Last year, Texas Children’s Health Plan celebrated the fifth anniversary of The Center for Children and Women. With two locations, the center has prospered and continues to provide high-quality community-based primary health care. Learn more by visiting our 2018 virtual Annual Report.
On April 2, in celebration of World Autism Awareness Day, representatives from BBVA Compass Stadium, KultureCity and Texas Children’s Health Plan unveiled the Texas Children’s Health Plan Family Suite at a ribbon-cutting ceremony at the stadium.
Located in the northeast corner of the stadium outside of Section 220, the Texas Children’s Health Plan Family Suite includes a Sensory Room and a Mothers Room, making BBVA Compass Stadium the first sensory-inclusive facility in Major League Soccer. The Sensory Room was designed and installed in cooperation with KultureCity and Mothers Room at the BBVA Compass Stadium. KultureCity is the nation’s leading nonprofit dedicated to fight for inclusion and acceptance of all individuals, and advocates for those with sensory challenges such as autism and PTSD, just to name a few. It also provides training and equipment to public and private spaces in order to create an inclusive experience for everyone.
“KultureCity is truly honored to work with BBVA Compass Stadium and the Houston Dynamo to make them the first KultureCity Sensory-Inclusive MLS stadium. By recognizing this growing need and wanting to do something about it, they are truly putting their fans and guests first so that everyone regardless of their disabilities or sensory needs can be accepted and included,” said KultureCity co-founder Julian Maha, M.D. “This is a great day for the City of Houston and a great day for Major League Soccer in general. Thank you to the amazing team at the stadium and the entire Dynamo and Dash organization.”
The Mothers Room provides private space for mothers to nurse or pump while at the stadium and features seating for parent and child, as well as power outlets, a changing station and a television so mothers and children won’t miss a moment of game action.
In addition to the sensory room itself, the stadium will provide sensory bags created by KultureCity to guests who visit the space, and BBVA Compass Stadium and Houston Dynamo and Dash employees participated in sensory awareness training in order to understand how best to serve fans with unique needs and concerns.
“We take great pride in creating the most welcoming and inclusive atmosphere possible for all events at BBVA Compass Stadium, and we’re extremely excited about the addition of the Texas Children’s Health Plan Family Suite,” said Stadium Executive Vice President and General Manager Juan Rodriguez. “The Mothers Room will provide a private and comfortable space for women to care for their young children, and the Sensory Room affords fans with sensory needs the opportunity to step away if the sights and sounds inside the stadium become too much for them. We’re very grateful to the experts at KultureCity for their assistance in creating the space and training our staff.”
Since 2011, Texas Children’s Health Plan has been the official health insurance plan for Medicaid and the Children’s Health Insurance Program (CHIP) of the Houston Dynamo, Houston Dash and BBVA Compass Stadium. In addition to the new Texas Children’s Health Plan Family Suite, the health plan also sponsors the Texas Children’s Health Plan Family Section, located in Section 201 on the southwest corner of the stadium.
“We are proud to be a sponsor of the Houston Dynamo and are very excited to be part of the new Sensory Room and Mother’s Room at BBVA Compass Stadium,” Vice-President of Texas Children’s Health Plan Sherry Vetter said. “This innovative space is consistent with our mission to create a healthier future for children and women throughout our global community. The dedicated Mother’s Room gives nursing moms a private place to care for their infants while staying connected to the match and the Sensory Room provides a sensory-sensitive space for parents and children to enjoy and engage in matches on their terms.”
Patients along with their family members and even neighbors had the opportunity to enjoy Spring Break at an event hosted by The Center for Children and Women that included tons of family fun open to the community. The Center invited families to take part in over-the-top entertainment all while picking up a few health and wellness tips to get kids through the remainder of the school year.
The Center introduced this event about 5 years ago targeting physical fitness strategies and goals for children. This year they decided to bring this family affair back for Nutrition month.
“We have a lot of tips on nutrition, some on healthy snack options, along with resources that perhaps they would not have known about if they had not attended this event,” Marketing Manager at Texas Children’s Health Plan, Veronica Arzayus said. “We also welcome the opportunity for the community to see the Center and all the wonderful services that it offers while enjoying the festivities. This is definitely something that you would want to take your kids to in a safe and comfortable environment.”
This two-weekday event was held last week at The Center’s Greenspoint location on Wednesday and at the Southwest location on Friday. Despite unexpected rain and thunderstorms on the first day, according to The Health Plan, over 500 attendees flooded The Center as activities were brought inside.
Events such as this are important as one of our system-wide operational goals focuses on childhood obesity. The goal is to help prevent diabetes, high blood pressure, and high cholesterol in children, and promote a healthier lifestyle overall.
