FRONTLINE FOR CHILDREN | JULY 2020

CHILD PROTECTION POLICY – NEW AND NOTEWORTHY

Maternal and Child Health Inequities Emerge Even Before Birth (Child Trends)

Highlighting findings from the State of Babies Yearbook: 2020, this brief focuses on the evident disparities in maternal health and birth outcomes among babies and families of color: “To have a healthy pregnancy and positive birth outcomes, women and their infants require access to appropriate health care services, before, during, and after birth.”

TexProtects’ Takeaway:  Black and Indigenous babies have a much higher risk of birth complications, low birthweight, and death within their first year of life in comparison to white babies. To achieve the strongest possible outcomes for all, we must meaningfully address health disparities in our communities, beginning with the earliest days of each child’s life.

Tracking COVID-19’s Effects by Race and Ethnicity (Urban Institute)

To work toward an equitable recovery for all U.S. citizens, policymakers and practitioners should pursue solutions that acknowledge and account for COVID-19’s disparate impact on communities of color. “To design these race-conscious policies, policymakers need data to gauge how the pandemic may be affecting people’s health, housing, and livelihoods. This tool uses the near-real-time Household Pulse Survey data to track a set of measures for US households as the pandemic and recovery unfold.”

TexProtects’ Takeaway: The onset of this health crisis has further exposed how systemic racism is creating harmful disparities between white communities and communities of color. The Texas Health and Human Services Commission (HHSC) is taking the first step and has recently announced that it is seeking to remedy the lack of information about how Black and Latinx/Hispanic communities are affected by the virus. All labs that test for COVID-19 are now required to collect information on race, ethnicity, and other factors.

Start with Equity: From the Early Years to the Early Grades (Bipartisan Policy Center & The Children’s Equity Project at Arizona State University)

“Millions of young children are disproportionately underserved, over-punished, and barred from high-quality education in American schools…. The Children’s Equity Project and the Bipartisan Policy Center have come together to create an actionable policy roadmap for states and the federal government—as well as for candidates at all levels of government vying for office—to take meaningful steps to remedy these inequities in early learning and education systems.”

TexProtects’ Takeaway: More than half of the children in the United States are children of color. COVID-19 is exacerbating the inequitable distribution of opportunity in our education system. This policy agenda supports fully funding programs like Head Start, requiring states to report plans on who they will work to make learning systems more equitable, supporting and funding equitable educator training, and ensuring all education legislation prioritizes racial, ethnic, linguistic, socioeconomic, and ability-based integration.

Health Care Access for Infants and Toddlers in Rural Areas  (Child Trends)

“While many public reports provide indicator data on rural health care access at the national level, this brief uses data from the State of Babies Yearbook: 2020 to examine state-level differences in how infants and toddlers living in rural areas are faring. Equipped with these data, state policymakers can explore strategies to support the needs of very young children and their families.”

TexProtects’ Takeaway:  Only 0.5% of infants and toddlers in Texas who could benefit from evidence-based home visiting (HV) programs are receiving those services. This upcoming legislative session, policymakers in Texas must identify why there are gaps in how existing HV programs serve rural children and families.

As schools reopen, addressing COVID-19-related trauma and mental health issues will take more than mental health services (Child Trends)

To address COVID-19 related trauma and mental health concerns amongst students, Child Trends recommends that decision-makers in education take a comprehensive approach that extends beyond offering school-based mental health services. Such an approach includes (but is not limited to) educating all school staff about trauma and mental health; acknowledging that not every community has experienced the pandemic in the same way; and ensuring that school staff know how to connect students to community-based mental health resources.

TexProtects’ Takeaway: Through the passage of HB 18, the Texas Legislature took a step last session to ensure that all school staff are adequately trained to understand the impact of trauma on students, implement strategies to minimize the negative impacts, and maximize academic opportunities in an environment of safety and connection, making referrals when needed and with parental consent. Policymakers and organizations like TexProtects must hold school districts accountable and ensure that these mandatory trainings are taking place in a timely fashion.

To support infant development, states can encourage parents to read, sing, and tell stories with their children (Child Trends)

“Here’s an easy, evidence-based, and low-cost investment for early childhood leaders and policymakers to promote young children’s development, empower parents, and strengthen families: Encourage parents and other caregivers to read, sing, and tell stories to their children. It’s that simple.”

TexProtects’ Takeaway: Building the caregiver-child bond through singing, reading, and telling stories contributes to strengthening resiliency and encouraging literacy skills and cognitive and socioemotional intelligence in young children.

CHILD PROTECTION RESEARCH – NEW AND NOTEWORTHY

Different brain profiles in children with prenatal alcohol exposure with or without early adverse exposures (Andre, Q., McMorris, C., Kar, P., Ritter, C., Gibbard, B. Tortorelli, C., & Lebel, C.)

