The impact of the pause in Supplemental Nutrition Assistance Program (SNAP) benefits is significant, given the existing challenge of food insecurity in North Texas. A recent Cook Children’s Community Health Needs Assessment found that one in five children are food-insecure in the U.S., and Texas has the largest number of food-insecure children in the nation. The rate and number of children experiencing food insecurity are the highest it has been since 2014, with the largest one-year increase since 2008. The report also indicated that in Cook Children’s eight-county service area, 21% of children, about 236,400, live in a household that reported receiving food stamps or SNAP benefits in the past year.

“A child’s everyday behavior could be distracted by their hungry belly or stressed because they don’t know what they will be able to eat for dinner that night,” said Cabarcas.

Recognizing that health is all-encompassing, Cook Children’s Health Care System has actively worked to mitigate the impact of food insecurity before the government shutdown by piloting food distribution to eligible patient families, the Center for Community Health program families, and Health Plan members. 

“For the past three years, Cook Children’s has been building our response to food insecurity in general and has implemented many partnerships and new efforts to contribute to the cause,” said Courtney Barnard, director of community wellness for the Center for Community Health at Cook Children’s Health Care System.

Barnard shares essential information for families impacted by the pause and where they can access food assistance:

• Parent Pass app: Vetted resources for families
• Tarrant Area Food Bank (TAFB) at https://tafb.org/find-food-main/
• North Texas Food Bank (NTFB) https://ntfb.org/food-assistance/find-a-food-pantry/
• Programs such as WIC and free and reduced lunch programs at schools are unaffected at this time. Eligible families should enroll.
• The TAFB is still helping people enroll in SNAP. Families should still apply and enroll, as benefits will be retroactive once the pause is lifted.
• TAFB is working to double food sourcing and distribution to meet the increased need.

“As physicians, we educate our patients about eating five servings of fruits and vegetables per day as part of a healthy diet, but that goal is really difficult to attain when those fruits and vegetables cost much more than a bag of chips or a fast-food cheeseburger,” said Cabarcas. 

The system works alongside food pantries across its eight-county service area to provide additional food and education to families, train pantry staff and volunteers, and build capacity to serve more people. Cook Children’s collaborates with TAFB to support a new mobile market serving Denton, Wise, and Cooke counties. The system also formed partnerships with Texas Health Resources to support Good for You Healthy Hubs at the Eastside YMCA and Eugene McCray Community Center.

“Our patients’ families can struggle to pay for housing, utilities, childcare and healthcare, so adding the additional challenge of affording nutritious foods for their family causes psychological stress felt by all members of the household,” explained Cabarcas.  “I have noticed that as children mature, they sometimes disclose to me that they feel a burden of guilt due to their parents having difficulty paying for their basic needs.”

In August, the neighborhood health center in Las Vegas Trail opened its doors, helping to fill critical community needs. West Aid Food Pantry, which has been a staple in Southwest Fort Worth for 40 years, is now located at the health center. This collaboration aims to end the area's status as a food and health care desert.

Cook Children’s Neighborhood Health Centers provide unique services in the community. Staff work with families to overcome barriers to future health care access and bridge the gap. Patients of the Neighborhood Health Centers have access to dieticians, referral coordinators, speech therapists, behavioral health therapists, community health workers, and even dental services.

“Food insecurity impacts children’s oral health because it often limits access to nutritious foods rich in calcium, vitamins, and minerals that are essential for healthy teeth and gums,” explains Ottis Goodwin, director of community oral health for Cook Children’s Health Care System. 

Cook Children’s Health Care System provides access to these services all within their medical home. These teams work seamlessly with the community and Cook Children’s partners to assess and address patient needs in a timely and holistic manner.

Cook Children's has more than 40 pediatric offices and neighborhood health centers in North Texas. To become a patient, learn more about our locations here. You can also find additional information on community resources on our page here.

About 7,000 Cook Children’s Health Plan members reside in the Las Vegas Trail corridor. Until the establishment of this new role, most of their interactions with the health plan were over the phone. Now, they’ll have someone to visit with in-person. Guests can access this service through the health education center at the new facility.

“Having a community health worker on-site at a health center is a brand new role for the health plan,” said Kathy Schwab, MSN, RN, director of STAR/CHIP Service Coordination and Population Health at Cook Children’s Health Plan. “The vision is that the community health worker will be available for anyone visiting the center who might need linkages to other kinds of resources.”

For example, a student in the center’s job training program may also need food assistance, and can receive help getting connected to the West Aid Food Pantry located just steps away from where they are learning. Or, a patient receiving health services may need assistance with setting up transportation to another medical visit.

“They may even need someone to just sit down with them and go through an assessment of the big picture of what's going on in their life medically or socially, or what's going on with their kids,  and what resources they are needing,” Schwab said. “Sky can do that, and then put together a plan and some resources to help them with whatever it is that they might be struggling with.”

Assistance from the community health worker is not limited to health plan members. Anyone from the community visiting the center can access this service, which includes help completing Medicaid and SNAP applications.

In addition to being a community health worker, Ramos holds a degree in social work. While earning her degree, she completed an internship with the Boys and Girls Club, where she worked with at-risk youth and their parents. Ramos is also a member of the board of directors for a support group for moms of children with autism.

But her qualifications for this role go far beyond her professional credentials and education. Ramos’ connection with those living in the Las Vegas Trial community and the challenges they face is much more personal. She is the daughter of immigrants and, like many of those who reside in the Las Vegas Trail corridor, English is her second language. She is also a single mom who once called Las Vegas Trail home. 

“I’ve been through the struggles of being a single mom, so I really understand our moms and can connect with them on that level,” Ramos said “I know what it feels like to come from a family who's struggling with low income, and also coming from an immigrant family and having that language barrier because I didn't always speak English. So I’m really excited to be able to relate to them and empathize with them because I understand where they are coming from. I think it takes somebody who knows the struggles to really understand what help is needed.”

Schwab is confident Ramos is the right person for this pioneering role, too.

“I see this role as one that can help empower people and help them really rise up,” Schwab said. “That is what I love about Cook Children’s Health Plan, because it’s not just about providing health care coverage. It’s about providing things that help people rise up out of their circumstances and empower them to have better health and a better life. Sky is the perfect fit for actually doing that.”

To access services provided by the community health worker, call 682-303-8319 or visit the neighborhood health center’s website.

Many of our 125,000 health plan members and others have asked how they can help us #SaveCookChildrensHealthPlan, and this is one way.

Show your support:

• Take a photo of the display or snap a selfie.
• Post it on your social media pages.
• Tag Cook Children’s.
• Use the hashtags #savecookchildrenshealthplan and #SaveCCHP.

Thank you for making a difference!

“Many in my family have been on Medicaid. My children are grown now but, when they were small, they received Medicaid services,” Padilla said. “I know how important Medicaid is for families and children and I am so honored that daily I can make decisions about the services that our Medicaid members receive.”

A lifelong Dallas resident, Padilla and her husband have four children and nine grandchildren. She began her career in health care as a peer counselor in the Women, Infants and Children (WIC) Program, followed by 16 years at Parkland Health where she worked in many of the hospital’s community based programs. Along the way, she completed her bachelor’s and master’s degrees and became a Community Health Worker (CHW) and Community Health Instructor (CHI).

In July 2021, Padilla joined Cook Children’s Health Plan as manager of Community Marketing and was promoted to director of Member Experience within six months. Of all of her jobs in health care, her current leadership role is the one she is most proud to be doing. It’s allowed her to direct and manage programs and interventions that have truly impacted lives all across Texas, she says.

Padilla loves making a tangible difference where it matters most — on the ground in the community, where she says 80% of health care happens. It takes a keen understanding of the social determinants of health as well as the cultures within the service area to truly influence the health and well-being of those living there. Padilla believes no other organization does culturally competent, community centered health care management better than Cook Children’s Health Plan.

She’s concerned that boots-on-the-ground insight could all be lost If Texas’ Health and Human Services Commission (HHSC) is allowed to follow through with its decision to deny CCHP a new contract for managing the state’s Medicaid programs. Instead, HHSC seeks to award contracts to large, national insurance providers through an unfair and faulty contract review process. 

“I can tell you with my soul, that the biggest impact from going from this community based program to a national, for-profit payer is going to be the loss of the knowledge base and perspective that comes from the front lines,” she said. “We know the ins and outs here. We already know the partners we can and are working with to build services around food insecurity, housing and job readiness. We understand the cultures in the area and know how to effectively communicate with them. Any health insurance company can come in here and be a payer, but no one can come in and meet the people in the community where they are to make the most impact like we can.”

While CCHP waits for the Texas Legislature to weigh in on the issue and deliver a permanent solution for HHSC’s Medicaid contract procurement process, Padilla remains committed to her team and the members they serve. Her singular focus is and will always be on delivering impactful health care and services to members and their families.

In 2024, the Texas Health & Human Services Commission (HHSC) denied contract renewals to several Medicaid providers, including three non‑profit, Texas‑based children's hospital plans: Cook Children's Health Plan, Texas Children's Health Plan and Driscoll Children's Health Plan. Despite their combined 60-plus years of proven, high‑quality care, HHSC awarded the multi‑billion‑dollar Medicaid STAR/CHIP contracts to several publicly traded insurers beholden to out‑of‑state shareholders.

This precarious situation will have devastating consequences for 10,000 children with complex medical conditions, including 170 relying on ventilators and 1,700 who use wheelchairs. Beyond the direct impact on these children and their families, the repercussions extend to our community's economic stability, potentially costing 400 jobs in Tarrant County and up to 2,000 jobs across the state within Texas-based children’s health plans if this issue is not resolved. 

The Fort Worth Star-Telegram provides coverage of the situation here. 

CCHP joined forces with the Tarrant Area Food Bank, Arlington Independent School District (AISD), and the American Heart Association at a three-day event held at AISD Food and Nutrition Services from May 6 - 8. The partnership event, which was a first for the organizations, served as a one-stop hub, offering families application assistance for programs like Medicaid and SNAP (Supplemental Nutrition Assistance Program), as well as education and resources focused on healthy living.

For CCHP, the focus on nutrition during Texas Health and Human Services’ Healthy Texan Week underscores a fundamental belief that access to nutritious food is a cornerstone of good health.

"Cook Children’s Health Plan is more than just a Medicaid provider. We live in the community we serve and know first-hand the struggles families face,” said Blanca Rodriguez, manager of Community Marketing Department of Member Services at CCHP. “Food insecurity is a significant challenge in North Texas, and we are dedicated to finding innovative ways to support families in accessing the healthy food they need."

Addressing food security is not new for CCHP. In 2023, the health plan funded the R.E.D. Mobile grocery store (Resource and Education Delivered), a truck that brings free, nutritious food directly to underserved neighborhoods in Denton, Wise, and Cooke Counties. A similar truck, known as the R.E.D. Bus, was also parked at the event this week in Arlington.

As Eleanor Rakestaw, director of community resources at TAFB, explains, the R.E.D. initiative goes beyond simply handing out groceries.

“Our primary goal for the R.E.D. Bus is to provide education, resources, and assist with SNAP applications, so that we can help families purchase their own food and groceries in the future,” said Rakestaw. “It’s about empowering the people we serve to achieve long-term food security.”

For Cook Children's Health Care System as a whole, the link between food access and health is a major focus. Earlier this year, Cook Children’s Center for Community Health announced its funding of the new Healthy Food Hub at the Eastside YMCA in Fort Worth.

