III.E.2.c. State Action Plan - CSHCN - Application Year - Texas - 2022
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NPM 11: NPM Percent of children with and without special health care needs having a medical home.
According to 2018-2019 National Survey of Children’s Health (NSCH) data, children and youth with special health care needs (CYSHCN) make up over 17% of children age 18 and younger in Texas. The same data identified that 45% of CYSHCN in Texas receive care in a medical home, compared with 42.3% of CYSHCN nationwide. The Joint Principles of a Patient-Centered Medical Home describe a medical home as a place CYSHCN experience health care where the provider knows them well, care is comprehensive and continuous, and families are valued partners on the care team.
In the 2019 Title V Parental Outreach Survey, distributed by the Children with Special Health Care Needs Systems Development Group (CSHCN SDG), respondents reported that 61.8% of parents and guardians organized their child’s care themselves. The same data showed that more than half of respondents had a plan for a medical emergency (63.2%) and a natural or man-made disaster (53.1%). Still, a large portion of this population had not planned for emergencies. In fiscal year (FY)22, CSHCN SDG will lead, fund, partner, and support efforts to improve care coordination for CYSHCN and their families, increase the percentage of CYSHCN having a medical home, and help families establish emergency plans.
The CSHCN SDG has led the statewide Medical Home Learning Collaborative (MHLC) since 2004 and will continue bringing together interested stakeholders (including providers and parents of CYSHCN) to increase knowledge, exchange resources, share best practices, and collaborate on efforts to improve access to a medical home. In FY22, CSHCN SDG will continue to survey MHLC participants following each quarterly meeting to ensure webinar topics and activities are meeting the members’ needs. CSHCN SDG will keep members updated on current learning opportunities, new resources, recent publications, and other information pertinent to medical home through monthly communications. The program will structure meetings to promote collaboration and include active discussion on medical home innovation, best practices, and advancing optimum health outcomes for all Texans.
Also, CSHCN SDG will conduct outreach and consult with external partners to increase understanding and implementation of the medical home model for CYSHCN, families, and providers. Outreach activities will include ongoing development of educational resource materials, such as the “Every Child Deserves a Medical Home: A Guide for Families” brochure. Materials will be distributed to families, community-based contractors, clinicians, and partner organizations. CSHCN SDG will continue building a virtual presence through its website and DSHS social media platforms. The program will present on medical home best practices at local, regional, and state events and maximize opportunities to co-present with educators and family members. Efforts to increase membership on the medical home distribution list to expand outreach and build new partnerships will continue. CSHCN SDG will build on lessons learned during COVID-19 to connect with families, providers, and community stakeholders through virtual platforms.
The 2020 Title V Needs Assessment findings identified a state priority need to implement health disparity strategies throughout all maternal and child health populations. In 2021, CSHCN SDG developed a new initiative to identify communities experiencing health inequities and target interventions to strengthen services for underserved CYSHCN. The application will be open in FY22 and is scheduled to begin in FY23. DSHS will select an applicant demonstrating strong relationships with communities experiencing health inequities, extensive knowledge of culturally responsive practices, and a track record of program development and implementation.
CSHCN SDG identified the need to improve case management services in Texas by strengthening case managers' knowledge of family-centered, comprehensive case management for CYSHCN and their families. In FY22, CSHCN SDG will continue to fund the Texas Institute for Child and Family Wellbeing (TXICFW) to develop a standardized, best practice approach and training curriculum for case managers across the state. The three-year project, which started in FY20, includes an assessment and development phase, a training phase, and a technical assistance and evaluation phase. The assessment and development phase was conducted remotely in FY20 because of COVID-19. In FY21, TXICFW continued the assessment and development phase, and began the training phase. In FY22, TXICFW will conduct training for case managers in regional and local health offices and provide ongoing technical assistance. DSHS and TXICFW will evaluate the feasibility of in-person training because of COVID-19 and adjust accordingly. Case managers and their supervisors will have access to an online learning community to ensure sustainability.
In FY22, TXICFW will complete outcome and process evaluations for the project that were developed alongside the practice model. As part of the evaluation plan, TXICFW will collect data from multiple sources including a survey of case managers to understand their perceptions of the effectiveness of the practice model and their retention of training concepts. The plan will include qualitative interviews with families and staff. TXICFW will also develop fidelity tools to understand the extent the practice model is followed by the case managers who participated in the training.
DSHS contracts with community-based organizations throughout Texas to provide gap-filling services to CYSHCN and their families who do not meet eligibility requirements for other programs. In FY22, CSHCN SDG will continue to fund eight organizations to provide case management (CM) and 14 organizations to provide family support and community resource (FSCR) services.
In FY22, contractors will work to advance medical home practices in their communities. Both CM and FSCR contractors will connect CYSHCN to primary care providers and specialists; help families access needed medication, medical supplies, and equipment; access services to meet basic needs; and educate families and professionals on the importance of the medical home. The CM contractors will provide comprehensive planning including a needs assessment, development of an individual service plan, ongoing assistance, and follow-up for families of CYSHCN. Some organizations will also manage medical equipment loans and recycling programs to reduce financial pressures on families.
Culturally responsive health care and care coordination system is a core component of the medical home. To help reduce health disparities and advance optimum health in their programs, CM and FSCR contractors are required to complete two outreach activities to underserved populations each quarter in FY22. Examples of qualifying outreach activities include:
- Meeting with an underserved population-serving organization
- Presenting/exhibiting at an underserved population event or conference
- Presenting on underserved population-specific disabilities or issues
- Partnering with underserved population-serving organizations to provide services to families
- Serving on a community board or group which targets activities to underserved populations
In FY22, CM and FSCR contractors will continue to partner with Federally Qualified Health Centers (FQHCs), local community organizations, and providers to increase CYSHCN access to health coverage, medical and dental services, primary and specialty care, medical transportation, medications, durable medical equipment, and other health-related needs. Contractors will continue collaborating with first responders, sharing resource information, and assisting with writing preparedness plans to help families of CYSHCN be ready in the event of a natural disaster, a need to shelter in place, and other emergencies.
In September 2021, CSHCN SDG will host a virtual training to keep contractors informed of public health priorities, review contract requirements, and provide technical assistance on DSHS’ Maternal and Child Health (MCH) Title V performance measures. The sessions will offer contractors opportunities to network with each other and exchange ideas for replicating successful activities. CSHCN SDG will review contract requirements addressing the CYSHCN-specific performance measures and state priority needs, including medical home, transition to adult health care, and community inclusion. This annual event will give contractors a better understanding of the MCH framework and how their activities contribute to advances for CYSHCN and their families.
