Medical Homes in Texas
This page is designed to keep you informed about events and activities happening in Texas that will help improve access to medical homes for children with special health care needs (CSHCN).

Medical Home Initiatives
This section provides information on state medical home initiatives/programs. States that are a part of the mentorship network will have a "Promise to the State" which outlines how they will achieve ensuring that all children have a medical home by 2010. This is based on the Healthy People 2010 goals which is a 10 year action plan to achieve and measure success for all CSHCN.

Texas Medical Home Team Contact:

Name: Lesa Walker, MD
Contact: Phone: 512/458-7111 ext. 2567 | Email: Lesa.Walker@dshs.state.tx.us
State Team Roster available at: www.medicalhomeinfo.org/model/downloads/State Teams/Texas Medical Home Team.doc

Texas is participating in the National Initiative for Child Health Quality (NICHQ) Medical Home Learning Collaborative - (October 2004 - September 2005)
The Medical Home Learning Collaborative is a 15-month project committed to helping primary care practices become accessible, family-centered, and provide care that is continuous, comprehensive, coordinated, compassionate, and culturally effective. A particular emphasis is placed on care coordination and family involvement in decision-making for children with special health care needs (CSHCN).

Texas Department of State Health Services
The Children with Special Health Care Needs (CSHCN) Services Program of the Texas Department of State Health Services recently published a bilingual booklet titled, “Emergency & Disaster Planning for Children with Special Health Care Needs".  Click here to download the booklet.

The booklet contains a bilingual Emergency Information Form for Children with Special Needs. The form was developed by the American Academy of Pediatrics and adapted by DSHS. The Emergency Information Form can also be downloaded for free from http://www.dshs.state.tx.us/cshcn/Newspage.shtm

Family-Centered Care Champions Incentive Grant
Goal: To organize a Parent Group Network designed to promote family-centered care by providing information and support to parent groups at the local level. This includes the identification, production and dissemination of family-centered and practical tools/methods for families to use in order to build partnerships with health care providers that promote both family centered care and effective medical coordination within the medical home.
For more information contact: Laura J. Warren, Executive Director
Phone: (512) 458-8600 | Email: laura@txp2p.org


Healthy Tommorrows Program for Children Grant 2002-2007
Montwood Wellness Center
Texas Tech University Health Science Center Department of Pediatrics - El Paso, TX
The mission of the Montwood Wellness Center is to improve the health and quality of life within the community by integrating the education system, the health care system, and community groups to provide comprehensive care with dignity and respect. The project provides comprehensive pediatric care for children in the Socorro Independent School District area, a community with 38.6% of the population at or below the federal poverty level. This collaboration between Texas Tech University Health Science Center Department of Pediatrics and Socorro Independent School District establishes a medical home for children who face many barriers to access health care.

Program goals include: establish a medical home for children who have no primary care provider; increase and enhance each student's academic potential through health maintenance and education; create a new system of community support individuals that will work as a link between individual homes, parents, families, and the wellness center; and develop continuous evaluation, feedback, and research based on the results of the program.

Healthy Tommorrows Program for Children Grant 2005-2010
Behavioral Developmental Primary Care Program
People’s Community Clinic, Austin, TX

Program goals include: provide an improved system of behavioral/mental health/developmental screening, assessment, and care coordination for school- aged (3-19) patients and to offer an improved, formalized resource to the larger Central Texas community by providing diagnostic assessments, case coordination, and a medical home to youth and families referred specifically to the program by schools, youth serving agencies, and individuals because of behavioral/developmental/mental health concerns. Click here for more information on this project. www.medicalhomeinfo.org/states/Downloads/TX HealthyTom Grant.doc for more information on this project.

For more information on the Healthy Tomorrows Grant Program go to: www.aap.org/commpeds/htpcp/index.html For more information on HTPCP projects, please e-mail your name, address, telephone, and fax numbers with your specific request to healthyt@aap.org.

Related Grant Initiatives
This section provides information on current state grants that are working on medical home initiatives. This includes the grant abstract as well as key contacts for the grant.

