Please click on the topics below to access information, materials, and resources for each of the following subjects:
Hill Country Floods:
10/22/18 - The Texas State Board of Pharmacy has issued guidance (PDF) for the emergency dispensing of prescription medications as a result of the Hill Country floods. Please take a look at the link above.
In the aftermath of the devastating storms and flooding that has hit our state in the wake of Hurricane Harvey, TPS, the Texas Chapter of the AAP, is reaching out to our members to find out if you or your practice were adversely affected. We know that there are children and families who have faced serious losses and may be in need of services and support.
TPS has posted resources on our website to assist you in securing services and disaster relief. We will continue to monitor the situation and post updates to the website as needed.
Update from FEMA
The federal government’s emergency responders continue to respond to states, local communities, and tribes as impacts continue across southeast Texas.
FEMA’s priority continues to be protecting the lives and well-being of those in affected areas; the federal government is focusing on search and rescue and first responder operations to ensure people who need help get assistance.
Read the full press release from FEMA here.
HOW TO HELP DISASTER SURVIVORS IN TEXAS
August 29, 2017
The compassion and generosity of the American people is never more evident than during and after a disaster. It is individuals, non-profits, faith- and community-based organizations, private sector partners, and governmental agencies working together that will most effectively and efficiently help survivors cope with the impacts of Tropical Storm Harvey. Click here for more information.
AAP Preparation Resource Preparedness Checklist for Pediatric Practices (AAP)
Additionally, the TPS/Texas Chapter has identified several resources that may assist you in providing coping and care services for your patients and families.
- AAP and Children and Disasters Website www.aap.org/disasters
- Floods/Flash Floods www.aap.org/disasters/flood
- Helping Children Cope and Adjust www.aap.org/disasters/adjustment
- Information for Pediatric Practices www.aap.org/disasters/PediatricPractice
- Flooding Information for Parents Flash Flooding Recovery Info for Parents
FEMA link: The NBEOC Operations Dashboard is activated and available here: https://fema.connectsolutions.com/nbeocopsboard/ - Download the FEMA app for iPhone with emergency information by county here.
For volunteer opportunities, click here: https://txpeds.org/hurricane-harvey-volunteer-information
Additional state resources can be found here: https://txpeds.org/hurricane-harvey-state-resources.
Additional national resources can be found here: https://txpeds.org/hurricane-harvey-national-resources
The National Academy of State Health Policy and The Commonwealth Fund has issued the report, Improving the Delivery of Health Care that Supports Young Children's Healthy Mental Development: Update on Accomplishments and Lessons from a Five-State Consortium. The Commonwealth Fund provided grant money to NASHP to implement pilot programs in five states to test ways to improve mental health services for children.; This report updates information on the results of those pilots.
Healing Thresholds is a website dedicated to surveying the scientific literature for peer-reviewed studies on autism therapies. Please visit their website at http://autism.healingthresholds.com/ to see a summary of the contents of these papers or to sign up for weekly eBriefs.
- Helping Foster and Adoptive Families Cope With Trauma - ADHD is often over diagnosed and similar symptoms can mask signs of trauma.
- Texas System of Care
- Texas CRCGs
- Find a Local Mental Health Authority (LMHA)
- Sleep Better! A Guide to Improving Sleep for Children with Special Needs - V. Mark Durand
- Child & Adolescent Clinical Psychopharmacology - 4th ed. - Wayne Hugo Green
- The Kazdin Method for Parenting the Defiant Child” - Alan E. Kazdin, Ph.D.
