Texas Health and Human Services Digest: September 16, 2020

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Upcoming Public Meetings.

Previous meetings have made alternative arrangements like phone capability or have been cancelled. These meetings are on the Calendar as of today.

September 16, 2020

September 17, 2020

September 18, 2020

September 22, 2020

September 23, 2020

September 24, 2020

HHSC has the Following Rules Available for Comment.

The Administrative Procedure Act (Texas Government Code, Chapter 2001(link is external)) 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.

The Administrative Procedure Act (Texas Government Code, Chapter 2001(link is external)) 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.

TitleProject No., DescriptionContactComment End Date
Title 25, Chapter 1, Subchapter V, Adult Stem Cells#20R014: Informed Consent for Investigational Stem Cell TreatmentHHS Rules Coordination Office10/12/20
Title 25, Chapter 97, Subchapter A, Control of Communicable Diseases#20R059: Notifiable ConditionsHHS Rules Coordination Office10/12/20
Title 40, Chapter 9, Sections 9.153 and 9.553; Chapter 42, Section 42.103; Chapter 45, Section 45.103; and Chapter 49, Sections 49.102, 49.208 – 49.210, 49.532, 49.551, 49.601, 49.702, and new Section 49.561#20R048: Convert Open-Ended Contracts to Term ContractsHHS Rules Coordination Office10/12/20
Title 25, Chapter 37, Maternal and Infant Health(link is external)#19R012: Texas School Health Advisory CommitteeDSHS School Health9/28/20
Title 25, Chapter 85, Local Public Health(link is external)#20R003: Data Request Process for Public Health Practice PurposesDSHS Center for Health Policy and Performance9/28/20
Title 25, Chapter 221, Meat Safety Assurance(link is external)#20R013: Low-Volume Livestock Processing EstablishmentsDSHS PSQA Meat Compliance Unit9/28/20
Title 1, Chapter 355, Reimbursement Rates(link is external)#20R054: HCS and TxHmL Respite and Day Habilitation ReimbursementHHS Rate Analysis Department9/21/20

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.
Title Project No. Contact Comment Start Date Comment End Date
Title 25, Chapter 228, Retail Food, concerning Texas Food Establishments#20R023DSHS Consumer Protection Division9/8/209/30/20
Title 40, Chapter 85, Subchapter A, Section 85.2, Definitions, and Subchapter D, Section 85.302, Nutrition Services#20R031HHS Rules Coordination Office9/4/209/18/20

CMS: Independent Nursing Home COVID-19 Commission Findings Validate Unprecedented Federal Response

Today, the Centers for Medicare & Medicaid Services (CMS) received the final report from the independent Coronavirus Commission for Safety and Quality in Nursing Homes (Commission), which was facilitated by MITRE.  CMS also released an overview of the robust public health actions the agency has taken to date to combat the spread of the coronavirus disease 2019 (COVID-19) in nursing homes. The Commission’s findings align with the actions the Trump Administration and CMS have taken to contain the spread of the virus and to safeguard nursing home residents from the ongoing threat of the COVID-19 pandemic. Today’s announcement delivers on the Administration’s commitments to keeping nursing home residents safe and to transparency for the American people in the face of this unprecedented pandemic.

As the capstone to the Commission’s extensive report, tomorrow, Administrator Verma will join Vice President Mike Pence and the Centers for Disease Control and Prevention (CDC) Director Dr. Robert R. Redfield, some members of the Commission, and other public health and elder care experts at the White House. The Vice President, Dr. Redfield and Administrator Verma will lead the group in a discussion regarding the Commission’s findings and general issues facing the nation’s elder care system.

Nursing homes and other shared or congregate living facilities have been severely affected by COVID-19, as these facilities often house older individuals who suffer from multiple medical conditions, making them particularly susceptible to complications from the virus. To help CMS inform immediate and future actions as well as identify opportunities for improvement, the   Commission was created to conduct an independent review and comprehensive assessments of confronting COVID-19. The Commission’s report contains best practices that emphasize and reinforce CMS strategies and initiatives to ensure nursing home residents are protected from COVID-19.

