Table of Contents

Introduction

HHSC

Developed Statewide Human Services Transportation Plan and Report to guide agency policy and operations.

Met with agency staff regarding client transportation cost reporting issues to improve the availability and accuracy of data.

Began the implementation of a business process improvement model for analysis of agency transportation operations.

Participated with TxDOT and TWC on national workgroup looking at federal legislation reauthorization to improve the cooperation of human services and transportation agencies.

Coordinated meetings among human services agencies and between human services and workforce agency to clarify understanding of roles, responsibilities and potential collaboration.

TDoA

TCADA

TCADA-funded providers are encouraged to provide transportation services for clients. Fiscal year 03 contracts include provisions for transportation services as requested in individual provider budget summaries.

4th Quarter FY 2001 trips = 640,362
4th Quarter FY 2002 trips = 705,057
10.1% increase in trips

HHSC

22 Area Information Centers (AICs) have data available on the web site. AICs are continually updating the resource information. Remaining three actively working on databases to be uploaded this year.

Finding Help system had 34,141 hits during this time period.4 AICs are nationally accredited with 14 other AICs in the process.

Implementation plans and activity work plans have been completed for the installation of 2-1-1 beginning in October. 14 sites will be installed by December 2002.

TD0A

In the second quarter, TCADA participated in updating the I & R system database with information about agency programs and services.

ECI will participate in the testing of a template developed by HHSC for state agencies to provide standardized I&R data.

A media campaign advertising the Internet site for choosing childcare was kicked off on July 29th during a news conference at a local day care center in Austin. The Public Information Officers, with the support of licensing staff in each region, will hold similar news conferences during the next two weeks. Several media outlets are continuing to call about doing follow up stories. The campaign continued throughout the month of August. There was extensive coverage throughout the state. As part of the campaign a compact disc (CD-ROM) with childcare resource information was mailed to all licensed and registered day care providers. 

The new Communities In Schools campaign was launched at the State Capitol during a press conference. Local media as well as the capitol press corps attended. The press conference and the Public Service Announcement (PSA) were broadcast statewide via satellite. Over the next 13 weeks, the PSA will be tracked digitally to determine the number of times the spot is played. Radio PSAs are also complete and will be shipped to the local Communities In Schools programs for distribution.

HHSC

TDoA

TCADA

In the second quarter, with all TCADA-funded providers evaluated for readiness, training continues to be performed across the state. Approximately 290 participants in 51 provider organizations were trained to use BHIPS bringing the total (cumulative) number of users to 455 in 80 organizations. Treatment/Service plan functionalities have been completed and initiated as a pilot among selected organizations with a timeline for full implementation beginning April 15, 2002. Training manuals have been revised to include instructions for use of the treatment/service plan in future trainings.

In the third quarter TCADA released the following functionalities in BHIPS: treatment planning and review, data download and available capacity reporting. Providers continue to be trained and to date 135 provider organizations have been trained to use the system. An algorithm for matching duplicated clients was developed and the data warehouse currently has a unique identifier for each client. Modifications have been made to the system and NorthSTAR providers have been trained on BHIPS and may now perform reporting through the system. Several presentations have been made to the LBB, Governor's Office of Budget and Planning and HHSC staff.

In the fourth quarter, modifications were made to BHIPS to enable the NorthSTAR project to use BHIPS. A forum (or bulletin board) was added to the system for providers to communicate among themselves about topics and share ideas and reports they have created. The forum is also used to survey providers on specific topics and serves as a user group repository. A computer-based training CD-ROM on how to create a treatment plan was developed and distributed to providers. All funded providers have now been trained and are using the system. Specifications for case management and HIV Early Intervention (HEI) measures and quarterly reporting were begun. Planning activities were started for the conversion of BHIPS to IML and Web Services technology. This conversion will bring the system into a state-of-the-art operating environment which makes the system more flexible and portable. 

TCADA provided demonstrations of the system with the state of Nevada, South Dakota, Louisiana and Alaska. The agency continues in its partnership with CSAT-SAMHSA's Web IT project by providing the system code and technical expertise. HIPAA requirements are being evaluated in anticipation of system changes necessary to be compliant. 

Since September 2000, 22,720 individuals have been screened, 21,022 assessments have been completed and 27,987 clients have been admitted for treatment. Other utilization statistics are available.

TDH

Completed in August 2002. Submitted proposed rule changes for Title 25, 1.91 for September 2002 Board of Health agenda; integration of eligibility will continue in response to TDH Executive Management Issue #5-Program Effectiveness and Efficiency 7/02 Revised 1.91 to include stakeholder input.

Develop Screening Tool to Identify Potential Eligible Clients

Completed initial development of automated screening system in August 2002. There will be ongoing with inclusion of new programs and through stakeholder input and program changes. Development will continue as part of TDH Executive Management Issue #5-Program Effectiveness and Efficiency through policy integration.

Submitted Monthly Quality Assurance Team (QAT) reports to LBB.

Provided a TIERS status update briefing to Lt. Governor Ratliff, the Governor's Office and other legislative staff members Met with representatives of the advocate community to provide a Project update

Held monthly TIERS Project status update meetings with internal and external stakeholders to provide information on accomplishments and challenges facing TIERS.