“Prenatal alcohol exposure (PAE) has been linked with widespread brain abnormalities including reduced brain volume, altered cortical thickness, and altered white matter connectivity. Fetal alcohol spectrum disorder (FASD), the neurodevelopmental disorder associated with PAE, is the most common cause of preventable developmental disabilities in children… The goal of this study was to determine how PAE in the presence or absence of postnatal adverse exposures is associated with brain structure and mental health symptoms in children.”

TexProtects’ Takeaway: This research contributes to a long line of research on adverse childhood experiences (ACEs) and how they shape the physical and mental brain health of children. TexProtects is working with policymakers on legislation that would create a framework in Texas on how to mitigate and treat ACEs on a statewide level to ensure the health of every child.

Father-child play: A systematic review of its frequency, characteristics and potential impact on children’s development (Amodia-Bidakowska, A., Laverty, C., & Ramchandani, P.)

This paper reflects a systematic literature review of publications in psychological and educational databases (until the year 2018) to “characterize the nature and potential impact of father-child play” for children ages 0-3. Given their findings, the authors suggest that father-child play can substantially benefit children’s development, which “provides a clear imperative for policy makers and practitioners to facilitate and support fathers, as well as mothers, in developing more positive and playful interactions with their infants.”

TexProtects’ Takeaway: Fathers matter! Encouraging strong father-child relationships is part of building protective factors for resiliency in children. This report enforces that early father-infant play is linked to positive social, emotional, and cognitive outcomes.

CHILD PROTECTION IN PRACTICE – NEW AND NOTEWORTHY

African American, American Indian, and Alaska Native children are all more likely to live in grandfamilies – “families in which grandparents, other adult family members or close family friends are raising children with no parents in the home” – than other racial or ethnic groups. The following two reports by Generations United are intended to support child welfare or other government agencies, as well as nonprofits, to better serve the grandfamilies with which they work:

TexProtects’ Takeaway: Children of color are dramatically overrepresented in kinship care both within and without the formal foster care system. Historically, there has been a severe lack of support and services for these families – especially those that are culturally appropriate.

Road to Resilience: Raising Healthy Kids (Mayo Clinic Health System)

“This six-week virtual program will help you and the youth in your life combat the effects of Adverse Childhood Experiences (ACEs). There are a variety of resources in linked pages on this site that you and your youth should review at your own pace. You can read content, watch videos or do activities.”

TexProtects’ Takeaway: Adverse childhood experiences (ACEs) can lead to negative mental and physical health effects later in life. This tool is a great way to help build resiliency against these potential negative outcomes so that ACES do not dictate a child’s future.

Using Media Effectively with Young Children and Virtual Visitation (Youth Law Center & Quality Parenting Initiative)

“While in-person visitation is the best way to support families, it isn’t always possible during this emergency. Now more than ever, it is critically important that birth and foster parents partner together to ensure that children experience continuity of relationships and can maintain contact with the people they love.” This brief shares research and practical suggestions from Dr. Rachel Barr, an expert in media and young children, to help parents navigate and make the best of virtual visitation with their young children.

TexProtects’ Takeaway:  Virtual visitation can be used to maintain and strengthen relationships for young children. Learn how to navigate difficulty holding a child’s attention, problems with eye contact and sharing attention, loss of physical contact, technical problems, and toddler independence.

OP-ED: Healthy Childhoods One of Many Ways to Prevent Violence

This op-ed was published in the Houston Chronicle, Corpus Christi Caller-Times, Longview News-Journal and Alice Echo News-Journal.

By Sophie Phillips, TexProtects CEO

Yet again, more mass shootings have our nation desperately searching for answers to difficult questions. How could they have been prevented? Some question whether prevention is within our reach.

            This question sparks debate around issues such as the proliferation of guns in America, hateful political ideologies, violence in video games and movies, and mental health issues (further stigmatizing it), among many others.

            Negative rhetoric is the matchstick sparking the combustion of destruction and prevents us from finding true solutions, including one I believe we have not brought into the fold: evidence-based prevention and early intervention programs in childhood that support families and build resiliency in children.

            Science tells us there are commonalities behind the violent acts devastating our country beyond those currently debated.

            In an August 4 op-ed in the Los Angeles Times, researchers Jillian Peterson and James Densley of The Violence Project studied every mass shooter in the past 53 years and identified four commonalities, the first of which caught my eye.

            Peterson and Densley wrote, “the vast majority of mass shooters in our study experienced early childhood trauma and exposure to violence at a young age.”

Certainly, neither I nor Peterson and Densley suggest that children who experience severe trauma are destined to become mass shooters or otherwise engage in violent behavior.

