Online Newsletter


Online Newsletter


In This Issue

DSHS Austin Lab Update

New Online Order System

Online Provider Education Updates

New CDC Blood Lead Levels

Staff News

Regional News

What's New!

DSHS Austin Laboratory Update Effective September 1, 2013

Effective September 1, 2013, the DSHS Laboratory Services Section transitioned to supply the BD MAP tube for finger stick collections for blood lead and hemoglobin testing. The old Microtainer tube is still an acceptable collection tube for these tests, but it is no longer supplied. Providers may continue to use their current supplies of Microtainers until exhausted, or they may immediately submit a supply order for BD MAP tubes.  Specimens submitted in Microtainers to the DSHS Austin Lab after September 1, 2013 will be processed and tested as usual.

This product change is expected to facilitate provider specimen collection and to optimize automation processes within the lab. This change is not applicable if only venous specimens for blood lead and hemoglobin testing are submitted.

In preparation for the transition, the DSHS Lab began sending out a flyer along with a sample of the BD MAP tube with all supply orders on August 15, 2013. The lab has updated information on their website, educational materials, in the THSteps online Specimen Collection module and on the CLPPP blood collection poster.  Updated information will include a picture of the MAP tube. 

MAP lab tube

Becton Dickinson (BD) Microtainer® MAP Tube, 250 – 500 µL, Product Number REF 363706

The order form for Child Health Laboratory Supplies has been updated with the new product and is available on the Lab website at

Provider comments and questions can be submitted to


New Online Order System for THSteps Publications

Beginning September 1, 2013, MAXIMUS will have a new Texas Health Steps publications online ordering system. Upgrades have been made to make it safer and easier to order, and receive important information about Texas Health Steps publications.

Some of the improvements include: 

  • Email order confirmation
  • Detailed tracking of your order
  • Order history
  • Shipping Confirmation with UPS tracking numbers

All the publications on the Texas Health Steps products website will still be available as downloadable PDFs.

To place an order, you will now need an account with an email address, a user log in, and a password. Some current utilizers of the current system will begin receiving that information in September. Others will need to email a request to

Please make sure you include the following information: 

  • Organization Name
  • Physical Street Address (We cannot ship to PO Boxes)
  • City, State, Zip Code
  • Contact Person
  • Telephone (with area code)
  • Email address (an email address is required to receive an online account to order materials)
  • Even if you have ordered before, we will need this information again to create an online account for you.

Once the request has been received, it will be reviewed and a notification will be sent via email with login and password information. The new website can be accessed by logging on to the THSteps internet home page and then clicking on THSteps Catalog located on the left navigation bar. The URL for the new site is

Online Provider Education Updates

 The OPE released three new important modules in August: 

  • Recognizing, Reporting, and Preventing Child Abuse (RRPCA)
  • Motivational Interviewing (MI)
  • Infant Safe Sleep (ISS) 

We also have a new delivery method for CE credit: Tutorials, which are 30 minutes in length.  Three new tutorials went live in August as well: 

  • Texas Health Steps: Overview (THSO-T)
  • Texas Medicaid Services for Children (TMSC-T)
  • Screening, Brief Intervention, Referral, and Treatment (SBIRT-T)

The RRPCA and MI modules offer ethics credit for physicians (CME) and social workers (SW), along with the SBIRT tutorial.  Also, we continue to offer ethics credit for Cultural Competence and Teen Consent and Confidentiality.  Additionally, the newest updated version of Transitions for Children and Youth with Special Health Care Needs (formerly named Case Management Transition Services) will also offer ethics credit.  The newly-accredited module is expected to be live in late fall.

The X-ray promotional campaign is in full swing. Print ads have run in several medical, nursing, and social worker journals the last two months as well as conference programs.  Also, there are web banners, HTML emails going out, and pop-up banners. Hopefully, your providers have been seeing these promotional messages in either print or on the web or both.  Also, there have been radio spots on NPR radio in Houston, Dallas, San Antonio, and Austin. We expect to broaden and continue this campaign.

