When a child has a health issue, it involves the whole family. Driscoll Health Plan, a Medicaid-managed care plan that serves the Rio Grande Valley, understands this deeply. That’s why they put the family as well as the child at the heart of providing healthcare services.

“As a friend of the family, Driscoll Health Plan provides extra support when members and their families need extra help,” said Mary Dale Peterson, MD, president and chief executive officer of the health plan. “We work to ensure they get the right kind of care, at the right time.”

Driscoll Health Plan provides health insurance coverage to more than 175,000 members. It is the only nonprofit, community-based Medicaid plan in the region, serving children from birth through age 20, pregnant women, and low-income adults who qualify. It is the only regional plan that is part of a health system with a freestanding children’s hospital, Driscoll Children’s Hospital. Driscoll also has local specialty centers in McAllen, Harlingen and Brownsville.

“Everyone here is committed to the mission of Clara Driscoll, who founded the hospital to improve lives through quality healtcare for children in families with low incomes,” said Dr. Peterson. She has led the health plan for more than half of its 21 years. She is also the executive vice president and chief operations officer of the Driscoll Health System.

Dr. Peterson has one word to describe all of the people who make up the staff and provider networks of Driscoll Health Plan: “Awesome.”

The high level of care provided through Driscoll Health Plan comes with an equally high level of compassion and personal support, all built on an in-depth knowledge of healthcare needs in the area. This combination has helped make Driscoll the highest-rated health plan in the region. The latest Medicaid quality of care study ranked Driscoll #1 in the state in providing access to primary care.

(Back row, L-R): Driscoll Health Plan Service Coordinators Jo Ann Garcia, BSN, RN, Jacqueline Deanda, RN, Lori Rocha, RN, and Maria Puga, RN. (Front row, sitting, L-R): Rosie Mata, RN, and Xavier Siller, RN.

“In addition to having primary care physicians in our network, we have all of the pediatric medical and surgical specialties, like pediatric rheumatology, which are rare in this area,” said Dr. Peterson. “Our physician teams at the main hospital and the specialty clinics in the Rio Grande Valley also provide educational support and telemedicine to doctors in local hospitals.”

Besides the full range of primary and specialty care, Driscoll Health Plan offers value-added services to help children stay healthy. Driscoll’s value-added services include Boys & Girls Club memberships, eyeglasses, asthma camp, school/sports physicals, a gift when a child completes preventive care checkups, and cellphone minutes and texting.

High-quality healthcare and value-added services have a single goal: to improve health and well-being for children and families in the Rio Grande Valley.

A Part of Your Communities

“For Driscoll, being a friend of the family means helping Rio Grande Valley families live the healthiest lives they can,“ said Stephen P. Collins, chief operations officer, Driscoll Health Plan. “It also involves being a part of the communities in which our member families live.”

“The doctors and other health professionals in Driscoll’s provider networks live and work in the Rio Grande Valley,” Collins said. “So do other staff. When families call our Member Services center for assistance, the person they speak with is local. The same is true of our service coordinators and education and outreach staff. All play a crucial role in the lives of their members and their communities.”

Driscoll also partners with many local, community-based organizations. “Driscoll Health Plan looks for organizations to partner with that provide non-medical support to Rio Grande Valley families,” said Joseph Cecil, vice president of operations, Driscoll Health Plan. “We listen to the doctors in our provider network, our members, and our member advisory groups to learn what area families most need, and we figure out ways to meet those needs.”

Always Looking for New Ways to Improve Members’ Lives

“Being a nonprofit allows us to do more for our members,” said Collins. “Driscoll is fast to react to new opportunities. We look for what will bring value to the families and enable members to get services and benefits to help them be healthier. For us, healthcare is not just about medicine. We address other factors that affect our members’ health.”

Another element of Driscoll Health Plan’s success is its close relationships with local doctors. “Driscoll gets our providers’ input on ideas and decisions,” Collins said. “We ask them, ‘What do you need to make this better for you and your patients?’ ”

Driscoll has introduced advances in health services that benefit not only their own members but also other children and families in the Rio Grande Valley. One is an important oral health service provided in primary care offices for young children in STAR Medicaid.

(Left side of table, sitting, L-R): Driscoll Health Plan Service Coordinators Maria Puga, RN, and Xavier Siller, RN; (Left side of table, standing): Driscoll Health Plan Service Coordinator Lori Rocha, RN. (Right side of table, L-R): Driscoll Health Plan Service Coordinators Jo Ann Garcia, BSN, RN, Rosie Mata, RN, and Jacqueline Deanda, RN.

“My background as a pediatric anesthesiologist made me aware of how childhood caries (tooth decay) can create serious health issues,” said Dr. Peterson. “Children came in for surgeries due to dangerous infections from caries. I learned from pediatric dentists that fluoride varnish can almost completely prevent caries when done early. We started a program to educate primary care providers about applying the fluoride varnish in their offices.”

Dr. Peterson went on to recommend that Texas Medicaid cover the service. Her advocacy is one reason the Oral Evaluation and Fluoride Varnish program is available to children in STAR Medicaid across the state. At Driscoll, families also receive guidance about how proper nutrition and daily oral hygiene can protect their children from bacteria that cause tooth decay.