However, exposure to multiple, prolonged, severe, and compounded events – including child abuse and neglect, living in a household with intimate partner violence, parental substance abuse, untreated mental health concerns, loss of a parent, bullying and more – have been identified in research as precursors to serious social, mental, and physical health problems later in life such as depression, suicide, substance abuse, and others if left untreated or without effective coping mechanisms.

One might be surprised at the large percentage of children that experience trauma. National research firm Child Trends analyzed data from the 2016 National Survey of Children’s Health and found that while 49% of Texas children have experienced at least one early adversity, 12% (nearly 900,000) experienced three or more, excluding child abuse (but including being a victim of violence), making the likely impact much more severe.

The solutions aren’t necessarily difficult. Research has shown just one loving adult in a child’s life can buffer trauma’s impact.

Additionally, programs and interventions exist that work with families to not only prevent traumas but also mitigate the effects. These include voluntary home visiting programs, high quality childcare, parenting training and support, access to quality healthcare, treatment of mental health and substance abuse concerns, and domestic violence prevention.

            Let me be clear: this is not about labeling children or flagging potential shooters because of early trauma or mental health concerns. 

            Rather, it’s an effort to invest in our most precious generation, when children’s brains experience the most development. Every child deserves to be strong, safe and secure. By investing in prevention, we create a foundation in which children are resilient and have supports in place to build healthy lives.

            The organization I lead – TexProtects, the Texas chapter of Prevent Child Abuse America – worked hard in the most recent Legislative Session educating lawmakers on the detrimental effects of adverse childhood experiences (ACEs). Along with other advocacy partners, we pushed for development of a statewide strategy to prevent and mitigate ACEs impacts by building resiliency in kids. Unfortunately, despite strong House support, the legislation died in the Senate in the final days of session.

            I don’t know what the perfect solution is to preventing violence in our nation – there probably isn’t one, as any individual violent event can be pinned to multiple causes. However, I do know that the earlier we intervene the better, and prevention of early childhood trauma and treatment later in life should be two of many strategies.

            Prevention is absolutely within our means to address and childhood is the earliest point possible.

Sophie Phillips is CEO of TexProtects. TexProtects’ study of Adverse Childhood Experiences is at bit.ly/acesuncovered.

Op-Ed: Mistreatment of migrant children by our government is intolerable

This op-ed was distributed to and published by newspapers statewide in Texas, including the Dallas Morning News, Longview News-Journal and Stephenville Empire-Tribune. Permission to reprint is freely granted under these conditions:

  • The text may not be edited in any way.
  • Authorship must be properly credited.
  • Online reprints must link back to this blog post; paper reprints must mention our websites (texprotects.org and texprotects.blog)
  • It may not be reprinted on any website or other forum that is contrary to TexProtects’ mission of child protection or that promotes illegal activity.

Photo from dallasnews.com

By Sophie Phillips, CEO, TexProtects

In the past 12 months, despite an executive order to end the policy allowing the separation of migrant children from their parents, followed by a judicial order to reunify those families, our government has continued to separate and traumatize children.

One might ask how this tragedy continues to occur – you could be forgiven for thinking both orders would have ended the matter. However, that is not the situation we find ourselves in, and certainly not the situation the 5,700 children in Texas shelters are in.

There were loopholes in the court’s decision: children could still be separated from parents with criminal histories, or considered dangerous to the child, or if they suffered communicable diseases.

All seemingly reasonable stipulations, except that advocacy groups who are face to face with these families are reporting the government is inappropriately exploiting those loopholes – reducing the orders to ineffective words on paper. Examples include children taken away from a parent for violations such as driving with an expired license or experiencing a brief hospitalization. They can also be separated from other relatives such as siblings or grandparents. We would never tolerate such flimsy pretenses for taking away children from U.S. citizens.

This result has been more than 700 immigrant families separated after the policy supposedly ended.

The organization I lead – TexProtects, the Texas chapter of Prevent Child Abuse America – makes no claim to immigration policy expertise. We’ll leave the crafting of immigration solutions to those who do.

Instead, our expertise is in children and policy that impacts them – specifically, how to keep children safe from trauma. And make no mistake – being separated from a parent, regardless of the situation, is itself an extreme trauma.

TexProtects fights tirelessly to make families stronger and more resilient, helping prevent crises that lead to child removal. Putting children in foster care must be the measure of last resort – all options for keeping a child safely with his or her parents must be explored before taking the extreme measure of separation.

We’ve worked to embed this philosophy within our government, gaining lawmakers’ support for prevention programs and strengthening family preservation services.

That’s why the current policy is unthinkable. We are witnessing the government, rather than protecting children from harm, actually inflicting trauma upon children as an instrument of policy.