“We’re grateful to collaborate with other community organizations to keep hearts and bodies healthy,” said Hilda Colunga, Community Impact Director at the American Heart Association in North Texas. “Providing healthy recipes and nutrition resources aligns with our mission to improve cardiovascular and overall health and well-being of everyone everywhere.”

This week’s events in Arlington are a key example of how CCHP differs from for-profit insurance companies – who CCHP members may soon be forced to enroll with if the Texas Legislature doesn’t act soon.

As a nonprofit organization, CCHP channels resources back into local needs – not out-of-state shareholders. These not only include programs addressing food insecurity but also outreach efforts focused on asthma, drowning prevention, gun safety, and nine Neighborhood Health Centers. These centers provide physical, behavioral, and dental health services to children in underserved areas of Tarrant County.

The loss of Cook Children's Health Plan would mean losing a trusted community partner that pours resources back into the local ecosystem. Taxpayer dollars allocated for Medicaid would be redirected to for-profit insurance companies, many based outside of Texas, who prioritize shareholders rather than local families.

“Cook Children’s Health Plan is more than health coverage. It’s a community where you are taken care of,” said Rodriguez.

Texas lawmakers have until June 2 to pass a bill that would allow CCHP to remain operating. Learn more at savecookchildrenshealthplan.com.

In March 2024, the Texas Health & Human Services Commission (HHSC) announced plans to deny contract renewals to several Medicaid providers, including three non-profit, Texas-based children’s hospital plans: Cook Children’s Health Plan (CCHP), Texas Children’s Health Plan, and Driscoll Children’s Health Plan. Despite their combined 60+ years of proven, high-quality care, HHSC intends to award the multi-billion-dollar Medicaid STAR/CHIP contracts primarily to publicly-traded insurers beholden to out-of-state shareholders.

On June 2, 2025, the clock will run out on the Texas Legislature to prevent the largest Medicaid upheaval in state history, costing Texans nearly 2,000 jobs and millions in tax dollars. Without immediate legislative action, at-risk families may lose access to pediatric specialists, leading to the loss of hundreds of local jobs. Furthermore, taxpayers might bear the burden of increased ER overcrowding and higher uncompensated care costs resulting from coverage gaps due to this disruption.

What’s at stake

•  1.8 million children and pregnant women across Texas would be forced to change health insurance plans if HHSC’s current award stands.
• 125,000 North Texas children, including as many as 10,000 medically complex kids who count on Cook Children’s Health Plan (CCHP) today. 
  •  Includes 170 children on ventilators who cannot afford a lapse in care and more than 1,700 children dependent on wheelchairs.
•  Texas stands to lose billions in taxpayers’ dollars if Medicaid and CHIP funding are redirected to out-of-state, for-profit corporations. This change will shift profits to shareholders across America, and away from reinvestments in local non-profit children's health plans based health care programs and access points throughout Texas. Don’t let these dollars leave Texas!
•  Three children’s hospital plans at risk: Cook Children’s, Texas Children’s, and Driscoll Children’s non-profit Health Plans swapped in favor of for-profit insurance companies, most of whom are out of state.

Economic Impact

Why non-profit children's health plans outperform for-profit insurance companies

• Texas-based, non-profit children's health plans pour their resources and earnings back into the communities they serve. These reinvestments build and strengthen communities across Texas.
• 107-year local legacy: Cook Children’s reinvests more than $200 million back into the community every year through community benefits and uncompensated care, not Wall Street dividends. 
• Nine neighborhood health centers (two opening this year) are placed in high-need ZIP codes at no additional cost to taxpayers. This keeps families out of emergency rooms for primary care needs. Cook Children’s funds $1 million annually for each center (total $9 million). Checkup Newsroom
•  Top-tier member satisfaction and quality metrics HHSC failed to consider in scoring the 2024 bids, prompting bipartisan criticism of a “subjective and unsound” procurement. AP News

The Solution:

Several bills have been filed in Austin, and officials are actively shepherding this cause.  We are hopeful there will be legislation finalized prior to June 2.

What’s the benefit of Texas-based, non-profit children's health plans?

• Local control of taxpayer dollars. Funds stay in Texas communities, not out-of-state shareholders.
• Free-market competition. Offers more consumer choice instead of narrowing it.
• Fiscal stewardship and ensures quality care. Maintains a proven, nonprofit plan with an integrated health system and a proven quality track record vs. paying corporate margins.
• Family values & self-reliance. Protects parents’ ability to choose trusted doctors and keeps medically fragile kids out of crisis care that drives up costs.

Additional Fast Fact:

• Cook Children’s Healthy Homes Asthma Program significantly improves the quality of life for families by remediating homes to eliminate asthma triggers and providing essential resources like cleaning supplies. To date, we have improved the home environments of 760 children living with asthma, including 314 health plan members.

SaveCookChildrensHealthPlan.com is a valuable resource packed with facts, articles, timelines, photos, member/patient stories, and more. Visit the website here.

In 2024, the Texas Health & Human Services Commission (HHSC) denied contract renewals to several Medicaid providers, including three non‑profit, Texas‑based children's hospital plans: Cook Children's Health Plan, Texas Children's Health Plan and Driscoll Children's Health Plan. Despite their combined 60-plus years of proven, high‑quality care, HHSC awarded the multi‑billion‑dollar Medicaid STAR/CHIP contracts to several publicly traded insurers beholden to out‑of‑state shareholders.

Cook Children's Health Plan President Karen Love spoke with Becker's Hospital Review to provide an update on the situation and an explanation of the impact this decision would have on the state of Texas and children's access to non-profit health care coverage.

“We take our direction from our community,” Love told Becker’s. “Provider-affiliated plans like ours, where you have the hospital and the doctors and the payer all working together for the benefit of these children, is a different model of care and a different model of coverage than the large national for-profit companies.”

Read the article here. 

Imagine being forced to forfeit a local, trusted resource that serves as your medically fragile child’s lifeline to out-of-state strangers for no good reason at all. That is exactly what Texas’ Health and Human Services Commission will do by cutting off access for Texas families to long-established, community-based health services.

Last year, the Health and Human Services Commission, which oversees the contracts and funding for the state’s Medicaid STAR and CHIP programs, denied Cook Children’s Health Plan renewed contracts to serve its membership. It did the same to two other nonprofit community health plans in South Texas and the Houston area. Instead, the commission chose to give those contracts to numerous for-profit health care companies, most of which are not based in Texas. The decision would force 1.8 million children and pregnant women who qualify for the Medicaid STAR and CHIP programs to switch from the health plans they rely upon to unfamiliar, corporate insurers beholden to shareholders.

We are doing everything we can to protect North Texas families from this harmful decision. But we can’t do it without the support of Texas Legislators.

If lawmakers do not intervene, the commission’s decision will upend the lives of Texas families, including 125,000 vulnerable North Texas children who rely on Cook Children’s Health Plan. They’ll have to start from scratch with a new health insurer and possibly new doctors after years of establishing a specialized medical team and complex care plans for their children. This could result in delayed or disrupted care, including for patients on a ventilator who are enrolled in Cook Children’s Health Plan.

Very soon, Texas Legislators are expected to consider several bills to protect the health care of vulnerable Texas children.

These bills would change the law on how the commission awards contracts for the management of its STAR and CHIP programs. Simply put, they would give Texas families a choice in health insurers and protect their right to have their Medicaid-dependent child’s health care managed locally.

Needlessly foisting a change onto the most vulnerable in our community could be disastrous for Texas families. Change is hard even in the best of circumstances. When you have a medically fragile child, forced changes pile hardship onto an already heavy burden. Just ask Breanna Hernandez.

Her son, MJ, was born prematurely at 27 weeks. Now 10 years old, MJ requires complex care from multiple specialties like neurology, pulmonology and gastroenterology, to name a few. All of MJ’s current doctors, along with many of his therapies and services, are part of the Cook Children’s Health Plan network. His family relies on the STAR Kids program through the health plan to cover most of MJ’s health care costs, including the supplies that allow him to receive nutrition safely through a port in his stomach.

“Losing the health plan would be like a tsunami or a tornado coming through our lives,” Hernandez said. “We never know what we’re going to get every morning when we wake up, but waking up with the knowledge that we have this established resource is a lifeline, a constant. It being taken away is something else that we would also have to worry about.”

Hernandez is on a first-name basis with MJ’s case manager at Cook Children’s Health Plan. That type of connection, where everyone feels like family, is central to Cook Children’s culture. Knowing the people who manage your child’s care also live and raise their families in the same area is another key benefit of a community-based health plan. They have first-hand knowledge of the local resources and how to help members navigate them. They understand the unique needs of local children and care deeply about the health of the community because it’s their community, too.

Private, out-of-state insurance companies can’t offer the same connection. The majority aren’t embedded in the communities they serve.

Cook Children’s Health Plan has been providing health care coverage for families and children with limited resources for more than 20 years, and Cook Children’s itself has been serving this community for more than 107 years. As a nonprofit organization, we use our resources to support our promise of improving the well-being of every child in our care and in our communities.

This year, Cook Children’s will open two new neighborhood health centers, for a total of nine centers strategically located throughout Tarrant County in areas with little access to health services close to home. The majority of neighborhood health center patients are dependent on Medicaid. These centers offer basic, yet critical, health and wellness services, including behavioral health, for children who otherwise might go unserved. It’s your health care dollars in action, making a real difference in the lives of children in your community — a stark contrast from several out-of-state corporate insurers selected by the Texas Health and Human Services Commission whose profits flow to shareholders.

The commission’s decision is flawed and wrong for Texas families. It’s the result of a subjective and unsound contract-renewal process that is not consistent with the law. Instead of considering past performance and quality when awarding these contracts, which the commission was legally required to do, it ignored decades-long telling track records, like Cook Children’s Health Plan’s high member ratings and demonstrated quality of care, and chose untested promises made by many for-profit insurance companies.

The proposed bills would replace the current error-prone, subjective bidding process with a more modern and straightforward system. Most important, the bills would allow families enrolled in STAR, CHIP and other Medicaid programs to choose whether they want to remain on their current health plans or switch to the private insurers.

“I would ask lawmakers to spend one day, or a week, in our lives,” Hernandez said. “There are a lot of things that us parents go through daily with these kiddos’ lives, and seeing it from somebody else’s perspective, really digging in there and living that day-to-day, would change your mind on a lot of the decisions you make. Please, save Cook Children’s Health Plan.”

We urge the Legislature to join us in viewing the world through the eyes of the Hernandez family and the thousands of others like them. Support the proposed legislation, and give Texas families the power to choose. Focus on the well-being of the children in our communities, and not the countless out-of-state shareholders, by supporting nonprofit community-based health plans. Let’s protect our children and ensure they receive the quality health care they deserve.

Rick W. Merrill serves as president and CEO of Cook Children’s Health Care System.

Cook Children's Health Plan President Karen Love and member Liz Piñon spoke with CBS 11 to share the real impact this decision will have on children’s access to non-profit health care coverage.

Read the full story here. 

Here's how you can show your support:

Cook Children’s is asking for your help to show the real impact this decision will have on children’s access to non-profit health care coverage. 

Step 1: Record Your Video!

• Capture a quick clip of your child smiling, laughing, playing or however they express joy. It could also be a clip of your child with their vital medical equipment.
• Keep it Horizontal: Film your video horizontally (long and wide) – perfect for media outlets to share on the news and online. 
• Keep it Concise: Aim for a video that is no longer than 15-30 seconds. Get straight to the heart of your message. 
• End with a Call to Action (Optional but Recommended): You can briefly say something like, "We love the Cook Children’s Health Plan!” or “The Cook Children’s Health Plan cares for us like family.” or “Our case manager always calls to check on us and always shows us kindness.” 

