Texas recognizes the value in developing the Texas MCH and CSHCN workforce and enhancing MCH capacity at DSHS. To better serve MCH populations, address and adapt to the changing needs in the state, and improve health outcomes, the Title V workforce in Texas strives to maintain optimal subject matter expertise and staffing infrastructure.

The Maternal and Child Health Section (MCHS) is housed within the Community Health Improvement Division (CHI) at DSHS. The CHI Division includes MCH, Health Promotion and Chronic Disease Prevention (HPCDP), Environmental Epidemiology and Disease Registries, and Vital Statistics. MCHS consists of the MCH Unit (MCHU), MCH Epidemiology (MCHE), The Newborn Screening Unit, and the Health Screening and Oral Health Unit. The MCHU is where the core functions of MCH programs are housed. Areas within this Unit include Child and Adolescent Health Branch, the Healthy Texas Mothers and Babies (HTMB) Branch, and the Office of Injury Prevention. The Child and Adolescent Health Branch houses the CSHCN Systems Development Group (SDG) as well as Child and Adolescent Health programming. The HTMB Branch houses all Maternal/Women’s Health and Infant/Perinatal Health programming and expertise. Key positions in the MCHU include the Title V MCH Unit Director and the State CSHCN Director/ Child and Adolescent Branch Manager. Key positions within MCHS include the State MCH Director and the Block Grant Administrator.

The HTMB Branch within the Unit is led by the State Breastfeeding Coordinator/MCH Nurse Consultant and includes the Maternal Mortality and Morbidity (MMM) Nurse, the Women’s and Perinatal Coordinator, and the Perinatal and Infant Coordinator. Regional Population-Based activities are implemented across the state in communities through DSHS regional staff and are coordinated through the MCH Regional Programs Administrator. Child Health and Adolescent Health Coordinators work closely with the state Child Fatality Review Team coordinator and CSHCN staff on programing and surveillance activities.

The Child and Adolescent Health Branch is led by the State CSHCN Director and includes the CSHCN SDG. The CSHCN SDG oversees the implementation of the CSHCN Title V performance measure activities. The CSHCN SDG includes the Texas Title V CSHCN Director and four full time Program Specialists. Three team members have Masters level degrees in public health and education. Staff who are parents of CYSHCN participate in the development of programmatic activities and decision-making. Title V funds a health care benefit program administered by HHSC which includes Family Support Services. Case Management and Family Support and Community Resources are provided to CYSHCN and their families through community-based contractors and/or regional DSHS staff. CSHCN SDG staff serve as subject matter experts for contractors and provide technical assistance, education and resources. Program staff lead and facilitate the Medical Home and Transition to Adulthood Learning Collaboratives and participate in other statewide initiatives including the planning committees of the Baylor College of Medicine Annual Chronic Illness and Disability: Transition from Pediatric to Adulthood conference and the Texas Primary Care Consortium, Texas Council for Developmental Disabilities, Policy Council for Children and Families, and Community Resources Coordination Groups Statewide Workgroup. The CSHCN Director and the State CSHCN Health Coordinator are members of the Texas Children with Medical Complexity (CMC) Collaborative Improvement and Innovation Network (CoIIN) team led by Boston University. The CSHCN Special Projects Coordinator was selected to participate in the 5-month Arc of Texas’ Partners in Disability Leadership Program, an advanced leadership development training program created for professionals who are interested in being stewards of the disability rights movement and leaders within their agency or organization.

The State Child Health Coordinator and the State Adolescent Health Coordinator lead and facilitate the State Developmental Screening Workgroup and the State Adolescent Health Workgroup, respectively. The State Child Health Coordinator sits on an interagency workgroup focused on early childhood topics and is a part of the BUILD Team. The BUILD state team is a cross-sector team of agencies that lead programs, services, and initiatives that advance the health of young children and their families. The spring meeting focused on collective leadership development that produces action and outcomes

Additionally, the State Adolescent Health Coordinator in MCHS serves as Texas' Family Delegate to the Association of Maternal and Child Health Programs (AMCHP), is a former AMCHP Family Scholar, and serves on multiple AMCHP Committees. As a parent of an adult with special health care needs and with over 20 years’ experience in the interest of CYSHCN, she is a valued participant in program initiatives.