CSHCN SDG requires CM and FSCR contractors to provide every family served at least one opportunity during the fiscal year to voluntarily complete a satisfaction survey. Families can complete either a paper or electronic version. Survey questions related to medical home will assess whether services are easily accessible, family-centered, comprehensive, continuous, and culturally effective. The CM contractor surveys have specific questions to assess family experience with service plan development, emergency preparedness planning, and timeliness of follow-up. To ensure data integrity, families will send completed surveys directly to CSHCN SDG for analysis. CSHCN SDG will share results with contractors to review areas of strength and those needing improvement.
DSHS Public Health Region (PHR) staff will collaborate with CM and FSCR contractors to ensure comprehensive care and responsive programming for families while ensuring services are not duplicated between PHR staff and the contractors. CSHCN SDG will provide PHR staff education on contractor activities in FY22 to help maximize partnership opportunities.
To increase the number of dentists with expertise in specialty care, CSHCN SDG will fund the University of Texas Health San Antonio School of Dentistry in FY22 to establish a Special Needs Dentistry Clinic (SNDC.) The clinic will be devoted exclusively to improve oral health for people with disabilities and special health care needs. The SNDC will be designed in close collaboration with public health agencies, community health organizations, and existing special health care resources. The operational plan will be developed after completing a needs assessment and will emphasize strategies that promote access to the SNDC, particularly for historically underserved populations. The SNDC will offer training that prepares future dentists and dental hygienists, school of dentistry faculty members, and private practitioners to serve the varying physical, mental, and sensory needs of CYSHCN. The clinic will also establish a SNDC Community Advisory Committee (SNDC-CAC) to provide guidance for the project. The SNDC-CAC will be comprised of patients, health care providers, parents, caregivers, self-advocates, and representatives of health organizations and facilities who are active in the community of San Antonio and surrounding regions. After the clinic is established, CSHCN SDG will explore opportunities to expand the training and share lessons learned from the project across the state.
CSHCN SDG will continue to partially fund the Health and Human Services Commission’s (HHSC) CSHCN Services Program in FY22. The CSHCN Services Program’s comprehensive health care benefits make it possible for CYSHCN across the state to access medically necessary health care. The program helps CYSHCN ages 20 and younger who meet eligibility criteria, and people of any age with cystic fibrosis, improve their health, well-being, and quality of life.
In FY22, CSHCN SDG will continue work on the advancing priorities of the Children with Medical Complexity (CMC) Collaborative Innovation and Improvement Network (CoIIN) project. Due to the success of the multi-state project, HRSA awarded supplemental funding for evaluation, sustainability and dissemination for an additional year. Texas team members include the Comprehensive Care Clinic (CCC) at Dell Children’s Medical Group, TxP2P, Dell Medical School at the University of Texas, HHSC Medicaid, and Blue Cross Blue Shield of Texas (BCBSTX). BCBSTX supports children served in the clinic through Texas’ STAR Kids Medicaid managed care program and will continue working to streamline redundant processes to reduce administrative burden. Dell Medical School researchers will contribute expertise in quality improvement to drive system changes.
The CMC CoIIN’s overarching goals focus on improving the quality of life for CMC, the well-being of their families, and the cost-effectiveness of their care. These goals will remain project priorities in FY22. Telemedicine services, which expanded because of COVID-19, allowed for multiple sub-specialists, home health agencies, therapists, and equipment providers to attend a single appointment. Building on this advancement, the CCC will pilot a “whole child” visit designed to streamline assessments and develop a shared plan of care focused on what matters most to families. In FY21, the CMC CoIIN Family Workgroup developed outcome measures to assess family experience with the visits that will be incorporated into the FY22 post-visit survey. Assuring active, meaningful engagement, and empowerment of families who represent the diversity of the clinic population will be central to all project initiatives. In FY22, CSHCN SDG will support this project by:
- Helping advance the team’s sustainability plan to help ensure continuing collaboration and progress to improve the quality of care for CMC and their families.
- Promoting ongoing, meaningful family engagement in all project initiatives.
- Participating in monthly team meetings and other project activities as requested.
- Contributing to the development of research papers, conference presentations, and posters.
- Identifying opportunities to scale project learnings to other initiatives including Texas’ STAR Kids managed care program for CYSHCN.
CSHCN SDG will continue supporting several organizations that conduct activities aimed at increasing the percentage of CYSHCN who have a medical home including the Mountain States Regional Genetics Network, the Texas Primary Care Consortium, and Texas Health Steps.
- Offering educational activities for providers, families, and other stakeholders
- Developing and expanding educational resources for health professionals
- Developing educational resources for families and supporting family leaders to participate in the MSRGN and genetics care delivery system
- Facilitating the use of telehealth and telemedicine in the genetics health care delivery system
- Providing technical assistance, training, and support to providers on telehealth
- Facilitating implementation and expansion of telehealth in genetics service provision
In addition to CSHCN SDG staff, the MSRGN Texas team includes family members, geneticists, genetic counselors, and genetic student interns. One of Texas’ two Act Early Ambassadors for the Center for Disease Control and Prevention’s Learn the Signs Act Early initiative joined the team in FY21 and will bring expertise in early childhood intervention services. Texas team activities for FY22 will focus on identifying two clinics to serve as “genetic champions” to educate, equip, and empower pediatric and primary care providers to improve their ability to serve those impacted by pediatric genetic conditions. Additionally, the Texas team will continue building partnerships to increase awareness of and access to genetic services in the state through outreach and resource sharing to families, clinicians, and other professionals serving CYSHCN.
CSHCN SDG staff will serve on the steering committee of the Texas Primary Care Consortium (TPCC) in FY22. This statewide collaborative of diverse stakeholders seeks to ensure all Texans have access to high quality, timely, and person-centered primary care. TPCC hosts an annual statewide conference on primary care and the medical home, known as the “Texas Primary Care and Health Home Summit.” The consortium will continue engaging additional stakeholders and examining the most effective methods to improve the health of all Texans.
CSHCN SDG will continue to provide subject matter expertise for updates to Texas Health Steps’ medical home and other related modules. CSHCN SDG will also promote modules relevant to medical home through the Medical Home Learning Collaborative and other forums.
NPM 12: Percent of children with and without special health care needs who received services necessary to transition to adult health care.
According to the 2018 Clinical Report “Supporting the Health Care Transition from Adolescence to Adulthood in the Medical Home”, youth, young adults, and family awareness of the importance of good health and continuity of care is vital for achieving goals in adulthood.
Findings of the 2018-2019 NSCH identified that 18.6% of CYSHCN in Texas ages 12 through 17 received the services necessary to transition to adult health care. This is a significant improvement from the 2016-2017 NSCH survey (8.5%) and beginning to approach the national average of 22.9%. In the 2019 Title V Parental Outreach Survey, 76% of respondents with transition-aged youth 12-17 did not feel prepared for their child’s transition to adulthood. Respondents most often reported that they had not prepared for their child’s transition in multiple areas including health care, postsecondary education, and addressing legal needs. Texas will continue raising awareness and conducting educational activities for families and professionals to increase the number of CYSHCN who receive services necessary to transition to adult health care.
