Texas Health and Human Services Digest: December 18, 2020

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From HHSC: While every effort has been made to offer an accurate and current listing of meeting agendas and events on this calendar, the information has been compiled from a variety of sources and is subject to change without notice to the user.

December 22, 2020

Proposed Rules
Formal Comments via the Texas Register
To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State. Interested parties then can review and comment on the proposed rule. The Secretary of State publishes a new issue of the Texas Register each Friday.

The Administrative Procedure Act (Texas Government Code, Chapter 2001) requires the notice published in the Texas Register to include a brief explanation of the proposed rule and a request for comments from any interested person. The notice also includes instructions for submitting comments regarding the rule to the agency, including the date by which comments must be submitted. Agencies must give interested persons “a reasonable opportunity” to submit comments. The public comment period begins on the day after the notice of a proposed rule is published in the Texas Register and lasts for a minimum of 30 calendar days.

Below is a list of proposed rules that have been published in the Texas Register. The proposed rules that are published in the Texas Register are open for public comment until the end of the comment period.

TitleProject No., DescriptionContactComment End Date
Title 1, Chapter 393, Informal Dispute Resolution and Informal Reconsideration#20R093: Informal Dispute ResolutionAllison Levee12/28/20
Title 26, Chapter 746, Minimum Standards for Child-Care Centers#20R024: Physical Activity, Nutrition, and Screen Time for Licensed Day Care and Registered HomesHHS Child Care Regulation12/21/20
Title 26, Chapter 747, Minimum Standards for Child-Care Homes#20R024: Physical Activity, Nutrition, and Screen Time for Licensed Day Care and Registered HomesHHS Child Care Regulation12/21/20
Title 25, Section 133.48, Patient Safety Program repeal#20R010: Medical Error ReportingHHS Policy, Rules and Training12/21/20
Title 25, Section 135.26, Reporting Requirements, and Section 135.27, Patient Safety Program repeal#20R010: Medical Error ReportingHHS Policy, Rules and Training12/21/20
Title 26, Section 510.47, Patient Safety Program repeal#20R010: Medical Error ReportingHHS Policy, Rules and Training12/21/20
Title 26, Chapter 742, Minimum Standards for Listed Family Homes#20R021: Listed Family HomesHHS Child Care Regulation12/21/20
Title 26, Chapter 744, Minimum Standards for School Age and Before or After School Programs#20R024: Physical Activity, Nutrition, and Screen Time for Licensed Day Care and Registered HomesHHS Child Care Regulation12/21/20

Draft Rules Informal Comments

Informal opportunities to comment occur before a rule is published in the Texas Register. HHS staff may solicit informal public and stakeholder input by:

  • inviting stakeholders to submit comments on potential rule changes during rule development.
  • sharing a draft rule with stakeholders for review.
  • using existing HHS advisory committees to comment on rules.

There are currently no rules available for comment.

2020 Schedule

TitleProposed Effective DatePacket UpdatedDocuments
Notice of Adjustments to Fees, Rates or Charges for Quarterly Healthcare Common Procedure Coding System (HCPCS) Updates Related to Coronavirus Disease 2019 (COVID-19) Vaccine AdministrationDecember 11, 2020 Notice of Adjustments to Fees, Rates or Charges for Quarterly Healthcare Common Procedure Coding System (HCPCS) Updates Related to Coronavirus Disease 2019 (COVID-19) Vaccine Administration
12-11-2020-hcpcs-update-covid-19-vaccine-admin-rate-info.pdf

2021 Schedule

TitleProposed Effective DatePacket
Updated
Documents
Notice Of Proposed Prospective Reimbursement For Rural Hospitals Participating In MedicaidSeptember 01, 2021 Notice Of Proposed Prospective Reimbursement For Rural Hospitals Participating In Medicaid
09-01-2021-prospective-reimbursement-rural-hospitals-in-medicaid.pdf

Notice Of Proposed Prospective Reimbursement For Rural Hospitals Participating In Medicaid Attachment
09-01-2021-prospective-reimbursement-rural-hospitals-in-medicaid-attch-rate-vis.pdf