Conducted a demonstration of the TIERS system to representatives from the country of Jordan that were on a USA study tour to obtain information on setting up a cash assistance and workforce program in Jordan.

Submitted Federal Monthly Update reports to our federal partners.

Received Food Nutrition Services approval of waiver for TIERS policy simplification initiative.

Submitted federal funding document, As Needed Implementation Advance Planning Document (IAPD)

Completing final phase of Texas Works functionality (Stage 2) development activities.

Revised TIERS deployment schedule to help ensure all design and development requirements will be met. 

Began data purification efforts to prepare for data conversion.

Developed Go/No-Go decision points to better manage TIERS pilot and rollout activities.

Met with trading partners regarding Interface testing, and held agency meeting with partners to discuss TIERS inquiry.

Held Kickoff session to begin requirements review validation for the Long Term Care portion of the TIERS system.

Finalized and approved TIERS training schedule for Texas Works functionality (Stage 2).

Developed an Agency Business Processes Workgroup to address and prepare for business process changes as it relates to TIERS.

Region 6 implemented the Regional SWAT (Special Workers Assisting TIERS) Team to help facilitate a smoother transition into TIERS. Currently working on data purification and clearing error prone cases that will not convert from current automated system to the TIERS environment. Team is comprised of staff from Texas Works, Long Term Care Services, and Office of Program Integrity. 

Region 10 TIERS staff has done "true time" State of Texas Assistance and Referral System (STARS) demonstrations at five Community Health and Awareness fairs this quarter. Computers were connected to the internet, enabling consumers to log on to STARS, go through the program, and print their results. Public reaction has been extremely positive, as people are impressed with the simplicity of the program, the resources available, and the confidentiality factor.

HHSC

TCADA

ECI

TDHS

The Region 6 Educational Services Division provided training for both trainees and tenured staff who determine eligibility in the Simplified Children's Medical Program for a Centralized location. After moving to the Centralized location, the trainees were mentored by trainers on application policy, procedures, telephone etiquette, CHIP referral process, and eligibility determination process.

TDMHMR

HHSC

Children's Policy Council Report entitled "And How Are the Children?" completed and submitted to HHSC Commissioner and Legislature September 1, 2002. Awarded grant from Texas Council on Developmental Disabilities for assistance in implementation activities for permanency planning legislation. Developed permanency planning training curriculum. Worked with agencies to develop web-based resource site for case managers whose clients are children. Established data system for review and reporting of permanency planning activities. Awarded contract for development and implementation of a system of family-based alternatives for children in institutional care in the central Texas area. 

The State Office of Community Resource Coordination Groups continued its role in providing technical assistance to local interagency CRCGs serving children with complex needs and their families:

Memorandum of Understanding under Texas Government Code Section 531.055 fully signed and disseminated. 

Completed a survey of all CRCGs regarding referrals for individual service planning to identify patterns and improve technical assistance provided.

Provided specialized trainings for local CRCG leaders and other community members through 2 regional meetings in March and April 2002 (Houston and Lubbock) and specialized training for CRCG coordinators in July 2002.

Explored integration of CRCG and TIFI (Texas Integrated Funding Initiative).

Provided information and training regarding CRCG responsibilities within Permanency Planning under Senate Bill 368.Provided 33 onsite technical assistance visits to 62 counties.

Published 2001 CRCG Data Report identifying key elements related to coordination of services for children with complex needs.

Implemented toll free line at the State CRCG Office to increase communication with consumer, families, and local CRCGs.

TCADA

TCADA is also leading a collaborative group comprised of other health and human services agencies to develop a statewide plan to prevent, intervene and treat child trauma related to substance abuse. A technical assistance request was submitted to the federal Center for Substance Abuse Treatment (CSAT) to provide a national expert to lead a 2.5 day planning session on systems integration and coordination for this project. As a second component, a conference grant proposal was submitted to CSAT to hold a statewide educational, planning and systems integration conference to address regional issues related to this area. 

In addition, the Texas Department of Health contracts with TCADA to perform prevention and control activities in San Angelo, Abilene, Midland-Odessa and Del Rio in an effort to prevent youth tobacco use, to protect the public from involuntary exposure to environmental tobacco smoke and to reduce tobacco use among diverse and special populations. The contract also includes cessation interventions in McLennan, Brazos and Fort Bend counties. In these areas TCADA works with local county medical and dental societies to promote the American Cancer Society Quit Line, disseminates information about the Quit Line, distributes tobacco prevention and cessation guides to clinicians, and conducts educational activities to educate health care providers on tobacco issues regarding cessation. 

Community coalitions promote healthy, safe communities through community mobilization. TCADA 20 funded community coalitions designed to encourage interagency collaboration at the local level in fiscal year 2003 contracts. 

Approximately 500 attendees participated in TCADA's third annual prevention conference in November 2001. In addition, TCADA has participated in a variety of state-initiated activities such as coalition building activities with other agencies to improve communication and coordination and to inform organizations about the issues of substance abuse.

