World Class Therapy for Chronic Pain and Nerve Disease Proven to Provide Lasting Relief

Chronic Pain Specialist in Foster, TX

 Oxygen Therapy Foster, TX

How the Brain to Body System Provides Chronic Pain Relief in Foster, TX

To reverse chronic pain and/or nerve disease, areas of the body that have become weak due to disease or injury must be strengthened. This includes your brain, nerves, muscles, blood vessels, and cells. Our experts here at Texas Nerve and Spine developed the most advanced pain and nerve therapy system to do all of this and more, and we call it the Brain to Body System.

From fibromyalgia and disc herniations to diabetic neuropathy and sciatica, our Brain to Body System helps restore your health and corrects the causes of your problems. Unlike treatments from other nerve and spine clinics, our system provides long-term relief without relying on invasive surgeries or dangerously addictive pharmaceutical medications.

To understand how our Brain to Body System solves chronic pain and similar conditions like nerve disease, you need a basic knowledge of the conditions themselves. That way, you can understand why so many who suffer from them rarely improve.

Chronic Pain

Chronic Pain

This is a type of pain that does not get better on its own or that doesn't alleviate after traditional medical treatments or prescription pain meds.

Nerve Disease

Nerve Disease

This is a type of pain that does not get better on its own or that doesn't alleviate after traditional medical treatments or prescription pain meds.

Chronic pain from nerve diseases and serious injuries causes a domino effect within your body. It starts with inflammation, which leads to decreased blood supply. This reduced blood supply results in a lack of oxygen. When your body doesn't get enough oxygen, it loses crucial nutrients that your body needs. This progressive effect often leads to long-term problems such as:

  • Chronic Pain
  • Motor-Function Loss
  • Loss of Sensation
  • Muscular Atrophy
  • Loss of Movement
  • Depression

But with Texas Nerve and Spine's Brain to Body system, patients suffering from chronic pain and nerve disease build strength through rehabilitation. This advanced system helps:

  • Stimulate New Nerve Pathways
  • Strengthen and Grow Muscles
  • Promotes Cellular Repair
  • Improves Circulation and Blood Flow

Our Brain to Body System is central to our approach to chronic musculoskeletal pain relief and chronic nerve pain relief in Foster, TX. By following the Brain to Body system, we can provide several services to patients suffering from chronic pain and nerve damage.

EWOT:Exercise with Oxygen Therapy

Here's a fact you might not know: Breathing in higher levels of oxygen than you normally take in actually helps improve your health. Also called EWOT, exercising with oxygen is a technique that increases oxygen circulation at a much more rapid pace than oxygen therapy alone. Create New Blood Cells

How Does EWOT Work?

At Texas Nerve and Spine, our doctors use the NuStep Recumbent Cross Trainer to help achieve the aforementioned benefits. This specialized machine trains your muscles, brain, and nerves to work together, which supports your body's healing processes. While using the NuStep Recumbent Cross Trainer, patients are hooked up to an oxygen generator to enjoy the benefits of EWOT and reach their chronic pain relief goals.

When you oxygenate your blood with EWOT, it can have amazing benefits that can:

  • Restore Blood Flow
  • Improve Oxygen Circulation
  • Reduce Inflammation
  • Boost Energy
  • Increase Strength
 Laser Therapy Foster, TX

TherapyFlexion/Distraction Therapy

Many patients who visit Texas Nerve and Spine are suffering from an injury or disease of the vertebral discs of their spine. It requires the right kind of care from highly specialized doctors. If you're in search of a safe, gentle, controlled treatment for back and spinal pain, Flexion Distraction therapy may be for you.

 Knee Pain Specialist Foster, TX

How Does Flexion/Distraction Therapy Work?

Finding relief for this type of condition and pain is often easier said than done. Fortunately, relief is right around the corner at Texas Nerve and Spine. Our Flexion/Distraction Table stretches the spine safely and gently, allowing injured tissue and damaged discs the chance to heal and become hydrated, which lets the affected area recover more effectively and efficiently.

Patients looking for chronic back and neck pain relief in Foster, TX choose Flexion/Distraction therapy because it:

  • Significantly Reduces Spinal Pain
  • Fosters Healing in Damaged Discs
  • Removes Pressure on Spinal Nerves
  • Is Non-Invasive
  • Is Cost-Effective
  • Does Not Require Downtime
  • Has No Risk of Infection
  • Provides Quicker, Easier Healing

LaserLaser Therapy

With more than 50 million adults in America suffering from chronic pain, it makes sense that most of them want a solution that doesn't require pain medication or harmful surgery. That's where laser therapy from Texas Nerve and Spine comes into play. Laser therapy has been used for therapeutic purposes in medical environments for years. In fact, it is FDA-approved and backed by more than 2,500 research studies, which have demonstrated its efficacy in chronic musculoskeletal pain relief in Foster, TX.

How Does Laser Therapy Work?

Though laser therapy is a common treatment option, not all lasers are the same. Our Class IV laser therapy, used in all applicable programs, is the most efficacious and powerful laser available for tissue healing and regeneration and healing. Class IV lasers use photobiomodulation, which provides excellent results for Musculoskeletal disorders. This process has also been proven to help with other various conditions that cause chronic pain, such as sciatica, carpal tunnel syndrome, low back pain, shoulder pain, and much more.