The trauma goes beyond taking children away from parents, which is painful enough. Recent news reports have exposed children, including toddlers, being warehoused in horrific and dangerously unsanitary conditions.

This will not be a minor event in these children’s lives. During the Texas Legislative Session, TexProtects educated lawmakers across the state on the consequences of “adverse childhood experiences” (ACEs) – severe events such as mental illness, violence or substance use within the home, an incarcerated caregiver, or abuse or neglect.

In our ACEs Uncovered report earlier this year (http://bit.ly/acesuncovered), we outlined long-term consequences that can result from such experiences.

Research has shown that left untreated, people who suffered multiple adverse childhood experiences had, in adulthood, higher rates of disease, disabilities, social and mental health problems including suicides and suicide attempts, depression, a high number of sexual partners, sexually transmitted diseases, obesity, smoking, substance abuse, and early death.

Now, we – through our government – are creating more children who, assuming they survive this ordeal, could grow up with such health consequences.

As said, TexProtects will “stay in our lane” on immigration and refugee policy and refrain from suggesting what actions should be taken.

However, we have a moral imperative to rule out what action should not be taken: willfully traumatizing children absolutely cannot be an option.

Even if the policy produced the president’s desired result of fewer border crossings (it has not, as detentions and migrant deaths have surged again), hurting children would still be unacceptable.

Americans are outraged when parents abuse or neglect children. We must be equally outraged when our government does the same.

How Did Prevention and Early Intervention Fare in the 86th Texas Legislature?

DID YOU KNOW?

  • Four children die from abuse/neglect each week, and 80 percent of victims are 3 years of age and younger.
  • 181 children are confirmed as abused/neglected every day, and the highest rates occur in children under age 5.
  • Evidence-based home visiting programs can reduce child maltreatment by up to 48 percent and have a positive return for each dollar invested.
  • Currently, only 3.5% of families with the highest need have access to proven prevention programs.

Welcome to the second part of our look at how child protection legislation fared in the 86th Texas Legislature. We began this series in May with our top-priority bills. This begins the first of three deeper dives into specific subject areas. This post is about Prevention and Early Intervention legislation; it will be followed by Child Protection Systems and will conclude with Mental Health and Trauma.

For a PDF version of this blog post, click here.

Prevention and Early Intervention Background

The Adverse Childhood Experiences (ACEs) Study – as well as decades of subsequent, validated research – has made clear that the impact of severe childhood adversities, including child maltreatment, is a public health crisis.

In the absence of supportive relationships and environments, chronic and compound ACEs increase the likelihood of negative behavioral, educational, health and economic outcomes. Prevention strategies can reduce the prevalence and impact of ACEs and increase a child’s opportunity for cognitive and emotional development, productivity, health, and economic wellbeing.

Prevention efforts fall across a spectrum that includes:

Primary
Primary prevention focuses on reaching families before the first occurrence of child maltreatment.
Secondary
Secondary prevention focuses on efforts to prevent maltreatment among families considered to be at high risk.
Tertiary
Tertiary prevention focuses on mitigating the negative effects and prevent re-occurance in families where maltreatment has already occurred.

Evidence-based in-home parenting programs (known as home visiting) have proven to be the most effective and efficient model for prevention. These programs connect expectant and new parents who enroll voluntarily with a trained nurse, social worker, or early childhood specialist who promotes health, child development, parenting skills, education, and employment. By intervening to prevent adversity and build resilience during a child’s most critical years of neurodevelopment, in-home parenting programs impact outcomes across multiple domains and generations.

Evidence-based programs currently operating in Texas include AVANCE, Early Head Start, Family Connects, Healthy Families America, Home Instruction Program for Preschool Youngsters, Nurse-Family Partnership, Nurturing Parenting, Parents as Teachers, SafeCare, Systematic Training for Effective Parenting, and Triple P- Positive Parenting Program.

While some communities have been able to initiate programs with private and/or local funds, most in-home parenting programs implemented in Texas are funded through the Prevention and Early Intervention Division at the Department of Family and Protective Services. In 2018, funding was available to provide approximately 16,000 families with evidence-based in-home parenting support; however, 423,000 families in Texas have young children and three or more risk factors. Our goal is to continue working until many more of those families can access these beneficial programs.