CSHCN SDG will lead efforts to advance progress towards the seamless transition of young adults with special health care needs from pediatric to adult health care in FY22. CSHCN SDG will maximize opportunities to increase understanding of health care transition and promote active, intentional planning through education and resource sharing with youth, families, providers, educators, transition specialists, case managers, and others supporting CYSHCN and their families.
CSHCN SDG will continue building and strengthening relationships with families and professionals by leading the Transition to Adulthood Learning Collaborative (TALC) in FY22. Through the implementation of the TALC strategic plan, members will help drive improvements to advance awareness of health care transition and promote active planning in all areas of transition, including higher education, employment, and independent living. The TALC will convene via webinars and support a collaborative approach to transition planning by engaging parents, clinicians, educators, case managers, community-based organizations, and other key stakeholders in quarterly meetings. TALC will serve as a statewide forum for sharing knowledge, implementation strategies, resources, new publications, funding opportunities, updates on state and national transition initiatives, and upcoming transition-related events.
CSHCN SDG will continue funding TXICFW in FY22 to develop a family-centered, comprehensive case management model and training to increase the percentage of CSHCN who are receiving services necessary to transition to adult health care. This curriculum will be provided to all DSHS regional case management staff and will include specific training on partnering with families to prepare for their CYSHCN’s transition to adulthood. The training will standardize elements of the case management and ensure that clients get the services they need. More information on the project can be found in NPM 11.
In FY22, CSHCN SDG-funded community-based organizations will promote health care transition and assist CYSHCN, ages 12 and older, and their families with the transition planning process. The CM contractors and PHR staff will work closely with youth and families to facilitate active preparation to transition from pediatric to adult-based health care by:
- Conducting readiness assessments
- Promoting health care self-management
- Increasing family understanding of age limit policies in both pediatric practices and children’s hospitals
- Sharing resources
- Encouraging families to initiate conversations with clinicians to identify adult providers
- Providing linkages to adult services
Contractors will distribute transition resources through online forums such as electronic newsletters and social media. CSHCN SDG will continue to require contractors to actively engage families in meaningful ways to ensure the family perspective is incorporated into transition program development. CSHCN SDG will continue encouraging contractors to invite families to serve on the organization’s advisory board and respond to family experience surveys.
In FY22, CM and FSCR contractors will continue collaborating with youth and families to plan and host transition fairs and workshops. Contractors will offer in-person events and adhere to COVID-19 safety guidelines for public meetings. Many transition trainings will continue to be offered virtually to maximize opportunities to engage families unable to attend in person. A hybrid approach of both online and in-person trainings will help address attendance barriers and reach a wider audience.
In addition to focusing on the transition to adult health care, CM contractors and PHR staff will help families prepare for legal changes at age 18 and help youth and their families plan for higher education, vocational training, employment, and independent living. Case managers will meet with youth, young adults, and their families to identify priority transition goals using the family need assessment tool and develop an individual service plan. FSCR contractors will also work to increase the number of adolescents, both with and without special health care needs, to develop skills to prepare for transition to adulthood.
CSHCN SDG requires contractors to offer two transition workshops each fiscal year to help youth develop knowledge and skills to transition to adulthood. One workshop must focus on health care transition planning or building health care self-management skills. The other workshop may include broader transition-related topics such as higher education, vocational and employment skills, and independent living. Contractors will offer all youth ages 12 to 21, and their families, the opportunity to attend both workshops.
The annual Baylor College of Medicine’s Chronic Illness and Disability Conference: Transition from Pediatric to Adult-based Care will be held virtually in October 2021. CSHCN SDG staff will participate on the conference advisory board planning committee and attend the conference. The national conference brings together young adults, parents, physicians, and other health care professionals to learn from national thought leaders about how to better facilitate the successful transition from pediatric to adult-based care.
CSHCN SDG staff, together with Texas Parent to Parent (TxP2P), the Texas Center for Disability Studies, and Title V colleagues in Minnesota, New Mexico, North Carolina, and Wisconsin will continue to partner on a grass roots initiative to advance health care transition planning in schools. Federal and state legislation requires schools to address transition services in the Individual Education Plan (IEP) together with students and parents. With families already engaged in the process, including “health” in the IEP is a natural fit. Good health is the foundation for success in all other areas of transition - higher education, employment, and independent living. In FY22, the multi-state collaborative will continue to exchange resources and further develop outreach strategies to engage families, teachers, transition specialists, and school nurses to advance health care transition planning in school. Got Transition is a key collaborator in this effort and will offer guidance and expertise.
Texas Health Steps’ web-based, self-paced provider training modules offer free continuing education credits for primary care providers and other health professionals. The courses offer information on Texas Medicaid and provide guidance on clinical, legal, regulatory, and practice management issues. CSHCN SDG will continue to provide subject matter expertise for updates to Texas Health Steps modules that address transition to adulthood. CSHCN SDG will also promote the transition-related modules through the Transition to Adulthood Learning Collaborative and other forums.
The Adolescent Health Learning Collaborative, led by the state adolescent health coordinator, meets quarterly to bring together youth-serving professionals to share program updates, new resources, learning opportunities, and strengthen partnerships. In FY22, CSHCN SDG will attend group meetings, contribute resources, and identify collaborative opportunities to improve the health of youth and young adults.
SPM 1: Percent of CYSHCN and their families who received the supports and services necessary to be included in their communities.
The Americans with Disabilities Act (ADA), signed into law in 1990, conveys America’s commitment to ensuring that people with disabilities are fully integrated and included in all aspects of daily life. All families and children benefit from a sense of belonging in their communities. For CYSHCN, inclusion provides equal access to community activities and offers benefits of friendships, peer models, and teaching others to accept differences.
CSHCN SDG surveyed certified community health workers (CHWs) in Texas to identify gaps in knowledge regarding services and supports available to families of CYSHCN. Results showed that CHWs were not informed on the unique needs and challenges of CYSHCN families, or available resources to support them. In response, CSHCN SDG developed an introductory training module to expand the capacity of CHWs in Texas to assist families of CYSHCN. This free, online training will continue to be promoted, evaluated, and updated as appropriate in FY22. CSHCN SDG will continue to survey CHWs to assess their knowledge, interests, and educational needs in working with families of CYSHCN. If indicated, CSHCN SDG will create additional learning opportunities for CHWs in Texas.
In FY22, CSHCN SDG will continue leading a nutrition initiative, which joins efforts across the life course by breaking down program silos and promoting healthy eating behaviors across domains. This initiative aims to integrate best practice principles and family voices in the project. To accomplish this mission, the team created a series of presentations incorporating caregiver, adolescent, and individual nutrition and healthy eating strategies, including ones specific to CYSHCN.