Our chronic pain patients choose laser therapy from Texas Nerve and Spine because it:

  • Provides Significant Relief Without Pain or Side Effects
  • Cost-Effective
  • Reduce Inflammation
  • Boost Blood Flow
  • Accelerate Tissue Repair
 Knee Pain Therapy Foster, TX

TherapyMotor Function Re-Training Therapy

When your motor functions are limited or non-existent due to a serious injury or surgery, it can ruin your life. You lose the ability to be independent - one of the hallmarks of being human. Fortunately, with motor function re-training at Texas Nerve and Spine, patients suffering from motor function issues have a light at the end of the tunnel. This type of specialized physical therapy helps people recover from injuries or surgeries that leave their motor functions lacking. The goal of motor function re-training is to regain coordination and strength in the areas affecting the patient.

Motor function re-training therapy is a crucial part of the motor function rehabilitation process because it helps patients regain the independence they lost. Perhaps equally important, it also helps them return to their original level of motor function or better.

 Herniated Disc Specialist Foster, TX

How Does Motor Function Re-Training Work?

Based on our Brain to Body system, our specialists design custom exercise programs based on our patient's motor function needs. Depending on the type of injury and lack of motor skills associated with it, we may also use electrical stimulation and other modalities for more effective treatment and recovery.

Motor function re-training provides many benefits for affected patients, including:

  • Improved Flexibility
  • More Strength
  • Better Range of Motion
  • Re-Claim Independence
  • Live a Normal Life

ReleaseMyofascial Release Therapy

Myofascial Release therapy gives patients chronic pain relief in Foster, TX, and boosts joint mobility by loosening up restricted, tight muscles. Though there are similarities to traditional massages, myofascial release therapy focuses on soft tissues and the muscular system in your body to relieve tension and stress on muscles.

How Does Myofascial Release Therapy Work?

Restricted muscles have reduced blood flow and less oxygen. When this happens, it leads to limited movement and pain that is often intense. Our program uses state-of-the-art technology to apply acute, high-velocity vibration directly to the affected tissue to provide the patient with the environment necessary to increase mobility which, over time, can exponentially reduce pain

Benefits of this type of treatment include:

  • Improved Tissue Recovery
  • Reduced Soreness
  • Improved Joint Range of Motion
  • Improved Blood Flow
  • Better Neuromuscular Efficiency
 Herniated Disc Therapy Foster, TX

ActivationNeuro Activation Wall Therapy

As is the case with any spinal cord injury, the nerves around the spine get weak. When this happens, pain develops, and recovery is halted. Suppose you're searching for a safe, effective way to deal with a painful spine issue like sciatica or a herniated disc. In that case, neuro impulse therapy is a great chronic nerve pain treatment in Foster, TX. Unlike common chiropractic treatments, this advanced therapy does not involve any "cracking" or significant adjustments.

 Leg Pain Specialist Foster, TX

How Does Neuro Activation Wall Therapy Work?

Any type of injury can cause dysfunction and weakness in your brain. To improve cognition and the neurological connection between the brain, the muscles, and the nerves, some injured patients choose to undergo interactive neurocognitive therapy using our neuro activation wall. Our neuro activation wall retains, strengthens, and restores proper function to the brain and nervous system without relying on medications or outlandish therapies.

Texas Nerve and Spine patients choose neuro activation wall therapy because it:

  • Improves Cognition
  • Strengthens Nerves That Have Been Damaged
  • Boosts Balance and Mobility
  • Is Non-Invasive
  • Does Not Require Addictive Medicines
  • Does Not Require Recovery Time
  • Does Not Present Any Risk of Infection

TherapyNeuro Impulse Therapy

As is the case with any spinal cord injury, the nerves around the spine get weak. When this happens, pain develops, and recovery is halted. Suppose you're searching for a safe, effective way to deal with a painful spine issue like sciatica or a herniated disc. In that case, neuro impulse therapy is a great chronic nerve pain treatment in Foster, TX. Unlike common chiropractic treatments, this advanced therapy does not involve any "cracking" or significant adjustments.

How Does Neuro Impulse Therapy Work?

Neuro Impulse Therapy works by using very specific impulses directed at the area causing pain. These targeted impulses send a signal to your body so that it can begin healing and repairing your body naturally. Benefits of this therapy include:

  • Re-Training Nerves to Work Again
  • Strengthen Nerves
  • Dramatically Speed Up Injury Recovery
  • Quickly Reduces Pain
 Leg Pain Therapy Foster, TX

PeripheralNeuropathy Rehabilitation

Peripheral neuropathy occurs when there is a lack of blood flow to the nerves in areas like your feet and hands. When these nerves are devoid of blood, they begin to decay and degenerate because they don't have enough oxygen or nutrients. Eventually, the nerves in your body shrivel up, causing pain, numbness, balance problems, and other painful symptoms.

How Does Peripheral Neuropathy Rehabilitation Work?

Our Brain to Body program works wonders for neuropathy issues like these by using state-of-the-art technology like laser therapy and personalized, strategic plans of action created around our patient's needs. If you're looking for both short and long-term pain relief from peripheral neuropathy, this could be the solution you need.

 Neuropathy Foster, TX

TherapySpinal Decompression Therapy

Spinal conditions range in severity from barely noticeable to absolutely crippling. To get to the bottom of your spine conditions, our team uses X-Rays to pinpoint the location of your spine's disease. From there, we craft a custom rehabilitation program that addresses the underlying causes of your spine pain. Often, part of that therapy includes spinal decompression.