Notice of Proposed Adjustments to Fees, Rates or Charges for Wound CareMarch 01, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for Wound Care
03-2021-policy-woundcare.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Telemonitoring UpdateMarch 01, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for Telemonitoring Update
03-2021-policy-telemonitoring.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Stereotactic RadiosurgeryMarch 01, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for Stereotactic Radiosurgery
03-2021-policy-stereotactic-radiosurgery.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Nutritional (Enteral) Products, Supplies, and Equipment – Home Health & CCP: Immobilized Lipase CartridgeMarch 01, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for Nutritional (Enteral) Products, Supplies, and Equipment – Home Health & CCP: Immobilized Lipase Cartridge
03-2021-policy-nutrional-prod-sup-equip.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Digital Breast TomosynthesisMarch 01, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for Digital Breast Tomosynthesis
03-2021-policy-dbt.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Colorectal Cancer Screening PolicyMarch 01, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for Colorectal Cancer Screening Policy
03-2021-policy-colorectal-cancer-screen.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Healthcare Common Procedure Coding System (HCPCS)March 01, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for Healthcare Common Procedure Coding System (HCPCS)
03-2021-policy-hcpcs.pdf

Notice of Proposed Adjustments to Fees, Rates or Charges for Healthcare Common Procedure Coding System (HCPCS) Attachments
03-2021-policy-hcpcs-att.zip

Biennial Calendar Fee ReviewMarch 01, 2021 Biennial Calendar Fee Review
03-2021-biennialcalendarfeereview.pdf

Biennial Calendar Fee Review Attachments
03-2021-biennialcalendarfeereview-att.zip

Notice of Adjustments to Fees, Rates or Charges for Quarterly Healthcare Common Procedure Coding System (HCPCS) Updates Related to Coronavirus Disease 2019 (COVID-19)January 01, 2021 Notice of Adjustments to Fees, Rates or Charges for Quarterly Healthcare Common Procedure Coding System (HCPCS) Updates Related to Coronavirus Disease 2019 (COVID-19)
01-01-2021-notice-adjfeesratescharges-hcpcs-covid19.pdf

Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set Quarterly Q&As, December 2020: The Centers for Medicare & Medicaid Services (CMS) is publishing the LTCH CARE Data Set (LCDS) Quarterly Q&As, December 2020 document so that all LTCH providers have the benefit of the clarifications to existing guidance. Through inquiries to the LTCH Post-Acute Care (PAC) Quality Reporting Program (QRP) Help Desk, CMS identifies the opportunity to clarify or refine guidance.

The Quarterly Q&As document can be accessed via the LTCH-Care-Data-Set and LTCH QRP Manual webpage.

Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Quarterly Q&A, December 2020. The Centers for Medicare & Medicaid Services (CMS) is publishing the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Quarterly Q&As, December 2020 document so that all IRF providers have the benefit of the clarifications to existing guidance. Through inquiries to the IRF Post-Acute Care (PAC) Quality Reporting Program (QRP) Help Desk, CMS identifies the opportunity to clarify or refine guidance.

The Quarterly Q&A document can be accessed via the IRF-PAI and IRF QRP Manual webpage.

CMS Announces New Model Opportunity for Medicaid Managed Care Organizations Serving Beneficiaries Dually Eligible for Medicare and Medicaid. The Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare & Medicaid Innovation is announcing a new opportunity to enable Medicaid Managed Care Organizations (MCOs) to better serve enrollees who are dually eligible for Medicare and Medicaid. This new Model opportunity is the first CMS initiative designed to harness the power of Medicaid MCOs to coordinate Medicare and Medicaid services and improve health outcomes for the population of dually eligible beneficiaries who are in both Medicaid managed care and Medicare fee-for-service (FFS).

Currently, Medicaid MCOs do not have an incentive to coordinate care in a way that reduces Medicare FFS costs for dually eligible beneficiaries.  By better aligning incentives, the new opportunity for MCOs to participate in the Global and Professional Options of the Direct Contracting Model seeks to encourage Medicaid MCOs to partner with providers and suppliers and implement care coordination programs that can improve quality and reduce Medicare FFS costs.