CSHCN SDG will establish a new Family Engagement Learning Collaborative (FELC) in FY22 to ensure the family voice is central to programmatic direction and policy decisions. The FELC will give families a forum to have meaningful opportunities to impact program policies, procedures, and initiatives while learning about quality improvement and public health work. The FELC will initially focus on families of CYSHCN and young adults with disabilities. The intention is to expand the initiative to include all Title V population domains in the future. The FELC will be a platform for exchanging resource information, education, and raising awareness of programs and services.
CSHCN SDG will continue to fund community-based organizations to implement respite programs and host community activities for families and CYSHCN in FY22. These activities aim to strengthen community connections and reduce barriers to inclusion for CYSHCN and their families. Specific services available to CYSHCN and their families vary by contractor and community needs.
The FSCR contractors provide home- and center-based respite to give parents and caregivers a break from daily responsibilities and stressors. Some center-based respite contractors employ nurses making it possible for children with medical complexity to participate.
The FSCR contractors will continue hosting family and sibling support groups, social and recreational activities such as a sensory-friendly movie night, and other local events to strengthen family bonds and advance community inclusion. To expand opportunities for CYSHCN to build friendships with their peers without disabilities, contractors will offer camps throughout the year and provide scholarship funds when able, so more children can participate.
The CM contractors and DSHS regional staff assist families with accessing needed resources including insurance coverage, health care, specialized therapies, durable medical equipment, counseling, behavior specialists, respite, and long-term services and supports. These efforts, along with linking families to critical resources to meet basic needs such as food, housing, clothing, and transportation, will continue in the FY22. Helping to ensure CYSHCN remain living at home with their families is a CSHCN SDG priority.
Case management staff will assist school-age CYSHCN by helping parents prepare for IEP meetings. When requested by families, case managers will attend IEP meetings to support CYSHCN with accessing the general education curriculum and other school-based services. Meaningful inclusion at school offers all students opportunities to learn from each other, be more accepting of differences, and build lasting friendships.
COVID-19 amplified the financial hardships many families of CYSHCN experience. Parents may have lost jobs or experienced reduced work hours, leaving many struggling to meet basic needs. In response, CSHCN SDG allocated additional FY22 funding for CM and FSCR contractors to give financial help to families. The funds may be used for food, clothing, utilities, furniture, transportation, phone, laundry, supplies for the home, medical supplies, medical equipment, and other basic needs. Contractors are responsible for developing internal policies and procedures to identify and prioritize families in their area and ensure that funds are distributed to families within the 12-month timeframe.
In FY22, the Title V CSHCN director and program staff will continue to represent MCH Title V as voting members of the TCDD, which strongly advocates for the full, meaningful inclusion of individuals with disabilities in their communities. In FY22, staff will continue to participate on the TCDD Project Development Committee. The TCDD Project Development Committee provides expertise and recommendations on the grants the council funds throughout Texas. The grants address a variety of needs and areas of focus— including competitive employment, education, health and fitness, positive behavioral interventions and supports, local advocacy networks, leadership training, strengthening communities, and cultural competence and sensitivity. CSHCN SDG staff will also participate in discussions regarding the implementation of the TCDD FY22- FY26 state plan.
The Title V CSHCN director will represent DSHS on the federally mandated Texas Early Learning Council (TELC) in FY22. The goal of the TELC is to improve the quality of and access to early childhood services throughout Texas. The TELC is comprised of cross-sector stakeholders who work to increase coordination and collaboration among state agencies and local entities. TELC will continue to assess the impact of COVID-19 on Texas’ early childhood services and identify solutions.
CSHCN SDG will continue to collaborate with statewide partners to plan an online series about inclusive care for children with intellectual and developmental disabilities. The purpose of the Child Care Inclusion Workshop Series is to increase knowledge, resources, and understanding for child care providers and other professionals working with CYSHCN and their families in a child care setting. Once a week for eight weeks, participants will take an online training module and attend a live webinar developed and presented by faculty, state, and local service providers, experienced child care providers, and parent advocates.
The Policy Council for Children and Families (PCCF), a legislatively mandated statewide workgroup, strives to improve the coordination, quality, efficiency, and outcomes of services provided to children with disabilities and their families through the state’s health, education, and human services systems. PCCF formulates and submits recommendations on system improvements to the executive commissioner of HHSC and the Texas Legislature. In FY22, CSHCN SDG staff will represent DSHS as an ex-officio member to the council and provide subject matter expertise on transition to adult health care, medical home, and community inclusion.
Community Resource Coordination Groups (CRCGs) are county-based interagency groups comprised of public and private agencies that convene voluntarily and play a vital role in helping CYSHCN with complex needs, which cannot be met by a single agency. In FY22, CSHCN SDG staff will remain active on the CRCG Statewide Workgroup which serves as the point of contact for local CRCGs to report concerns and focuses on assuring access to needed supports for youth at risk of or experiencing a crisis. In FY21, three sub-committees merged into one to better align with the strategic plan. CSHCN SDG staff will serve on this newly formed sub-committee. Both CSHCN SDG CM and FSCR contractors will support their local CRCGs by attending staffing meetings and sharing critical resources to help keep children at home in FY22.
The Texas Respite Advisory Committee, established by the Texas Legislature, assists HHSC to:
- Develop strategies to reduce barriers to accessing respite.
- Improve the quality of respite services.
- Provide training, education, and support to family caregivers.
In FY22, CSHCN SDG will support the TRAC by attending meetings and monitoring statewide respite initiatives to identify opportunities to improve access for families of CYSHCN to quality, affordable respite services.
Outdoor Learning Environments Texas (OLE! Texas) is a statewide initiative that seeks to address obesity by improving outdoor spaces at child care centers. CSHCN SDG will continue to support OLE! Texas in FY22 by serving on the leadership committee. OLE! Texas will convene and support local coalitions to assist early childhood education centers with the process of developing and constructing a high-quality outdoor learning environment. The OLE! Texas leadership committee will also develop a network of trained landscape and design professionals to design outdoor spaces featuring best practices.
The Texas Developmental Screening Workgroup (DSW) is a group of stakeholders who collaborate on increasing developmental screenings and enhancing quality service referral mechanisms statewide. CSHCN SDG will continue to participate in bimonthly workgroup meetings. In FY22, workgroup members will participate in the identification of relevant initiatives to partner with, dissemination of screening resources to providers and families, and generation of standard language and definitions across sectors and applicable data sets where possible. In FY21, the DSW began exploring opportunities for creating a statewide hub to house developmental screening data that would provide a means for sharing screening results across community settings. The DSW will continue exploration of this effort in FY22 through identification of potential platforms and generating recommendations for implementation.