The Child and Adolescent Health Branch was selected for the 2020 MCH Workforce Development Center Cohort. Several team members attended a the required professional and leadership development training in North Carolina in February 2020.

MCHE provides centralized epidemiologic, data, research, and reporting support to all MCH programs. MCHE possesses the capacity to provide MCH epidemiologic, data, research, and reporting support for Title V program areas, including expert statistical analysis, data management and performance measure reporting, geographical/spatial analysis, research studies and consultation, and program evaluation and monitoring. All staff are highly skilled in multiple and complex computer programming “languages” and software (e.g., Access, ArcGIS, Python, R, SAS, STATA, Tableau), and all have received specialized training MCH research, epidemiology, and program evaluation. MCHE directs the State Systems Development Initiative (SSDI) and the Texas Pregnancy Risk Assessment and Monitoring System (PRAMS), both of which are used to inform policy and practice in MCH. Please refer to Supporting documents for key MCHE publications and presentations.

Manda Hall, M.D. was named the Associate Commissioner for the Community Health Improvement Division at DSHS in September 2017. Prior to this position, Dr. Hall served as the Texas Title V MCH Medical Director for nearly two years, and the Children with Special Health Care Needs Director for over three years. Dr. Hall received her Bachelor of Science Degree in Biology from Lamar University and her Medical Degree from Texas A&M University Health Science Center College of Medicine. She completed her Internal Medicine/Pediatrics residency and an Allergy and Immunology fellowship at the University of Alabama at Birmingham.  Dr. Hall was recently elected to serve as the Association of Maternal and Child Health Programs Region VI Director and is a member of the organization’s Annual Conference Planning Committee.  She graduated in May 2014 as a fellow in the Maternal and Child Health Public Health Leadership Institute at the University of North Carolina at Chapel Hill and the Texas Health and Human Services Executive Leadership Academy in 2017.  She is a faculty member of the DSHS Preventative Medicine and Public Health Residency Program and serves as a mentor in the University of Texas Health Careers and Mentorship Program. Dr. Hall is the President-Elect of the Association of Maternal and Child Health Programs.

Dr. Kelly Fegan-Bohm, MD, MPH, MA is the Medical Director in the Community Health Improvement Division. Dr. Fegan-Bohm attended undergraduate school at University of Texas at Austin where she graduated with a degree in Human Biology in 2006.  She received her Master’s in Exercise Physiology from UT Austin in 2007. She then attended medical school at UT Health Science Center in San Antonio where she graduated in 2011 with her medical degree as well as a Master’s in Public Health. She completed her pediatric residency at Doernbecher Children’s Hospital in Portland, Oregon, in 2014 and her Pediatric Endocrinology Fellowship at Texas Children’s Hospital in 2017. She then worked as an assistant professor at Texas Children’s Hospital in the Pediatric Endocrinology Department with a focus on clinical care and Quality Improvement initiatives for children and young adults with diabetes.  In March of 2020 she started her position as Medical Director for the Community Health Improvement Division of Texas Department of State Health Services.

Jeremy Triplett is the Maternal and Child Health (MCH) Section Director at the Texas Department of State Health Services (DSHS) and serves as the MCH Title V Director for the State.  Jeremy’s career has spanned over 21 years and has included work with the Texas Workforce Commission as a Lead Economist and Statistician who prepared, analyzed and disseminated labor force statistics, as the Operations Manager for Health Benefits programs at DSHS, and as the MCH Unit Director.  Mr. Triplett earned his Bachelor of Arts degree in Psychology from St. Mary’s University in 1998, where he learned about public health and being a servant leader in the community.  Jeremy has spent his career working in the public sector and is committed to improving the health and safety of Texans across the state.