Some examples of the actions MCOs and their affiliates serving as MCO-based Direct Contracting Entities (DCEs)—organizations that participate in Direct Contracting via a participation agreement with CMS—could take to better serve dually eligible beneficiaries include:

  • Establishing processes to connect aligned beneficiaries to a primary care provider, particularly high-value Medicare fee-for-service healthcare providers;
  • Risk-stratifying and targeting care coordination resources toward aligned beneficiaries at risk of high Medicare spending;
  • Deploying care coordinators or in-home aides who provide Medicaid long term services and supports to also actively promote flu vaccines, preventive screenings, evidence-based falls prevention, and diabetes management activities;
  • Having care coordinators or in-home aides who provide Medicaid long term services and supports assist enrollees with managing Medicare-covered medical appointments to help reduce missed treatments;
  • Training in-home aides – who often cook meals for their clients – on meal preparation for individuals with nutrition-sensitive conditions, like diabetes; and
  • Entering into value-based purchasing arrangements with nursing facilities that factor in facilities’ hospitalization rates.

In 2019, 12.2 million Americans were concurrently enrolled in both Medicare and Medicaid. Dually eligible individuals are an especially high needs population, with 70 percent of dually eligible individuals having three or more chronic conditions and more than 40 percent having at least one mental health diagnosis.  These dually eligible individuals must navigate two separate programs for their healthcare: Medicare for the coverage of most preventive, primary, and acute health care services and drugs, and Medicaid for coverage of long-term services and supports, certain behavioral health services, and for help with Medicare premiums and cost sharing. A lack of alignment and cohesiveness between Medicare and Medicaid can often lead to fragmented and episodic care for dually eligible individuals. This can result in reduced quality of care for these individuals as well as increased costs to both the Medicare and Medicare programs. Dually eligible individuals account for approximately 20 percent of all Medicare enrollees, but more than one-third of Medicare costs.

CMS believes that dually eligible individuals can benefit from more integrated systems of care that meet all of their needs — primary, acute, long-term, behavioral, and social — in a high quality, cost-effective manner.  This new opportunity to participate in Direct Contracting creates the incentives and flexibilities for Medicaid MCOs to better integrate care for these beneficiaries.

To ensure that the participation of MCO-based DCEs in Direct Contracting aligns with states’ plans to better serve dually eligible beneficiaries, MCO-based DCEs will be required to obtain a letter of support from their state Medicaid agency to participate in the model.  CMS will track both Medicare and Medicaid expenditures in order to ensure there is no cost-shifting from Medicare to Medicaid or vice versa.

In early 2021, the Innovation Center expects to release a Request for Applications (RFA) for all Professional and Global DCE types, including MCO-based DCEs. This will be the first Direct Contracting RFA to include MCO-based DCEs. MCO-based DCEs will begin participating in the model in January 2022.

For more information, please visit: https://www.cms.gov/newsroom/fact-sheets/direct-contracting-model-professional-and-global-options-medicaid-managed-care-organization-mco

MCO-based Direct Contracting Entity Type Announced for the Direct Contracting Model Professional and Global Options. The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation is excited to announce a new type of Direct Contracting Entity (DCE) to better serve the needs of individuals dually eligible for Medicare and Medicaid. This new DCE type will allow Medicaid Managed Care Organizations (MCOs) and affiliated organizations to better coordinate care for their dually eligible Medicaid managed care enrollees under the Direct Contracting Model Professional and Global Options. Currently, Medicaid MCOs do not have an incentive to coordinate care in a way that reduces Medicare fee-for-service costs for dually eligible beneficiaries. By better aligning incentives, the new MCO-based DCE type seeks to encourage MCOs to partner with health care providers and implement care management programs that can improve quality and reduce Medicare costs.

In early 2021, the Innovation Center expects to release a Request for Applications (RFA) for all Professional and Global DCE types, including MCO-based DCEs. This will be the first RFA under Direct Contracting to include MCO-based DCEs. MCO-based DCEs will begin participating in the model in January 2022.

For more information, please refer to the recently released “Medicaid Managed Care Organization (MCO)-based Direct Contracting Entity (DCE) Fact Sheet” on the Direct Contracting webpage at https://innovation.cms.gov/innovation-models/direct-contracting-model-options. Stakeholders can also email the model team with questions and comments at DPC@cms.hhs.gov.

