The percentage of children under age three (including children who turned three) enrolled in Children’s Medicaid (STAR) who were screened for developmental, social, and behavioral delays using a standardized tool in the 12 months before their last birthday. In Texas, these data and other pediatric measures are available statewide and for each of Texas’ thirteen geographic managed care regions thanks to a publicly available database, Texas Healthcare Learning Collaborative. Specifically, Hays and Caldwell County data is included in the data for the 8-county Travis Managed Care Service Area. 

What factors in Hays County are helping children ages 0-3 to access developmental screenings? 

• Getting children insured in Medicaid and CHIP
• Partner support and coordination that occurs within the coalition
• Well-trained providers that are skilled in identification and communicating/coordinating with families - ECI, Early Head Start/Head Start, Texas Home Visiting programs, Hays and San Marcos CISDs, and private pediatric home health providers
• Helping parents to understand the potential and value of early intervention
• Parents are eager to know how their child is developing and if they are on track
• Required more consumer education about the need for screenings (specifically, parents)

What factors in Hays County are preventing children ages 0-3 from accessing developmental screenings?

• Not enough providers accepting Medicaid or CHIP
  • Reimbursement rate is low
  • Not enough medical practices in HC
• Providers may not know where to send parents for referrals
• Former ECI provider was not fully engaged with the coalition
• Process of applying/reapplying for Medicaid is long, complicated, and frustrating
• Teachers and providers are not case managers, when case management is required
• Stigma associated with accessing services through program

• Parents - be knowledgeable, advocate for children
• Childcare provider - provide screenings, refer to intervention, engage with parents
• Medical providers - administer screenings, educate families
• City/County government - champion the efforts to support early development screenings
• Texas State University - train new professionals in the early childhood sector
• Any Baby Can - provide ECI
• School Districts - engage and educate parents
  • EC department, Special Ed. department, Curriculum and Instruction, Parent Liaisons 

The solutions below were determined by partners based on the factors identified during the Story Behind the Curve discussions:

Evidence-Based Practices

• Implement Family Connects (evidence-based practice)
• Help Me Grow
• Continue to operate ECI, THV, EHS and HS (evidence-based practice)
• Healthy Steps
• Bright Futures

Promising Practices

• Engage parents to formalize their knowledge and peer educate
  • Create parent learning exchanges (e.g., dual language and special education)
  • Prepare a cadre of parents who are knowledgeable about the Medicaid/CHIP application process

• To increase the Medicaid/CHIP application rate, train more people through HHS Community Partner Programs
  • Have CPP computer available
  • Have staff trained in HHS-CPP
  • ISD expert in application process

Low cost/No cost solutions

• School nurse promotes awareness about importance of early developmental screenings to all families
• Create a school climate that values and promotes EDS
• Build a community outreach structure that promotes the value of developmental screenings (faith-based businesses, other non-traditional stakeholders)

• Fully engage with the Early Childhood Intervention (ECI) provider Any Baby Can to ensure they are fully integrated with the coalition

• Talk-Sing-Read out of CA

Note: the proposed solution to "operate a school-based clinic" was removed from the above list upon further discussion with coalition partners at the September 13th ECC-HC meeting.

Prioritized Strategy: Build a community development structure that promotes the importance of early developmental screenings, including faith-based networks and business (peer-education piece)

Action Steps:

1. Coaltion leadership will engage with the Texas Prenatal to Three (PN-3) Collaborative: Screenings, Referrals and Home-Based Services Workgroup 

2. Adapt and distribute ABCD Referral Toolkit for local use.  

3. Adapt and distribute Learn the Signs. Act Early. materials; including encouraging use of the Milestone Tracker app. 

4. Apply to become a Help Me Grow Texas community

Prioritized Strategy: Develop and train staffs from stakeholder organizations and schools how to support parents as they apply for Medicaid/CHIP

Action Steps:

1. Educate community groups about HHSC Community Partner Program

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Prioritized Strategy: Provide community-wide universal home visiting to parents of newborns through Family Connects

Action Steps:

1. Coordinate with United Way of Greater Austin to establish refferal sources for families who deliver at Family Connects-particpating hospitals but live in Hays or Caldwell Counties. 

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Prioritized Strategy: Expand evidence-based approach of engaging parents and caregivers in their home environments

Action Steps:

1.  Expand intensive home-visiting services to Caldwell County.

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