Michael Spencer was selected as the MCH Unit Director in the MCH Section in May, 2019. Mr. Spencer previously worked at DSHS from 2007 to 2014, and was the Title V Administrator for three years in the Office of Title V and Family Health. Mr. Spencer also worked at the HRSA’s Maternal and Child Health Bureau in Rockville, MD as a Public Health Analyst and Title V Block Grant Project Officer.  Prior to returning to DSHS, Mr. Spencer also served as the MCH Bureau Director and Title V MCH Director for the Maryland Department of Health. Mr. Spencer has a Master’s Degree in Social Work from Tulane University, a Bachelor’s Degree in English from Purdue University, and a Bachelor’s Degree Journalism from Indiana University. 

Audrey Young was named the Manager of the Child and Adolescent Health Branch and the State CSHCN Director in the MCH Unit in June 2019. Ms. Young had previously served as the Unit Coordinator overseeing initiatives including Texas AIM, and worked with the DSHS Office of Healthcare Delivery Redesign as a Health Policy Analyst. Ms. Young holds a Master of Public Health in Health Policy and Management from Texas A&M University. 

Dr. Michelle Cook was named the Director of the MCH Epidemiology Unit at the Texas Department of State Health Services in February, 2019. Previously, Dr. Cook established the research department at the American Association of Nurse Practitioners where she expanded research services, standardized data collection, and executed the nurse practitioner research agenda. She was also the Behavioral Risk Factor Surveillance System coordinator in both Texas and Michigan. Dr. Cook received her PhD in epidemiology with a minor in biostatistics from the University of Texas Health Science Center and her MPH in epidemiology from the State University of New York at Albany.

Chris Webb, PhD, joined MCHE as a Technical Team Lead in January 2019 Dr. Webb reviews research and provides statistical expertise. Prior to joining DSHS, he was a demographic researcher for HHSC where he focused on analyzing access to care and disease prevalence in the Medicaid and CHIP populations. He has a PhD in Epidemiology with a minor in Biostatistics and a concentration in MCH at the UTHSC-Houston School of Public Health. Chris also earned an MPH from the school and a BS in Public Policy from Georgia Tech. He has experience working with Medicaid, birth certificate, BRFSS, and Census data.

Meagan Guilfoyle, PhD, is a Research Specialist for the Maternal and Child Health Epidemiology Unit at the Texas Department of State Health Services. As a biocultural medical anthropologist, her focus is on maternal and infant health, reproductive health, developmental origins of health and disease, and fetal and lactational programming. She earned her PhD in 2019 from Indiana University researching the impact of maternal fasting for the Islamic month of Ramadan on birth outcomes and breastmilk endocrine composition in Morocco.

Ms. Aliyah Abdul-Wakil is the lead epidemiologist for the Texas AIM program and sits under the Healthy Texas Mothers and Babies team within the Maternal and Child Health Epi Unit. Prior to her current role, she was a Data Analyst working with the CDC in Washington, DC to monitor the performance of a global HIV/AIDS program through data management, analysis, and data visualization. She has experience providing technical assistance to program partners and facilitating trainings. Ms. Abdul-Wakil received her Master of Public Health in Epidemiology from George Washington University in Washington, DC.

Kacey Russell is currently an epidemiologist in the Maternal and Child Health Epidemiology Unit with Texas Department of State Health Services (DSHS) where she focuses on maternal mortality.  Prior to this role, Kacey served as an epidemiologist in the TB/HIV/STD Section at DSHS.  Since 2008, her experience with TB/HIV/STD Section includes serving as the perinatal HIV surveillance coordinator, providing technical assistance to surveillance sites for core HIV surveillance activities, data analysis for congenital syphilis and perinatal HIV and serving as a member of the Perinatal Taskforce and Fetal and Infant Morbidity Review for Syphilis and HIV (FIMRSH) Core team member for Texas.  Kacey Russell received her Master of Public Health degree with a concentration in Epidemiology and Biostatistics from Texas A&M School of Public Health in 2007.  