- Educational Care: A System for Understanding and Helping Children with Learning Problems at home and in school - Dr. Mel Levine
- Identifying & Addressing Developmental-Behavioral Problems: A Practical Guide for Medical and Non-Medical Professionals, Trainees, Researchers, and Advocates - Editors Glascoe, Marks, Poon, and Macias
- Pediatrician Advocacy Toolkit
- Partner Advocacy Toolkit
- AAP Immigrant Child Health Toolkit
- Houston Chronicle op-ed by AAP President Benard Dreyer, MD
- AAP Immigrant Health Special Interest Group
- TMA Border Health Caucus
- Office of Refugee Resettlement Unaccompanied Children’s Services
- Pediatrics in Review article “Caring for Refugee Children”
Recent News (updated 1/9/19):
In light of the escalation of problems at the border and the recent tragic deaths of 2 children, Texas Pediatric Society leadership has been made aware that there will be an increase in the release of unaccompanied children (UAC) from Office of Refugee Resettlement (ORR) facilities as they are united with their sponsors across the state. With their sponsors, these children will likely seek medical care in the community of their sponsor. In addition to the basic needs of every child, these children may have additional issues for which they should be screened. A link to the AAP Immigrant Child Health Toolkit has been provided below, which you may find useful as you evaluate these children and provide care for their physical, emotional, and social needs. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Immigrant-Child-Health-Toolkit/Pages/Immigrant-Child-Health-Toolkit.aspx
Recent News (updated 6/2/17):
In mid-May, the TPS and the AAP issued a press release opposing SB 1018, a bill that would have given the state authority to license family immigration detention centers as childcare facilities, allowing for the prolonged detention of asylum-seeking children in prison-like facilities that are devoid of adequate medical and mental health supports. Two of the three US detention centers are in Karnes and Dilley Texas are operated GEO Group and CoreCivic respectively. GEO Group and CoreCivic (formerly Corrections Corporation of America) are private for-profit prison companies that hold federal contracts with Immigrations and Customs Enforcement to detain children and families awaiting hearing for asylum. TPS worked closely with several other advocacy groups to successfully prevent the passage of this bill, which made it through the Senate, but failed make it out of committee in the House.
In 2016, the state briefly granted the licensure of these facilities through the regulatory process, but Grassroots Leadership swiftly brought forth a lawsuit that put an end to the state licensure. Shortly after the final judgement was issued, the 85th Texas Legislative Session began and legislation to grant licensing authority in statute was filed in both the House and Senate. TPS and other advocates went to work educating legislators about the concerns that the legislation would not only allow for the prolonged detention of children in these facilities, but also allow the state to carve out exemptions for these facilities from current state childcare standards, further endangering children and increasing state liability. In March, the AAP published a policy statement co-authored by TPS member, Dr. Marsha Griffin, that explains the background and nature of detention as well as its detrimental effect on children and families. Additionally, Dr. Marsha Griffin and Dr. Kimberly Avila Edwards testified on behalf of TPS during committee hearings throughout session.
Why the sudden push for state licensure of these facilities? In 1997, the Flores Settlement Agreement posed strict regulations on the detention of children in unlicensed facilities in an effort to steer children toward community-based alternatives. The detention centers have since been operating as “temporary holding facilities” for children and families and the corporations that operate them have been pushing for state licensure. GEO Group, the company that runs the Karnes detention facility, stated in SEC filings, “Presently, the center operates as a short-term processing facilities and this licensing process will allow for longer lengths of stay.” What do the companies who operate these centers stand to gain from licensure? While most people seeking asylum have family, friends or other community-based alternatives to accommodate them throughout the process of seeking asylum, these private prison companies saw an opportunity to profit from the influx of asylum seekers by contracting with the federal government to detain asylum seekers. CoreCivic makes $300 per person per day through the detention of children and families in the Dilley detention center. The ability to hold children and families for longer periods of time puts money directly into the pockets of the companies who operate these facilities. Texas pediatricians and other advocates made it abundantly clear throughout the regulatory and legislative attempts to license these facilities that detention centers are no place for children.
As the legislative session came to a close, the TPS and AAP issued another press release applauding the Texas House of Represenatives for leaving the bill pending in committee.
Previous News (updated 12/9/16):
The Refugee and Immigrant Center for Education and Legal Services (RAICES) released a statement that, "Over the weekend, Immigration and Customs Enforcement (ICE) hurriedly released over 460 mothers and children from Karnes and Dilley Family Detention Center to Casa RAICES in San Antonio, Texas. This massive release to our shelter came after an Austin judge sided with Texas advocates and detained families and ruled against the Texas Department of Family and Protective Services, as well as GEO and CoreCivic, the two private prison companies that operate Karnes and Dilley, by issuing a final judgement which prevented the Texas DFPS from issuing child care licenses to ICE controlled family detention centers."
According to RAICES' statement, "The families released over the weekend were in various stages of the legal processes that normally take place in detention, which stands against ICE’s long standing claim that detention is necessary for families to undertake legal processing prior to release. Approximately 25% of families were released without a credible fear interview. The majority of families were released without travel plans, forcing RAICES staff and volunteers to work until 4:00 AM on Saturday night to communicate with families and arrange travel. RAICES has opened additional shelter space at a local church and convent in San Antonio to accommodate the overflow from our shelter."
To read the full statement from RAICES and for contact information to find out more, click here.