Pain Specialist Foster, TX

How Does Spinal Decompression Therapy Work?

Spinal decompression works by gently stretching the spine. When the spine is stretched, it changes its position. This change relieves pressure off the discs in your spine, which act as cushions in your back. By creating negative pressure, herniated and bulging discs retract, giving the nerves and structures in your back relief. This relief sends nutrient-rich fluids and oxygen to the discs in your back so they can heal properly.

Your Path to Chronic Pain Recovery Starts at Texas Nerve and Spine

Chronic pain can be debilitating. But it doesn't have to be permanent. Your journey to a pain-free life starts with a simple four-step process at Texas Nerve and Spine:

phone-number 832-979-5117
Step 01

Identify the Root Cause of Your Pain

At Texas Nerve and Spine, our doctors understand that true back and chronic nerve pain relief in Foster, TX won't happen until we can uncover the underlying causes of your pain. To do so, our specialists will perform detailed exams and review your medical history to understand the full scope of your needs. That way, we can craft a personalized treatment plan to provide long-term relief for your chronic pain.

Step 02

Develop a Plan for Healing

Once we have discovered the underlying reasons for your painful condition, it's time to get to begin healing. Our team will work together to create a customized therapy program designed exclusively for you and your body.

Step 03

Provide a Plan of Care

Once our team develops your own custom plan for healing, we'll use our experience and resources to provide you with your plan of care. This plan will be based on your needs and our Brain to Body system, giving you the relief you deserve in a natural manner.

Step 04

Continued Support

Chronic pain relief cannot be accomplished without a tested pain relief system and a purpose-driven team that supports your recovery. That's why our expert staff will assess your journey to recovery and be there for support every step of the way. Because when you treat chronic pain at Texas Nerve and Spine, you're never alone.

Book an Appointment

Contact our office today to get started on your journey to a pain-free life.

Latest News in Foster, TX

Facing pressure from judge, Texas reassigns workers to care for foster kids in unlicensed homes

Sign up for The Brief, The Texas Tribune’s daily newsletter that keeps readers up to speed on the most essential Texas news.Texas child welfare officials are reassigning staff to focus on monitoring the unlicensed motels and rental homes that house some of the most vulnerable children in the foster-care system — a move o...

Sign up for The Brief, The Texas Tribune’s daily newsletter that keeps readers up to speed on the most essential Texas news.

Texas child welfare officials are reassigning staff to focus on monitoring the unlicensed motels and rental homes that house some of the most vulnerable children in the foster-care system — a move officials said Monday is the latest attempt to comply with a years-old court order to keep those children safer.

Stephanie Muth, commissioner of the Texas Department of Family and Protective Services, told a federal district judge in Corpus Christi on Monday that her agency has trained about 30 experienced caseworkers to focus full-time on caring for children who have been removed from their homes but for whom the state has no licensed facility to place them.

Those children, known as children without placement, can be as young as 10 but are often teens with complex trauma and behavioral needs. Prior court hearings have revealed that they have lived in unlicensed facilities and were supervised in as many as six shifts a day by a rotation of already overworked DFPS caseworkers instead of trained medical professionals. The result was unsafe conditions rife with violence, abuse and neglect.

The staffing changes are designed to make it so that regular caseworkers aren’t expected to work overtime rotations to care for the children without placement. Those caseworkers have said those shifts were burdensome, sapped their morale and led to unsafe conditions for both the children and the workers.

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U.S. District Judge Janis Jack said she’d rather those unlicensed locations be closed altogether and that the children be directly placed in licensed state facilities that are equipped to handle their considerable needs.

“They’re still going to be in those awful hotels with the outside staircases and the sex trafficking and the drug deals,” Jack said.

Muth and Prerak Shah, the attorney representing the state, said the agency’s primary goal is to find licensed placements for all children and to keep children out of the unlicensed facilities.

Children are currently kept in locations that include four single-family homes the state rents in or near Killeen, Belton and Temple in the Central Texas region. Six other residences — including apartments and religious-run group homes — are located in Houston, El Paso and Big Bend areas, Northeast Texas, and the Midland-Odessa area. The state uses hotel and motel rooms mostly in the urban areas.

The overtime shifts by caseworkers at those places, described by court officials as dangerous and chaotic for both kids and staff, are a major contributor to high staff turnover and low morale at the agency, officials say.

The new staff positions caring for children without placement have been filled by current or former caseworkers. Those workers will travel to locations across the state as needed depending on how many children are living in each place at any given time, officials said.

Two of the new positions started Monday, and more will start in the coming days, officials said. They will not have any other cases, allowing them to focus entirely on supervising the children in those temporary placements, officials said.

Monday’s hearing was part of a nearly 13-year-old lawsuit in which Jack has found Texas was violating the constitutional rights of foster children by exposing them to an “unreasonable risk of harm.” Jack made her first ruling condemning the state foster care system in 2015, and three years later, the conservative Fifth Circuit Court of Appeals agreed. Since then, she’s ordered several fixes over the years and continuously criticized the state for not complying with her orders.

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She spent much of Monday’s hearing blasting state officials for slow progress in the system.

She also repeatedly rebuked state officials for failing to bring to Monday’s hearing documentation she ordered that would show her what kind of progress the state was making toward fixing the problems facing the agency.