Step 2: Share Your Video on Social Media!

• Use the Hashtags: This is important for the campaign to gain visibility! Please include these hashtags in your post:
  • #SaveCookChildrensHealthPlan 
  • #ProtectTexasKids 
  • #TXLege 
  • #ProtectCommunityHealthPlans 
     
• Write this Caption and Call to Action: “This smile is possible because of Cook Children's Health Plan. Don't take it away. Please share and show your support for Cook Children’s!"
• Share Widely: Post your video on all your social media platforms – TikTok, Instagram, Facebook, Twitter/X, etc. Encourage your friends and family to share your post. 

Step 3: Encourage Others to Participate! 

• Share this toolkit with other parents you know who are affected. 
• Sample Social Media Post: 

[Child’s Name] smile and well-being is possible because of Cook Children's Health Plan. Don't take it away. Cook Children's Health Plan is a lifeline for my child and losing it would be devastating. Please share and show your support for Cook Children’s! 

#SaveCookChildrensHealthPlan #ProtectTexasKids #ProtectCommunityHealthPlans #TXLege

Important Reminders: 

• Privacy: Only share what you are comfortable sharing publicly about your child and family. 
• Respect: Please keep your videos and captions respectful and focused on the importance of health care access.
• Urgency: Time is of the essence. Please record and share your videos as soon as possible! 
   

Together, our voices can be powerful. By sharing our stories, we can show the critical role Cook Children's Health Plan plays in the lives of our children and urge them to take action to prevent this devastating shutdown. Thank you for your participation and for being a champion for your child's health.

By: Rick W. Merrill, President & CEO, Cook Children’s Health Care System

Imagine being forced to forfeit a local, trusted resource that serves as your medically fragile child’s lifeline to out-of-state strangers for no good reason at all. That is exactly what Texas’ Health and Human Services Commission (HHSC) will do by cutting off access for Texas families to long-established, community-based health services. 

Last year, HHSC, which oversees the contracts and funding for the state’s Medicaid STAR and CHIP programs, denied Cook Children’s Health Plan renewed contracts to serve its membership through these programs. They did the same to two other non-profit community health plans in South Texas and the Houston area. Instead, HHSC chose to give those contracts to numerous for-profit health care companies, most of whom are not based in Texas. The decision would force 1.8 million children and pregnant women who qualify for the Medicaid STAR and CHIP programs to switch from the health plans they rely upon to unfamiliar, corporate insurers beholden to shareholders.

We are doing everything we can to protect North Texas families from this harmful decision. But we can’t do it without the support of Texas Legislators. 

If lawmakers do not intervene, HHSC’s decision will upend the lives of Texas families, including 125,000 vulnerable North Texas children who rely on Cook Children’s Health Plan. They’ll have to start from scratch with a new health insurer and possibly new doctors after years of establishing a specialized medical team and complex care plans for their children. This could result in delayed or disrupted care, including for patients on a ventilator who are enrolled in Cook Children’s Health Plan. 

Very soon, Texas Legislators are expected to consider two proposed bills that protect the health care of vulnerable Texas children—House Bill 3538, introduced by Rep. Charlie Geren, R-Fort Worth, and Senate Bill 2388, filed by State Senator Juan “Chuy” Hinojosa, D-McAllen. 

These bills would change the law on how HHSC awards contracts for the management of its STAR and CHIP programs. Simply put, they give Texas families a choice in health insurers and protect their right to have their Medicaid-dependent child’s health care managed locally. 

Needlessly foisting a change onto the most vulnerable in our community could be disastrous for Texas families. Change is hard even in the best of circumstances. When you have a medically fragile child, forced changes pile hardship onto an already heavy burden. Just ask Breanna Hernandez. 

Her son, MJ, was born prematurely at 27 weeks. Now 10, MJ requires complex care from multiple specialties like neurology, pulmonology and gastroenterology, to name a few. All of MJ’s current doctors, along with many of his therapies and services, are part of the Cook Children’s Health Plan network. His family relies on the STAR Kids program through the health plan to cover most of MJ’s health care costs, like the supplies that allow him to receive nutrition safely through a port in his stomach. 

“Losing the health plan would be like a tsunami or a tornado coming through our lives,” Hernandez said. “We never know what we’re going to get every morning when we wake up, but waking up with the knowledge that we have this established resource is a lifeline, a constant. It being taken away is something else that we would also have to worry about.” 

Hernandez is on a first-name basis with MJ’s case manager at Cook Children’s Health Plan. That type of connection, where everyone feels like family, is central to Cook Children’s culture. Knowing the people who manage your child’s care also live and raise their families in the same area is another key benefit of a community-based health plan. They have first-hand knowledge of the local resources and how to help members navigate them. They understand the unique needs of local children and care deeply about the health of the community because it’s their community, too. 

Private, out-of-state insurance companies can’t offer the same connection. The majority aren’t embedded in the communities they serve. 

Cook Children’s Health Plan has been providing health care coverage for families and children with limited resources for more than 20 years, and Cook Children’s itself has been serving this community for more than 107 years. As a nonprofit organization, we use our resources to support our Promise of improving the well-being of every child in our care and in our communities. 

This year, Cook Children’s will open two new neighborhood health centers, for a total of nine centers strategically located throughout Tarrant County in areas with little access to health services close to home. The majority of neighborhood health center patients are dependent on Medicaid. These centers offer basic, yet critical, health and wellness services, including behavioral health, for children who otherwise might go unserved. It’s your health care dollars in action, making a real difference in the lives of children in your community—a stark contrast from several out-of-state corporate insurers selected by HHSC whose profits flow to shareholders. 

HHSC’s decision is flawed and wrong for Texas families. It’s the result of a subjective and unsound contract-renewal process that is not consistent with the law. Instead of considering past performance and quality when awarding these contracts, which HHSC was legally required to do, it ignored decades-long telling track records, like Cook Children’s Health Plan’s high member ratings and demonstrated quality of care, and chose untested promises made by many for-profit insurance companies. 

The proposed bills would replace the current error-prone, subjective bidding process with a more modern and straightforward system. Most importantly, the bills would allow families enrolled in STAR, CHIP and other Medicaid programs to choose whether they want to remain on their current health plans or switch to the private insurers. 

“I would ask lawmakers to spend one day, or a week, in our lives,” Hernandez said. “There are a lot of things that us parents go through daily with these kiddos’ lives, and seeing it from somebody else’s perspective, really digging in there and living that day-to-day, would change your mind on a lot of the decisions you make. Please, save Cook Children’s Health Plan.” 

We urge the Legislature to join us in viewing the world through the eyes of the Hernandez family and the thousands of others like them. Support the proposed legislation, and give Texas families the power to choose. Focus on the well-being of the children in our communities, and not the countless out-of-state shareholders, by supporting nonprofit community-based health plans. Let’s protect our children and ensure they receive the quality health care they deserve. 

To learn more and support our efforts, please visit SaveCookChildrensHealthPlan.com. 

For nearly 25 years, CCHP has been a dedicated provider and protector in ensuring the well-being of every child.  The Texas Health and Human Services Commission (HHSC) has denied CCHP a renewed contract for the upcoming year causing many families to face uncertainty in the future of their child’s care.

If nothing is done to help community health plans, many children will be forced to change their doctors, nurses, and specialized care providers. For families, this ongoing care for their children has been part of their daily lives for years. Our state officials can prevent the children in our care from being forced to leave what they consider home.

“Cook Children’s has built a relationship with myself and with my children, and they have gotten to know them well over time. Especially when you have kids with special needs, that’s very important because Cook Children’s has taken the time to get to know them, to really see how they respond to different treatments and how they are when they’re sick. Cook Children’s knows what I need as a parent. So that’s been very important to our family,” Rebekah Jones, mother of three boys said.

“It really impacts everything in your life. All these years that the kids have been with these physicians and nurses and staff who have gotten to know them — and that changing is like leaving a family and changing families. It’s not just a simple procedure,” Jones added.

Our health plan ensures the best possible care for Tarrant County area children through a comprehensive network of support. Families benefit from a vast primary care and specialty care network, two medical centers and conveniently located Neighborhood Health Clinics, Urgent Care Centers and Home Health services. We also offer families a host of community health programs and educational offerings. 

President of Cook Children’s Health Plan Karen Love said other nonlocal for-profit health plans do not know the community as well as the employees and providers who live in and want to serve their community.

“The national for-profit plans don’t know the community the way that we do. They don’t know the resources that are available to help our members with things that are outside the medical benefit realm,” Love said. “So, a mom’s struggling to afford diapers. Where’s the diaper bank? Where’s the nearest food pantry? All those things that families may need help with. They need it from somebody who knows the area and can advise them on where to go.”

Our health plan ensures access to vital care for our most vulnerable. If nothing is done, this decision by Texas Health and Human Services Commission (HHSC) to deny CCHP a new contract then over 76% of Tarrant County and 56% of Texas Medicaid and CHIP Members will be forced to choose a new health plan.

The potential disruption of community health plans causes uncertainty for families and jeopardizes the health of our children. We ask our state officials to find a way for CCHP to continue our crucial work in the community and serving our children.

Very soon, Texas Legislators are expected to consider two proposed bills that protect the health care of vulnerable Texas children—House Bill 3538, introduced by Rep. Charlie Geren, R-Fort Worth, and Senate Bill 2388, filed by State Senator Juan “Chuy” Hinojosa, D-McAllen. 

To learn more about how this is impacting our community, families and employees please visit Save Cook Children's Health Plan.

To read what Cook Children’s Health Care System President and CEO Rick W. Merrill has to say on this issue, please click here. 

However, the very existence of the Health Plan is threatened after the Texas Health and Human Services Commission (HHSC) denied Cook Children’s Health Plan a renewed contract to serve its membership.

The end of Cook Children’s Health Plan could be devastating for thousands of families. Many children could be forced to leave the trusted doctors, nurses, and specialized care clinicians who have become an integral part of their lives. For these families, the consistent and personalized care their children receive has been a cornerstone of their daily routines for years. Thankfully, our state officials possess the power to prevent this upheaval and ensure these children can continue to rely on what they consider home.

Rebekah Jones, a mother of three boys, captures the deep connection families have with Cook Children's, “Cook Children’s has built a relationship with myself and with my children, and they have gotten to know them well over time. Especially when you have special needs, that’s very important because Cook Children’s has taken the time to get to know them, to really see how they respond to different treatments and how they are when they’re sick. Cook Children’s knows what I need as a parent. So that’s been very important to our family.”

Jones further emphasizes the profound impact of changing plans, “It really impacts everything in your life. All these years that the kids have been with these physicians and nurses and staff who have gotten to know them — and that changing is like leaving a family and changing families. It’s not just a simple procedure.”

Cook Children’s Health Plan ensures the highest quality care through a comprehensive support network, including Neighborhood Health Clinics, convenient At Home Health options, vital Community Health Centers, and advanced Medical Centers.

President of Cook Children’s Health Plan, Karen Love, points out the critical difference between their community-rooted approach and that of nonlocal, for-profit health plans: “The national for-profit plans don’t know the community the way that we do. They don’t know the resources that are available to help our members with things that are outside the medical benefit realm. So, a mom’s struggling to afford diapers. Where’s the diaper bank? Where’s the nearest food pantry? All those things that families may need help with. They need it from somebody who knows the area and can advise them on where to go.”