Gloria Mutombo is the Epidemiologist III for the Maternal and Child Health Epidemiology Unit at the Texas Department of State Health Services. Prior to her current role, she was the Health informatics specialist with the infectious disease unit at the Texas Department of State Health Services, collaborating with several Hospitals on disease reporting to the state. She also has previous experience working as the Sudden Unexpected Infant death (SUID) coordinator and Multi-site Gram-negative Surveillance Initiative Epidemiologist at the Minnesota department health. Gloria received her Master of Public Health from the university of Toledo in Toledo, OH.

Ms. Laliberte is the coordinator for the Pregnancy Risk Assessment Monitoring System at the Texas Department of State Health Services. Prior to her current role, she was the Behavioral Risk Factor Surveillance System (BRFSS) coordinator in Kansas where she over saw daily phone operations of the program, provided technical guidance for data users, and assisted in disseminating health indicator estimates using BRFSS data of Kansas residents 18 years and older. Ms. Laliberte received her Master of Public Health from Georgia State University in Atlanta, GA.

Montana Gill is a Research Specialist for the Maternal and Child Health Epidemiology Unit at the Texas Department of State Health Services. Ms. Gill is a recent graduate of Emory University where she received her Master’s in Public Health focused in Behavioral Science and Health Education. During her time at Emory, Ms. Gill worked on projects related to reproductive healthcare access in rural communities, maternal to child HIV transmission, and intimate partner violence on college campuses.

Ivy Goldstein is the State Children with Special Health Care Needs (CSHCN) Health Coordinator and has worked in MCH in Texas for nearly 12 years. She holds a Bachelor of Science degree in Business Administration from Boston University and is a graduate of the nationally recognized disability leadership program, Partners in Policymaking. Ivy, mom to a young adult daughter with a rare genetic syndrome, knows firsthand the joys and challenges of parenting a child with special health care needs.

Cassandra Johnson, MPH, is the CSHCN Project Coordinator. Ms. Johnson joined the program in November 2018 and has a Master of Public Health in Community Health from East Tennessee State University. Previously, she worked directly with CSHCN and their families in a variety of roles and settings.

Dawn Ferriter joined the CSHCN SDG team as a Program Specialist IV in May, 2019, where she currently manages case management and family support and community resource contractors located in all regions in Texas. Ms. Ferriter previously worked in Newborn Screening and has a BA in Sociology and a BA in Education, Health, and Human Development. She has over 7 years of experience in Public Health, 5 of which were in Newborn Screening.

Claire Niday, MPH, joined the MCH Unit in August 2019 as the State Child Health Coordinator. She came from a research background, conducting evaluation for Texas SNAP-Ed for two years and leading surveillance for the Texas School Physical Activity and Nutrition project for four years, which is funded by a grant provided by MCH. She has over 7 years of experience in health coaching and behavior change, food systems, prenatal and early childhood health, data collection and analysis, and program planning, implementation, and evaluation. Ms. Niday has a Master of Public Health in Health Promotion and Behavioral Science from the University of Texas Health Science Center.

Julie Stagg, MSN, RN, IBCLC, RLC, is the Healthy Texas Mothers and Babies Branch Manager as well as the DSHS State Breastfeeding Coordinator. Ms. Stagg leads a growing team of subject matter experts with the Healthy Texas Mothers and Babies Branch.

Effective February 1, 2020, Allison Waage, MSN, RN re-joined the Healthy Texas Mothers and Babies (HTMB) Branch as the Maternal Health and Safety Nurse Consultant for the Maternal Mortality and Morbidity program. Allison, who previously supported the Maternal Mortality and Morbidity program from December 2017-March 2019, returned to this role to continue pursuit of her passion to improve maternal health in Texas. Allison’s prior experience includes seven years working as a triage nurse for an ambulatory clinic specializing in obstetrics, and work as a postpartum home health nurse for a birth center.  