NPM 11: NPM Percent of children with and without special health care needs having a medical home.
According to 2018-2019 National Survey of Children’s Health (NSCH) data, children and youth with special health care needs (CYSHCN) make up over 17% of children age 18 and younger in Texas. The same data identified that 45% of CYSHCN in Texas receive care in a medical home, compared with 42.3% of CYSHCN nationwide. The Joint Principles of a Patient-Centered Medical Home describe a medical home as a place CYSHCN experience health care where the provider knows them well, care is comprehensive and continuous, and families are valued partners on the care team.
In the 2019 Title V Parental Outreach Survey, distributed by the Children with Special Health Care Needs Systems Development Group (CSHCN SDG), respondents reported that 61.8% of parents and guardians organized their child’s care themselves. The same data showed that more than half of respondents had a plan for a medical emergency (63.2%) and a natural or man-made disaster (53.1%). Still, a large portion of this population had not planned for emergencies. In fiscal year (FY)22, CSHCN SDG will lead, fund, partner, and support efforts to improve care coordination for CYSHCN and their families, increase the percentage of CYSHCN having a medical home, and help families establish emergency plans.
The CSHCN SDG has led the statewide Medical Home Learning Collaborative (MHLC) since 2004 and will continue bringing together interested stakeholders (including providers and parents of CYSHCN) to increase knowledge, exchange resources, share best practices, and collaborate on efforts to improve access to a medical home. In FY22, CSHCN SDG will continue to survey MHLC participants following each quarterly meeting to ensure webinar topics and activities are meeting the members’ needs. CSHCN SDG will keep members updated on current learning opportunities, new resources, recent publications, and other information pertinent to medical home through monthly communications. The program will structure meetings to promote collaboration and include active discussion on medical home innovation, best practices, and advancing optimum health outcomes for all Texans.
Also, CSHCN SDG will conduct outreach and consult with external partners to increase understanding and implementation of the medical home model for CYSHCN, families, and providers. Outreach activities will include ongoing development of educational resource materials, such as the “Every Child Deserves a Medical Home: A Guide for Families” brochure. Materials will be distributed to families, community-based contractors, clinicians, and partner organizations. CSHCN SDG will continue building a virtual presence through its website and DSHS social media platforms. The program will present on medical home best practices at local, regional, and state events and maximize opportunities to co-present with educators and family members. Efforts to increase membership on the medical home distribution list to expand outreach and build new partnerships will continue. CSHCN SDG will build on lessons learned during COVID-19 to connect with families, providers, and community stakeholders through virtual platforms.
The 2020 Title V Needs Assessment findings identified a state priority need to implement health disparity strategies throughout all maternal and child health populations. In 2021, CSHCN SDG developed a new initiative to identify communities experiencing health inequities and target interventions to strengthen services for underserved CYSHCN. The application will be open in FY22 and is scheduled to begin in FY23. DSHS will select an applicant demonstrating strong relationships with communities experiencing health inequities, extensive knowledge of culturally responsive practices, and a track record of program development and implementation.
CSHCN SDG identified the need to improve case management services in Texas by strengthening case managers' knowledge of family-centered, comprehensive case management for CYSHCN and their families. In FY22, CSHCN SDG will continue to fund the Texas Institute for Child and Family Wellbeing (TXICFW) to develop a standardized, best practice approach and training curriculum for case managers across the state. The three-year project, which started in FY20, includes an assessment and development phase, a training phase, and a technical assistance and evaluation phase. The assessment and development phase was conducted remotely in FY20 because of COVID-19. In FY21, TXICFW continued the assessment and development phase, and began the training phase. In FY22, TXICFW will conduct training for case managers in regional and local health offices and provide ongoing technical assistance. DSHS and TXICFW will evaluate the feasibility of in-person training because of COVID-19 and adjust accordingly. Case managers and their supervisors will have access to an online learning community to ensure sustainability.
In FY22, TXICFW will complete outcome and process evaluations for the project that were developed alongside the practice model. As part of the evaluation plan, TXICFW will collect data from multiple sources including a survey of case managers to understand their perceptions of the effectiveness of the practice model and their retention of training concepts. The plan will include qualitative interviews with families and staff. TXICFW will also develop fidelity tools to understand the extent the practice model is followed by the case managers who participated in the training.
DSHS contracts with community-based organizations throughout Texas to provide gap-filling services to CYSHCN and their families who do not meet eligibility requirements for other programs. In FY22, CSHCN SDG will continue to fund eight organizations to provide case management (CM) and 14 organizations to provide family support and community resource (FSCR) services.
In FY22, contractors will work to advance medical home practices in their communities. Both CM and FSCR contractors will connect CYSHCN to primary care providers and specialists; help families access needed medication, medical supplies, and equipment; access services to meet basic needs; and educate families and professionals on the importance of the medical home. The CM contractors will provide comprehensive planning including a needs assessment, development of an individual service plan, ongoing assistance, and follow-up for families of CYSHCN. Some organizations will also manage medical equipment loans and recycling programs to reduce financial pressures on families.
Culturally responsive health care and care coordination system is a core component of the medical home. To help reduce health disparities and advance optimum health in their programs, CM and FSCR contractors are required to complete two outreach activities to underserved populations each quarter in FY22. Examples of qualifying outreach activities include:
- Meeting with an underserved population-serving organization
- Presenting/exhibiting at an underserved population event or conference
- Presenting on underserved population-specific disabilities or issues
- Partnering with underserved population-serving organizations to provide services to families
- Serving on a community board or group which targets activities to underserved populations
In FY22, CM and FSCR contractors will continue to partner with Federally Qualified Health Centers (FQHCs), local community organizations, and providers to increase CYSHCN access to health coverage, medical and dental services, primary and specialty care, medical transportation, medications, durable medical equipment, and other health-related needs. Contractors will continue collaborating with first responders, sharing resource information, and assisting with writing preparedness plans to help families of CYSHCN be ready in the event of a natural disaster, a need to shelter in place, and other emergencies.
In September 2021, CSHCN SDG will host a virtual training to keep contractors informed of public health priorities, review contract requirements, and provide technical assistance on DSHS’ Maternal and Child Health (MCH) Title V performance measures. The sessions will offer contractors opportunities to network with each other and exchange ideas for replicating successful activities. CSHCN SDG will review contract requirements addressing the CYSHCN-specific performance measures and state priority needs, including medical home, transition to adult health care, and community inclusion. This annual event will give contractors a better understanding of the MCH framework and how their activities contribute to advances for CYSHCN and their families.
