If we aren’t there, they often crash in an emergency room. There are 39 similar agencies in Texas, and we’re the second largest.”
He says many clients access their services through the intake number, (877) 466-0660, but MHDDC also takes referrals from numerous other non-profit agencies, emergency rooms, and word of mouth when a client tells someone who needs services how they were helped. Plus, they get people who are “stepping down” from psychiatric hospitals.
MHDDC also has a crisis stabilization unit, he says. “It’s a 16-bed unit that offers a one-to-two-week acute program. A lot of times people will come there from an emergency room. We can stabilize them, help them find the right combination of medications, then transition them to outpatient services. We’re very lucky to have one of the four Texas units here in Kerrville, there’s a dramatic need for more centers. There are discussions going on to establish another crisis unit in Comal County. The Comal County Court would build the facility, but state funding would run it. It would fill a big gap. Because of population densities, a lot of patients in the Kerrville CSU are from the I-35 area.”
Citron says his role is strategic planning for the agency. One of his main problems right now, like so many other businesses, is staffing. “I’m supposed to supervise 450 employees. We’re about 100 people short. We have openings for high school graduates, people with bachelors degrees, masters-level practitioners, and even a psychiatrist. But we are doing better than some. One of the state’s four crisis units is closed until they find enough nurses.”
Citron says he was born in New York City, and raised in Rockland County about 40 minutes from the Big Apple. He graduated from Pearl River High School in 1979, then went to the State University of New York in Oswego, on Lake Ontario about five hours north. He earned a bachelor of arts in psychology and communications, then went to Georgia, where he earned a master of social work from Atlanta University. He started his career running a group home for teens with behavioral health problems, then attended Mercer University in Macon, Ga.
After graduating with a second masters degree, in health care administration, he says he spent 16 years as the CEO of a community mental health center in a suburb of Atlanta. Then he spent a short time working with a health care compliance company, monitoring the Georgia state Medicare program.
“Compliance wasn’t my cup of tea,” he says. “I like being a provider of care, and I wanted to get back in operations.”
Skipping back, he says, “I met German Arango in the 1980s, when he was on an exchange program SUNY, and we’ve been friends ever since. He’s a brain surgeon, working in Bogota, so in 2019 I went to see him. He introduced me to Esmeralda Zapata, and I invited her to take a gondola ride to the top of the mountain. After a bit of consulting back in Atlanta, I did an Indeed Jobs search, and that led me to the position in Kerrville. I came here Aug. 2, 2021, and Esmeralda and I were married here in December. My Atlanta condo finally sold, so we’re looking for a house.”
He says he also has two adult children. Matthew is a musician in Georgia, and Chloe is an aspiring actress in Brooklyn, N.Y.
Citron says, “My hobby is minor league baseball. I’ve been to 54 minor league stadiums, including the Missions stadium in San Antonio, but there are several more in Texas.”
He’s also a member of the Texas Council of Community Centers, the Mental Health Corporation of America, and the Advisory Committee of Kerrville State Hospital. He enjoyed being a member of Kiwanis when he was in Atlanta, and may join a Kerrville service club.
He says, “If someone needs mental health help, pick up the phone, (877) 466-0660. We need more community promotion of mental health awareness. We operate most effectively behind the scenes, wrapping people with services to keep them stable in the community.”