“It is important to shine a positive spotlight on healthy nutrition, activity, exercise, etc., all while engaging with the community in a meaningful way,” Vice President of Texas Children’s Health Plan, Tangula Taylor said. “I think that’s part of us giving back, helping, assisting, partnering with our community, the families that we serve to share healthy lifestyle options and alternatives that can have an impact on their overall quality of life.”
Along with providing educational material on nutrition, thanks to the corporate sponsors of the event, The Houston Food Bank, the Houston Dynamo, corporate partners, The Children’s Museum of Houston and Boys and Girls Clubs of Greater Houston, and community partner Kids Meals, there were also food and activities for the entire family to encourage exercise and healthy eating habits.
Other activities included, mini Zumba lessons, music and fun performances with a live DJ, face painting, an inflatable obstacle course hula hoop/ jump rope competitions, and a healthy snack tasting challenge.
With a total of over 800 participants for both days this year, The Center is excited to see this event continue annually.
“I’d like to see it grow. When you have an event such as this, you want it to be successful in terms of the number of participants, target audience, and then, once it’s successful, you want it to grow,” Taylor said. “We want to connect with more families, tell them about the Health Plan and the Center and ultimately be a partner for them along their health and wellness journey.”
When opportunities arise, Texas Children’s Emergency Management plans functional active shooter exercises on our campuses. Thanks to the leadership and staff of the Texas Children’s Health Plan, or the first time on February 27, the exercise was geared toward those who work in an office environment rather than a clinical space.
The purpose of these exercises is to test Texas Children’s emergency notification procedures, staff training for response to an active shooter (Run, Hide, Fight), and to give our law enforcement partners a chance to practice their tactical response to an active shooter. Holding this training in an administrative rather than a clinical setting provided an excellent opportunity to test the “Run, Hide, Fight” training and a different environment.
The most important aspect of the exercise is the difference in an administrative setting versus a healthcare setting. Hospitals have multiple patient rooms and storage rooms for other medical purposes, whereas, in most office buildings there are large open areas that have cubicles. When the staff practice the “Run, Hide, Fight” method, most people’s first thought is to hide under a cubicle desk.
“That is not the safest place during an active shooter situation,” manager of Texas Children’s Emergency Management Aaron Freedkin said. “They need to find another place, either leave the floor or find a room that they can lock or block the door with furniture. That’s preferable to just hiding under a desk.”
The exercise included 175 participants, 14 logistical volunteers, 32 observers and 48 law enforcement officers such as: UT Police, Bellaire Police, Houston Police Department, Precinct 5 Constables Office, and Pasadena Police Department SWAT. Having multiple agencies involved in simulating an active shooter incident response creates an environment that is as realistic as possible and allows law enforcement agencies to practice their skills in a new environment. A secondary benefit is having the opportunity to train in the office setting, which would be valuable in the event of a real active shooter incident. It is a chance for them to train together with other agencies and get exposed to different training aspects that ultimately have the same basic goals and mission.
“We are excited to partner with these law enforcement agencies,” Freedkin said. “They get many opportunities to practice in empty buildings with law enforcement participants. This exercise will give them all a chance to practice their building clearing and searches with the unpredictability of non-law enforcement officers playing the role of victims and so there is definitely something in it for everyone participating.”
After the participants arrived, they were put through a safety briefing with Texas Children’s Hospital Emergency Management, followed by further orientation with The University of Texas Police Department, and “Run, Hide, Fight” training provided by Texas Children’s Security. During these exercises blank ammunition was used to simulate gunfire to increase realism while maintaining safety.
Law enforcement was staged on the 13th floor and the exercise began as they proceeded down the stairwell. Meanwhile, there is a person on the 12th floor acting as the aggressor toward employees. The challenge then comes as the aggressor engages in a discussion with the employee that may result in them not thinking immediately about, “Run, Hide, Fight.” After the exercise is reset and begins a second time, there is quicker movement of people because they have had time to immediately think about it and learn from their initial mistakes.
“It is always interesting to observe an exercise such as this because people react in unexpected ways such as seeking shelter and protection in places that are not ideal,” Freedkin said. “That is one of the reasons we conduct this training so that people have an opportunity in advance to consider their training and what their reaction should be.”
There were three sessions and all were structured the same way. Between the first evolution and second evolution of each session, a portion of the scenario changed. A debrief discussion was later held and everyone was able to reflect on their reactions.
“The exercise went extremely well and was well received by the exercise participants and senior leadership who were present,” Freedkin said. “For future exercises, we are working with our law enforcement partners to add additional elements of realism to the exercise while still maintaining the safety of our participants.”