2018 MCBS Chartbook is now available! CMS has released the annual update to the Medicare Current Beneficiary Survey (MCBS) Chartbook with data for 2018 located here.  The MCBS Chartbook is designed to provide the public with a collection of charts and tables presenting estimates from the MCBS.

The MCBS Chartbook is organized into 5 sections:

  • Section 1: Who is in the Medicare Population? Demographic and socioeconomic characteristics of Medicare beneficiaries.
  • Section 2: How Healthy are Medicare Beneficiaries? Self-reported health status and health behaviors of Medicare beneficiaries.
  • Section 3: What is the Medicare Population’s Access to Care and How Satisfied Are They with Their Care? Access to and satisfaction with health care services.
  • Section 4: What Health Care Services Do Medicare Beneficiaries Receive? Health care use by Medicare beneficiaries across nine service categories, including: inpatient hospital services, outpatient hospital services, physician/supplier services, dental services, prescription drugs, Medicare hospice, Medicare home health, skilled nursing facility, and long-term nursing home care.
  • Section 5: How Much Do Health Care Services for the Medicare Population Cost? Health care expenditures and all sources of payment across service categories.

The 2018 MCBS Chartbook features several updates. Two measures have been permanently added to the Chartbook with this release: (1) self-reported limited English proficiency in Section 1 and (2) out-of-pocket Medicare premium expenditures in Section 5. In addition, the 2018 version of the Chartbook includes a special feature on language use among Medicare beneficiaries.

MCO-based Direct Contracting Entity Type Announced for the Direct Contracting Model Professional and Global Options. The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation is excited to announce a new type of Direct Contracting Entity (DCE) to better serve the needs of individuals dually eligible for Medicare and Medicaid. This new DCE type will allow Medicaid Managed Care Organizations (MCOs) and affiliated organizations to better coordinate care for their dually eligible Medicaid managed care enrollees under the Direct Contracting Model Professional and Global Options. Currently, Medicaid MCOs do not have an incentive to coordinate care in a way that reduces Medicare fee-for-service costs for dually eligible beneficiaries. By better aligning incentives, the new MCO-based DCE type seeks to encourage MCOs to partner with health care providers and implement care management programs that can improve quality and reduce Medicare costs.

In early 2021, the Innovation Center expects to release a Request for Applications (RFA) for all Professional and Global DCE types, including MCO-based DCEs. This will be the first RFA under Direct Contracting to include MCO-based DCEs. MCO-based DCEs will begin participating in the model in January 2022.

For more information, please refer to the recently released “Medicaid Managed Care Organization (MCO)-based Direct Contracting Entity (DCE) Fact Sheet” on the Direct Contracting webpage at https://innovation.cms.gov/innovation-models/direct-contracting-model-options. Stakeholders can also email the model team with questions and comments at DPC@cms.hhs.gov.

Thank you,
The Direct Contracting Model Team

Monitoring for Hospital Price Transparency. Hospital Price Transparency requirements go into effect January 1, 2021.  CMS plans to audit a sample of hospitals for compliance starting in January, in addition to investigating complaints that are submitted to CMS and reviewing analyses of non-compliance, and hospitals may face civil monetary penalties for noncompliance.

Is your institution prepared to comply with the requirements of the Hospital Price Transparency Final Rule? Effective January 1, 2021, each hospital operating in the United States is required to provide publicly accessible standard charge information online about the items and services they provide in 2 ways:

  • Comprehensive machine-readable file with all items and services
  • Display of 300 shoppable services in a consumer-friendly format

In the final rule, CMS outlined a monitoring and enforcement plan to ensure compliance with the requirements.  We finalized a policy that CMS monitoring activities may include, but would not be limited to, the following, as appropriate:

  • Evaluation of complaints made by individuals or entities to CMS
  • Review of individuals’ or entities’ analysis of noncompliance
  • Audit of hospital websites

If we conclude a hospital is noncompliant with one or more of the requirements to make public standard charges, we may take any of the following actions, which generally, but not necessarily, will occur in the following order:

  • Provide a written warning notice to the hospital of the specific violation(s)
  • Request a Corrective Action Plan (CAP) if noncompliance constitutes a material violation of one or more requirements
  • Impose a civil monetary penalty not in excess of $300 per day and publicize the penalty on a CMS website if the hospital fails to respond to our request to submit a CAP or comply with the requirements of a CAP

See 45 CFR part 180 Subpart C- Monitoring and Penalties for Noncompliance.
Visit the Hospital Price Transparency website for additional information and resources to help hospitals prepare for compliance, including:

View this edition as a PDF (PDF)

NIH researchers discover brain area crucial for recognizing visual events. Researchers at the National Eye Institute (NEI) report that a brain region in the superior temporal sulcus (fSTS) is crucial for processing and making decisions about visual information. The findings, which could provide clues to treating visual conditions from stroke, appear today in the journal Neuron. NEI is part of the National Institutes of Health.

Read the release.

Cataract surgery in infancy increases glaucoma risk. Children who undergo cataract surgery as infants have a 22% risk of glaucoma 10 years later, whether or not they receive an intraocular lens implant. The findings come from the National Eye Institute (NEI)-funded Infant Aphakic Treatment Study, which today published 10-year follow-up results in JAMA Ophthalmology. NEI is part of the National Institutes of Health.

Read the release.

Changes to Texas Administrative Code Chapter References for HHS System. As part of the transformation of the Health and Human Services (HHS) system, rule chapters are being relocated in the Texas Administrative Code (TAC).
Effective January 15, 2021, rules in:

  • 40 TAC Social Services Assistance, Part 1, Department of Aging and Disability Services, Chapter 98, Day Activity and Health Services Requirements

Will be transferred to:

  • 26 TAC Health and Human Services, Part 1, Texas Health and Human Services Commission, Chapter 559, Day Activity and Health Services Requirements.

The table below outlines recent rule transfers.

Rule TitleCurrent TACNew TAC
Introduction40 TAC 98, Sub A26 TAC 559, Sub A
Application procedures40 TAC 98, Sub B26 TAC 559,  Sub B
Facility Construction Procedures40 TAC 98, Sub C26 TAC 559, Sub C
Licensure and Program Requirements40 TAC 98, Sub D26 TAC 559, Sub D
Inspections, Surveys, and Visits40 TAC 98, Sub E26 TAC 559, Sub E
Abuse, Neglect, and Exploitation: Complaint and Incident Reports and Investigations40 TAC 98, Sub F26 TAC 559, Sub F
Enforcement40 TAC 98, Sub G26 TAC 559, Sub G

You will need to refer to the new TAC chapters after January 15, 2021. All letters, memoranda, and other guidance remain in effect while HHSC updates outdated references. The rule transfer notice was posted in the December 18, 2020, issue of the Texas Register.

If you have questions about these administrative moves, email the Rules Coordination Office.

Read more.

Resources for PEI Stakeholders and Providers. Strengthening families and communities has never been more important than it is right now. PEI is here to help.

Our program specialists have been compiling family and caregiver resources alongside public health information for you.

To review previously released resources visit our website.

I. COVID-19 and Texas
COVID is on the rise in Texas. 
Now more than ever it’s important for Texans to practice safety precautions where they live, work, and play.

Coronavirus Guidance from DSHS and the Governor is available online for all Texans as we respond to the pandemic. Information changes weekly; it’s a good idea to bookmark this page for the most up-to-date, accurate information on current response efforts.

The Texas Department of Housing and Community Affairs has published updated resources for Texas families regarding the eviction moratorium on their COVID-19 page.

Additional COVID resources

II. Funding Opportunities
The Prevention and Early Intervention (PEI) Division seeks applications to develop and implement the following program:

All requests, questions or other communication about this RFA shall be made in writing to:
Jennifer Kim, CTCD, CTCM
Health and Human Services Commission 1100 West 49th Street; Mail Code 2020 Building S Austin, TX 78756
Jennifer.Kim@hhs.texas.gov

All communications between Applicants and DFPS staff members concerning the RFA are strictly prohibited, unless noted elsewhere in this RFA. Failure to comply with these requirements may result in disqualification of Applicant’s Grant Application.

