F. Trauma Work in Texas
1. Reports
Building a Trauma-Informed Child Welfare System: A Blueprint[185]
Trauma-Informed Care Final Report, The Meadows Mental Health Policy Institute for Texas[186]
Building a Network of Trauma Informed Courts in Texas, Texas Alliance of Child and Family Services [187]
2. Statewide Initiatives
a. The Statewide Collaborative on Trauma-Informed Care
In July 2017, the Children's Commission launched the Statewide Collaborative on Trauma-Informed Care (SCTIC), which aims to elevate trauma-informed policy in the Texas child welfare system by creating a statewide strategy to support system reform, organizational leadership, cross-systems collaboration, and community-led efforts with data-informed initiatives to develop champions, consensus, and funding. The SCTIC began with a planning group with the Children's Commission, Meadows Mental Health Policy Institute (MMHPI), Texas CASA, and the Department of Family and Protective Services and created workgroups to carry out its mission.
b. Behavioral Health Division at DFPS
In Fiscal Year 2019, DFPS formed the Behavioral Health Services Division within CPS, managed as a separate division within the CPS Medical Services Division. The division includes a Behavioral Health Services Division Administrator, three Behavioral Health Services Program Specialists, three Substance Use Program Specialists, one CANS Program Specialist, and a Mental Health Program Specialist Lead. The Medical Services Division is a statewide team that covers medical, physical, and dental issues for CPS with Nurse Consultants and Well-Being Specialists. The Medical Services Division focuses on the services provided through STAR Health. The Behavioral Health Services Division Administrator is located in Lubbock, Texas, and manages the statewide team which focuses on the public behavioral health system. The Behavioral Health Services Program Specialists are located in Houston, Fort Worth, and San Antonio, Texas. The Mental Health Program Specialist Lead is located in Waco, Texas. The CANS Program Specialist helps to manage the eCANS system, in which CANS 3.0 assessments for children in conservatorship are entered, and is located in Rockwall, Texas.
The division includes three Substance Use Program Specialists located in San Antonio, Dallas, and Houston, Texas. These positions complement two additional Substance Use Program Specialists and two Mental Health Program Specialists who report to Child Protective Investigations. These staff work together to provide support, resources, and technical assistance to direct delivery staff in their work with families experiencing substance use disorders through every stage of service.
Both the Medical Services and Behavioral Health Services teams not only support children in conservatorship, but also assist with investigations and Family-Based Safety Services cases when the need arises. Additionally, the teams work with CPS and SSCC staff statewide and are generally located in the regions they support.
In 2023, in accordance with Article II Rider 44 of the 88th Texas Legislature, the Department created the Office of Behavioral Health Strategy to provide coordination and cooperation between DFPS and the myriad of state funders and local providers of pediatric behavioral healthcare as a means to improve access to services for youth in DFPS conservatorship. The goals of the office are to identify the behavioral health needs of DFPS youth, address barriers to care, improve access to services, and identify and recommend ways to expand the capacity of the children's behavioral health system to meet the unique needs of youth in DFPS conservatorship. This includes recommendations on how to improve access to STAR Health services, address policy and procedural barriers, and improve behavioral health outcomes for DFPS involved children and youth.
c. Cross-Systems Trauma-Informed Care initiative
The Texas Health and Human Services Commission (HHSC) Office of Mental Health Coordination leads a Cross Systems Trauma-informed Care (CSTIC) initiative. The vision of the CSTIC is a coordinated behavioral health system, as envisioned by the Texas Statewide Behavioral Health Strategic Plan, which is healing-centered and trauma-informed in its foundation and unified in its implementation of a person-centered and family-focused approach across Texas. The CSTIC initiative involves working with state agencies across Texas to advance trauma-informed organizations, culture, and services. The collaboration includes representatives from state agencies who receive state funding for behavioral health training or services. As part of the CSTIC initiative, HHSC leads an internal Trauma Transformation Team with representatives from different divisions and departments within the agency who facilitate trauma-informed change within HHSC. Additionally, beginning in 2020, the Cross-Systems Trauma-Informed Care Projects Committee collaborated with The University of Texas at Austin Texas Institute for Excellence in Mental Health to develop free trauma-informed care training modules for professionals seeking high-quality, in-depth training. Over several years, the committee helped develop a multi-session, trauma-informed care training named Trauma-Informed Care Basics.
d. Children's Advocacy Centers (CAC) Practice Model
In 2013, the Texas Legislature raised the standard for mental health services in CACs, requiring that all mental health services be trauma-focused and evidence-based. Additionally, mental health services must be provided by professionals who have a master's degree and are licensed, or who are students in an accredited graduate program and supervised by a licensed mental health professional.
e. Trauma-Informed Care Specialty Network
Created by STAR Health, the Trauma-Informed Care Specialty Network allows its providers to list the training on trauma that they have pursued and helps identify providers who have been trained in trauma-informed care in the STAR Health network for caseworkers, caregivers, and others in the child welfare community. STAR Health also offers TIC trainings to CPA, kinship families, RTC staff, and Emergency Shelter staff.
3. Examples of Community-Level Initiatives
a. North Texas Foster Care Consortium
Established in 2015 to promote collaboration and information sharing among the many stakeholders committed to the well-being of children in the child welfare system. the North Texas Foster Care Consortium facilitates productive partnerships and sponsors informative programming, drawing on the resources of integrated healthcare and other service providers, child advocates, policy groups, child placing agencies, education liaisons, foster parents, court personnel, single source continuum contractors, and DFPS leadership.
b. The Travis County Collaborative for Children (TCCC)
Led by Texas Christian University's (TCU) Karyn Purvis Institute of Child Development (KPICD), the TCCC implemented system-wide changes to the way children in Travis County are cared for during and after their time in state custody. TCCC's goal is to accelerate healing and speed to permanency for children in foster care utilizing KPICD's research-based Trust-Based Relational Intervention (TBRI®) principles and practices.
c. The South Texas Trauma-Informed Care Consortium
The South Texas Trauma Informed Care Consortium is a collaboration between The Children's Shelter, Voices for Children, and City of San Antonio Metro Health Department that brings together community participants who are committed to addressing the impact of trauma.