Beyond the impact on families, Love also highlights the difficult situation for their dedicated workforce: “[Also], it's been particularly hard for our employees, because they didn't do anything wrong. They've been doing their job and they've been doing a really good job at it. How do you explain to them despite your great work, you know, we're in this situation? They are incredibly dedicated to the kids that we serve.”

Our health plan ensures access to vital care for our most vulnerable. If the Texas Health and Human Services Commission (HHSC) decision to deny Cook Children’s Health Plan a new contract is not addressed, more than 76% of Tarrant County and 56% of Texas Medicaid and CHIP Members face the prospect of losing their trusted health plans, impacting not only the families but also the committed individuals who serve them.

This session, Texas Legislators are expected to consider two proposed bills that protect the health care of vulnerable Texas children—House Bill 3538, introduced by Rep. Charlie Geren, R-Fort Worth, and Senate Bill 2388, filed by State Senator Juan “Chuy” Hinojosa, D-McAllen.

To learn more about this issue and how to support our efforts, please visit SaveCookChildrensHealthPlan.com.

To read what Cook Children’s Health Care System President and CEO Rick W. Merrill has to say on this issue, please click here. 

“I knew about Cook Children’s, but I thought it was just for babies. I didn’t know they had a plan actually to prepare mothers,” Evans said. 

CCHP covers the health care of pregnant mothers and offers additional services. Chrystal Bryant, a high-risk maternity case manager at CCHP, calls Evans monthly to check in. Under the health plan, each high-risk pregnancy is assigned a case manager. 

“We ensure they have adequate prenatal care, that they’re going to their doctor’s appointments, and that they have their prenatal vitamins,” Bryant said. 

At four months pregnant, Evans was told her baby was measuring small. Doctors informed her that her daughter might need to spend time in the neonatal intensive care unit (NICU) at Cook Children’s Medical Center-Fort Worth. Although concerned, Bryant and her medical team helped put her at ease. 

“I have a whole dedicated team for her. It’s amazing,” Evans said. 

Maternal and infant mortality is a concern in Tarrant County. In 2024, the Tarrant County Maternal and Infant Health Coalition presented the city of Fort Worth with data showing Tarrant County had the second-highest maternal mortality rate among Black women in the state. 

“Cook Children’s Health Plan is committed to ensuring that all children in our community are safe and healthy, and that begins at conception,” Bryant said. 

CCHP understands this and focuses on ensuring mothers and children’s medical and essential needs are met. 

Members can earn gift cards, a car seat, and a portable crib by attending their prenatal and postpartum appointments and classes. 

“Cook Children’s Health Plan is unique because we are embedded in the community as a community plan,” Bryant explained. 

A former labor and delivery nurse, Bryant provides mothers with an added resource as she is able to answer questions and direct patients to the appropriate resources, such as transportation vouchers, rental assistance and food delivery. 

Evans said it makes a difference. 

“They make sure the baby has everything she needs to grow,” Evans said. As her nutritional needs increased, Bryant helped Evans get food boxes delivered to her home every two weeks. 

CCHP case managers are embedded in the community, enabling them to form relationships with organizations to help meet members’ needs. 

Meeting for the First Time 

Evans and Bryant, who had spoken on the phone for months, met in person for the first time in March. They shared a hug and began conversing as if they had known each other for years. 

Bryant asked Evans about her medical appointments and her mood. 

In December, Evans's mother died. Bryant became more than a caseworker; but a shoulder to lean on and encourage her. 

"Not only did she become my caseworker, but she also became my mental health caseworker," Evans said. Bryant helped her navigate her emotions. 

During the meeting, Evans shared that her daughter would be named Hazel, after her mother. She expressed her excitement about meeting her daughter. 

Evans showed Bryant a 3-D sonogram of Hazel, noting her resemblance to Evans’s fiancé. 

Bryant took notes as Evans discussed her recent doctor's appointment. Bryant accessed Evans's medical records to answer questions. 

They discussed nutrition, ensuring Evans was receiving nourishing foods. 

"She's concerned about the baby, but she's also concerned about me as well," Evans said. 

They also discussed baby items that Evans could get through classes.  

Chrystal let Evans know she could receive a bassinet for completing a Safe Sleep class hosted by Cook Children's Center for Community Health. 

Through other classes, she could earn a car seat and a gift card for other baby items. 

"They [CCHP] have a team of people willing to help me with a lot of things," Evans said. "They are helping me in the process of helping the baby grow." 

What’s at Stake 

CCHP helped Evans thrive during her pregnancy. She may not have received the support and resources under a different insurance plan, like the ones the state plans to fund instead.  

The current CCHP STAR and CHIP contracts will remain active through Aug. 31, 2025. At that time, families enrolled in CCHP will be forced to choose a new plan from four national, for-profit insurance companies – Aetna, Blue Cross Blue Shield of Texas, Molina, and UnitedHealthcare – three of which have no experience in our local market.  

Until then, CCHP will continue to appeal against the state’s flawed decision and work with all stakeholders to ensure that its members continue to receive the best possible care.  

For more information, including key facts, videos, photos, and recent media coverage, please visit SaveCookChildrensHealthPlan.com.  

A health plan that serves 125,000 vulnerable children and families in the Tarrant County area is in danger of being destroyed.

Cook Children’s dedication to the North Texas community is far reaching and deeply rooted. In addition to operating two medical centers, neighborhood health centers, urgent cares, home health and more, we operate a health plan that currently serves 125,000 Tarrant County area residents, most of whom are children.

Cook Children’s Health Plan has provided health care coverage for families and children with limited resources for more than 20 years, and Cook Children’s itself has been serving this community for more than 107 years.

However, last year, the Texas Health and Human Services Commission (HHSC) denied Cook Children’s Health Plan a renewed contract to serve its membership. This threatens the health care choices of thousands of vulnerable North Texas children.

HHSC’s decision would upend that choice of coverage for North Texas families in need. We are doing everything we can to protect those families from this harmful decision.  

Two proposed bills offer a ray of hope. House Bill 3538, introduced by Rep. Charlie Geren, R-Fort Worth, and Senate Bill 2331, filed by State Senator Tan Parker, R-Flower Mound, would give families the right to choose whether they want to remain on Cook Children’s Health Plan, and other care plans, or not.

Cook Children’s Health Plan provides care through two state programs: STAR (Medicaid) and CHIP. HHSC oversees the contracts – and therefore, the funding -- for those programs. In March 2024, HHSC announced it would not renew contracts for major community-based, not-for-profit health plans, including Cook Children’s Health Plan and two other health plans in South Texas and the Houston area.

Instead, HHSC chose to give those contracts to for-profit health care companies, all of which keep their central operations out-of-state and their proceeds benefit out-of-state shareholders. The decision would force 1.8 million children and pregnant women who qualify for the Medicaid STAR and CHIP programs to switch from the health plans they rely upon to unfamiliar, corporate insurers.

This move would needlessly yank away the familiar integrated care that families rely on and hand it to strangers. This could delay or disrupt care for vulnerable children, including patients on ventilators, who are enrolled in the Cook Children’s Health Plan.

Liz Piñon’s family is among those who rely on Cook Children’s Health Plan, which she described as a “godsend.” Piñon’s 12-year-old triplets and 19-year-old son have various complex medical needs and have relied on Cook Children’s Health Plan for six years. Through the plan, she has access to specialists, therapists and unique programs under the same roof, as opposed to having to navigate multiple practices for each medical need.

She also was paired with a service coordinator, who helps coordinate all the specialized care the family needs. In Piñon’s case, the coordinator not only connected the family with specialists and set up appointments, but she also ensured the triplets could attend daycare. 

“It was such a nightmare doing private insurance for our kids,” Piñon said. “We were living check-to-check. Even though my husband had a white-collar job, we were in the food lines the last week of the month to get vegetables to puree.”

Cook Children’s Health Plan is able to provide personalized care like the Piñons’ because its staff live and work alongside the families they serve. Staff work one-on-one with families and go the extra mile; they help with transportation to appointments, provide healthy groceries when resources are limited and offer emotional support.

But private, out-of-state insurance companies are not embedded in the communities they serve. And the profits those companies earn from covering Texas families flows to corporate offices and shareholders’ pockets out of the state.

We believe HHSC’s current contract-renewal process is unsound and has led to HHSC’s flawed decision to decline contracts to high performing health plans, like Cook Children’s Health Plan. The current process is subjective and ignores how health plans, like Cook Children’s, have been providing quality care for Texans for more than two decades.

That is why the proposed bills would change the law on how HHSC awards contracts. The bills would replace the current error-prone, subjective bidding process with a more modern and straightforward system. Most importantly, the bills would allow families enrolled in STAR, CHIP and other Medicaid programs to choose whether they want to remain on their current health plans or switch to the private insurers.

We believe HHSC’s decision-making process was not consistent with the law. HHSC was legally required to consider past performance and quality when awarding these contracts. However, HHSC’s decision did not take past performance of the plans into consideration. HHSC ignored telling track records, like Cook Children’s Health Plan’s high member ratings and demonstrated quality of care, and instead chose untested promises made by for-profit insurance companies.

This goes against even common-sense decision-making.

Imagine choosing between two doctors. One has a website where they promise they’ll take care of you. The other has decades of experience and thousands of patient reviews about incredible care. Which will you choose? The state chose the first. But we believe families should make their own choices.

We urge the Legislature to give families the power to choose. Proposed legislation would give families this right. Let’s protect our children and ensure they receive the quality health care they deserve.

To learn more and support our efforts, please visit SaveCookChildrensHealthPlan.com.

Rick W. Merrill is president and CEO of Cook Children’s Health Care System.

For more than two decades, CCHP has been a trusted provider of high-quality health care coverage to low-income families, expectant mothers, and children with complex medical needs. We believe this ruling will help ensure that our Members continue to have access to the care they need, when they need it.

We would like to express our gratitude to the court for their careful consideration of this matter and for their decision in our favor. Cook Children’s will continue to monitor the situation closely and work with all stakeholders to ensure that our Members continue to receive the best possible care.

Vivienne Molen, a 15-year-old with type 1 diabetes, is one of thousands of children who rely on the Cook Children’s Health Plan (CCHP) for life-saving treatment. Now, she is at risk of losing insurance coverage for the care she needs.

On March 7, 2024, CCHP was denied a new contract for STAR & CHIP Managed Care Services by the Texas Health and Human Services Commission (HHSC). Though CCHP’s initial protest to the state’s decision was rejected, the team has filed another appeal and continues to fight for a contract renewal.  

If not reversed, this ruling will result in a serious disruption in care for nearly 125,000 low-income families, pregnant women, and medically complex children like Vivienne. 

Vivienne's Story 

In December 2019, when Vivienne was 10 years old, she became critically ill with both the flu and strep throat. When she wasn’t responding to typical treatments, her mother, Tricia Moon, brought her to the emergency room. From there, Vivienne was rushed to the ICU, where she was diagnosed with type 1 diabetes. “It was confusing, scary and overwhelming,” Tricia said. “Vivienne’s care became quite complex.”

When Tricia went through a divorce, she and Vivienne lost their health insurance coverage. Since then, they have been members of the CCHP STAR Medicaid plan. 

“Insulin is so expensive and we are so grateful that it’s covered under the STAR plan,” Tricia said. “We’ve always felt supported. I think it would just be terrible [if the new contract is denied].”

For Vivienne, getting diagnosed with type 1 diabetes was life-altering. Her chronic health issues have robbed her of the opportunity to be a normal teenager, but she has found a safe space in Cook Children’s. 