ACEs and trauma do not dictate the future of a child. Children with protective factors (e.g. healthy attachment to parents, access to community resources, and supportive school and home environments) can build the resilience needed to thrive despite adversity. Evidence-based and effective solutions can strengthen families and help ensure that children start with a secure foundation of health and safety.

prevention in the 86th texas legislature

Top-Priority Bills passed

House Bill 1 – The General Appropriations Act

Champions – Sen. Jane Nelson and Rep. John Zerwas

In response to research, federal initiatives, and best practices, the landscape around prevention funding has changed within the past couple decades. The ACEs research makes clear the public health ramifications of severe adversities in childhood. Emerging brain science continues to demonstrate the importance of the development that happens in the first five years of a child’s life. This has created new urgency and a growing and diverse group of stakeholders who are invested in improving access to proven programs. The federal Family First Prevention Services Act demonstrates an increasing prioritization by the federal government in programs that provide evidence-based services to ensure that, when possible, children can remain safely at home. Protecting a child’s development by strengthening families to increase resilience and protective factors, and empowering communities to offer needed supports before a crisis occurs, have become the clear path forward.

Each session, TexProtects prioritizes increased investments in primary, evidence-based in-home parenting programs. Despite cuts to the Health and Human Services budget overall, the Legislature included funding to maintain Project HOPES (Healthy Outcomes through Prevention and Early Support) and the Nurse-Family Partnership (NFP) Programs and appropriated an additional $4.3 million to expand those programs.

Evidence-Based Prevention2020-21 Base BudgetAdditional Investment
HOPES$39.9 million General Revenue/All Funds$1.5 million
NFP$30.2 million All Funds ($5.6 million General Revenue)$2.9 million
Total$70.1 million All Funds$4.3 million

Healthy Outcomes Through Prevention and Early Support (HOPES) is a prevention approach developed to be a flexible and community-based solution to child abuse and neglect in high-risk counties by increasing protective factors of families served. It is currently serving families in 55 counties with children ages 0-5 at risk for child abuse and neglect. The evidence-based programs chosen by the communities each have proven positive outcomes across multiple domains and returns on investment that range from $1.26 to $8.08.

The Nurse-Family Partnership Program is an evidence-based, community health approach with over 40 years of evidence currently serving families in 43 counties. NFP works by having specially trained nurses regularly visit young, first-time expectant moms and fathers, starting early in the pregnancy, continuing through the child’s second birthday. For every dollar invested, there is a return on investment of $5.70 including savings on medical care, child welfare, special education, and criminal justice.

Senate Bill 355

Champions – SEN. ROYCE WEST AND REP. STEPHANIE KLICK

SB 355 directs the Department of Family and Protective Services to develop a strategic plan to leverage federal funds made available through the Family First Prevention Services Act to increase access to mental health care, substance use treatment and in-home parenting programs that can prevent child maltreatment and keep children with their families. This will result in cost savings to the state and better outcomes for Texas children. For the first time, federal dollars previously only available for children in the foster care system will be made available to fund evidence-informed and community-based early interventions so that children can remain safely at home when possible rather than placing them in foster care. These prevention strategies address key drivers of child abuse and neglect: substance use, mental health issues, and parenting skills. Such services build on the knowledge that most children can be safely protected and remain within their own homes when parents are equipped with appropriate support and opportunities to care for their children.

SB 708

Champions – Sen. judith zaffirini and rep. john Raney

SB 708 requires the Health and Human Services Commission to use existing procedures to collect, make publicly available, and report to the Legislature data on child safety in licensed child-care centers. Data must include violations that impact the health, safety, and well-being of children as well as information on the number of children and caregivers in each classroom. This data will allow lawmakers, providers, and parents to make better decisions to ensure the safety of children in care.

TexProtects Goal – Provide training to promote prevention and early intervention

HB 111 – Rep. mary Gonzáles / sen. pat fallon

HB 111 requires that existing child abuse training for school staff must also include information on students with significant cognitive disabilities. Persons with disabilities are victimized at much higher rates than those without disabilities and are much less likely to report abuse.

HB 403 – rep. senfronia thompson / sen. joan huffman
HB 403 requires that the board of trustees and superintendent of a public school district complete one hour of training on identifying and reporting potential victims of sexual abuse, human trafficking, and other maltreatment of children every two years.
HB 2059 – Rep. Cesar Blanco / Sen. Larry Taylor
HB2059 equips health care practitioners who provide direct patient care with the training needed to help detect potential victims of human trafficking and provide them with adequate care, including referring them to additional support services. Ensuring that health care providers are knowledgeable and adequately prepared is vital in combating human trafficking in Texas. Approximately 80 percent of human trafficking victims are women, and health care providers are often the first professionals to have contact with trafficked women and girls.

TexProtects Goal – Improve Maternal and Newborn Healthcare

HB 25 – Rep. Mary Gonzáles / Sen. Judith Zaffirini

HB25 creates a pilot program to allow pregnant and postpartum women utilizing the Medicaid medical transportation program to travel with their children to pregnancy-related appointments. Women enrolled in the STAR Medicaid managed care program during pregnancy or after delivery often miss prenatal or postpartum appointments because the medical transportation service program does not provide an option for women to bring their children along with them to appointments. This pilot could increase access to health care during this critical time for mom and baby.