As outlined in the overview released today, the Trump Administration has already taken significant steps to implement many of the Commission’s findings. The Administration has worked to support nursing homes financially during this challenging time, distributing over $21 billion to America’s nursing homes – more than $1.5 million each on average. To ensure nursing homes had access to supplies, the Trump Administration shipped a 14-day supply of personal protective equipment (PPE) to more than 15,000 nursing homes across the Nation in May.

The Administration has also required facilities to report data about COVID-19 cases, deaths, and supply levels, with 99.3 percent of facilities currently reporting. CMS took action to keep COVID-19 out of nursing homes by requiring them to test staff, a requirement that was paired with the Administration’s distribution of 13,850 point-of-care testing devices to America’s nursing homes. The Administration has also deployed federal Task Force Strike Teams in six waves, in 18 states so far, to 61 facilities particularly affected by COVID-19 to share best practices and gain a deeper understanding of how the virus spreads. CMS also required states to conduct focused infection control inspections at their nursing homes; between June and July, states completed these inspections at 99.8 percent of Medicare and Medicaid certified nursing homes.

Additionally, since March, CMS has conducted weekly calls with nursing homes, issued over 22 guidance documents and established a National Nursing Home COVID-19 Training program focused on infection control and best practices.  CMS is also using COVID-19 data to target support to the highest risk nursing homes. In May, CMS released a new toolkit developed to aid nursing homes, Governors, states, departments of health, and other agencies who provide oversight and assistance to nursing homes.  The toolkit is a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19. CMS updates the toolkit on a biweekly basis.

To view the full independent Coronavirus Commission for Safety and Quality in Nursing Homes report, visit here:  cms.gov/files/document/covid-final-nh-commission-report.pdf

To view the Trump Administration Response to Commission findings, visit here: cms.gov/files/document/covid-independent-nursing-home-covid-19-federal-response.pdf

To view the COVID-19 Guidance and Updates for Nursing Homes during COVID-19, visit here: cms.gov/files/document/covid-guidance-and-updates-nursing-homes-during-covid-19.pdf

The full list of CMS Public Health Actions for Nursing Homes on COVID-19 to date is in the chart below.