Mobile Case Studies. Four different case study “teasers” have been emailed to providers during August.  Each week a different case study was emailed to various provider groups, addressing: 

  • Adolescent Health                          
  • Ethics
  • Health Screening
  • Referral Guidelines 

Each case study consists of a scenario and a question about what steps to take to address the issue.  After the correct answer is revealed, recommendations for courses on that topic appear with a link to the OPE site.  We expect to create more case studies in the future as a means to promote the OPE and the accessibility via mobile devices.

Updates to the OPE website:

A new FAQ page has been added to the website for help and assistance navigating the website.  We think you’ll find this helpful and encourage you to share it with your providers.  Also, the Resources page has been added to and updated.  Keep in mind that we have subject matter experts send us information, links, and various resources fairly often and continue to share this information on the Resources page as it applies to each module.  It’s a great resource and can be accessed without signing into the system.

We will also have a video library added to the page in a similar fashion as the Resources.  The videos from each module will be available as “refreshers” or for specific information immediately.  We expect to add videos here in a similar fashion as the information on the Resource page. Please check these resources occasionally to see what information is available for you and for your providers.  Being aware of the available resources can prove to be very helpful when visiting with providers. 

We have exhibited at the following conferences recently:

  • Texas Pharmacy Association, Dallas, July 25, 26
  • Texas Association of Family Physicians, Ft. Worth, August 1-3

 Upcoming Conferences where we will be exhibiting:

  • National Association of Social Workers, Austin, August 31 - September 2
  • Texas Pediatric Society, Galveston, September 19 - 21
  • Texas Academy of Physicians Assistants, Austin, September 20-22
  • Texas Nurse Practitioners, The Woodlands, September 26-29

Other Information

THSteps Adopts New CDC Blood Lead Levels

 Experts agree that there is no safe level of lead exposure for children and that the best way to protect children from lead exposure is through primary prevention rather than a response to exposure after it has taken place. In 2012, the Centers for Disease Control and Prevention (CDC) approved the Advisory Committee for Childhood Lead Poisoning Prevention’s (ACCCLPP) newest recommendations on blood lead levels. Recommendations included elimination of the term “blood lead level of concern” as well as the use of the new reference value based on the 97.5 percentile of the population blood lead level (BLL) in children aged 1-5 years (currently 5 mcg/dL). The new reference value changes the blood lead level at which action is necessary from 10 micrograms per deciliter (mcg/dL) to 5 mcg/dL. 

Texas Health Steps (THSteps) recently adopted the new reference value of 5 mcg/dL and is currently in the process of updating policy to reflect these changes. Once completed, policy and procedure changes related to blood lead level changes will be noted in the Texas Medicaid and Healthcare Partnership (TMHP) Texas Medicaid Provider Procedures Manual. THSteps providers should monitor the TMHP website and THSteps website for additional information on these changes.

The Texas Childhood Lead Poisoning Prevention Program (TXCLPPP) is also recommending using a blood lead level of 5 micrograms per deciliter as their reference value for follow-up action by health care providers. Find more information related to the Texas Childhood Lead Poisoning Prevention Program, or blood lead reporting requirements at

Staff News

After 27 years of state service, Jann Melton-Kissel is retiring.  Her long and distinguished career began long before coming to DSHS, as an obstetrical nurse at Brackenridge Hospital; and will continue long after retirement, as a Lieutenant Colonel in the Texas State Guard Medical Brigade and active participation in Operation Lone Star, which provides free medical and dental care to people in South Texas. 

Jann joined DSHS (TDH) in1986 in the regulatory arena, surveying birthing centers, hospitals, end stage renal disease facilities, home health agencies, abortion facilities, and ambulatory surgery centers for compliance with state/federal regulations and quality of service.  Jann provided leadership for several programs in the Specialized Health Services Section, including the Children with Special Health Care Needs Services Program; Kidney Health Care Program; Hemophilia Assistance Program; Texas Health Steps; Oral Health Program; Case Management for Children and Pregnant Women; Newborn Screening Care Coordination; Newborn Hearing Screening; Genetics; and Vision, Hearing and Spinal Screening.

Jann celebrated Friday, August 9, 2013, with colleagues wishing her the very best in her retirement and future endeavors.