HB 253 – Rep. Jessica Farrar / Sen. Lois Kolkhorst
HB253 requires the Health and Human Services Commission (HHSC) to develop and implement a recurring five-year strategic plan to improve access to postpartum depression screening, referral, treatment, and support services. Postpartum depression (PPD) affects 1 in 9 mothers nationally, according to the Centers for Disease Control. PPD can affect a mother’s capacity to attach and interact with her child. This can disrupt healthy development and family functioning. Depression is treatable and most mothers improve with access to adequate support.
HB 405 – Rep. Ina Minjarez / Sen. Lois Kolkhorst
HB405 designates June as Neonatal Abstinence Syndrome (NAS) Awareness Month.Neonatal Abstinence Syndrome (NAS) is a group of conditions caused when babies withdraw from certain drugs that they have been exposed to before birth. Rates of NAS in Texas increased by more than half between 2010 and 2015. This bill would increase public awareness and access to information and resources to decrease stigma and encourage mothers to seek help.
HB 1576 – Rep. Dade Phelan / Sen. Dawn Buckingham
HB1576 allows the Health and Human Services Commission (HHSC) and Medicaid managed care organizations to contract with transportation network companies (TNCs) and transportation vendors such as Uber and Lyft for the delivery of nonemergency medical transportation. The medical transportation program currently provides non-emergency transportation services to and from covered health care services — based on medical necessity — to recipients under Medicaid, the children with special health care needs program, and indigent cancer patients program who have no other means of transportation. This would increase options and flexibility and decrease the use of emergency medical transportation resources for non-emergency transport.
HB 1651 – REP. MARY GONZÁLES / Sen. Carol Alvarado
HB1651 requires the Commission on Jail Standards to prohibit the use of restraints for women who are incarcerated during pregnancy and 12 weeks postpartum unless clearly required for the health and safety of the mother or staff. Shackling pregnant inmates is banned in Texas state prisons and was recently outlawed at the federal level. This bill extends the same protection to the inmates of our state’s county jails. The bill also requires an annual report on any use of restraints on pregnant and post-partum women.
SB 436 – Sen. Jane Nelson / Rep. Four Price

SB436 requires the Department of State Health Services (DSHS) to collaborate with the Maternal Mortality and Morbidity Task Force to develop and implement initiatives to improve screening and continuity of care for women with opioid use disorder, as well as newborns with neonatal abstinence syndrome, while increasing access to medication-assisted treatment and decreasing the number of opioids prescribed before, during, and following delivery. A report on these initiatives is due to the legislature by December 2020.

SB 748 – Sen. Lois Kolkhorst / Rep. Sarah Davis
SB748 would create a general revenue dedicated account to fund newborn screenings conducted by the Department of State Health Services (DSHS). The public health laboratory at DSHS tests 400,000 infants per year for 53 disorders or medical conditions. Dedicated funds could be used to maintain the lab and add additional screenings to the panel to meet federal requirements.
SB 750 – Sen. Lois Kolkhorst / Rep. Eddie Lucio III
SB 750 seeks to maximize Texas’ efforts to address maternal mortality as detailed by the Health and Human Services Commission’s report, State Efforts to Address Materna Mortality and Morbidity in Texas, by improving access to healthcare during the prenatal and postpartum period for women enrolled in the Healthy Texas Women Program. This bill also renames the Maternal Mortality and Morbidity Task Force as the Texas Maternal Mortality and Morbidity Review Committee and extends its work until 2027.

TexProtects Goal – Increase Access to High-Quality Early Care and Education

HB 3 – Rep. Dan Huberty / Sen. larry Taylor
HB 3 creates an early education allotment to fund full-day Pre-k for eligible students, provides additional funding for districts with high concentrations of poverty, increases funding per student, and provides funding for extended summer instruction.
HB 680 – Rep. Joe Deshotel / Sen. Kirk Watson
HB 680 requires the Texas Workforce Commission to assess and report the information on the quality and types of childcare being used by families receiving childcare subsidies. This information will include the average cost of childcare and the total number of providers and children participating in the state’s quality rating system, Texas Rising Star. The Texas Workforce Commission (TWC) administers a federal program that provides childcare subsidies to low-income families so their parents can work or attend workforce training. The data collected can help decision makers better improve access to high quality care.
SB 1679 – Sen. Royce West / Rep. John Turner
SB 1679 authorizes children at the age of three who were eligible for enrollment in a free Pre-k class to remain eligible for enrollment for the following school year. This will eliminate confusion and the burden on families that can result in children not being enrolled.