CMS Public Health Action for Nursing Homes on COVID-19 as of September 16, 2020
February 6, 2020CMS took action to prepare the nation’s healthcare facilities for the COVID-19 threat.
March 4, 2020CMS issued new guidance related to the screening of entrants into nursing homes.
March 10, 2020CMS issued guidance related to the use of PPE.
March 13, 2020CMS issued guidance on the restriction of nonessential medical staff and all visitors except in certain limited situations.
March 23, 2020CMS announced a suspension of routine inspections, and an exclusive focus on immediate jeopardy situations and infection control inspections.
March 30, 2020CMS announced that hospitals, laboratories, and other entities can perform tests for COVID-19 on people at home and in other community-based settings outside of the hospital – including nursing homes.
April 2, 2020CMS issued a call to action for nursing homes and state and local governments reinforcing infection control responsibilities and urging leaders to work closely with nursing homes on access to testing and PPE.
April 15, 2020CMS announced the agency will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases.
April 19, 2020CMS announced it will require nursing homes to report cases of COVID-19 to all residents and their families, as well as directly to the CDC. On May 1, CMS published the proposed policy in an Interim Final Rule. The rule became effective on May 8.
April 30, 2020CMS announced the formation of an independent commission by a contractor that will conduct a comprehensive assessment of the nursing home response to COVID-19.
May 6, 2020CMS released a memorandum to State Survey Agency directors providing more details on the new reporting requirements of the May 8, 2020, Interim Final Rule.
May 13, 2020CMS published a new informational toolkit comprising recommendations and best practices from a variety of front line health care providers, governors’ COVID-19 task forces, associations and other organizations and experts that is intended to serve as a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19. Toolkit is found here: Toolkit
May 18, 2020CMS issued guidance for state and local officials on the reopening of nursing homes.
June 1, 2020CMS issued guidance to states on COVID-19 survey activities, CARES Act funding, enhanced enforcement for infection control deficiencies, and quality improvement activities in nursing homes. CMS also issued a letter to Governors.
June 4, 2020CMS posted the first set of underlying COVID-19 nursing home data and results from targeted inspections conducted by the agency since March 4, 2020, linked on Nursing Home Compare.
June 19, 2020CMS announced membership of Independent Coronavirus Commission on Safety and Quality in nursing homes
June 23, 2020CMS released FAQs on nursing home visitation.
June 25, 2020CMS released a memo announcing the end of the emergency blanket waiver for the nursing home staffing data submission requirement.
July 10, 2020CMS announced it will deploy Quality Improvement Organizations (QIOs) across the country to provide immediate assistance to nursing homes in hotspot areas.
July 14, 2020HHS and CMS announced an initiative for rapid point-of-care diagnostic devices and tests in nursing homes.
July 22, 2020CMS announced several new initiatives designed to protect nursing home residents from COVID-19, including new funding, enhanced testing and additional technical assistance and support.
August 7, 2020HHS announced the distribution of $5 billion in Provider Relief Funds, consistent with the Administration’s announcement in late July, which will be used to protect residents of nursing homes and long-term care facilities from the impact of COVID-19.
August 14, 2020CMS released nursing home enforcement actions during pandemic.
August 24, 2020CMS issues informational bulletin on Medicaid Reimbursement Strategies to Prevent Spread of COVID-19 in Nursing Facilities
August 25, 2020CMS announced an unprecedented national nursing home training program for frontline nursing home staff and nursing home management.
August 25, 2020CMS strengthens COVID-19 Surveillance with New Reporting and Testing Requirements for Nursing Homes, Other Providers. On Aug. 26, CMS posted guidance for the new requirements.

 

CMS: Updated Core Measures Focus on Improving Patient Care, Reducing Burden, and Eliminating Redundancies

Today, the Core Quality Measures Collaborative (CQMC) released four updated core measure sets covering specific clinical areas as part of its mission to provide useful quality metrics as the nation’s health care system moves from one that pays based on volume of services to one that pays for value.  These updated core sets are a result of months of consensus-based review and deliberation among the group’s 75+ multi-stakeholder member organizations, evaluating hundreds of existing quality measures against the CQMC’s rigorous criteria. CQMC will release four additional updated core measure sets and two new core measure sets over the coming months.

The transition to a value-based payment system has seen an increased reliance on performance measures to assess the success of health care providers in delivering high-value, high-quality patient care within alternative payment models (APM).  As APMs have grown in popularity, so too has the number of performance measures tied to these models.  This explosion in performance measures has increased the data collection burden on providers and resulted in conflicting measure results that have confused both providers and consumers alike.

CQMC’s core measure sets address these challenges by promoting better patient outcomes, aligning measures across public and private payers, and reducing the burden of measurement by eliminating low-value metrics and redundancies. The CQMC has determined that the measures included in these sets are high-value, high-impact, and most appropriate for inclusion in APMs and other value-based contracting arrangements.

The four updated core measure sets released today cover:

  • Gastroenterology
  • HIV and Hepatitis C
  • Obstetrics and Gynecology
  • Pediatrics

In the coming months, the CQMC will release updated core sets in the following areas:

  • Medical Oncology
  • Orthopedics
  • Primary Care/ Patient-Centered Medical Homes/ Accountable Care Organizations
  • Cardiology

The CQMC will also release two new core sets that cover:

  • Behavioral Health
  • Neurology

The CQMC is a diverse coalition of health care leaders representing over 75 consumer groups, medical associations, health insurance providers, purchasers and other quality stakeholders, all working together to develop  and recommend core sets of measures by clinical area to assess and improve the quality of health care in America.  The coalition was convened in 2015 by America’s Health Insurance Providers (AHIP) and the Centers for Medicare & Medicaid Services (CMS) and is housed at the National Quality Forum (NQF).