Effective February 1, 2020, Erin Thompson, MEd, CHES joined the HTMB Branch in the new HTMB Program Coordinator position.  Erin previously served as a Project Coordinator for the CSHCN Systems Development Group/Child and Adolescent Health Branch in the MCHU for the previous two years.  She also has experience with the Birth Defects Registry program at DSHS prior to joining MCH and CSHCN.  Erin’s has experience and strong interest in minority health, health equity, and maternal/women’s health. Her new position presents the opportunity to be involved in programming that encompasses all three of these areas and contribute to maternal health programming in Texas. 

Effective March 9, 2020, Laura Wando, MPH joined the HTMB Branch in a new Maternal Health and Safety Coordinator position. Laura has extensive experience in the field of Reproductive Health in organizations. Laura’s technical expertise includes Family Planning, Adolescent Reproductive Health, HIV prevention and Care, Program Development, Program Management, and NGO leadership. Her most recent role was the Country Director in Uganda.

Effective March 16, 2020, Rosa-Maria DiDonato, RNC-OB joined the HTMB Branch in a new Maternal Health and Safety Public Health Nurse position. Rosa-Maria has a wide range of experience in nursing, primarily in perinatal care. She has provided care in homebirth, birth-center and hospital settings including as an obstetric nurse in semi-rural Labor & Delivery, Recovery & Postpartum (LDRP) unit and in low-risk and high-risk urban OB units. She also has experience as a hospice nurse.

Effective March 16, 2020, Yahaira Rodriguez, MA, MEd joined the HTMB Branch in the new HTMB Educational Specialist position. For more than 15 years Yahaira has worked with individuals, communities, and organizations in a wide range of local, national, and international programs. Her professional experience includes managing social services programs providing case management and pregnancy/parenting education; working with domestic and international subcontractors; and coordinating community coalitions and training services in Puerto Rico.

Tausi Suedi, MPH joined the HTMB Branch on June 1, 2020 as a Perinatal and Infant Health and Safety Coordinator. Tausi has over 12 years of international and local experience in maternal, newborn, child, adolescent, and community health programs. She previously served as the MCH Deputy Director at the Baltimore City Health Department where she oversaw care coordination and special projects benefiting at least 6,000 pregnant women and infants annually. She also served on the Maryland Maternal and Child Health Task Force and spearheaded key policy recommendations to improve maternal and child health. 

Michelle Hill joined the HTMB Branch on June 1, 2020 in the new Maternal Mortality and Morbidity Administrative Assistant position. She has worked with the state and HHSC agencies for 16 years with her last position being the Admin for DFPS Child Protective Services. This position is funded by the CDC ERASE MM Grant.

In November 2019, the TexasAIM Initiative and the MCH TexasAIM Team including MCH program, epidemiology, and leadership staff, were recognized with the DSHS Commissioner's Excellence in Public Health Shine Award. This award recognizes “a significant achievement that directly advances the mission and/or vision of the agency.” The Commissioner noted the high participation rate—with voluntary enrollment of 97 percent of Texas hospitals with obstetric service lines, accounting for 98 percent of the state’s approximately 400,000 annual births—as a testament from participating hospitals, doctors and nurses to the value that their engagement with TexasAIM provides to the patients they care for.  

The TexasAIM team program members include Julie Stagg,
Ashley Steenberger, Megan Coulter, Audrey Young, and Luke Chalmers. Leadership members include Dr. Manda Hall, Jeremy Triplett, and Michael Spencer. Epidemiology team members include Michelle Cook, Katrina Flores, Michelle Kormondy, Chris Webb, Natalie Archer, and Karen Ruggiero. The Maternal Mortality and Morbidity Review Committee was also recognized with the Commissioner's Partner in Public Health Shine Award for the group’s outstanding contribution in partnership with DSHS to advance the mission and vision of the agency.