TexProtects Goal – Increase Safety for Children in Childcare

SB 568 – Sen. Joan Huffman / Rep. Greg Bonnen
SB568 transfers certain regulatory authority over childcare facilities and family homes from the Department of Family and Protective Services (DFPS) to the Health and Human Services Commission (HHSC). The bill creates a safety training account of dedicated funds, requires liability insurance unless it is cost-prohibitive, and establishes safe sleeping standards. A family home is a caregiver who provides regular care in their own residence for six or fewer children who are younger than 14, excluding children who are related to the caretakers.
SB 569 – Sen. Joan Huffman / Rep. Greg Bonnen
SB569 transfers regulatory authority for listed family homes from the Department of Family and Protective Services (DFPS) to the Health and Human Services Commission (HHSC). The bill requires HHSC to adopt minimum standards for listed family homes, requires liability insurance unless it is cost-prohibitive, and requires certain training like safe sleep training. The bill requires the HHSC to inspect listed family homes whenever the commission receives a complaint. Listed family homes are adult caregivers that provide care in their own home for compensation for up to three children unrelated to the caregiver.
SB 706 – Sen. Kirk Watson / Rep. Bobby Guerra
SB706 requires there be an investigative unit within the childcare licensing division at the Health and Human Services Commission to identify childcare facilities operating without a license, certification, registration, or listing and initiate appropriate enforcement actions against those facilities.

Missed opportunities for prevention and early intervention

Cross Sector Collaboration to Prevent Adverse Childhood Experiences

Research conducted by the Centers for Disease Control, the National Institutes of Health, the American Academy of Pediatrics, and others has made clear that ACEs are prevalent and can have lifelong consequences on health and behavior. Currently, prevention efforts in Texas are spread across multiple agencies. Communities do not have access to the informaiton and resources they need to make strategic decisions toward safer and healthier families. HB 4183 would have facilitated a cross-agency strategic planning process to better coordinate statewide data and initiatives and give communities a better toolkit for providing services that can strengthen families and prevent trauma. The bill passed in the House but not in the Senate.

Strengthen ECI

Early Childhood Intervention (ECI) is a statewide program within the Texas Health and Human Services Commission for families with children from birth up to age 3 who have developmental delays, disabilities, or certain medical diagnoses that may impact development. ECI services recipients can access needed therapies and be school-ready. The agency made a $72 million request for the funds needed to keep ECI sustainable; however, the budget appropriated only $31 million. HB 12 would have strengthened the ECI program by addressing prior authorizations, requiring health benefit plans to cover services, and creating a tele-health pilot and  ombudsman office. The bill passed the House but did not move in the Senate.

Extend Medicaid Coverage for Women Postpartum

Texas has the nation’s worst uninsured rate for kids AND the nation’s worst uninsured rate for women of childbearing age — with often devastating consequences for moms and babies. Extending Medicaid coverage for women postpartum up to 12 months post-child birth would have addressed the first recommendation from the state’s Maternal Mortality and Morbidity Taskforce; however, the issue faced significant challenges prior to House passage and was not referred to committee in the Senate.

Strategically Expand Proven Prevention Programs

While we are relieved to see continued investment in evidence-based child abuse prevention programs, we still have a long way to go. HB 1549 in the 85th legislative session directed the department to develop a plan to take these programs to scale in order to impact statewide outcomes. Current investments are only providing services to 3.5% of those families in highest need. In order to move the needle, Texas needs to make strategic investments that outpace population growth and inflation and can move us toward a reality in which at least 30% of families in need have access to services.

TexProtects report, lawmakers call for statewide strategy on Adverse Childhood Experiences

FOR IMMEDIATE RELEASE
January 16, 2019
Contact: Lee Nichols
512-796-9877
Lee@texprotects.org

Photos of the press conference available upon request. See video of the press conference here.

Science Meets Policy

ACEs Uncovered: Powerful preventative strategies to promote resilience and brain health for a better Texas tomorrow

Austin, Texas — Adverse experiences early in life, known as Adverse Childhood Experiences or ACEs, can result in trauma that potentially affects the brain architecture of developing children. In 2016, an estimated 3.4 million Texas children had one or more ACE. Child maltreatment in its many forms makes up half of the recognized ACEs. Advocacy group TexProtects, Champions for Safe Children, estimates child maltreatment cost Texas over $55 billion in 2017.

A coordinated, statewide strategy across the healthcare, child welfare, early childhood education and justice systems can prevent and mitigate the impact of trauma, and equip children, families and communities with the resilience to have healthy futures.

That’s the conclusion of ACEs Uncovered: Powerful preventative strategies to promote resilience and brain health for a better Texas tomorrow, a new report by TexProtects, unveiled Wednesday at the Texas State Capitol. Flanked by Texas lawmakers, TexProtects CEO Sophie Phillips said that building a statewide collaboration will take the support of the 86th Texas Legislature.