“This is no way to conduct a hearing about the safety of children,” Jack said. “I mean, it's one thing, doing these unbelievably poor investigations for these children in your care, but to disobey a court's order to produce documents about something as important as the children without licensed placement is inexcusable.”

At one point, she threatened contempt before agreeing to give them until Wednesday to produce the ordered documents.

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“Have you ever seen the inside of a jail cell?” she asked Muth and Cecile Erwin Young, executive commissioner of the Texas Health and Human Services Commission.

Jack has not yet decided, after a December hearing, whether DFPS, which manages the foster care system, should be held in contempt of court for the third time since the lawsuit was filed.

Since 2019, DFPS has been under the supervision of court-appointed monitors who have released periodic reports on Texas’ progress toward eliminating threats to children’s safety in the foster care system.

Their most recent report, filed earlier this month, cited progress in the area of staff training but continued weaknesses in the agencies’ responses to investigations into allegations of abuse and neglect made by children or those who contact them.

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In one instance, according to the report, staffers at a school where children with intellectual disabilities from one unlicensed facility attended told DFPS officials they were showing up unbathed, with unbrushed teeth and dried feces on their clothes.

They were bruised and scratched, they’d show up with skull fractures, other injuries, many untreated, the report said. They included elementary and high school students with autism and other issues, the report said.

Jack blasted state officials on Monday for having few details about the incidents in the report, and for not closing down the location — where there are still three children living. Officials said the state took some “safety actions” but did not elaborate in testimony.

Children without placement wind up in unregulated, unlicensed and often poorly supervised homes because the state cannot find private providers who can or will accept them. They are removed from their homes due to circumstances that can include abuse at home, or complex health needs that parents are unable to manage without help, or the loss of their family caregivers.

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Court monitors say they have found evidence that they are poorly supervised, frequently overmedicated, targeted by traffickers, and unable to get help if they’re facing continued abuse. Some 2,100 “serious incidents” of death, abuse, neglect, runaway and suicide attempts were reported at the CWOP houses last year, said Paul Yetter, an attorney for the children.

Reports include children becoming pregnant, being trafficked, abusing alcohol and drugs, skipping school and medical regimens, attacking each other, threatening suicide and being placed in multiple temporary placements for months at a time.

Staffers have reported being threatened, groped and attacked.

In 2022, Texas DFPS caseworkers put in more than 600,000 hours of overtime at the state’s so-called CWOP facilities, Yetter said.

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When final OT numbers come in for 2023, he said, that number will likely surpass 700,000 hours.

Staffing has been cited by the state repeatedly in court hearings as a major issue contributing to challenges at the CWOP locations.

In exit interviews of former caseworkers, some of which Yetter and Jack read aloud in court on Monday, they said they were quitting because the CWOP houses had become “catastrophic” for the agency due to the sheer burnout on staffers and the dangers faced by staff and children.

The burden of poor staffing, which officials said has plagued the agency for years, reaches into several areas of the system, Yetter told the court on Monday.

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Last year, more than 173,000 calls to the agency’s statewide intake center, which receives reports of abuse and neglect of children and adults in state care, were abandoned by the callers because they weren’t answered in time, according to DFPS records, Yetter said.

Wait times for those callers averages over five minutes, he said.

Muth told Jack that the agency had asked the state for budget increases to reduce those wait times but didn’t get it.

“Is it safe for children to have these calls that are dropped?”Jack asked. “Is that safe for the children [when] there would have been somebody who would have reported their abuse, neglect or exploitation?”

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Judge raises specter of jail time for Texas officials in foster care reform case

CORPUS CHRISTI, Texas (CN) — “Have you ever seen the inside of a jail cell?” a federal judge asked two top Texas officials on Monday, angered they had not produced documents concerning the state’s troubled foster care system.Leading an effort to improve Texas’ care of youth in its long-term care, Senior U.S. District Judge Janis Graham Jack ordered the chiefs of two child welfare agencies to bring an array of documents to a hearing Monday.But Texas Department of Family and Protective Services Commi...

CORPUS CHRISTI, Texas (CN) — “Have you ever seen the inside of a jail cell?” a federal judge asked two top Texas officials on Monday, angered they had not produced documents concerning the state’s troubled foster care system.

Leading an effort to improve Texas’ care of youth in its long-term care, Senior U.S. District Judge Janis Graham Jack ordered the chiefs of two child welfare agencies to bring an array of documents to a hearing Monday.

But Texas Department of Family and Protective Services Commissioner Stephanie Muth and Health and Human Services Commissioner Cecile Erwin Young showed up empty-handed for the 9 a.m. proceeding.

“You were ordered to bring them to court today,” Jack said. “Where are they? I need them now, otherwise somebody is going to be held in contempt, right now. This is not amusing.”

“Commissioner Muth, Commissioner Young, have you ever seen the inside of a jail cell?” she added.

They answered with silence.

But at the end of Monday’s five-hour hearing, the state’s outside counsel, Prerak Shah of the Houston office of Gibson, Dunn & Crutcher, reached a deal with Jack.

He agreed to get the documents to her by 5 p.m. Wednesday. If not, she said, the state will face contempt fines.

Jack asked for paperwork pertaining to plans Texas has to implement recommendations issued in 2021 by three experts with experience improving child welfare practices in numerous U.S. states.

The trio were retained to make suggestions for how Texas can stop its practice of placing children in dangerous unlicensed housing.