If you have a plan for helping your community, Walmart may be able to help. Walmart’s Local Community Grant Program awards grants to eligible kindergarten-through-12th grade public, private or charter schools. Proposed projects could be a soup kitchen, food pantry, clothing closet or other activities that benefit the community at large. The deadline to apply is December 31. Visit the Local Community Grant Program for a complete list of eligibility requirements and areas of funding.

III. HelpAndHope is now GetParentingTips.com
Our parenting tips website HelpAndHope.org has a new look, feel, and URL. We listened to parents and built it to be easier to find for parents looking for help. You can now find our updated resources at GetParentingTips.com! While the name has changed, the mission of our site stays the same: to provide quality parenting resources that help normalize the challenges of parenting, encourage seeking help, and support parents through their parenting journey. Bookmark the site today and share with families in your programs.

IV. Provider Spotlight
Laredo
As Part of the Prevention and Early Intervention “Where I Come From” series, The Community Youth Development Program with Las Promesas de Laredo (Southwest Keys), submitted a quirky, fun, and moving trio of videos created by youth participants about life under COVID.
An Unwelcome Guest 
Saying Goodbye to COVID
Where I Come From – Laredo

Letters about life during the pandemic, drawings, and discussions about youth and mental health build a profile of resilience in the community. Some examples from youth letters:

  • “I Miss Going to the Gym and Music.”
  • “I miss my School.”
  • “When the pandemic first hit it was during my spring break and of course I was hyped about this; looking back on it I thought I would lose my mind for sure.”
  • “I like that I’m not shy to talk to the teacher on the computer.”
  • “Does anyone ever feel down, not being able to do things or not being able to enjoy our high school years? I get real sad not being able to enjoy senior year and have the happy memories that everyone had before us.”

V. Request for Feedback: FAYS Program
The Prevention and Early Intervention (PEI) division is seeking feedback regarding the Family and Youth Success (FAYS) (formerly STAR) Program. FAYS is the longest-standing statewide prevention grant program administered by PEI. FAYS addresses family conflict and everyday struggles while promoting strong families and youth resilience.

PEI welcomes written responses and comments by January 29, 2021 at 2:00 P.M. CST.

Visit the PEI Request for Feedback page for more details.

VI. PEI Community Resources
The Brain Architects Podcast: Connecting Health & Learning Part I: The Science

The environments we create and the experiences we provide for young children and their families affect not just the developing brain and early learning, but also many other physiological systems and lifelong health. Derived from the science in their most recent working paper, the newest episode of The Brain Architects podcast addresses all of these questions by explaining how early childhood development and lifelong health are intertwined. Listen to the episode.

VII. Resources for Families
Stop TX Eviction portal now online. 
The Stop TX Eviction portal is an online tool for anyone having trouble paying their rent in Texas. This interactive tool helps people understand their legal rights, the typical eviction process, and what steps they should take to protect themselves. All of the information and resources provided throughout the site and tool are free. The service is available in English and Spanish.

This holiday season looks different for many families. This article from Motherly can help guide you as you talk with your child about managing holiday disappointment and building a positive perspective as a family.

Self care is for everyone, including kids. Check out this post from the Texas Youth Action Network on helping your child to set some self-care goals this winter that will keep them going ’til spring.

Remember to be careful with toys, wrapping, and decorations to keep your kids safe this holiday season. Here’s two resources to help families stay safe:

VIII. Resources for Kids at Home
PBS has a variety of educational resources on their website each month.
 Check out the educational programs for December, and bookmark the Learning Opportunities page for more information.

Know any kids who’d like to call Santa? Santa’s Hotline is a free resource for families that allows kids to send a message.

December is full of all sorts of holidays around the world. Check out this list of Winter Holidays to see how people celebrate the most wonderful time of the year!

IX. 2021 Prevention Calendars Now Available

This free family resource is filled with helpful tips for parents and caregivers of children of all ages. It’s available in English and Spanish, and endorsed by The Texas Pediatric Society.

Order while supplies last! Calendars are shipped for free and in quantities of 100 calendars per box. Questions? Contact us.

Order 2021 Calendars