“I always love coming to Cook Children’s and I look forward to coming to my appointments,” Vivienne said. “It is the one place where I feel like I can try to gain control of my diabetes.”

Vivienne’s robust care plan involves seeing numerous specialists and getting labs and scans on a regular basis. She also frequently visits the emergency room. 

“I couldn’t imagine the stress it would put on my family, my mom, to have to pay for everything,” Vivienne said. 

As Tricia reflects on Vivienne’s journey, she becomes overwhelmed with emotion. 

“Vivienne is so resilient,” Tricia said. “She should never ever have to worry about how the adults in her life are going to care for her. That responsibility is not hers to bear.” 

What's at Stake  

Vivienne and other STAR and CHIP members could not only lose their health coverage, but also the vital support of their case managers. 

The CCHP case management team helps members in countless ways, from connecting them to food and transportation resources, to coordinating appointments and follow-ups, to ensuring they receive the medications they need.  

“Our health plan staff is very knowledgeable about the programs and resources in this community. They know how to access those services and get things for families that they need,” said Vivienne’s case manager, Jami Jensen, RN, CCM. 

If the STAR and CHIP contract is ultimately denied, more than one hundred thousand members and children could be forced to switch health plans, find new in-network doctors, and undergo lengthy authorization processes for life-saving treatments. 

“There could be issues with getting the care they need in a timely manner,” Jami said. “It’s just added stress on them, trying to navigate something from the start when there were services already in place that they were happy with.”

Without the STAR and CHIP programs in place, CCHP would likely become unsustainable—and Jami, along with hundreds of other CCHP employees, could lose their jobs. 

“I want to make sure these families get the things they need for their health, and I have a lot of experience and skills doing that,” Jami said. “Not being able to continue to help would be hard.”

What's Next? 

The current CCHP STAR and CHIP contracts will remain active through Aug. 31, 2025. At that time, families currently enrolled in CCHP will be forced to choose a new plan from four national, for-profit insurance companies— Aetna, Blue Cross Blue Shield of Texas, Molina, and UnitedHealthcare—three of which have no experience in our local market. Until then, CCHP will continue to appeal the state’s flawed decision.

“We’re putting our money back into the community, and we feel like that is what makes us different from the national companies,” said CCHP president, Karen Love.

Love is ready and willing to compete with other plans in the area, as long as families continue to have meaningful options. 

“This is not about money for the system. This is because Cook Children’s Promise is to care for every child who needs us,” Love said. “This is a fight for the children in our community, to make sure they still have access to the high-quality care that we provide.” 

For more information, including key facts, videos, photos and recent media coverage, please visit SaveCookChildrensHealthPlan.com.  

Rebekah Jones, who has had four children on Cook Children’s Health Plan, knows too well how big of a difference consistent, quality medical care can make.

Rebekah, who has been a nurse at Cook Children’s for 20 years, is the mother of four children with medical complexities. In 2017, her adopted son, Danny, passed away. After he died, Rebekah decided to foster medically challenged kids and has since adopted three of those children.

As a staff member and mother of patients, Rebekah has seen every aspect of Cook Children’s care. For her, the key to the quality care at Cook Children’s is the relationships that Cook Children’s physicians and providers build with kids over time.

“I am a little biased because I love Cook (Children's) and I think it is the best hospital in the world. And Cook Children’s is our home,” she said. “Part of it is just building that relationship, having doctors that trust you, listen to you, that you can call and say, ‘Hey, like something's not right,’ and you know they would just listen to you and believe you.”

Those relationships are not easily replicated. Rebekah worries if Cook Children’s Health Plan loses essential state funding, her children will have to start all over with new physicians, providers and therapists. She has some experience with having to coordinate with a new medical facility; in 2013 she had to transfer some of Danny’s care to another hospital to be put on the list for a heart transplant. The providers there did not know her or Danny, and in a way, it felt like starting over. Anytime you move medical care, she said, you face the headache of paperwork and trying to find new providers and schedule with all of them. Even the testing and data in a patients’ medical file might need to be repeated at the new medical facility.

For Rebekah’s three children, the relationships built at Cook Children’s under Cook Children’s Health Plan are essential to their quality of life. Because of the Texas Health and Human Services Commission plans to deny Cook Children’s that funding, Rebekah and her kids are in a sort of medical care limbo, wondering what will happen next.

The state of Texas is trying to end a program that allows thousands of children to thrive.

That’s the message Liz Piñon wants to send to state leaders trying to end the Cook Children’s Health Plan. Liz’s children are among the 8,000 medically fragile kids on the health plan; her 12-year-old triplets and 19-year-old son have various medical needs and have relied on CCHP for six years.

In March, the Texas Health and Human Services Commission announced plans to deny Cook Children’s a new contract for the Medicaid STAR and CHIP managed care programs. In June, Cook Children’s took legal action against the state for its decision to cut funding for the program, which has provided care for more than 20 years.

“If they don't have a child like we do, I feel like all families have to know that they can be in this position from one minute to the next,” she said. “And if they do, you know, having a system like the Cook Children’s Health Plan is such a godsend.”

For Liz’s family, paying for medical needs was like paying for another mortgage.

Liz’s triplets, born at 25 weeks, each have their own medical complexities requiring four or five specialty medications. Liz initially had to stay home with the kids because no daycare would take them due to their medical needs. The financial cost of medication, medical care and other specialty needs quickly added up.

“It was such a nightmare doing private insurance for our kids,” Liz said. “We were living check-to-check. Even though my husband had a white collar job, we were in the food lines the last week of the month to get vegetables to puree.”

Six years ago, everything changed when the family applied for care with Cook Children’s Health Plan. When Liz called to apply, the nurse she talked to knew the kids’ doctors, the equipment they might need and the therapists they might need now and in the future. This was different from talking to a private insurance agent who likely had no connection to Liz’s family, the doctors they saw or the community care available to them.

With Cook Children's Health Plan, the family has access to specialists, therapists and various programs under the same roof as opposed to having to navigate multiple practices for each medical need.

For almost eight years, the family saw the same pediatrician at Cook Children’s. While the doctor is no longer at the hospital, it made all the difference to have a physician who developed a relationship with the kids and the family as a whole.

“It's not easy being a Latina with special needs kids in Texas, right? I feel like I was always scrutinized a whole lot more,” Liz said. “So it was just nice to know that this doctor knew my family, knew everything I did for my kids, right? And was a voice for our family.”

Cook Children’s Health Plan also connects families with a service coordinator, who helps coordinate all the specialized care the family needs. In Liz’s case, the coordinator not only connected the family with specialists and set up appointments, but she also ensured the triplets could attend daycare. This alone changed Liz’s life; Liz has been able to serve as an expert on the Department of Education Committee because she does not have to stay home 24/7.

As young tweens, the Piñon triplets are thriving. One of her daughters participated in a wheelchair dance performance in Los Angeles this summer. Her other daughter, who has severe anxiety, was able to perform on a stage in Disney with her choir.

“Anyone that sees my kids says, ‘Oh, they look fine,’” she said. “They don't know all the thousands of appointments, thousands of hours of therapy, thousands of phone calls that have been made for them to be thriving and doing as well as they are.”

The Cook Children’s Health Plan has allowed Liz and her family to thrive. That may not have been the case under a different insurance plan, like the ones the state plans to fund instead. Without Cook Children’s Health Plan, thousands of kids may lose that same opportunity to truly thrive.

On March 7, 2024, Cook Children’s Health Plan (CCHP) was denied a new contract for STAR & CHIP Managed Care Services by the Texas Health and Human Services Commission (HHSC). Though CCHP’s initial protest to this decision has been denied, the team refuses to back down and is currently fighting for a reversal in the courts.

If not reversed, this decision will result in a serious disruption in care for nearly 125,000 low-income CCHP Members , pregnant women and medically complex children. It could also leave hundreds of CCHP employees—who work tirelessly to serve their community—in search of a job.

CCHP Complex Case Manager, Jami Jensen, RN, CCM, shared some of the crucial ways she helps patients navigate the complex health care system daily—and the potentially devastating consequences of a STAR & CHIP contract denial.

ABOUT CCHP CASE MANAGEMENT

CCHP case managers advocate for vulnerable families and children in our community all day, every day, through three vital areas of focus:

• Social determinants of health
• Coordination of care
• Education

These services have been proven to increase preventive care, decrease ER visits, and empower low-income local residents as they navigate health care.

THE CCHP DIFFERENCE

Unlike national health plans, CCHP is intertwined with Cook Children’s Health Care System and the local community.

“Some of us have worked within the Cook Children's Health Care System, and some of us have children of our own who have been through the system as a patient,” Jensen said. 

Because of their close proximity, case managers can communicate with providers seamlessly, get Members answers quickly, and even offer occasional on-site support. 

“I have gone to clinic appointments with patients before, and we’ll sometimes even meet complex patients at the hospital or in their home,” Jensen said.

CCHP case managers maintain an open-door policy—even for Members who have left the health plan.

“Even if they just have a simple medication issue, they know who to call,” Jensen said. “It’s so easy for them to reach out to us if they need something.”

SOCIAL DETERMINANTS OF HEALTH

Social determinants of health are the non-medical factors that influence health outcomes, such as socioeconomic status and access to basic needs. Before concentrating on health care issues, people must have their basic needs met.

Many CCHP Members lack reliable transportation, access to consistent food sources, and knowledge of community resources. That’s where CCHP case managers step in—to help families acquire all of the local benefits they qualify for. The knowledge and resources that come from building relationships between case managers and Member families are invaluable.

COORDINATION OF CARE

Case managers constantly collaborate with nurses, social workers, and providers within the Cook Children’s Health Care System to communicate Members’ needs, coordinate appointments and follow-ups, and close gaps in care.   

Oftentimes, when families are overwhelmed with a child being in the hospital, crucial steps for care get overlooked during discharge. Case managers bridge those gaps by reviewing each patient’s record, following up after their admission, and ensuring the family has all necessary next steps and appointments in order.

EDUCATION

Case managers go above and beyond to solve any and all types of Member needs. From helping families apply for state programs for children with special needs, to helping new moms find Medicaid-covered formulas, there’s nothing CCHP won’t do to make Members’ lives easier. 

With the help of staff members, who have extensive nursing backgrounds, CCHP has also been able to implement preventative programs and services for high-risk populations, including members with diabetes, asthma, and pregnancy risks.

CONSEQUENCES OF STAR & CHIP CONTRACT DENIAL

If the STAR & CHIP contract is ultimately denied, approximately 125,000 Members and children could be forced to switch providers and find new, in-network doctors.

Patients relying on life-saving treatments and medical equipment, such as ventilators, might have to find new suppliers and undergo lengthy authorization processes. These delays could cause serious harm to their health.

The loss of on-the-ground support from CCHP would force Members to navigate national call centers for support through these disruptive transitions—and there’s no guarantee that their new plans will offer knowledge of local resources.

“These families already have so much on their plates and it’s a lot of new information they might not understand,” Jensen said. “It’s so awful thinking how much stress this will add for them.”

WHAT’S NEXT?

Though Health Plan case managers continue to work tirelessly to support their Member families, they are also battling the anxiety of potential unemployment. A denial of the contract would more than likely threaten the sustainability of CCHP as a whole.

The CCHP team laments the potential loss of the heart, soul, and hard work they have poured into making health care more accessible for the most vulnerable Members of our community. National, for-profit insurers—favored over CCHP by the HHSC—cannot match the exceptional commitment and dedication that CCHP has demonstrated for over 20 years.