The number of youths Texas puts in these settings — which range from rundown motels to budget hotels, to rented homes, churches and Family and Protective Services office buildings — had dropped to 79 last month, a small percentage of the roughly 8,000 kids who are wards of the state after being removed from their families due to abuse, neglect or inability to care for their extreme disabilities.

But the so-called "children-without-placement" settings are driving caseworker staffing attrition — Muth testified Monday that Family and Protective Services has a caseworker turnover rate of 25% per year — as those leaving the jobs are complaining in exit interviews about mandatory overtime shifts supervising kids in unlicensed facilities.

Paul Yetter, lead counsel for a class of Texas foster children, read excerpts from some of the surveys Monday.

Departing caseworkers complained that they had been assaulted or threatened by foster kids in such settings, and that young teenage girls were turning up on sex trafficking websites after running away and being taken in by pimps.

“It’s a disgrace … Everyone is leaving, especially tenured workers like me,” Yetter said, quoting a former caseworker’s statement in an exit questionnaire.

Shah, the state’s retained counsel, said Texas is considering repurposing vacant buildings on the campus of Rusk State Hospital, an in-patient psychiatric facility, to house foster youth for whom it cannot find licensed placements.

The environment would not be unfamiliar to many of the children. A large percentage of them have a history of psychiatric or mental health hospitalization, according to reports from two child welfare experts that Jack dubbed “monitors” and appointed to ensure the state’s compliance with her reform orders.

Jack has proven to be a fierce advocate for Texas foster children. In hearings for the case, she often chastises top officials for what she perceives as ineptitude.

The Bill Clinton appointee stayed true to form Monday.

“I don’t think in my almost 30 years on the bench I’ve ever dealt with an agency that’s more dysfunctional,” Jack told Muth.

Muth explained to her on the witness stand how the state is working to provide safe housing for all foster children.

She said her agency convinced the state Legislature last year to allocate funding to double the pay rate for kinship foster parents — those who are related to the children they agree to take in — to $25 per day starting in 2025.

Muth also noted Health and Human Services is setting up 17 mobile crisis teams to provide support for kinship families, and Family and Protective Services had decided to dedicate 30 caseworkers to only caring for children in unlicensed placements.

But these are rare positive developments in a slow reform effort, and Jack has signaled sanctions are in the works.

She has already held Texas in contempt twice and fined it $150,000 for not complying with remedial orders she finalized in 2018, three years after she decided it was violating foster kids’ 14th Amendment due process rights to adequate care and a safe placement while in state custody.

She entered Monday’s hearing with a third contempt motion pending against Texas but gave no timeline for a decision.

Yetter, the plaintiffs’ counsel of the Houston firm Yetter Coleman, citing an investigation from the case monitors, presented evidence in a contempt hearing in early December that Texas was flouting Jack’s orders by not timely investigating reports of abuse and neglect of foster kids at group homes and overmedicating them with psychotropic drugs.

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Privatized foster care is coming to Texas' biggest cities. Here's what it could look like.

In the back of a warehouse about 15 minutes from downtown New Braunfels, four small, blue chairs sit at a white table. Nearby, an easel is ready for a new artist. A play kitchen is waiting for a chef. A wooden train set is in search of a conductor.The rainbow text on the wall, surrounded by tiny, painted handprints, says it all: “The future of the world is in this room.”FOSTER CARE FIGHT: ...

In the back of a warehouse about 15 minutes from downtown New Braunfels, four small, blue chairs sit at a white table. Nearby, an easel is ready for a new artist. A play kitchen is waiting for a chef. A wooden train set is in search of a conductor.

The rainbow text on the wall, surrounded by tiny, painted handprints, says it all: “The future of the world is in this room.”

FOSTER CARE FIGHT: Meet the Houston lawyer whose charity work sparked the epic battle over Texas foster care


Article continues below this ad

Here, staffers work with foster children and their caregivers, but they aren't “Child Protective Services.” And the people who help families navigate the system are not “caseworkers.” They are “permanency specialists.”

It’s a conscious decision for the leaders of SJRC Texas, a nonprofit supporting children and families who have been affected by trauma, abuse and neglect. For two years, the organization has been leading the Hill Country’s transition to privatized foster care — part of a mammoth statewide initiative lawmakers call “community-based care.”

“One of the gifts of community-based care is we're not CPS,” SJRC Texas CEO Tara Roussett said, acknowledging that many of the families who come through the organization have negative feelings about the state agency. “Yes, we're doing the work of CPS, but that's not who we are.”

The Department of Family and Protective Services, the umbrella agency that includes CPS, still investigates allegations of abuse and neglect and decides whether to remove children from their homes. But state leaders hope the transition to community-based care afterward — to help reunite families and place children in stable homes — will localize services and increase positive outcomes for foster children.

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It’s been a slow and at times pained rollout statewide, and the shift has been six years in the making. Some providers backed out of contracts because they were losing money. The San Antonio metro area transitioned to community-based care and then had to reverse course in 2021 after the contractor faced accusations of physical abuse and neglect at an emergency shelter.

But lawmakers frustrated with the state’s child welfare agency have moved forward with the plans. The rollout so far has been limited to areas like the Panhandle and North Texas, but the Legislature approved funds this year to start the shift in four new regions — including Houston and El Paso, along with a relaunch in San Antonio — and the agency plans to transition the entire state by 2029.