Members photographed with the DSHS Commissioner Dr. John Hellerstedt include Dr. Lisa Hollier, Co-Chair; Dr. Carla Ortique, Co-Chair; Nancy Alderman; Dr. Pamala Gessling; Ms. Kimberly Griffen, Dr. Manda Hall; Dr. Amy Raines Milenkov; Dr. D. Kimberley Molina; Dr. Christina Murphey; Dr. Sherri Onyiego; Dr. Patrick Ramsey; Nancy Jo Reedy; Dr. Eumenia Castro; Dr. Meitra Doty; Dr. Linda Gaul; Dr. James Maher; Dr. Lavannya Pandit; Former members also honored include Ms. June Hanke and Dr. Ronald Peron.

MCH Texas Title V recognizes staff accomplishments, leadership, and workforce development efforts. The Title V Block Grant supports DSHS regional staff across the 8 PHRs to plan, implement, and evaluate population-based programs in their communities to address Title V National and State Performance Measures. Title V supports 90 full-time employees throughout the PHRs, boosting the MCH infrastructure throughout the state. Staff in the regions are in a unique position to collaborate with others in assessing local needs and identifying potential solutions that reflect the values and cultural make-up of communities.

Kim Beam joined the Maternal and Child Health Unit as the new MCH Regional Programs Administrator in June 2020. Mr. Beam has 10 years of experience in regional/community-level public and population health work and supporting maternal and child health through program planning/development, implementation, and evaluation in Public Health Region (PHR) 6/5S.  Most recently, he served as the DSHS’ MCH team lead in PHR 6/5S working with a comprehensive team to develop and implement activity plans and reporting under the Title V Block Grant.  He was also responsible for the training development of team members working in MCH within the regional office.  Additional areas that he has coordinated and supported within the PHR 6/5S include activities in health promotion (tobacco control and prevention and obesity prevention), suicide prevention, and child fatality review. He has a Master’s degree in Public Health from Texas A&M University and a Bachelor’s degree in Psychology from Arizona State University. 

The MCH Regional Programs Administrator serves as the key MCH liaison between DSHS central office and the DSHS regional offices, and works to enhance the technical competence of regional staff. The MCH Regional Programs Administrators role is to improve the alignment of regional activities with the Title V MCH Block Grant objectives. To facilitate this, the SharePoint site was expanded to serve as a repository for evidence-based practices, a forum for communication, and a workforce development and training resource. The Regional Administrator also coordinates an ongoing series of learning opportunities conducted virtually and archived on the SharePoint site, including the monthly MCH Learning Consortium, the quarterly MCH Regional Showcase, discussions with guest speakers, and Meet the SME sessions.

Regional staff participate on local and national committees and workgroups including the Texas Medical Home Learning Collaborative and the National Child Safety Learning Collaborative organized by the Children’s Safety Network and HRSA. The Consultant convened several workgroups made up of regional MCH staff, including the Workforce Development Workgroup which has continued to refine the Survey Monkey Tools, a Title V Needs Assessment Workgroup which is informing the implementation of the Five-Year Needs Assessment at the local level and a workgroup working on development of a standardized toolkit for performance measure implementation.

Learning needs associated with Title V Performance Measures are addressed through the monthly MCH Learning Consortium, regular Meet the Subject Matter Expert (SME) webinars and the quarterly MCH Regional Showcase. Staff utilize resources for independent learning available through MCH Navigator, CDC’s Public Health 101 Series, the Georgetown National Center for Education in Maternal and Child Health (MCH Evidence), Kansas University’s Community Toolbox and other resources.

The 2020 AMCHP conference, originally scheduled for March, 2020 was offered virtually in August 2020 due to COVID-19. This change allowed for additional Texas Title V team members to participate in the online conference for a total of 17 Texas attendees.