CSHCN SDG requires CM and FSCR contractors to provide every family served at least one opportunity during the fiscal year to voluntarily complete a satisfaction survey. Families can complete either a paper or electronic version. Survey questions related to medical home will assess whether services are easily accessible, family-centered, comprehensive, continuous, and culturally effective. The CM contractor surveys have specific questions to assess family experience with service plan development, emergency preparedness planning, and timeliness of follow-up. To ensure data integrity, families will send completed surveys directly to CSHCN SDG for analysis. CSHCN SDG will share results with contractors to review areas of strength and those needing improvement.
DSHS Public Health Region (PHR) staff will collaborate with CM and FSCR contractors to ensure comprehensive care and responsive programming for families while ensuring services are not duplicated between PHR staff and the contractors. CSHCN SDG will provide PHR staff education on contractor activities in FY22 to help maximize partnership opportunities.
To increase the number of dentists with expertise in specialty care, CSHCN SDG will fund the University of Texas Health San Antonio School of Dentistry in FY22 to establish a Special Needs Dentistry Clinic (SNDC.) The clinic will be devoted exclusively to improve oral health for people with disabilities and special health care needs. The SNDC will be designed in close collaboration with public health agencies, community health organizations, and existing special health care resources. The operational plan will be developed after completing a needs assessment and will emphasize strategies that promote access to the SNDC, particularly for historically underserved populations. The SNDC will offer training that prepares future dentists and dental hygienists, school of dentistry faculty members, and private practitioners to serve the varying physical, mental, and sensory needs of CYSHCN. The clinic will also establish a SNDC Community Advisory Committee (SNDC-CAC) to provide guidance for the project. The SNDC-CAC will be comprised of patients, health care providers, parents, caregivers, self-advocates, and representatives of health organizations and facilities who are active in the community of San Antonio and surrounding regions. After the clinic is established, CSHCN SDG will explore opportunities to expand the training and share lessons learned from the project across the state.
CSHCN SDG will continue to partially fund the Health and Human Services Commission’s (HHSC) CSHCN Services Program in FY22. The CSHCN Services Program’s comprehensive health care benefits make it possible for CYSHCN across the state to access medically necessary health care. The program helps CYSHCN ages 20 and younger who meet eligibility criteria, and people of any age with cystic fibrosis, improve their health, well-being, and quality of life.
In FY22, CSHCN SDG will continue work on the advancing priorities of the Children with Medical Complexity (CMC) Collaborative Innovation and Improvement Network (CoIIN) project. Due to the success of the multi-state project, HRSA awarded supplemental funding for evaluation, sustainability and dissemination for an additional year. Texas team members include the Comprehensive Care Clinic (CCC) at Dell Children’s Medical Group, TxP2P, Dell Medical School at the University of Texas, HHSC Medicaid, and Blue Cross Blue Shield of Texas (BCBSTX). BCBSTX supports children served in the clinic through Texas’ STAR Kids Medicaid managed care program and will continue working to streamline redundant processes to reduce administrative burden. Dell Medical School researchers will contribute expertise in quality improvement to drive system changes.
The CMC CoIIN’s overarching goals focus on improving the quality of life for CMC, the well-being of their families, and the cost-effectiveness of their care. These goals will remain project priorities in FY22. Telemedicine services, which expanded because of COVID-19, allowed for multiple sub-specialists, home health agencies, therapists, and equipment providers to attend a single appointment. Building on this advancement, the CCC will pilot a “whole child” visit designed to streamline assessments and develop a shared plan of care focused on what matters most to families. In FY21, the CMC CoIIN Family Workgroup developed outcome measures to assess family experience with the visits that will be incorporated into the FY22 post-visit survey. Assuring active, meaningful engagement, and empowerment of families who represent the diversity of the clinic population will be central to all project initiatives. In FY22, CSHCN SDG will support this project by:
- Helping advance the team’s sustainability plan to help ensure continuing collaboration and progress to improve the quality of care for CMC and their families.
- Promoting ongoing, meaningful family engagement in all project initiatives.
- Participating in monthly team meetings and other project activities as requested.
- Contributing to the development of research papers, conference presentations, and posters.
- Identifying opportunities to scale project learnings to other initiatives including Texas’ STAR Kids managed care program for CYSHCN.
CSHCN SDG will continue supporting several organizations that conduct activities aimed at increasing the percentage of CYSHCN who have a medical home including the Mountain States Regional Genetics Network, the Texas Primary Care Consortium, and Texas Health Steps.
- Offering educational activities for providers, families, and other stakeholders
- Developing and expanding educational resources for health professionals
- Developing educational resources for families and supporting family leaders to participate in the MSRGN and genetics care delivery system
- Facilitating the use of telehealth and telemedicine in the genetics health care delivery system
- Providing technical assistance, training, and support to providers on telehealth
- Facilitating implementation and expansion of telehealth in genetics service provision
In addition to CSHCN SDG staff, the MSRGN Texas team includes family members, geneticists, genetic counselors, and genetic student interns. One of Texas’ two Act Early Ambassadors for the Center for Disease Control and Prevention’s Learn the Signs Act Early initiative joined the team in FY21 and will bring expertise in early childhood intervention services. Texas team activities for FY22 will focus on identifying two clinics to serve as “genetic champions” to educate, equip, and empower pediatric and primary care providers to improve their ability to serve those impacted by pediatric genetic conditions. Additionally, the Texas team will continue building partnerships to increase awareness of and access to genetic services in the state through outreach and resource sharing to families, clinicians, and other professionals serving CYSHCN.
CSHCN SDG staff will serve on the steering committee of the Texas Primary Care Consortium (TPCC) in FY22. This statewide collaborative of diverse stakeholders seeks to ensure all Texans have access to high quality, timely, and person-centered primary care. TPCC hosts an annual statewide conference on primary care and the medical home, known as the “Texas Primary Care and Health Home Summit.” The consortium will continue engaging additional stakeholders and examining the most effective methods to improve the health of all Texans.
CSHCN SDG will continue to provide subject matter expertise for updates to Texas Health Steps’ medical home and other related modules. CSHCN SDG will also promote modules relevant to medical home through the Medical Home Learning Collaborative and other forums.
NPM 12: Percent of children with and without special health care needs who received services necessary to transition to adult health care.
According to the 2018 Clinical Report “Supporting the Health Care Transition from Adolescence to Adulthood in the Medical Home”, youth, young adults, and family awareness of the importance of good health and continuity of care is vital for achieving goals in adulthood.
Findings of the 2018-2019 NSCH identified that 18.6% of CYSHCN in Texas ages 12 through 17 received the services necessary to transition to adult health care. This is a significant improvement from the 2016-2017 NSCH survey (8.5%) and beginning to approach the national average of 22.9%. In the 2019 Title V Parental Outreach Survey, 76% of respondents with transition-aged youth 12-17 did not feel prepared for their child’s transition to adulthood. Respondents most often reported that they had not prepared for their child’s transition in multiple areas including health care, postsecondary education, and addressing legal needs. Texas will continue raising awareness and conducting educational activities for families and professionals to increase the number of CYSHCN who receive services necessary to transition to adult health care.