The leaders at SJRC Texas believe their experience is a testament to what community-based care can and should be — family-oriented services that not only support foster children and their caregivers, but also the community at large. It’s about “changing the culture of child welfare,” Roussett said.

The playroom in the back of the New Braunfels Family Resource Center is part of the equation. There’s also a visitation room where families reconnect, a spot for parents to work on resumes while their kids play and a “recharge room” where visitors can decompress after difficult conversations. The center also offers onsite doctor’s appointments and health screenings through a partnership with UT Health.

“We are here to provide whatever services can set you up to be the best parent that you can be, and we want you to succeed,” said April Molina, the communications director for SJRC Texas.

'WOEFULLY INADEQUATE': With Texas foster care in crisis, expert panel calls for accountability, specialized services

There are also rooms where staffers host regular events open to anyone in the community — parenting and fatherhood classes, family yoga, breastfeeding and pumping support groups, play groups. They also offer special events, such as free car seat inspections or group strolls. Their partnerships with local businesses allow them to sometimes offer families free tickets to sports games or other activities.

“Raising a family is very expensive,” said Meliss Loyola, the organization’s community prevention supervisor who plans local events for clients. She calls them “free family fun.”

“We want these magical moments, and we want to make sure that every child can be included in something like that if they know it’s available,” she said.

Scaling up

SJRC Texas is in the second of three stages of community-based care transition. In the first stage, which usually lasts about six months, providers start building a network for programming and housing. In the second stage, which takes a year and a half, the organizations take over case management and work on reuniting families. The final stage is essentially just a checkmark — this organization is fully in charge of child welfare services, and the state agency monitors its performance.

Houston and San Antonio are set to begin the first stage next year. Marissa Gonzales, a spokeswoman for DFPS, said the goals of community-based care — “child safety, permanency and well-being” — are the same no matter the area, but the transition can look different. Urban areas often have existing service networks, while rural areas require more development, she said.

Providers, “with their deep knowledge of their areas, can determine what’s needed in their specific communities,” she said. “They have flexibility to be innovative in addressing service gaps.”

EDITORIAL: Texas foster care needs money to keep kids safe. Lawmakers have billions

Over the last year, DFPS and its Office of Community-Based Care Transition have been working with local leaders in Houston and San Antonio to prepare for the shift, she said. Both areas have their own collaborative groups that have been working on the transition since 2021.

The agency has also “taken feedback from stakeholders and staff” since the failed rollout in San Antonio, Gonzales said. In 2021, the local community-based care provider pulled out of its state contract after facing high-profile accusations of insufficient care, abuse and neglect at an emergency shelter. The provider had first won a contract in 2018.

“What we’ve heard repeatedly is that more frequent and effective communication and listening … is needed through every step of implementation,” she said. “This is vital so everyone involved feels knowledgeable and empowered. It also makes it possible to identify gaps and put the right supports in place to make CBC successful.”

UNSAFE NONPROFITS: Judge blasts San Antonio-based nonprofits as ‘dangerous, unsafe’ for foster children

The Department of Family and Protective Services recently established a “CBC Operations Division” that is trying to prepare the agency for its eventual oversight role in child welfare services, Gonzales said. Some of the most vocal opponents of community-based care have been the agency’s own employees — caseworkers whose jobs will be eliminated because of the transition.

Roussett, the CEO of SJRC Texas, said she hired about 140 employees as the organization ramped up its community-based care plans (it has just over 300 staffers in total today). Many of the new hires were DFPS caseworkers who she said feared that they would have to take a pay cut, lose state benefits or give up job security.

Some have said the state should instead rebuild its own services instead of contracting them out, and others have questioned the efficacy of community-based care. Gonzales said the department has seen better outcomes through the new program, but it’s difficult to do a full analysis with a limited rollout and small data sets.

FOSTER CARE FAILURES: Texas foster care home was supposed to help sex trafficked kids. Instead it was trafficking them

Roussett said the organization did its best to alleviate those concerns. Plus, Roussett said all of the organization’s “permanency specialists” have the recommended caseload, and it’s been more than a year since the group last had a child without a placement, a persistent problem for the state.

“Our teams and our providers work 24/7, around the clock, to ensure that our kids are in a safe place — not sleeping in a hotel, not sleeping in an office, not sleeping anywhere that they shouldn't be,” Roussett said. “That doesn't make us better than anybody else. It just shows what smaller communities can do.”

The state is still looking for providers to run community-based care operations in Houston and San Antonio, and Gonzales could not discuss the ongoing procurement process. But Roussett said SJRC Texas is making a bid to run the San Antonio operations, where her organization also has an office and a local network.

“We just feel like with all of the connections and the partnerships and everything that we've been able to do successfully, it's probably the next best step,” she said. “We’re waiting to see.”

Dec 4, 2023

By Cayla Harris

Cayla Harris covers Texas politics and government for the San Antonio Express-News and Houston Chronicle. She can be reached at [email protected].

She also serves as training director of the Hearst Fellowship Program, a two-year initiative allowing early-career journalists to gain experience at Hearst newspapers across the country.

She previously covered New York state government for the Albany Times Union. She grew up in New Jersey and is a 2019 graduate of the George Washington University, where she studied journalism and Spanish.

Texas judge considering holding the state in contempt over foster care – again

A Texas judge will decide this week whether the Texas Department of Family and Protective Services should be held in contempt of court for the third time in recent years.The department is also the subject of an ongoing lawsuit over foster care conditions in the state and has been under the supervision of court-appointed monitors since 2019.Texas has abo...