ECI

ECI has begun participation in the Partners in Excellence project, which is funded by the national Center on the Social and Emotional Foundations for Early Learning. Staff from ECI, Head Start, the Texas Workforce Commission (TWC), the Texas Education Agency (TEA) and several other agencies have formed a state planning task force to collaborate on efforts to ensure that Texas children, birth through five, will be cared for by adults who have the knowledge, ability and resources to support their healthy social and emotional development.

TDH

TDPRS

On July 19, 2002, members of the Texas Integrated Funding Initiative Consortium (TIFI) and the Community Resource Coordination Group of Texas (CRCG) participated in a joint work group to continue strategic planning to develop an improved Systems of Care model in Texas. This work group has been charged with addressing the future merger of TIFI and CRCG and the identification of any needed legislation to increase the availability of strength-based, family-centered mental health services for children and families.

Authorized CPS staff have access to the Texas Department of Health's (TDH) Bureau of Vital Statistics (BVS) system, which allows them to verify birth information for children in PRS conservatorship who were born in Texas.

Senate Bill 36 was created to address cross-agency training that would increase a caseworker's knowledge and awareness of the services available to children at each health and human service agency or local mental health or mental retardation authority. It is specifically hoped to increase accountability and responsiveness to parents seeking services for children. HHSC has the responsibility of implementing Senate Bill 36. The agency programs of CPS, PEI and CCL are competing the surveys and appropriate links to our Website. This will be uploaded to HHSC by September 9th, 2002.

Statewide, TCB served 160 consumers in Supported Employment with 15 consumers achieving successful employment outcomes in 2002. At year-end, supported employment funds budgeted and expended were closely matched, emphasizing the increased usage of these services for individuals who benefited.

TDMHMR

TRC

HHSC

TDoA

Gaps and Coordination of Services for Older Texans: Survey Results. Survey Responses on the Readiness of State Government to Meet the Challenges of an Aging Texas
Housing and Older Texans
Workforce and Older Texans
Healthy Aging

A new partnership was developed with Sam's to conduct ATW community events. 

A Texercise outreach/component was included in the Willie 10K event held in Austin. We have developed new partnerships with the Texas Department of Health and AARP and Texas Volkssport to further expand Texercise. An award was made to conduct a major study of caregiving in Texas to Lewin Associates. The Housing Research Project completed the first phase of its research and began work on the survey design. 

Aging Texas Well was included as an educational track at the next Texas Conference on Aging.

TCADA

TDH

TDHS

Region 1 Long Term Care Regulatory Director, Ralph Harmon, provided a presentation on August 20, 2002, to the Senior Ambassadors Coalition entitled "How to Choose an Assisted Living Facility".

On July 26th and 27th the Texas Elder Abuse and Mistreatment (TEAM) Institute conducted two eight-hour trainings for physicians on caring for older victims of abuse, neglect, exploitation, and self neglect. TEAM used funding from a U.S. Department of Justice grant for the training and included information on the scope of elder mistreatment, diagnosis and treatment, APS intervention, interviewing victims, exploitation, and legal remedies. Fifty-two people attended. Physicians received continuing medical education credit for the course.

HHSC

Continuing the work from the last quarter - HHS agencies as well as their partners, TWC, TEA, and TAMU, have added to the three original sites (Cameron Park, Sebastian, and Progreso) with new sites in the Rio Grande Valley, at San Carlos and Lasara Community Centers.

Service plans have been developed by the Regional Workgroups in El Paso and in Laredo for their areas.

El Paso agencies have developed service delivery systems in the following sites: Sparks, Montana Vista, and Rio Vista Community Centers.

Laredo agencies have developed service delivery systems in the following sites: El Cenizo, Larga Vista, and Rio Bravo Community Centers.

A Promotora Directory has been developed for all three sites, which lists agencies that use promotoras in their delivery process. Training of TAMU promotoras was standardized into a methodology of regular training as well as a published training calendar. This insured participation of HHS agencies and their partners in meeting the needs of the promotoras. This process has been duplicated at all sites.

Coordinated scheduling of services and publishing of a monthly service calendar has been accomplished at all 11 sites.

Planning Meetings continue to be held with HHS agencies and our partners in order to increase collaboration of agencies and ensure quality services to residents of Colonias. Meeting vary from monthly to every other month, depending on local needs.

A tracking system to measure the effectiveness of agency services has been developed and presented to the Austin workgroup for approval. The Austin workgroup has delegated the reporting methodologies to the local workgroup. Tracking has started in this new process, beginning in September 2002.

An MOU has been signed with the University of Texas Health Science Center's RAHC in Harlingen, to have a third year medical student help in delivering training and information to promotoras and to the community, as well as educating the student on agency programs and service resources available to the community. This student is assigned to the Office of Border Affairs.

HHSC Office of Border Affairs has developed a newsletter. Logistics are being developed to the mechanics that will be used for publication of this newsletter.

Colonias orientation training has been delivered to agency staff who are working in the Colonias. Training included a focus on cultural competency and customer service.

The Austin Colonias Oversight Workgroup met with the Valley workgroup in Edinburg and toured several Colonias and community centers.