Genetics MCHB Grant
Purpose: This cooperative agreement provides for a National Newborn Screening and Genetics Resource Center (NNSGRC) to: (1) provide a forum for interactions between the Genetic Services Branch (GSB) and others regarding policy initiatives and emerging issues in newborn screening (NBS) and genetics by enhancing timely, interactive communication and information sharing with key stakeholders (including community leaders, policy makers, consumers, health care professionals, government officials, and researchers); (2) provide consultation and technical assistance to GSB grantees and state and territory public health agencies in their NBS and genetics activities (including integrating genetic services into public health programs at the community level) through expert technical assistance teams and to provide consultative services on developing and implementing integrated data management for newborn and child health information; (3) implement a dissemination and education strategy for providing educational opportunities in NBS and genetics, particularly for the public health community; (4) standardize, maintain, and analyze quantitative information to monitor and evaluate the impact of State and Territory NBS programs; (5) support unique projects that translate genetic technological advances into public health practice; and (6) support activities to strengthen genetics planning at the State and local levels, including coordination of regional genetics networks information sharing and working with the Coalition of State Genetics Coordinators (CSGC).

Hemophilia MCHB Grant
Purpose: The purpose of this project is to provide comprehensive care to any individual with a congenital bleeding disorder in the states of Arkansas, Louisiana, Oklahoma and Texas. This area is designated as Hemophilia Region VI by MCHB.

Partners in the State
This section provides information on who in the state (individuals and agencies) are working together to create medical homes for children.

American Academy of Pediatrics (AAP) Chapter:www.txpeds.org/
The Texas Pediatric Society, the Texas Chapter of the American Academy of Pediatrics, is a state professional nonprofit organization of 2,800 Texas pediatricians and 600 medical students. The goal of the Society is that all children in the State attain their full potential for physical, emotional, and social health.

American Academy of Family Physicians (AAFP) Chapter: www.tafp.org/
The Texas Academy of Family Physicians is a medical specialty organization dedicated to the delivery of quality health care made up of ten local chapters in the state.

Title V Children with Special Health Care Needs Program Information and Overview: www.dshs.state.tx.us/cshcn/default.shtm | CSHCN Inquiry Line: 1-800-252-8023

Title V Block Grant to States
Title V of the Social Security Act is one of the largest Federal block grant programs. It leads the nation in ensuring the health of all mothers, infants, children, adolescents, and children with special health care needs (CSHCN). Title V is administered by the Maternal and Child Health Bureau (MCHB) as part of the Health Resources and Services Administration, U.S. Department of Health and Human Services.

Title V and Children with Special Health Care Needs
MCHB Objective: Support development and implementation of comprehensive, culturally competent, coordinated systems of care for the estimated 18 million U.S. children who have or are at risk for chronic physical, developmental, behavioral or emotional conditions and who also require health and related services of a type or amount beyond that required by children generally

Early Hearing Detection & Intervention (EHDI) Contact(s):
State EHDI programs promote universal newborn hearing screening, develop effective tracking and follow-up as a part of the public health system, promote appropriate and timely diagnosis of the hearing loss, prompt enrollment in appropriate Early Intervention, ensure a medical home for all newborns and
strive to eliminate geographic and financial barriers to service access.

Name: Gwen Lewis
Contact: Phone:(512) 458-7111 extension 2600 | Fax: (512) 458-7125
E-mail: gwen.lewis@dshs.state.tx.us

State Genetics Program: http://www.dshs.state.tx.us/genetics/default.shtm

Early Childhood Intervention/Part C Coordinator: Early childhood Intervention (ECI) is a coordinated system of services available in every Texas county for families of children, birth through 2 years, with disabilities and developmental delays. ECI is federally and state funded through the Individuals with Disabilities Education Act (IDEA.) The Division for Early Childhood Intervention Services is a division of the Department of Assistive and Rehabilitative Services.

Name: Mary Beth O'Hanlon, Assistant Commissioner
Contact: Phone: (512) 424-6751 | Fax: (512) 424-6749
Email: MaryBeth.O'Hanlon@dars.state.tx.us
Web Site: www.dars.state.tx.us/ecis

Section 619/Special Education for ages 3-5 Coordinators:
This program provides free appropriate public education (FAPE) for children, ages 3 through 5 years, with disabilities:

Name: Kathy Clayton, 619 Coordinator
Contact: Phone: (512) 463-9414 | Fax: (512) 463-9560 | Email: kclayton@tea.state.tx.us
Web Site: www.tea.state.tx.us/

State Interagency Coordinating Council (ICC) Chairs:
The ICC advises appropriate agencies on the unmet needs in early childhood special education and early intervention programs for children with disabilities, assists in the development and implementation of policies that constitute a statewide system, and assists all appropriate agencies in achieving full participation, coordination, and cooperation for implementation of statewide system.