A Texas judge will decide this week whether the Texas Department of Family and Protective Services should be held in contempt of court for the third time in recent years.

The department is also the subject of an ongoing lawsuit over foster care conditions in the state and has been under the supervision of court-appointed monitors since 2019.

Texas has about 9,000 children in permanent state custody, removed from their homes due to circumstances that can include abuse, complex health needs or the loss of their family caregivers.

Bob Garrett, the Austin bureau chief for The Dallas Morning News, said the lawsuit was brought by a nonprofit out of New York: Children’s Rights, founded by lawyer Marcia Robinson Lowry.

Lowry “started the whole category of lawsuits about foster care, and she subsequently formed another group,” he said. “But they recruited two silk stocking Texas law firms, you might say – Haynes and Boone in Dallas and Yetter Coleman in Houston – to do work pro-bono. And they’ve been driving this since really about 2010.”

The defendants include Gov. Greg Abbott, who tried to do away with the suit when he was attorney general, Garrett said.

“Abbott changed the defense strategy for the state, consolidating the two state agencies and himself into one entity and hiring an outside law firm, Gibson, Dunn & Crutcher. They are more aggressive,” he said. “The judge in this case, Janis Jack, yesterday openly said, ‘I know you’re wanting to find me doing something that you can go to the Fifth Circuit and get me reversed on.’ And that’s the larger backdrop for the push by the Children’s lawyers to say the state has been slow-walking needed improvements.”

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The case against the state includes allegations that Texas has fallen short of the standards of care that should be given to foster kids. The Legislature banned the practice of kids sleeping in CPS offices, but young people in state custody are still sleeping in locations such as hotels and churches.

“This is a double whammy, as you know. It’s not good for the kids. These are the toughest kids that private providers won’t accept. And it’s not good for the CPS caseworkers who have to, in four-hour shifts, babysit these kids 24/7,” Garrett said. “They’re burning out and heading for the exits again, which was one of the main things this lawsuit was designed to stop, which was kids not even knowing their CPS conservatorship caseworker. Other issues are overuse of mental health drugs and some bad investigations of outcries by intellectually disabled kids.”

Garrett said the state could be held in contempt again if the judge feels the agency is not making changes quickly enough.

“In 2019, she slapped $50,000-a-day fines for three days before suspending them and being satisfied the state had met the requirement,” Garrett said. “The issue at hand this year, the new wrinkle, is that the plaintiff’s lawyers have said she should declare parts of the program to be put in a receivership – almost like a bankruptcy of a company – to manage directly for the judge. That would be an unprecedented step, almost: It has only happened once before, in the District of Columbia in the 1990s.”

This move would put the judge in an oversight role over foster care in Texas.

“It would put her in charge, directly, of bureaucrats,” Garrett said. “I think Texas, the governor and the Legislature, would go bonkers and would try to get to the Fifth Circuit immediately. How that would all turn out is anyone’s guess.”

Garrett said the hearings are expected to last throughout the week.

“The plaintiffs are going to put on a Harvard Medical School professor today about the misuse of psychotropic drugs,” he said. “There’s other witnesses. Then the state will get to put on its witnesses. It’s almost like a mini trial, and it’ll probably last into Thursday or Friday.”

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Texas foster care system placement crisis indicative of deeper reform issues

The signs of past abuse on Britney are unmistakable.“I always get judged for my arms,” she said.The 18-year-old’s left arm is covered in scar tissue from hundreds of self-inflicted cuts.“For me, people didn’t want to keep me — didn’t want to have anything to do with me because I look like I'm insane. But in all reality, we're not insane. We’re just looking for somebody to love us,” she said.The cutting helped her cope with past trauma from an abusive family, sh...

The signs of past abuse on Britney are unmistakable.

“I always get judged for my arms,” she said.

The 18-year-old’s left arm is covered in scar tissue from hundreds of self-inflicted cuts.

“For me, people didn’t want to keep me — didn’t want to have anything to do with me because I look like I'm insane. But in all reality, we're not insane. We’re just looking for somebody to love us,” she said.

The cutting helped her cope with past trauma from an abusive family, she said, and with being in Texas’ foster care system the past four years.

Since she was 14, Brittney described her time in the system as being shuttled between treatment centers and psychiatric hospitals. Often changing doctors and medications each time — never finding stability.

Now, more than a dozen placements and 230 different medications later, she said the state’s child welfare system is a lie.

“I feel like it's a lie because they say they're trying to protect us. They want to keep us safe. They want to make sure we’re being taken care of. But we're not,” she said.

Her cycle often led to having no place and being labeled a “Child Without Placement” or CWOP.

That means being warehoused in taxpayer funded hotel rooms with other kids. At one point in 2021, there were more than 400 children a night.

Britney spent months in them. Months eating fast food or a sandwich for each meal (she can’t eat sandwiches anymore), being squeezed into a two-bed room with three or four case workers paid to watch them.

While at the hotel, the state often offered no psychiatric treatment or other services.

And after some hotels started throwing foster children out over their behavior — state staff cracked down even more.

“It got to the point where we couldn't go nowhere,” she said. “We had to stay in our hotel room and not move. We were like locked in there. A CPS worker would sit at the door. We couldn't get out because technically we are putting our hands on somebody and we end up in jail.”