TDoA

TCADA

In El Paso, the Texas A&M Colonias Prevention Program reports alternative activities for families who have participated in the program for the months of May, June and July. These activities address and reinforce the risk and protective factors in the Familias Fuertes program and allow the program to offer services to parents and youth for the purpose of family bonding and education and to experience positive interactions. Services were also offered to families in Montana Vista, Rio Vista and the Sparks Community Centers through the Families Fuertes Program. There were three community fairs provided to the residents to ensure that they are informed about health and human services.

In the Valley, the workgroup continues to meet monthly. TCADA providers are working closely with promotoras and offering prevention and treatment services to residents on a monthly basis. Also, they have been providing information on alcohol and drug abuse to promotoras and residents and coordinating services through a calendar maintained by Texas A&M Colonia Program staff. There have been two community fairs that TCADA providers have helped to produce and have participated in.

In Austin, the workgroup is developing processes to address recommendations identified through the March Colonias Initiative Evaluation. The Austin workgroup is better defining the role of agencies and services to be provided at the Colonias community centers. HHS agencies need to ensure access to services and to address client and communities concerns, and to identify solutions that would stabilize promotoras as a work force by reducing turnover and establishing reliable funding sources. The workgroup is developing procedures that will improve communication and information flow among promotoras, regional workgroups and administration in Austin.

TCB

El Paso Region:
El Paso staff participated in three Colonia Health Fairs this last quarter and provided visual screenings, information and referral for 103 Colonias' residents.

TCDHH

Contracted Regional Specialist for HHSC Region 11 attended 2 team meetings in Laredo and 3 in McAllen.

Contracted Regional Specialist for HHSC Region 10 attended 2 team meetings in El Paso.

ECI

TDH

August 30 Training sessions were provided to Colonias promotoras at the Texas A & M Center for Housing and Urban Development in Weslaco on the following topics: Tobacco Prevention, EMS and Zoonosis.

TDHS

Region 10 staff participated in three awareness and health fairs at the Sparks, Montana Vista, and Rio Vista Colonias held in June 2002.

Staff in Region 11 provided training on June 20, 2002 for Promotoras on TP 40 Medicaid coverage for Pregnant Women.

TDMHMR

HHSC Forums and Training in Lower Rio Grande Valley (Weslaco), Laredo, and El Paso. Educational presentations provided to HHSC agency field office personnel and promotoras on each agency and various services provided by the agencies.

The Children's Services department has been working with the promotoras to ensure accessibility to Screening and Intake Services for those children with severe emotional disturbances. During this time children and families identified by the promotoras are screened for severe emotional disturbances and provided intake to services when appropriate. Further outreach and services to this area are anticipated. 

Adult Mental Health Services provides psychiatric services in the targeted areas to those individuals who meet the priority population definition. Center staff conducted presentations on services to the promotoras in the targeted areas. 

Adult Mental Retardation Services provides long-term services in the targeted areas to those individuals meeting the priority population definition. Center staff conducted presentations on services to the promotoras in the targeted areas. 

Local Planning Initiatives are taking place. In order to ensure that the needs of the Colonias were taken into consideration when developing the Local Plan, community forums have been held and needs surveys distributed to individuals dwelling in or supporting the Colonias. As expected, community input and survey responses received showed high need in many areas of HHSC, including mental health and mental retardation information and services.

Q4 -- The Colonias activities listed above are continuing/ongoing.

TDPRS

PRS regional representatives to the Colonias project are based in El Paso, Laredo, and Edinburg. An Austin PEI staff member serves on the Austin HHSC Colonias Initiative Workgroup. PRS State Office staff attend the HHSC sponsored Colonias Initiatives Interagency Workgroup held quarterly.

Stephanie Harrison, TFTS Program Specialist, attended the HHSC Colonias Initiative workgroup meeting in Harlingen July 9th - 10th. This meeting was the first to join the Austin HHSC Colonias Initiative workgroup with local agency representatives in the Rio Grande Valley. Austin workgroup members toured the Cameron Park Colonias and Progresso Colonias and saw first-hand the need for continued collaboration between HHS agencies in regard to service provision in these areas.

TRC

HHSC

TDoA

TCADA

TCADA continues to participate in the PeopleSoft planning efforts through the Change Control Boards and the HHSAS Steering Committee to ensure the effective design and rollout of the system modules. TCADA is scheduled to migrate to PeopleSoft as of the beginning of fiscal year 2003. 

TCADA staff participated in the HHSC work group made up of other state agencies, and third party payors to define elements needed in a statewide Encounter Data System. This system will allow for sharing of encounter information and yield useful data from the CHIPS/Medicaid system.

TCADA has been designated as the lead agency for consolidation of the third-party audits function of the HHS enterprise agencies that is projected to be effective at the beginning of fiscal year 2003. TCADA has been working with the other relevant HHS agencies to accomplish this. By the end of the third quarter the following had occurred:

• identified HHS agency staff and positions currently performing the function
• identified costs associated with the current function
• developed a budget reflecting 60 percent of current costs and a budget reflecting 80 percent of current costs
• created an organizational chart showing line authority
• devised an implementation schedule to achieve the September deadline
• identified components of a service level agreement for all HHS agencies.