“We're not in this line of business for the profit,” Jensen said. “We are doing, and have always done what's best for the children in our community.”

By Kaley Johnson

Cook Children’s operates seven Neighborhood Health Centers around the Fort Worth area, with two more set to open in the next 18 months. The centers provide unique services in the community, particularly for underserved children and families.

The main mission of the Neighborhood Health Centers is to provide holistic health care and primary medical care to underserved communities, explained Vida Amin, M.D., Medical Advisor for the Neighborhood Health Centers. The centers are strategically placed in areas where residents have less access to health care due to lack of transportation, low socioeconomic status or other factors.

In 2023, the Neighborhood Health Centers saw 125,761 patient visits across the seven locations; over 50% of those patients were on Cook Children’s Health Plan and the rest were on a variety of other government insurance plans.

“Health care should be available to children across the board,” Dr. Amin said. “We are ensuring that we are not only taking care of the child's health but also ensuring that we’re helping the families as well, to support their child.”

That support extends beyond basic medical care. Christina Reed, LMSW, has been the Neighborhood Health Centers’ Operations Director for five years. She explained the vast support system the Neighborhood Health Centers provide for families in each area. Patients of the Neighborhood Health Centers have access to dieticians, referral coordinators, speech therapists, behavioral health therapists, community health workers and even dental services, all within their medical home. These teams work seamlessly with the community and Cook Children’s partners to assess and address patient needs in a timely and holistic manner.

“Whether it’s transportation needs or maneuvering through school issues, the NHC providers and staff are part of the child’s support system, working to help the child and their family be successful beyond basic medical care,” said Veronica Tolley, Vice President of Primary and Specialty Services. 

This holistic approach to care emphasizes the importance of going beyond “basic” medical care to set families up for healthy lives. Dr. Amin understands the significance of health care access firsthand; she and her family visited health centers after her family immigrated to the U.S. when she was young.

“For children, if you can intervene in health, it can make such a massive impact on the trajectory of a child’s life,” she said. “It’s not just with the patient, but with the family and how to support their child.”

In order to set patients up for better health in the future, the Neighborhood Health Centers emphasize health care education and health screenings for patients. Staff members screen patients for adolescent depression, postpartum depression, cholesterol levels, food insecurity and common illnesses to identify areas where families might need more support. Immunization is also an important piece of the centers’ care; in 2021 to 2023, nearly half of the visits at the health centers were for patients receiving vaccines.

Staff also work with families to overcome barriers to future health care access. A large part of that support system involves partnerships. For example, the Neighborhood Health Centers collaborate with the Cook Children’s Homeless Initiative to provide primary care services to children staying in local shelters.

“It brings me a tremendous amount of pride in what we do,” Christina said. “The way we collaborate with the Cook Children's system and our communities; it is absolutely the most impactful work that I’ve been a part of.”

We look forward to sharing more future stories about the special people working in the Neighborhood Health Centers who live the mission every day in keeping our Cook Children’s Promise!

Where Are Cook Children’s Neighborhood Health Centers?

Cook Children's Neighborhood Health Centers provide a pediatric medical home for children's health care needs, including well-child checkups, sick care, dental, immunizations, behavioral health services, nutrition services and speech therapy. Learn more.

• Arlington: 1525 S. Cooper, St. Arlington 
• McCart: 6421 McCart Ave., Fort Worth 
• Miller: 2755 Miller Ave., Fort Worth 
• The Morris Foundation Center for Innovation in Children's Health: 1729 8th Ave., Fort Worth 
• Northside: 4405 River Oaks Blvd., Fort Worth 
• Renaissance: 2600 East Berry St., Fort Worth 
• Richland Hills: 7120 Blvd. 26, Richland Hills 

Samuel and Kathy Grace Sudolcan’s home is filled with love, joy and hope. You see it in the smiles of their three sons, including 2-year-old Zechariah, despite the fact that every breath he takes is dependent on a well-equipped and working ventilator.

Samuel calls Zechariah’s vent “the old workhorse.” Though it's an older model, it never misses a breath. Over the years, the couple has mastered the art of operating, cleaning, and changing its fittings, and they wince at the thought of trading it in for a newer model. After all, why fix what isn't broken?

Change is hard, even in the best of circumstances. Change while caring for a child with complex medical needs, especially when unnecessary, is like adding a mountain to an already steep climb. It’s challenge on top of challenge. Stress on top of stress.

But that’s what thousands of families served by Cook Children’s Health Plan (CCHP) are facing due to a recent decision by Texas’ Health and Human Services Commission (HHSC). Despite having a 20-year record of excellence serving children and families in Tarrant County and surrounding areas, HHSC denied the renewal of Cook Children’s Health Plan’s contract for managing Texas’ STAR Medicaid and CHIP programs in its service area, starting in Sept. 2025.

Instead, the commission plans to award contracts to four national, for-profit insurance companies. The decision, made through an unfair and flawed re-contracting process, places more than 125,000 low-income families and children at risk of losing vital services and interrupting long-established relationships with their physicians. It ignores the human cost of removing access to well-performing, non-profit community resources such as Cook Children’s Health Plan and its trusted network of medical providers, and forces families to rely on out-of-state, for-profit providers.

Zechariah is one of the more than 8,000 medically fragile children covered under Texas’ STAR Kids program by Cook Children’s Health Plan. While his health care coverage is not yet impacted by HHSC’s decision, his story illustrates the important role Cook Children’s Health Plan plays in the lives of its members and their families. More importantly, if CCHP loses the STAR Medicaid and CHIP contracts, the future of the STAR Kids program at CCHP could become uncertain.

“This decision won’t hurt Cook Children’s as much as it will hurt our members we serve, many like Zechariah and his family,” said Karen Love, president of Cook Children’s Health Plan. “The families and children covered by Cook Children’s Health Plan deserve the ability to choose us. That’s why we have decided to file litigation in court to stop the state from ending our Medicaid STAR and CHIP managed care programs.”

The Steep Climb

The Sudolcans learned of Zechariah’s potential medical complications in the fourth month of Kathy Grace’s pregnancy. Her 20-week anatomy scan showed malformations of his heart and issues with his kidneys. Physical markers similar to what is seen in Down Syndrome were also present, leading doctors to believe Zechariah likely had some type of chromosomal abnormality. More invasive diagnostic testing would have put the pregnancy at risk without providing much treatment benefit, so Samuel and Kathy Grace could only wait, hope and pray for the best.

As the months ticked, by doctors outlined three likely scenarios the Sudolcans could face with Zechariah. There was a very real possibility he would not make it to birth. If he did, because his heart was small and weak, he may only survive a matter of hours after birth. Or, he could be stable enough to undergo surgery to repair his most critical cardiac malformations. 

“Because of how severe his heart and lung issues were, we made the decision to hold him for a bit after birth to spend time with him before he passes, instead of going immediately into the operating room where they were willing to do surgery but didn’t have extremely high confidence in his ability to survive,” Samuel said. “They gave us the option, which was hard but incredible that they trusted us with that decision.”

Ever the fighter, Zechariah not only made it to birth, but proved himself stronger outside the womb than in. Although weighing only 3 pounds, his vitals just after delivery were stable enough for him to be intubated and transferred to the Neonatal Intensive Care Unit (NICU) at Cook Children’s Medical Center – Fort Worth where doctors monitored his condition while mapping a treatment plan.

Zechariah spent five months in the NICU, followed by two months in the Transitional Care Unit (TCU). In that time, he underwent heart surgery and a number of procedures. Genetic testing revealed he has dystal 1q trisomy, a rare anomaly involving a duplication in chromosome 1.

“There are only 40 to 50 recorded medical cases of it. Even then, none of the others have his exact duplication,” Samuel said.

The list of complications from Zechariah’s anomaly is long and impacts nearly every system in his body. Today, about 35 medical professionals are involved in his care, including a mix of physician specialists, in-home therapists and a home health nurse.

In addition to his ventilator, the Sudolcan home is filled with medical supplies, equipment and accessories necessary for his care. Much of it is stored in a number of bins that line a wall in Zechariah’s room. Excess resources are kept in the family’s pantry.

If not for the help and support of Cook Children’s Health Plan, managing it all would be overwhelmingly complex and costly.

A Safety Net At Risk

While still in the NICU, a social worker introduced Zechariah’s parents to the Cook Children’s Health Plan. The health plan provides a robust support system for the Sudolcans, allowing Zechariah to be cared for at home, surrounded by those he loves, including his 4-year-old brother Malachi and 10-month-old brother Shepherd. From medical equipment to in-home physical, occupational and speech therapy to weekly visits by Zechariah’s beloved nurse, it’s all covered financially through various Cook Children’s Health Plan benefits and coordinated by a case manager.

The family communicates regularly with their service manager, Cheryl. She champions every need of Zechariah and his family, from scheduling appointments to ordering equipment. Cheryl helped the Suldocans get a specialized stroller that adapts to Zechariah’s growth and even suggested accessories that would help keep him comfortable in the Texas heat. As a fellow North Texan, Cheryl understands how harsh the weather can be. Additionally, her engagement with other families in the community who face similar challenges as the Sudolcans offers her valuable insights into local resources, which she’s quick to share with Samuel and Kathy Grace. 

From time to time, Cheryl even checks in on Kathy Grace to see how she is holding up under the stress of caring for a special needs child.

From personnel to equipment, together these benefits are a life-sustaining safety net for Zechariah and an invaluable support system for his family.

“I don’t know how to teach him to meet his milestones, because his development is so different from my oldest son,” Kathy Grace said. “So having these therapists come in has really helped me learn how I can best love and take care of him. On top of that, his nurse that comes in four times a week has taught me different medical things so I can help him to grow and stay comfortable. Because of them, I’m more confident as his mom.”

But all of it is at risk.

Why Fix What Isn’t Broken?

For Samuel and Kathy Grace, switching benefit providers could disrupt Zechariah's care, force a change to essential equipment like his ventilator, and consume hours on new authorization paperwork and phone calls to schedule appointments with new providers.

Zechariah could have to say goodbye to the Cook Children’s doctors who have cared for him since before his birth and the therapists and nurses he’s come to know and trust, losing a valuable well of knowledge of his background and progress.

It would be a tremendous upset to their whole lives, Samuel says, and now more than ever before.

An Unexpected Turn

Since first sharing Zechariah’s story at a press conference in June, his journey has taken an unexpected turn. A severe seizure just weeks after that appearance marked a significant change in Zechariah’s health.

While this has undoubtedly been a heartbreaking experience for the family and all who know them, the Sudolcan’s unwavering faith and resilience continue to inspire us. Their days are now filled with a delicate balance of hope and care. Monday visits from Zechariah’s grandparents bring cherished moments of laughter and love, a vital lifeline amidst the challenges.

As Zechariah’s needs have evolved, palliative care has become an integral part of his treatment plan. His parents and caregivers are dedicated to ensuring his comfort and happiness every step of the way.

Through it all, Samuel and Kathy Grace remain hopeful that HHSC will do what is right for the children of Texas and allow them the stability of remaining with Cook Children’s Health Plan and the benefits, equipment and providers they depend on. Cook Children’s is committed to providing uninterrupted Health Plan services as the family navigates this new chapter, offering unwavering support during this difficult time.

“Our families are worth fighting for, and we are going to continue to fight until the state does the right thing,” Love said. “The stakes are too high and the consequences are too great to let this flawed decision stand. And we are determined to ensure that it does not.”