Children without placement hotels exist because Texas doesn’t have enough places for children like Britney — ones with high mental health needs— to go.

Federal court monitors call these placements dangerous — noting in its reports times when kids got assaulted, ran away or were sex trafficked.

And for more than three years — what was supposed to be a temporary placement for kids — has often lasted for weeks or months. The state showed it cut the numbers in CWOP in half — but it’s still more than 100 kids a month.

It cost more than $260 million over three years.

Texas spent over $250 million housing foster kids in ‘dangerous,’ unregulated places

State documents show Texas paid $260 million over three years to keep kids in hotels and leased homes temporarily. Unregulated placements that advocates say warehouse youth with the most needs in the most dangerous way.

Texas’ foster care — run by the Department of Family and Protective Services and the Health and Human Services Commission is among the most troubled in the nation, and Texas regularly ranks towards the bottom of child well being.

For more than a decade, the state has faced federal action over what a Judge called a “broken” foster care system.

A federal court is now weighing whether to impose hefty fines over the state’s inability to make progress on court-ordered reforms.

“There’s just so much waste,” said Paul Yetter, an attorney representing current and former foster youth in the ongoing federal lawsuit against Texas' system.

"There is no coherent plan to fix the problem. The state is just dumping buckets of money on a shadow system that is hurting children,” he said.

Yetter said this shadow system is a good example of how Texas has failed to reform.

Texas is a big state and state officials can't just snap their fingers and fix it. But he said — for much of the last 13 years — it wasn’t trying.

“It has instead been aggressively refusing and opposing reform. So we have a big system with lots of problems, and we have a leadership that is just not willing to work cooperatively to get it fixed or to find solutions,” he said.

Yetter pointed to a hearing just last week showing the state’s uncooperative attitude.

Judge Janis Jack — who called the system broken when she ruled against the state years ago — has been overseeing the implementation of her orders ever since. The Clinton-appointed judge has a no-nonsense reputation and doesn’t shy away from grilling state executives.

A week before the hearing, Jack ordered the state to bring documents showing what if any effort the state had put into executing on recommendations an expert panel made to end CWOP from years ago.

At the time the panel, made up of child welfare experts some of whom had run other state’s systems, said they were shocked at the kinds of numbers they were seeing without placement in Texas. Their recommendations were not binding.

Within minutes of beginning the hearing, it became clear the state had not delivered the court-ordered documents.

“It's after 9. Where are the documents? I need the documents in hand right now,” Jack said.

The state’s attorneys did not have them.

Judge Jack threatened contempt.

”Commissioner Muth, Commissioner Young,” she said, addressing the heads of the Department of Family and Protective Services and the Health and Human Services Commision, ”have you ever seen the inside of a jail cell?”

Ultimately, she agreed to give the state more time — two more days. But later in the hearing, her frustration boiled over. Judge Jack calls the bureaucracy that produced these ongoing failures “horrible.”

“You know what year this is? This is 2024. How long have we been wrestling with this problem?”

Conservatives like Texas State Rep. James Frank allege the lawsuit itself causes some of the problems it's railing against.

“The judge is the arsonist saying there’s a fire,” Frank said.

He, like many others in his party, believe the federal lawsuit wastes money and resources. The Dallas Morning News recently reported the state had spent $180 million on the foster litigation. He said it's scaring away scarce treatment providers that could care for these kids.

“Basically nobody wants to work with the state of Texas on high risk kids, because you are going to end up under the thumb of the judge if you do,” he said.

Texas has argued its foster system has shown significant progress on many of the court’s orders and is substantially in compliance.

In the coming weeks, Jack will decide if they actually are — potentially levying hefty contempt fines.

The system is still clearly in crisis, said Christie Carrington — a retired DFPS worker who now works for the state employees union.

“It's not safe for anybody,” she said, referring to CWOP.

Safety around CWOP is one of the reasons people are fleeing the department. One in four case workers leave within a year of being hired. While only a fraction of the more than 25,000 Texas kids in foster care are in CWOP — Carrington testified at an earlier hearing that CWOP had hijacked the department.

“Keeping children safe is our job. That's the only reason we exist. And if we're not doing that, then we might as well pack up and go home,” she said.

She said the lack of progress is astounding, and she asked, if state leaders can spend billions erecting barriers on Texas’ southern border, why can’t they can’t fix this?

“The governor can do it. He does everything else, you know, razor wire in the rivers. What about these children?” she asked.

Texas is not the only state to deal with legal fights over foster care. Alabama, Mississippi, Kansas, and a host of others have all dealt with federal oversight — many still are.

18-year-old Britney's time in Texas foster care went straight from a CWOP hotel … to county jail.

Like many kids with high needs in the program, she broke the rules — and a worker said Britney hurt her when she tried to take away the girl’s phone. Britney denied she ever touched the worker but she spent two weeks in the Brazoria County Jail for a misdemeanor.

She said her time with Child Protective Services was so bad that she would have rather stayed with her abusive family.

“Because we didn't ask to be in CPS. I didn’t ask CPS to take me away from an abusive family,” she said. “All we want is a family. And when we're not getting that, it hurts.”

Now living in a private group home, Britney is free of the department. Tattooed over the hundreds of cutting scars on her left arm in dark cursive black lettering is the word "Survivor."

Editors note: After publication, we removed the last name of the young woman featured in the web vesrion of this story at her request.


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