\n\tColleen DeGuzman<\/span><\/p>\n

The decades-old system Texas foster care officials use to track and monitor the health records of the nearly 20,000 children in their custody is both outdated and unreliable \u2014 so much so, advocates say, that children have been harmed or put at risk. And those deficiencies persist despite a 2015 order by a federal judge that state leaders fix the system\u2019s deficiencies.<\/p>\n

\u201cThe frustration with IMPACT is well known,\u201d said Texas state Rep. Gene Wu<\/a>, a Democrat from Houston, referring to the aging software.<\/p>\n

That frustration, he added, is felt widely, from caseworkers to the court system, and boils down to a simple reality: IMPACT, Information Management Protecting Adults and Children in Texas<\/a>, has been in place since 1996. It was designed to be a secure location for foster children\u2019s records, including their health records and histories of neglect and abuse. But it doesn\u2019t allow such information to be easily added by or shared among state and local health agencies, Medicaid, and even health care providers for the foster children in Texas\u2019 care. Without that ability, children\u2019s medical needs are getting lost in transit. After all, foster kids tend to move from place to place, home to home, and doctor to doctor.<\/p>\n

A report released this year<\/a> by court-appointed monitors is full of harrowing stories and frightening missteps. For instance, in January 2022, a residential treatment center lost track of a 16-year-old boy\u2019s medications. The supply ran out but the center \u201cdidn\u2019t realize it.\u201d The boy, who had a history of suicidal ideation, had to undergo an emergency psychiatric consult.<\/p>\n

The report also told the story of a foster child who had to stay in a Dallas hotel because caseworkers were unable to find her a family. But no one knew she had prescription drugs in her backpack. When she was left alone in her room, she swallowed a handful of pills. She was taken to a behavioral hospital. As of last September, she was in juvenile detention.<\/p>\n

Such accounts, and the concerns they trigger about the state\u2019s broken foster care system, have begun to find traction this legislative session.<\/p>\n

The state\u2019s Department of Family and Protective Services, for instance, which oversees the system, has been called in for a series of status hearings regarding its overall progress. Those involved say lasting improvement has to start with modernizing DFPS\u2019 technological infrastructure, but whether their pleas will be met with action is unclear.<\/p>\n

Making matters more frustrating for caseworkers is that the federal government in 2015 introduced a new set of regulatory requirements. States could use them to build a framework and become part of a national network<\/a> that, from the federal view, would help states better track foster kids and their health care needs. Texas, however, is one of four states that has so far opted against using it.<\/p>\n

The state now finds itself in the unprecedented situation of having a budget surplus of $32.7 billion<\/a>, and DFPS is bidding to snag some of that windfall. During an appropriations meeting in February, commissioner Stephanie Muth<\/a> said that priorities for any such allocation would include building community-based care teams and increasing pay to boost employee retention. The department isn\u2019t planning to replace or make sweeping changes to IMPACT anytime soon.<\/p>\n

That\u2019s despite the fact that IMPACT is older than Google \u2014 and has had far fewer updates.<\/p>\n

Marissa Gonzales, DFPS media relations director, said that when states were given the option to adopt the new federal standards \u2014 which incorporated modern technology to enable data to be shared between systems \u2014 the agency opted out because they found the requirements \u201cquite restrictive.\u201d On the table now, however, is a federal offer to cover half the cost of transitioning, she said, adding that the agency is \u201ctalking to other states about their experiences, and evaluating our own needs, before deciding next steps.\u201d<\/p>\n

According to a report by think tank Texas 2036<\/a> and the Texas Alliance of Child and Family Services, transitioning to the new program would cost the state $80 million. It said the state had already spent more than $80 million since 2015 to maintain its current system.<\/p>\n

One of the biggest concerns of caseworkers is that IMPACT isn\u2019t capable of supporting data-sharing, also known as interoperability, and flagging potential problems, such as when doctors separately prescribe medications that are dangerous when taken together. This is critical, because foster children are prescribed psychotropic drugs to treat mental health disorders at more than four times the rate<\/a> of other children on Medicaid.<\/p>\n