For Immediate Release
June 26, 2024  

Fort Worth, Texas - Cook Children’s Health Plan today announced it is taking legal action to stop the flawed process that led to the Texas Health and Human Services Commission (HHSC) taking away Cook Children’s longstanding contract administering Medicaid to local families. Cook Children’s has successfully run the Medicaid STAR and CHIP program for more than 20 years and has provided more than $200 million in charity care and other community benefits out of its own pocket to families not covered by Medicaid.

“The State got it wrong, and we are asking the courts to make it right,” said Karen Love, President of Cook Children’s Health Plan. “We have taken such good care of our Members for so many years because we live here, and they are our neighbors. We genuinely care about them. And our providers know them by name. Now, thanks to a flawed process that did not follow the guidelines set by Texas law, these families will be at the mercy of national for-profit insurance companies.”

The HHSC process was deeply flawed and failed to follow the law requiring it:

• Recognize and give preference to health plans with long and successful track records of facilitating care for the children and mothers in our community and with ties to charity care providers.
• Give weight to health plans that provide care to special populations like children.
• Consider how continuity of care would be impacted, as well as costs to the state.

Finally, HHSC did not go through the proper rulemaking process for making critical changes to the Request for Proposal (RFP). Their scoring was riddled with mistakes, and they gave one of the winning bidders an unfair advantage by prematurely disclosing copies of its’ competitors’ proposals.

Cook Children’s has filed a Petition for Declaratory Judgment and Injunctive Relief against HHSC Commissioner Cecile Erwin Young. This is the lawsuit to overturn the decision. In the meantime, Cook Children’s has also filed a Temporary Restraining Order request to stop HHSC from finalizing its procurement results. Both actions were filed in Travis County.

Cook Children’s also filed a protest of the STAR Kids RFP to stop HHSC from making the same mistakes it made in the STAR & CHIP RFP and from taking away options from the kids who need help the most.

“These actions we take are strong but necessary,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “For more than 20 years, Cook Children’s has set the standard for serving Medicaid families in outstanding fashion. Our reviews from our Members are always high. And we go the extra mile to cover costs they can’t. There is zero chance that a national for-profit will care about these patients the way we do.”

For more information, including key facts, videos, photos and recent media coverage, please visit SaveCookChildrensHealthPlan.com.  

For years, Breanna Hernandez spent her days driving her 10-year-old son, MJ, from appointment to appointment. They spanned the Metroplex from Fort Worth to Dallas to Waxahachie and points in between. Visits with specialists and hours upon hours of intense physical, occupational, speech and feeding therapy helped MJ reach the point where he now attends an applied behavior analysis (ABA) center, at which he receives multiple therapies, and continues with outside therapies as well.

“The last two years, we’ve had a more consistent schedule,” Hernandez said. “I feel like we are finally able to just breathe and live a little.”

However, a decision by Texas’ Health and Human Services Commission (HHSC) threatens to upend their lives once again. Despite having a 20-year record of excellence serving children and families in Tarrant County, HHSC has announced plans to not renew Cook Children’s Health Plan’s contract for managing Texas’ STAR Medicaid and CHIP programs in its service area, starting in Sept. 2025. Instead, the commission plans to award contracts to four national, for-profit insurance companies. The decision, made through an unfair and flawed re-contracting process, places more than 125,000 low-income families and children at risk of losing vital services and interrupting long-established relationships with their physicians. 

MJ is one of the more than 8,000 medically fragile children covered under Texas’ STAR Kids program by Cook Children’s Health Plan. While his health care coverage is not yet impacted by HHSC’s decision, his story illustrates the important role Cook Children’s Health Plan plays in the lives of its Members and their families. More importantly, if CCHP loses the STAR Medicaid and CHIP contracts, the future of the STAR Kids program at CCHP could become uncertain.

Breakdown of STAR, STAR Kids, and CHIP in Texas:

All three programs provide health insurance for children in Texas.

• STAR (Children's Medicaid): This is for children from low-income families who don't have complex disabilities.
  
   
• STAR Kids (Medicaid Managed Care): This is for children with complex disabilities up to age 20 who qualify for Medicaid. It offers extra support services beyond basic Medicaid.
  
   
• CHIP (Children's Health Insurance Program): This is for children whose family income is too high for regular Medicaid, but they can't afford private insurance.

MJ’s Early Start

Born at 27 weeks, MJ spent 190 days in a neonatal intensive care unit (NICU), including Cook Children’s Medical Center. Today, he lives with a variety of health issues that require him to see a number of specialists, like neurology, pulmonology and gastroenterology, to name a few. All of his current specialists and many of the therapies and services he needs are covered through Cook Children’s Health Plan, of which he is a member. This includes the STAR Kids Medically Dependent Children’s Program that provides in-home and community-based long-term services and supports for children with complex medical needs.

Choosing Cook Children’s Health Plan was a no-brainer for Hernandez.

“Cook Children’s is like our second home. It’s who we know and trust,” she said. “His records are there from the beginning, and all the specialists have access to them in one spot, including Amber, our case manager at the health plan.” 

Yes, Hernandez is on a first-name basis with her CCHP case manager. That type of connection, where everyone feels like family, is central to Cook Children’s culture. It’s also one of the benefits of having a non-profit, community-based health plan where the people who manage your child’s care live in the area, too. They know first-hand the resources in and near Tarrant County and how to help parents and caregivers navigate them. They understand the unique needs of local children and care deeply about the health of the community.

“The Health Plan has people that will find the information or resources you need and try to get that to you,” Hernandez said. “They are able to do the research about programs that us parents have no idea they exist. Because we do a lot. We’re all the things for our kids: caregivers, parents, therapists, doctors, nurses, advocates all while trying to navigate this life."

And then there’s the financial burden made easier by Cook Children’s Health Plan. Hernandez estimates the cost for MJ’s care since birth, which includes visits, hospital stays, surgeries, therapies and medical equipment, is well over $4 million and counting. She says managing that without CCHP would be unimaginable.

Starting From Scratch

If HHSC’s decision stands, Hernandez’s life will once again become even more complicated than it already is raising a child with special needs. As will the lives of thousands of special needs parents like her, especially the parents of the more than 170 ventilator-dependent children currently covered by CCHP.

For Hernandez, it would mean starting all over, just as life got a little easier.

“I don't even want to think about it because it causes fear, anxiety and added stress,” she said. “It would probably turn our world upside down just thinking about how to start all over getting established with a new plan. Is this new plan going to be accepted by the doctors that I've already established care with since he was a baby? These doctors have seen him since he was in the NICU.”

If she is forced to make a change, Hernandez worries about how a new managed care provider and potentially new doctors will affect MJ’s continuity of care. Will they understand MJ’s unique needs? Will she get timely answers to her questions and receive medications on time?

These are the questions burdening her and fellow parents of children with special needs that she wants HHSC and Texas lawmakers to consider.

“With our kids’ health, our world is constantly changing. We don't get a lot of the ‘normal’ or ‘constants’ in life,” she said. “What if you were put in the position where your life was made more complicated than what it already is for no good reason? With our kiddos that have special needs, this is a whole other world that nobody gets to see, unless you live in it each and every day. If you haven't spent time with a child or an adult that has special needs or different abilities, please do. You'll definitely be shaken by all of the different things that our families experience in our homes and out in the ‘normal’ world. It would definitely be an awakening.”

For now, Hernandez holds on to hope that HHSC will reverse their decision for the STAR Medicaid and CHIP contracts before the discontinuation of CCHP services in September 2025.

The procurement process for MJ’s coverage under STAR Kids begins this summer. Only time will tell if HHSC will protect MJ and the thousands of children and families who rely on CCHP. In the meantime, Hernandez takes every opportunity to speak out for those who can’t speak for themselves.

Texas Health and Human Services made a concerning decision recently. It announced its intent to award contracts in our area to four national, for-profit insurance companies through a questionable bidding process. Shockingly, it did not renew Cook Children’s Health Plan, despite our 20-year record of excellence serving our community. This disrupts a vital system, without any explanation or justification. 

For over a century, Cook Children’s has been a pillar of our community. We’ve grown alongside generations of families, weaving a promise of exceptional health care into the very fabric of our city. That promise is clear: Every child, especially those most vulnerable, deserves the best possible care, delivered with both excellence and compassion.

Our strength lies in our integrated pediatric health care system, a model of efficiency that provides children and families with a seamless experience. From preventive care to emergency and specialty medicine, all the way to home health, our system offers everything a child might need. The Cook Children’s Health Plan, a vital component of our system, serves families enrolled in Medicaid and the Children’s Health Insurance Program, or CHIP. This integrated design, admired by health care leaders across the nation, ensures smooth coordination between all our services, ultimately leading to the best possible outcomes for our young patients. 

There is more reason to be concerned about Texas HHS’ decision. The Texas Tribune reported that the re-contracting process was deeply flawed, with Aetna receiving advance copies of proposals from 17 competitors, including ours, likely. This gave Aetna an unfair advantage and demands a swift correction from the state.

Beyond the procedural problems, the decision itself is devastating. It robs hundreds of millions of dollars from our communities, and places those checks in the pockets of out-of-state corporate shareholders. This isn’t just about paperwork; it jeopardizes the well-being of 125,000 children and mothers, including over 170 ventilator-dependent patients who rely on our seamless care. The impact goes far beyond Tarrant County — it affects 1.8 million children and expectant parents across the state, according to The Texas Tribune. 

For more than two decades, Cook Children’s Health Plan has been a trusted and proven model for managing care. We urge the state to reverse its recent decision to ensure Cook Children’s Health Plan, along with other qualified plans, can continue seamlessly serving our communities and caring for our most vulnerable children and families.

Without the health plan, our ability to deliver exceptional care across the system will be crippled. Children relying on Medicaid would be disproportionately impacted, left vulnerable and more at risk. 

I want to share a few facts and scenarios with you that might help paint this picture more clearly: 

• In our service area alone, more than 75% of the children and mothers on Medicaid will be forced to switch plans, causing an unnecessary shift in care, and this is on the heels of the unwinding of the pandemic and the disruption these families have already experienced with re-enrolling in a health plan. 
• Imagine the chaos this change will cause for the family of a child with complex medical needs on a ventilator and in a wheelchair — being forced to find new doctors, new in-home therapy and nursing, and a whole new system to navigate. If you’ve ever been frustrated trying to obtain a simple pre-authorization for a routine surgery, imagine that frustration tenfold. 
• We are passionate about and uniquely equipped to serve our community. Every year, Cook Children’s provides more than $200 million in community benefits and uncompensated care to families in need. 
• We reinvest our dollars back into countless programs like our Neighborhood Health Centers in underserved areas rather than for-profit shareholders. Our upcoming ninth center in the Las Vegas Trail area will be another beacon of hope for families struggling to access quality care when it opens next year. 

This fight is for our children, for a system that works, for stability, and for the health of our community and the promise we have made to every child. We have the facts on our side, and we will not give up on the families who need us most. This is about protecting a legacy built on decades of trust and data-driven results. 

Texas HHS, it’s not too late to do the right thing. Let Cook Children’s Health Plan continue to coordinate and manage the care for the children and families who depend on us. 

The health and well-being of our children depends on a proven and trusted system, not a gamble on the unknown.

“Aetna, which is set to win a multibillion Texas Medicaid contract, got a peek at sensitive information submitted by 17 rival health plans during the bidding process after the state Health and Human Services agency erred and sent competitors’ proposals to the health insurance giant too early, according to emails and documents obtained by The Texas Tribune.”