Previous TPS Activities:
During the 2015 Annual Leadership and Planning Summit (ALPS) guest speakers, Dr. Kenneth Smith Ph.D. and Dr. Rebecca Hester MA, Ph.D. from UTMB presented, “Addressing the Health Needs of Child Refugees from Central America” which discussed the crisis of immigrant children in Texas. For access to that presentation click here.
TPS released a statement on the increasing number of refugee children at the southern Texas boarder. TPS urgently calls upon state and federal agencies to come together wtih charitable organization to assist these children.
In December 2015, four TPS members visited a family residential center in Karnes City: Dr. Kim Avila Edwards, Dr. Lauren Gambill, Dr. Jim Lukefahr, and Dr. Joyce Mauk. This issue has also been a priority for the AAP.
CATCH is a national program of the American Academy of Pediatrics (AAP) designed to improve access to health care through community-based efforts. The program began in 1991 and receives funding from a variety of sources.
The mission of CATCH is to support pediatricians who work with communities to ensure that all children have medical homes and access to other needed health caservices. To achieve this goal, the CATCH Program provides pediatricians with training, technical assistance, peer support, networking opportunities, and funding opportunities for project development.
For more information on CATCH, grant funding, and projects that have been previously awarded funding, please click here..
- Medical Evaluation of Sexual Abuse Manual
- TPS Sexual Abuse Protocol
- TPS Version of Inpatient Clinical Practice Guideline for Child Abuse
In times of national tension, children may experience increased exposure to violence, racial bias or other adverse events in their social environments. The American Academy of Pediatrics shared the following links in order to help physicians and parents support children when faced with these complex and difficult circumstances.
- Talking to Children About Racial Bias
- How to Support Your Child’s Resilience in a Time of Crisis
Texas is prone to disasters of all kinds, from severe weather events to industrial accidents. Many of the victims of humanitarian emergencies and natural disasters are children, and pediatric expertise in responding to the needs of children in these situations is important. In support of our members, TPS has compiled a list of resources to help prepare for emergencies and natural disasters.
- 2018 AAP Webinar: Hurricanes and Storms: From Preparedness to Recovery, Strategies for a Brighter Future (Webinar Archive and Webinar Slides)
- 2015 Disaster Preparedness News from the AAP
- AAP Pediatric Preparedness Resource Kit
- AAP Preparedness Checklist for Pediatric Providers
- TexasPrepares.org: free resources for community leaders
- CDC: Caring for Children in a Disaster
- Georgia Chapter Disaster Preparedness
- TPS Committee on Pediatric Emergency Medicine
- Infrastructure System Overview (ISO): Extended
The Disease Reporting/Notifiable Conditions page of the DSHS web site is a handy reference for physicians. The page includes notifiable conditions, investigation and surveillance forms, reporting forms, epi case criteria, CDC case definitions, antibiotic resistant isolate, blood lead level reporting, cancer reporting, contaminated sharps injury, electronic reporting (NEDSS), HIV/STD reporting, laboratory reporting, and TB forms. Please click on the links above to access information on a particular topic or vist the website at: http://www.dshs.state.tx.us/idcu/investigation/conditions/default.asp.
Please click on the links above to access information on a particular topic or vist the website at:
- Amplification, Implants, and FM Systems for Infants & Young Children with Hearing Loss
- Genetics of Early Childhood Hearing Loss The Facts
- Beyond Newborn Hearing Screening:Recognizing the Signs of Late Onset Hearing Loss in Infants and Young Children
- C-33 Form (immunization changes on TVFC)
- Statewide ECI Referral Form
- Doctors. Saving Lives. Patient Safety Resources Order Form
Human Papillomavirus (HPV): Visit the TPS HPV webpage for additional information on the HPV vaccine.
Zika: Learn more about Zika in Texas by clicking on the TPS Zika page here.
Other Zika Resources:
DSHS Zika website: http://texaszika.org/
AAP Zika Information: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Children-and-Disasters/Pages/ZikaVirus.aspx
CDC Zika Information: https://www.cdc.gov/zika/
RSV: The Texas Pediatric Society Infectious Diseases Committee is pleased to provide information on respiratory viral surveillance in children in our state.
RSV activity is shown by number of test performed, number of tests positive, and the percent of tests positive. A line indicates a cutoff of 10% for the percent positive RSV tests. The CDC definition of the start of the RSV season is the first of 2 consecutive weeks with greater than 10% positive tests. The definition of the end of the RSV season is the last of 2 consecutive weeks with over 10% positive tests.