The Emergency Management Team looks forward to providing more trainings geared toward the administration staff throughout the system, and wants people to know if an opportunity comes up to participate in an active shooter exercise like this, staff should take advantage of it. The more realistic your training experience the better you’re going to react in an actual incident.
For Jarred Bolt, receiving a job offer near the end of his internship with Project Search at Texas Children’s Health Plan (TCHP) was as unexpected as it was exciting.
“When I received the great news from my job coach, I said, ‘This is impossible! How am I hired?’ And everyone cheered,” said Bolt, who’s now a claims and transactions entry clerk with the Health Plan.
Project Search, the program that brought Bolt and the Health Plan together, was launched in 1996 out of Cincinnati Children’s mission to help people with disabilities find employment opportunities. TCHP partners with Houston Independent School District (HISD) and the Texas Workforce Commission to place students with intellectual developmental disorders and other diagnoses in Project Search internships at the Health Plan. The program is in its third year at TCHP, and Bolt is their first internal hire.
“Jarred is just very personable,” said Health Plan Claims Administration Manager Jenni Aguilar. “He always speaks, and he always has a smile on his face. He’s just a good, smart young man, and he is a really good asset for our team.”
Throughout the duration of their year-long internships with Project Search, interns rotate to different departments where they learn various areas of the business, acquire new skills and meet new people. During Bolt’s final rotation, the Claims team started a big project that required all hands on deck. Although Bolt was interning in another department, the Project Search coaches suggested he be placed on the Claims project.
Bolt was a natural. He sped through data entries, and his work helped the team to push the project across the finish line. His dedication and willingness to step up caught the eye of Health Plan leaders, and he officially started as a full-time Claims employee in August.
For many of the interns, the skills they learn through Project Search are brand new. And typically by the end of the internships, they are able to apply their newly learned skills – like computer literacy and business etiquette – in future positions.
“You just have to give them a chance,” Aguilar said. “These kids are really smart. They may sometimes communicate a little bit differently or handle things a little bit differently, but that’s what makes them unique.”
Bolt rides the Metro to work, he clocks in by 7 a.m., and he promptly starts checking off tasks. He prizes punctuality and pitching in where needed. Some of the skills he’s learned, in addition to vast computer know-how, include mailing handouts, distributing mail and scanning forms.
“The Project Search partnership is a strong example of one of the many ways Texas Children’s invests in building healthy communities,” said Dr. Heidi Schwarzwald, chief medical officer of pediatrics at Texas Children’s Health Plan.
To qualify as interns with Project Search, students must be 18 to 22 years old and meet certain requirements, such as having a high school diploma or GED. At the Health Plan, in addition to their internship rotations, they take classes from an HISD teacher once a week. The application process gets competitive, as there are only 10 spots available, but the Health Plan hopes to eventually increase capacity.
“This is a program that could successfully expand across the system, and I’d be happy to talk to anyone who would want to be an advocate for seeing it through,” Schwarzwald said. “The more all of us at Texas Children’s get involved in programs like Project Search, the greater the influence we can have on helping differently abled people thrive.”
The Centers for Children and Women at Texas Children’s recently received community pharmacy practice accreditation from the Center for Pharmacy Practice Accreditation (CPPA). This accreditation demonstrates Texas Children’s ongoing commitment to high quality care and patient safety.
With approximately 33,000 community pharmacies located across the United States, The Centers in Greenspoint and Southwest are the first in Texas to gain this esteemed accreditation.
“Gaining this voluntary accreditation is an important way for us to show our investment in continuous improvement of our pharmacy practice,” said Yen Phan, pharmacy manager at The Centers for Children and Women. “Our team worked very hard to meet the rigorous CPPA requirements for accreditation, and we will continue to focus our efforts on providing exceptional patient-centered care.”
The CPPA, a non-profit organization, recognizes pharmacy practices that foster medication safety and effectiveness, ensure continuous quality improvement and facilitate desired patient health outcomes.
The Centers at Greenspoint and Southwest implemented several initiatives to meet the CPPA standards for community pharmacy accreditation including creating a Quality Committee that provides an organized forum to review quality metrics and develop solutions to prevent potential medication errors. The Quality Committee also assessed overall performance and identified areas in need of quality improvement.
“The surveyors were very impressed with our best practices and model of care,” Phan said. “Our hope is that our best practices can serve as a benchmark for other community pharmacies to replicate.”
Amerigroup currently insures 9,500 past and present Texas Children’s patients under Amerigroup STAR, Amerigroup STAR Plus, Amerigroup STAR Kids, or Amerigroup Children’s Health Insurance Program (CHIP) plan.
