The Texas Example
By Rachel Jew, MPA
Title V CSHCN Director
Manager, CSHCN Systems Development Group
Title V Maternal and Child Health
Texas Department of State Health Services
The 2017 AMCHP Conference brought together state and federal MCH leaders to discuss the response to Zika. This is a summary of how Texas is responding to Zika by engaging with many local and federal partners.
The Texas Title V program has been working closely with partners within and outside of the Texas Health and Human Services system to address the emergence of Zika virus through education, surveillance and connection to services.
Along the Texas/Mexico border, community health worker (CHW) programs will be increasing education activities using a revised Zika training curriculum and tools. The Department of State Health Services (DSHS) Office of Border Services is an essential partner in this effort and will be responsible for training CHW instructors and programs to use the new curriculum and tools.
New materials (flow charts/decision trees) for the medical community are under development. This visual presentation of DSHS and Centers for Disease Control and Prevention (CDC) guidance documents will help providers know whom and when to test and how to manage suspected Zika infection in pregnant women and suspected Congenital Zika Syndrome in infants. DSHS will implement a communication plan to increase provider awareness of the new tools.
The DSHS Birth Defects Epidemiology and Surveillance (BDES) branch received a CDC grant focused on surveillance, intervention and referral to services for infants with microcephaly and other Zika-related conditions. Family outreach will be conducted through a partnership with the Family Voices State affiliate organization, Texas Parent to Parent.
In July 2016, DSHS convened a workgroup to discuss the system of services for children and families affected by Zika. Led by the Texas Title V program, the workgroup developed a flow chart depicting the system of services for children with Congenital Zika Syndrome. To aid in BDES' referral and outreach efforts and to determine the efficacy of the flow chart, DSHS will conduct a pilot to connect families to services. The pilot will be limited to statewide cases of severe microcephaly (< 3rd percentile head circumference) and Congenital Zika Syndrome.
Other efforts by DSHS include providing education about Zika virus through the TexasZika.org website, fliers and brochures that provide prevention tips, a podcast about Zika in Texas featuring DSHS Commissioner Dr. John Hellerstedt and produced in partnership with Texas Health Steps Online Provider Education, and a forthcoming page on the NavigateLifeTexas.org about Zika for families.
Texas also participated in national Zika efforts. The Title V Maternal and Child Health Medical Director participated in the AAP/CDC Clinical Evaluation and Management of Infants with Congenital Zika Virus meeting and was a contributor to a report that provided updated guidance for the evaluation and management of babies with possible Congenital Zika Virus Infection. She was invited to serve on the AAP's Project ECHO Zika Advisory Committee. Texas looks forward to partnering with the CDC on its Zika Care Connect project.