DSHS recognizes the value of the Community Health Worker (CHW) workforce in serving as a key component in response to emerging health issues in Texas. In many areas of the state, DSHS regional staff may also be certified CHWs and often collaborate with regional or local CHW networks or training programs. Title V supports staffing and infrastructure for the Promotor (a) or Community Health Worker Training and Certification Program, which is now housed within the HPCDP Section at DSHS. Staff include two program coordinators, three program specialists, and an administrative support specialist. The Program oversees the certification of CHWs and instructors and certifies organizations that provide initial training and continuing education.

DSHS partners with a range of CHW training programs, including community colleges, other academic institutions such as University Health Science Centers, Area Health Education Centers (AHECs), FQHCs, CHW associations, community-based organizations, and others. DSHS and the approved training programs share a deep commitment to ensuring quality CHW education. Texas was an early leader in the nation in adopting legislation to implement a statewide certification process for promotores and community health workers (CHWs) and continues to seek ways to expand the use of CHWs to assist Texans in accessing needed health and social services.

The Association of State and Territorial Health Officials (ASTHO) was funded by HRSA to work on the Alliance for Innovation on Maternal and Child Health project.  ASTHO included Texas in a series of state stories to highlight state strategies for utilizing promotores or community health workers (CHWs) to improve access to care and continuity of care for pregnant women and children.

CHWs often share the same linguistic or cultural experiences of the individuals they serve and work to provide culturally competent services in a way easily understood by a target audience. CHWs receive continuing education credit for online modules developed by HHSC related to the culturally effective health care and Culturally and Linguistically Appropriate Services (CLAS) Standards.

DSHS and HHSC continue to work to increase utilization of CHWs in Texas. CHWs are employed by community-based clinics through DSHS to facilitate access to services and improve the quality and cultural competence of primary, preventive and screening health care services for women across the state. HHSC surveyed the state’s Managed Care Medicaid/Children’s Health Insurance Program (CHIP) health plans. Most of the plans (80%) noted that they utilize certified CHWs to improve services and access to care. CHWs provide health education, information and referral, assist clients in navigating complex health and social service systems, and provide follow-up through clinic and home visits. Maximus, HHSC contractor for Texas Health Steps (Children’s Medicaid) enrollment broker operations, employs CHWs as outreach counselors. Under an 1115 Medicaid waiver, Texas funded projects to incentivize hospitals and other providers to transform service delivery practices to improve quality, health status, patient experience, coordination, and cost-effectiveness. Projects included expanding the use, and integration of, the CHW workforce in the Texas health care delivery system. CHWs provide services to increase access to care and facilitate appropriate use of health resources through outreach and cultural linkages between communities and delivery systems; reduce costs by providing health education, screening, detection, and basic emergency care; and improve quality by contributing to patient‐provider communication, continuity of care, and consumer protection.

CHWs provide patient navigation services to enhance social support and culturally competent care to vulnerable and/or high‐risk patients and serve as members of Health Home interdisciplinary teams. The number of certified CHWs in Texas continues to increase over time as awareness and utilization of the CHW workforce grows.

The Texas Birth Defects Registry was established in 1993 by the Texas Birth Defects Act (Chapter 87 of the Texas Health and Safety Code, Birth Defects). The Registry has been in operation since 1994 and is overseen by the DSHS Birth Defects Epidemiology and Surveillance Branch (BDES). Statewide data became available in 1999. Highly-trained regional staff visits medical facilities to review logs, hospital discharge lists, and other records to find babies with possible birth defects (structural malformations or chromosomal disorders). If the record indicates that the infant or fetus has a condition covered by the registry, detailed demographic and diagnostic information are abstracted and entered into the computer for processing. The Registry ascertains cases and diagnoses up to the first birthday. Quality assurance activities are conducted throughout data collection and data processing to monitor the accuracy, completeness, and timeliness of the Registry’s data. Data from the Registry are used for many different reasons, including for cluster investigations, looking at the occurrence and patterns of birth defects, prevention and family outreach, studies of access/proximity to services, studies of mortality and survival, studies of causes of birth defects, and understanding changes over time. All information is held in strict confidence in accordance with state and federal privacy laws.