The final report for the HHSC AIS project was completed and transmitted to HHSC. It has since been decided that third party audit will not be consolidated and HHS agencies will work to coordinate and share work letters.

TCB

TCBWorks:
During this quarter, the Database and Conversion phase, Reports Programming Completion phase, Programming Completion phase, and Reports Unit Test phase were completed and codes for the application were delivered. Staff began developing training materials, revising job descriptions, revising policy manuals, drafting TCBWorks users guide, and unit test of the application.

TCDHH

Agency adopted standard rules and practices for purchasing, use of HUB's and contract dispute resolution.

ECI

HR Consolidation 
ECI is actively involved in HHS Administrative Services Improvement workgroups to advance consolidation efforts for Human Resources services throughout HHS agencies. 

HHS Administrative Improvements Steering Committee 
ECI staff continue to participate on the Health and Human Services (HHS) Administrative Improvements Steering Committee to assist the Health and Human Services Commission (HHSC) in its review of the effectiveness and efficiency of the business processes of all of the HHS agencies. 

Centralized Database 
ECI released version 1.0.4 of the T-KIDS application to fix or enhance several minor functions. Development focused on planned enhancements for version 2.0.0, scheduled for release in September. Major enhancements included the service coordination module, additional contact fields throughout the application, intake information and changes for the entry of services information.

TDH

The combined acceptance/system integration test will execute functional testing to verify business requirements by entering simulated transactions into the HHSAS HRMS test environment. This phase of testing provides the first opportunity for staff to use the system in a manner that simulates production. This testing will confirm that the system meets the acceptance criteria and will continue thru October 2002.

TDHS

Phase I of DHS Teleworking began during this quarter in Region 1.

DHS Region 7 implemented a new application rotation system creating a method to ensure an even workload for all Medicaid Eligibility workers, and better customer service resulting in completing applications in high volume areas of the region.

TDMHMR

TDPRS

The Franklin Covey "Four Roles of Leadership" training will be offered to 200 PRS managers beginning in September 2003. Trainers were certified for the Four Roles training this month. PSTI will be coordinating this training. Additionally, a 360 individual assessment on each manager who attends the "Four Roles of Leadership" training will be conducted prior to the managers' attendance. Individual scores will be given to the managers during the Four Roles training. Aggregate scores will be available to the agency and will be incorporated into the evaluation of the PRS Tomorrow program. 

The annual revision of contract forms and tools helped to streamline procedures, and allowed contract staff time to focus on areas of significant risk. While CAD and contract management staff have consulted throughout the revision process, all revisions will be circulated among the contract points of contact for comment prior to September 1st implementation.

APS state office In-Home team, with input from the Program Improvement Committee and the Program Administrators, developed documentation templates that were implemented in September. The templates were created to make documentation more outcome-based. The templates simplify some elements of documentation by inserting prompts, standard phrasing, and check boxes. The templates also make it easier for staff to comply with standards, decrease the number of CAPS windows staff have to open, and increase the caseworker's ability to give a complete picture of the client's situation.

The Human Resources Recruitment and Retention (R&R) Section reported the results of the separations survey for staff that voluntarily separated from the agency during the 3rd Quarter (Mar-May). R&R identified 141 former staff from the separation codes used in USPS during the quarter. The rate of return was 33%. HR forwarded the results to the Deputy Director for Programs, Regional Directors (RD), Deputy Director for Administration and the Human Resources Director.

The new TALES system has been tested and piloted for implementation in September 2002. This new system features a 75% reduction in paperwork, 80% elimination of previous data entry errors, employees receiving monthly leave summaries via e-mail and actual dollar savings due to reductions in staff and materials. 

The TeleLegal Education Project is expanding its reach to Regions 1, 2, 5, 8 and 9 to deliver Basic Skills Development Training via closed-circuit television. A "Train the Trainer" Workshop is scheduled for September 18th, 2002 in Houston for training staff and attorneys.

The HHS Training and Development Workgroup, chaired by TRC HRD, has published the initial chapters of the Training and Development Best Practices Manual on the SAO web site, with other chapters to follow. At the request of HHSC, this Workgroup has suspended operations until further notice. The HHS Administrative Training consolidation workgroup began meeting on March 28th and is meeting each Thursday. The scope of the workgroup is to assist in the designing of an Administrative division that will provide 15 areas of In Scope training, i.e., New Employee Orientation, EEOC compliance training, leadership training, IT end user training, etc. In addition, the consolidated effort will also oversee the function of external registration for training. Templates regarding the proposed design of this function were in place by May 23rd with submission to the HHSC.

TRC HRM continued as a member of the HHSC Enterprise HRM Consolidation Workgroup and participated in several sub-workgroups. The sub-work groups developed consolidation plans for the primary functions of HRM and presented them to the Enterprise HRM workgroup for approval and submission to Commissioner Gilbert. As a result of Commissioner Gilbert's further guidance, the HHSC Enterprise HRM Consolidation Workgroup will continue to meet to research and develop further streamlining initiatives in which TRC's HRM office will again participate. In addition, TRC HRM participated in the development and review of the HHSC Enterprise HRM Manual. The Enterprise HRM Manual has been cross-referenced to TRC HRM Manual. All TRC HRM policies and procedures under development (currently 12) are reviewed and coordinated with the HHSC Enterprise HRM Policies and Procedures Manual.