Please click here for more information on the CQMC core measures.  You can also view the CQMC Implementation Guide by clicking here.  This guide provides strategies and actions for stakeholders seeking to implement or evolve value-based payment (VBP) programs

CMS: September 2020 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set Quarterly Q&As

The Centers for Medicare & Medicaid Services (CMS) is publishing the LTCH CARE Data Set (LCDS) Quarterly Q&As, September 2020 document so that all LTCH providers have the benefit of the updates/clarifications to guidance. Through inquiries to the LTCH Post-Acute Care (PAC) Quality Reporting Program (QRP) Help Desk, CMS occasionally identifies the opportunity to clarify or refine guidance. Moving forward, CMS plans to publish LCDS Q&As on a quarterly basis.

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

CMS: CMS Releases Medicaid and CHIP T-MSIS Data to Provide Public Access and Transparency into Program Performance

Public availability of current data increases accountability and strengthens oversight of Medicaid program.

Today, the Centers for Medicare & Medicaid Services (CMS) released updated Medicaid and Children’s Health Insurance Program (CHIP) data that is used for monitoring program performance and analyzing state and federal payments for services. The Transformed Medicaid Statistical Information System (T-MSIS) data provides information on key topics including service utilization and spending, and supports research and analysis that helps improve quality of care for beneficiaries.

T-MSIS data is the most current and complete Medicaid and CHIP data resource available and builds upon years of CMS’ work toward strengthening data availability for these coverage programs that serve more than 73 million low-income Americans. Today’s data release includes research-ready data files for calendar years 2017-2018.

CMS has worked with each state to improve the quality and completeness of its T-MSIS data and identified 32 focus areas for all states to address as a high priority. The agency established an ongoing collaboration with states to address these focus areas, and is tracking these as part of the Administrator’s Scorecard. The 2017 and 2018 data release marks a watershed in the timeliness and quality of Medicaid and CHIP data available to the public.  Additionally, later this year, updated T-MSIS data for calendar years 2014, 2015 and 2016 will be released to reflect the substantial data quality improvements undertaken by state partners.

In keeping with the agency’s commitment to transparency, CMS launched the Data Quality (DQ) Atlas tool on July 31, 2020. This tool allows the public to review the quality and usability of the T-MSIS research-ready files for all calendar years of published T-MSIS data. The DQ Atlas is an interactive, web-based tool to help policymakers, analysts, researchers, and other stakeholders explore the quality and usability of the T-MSIS data for their analytic needs. These needs include the ability to conduct insightful, methodologically sound analyses of key Medicaid and CHIP topics such as enrollment, claims, expenditures and service use.

External researchers can obtain access to T-MSIS data by submitting a request to the CMS Research Data Assistance Center (ResDAC) and signing a CMS data use agreement containing strict beneficiary privacy and data security requirements.  To learn more visit the ResDAC website: https://www.resdac.org/.

To view fact sheet, please visit: https://www.cms.gov/newsroom/fact-sheets/additional-medicaid-and-chip-t-msis-analytic-files-data-release

CMS: Centers for Medicare & Medicaid Services (CMS) Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Quarterly Q&A, September 2020

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

NIH funds community engagement research efforts in areas hardest hit by COVID-19

The National Institutes of Health today announced a $12 million award for outreach and engagement efforts in ethnic and racial minority communities disproportionately affected by the COVID-19 pandemic. The award to RTI International, a non-profit research institution, will support teams in 11 states established as part of the NIH Community Engagement Alliance (CEAL) Against COVID-19 Disparities. These teams have received initial funding to immediately create CEAL programs, and RTI will serve as the Technical and Administrative Support and Coordination (TASC) center.