The Oral Health Improvement Program (OHIP) within the MCHS strives to identify the oral health needs of Texans and to provide resources that meet those needs. The OHIP staff include Central Office staff, located in Austin, and five Regional Dental Teams (RDT), each consisting of a dentist and registered dental hygienist.  The regional teams are based in San Antonio, Houston, Lubbock, Tyler and Midland. 

The OHIP conducts statewide oral health surveillance, including a Basic Screening Survey (BSS) of third grade and Head Start students.  This is a weighted survey using probability proportionate to size sampling methodology. The OHIP is the only program that conducts oral health surveillance of this type in Texas.  These surveys are conducted every five years and the information acquired allows the OHIP to track trends of the prevalence and extent of oral disease and the presence of dental sealants. 

The RDTs also provide oral health education and preventive dental services, including limited oral evaluations, fluoride varnish and dental sealants for students who qualify. The RDTs have portable dental equipment and travel to schools, Head Starts and other programs to provide their services and conduct surveillance. Title V continues to identify opportunities to collaborate on the shared goal of improving the health of mothers and children.

Rhonda Stokley, DDS, serves as both Public Health Dental Director and Health Screening and Oral Health Unit Manager for the Texas Department of State Health Services.  Dr. Stokley has been with DSHS for four years and has over 10 years of state service. She has private practice experience and has also served Texas by providing dental care for adults with special needs. She received her Doctor of Dental Surgery degree from Louisiana State University Health Sciences Center School of Dentistry in 2005.

Title V funds are used to support the Newborn Screening (NBS) Program. The NBS Program screens for genetic conditions using blood spots, as required by Texas law (Health and Safety Code, Chapter 33) in order to help identify infants who may have treatable genetic disorders or medical conditions. Early identification can prevent serious complications, such as growth problems, developmental delays, deafness, blindness, intellectual disabilities, seizures, and sudden or early death. Texas operates the largest newborn screening program in the nation, testing approximately 775,000 specimens per year, or nearly 400,000 babies annually.

The NBS Program continues to meet its annual objective of 100% follow up and case management of identified presumptive positives. NBS supports workforce development and overall infant health education in the state by informing thousands of health care professionals and expectant and postpartum parents about the importance and benefit of newborn screening and follow-up to positive tests. NBS promoted quality improvement measures by monitoring the number of unsatisfactory specimens submitted to the DSHS laboratory, following up with educational resources. as well as monitoring the average statewide transit time from specimen collection to receipt in the DSHS Laboratory to ensure timely follow-up to definitive diagnosis and management of conditions.

The Texas Early Hearing Detection and Intervention (TEHDI) Program is dedicated to ensuring newborns and young children who are deaf/hard of hearing are identified as early as possible, with the goal of providing appropriate intervention services in order to prevent delays in communication and cognitive skill development. TEHDI continues to disseminate Newborn Hearing Screening Program report cards to licensed birthing facilities to communicate their performance on a set of nationally recognized benchmarks and quality indicators. The report card provides a snapshot of the birthing facility’s use of the TEHDI MIS over the previous two months. These same criteria are used to evaluate birthing facilities for newborn hearing screening program certification when a facility is up for a certification review. The certification process occurs in two cycles, the first in January and the second in July. Each facility’s certification is based on the data for the preceding six-month period.

David R. Martinez is the Newborn Screening Unit Manager. He maintains a BA from the University of Texas at Austin and has over 25 years of experience in state government. Mr. Martinez has managed programs related to medical dispute resolution where providers sought relief for payment of medical reimbursement for care injured workers in the Texas workers’ compensation system. He also managed a quality assurance program evaluating physicians in the workers’ compensation for quality of medical care and services. Currently he is responsible for expanding the Newborn Screening and Newborn Hearing screening programs for the Department of State Health Services, and has expanded the number of screened genetic conditions screened from 7 to over 50 genetic conditions as of 2019. He is a subject matter expert for the Newborn Hearing and Newborn Bloodspot Screening programs for over 15 years.