The HHS Records Management Workgroup completed their work on the development of an HHSC policy to standardize Record Management policies that are common throughout the HHS agencies. Policy draft was forwarded to HHSC for their action.

TRC completed the conversion of the TDHS to the new Exchange forest server bringing the total to 6 HHSC agencies now on the system. This system makes available e-mail addresses, calendars, and task lists to all users within the Outlook software.

TRC is actively involved in the ASI Facility Leasing Workgroup that is attempting to create an enterprise office leasing and space utilization service bureau. Significant progress has been made on the development of an enterprise database of office leasing data and the beginning of a process for more effective strategic planning for collocations of HHS offices in the future. In more recent activity, the workgroup is revisiting the scope of the service bureau as well as developing a detailed transition plan for addressing the establishment of the service bureau at DHS, an organizational structure for this service bureau, and how the service bureau will interact with the other HHS agencies to carry out meeting the agencies' needs for office space. We are also active on the subgroups for Lease Compilation and Automation.

TCADA

During the first quarter, TCADA announced the next round of Community Champion Award recipients. The Community Champion Award recognizes individuals and organizations that have shown a commitment to strengthening Texas children and making neighborhoods safe through education, awareness and community support. Recipients in San Antonio, El Paso, Alamo Heights, Greenville and Brazos counties received this honor. 

TCADA's Demand Reduction Initiative is an approach to more effectively address substance abuse issues by building alliances with other public and private agencies that share a common vision and purpose to increase the coordination among these agencies and to build important connections to communities and the private sector. Acting on SB 558 enacted in 2001, TCADA convened the Drug Demand Reduction Advisory Committee. At its October meeting, the Committee appointed a planning workgroup to develop draft vision and mission statements and objectives. The planning workgroup met in November and developed overview presentations and draft statements of vision and guiding principles.

In the second quarter, the Drug Demand Reduction Advisory Committee reviewed the activities of prior drug demand reduction efforts at it December meeting. In February, Jim McDonough, director of Florida's Office of Drug Control, discussed the state's activities and accomplishments in the area of drug control supply and demand.

Through the end of the fiscal year, the Drug Demand Reduction Advisory Committee workgroups had developed recommendations for all areas of the report, including prevention, treatment and enforcement.

TCADA has developed five interagency initiatives to be implemented over a three-year period. The underage drinking initiative was implemented in fiscal year 2001. In fiscal year 2002, school violence prevention and inhalant abuse prevention have been implemented. Each of these initiatives involves TCADA working with a number of other agencies and organizations, including the 11 TCADA-funded Prevention Resource Centers to address various aspects of substance abuse issues statewide.

TCADA co-sponsored a national conference on the multiple needs of the dual diagnosis population in March with approximately 500 participants from around the state and the nation. 

In the fourth quarter, TCADA sponsored the annual Institute which drew 1,130 attendees and 46 paid exhibitors. More than 40 percent of the attendees completed the overall evaluation form. Of those, approximately 98 percent of the attendees ranked the conference as either "average," "good" or "excellent." Seventy-eight percent rated the conference as "good," the highest rating on the evaluation. The focus of the Institute paralleled the five domains established in the Substance Abuse and Mental Health Services Administration's "National Treatment Plan: Changing the Conversation." 

TCADA delivers weekly prevention messages to radio stations across the state through the Drug-Free Texas Radio News Network. The network provides taped messages to more than 250 Texas radio stations with the potential to reach more than one million listeners. 

To enhance state, regional and national collaboration, TCADA provides office space and staff support for a full-time State Liaison from the Southwest Center for the Application of Prevention Technology. The State Liaison works with TCADA and the statewide prevention system to promote technology transfer and to provide training and technical assistance on best practices in prevention. Efforts in the fourth quarter focused on providing substance abuse prevention generalist training to prevention providers. This training, which is a requirement in TCADA contracts, includes 40 hours of instruction.

In the third quarter, TCADA was notified that it had been awarded the federal State Incentive Grant (SIG). Funds from this grant will be used to strengthen community prevention efforts. The SIG Advisory Committee consisting of state agency representatives and public and private sector representatives, was appointed by Governor Perry to oversee the implementation of the grant. The advisory committee met twice in the fourth quarter to begin evaluation of the current system and to make recommendations for the prevention plan. 

TCADA provides funding to prevention programs that also contribute to the agency objectives. TCADA funded organizations provide prevention services targeted to children of substance abusing parents who may or may not be in treatment, children living in poverty and children of the incarcerated. TCADA-funded prevention services were provided to 41,592 adults and 227,093 youth in fiscal year 2002.

During the first quarter, continuation contracts were signed with the Texas Youth Commission in October to provide treatment services to incarcerated youth. TCADA and the Texas Department of Protective and Regulatory Services signed an MOU that will allow TCADA-funded youth providers to treat children in TDPRS custody with chemical dependency problems as a priority youth population. 