Name: Peter W. Ellis, ICC Parent Chair
Contact: Phone: (210) 822-7266 | Email: peter.e@sbcglobal.net

Resources/Documents
State Waiver Information: www.cms.hhs.gov/MedicaidStWaivProgDemoPGI/08_WavMap.asp
Waivers are the result of a process that allows state Medicaid agencies to apply for and receive permission from HCFA to provide services not otherwise covered by Medicaid and/or to do so in ways not described by the Social Security Act. Most Medicaid managed care programs require Waivers. The Waivers, which can differ greatly, are known by their numbers (1115, 1119), or as home-and community-based, or as Katie Beckett Waivers.

Educational Initiatives
This section provides information on training initiatives on the medical home. Some states will discuss their outreach projects in relation to physicians, families, and the community.

Texas Parent to Parent will hold their annual statewide conference at the University of Mary Hardin-Baylor in Belton July 22-24, 2005.

Conference flyer and registration information coming soon

Online registration will be available on the Texas Parent to Parent website www.txp2p.org

Screening Initiatives
This section provides information on surveillance and screening initiatives in the state.

Developmental Surveillance and Screening Policy Implementation Project (D-PIP)
Midland Community Healthcre Services from Midland, TX is participating in the Developmental Surveillance and Screening Policy Implementation Project (D-PIP). The D-PIP has selected 17 practices from across the United States to implement the AAP policy statement (scheduled for publication in July 2006) “Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening” to 1) determine if the algorithm is efficiently and effectively implemented into pediatric practice; 2) recognize strategies for implementing the algorithm; and 3) examine outcomes of implementation. Following the project, information and outcomes will be shared with pediatric clinicians and other health care professionals who are seeking to improve the delivery of developmental surveillance and screening.

Additional information on the D-PIP is available at: www.medicalhomeinfo.org/screening/DPIP.html

State Newborn Screening & Genetics Programs: genes-r-us.uthscsa.edu/resources.htm

• State Newborn Screening Program Links
• State Genetics Program Links
• Regional Genetics and Newborn Screening Collaborative Links
• Newborn Screening State Contact Fact Sheet

Family Corner
Family Voices: www.familyvoices.org/st/Tx.htm
Partnering with professionals and families to advocate for health care services that are family-centered, community-based, comprehensive, coordinated and culturally competent.

NAMI of Texas (National Voice on Mental Health): texas.nami.org/
Education, advocacy and support for persons with brain disorders (mental illnesses) and their families

Family Village: www.familyvillage.wisc.edu/index.htmlxx
A global community that integrates information, resources, and communication opportunities on the Internet for persons with cognitive and other disabilities, for their families, and for those that provide them services and support. This site offers informational resources on specific diagnoses, communication connections, adaptive products and technology,adaptive recreational activities, education, worship, health issues, disability-related media and literature, and much, much more!

The Arc of Texas: www.thearcoftexas.org/
The Arc of Texas is the oldest and largest nonprofit, volunteer organization in the state committed to expanding opportunities for people with mental retardation and other developmental disabilities to be included in their communities. The Arc supports families, advances public policies, provides training programs, and builds a statewide network of advocates.

Partners Resource Network: www.partnerstx.org/
PRN is the non-profit agency awarded three PTI Projects which now cover the entire state of Texas. These project operate independently but do share some central administrative functions. All the projects share the common purpose of empowering parents of children and youth with disabilities in their roles as parents, decision makers, and advocates for their children.

Texas Parent to Parent Network: www.main.org/txp2p/
Provides peer support, resource and referral information and advocacy.

State Resources on the Internet: www.medicalhomeinfo.org/states/index.html#res

Note: The information provided on the state pages was submitted by the state medical home teams.As this is not an exhaustive list, please let us know if you have additions for your state resource page. You can contact us at: medical home@aap.org.

http://www.medicalhomeinfo.org/states/state /texas.html

Last Updated May 4, 2007