In addition to promoting fluoride varnish, Driscoll advocates for fluoridation in local water supplies and has worked with physicians to provide infant supplements in areas where water is not fluoridated.

Driscoll Health Plan has a history of filling gaps in healthcare services. One significant example is Driscoll’s approach to behavioral health at every stage of life, from helping expectant mothers with issues such as substance use to providing services to children and families affected by ADHD, autism and other challenges. Driscoll forges relationships with medical specialists, mental health service providers, school districts and other groups to benefit children and families.

“Driscoll Health Plan believes that mental and behavioral health cannot be separated from physical health,” said Dr. Peterson. “Health services must be viewed holistically.”

Get Ready for Baby — Driscoll’s Program for Pregnant Women

Pregnant women in the Rio Grande Valley who are members of Driscoll’s STAR Medicaid program get many benefits from the plan’s Get Ready for Baby services. “Our goal is to enable moms-to-be to stay as healthy as possible,” said Collins. “They also receive many value-added gifts and services to help them.”

Jennifer Aguilar of Brownsville joined Driscoll Health Plan when she became pregnant. She’s a big fan.

“They have a lot of events for pregnant women that can help you out, and give you a lot of information,” she said. “If you’re a first-time mother or even a second-time mother, I think it’s the best. Driscoll really is a friend of the family.”
Jennifer Aguilar

Jennifer’s OB/GYN, Dr. Patrick Ellis, promotes Get Ready for Baby to his patients. “I’ve seen in the years of my practice that Driscoll provides all that patients need,” he said. “They feel safe, in good hands. Driscoll provides a lot of benefits outside the medical office, which helps doctors provide better care for the patient.”

(Standing, L-R): Driscoll Health Plan Service Coordinators Rosie Mata, RN, Maria Puga, RN, and Jacqueline Deanda, RN. (Sitting): Driscoll Health Plan Service Coordinator Xavier Siller, RN

Driscoll’s extensive medical network includes Maternal Fetal Medicine specialists, who care for women with high-risk pregnancies, as well as nutritionists and lactation specialists. Driscoll also provides pregnant women routine immunizations to protect them from whooping cough and flu. As a result, fewer infants have been hospitalized with complications and illness in the Rio Grande Valley.

“The most gratifying outcome is that more infants have the chance to live a normal life,” said Dr. Peterson.

The Get Ready for Baby program provides education on healthy foods and meal planning, assistance with finding community services, birthing classes, breastfeeding support and up to $500 in dental services for women 21 and older. Members of the Driscoll Health Plan may also receive gift cards for activities such as attending a parenting class, completing a pregnancy risk assessment and downloading the plan’s mobile app.

Cadena de Madres is an innovative feature of Get Ready for Baby. Moms-to-be are invited to attend a baby shower, which may be offered in Spanish. Women learn about eating healthy and breastfeeding, what to look for if there are problems with their pregnancy and when to get help, and what to expect during childbirth. They receive gifts and healthy snacks at the shower and get a $100 gift card for attending.

Driscoll also offers home visits to women three to 10 days after they give birth. New moms receive a gift card as well as education on postpartum care, infant care, breastfeeding, and good nutrition.

One-on-One Help from Driscoll’s STAR Kids Program

Mindy Moya’s daughter, Maria, receives her healthcare through Driscoll’s STAR Kids program, which is for children who have special needs. Mindy is clear about what Driscoll Health Plan means to her family. It has made a world of difference for them.

“It’s been a blessing to have Driscoll Health Plan in our lives.”
Mindy Moya

“When we met our service coordinator for the first time, she said Maria’s illness was rare, and she did research to learn all about it,” said Mindy. “That was all it took. I’m very grateful for this program because you have someone to talk to directly who knows your situation.”

Many STAR Kids have complex health conditions and require different kinds of specialty care and support. Driscoll’s bilingual staff reach out by phone to learn more and match the child and family with a service manager.

For families, the program can seem like a lifesaver. “The support, the dedication — Driscoll comes in, and these doors start opening,” said another mother whose child is in Driscoll’s STAR Kids plan. “It’s just good to know that there is somebody there who is supportive and willing to be your advocate and speak for you.”

With Driscoll’s “health homes” approach, service coordinators connect STAR Kids members with services and resources that support their health and well-being. “Our health homes teams help families understand what their child needs and relay the information to their doctors,” said Cecil.

“Driscoll’s service coordinators help the child get doctor visits and make sure everything is ready for the visit ahead of time,” he explained. “They also help get authorizations for specialist care, therapies, private duty nurses, medical equipment such as wheelchairs and ventilators, and other services. This care coordination makes it much easier on both families and doctors,” said Cecil.

A Deep Commitment to Families

Driscoll Health Plan’s devotion to family-centered care guides the decisions they make, the value-added services they offer, and the manner in which they provide those services. Their motto, “A friend of the family,” is ingrained in everything they do.

Dr. Peterson summed up their beliefs: “Each person who works for Driscoll Health Plan thinks of the Rio Grande Valley families they serve as part of the Driscoll family.”

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