“Chronic health problems, criminal or risky behaviors, and poor academic and workforce performance can all result from ACEs – but with the right support structures and prevention strategies, it doesn’t have to be that way,” Phillips said. “With the help of our lawmakers, Texas can build a cross-systems, preventative approach that leads to self-sufficient families, healthier children and taxpayer savings.

“TexProtects will push for this coordinated system throughout the legislative session, especially on February 12, when we will bring child protection advocates, including 125 seventh-grade students from Dallas, from across the state to the Capitol for a day of action,” Phillips added.

Katherine Snyder, Child Abuse Pediatrician for the CARE Team at Dell Children’s Hospital, provided some expert perspective on ACEs: “Stress is a normal part of life, but exposure to chronic stress has important consequences on the short and long term physical and psychological health of the child and the adult they become. Intervening as early as possible to create safe environments, healthy and protective relationships and empower healthier coping mechanisms for the child and caregiver is paramount to the overall health of the community and society.”

Phillips and key lawmakers laid out three priorities for the session, which began on January 8:
• Develop and implement a statewide strategic plan to address causes and symptoms of adverse childhood experiences (ACEs).
• Strengthen investments in community-based, primary child abuse prevention programs like home visiting.
• Improve coordination and effectiveness of services for children at risk of entering foster care.

Rep. Tan Parker, R-Flower Mound, said that the emerging science of Adverse Childhood Experiences must be thoroughly ingrained into Texas’ care of children who have been abused and neglected. On Tuesday, he introduced House Bill 4183 which will facilitate coordination of agencies in developing a statewide strategic plan.

“In the past, when children or adults have engaged in high-risk or socially unacceptable behaviors, our reaction was to ask, ‘What’s wrong with you?’ Today, we realize the better question is, ‘What happened to you?’ If the adults in their life helping them on that journey don’t understand what they’ve endured and how it still affects them, then those children have higher odds of falling short in education, in health – including mental health – and in personal relationships,” Parker said.

State Rep. John Zerwas, R-Richmond and a physician who served as Chair of the House Appropriations Committee in the 85th Legislature, spoke of the value of making prevention programs available to families:

“Evidence-based, voluntary prevention programs such as home visiting produce stronger, more self-sufficient families, and save taxpayers money. But Texas is reaching only 5% of the 423,000 families with children under 6 who can benefit from prevention services. We can do better! Investments in proven programs, such as Nurse-Family Partnership (NFP) and Healthy Outcomes through Prevention and Early Support (HOPES) prevent negative outcomes and avert costs in the criminal justice, health care and educational systems,” Zerwas said.

In its legislative appropriations request, the Department of Family and Protective Services is asking for $5.5 million to help NFP reach an additional 550 families in each year of 2020 and 2021, in turn saving Texas taxpayers over $31 million by preventing negative outcomes. DFPS is also requesting to expand the community-driven HOPES program by $9.4 million to reach an additional 1,200 families.

Sen. Royce West, D-Dallas and a TexProtects Advisory Board member, emphasized the need for the Legislature to leverage new federal funds made available by the Family First Prevention Services Act. Tuesday, he introduced Senate Bill 355 to enable this.

“Family First provides flexibility for states to use money previously reserved only for foster care and channel it toward programs that prevent children from ever being removed from their homes. But the Legislature will need to strengthen the infrastructure and effectiveness of programs eligible for Family First funds,” West said.

“Last session, the Legislature and Governor identified child abuse and neglect as a key issue and took historic steps in changing how our state deals with it. But it is critically important that state leaders and the public realize: The efforts in 2017 did not mark an end point in Texas’ fight against child abuse and neglect – it marked a beginning,” Phillips said.

Advocates wishing to RSVP for TexProtects’ Child Abuse Prevention Day at the Texas Capitol on February 12 (including a free, round-trip bus ride between Dallas and Austin) may do so at http://bit.ly/2019PCATDay.

ACEs Uncovered: Powerful preventative strategies to promote resilience and brain health for a better Texas tomorrow may be accessed any time at http://bit.ly/acesuncovered

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TexProtects, Champions for Safe Children, was created to tackle issues of Child Protective Services (CPS) reform, prevention and public awareness to bring a collective, organized voice representing the needs of children at risk of abuse and survivors of child abuse and neglect. TexProtects is the Texas Chapter of Prevent Child Abuse America. TexProtects is autonomous, nonpartisan and nonpolitical, designed to educate decision makers, private funders and the public at large. To date, it is the only Texas organization that has a dedicated focus on the main issues of protection, prevention, and healing of abused and neglected children. For more information, please visit www.TexProtects.org.