JannJann with husband Bob at retirement party

Regional News

Submitted by: Oscar M. Vasquez / Health Services Region (HSR) 9/10

Reminiscing what this calendar year has been in terms of outreach experience and opportunities, I truly believe that it has been an extraordinary year for the Texas Health Steps (THSteps) Health Services Region (HSR) 9/10 Program since we had the opportunity to truly assist many families throughout our extensive geographical area that consists of 36 counties of West Texas and covers 61,428 square miles. It is always rewarding to inform, but at the same time educate, the parents about the many benefits of taking their children to receive their annual THSteps checkup as well as providing them information about additional services offered through the DSHS Specialized Health and Social Services (SHSS) such as Personal Care Services, Case Management for Children and Pregnant Women, and Children with Special Health Care Needs Services Program during the many community events that took place in our region.  

Thanks to the many partnerships and collaborations that we have been able to create and foster with the numerous independent school districts, community based organizations, local and state agencies, as well as the regional Medicaid Managed Care Organizations (MCOs), we were able to attend approximately 90 community events that included health fairs in numerous schools, and meetings/workshops/conferences where we had the opportunity to present and promote information on the THSteps and SHSS programs. We also had the opportunity to organize different workshops with the objective to inform, promote and educate regional health providers, community representatives, stakeholders, and the community at large about the THSteps and SHSS program services and benefits. 

On May 7, 2013, THSteps regional staff organized and conducted the “Helping Families Get the Most Out of Medicaid” Community Workshop in El Paso, Texas where approximately 134 individuals attended the workshop.  The objective of the workshop was to; 1) Provide a better understanding of Medicaid eligibility and the application processes; 2) Provide greater awareness of the benefits and services of Children’s Medicaid and the Medicaid Managed Care Organizations, and; 3) Provide a venue for networking and improve interagency communication and collaboration.  During the workshop, representatives from the regional health/dental plans, HHSC, MAXIMUS, and DSHS-THSteps and SHSS programs, provided information on the Medicaid programs and its enrollment process, as well as presentations on STAR, STAR+PLUS programs and dental services for Medicaid recipients.

Also, in collaboration with the THSteps Programs from Region 1, 2/3, and 9/10, the 5th Annual West Texas Health Steps Rural Health Clinic Conference took place on June 14, 2013 at the Texas Tech University Health Sciences Center Auditorium in Odessa where approximately 110 participants attended the conference.  Information on the Affordable Care Act, Healthcare Delivery System for West Texas Adolescents, Adolescent Health, and Adolescent Mental Health was provided to the participants.

These, along with other community events that took place during the 2013 state fiscal year, were possible thanks to the solid partnerships and collaborations that the regional THSteps Program staff have built and continue to foster with the numerous community based organizations and Medicaid Managed Care Organizations.  Without a doubt, all the combined efforts from all the agencies involved in this magnificent area have given us the opportunity to truly outreach, advocate, educate and empower parents about Medicaid, its programs, and the many benefits for their children.

In order to continue informing Texas families about these services with the same passion and commitment, THSteps HSR 9/10 staff will continue working diligently with our regional community based organizations and Medicaid Managed Care Organizations to host and/or participate in as many outreach community events that we can throughout the El Paso, Hudspeth, Culberson, Brewster and Presidio counties with the objective of promoting a healthier lifestyle for our children.


Submitted by: Ricardo J. Chafino, M.Ed. / Health Services Region (HSR) 10

 Throughout the year, HSR10 THSteps Provider Relations conducted numerous site visits with both medical and dental providers within the region to include the counties of El Paso, Hudspeth, Culberson, Presidio, and Brewster.  Through these visits, over l5 new providers were enrolled to provide Texas Health Step services.  During the visits, the THSteps Provider Relations Representative was able to provide updates and training to provider personnel.

THSteps collaborated with Southwest University and Project LAUNCH in order to provide training seminars to provider staff, and MA/PA students, on the proper process for implementing and documenting the correct use of developmental screening tools such as: PEDS, ASQ/ASQ-SE, and MCHAT.  Over 40 individuals participated in the training seminars thus enabling those attendees to conduct thorough developmental screening using appropriate screening tools – therefore providing a better THSteps checkup for the patient.  HSR 10 THSteps also became partners with the University of Texas El Paso - Community and Academic Partnerships for Health Sciences Research (CAPSHR).  Through collaborative efforts, THSteps was instrumental in assisting the CAPSHR committee with communicating with local pediatricians to promote the use of developmental screening tools in order to identify and treat children “at risk” for developmental delay.