The CEAL research teams will focus on COVID-19 awareness and education research, especially among African Americans, Hispanics/Latinos, and American Indians — populations that account for over half of all reported cases in the United States. They also will promote and facilitate the inclusion and participation of these groups in vaccine and therapeutic clinical trials to prevent and treat the disease.

The communities of special focus include counties in Alabama, Arizona, California, Florida, Georgia, Louisiana, Michigan, Mississippi, North Carolina, Tennessee and Texas.

CEAL is an NIH-wide effort led by the National Institute on Minority Health and Health Disparities (NIMHD) and the National Heart, Lung, and Blood Institute (NHLBI). It expands existing community outreach efforts already underway by NIH COVID-19 trial networks.

The CEAL research teams will leverage established relationships between NIH-funded researchers and local community-engaged leaders to help reach underserved communities that might not be located near COVID-19 clinical research recruitment sites.

CEAL research teams include NIH and other federally funded entities that have community engagement expertise, non-academic community-based organizations,  Federally Qualified Health Centers (FQHCs(link is external)), state and/or local health departments, and others. Their goal is to quickly launch outreach efforts that can help reduce the impact of COVID-19 on the most vulnerable populations and to evaluate these efforts through community-engaged research.

For more information about CEAL, visit the NIH COVID-19 communities page.

The CEAL principal investigators and institutions are:

Mona N. Fouad, M.D., M.P.H.
University of Alabama at Birmingham

Sairam Parthasarathy, M.D.
University of Arizona College of Medicine, Tucson

Arleen F. Brown, M.D., Ph.D.
University of California, Los Angeles

Olveen Carrasquillo, M.D., M.P.H
University of Miami

Tabia Henry Akintobi, Ph.D., M.P.H.
Morehouse School of Medicine, Atlanta

Marie A. Krousel-Wood, M.D.
Tulane University, New Orleans

Erica Marsh, M.D.
University of Michigan, Ann Arbor

Caroline Compretta, Ph.D.
University of Mississippi Medical Center, Jackson

Anissa I. Vines, Ph.D.
University of North Carolina, Chapel Hill

Paul Juarez, Ph.D.
Meharry Medical College, Nashville, Tennessee

Jamboor Vishwanatha, Ph.D.
University of North Texas Health Science Center, Fort Worth

Linda Squiers, Ph.D.
Technical Lead, TASC
RTI International, Research Triangle Park, North Carolina

HHSC: LPPF Reporting Portal is Open from Sept 16 to Oct 10

The Local Provider Participation Fund (LPPF) Reporting Portal is open beginning today, September 16 until October 10, 2020 for fourth quarter reporting. Units of government operating an LPPF will be able to enter required financial information for the federal fiscal quarter of July to September 2020.

The reporting portal opens before the end of each federal fiscal quarter to allow users to input their data and information prior to the deadline. In 2020, the remaining deadline for reporting quarterly LPPF data and information is October 10.

Penalty for Not Reporting by Deadline Temporarily Waived

Due to the public health emergency caused by the novel coronavirus (COVID-19), the Health and Human Services Commission (HHSC) requested and received approval from the Office of the Governor to temporarily waive the penalty for non-compliance with Texas Administrative Code §355.8068.

Units of government operating LPPFs are still required to report certain financial information, but will not be penalized if the information is not reported by the quarterly deadline. This waiver is in effect until terminated by the Office of the Governor or until the March 13, 2020 disaster declaration is lifted or expires.

Answering Questions about LPPF Portal

If Portal users have questions, please use the appropriate email to get answers:

  • Questions related to the functionality of the Reporting Portal (e.g. error messages, can’t log in, can’t assign users), email: costinformation@hhsc.state.tx.us or call 512.438.2680.
  • Questions about how to report certain information in the portal or if your report was received, email: LPPF@hhsc.state.tx.us

DFPS: 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.

COVID-19 and Texas 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.