To make sure these patients receive uninterrupted access to care at Texas Children’s, we are recommending they change their coverage to a health plan that Texas Children’s is in-network with. As an eligible STAR, STAR Plus, STAR Kids, or CHIP plan member, they have a choice in the plan they select for coverage. They also have the right to change plans.
“We have been treating these patients out-of-network for the past five years hoping Amerigroup would work with us to either become an in-network provider or educate their customers about the options available to them,” said Kabby Thompson, director of managed care contracting. “It is clear that’s not going to happen. We feel it is in our patients’ best interest to educate them about the plans we are in network with and to help them transition into an in-network plan if that’s how they want to move forward.”
A similar plan of action worked well last November when Texas Children’s became an out of network provider to 6,000 Molina members. More than half have switched to an in-network plan.
A letter has been sent to patient families who have been a Texas Children’s patient within the past year and whose records say they are covered by Amerigroup. Depending on your role at Texas Children’s, you could receive questions from patient families and others about this change. Below is information to help you answer those questions and to places to direct people if you cannot.
“We appreciate your help in getting these patients and families the help they need,” Thompson said. “Their health care is important to us.”
Click here to access the information below and more.
How can Amerigroup patients and families change their health plans?
For Amerigroup STAR, Amerigroup STAR Kids and Amerigroup STAR Plus members: The Texas Medicaid program allows people to change their or their child’s health plan.
- Patients and their families can learn more by calling the Texas STAR Program Helpline at 1-800-964-2777.
- Patients and families can request to change their health plan at any time for any reason. If they call to change their health plan on or before the 15th of the month, the change will take place on the first day of the next month.
- If they call after the 15th of the month, the change will take place the first day of the second month after that. For example:
- If they call on or before October 15, their change will take place on November 1.
- If they call after October 15, their change will take place on December 1.
For Amerigroup CHIP members: The Texas Medicaid program allows patients and their families to change their or their child’s health plan.
- Patients and families can learn more by calling CHIP toll-free at 1-800-647-6558.
- During the first 90 days after they or their child are enrolled in a health plan, they can change to another plan once for any reason.
- If they show good cause, they can also change health plans at any time. An example of “good cause” is when they or their child can’t get the care you need through the health plan. An inadequate network or a change in the network status of their treating provider is also considered “good cause.”
- They can also change health plans during the annual CHIP reenrollment period.
The Texas Medicaid program allows patients and families to change their or their child’s health plan every 30 days. They can learn more about how to do this and begin to make the change by calling the Texas STAR Program Helpline at 1-800-964-2777 (STAR or STAR Plus) or CHIP toll-free at 1-800-647-6558.
Questions patients and families might have about care at Texas Children’s:
As an out of network member, will patients still be able to receive care at Texas Children’s Hospital?
Rescheduling: In cases where Amerigroup has not responded to requests for both out-of-network authorizations and Single Case Agreements before the scheduled visit, Texas Children’s will contact patients/their families before their scheduled visit to reschedule once Amerigroup has responded.
Emergency Medical Care: Amerigroup advises that you go to an in-network provider for emergency care. Texas Children’s Hospital will treat children in the event they have an emergency. If a child is seen in the Emergency Center for emergency care, the medical team will work with the patient and their family to decide how to provide care after the doctor’s medical evaluation. Amerigroup will help find follow up care with a provider who is in network.
Urgent Medical Care: In order to receive urgent care at a Texas Children’s Urgent Care location, Amerigroup must approve an out-of-network authorization. This could be difficult because of the urgent nature of a patient’s condition and the time it takes to get an authorization. Amerigroup may also redirect care to another in-network provider.
Routine Care: In most cases, Amerigroup will require patients and their families to receive routine or urgent care from a network provider. In order to receive care at Texas Children’s, Amerigroup must approve an out-of-network. Amerigroup may also redirect care to another in-network provider.
Who should I contact if I have further questions?
If you want to learn more about changing your or your child’s health plan, you can call the Texas STAR Program Helpline at 1-800-964-2777 or CHIP toll-free at 1-800-647-6558.
If you have questions for Amerigroup, you may call their Member Services department toll-free at 1-800-964-2777. If you are not satisfied with the response from Amerigroup, you can contact the Texas Health and Human Services Commission (HHSC) by calling toll-free 1-866-566-8989.
If you have questions for Texas Children’s Hospital or Texas Children’s Physician Services Organization, you may call us at 832-824-1000 Monday through Friday from 8 a.m. to 5 p.m. Central time. Texas Children’s Pediatrics can be reached at 832-824-2999.
What Medicaid Health Plans is Texas Children’s in-network with?
Texas Children’s Hospital and Texas Children’s Physician Service Organization are in-network with the following Medicaid Health Plans
Texas Children’s Pediatrics is in-network with the following Medicaid Health Plans