This information is submitted by an increasing numbers of clinical microbiology labs that serve large numbers of children around the state. This began as a voluntary unfunded program with the Centers for Disease Control, Texas Department of State Health Services, and the Texas Pediatric Society with 8 labs representing larger pediatric centers around the state. It expanded with the addition of many more hospital laboratories with some support from MedImmune, via SDI. All of this data is combined at the CDC, in the NREVSS database. It is returned to us to clean up and present. The sites are grouped into regions and the data from those areas are combined. A list of the current sites and their grouping is provided. This was done for several years by Diana Newton and Dr. Don Murphey at Cook Children’s Medical Center in Fort Worth. It is now done by Ms. Lesley Bullion at DSHS in Austin with assistance by Dr. Murphey and the TPS Infectious Disease Committee members. If you have questions about the project contact Dr. Don Murphey at email@example.com, 682-885-1485.
Update as of 2/14/17: RSV activity in Texas this winter peaked around January 1 and is declining. At present there are no signs indicating a late end to the RSV season this year.
For additional respiratory viral surveillance information see the websites listed below: http://www.cdc.gov/flu/weekly/fluactivity.htm http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2009/ http://www.flustar.com/
STAR Kids Medicaid managed care program
Read about the STAR Kids program and access resources on the TPS STAR Kids page here.
The Texas Pediatric Society was vocal, engaged, and instrumental in passing a key resolution at the Texas Medical Association 2017 House of Delegates in May. TPS, along with colleagues from the Texas Association of Obstetricians and Gynecologists and the Texas Academy of Family Medicine, presented Resolution 407 to the House and testified at the Reference Committee on Socioeconomics. TPS Executive Board Member and TMA Delegate Dr. Ben Raimer, TPS President Dr. Joyce Elizabeth Mauk, and other TPS officers and members testified at the Reference Committee on Socioeconomics. Testimony included our partners from TAOG and TAFP. The result was an amended resolution that included the recommendations in the Council on Socioeconomics and Select Committee on Medicaid, CHIP, and the Uninsured Joint Report. This report combined with compelling testimony by physicians at the reference committee resulted in policy adopted by the TMA House. You can access the final policy here. Go to the highlighted portion, on page four of the document to see TPS efforts.
TPS’s own Dr. Ryan Van Ramshorst serves as the Chair of TMA’s Select Committee on Medicaid, CHIP and the Uninsured and co-presented the joint report on the impact of the AHCA on Medicaid and children. You can find the report here.
Given the current debate in Congress about health reform, we are asking all pediatricians to remain vigilant and keep up the efforts by contacting lawmakers to educate them about the impact the proposed AHCA has on children. The TMA Resolution is a major step in the right direction for our state, let’s not stop there!
- Tools and Resources
- Online Resource Guide
- Technical Assistance and Support
- Texas Pediatric Medical Home Initiatives
- Major Insurers to Cover Higher Newborn Screening Fee
- The Department of State Health Services (DSHS) has begun screening newborns for 27 genetic disorders with an additional screen beginning February 5, 2007. DSHS and the Newborn Screening program have developed a Newborn Screening Online Training Module which is now available. The Module includes information on the program's expansion. There is no fee for taking the online module and continuing education units are available. The module can be accessed at: http://txhealthsteps.com/
The Texas Pediatric Society Obesity Toolkit offers practical guidelines to aid pediatric practitioners in the prevention, early recognition, and clinical care of children and adolescents who are overweight or obese.
- In times of national tension, children may experience increased exposure to violence, racial bias or other adverse events in their social environments. The American Academy of Pediatrics shared the following links in order to help physicians and parents support children when faced with these complex and difficult circumstances.
- Doctors. Saving Lives. Campaign
- Hard Hats for Little Heads promotes fun exercise, and teaches parents and children the importance of wearing a properly fitted helmet. The Texas Pediatric Society, the Texas Chapter of the American Academy of Pediatrics (TPS) offers its members a unique benefit. TPS will cover the cost of up to 25 helmets for its members who host a helmet giveaway. TMA provides an equal match of free helmets on these purchases, so TPS members can get up to 50 helmets to give away at no cost.