Important Information for CCHP Members:

• Your coverage is still active: Your health insurance with CCHP remains active for at least the next year and a half.
• Keep seeing your current doctors and other providers. Nothing has changed. You can continue seeing all your favorite doctors and specialists both at Cook Children's hospitals and clinics as well as our other network providers, just like always. Absolutely nothing will be different for you.
• If you are a STAR Kids Member, there have been no announced changes to that program.
• Share your experience as a CCHP member or ask questions here: CommunityMarketing@cookchildrens.org.
• Stay informed: Visit cookchildrens.org for updates.

RELATED STORIES

Fort Worth Report: Cook Children’s Health Plan Denied STAR & CHIP Managed Care Services Contract (checkupnewsroom.com)

Texas Tribune: Cook Children’s Health Plan Denied Contract (checkupnewsroom.com)

Nearly 125,000 CCHP Members from low-income families could lose access to vital health care services and providers.

We strongly disagree with this decision, believe it will jeopardize access to health care and could harm vulnerable children and families. And that’s why we are appealing the decision.

Important Information for CCHP Members:

• Your coverage is still active: Your health insurance with CCHP remains active for at least the next year and a half.
• Keep seeing your current doctors and other providers. Nothing has changed. You can continue seeing all your favorite doctors and specialists both at Cook Children's hospitals and clinics as well as our other network providers, just like always. Absolutely nothing will be different for you.
• If you are a STAR Kids Member, there have been no announced changes to that program.
• Share your experience as a CCHP member or ask questions here: CommunityMarketing@cookchildrens.org.
• Stay informed: Visit cookchildrens.org for updates.

Thank you to the Fort Worth Report for covering this important issue. This decision by the Texas Health and Human Services Commission could impact health care coverage for 125,000 Cook Children's Health Plan (CCHP) Members. We encourage you to stay informed about this developing story.

The United States Department of Agriculture defines food insecurity as a lack of consistent access to enough food for every person in a household to live an active, healthy life. Food insecurity is associated with health problems and behavioral challenges for children that may negatively affect their ability to function normally and participate fully in school and other activities.

“Children who don’t get enough to eat — especially during their first three years — begin life at a serious disadvantage,” said Karen Love, President of Cook Children’s Health Plan. “Children facing hunger are more likely to experience problems in school. They’re also more likely to be hospitalized and face risks of serious health conditions such as anemia and asthma.”

According to Cook Children’s 2021 Community Health Needs Assessment, an estimated 303,000 children (nearly one in four children) in our eight-county service area live in households that could not always afford nutritious foods.

Local and national research reflects that food insecurity and diet-related diseases have a disproportionate impact on children in historically underserved communities. Environments, including surrounding neighborhood infrastructure, accessibility and affordability barriers predominantly cause food insecurity.

Food insecurity has always been an issue, but it has been exacerbated by the ripple effects of the COVID-19 pandemic and inflation, which has caused the cost of food and many other goods to increase drastically.

Community Collaboration

Cook Children’s Center for Community Health and Health Plan have many programs and resources in place for community health outreach. In addition to those programs, the teams are collaborating with community partners to support families as best they can.

“Recognizing the important intersection between food insecurity, social determinants of health, and healthy children, Cook Children’s embarked on a system initiative in fiscal year 2023 to identify strategies for addressing these important concerns,” Love said. “This initiative strongly connects to our system’s Promise: Knowing every child’s life is sacred, we promise to improve the well-being of every child in our care and our communities.”

Cook Children’s primary strategies are to:

• Support efforts to screen for food insecurity with health plan and community members, as well as with patient families within our Neighborhood Health Centers and other areas
• Proactively identify communities with extensive food insecurity needs
• Improve access to healthy food
• Increase enrollment in underutilized child nutrition programs, such as SNAP and WIC
• Increase and support community education efforts around nutrition and food access

“We understand that tackling big issues like food insecurity requires the whole community to come together,” said Emily Epperson, Child Wellness Program Manager at Cook Children’s Center for Community Health. “So many organizations already do so much to serve children and families in their local community. Working alongside them is another way Cook Children’s can fulfill our Promise at a broader scale.”

A Hand Up, Not a Handout

Cook Children’s Center for Community Health and Health Plan connect families to food through a partnership with The Center of Hope.  

The Center of Hope offers short and long-term poverty assistance in Parker County. Throughout its 25 years of service, the nonprofit organization has helped individuals holistically, addressing their physical, emotional and spiritual needs. Center of Hope offers real solutions that will equip and empower individuals to live a more successful life.

Since 2005, the Center of Hope has hosted Camp Hope at local churches to provide an environment for children to focus on community, healthy choices, life skill development and character building. Each summer, campers participate in fun games and activities, learn how to prepare their own meals and more.

“Our philosophy is to provide a hand up and not a handout,” said Staci Markwardt, CEO at Center of Hope. “We developed the Camp Hope program to encompass giving out more than just food. Kids learn to prepare meals and then they get to take home those same ingredients so they’re able to prepare their meals at home. They also get a week’s worth of groceries throughout the month. It’s just a fun camp!”

Markwardt says the partnership with Cook Children’s enabled Camp Hope to provide food and education to 300 kids this summer. The children learned how to cook healthy meals and make healthy choices using the 5210+ Every Day toolkit.

“The support we received from Cook Children’s was amazing,” Markwardt said. “Our true passion is to help people out of their situations. It really does feel so good knowing we’re making an impact, helping kids break that cycle of poverty, so they can learn and grow and not end up in poverty like their generations before.”

Key Partnerships to Address Food Needs

Cook Children’s continues to explore opportunities to partner with organizations and tackle the issue of food insecurity. Recently, Cook Children’s partnered with Tarrant Area Food Bank and H-E-B to open another R.E.D. Market, which is essentially a grocery store on wheels. It’s a refrigerated trailer that includes shelves just like a supermarket, which are stocked with items such fresh fruits, vegetables and dairy items. The R.E.D. Market vehicle will make multiple stops in a single day, connecting families to food, SNAP benefits and additional community resources to address housing, education, and employment. TAFB will work with Cook Children’s to identify specific community neighborhoods in need based on income and food insecurity screening data.

The day ahead was already filled with taking care of her daughter Winslow, who hadn't even taken her four medications during the day because of her medical condition. Plus, Shelly still had to breast pump and then feed her daughter through Winslow’s G-button. 

Shelly didn’t have time to be on hold, but she did know the one person she should call.

“Rebecca Melville. She’s amazing. Rebecca has always been there for me. She’ll call me or I’ll call her and with a snap of the fingers, she gets things done,” Shelly said. “I needed to speak to someone at Medicaid to update them on something. And it was just impossible. I called early in the morning and then I waited and waited. I called Rebecca and ‘Boom!’ everything was done.”

Rebecca Melville, RN, is a case manager and service coordinator for Cook Children’s Health Care Plan. The program is a local, non-profit company that provides health care for STAR (Medicaid) and CHIP members in a six-county service area in North Texas.

“It can be frustrating for parents, especially for someone like Shelly who does not have time to be on the phone all day. She needs to take care of her child,” Melville said. “I have one contact person who works with the state and I can talk to very quickly. If there’s a medication application or an eligibility issue, our contact is very quick to respond to us. Our role at the Health Plan is to intervene on the parent’s behalf and to be a liaison between them and the state.”

Melville has 42 patient families on her current caseload. She speaks to the families regularly. For instance, she speaks to Shelly once a month and then sees her every three months in person.

“And of course if Winslow gets sick, I go visit her in the hospital and when she gets out,” Melville said.

Each month, Melville calls to make sure that Shelly is receiving the services she’s authorized for and everything is working smoothly for her. Through the Health Plan, Winslow receives her formula and feeding supplies, as well as any private duty nursing she needs.

Shelly admits to being surprised that she and her husband, David, even qualified to be a part of the Health Plan and Medicaid. They both worked and had insurance.

“I thought when you were in a certain income or tax bracket, it disqualifies you for Medicaid,” Shelly said. “But after all we’ve been through and as much time as Winslow has spent in the hospital, I don’t care how much money you make, you are going to be broke after this. So I was pleasantly relieved that we not only qualified but continue to receive help today.”

As Shelly’s telling her story, you can hear Winslow, who is 5 years old, playing with her dog and urging her mom to get off the phone so they can go to the movie.

It all sounds so blissfully normal.

But that’s not how things started from the moment Winslow came into this world.

Winslow was born on Jan. 1, 2014, the first baby born in Wise County that year. Soon after her birth, the celebration ended.

Shelly and David Ogle’s little girl was born with a condition called heterotaxy syndrome. Though heterotaxy syndrome is extremely rare – in the U.S. about one in every 250,000 children are born with it --- it is the cause of some of the most complex and complicated heart defects.

Heterotaxy is a disorder that results in certain organs forming on the wrong side of the body, most typically the heart, lungs, kidneys, liver, stomach, intestines and spleen. Sometimes organs may be facing in the wrong direction, may be divided into multiple sections and even missing.

The result is that a child’s organs cannot function correctly, placing the child’s life at risk.

Vincent Tam, M.D., a thoracic surgeon at Cook Children’s, performed complex heart surgery to repair Winslow’s right ventricle that pumped backward.

The next big surgery was to repair her liver flow into the bowel of the child. Many times children who have Winslow’s condition need a liver transplant by the time they turn 2. Winslow is almost 5 and a half and is doing remarkably well and so far doesn’t need a transplant.

Because of her congenital condition, Winslow was born without a spleen and doctors removed her appendix, which was on the opposite side (the left side) of where it is supposed to be on the body.

By the time Winslow arrived home in August 2014, she was quarantined. After a couple of months, blood work came back to say Winslow was strong enough to go out in public for the first time.

With surgeries behind her, now it was time to begin life at home. That meant four doses of medicine a day, feeding tubes, breast pumping, cleaning supplies, and a G-button.

“Winslow is doing great,” Shelly said. “We think she can live a normal life, go to school, have children ... The only thing we think we will have to say no to is no high impact sports. I want her to be a band camp kind of kid.”

For Shelly to make jokes about her daughter’s condition shows how far she and her family have come. She credits the multiple doctors and nurses who looked after Winslow for saving her daughter’s life. And now she has people like Rebecca Melville taking care of Winslow’s needs.

“Rebecca has always been there for me. She’ll call me or I’ll call her and with a snap of the fingers, she gets things done,” Shelly said. “If I were going to refer anyone, it would be Cook across the board. They saved my daughter’s life. All the team members. The doctors, nurses, coordinators, the STAR Kids Program. You know that little say about it takes a village? Well, they are our village.”

In 2011, she shadowed a social worker in the Emergency Department, and after that day she knew Cook Children’s was the place for her.

“When I was at the medical center I felt so many positive vibes and I just can’t wait to be a part of that and to learn as much as I possibly can,” said Rustin.

Rustin, a licensed baccalaureate social worker, will be part of a brand new team called STAR Kids, the new Cook Children’s Health Plan. STAR Kids is a state level medical program that helps children across Texas. Cook Children’s recently built brand new facilities for their team and is in the process of hiring over 100 new employees.

Before working at Cook Children’s, Rustin worked with a mental health organization in Fort Worth. She hopes to go back to school in the next few years to receive her Master’s Degree in social work. And with Cook Children’s generous tuition reimbursement plan, she sees it as a very attainable goal. After getting her Master's, she hopes to return to Cook Children’s and build her career within the medical center.

- Written by John Davidson