CSHCN SDG will lead efforts to advance progress towards the seamless transition of young adults with special health care needs from pediatric to adult health care in FY22. CSHCN SDG will maximize opportunities to increase understanding of health care transition and promote active, intentional planning through education and resource sharing with youth, families, providers, educators, transition specialists, case managers, and others supporting CYSHCN and their families.
CSHCN SDG will continue building and strengthening relationships with families and professionals by leading the Transition to Adulthood Learning Collaborative (TALC) in FY22. Through the implementation of the TALC strategic plan, members will help drive improvements to advance awareness of health care transition and promote active planning in all areas of transition, including higher education, employment, and independent living. The TALC will convene via webinars and support a collaborative approach to transition planning by engaging parents, clinicians, educators, case managers, community-based organizations, and other key stakeholders in quarterly meetings. TALC will serve as a statewide forum for sharing knowledge, implementation strategies, resources, new publications, funding opportunities, updates on state and national transition initiatives, and upcoming transition-related events.
CSHCN SDG will continue funding TXICFW in FY22 to develop a family-centered, comprehensive case management model and training to increase the percentage of CSHCN who are receiving services necessary to transition to adult health care. This curriculum will be provided to all DSHS regional case management staff and will include specific training on partnering with families to prepare for their CYSHCN’s transition to adulthood. The training will standardize elements of the case management and ensure that clients get the services they need. More information on the project can be found in NPM 11.
In FY22, CSHCN SDG-funded community-based organizations will promote health care transition and assist CYSHCN, ages 12 and older, and their families with the transition planning process. The CM contractors and PHR staff will work closely with youth and families to facilitate active preparation to transition from pediatric to adult-based health care by:
- Conducting readiness assessments
- Promoting health care self-management
- Increasing family understanding of age limit policies in both pediatric practices and children’s hospitals
- Sharing resources
- Encouraging families to initiate conversations with clinicians to identify adult providers
- Providing linkages to adult services
Contractors will distribute transition resources through online forums such as electronic newsletters and social media. CSHCN SDG will continue to require contractors to actively engage families in meaningful ways to ensure the family perspective is incorporated into transition program development. CSHCN SDG will continue encouraging contractors to invite families to serve on the organization’s advisory board and respond to family experience surveys.
In FY22, CM and FSCR contractors will continue collaborating with youth and families to plan and host transition fairs and workshops. Contractors will offer in-person events and adhere to COVID-19 safety guidelines for public meetings. Many transition trainings will continue to be offered virtually to maximize opportunities to engage families unable to attend in person. A hybrid approach of both online and in-person trainings will help address attendance barriers and reach a wider audience.
In addition to focusing on the transition to adult health care, CM contractors and PHR staff will help families prepare for legal changes at age 18 and help youth and their families plan for higher education, vocational training, employment, and independent living. Case managers will meet with youth, young adults, and their families to identify priority transition goals using the family need assessment tool and develop an individual service plan. FSCR contractors will also work to increase the number of adolescents, both with and without special health care needs, to develop skills to prepare for transition to adulthood.
CSHCN SDG requires contractors to offer two transition workshops each fiscal year to help youth develop knowledge and skills to transition to adulthood. One workshop must focus on health care transition planning or building health care self-management skills. The other workshop may include broader transition-related topics such as higher education, vocational and employment skills, and independent living. Contractors will offer all youth ages 12 to 21, and their families, the opportunity to attend both workshops.
The annual Baylor College of Medicine’s Chronic Illness and Disability Conference: Transition from Pediatric to Adult-based Care will be held virtually in October 2021. CSHCN SDG staff will participate on the conference advisory board planning committee and attend the conference. The national conference brings together young adults, parents, physicians, and other health care professionals to learn from national thought leaders about how to better facilitate the successful transition from pediatric to adult-based care.
CSHCN SDG staff, together with Texas Parent to Parent (TxP2P), the Texas Center for Disability Studies, and Title V colleagues in Minnesota, New Mexico, North Carolina, and Wisconsin will continue to partner on a grass roots initiative to advance health care transition planning in schools. Federal and state legislation requires schools to address transition services in the Individual Education Plan (IEP) together with students and parents. With families already engaged in the process, including “health” in the IEP is a natural fit. Good health is the foundation for success in all other areas of transition - higher education, employment, and independent living. In FY22, the multi-state collaborative will continue to exchange resources and further develop outreach strategies to engage families, teachers, transition specialists, and school nurses to advance health care transition planning in school. Got Transition is a key collaborator in this effort and will offer guidance and expertise.
Texas Health Steps’ web-based, self-paced provider training modules offer free continuing education credits for primary care providers and other health professionals. The courses offer information on Texas Medicaid and provide guidance on clinical, legal, regulatory, and practice management issues. CSHCN SDG will continue to provide subject matter expertise for updates to Texas Health Steps modules that address transition to adulthood. CSHCN SDG will also promote the transition-related modules through the Transition to Adulthood Learning Collaborative and other forums.
The Adolescent Health Learning Collaborative, led by the state adolescent health coordinator, meets quarterly to bring together youth-serving professionals to share program updates, new resources, learning opportunities, and strengthen partnerships. In FY22, CSHCN SDG will attend group meetings, contribute resources, and identify collaborative opportunities to improve the health of youth and young adults.
SPM 1: Percent of CYSHCN and their families who received the supports and services necessary to be included in their communities.
The Americans with Disabilities Act (ADA), signed into law in 1990, conveys America’s commitment to ensuring that people with disabilities are fully integrated and included in all aspects of daily life. All families and children benefit from a sense of belonging in their communities. For CYSHCN, inclusion provides equal access to community activities and offers benefits of friendships, peer models, and teaching others to accept differences.
CSHCN SDG surveyed certified community health workers (CHWs) in Texas to identify gaps in knowledge regarding services and supports available to families of CYSHCN. Results showed that CHWs were not informed on the unique needs and challenges of CYSHCN families, or available resources to support them. In response, CSHCN SDG developed an introductory training module to expand the capacity of CHWs in Texas to assist families of CYSHCN. This free, online training will continue to be promoted, evaluated, and updated as appropriate in FY22. CSHCN SDG will continue to survey CHWs to assess their knowledge, interests, and educational needs in working with families of CYSHCN. If indicated, CSHCN SDG will create additional learning opportunities for CHWs in Texas.
In FY22, CSHCN SDG will continue leading a nutrition initiative, which joins efforts across the life course by breaking down program silos and promoting healthy eating behaviors across domains. This initiative aims to integrate best practice principles and family voices in the project. To accomplish this mission, the team created a series of presentations incorporating caregiver, adolescent, and individual nutrition and healthy eating strategies, including ones specific to CYSHCN.