TCADA staff worked with CRCG and TIFI staff this past year to fortify and expand coordination of community resources with the goal of implementing systems of care models for children with extensive/special needs.

TDMHMR

TDoA

ECI

During this quarter, Region 11 promoted and marketed a PBS documentary program, And Thou Shalt Honor, to the local community. By promoting this program, Region 11 hoped to raise awareness of what caregivers go through on a day-to-day basis. The documentary will be aired nationally on October 9, 2002 and benefits the elderly, their caregivers, and the general public. The documentary focuses on caregiving issues as one of the most critical social issues our community faces. 

In August 2002, a Memorandum of Understanding (MOU) was completed between DHS Region 11 and the Area Agency on Aging (AAA) Rio Grande Development Council. The MOU creates a partnership with agencies that serve the same clients and helps those caregivers who need services. The MOU established a referral system so DHS staff can send clients needing help with respite care to AAA for additional assistance. The new referral system gives the AAA and DHS an opportunity to reach more clients and caregivers, especially caregivers in need of respite care.

The PEI project in Amarillo provided respite services for families in crisis situations during the fourth quarter of 2002.

The State Office of Community Resource Coordination Groups continued to work with local CRCGs and other interagency coalitions to expand the capacity to serve older youth and adults with transition and other complex needs through a CRCG. 

Memorandum of Understanding under Texas Government Code Section 531.055 fully signed and disseminated. MOU expands mandate for counties to develop capacity to serve older youth over age 18 and adults through a CRCG, including young adults with complex needs in transition to adult serves.

During the period, an additional seven (7) sites implemented the development of individual service planning for adults, including six (6) CRCGs for Children and Youth who expanded their focus to include adults and one (1) additional group developed to serve primarily adults. As of August 31, 2002, 28 sites (including multi-county CRCGs) covering 65 counties in Texas were serving adults through a CRCG. 

Provided transition training through 2 Regional Conferences in March and April 2002 (Houston and Lubbock). Total conference participation exceeded 250 attendees.

In the second quarter training was provided to a total of more than 900 people in Laredo, Austin, Amarillo, Dallas, Harlingen, Houston, Odessa, San Antonio and Mesquite. Trainings included topics on adolescent mental health, documenting prevention activities, DWI education programs, dual diagnosis, HIV overview, rules training, and DSM-IV.

In the third quarter, training was provided to approximately 1,000 people in Amarillo, Austin, Beaumont, Corpus Christi, El Paso, Fort Worth, Houston, Longview, Lubbock and San Antonio. Training topics included dual diagnosis, demons and self-medication, TCADA chapter 150 rules, continuum of care; treatment planning and client, cultural sensitivity training, opioid treatment, DSM-IV and Medicaid fraud training.

In addition, ECI continues to:

Collaborate with TEA, Head Start, Migrant Head Start and Early Head Start programs to enhance linkages.

Work with the Texas Department of Protective and Regulatory Services (TDPRS) and the Texas Workforce Commission (TWC) to inform childcare providers about ECI services.

Region 3 expanded the Rock Soup project. A Memorandum of Understanding was signed during this period with Catholic Charities of Dallas.

All recipients of the Region 3 Medically Dependent Children Program (MDCP) and Comprehensive Care Program (CCP) are being contacted before they "Age Out" (reach their 21st birthday) of the program. Home visits will be scheduled to provide information on service options and begin the planning process for continued service delivery.

Texas Tech University began planning for a PAL partnership that will provide scholarships, a college conference, and other types of support to PAL students who attend the university. CPS PAL staff in Lubbock and state office will be working with Texas Tech staff on this new partnership.

Lapsing 2001 Chafee funds were used by regions to purchase telephone calling cards for youth in foster care (or recently out of foster care) to preserve connections with siblings/significant others, bus passes or bus tokens for youth transportation, and additional computers for youth. State office PAL purchased "Ready, Set, Fly" guidebooks for foster care providers to help youth learn life skills, and E-Mentoring services from the Orphan Foundation of America for 45 youth attending college or vocational training.

HHSC

A housing MOU to assist in the dissemination of 35 housing vouchers received from HUD for use with the Olmstead population in their efforts to transition from institutions to the community in accessible, affordable, integrated housing.

Additionally the housing workgroup, which is a sub-workgroup from the SB367 Task Force, continues to meet to work on housing issues in general and the process involved in the distribution of these vouchers.

The HHSC also directed the TDMHMR to develop a selected essential services waiver with existing general revenue and to direct the savings generated by this waiver at the home and community based waiting list. Development of the waiver continues and is targeted for submission to CMS in November of 2002. This waiver will serve individuals in the community, with an array of selected essential services within an annual service cap of $10,000.00. We anticipate through the development of this waiver to serve a large number of individuals waiting for just this limited service package. The waiver will be entitled the Texas Home Living Waiver and the HHSC and TDMHMR are currently working with the local mental retardation authority centers fiscal staff in order to determine the service array and discuss the needed service rates.