Other training opportunities offered included; Vision-Hearing certification/re-certification, CPR certification/re-certification, and laboratory services.

Submitted by: Elizabeth Stanford / Health Services Region (HSR) 1

August is here and families are getting ready for kids to return to school. School registration was held in Amarillo this year with a twist…Texas Health Steps was a stop at registration in five local schools. DSHS Texas Health Steps (THSteps) employees Elizabeth Stanford and Frannie Nuttall along with representatives from MAXIMUS, Amerigroup, First Care Health Plans, Superior Health Plan, and DSHS Children with Special Health Care Needs were all in attendance at school assisting refugees with THSteps medical checkups.

Andrea Cruce, Community Ambassador with Superior Health Plan, noticed that many children from the Amarillo refugee population were behind on their THSteps visits. She contacted Frannie Nuttall, THSteps Provider Relations Representative in the DSHS HSR 1 Canyon office and Connie Jimenez, Regional Manager for MAXIMUS Lubbock Service Area HSR 1, to help plan a Back to School THSteps Clinic for the refugees. All of the Health Plans in HSR 1, MAXIMUS, DSHS, Amarillo ISD Refugee Coordinator, Medical Clinic Representatives, and the Refugee Support Organizations including those who provide interpreters came together and planned the event.

Refugee status or asylum may be granted to people who have been persecuted or fear they will be persecuted on account of race, religion, nationality, and/or membership in a particular social group or political party.  They flee to the United States and are resettled throughout the country.  Texas has the largest refugee resettlement population in the United States. Families and individuals are welcomed to the Amarillo and Dumas communities and are provided safe, furnished housing, food, clothing and other necessities to begin a new life. They receive a health assessment within 30 days of arrival and children are enrolled in school. The adults begin learning English and they receive an orientation to the new community and society. Many of the adults work at the local meat packing plants and begin to become self-sufficient. In Amarillo and Dumas there is a large population of refugees from many countries: Somalia, Eritrea, Iran, Iraq, Burma, Myanmar, and the several countries from the former Soviet Union.

On August 12th and 13th, there were five member teams at each of the five schools who have high refugee populations during their school registration. The schools had interpreters there to assist with registration. The families were screened by MAXIMUS and DSHS staff to see if the children were enrolled in Medicaid. Once confirmed, they were able to talk to their Health Plan to schedule an appointment with three of the clinics that participated in the event, if one of them were their medical home.  The three participating clinics set aside a total of 40 appointments for August 14th and 15th. 

                                                                                                                                                                                refugee 1                                                            refugee 2

The Health Plans paid for the interpreters to attend the appointments with the families during these special clinics. The Health Plans also provided lunch for the clinic staff during the special refugee clinics.  If the child had a different Medical Home than one of the three participating in this event, the Health Plans assisted in scheduling a THSteps checkup with their PCP if a checkup was due. The event was a tremendous success. It taught the THSteps community many lessons to successfully integrate the refugee population into Western healthcare. Approximately 500 refugees were screened for healthcare status during the two-day school registration.  Thirty nine appointments were scheduled in three medical clinics during the two day clinic visit period.  Two hundred fifty refugees will be followed-up with by the Health Plans.  They will be assisted with scheduling a THSteps checkup if needed.  Many of the families also needed assistance in selecting a Medical Home. Because of this collaborative event, a weekly time has been set aside to continue checking eligibility and making appointments for the refugees with their medical home. Plans are already being made to conduct this event next year.

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Please Note: The primary purpose of this regularly published newsletter is to update regional and DSHS staff concerning ongoing issues related to THSteps. Providers are directed to review the Texas Medicaid Provider Procedure Manual, web postings, and banner messages for policy updates.  If providers or other partners are receiving this document and have questions, please contact Lori Chapin by phone at 512-776-6630 or by e-mail at
Last updated January 06, 2014