Additional COVID resources

  • Help and Hope COVID-19 resource page: Visit HelpAndHope.org to find updated resources for providers and the general public.
  • The Department of Family and Protective Services has updated its front page to include coronavirus information and testing resources. Visit https://www.dfps.state.tx.us/ to see all the new changes.
  • The Texas Division of Emergency Management (TDEM) has an interactive map of COVID-19 testing locations. Visit tdem.texas.gov to find one of the 400+ testing locations nearest you.
  • The CDC has a helpful tip sheet and information for helping children cope with emergencies.
  • It’s hard for kids to read emotions through a mask. Here’s a tip sheet on how to make it a little easier for everyone, courtesy of Challenging Behavior and National Center for Pyramid Model Innovations.

Help Me Grow Texas Sites Announced

The Maternal and Child Health Division of the Texas Department of Public Health Services has published a list of cohort communities for Help Me Grow Texas 2020. The cohort will run from August 2020 to August 2021.

Help Me Grow Texas links families to resources in their community to help meet children’s needs. Community services include agencies that provide health care, quality early learning experiences, and information about healthy development.

Cohort communities were selected based on community readiness, need, capacity, and infrastructure. Each community designated a local organization to lead their communities’ efforts. The 2020 cohort participants are:

  • Easter Seals of Rio Grande Valley Serving: Cameron, Hidalgo, Starr, and Willacy County
  • My Health My Resources of Tarrant County Serving: Collin, Cooke, Dallas, Denton, Ellis, Erath, Fannin, Grayson, Hood, Johnson, Kaufman, Navarro, Palo Pinto, Parker, Rockwall, Somervell, Tarrant, and Wise County
  • North Texas Area United Way Serving: Archer, Clay, and Wichita County
  • Paso del Norte Children’s Development Center Serving: El Paso County
  • United Way for Greater Austin Serving: Travis and Williamson County
  • United Way of San Antonio and Bexar County Serving: Bexar County

More information about Help Me Grow can be found at helpmegrownational.org.

Healthy Texas Women Program Launches Enhanced Postpartum Care Services

The Texas Health and Human Services Commission (HHSC) has rolled out an enhanced postpartum care services package for eligible women enrolled in Healthy Texas Women, called HTW Plus.

Beginning in September, approximately 90,000 Healthy Texas Women clients will automatically receive this new postpartum care coverage for up to 12 months, which covers diabetes management services, heart and blood pressure treatments, asthma medications and supplies, tobacco cessation, and mental health conditions.

For more information visit the HHSC Newsroom

Public Call for Programs and Services

The Title IV-E Prevention Services Clearinghouse has requested public recommendations for mental health, substance abuse, in-home parent skill-based, and kinship navigator programs and services to be considered for systematic review.

This call is an opportunity for the public to recommend programs and services intended to provide enhanced support to children and families and prevent foster care placements.

Submission Deadline is October 5, 2020. Visit the Clearinghouse Home Page.

Resources for Families

Got questions about mental health and the 2020-2021 school year? Dr. Molly Lopez, director of the Texas Institute for Excellence in Mental Health and a research associate professor at the Steve Hicks School of Social Work at the University of Texas at Austin, has answers in her article about building resiliency for the entire family.

Flu Season is upon us. It’s more important than ever for people to be vaccinated. The CDC recommends that everyone six months of age and older get the flu vaccine every season. Bookmark and share these flu-related resources:

Resources for Kids at Home

Is your college freshman stuck at home? Here’s some survival tips for when COVID keeps college kids at home instead of in the dorm.

Does your child have their eyes on the stars? Next year NASA will launch a new telescope 100 times more powerful than the Hubble. Watch it being built. Learn how to make your own unfolding version at go.nasa.gov/32Odllg.

There’s no shortage of groan-worthy kid jokes. But just in case your family’s running low, here’s a list of back to school jokes for kids.

Keyboard skills are more important than ever. Red Tricycle has compiled a list of online games that improve your child’s typing speed and accuracy.