The HHSC has asked the Texas Workforce Commission to appoint a member to the SB 367 Task Force to assist in development of a plan related to workforce issues. Mr. Roy Kimble from the Texas Workforce Commission has been appointed and began attending the SB 367 Task Force meeting this summer.

The SB367 Task Force is developing a report to be submitted to the HHSC on September 1, 2002. This report will contain the stakeholders recommendations related to the Promoting Independence Initiative and the Executive Order RP-13.

The HHSC long-term care services and supports area did award a contract to the EveryChild Inc. in order to begin implementation of the "Family Based Alternatives Project".

The HHSC hired to staff positions through DD Planning Council funds to monitor placements of children in institutions as required by SB 368, as well train agency staff, providers, and staff surveyors regarding the essential elements necessary to develop a quality permanency plan for a child in an institution.

The SB 367 Task Force continues to monitor the implementation of the DHS Relocation Specialists pilots, the implementation of Rider 37, and the community living options process from TDMHMR to determine the impact on capacity of community services and the numbers of individuals moving from institutions through this initiative.

TDoA

ARCIL- Austin/Houston/Crockett area (Travis, Bastrop, Caldwell, Comal, Hays, Williamson, Anderson, Blanco, Burnet, Cherokee, Leon Milan Polk, Angelina, Harris, Nacogdoches, and Trinity counties).

Accessible Communities (ACI) - Corpus Christi area (Nueces, San Patricio, Aransas, Bee, Brooks, Duval, Jim Wells, Kenedy, Kleberg, Live Oak, McMullen, and Refugio counties).

COMBRIDGE- Temple area (Bell and Coryell counties). 

The contractors have developed and started distribution of outreach material regarding long term care options and relocation services. The contractors' relocation activities include identification, assessment and assistance to Medicaid eligible nursing facility residents (adults and children) interested in transitioning to community-based settings. Contractors' relocation activities include identification, assessment and assistance to Medicaid eligible nursing facility residents (adults and children) interested in transitioning to community-based settings. A total of 68 Nursing Facility residents have been identified for relocation to the community.

Referred 13 individuals to the Housing Voucher Program (HVP) at the Texas Department of Housing and Community Affairs.

Referred 2 individuals to the Transition to Life in the Community Program (TLC). The program allows $2,500 one time vouchers to be used for deposits, household goods, rent etc. 

Successfully transitioned 3 individuals to the community. 

The relocation activities were at the five pilot sites of Corpus Christi, Austin, Temple, Crockett, and Houston. 

Region 8 LTCS (Long Term Care Services) created a workgroup to assist in the transition of nursing clients to community-based care. The workgroup consists of LTCS staff and several advocacy groups. The workgroup considers individual cases to determine transition obstacles, then works to find ways to overcome these obstacles. 

The Office on Services to Persons with Disabilities (OSPD) held their seventh annual Health and Awareness Fair at Cielo Vista Mall in El Paso on August 17, 2002. More than 45 federal, state, county, city, non-profit and for-profit agencies were represented, offering many services for disabled individuals and their families. DHS sponsored this event, which has grown every year in agency participation, collaboration, and public attendance.

• Beginning 9/1/01, 259 new slots were distributed to MRAs using the Equity Formula.
• By the end of Q3, 254 persons were enrolled in waiver services.

State Mental Retardation Facilities (SMRFs):

• Of the 236 persons identified for movement to a community alternative by February 28, 2002, all but 2 moved or had their referral closed.
• An additional 164 persons were identified this fiscal year for movement to a community alternative. Of these, 78 persons moved and 68 remained with a current referral.

Large Community ICFs/MR

• Beginning this FY, 227 persons were living in large ICFs/MR (14 beds or more) and on the TDMHMR waiver waiting list; 
• Of the 227, 135 were either enrolled or pre-enrolled in TDMHMR waiver services and 31 persons remained (i.e., not enrolled or pre-enrolled)
• 303 persons were added to the waiver waiting list since 9/1/01. No new targeted waiver slots are available for these persons.

Persons in State Mental Health Facilities (SMHFs) Over 12 Months

• For this quarter, there were 396 patients who had been in SMHFs for more than 365 days. Of those, 38 had been determined to have barriers and for those patients who remained from the previous quarter, facility treatment teams will develop a continuity of care plan with the local mental health authority in order to remove the barriers preventing discharge.

Persons with Mental Illness and 3 Admissions to a SMHF in 180 days

• The Department has collected and analyzed CARE and encounter data on these persons. Plans are underway to do chart reviews and interviews with a sample of this group to better understand their service needs in the community. Strategies will be developed to address these needs. 
• An appropriations request has been developed that addresses this group as well as other high risk groups, including individuals with substance abuse disorders in addition to mental illness and individuals with mental illness who have frequent contact with the criminal justice system.

MOU

• An MOU between TDHS, TDMHMR, and TDPRS has been developed.
• Adoption by rule is required by SB 367; this was approved by the TDMHMR Board for adoption October 2002.

The Department is a partner with HHSC in these efforts, and the implementation of the Texas Promoting Independence Plan will have significant impact on department operations and policies over the coming years.

TCB