CSHCN SDG will establish a new Family Engagement Learning Collaborative (FELC) in FY22 to ensure the family voice is central to programmatic direction and policy decisions. The FELC will give families a forum to have meaningful opportunities to impact program policies, procedures, and initiatives while learning about quality improvement and public health work. The FELC will initially focus on families of CYSHCN and young adults with disabilities. The intention is to expand the initiative to include all Title V population domains in the future. The FELC will be a platform for exchanging resource information, education, and raising awareness of programs and services.
CSHCN SDG will continue to fund community-based organizations to implement respite programs and host community activities for families and CYSHCN in FY22. These activities aim to strengthen community connections and reduce barriers to inclusion for CYSHCN and their families. Specific services available to CYSHCN and their families vary by contractor and community needs.
The FSCR contractors provide home- and center-based respite to give parents and caregivers a break from daily responsibilities and stressors. Some center-based respite contractors employ nurses making it possible for children with medical complexity to participate.
The FSCR contractors will continue hosting family and sibling support groups, social and recreational activities such as a sensory-friendly movie night, and other local events to strengthen family bonds and advance community inclusion. To expand opportunities for CYSHCN to build friendships with their peers without disabilities, contractors will offer camps throughout the year and provide scholarship funds when able, so more children can participate.
The CM contractors and DSHS regional staff assist families with accessing needed resources including insurance coverage, health care, specialized therapies, durable medical equipment, counseling, behavior specialists, respite, and long-term services and supports. These efforts, along with linking families to critical resources to meet basic needs such as food, housing, clothing, and transportation, will continue in the FY22. Helping to ensure CYSHCN remain living at home with their families is a CSHCN SDG priority.
Case management staff will assist school-age CYSHCN by helping parents prepare for IEP meetings. When requested by families, case managers will attend IEP meetings to support CYSHCN with accessing the general education curriculum and other school-based services. Meaningful inclusion at school offers all students opportunities to learn from each other, be more accepting of differences, and build lasting friendships.
COVID-19 amplified the financial hardships many families of CYSHCN experience. Parents may have lost jobs or experienced reduced work hours, leaving many struggling to meet basic needs. In response, CSHCN SDG allocated additional FY22 funding for CM and FSCR contractors to give financial help to families. The funds may be used for food, clothing, utilities, furniture, transportation, phone, laundry, supplies for the home, medical supplies, medical equipment, and other basic needs. Contractors are responsible for developing internal policies and procedures to identify and prioritize families in their area and ensure that funds are distributed to families within the 12-month timeframe.
In FY22, the Title V CSHCN director and program staff will continue to represent MCH Title V as voting members of the TCDD, which strongly advocates for the full, meaningful inclusion of individuals with disabilities in their communities. In FY22, staff will continue to participate on the TCDD Project Development Committee. The TCDD Project Development Committee provides expertise and recommendations on the grants the council funds throughout Texas. The grants address a variety of needs and areas of focus— including competitive employment, education, health and fitness, positive behavioral interventions and supports, local advocacy networks, leadership training, strengthening communities, and cultural competence and sensitivity. CSHCN SDG staff will also participate in discussions regarding the implementation of the TCDD FY22- FY26 state plan.
The Title V CSHCN director will represent DSHS on the federally mandated Texas Early Learning Council (TELC) in FY22. The goal of the TELC is to improve the quality of and access to early childhood services throughout Texas. The TELC is comprised of cross-sector stakeholders who work to increase coordination and collaboration among state agencies and local entities. TELC will continue to assess the impact of COVID-19 on Texas’ early childhood services and identify solutions.
CSHCN SDG will continue to collaborate with statewide partners to plan an online series about inclusive care for children with intellectual and developmental disabilities. The purpose of the Child Care Inclusion Workshop Series is to increase knowledge, resources, and understanding for child care providers and other professionals working with CYSHCN and their families in a child care setting. Once a week for eight weeks, participants will take an online training module and attend a live webinar developed and presented by faculty, state, and local service providers, experienced child care providers, and parent advocates.
The Policy Council for Children and Families (PCCF), a legislatively mandated statewide workgroup, strives to improve the coordination, quality, efficiency, and outcomes of services provided to children with disabilities and their families through the state’s health, education, and human services systems. PCCF formulates and submits recommendations on system improvements to the executive commissioner of HHSC and the Texas Legislature. In FY22, CSHCN SDG staff will represent DSHS as an ex-officio member to the council and provide subject matter expertise on transition to adult health care, medical home, and community inclusion.
Community Resource Coordination Groups (CRCGs) are county-based interagency groups comprised of public and private agencies that convene voluntarily and play a vital role in helping CYSHCN with complex needs, which cannot be met by a single agency. In FY22, CSHCN SDG staff will remain active on the CRCG Statewide Workgroup which serves as the point of contact for local CRCGs to report concerns and focuses on assuring access to needed supports for youth at risk of or experiencing a crisis. In FY21, three sub-committees merged into one to better align with the strategic plan. CSHCN SDG staff will serve on this newly formed sub-committee. Both CSHCN SDG CM and FSCR contractors will support their local CRCGs by attending staffing meetings and sharing critical resources to help keep children at home in FY22.
The Texas Respite Advisory Committee, established by the Texas Legislature, assists HHSC to:
- Develop strategies to reduce barriers to accessing respite.
- Improve the quality of respite services.
- Provide training, education, and support to family caregivers.
In FY22, CSHCN SDG will support the TRAC by attending meetings and monitoring statewide respite initiatives to identify opportunities to improve access for families of CYSHCN to quality, affordable respite services.
Outdoor Learning Environments Texas (OLE! Texas) is a statewide initiative that seeks to address obesity by improving outdoor spaces at child care centers. CSHCN SDG will continue to support OLE! Texas in FY22 by serving on the leadership committee. OLE! Texas will convene and support local coalitions to assist early childhood education centers with the process of developing and constructing a high-quality outdoor learning environment. The OLE! Texas leadership committee will also develop a network of trained landscape and design professionals to design outdoor spaces featuring best practices.
The Texas Developmental Screening Workgroup (DSW) is a group of stakeholders who collaborate on increasing developmental screenings and enhancing quality service referral mechanisms statewide. CSHCN SDG will continue to participate in bimonthly workgroup meetings. In FY22, workgroup members will participate in the identification of relevant initiatives to partner with, dissemination of screening resources to providers and families, and generation of standard language and definitions across sectors and applicable data sets where possible. In FY21, the DSW began exploring opportunities for creating a statewide hub to house developmental screening data that would provide a means for sharing screening results across community settings. The DSW will continue exploration of this effort in FY22 through identification of potential platforms and generating recommendations for implementation.
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