- TheLearn the Signs. Act Early campaign has developed a free resource kit of materials on child development and autism for day care providers and teachers to share with parents of children in their care. The Child Care Provider Resource Kit, along with resources for parents and pediatricians, are available for free at http://www.cdc.gov/actearly
- The Texas Academy of Family Physicians has recently teamed up with the Texas Department of State Health Services to bring Tar Wars to Texas. This vital program has helped many kids stay tobacco-free through its innovative and interactive lesson plan in elementary schools throughout Texas and the U.S. Tar Wars invites doctors, dentists, nurse practitioners, students/ residents and other community health advocates to present a one-time, one-hour scripted and interactive lesson plan to 4th and 5th graders to discourage youth taobacco use. Since its inception in 1988, Tar Wars has reached over 7 million kids worldwide. More information and a place to sign-up as a presenter is available at www.tafp.org/tarwars
AAP Coding Resources
- Please submit all coding questions to the AAP Coding Hotline firstname.lastname@example.org
- The AAP has a collection of coding resources listed on www.aap.org/coding. We encourage you to bookmark this page and refer to it as often as needed. Most are free resources or member benefit.
- Also, there is a collection of coding news articles from AAP News. There is a monthly column called “Coding Corner” so feel free to look over the past year’s articles: http://www.aappublications.org/collection/coding-corner
- Position Statement: Safe Sleep for Infants - Texas State Child Fatality Review Team Committee
- A Parents’ Guide to Safe Sleep - American Academy of Pediatrics
- Consumer Product Safety Alert: Crib Sheets- U.S. Consumer Product Safety Commission
- Crib Safety Tips (English)- U.S. Consumer Product Safety Commission
- Crib Safety Tips (Spanish)- U.S. Consumer Product Safety Commission
- AAP Talking Points on Vaccine Reimbursement
The Texas Department of State Health Services Immunization Unit launched ImmTrac2 on April 3rd. The new system replaces the previous system, ImmTrac, and provides expanded capabilities for registered ImmTrac2 users. To learn more about ImmTrac2 and what to expect, please visit the ImmTrac2 website, where many resources are available, including the Implementation Guide, User Manual, Provider Online Enrollment Manual, webinars and PowerPoint presentations, which are all available for download at the ImmTrac2 Forms and Document webpage.
The DSHS Immunization Unit is expecting to see a large call volume for the ImmTrac2 Help Desk (1-800-348-9158). Due to the large call volume, the time it takes to speak to a Help Desk support staff member may be longer than usual. It is encouraged for registered users to email the ImmTrac2 Help Desk at ImmTrac2@dshs.texas.gov as the response time may be quicker.
SB 1612 was passed in 2009 to increase awareness of Velocarardialfacial Syndrome(a.k.a. DiGeorge or 22q11.2 deletion) in Texas. As a result parents whose children are receiving services for developmental delays through the state’s Early Childhood Intervention (ECI) programs may be contacting their pediatricians to ask whether their child may need genetic testing for the 22q11.2 deletion. For more information, please visit: http://www.txpeds.org/sites/txpeds.org/files/documents/vcfs.pdf.
- Practice Management
- Office Managers Section
- Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents
- Pedialink: The AAP Online Learning Center
- Prohibiting Concealed or Open Carry Handguns on Private Property and ordering no carry signs
Use this tool to search for an AAP member pediatrician, pediatric sub-specialist, or pediatric surgical specialist.
TPS does not provide a referral service. However, we are pleased to refer you to the Texas Medical Board, the State agency which licenses all physicians in Texas.
The TMB website we are referring you to will allow you to search for a physician by name or by city.
On the TMB website you must first "Accept the Terms and Conditions." Then ‘Enter Search Criteria’ page, click on ‘License Type’ and then select Physician. It will then display a ‘Specialty’ drop box and you may enter the ‘pediatric specialty’ and the city to receive the names and background information of pediatricians in the area you are searching for.
- The 81st Texas Legislature passed a bill creating a new physician loan repayment program that will pay up to $160,000 to physicians who agree to practice for four years in primary care Health Professional Shortage Areas, many of which are located in rural communities as well as urban centers.
- The Texas Higher Education Coordinating Board approved the final rules in October 2009. This page will be updated as the program is implemented. Please note that official information about the program can be accessed through the Texas Higher Education Coordinating Board or the Texas Department of State Health Services
- The Health Resources and Services Administration is now accepting new applications to support loan repayment for bonafide educational debt for primary care medical, dental and certain behavioral/mental health clinicians who want to work at National Health Service Corps (NHSC) sites. In exchange for the loan repayment assistance, clinicians serve for two years with the Corps. The new funds, totaling almost $200 million, are expected to support about 3,300 clinicians that will serve in health centers, rural health clinics and other health outpatient/ambulatory care sites that care for uninsured and underserved people.